AF - 45071City of Fridley, Minn.
BLT�LDING PERMIT
.._._..�
N° 5322
Da� .._._..�4�.�.r�'i' '� � _. _._. _... �
�
Ovaiier• _-,ir�r.�t.�.-...:{' ..,,,.!!�'„r� Builder �
, ,
, .
Address __.____...�.._..w___.._ _.�_:.._ _.._______ Address _.._..__—::_._._..._.�__.._..::..Y�... ...:. _
.. . ,�.4� . .
^� TION O U ,�; ,�"
�'}j . , , Y ,�
No. .����i� Stn�et y � .�:.. P t_...w.._._..... . ,
Z.ot .....�.�.._._.__ Block ....._.,�. ....._........._.. Addition o ub- .visio� , V
Corner Lot _.__._...._..____ InaiSie Lot .. _� _..._._ Setbaek . � , ^.
.._..._.__ 5ideyard � ._ ..��„�____
Sewer Elevatfon _..._..__�_.,...�_ _�....___ __ Foundation Elevatio� ___.�..._. w�
. �:
�,
� DESCRI�M OF BUILDliVG,
T e Use� : � - ,
_. .,_.. Froat �W� Depth Height �_.. Sq. Cu. F'k .
_ _.... �...� DePth Hei t ..; Sq. F't. Cti. ii't.
Type of ction . _ Est. C.�t ...�.._.._ To be Conapleted _..._..
, , ,
• - _ `� ��' �-'�
. . .. . . - 4��• . .. � . . . . '. .. � � � ' �
In eonsideration of the .issuanc�e to ine of a permit to cons�truct. the birilding described above I��ee tb do
the P�P�d work in accordance with the c3escription above set forkly snd in compliauoe with a�l p�wfda�ts o[
ordinances of the city of Frfdley. .
_.�......_.. `
In consideration of the payment of a fee of $..���� permit is hereby granted to '
to construct the building or addition as described above. This perniit is gi�an�ted tipos
the express condition that the person to whom it fs granted and his agents, employees and work�� ia all• Vaprk
done in, around and upon said building, or any �art thereof, shall conform fn all reepects to ti� or8�a�es e�
Fridley, Minne$ota regarding Iocation, construat�on, aT�eration, maintenance, repair and moving a� b�
�uvithu► tne dty liYntts ana tlus permit may t�e revoked at any tune npoa� violation of ae�yy oi the pro�vlaios�s aE
"ordinanc:es.
���� �
��
NOTICE:
ihis p�it doas not eowr tb� eonstnidioa, i�ail�tioa hr wiriao, �km�6in�, �s hwfin,, snr�r w wahr. M swr fe sw
fM 6uiMia� In�pKlor for »p�rah p�rmhs Toe �w ii�as.
- . � � �i4 . , � , .� �
l
APPLICATION FOR BUII�DING PERMIT
CITY OF FRIDLEY, MINNESOTg
�.
Owner's Name �=�� ���7_�•c� Builder .�.q��E�S/ C_iT c�S% �
iddress Address 9Z��_�? �'•�f%9�/T��� �.
LOCATION OF BUILDING
No. � r� �� 3treet L.L��=,c,/ �vv� Part of Lot
/ ,�.�,y„e��,�'s
Lot !� Block � Addition or Subdivision�.�.¢ i ar�+�y.Es��T�S ,z'`.'!'`'
Corner Lot �Inside Lot � Setback �� Side-Yard %a � �� � �
SEWER ELEVATION FOUNDATION ELEVATION
�pplicant attach to this form Certificate of Survey o£ I�t and proposed building
location.
DFSCRIPTION OF BUILDING
�o be used aa:
-. /' !/ f
�G:�'!"L L/�J� Front�Depth � � Height
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction /�2/��l� Estimated Cost ���o o�
To be Completed � d f-,�� �; /y�� �
Tha undersigned hereby makes applica.tion for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City 4rdinances and ruling oY
the Department of Buildings, and hereby declaxes that a11 the facts an presentations
stated in this application are true and correct.
