AF - 44053,
�
•
City of Fridley, Minn.
BUII.DING PERMIT N° 3 9 5 8
Date: . � : ; . � � . . �:�� . . . . . . . . . . . . �/�` � ����
Owner....................................... Builder ... . .. . .... ... ........ .......
Address...................................... Address .................................... ........
LC�CCATION OF BUILDING
/ �j r
No. .(a �R . . � Street . �..�eQ�.�'.tr:file4�C: �. . . ���.� Part o Lot . . . . . . . . . . . . . . . . .
.�
Lot ....'�..... Biock ...�........... Addition or Sub-Division . ....... .. ���%��...�
. . . . Setback .�� �� y Side ard . f �! '�a
Corner Lot ,�......... Inside Lot ........ y ..... 4 .............
DESCR[PT[ON OF BUILD[NG
T be Use as:
i
,�% . p % .�%
F�ont . . � . . � Depth �� .6 Fieight /! . _ � 4 Sq. Ft. f � �,K' Gii. F't.� � . ./. y
�/�'� ..... .. ... �ont . �:3-.a �� �.�'�.�� H�gn �Q:� sQ. �,�..% �. c�. �.�. .0.�
Type of C�ction . .. .. .. . . . . .. . . . . . . Fst. Cost. J.�� �j�. .,.�. : . To be Completed . .. .. ... .... .. .. ...
�
In consideration of tihe issuance to me of a permit to eonstruct e buil ' d�ibed above, I a to do
the prop�ed work in acc�rdance with the description above se��d i c 1' nce wi oi
ordinances of the city of Fridley.
.� ���� ....... ................... ... ..
.�/ 0�0
In cansideration of the payment of a fee oi $.� /...:':'":, permit is hereby granied to ...................
. .. .. .. .. .. . . ... . . . . . . .. . to construct the building or addition as described above. This pennit is granted upon
the express condition that the person to whom it is g�anted and h3s agents, employees and worlunen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, slteration, maintenance, repair and moving of buildings with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. �--�
. . .`.!�!�'. : . ,�uiltiing Inapector
NOTICE:
This permit does not cover the constructlon, instalfation or�lteration for wirin9, ptumbinp, gas heatins,
sewer or water. Be sure to see the Buildin� Inspeotor #or se�...ra4e permits for these itema
APPLICATION FOR BUILDING PERMIT _
CITY OF F1�IDLEY, MII3NES4TA.
Ownex�s l�.me ��L��'IdHP�S01� & S�` � Builder CtEM IONNSOPi & S0� :
. � 500 �, � , . � � . """"2�flQ'2tr�"�'�Ph' -r'-----�------ �. ,
Address • t MPLS 1B, t,�1�' _._.._ .., Address _ MPLS. 18, MIN`,.
• LOCATIQN OF BUILDING
. . ,
Stree ���.`._� P€�rt of Lot '
No . �io�� _ _._. __. _ .
� � • ..
Lot � Block _� ' -. Addition or 5ub. Aiv. �, f �%—
� , .
Corner Lot �—lnaide Lot ...._� Set Ba.ek, �� ,
Appl�.�ant atta.ch to�this form Certificate of Surve� of�Lot and proposed
buildi�ig ' liication. '
� DESC�.IPTION OF BUILDING
To be uaed as ' .
� ..�,r � , '� �. �
�.r/�'� � �i�.l�iV�`-_ �ont`.��_ Depth�� Height .,�...__,. .
Sq. Ft-� 1� �% G�.i. ' Ft. :
� /
���,�1'`� F�ont _�..—. Depth �.�Height „�._..._. '
Sq. Ft. .��i.� Cu. F't. �_
Type of �onstrnction _ e���� Estimaied Cost /� �
To be ccsm�leted �L.��.Li�!�/�s
The undersign�d;hereby:make� application �or a permit for the work
herein specified,�agreeing ta 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 representa.tions stated in this application �
are true ar� co s�ect. • .
�. ,. ..
Date Signatux '
� ,. . �
(A Schedule o£ Fee Costs can be found on the Reverse Side}
.�
. .
... . _ � � � ., .
