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AF - 35271_ _ _ . -• ��; �.�;. - - �`�118�e Of I+`�r%til@�', l�IiEi�. �IJ�.�II'�G P�T �° 57� { (Dflliee of I[1�iSP��CDR O� B�7II.�ING'rS ` � � Owner +�L�,�irii.�ru4�� .�� , �- Architect �rid,eS', Minn.,_ �.a'�� . 19��` � : _ Builder � J�.I�fdr. _ LL)CATION OF BUILDIIt1G No..�_„_�d� Street_ �� v Pa�t of I:at Lot � T31ock .'� Addition or Sub-Division ��_,,.= f � �� i DT�u�Ci�I�'TF�31'�t Q� �UII.DII�TG : ' .� f t . � Front Depth_��_ Eieight�_ St�ries_ � Ma,nner of Con3truction � , ��9' To be used �,s ,@�,i�fi�Yt'z�� To be completed +' �� EsCisr�atrcl Cost_�� *►" i � � � � � � � � "� r� 1'ermit is hereby granted to to ��#� � the lauilding +�, described in the above statement. T�iis peranit is granted ' upern the express conditian that the peraon ta whom it is gra,�ted, and liis agente, empioyee� and wprkman; in ail the wark done in, around and upczn said" buiIding; or any p�rt thereof, shall conform_ irt �II respects to the .4rdi- nances of Fridley, 1kEinn., regarding ihe constructi�n, altEration, mafntenance, repair antl� -moying; of build#r�gs within the city iimiis, and this permit may be revoked at any time upon violation of �,n3r of ihe prouisians t�f sa,i� ; � ordinaneee. ��. �`nep�tor of Buildings. � ', : �G�.��v� Ar�r.� swo�.� s�c�:�r��N� I _ In cons��ration of the isstae and delivery tc> m� b�- the �n�nec�or of ��dix�� .c�f �rzc�i�y .o£ i t�e above permit, I hereby �gree ta, do the pra�c�^e� �ac�� c� �.ccc�rr��nc� tvzth t�x� d��cz�€�t�.a� 'I abs�ve set f ortt� and ac�ording to the provisions of the ordia�u.nces of �'r�i�kle�, �ncl, bei� f rst id'�y swar�, T hex�by sfate and .say �hat th� facts stated by rr� a�� co��iz�eci i� t%e �bove .�err�it s�r� : ' true as t�erein stated. > . Subscxibed at�d s�vo�n �tc> be%xe me ai Fridley, �F2ir��e�ot�, tha� �� sv �. , �r.� ;y day of _.�� .A.D. 19!'�r�t: , � ��l��+w�� :,��, 1, �� ''� .-,._ � — _ � � .; . , _ _ .,. � � �,r � sue�ECr p �T City of Fridley ° 17 0 6 7 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � r � � ' ` ECEIPT NO. ' COMMUNITY DEVELOPMENT DIV. � • �: — r i � PROTECTIVE INSPECTION SEC. /� /-y ! � � // i ', -_ �;��'1,,J CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY L�� J\ 612-571-3450 910-F15 7/�6/83 � � JOB ADDRESS 6362 Baker Street N.E. t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt g 1 Moore Lake Highlands SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Robert M. Hoppe 6342 Baker 571-3347 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING residential 7 CLASS OF WORK ❑ NEW �7 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK XXXXXXX��3�iXi�iXi��i adding to a deck 9 CHANGEOFUSEFROM TO STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR EIECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTI�ATING OR AIR 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 CONS7RUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAVS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $OO.00 . 