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AF - 35642• City of Fridley r AT TNE TOP 0► TME TWINi , i` r rL"'^�-� GOMNuNITY DEVEI..O�MENT OtV, � � i MIOTECTIVR MNI�CTIpry pqT, l� � �---t � prr ►u►�� fR�D�.RY iMA i�.._.11.� .� N3-��0-3N0 Job Address 5�-81� -s-915. 51 iUOJEGT PLUMBI�Vr, PERf1IT QPPLICATI�� 63i.�o N. E Able Street ner Ad Robert D, Ke15e.y Contractor � .� a4iJE,,TF Av� MIINNEG.'�SC MPLS. MS Kind of Building Use Frame �etion Date - 5-14-7�, F+ u � I � �� I ,� ' I W 1) � W I I I C � i ' —I'� f � ��1 I � i--- I� jE 3 � I ' � � a��vo�� ( � � � .pp I�.i � I L'' � � I ! � , �,ddr� � ; f —_� — O � I 4ro T •z�r •as�w I � •saa, I 'enNiva � ;; sNisre '� H�ir� k �O r 9N��aa '3 �° �oo��l �w'd ,O � I saaMOaS+ ;o � I ��q '1NflOdl d HN7LI0 �o '�U �v� s�vall q � HsvM � s�N�s� Htva �uvM - - � �� i � � � � � / p - ,3 0 - 7�'.,�� O .r � C7 C3� � � � I! �, ess ss Res. , ��;i� one r;scima�ea t;ost , lo, o0 Plumbing Fixture Rates: N0. RATE TOTAL Number Fixtures X $2,ap �_ Future Fixtures x $1.50 New Fixture-Old Open. x $1.50 Catch Bastn x $3.25 �__ Water Heater-99,000 BTU x $3.00 Ground Run Old Bldg, x$3.25 Elec. Water Heater x $2,00 i� Gas Fitting Fees: ��lst 3 Fixtures x $2.00 � � ----. I - ; Additional Fixtures x $ .75 � Gas Range-199,000 BTU x $5.00 � Re sirs & Alterations � � w-See Description: Yn�tall Grill �ode 00 � + State Surchar�e C(�ss ��'A'� 5urcharge .50� 50 _ � j , . TOTAZ FEE • $ 5.50 I !The undersigned hereby makea application for a permit for �he work herein specified� agreeing to do all work . in strict accordance w ith the City Ordinance$ and rulin of the Department of �uild�nge�, and hereby declare that a11'the facta and representations etated in thia application are true and carrect. :-�.....�. f � ��, �, � rti.�� S�� i. O�- / .... r �..-. . ,. 'Signature ?C��1�.��„ � .�-- - - Date � . 1 � CITY OF FRIDLEY Effective Date May 1, T988 aPPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE QESIDEIGTIAL RATE Furnace Shell and Duct Work, Burner (Also replacement farnace) $ 2Q.00 Gas Piping $ 10.00 (piping needed with new furnace) Gas Range $ 10.00 Gas bryer $ 10.00 * Air Conditioning (all sizes� $ 10.00 Al1 Others/Repairs and Alterations 1� of Value of Appliance or WorY. COMMERCIAL/INDUSTRIAL 18 of Value of Appliance or Work Reinspection Fee State Surcharge TOTAL FEE ($15.00) � TprAI, Job Address 6340 Able St. NE $ 1�.�0 Depart.neent of Buildinqs, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley $ Tel. #571-3450 $ The undersigned hereby makes application for a permit for the woork herein specified agreeing to do all work in strict accordance with the City Cordes $ and rulings of the Departsnent of Auildings, and hereby declares that all the facts and representations stated in this application are true and correct. $ lO.00 Fridley, rLinn. June 28 � 19 88 owrisx Bob Kelsey $ KIND OF BUILDING Frame $ $ .50 $ 30.50 $ Rough Tnsp. �* Also installing one (1) nate Carrier 3$EH024/24 2 ton Fina1 Tnsp. �%" ��'�� air conditioner Date Approval for Permit i� MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00� PLUS $,50 STATE SURCHARGE Attach stack verification fonn with. replacelpent furnace pe�its *Air Conditioners can not be placed in side yard wi.thout written pezmission frart adjoinir►g neighbor. USED AS Residential TO BE COMPLETED ABOUT ESTIMATED COST $ 290D . OO OLD - NEW BTJILDING PERMIT NO. PERMIT NO. D DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Ori2 Trade rrame Carrier s�Ze rro. S8SS060 Capacity Sq. Ft. EDR BTU 6O, QQO HP Zbtal connected Load Kind of Fuel tlat. gas BURNER - Trade Name Size No. Capdcity Sq. Ft. EDR BTU HP Company �1�('1� 9 Q A Signed By�\:�!�-�'l�—\��4—��h��.slun Tel. No. � �� — SVL-� V sus�ECT PERMIT NO. City of Fridley � 16 2 7 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. ' j L �""-, . . �� r � � PROTECTIVE INSPECTION SEC. 1 ; , � � /'��1 � CITY HALL FRIDLEY SS432 NUMBER REV. DATE PAGE OF APPROVED,BV � �'---•�: `.� 612-571-3450 910-F15 6/12/81 � � JOB ADDRESS 634� A�11e Street N.E. 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION 5EE ATTACHED DESCR. ']�8 ( FZOY'P.Y2C2 �aYk SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE Robert K.elsey 634Q Able 5treet N.E. 571-3826 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. - Award Roo�ing 7801 Rsgent Avenue North_ 560-8849 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE �ICENSE N0. 5 ENGINEER MAILADDRfSS ZIP PHONE LICENSENO. 6 USE OF BUIIDING Res:idential 7 CLASS OF WORK ❑ NEW O ADDITION � ALTERATION ❑ REPAIR ❑ MOVE � REMOVE 8 DESCRIBE WORK Reroof Structure 9 CHANGE QF USE FROM TO STIPULATIONS Roof can be 2nd but not 3rd roof. Insta.11 ridged. galvanized valleys. ` TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICA�, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. AS],JYld�.'t THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. GU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEFEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE ANO CORRECT: ALL PROVISIONS OF IAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPUED $1,195 $. GO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE R LOCAL LAW REGULATING CON- STRU TION OR THE PERFORMAN OF CONSTFUCTION. $9• Q� PLAN CHECK FEE TOTAL FEE $9.6� � SIGNATUREO �C NiRACTOROAAUTHORIZEDAGENT YDATEI WHEN PROPERL VALIDATED THIS IS YOU�R PERMIT � , 2 sx�..Qei � SiGNATUREOFOWNER�iIFOWNER8UIl0ER� IDATEI BLDG iNSP DA E � CI'CY Of" ("ftIf�LCY • � Af'f'LICIITIU;1 f'Ofz RESIUt:i��ITIItL f3UILOI�lG ('ERtrT�TS � � � � (�det�r, /11 Ler��tions, /1ciciitions, or Rcrairs) . . Ot�lt�lER: -. c. � - . UUIL�ER: - �� '�\ '�s� � • 11DbRESS: iD�y b A.,�.�u. �.� /1bUfZESS: �� -rc�. ho: �� 1- 3�2 � rc� r�a: �� o-$g � 9 ' Construction Location ' . STItL��T N0 : �� F � S7.�RF}�T: _ �,,�Q�Q o � . C� L°z': $ _� �LO�c : l9 �nnz�rzo� . ��.�. i �— � Corner Lot: Inside Lot: .� SetbacY.: Sideyards: Ap�licant attach to L-liis form t�,ac� Certificates of Survey o� lot and prop�sed building toeation drawn on certificates ta scale.. . DE5CRIPTIOir' OF C�PjSTRUCI�IOPd . ��C�p (- I'ront: Uepth: Iieighi: Squa�e. Feet: Clibic Feet: Jr'ront : Depth : H eight: . Sc�uar.e� I'e�t: Ci�bic I'ee�: �'YPe of ConsLruction: - �J - L�_� Estimai:ed Cost: $ � ` l �T� �b Be Cbr.