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P - 37443Building Inspections 76�-572-3604 763-502-4977 FAX DATE U/ Zi/ 1 I SITE ADDRESS `7 _I� TH1S APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF INSURANCE PROPERTY TYPE PERMIT TYPE TYPE OF WORK: ��Z BUILT�ING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE I-I-201I Permit No.:,�Cj���� � Received Ry: Date Rec'd: � � !, YOUR E-MA1L ADDRESS I'1 cj.�1S0�'jC F y� ���pl , c3�; Y ❑ OWNER �CONTRACTOR NAME: ADDRESS: �, � .� Z�Z S* �I.� CITY PHONE: �G�� �—J/ ��3LC� STATEI�'�N Z1P S� i � NAME: CNl j�i - C't r' Gtn C1 i`f�✓4c��G�- 1 i n I.LC. STATE LICENSE #!�(1(,� �'% ��Q � LEAD CERT NUMBER ADDRESS: ��I�S �j?�ct,;n« S��` %�i CITY ;�Y1C1�'.�/ STATE ZIP PHONE �(J � Z- Ci�L`.� �� �I �"JG"r Z FAX ,� STNGLE FAMILY/NEW CONSTRUCTION SIZE 1`j�U ❑ TWO FAMILY/NEW CONSTRUCTION STORIES j ❑ ADDITION 18 GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK � SIDING ❑ OTHER ❑ SWIMMING POOL ❑ NEW HOME CONSTRUCTION 9 ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODGLING DESCRBE WORK BEING DONE: f�Ci� I!1G I Z.K Z� , SIZE OF IMPROVEMENT LENGTH ROOFING � ❑ HOUSE ONLY NUMBER OF SQUARES O HOUSE & GARAGF GARAGES �� �j,,y�te5) ❑ ATTACHED GARAGE PROPOSED SIZE: �,DETACHED GARAC�E PROPOSED HEIGHT: S[DING �j��� I$ Vinyl ❑SofYit � � Aluminum ❑ Trim � � Other ❑ Fascia � WINDOWS IN EXISTiNG OPENTNGS ❑Yes ONo LOCATION OF WINDOWS OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENTNG CHANGES & TYPE OF WTNDOW TO BE INSTALLED NUMBER OF WINDOWS C l� n -� c HEIGHT I Z� SQ FT Z� BASEMGNT REMODELING SUBMIT: l. Existing Floor Plan 2. Proposed floor pian 3. List of structural members to be used 2UZJ� FOR NEW CONSTRUCTION INCLUDING DF.CKS, -Z� � ADDI'1'IONS. & PORCHGS SUBMIT: �c /_ L Site Plan/Survey showing the existing sVuctures �D 7 lD� •� � and proposed project. ---- 2. Two sets of construction plans 3. Energy Calculations FOR WINDOWS — PROVIDE U-VALUE AND MANUFACTURE STICKER ON WINDOW. ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION �/,�;,�`t � �D�g7d OCCUPANCY TYPE __ Permit Pee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ $ $ $ $ $ $ $ $ $ $ �,, See Back Page for Fee Schedule 65% of Building Pennit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $5.00 $5.00 (State Licensed Residential Contractors) $2230 per SAC Unit (P(ans to MWCC for determination) �+6ft= ftx$25=$ $450 Conservation Plan Review Fee Determined by En�ineering Agreement necessary ( ) Non Necessary ( Make checks oavable to: Citv of Fridlev Attach Stipulations TNIS IS AN APPLICATION FOR A PERMIT-NOT VAL1D UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all w w h requires review and approval of pl�ns. t�I / SIGT�ATURE OF .APPUCANT _���. PR1NT NAME�.J'F, ITC�, 1SCi—� DATE �/ �/ / I APPROVAL INSPECTOR SIGi�ATURE PLEASE NOTE: SEPARATE PERMITS ARE �REQUIRED FOR PLUMBING. ELECTR3CAL AND NIECHANICAL WORK C; � � l.- � �_. � � _,� � � �, � c�. ..e' Kl �:: _-� �- ---�� j �� � �� �� � � -`�' .-� � �� ��_� �. �� x J� � � �� � � � � -� l�� —� � �,<1 � -w.. � C�'_.J ,�..� � __� � �� � 1� � � � c� _.� �'� -..� � � __�� . _�_ � �Nj \` I �,� -! , �� 1,�-� �.