5O DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 1S.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECKFEE TOTALFEE 15.50 SiGNnTUaEOFCON7aaC70a0an�7HOaiZE nGEN7 iDnTEi N PROPERLY VAL ED THIS IS YOUR ERMIT %"�''�`�.��'.�-�� - 7.�G �, �%�-��s C�� / � SiGNATUREOFOWNERiIFOWNERBUILOERi IDAT 1 � B�DG iNSP �1A7E �� CITY OF fItIDLEY A('PLIC/1TI�'� FOft RCSIDEi��TI/t� QUILDIi�G P�R►lITS (We►•�, Alter.ltions, Additions, or Repairs) OI+NE R: /L�� 7�/" ` ADDRESS : !o � �v � ��-'�� T�� no: _ ��/— .�� %% QUI LDER : Effective Aug, l, 1981 /IDDRCSS: TEL (10: Jr.7/—,..3,��f-� � Construction Location STRI�T NO: (o�� s2�r�r:T: i,o� : �� Bi,ocx: �- 1wnzTZO.�: �� ;�� ,..-��-%� Corner Lot: Inside Lot: ✓� SetbacY.: Sideyards: Ap�lic�-u-�t attach to tliis form twa Certificates o£ S�rvey of lot and / p=oposed building location draton on certiiicates to scale. i �2 DESC PTIO�� OF COi�JSTF:�JCTIOtJ �- X� �� ,.� . 1 _. Pront: Depth: Height. i Squanc fee�:��_ Qibic Feet: Front: Depth: Height: Squar.e I'e�t: G1.ibic Peet: C�'-�� `�C o,'? v �� 2�'e �- rj � iype of Construction : `'� � �CJ �� (�t— Estimated Cost: $ � Rb Be Oor,�pleted: Alt. A Alt. B Proposed Drive��ay Lr'idth If New Openinq Is Desired: � $ $ S�E F.EVF:R�L' SIDE OF SFIEET 15ie undersigned hereb�� :n33:c� appliczticn for a permit fcr the �:nrk herein specified, agreei»� to do .all work ii, striet accardance �•�ith the Ci�y of I'ridley Orciinances e�id rulii��s of the Department. of Buildings, and hea-eby declares that all the facts and represen �itiens stated ;n this applicatio� are true and correct. D.':TE: �" �C� '-� 3 SIGNATURr.: � , — 5tij�ulations : ��G� �� s� ,�-' _ � � l,� , �2 :1_, � • • - y�� - • - 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 repairs to any existing building or strueture, upon application therePore, require the payment by the applicant for such permit of Pees to the amount herein below set forth and in the manner herein provided to-wit: . .� �1.00 to �500.00 Fees $10.00 (Minimum $15.00) �501 to �2,000.00 �10.00 for the first $500 plus $1.50 for each additional �100 or fraction thereof, to and including $2,000 #2,001 to $25,000 #25,001 to $50,000 $50,001 to $100,000 �100,001 and up �32•50 for the first $2,000 plus $6.00 for eaeh additional $1,000 or fraction thereof, to and ineluding $25,000 $170.50 for the first $25,000 plus ��+•50 for eaeh additional $1,000 or fraetion thereof, to and including $50,000 $283.00 for the first $50,000 plus �3.00 for each additional $1,000 or fraction thereof, to and including �100,000 �433.00 for the first $100,000 plus $2-50 for each additional $1,000 or fraction thereof Plan Check: 25 percent of building permit fee. Drive�ay Depression Escro�: Concrete curb streets only. Alternate "A": Removal and replacement 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 , . - . � � ' '. .. _ . � Permits for construetion Wi�l be issued a minimum of 24 hours from the time of application to allox for prager review of the proposed strueture and oP the constru�tioa site. A CertiPicate of Survey of the lot, shoWing the location of the Poundation onee it has been constructed will be required before nroceedina With the framing. ,� �.