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AF - 356787' �., c;" ^k, y%�e �`i.� ;3�' �irir��" �'z�+•� �'; -�"iQ� '��,.c� `-�i' - a - �n - ,,S I � t `� , .3 _ '+ 3� - � _ 1 b I � } � � i , . �, _ . - _ �� , .+ _ � �� '` r •�I.�.A�!� O� F�1�.G�: ��.i�.. � s � — �3 `� � �� ` 1 � � �{ - _B�I�II�T� T"��Rl�` � �,�fi3 _ , 7 °t � � 9t � y ^ � � D'�r.�. ,�'�,`.:�`:� � � � = j � A:�� A O�ter r �uildea' .� ��G���?��;,;'� _ - A�ess � ` Addres� . � �* �:1� ... . : �.�.�P.�4•• � . . . . . .�. . 1 'p�. � �� ' � - , � _ �. ': :' � - : �,t7�� 7t �3F BU�LDi�1t� i�i�u. � �' . ,.��. � �treQt } ~ .��s��;r� .� �. Paa t c� LQt ,;?�" Bi� . :� 1Additic�� ar ` �ub ]�zvistan . F- �, �. - Corner L�at ittsizie I�trt � ' f �etb�ck 4 � :� ` • � � s�+�r+ ` �ide�arci; .r� ,'� � .� _ — ' �i °� � D�SC�[P'�"IUN C3�' BL7t�..�#1'�TC� ', �7 2Q. be,'Used as. j �; , , � �� .�L �t' +7?� `�`xo�� � � ��p#h t�" `. . :� He.��h� � � <: �. ;F'� Cu. Fti, �+ ' , �. - �� � �i� � - _ . _ �.. , _ = .: - F�ron� , bepth Tiet� Sc,�:' F�. C�z, �. � 2y'ls� of -Constructian .�� Es� C.ost• T�i ire. +C�ipl�ted +... ��*i , � «... % ' af �� ; ;�� �'�,'��, ` F� �' — � ' � �y �� - _ -��� �t il , I r _ - _ 1 ;� " „; ; �.�: i f ' µ'�� - - �, in ca�.sid�a�a� 9� �ie issua.nce t� a� �rf ; a-�rnii� � consi�et the builc� des�ifio�d ahOVe, � agree ta .,do' xh� p�ppsed work in ��cordarice vstith �.descr�pt�,t�rr� �.bove �t. fa�h ani� 3ra cpmp�taYS+ce wfth ail Pr�vlsicu�s .-of oxt�inances oi .the viliage o� �idley. - _. ,;�' � � . �� � � � -.� - �`� _ - _ '��, _ _ �..: .�,.'�s .. � ... i ` `, ; ", ' ` ' �� -. � In eo�iderat�on o� �t� �a�ment of a �f�e af $ � �" : :, �t �,s h�r � � . ,. .. . _ - _ „ �, �5t� � . . ��"� . . . r� .,�; .... � - _ -' - . , .•� . to consfi�t�c� the ..'bu�i�.c�fmg ayc . a�lditac�n �.s -c%s�il� ab�ve. �'ftis pera�it is gr�pited ugc�u : � � � e�sress con+dztir�n 'k�t �te � � th� ' ..` �son ��hor�, ii fs g,rat�ted artc� �is agants, ez�IaY�° �uI w�rkmet�; in' al1 r�ro�ek : , do�e 4n, �iround snet upo� said bwiciing, +ar a� �t �h�eof, shaa,lll cisr�orm im .al�! �. ��ie �erc�iaancae� '�af =�'rt4dleY, Niiainesota regard3ng l�ca.�cin, r.ansta•uciatoa, a1t�:rat�c�, �naixttetna�ic,� repa�r: �nd at�oving tsf btiilr7in� �=: i�n 'F�e viita�e `Iirnits aa��-fidua germ� �a� 't� r�voked �t� any 73me upt� �v%lataon i�. �y t�f '�e :�r�v3siori;� i�f s�td �r�nan�eS _ �ir ' ..� � ... .� . .,. • ' ; , : �;, ' � x - � � a � . `�� .. . . •_ . . , , ,. . ._._., �� _ _� - - . . � $i3��21g III$�pl+,r -.`;�110'I`#CE� _ ��i ., Yfiia prerm�fi� does nof c��ier �he eanstruot%n,. tn�tattati4n ar ai�era#i�n fari � i�g, �tlumbfn�, .9as f%�athr�, s�wrer ae wa#�r. �e sur� to,se�uildin� Inspec#or for seAa+�a�e Asrnii#s f'. items � _ � _ , i,. - - - - �' ,�� ��_�, _ _ �.r ; ,. ,�, ,, ._. 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M�NNEAp�` 1nSta1le� �com th6 1 Spp�e F+ 1n Pect°r Etidle � re�e��ea p 5{oc this ac ty�ana {°��1►- d►ng 5 ny e of natural 9av6 the cpP a�or me+gr• g g�i1 � 5 Co�P° -(�yth v�11a9e o� the M,n�6apolis G° ea the °SOn� We Wi11 h v;G6 p�pe an City °r aate a�tMor�Z Struct+ as s6� at�on� {or�e �o�e �rsta11ea the 9 CitY °r For Y°�r �nf�,o ona h°SS�C�ey `5 V i\1a9e i���°t6a� ta\lations�allationr+hen heatin9 t�6 in Dr�,ye C�ty or t;es to 5er�e 6221 Gar°1 �a�, Vi11a96 k,ur GUStom66raddre55 Su es � r �2 �` Ayer,ue N� `oss er d t C�Staller aaress 612�' �� � o�a.� ��' 1� 0� BtU `i5 Cz�S C�Mp AN`( ` ,�Stc\1er a .L,�,�erO1d� �nP°t MINNEAP� 1 t e CQo �Sm�� �on� New bll A�thoriz6a S►g�at�r � , Mar 24 19 �� . , �tea a ���, � W � � � � � r � � : O . � . � ' O . � : , � : � � � • i � � ( �j � I � \ � � � � � � w � a CN �S � � rf � � � � � C � '� f: ~ � '�i � $ s� „ � � M �� m � � � " � s � � � a ~ � � M � � .. �1 • p � �' � • � � �o � s � y y �O . . � a o , � �' ' (0 � ' : : � Q�Q � � • . . . . . � G � � � : : � . � � � � � � ' : ' : : . : : : 0 0 „ � N M k �t iC X il it � '� `� ��y+y+�� �p �3 �p � :: � �, S � � � O � O � � � p � M M N t�a M iw v► tn en � I i "� "'J H � � � 1 �'q � I � � � � o a� � v�+ � v � � � � A 0 � � , '� D � � I� � � � f� m � m � � � z � E a a N E. � a �. � � b � � 0 s � � i S ■...1 . �.. ■, ., i� .