DAT� �%��'i/� � � SIGNATURE "
(A Schedule of Fee sts can be found on the Reverse Side.)
i -��� •
Ci+y o# Fridley
App�ication fvr P`lumbing and Gas Fitting Perntit
Depi. of Bldgs. Phone SU 4-7470
DESCRIPTION OF WORK �`�� O
13umber, Kind and Lxation of Fixiures Location _
� � < � � � Y � � Z = N W w Z « � WATER HTR.
iiJ 7 �� � ? '�3� op ; �o U� <3 �< �U' � �O � N GAS ELEC.
Base / !
ist � �
2nd
3rd
4th
• Futute Coanection Opeaings
* New FixYure, Old Openu►gs
Coruiected with
�� � Sewer
�,.,�..�1, . %�`� Cesspool
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures . . . . . . . . . . . . . . . . . . . . . . � x $1.50 $ ' S� �
Future Fixture Opening ................ � x 1.20 $ -�� � a
New Fixture Old Opening . . . . . . . . . . . . . . x 1.00 $
Catch Basin ...... ..................... x 3.25 $
Water Heater (Up to 20Q,000 B'1'I7) . . . . . . � x 2.04 $ °� • �
New Ground Run Old Bldg . . . . . . . . . . . . . x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... '� x $1.50 $ % ' S �
Additiottal Fixtures .................... x .50 $
Gas Range to 200,000 B'1'LT . ........... .. x 2.00 �
REPAIR3 & ALTERATIONS—Refer to Code
Description ................................................$
. To�raL r�E $ �, � D
0
City of �idley:
�^ �
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J
�
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do �ll work in strict accordance with the City Ordinancs
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this applicatiy� are true and correct.
Fridley,
Owner
/
Kind of Building
Used as �
To be completed about ��
Estimated Cost, $�l - ���
� �--�-
Old ew Building Permit No �� Pezmit No.
Signe v
By �-�- "•
r Business Phone No. � -
ROUGH � � � � � �/
FINAL
az 2M
is� /
y � s `' ��'�
� =- �
, Application �or P�o�wer P�ants and He�oting. Cooting, Ventilcstion, .Refrigercr�ion Qind
Air Conditioning Systems and Device�s
PARTIAL RATE S�HEDULE
GRAVITY WARM AIR: RATE TOTAL ,
Furnace Shell & Duct Work . . . . . . . . . . . . . . . . . . . . . . . . . . 8.00 �
fteplacement of Furnace ............................. 5.00 1
Repairs & Alterations—up to $50Q.00 . . . . . . . . . . . . . . . . . . 5.00 $
Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . . . 2.50 $
MECH. WARM AIR
Furnaee Shell & I?uct Work to 124,OOQ BTIT . . . . . . . . . . . . 8.00 �
�each add. 60,000 BTiJ 2.00 �
.....> .................. -----
Replacement oP Furnace ............................. �.00 $
Repairs & Alterations—up to $500.00 . . . � . . . . . . . . . . . . . 5.00 $
Repairs & Alterations each add. $500.00 .......:... .... 2.50 $
3TEAM or HOT WATER $YSTEM
, F�zrnace Shell & Lines—ta 4Q0 sq. ft. EDR Steam. ...... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . : . 2.50 $
Each add. 320 sq. ft. EDft Hot Water . . . . . . . . . . . . . . . . . . 2.50 $
OIL BURNER—to 3 bal, per hour . . . . . . . . . . . . .. . . . . . . . . . . 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTIJ) . . . . . . . . . . . . . . . . . . . . . . . 5.00 �
GAS fITTI1KG FEES: NO RATE TOTAL
lst 3 Fixtures . . . . . . . . . . . . . . . . . . . . . . x $1,50 �$'
Additional F`ixtures ................. x .50 $
Gas Range to 200,000 BTL1 . . . . . . . . . . , x 2.00 $
AIR CONDITIONING ` ¢
_ FAN HEATING SYSTEM See Fee Scheduls
V£NTILATING SYSTEM $
ALTERATIONS 8c REPAIRS TOTAL F�E � �
i y ,�
ROUGH
FINAL
Depi. of Bldgs. Phoae $U. 4-7470
Lxation / � J v �%��� ��'7
City of Fridley: _
The undersigned hereby makes applica.tion for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
Fiidley, Minn. 19 —
Owner /-✓��-�--��+� L�ciC� _ _
Kind of Building
Used as �
To be completed about �' �— �� 6�
Estimated Cost, $
Old New Building Permit No. �' �°2 ��Pe=mit No. /�o �
DESCRIPTION OF WORK
Ii�ATING or POWER PI.ANTS�team, Hot Water, WCazm Air— o.�
Trade Name ��;k Size Na-��%� �" ll YU
Capacity �� d. d v o Sq. Ft. E.D.R. BTIJ H.P.