�pleted: � � . . , Alt. A Att. B Proposed Aza.ve�•�ay Width If New Opening Is Aesired: $� $ • , SL� RnVER`ai: SIDE OF SHEET . �.ile undezsiqned hereby ma}:es applic�-�i�icn for a pez-mit £cr the �:nrT:' herein specified, agreeing to do ,a13, work iri atrict ac�;ordance �•rith the City of I'ridle�r Ozclitiances a�1d rulings of the i7epartnieizt. of Biti3dings, and herc�by ciec�ares that all the �aei.s and represen �Ltiens stated ui this app�ication are tru� and correct. ; D1:TFs': �� Z. 0' SIGNIITUF.`r;: � � Stiz�ulations : , . . � 9� ° 6 . .. . . �o � q, � � . � , .. ; . � . . � .,.�: � � . )il1Jl�1)IhtG_i'��f�I�J"(' (.IY�".__:�(.fl(_1)Ul �:�� F�l;(':`l.':CO,i 2. '1'1i� 7:n�.c��cci�o�' a1: )3ui.).c?.i.�,�J ;:sl�r�a.]., hefo�:c: �.r,�.i.iiuc� ��c�»nits f.ox t�.hc �rc:ct:.i.on c,f: �,.�iy ),u�.].�I.i.n�j oz :,t::.«c.•t:ui:c, w- 1'c»: �,»�� iQ<I�.t:.i�>n !:� �,>>y c�r,a.:;t:i�� l�ui].clinc� c». :,Lr.1icLUr.a, . i»' i:c»' arry ti.l.t�z,.it�ia� ��r. r.rZ,�i.i.r.:� t.o •tu�y c;:.i t.i:»rf 1n�i.).c.ti.n-� or :;L-1:ucttir_c, uJ�c,n ar�J��.a.cat_.i.on tl�c��:� L�OY"C:� x:cqu�.rc t.l�c� ��y�nr_i�t: }�� tl�c rzp��]i.��ir�!: f:oy- suc•1� ��r�r.�:�S.L• 01.' fc:e:, tc� t�l►c a�no�ant }1CYt3.1.T1 }�eJ.ot•� st�l. TUr.th �inc1 �.�i t:lic �nannc�: hcx:cirr Y,�:ovS.cic:ci Lo-t•::it:: . 11);t�t COIJS'1`):UC'.CiQI�: Sing).c ).'amil.y llotr,cs and Gtu-�Zqcs.;: ;:�1.00/7_,0�0 cul�i.� £ec:t:. - 3?L7;'•2 C;Itl;rl:: 25 ��cr.cez,t: aL bu;.1�7i_�acJ ):>e�-,nit fee. I)iZl:V1,l•'111' llL•'1'R'�557.Ut•1: (CUncreCc, ��irb �L�reets Only} � - ' A].t-crii�it:e n; Itc�n�val atu3 r�•�>].��crmenL- oi conczete cur.b and c�ui:L•e� only; 17riveway �•�ic�tii p].us 6 feet• x$13.�0 . nitcrnate 13: �2emoval and rep�accment of concrete curb ana • gutter and iiistall a 3 fooL- wic�e a�proach cait�h ' .� 6�.nch depth, Dr�vc;�ray s•�ic:�h �plus 6 ieei x$15..75 • . .�� on�n�. 1 r�c= or�c��ntr or� � T'ar thP purl�se of co�nputi_ng fees far_ buS.ldir�g p`xmits,. i:i�e culii.cal_ co:atenL-s of any bui.ld�.ng or. addi�ion, is detcr.:n3.i2ed by rnuli�ip].yir�g t�ie gr.ound area c��vered f-ro:n a k��in 4 six {G) a.nches belo�� the iloor ]_�.ne ai tlie basement or th� cellzr to 'tlie avexage iieights o� ihc �upper sw-face or to the aveiage ileiJ}it of the roof. surf•ace ot i:.iie ;�ain ,c�ab].e of a pitclied r00%. ' I'or zeFa�.rs Qr atter<<tions i:o an ex?sta..ng sL-ructure, the fee shall be at the xate of $3 . 00 �er each five hundred do]�lars -� ($500. �0) or fra.ci:ion '�ller�of in t}re cost of alI proposer� wor.k. , - � Tn •no c�se �ha�:Z 't.he fee cliarged foX any per�nit as set forth i.n Se��a.on 2 be less � �tian $7, 50 pl.us $.5�� state swrcl2arge. � . • ' ' . _ VCRIFICATIO�t OF r-�u,tin -_n� tot� � � ' NOTE: Pennits : oz' c�nst�-uction ��il�: be isstied a m�.nimu� uf 24 hours f-r.ont t}�e tizne �S ��}�licatian to �]J.o�� for proper re��iew ot tlie proposcd stxucture and oi the constzuction s�te. ' I� Certi£ieatc � of Survey of the lot, sho�,iing t}ie location oi the foundation onc4 it lZas Uee�i cox�s�nictea �aa.11 be required uefore pr.oceedi.