�..■, ' ■���. • • ■■�'.. - � ....., � a � � N � � ; i� ,� ; � � \ � � � : � ., � �` l� . � 0 "C>'{ �� � � a ��o I" WATER aras�rs uauu�s �� � e�oea s�wia wAS11 TqAK DRINK. FOUM. SMMRS. FLOOR DAAINS U7CN . �� �wro W,� � � � � ��s OPENINOS � • Z • �' > T � M � n � o. � � �� �� � M � � � p � '9 �Q ���W .. ���� � � a� 5��� � M � � fA � � � � � � � � � � � � � � � v. �'�,o ���" �� m �� �� � � � M ���� � � � � A � .. � 3 � r• � � � � � � � ►� � O £z �S �i $� w. � � � a . � �. � � I � � � � � � � � � � °� ' I� � � � �� � � J � � �� � � � r ' � � � � �Q � � � � � m � � � � Or � e� �C � � n! s '� � � � ''9 � 6J ~ J '� � ,� � � � � M +� � � � :° � � � : � � � 0i° � �° �° �' '��° � � � � " � � .�.n .. , � � ° � � � � �� � � � � � � a � � � � :� $. ���o��a� :^ �m: . : �.�. ��W � � �] s = ~� � R J _ . � � • � p Qg o a p � �+ • . �p O a o . • . O m • �,7� �. � • . o � o � e . � � � : . . e v o . rn � s : . e . ° o � . m . < e o a . N � � • . . m , o o , ► 4 � . . . . . . a . : � � : :' . . . . • . o m . � . : t—� � * O O y: fl M M M N fe i M x� � M �Er } �Q . �Q �p � �o �[� �+ r�1 � • O � O . � A � A W � C � � • � i/Y M M � 6s N p M iA M� vt W :v O � � O O O O O � � I I � � �� o ,-, f a � ,� � � , _ . : � r- �,, � �, � �� � � 1 ._ °'a �; � :•�.�.;■�''� , E � � ',.`.I.d.� I �, � r � �.'�.� 3 ` ����;'�:��� � • I■�■�..', • .■■�, � � �t�-.r. � wA� esao�s aaa�e �� sasae� w� r�r� �RBN�. i�4. �� �� �aaao� �� �� �� � AR�aL. o�s � � Q��DIIIrCdS a O E • w � ii � � �� � � � � � �.�� � m . A' � � � � � � �� � � � � �. p o � � c, � Q� Ps r' ~ � � ��p � � N � � (A '� � �1 O a1 � -g �s � � ���8. � � � �` �. � ��� ���� ��Q � 1 � . _r � , ��� F-� O O 0 0 W FJ � IN � �- � �roo � � r � � � ��� A d o���� N � m � C ���,�a � � N ���� �,��p � ���� y � � � � � '[ � � � v � Y � • � � 3�.., � r� � � � �y � � � � � � � � � � � � � � . � , : � "0'� � � � � � �� rn � N � N N � W � � � � � s \1"l W 1 � .�" .� � N u N SUBJECT City of Fridley PERMIT NO � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T i � - - - � � RECEIPT NO. � �L ______ COMMUNITY DEVELOPMENT DIV. r j � PROTECTIVE INSPECTION SEC. /�6 � � . , i l-_-_ � �����,,� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE F PRO s �� 612-571-3450 910-F15 10/21/80 � � JOB ADDRESS 6221 Carol Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 3 Shoreraood Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3ames Skurich 6221 Carol Drive N.E. 571-3507 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO. Same 4 ARCHITECT OFi DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING �� Residentia.l 7 CLASS OF WORK ❑ NEW ❑ ADDITION �I ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install class "Bn Chi.mney for forced ai.r gas furnace 9 CHANGE OP USE FROM TO STiPU LATION S S EP��q �-E �lEATatV� �ER�fT� �EQ�r��D . P�CIAA� J�� ��� �t� FpR �,�I��H �►S0 SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT. CU. FT. AUTHORI2ED 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 HEREBY 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 WOiiK WILL BE COMPLIED �`]_OO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $.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- $TRUCTION OR THE PERFORMANCE OF CONSTRUCTION. S7. rJO PLAN CHECKFEE TOTALFEE �S` 8. �0 GNATUREOFCONT A TORORAUTHORIZEDAGENT . IDATEI WHEN PROPERLY L DATEO THIS IS YOUR PERMIT n � � � �s � — ' �t�' /� �c� GNATUREOFOWNERiIFOWNEPBUILDERi t ATEI �— BLDG WSP DA E ' • ° •� CI7Y Of' FRIOLCY - , kf'�'LIC/1'fI0'� �OiZ !,l:SI[)1:(�lTI/',i_ QUILDIitG f'CR,t�iTTS ���C1�1, Al �erai:ions, /l�iditions, ar Rcnairs) ' ot�t��a: S� V� l c�f ADORESS: � 2 2 ( �i4,� �- � � � �� !U� TEL �0: �7(— �So� 0 [3UI LpER : _ �63y-�1 � � . _-_________ /1DDRCSS: • TCL i�d0: • � ���� Consl:ruc�ion Loca�ion ° . sTZU��c rio : &TREET: _ C � +e-o � � � � U � � � _ . . Lox: C� sLOac: � r�nnzTZO�r: S` Corner Zot: Insic3e Lot: IC SetbacY.: • Sideyards: Ap�licant at-tach to this Eorm tcvo Cer�ita.cates of Sux�rey of ].ot and proposed building �.ocati.on drawn on certificates to scale. _ � UESCRIPTIOid OF COt�1STRllCTI0P1 - � i �+ �V ' rront: Depth: Height: �c�u�e. k'eet: C�ttbic Feet: . Front: Depth: Heiqht: Square� Feet: Cubic I'eet: 9 (�� 1t � 9 Type of Co�ls�truction: �v� ( f� C��SS � t��� � Esi:imai.ed Cost: $�� --� � . G`�l . . � Zb Be O�r,:pleted: �� — � O 2 . ` . _ Alt. �1 Alt. B Pro�osed Arive�ray Width If New Openinq is Desired: $' $ . . , SEE �VERSE SIDE OF SiIEET 7.iie undexsiqned hereby ma}:e� applic�tion for a pernlit fcr the t.nrk herei.n specified, agreeinc� to do .all war3: in s�rzct accordance �•�i.th the Ci4y of �'ridle�� Ordinances and xulings Qf the Del�zrtme.��t of Blii.ldings, and hei-eby declares that all. the tacts and zepresent.�ta.ei2� stated :n this applicatian are true azid correct. D.'�TF: D 2� �� SxGNATUI'�;; S�iz�ulations : i% ��� SZ� � � . v� 2�ZriLQ,p ,��r%G�,aI�K/�1 � . . , ��, . IIUJ L))11�1G t'��ftl1I"f (=C:�� ��CIIf:�UL�� � . S).:C'rr01�� 2. �'3.'1�L 7n�.cJ�ccic�r.' oL• lzui.lc?in�t :::hri).)., ticfv�:r. i.r, .ui�u� ��c�init� tor t:hc c.rc:cLi.on� uf .���y l�u�.l.rl.i.r��! ar :,i_�•uct:ure, w- fc»: any .idQi.i:S��n +�r� ai�y cr,i::L•a.»g l�uildincj or ::LYUCLur_e, , ci�- !`a�� a�iy a1.1:c�rt�t:ic-�ti or. r.cl�air.:� L•o •any c;:i. .1.i.n�� hai.t.di.�i�� oz sL�.�uc:ttirc, u���ri ar����.i.c:ati�n 'i:lir..r.�for.c, r.cqui�:c tJi� pa}�mc��L ?�y t1�c ���;,p].i.c:arzl: f:o�' ��ucl� per.mi.L• ol.� fec.^, fia Llic mnount- hcz�in bcJ.c�t•� sr.0 for.th aiicl �.�i i:1ic manric�: hcrei.n p�:ovxdaci ��-�•::i.C: • I;l.t•7 COIdS`I7:UC'xIOtJ: Si�ig7.e ]?amil.y Ilotaes anci Gax��t{es: Y9.00/7_,0�0 cul�ic £'ec:�. I?L1�F•2 C113:C1:: 25 l�cr.ccl�t: oL- bu�.�cli�lg }�er.�niL iee. , U1t1:VI:l•'11Y llL•'1'P1:SSX01•:: (CancreL•c_ Cuxb �trceL-� Only) � • R).tern�li:e R: lu:�noval �I1C3 Y'Cj)�.itC:�ment of conczete cuxb and gutL•er only; l�rivea�ay �•ridt}i p]_us 6 feeL• Y�:�..�',.75 111.L�ernatc II: Removal and zeplacemcnt of concrete curb and .. , guL-ter and iiist� 11 a 3 £oot ��ic3e approach ���it:h ' . 6 a.nc}i depth; Dri��evray �aidth �plus G£'eet x$17.85 � . . AI�pI i 1ON/1L_ IP�FOR[�"�l�TIOP! I'or the purl�se oi co�npui:�_ng �ees far. building permits, L-he cubi.ca]. contents of any buil.di.ng or addition, is deicr.mi.ned by rnultipzyisig ':he ground area covered from a p�i.nt si.s: (6) inches belof� the �loor J.9ne oi L-he basemeni: or tha cellar ta thc averaqe heights oi L-hc �upper surface or to ihe average iieight of the roof surf_ace oi tlie raain gahle of a pi.tched roof. �. For. ze�airs or al.teratians to an exista.ng stZ-ucture, f.he fee shal7: be at the xate ..of $3.00 rer. each five hundred do�lars °($500.00) er fraction L-hereof i.ri the cost ai' all proposecZ wor.Y. . . � In •no case sha3.l �he fee cliargeci fc�z any pp�nnit zxs set ior�h. �n Sectian 2 be less � than $7._ 5_ 0 pl.us $.50^state surcharge. � ' � � � V�R1'FIC,�TIO�! OF FOU�tiD111"IOfd 0 ' N�'IE: Permits .