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AF - 37068s�e,cc� PERMIT� O. City of Fridley 2 6 5 2 0 ArTHETOPOF.�E.W�NS gUILDING PERMIT � � � RECEIPT NO. � � � _ ____. GOMMUNI*y DEVELOPMENT OW � /�I�� � � ° PROTECTrvE INSPECTION SEC �� � i � /°'1 � CITV HALL FFIDIE� SS<J2 NUMBEA AEV 0�*E ��GF Oi evvpOVEO 8� �°°�; `.' 612-571-3450 9i0-F15 7-8-98 / / lOB ADDRESS 6633 9�3'd Central Avenue NE i LEGAL LOTNO BLOCK TRACTORADDIiION SEE�TTACHED DESCR ]0 Dennis Addn s"EET 2 PROPERTVOWNER MAILADDRESS Z17 PMOHE Geor e Peek 6633 Central Avenue NE 571-8357 ] CONTPACTOR MAILADDFESS Z�P PHONE LICENSENO Four Season Roofing & Remodeling, 7930 Universit Ave Fridle 55432 795-9410 � ARGMITECT OR DESIGNER MAILADDRESS ZIP oMONE LICENSE NO Lisc Ii20138780�� 5 ENGINEER MAILADDRESS ZIG PHONE �iCEN5EN0 6 USE OF BUILDING Residential � CLASSOfWORK Cl NEW ❑ ADDITION O ALTEFATION � REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Remove and Replace Roof i195q) tear-off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with State Building Code. TYPEOFCONST OCCUGANCVGAOUP OCCUPANCVLOAD SEPARATE PERMiTS ARE REOUIRED FOR ELECiRICAL. PLUMBING. HEATING. VENTILATING OR AIF CONDITIONING THIS 7ERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO.FT CU FT AUTMORIZEO i5 NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OA WORN IS SUSPENDED OA ABANDONED FOR A PERIOD O� l2p 04V5 AT ANY TIME AFTER WORM IS GOMMENCED NO DWLG UNIT$ OFFSTREET GPRKING i MEREBY CERTIFY TMAT I MAVE READ ANp E%AMINEO THI$ APPLIGAiION � $TALLS GARAGES PNDKNOWTHES/METOBE�RUEAN�COFRECi A�LPqOVI510N50%LAWS yq��,qT584 $Uq�p�9 PNp ORDINANGES GOVERNING THI$ TYPE OF WORK WILL BE COMPUED � q WiTH WMEiHER $PECIFlED HEREIN OA NOT TME GRANTING OF A PERMIT �OES NO1 PRESUME TO GiVE /.UTnORITV TO ViOLATE OF CANCEL THE pERMITFEE SAGCHAPGE PROVISIpNS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON� $5 ��•ZS F1T2 SC $ �,SH ST � ION P iHE � FOAMANCE OF CONSTRUC7iON � .�7 _� GIAN CHECN FEE L F E / License SC $5. .6�2 S�G�+4•uaEG CR��.y /OAOAaJ�rOA�1ED>GE�u� ,D�iF E PQ � �AU fD TN�S IS YOUR PERM �LRFOc�- AEG,�cOwNEPBV�IDfA� �G�*E� � iw5 , • ��� NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 ��% � BUILDING P�RMIT APPLICATION �(� �� �� � �1 _I � ��� ConstructionAddress: lDt,� 3�� ��vi �. � n+ra l _- Legal Description: Owner Name & Address: �eo ra e Pc e �C lcb3_3 old Cenfrc.l Tel. # S% 1��'' .3 S 7 Contractor. �0�,-5�,ti�„ ��{',.,Gd �Cemr.r�Fl;hs' LZL MNLICENSE# Address:. 1Q3v U h; �.rr `,+., Tel. Nf (.�IZJ �q5-qt//G Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Length L.ength Length DESCRIPTION OF IMPROVEMENT i W idth Width Width _ Height Sq. Ft. _ Height Sq. Ft. _ HgdGround _ Sq. Ft. u _. (' < I l e � n n �j o � Consuuction Type: ��,o,,�e� f�Pp �acc f�m� Estimated Cost: $ 3�-3y; � (Fee Schedule on Back) Driveway Curb Cut Width Needed: _Ft. + 6 Ft =_Ft x$ _$, DATE: �`C,�' I� APPLICANT: � k��� .c� Tel. �f 7%S� �%�i�C� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Pazk Fee Sewer Main Charge TaTAL STIPULATIONS: $ � �. ,' ��, $ /. < < � $ �'"1' $ $ ��r ��; $ $ $ $ $ -' 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 Contrac[ors) Al[. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] ��uiwe�} a� yuM Sutpaa�oid aio;aq pannbai aq l�M pa»nnsao� uaaq sEq 1? sEq 1? a�uo uoi�epuno; aq7;o uoile�ol aq1 �utMOqs `loj ay7;o ,ianinS;o a�e�r3[ua� y •a��s voi»nllsuo� aq�;o oue ainl�nns pasodoid aq1;o matnal iadoid io; molje oa uot1E�?Idde;o aunl aqJ cuoi; sinoq bZ 3o wncuiuttu e panss� aq titn� uot7�cu7suo� zo; slTw.iad AIOI.LVQ,�If103 30 AIOI,LV�L�RI�A 'SL'Si$ sawtl laa; 9 sn�d ylp?m �Cert�an��Q - cpdaP q�u? 9 y7?^'+ q�EOidda apin� l003 £� It�sui pue ialinS pae qin�;o 7uauia�eldai pas ienouia2i :,,g„ a7euialid 'OS'£T$ saunl 7aa; 9 snjd y7p�m ,ieman�iQ -�C[uo �a�7n� pue qm� 30 laacua�ejdai puE IEnouiag :,,y„ aiza-ta1[Y (,([np s�aaiis qm� a3ai�uo�) M02I�S� rIOISS�2Id�Q �C�h��ARIQ ;oaiaql uon�e�; �o ppp`T$ ieuotl?pp� u�Ea l03 SL'Z$ snid 000'000`i5 �slt� ay� so3 SZ'ZTOS$ 000`000'i$ $°lPn��ui pvs ol `3oa�a[{7 uon�El} �0 000'i$ leuot�iPPe q�ea io3 SZ'U� Snld 000`005$ �s��3 a4� 103 SZ'L88Z$ 000`005$ �u?Pni�ut pue ol `;oaiaql uo�7�ei; io 000`i$ je�ot��ppe q�za Jo; 00�5$ Snid 000'OOt$ 7sir3 io3 SZ'LS8$ O�Q`OOi$ $v�pni�ui puE ol `;oalaq7 uocl�2i� l0 000`i$ jeuon?PPE q�ea io3 SZ'9� Snld 000'OS� 7sn3.i°3 SL'bLS� 000'OS$ $vipn��ui pae o7 `;oaiayl uoil�e�; �o 000`i$ leuo�iiPPe q�aa io3 00'6$ Sn[d OOO�SZ$ lsig �03 SL'64£$ 000'SZ$ Satpnl�at pae o1 `;oaiayl uot»el; �o 000`i$ ieaoil?PPE 4�ea io3 OS'ZT$ Snid 000`Z$ asi�.3 Io3 SZ'Z9$ 000`Z$ $utpn��ut pvs o� '3oaiaqi uon�ei3 io OOi$ lzvoi�tppe q�ea io3 SL'Z$ SDId 005$ 7sit3 io; iZ$ (a�iEq�ins snid iZ$ si aa3 wnui?u?y�) iZ� S3H3 dn pus I00`000`i� p00`000`i$ 01 i00`OOS$ 000`005$ �l i00`OOTS 000`OOT$ 07 I00'OS� OOObS$ O1 T00'SZ$ 000`SZ$ °j i00`Z$ 000`Z$ �� i05$ 005$ �7 1$ �n�dn �dioi :um-ol papinozd uTaiaq �aweui ay� ut pve y7to3 �as molaq uTaiaq �unou� a� 01 saa;;o a?cu.tad q�ns io;lae�?idde ay� �Cq luaw,Ced aq� aiinbai `aio;aiay� uope�?idde uodn `ain7�ni7s io 3u�pjtnq �upsixa ,iue oi �?Edai io uone�a��e ,CvE io; �o `ainl�niis io �aip[?nq �upsrxa �(ue ol uon?ppe ,Cue io; io `ainl�nils io Suipj?nq ,Cvv. ;o uo«�aia ayl io3 s�tuuad Sumss� a�o3aq `[i�qs tEt�y30 $u?Pi?ng 3al4� a4.L , �'If1Q�H� ��3 .LINRI�d `JPIIQ'IIflg .��iilding BUILDING Pe�„�ttvo.: � Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY �acexe�'a: �- '�-� o,�ii- l2�_Z�`'V ���,cur-ni,vin>uki�s. �hli!1nif�i-- f�E� i='C9G(��D:� [c�n, ,���,��>�k�_ss ',�. >> C�htrai {�v,�-1��� �cilf�,t'^n 55y3� fIIIti:V'PLICANTIS�. �C%4i:F.R OCOVTKACTUH PROPERTI'OR'VER/ �,���E, � S L T@:I��A�T qDDRLSS:��f}�_ L��7�'J,(./ ��y�Q N¢'ITV' STATE�y�P 5��}3z PHONF: �J i ' Y.'