---. l C�, U c� `� � 'c�_�v - � r � � � � � O - < � At � * � � � 0 � C � T1 � � X _ � - � � � f O °' ° Z CD y � D � � � 7J -i � — � cn � � � < _ � �' � C D � @ _ r � �D r m m n m -� � � - O C < < 0 G m a � Ef3 I H3 �J . - m , i.'� � . � c �J .,, n L'\ � `- � c_, m n -a O Z o � � D .c� r — � j� C Z � cn � o --� �� z � C m (�.....� � Z � � ,�� m � m � � �c� m r (n m --��_ Ill O � °' cn O �� 'D D � I �� z m Z o � � � � � � C � � � �.0 � �.-.�.� _ � � N A 07 � ;Ti 7.7 w � co � � m 41 �; �. Cn �l � 1 � O � � � � � � �� :, m m � � � � �t � � �� t� � � ,,�___ �A �p i��;^�� N y� O -� O O 1� I � > � � � � � � � � � n w � o z _ � � � sv c �, � � � � � p � co - . c� m v� � �" ci c� °- r � � � � � �7 � T � � � s O � � T _ � (D p `G � Z .� —I =J :J �7 � v: co � J � :n m co m s� i � *� t� m � o � m�� c � `� � z� �F CD � (D r- � P� � � rD � � ,� � <� cn � t� tr. � >� < � i c° � � � m z � �D � � m � � Q �D ) A � N .n-« �. � il � o � * c;� � � c 1 � � � cD � � � ? —� > � m i Q > ^ m 7 m i I o �i � I I � � I I i I � � � i 4» � r� � Ey � cfl c�* t� � cn cn c� � Jt O O O J p-�t �i �J �.: CJ� �A �l O Q O O � O O O O C O O O 0 0 0 o Q o o � o 0 0 0 0 �� i ( � �i u� � m 07 � r c� c Z z � Q m � �� p � c� � Z L}" C � � � � �� o � O °.: � ID 1� �� , C � i�{ ' I C �� n � � � � } �, _ SJ � � � � � Z ' O r -i �� m r � z � � ° �v � � � � � '� ` -. �n � � � ,. p a� s� m —� � � � � s � a a � m m � � -" � � �' � a � � �s.' � N � (n � � ° � �. �, � � � @ O cD � � � � � � � � � m e G� io � � � � � o .� �- `n � 3 � � � � < 0 � � � � �� o � . w a� � � a J � � _ � � �. n� ti� o a � � �' � a� o �� O o � � a' � � Q �D a s� �' tl co � � c � � m �' � � � � . � � � � �. (n j t °- � � o ��, ° �' m s �. � � � �, � — � � i � S n O i � � � � � II � � � � � - N � CD N �` � � 1 � N � � � r C � � Z � �l X � C � f �l � D � m � z O D � � � 0 � D � O m D � � � m � � � � � � rn n ti � � � N f1 W I � � `G C � 7 � O � �• � Z � � � � � W �N < � Z Z m -�o f�l n _1 O Z � < '_ 7 7 � � � r t � D � � p � Z i -rt � O { � � .D � r i C . � > � i z . � D I Z i � . � i 9 � � � i � Z � � m � � � � m �. < � � o � � .� � S " � t^ 1 � � m S�B�ECT PERMIT NO. City of Fridley � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �� ' „ _ ' ` RECEIPT NO. ' ' COMMUNITY DEVELOPMENT DIV � `ti.-------� r � � PROTECTIVE INSPECTION SEC � � � � '� i '1` A� ��1 � CITV HALL FRIDLE� 55432 NUMBER REV DATE PAGE UF APPROVED BV `."'J \iI �.