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AF - 43097� City of Fridley, Minn. BUILDING PERMIT n � N° 3072 . C� './,� �' � � Date: .. ....�V...... .. Owner �. � . uilde .� . , . . . !. �,.a2i��.�!�-� . . . . . . . /; • +� • Q Addre�ss ..��%.�!.. . .............. Address ....�0 �. ....... ................. LO�CA IaN OF BUILD[NG No. ac! �v .. Street ... ................................ Part of Lot ...... ...... . ... LoY„Q_ ./�. � .�Block . . . . Q. . . . . . . . . . . �ddition or Sub-Di 'sion . . . . ' .� `�`��. � . . . Corner Lot . . . . . . . . . . . . Inside Lot . . . r . . . . Setback � � . . . . . Side rd . . � � . �. . . . . . .'. . . . . . . D C [PT[ON T b tJ as• . . , . . . � . . ront .aS�� . . Depth � / . . . Type of Construction ........ Depth ...... '!:L1 .... Est. Cost.�� ��,��� �'� � �� OF BUILDLNC Height���JG�� Height ...� �.�a�...... Sq. Ft. �! .�1. . Cu. Ft. . . . . . . . . Sq. Ft. ........ Cu. Ft. ........ To be Completed . .� �. .. ... .. In consideration of t7ie issuance to me of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. � . . . . . . . . . . . � . �C,'1�I�!:r�. . . In consideration of the payment of a fee of $. .��! O�rmit is hereb ranted t P Y g ................ ... .. .. .. .. .. .. .. ... .. ... to construct the building or addition as described above. This perxnit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in ali work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the city limits and this permit may be revoked at any time upon violation of ap3j of the provisions of said ordinances. / %% i // NOTICE: This permit does ,not cover the construction, installation or alteration for wirtng, plumb,ifig, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. '�, - � '`� � � PUBLIC WORKS � ANCE F�RI�DL,�EY DATE September 3, 1986 FROM �n Carrigan, Water Foreman SUBJECT 500 Dover Street N.E. MEMORANDUM TO The sewer and water have been inspected at 500 Dover Street and the water meter is hooked up. Everything is ok. � a-x� � Don Carrigan, ti9ater For n INFO � _ Ct1YOF FRtDLEY CNIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (6l2) 571-3450 September 5, 1986 TO WHOM IT MAY CONCERN: Re: 500 Dover Street N.Et, Fridley, MN Dear Sirss 0 This is to inform you that thE sewex and water lines�for ths ahove add�ess were installed in 1962 and the sewer has been billed since that time., The water meter was taken out in 1978 bu� the water was just connected to the dwelling in Septeznber, 1986. The water departsnen t has made their inspections on this connectibn �nd they have approved the connectibn. If you have any questinns on this matter, please feel free to contact me �t 571-3450. Sincerely, DONALD CARRIGAN Water Foreman DC/mh SUBJECT City of Fridley 2 O 5 O 7 AT THE TOP OF THE TWINS g � I L D I N G P E R M I T i • RECEIPT NO. � �• COMMUNITY DEVELOPMENT DIV. r � L � PROTECTIVE INSPECTION SEC. 3 7��Q � � � � � � /"'1 � CITY HALL FRIDLEV 55432 NUMBER REV. OATE PAGE Of APPROVED BV �_'__�; �.' bi2-571-3450 910-F15 8/8/90 � / JOB ADDRESS 500 Dover Street N.E. t LEGAI LOT NO. BLOCK TRACT OFi ADDITION SEE ATTACHED SHEET oesca. 1, 2, 3 8 Spring Brook Park 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Lewis 500 Dover Street N.E. 3 CONTRACTOR MAII ADDRESS Z�P PHONE IICENSE NO. Shep's Construction 2177 Shad wood Road [ni� zata MN 55391 471- 0 4 AFCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGtNEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CIASS OF WORK ❑ NEW C� ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK ��3�i Constxuct a 25' x 11� Deck.Additian� Remove window and add patio door 9 CHANGE QF USE FROM TO STIPULATIONS See notatians �� on �lan. W�Rt�1HG �efore diggrng ca11 fot all uii�i�i