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City of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ' � � � ECEIPT NO. � `L _ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. ��% � 9 1 = � �� /'��1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY ""� � ,`� 812-580-3450 910-F15 6 27 ?7 � � JOB ADORESS 6062 Central Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oesca. parcel 246 N� of Section 24 SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Thomas A. Gray 6062 Central Avenue N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENOINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASSOFWORK � NEW ❑ ADDITION [�C ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof dwelling 9 CHANGE OF USE FROM TO • STIPULATIONS Install ridged galvani.zed nalleys. New roof can be 2nd but not 3rd roof . SEPERATf P�RMfTS REQ�fiRE�i F�R WfRll�, M�ATING, P�.Ui1�8iNQ AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAp SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATINO, VENTILATING OR AIR CONDITIONING. (;e(ia,Y' $jZa]{@ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. 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. 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 SUATAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S�-iOOO �`.SO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAI LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � $7 • 5O PLAN CHECK FEE TOTAL FEE �S`8.00 SIGNAT REOFCONTRACTO RAUTHORIZEDAGENT IDATEI 1/�IHEN P PERLY VALIDATED THIS IS YOUR PERMIT � ' ' G-,��—?�- � � ��-�7 SI EOFOWNERIIF N BUI �DERI IDATEI - BLDG. WSP DATE � -- —� _ —�_s... .=_a�_s .fi�'1°'' iNif�;'i;� � �_._„s.= _.�._ ._,� �� ,�,__ _r.,� __.a r _ __�_ ___Y.._ � D �``��_�� a�.� �� i � ��. ., . . ` .° �v. v � 1 <.5 ,��'�1 � F T -, 9 f T 7, - Q � �� '�� i �� .� ,�-�� ,. ��.-Q � � w — �i �� i � " , ' — • . 9 _��,, : � e ..VI�I.�I��'9M9 . . ,,. � ,.��..r� �"; �, .. , _�'s � � � ,,,P',�°� � ' V _— �3� t��1f��9��,9� ariY. t; H� ` o� �� 6 ♦ Y.� �r�J�41+7y }1� . �.r i r� __.__ _' � ' '� ' _ �y �-..-.- I. �R.:C 1' 7 : . I �.� .cJ� �_ _ 3:;a� �' Tl� a a . .138 �' � SC 'r��31A= � ip�.� yYi.l e�.,�..z � � � , ` � �C��'. 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No.: Street: LOT: � o�I�gIACY.: CORNER LOT: INSIDE ?AT: Tel. No.. '� � ADDITION : !l1 ''� -, � S;sTB1�CK : S ID�YARDS : Applicant attach to this form �tao Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING e Used As: � Front: Depth: Height:a Square Feet: Cubic Feet: Front: Depth: • Height: Square Feet: Cubic Feet: Type of Construction: �j�i°Q(� }�) �,� �� Estimated Cost: $ �� To Be ComZaleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SE REVERSE SIDE OF SHEET) The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance �vith the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. See reverse side for a itional ' formation. � DATE: _ �� 5IGNATUi'.E: ` , � f Stipulations: l`�(�'l . �-�° � �V ' : - � G BUILDIPJG PER��IT 'FE�. SCNEDULE SJ:CTION 2: The Inspector of Buildings ,hall., i�eLora i:�suing ��er.mits for the erecti.on of any bu�.lainy or :;truct-ure, or f��r any acic7i.�ion Lo -any cxisting buildiny or. structurc, ar for any altcraL-ion ar repairs �o any cr.isting Uuilcii.ng or structurc, upon aj�plicatiaii_ therciore, requir.c the payment by the applicant £or such rermit of fces to t}►e amount herein bclow set forth and in the manner herein provided to-wit: NEW CONSTRUCTIOPI: Sinyle r.•amiiy Homes and Garages: $4.