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AF - 35687� � � � �o r o �� . � : o � �� . (A � :�'g :� � >� � : c . �' � ; � � � � : �, � � I vz v1 � o � 0 � � m � � � � � � g�+ �� pA � m � � � �s a, 8 � � � C i� n � � � � � �� . � � � � � p � � S � � °' � ' " � � l+i � • � e �o � O O y � G . . � ~• , � , � � O �e3 � �� . a � � � Q�: tD „�J, • 6'C : .. . �i . p' Q �W : °•° a . . : ' . . �, . . . : : : : • � : . . : ' . . : : . . . . . . . . . : • • . : : : , . . . . . . . . . 0 0 N al pl M M 01 il % if k 8 � O � � � O � � O p � « p a �. a o � o � + � I �� 0 V � � � �� A 0 ; , , ; D '� r � � � � 2 m v rC- m - ....1 : .■.■, � 3 ... ■, � �� • • .■■., � ...., � �� z � �, � � � � � ; � �. y = � a �' � � � � d � g � � � o :° � O N � ; �. > w�Ta a�os�rs t►au�wt r►rN T1J�S .�v►a SINIO TNA1fS DRINIf. FOU►IT. �. � �� GTCFI CASINS � w� � � � � OPENiqaS .. :. �+ � � . � � � n � �.a� �� g�� ►�.� � � g a. ci. � � Q, � �"'� i5. ° �S . � � � �� a�.� � ti��'m � � �..� � � � � N � � ' � � ti � � �, m � a . �.� �� R � � .. A �. � 3� � a � � � 96 �d � � �� q�° ~ � �° � ci � � � � � �. �. � � ' �� r�00 z � � �� , � � F w w � . � � � � sue�ecr PERM�D-.--....,_, City of Fridley 130'75 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T • � i � � t ; `L _ COMMUNITY DEVELOPMENT DIV. r j � PROTECTIVE INSPECTION SEC. I . ; �� _ �'°1 � CITY HALL FRIDLEY 55432 NUnnBER •'_•� � ,•� 612-580-3450 910-F15 JOB ADDRESS 5819 Old Central Avenue N.�. 1 LEGAL LOT NO. BLOCK TRACT OR AODITION DESCR. 8 Parkview 2 PROPERTYOWNER MAILADDRESS MAIL ADORESS 7 51 � ('.nn REV � � DATE PAGE OF APPROVED BY 7-7-75 � � SEE ATTACHED SHEET ZIP PHONE �32 74-0�79 Z�P PHONE LICENSE NO. �18 78L-9.5s � 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE � UCENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING Residence 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION �7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 9 CHANGE QF USE FROM TO STI PU LATION S 0 SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING AUTHORIZED IS NOT COMMENCED WITHIN 80 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. UN 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 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL FHE pER F PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR PER ORMANCE OF CONSTRUCTION. � PLAN C FE SIGNATURE F C N RACTOR OR AUTHORIZED AGENT (D �" �" �e u o�i i SQ. STAL�S GROUP OCCUPANCY CU. FT. OFFSTREET PARKING IGARAGES RGE AP.pLICATION FOR RESIDENTIAL, ALTERATION, OR AllllITION.BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: I� � I�t F�� . � n� BUILDER.: i L`�--� !'i -�.,J �/°�n, so,J � ADDRES S ; � � !�'`/ � IO � � u J4 d o N �' ADDRES S : _ � J / ,j , � �r i � ver � � v d- � � , ( NO : . � �i 1 , `L_ S TREET : � � � C� � i 2 � � u v.