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'_ . y �. ) > ' -. .- � <. �+� ' �y : - _ t�z� �... � . h - . �� F,�. . . v ��` , sn - . � - a�m e� � City of Fridley AT THE TOP OF THE TWINS B u I L D I N C� P E R�II I T � �������� i �` ���� COMMUNITY D ELOPMENT OIV. r � �' � pROTEC7IVE INSPECTION SEC. � � � � �""1 � CITY HALL FiiIOLE� 55132 NUMBEP �•-°� � �'� 612-571-34b0 9t0-F15 JOB ADDRESS 6640 Central Avenue E 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION oescR. pt. of 4F Aud. ub 2' 2 PROPERTYOWNER MAILADOR�,S$ 3 CONTRACTOR Owner 4 AfiCHITECT OR OESIGNER 5 ENGINEER 8 USE OF BUILDING Residential 7 CIASS OF WORK ❑ NEW B OESCRIBE WOHK MAIL ADDRESS REV OATfi 10/14/98 ZIP PAGE OF � � E IT NO. 28237 �, �� �� APPROVED BV SEE ATTACHEO SHEET LICENSE NO UCENSENO LICENSE NO ❑ ADDITION O ALTERATIQN � HEPAIR ❑ MOVE O REMOVE Reroof house (15,Sq) Tear-off 9 CHAN(3E OF USE F STIPULATIONS TO Underlayment must comply with the State Building Code. TYP� OFCONST. OCCUPANCV SEPARATE PERMITS ARE REOUIRED FOH ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONOITIONING. THIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSTRUCTIOM 20NING SQ. FT AUTHORIZED IS NOT COMMENCED YtIITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANQpNEO FOR A PERIOO OF /2p OAYS A7 ANY TIME AFTER WORK IS COMMENCED. NO OWLG. UNI7S I HEREBY CERTIFV TMAT I HAVE READ ANO EXAMINEO THIS APPLICA710N STA��S ANO KNOW TME SAME TO BE TF1UE AND COFiRECT. ALl PROVISIONS OF LAW$ yALUATION AND ORDINANCES GOVERNING THIS TYPE OF WpRK WILL QE COMPUEO WITH WMETMEfi SPEC�FIED HEREIN OR NOT. THE GRANTING OF A PERMIT �].285 DOES NOT PRESUME TO GIVE AUTHOR�TY TO VIOLATE OR CAMCEL TME pEqMITfEE PROVISIONS OF ANY OTHER STATE OFi LOCAL LAW REGULATING GON- � STR ON OR THE PERFORMANCE OF CONSTRUCTION l}3.00 ,.- ��� PLAN CNECK FEE SiGNATUAE OF CONCNACTOQ Op AUTNOFQED AGENT IDATEi WMEN``'r/ ER ALIDA� L � � S�GNATURE Of OWNEAaf OWNEpBUILDEAt �O�iEi 8 G�NS� ' � _ ROUP OCCUPANCYLOAD CU FT. OFFSTFEET PARKING IGARAGES $.64 SAC CNARGE Fire SC $1.28 TOTA�FEE $44.92 0 THIS IS VOUR PERM�T ��-�f��r�X f�6tf e . NEW [ l ADDN [ ] ALTER [� CITY OF FRIDLEY SINGLE FAMILY ANB DUPLEXES R-1 AND R-Z BUILDING PERMIT APPLICATION ConstructionAddress: � � �� �� � , � �,�, �li� Legal Description: Owner Name & Address: Effective 1/1/98 � p� � � � ��� r �� �, i� �-��Tel. � � %/� �I Y6 � ��° Contractor: �a�s� �- �' MN LICENSE #. Address LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height Length Width � Hgt/Gr�und �i_''. Tel. # Sq. Ft. Sq. Ft. Sq. Ft. � U " �- -- � � � /���. Construction Type: L�� f� Estimatcfl C�st: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: 1����%� APPLICANT: �JJ�� Tel. #��/�� ��� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ �. o v $ /- �8 $ �� $ $ $ $ $ $ $ y , 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 [ ] BUILDING PERMIT F'EE 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 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,OU1 to $50,000 $50,001 to $100,000 $100, 001 to $500, 000 $500, 001 to $1,000, 000 $1,OOO,Q01 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 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 frst $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 additionaZ $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 DEPRESSION ESCROW (Concrete Curb Streets Only) Altemate "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.