��c� �rith the £raminq: .�=L�Lr_�rcr�zE o� ��uP��cti� � �� ' I►rpli_catior� for a Cez-tificate oi Occup�Zticy sha1�. k�e mad:� ten (10) c3a��s pzior t:o the • u� e or.• occurancy oL- �ny structure far �ti�l�icti a builcli.aig �aerr,i�t l.as beei� issu�d; aiid s��icl struat:ure shal]. Iiot be used ar. occu��iea t:r�ti.�. a Cezt�a.�ic�ct�e oS Occu1�Znc�� h�s beeix xssued. � l � _ . � •. � . ' • i ' �' _ , • . . sua�ecr P T N O. c�ty of Fridley � 19137 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � , � IPT NO. • COMMUNITY DEVELOPMENT DIV. ' �ti: '-� - (/ r � � PROTECTIVE INSPECTION SEC. � G O�/ 1 � i i•--- � �/"';,� CITY HALL FRIDLEY SS432 NUMBER REV. DATE PAGE OF APPROVED BY L � � 612-571-3450 910-F15 8/27%87 � � JOB ADDRESS 6340 Able Street N. E. 1 LEGAL LOT NO. BLOCK TRACT Ofi AODITION SEE ATTACHED DESCR. 7�$ 6 Flox'ence P3Y�C A,C�C31't1071 SHEET 2 PROPERTYOWNER MAI�ADDRESS 21P PHONE Robert Kelsey 6340 Able Street N.E. 571-3826 3 CONTRACTOR MAIL ADDRESS Z�P PHONE UCENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Add aluminum overh�ng, soffits, gutters, etc. 8 CHANGE QF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIF CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK iS SUSPENDED OF ABANDONED FOR A PEFIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCE0. NO. DWLG. UNITS OFFSTREET PARKING I HEFiEBY CERTIFV THAT I-HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND,ORDINANCES CaOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $�- � SOO S• 75 DOES NO7 PRESUME TO GIVE AUTHORI7Y TO VIOLATE OR CANCEL THE pEqMiT FEE SAC CHAAGE PROVISIONS OF ANY OTHER S7ATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. S2S.00 PLAN CHECK FEE TOTAL FEE $25.75 . SIGNATUAEOFCONTRACTORORAU ORIZEDAGEN7 �onTEi � WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT � i�. . .,. r � Si ATURE F OW EAi�F OWN, BUILDERI � 1 EI BLDG INSP � n E N� [ J City of Fridley Effeetive 4/1/86 ADDN. [ ] � R-1� AND R-2� ALTER. [ ] Building Permit Application Construction Address: V ✓ � Q � �� ` �� y" "' • f � �'G�dL Ey /1�j/V. � Legal Description: owner Name & Address : 4 '�f�-11y ' Si�sYJ E AI f)i3 �� 2e�,: .# �^7/ -.38.2'6 � Contractor • t1,�� R r�l . � Address• Attaeh to this application, a Certificate of Survey of the lot, with the proposed construetion drawn on it to scal�e. DESCRIPTION OF IMPROVEMENT sr- LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length WidtA Hgt/Ground Sq. Ft. � OTHER; �� A�1 d v� �C H�1 A/C- S'DF/T1'- �r1 TT�*"C..l; �= T[` Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setback Type of Construction• Estimated Cost: $��D D• o� Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Hack Page for Explanation x DATE: �J ' o� /�' �.� .� � Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: APPLICANT: Tel. # �7��z� CZTY IISE ONLY $ �S.O U Fee Schedule on Reverse Side $ 25� of Building Permit Fee $ %5� $.50/$1,000 Va2uation $ $ 525 per SAC UniC $ Fee Determined by Engineering � $ a2�. %.L Agreement Neeessary [ ] Not Necessary [ ] ,. .. . . BU]ZDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and�in the manner herein provided to-wit: Total Valuation �1.04 to $500.00 $501.00 to $2,000.00 $2,001.00 to $25,000.00 $25,001.00 to $50,000.00 $50,001.00 to $100,000.00 $100,001.OQ_and u� Fees $10.00 (Minimum Fee is $15.00) $10.00 f'or the f�rst $500 plus $1.50 for each additional �100 or �'raction thereof, to and including $2,000. $32�50 for the firs� $2,000 plus $6.00 for eaeh additional $1,000 �r fraction thereof, to and including $25,000. $170.50 for the �irst $25,00� plus $�.50 for each add�tional $1,OOA or fraetion thereof, to and inelUding $50,000� �283•Oc9 for tTM.� first $50,000 plus $3.00 for each additional $1,000 or fraction thereof, to and ineluding �100,000. �433,-00 for the firat $10�,0(10 plus $2.50 for each additional $1,000 or fraction thereof. DRIVEi�TAY DEPRESSIOi� ESCROi1 (Concret� Curb Streets Only) Alternate "A": Removal and replacementYof curb and gutter only - Driveway width plus 6 feet times $13.50 Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approaeh with 6 inch depth - Driveway width plus 6 feet times $15.75 VERIFICATION OF FOUNDATION Permits for construetion will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the o�nstruction site. A Csrtificate of Survey of the lot, sh�w:��g the loe��ion of the foundation onee it has been constructed will be required before p*�:�ceeding with the framing. . . � ,� .� e SUBJECT City of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � � � � • COMMUNITY OEVELOPMENT DIV. r � v � PROTECTIVE INSPECTION SEC. � � 1 � , � �'��1��- CITY HALI FRIOLE� 55132 NUMBER REV OATE PAGE OF �""'�' �'� 612-571-3450 9t0-F15 9/14/98 / / �oe nooaess 6340 Able St t LEGAL LOT NO. BLOCK TRACT OR AODITION DESCR. 7,g 6 Florence Park Addition 2 PROPERTY OWNER MAIL ADDRESS Robert Kelsey Same 3 CONTRACTOR MAILADDRESS Steven R Lee 9465 Irving Ave Brooklvn Park 55 4 ARCHITECT OR DESIGNER MAIL ADORESS 5 ENGINEER MAI� ADDRESS 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW � ADDITION 8 DESCRlBE WOfiK Reroof house & garage (26SQ) Tear-off 9 CHANGE OF USE FROM STIPULATIONS 21P ZIP ❑ ALTERATION O REPAIR TO Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY SEPARATE PERMITS ARE REQUIRED FOR EIECTRICAL, PLUMBING, HEATING. VENTII.ATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SO. FT, AUTHORIZED IS NOT COMMENCED WI7HIN 60 DAYS, OA IF CONSTRUCTlON OR WORK IS SUSPENDED OR ABANDONEO FOR A PERI00 OF 120 OAYS AT ANY TIME AFTEH WORK IS COMMENCED. NO. DWLG. UNITS I NEREBY CERTIFV THA7 I HAVE READ AND EXAMINED THIS APP�ICA710N S7ALLS AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALl PROVISIONS OF LAWS VALUATION AND ORDINANCES GOYERNING TNIS TYPE OF WORK WIIL BE COMP�IEO �$�Q��g WITH WMETHER SPECIFIED MEREIN OR NOT. TIiE GRANTING Of A PERMIT �L,�ZZH.O DOES NOT PRESUME TO GIVE AUTNORITY TO VIOIATE OR CANCEL THE pEpM1T FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATiNG CON- STRUCTION OR TME PERfORMANCE OF CpNSTRUCTION. �7�F. JS � PLAN CHECK FEE "` �� y Lice 5 . 