��—C,i�%G COVTRACTOR NnME: SUI3MIT A COPY OF STATE LICE45E R FXP UATE Y'OUR $�fAT'G LICENSE ADDRESS�. CITY STATE_%IP _ WITII APPI.ICATION pHO G PAX PROPERTY TYPE �� �h'�LF FAMILti'�NC,W' CONtiTRUCTION SI'l,li ❑T1vOFAMILY/NEWCORSTRUCTION STORIIiS eERMIT TYPE ❑ nooiTrov ❑ cnenar�sFiFO ❑ wirvoows ❑ BASBM1iL:NT PINISII ❑ NOOP ❑ DNAIN TILG ❑ D[.CK ❑ till]INO ❑ OTHCR ❑ SVVIMM1iWG PoUL TYPE OF �VORK: ❑ New ❑ nomriuN ❑ M1tAINTENAKCCBEPAIH ❑ RIiMUUI:LIN(1 L DI�:SCRIk3F. W'ORK 13FIVG DO�E: .S�ti,�!)L�. !.�'k' V��Gi.L� il� 4i�4fC/Y�i'!�1 ��)�IEvfG� ��.L�. .,,� �(J[� SIZIi OP IMPROVEMENT LE�GTH WfDTH HEIGHT 5. Ft. HUOY'ISG ❑ IIOUSf ONLY vl:bllib:N OF tiQL'ARFS ❑ IIUCSf &(inRAG4: RASF.9IF.NT HEWODBLING SUHAfIT' (:.\HAGk:S ❑AT'I)\CIII?DG:INAGG L EziscingFloorPlan 2 Pmposedfloorplan PNt�pOtiFp��ZE. ❑DIfTACHEU(�4RAGIi 1, Lis�ofswauralmcmbcrs�obeuscd I'NUPUtif-D IIIlGI1T� - ti1D1?G FOR VF.tV COYSTftUCT10N INCLUDING DF,CKti, ❑ Vinal GSo17i� 4DDITIONS & POftCHFS SU6�7IT'. C 1luminum ❑ Trim L Sim PIan�Survey shuwiny the evis�inu swclures L] o�her _ ❑ Fascia and pro�wsed pro�ecl �`,������`�.S _. Taro�e[sofconztmctionplan: IV h:VSTIKtfOPI[NMGS DYes ONo LOG\TIO�'uf-U'INDfriYti �. FnereyCalculaGons nN FUR NI�Ai' UPI_NINGS-0ESCRINE SIZE OF UI'P�ING ('11:1NGL'ti k 1'yPP. uP W'INDUAV T06G INSTALLEU uUN131IR ul' �i'INUUIFti :1L1, h h.F.J AKh BAJN:U UIV Y:1LUA I IU�. IIVI. LUUI V l; 111N, l VJ 1 UN LA6UK AI� U �lA 1 Y.KIALJ: (USING IE 1997 G.B.0 FP:E SCIIEDULF.) l'O"PAI. JOB V.4LUATION � ���� OCCl;P:1tiCti' 'I'Y'PE Pcrmi� Fcc 5 _;J"�j. '� �7 Scc l3uck Pa�c tix Pn: Schcdulc Plan Rcvicw $ 65%nl'Buildine Pcrmit F'oc Piru Surchurae $ °jC .001 timcv �hc lolnl juh vxlu;ition Surdiai.GC $ �j� _OUIIS x Pcnnit Vuluutiun �lininnmi 5.SU Liccnvc Surchurgc $ SS.QO (Stu�c Lfccnscd RcsidcNi:d Contrnctors) SAC Churec $ 515�0 per SAC Uni[ (Plans [u MWCC for detenninution) Curb Cut Escrow $ fl� 6 ft — ft x S21 — S lCrasiun CuNrol $ 5450 Conscn��tion Plxn Rcvie�a P;u�k I�cc S Pcc Dc[cnnincd 6y Lngincering tiewer Y1ain Charge S Agrecinent necevs:vy 1) Nnn VecessarV f 1 lbtal Uue S a�. M1i•rke checks payrble to: Cih� of Fridle� A[tach THIS IS AN APPLICATI(1N 191K A PLRMILNI)T V:ALIU U� fIL PK��C FSSF.D I heroby npply (or a buildfno pemii[ and I acknmvlcdge Ihat �hc in(ormntion abo�'e is completc and accurate; �hat Ihc �cork will be in confurmance ai�h Ihe ordinunces and codes of [hc Cirv o( Fridlev anJ wrth !he Minnesn[.i Cons[nic[ion Codes: [ha[ I undertand thfs is not e pennft bW nnly an applicatfon for a permit and �cork i� not to start �afthuut a permit that the �vork will be in aceordance wilh ihe approved p4m in Ihe ca�e of all work �� ch rcywres re� iew .mJ ap roval nf plans. �{ ( ( �-7 �It�I.qTUlif(�IAPPLIUVT '���� U�_��� PRI'JTN,A�1P���En�j�(� `��'��" DATH���� �_��f _ >