� 6,i�
' � ' ' ' Co�lin , Ventilatian, Refri 'an and �
,�i Appl'�catio� fo� Pawer P�ants and He�at�ng. 9 9�
'f ' Air Cand�tianing Syste� and Devic,es �
,J
PARTIAL RATE SCHEDULE D�P:. of Bldgs. Phoae SU 4-7470 -
� , � �
GRAVITY WARM AIR: RATE TOTAL Localion lo�t) (7 -%��Q� d- ��''���-�-�-�C��° <�Z� ��---(��
Furnace Shell & Duct Work . . . . . . . . . . . . . . . . . . . . . . . . . . 8.00
Replacement of Furnace ............................. 5.00
Repairs & Alterations—up to $500,60 . . . . . . . . . . . . . . . . . . 5.OQ
Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . . . 2.50
MECH. WARM AIR
Furnace SheII & Duct Work to 120,000 BTU . . . . . . . . . . . . 8.00
each add. 60,000 BTU .......... ............. 2.00
Replacement ot Furnace ............................. 5.00
Repairs & Alterations—up to $500.OQ . . . . . . . . . . . . . . . . . 5.00
Repairs & Alterations each add. $500.00 . . .. . . .. . . . . . . 2.5Q
3TEAM or HOT WATER SYSTEM
�rnace Shell & Lines—to 400 sq. ft. EDA Steam ...... 8.00
Furnace S�hell & Line—to 640 sq. ft. EDR Hot Water ... 8.00
Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . . 2.56
Each add. 320 sq. ft. EDft Hot Water . . . . . . . . . . . . . . . . . . 2.50
$
�
$
$
$ �.
$
$
$
$
$
�
�
OIL BIIRNER—to 8 gal. per hour . . . . . . . . . . . . . . . . . . . . . . . . 5.00 �
over 3 gal. per hour—See Fee Schedule
c.-r'
GAS BURNER (ug to 400,000 BT[T) . . . . . . . . . . . . . . . . . . . . . . . 5.00 �
GAS PIPING <Up to 8 Fixture� . . . . . . . . . . . . . . . . . . . . . . . . . . 1.50 $. `°`�.
(Add 50c each over 8)
AIR CONDITIONINd
FAN HEATIMG SYSTEM
VENTILATING $YSTEM
ALTEAATIONS & REPAIRS
�M�s:
�-7�--2- Q.� ,
�I`
3ee Fee 3chednle
TOTAL FEE
� G / - �' � Lc�u -� �L�
�
.
City of Fridley:
The undersigned hereby makes application 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 ,�e true and correct.
Fridley, Mi � - �-- �^ � �� 195�
Owner �l'� 1) L- /��� v�. / -,c� -.� ` 185—
Kind of Building �=- � 2--�-�y �' ���-/ 195—
/.' c
Used as
To be completed about '� �- ' ` �
c'+
Estimated Cost, $
O1c�=New,i Building Permit No. �-- ��1
�-_���'
DESCRIPTION OF WORK
HEATING or PO�VER PLANTS—Stea�, Hot Wate ; Warm Air—No. %
�;;�' „ � /' �-�- ��-.- / �/ �
Trade Name �,.��=. �C. Q�E. d.k ��� C.-�c-�'Lt�C� Size No l��� !°�
Capacity 5q. Ft. E.D.R �� � z� BT[J H.P.
Total Conne¢ted Loacl � Kind oi Fue ��'�''!
BUR.NER — Trade Name Size No
Capacity Sq. E`t. E.D.ft. BTU H.P.
11 POST i M-8-58
RAY N, WELTER HEATING Cp
Sigaed
4637 CHICAGO AVE.
sy
, �
Business Phone No ` �� Q°
����'-a-�-�-°�
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•
i
City of Fridley, Miun.
BUILDING PERMIT
� � � s-- z,
N° '7916
nat�: ._.____�nne_ 17�1965
da�ss Butcher Grevcc Con�t..--In�..__...___...._..._�.�_.�
Owner: _.� Builder _.
.r_..�.
���0 ~Broakvi.eW Dr. 312l� Kyle No. i+linneapolis 22
Address_._._.._:..._._._..._._..__._..._. ..._.__...._..._...__._... Address __.._ __.._ .._. ._._.._.
