AF - 45265-� . ..,;q:yts,�+ :.r�; .. .-'-�r�- :�+_- ,.:: .:
sue�ecr PE .
City of Fridley 18 9 0 7
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
, � R IPTN
� ' v _ COMMUNITY DEVELOPMENT DIV.
r � � � PROTECTIVE INSPECTION SEC. a
� � �
� � /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. OATE� PAGE Oi APPqOVED BV
�---"�: '•� 612�=571-3450 910-F15 4/27/87 � �
J08 ADDRESS 5572 Fillmore Stareet N.E,
1 LEGAL �OT NO. BLOCK TRACT OR ADD�TION SEE ATTACHED
DESCR. 2� Parc A 1 Iwen Terrace sHEer
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Kenco Construction Inc, 10666 University Avenue, Coon Ra,pidsf MN 55433
3 CONTRACTOR MAIL ADORESS ZIP PHONE LICENSE NO.
757�4Q52
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS 21P PHONE LICENSE NO.
6 USE OF BUIIDING
Residentia,l
7 CLASSOFWORK NEW ❑ ADDITION ❑ ALTEFiATION ❑ REPAIR ❑ V� MOVE
�
8 DESCRIBE WORK
Constxuct a 33 "GD" x 24" DHrelling �nd a 20 �� 2a� caxa�e. Before digging ea11 local utilitie�
- GAS �t�
9 CHANGE OF USE FROM TO
STIPULATIONS pxovide a haxd surface dxiueway. Pxovide sod in the front and side
`yards. Provide C3ty �;�itfi. copy of verifyin� survey o� lot be�ore capping .
SEft�ER LOCATTON; 8'� VCP �t centerline of Fil�e Street, Approx* 7' Deep in 5tre t
WATER LOCATION; 6'� CI:P 1Q� PTest of Se�+rer L��� ��,,�
�
�R�qCx Fk �'. � - }.
NO EXISTING SERilTCEB j� ��� OF(/t,./C�i�k �
ANp tS � R � C�, � , � ' � :
Walls between units: must he tw�o 1 honr �i �
���d�� SI/yG H�SAT/pN Ur.� c```�%1 ,,�,��'
D�ivev�ray Escrow: ].6' � 6'' = 22F x 513.5� =$297.00 �fE ��. /N�p RPpSE P.S
� R'�tto� S�o c y
SE�ARAiE PERI�IT$ R���I��� ���
WIRINC, HEAfiIN�, pLUMBIN6 AND SIGN�,
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY IOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL ANO YOID IF WQRK OF CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHf1�80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONE� �Oa A PER100 Of Q20 DAYS AT
ANY TIME AFTEH WORK IS COMMfNCED. • 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 VALUAT�ON SURTAX
AND,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPUED
WITH WHETHER SPECIPIED NER81N OR NOT. THE GRANTING OF A PERMIT $6Q.�750 $30e�8
DOES NOT PRESUME 70 GIYE AUTHORITY TO VIOLATE OR CANCEL THE pERMiT FEE SAC CHARGE
PROWSION F'ANY O HER STATE OR �OCAL LAW REGULATING CON-
R CTIO 0F THE ORMANCE f' GONSTRUCTION. $332. J�Q $525, �Q..
PLAN CHECK FEE TOTAL FEE
$83 * 13 $�71 { Ql �h DW & PF
. SIGNATUfiEOFCON'RACT�WOR�AUTHORIZED�AGENT �DA i WHEN PRpPER� ALIDATED THIS IS VOUR PERMIT �
rs
S�GNATUAEOfOWNER11FpWNERBUILDERI � IOATEi BLDG �NSP ppT �
��
NEW �0'j
ADDN. [ ]
pLTER. [ ]
Construction Address:
Legal Deseription:
Cit� of Fridley
R-1 AND R-2
Building Permit Application
�� �l L L..�c�-- � �-1�
��
Effective u/1/86
' � / ��
t :
Owner Name & Address: I�.-'��-" � �'' �" ST � Z w� Tel. #%S 7-�+��Z
Contraetor:, S,r� r•-- � " Tel . 4
Address: �' � O Co %(o Lf,r-• ��-cti.S . r- �-u c� Co o�.� �v� �r � SS-4 33
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
' DESCRIPTION OF IMPROYEMENT
LIVING AREA: Length �� � Width ��g � Height �� Sq. Ft.