� �— � ,; ` :�; � 1 r � ,� �� �,.? -`.��� �� �. �, �� �. , ,'�s � � ��E �.,, . .� 4 ��-- O (I I I� i, S � �! ; � i � !� � _ __ �--Ci. _._ � � ' 1 � i I �� � � �� � � � ;t �� � i � ���_��� � _ .�, � � '; C; �± i �� � �,1 L � � f� . ' w Y � � 7� � ^ N , � �. �� � � �� 2 �� _ .� � • � ,� --� �`.s` j � ._ ����.� N' � ��� ��� . �"' + �,,_. _� � __S �� o; � N� ..`�, v �^ ��� � �, ,.� � �_. y �� � � � � . 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H t-� W a] F j q n i� � �+ N ,� r a' � = 3 t � � �j� _ Q � � � � � � ry � :�'Jh� � N _'��'- (.� - �y� i � T '�- _ � I `� J I � N - r1 _ � �o O � i - ,� `s' ' � u� m i � � �u 3 I ✓ rn � - � .-. � � m _ ii W � � ii: `� O I G ._l ~� � �� , _,� _ ._ . . � �a��� �"s c$a �� o zi���C N° g���� 5�n "g��� � � ����� ����a� Ed ^� c ���,�� s��=s��: H N ����� �34gS���9 �'x y°9g� �lia�����t �� H�� g� , a s2 e H� � 'd� ��g�`4€$� � ��t�s P�y�^���� gg { � ��`>�S�° d'k��ikr$C � �<.Rt� ���� :-my� '1 � � � ,^ ' tl ` " ` � , �' Q S .Y h 1 "��Na° e��ge��b�" � ��„'�o <��3e�a��a �9���u ��6���3 `� �me � �$z£5'� ��gyg���'�k�gB zp�tl�a YB�����9 �.:�Sp ���� �h4�4„' `�$a°s. ;�ae���ees E ] � � � � � O1 W W .. 7 Z o C n� C 3 d E � � 8 ;; �, a � � 3 �' ° �i H � v � 7 H 4 ,� F• a, — 8Z968 # u��saa Design # 89628 tems Selected: Gable roof wl 4112 pitch, standartl trusses 2' O.C, Truss Design Location Zip Cotle; 55432 2z4 Wall Framing Material 24' Witle X 12' Deep X 8' High Mainsireet Vinyl Double 4" Dutch-Lap Sitling • Light Maple 112" OSB Wall Sheathing Nova Wrap 12" gablel24" eave overhangs 112" OSB Roof Sheathing 20 yr, Classic, Shasta White Shingles Slant Back Veni�Metal), Black White Aluminum Soffit & Fascia White Premium Roof Edge White Vinyl Overheatl Door Jamb Materials From Endwall On Back View Not Estimated Da ign-lt° .,. Options Selected: The options you have selectetl are; 15 LB Roof Felf 2 Aows Granular Ice & Waler Barrier I oday's estimated base price; $1,486.59 The base price includes: 0" Eave10" Gable Overhangs, Framing Materials, 7116 OSB Roof Sheathing, 20 yr. Fiberglass Classic - Onyx Black Shingles, Pine Fascia, Galvanizetl Regular Roof Edge, 8' Teztured Ver�ical Hartlboartl Siding, No Service Doors, No Overheatl Doors, No Wintlows, or Any Other Options. Front View Pa e 1 of 2 71812011 ---� -- �_; f���`�' � - . !���C' �. � ..�,u�J __ .. _ _ __— �_-- Back View With Open Gable Endwall _--��,_ � ,,%� ` �,<,, -_-- _ --=�, � = --_-�=�-- � --- — ' I _ __ _- �. Today's estimated price: $2,302.18 If purchased today, you save: $146.30 Monthly BIG Card payment: $64,65 ��� Take this sheet to the Building Materials counter to purchase your materials, ��� all information on this form, ofher fhan price, has been provided by guest and Menards is not responsible for any e« ors in the information on this estimate, including but not limited ro quanfiry, tlimension and quality. Please ezamine this estimale carefully. MENAROS MAKES NO REPRESENTATIONS, ORAL, WRITTEN OR OTHERWISE, THAT THE MATERIALS LISTED ARE SUITABLE FOR ANY PURPOSE BEING CONSIDERED BY THE GUEST. BECAUSE OF THE WIDE VARIATIONS IN CODES, THERE AAE NO REPRESENTATIONS THAT THE MATERIALS LISTED HEREIN MEET YOUR CODE REQUIREMENTS.