0 SIGNATUf7E OF CON � RAC R O UTMOQiZED AGENT IDATEI eu onoc v iw� �nw R iIF OWNEA BU�LDEAI IDATEI I �. ,. �i�-. PHONE 27742 RECEIPT NO. �f APPROVEO BY SEE ATTACHEO SHEET 3826 LICENSE NO. 3 5758 LICENSE NO. LICENSE NO. O MOVE O REMOVE IUP OCCUPANCYLOAD CU. FT. 'FSTREET PARKING IGARAGES 1RTAX $1.11 �C CHARGE Fire SC $2.23 )�7 FEE� / 83.09 TNIS ��E � � r � NEW [ ] Effective 1 / 1 /98 ADDN [ ] CITY OF FRIDLEY ALTER [] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �� 1� '}� `/.� �� ConstructionAddress: � � � � � (� ST Legal Description: Owner Name & Address: �� '" �l�/s �,,., Tel. # ��/�- ��'�o Contractor: �%--�� %� � ..e�_ MN LICENSE # � 7�� Address: % �/ � -� �y' v� • 2,s ,�.�, ��%��, �a�/ Tel. # �°oZ-}°— //�� Attach to this application, a Certificate of Survey of the lot,_ with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: Length Length Length DESCRIPTION OF IMPROVEMENT Width Width Width Height Height Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. OTHER: � � �� $ Construction Type: -�.-y. ;,,�?--� �L i�A. �.��— Estimated Cost: $ ��'� � (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: /�� y % APPLICANT: �` _ Tel. #�� , j'— I 7 9� T Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ � S� $ � �.3 $ �. / I $ $ �: o0 $ $ $ $ � 83. v CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $100U per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] W BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $54Q $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 , $500,001 to $1,000,000 $2887.25 for the frst $500,000 plus $4.25 for each additional $1, 000 or fraction thereof, to and including $1,000, 000 $1,000,001 and up $5012.25 for the iirst $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets On�y) Altemate "A": Removal and repl��ment of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATTON Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. . . 3 :,Il'Y �F FRlQLEi( iP1��G�I�M1f DIV. i43�f Uni�ners3ty Ave iVE d. =tidley, MN �5432 m 763j 572-3604 M m d � V � V t0 M tQ � � lD EfFec�ve On Jam 1. 2002 ��rro� r� �u�c � c�as �rrnnx� Pe�r�rr P o 3 i 3 3 TiQN 1TT1 � � . �U �LUMBING FUtTUftE Ra4TES: MQ. Rf4TE T'a7AL 0 '' dew Fixtu�+es }�d Ope�tin9, N�w �ixbure 3eEr �� nr C}ff Basin � Basin w �ai� UlFaber Lead�r Q w�fReceiving T�k � Vater Tr�et�ng �li�oe ,� Vater H�r -�ler,�ri� 0 } 'Va�' Heafer - Ges� � � �� as Dry�'= � k�ek Raw R�ren#,er Req� {�'"�es () No � �� i.fw $ 4-tIQ $ 5.tyd $ 7.� � 7.� � 7.UE} $ 7.�f1 $1Q.0(I � 7.�1 $90.4� $9tf.�u �10.00 $15.tIfl � � :eir�spectian Foe $47.0�IHr �.u. aTHERS ANDIOR REPAIRS qi� AlTERATfONs � 1.5°Yo c�f Vaiue of Fa�,re ar App�nc� N �; �ate S'I,iiC�la� � � � TQT1�L F� � 'Zc�. VU 3 .5Q ��C� �va �oa�ss Co3 �0 1� 3l e S�. I�C-„ The �der�ed h�reby malces a�tic�n for e pemn� far � wark herPin spec�ied a�ein9 to da � a�cxic in �rictaa�� with the afX c� and rulings of �e �ilc�g �n, and he�by d�r� that ail t� �s a�d re�� a#ed in Ntis a�ticrn �e tru� and cSOr�E. _ /�'�F}l�� Z�iv+~ , � O � �wner � �� e � S 2 � �ta�ding E1sQai As �� Est�a�ed Ca� � P�i' NQ. � I PLIJ�IdG COI�ANY � l�?� ii� e.CJi/4N' i Cf� � � 8Y r'�^ • TEL NQ. �OS ��0 3 i0' % 22Z �ax� S'� - (v (o— �7 � � �.