�; 9�/ � LQT:� B�OCK:�� ADDITION: �j��/'G� /��tOd CORNER LOT: INSIDE LQT: SETBACY.; SIDEYARD: Apglicant attach to thi:y form Two Certificate: of Suxvey of L�t and proposed building location drawn on Chese Certificates. � To Be Used As: HESCRIPTION OF BUILDING Front• Depih: Height• Square Feet: Cubic Feet: Front• Depth• Height• � Square Feet; Cubic Feet: �rpe of Construction: U�-- - Estima.ted Cost;_$ �J�a. � To Be Completed: The undersigned hereby makes applicativn for a permit for the work herein speciiied, agreeing to do all work in st�ict accordance with the City of Fridley Ordina.nces and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated i.n this application are true and correct. c- DATE : �% � % — % .1/_ S IGNATURE : �' ^� 6� (See Reverse Side For Additional Information.) . � �� _ •panssi uaaq s�u ��uedn��p �o a��xa� ��un pa�dn��o so pasn aq �ou �Z�us axn��n��s piES pu� :panss� uaaq s�u ��nraad �uTpTtnq E u��uM ao� a�n��nz�s �u� �o ��u�dn��o �o asn aq� o� zo��d s��P �OI) ua� ap�na aq jl�us �au�edn��p �o a��3��za� � xo� uo��zlddy ��N�dn��0 d0 �Zb�I3IS�� •�u�m�z� aq� q�tM uipaa�oa azo�aq pazinbaa aq IZzM `pa��nx�suo� uaaq ss� �� a�uo �uo��puno� au� �o uo��oT au� �utMOqs `�oi au� �o �an.zng paz�z�za� � •a��s uot��n.z�suo� aq� �o pue axn��ns�s pasodoad aq� �o Maznas xadoxd ao� c�wZt� o� `uoi��zZdd� �o antt� au� �aoa� s�no�, +�Z �o �¢nm.tuzui �e panssz aq Z-�ZM uoz�.�nz�suoa ao� s�zu¢zad :�yON 1�0I Z`dQNf103 d0 NOI,Ld� I3I2I�A '00'S$ u�eu� ssaZ aq Z uo�C��as uz u�.zo� �.as s�e �.-�mzad �uE ao� pa�z�u� aa� ay,� ZZ�qs as�e� ou uI •xaoM pasodozd jZ� �o �so� au� ui �oazaq�. uo-��.��z� ao (00"OOS$) s�ElTop paap�xnu anz� u��a xad 00'£$ 3o a�Bx a�,�. �� aq Tl�qs aa� aq� °a�n��nz�.s �u��.szxa ue o�. suoz�.�aa�1� ao saY�daz zo3 •�oo� pau��id ��o ajq�� uZ�em au� �o a�E�zns �oox a�,� �o �u�?au. pa��zan.� au� o�. zo a��ans zaddn au� �o s�u�iau a��zaa� au� o� z�1�a� aq� xo �uauzas�q au� �o auij aoo1� a�� Mo1aq sa�,ouz (g) xis �u-cod e w.ox� paxanoo �az� puno.z� au�. �uz�Zdz�.tnm. �q peuZUUa�ap si ° uoz�.zpp� zo �uipjtnq �Cu�e �o s�ua�uo� j��zqna au�. 65�iur.zad �uiplznq ao� saa� �uT�nduio� �o asodand au�. xo� NpIZb'I�RI03NI 'I'dNOI,LIQQd •�aa� �tqn� pu�esnoq� auo q��ea �o� S8'Z$ - S'4 £�d�y •s�ua�uo� I�e�zqn� u�ns uz `�oazau� uoz�� xo ��.aa,� �iqn� pu�esnou� auo �,��a zo� SZ • Z$ - +� � Z `Z ad� . �QO� �t�zazzng �xo3usti :�iM-o� papznosd uiaxa�, �auu�m au� u-r pu� q�zo� �as NioTaq utaiaq �unoure aq� o� � saa� �o ��w�.xad u�ns ;zo� �u��zZdd� a�� q �uaw.��d au� aaznbaz �aa�o�a.za�,� uoz�E�ildd�e uodn �azn�onz�.s zo �uzpt�nq �uz�sgxa �u� o� szY�edaa ��o uo��eza�t�e �iu� �o� zo �azn��n:c�s xo �uipt�Cnq �uz�szxa �ius o� uoi�YppE �tre zo� �o �axn��n:t�s ao �u-�pltnq �u� �o uo��axa a�� zo� s��m.zad �uinss� aao�aq �jt�us s�uZcpt�ng �o ao��adsul aqy •z KpIZ3�S .. , r S'If1Q�H�S ��3 ,LIL�t2I3d �NIQ'Iiflii_ C� � 00 C � °z � � 2 A t" r m m -� � O v m v� m � C � n � m � � w � D Z O � r � � .