� 612-571-3450 910-F15 6/28/96 � � JOB ADDRESS 6362 Baker Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 9 2 Moore Lake Highlands sr+Eer 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE James/Ann Youngquist 6362 Baker Avenue 572-2251 3 CONTRAC70R MAIL ADDRESS ZIP PHONE UCENSE NO Quarve Contracting 8427 Center Dr NE, Spring Lake Park 785-1472 6016 4 AFiCHITECT OR DESIGNER MAIL AODRESS ZIP PHONE UCENSE NO 5 ENGINEER MAIL ADDRESS ZIP PMONE UCENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof/Gutters 9 CHANGEOFUSEFROM TO STIPULA710NS Underlayment must comply with the State Building Code. SEPARATE PERMiTS AFE REOUIRED FOfi ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTILATING OR AIR CONDITIONING THI5 PERMIT BECOMES NULL AND VOID IF WORK OR CONS7RUCTION ZONING SO. FT CU 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 WOFK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARK�NG I HEREBY CERTIFY THAT I HAVE FEAD AND EXAMINED THIS APPLICATION 1 STA�LS GAFAGES AND KNOW THE SAME TO BE TRUE AND COFREC7. ALL PROVISIONS OF LAWS VALUATION SURTAX WND OvRDENHER SPECOIF ED H REINIOR NOTOTHE OGRANTING OP AOPERMIDT N'6�000 $3.00 DOES NOT PRESUME TO GNE AUTHOFiITV TO VIOIATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- @ STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �p 112. 2S Frie SC �G .00 PLAN CHECK FE TOTAL FEE Li �� S 5.00 $126.25 5�cn,AruaeoFCO�rc�acTOaoanuTr+oaizEOnceN1 �onre, P RLY ID ED THIS IS VOUR PERMIT S�GNATUREOF[�yNNEa��FOWNEaBUILDERi iDATEi WS ' �' f41F - N�w il ADDN (1 ALTER ( � .. ,., . CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Effective 8/ 1195 � Construction Address : � � �', i��- ��'�� '`� • -- - Legal Description: Owner Name & Contractor: �I Address:�� LIVING AREA: GARAGE AREA: DECK AREA: OTHER: ' Tel. # � %,�- ' :��`7 � MN LICENSE # �L%OI l� Tei. # I��'I'--� 1� � of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height �n� wld� Height �ng� wld� Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Comer Lot [] Inside Lot [� Ft. Yd Setback Side Yard Setbacks ,1 C`�� Type of Construction: C� - r'� �T ` . �'� � Estimated Cost: $ �' �,�� . — Approx. Completion Date: � jC (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: __ APPLICANT: Tel. # _ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ � � +�. �� .C�� $ ?� - C�G $ � � . ��y $ $ $ $ $ _.� l� • _�� CITY USE ONLY Fee Schedul� o� Revsrse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $S50 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 [ ) STIPULATIONS: - � " BUILDING PERMIT FEE SCHEDULE The Chief Buiiding Official shall, before issuing permi�s 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 $S00 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,Q00 $100,001 to $SOO,Q00 $500,001 to $1,000,000 $1,000,001 and up 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 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1, 000,000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEpRESSI�.II� �S�It�JW (Concrete Curb Streets Only) Alternate "A" : Removal and replacement 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 