��/1,000 cuY�ic feei.. PLI�N C1iLCK: 25 percent of building perr,iit fee. DRIV�WAY llLPRESSIOP�: (Concrete Curb Streets Only) Alternate A: itemoval and repl.acement of concrcte curb and gutter only; Driveway width plus 6 feet x$11.75 Alternate B: Removal and replacement of concrete curb and gutter.and install a 3 foot wide approach �•�ith 6 inch depth; Driveway width plu:.� 6 fe�t x$15.40 ADDTTiONAL INFORNIATION For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a noint six (6) inches below the floor line af the basement or the cellar to t:ne averaRe Yieignts of the upper sv.r.face or to the average height of the roof surface of the r►ain gable of a pitched roof. k'or repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 l�er each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. � In no case shall the�fee charged for any pez:mit as set forth in Section ?, be less than $7.5Q plus $.50 state surcharqe. EV RIFICATION OF FQUNDATIOfV tdOTE: Permits for consi:ruction �vill be issued a minimum of 24 hours �rom the time of applicati�n to allow for proper review of the proposed structure and of the construction site. A Certi�icate of �u�rey of the lot, showing the lacation of the foundation once it has been canstructed ��ill be required before proceedir.g with the framing. CtRTIFICATF Q.F OCCUFANCY application for a Certificate of Occupaiicy shall be made ten (1G) days prior to the use or occu�ancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certifica�:e of Occupancy has been issued. ■ 4_ ` w _,= sue�ecr PE City of Fridley 15182 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �� r ; � RECEIPT . • COMMUNITY DEVELOPMENT DIV. � LV � � � / �/ r � � PROTECTIVE INSPECTION SEC. 9,�'� fv 4° I = � � /�"1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �"'"'� � ,�� 612-571-3450 910-F15 5/11/79 � � JOB ADDRESS 6062 Central Avenue N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. PdiCE�. 24 O North Half of 5ection 24 SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Thomas A. Gray 6062 Central Avenue N.E. 571-3933 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS 21P PHONE LICENSENO. B USE OF BUILDING Residentia.l 7 CLASS OF WORK ❑ NEW �7 ADDITION � ALTERATION ❑ REPAIR � MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 23' x 26' Additi.on and a 24' x 24' Garage 9 CHANGEqFUSEFROM TO STI PU LATIONS Provide a lzard surface drivewaye Provide combustion air to furnaceo 1 "�,rt�l., .v►� �L�vr► �i-, ck�-/u � �s�� a � Ay �1AR�WHG Bef�e dtgging 1�11 loca! util�fes � ��NE • EtECTRIC • Cp$ Et�, REQUI�g�p gy �y� �EPERA'TE PERMITS REQUIRED Fp}Z y�RE�, H�T�NG. PLUM8ING A�1l� SIG4V� TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICA�, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. WOOd Fr3ID@ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF I.AWS VA�UATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE �RANTING OF A PERMIT �S`3S�ZOO �`�.9.I.O 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $9O.OZ NONE PLAN CHECKFEE TOTALFEE yfiGGS SQ �131� VZ - IGNATUREOFCONTRAC�ORAUTHORIZEDAGENT IDATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT a �� C�� s—/J—% SIG REOfOWNE E I ER� �DATEI BLOG �NSP �ATE . .' .; �ITY OF iRIll�EY , � � ' /�PF'LICl��r�o�� rar� RESIllf_fdTI/1L LUII..DING ('ER��ITS . ' ' (��C�J, �LTC{Zl1i"ION�, i�DDITIOtJS,' OR REP/�I(ZS) . . . . • . � . � _� • . orn�»R: � � �UZL�a:R: �� ' ,. �� i � , Addgess : ��, Rddress s ..��.