AF - 41987sue�ecr PERMFIt AK?. "
City of Fridley .� '"� 8792
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� � RECEIPT NO.
� �v _____ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. `'�a
1 i ; ��J �
`.-_-� �"��1 `, CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPqOVED BY
i � � 612-571-3450 g10-F15 2/6/87 / /
JOB ADDRESS 689 Fair�ont Street N.E.
1 LEGA� LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oescR. 17-20 T Riverview Heights. sHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
David/Sheri McCai.n 689 Fairmant Street N.E. 786-0974
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZtP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS 21P PHONE LICENSENO.
8 USE OF BUILDING •
Residential
7 CLASS OF WORK
❑ NEW �1 ADDITION ❑ ALTERATION ❑ REPAIR � MOVE ❑ REMOVE
8 DESCRIBE WOHK
Construct a 24' . x 12' Addition (288 sq., ft. ) to Dwelling
8 CHANOE OF USE FROM TO
STIPULATIONS
See nota,tions on plan.
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SE�A�AY� ����li"i� R�Q�I��� ��R �41�
VLI9RfN�, I�EATIR�G, PLUINBING AND SIGNS.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, �PE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTIIATING OR AIR CONDITIONING.
THIS PEF;MIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IP CONSTRUCTION
OR WORK IS SUSPENDED OH 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 HEAD 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S�-4,►000 y�%, OO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PEHFORMANCE OF CONSTRUCTION. $�.04. SO None
N fEE TOTALFEE
$ 26. 3 $�:37.63
SIG � URE OF CO//y,'�RACTOR OR AUTHORIZED AGENT IDATEI
G2���Lli' � � � / �►� ,. WHE RO R A HIS YOU PER
(a r�
S ATU:iE OF OWNER iIF OWNE BUILDERI 1 ATEI INSP �ATE
N� [. ] City of Fridley Effective 4/1/8b
ADDN. � R-1 AND R-2
pI,TER. ] Building Permit Applicat3on
Construction Address: �� ���� � ��� � T � �
Le�al Description °� r7 T�Z � %�� �C /� � � �i�s�i'!/` �'r� g c
Owner Name & Address � ��'�l%//� � ��1 � % / �fif`�% Tel . � ���° ° �9��
Contractor• -S�� � Tel. �
Address:
Attaeh to this application, a Certificate of Survey of the
lot. with the proposed eonstruction drawn on it to acale.
DESCRIPTION OF IMPROYEMENT
/
LIVING AREA: Length �� / Width �°Z ` Height � Sq. Ft. ���
GARAGE AREA:
DECR AREA:
OTHEa:
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
o�2��j0 � �i V lq . ��{
Corner Lot [] Inside Lot � Ft. Yd. Setbaek Side Yard Setback
Type of Construction: !���l1`/a� Estimated Cost: $
Approu. Completion Date: ' ���� �
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
�
DATE: l � 9 g � APPLICANT: ` � Tel . # ��� �� ��
Permit Fee
Plan Cheek
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY IISE ONLY
$ Q�" Fee Schedule on Reverse Side
$ �(te.t� 25� of Building Permit Fee
$ � � � $.50/$1,000 Valuativn
$ $ 525 Per SAC Unit
$ Fee Determined by Engineering
�
� �/_� Agreement Necessarq [ ] Not Necessary [ ]
$ �9
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020�- aZ.�
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BIIII.DING PERMIT FEE SCHEDOLE
The Chief Buildin� OfPicial shall, before issuing permits for the erection of anq
building or structure, or for any addition to any existing building or strueture, or
for any alteration or repair to any existing building or structure, upon applicatio n
therefore, require the payment by the applicant for sueh permit of fees to the amount
herein belo� set forth and in the manner herein provided to-wit:
Total Valuation
$1.00 to $500.00
$501.00 to $2,000.00
Fees
$10.00 (Minimum Fee is $15.00)
$10.00 for the first $500 plus $1.50 for each
additioaal $100 or fraction thereof, to and ineluding
$2,000.
$2,001.00 to $25�000.00 $32•50 for the first $2,000 plus $6.00 for eaeh
additional $1,000 or fraetion thereof, to and
ineluding $25,000.
$25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each
additional $1,000 or fraction thereof, to and
ineluding $50,000.
�50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each
additional $1,000 or fraetion thereof, to and
ineluding $100,000.
$100,001.00 and up
$433.00 Por the first $100,000 plus $2.50 for each
additional $1,000 or Praetion thereof.
DRIVEWAY DEPRESSION ESCRW
(Conerete Curb Streets Only)
Alternate "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
approaeh with 6 inch depth - Driveway width plus 6 feet times $15.75
VERIFICATION OF FOUNDATION
Permits for construetion will be issued a minimum of 24 hours from the time of
application to allow far proper revieW of the proposed structure and of the
construction site.
A CertiPicate of Survey of the lot, showing the location of the foundation onee it
has been c:onstructed will be required before proceeding with the framing.
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