LOCATION OF BUILDING
No. ..._� �&?�... Street BTOOk�'ri8i7 D_! .. Part of Lot _____._._
..r.t _.__.__.T....._.....---•--•-•-•----- - --
Lot _.__.� .__._.._._._ Block -•? ---._.�._---._..._.___ Addition or Sub-Division ._.___Bl'EJOk�6i�T '�'g�'_�_ �..Add•
Corner Lcrt _._____._._ Inside Lot ._._._._..._..�_.___ Setback __..__._._.._..__._._ Sideyard w_—.� _.
Sewer Elevati� _._._._...._.._.� _..�.. ._._.___._ Foundation IIevation _...__ �
To be Used as:
Frant
Front
Type of Construction
DESCRIPTION OF BUILDiNG
Depth __________ Height
Depth _..--- 6 �H�eight
__.. Est Cost ._...�.._._..._..._..
Sq. FL ._.._.. Cu. FL
Sq. F� _.__.r...._.. Cu. Ft
To be C�npleted _:_ ...�
Rspa3r Stc�rm Da�aa,ge
In cansideration of the issuance to me of a permit to construct the building deecribed above, I agree to do
the prop�ed work in accordance with the description above set forth and in compliance with all prov3sions of
ordinances of the city of Fridley.
.L�.��'�_....��''`*,-�- ,�...�-
In comsfderation of the payment of a fee of �.� 1�_'� _.., pertnit is hereby granted to ���c� �t�
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
daae 3.n, around and upon said building, or any gart thereof, shall conform in all respects to the ordinances o�
FridleY� Minnesota regarding location, construction, alteration, maintenance, repair and maving of buildings
within the dty limits and this permit may be revoked at ar�y tirne upou violation of any of the provisions of said
ordinances.
gl].en Je�sen B� ���
NOTICE:
ilds p�enst doa net �owr th� eonstruelbe. in�hilatlen for wirino. Pluml+in�. O�s h�aNno, s�ww er wabr. !� sun M aM
t6� Buildiea la�p�ele� fer a�paaT� p�emits fer fha� ttNn�.
. -
�,
OWNER'S NAME
�
� �
�
APPLICATION FOR Bt���iNG PEFMIT
�
;CITY OF FRIDLEY,,�INN�SOTA
0
��.�[ . � _i�� _.I .�.s..L
�% . _! �. /L:, I
, LOCAZ"tON OF E�Ii�
Na. ' Str`eet Part of Lot .
- _ �-�--�- �
Lot Block Additio�r or Subd�vi�ion i�-�..—���.P-�-. �"�..;
Corner Lot Inside i,ot __:._,�et�'�tk Side-Yard �
SEWER E�,EVATIQN FOUNDATION EL�V'AfiZON
Applicant.,attach to th�i3 form �'wo Certificates of. Survey of Lot and proposed b�rild--
ing location dr��rn ot� these �2l�tificates .
Tb be used �s:
DESCttIPTION OF BtJILDING
� G{'� " � � �t=��
_, .
�'ronC Depth Height, �'
9q. Ft. Cu. Ft.
k'rar►t Depth Neight
St�. Ft. Cu. FL.
Type af Construction Estimated Cos�� ��
_. lt�--b�: . �O'�pa-et�'•d
The undersigned hereby makes application for a pe�cmit for the work lierein specified,
agreeir�g to �o all work iri strict accordance with the City of Fridl�'y Ordina.nces and
rulings o� tt�e Department� of Buildings, and hereby declares that aIl the f�cts and
representation.s stated in this application are true and correct.
�i " '
�` -- - SlGrtt�uR� �r� ,�' �-=��.:�.�-*,�;
�h�1e of Fee Costs can be found on the Reverse Side).
� � Y ~ .