�,c� _ __ . Te].. Ivo. : ,��/ '�"�. � - 0 No.: 5treet: y,pxo �G��%Cl� BIACY.: RDDITION: CO1tNER LOT: INSID� IlJT: � SLTBACY.: � SIDEYAItDS: Applica'r�t attach 'to this foxm �o Certiiicates of Survey of Lot and propos�d building location drawn on 'these Certificates. • � . 3 DESCRIPTiOPJ OF BUIL.DII�G To Be Used As: Front: d� Depth: � � ' Height: � � " Square Feet: Cubic Feet: Front: O� �_ Depth: o� Height: l� - ' Square Feet:_�` Cubic Feet: � Tyge of Construction: Estimated Cost: $ � � . � 3$. Zo� 7b Eie Completed: � A1�. A Alt. B Praposed Driveway Width If New Opening Is Desired S $ ' (SE� Ft�VERSE SIDE OF SHEET) The undersigned hereby makes application for a permit for the work l�erein specified, agreeing to do ail evork in strict accarda�ce with the City of F�idley Ordinances and rulings of the Department of Buildings, and hereby deelares �hat.all the facts aiid re�resentations stated in this application are t�ue and correct. See reverse side far aclditional inf ation. . �13�1TE: �` �� % SIGNATURE: Stipul.ations : - Cj� �Q.o�,�w N ��o �►�c � ��; r. q 0. 02 Q ct� u�� • Pa�� 22• s° . T'iG t�j . � � . � 131.�Z . a � ptZOv.�, c� � V sT1 v•+ 1� �K , . � . 0 ' � �,a. tz �tl w� �Irc�, • ; ,.::,,..__ _,. .� , . . ...�. .. _._ . :_ .. : . . _ : , �3t;iL�Ii�G P�R(�IT FEE SC{{EDULE . , . . , .... , .�.,Y�, �� SECTZON 2. T'he Inspector oi 13uilclings sh,all, befoz'c' i:,s�i.ng g�crmits for the erection oi any bu::lding or structl.axe, or for any adc�itic>n �o any er.isting building or structure, or for any a�.teration or r.epairs to any er.i:.tiny bui.lding or s��vcture, up�n ap�licatiion tiheref'ore, r�quire the �,�ayment by the appl.icant for such permi� of �ees to the amount her�in below set forth and in 'the manne� herei.n provided to-wit: N�t�� CONSTRUCTSON: SingLe T'amily Fiomes and Ga.rages : $4 . 00/1, 000 cubi.c fceet. PLAN CHECK: 25 percer.r of building permit fee. , DRIVL•'�JAY D�PRESSIOPJ: (Concrete Curb Streets Onl�►j • AlternatP A: Removal and replacemen4: of concrete curb and gut�er on1y: Driveway wzdth plus 6�eet �$,b5.75 . Atternate B: Removal and replacement of concrete curi and gutter and install a 3 foot wide approach with � 6 ir.ch depth; Drive��ay width plus 6 geet- x$17.85 DDITI�PdAL YPIFURMATION For the purpose of computing fees for building p�rmits, the cubical cantents of any building or addition, is determined by multiplya.ng the ground area covered from a point six (6) inches below the floar line of the bas�nen� or the cellar to the �verag� heigh�s of iche uppea su�f�ce or to the average heigh� of the roof surface o� '�he �tain gable of a pitche3 roof o For repairs or alterations -co an existing structure, the fee shall be at iche rate oi $3.00 per each five hundred dollars-($500.00) or fraction thereof in �he ca'st of all proposed ��ork. � Xn •no case shall the fee charged for any permi.t 3s set farth in Section 2 be l.ess than $i.50 plus $.50 state surchargeo ' ' i . � � , � , , 1 : . � . NQTE: Permits for construc�ion will be issued a minim�n of 24 hours from the time of appiication ta allo�,rfor proper review of the proposed struc�ure and of the e�nst�uction site. . A Certificate o£ Sur.vey o� the lot, sh�wing the location of the foundation once i.t has been constructed �ti�ill be required before proceeding with the iramingo ► ' � '=► App7Lica�ion for a Certificate of Occupancy shall be made ten (10) days prior to the tase or occupancy of any structuz�e for which a building ,permit has been issued; and sai.d structure shall not be used or occupied until a Certificate of Occupancy has been issued. � r . ��,� C�p�� - CD�►�...