dmes $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hows 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. sue�ecr p City of Fridley 2 8 905 AT TME TOP OF TME TWINS g U I L D I N G P E R M I T r � . � � RECEIPT NO. � COMMUNITY DEVELOPMENT DIV. � �V'_"'_ , r � � PROTECTIVE INSPECTION SEC. �� , 1 � � � �'�'1 � CiTY HA�L FRIOLE� SS132 NUMBER NEV DATE PAGE O� APPROVED BY �� ,�� 612-571-3450 910-F15 2/9/99 / / J08 ADDRESS 6362 Baker Avenue NE 1 �EGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 9 2 Moore Lake Highlands SHEET 2 PROPERTY OWNEfi MAII AODFiESS ZIP PHONE James Youngquist 6362 Baker Avenue NE 572-2251 � CONTRACTOR MAIL ADORESS ZIP PHONE LICENSE NO Twin City Exteriors Co 9060 Zachary Ln N��108, Maple Grove, MN 2595 d ARCMITECT OR DESIGNER MAIL AOORESS ZIP PHONE LICENSE NO 425-4737 5 ENGINEER MAIL ADDRESS 21P pHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION O ALTERATIQN � REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reside 9 CHANGE OF USE FROM TO STIPULATIONS Call for building wrap inspection before covering. SEPARATE PERMITS ARE REOUIREO FOR EIECTFICAL. P�UMBING. HEATING, TYPE OF CONST OCCUPANCY GROUP OCCUPANCV LOAD VENTI�ATING OR AIR CONOITIONING. TMIS PEi;M1T BECOMES NULL AND VOID IF WORK OR CONSTRUCTiON ZONING SO. fT CU fT AUTHORIZEO IS NOT COMMENCED WITHIN 60 OAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOii A PER100 Of 120 DAYS A7 ANV TIME AFTER WORK IS COMMENCED NO DWIG. UNITS OFFSTREET PARKING I HEFIEBV CERTIfV THAT I HAVE READ AND E%AMINEO TMfS APPLICATIpN 1 STA�LS GAFAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS yq�UATION SURTAX ANO ORDINANCES GOVEfiNING TMIS TYPE OF WO.RK WI�L BE COMPLIED WITH WMETMEq SPEGFIED MEREIN OR NOT. THE GRANTING OF A pERM1T �S�OOO � �L.SO DOES NOT PRESUME TO GIVE AUTHOiiITV TO VIOLATE OR CANCEL THE pEqM1T FEE SAC CHARGE PROVISIONS OF ANV OTHER STATE OR IOCAL LAW REGU�ATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION �99.75 � Fire SC �S.00 PLAN CHECK FEE TOTA� FEE License SC $5.0 $112.25 S�GtiaruAEO�CON'AnCTOQOASUT�OA�2EDaGENT i��tE� WMEN PROPER� . A�IOATED THIS ISyV UR� RMIT _ � �� 1 ///��///��' , �J/�J/�J/CCC...///�� S�GNA7UAE O� OWNEA�� OwHEA Bu�IDEAi. �O�iE� BL ��vSP � � i��e,� NLW [ ] AllDN [ J ALTER [ ] ConstructionAddress: L'egal Description: CITY OF FRIDL�Y SINGLE FAMILY AND DUPL�XES R-1 AND R-2 BUILDING PERMIT APPLICATION � Effective 1/1/97 � �;1�� '� �� ` Owner Name & Address: Tjn�'S �ot2,� 6C�� 5T Tel. # ij �� -aa`�'J Contractor: � MN LICENSE # p?� �r Address: ,� � _ � 4 Tel. #,6/a �� y� �� -r-_-.-- Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING A.REA: GA,RAGE AR�A: DECK AREA: OTH�R: DESCRLPTION OF IlVIPROVEMENT �ng� Width Height �ng� Width Height Length Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: �E S l�� Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ —$ DAT�: p?