�
2 2.
sue�ECr PE •
c�ty of Fridley 2 7 5 6 3
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
� � •
� `y _____ COMMUNITV DEVELOPMENT DIV.
r � � PqOTECTIVE INSPECTION SEC. 7� �
� �
1 � /"'1 � CITY HALL FRIDIE� 55�32 NUMBER REV DATE PAGE OF APPROVED BY
�""'�' �'' 612-571-3450 9�0-F15 � /
9398
JOB ADDRESS 6880 Brookview Drive NE
t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO
DESCR. �� 4 2 Brookview Terrace 2nd Addition SMEET
2 PROPEFiTY OWNER MAIL ADORESS ZIP PHONE
Chuck Bullock 574-2251
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Midwest Roofin & 'd' -
d ARCHITECT OR DESIGNER MAI� AODRESS ZIP VHONE LICENSE NO.
5 ENGtNEER MAII ADORESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION � REPAIR O MOVE O REMOVE
6 DESCRIBE WORK
Reroof house and ara e 2 S T r- f
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PEFiMITS AFE REOUIRED FOF ELECTRICAI, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
VENTILATING OR AIF CONDITIONING.
THiS PERMIT BECOMES NULL AND VOIO IF WORK Ofi CONSTRUCTION ZpNING SO. fT. CU. FT.
AUTHOFIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OF ABANDONED FOR A PERI00 OF 120 DAYS AT
ANV TIME AFTER WOHK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION STALIS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yq�UATION SURTAX
ANO ORDINANCES GOVERNING THIS TYPE OF WOIiK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. TME GRANTING Of A PERMIT 211}2 ]..07
DOES NOT PFESUME TO GIVE AUTNORITY TO VIOLATE OR CANCEL THE pEqMITFEE SACCMARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STFiUCTION OR THE PERFOFMANCE Of CONSTqUCTION. ]LF. ]5 Fire S�', 2. I�F
PLAN CHECK FEE TOTAL FE
icen 5.0 82.
SiGNAlUAE OF CON�AACTOA OP AUTHOR�ZED AGENT IDATEI � N OPE LIDA7ED �S YO R P `IJ��
C�
S�GNATUREOFOWNEAi�FOWNERBUILDER� IOATE� BLO �NS� f�4TE �
� R��G--�8-199B 10.04 F�M CI'rY � FRIDLEY T4
,
��� � �
t�ADD� [ ] CI'�'Y 4F F`�II3iEY
�-'� L l SINGI.� FAM�Y AI'�D D� R-11#1�iD R 2
BUiLDIAiG P�RMTi �4,PP�CATIUN
co��o���: � 8 g 0('�YO�k-U �� C� �.�
r�� n����:
O+uner N�me c�r. A.ddress:
Cs�ntraCtOZ:
LIVING A1tEA:
CARAGE AZtEA:
AECK AREA:
�}'1'�ER:
4164�05 P.01•�02
Effettive 1/1/98 �
t�
� �
�� ��
- �
Tel. # � 1�-( �
� � i � / � • �.1.� 1 .
l�'� ��I�_.l``�� � 1 �� - i � 1
Attach to this application, a Certiiicate aE Sbrvey of
�ot� with the propo�d Co�sdn�ction drswu �n it to s�ale.
n�sc�z�rr a� �ov�rr�
�grn _ � . �vidrh► � H�igbt _„�,� �q. Ft.
�ngth widrh � xeit�ht ___,�___ Sq. Ft.
___.r----__�
Lengtk� � �Vidth � HgtJC�round S+q. Ft.
�o�nstruction 1`yp�: �. C Esti�►eed Cast: $ l�b�5� �/ ��
iF�e Sc.h�c�u� � on Ba� ck)
a�,►�w�y c� cut w�a� N�aaa: �c. +� Ft = rc � s ��
DA�`E: �( � ! � � APP'LI�.A►1�tT: � �J Tel. � � � ��______„_,� ��
[�e1�It FGc
�ire Surcharge
5#ate Surc�arg�
SAC Charge
Lieen,se SUrcharge
Driveway E�carow
Paosiqn �oatrot
Pat'k �ee
Sew�r i�in Charg�
��s . .i •
$ � , S� Fe� �Ch�dtll� On RP.Y�1'S� Si�d�
$ �� / �/ .Q()X of 2�er�mit Valnatios (1Ji0th�)
$ �, C) % $.54/$I.fi(30 Valu�tion
$ $10�D per SA� Unit
�__,� .� C�(`� $S.� {St�tne Lfccased Rssi�tential Ca��to�s)
$ Alt. "A" ar Ait. °B" Above
$ $4SO.t�p Co�erv�t3on Pl�n R�eview
$ Fe� l�t�. by �ngiae�ring
$ Agraem�nt N�a.tt�+ ( ] ATat Ne�cessazy [ ]
TC3TAL $ %"� �
�•��C
ST��-.A'i`IOIVS:
CI�1f OF FRIDLEY•INSPECTION DIViSION
6431 University Ave NE
;� �► �� � i �p :
� ��
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND MEATING, COOLING, VENTILATION�
763•572•3604 - REFRtGERATION AND AIR CONDITFONING SYSTEMS AND DEVICES
JOB ADDRESS C� 8+��
RATE SCHEDULE
Residential
Furnace Shell and Duct 1Nork, Burner -
Also Replacement Furnace
(Side Vent • Fill Out Back)
Gas Piping (Needed witfi=new furnace,
but not replacement)
Gas Range .