�ar construcL-ion wrill be isstted a minimt� ai 24 hours �rom ihe tim� nf ��Plication to al.lo�o for proper revieca of i:he proposed structurc and vi the . construction site. , A Ceri:ificate � of Survey of the l�t, sho<<�ing the location of the foundation once S.t ( has been cons�nicted �eill be required before pr.oceeding �•rith the �rami.nq. � TL-�FI�LLT� OF O�.GUPA(�Cti' . . ' 71PpZication f:or a Certificate oi' Occupaz�cy shall be mad�� ten (10) days prior L-o the u::e or OCCL1r�IlCj� ot any st;ruciure for �rhich �i ��illl.t�l_11C3 k?CLIiIl� }:as been issued; and stiicl struct:ure shal� �iot l�e used or. occuyied L:nL•il a Cez:i;�.ticlte Q� OCCUj�ill'iC�► has becn issued. n 0 � - � ,°'"-c '� . �'� � SUBJEC7 City of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ;, ,� ; �L _ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. L� S � ._--� ��"' �`� CITY HALL FRIDLEY 55432 NUMBER REV. DATE L 612-571-3450 910-F15 7/7/86 JOB ADDRESS 6221 Carol Drive N. E. t LEGAL LOT NO. BLOCK TRACT OR ADDITION DESCR. 4 3 Shore�rood Addition PAGE OF � � BPER NO. 11� 18527 RECEIPT NO. �/�! � APPROVED BY SEE ATTACHEO SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Slsirch 571-3507 3 CONTRACTOR MAILAUDRESS ZIP PHONE UCENSENO. T. C. Construction Co. 7685 Wedgwood Court, MAELE GROVE 55369�. 420-3334 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR p MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 20` x 20' Addition to Re�r of D�elling 9 CHANGEQFUSEFROM TO STIPULATIONS . Install fire alarm SEPAR�4TE �'�R�ItiTS ����REa ��� wiRO��i, ��►�ii�i�, ��.c����.�. ��� ����s. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBIN(3, HEATING, �PE OF CONST. VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT yS`Z].. %rjO OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- TRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � AN CF ���-.�, �. �-�-p;� SIGNATURE OF CONTRACTOP OR AUTHORIZED AGENT IDATEI SIGNATUREOFOWNERiIFOWNERBUIL�ERi IDATEI ` � 152. .13 ���d�� ����/ 1"E��'jrHpd���ih,� �� �� R� ��. �����i� �� ���,�;�� Q���,�� � �� �.�� � �� � OCCUPANCY OROUP SQ. FT. OFFS' STALLS OCCUPANCYLOAD CU. FT. REET PARKING IGARAGES 1X $1.�. $8 AL FEE � 201. 51 iIS aS NEW ADDN. ALTER. � � � � � � City of Fridley R-1 AAD R-2 Building Permit Application Construction Address: �°% �� � ��� �� ��� � Effective 4/1/86 Legal Description: Owner Name & Address: � • �- � .���� Tel. � S�7/ - .��d� Contractor: �� �• �� � �° � Tel. � `�v� �S 35� Address: ���� w-r�� N� ��� ��Q ,�� � ���� r LIYING AREA: GARAGE AREA: DECH AREA: OTHER: Corner Lot [ ] Attaeh to this applieation, a Certificate of Survey of the lot, with the proposed construetion drawn on it to seale. DESCRIPTIOA OF II�IPa09EI�+�NT ' P � Length a b �lidth o� � Height � Sq. Ft. ���� Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. 6 � .��r = �D. � � Za � °° � � 7— Inside Lot [f] Ft. Yd. Setbaek Side Yard Setback � Type of Construction: �/�" ��z� s� � s�. Approx. Completion Date: , Estimated Cost: $ �� �? I, 7�. C�ee Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: C� � 3� � P �° APPLICANT : 1 �• �� � � � Tel . � �� � �S 3'�" Permit Fee Plan Check State Surcharge SAC Charge Park Fee CITY IISE ONLY $ .� �� Fee Schedule on Reverse Side $ ��5.�� 25� of Building Permit Fee $ ��•� � $.50/��,000 Valuation $ � $�}75 per SAC Unit $ " Fee Determined by Engineering SeWer Main Charge $ �� �-� Agreement Neeessary [ ] Not Necessary [ ] TOTAL $ "� STIPULATIONS : �� %j , � � �C7 Cj C/'� � � � �SI(� ,J � � �.�� � ��� � � �3���I �. �,��Q ��� � , � � �-- �2. �'�.� ` � cj �` � � o�. � . �a � f � � � BIIII.DING PERMIT FEE SCSEDIILE 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 strueture, 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 smount herein below set forth and in the manner herein provided to-Wit: Total Valuation $1.00 to �500.00 $501.00 to $2,000.00 Fees $10.00 (Minimum Fee is $15.00) $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,000. $2,001.00 to $25,000.00 $32•50 for the first $2,000 plus $6.00 for each additional $1,000 or fraetion thereof, to and including $25,000. $25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $�.50 for each additional $1,000 