� � �r � <i aa-�� =�_ + :kl = �.i: :��_ i � �i �_�= .�� .* .t :OMBUS11pN AIR SHAE.1. BE PR4VI�ED P�? UMC SECTtOPI 5�44{A) AND TABLE 8 A. GtJMNK}N V�IT INFO 41d B��IC S�DE Building [nspections 763-572-3604 DATE —X ^ � ' � SITEADDRESS{�-� '7 � THIS APPLICANT IS: BUILDING Permit No.: �1�:�:� t-�Ctz� RESIDENTIAL APPLICATION Received By: CITY �F FRIDLEY Date Rec'd: �-- ��--�� YOUR E-MAIL ADDRESS / C S �� C� r�� D�� C� .) � i ❑ OWNER �EflNTRACTOR PROPERTY OWNER/ N,�E: /��i- � c� /T � ls e TENANT ADDRESS: .3 Y O � Q3/ e s T CITY �/' � d�[� STA PHONE: �/ J .2. _ �� i$ � s �3 —.Ss�-a ��. �► � � sS CONTRACTOR !�c ix 6 U S L' �" f'" � r` . 6 r— STATE LICENSE # S� EXP DATE ��' 3�� d� YOUR STATE OLIC NSE AnDxESS: � � �3 / // ''�Z 'L nJ .�-J crrx �° Q •� �•��1''Ol STATE�?' ZIP -SS �! �-3 WITH APPLICATION PHONE �� 3- ��2 - 8-r/ i� F,o,X i�-3 � 7 B`i —/ L/ 2� PROPERTY TYPE PERMIT TYPE TYPE OF WORK: ❑ srrtGt,E Fa,�tiLYrniEw cc ❑ TWO FAMILY/NEW CON� ❑ ADDITION ❑ BASEMENT FINISH ❑ DECK �W AINTENANCE/REPAIR DESCRIBB WORK BEING SIZE OF IMPROVEMENT ROOF G � � NUMBER OF SQUARES C�ARAGES PROPOSED SIZE: PROPOSED HEIGHT: SID Q Vinyl ❑ Aluminum ❑ Other � SIDING 0 SWIMMING POOL ❑ ADDITION ❑ REMODELING / �li�'"D f �/ LENGTH 0 HOUSE ONLY ❑ HOUSE 8c GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GAR.AGE ❑Soffit � Trim ❑ Fascia ❑ DRAIN TTLE ❑ OTHER � us �- / 6 A�h- /a- C7 � �TH HEIGHT _ Ft. BASEMENT REMODELING SUBMTf: l. Facisting F7oor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS & PORCHES SUBMIT: 1. SiYe Plan/Sarvey showing the existing swctures and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations TN EXISTING OPENINGS �Yes ONo IACATION OF WINDOWS OR FOR NEW OPENINGS-DESCRiBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $.S, Oa 6� OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Cbarge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due � • �J� $ �" $ • L� O $ � �.� $ . � '. OZ� $ $ $ $ See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$20=$ $450 Conservation Plan Review Fee Deternuned by Engineering �greement necessary ( ) Non Necessary ( ) ake checks payable to: City of Fridley Attach A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building pemut 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 perxnit but only an application for a pernut and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work whi requires re�vjew and approval of plans. / SIGNATUREOFAPPLICANT �"- —�— PRINTNAME�� l ,� /(�,u ��f DATE ` �� — Dy Page 2- Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repa.ir to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE FEES $1 to $500 $23.50 (M�n�*rn�*n Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for ls` $500 plus $3.05 for each additional $100 or fracrion, to and includin $2,000 $2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional $1,000 or fraction, to and includin $$25,000 $25,001 to $50,000 $391.25 for 1�` $25,000 plus $10.10 for each additional $1,000 or fraction, to and includin $50,000 $50,001 to $100,000 $643.75 for 18t $50,000 plus $7 for each