Gas Dryer �
*Air Conditioning • AII;Sizes
All Others/Repairs &�Alterations (LIST ON BACK)
1% of Value of Applianee or:Work
Commercial/Industrial �.
1.25°'Jo of Value of AppViance or Work
Rate
$ 30.00
$ 10.00
$ 10.00
$ 10.00
$ 25.00
State Surcharge
TOTALFEE
MINIMUM FEE FOR ANY�HEATING/COOLING/VENTiLATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PWS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
I*Air Conditioners can not be placed in a side yard without
� written permission from adjoining property owner.
TOTAL '
$ �,�? - ��
$
$_ _
$
$
$
$
$ .50
$ Q "�C�.
��
OWNER__ � I C'i 1 ��[ C2�
Effective On: January 1, 2001
(C �t�;,� �
�
BUILDING USED AS �-�7 ���
ESTIMATED COST �� S� PERMIT N0. ' �"7�
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (H Wa#er) arm ')
Trade Name S+ze No. � �3
BTU� - _ HP EDR
Fuel Total Connected Load:
Burner firade Name Size No.'
BTIJ HP EDR
Th� undersigned hereby makes application for a permit for the work herein
sp�cified agreeing to do all work in strict accordance with the City Codes an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct:
DATE '� � % 4
_ - � 1i ..P�rll 1, - �;�i '� .il�='-, ( ° '�..;��'i ��I ti�` r�} ,
r`i,: v ,. i.�.: i�h'������17 VV.
HEA7ING CO - --`�jG �'��5� �' ��� �TREET: '
��a-���.-2;�T�� #
,:--
_
_
CITYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
August 23, 2002
Xia Thao
6880 Brookview Drive NE
Fridley, MN 55432
Re: Final Inspection at 6880 Brookview Drive NE
Contractor: Standard Heating & Air Conditioning Co
Dear Xia Thao:
A mechanical pernut was issued on July 19, 2001 to install a furnace at your address.