or fraction thereof, to and including $50,000. �50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each additional $1�000 or fraetion thereof, to and ineluding $100,000. $100,00"I.00 and up $433.00 for the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof. DRIVEWAY DEPRESSION ESCROiI (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 approaeh with 6 ineh depth - Driveway �idth plus 6 feet times $15.75 VERIFICATION OF FOIINDATIOA Permits for construction �till be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construetion site. A Certificate of Survey of the lot, showing the location of the foundation onee it has been eonstructed will be required before proceeding with the framing. h f _ � ;_ VT� �U -S � 0S ` � � � � r \ � � � � � �� 0 � '� � rs✓ � -� � `., ' � r✓ � ry ��� a �l , ��/ ,. - � . � x A � ► _ � � J �� �� � rx _ � k '_ o � �, j •n � �r � .` 3 � t +.. � �je- � �.- -�� �� /,A'/ � f � _ ijr/ °c � ---- - -- �� _.__ � _. - - - - �'-. 0 w � � � _ � F -� � � � 0 f � � � r � � � � �-� � � , � � P � � r � • � � � �� � 6 �a � � b� � � � b � R d c � 6 , � �, , ` � � � —1- > � � q , � �� ��d —F, _� n .,(�\ '� ► s e � � � 1 \ �� � � w: � , - �,. s � e � . , Q t��'� � 7Ci V � �1 �'�, ' � D C V,r _ � � � n . � t ot� �y � �t u A � R �n N n' � n7 � ? � � - � � � � _ � ; ,� � � ^ ., � � ° � � � � � s '-' l�' � -� � � a � � s � a� � r E �— v s � 4 � � � o �T���� , r �� / � o �� � �c G� � �'� '��' k,�T .�,, � � :r � '� C� � �--- _ � �� � i -_,��. �. � � _.� � �� .- i °�' ' . � ?f* ' � ` rr \ � � N P oc, � ; :D = � I , � i c � �,� +q x ;. C o °, 1 b' � ' lr ' � � � �~ � � I � � ; � I � � �� H I ( i � ` ! i ' I � ? { ' ; � i � � i � + I 1 � _ _ V -- � I tn ti��1 r . Su8JEC7 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 DEVELOPMENT DIV. r j L � PROTECTIVE INSPECTION SEC. l, _ , •-__� ��"" ��� CITY HALL FRIDLE� 55432 NUMBER L 612-571-3450 910-F15 J08 ADDRESS 6221 Carol Drive N. E. t LEGAL LOT NO. BLOCK TRACT OR ADDITION DESCR. t,� 3 Shorewood 2 PROPERTYOWNER MAILADDRESS Jim 5kurich 6221 Ca,ro1 Drive N E 4 REY I DATE ['7 TRACTOR MAIL ADDRESS Z�p T.C. Construction Co. 7685 Wedgwood Court, Maple Grove HITECT OR DESIGNER MAIL ADDRESS Z�p PAGE OF � � _18540 �.�3�� APPROVED BV SEE ATTACHED SHEET �HONE 571-3 50 7 �HONE LICENSE NO. 420-3934 �HONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE ' UCENSENO. 8 USE OF BUILDINC3 . RG'S].CZE11'kla]. ` " 7 CLASS OF WORK _p NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WOHK Construct a, 24� x 24' Detached Ga,rage and reduce attached garage width by 6 feet to obta:i.n more room to lot line. 9 CHANOEOFUSEFROM TO STI PU LATIONS Provide a hard surface driveway tA new garage, three feet off froan lot line unless written permission to go closer is obtained frc� the neighbor. Convert paxt of ex%sting, remaining garage to living area by ti.me new gaxage is finished. SEPARATE PERMITS RE�U�RED Fp -w���N�,. HEATING, PLUA�IB�N� ANp � ���r�sv SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONS"i VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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 AFTEF WORK IS COMMENCED. • N0. DWLG. U� I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION 1 AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT +�7 tQ67 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. yS`68.SO TURE OF CONTi}pCT(qR OR AUTHOR,EZED AGENT IDATEI � tl dl v G/ R BUILDERI IDATEI I,��-BLpG i 8efarc ; ' ���� � TE(EpyO���g �,�� ���` � IQFQv� Eb �t �'cf�,� eA airr;�s REp � r SErE [q �,, • OCCUPANCY(iROUP OCCUPANCYLOAD SQ. FT. CU. FT. OFFSTREET PARKIN( STALLS GARAGES SURTAX $3 . 