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AF - 37072City of Fridley, Minn- BIJILDING PERMIT NA s�o7 \° Date: �_� � ^"�` � � � Owner: � Builder �_�_ �� Addreas Addrees ,,,, LOCATIO ��D NG Na '' Street � .�''�� '� P o Lot ° Lot ��Black Additian or Sub-Division -�-?� � Q.,� r�r �.-��. �p/ a�' p C o r ae r a L o t — I n a i d e L o t —.�'� _ Se t bac k S i d e y n r d �� Sewer IIevation Foundation IIevation DESCRIPTION OF BUILDING +� TO �C BCa� f� ' ,' '� "' Front �E� Depth ..�..,�..._. Aeight .�� Sq. Ft ��F .� ; � ``Y Cu. Ft �� Fro Depth fTeight ' Sq. Ft. Cu. F't. , �, Type oP ConsLructio �'�.�y. Fas� I��,,,�' �- �} � To be Completed — In consideration of the issuance to me of a permft to construct the building described above I agree to do the proposed worl� in accordance with the description above set forth and ia compliance with afl proviaiona of ordfnances of the dty of Frfciley. � Ea consfderation of the payment oP a fee of $3„�� , permit is hereby granted to to construct the buflding or addition as described above. This permit ia granted upon the �express condition that the person to whom it is granted and lua agents, employees and workmen, in all work done in, around end upon said building, or any �art thereof, shall conform in all respecta to the ordinaaces of Fridley, Minnesota rega�dfng lpcation, construction, alteration, maintenance, repair and moving of buil�inga within the dty ]imits and this permit may be revoked at any time upon violation of any of the provisions of said ordinancea _ _ � �..��'�>�=�.��'`.,� � �;� s�a�s �� NoncE: Thb psrmit das not cowr fhs conueaeiloe, Pestalladoa te� �leiny, �InmbinY, �a 6at6�o, s�vwr er rr�r. B� am to as tin Buildiee lespsetor fo� apuat� pamih Por �h�a It�ms. - _. � r►. : �.�. •_ _ � ' - -- � .'- -� Owner'8 Name Addresa � � Ar�r.ic�io� �o� sti�z�tc ��r CITY OF FRIDLEY, MINIV�SOTA '� '�� Buil�er � �' �` � � � �d � � l, �� ioN oF Bu�iivG No. �-, � � ^� __ . Str�et �i,l.��%+�� ' �� Part ot Lot' ��' Lot Block�_ Addition or Subdivi�ion �fl^+. �. a � . Corne�r Lot � `� Inside Lot�S�tbackt��, � Side=Yard f�' • l�Ei�3BR EI;�VATION FOUNDATI01� EL�VATTOAT Applicant atCach to this form Two CertificaCes of'Survey of Lot and proposed building location drawn on these Certificatea. DESCRIPTION OF BUILDING To be used as:�� .. �° � �' � � Q '�• Front � D Depth�Height Sq. Ft. Cu. Ft. � ' F�tont Depth Height Sq. FC. � Cu..Ft. Type oi Construction � y� /''� 1P�r'� � EstimaCed Cost � �� „"' To be Completed � �ld � � � The undersigaed hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordaace with the City af �'rtdley Ordinances and rulinga of the DspartmeaC of Buildiage, and her�by declarea th�t all the facts and representations atated in this applicatioa are true and cdrrect. ., DATE � � l � � �,_, � , , (Schedule of Fee Costs can be found oa the Reverse Side), r � _ �'1 � � _ d _ � ��,�� m a BIJILDT�G PERMIT FEE S(�IEDULE Section 2. The Tnspector of Buildings ehall, before ib�uin� an;y permit for ; the erect3on of, eny building or structure, ar for any addittion tc aaq ex3eC- ing building or �tructure, or.for any alteratioas or r.epairs.to any exisg�.ng build�ing'-or sicructure, �upon application �therefor, require the payment bq the applicant for such permit of.fees to the.amot�nt,herein below set fa�th and ia the manner here3n provided'to-�it: '"` �4 " 2.1. For any such permi� for �he erection bf aay fire-proof building, other ehan a garages warehouse; factory or grain elevator, or for the erection of any fire-proof addition, for �tmilar ,oc'cupancy, to any exietiag'•.bdilding shal.l be �C the rate of $�,.40 for esch one thousand cubic feet, or fraction