loc�tiort� �A-0002 R�QUIRED 8Y i,A�V TYPE OF CONST. OCCUPANCY GfiOUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITNIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WOFK IS COMMENCED. NO. DWLG. UNITS OfFSTREET PARKING I HEfiEBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION �' STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMPLtED $3�SQO $]-.']S WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OF CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- $63, OO. STRUCTION OR THE PERFORMANCE OF_ ONS7RUCTION. � � �7 PLAN CHECKFEE TOTALFEE �> <�� �. $64. 75 - S�GNATURE OF CONiaAC OR AUTHOR12ED AGENT IDATEi HEN PROPEFi Y V IDATED THIS IS YOUR PEFMIT a ` ' ����� � SiGNATUAE OF OWNEFliiF OWNEFl BU�LDERI iDATE� BIDG �NSP �A � � x__�.... _ ' �, �� , � , , ; �, � � i . I� j �I�I �� � I � f I i I E� �, .N P ON TR TioN S C S U �� SHE C � � '� � � ; �� .�� � MARK SHEPHARD ,� '. j �� !! I 2177 SHADYWOOD ROAD ' � ' � WAYZATA, MN 55391 � � 471-7006 � � ' � ,�cw � � ' � � � 6 - t - 90 � � ��� �S'`'' ' � � C� ot '' �c� �.�wt s �s ,, �i � � �� e � �� u'�''yo�',s � ! I, IF� �,� pR �z�,--����. � <<�-, ���5� ,,.�s �( ��1 i. �� 0. v� s� o�� c,. c= �� s c-� 2 e r-t M�W S° P� � �O D+� � .,� _ ..:.. , . : ,_ , ,� ,. j ' l�c: �--r � c� t-fc� us� � �� � � lv , z n c`3 �c r�-t ;1 C c�3 � _ __ _ _ —_ ____ _ _ . , = _ ____ __ _ -- ___ _ _ i � � � ' 0� ,� �x�, c.e:�.t�Ax�� n�ck�tvv �at, �` `4 � � � _ �h� i ��� � �� , v , � �� � u� 1 � � -' ' 2 � Z � 1 v9 ���� � , _ - ---- -.-- c j \�� � i _ 1 I �, �� , � R�IL =-1 x 4 cc-n�az� �oS ;.5 y � - Z�8 �" 4� x .�iZ" GC�� �'�C> �; �' �'Foo�1v� - � I �� i , ,� I5-O�� . '!p -�- _ _ ^--- _ - _._— �,..._j..� ----- ----- I� � i +-�. t`� 1.--�*,i'� � r �' � t ----------- -- ___� 2,,d ct]�.R __— �_ --- -- - f -- -- - -- 2�2 Co" o•�.,__ _. S m ' --_ _ _.___ ____ _ ; j . � _____ _ :_- - . _ Z� Zx� m��J ; ��A1► ' ':�� i � ll..._ � --- - � � - — A ♦ 0 0 . . � � �. � :?c kS � (�ip�� � 4�. --------- -----���-•�� ------ � C�./ V� � NEW [ ] Effective 1/1/90 ADDN [}� R-1 AND R-2 P�L'I'EEt [ ] Building P�ermit Application construction �s.s: � � � a�o V�►2 �S.,i - Legal Description: owner r�ame & Address: �f C� c-f rv �. `.w l s Z�e.t. # c'ontractor: c5C-�c=t� ,S G� c�S� Te1. #� ZI �7C�0� �: 2t-�� �st�����vc�� �t� iN�'�' �� �"� r�r� ����39 � Attach to this application, a Certificate of SuYVey of the lot, with the proposed construction drawn on it to scale. ., «• ., . � r •.. a� ia� LNII�1G AREA: Iength Width Height Sq. Ft. C�R�GE AREA: Lenc�th Width Height Sq. Ft. DF�R AREA: Lerigth �� -�a Width (�� � Hgt/Graund o� o Sq. Ft. Z�4 d Zr55to► , OTi�R: REr-�c:`i` �...�fiV �' f��r� t'�A <<C� c..1("'�(? 8 25� �C �?. � ���?. � a -4 4du ^. Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yan3 Setbacks 'Ij�pe of Construction: wo�� �=r�Ar�-r �. Estimated Cost: $ 3�[`>C� ,� Approx. Oca�letion Date: SE� ; ���r--� Proposed Driveway Width If N�a Opening Is Desired: Ft. $ $ ' th + 6' See Back Page L�ATE: �- Y���j APPLIC�IV'r: �'"�� Tel. #,4 7J � TOC�, CITY USE ONLY . Permit Fee $ �p 3, C�(:��y: `���� Fee" Schedule on Reverse Side -� �: ;�. state surcr�arge S 1; �'�r ;_�,�'�.'... $:�d/Sl, o0o valuation SAC Chazge $ ���°'��'n� '�";,�600 per SAC Unit ,,, "'� `� , I1Y'1V@4Tdy ESCY'C1W $ .� r, �n .�•t: ��A�� OY' Alt. °B�� AbC3V2 Park Fee $ � � , , ' ` �Fee Determined bY �J�r�J Sewer Main Charge $ Agreemexit Neoessary [ l Nat NeoessaiY [] �mrp,L S % �Q s�z�zzorrs �ls 3� ,c�c� ��7� a 3�a� � aoUC.