53 SAC CHARGE TOTALFEE $72.03 RLY V�DATED THIS IS YOUR PER NEW [ City of Fridley Effeetive 4/1/86 ADDN. ] R-1 AND R-2 ALTER. [ ] Building Permit Applioation Construction Address:� � 2� �- �.V`o f !f f^ 11O �� Legal Desoription: �i 6� � 4Odc� b�lv�l� 5� �'1�S i owner Name & Address : �� M� � �(� � L G %�- ,/�(v �- �� C` Q /� f o � ��' Tel . � s�' ? �- � 5°D�7 Contraetor: � c �A �1 � ]� [�'c�c� I o {1 Tel . � Address: Attach to this application, a Certifieate of Survey of the lot, with the proposed construetion drawn on it to scale. LI9ING AREA: � �_,�� GARAGE AREA: DECR AREA: ' OTHER: � R� d ��� Corner Lot [ ] DESCRIPTIOA OF IMPaOYEMENT Length iiidth Height Sq. Ft. Len�th �'.� �' Width `�.. �4 P Height 1�._ Sq. Ft. �7 Length � �y � i a°r�• Inside Lot �] Type of Construction: ��'� r�l� Approx. Completion Date: Width Hgt/Ground Sq. Ft. � �� � � � � d -tl� b � � � � �F� �`o ��1� 1 t�,�� � Ft. Yd. Setbaek � r Side Yard Setbaek � Estimated Cost: $ � 1�.`1ie� Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation BATE: Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL APPLICAIJT: Tel. � CITY IISE ONLY , $ �.�'t� $ $ �� � $ $ $ � .0 3 Fee Sehedule on Reverse Side 25� of Building Permit Fee $.50/$1,000 Valuation $�175 per SAC Unit Fee Determined by Engineer3ng Agre�ent Neeessary [ ] Not Necessary [ ] STIPULATIONS: � ` � U i i l iL �C �� `L '�.o�t ct l��A9 .E' /i � y �ao�I I+l � 01 � �t °►�C � . � �2 d �i � 8, W t � �1 v t�' � e- �l C ��t f"e� � �Oal _ ( � . fo � 1`�6 L'P ' �+f �. p,�c �� 9 t�� 1��` ����. �, �`Or a4P�u.��-c��,c� % P��►os��l 2 �-- Q_ � � ��` �/l �S �%�vlD Cal'� C+dQ(V��{� s r,,k,�� ��"'_, ���. -" .`! _n- „r.....<.,� I� %w�—r,-,�i�"e ....-,:4�.�-T : d. �. i. �� _ - � .:+k�s., • .. _ _. � � . -� •.. ! . . '� � I - . .. . . _.. ' ` , ' � ,�', t� !�, , .: , - "'.... ,.. � , s!• �� �, .,, r^ � a ° � �...: .. .� ' , �. .... _ - -- -- �� �/ BIIII.DING PERMIT FEE SCAEDIILE The Chief Building Official shall, before issuing permits for the ereetion of any building or structure, or for any addition to any existing building or strueture, 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 $1.00 to $500.00 Fees $10.00 (Minimum Fee is $15.00) $501.00 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. $2,001.00 to $25,000.00 $32•50 for the first $2,000 plus $6.00 for eaeh additional $1,000 or fraction thereof, to and ineluding $25,000. $25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $�4.50 for eaeh additional $1,000 or fraction thereof, to and ineluding $50,000. �50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each additional $1,000 or fraetion thereof, to and including $100,000. $100,001.00 and up $433.00 for the first $100,000 plus $2.50 for eaeh additional $1,000 or fraction thereof. DRIVEiTAY DEPRESSION ESCROW (Conerete 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 Kith 6 ineh depth - Driveway width plus 6 feet times $15.75 9ERIFICATION OF FOIINDATION ' s•' Permits for construction Will be issued a minimum of 2u hours from the time of application to,allow for proper review of the proposed strueture and of the construction site. � A Certificate of Survey of the lot, sktowing the location of the foundation onee it has been eonstructed will be required before'proeeeding with the framing. . a s _ . � � � � �� i � . � .., - usuw�wN ' rw�onra s�,�e �Ma��s�rnMO w� Mr�o a� - ' ' • s�o+no. eooaaro aw a r�.r c�. s.r T..e,r. t�..r se..,,,�. �.r r+.�,� � w� cNn ae.a . t�ak �w �ssn Certilic�te ot Survey tor "�M ��K�t " .. , �• �� �� - � o . . . � �� ,,{, � ' ' . "�' / `� fi � / . � �� . �. �� , , � �� �v � � ° \ \ P C � � � a��/ � \ ��� o � �� x• R �} _ . �! r /(( J Z. o \ i'F' O ,; •s �' �t � . � �� �: � o ••. ���¢S �✓or1 W►•nu►na��" �= t�aha�as d�aiv.�e � u��i;� �sc.»,e�+�-s .o , y�� : � _ �o. �� 6 T ��� �c�c�c 3 -- r 4!����.r ��� � s�d��� �. ¢q��� . �e� .��� y � br.�r ss.Hir rh.� NIs b a►►�n � s�r►�s� rpr,�s�at��bw M•�w��y �f tla �rls� N N�� �Mw i�ssrl4.