HomeMy WebLinkAboutPermit Building 1995-9-28
Page 1
RESIDENTIAL PERMIT APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION
BUILDING SAFETY
Job Number: 951400
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location of Proposed Work: 6935 MAIN ST
Assessors Map #: 17023533
Lot: Block:
Tax Lot #: 06100
Subdivision:
~
~
Owner: RALPH JENSEN
Address: 6935 MAIN STREET
Phone #: 747-7282
City/State/Zip: SPRINGFIELD, OREGON 97478
Describe Work: SHOP ADDITION
ADDITION
Contractor
Const.
Contractor #
Expires
Phone
General:
OWNER
747-7282
Electrical: OWNER
QUAD AREA: 4RSE
ZONING CODE: LDR
VN
SQ FOOTAGE: 620
OFFICE USE --
LAND USE: 1111
OCCY GROUP, M
# OF BLDGS: 1
CONSTR. TYPE,
TO request an inspection, call the 24 hour recording at 726-3769.
All inspections requested before 7:00 a.m. will be made the same working day,
inspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS ---
FOUNDATION - After forms are erected but prior to concrete placement.
FRAMING - Prior to cover.
STORM SEWER LINE - Prior to filling trench.
FINAL BUILDING - When all required inspections have been approved and
the building is complete.
FINAL BUILDING - When all required inspections have been approved and
the building is complete.
FINAL BUILDING - When all required inspections have been approved and
the building is complete.
Total Height: 12
Lot Type: INTERIOR
Setbk From NPL: 182
Solar Approved: Y
Item
Main
Garage
SHOP ADD.
Total Value
BUILDING PERMIT ---
Square Feet x $/Square Feet
620 14.1
Value
0.00
0.00
8,742.00
8,742.00
Building Permit Fee
Surcharge/Admin
74.50
5.97
TOTAL FEE
(A)
80.47
--- SYSTEMS DEVELOPMENT CHARGE (SDC) ---
(B)
132.30
Systems Development Charge is due on all undeveloped properties within the City
limits and the Citys Urban Growth Boundry which are being improved.
Job Number: 951400
Page 2
--- PLUMBING PERMIT ---
Item
Storm Sewer
Fee
25.00
Plumbing Permit
Surcharge/Admin
25.00
2.00
TOTAL CHARGE
(C)
27.00
(Excluding Electrical)
unless otherwise noted
TOTAL AMOUNT DUE
(A, B, C, D, and E combined)
239.77
--- BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT ---
This permit is granted on the express condition that the said construction
shall, in all respects, conform to the Ordinance adopted by the City of
Springfield, including the Development Code, regulating the construction and
use of buildings, and may be suspended or revoked at any time upon violation
of any provisions of said ordinances.
Plan Check Fee:
Received By:
Plans Reviewed By: DON
Building Site Reviewed
48.43
Date Paid: 08/28/95
Receipt Number: 18846
MOORE Date: 09/28/95
By: LISA HOPPER
--- ADDITIONAL COMMENTS
THIS STRUCTURE CANNOT EXCEED HEIGHT OR SIZE OF
MAIN STRUCTURE (RESIDENCE)
SEPARATE ELECTRICAL PERMIT IS REQUIRED FOR MODIFICATIONS TO THE ELECTRICAL
SYSTEM
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all information hereon
is true and correct, and I further certify that any and all work performed
shall be done in accordance with the Ordinances of the City of Springfield,
and the Laws of the State of Oregon pertaining to the work described herein,
and that NO OCCUPANCY will be made of any structure without permission of the
Community Services Division, Building Safety. I further certify that only
contractors and employees who are in compliance with ORB 701.055 will be
used on this project.
I further agree to ensure that all required inspections are requested at the
proper time, that each address is readable from the street, that the permit
card is located at the front of the property, and the approved set of plans
will remain on the site at all times during construction.
11:114/ ~~fi. -1'~/
S~g ture
~? h<<7/9'0-
Date ./
--- VALIDATION
Date Paid:
/?7/~
. -
""7 --28''7':;;-
-"2.. '":3 9. ??
a~~
,tfS- -~;.
Receipt Number:
Amount Received:
Received By:
or
..;
.
.
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
Name or Company: RALPH JENSEN
Location: 6935 MAIN ST
Developement Type: A Building Size:
1. STORM DRAINAGE
Impervious Sq Ft
600
2. SANITARY SEWER - CITY
Number Of PFUs 0
(see Page 2)
3. TRANSPORTATION
Number Of Units
x
Trip Rate
Transportation Total
4. SANiTARY SEWER - MWMC
Number Of PFUs
o
MWMC CREDIT If Applicable (see Page 2)
TOTAL - MWMC SDC
SUBTOTAL - (Add Items 1, 2, 3 & 4)
5. ADMiNISTRATIVE FEES
Base Charge (Subtotal Above) x
TOTAL SDC
Reviewed By: TROY MCALLISTER
x
x
Job No.: 951400
Lot Size:
0.210
Per Sq Ft Q
43.43
Per PFU
x
Cost Per Trip
x
X
Per PFU + MWMC Admin Fee
18.750
0.50
Date: 08/29/95
Page 1
Sq Ft
$126.00
$0.00
$0.00
$0.00
$0.00
$0.00
$126.00
$6.30
$132.30
.--.
.J.
.
Job Number, 951400
.
FIXTURE UNIT CALCULATION TABLE
Page 2
Fixture Type
Bathtub
Drinking Fountain
Floor Drain
Interceptors For Grease/Oil/Solids/Etc
Inteceptors For Sand/Auto Wash/Etc
Laundry Tub/Clotheswasher
Clotheswasher - 3 Or More
Receptor For Refrigerator/water Station/Etc
Receptor for Commercial Sink/Dishwasher/Etc
Shower, Single Stall
Shower, Gang
Sink, Bar, Commercial
Urinal, Stall/Wall
Wash Basin/Lavatory, Single
Water Closet, Public Installation
Water Closet, Private
Miscellaneous
Number of
New Fixture
Unit
Equivalent
Fixture
Units
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
TOTAL FIXTURE UNITS 0
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
2
1
2
3
6
2
6
1
3
2
2
2
1
6
4
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occured
after annexation date, credits are calculated separately.
(calculations are by $1000)
Year Annexed:
Credit For Parcel Or Land Only If Applicable:
Improvement (if after annexation date) :
o
X
0.00 =
0.00
0.00
$0.00
(If land value is multiplied by 1 then the parcel/land credit is not accurate.)
o
X
0.00
CREDIT TOTAL ;