- �- �' � A.PPLICANT: Tel. # � /d - `�aZ � �% 3 � CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow �rosion Control Park Fee Sewer Main Cliarge TOTAL S1'IPULATIONS: 7 �� $ .�.- $ �- $ C�_ $ b $ s° $ $ $ $ �� r. �. Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.�0/$1,000 Valuation $950 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 [ ] � �, ��`��J (�r � Building pLIJMBING Permit No.: i Inspections �+ S�ENTIAL A.PPLICATION Received By:'�`=-�- � 1763-572-3604 v Date Rec'd: ? - CITY OF FR�DLE � � DATE YOUR E-MAII. ADDRESS SiTE ADDRESS THIS APPLICANT 1S: ❑ OWNEIt C�N PALDEN, �HUPTEN PROPERTY 6362 BAKER AVENUE NORTHEAST N�' FRIDLEY, MN 55432 OWNER/ a.DDttFSS: TENANT (763) 502-6821 STATE ZIP PHONE: cox�cTOR �;u,,¢: nRRi M PL11M61��^. , 3UBMIT A COPY OF STATE LIC EXP DATE YOUR STATE ADDRESS: C1TY STATE ZIP LICENSE WTTH pHONE • � APPLICATION � PERNIIT TYPE STNGLE FAMII.Y ❑ TWO FAMII,Y ❑ TOWNHOUSE TYPE OF WORK: ❑ �'' ��P�'��T DETAII.ED DESCRIPTION OF WORK r� Pl � c�- �v zt e� n� Z� �✓ PER MS 16B.665 the permit fee is a minimvm of 515.00 or 5% of the tota! cost up to 5500.00, w3uchever is greater, for the improvement, installati�n or replacement of a residential fixture, excluding the fixt�es. (This should reflect only the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = . FCR PR03ECTS WHERE LABOR EXCE£DS 5500, FEES ARE BASED ON $10.00 PER Fi7CTURE, EXCEPT Wi�RE 23dTED. �TURFS: (INDTCATE TOTAL NUMBER OF EACH BELOV� BATH SINK/I.AV _Fi..00R DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING (Nt�DCm'r�C�+sEj SWIlvIIyIING POOL WATER SOFCNER ($3.� CLOTHES WASHER KITCHEN SINK � WATIIt CLOSET BACICFLOW PREV. (S15) _ DISHWASHER _ LAUNDRY TRAY �WATER HEATER (S35) FOR IRRIGATIOTI _ WATER MEPER _ OTHER � _ � �, riw . .. . , . , .. . �, _..:_.. .�_ _.r__ r._._ � . ,.. .:� - Fermit Fee . $ Number of fixtures Q$10.00 x$I0.00 =$ Surch e ' _50 Number of fixtures Qa`$15.00 x�15.00 =$ TOTAL DUE $ Number of fixtures @ $35.00 _L x $35.00 = $ � � State Surchazge = $ SO Tota1= $ �S��S'i� THIS ]S AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED f 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 ConsKruction Codes; that I understand this is not a permit but only an appli�ation for a p rmit and work is not to start withont a permit; that the work will be in accordance with the approved plan in the case of all k 'c requ �s review and approval of plans. SIGNATURE OF APPLiCANT �j �ii��1'/l/`` PRINT NAME �� l t N(� � U� OW 1 DATE �!� �� , � �, � - . _ -- _ �. , _ �� ' � 4 �� _ ,.. ,_ _ ...,.._< .� ,_ .. .,_.a:._. ,__� » � , ...:.,. .:�... °.' v . , _, �� ... a. _ u . . _ _ � . ...,... . � � , ,, ,_ .