� O a r � rn m � � � c � `� � � W �s � o � � a � � O � 3 C7 m � b � c� � � � �� . �� m �,o� �O� �• 3 �� $ � �� Z v r � � 0 2 � �� e m m a°c°bz -�� f1i � �� .�� a� � � �� . � �� 3, . �'�� ;�� m � � s �6 z � �,�� , =� ,�� , , �,, ,, � � �0 ' � o . � , , . � v o I I „ 1 �� I F I � I I I I � � d 0 � � � r Z C rn � 0 0° 00 � � 0 � D � .� � z c � � C� -.. � 6 � r ��, �� w��,�� v �,1�"'►,�,`'�oo,r1aoaao g$ g g� g g g$ g S g W �: .,, . � m � � • 0 � � �� -� � � � z 0 . r� � � d m �, o. , � � m O y. v �ra � � G 1 '�' � I� N 0 � lS� N •o� m -I � � � � � � c ._ � a a �� , a o � �� a ta y� O � � a � ��'�� a c° at � •o w .�.� 2 o m ? dl "'� y� c'n' a' 'r a, ? a � � � b �� i a � na o �• � � � ��' �Q�� '� �� °� �� a.�,�Q � � o a: �p r�. ��o m �. � � � VJ ..� N ro � � � � � o� � n � � � m � � z 0 � � O � r L O � n C� � �� , � � �N �� cn `_� c � r� � �, O 1.. � � � �d r �� n� � � m n � 0 Z d � a.�a•d zve•oN sNOS �a3azn��w wdse:b se�z•aa•�nd a��ee et; Pe� pe3zn�, jo sua��g�oua� � woa•suos�u�e��n��w�� . LL96-ZE6-�56 3�dd 9L96'Z£6'Z56 � t��-�t��gg �yyy 'sut�do� �ncr� anUVnb �izT gog , ;� . � ��1!�� al�� .Y� �� - t� � �o��,h � �� _ ' `t'" �� ' �' t'vu,�fa�r� fiy� � ��p�,F� -�� ` =�� }e--� �'`. � � ;�, z.� i � d �.v0 • oN a�� Q�«opa �i ��la�A�� u�Awn�d �IV�� " ��1�� SNOS '�3�1I��W IJdSO : b S00Z ' ZZ '�(ld pCT-12-2005 10�28 CITY �F FRIDLEY Buildia �„ Inspec :ipns 763-5r ��3�04 .�... �TJIL��N� RESID�EN''I'IAL A�'F�YCA►�IC�N' CITY" OF F�I,EY P . ' 'iO3 Fermi.t Ivo. � �.��.� �� R�E2V � � � '— — . � J�ate R �c'd � .�� DA'f$ YO1Jl� �-MAII. AD�RES5 _ _ _ STfE ADDR A S � ,% �� '`� �� _ . _ �. . rxts �z.� :, �r �s: o o�x�x ocorrrx�crox i�1tOPE�t �' X()WN�Yt/ N�; s�n ��t �, S c✓� i�v� t --- — r-�- TE i� ANT ADpR�SS: CITY S' 'ATE Z�.' _... ,� �'k1C>NE: CON7 `FACTOR NAN�: _ . r.. — . - - SU$Mi" ' A COPY OF STAT� L.tCENSE � �- / � v•`-�... � DATE _ YQVR ST A TE LIG�NS� ALURESS: C1TY _S7. 7E_. ?n . iYJITH A ?I'LICA'�'tON PHONE FAX �'�tQp� RTY TY�'� ❑ SIIVGLE �'A1�D..X/NEW CONSTitUC7xON SiZE --T -- -- O Ti�►O FAMII..Y/NEW CON TR[3CTION STORI�S P�Y�1"�:T TY�� ❑ ADDITtON CI CyARAGE/SI�D ❑ WIATDbWS --- �- - O SASEMENT FINISH � ROOF O D� Tfl F ❑ DEAC SIN71NCr ❑ OTf�R ❑ SWIlvIlVIDVG POUL _ . �_ �. . 'TY'pE a F waRx: o rrEw o nrrior� D MAII�tTE�iANCE/REPAIEt O Tt�MObELW �ESC� � �ov0itx aE�G �ox�: � �� - `C� — — .— - 5IZE OF: Dg'R4VfiMENT ._ ROO Ni3Ni8FR C �F SQUARES �, C�ARAGES PROPI7S�S SiZE: PROPOSEL i�EIGHT: 1bi7Vty D v'myt ❑ Aluminm a D bther � _ VYfh1bOW'.. IN EXtS�`'G QPnJII�GS OXes �No OR FOR Aif :G�' OP�I�SINtiS-D�^CRIBE 5lZ� dF OPENENG � :i�iANCYES & TYP'8 OF V'II 7DOW T(? BE iNSTAt .i _�n C3 Ii0U5� & GAR.4t3E O A'TT'1#CH$D C�rAiiAGE ❑ DETAC�D (`iARAGE �Soff(t � Trim 0 Fascia LOCA?IpN OF WIIrIDOWS NUNIS�t OF WArTAQWS A:,1:, �'EES A,T,tE BAS� ON V.4�LUA'TY�N, INC�IJJ.1]N� Ti� COS�` OF (il'SYNC Tl� ].997 i7.