Total Connected Load -5 v���% Kind of Fue1 ��
BUFtNER — Trade Name Size No.
Capacity Sq. Ft. E.D.R. BT[T H.P.
(REMARKS—OVER)
�';r�<x 4M 7-59
Signed '��i.e.�-*�r�
By
Business Phone Na �
HEATII+fG AND AfR CONDITIONING Ir+e.
�Q �� �i.� M1�MdEAPOLtS 16, MINN. \
.
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_ _ - -
.
CRONSTROMS HTG. & AIR COND.� INC. �ob Name
D-56 ��0 Exe�lsior ooubvard, Miaa�opolis 16, Mina.
.,�Y6 NlAT LOfS CALeYLAT10N� Job Addreu ,
Wcatherstrips _'4' G�l� COAE�iUCt10A NO. � Insulatios.
Windows Doora Reference Out. Wall Int. Wall C.eiling Roof Floor DCind "' �r �
Cin
es--No � Yea—No 19_ ,
Fl•� .? s-1��Room Length j� Width � v Height $' Fl.� -L t/ Room Length .� Wi�h
Windows and Doora—Crackagc and Area Windowa and Doors—Crackage sad A�ea
�Vidth HefBht No. ot Lineat ft. Area �� a�Q Wtdth Heli�t Na ot Linwl tt. +R30� -'
No. of Dane of pane lights of crack q. ft / No. o[ paoe ot Dans 1�tAts oteraoR' tt.-'
7, �tv Yv � / �¢�� � 2v � �
�o R �v t;
�.— -'� q �
� Coef. Btu � � � � H�
Inhltration 6' � � 3�6 0 ,In6ltration Go .�'d
Glasa " ,f'O � Glass � ;" + d t� '
rExp. wall
Net exp. wail � J / 0 3,i 4 D
Int. wall
' Ceiling r �j/ 4�'
F'loar
3'otaI Btw �
Required aq. ft. E.D.R, or aq. ina. W.A. I.eader ana
F7.� E�vi Room Length Width Height
Windows and Doors--Crackage aad Area
Id h Hefsht No. ot Llaeal it. At�a
No. of pane of pane lfsht� of craok p. tt.
Coef. &u
Infiltration p
Cla� o 0 o v
Exp. wall �
Nec exp. wall a � o�
' 1at. wall
Ceiliag / "_' �' � / S' '� �
Floor
Total Btu.
Required aq. ft. E.D.R. or sq. iaa. W.A. La;ader area
Fl. 15+�`� Room ( Lengt6 Wickh
Windows and Doo"rs--Crackage and Area
Wfdth Hettht No. of Lineal tt. Area
No. oi Dsns ot psas It`ht� ot crack M. tt
C G � .�
Infiltration � l�
Glass __� �
�p. w�►u 3 --�— �
Net esp. wall ,i
Int. wall
J
Tbta� Btu.
Reqaind sq. ft. E.D.R. or aq. ins. W.A. l.eader area
�
Esp, wa11 —
Net ezp. waII
Tnt. wall
Ceiling
Floor
Total Btu.
Required aq. k. E.D.R or aq. ina. W.