— �,C�Ci a�� -1� G 3� � � ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 s�2-36u4 r�aa�: : 500 DOVER ST NE : 033024310084 : LTNAVAILABLE : LOT BLOCK : HEATING : RESIDENTIAL : ADDITION/ALTERATION 571-1ZIi7 2 3�v PERMIT NO.: 2004-00135 � DATE ISSUED: Ol/28/2004 VALUATION . NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A REPLACE FURNACE (WARM AIR, TRANE, 80,000 BTU) VALUE OF APPL OR WORK 0 # FURNACES 1 # GAS DRYERS APPLICANT PRIDE HEATING & AIR COND INC 22713 BUCHANAN ST NE EAST BETHEL, MN 55005- OWNER HATCHNER TIMOTHY P 500 DOVER ST NE FRIDLEY, MN 55432 0 # GAS RANGES AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl� will be complied with whether specified herein or not. The granting of a permit does not presume to give autharity to violate or cancel the provisions of any other state or local law regulating construction ar the performance of construction. Applicant Date Bldg Insp HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 3870 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 0.00 30.00 0.00 0.00 0.00 0.50 30.50 `i 1 \ CITY OF FRIDLEY INSPECTION DIViSION � Effective On January 1, 2002 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572•3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS__,� t XJ��� ��:%��J RATE SCHEDULE 1:_i��a ` OWNER�C�' L�t�l C_'il� Y�'1.C�il ' Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1°Jo of Value of Appliance or Work Commercial/Industrial 1.25�"/0 of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTALFEE TOTAL $Z- ' $ BUILDING USED AS_�C S �� �iil��' / e ► ..- ESTIMATED COST �Y`, %SC� � PERMIT N0: �' , 'C� �l�J DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units � Circle One (Steam) (Hot Water (Warm Air) � $ Trade Name '�Yc.�-Y.�.. Size No. � C� BTU �SU;C� HP EDR $ Fuel i��'[,wC`.�.J1 L-��� Total Connected Load Burner Trade Name�c � i No. � 7� $ BTU F�(�, OC�!'� HP EDR 1�iA�' 1�' � $ .50 � �� $ /� MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION � G� �' •�Z� REFRIGERATION/AIR CONDITIONING PERMIT 15 ffi25 00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from atljoining property owner. The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. �7_ �� �r3 .� ' DATE I I � � �(j � TEL # `TC � ��� DBC� THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED •uu•► ► ► •►► •: �►� •��: •► e - � •► When re In acing an _xis in� f iran __, the undersigned hereby verifies that the -� venting has been examined and is free from rust, deterioration, obstnactions, �� and is securely supported and firestopped where required. The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The Pxis+in� comb ��tien air is sized and installed to meet the current codes and manufacturer's specifications. When required to in�tan a n_w came ,� ien air�it will be sized and installed to meet the current codes and manufacturers specifications. When ins allina a new ventinq cyctpm, the undersigned hereby verifies that it is a listed assembly and meets the cuRent codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Is the common vent and vent connectors sized and installed corre�tly after an appliance has been removed from the common vent and vented separately as per current codes. Yes(�No( ) Yes (1�} No ( Yes ( ) No ( ) Yes �o ( ) Yes�No ( Yes(�o( ) ! • • . � ' � ' . � • ' • 11 11 • / ' � - � • " � • � � ' M • / • �11 . • � Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances �_ Total Btu Input $�Q � J Common Vent Type �(� Vent Height �� Diameter _`� inches Appliance #1 Vent Connector Height ft Length ft Diameter in ?ype Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type � :� •► �- ..- r � . � � ,. - - i, ' . — HEATING CO: Signed By: .� Building In�pect'rons 763-572-3604 BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY �U --"" Received By: Date Rec'd: DATE � G� �� �'� YOUR E-MAIL ADDRESS SITE ADDRESS J�O� ��� � S� THIS APPLICANT IS: ❑ OWNER �ONTRACTOR PROPERTY OWNER/ N,yT,�: S�4N t�V �_.j, Y� � 1 TENANT �Dx�SS: �'b0 �O11 ��12._ S'T C1TY '�21 1� STA'rE_zrn PHONE: ��v� � S�%�' — 2'�S3 CONTRACTOR SUBMIT A COPY OF STATE LICENSE a YOUR STATE LICENSE ADDRESS:�� WITH APPLICATION pHONE (1TS( � PROPERTY TYPE PERMIT TYPE �XP DATE �� �1 (,jv CITY. F.