.
GARAGE AREA:
DECR AREA:
Length a� Width a� � Height _
Length Width Hgt/Ground
Sq. Ft.
Sq. Ft.
OTHER:
Corner Lot [] Inside Lot [] Ft. Yd. Setback ��.../ Side Yard Setback ���'� Iv� l�+°'"�
�
Type of Construction: �/L�a-�'y+� Estimated Cost: �
Approx. Completion Date: �� �"� ������
` � Alt. A Alt B
Proposed Driveway Width If Nex Opening Is Desired: $_� �
See Back Page for Explanation
DATE: � APPLICAh'T: Tel. � ��?�7�S�Z
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
SeWer Main Charge
TOTAL
STIPULATIONS:
CITY IISE ONLY
� ��i. s�
� �3•1
s 3t�.`�
� .
� 7 .Od
� �
$ � '� �0 I
o��r a��.�
� d1�.dl
w Nr�s �C�' � � �'
oZ. � - /.� � � '�
Fee Sehedule on Reverse Side
25� of Building Permit Fee
$.50/�1,000 Valuation
$ 525 Per SAC Unit
Fee Determined by Engineering
Agreement Necessary [] Not Necessary [ t]
.
C� w� E� WL ugr �►
C� �8=ice �U �v�„�
,--------�
.� �
- • �,; ElRE1t10R ENYELOrt AVEMaE 'y�" COM�UTATION ' '
. .M.. _ ' . . , . . :� _ �
ER: • � � y`;
�.��`
E AQDRESS s , r � J � . ' � ��.
��......�.�r
f MCTOR: pATE : ` � �MONE :
DETEIIMiNE HOIIKiNfi s0UA1tE POOTIICE OF EACH: '�- '
T01AL ExPOSEO WAII AREA........ " � � • '`:
.��'`�`� fo �t x 'U' � . °r2. �
TOTAL I100f/CE I l I N6 AlIEA. ....... ;� _��,pq'' c� •O tt x"U" ��e_� . ZO.q
T01A1 EX'OSEO WAII AItEA CALCUlAT10NSs
�
Totai •xpos�d Na11 ;
a�� •bov� l ioor........ �� �� .°� �a I t �... ;�:
a) Tot�l w�il windaw •r��: , � �
�:�... �
, � ,-��,,
qia:�d�.•••. r�j� �q �� x ��V�1 �2.� . r r.
- � 1 �i�� ��,i�a
� 4yo
� qlat�d,..... —. sq ft x ����� � ^ 1 �
�.._..._�
b) Total doo� ar�a ......... �1 sq tt x��U�� � � C�7 �. 2�(p_�
cI Totai �Ilding qlas� doo� a���i , �:
91as�d. . .... ��.�' .�.�.�..� •q f t x ��u�� 1 '�i � _ �, _ •, „ _
_�! ,__ 1� 7ti
qta�d...... — sq tt x "U" — . �.
_=
d) Total fireplac� wall a��� � ��q tt x"U" , It '. .. ,
_..�CP�_. .,.___.�.► :
•I Total wall t�a�ninq a��a �
(Ave�aq� 10�� . .......... �On fq• tt x ����� �.�=�� � • ,�
f) Total nst w�ll a��• �bow
.
floo� (Insul�t�d)....... ����°1 •q tt x ����� .� !>'�^?� • 2�7•�j
_�...�.._...�
9� Total �I� Jol�t a���...... �� •q It x����� .0,4,' . �� �
Totel tou�datlon
ar�a iExpos�d)..........�... J ,_ sq tt
h) Total foundatlo� '
M�IIdOM ii��������������• �' �q ft ii I�u11 � � �
.�.�..r�.