� Ft.l Room ( L�ength ! S
Windows�n—Ccackagt amd
wldeh Hoish� Na o! I�ines�
Na ot psn� i t pan� 1 ot �c
:, •3 � `la / .,
Yo �o � l�
! '� c ,,,.
In6ltration '3 �
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� " ' `
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� �
.
� ' ; ��
��
�'�� _�_.�
� rr: .
�.
� :
■�`;e!
Glaas ' r ;'�:
E�tp. wall '"' )c' � � � � � � �
Net exp. wall - . -!'i ��
Int. wall
�
Ceiling ;�`a ,,,►'`�+ ► -
Floor
Total Btu.
Required .q. ft. E.DR or aq. in�. W,A. I�d�r a� ,:
� Fl• �" R�oom I Le� --�'�..:. ��` :' h�
1�l'mdow� a� Dnors-�ruka�e aad
Idth HN� t a
Na oi pane ot.pane Iis�ts - at aeae� '
d b �d 1 R .a �
/ � v Ya
Bc� I I
� Infiltration
� � E� �u 2
q o Aler exp. ,�tl
In� wall
C � Ceiling
�'loor
�� Totai Btu.
Required sq. h.
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_ . .I :
�� r � m
� �
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—
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CROIMSTROMS HTG. & AIR COND.� INC. �ob Nam
D�S6 '�10 E�ceelsior Boul�vord. Miaesapolis 16, Mtan.
�Y. NEAt' LOif �ALCYLATIONf Job Address �
VVeatheratrips _ A Guide Conatruction No. I Insulation
Windowa Doors Reference Out. Wall Int. Wall Cxiling Roof Floor � ICind i-kw Ap�d
Y�- ( Yes—No 19—
Fl.� � Room Length Width Height Fl.� ���toom Length Qii�h �t
Windows and Doors-Crackage and Area Windowa and Doors--Crackage and Area
�Vidth HeiBht No. ot Lineal t. Ares Wldth Hetght Nabt Llmal tG r►tM
� No.� ot pane ot Dane ifghts � ot crack �q. tt. � No. of Dsne o[ Daas lig6ts � ot eraol[ ��� !t. �� . -� . �
7, �1 �-- �'S ,a
Y< �.2 � � � � 3 C�`
Coef. Btu � ''
In6liratioa r2- .2 9' 3 S In6ltration ' �d `�,�+C�
GJaas
Exp. wall "" /
' Net exp. wall
Int. wall
�i
�
Total Btu.
Required sq. ft. E.D.R. or aq. ina. W.A. Leader area
F7.� L! -,(, Room Leagth / Width;�.
Windowa and Door�Crackage and Area
Wtd h Hel�ht Na o[ Lineal tt. Area
No. of Dane of pane ll�bts ot craak iq. it.
y Yy Y� .x -- ��
�
In6ltration
Cdass
Exp' wall - � Y
Net exp. wall
1nt. wall
Ceilin
Floor
r�
� Y S � Gisu y� . �,'�
Esp. wail - � v � � . t, Y
� s� Net ezp. wall � t o
.-�e� wall .���� � t ` C> �
� 7 Y+� Ceiling .
•.--�' Floor 'P�',r.T L -+p'. �
�s ,r Total Btn. 6`S�
Required aq. f� E.D.R. or aq. iss. �t.A. L,ot�ddr art��.
�—
�eight Fl.I Room (1•�� ':�, ` �t
Windows and Doors--Crsclw�e sa�d At�es
Wfdth Hd=ht No. of Lln�a tN►
No. of psns oL paa� 1l�hb o[ enlek° .�t. _
�
BEu y_
� Yoo Infiltration
S' i � � Glau
Exp. wall
� 6ca Net ezp. wall �
Int. wall
6.i Ob Ceiling
Floor
_- - ---- -- - -- --_ _ _----
Tocal Btu. 6 7 Total &u.