�x cp -.��'- l• co � 3. �+SWGLE FAMILY/NEW CONSTRUCTION ❑ TWO FAMILY/NEW CONSTRUCTION 0 ADDITION �GAR.AGE/SHED � BASEMENT FINISH ❑ ROOF ❑ DECK ❑ SIDING ❑ SWIMMING PO� TYPE OF WORK: I �E�' � � MAINTENANCE/REPAIR ❑ DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT ROOFING NUMBER OF SQUARES GARAGES PROPOSED SIZE:� C�Z� PROPOSED HETGHT: �_ SIDING ❑ Vinyl ❑ Aluminum �other G£M��JT �(�E� WINDOWS IN EXISTING OPENINGS ❑Yes ❑No OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED__ LENGTH ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia IACATION OF WINDOWS NUMBER OF SIZE ❑ DRAIN TILE O OTf�R HEIGHT AT91�1�P�_( BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING TH� 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ p�� SII -��P OCCUPANCY TYPE Permit Fee Plan Review Surcharge Fire Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due See Back Page for Fee Schedule 65% of Building Permit Fee (.0005) times the total job valuation — Minimum $.50 .001 x Permit Valuation (1/10%) $5.00 (State Licensed Residential Contractors) $1450 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and es of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an applicatio for permit d work is not to start without a permit; that the work witl be in accordance with the approved plan in the case of all work i requires evi w and approval of plans. 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TFH�t:+�.��n ��xr i�oG f� �w��-��, L_� #� ��^�"a'�— „ /�-- � 6 0 �.1 � ��' � .�,_a Lot�"�� I�I.C�,�- ��3� 0 REV�EWED ��`���. �OR QpDE '' — 0 � 1� t•s�.', S,4-t�.�t� � � I rvl !P (.,.; , cj00 .�tl�(2.5'r', ��� �� _� r�-�eaE.-�o �2;.. rtia.rza,u,�s, �n�� `5 g R-� �To � (�5'l�co3c� �23�s 3uil�ing � nspections 163-572-3604 )ATE s r �� �ITE ADDRESS � 'HIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH A.PPLICATION BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS ❑ OWNER Permit No.: � Received By: Date Rec'd:! 1,�, G �,fi� ADDRESS: .�Z'D //�!'4/"' �� CITY ��"''�l STA' PHONE: �• �04- - c�o G=�7 �� ' �L „� � c�,.` � 1�"4�3 Z. STATE LICENSE # . EXP DA d3�s `1 Zy,� J� 3 6�' nnDxESS• �3�3 3 �`f � r I" � N CITY /��� ���`= STATE_ZIP PHONE iG !2J �23 ��S".� F� 17�6 3� 4� �- 4 7 s� PROPERTY TYPE � ❑ SINGLE FAMILY/NEW ❑ TWO FAMILY/NEW CC PERMIT TYPE ❑ ADDITION U �iAKACir✓st ❑ BASEMENT FINISH ❑ ROOF ❑ DECK ❑ SIDING ❑ SWIMMING TYPE OF WORK: ❑ NEW � MAINTENANCE/REPAIR DESCRIBE WORK BEING SIZE OF IMPROVEMENT NUMBER OF SQUARES _ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other i2s... � � WII�DOWS IN EXISTING OPENINGS OYes �No OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 2SZ�0 OCCUPANCY TYPE D TILE �' \ R — :hs-f:l��-, Z c�.�r '�i WIDT'�i o xousE orrt,Y ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim O Fascia IACATION OF WINDOWS HEIGHT Ft. BASEMENT REMODELING SUBMIT: 1. Existing Fioor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: 1. Site Plan/Survey showing the existin� structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Chazge Total Due $ �� �j. Z� $ • $ 2� °5 $ � . Z� $ �; � U G' $ $ $ $ $ � $ 'i Z-�,� C'T? �, See Back Page for Fee Schedule 65% of Building Pernzit Fee .001 rimes the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (Sta.te Licensed Residenrial Contractors) $1550 per SAC Unit (Plans to MWCC for determination) �+6ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach TION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building pemrit 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 pe 't and w rk is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work 'ch req es evie and approval of plans. qC SIGNATURE OF APPLICAN PRINT NAME ��c�a.1 eV ��-- DATE � b'" G �C/ , _. 