additional$1,000 or fraction to and includin $100,000 $100,001 to $500,000 $993.75 for 1�` $100,000 plus $5.60 for each additional $1,000 or fraction to and includin $500,000 $500,001 to $1,000,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each additional $1,000 or fraction to and includin $1,000,000 $1,000,001 and up $5,608.75 for the 1�` $1,000,000 plus $3.15 for each addirional $1,000 or fraction VERIFICATION OF FOUNDATION Permits for canstruction will be issued a minimum of 24 hours from the time of application to allow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Onlv City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 From: City of Fridley To: 651-203-0554 Page: 4/5 Date: 7/26/2006 12:02:13 PM ��j�j-� Building BUILDING Permit Ivo.:,'��,2jC�`� - � Inspections RESIDENTIAL APPLICATION Received B: 763-572-3604 Date x��t�� P � CITY OF FRIDLEY DATE C5 t ��L SITE ADDRESS \ 9 ��'t vx _�-� THIS APPLICANT IS: ❑ OWN6R PROPERTY OWNER/ I NAME:= TENANT ,�Dx�ss: CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE TYPE OF WORK: NAME: ►\(�C S; ATE LICENSE #� ADDRESS:�,a PHONE ZO INGLE FAMILY/N] ❑ TWO FAMILYMEW ❑ ADDITION ❑ BASEMENT FINISH ❑ DECK DESCRIBE WORK BEINQr DONE: SIZE OF IMPROVEMENT ROOFING NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIQHT: YOUR E-MAIL ADDRESS �r��Ol �---- )NTRACTOR �.! �,�.�_1 �-�-- ��- S-�: ` �1�a � � ��-��'_c�� l'�.) � � \�-} q __ F AX _ �ONSTRUCTION NSTRUCTION ❑ C}ARA(}FJSHED ❑ ROOF O SIDING ❑ SWIMMING PO LENGTH ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE CITY EXP DATE _ ATEM�IP� jZ CITY�i��V rlclf� STATFl�"'�1P��p r r, �,��1 ❑ DRAIN TILE ❑ OTHER WIDTH BASEMENT REMODELING SUBMIT• 1. Existing Floor Plan 2. Proposed floor plan 3. List of swcturai membors to be used SIDING FORNEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl OSoffit �n1TiaNS & PORCHES SUBMIT• ❑ Aluminum ❑ Trim i. Site Pian/Survey showing tho existing swetures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction pians �� 3. Energy Calculations 1N EXISTING OPENINGS �I'es ONo LOC TION OF WINDOW � Q� OR FOR NEW OPENINGS-DESCRIBE SIZE OF ,�� '� OPENING CHANGES & � 1 TYPE OF WINDOW TO BE INSTALLED ��w NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997' iJ.B:C FEE SCHEDi�LE) TOTAL JOB VALUATION $ 2� o O OCCUPANCY TYPE __ Permit Fea $� 3,,��-�j Sae Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ a•/ 0 .001 times the total job valuation Surcharge $�, l)� .0005 x Permit Valuation Minimum $.50 Licanse Surcharge $�-� i)� $5.00 (State Licensad Rasidential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft+ 6 ft= ft x$21 =$. Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessazy O Non Necessary O Total Due $�1,�0 Make checks payable to: City of Fridley Attach 5tiDulations THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information abova 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; that the work will be in accordance with the approved plan in the case of all work w' h requues review and approval of plans. SI(3NATURE OF APPLICANT --��-'�^" �_—d.�!�� FR[NT NAME_� DATE 7_//�� r