��. 2y xZ� � S�G � X� �" �� Z 3•c i� �� x � ! 1�' �e..o4, 2'lre2= � S'�Y tt Fl � z�� 3•�'Z.� � S1 � �c 1'� '� ��a � �!- y �Y� �-� �4'i �`'� �Y �• � l 7 t. �-► � Z2� Sa`f s°�� x � �-3� � 4p� 1� .: �;� x �' �.a� A� 3a�•B� �� k `� ?5.3� '� �5� �43►2'L �� Y � Zs.35 = IS� IY3.tt �g� �-13, y�i a,. _ ��-�� . -t.2. Soy �c �}. o• �.�a � 9d.o'L P�.�s� u� � 2�..so .�6 �.-1,1� ,£� 1Q�� _ �-1... �� - . � 3�, 'tpo ENEFkGY CO:�TSFFiVA'PiON 5UPPLEMI:YJT TO BUILD�NG �'�P,MTT 7�1•'PLIC11'L'ION PI,AIdNING I�I�tD INSPECTIQN DEPARTIN�NT , CL'i'Y OF FRIDLEY, MI1VIdESOTA This supplernent is provided to assist the applicant ir. camputiiig F:XTERIOR EN�'ELOPE AVERAGE "U" FAC�'OR SNFURMIITION. This informati.on is requ�red �� the BUILDI:dG OFFICI.�L can deterntine that submitted plans c�nply with tki� ENERGY CONSERVATSON DESIGN CRITErcIA of 'che STATE BUILDING CODE (Sectior� 6000). Tt is the APPLICANT'S responsi�,ility to accurately compute the data; zeflect i:he proper DESIGPd CRITERI?1 in the plans; submit product specific:ations, if needed to support the "R" and "U" factors used; and to assure construction is per appraved�plans. JOB LOCi�TION: OWNER/CONTRACTOR: / ADDRESS :� fi/ �� 5�- [%2%�% PHOIVE: Gj�� ,3� A. Determins the Total Expc?sed �9a11 Area as follows: � l.! Total wall window area 2. Total dooz area ' --�r Total sliding glass door area '�4T" Total fireplace wall arP�. 5." Toital wall framing area (.averaye .10%) 6. �.'otal net wall area above f 1_oor (average 90 0) 7. Total rim joist area � Sul�tc�tal: Tot�.l exposed wall area above flo�� :° Total fouiidation window area 9. Total ne'c foundation area above grade Si:btotal: Total expased foundation axea GRI-�i�TD TdrAL EXPOSED ir?.�-1.LL AREA G � s� P� / �� P � �� « / �' `�` � �� `� � ��-0 � �N � ,' B. Multiply the GRAND TOTAL EXPOSED WALL AREA X.17 = C. Determine the Total E�posed Roof/Ceiling �rea as follows: � Total skylight area 11. Total roof/ceiling fraining area (10�a) 12. Total neic irLSUlated roof/�eiling area GRAND TC�TAL EfiPOSED ROOF/CEILING ARFA _�____.__.— �c� � � �� D. Multiply t_he GRAND TOTAL EXPCISED i200F/CEILING AREA X.Q5 = . � �� " �` � — . Item I �� , ` zt�m r_r. � �' , E. A�termine the "U" value of pach segmenL• (1-9j and multip�.y by the area as • follows: ' l. X "U" _ � 2. X "Uro _ 3. X ^U" — -- �. X uUn = 5 . X �� U" _ 6. X "U" _ 7. X aU° _ 8. X niln = 9. g ��U�� _ IjDD 1-9 FOR TOTAL H7ALL SFGMEIdTS, = ITEM IyI i F. Determine the "U" value ot each segment (1�-12) and multiply by the area as follows: � ` 10. 11. 12. X "U" X "U" X "U" _ ADD 10-12 FOR TOTAL ROOF/CEILIIVG SEGMEATTS = ITEM IV G. If Item III is the same as, or less than Item I, yau have met the intent o� State Building Code 6006 (c) 2. ii. If Item IV is the same as, or lass fhan Item II, you have met the intent of Siate Building Code 6006 (c) 1. I. Add Ttem I J. Add Item III . + Item II + Item IV e K. If the sum of Items TII and IV are less than Ite�ns I and II, you have met the intent of the Code for total envelape system. The undersigned, as applicant for a building permit, hereby affirms the above information has been prepared and submitted by himself or under his direction, her�by acknowledges the information to be correct and accurate; and hereby presents the infornw.tion with required plans in support of the building pernu.t application. BY � + DATE: F � sue�etr p City of Fridley 2 9 3�9 