thereof, in such cubical,contents. � 2.2. For any.such permit £.or Che erec�ion of any fire-proof garage, warehouse, f�.e�ory or grain elevator, or for the erect3on of any fire-proof �ddition, for similar occupancy, to any exiating buildiag shall be at Che rate of $1.25 for each one thousand cubic feet, c1"assified as °tfireproof01 by Section 502 of the Minneapolis Building Code. • , �� 2.3. For any such permit for the erection of any noa-tireproof building other than a garage, warehouse, factory or graia elevator, or any non-fireproof addition, £or siml.lar occupancy, to any exis�ing buildiag - permit $1.00 for each one thousand cubic feet. . . GARAGES 2.4. �'or any such permit for the erectian of any aon-fireproof garage, warehouse, factory or grain elevator, oz for the erection of any nan-fizeproof addition, for similar occupancy, to anq exist3ng buildiag or for each auah building or add3tion - aine�y cents ($0.90) for each one �housa�ad cubic feet or fracCion thereof, in�.,�he cubical caatents _thereof. with a minimum of $4.0�. For the purpose of computing fees for building permita, the c�abical contents of eay building or addi.tioa to a uniform height throughout by multiplying the ground area. cover�d fram a poiat:six (�i:) inches below the floor line of the basemeat or cellar to the average height of the upper surfacQ or to the av�rege height of the roo£ surface,of the main gable of a pitched roof. 2.5. For repairs or alterations to an �xiat3ng structure, the fee aha11 be at the rate o£ $3.00 per each Five Hundred Dollare ($500,00) or fraction thereof ia the cpst of al,1, :�i,ropoaed work. - �. 2.6. In no�°case ah�ll the fe2`�harged �or any permit as �et forth in Section 2 be less th�n $4.Q0. /'�` � � .-� t.. ,.. � -� _ City of Fridley, Minn. BUILDING PERMIT N° 6234 .:- . r �'� � ,� • " �� .a/�i. 1 .i .E � ,r • �� LOCATION � ING No. .�,�:,� StcEet __�� •— — .:,,�___. Part ! I�ot 4 - , Lot °� �� Block Addition or Sub-Divisioa � �� --•-��•�! ;�-`� ` � r., Corner Lo '_.� Insatde Lot —._.._ '"�"r Setback _�W— Sideyard �,rC"° ,,�,`.� Sewer IIevatian —. _ Fotmdation IIeval3on DESCRIPTION OF BUILDING T � F"°� � Front �� Depth �.G!' Height !� Sq. F't ,�!s„�--�" C�. F't f� — —.— Fron Depth __�E�T ght .� Sq. F't. G�. F't. � 7j�pe of Construction �� Fs� Cost � _��o Ue completea In consideration oP the issuance to me of a permit to construct the building described above, I agree to do th� proposed work in accordance with the description above set forth and in cumplisnce with all provisions of ordinancea of the dty oP Fridley. ,A' Ea consfderation of the paqment of a fee of $`�``'"°' , permit 9s hereby granted to to construct the buflding or addition as described above. This permit is granted upon the express condition that theperson to whom it is granted and his agenta, employees and workmen, in all work done in, around and upon said buildiug, or any �art thereof, shall conform in all reapects to the ordinances of Fridley, Minnesota regarding location, construchon� alteration, maintenance, repair aad moving of bufldinga �� dty limits and thia permit may be revoked at any�ti�_�pon violatioA,of any of the provisions oP said ) Building Inapector NOTICE: '�hts p�rmit dea eot eawr �lu �omlroeNoe, in�taQaHen te� �a �romt,tna �.s h..xea � o� �►.�.r. 8� sun ►o a� tM Bnildieg lesp�eto� fer pp�rat� p�emih Poe f6�a hMa. i.,. 3 ^•.�-� �`�, .'�� i.=.._� „'�'' Oc,mer's Name Addreas APPLICATION I�'OR BUILDING PERMCT CITY OF FRIDLEY, MINNTSOTA ��;�� o - _ ✓� `r ! �,� . �� LOCATION OF BUILDING No. �� Street d�� Part of Lot /�� Lot Block Addition or Subdivision Corner Lot Inaide Lot�_Setback Side�-Yard ��WER ELEVATiON FOUNDATIOIV �ZEVATION Applicant attach to this #orm Two Certificatea of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUTLDII�G To be us 1 as• � � Front /�� Depth /1� Height �' Sq. Ft, Cu. Ft. Front Depth Height Sq. Ft. /��. Cu. Ft. , Type of Construction �i►,��.