� I�wd�.wr M NH I�s�tl�u N�1,F(1 Mi1�M fA ��•11 • I►M �� la�as�� N � bwr. A� w���� �� IN�.�1��W d A.O. 1� p a r �. hn� �r w it� IIRI�Ap� i�,N �i ' O. INC. ���� � fr•w„n All Rl�4 R�arwd �T_. _ � � � �� . u�uw�wN - �r„o�, sa�� .NO�ws�w�Na_ - y���� x ,,� . �� c�w a r� r,e.K,o,r• sw r� . wr s..�,a� • �r ra.�� � m'cnn°�w+e " eooa6m � �� , / w�.w�. � s� � �•:titi�at• o! 8urvey tor �/M . ��d�!Kt'j �" r- • � o ,,. . � , - . ' �- ' �• � 4 . � ; ��' . - . ,y/ � � . , . � ,��� , . _ � ,. . C o° :�� ` x• � � . ; . . � � . �, �. . . , ,� , � - � , r ti° , •p � �•V , \' ,�'' N,(� `sr�a T�' / A ' � � � S� . �, . AP' �� �w � � : t �. � � �� ��%' �.b.lh, � � y,,�" �eL� � a• \ �� � � � .�s o 'S � L ��� �°.o '�0,0 � '� �O ' � ♦ 4 \ � i i � py!' o� �/ ♦ V'1��fc0 / � / �, \dC� p � // �� fi �� ,�� ' " {/ V' . , s r! . s ■ / �, - . J z. o o .•. S�a+�►�T¢s ��0✓1 1'K�nu►r�� .__ t�¢na�¢� draiv.u�e � a���;� Qascwra•��-s �� : / � 30. ____.__. - , :, ; . - - �� � �. T 4 �L�c� 3 _ r s�,� � . � , - � . / � � � � � _ 5d6�¢c� Ti ¢as¢rnm�l"5 . Aiio �ir� � ❑ - 1�...►r a.Ni�► �w• N�. b. n.. .wr s....:� a�N I�w�. A�iw :Ha I�s��l� N�1 �il� *���h�la H• arr•�r �� Ma M��►IN N N� �w _ �f� �f w» t►1�1�+p � �w� �11 v I�b hsr� �ef�� N�r, ir�s �r w A.O. 1 :V uRS EN � � O, INC. e�.a.. •r...y... � �9 �11+�blhlyd: All Ri�b Rsa�wd e ----- . _ a „ SUBJECT c�ty of Fridley PER � AT THE TOP OF TME TWINS g u � L D I I� G P E R M I T 2 8 � 4 4 „ ,� ; `V _ COMMUNITY DEVEIOPMENT OIV. r j � PROTEC7IVE INSPECTION SEC. l--__����"' �'� CITY MALL FRIDLE� 55132 NUMBER i 612-571-3450 910-F15 J08 ADDRESS 6221 Caro1 Drive NE 1 LEGAL LOT NO. BLOCK TfiACT OR ADOITION DESCR. [�, 3 Shorewood Ac 2 PROPERTY OWNER MAIL ADDRES$ � Jim Skurich 3 CONTRACTOR MAIL ADORESS Steven R Lee Contr. 9465 Irvin� Ave Broa 4 ARCHITECT OR DESIGNER MAIL ADDRESS 5 ENGINEER MAIIADDRE$S B USE OF BUILDING Residential 7 CLASS OF WORK nEV pATfi _ 12/14/98 ZIP ��3�� PAGE OF APPROVEO BY � / SEE ATTACHED SHEET PHONE 571-3507 PHONE LICENSE NO 575R PHONE LICENSE NO. PHONE LICENSE NO ❑ NEW O ADDITION ❑ ALTERATIpN � REPAIR ❑ MOVE ❑ REMOVE 8 OESCRIBE WORK Reroof house and garage (31 Sq) Tear-off (�arage onlv 2nd laver� 9 CHANGE OF USE fROM STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIREO FOR ELECTiiICAL, PLUMBING, HEATING, TYP� OF CONST VENTILATING OR Alq CONDITIONING THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING AUTHORIZED IS NOT COMMENCED VyITH�N 80 OAYS. OR IF CONSTRUCTION OR WORK tS SUSPENDEO OR ABANOONED FOR A PERIOD OF 120 DAYS A7 ANY 71ME AFTEfi WORK IS COMMENCED. NO DWLG. UN17S � HEREBV CEHTIFV 7HAT I HAVE READ ANO EXAMIN�D THIS APPLICATION AND KNOW THE SAME TO BE 7RUE AND CORRECT. ALL PROVISIONS OF LAWS ypLUATION ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILI QE COMPLIEO WITH WHETHEii SPEC�FIED HEREIN OR NOT. THE GRANTING Of A PERMIT $2656 DOES NOT PFESUME TO GIVE AUTMOiiITY TO VIOLA7E OR CAMCEL THE pERMIT FEE PROVISIONS Of ANY OTHER S7ATE OR �OCAL LAW REGULATING CON- STqUCTION OF THE PERFORMANCE OF CONSTRUCTION $7(�,.�5 � PIAN CMECK FEE ���� �� � Lice S�GNA qE OF CON"RACTOA OR 4UTMOAl2E0 AGENT �DAiE� EN P C S�GN4TUAE O� OWNEQ��� OWNEA BU40EFii IOATE� e� nn ...ce SO. STALLS NG� GFiOUP OCCUPANCY LOAD CU FT. OFFSTREE7 PAqKING GAiiAGES SUR7AJ( $1.33 SAC CHARGE Fire C $2.66 / TOTAL F E � 8 .74 IDATE T IS IS VO R PERMIT / , i � f�F T .. - �, NEW ADDN ALTER [� �) �) ConstructionAddress: Legal Description: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R_Z BUILDING PERMIT APPLICATION � � � Etfective 1/1/98 �� �� pb � �� Owner Name & Address: , �� "� c�lc�,,,,� , � � �� � ��� � j�� Tel. # �7 �— �.� � Contractor: ���� 12. � MN LICENSE #� 7�� Address: `�° `zo !o ,Y" �'Yv� ,�.a s�� %��.�/�—��� Tel. # �/.�Z �-- // °l� � � Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: e GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IMPROVEMENT �n8� Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq� t. � �31 �'�,� �-<-�L b� �- Y..