AT THE TOP OF THE TWINS g U i L D I N G P E R M I T f � � 0. ; `y _�� COMMUNITY DEVELOPMENT DIV. M�,.,,,,,,/► r � � PROTECTIVE INSPECTION SEC. ��w�dl��'�'��' �� i � ' `-__- �;��,'; CITY NALL FiiIOLEv jj�32 NUMBEF NFV O�TE PAGE OF APPROVED BY ` „ 612-571-3450 910-F15 4/28/99 / / JOB ADDRESS 6062 Central Avenue NE t LEGAL LOT NO. BLOCK TRACT Oii ADDITION SEE ATTACMED oescA. parcel 24 0 N� of Section 24 SFIEET � PROPEFTY OWNER MAIL ADDRES$ 21P PMONE Thomas Gra 6062 Central Ave NE 571-3933 J CONTqACTOR MAIL ADDRESS 21P PMONE LICENSE NO Sela Roofing & Remodeling Inc 4100 Excelsior Blvd, St Louis Park, MN 55416 d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PNONE LICENSE NO. 823-8046 1050 S ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILOING Residential 7 CLASS OF WORK O NEW 8 DESCRIBE WORK Reroof House & Gar 9 CHAN(3E OF USE FROM STIPULATIONS ❑ ADDITION ❑ ALTERATION 70Sq) Tear-off TO � REPAIR ❑ MOVE ❑ REMOVE Underlayment must comply with the State Building Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. SEPARA7E PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATINCa, TYPE VEN7ILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION 20N AUTMORIZED IS NOT COMMENCED WITMIN 80 OAVS, OR IF CONSTRUCTION OR WORK IS SUSPENOED OR ABANDONEO FOR A PERIOO OF 120 DAYS AT ANY TIME AFTER WOf±K IS COMMENCED. NO. I HEfiEBV CERTIFY THAT I NAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PWOVISIONS OF �AWg �A� AND OfiDINANCES GOVERNING 7HIS TYPE OF WORK WILL BE COMPLIED WITH WMETMER PECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRE U TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pEq PROVI O NY OTMER S7ATE OR LOCAL LAW REGUTATING CON• STq TIO OR M P CE OF CONSTRUCTION �� °l�j a��` PLA 1 �' 1S S�GNATUAEOFCON:AACTOpONGUTHOA�2E00GENi IDAiE� ING SC. FT DWIG. UNITS 1 STA�LS UATION $5,999 MIT FEE $112.25 N CMECK FEE L�SC $5,� OCCUPANCV CU FT. � PAqKING GARAGES $3.00 SAC CN E Fir S $6.00 �OT F 126.25 ►+i5 iS r0 PEAAI ��/��%��/��;QI,r� , �� . = � [) [] [] ConstructionAddress: ( � �---_ Lega� Description: � � CITY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �_I • ` '� � � �� Effective 1/1/99 G' . Owner Name & Address: � �y111,t�.� �, J� Tel. # ,��'1 I ' �� Contractor: MN LICENSE # /O�C� Address: �ELA ROOFING & hEMODELING, INC. Tel. #�a2.j -��c.' ..��a� a. ST. LOUIS �� l�PPlication, a Certificate of Survey of the ��i the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECS AREA: Length Length Length DESC�tIPaION OF �dPROVEIO�NT Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. OTHER: � � � �� " � � Construction Type: � Estimated Cost: $_ � �� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. 6 Ft = Ft x$ _$ DATE: � APPLICANT: � � —�� Tel. # � �3 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ r2. Z � $ �', e J $ .S, � $ �� $ CITY USE ONLY Fee Schedule on Reverse Side .QOl of Pernait �aluation (1/lOth o) $.50/$1,000 Valuarion $1050 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 [ ] $ /��, �`S BUILDING PERMIT FEE SCHEDULE 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 appl'ication 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,OOlto $50,000 $50,001 to $100,000 $100,001 to $500,000 $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 ea�ch 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 DE�RESSION ESCROW (Concrete Curb Streets Only) Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Altemate "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.