�.� Eatimated Goat � C� D, ' To be Completed i�i� f.. 1'he undersigned hereby makes application for a permit for the work herein specified�, agreeiag tb do all work in strict accordance with the City of �'ridl�y Ordiaances and rulings of the Department of Buildings, and hereby declares that all the taets and representations atated in this application are true and correct. DATE SZGNATURE �� , (Schedule of Fee Coete can be found oa the Reverse 3ide). ;� y� > 4 iY � � � i R !; D 4=��; �, . . . , _ t'' SUILDTIVG PERI�CT FBE SCHEBULE Section 2. The Inspector of Buildia�s ehall, before iesuing any permit for Che erection of eay buildiag or etructure, o� for aay addition to anq exist- in� buildin� or strucCure, or for any alteratiiogs or zepaisa to any ex�eting buildiug or s�ructure, upoa applicaeion therefor, require the paymea� by �he appl�cant for auch permit of fees to the amount herein below set forth and �a the max�nez herein pr,ovided to-wit: �;.F ��:<'�. 2.1. For any sucl� permi.t for Che erection of any fire-proof building, other ehan a gar.age! warehouse, factory or grain elevaL•or, or for the erectioa of aay fire-proof addition, for�similar occupaacy, ta any existin� bcailding shall be �t the rate of $1.40 for each one thousand cubic feet, or fraction �hereof, in such cubical contents. 2.2. Fos aay auch permit for rche erection of anq fira-proof garage, warehouse, fac�ory or grain elevator, or for the erect�.ons±of any fire-proof addition, for simil�r occupancy, to any existing buildiag sh�1Z be at the rate of $1.25 iCor each one Chousand cubic feet, : classi�'ied; as °'fireproof11 by Sectioa 502 of the Minneapolie Building Code. � � HOUS�'S 2.3. For any such permit for the�erection of e.my non-fireproof building other than a garage, warehouse, factory ar grain elevator, or any non-€ireproof addition, for similar occupancy, to auy enisting bu�ilding - permit $1.00 for each one thous�ad cubic feet. GARAGFS 2.4. For aay such permit for the erection of any aoa-fireproof garage, waxehouse, factory or graia elevator, or for the erection of aay non-fi�eproof addition, for sianilar occupancy, to any existing buildiag or for each such building or add3tion -;,nfnety cents ($0.90) for each one thoueand cu5ic feet or fraction thereof,,in`the cubical contents thereof with a minimum of $4.00. For t�ie purpose of camputcing fees for building permits, the cubicai contenta of any building oac additioa to a uniform height throughout Uy mul�iplying the �rourad area covered fram a poiat six (6) iaches belaw the floor line of the�. basemeat or�cellar to the average height of the upner surface or to the average�height of the roof surface of.the maia gab].e of a pitched roof. . 2�5. For repairs or alteratioas to an existing structure, the fee ehall be at the rate of $3.00 per each Five..�iund�ced Dollars ($500.00) or frection ther�eof in the cost of a11 progoaed work. � . 2 46'. - '7.� no case Sectioa 2 be lees shall the fee cliarged for anq permit as set forth in than $4.00. 4 � _ � ' • � _ � �► � � � a �O r 0 � � 0 t i , �, .- :: , `� rn � t.]'v :.y . J � � � � � � � � � o � � p � O R � � p � � _ � � . � \ • �� ! � � � � � � � �! �� s � �� s .. � '� � � � �� i� ' 3 � � M � o � � � � M M �'� i N � �y � � �i � � � m � O I � r I � �� 8 � 1 � � � O r ee � � � �� w � �� go �° C .. � � � � � N I� � � � �� 4 � � ��' � �� o� �� x x �� ,� � � � � � � � � � � � o 0 � 3 8 S � � M 1 I I I � � � � � � �� a� �� ' a � , � � . � � � : � 8 � � � � � � , m �' �A Or i � � � I� " � I (� � � � i i ' � !