1) Total n�t �oundation
• �►�a �bov� qr�d�........ � �q �t x "�" • l,/ . [p��
. TOTAL �) thru i ) • �'.� ( `�'
f tt� �3 Is c1w •� a�� er 1��• thM 1t� I�1� you haw Mt tM intent ot {'
2 MCAR 1.16008 A and 0. ..
�3,� ,L �2.,� : .� viL ,
,
� � Paf� 1
�
ToTAL ExPOSEO aoof/CElllaa ����Tlars�
.
Total •x��td .
roof/c�lll�q �r�a........ � v .5 �q ��
.
�
;.�,.
.{
� �
. . , �;: ��f,i�i�t.
- _ ���f„=z;
1i Tot�1 skyile.iht •r��....... _ �q �� x ��� . . . . � . i
�._..
k) Total �oof/c�llinq /��wl�p •►.
•r�a (Aw��� ��1�� � � � � � • ' � �� t t !� ��� w C%Z-�I • � i0°� •.i;�E� � �
....,..�.� .
1) Total n�t Insulat�d '+� ��`"� •
, roof/c�i i inq an�..... �. ��-�" fi �( x "(�'� � aZZ • � �-J���Zj , ..
� ' �'�� .•'.�Y ����F: � c.' ,
TOTAL J) tAru 1 j I S,oZ ;, •
.,
i':
I'� cocat of �� ts the :� •s. o� I�s� th�� �2. rou h�w �t tA� I�t�nt o� `'��° �
' NGAIt 1.16008 A �d 0. ' � ( $.02 G ��°� ,' . v I� y`'!�'.�;},
� . . • • . F. ► � ''!� I
0
. �ik �.
•'�. `� � _
} :g�. ,,•
' ' .'�1��• v 1
ALTEIIMATE S111LDIMG ENYE�O�E IfESIGN i���=�
����
'�, � uti i l:� ths totai �nwiop� •y�t� �thod. th� v�lws �sc�bl ish.d by th� �u� +}t�� '�
' f it� �j a�d f� sMll �ot b� 9�ut�r thie tM suw ot it� �1 �nd /2.
. �'
1 ♦ : � . ` '�
:�:: ' ��'
3. ♦ y� � � '
�
�
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1
tERT1i1CATIAN
i h�reby certity th�t 1 haw e�lcul�t�d tA� "U" faatort and "11"
�Iws I+�nin �nd th�t th� bul idinq Mr� A��e�IMd wnt� or �xe��d• th� State
, f NlnMSOt• En��p� Co�t��vatien Jkt.
. p ��R
4 .x
u '�
+
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E
? `: 6 Studs
O�ISTRUCT I ON
RAMING SECTION:
1 Inte�lor al� film
2 •Z :ee roc.c
; � Inches so t w
b ._ �. r te ShtP.
S .i in
(+ Exter or a r m
WALL SECTION (INSULATEO)
--(1 Interlor air film
—� 2 3�'' , . -
—� 3 � , ns aticxi
--(4 ._5 3�_ Bi cxite Sl
—� 5 Si c?ing
--i�+ Exterlor at� #ilm
R V�
U • 1/R • _nn
I�IAL R � Z�.17
U � 1/R � .Q43
lilM JOIST SECTION:
1 Intertor alr film n,GR
2 S1; Insulaticm - 1�.0�
� '3 —1� T.'ood 1.8?