�>. _ .. ��.... ..., �._ .,�.., , City of Fridley Building Inspections Department 6431 Ur�iversity Avenue NE, Fridley, MN 55432 763-572-3604 Building - BUILDING pezla�it No.: ;-�-�:�'1-o L� �� 5Z� Inspections R�i SjDENTIAL APPLIC,A.T'�ON �ecei�ec� sy: 763-572-3604 CITY UF FRID�EY' a�cz R��°d: �1� �`� ��`I pqp� 05/24/07 vDURE•MA[LnDDRGSS eatherd@prpl�uiltam.COm stre.aanRESS 6362 Baker Ave N TII1S .aPPLIC.aN r i5: q OwNSR OCON'CRnCTOR PROPERTYOw1YER/ NAME: �'k1L1J�t�11 Palden TEN,�NT Au„Rh55: same as site ccrY� STRTE_lIP rHprrF; 763) 502-6$21 CONTitACTOR �AM�: ProBuilt AmeYica SU6M1T A COPY OF STATE LlC�NS� � B� - z 0 3 5 6 B 4 7 E?CA DnTG �� U� � YOURSTATE[,IC�NSE ADARESS; �G11 11LY1 �,vE � C1TY Nartkl S�j STATH z�r ��lb WiTHAPPLlCATIOV pHONC 651,770-5570 pqX �51-770-0495 PROPERTY TYPE � SrNG.LE FAMILYMEW CQNSTRUCT[ON SIZE ❑'T'�.Vq FriM[LY/hlEW CONSTRUCTION 5TOA[ES PERI�IIT TYP� ❑ ADDITI(7N ❑ GaRaC�1SHEU ❑ wrxnOwS ❑ BA5fiMENT FINiSH p[ZQpC ❑ DRAIN TtLE � �ack ❑ S[D[NC ❑ OTHER O SW[MMINO P4pL TYP�, UF WORK: ❑ Nsw 0 ADC7lTlON ❑ MAINT'6NANCFJRF.Pn1R 0 flEMODELING DESCRiBE'WqRKHEINGDO�TE: Replacinq 8 windDw, iiot Chanqinq sizes SIZE OF IMPROVEMENT LENGTH W1DTH HEIGHT S. Ft. ROON"INC ❑ HUUSE ONLY' NUMBER nF SQ[JARES ❑ Hf)liSF & G�RAGE BASF.MRN'C RfiMOQELING SUpMfT• GnRAGF.s D aTTAC'HF� c;RRAGE �• Existiu�, Floor Fla�f � PRUPUSED SiZE: ❑ DETACHED CrARArE z• �'roposed flaorplan PROPaShll H�IGHT: 3. Li�t ofshvcmrnl ittambars ia be usr�l s�� FOR KEW CONSTRUCTION �HCLi�Dirrc� nFCKS, Q vmy� �5��'rt ADf]TTIONS..4c Rf�RCHGS SC�MIT: ❑ Atmuinum ❑ Trim I. Rite Pl�ti/Survzy Shuwing thn cxisting smicmrcc � d�� _ . 0 Fascia ---- and p�vposed p�ujac;t. wI1VDOws 2. Twn �ets ofcoos[ruc�ion plans M GXIST[NG OPE,NINGS ❑Yt,+s ONo LOl'ATfUN OE' WfNDC)Wr'$ 3. FnCigy C31CUl(il1'otts OR POR NEvJ OP�;NIN(;5-DESCRiAF S[ZE OF OPE�fING CHANG�.S & '�'YPEUF w[1VUOW CU 8E Ihi57Af.f.F.D hiUMKER UF WINfX7W$ a ALL FEES ARE �ASED ON VALUATION, INCLUUXIVG THE COST OF LABOR A�VI? MATERIALS: Permit Fee Ptan Rcview Fire Surcha[gz Surcharge i.iCense 5urChargc 5AC Charge Curb Cu[ Escrow Erosion Contral Park Fco Sewer Main Char�c Total Due (USING THE 1997 L'.B.0 �'EE SCHEDULE) JOB Vq�,UATION S 2 B 4 5 C)C'C'iiPAN(` ��' ��.� See Back Page for Fec Schcdulc $ 65% of Building Permit Fee � ��.� .001 times the tocal jub val�iation $ _I • �-�- .0005 x Pcrmit Valua[ipn lvli�►imum $.50 � -;� .L�1^ , $5.00 (S�ate Licenscd Residential Contrac[ors) $ �1675 per SRC: Unit (Plans to MWCC for determinacion) $ ft+6ft= ftx$21=� � $450 C'onservation Pl3n Rcvicw $ _ �'ze Deterniined by Engineerin$ � ^ _ Agreement neces3ary ( ) Non Necessary ( ) l"F[lS [S AN APPLICATIUN FQR q PERMIT•NQT vqLID [1NTII. PROCESSED � hereby apply for a building permit and I acic.etowledge tht�t tho inforn�a�ion above is completc and accurate; [ha� [he wurk will bc in co»formance with thc ordinances a.rid codes of the City of Feid�ey and with the Minnesota C:onstruction Codes; tktac I understand this is no� a permit but only 2.n application for a pern7i� and work is noc �o staR rvithout a permit; that �he work will be in accprdance with thc approved plan in die case of all work which requiPes revitw and approval of plans, S1CiNATURE OF qPpL(C'A�'C PRtNT NAME_ E 8 t�'1� X Dahl nATE 5� 2 4� 0 7