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" . � '-: i � ,i � � � '�—..�._,,_,�-� �,�—�.e'. � � �f � �'�� � � � � � � v � Y � ,� � ; - � � ; '� � Building Inspections 763-572-3604 BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY Permit No Received By/�� Date Rec'd: �L > / / DATE �Z � YOUR E-MAIL ADDRESS ll�+'+Q �l1� /Z S/`L1» ��+ v �4 i'�'�Yt� SITE ADDRESS �� P� UE-'� S NLC.�7 TH1S APPLICANT IS: ❑ OWNER �CONTRACTOR PROPERTY OWNER/ � NAME:_ TENANT ADDRESS: CONTRACTOR SUSMIT A COPY OF YOUR STATE LICENSE WITH A.PPLICATION PROPERTY TYPE PERMIT TYPE TYPE OF WORK: � STATE LICENSE # ZO S I�T �o � E} �DxESS: � 3 � � 3 � - � PHONE / Z Z `" �3�� FAX � INGLE FAMILY/NEW CONSTRUCTION ❑ WO FAMILY/NEW CONSTRUCTION ❑ ADDITION ❑ GARAGE/SHED ❑ BASEMENT FINISH � ROOF ❑ DECK ❑ SIDING ❑ SWIMMING POOL ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR �@'REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT ROOFING NUMBER OF SQUP.RES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: _ SIDING ❑ Vinyl ❑ Aluminum ❑ Other LENGTH ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE OSoffit ❑ Trim ❑ Fascia _ ,�?� ( STATE�!�LIP ✓ �.3 �Z /.�1 DATE 3107 �� CITY s� iA/i' STATE_ZIP '�-36 9 :� 1 �2� - 97s`� WINDOWS IN EXISTING OPENINGS ❑Yes ,`Io LACATION OF �yI� IDOWS OR FOR NEW OPENINGS-DESCRIBE SIZE OF S7 y K a�o OPENING CHANGES & �� e� 2 TvPE c�F WINDOW TO BE INSTALLED �'1 NUMBER OF WINDOWS SIZE STORIES �❑ D IN TILE T�HER /KT��2/pQ. �Nl.s ¢f �t WIDTH HEIGHT BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used Ft. FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCfIEDULE) �_ 3 T a TOTAL JOB VALUATION � 70 P� D OCCUPANCY TYPE SL ' Perxnit Fee $ 1 9,� S See Back Page for Fee Schedule Plan Review $ . S I 65% of Building Permit Fee Fire Surcharge $ �,Q[� .001 times the total job valuation Surcharge $ 3� �U .0005 x Pernut Valuation Minimum $.50 License Surcharge $ ,5 , c� $5.00 (State Licensed Residential Contractors) ! SAC Charge $ $1550 per SAC Unit (Plans to MWCC for deternrination) Curb Cut Escrow $ ft + 6 ft = ft x$20 =$ Erosion Con�ol $ $450 Conservation Plan Review Park Fee $ Fee Deternrined by Engineering Sewer Main Charge $ Agreement necessary () Non Necessary () Total Due $ a'� S v� Make checks payable to: City of Fridley Attach Stipulations _ THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building pernut and I aclmowledge 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 worlc is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work w re ' s review an approval of plans. �/ SIGNATURE OF APPLICANT � PRINT NAME '�'"� �/�J� DATE T�Z� C� 6 Page 2- Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or struchzre, 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: 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 proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Onlv City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 � � �� ��� �� � - s� � : ��w G.�, � ( � s� oa,�.r s-� � .�.Z,Q d.� s—�-y 3 L � � � �v-e.,.'-� .�. r3-�h ,� ii�� �'�'� -�v � �3 � J/� 4 c;,+� . � f rP�.n,e c.�,! o� °�J'<< u�.,, a�,�;r/t� /�'o� � � U R� nnl �.� e �� � -, --��.h, � ��,�b � Cz� /I'/d `c✓c � 'N x^ ,� „ � . N � � �. 0 , �� �: � T��.m rZ � � ��-n 0 �n- . � � _.. _ - . _--_ ,'_.�, E'� r s7..,��1 xx � w.� (( �` i���' ��;�� 1 �� ^ '����jtJ �M 1�1 c � ' �'� uE � '`�l� �at 0 � �Q R 3�`7, ( � � � �� ��� + �a�'F �-�4 CJ n�'S �-1,� (L R 2 e�, �" "` �v � � T �o .Lf� K6 �, �� � o,� �� i i R.�.-1�► o v� C� A�RA47. 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