Reyu�red aq. ft. E.D.R. or aq. ina. W.A. I.eader area Required aq. ft. E.D.R, ac aq. i�. W.l�1. %sadtie at�qt
F7. � C Room � I.ength j S1 Width Height Fl. Roomv I Leo�lt 1�'t,� �ht
Windowa aad Doora--Crackage and Ana \y'�� � p�i���� �j p�
Wldth Halgdt Na ot Ltnsal tt. Area WtdtA �t�ht Na Lla !t. A�L ;
No. of Danr oL pane Il�ht� ot crack p. t4 Na ot p�na ot.psa� Ii�hL� ot cra41[ - !k �
�, YD 1 9' ._
Inhltration f?
�a.�
Exp. wall
Net exp. wall
I�MrerN-� �
Ceiling
$tu.
c-/.i�:t 3�%x
�•`
.
ft. E.D.R. or aq. �na. W.A. Leader area
Btu � Ceef, �qr ::
.—._,_
J S,S-0 Infihration
.s
�
� s � c�a�s
Fap. wall
„� 6 Y� tv�c e�. walt
t� : o•• o In� wall
Ceiling
l O .� �' Floor
/c9 6' Totat &u. ° :
� � Required �. h. E.D.R. or sq. ins.`�1.�1. t��
SuBJECT E .
City of Fridley ' 0 1794
A7 THE TOP OF THE TWINS g U I L D i N G P E R M I T
r
; � R 4PT NO.
� ; y � COMMUiVITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. /� JC. �/
� • �
( � �'�'1 � CITY HALL FAIDLE� 55432 NUMBER . REV. DATE PAGE OF APPiiOVED BV
�'""�"� �'� 612-571-3450 9�0-F15 S/3/85 / /
JOB ADDRESS 7650 1�lden Way N.E.
1 LEGAL ��T NO. BLOCK TRACT OR ADDITION SEE ATTACHED
�escA. 16 5 Pearson's Craigway Esta.tes 2nd Addn. SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PNONE
C.Martinson 7650 Alden Way N,E.
3 CONTqACTOR MAIL ADORESS ZIP PHONE LICENSE NO.
T. J. Roo�ing $5 Inner Drive, Circle Pines, MN 786-9687
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEEH MAII ADORESS ZIP PHONE LVCENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION X ALTEAATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRiBE WORK
R�roof Dwellin
9 CHANGE OF USE f ROM TO
STIPULATIONS
��g Roof can be the 2nd roof layer but not
the 3rd. Instail ridged galvanized v�.11eys.
SEPARATE PERMI�S ARE RE�UIRED FOR ELEC7RICAL, PLUMSING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WOHK OR CONSTRUCTION ZONING SO. FT. CU. fT.
AUTHOAIZED IS NOT COMMENCED WITHIN 60 DAYS, OF IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEFEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
ND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED yS`3 � ODO y�l . SQ
W WHE SPECIFIED HEFiEIN OR NOT. THE GRANTING OF A PERMIT
DOES OT PR ME TO GIVE AUTHORt?Y TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
ROVIS N OF A Y OTHER STATE OR LOCAL LAW FiEGULATING CON- y�`3H. SO
R CTI N R TH P CE OF CONSTRUCTIO
'� AN CHECK FEE TOT$I,FQEEOQ
_,,,� 4
SIGNATUFE C NTFAC RORAUTHORIZEDAGENT � TE� WHEN,.P�ROPERIY VA ED THIS IS YOUR PERMIT �
y ° G�
-- S�GNATURE OF OWNER iIF OWNEA BUILDEF� IDATE� BIDG �NSP OF E
p� [ j City ot Fridley Effective 4/1/84
ADDN. I J R-1 AND R-2
AL,TER. [ 7 Buildin,g Permit Application
Construction Addresa
Legal Description:_
Owner Name & Addr
Contraator:�,
Addresa• � �
LIVING AREA:
GARAGE AREA:
DECB AREA:
OTHER:
[ /.��: " _ ' , �.L'�
.
�. ��
��nT�7� . �� . ���
2-�.i 1. - .�• r - -
�� tt � ►�
Attach to this application, a Certificate oP Survey of the
lot, With the proposed construction draWn on it to scal.e.