�v �' '�– � �-v� � .s�h.r g � r.o y� � �.— Q h �'Q/". o vt i�/ Construction Type: � � � '�p Estimated Cost: $ �� �°- � � � (o S(o (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: IOZ- l Y i J' ApPLICANT: �� Tel. 1# %v�. �— // g� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charg� TOTAL STIPULATIONS: $ �l'ti� %.s� $ o� � (o b $ l, .3� $ $ S� � o $ $ CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1000 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 [ ] $ �3��'�/ m BUILDING PERMIT FEE SCHEDULE A 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 $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up ����I.y $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 �rst $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,Ot10,000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (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. VERIFICATION OF FOUNDATION 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. — � -, D rt � � p � � rn Q: � � 3 0 v,• � N � . y O � n � �' o � 3 � O � ''t' a � 0 �•-a �• n� � A m � Q' � �. 0 m °' �� Q o tD � � � � Q � 0 c � � m z N � m � O Z � '�'I ` . . rn m 4�9 .�, V O' � Z -s C� _ �-.� p � D A G� f�7 L� D'n e�p v� � C; Iv � -, Gt a� c� �, � m C� 'A -� o � �O O � � Z7 � � � Q. v � � "t ° � O s� � tR • O n. <y � � � �' �� � � V� � O d � 'i; -, an �' ca. �, t� � • � �� m. m � ��� G � S` W Z m �7 ,". : ' ' , , ; , i � �7. a �• : , �k Z fD � ro �7 � U7 rt �7 :'�l .. o =.,:v p ��. � ^ �.�.� � i r�f. -f� CJI�: Rl ,y * � N� ' o � �.Q rn w�� ,''S , '�+:;; + "' tn ; . 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' _. � ... A�t � � � \ c T °' m °' y W `G ��e�t . 1 J ♦ % � ...� A � � i � il � y '� � �I � i �� L � Building PLUMBING Pernut No.: ' Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Da�'d�GT = 200 DATE I�`� —o � YOUR E-MA[L ADDRESS SITE ADDRESS �n '� 2� �� /i�� p%� o N E THIS APPLICANT IS: ,� OWNER ❑CONTRACTOR PROPERTY � NAME: �% n - 1 � ADDRESS: �Q � '�. � C�' � l�. C�L (.! �� � v �Y � .2 STATF��ZIP,��3 TENANT pHONE: % fe �i -- ' �71���v7 CONTRACTOR NAME: ��T£-61�EAIS£ # - . _ --- EXR DA3'E _ _ -- - SUBIVIIT A COPYOF - — -- --- - YOUR STATE ADDRESS: CITY STATE ZIP LICENSE WITH pHONE FAX APPLICATION PERMIT TYPE /�'��NGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: � NEW �-REPLACEMENT DETAILED DE CRIP ION OF WORK J2 �`�=� O C VQ S U d ' � �Q � �� PER MS 16B.665 the petmit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (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 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.Q0 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (IlVDICATE TOTAL NUMBER OF EACH BELOW) BATH S(NK/LAV FLOOR DRAINS SHOWER WATER PIPMG BATHTUB GAS PIPING �Ntta� c7iTl.lt7:NSF:) SWIMMING POOL WATER SOFTNER ($35) CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15) DISHWASHER LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION _ WATER METER ,_,� OTHER ' i . �� <; .� , �:������� �; � `� � � � �� < _ �- � �* ,x , � �. � � � � � a� + � . � � '�� . � �' €. .:��: , .„� . :� s� . �� ��� • � < �. Permit Fee $ � _ _ _ � z Number of�fixtures (a� $10.00 x $10.00 = $ Surchar e- .50 Number of fixtures @$15.00 x$15.00 =$ TOTAL DUE $ Number of fixtures @$35.00 x$35.00 =$ � State Surcharge = $ .50 Tota1= $ THtS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL P�tOCESSED 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; that the work will be in accordance with the approved plan in the case of all work which re ui�es review a d approval of plans. SIGNATURE OF APPLICANT � PRINT NAME ATE f�,- �-0�7 :����r��. �': �H,�����,'�'�� `:��` S���r i �'+ , � r �€ City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977