�.0 FEE SG'�DITL�) HEIGHT' _..� . �.. 4i � L BL�SEN,i�2�7" 1�MOD�I W�r; ('�j t; i. Existing F1�t Piaa 2, �ed flaa p1ar� 3. Lisi of structt� �al me � ycrs � o be � sd FdR 13�W CQTI3TRUC ;TOt3 r!CI.I DIT : DE�Y�S, ADDI7TON5. ,,� '�S S� E Iv1IT �. Site P}anf5un :y shc +�ng G i� �� ing strucnsres snd propos�d >rojcc 2. itvo sets of a nstauc i.m pl ms 3. Enc['gy Caicu atit►n5 ANA 1V,[,A�TE�tI �iLS . � � _ TOTAL JOS YAY„Y3ATION � OCCY7P'ANCX TYPE P� e � , �S $ . See $ack Pa.pe �or Fee Schedule . � � . Pla� Revi e�v $ 6S% of Buiiding Permit Fee Surchar;E �, t� � (.0005) times tb�e'�tal job valuatzaz� — Minimum S.5( Fire Surc' �arge •. �� S .001, x pen�it Vaivation (1/10%) License � w�claarge $ 55.00 (Stat� �.icansed Residenii�.] Cantractors} SAC Cha �ge S $�450 per SAC U�a�it (�]ans to MWCC £or detezmina ion) Cuu�b Cut Escrow $ �+ 5 ft= ft x$20 = S Erosion t�o�ol $ $45Q Conservation plan Review Park Fee $ Fee Uetermioued by Engineering Sewer M, w� Ch�rge �-7 � ,A�reement necessary () Non Necessary (} Tata1 Au e ��°°� /$ - N1ake checic5 ps�+able to: City o� �ridIey �.tt�c d��ul: t Jns ..��_ �� .�-. ..... T1;IS IS A13 APPLICA'C10N F4R A P£RMl't 130T V.q�..iD UNTlL PROCESSED ; I hereby appiy �or a build�� permit amd I aelaxowled�e t�at the information above is complete and accurat :; th, t t1�e w+ r: wiil be iu� ' conforma n�:e with the ordinances and codes of the City of Fridley and with ;tb�e Mimuesota Constructioa Codes; t? �at I;�der �t� : t3�is is not a� parn�ut bi t only an a�lication for a permit azad wurk is not to start without a permit; that the work will be in ac aord: r ce � ritt ��e approved � pian in d� � �ase v� ell werk which re�uia�es review and approvsl of plans. � ._. , � SiG2�1ATU1:E OF APPLICATIT sn '� PitIN� k�AME �!•? �''e `= SG+'' DATE. /D '° /3,_�$ I i � ��j� L � D �/�'�l� �'ivd�-� � �..�-�& �°� ��`� �� ( Building Inspections 763-572-3604 763-502-4977 FAX PLUMBiNG RESIDENTIAL APPLICATION CITY OF FRIDLEY DATE eD�� YOUR E-MAIL ADDRESS SITE ADDRESS i CF N r 2/� L .�� t/ ,� �% � 'i'H1S APPL3CANT IS: O OWNER �CONTRACTOR PROPERTY OWNER/ TEN ANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND CERTIFICATE.OF MSURANCE PERMIT TYPE TYPE OF WORK: NAME:_ ADDRESS: o ,� , .