\ � ; ` �� _I � �. w I� � 4 � �. M � a a I. � � � � � m � � � � � �� o0 �� : �� . � : � � � � � � � � � 1 I � �� a�R � n �! � � A � � � � �� .�. ,. � �� s� �� .�� ,� �� . �o� � �' �q � � �� r...� �—:�� w � � �,�� [�� a � �&�� i � � � :,, '� v � +�?@ _ .�. '%,+ �.�:-, �:;` ~ I.R• .':Y 3:.+ _� �� : �� _:: 4^ ��y � � ,; 4V��....r P.�� ..�:�... � =� �ti;� a i� � �� . 0 sue�ecr PER . City of Fridley 2�. 6 5 4 AT THE TOP OF THE TWINS g U i L D I N G P E R M I T r ; � RECEI O. � `L _ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. � � � � /"'1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE Of APPROVED BV �""'� � �`� 612-571-3450 910-F15 11/13/92 � � JOB ADDRESS 6825 Ghannel Road 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. E� Of 9 Brookview Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Dahl 6825 Channel Road Fridley 55432 571-0116 3 CONTFiACTOR MAILADDRESS ZIP PHONE LICENSENO. First Choice Exteriors 6587 Berkshire Lane MG 553-1918 4266 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. B USE OF BUILDING 7 CLASSOFWORK O NEW ❑ ADDITION C� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK �� Reside house 9 CHAN(iE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL. PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD YENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT. CU. FT AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO 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 WORK WILL BE COMPLIED � $L� 6OO,OQ $Z.3O WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT � 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- 72� �� Fire SC " y�4. CO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $ �O�� PLAN CHECK FEE TOTAL FEE ��(� �� — / �f � � $5.00 $83.90 SiGNATUREOFCON'�pACTORORAUTNORI2EDAGENT IDATE� , � yy EN P PE Y V/,LIDA D HIS IS YOAU`R PERMIT ! /�� G� SiGNATURE OF OWNER iiF OWNER BUILDERi IDATEi � OG � SP Da7E NEW [ ]" ADDN [ ] ALTER (�(j i° CITY QF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: �� a� � �� C' � �, �, �� 1 �� Effective 3/ 11�2 Legal Description: Owner Name & Address: �� i � . � � =: � � Tel. # .S� � / - � � � � Contractor: }, v� s 7 C G+ �� .� � X`1'� MN LICENSE #� o� (.� (, Address: �.� J y � � r �%� L � L ►-�. � �G,%' L �� -.� Tet. # s`J�'� -/ � ��` Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Ix�gth Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: � e S f c�l�' Corner Lot [] Inside Lot [) Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimat� Cost: $ `%Cr� �`� Approx. Completion Date: / a� Lp � a (Cost on Backj Driveway Curb Cut Width N�ded: Ft. + 6 Ft = Ft x$ _$ DATE: l � � � a � � � APPLICANT: ^ Tel. # S � � `1 � �� Permit Fee S "7�� Fire Surcharge $ � 6% State Surcharge $ 1.3% SAC Charge $ License Surcharge $ ��_ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL $ �� CITY USE ONLY Fee Schedule on Reverse Side .�1 of Pemut Valuation (1/lOth%) $.50/$1,Q00 Valuation $700 per SAC Unit $5.00 (State Licensed Residential Conh�a.ctors) Alt. "A" or Alt. °B" At�ve Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: � -- 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 bailding 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 a,mount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $5t� $501 to $2,(�0 $2,001 to $25,�0 $25,001 to $50,�0 $50,�1 to $100,0(%? $10(},001 to $500,(JUO $5�,001 ta $1,000,0� $1,00(3,(�1 and up FEES $15 (Minimum Fee is $15 plus surcharge) $15 for first $500 plus $2 for e,ach additional $100 or fraction thereaf, to and including $2,000 $45 for first $2,000 