According to the 1991 Uniform Mechanical Code a fmal inspection shall be conducted on
the work authorized by this pernut. As of this date the inspection has not been requested.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Codes. We will keep your pernut open for another 30 days and if we do
not hear from you within this time to set up the inspecdon, we will mark the permit "no
inspection called for by homeowner after notification" and take no further action.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
DJ/mh
. �
^�D ���T C I TY OF FR I DLEY
3u��ding
:nspections
163-�72-3604
�3Il�I�,DIlV�
�.ESYUENTYAL A►�'PY.YC�.'�'IUN�
CI'�'Y O� FR���"Y
�y��
Permit No.: � "
ReceiVea By:
Date ReC'C1: _ � �'�''
�A� Yau�t E-�z�. ��.ss
�TfEADDR�SS �i� �uokv�c� k�� �
"Ha$ APPLICANT 15; D d� �(CONntACTOR
PRO��RTY O'WrIE�t/ �,,,,r,iE,: a� i �' � 0. d
TrN�v�' ,e,nnx�ss crrY � t�Q. sr���� SS y 3�
PHQNE:
corrrx�cro� x,�:�,1�AT�f R�it�3�D CQN"�3''R�Qi� --
SUBNlTT A COPY OF S7AT£ LICENSE # �iCi' DATE �M ��. ���
T i^
YpUiz STATE L�CLNSE .4DDR£S5: J'� � L. �E CTTY Si�L�LW/�%��/�STA S C��a�
WITH APPLIGA'i"ION PH�NE pAX
��tVPERTY TX�E
PEitMiT '�'XPE
�rYPE O�' wOYtK:
O BAS£A�N7 FXNISH
O DF,CK
n�sc�� wo�x BEn�rc� �orr�:
SI2E
SQUAiL�S � J c� C�
�ES
Pit4PflSfiD SXZE:��
PROPOSED E�iGHT_
St�ING
D vinyl
❑ aluminum
C10ther
wY1V�OR'S
FN E3QS7X�1Cx OPENiNGS [3Yes �Tlo
OR F+UR NEW OPfiN�IQS-D£SCRI�E SIZE OF
OP£NII�iG CkI�►NCxES &
TYFB OF WINDOW TO BE lNSTALT.ED N[7MBER OF W�1l�(7W3 -
V'ALUAT�ON, IlvC�.LTp�iG THE COS'x' dF
(USING T� 1997 U.B.0 �'EE SC�IEDIEJLE)
IN � , 'j O'� � . � OCC[TP.4,I�TC
CANS'FRUC'I'�ON `
O ARAGFJSHED
"�pOF
� Sm'LPk3
Q S�G POQL
p AApITiON
pA.1lR � itEMODrL..II�1G
r- o(-� �- /�.� r o �
LENGTH „__
O HOUSE 013LY
❑ HOUSB Bt GA�.AG�
0 ATI'AQiED GA1tAGE
O DE'�ACHED GARACsE
O WIIdDO�'NS
O AR,AIId 7TI.E
❑ OTEI�
r-�t��r
�c.
S�MENT M�T.
1 _ fixist6tg rl7ovf �San
2. Prapos�ed $oa plan
3. List o�stmcmral nzembers to bc osed
FOR NEW COiNS"'�RUCTfON iNCLUDING 1?E�KS,
C7Soffit � �
D Trim !. Sitc P3arJ5lm'ey shawviug t!u cxisdnP struetures
❑ Fascia and proposed projact.
2. T'svo scts o� cortsi�uctiot► g2ans
3. Energy CaEcuiations
LACATION OF WINDOWS
AY,Y. �'EES AR� BASED
TO'TAL JOB V'
Permit Fee
Plaz� �ieview
Surcharge
�ue Surchazge
License Succharge
SAG Charge
Gbrb Cut Escrow
Erosion Control
Park Fee
Sewer Main Gi�arge
'FntnlilnP
��
iERIA�S:
----
$ ', a 5ce Back Page �or �'ee Schedule
$ �j _ SS% of Building Penu�it �'Ee
$ '3 �(.0005) ti�es the total job valuation — Mi�iimmum $.50
$ I .� .001 x Permit Valuatian (i/10%)
$ '' .� $5.00 (State Licensed Residential Contractors)
g $1450 per SAC Unit (Pians to M'�VCC foa deter�ination)
$ �ft+6ft= ft�$20=$
� $450 Go�nservation Pla�a Review
$ �'ee Dete�rmined by Ettgineering
$ Ageesnent necessary ( ) Non N�essary ( )
$ / r� . RSo Make �becks a b�e te: Ci of Fridl Atta�
TEiI5 i5 AN APYLICATIO'�i FOR A PERMXT-NOT VALID i)N�TII- PROCfiSSb�?
i hereby appiy �or a bui�Idung pcnnit and � a�cknowled�e t�at me information above zs complete and acc�uate; that the work will be in
conforma�e� witli r�e oxdiwances �d codes of the City of Fridley and with the Maxunesota Constzuction Codes; that I u�derstand this is not a
pen�xait but only an applieation foz a permit an,d woric is not to start without a�ermit; that We work will be in accordanee with tiae approved
ptan in t�ite case of all work w)�ie ' review az►d approval of plansA��� -� �`~ � � 0�
PRIAIT N � C h °� UATE„ I�—
SIGNATUitE OF APPLICANT ,�.,,,,_� -