� /Z �; e � � G- c � �j'1�'� / e i-,.J; l2A-L �-cJ� C4TY �r2'� J t� PHONE: ",/03 - ��/- ��y3 NAME: STATE LICENSE # �' � � �� STATE BOND � ADDRESS: PHONE '�I � � �� `� �� SINGL£ FAMILY ❑ NEW DETAILED DESCRIPTION OF WORK � TWd FAMiLY Permit No.: Received By: Date Rec' Terry Overacker Plumbing, Inc. 502 E Main Street Anoka, MN 55303 �REPLACEMENT � TOWNHOUSE ATE�t�Z1p `�S �1'3 TATE Z�P PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the totaf cost up to $500.00; whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This s Xouo15 reflect only thp]USS50 s�urcharge Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor FOR PROJECTS WHERE LABOR EXCEEDS $SOd, FEES ARE BASED ON $IOO.00 PER F[XTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELON�. MINIMUM FE� $I5.50. SHOWER WATER PiPING BATH SINKILAV _FLOOR DRATNS — WATER SOFTNER ($35) BATHTUB GAS FIPING (NEED C1TY L(C) ,_ SWiMMING POOL — BACKFLOW PREV. ($IS) CLOTHES WASHER KiTCHEN SINK _ WATER CLOSET —. — WATER HEATER ($35) FOR tRR1GATlON _ DISHWASHER _ LAUNDRY TRAY — �yATER METER _ OTHER Permit Fee TOTAL DUE $ $ .50 �r s�;; �,�:„�., :�.�:,�, ,....,., .,,._,,.,. . _. ._ Number of fixtures @ $10.00 x $10.00 = $ Number of f xtures @$15.00 / x$15.00 =$ � S cp ° OR Number of fixtures @$35.00 x$35.00 =$ 50 State Succharge = $__�. (MINIMUM $I5.50) Total = $ �� (MINIMLJM $15.50) THIS IS AN APPL1CATiON F(3R A PEFMIT-NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and wo is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all work which re tres review and approval of plans. � —�/-F G 6G � � dC� PL .a .�sJ � DATE � � ° r � � SIGNATURE OF APPL}C / PRiNT NAME .p . �% . _ a n� DATE `�% DO APPROVED BY City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 From: 7632626201 Page: 1/3 Date: 10/7/2008 3:10:06 PM FROM :KASPER EXCAVATING LLC FAX N0. :7632626201 Oct. 07 2008 03:11PM P1 �rom: Ciry vf Frid��y Tc; 783262�2C1 ?age: 4:5 Date:10/7/20C811:42.24 �4M �uildi�g � � � Vl�AT1�+ R (�I� SE1►�V.ER . pzrmit ��,.:� _ �. � `� U�_ �i�pec:ti�n� ; �L�+�1�MYT' �,�$"�ICATI�N x . ;d. � :�'� ��3-�,?-:�c;c� ' �� C7.. 8...2 0� � CIT� �lF �+,��;Y D� � �:... ... _. 7C?;-502-4977 f$x ' �;�:�t�-rivr !-�-ur .. . -- �-- �rr�.ic�7��r; a4Te: ..._.._. /Gf — y-�'� --,.--.-.- -.-.— i u� � �.•ti4.�1L 4U�?Ft�:GS: . ._. . . _..—_. __......._..._.. . ......... . TH15 APPLIf`A�1" iS: �.EON'ifZhCTUIt ❑ �Wi�'El� Jt]B ADL7PLESS: .. �1'� G'.,R�,� 1�U� ��'� �✓'� NNV4' C'UIvS'l':tliC"I'{UEv Y�R.�fl'l'�(i1r'AYf'Lli.:,��iLL•.'>: PRt]L�ERi'�' i ri'AME f��_.iva:l.C�!r� i", !f, , � �� . . . . . _ . . .. _.__.._.... ._..--� �•- •- --�.— ...___..,... UW'I�L-",rir ' AUL1lLh�5: S`Srii , C.R�+�.VI _I�Lr,e+.t�_C11'Y': ,�".ya.s�r�„ tiT.�,TE; N7!!/'Lli'3'3's[7� T�:�.�ivT t'HUK E: _ � � � 3 - �`�/—.�.+Z�!.� . . . . . .. _...-•--•------•--•---.... -- (.`(�f�f'k''EL�CT'OR i NAa'v[E: ,••9�'�` �as�o� vo?'P«� . Sltx�ilT A COPi' C�F � .4.DDRESS: . . '�5y' C"; ,'Y: ec ,• -- �.1�"'.�.— ---�-- ..... . . ___.. _. . . _ __-��_._ .. .. 5 i:arF� sLJ 7.1P:.f'�� ' YDLtR STr10E i_IC£NSL I PF�OA C:. �_---•• -• .. .. ..