plus $9 for each additional $1,000 or fra.ction thereof, to and including $ZS,Q00 $252 for first $25,Q00 plus $6.50 for each additional $1,� or fraction thereof, to and including $50,� $414.50 for first $50,� plus $4.50 for each additional $1,�0 or fraction ther�f, to and including $1W,000 $639.50 for first $1�,� plus $3.50 for �ch additi.onal $1,(}00 or fra.ction thereof, to and including $500,(�0 $2039.50 for the first $500,000 plus $3 for each additional $1,(�00 or fraction thereof, to and including $1,�?O,ODO $3539.SU for the first $1,�,� plus $2 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSIUN ESCROW (Concrete Curb Streets Only) Altemate "A" : Removal and repla.cement 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 issu� a minimum of 24 hours from the time of applica.tion to a11ow for proper review of the proposed structure and of the const�uction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been consbructeti will be required before proceeding with the framing. � _ � sue�ecr PERMIT NO. City of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M I T 2 2 4 3 r ; � RECEIP . � `v _ COMMUNITY DEVELOPMENT DIV. � �� r � � � PROTECTIVE INSPECTION SEC. I = � � /'�'1 � CITY HALL FRIDLE� 55432 NUbIBER REV. DATE PAGE OF APPROVED BV �"""� � �'' 612-571-34b0 910-F15 4/19/94 / / JOB ADDRESS 6825 Channel Road NE 1 LEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACHED oescR. pt 9 Brookview Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE R Dahl 6825 Channel Road NE 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Sela Roofing 4100 Excelsior Blvd, St Louis Park MN 5 16 - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PFIONE LICENSE NO. B USE OF BUILDINCa Residential 7 CLASS OF WORK � NEW ❑ ADDITION ❑ ALTERATION � REPAIR O MOVE O REMOVE 8 DESCRIBE WORK 9 CHAN(3E OF USE FROM TO STIPULATIO.NS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATIN(i, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOH A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCEO. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OH NOT. THE GRANTING OF A PERMIT �1a12S .SC DOES NOT PRE TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEpM1T FEE SAC CHARGE PROVISION F A ER STATE OR LOCAL LAW REGULATING CON- TRUCT OR T FORMANCE OF CONSTRUCTION. �29.�� Fire SC 1.13 PLAN CHECK FEE TOTAL FEE `� � `� �t�{ License SC 5.00 $35.69 SIGNATURE OF CON i RACTOR OR AUTMOR ZED AGENT �onrEi , RpPE V V IOATED THIS IS YOUR PERMIT � (�� / � � SiGNATURE Of OWNER�iF OWNER BUILDER� IDATE� " BLOG iNSP naTE NEW ADDN AL'�ER [l [1 [l CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAdciress: ��Z-'S Legal Description: � � .a-� � .s,� � .�o � Effective 1/ 1/94 �t � r� Owner Name & Address: � � ��-� � Tel. # �t� / � � � � Contractor: �� ( +�- � � �= ��y MN LICENSE # � ° �� Address: � [ c� o rz� c.� �, �•�. � � �� Tel. # � 3 �' �.� LIVING AREA: GARAGE AREA: DECg AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length L+ength Length DESCRIPTION OF IMPROVEMENT � Corner Lot [) Inside Lot [) Ft. Yd Setback Type of Construction: Approx. Completion Date: _ Width Width _ Height _ Height _ Hgt/Ground � HD�s� Sq. Ft. Sq. Ft. Sq. Ft. ! � Sc, g��c , Side Yard Sect�acks Estimated Cost: $ �� /% ,2.