DBSCRIPTI011 OF IMPaORHENT
Tel. �
Tel . #�'�� �[�P.�
Length ilidth Height Sq. Ft.
Length iiidth Height Sq. Ft.
Length Midth Hgt/Ground Sq. Ft.
Corner Lot [ j Inside Lot [] Ft. Yd. Setback Side Yard Setback
Type of Construction�l.o�.�c� ,_ Estimated Cost: � 3d0�• ^
Approx. Completion Date:
Proposed DriveWay Width If
DATE: � � �� APPLICA\
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Serrer Main Charge
Eii�
STIPULATZONS:
Alt. A Alt B
Desired: E a
See Back Page for Explanation
Tel . # � '
CITY � IISE ONLY
� ��-,'�S� Fee Schedule on Reverse Side
� 25x of Building Permit Fee
a �� �� �.50/�1,000 Yaluation
a a�25 P�r s�c u�t
a Fee Determined by Engineering
a
�
D• O O �reement Necessary I] Not Necessary []
��
__._...___...._
_ ,
'7� U U
Building BUILDING Permit No.: -' 13�
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY Da 'd•
DATE � l � �DrI �YOUR &MAIL ADDRESS
SITEADDRESS 7 �`f�PXI �7�ra t"i'iU�f.(.� ���2-t - —
THIS APPLICANT IS: ❑ OWN �ON CTOR
PROPERTY OWNERi x,�:� �r,., rn 0 Fl`�o��
TENANT qDDRESS: %(�_I���l .1�. CITY ��dI2dA STA'I'E�IP_�S�
PHONE:�O�o�'�J�7-�,�2 f
CONTRACTOR NAME: i
SUBMIT A COPY OF STATE LICINSE # DATE ��7I� Il��
YOURSTATELICENSE ADDRESS:��C%(7� �'' �,e. � CITl�ap��_STATL�ZIP`� '
WITH APPLICATION pHONE - !' FAX 7
PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
P�RMIT TYFE ❑ �DITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASENIIIVT FINISH �tOOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ O'THER
❑ 5WINIIvIING POOL
TYPE OF WORK: ❑ NEW ❑ ADDITION
MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: 7,�.c�# �•R> r� I-�a� /�����-.��.
SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S. Ft.
RQOFING ❑ HOUSE ONLY
NUMBER OF SQUARES � ,�HOUSE & GARAGE BASEMII�TT REMODELING SUBMIT:
GARAGES ATTACHED GARAGE 1. Fxisting Floor Plan
PROPOSED SIZE: O DETACHED GARAGE Z• Ptoposed floor plan
PROPOSED HEIGHT: 3. List of structural members to be used
SIDING FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl ❑Soffit ADDITIONS, & PORCHES SUBMIT:
� Aluminum O Trim 1. Site Plan/Survey showing the existing structures
O Other ❑ Fascia and proposed project.
WINDOWS 2. Two sets of construction plans
IN EXISTING OPEI�IINGS �Yes ONo LOCATION OF WINDOWS 3. Energy Calculations
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 LABUR AND MA'1'L;IilALS:
(LTSING E 1997 U.B.0 FEE SCHEDULE)
; � TOTAL JOB VALUATION $ [(J'� OCCUPANCY TYPE
Permit Fee $/. � See Back Page for Fee Schedule
P1an Review $ 65% of Building Permit Fee
Fire Surcharge $ - jy'% .001 times the total job valuation
Surcharge �_ ,33 .0005 x Permit Valuation Minimum $.50
License Surcharge $ �-j ,�j $5,00 (State Licensed Residential Conhactors)
SAC Charge $ $1675 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 necessary () Non Necessary ()
Total Due $ ,� '� �� Make checks navable to: City of FridleY Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID LTNTIL PROCESSED
I hereby apply for a buildi ermit d I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the or ' ances an c des of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an appl' ation f it 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 rk w uires review and approval of plans.
SIGNATURE OF APPLICAN PRINT NAME ��.h�vUL l.(�"'t9t" DATE �/a! /m