---..._ Ci:l. i. !'1•lUh�: .4l�G BOtiU ; ST'AT'b LIC: C�► � > . ... .-• - -••----••---- • • - • 76l $t'�=�1�.� _ . .� T�T � BUI�'D --•---..._.. F:�P: � N�+:iS.IVi�'i"!'1r Pl+: .riRWFR C't�V'JT't:"I'3C)N !'FRMFT �-i) WATER CU�I VF..C�TI{��1 P�Ri,i1T �=t) WATER�5�1�`F..R �f: [1iF,, R�PAIk pFR�t?T �t� (�' � � —�_ , . � ..-`-°�—: _�= .. _..._. .ADD ST.�.T�: SC.I�tL':HAR(�� _St� ° � S!LC: C;�,c,RGF ----•- :ri: �bl K?S -._.. ..... _ TOT.�.I.. � � � __. � ��9 . (D't'HER GI�A��S tiF �r�c,scaQS.�:� ��- �c� L�r�Lfr�• �ita.�!�c: Vf�� i�'ATr.R i�fETF.R C'C)ST �--!T:LiTI'1?1LL:�c, sPr,-.c-:i�L ��saL��,.F:.'vi's �:��: rt,.,��t 4VA'I'FR TAP >-� i��:l��:E�ii!�a ��T�: 1Ur�TER 1�IE'Z'FR kEPAIR. �V�� (�!Z ��i fT'i�F� : i�'L'�i�.k�i:�.t.:i•;:�J.:`.'S �1 �' r a"�l'��:��[Z.�.�i1, ' 7'Hl$ IS Ati .11'I'LlC'.47'IC?�V !'t:ft .a Nt;i1WiT :�vT1 i vAL117 li;�T1L I`!t('7Cr5]tL' f I:�rcb}� rtp�,ly !ur u wx[c,• ur ;+��,;;r (�:c;�� _��s•�ricsriur ur r,�cir; ,:crnlit Gitd 1 acai:uL:�;t��g� t1�st !Itc• ir.fvrmuti�:sn ;1x:tc i. cc�n:p;ct� ��L ;�acur'�tte; th�lt' 8�C �t��rl. �r•it! b�'.n ccr:tbrrrsA�,��t w�iti� thr or.a.ir�r.c.:, anci cu�'c. a' th. C':ty p!':=ri;�;ct•. 1.�r�c.vr�s��c; L'!:s �, �s�i: a p,;n�i; �� an1N an ap��tra«,n :ur d�?C•PltllT lt1+fl; '�; nat tc� start w' h��ut �: �cimit. SItiNAi't:RfiOF.��'PLlCA!'r'T:,�� _ _ _ __._ �►Rlh'T\'<Ac14��'!�!!1_'yis��` QQTf= i$'"7' ..� ._... • � . ... .... ......_.._... APPt��4�Fn 8Y: �• + ._ .. _ ---- �• .. . . _ , aa-rF t��l� c�,v�ra ro: ��Lrr� �t�.�.txa �-� --... . _ . . .._._.— ----- � �--� City of Fxidley Buiidi.�� inspectio�ts Departmene 6�3! Uni��r;iry!'�yenue :VL-, �"iidle��r VIV Sa�3? 763-:�7�-3(�t}� ' F11Y: ?fi3-S02-�F�)7? �� . �a `j u � ✓ �� Building [nspections 763-572-3604 763-50?-4977 F1�X BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE I-1-08 DATE Pd /a3��8" YOUR E-MAIL ADDRESS srrE a.nDxESS SS/9 GF� r��a r4U� � THIS APPLICANI`1S- ❑ OWNER I�ONTRACTOR PROPERTY OWNER/ TENAN'Y' Permit No.: �� "�' Received By:l � �t` D�C�� T � 3 2008 ADDRESS: SS'I � G�� E S� CITY �2�l�/�y STA �� d� PHONE: 7�3 " S7I -� &''�.3 CONTRACTOR ADDRESS: Od �!� P�4%�l,E 1�� d'U � CITY ST. Na SUBMIT A COPY OF PHONE F$�"'7 y' SS �a F� �� -��y� YOUR STATE LICENSE STATE LICENSE # e�0 0�% � r7 �o�D EXP DATE _ PROPERTY TYPE I I�SINGLE FAMILYMEW CONSTRUCTION ❑ TWO FAMILYMEW CONSTRUCTION PERMTT TYPE fl �DITION ❑ BAS�IvIENT FINISH ❑ DECK TYPE OF WORK: I❑ NEW HOME CONSTRUCTION fiCMARJTENANCFJREPAIR DESCRIBE WORK BEING SIZE OF ROOFING �� ANMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: � V'iWnyj �OS� = ��0 �✓ ❑ Alnminum ❑ Other WINDOWS IN EXISTMG OPENINGS �Yes �lo OR FOR A1EW OPENINGS-DESCRIBE STZE OF OPENING CHANGES 8c TYPE OF WINDOW TO BE INSTALLED :D ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: �OO(�,j�ING T�HF�9��7�C FEE SCHE OCCUPANCY TYPE e� ❑ ADDTfION ❑ REMODELING ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE OSoffit ❑ Trim O Fascia LOCATION OF WINDOWS �d� NUMBER OF ❑ WINDOWS ❑ DRA1N TILE O OTHER L 3 ATE I'�ZIP S� FI' BASEMENT REMODELING SUBMIT: I. Existing Floor Plan 2. Proposed floor plan 3. List of siructural members to be used. FOR NEW CONSTRUCTION INCLUDING DECKS, �nrnTtnl�ts_ & PORCHES SUSNIIT: 1. Site Plan/Survey showing the existing structures and proposed project 2. Two sets of conswcrion plans 3. Energy Calculations ALL FEES ARE TOTAL JOB VALUATION $ Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge G�rb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ $ �� $ � $ $ $ $ $ $ L , See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1825 per SAC Unit {Plans to MWCC for determination) ft+6ft= ftx$21 =$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach THIS 1S AN APPLICATION FOR A PERMTT-NOT VALID UNTIL PROCESSED 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 on site; that the work will be in accordance with the approved 1 in the case of all work which requires review and approval of plans. / SIGNATURE OF APPLICANT PRINT NAME Q�^�` C��ir�� DATE f�/3 /0� APPROVED BY DATE ' Page 2- Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building O�cia1 sha11, before issuing permits for the erection of any building or stxucture, or for any addition to any existing building or structure, or for any alteration or repair to�za3� existing bu'1�1.� or .�cture, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE FEES $1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for 1�` $500 plus $3.05 for each additional $100 or fraction, to and including $2,000 $2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional$1,000 or fraction, to and including $$25,000 $25,001 to $50,000 $39125 for 1�` $Z5,000 plus $10.10 for each additional $1,000 or fraetion, to and including $50,000 $SO,Q01 to $100,000 $643.75 for 1�` $50,000 plus $7 for each additional $1,000 or fraction to and including $100,000 $100,001 to $500,000 $993.75 for 1�` $100,000 plus $5.60 for each additional $1,000 or fraction to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each additional $1,Q00 or � fraction to and including $1,000,000 $1,000,001 and up $5,608.75 for the 1�` $1,000,400 plus $3.15 for each additional $1,000 or fraction VERIFICATION OF FOUNDATION Pernuts for construction will be issued a minimum of 24 hours from the time of application to a11ow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will bs required before proceeding with the fraxning. New Houses Onlv City of Fridley Bnilding Inspections Department 6431 University Avenue NE Fridley, MN 55432 ' 763-572-3604 Faz: 763-502-4977