�—' (Cost on Back) Driveway Curb Cut Width Need�: Ft. Fr,,= Ft x$ _$ DATE: �-( ( ��1`� APPLICANT: � � Tet. � � z� ��i � Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ � �, C,� � �. /.3 $ �� $ $ �S c� C� $ $ $ $ � ��i CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $800 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.IX� Conservation Plan Review Fee Determined by Engineering Agr�ment Necessary [ ] Not N�essary [ ] BUILDING PERMIT FEE SCHEDULE The Chief Building Official shail, before iss�.ting pe;mits for the erection of any building or structure, or for any addition to any existing building or structare, or for any alteration or repair to any existing building or structure, upon application therefore, require bhe pay�nent 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 $S00 $SOl to $2,000 $2,001 to $25,000 $25;001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $S(?0,001 to $1,000,000 $I,OOQ,001 and up FEES $15 (Minimum Fee is $15 plus surcharge) $15 for first $S00 pins $2 for each additional $100 or fracrtion thereof, �to and including $2,000 - $45 for first $2,000 plus $9 for each additional $1;000 or fraction thereof, to and including �25,000 $252 for first $25,000 p1�s $6.50 for each addirional $1;000 or fraction th�eof, to. and including $50,000 $414.50 for first $50,000 plus $4.50 for each additional $1,U00 or frdction thereof, to aad including $i00,000 $639.50 for fn� �$i00,OQ0 plus $3.50 for each additional � $1,000 or fia.ction thereof, to and including -$500,000 $2039.50 for the first $500,000 plas $3 for each additional $1,(�0 or fiaction thereof, to aad includiag $1,000,000 $3539_SO for the first $1,OQ0,000 plus $2 for each additianal $1,000 or fraction �thereof - DRIVEWAY DEPRESSION ESCROW (Concrete Gtirb Strcets On1Y) Alternate "A": Removal an.d re,placement of curb and gutte� only - Driveway width plus 6 fe� times $13.50. � Alternate "B": Removal and replacement of curb aad gvtter aad install a 3 foot wide. approach with 6 inch depth - Driveway widdi plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structwre and of the coastn�ction site. A Certificate of Survey of the lot, showing the loca6oa of the fvundation once it has it has been constructed will be required before proceeding with tfie framing. � � � rn, Z � � � � rn � � � � � o 3 � Z o� m 3 3 � a �' `o m � 3 � � p - � a � � ' � m m � � � ° O � � � i� � � � � � � Q- �� o � � A .. 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O. � v � � � o si 3 -° � � � � � � �� -a� �. m�� A � a ., m A �T � � O •► „1, � s �-.� � � m� � `� b s � p x' � � � � � � � � � a � � ... :.: a:�+r.:::.v>c.o.�:w..wvv.�.r.:.. w � O W v v � � � CHIMNSY AND STACK VBRIFICATION S � The undersigned hereby verifies that the existing chimney or stack: e 1. Has been carefully examined Yes (,Q No O 2�. Is free from rust or,deterioration � Yes (� No ( j 3. Has no foreign objects lodged within Yes`�j No O 4. Is securely supported Yes (� No () 5. Meets all current Code requirements for size�and total BTIJ's connected 6. Has total heating BTU's of �,�� v All other BTU's � 3 i� �� TOTAL BTU' s _ ,��'-7 ��7� � � , Remarks Yes (� No ( j List Alterations Beincr pone: ,��i`�� .�/l.. 1,��.� 7l� ��% ��/� p �_i��i,�C e?� �C � � ✓> ��G /� � HEATING COMPANY Signed By Date � ��r� Ai� C�n�itioninp � Heating, la�. � - , , _ , _�_ . � ci � � � z � _ � nu m � � � � m 0 -o m �a C n m n -i z � a 0 �b''o n�i � I D Z � � � � D h rn � 0 � rn rn � � � . . . .. . . . . .. . . . . . . . ...� . . .� . .�..� ... .�.�,�:.: . . . : :�, . . . . . . . . . . � D � � .j � � �� rn� � N>r� �� rr�� o � r ��$ N c �J m 3 �p $�� .�: � � �� `�. � � � D �� -i c. � . e U! .,,. . � � � � � � v � c � S 1 � ro� � � � �. � � m �� o� p1 91 ¢1 -i��n��'mm3��g'� `° v� �__; ��m�°$� g � � � � � � � y �a � c m � *�� .�.� � �� w � "' � rnc�, � � � � � � ��, � � *�� c � � . . �� . : � �� 1 I � � � � � � �� '��n�� cn 000;p•�c;p�•�v.�cn �;a O O O O O g O S O O O� O � � D � ►�J L � � � � � � m � � � a � �. � � � � �) d � V p � G� L rn � � � � '� � 7. � 3 � ? 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