--i 4 �5 /�� T':i 1 r�ri 2, r
S � 81
f� Exterior atr�i�m n.17
TOTAL R � ?4.6
FOUNDATION INSUI.ATIOP� REQUIRED: •
Min. R-5 on entire wall OR U� i/R �_ _(!4
Min. R-10 down to frost depth
FOUNDATION SECTION:
—{1 Interior air film �.�R
2 tyro ns .„
3 .� occ
4 Exterfor a r i m �,17
(5
'� (G
TOTAL R �
�'�—�(-� U � 1 /R � .17
SLAF3 ON GRADE
Unheated Slabs:
Minimum R = 6.2
, , :
- - � - � ... .• - • • � a�.- ,
. . � �. ., q l .• ..d ;�'!
� • d • ' ...
� . . d . ,. ••. . q: , , , . . ,
. , �,�
, . • • ' ' � � �,i�f�"�+-,
.
,4 ' . �' ','u _� ,'•� � :
Page 3
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VENTED
0
0
�Q �E.ti!" s��
CONSTRUCTION R VALUC� �
. ����
CEILIN� SECTIQN (INSULATED): •
I Interlor air fiim. 0.�
2 5/R ' St'
3 £]. xi I sul 44 . C
b Exte�lo� air fllm stili r1.�1
TOTAL R �4�78
U� 1/R��2
CEILING FRAMING SECTION:
1 Intt�lor alr film �.FI
2 S/ SF,
3 Insulatioci �1�
4 interior air ilm still �. 1
5_3 '� i nches sof t wooci 4. 35
TOTAL R =3�-I?
U� 1/R� ,0?fi
CE I L I Nc SEr,T I ON ( I r1StfLATED) :
1' Interior ai� film �.F1
2
3
4 Exterio� air film still t1. 1
TOTAL R =
U� 1lR�
CEILINR FRAMI�lR SECTION:
1• Inte�ior air film �.F1
3
4 Exte�ior air ilm still �. 1
S (nches soft wood
TOTAL R =
U= 1/R=
1 ,Inside alr film �.�1
2
3 �
4
5 Outstde air film �.17
TOTAL R �
�_
U= 1/R�
Page 4
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CtTYOF
FR[DLEY
C1VtC CENTER • 643 t UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
July 1, 1987
Mr. Kent Roessler
Kenco Construction Inc.
10666 University Avenue, #105
Coon Rapids, MD1 55433
Re: Prefinal Inspection at 5570-5572 Fillmore Street N.E., Fridley
Dear Mr. Roessler:
On June 30, 1987 I met with the two potential owners of the above units, to
answer some of their concerns. There are same corrections and uncoanpleted
items that will have to he done prior to the City's final approval.
1. Provide sod in the frant and side yards.
2, Post address on structures.
3. Provide City with copy of verifying survey of the lot.
4. Install 2" x 6" lateral bracing in floor truss system.
5. Instal 1 sheetrock on the basement side of common wall adjacent
garage (this rock must go up to the f loor sheathing).
6. Repair broken trusses by sandwiching the area of damage with �
plywood or equivalent.
7. Fill open cores of brick ledge on block walls of the garages.
to
inch
We will expect the above items to be completed and a f inal inspection called
for. If you have any questions on these itans , please feel free to contact
me at 571-3450.
Sincerely,
J
t � � �
DARRE G. CLARK
Chief Building Official
DGC/mh
-
_
C��iY OF'
F[Z[DLEY
CIV[C CENTER • 6�31 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
July 20, 1987
Mr. Kent Roessler
Kenco Construction Inc.
10666 University Avenue, #105
Coon Rapids, MN 55433
Re: Final Inspection at 5570-5572 Fillmore Street N.E., Fridley
Dear Mr. Roessler:
A f inal inspection was conducted on July 15, 1987 of the above units and the
following items were noted which must be completed before the structure can
be finaled out:
1. Provide sod in the front and side yards by September 30, 1987. �,f'\ 8���
2. Provide City with copy of verifying survey by August 7, 1987. �:I�S��
3. Canplete f irewall in basement on side of common wall adjacent•to the �b �
garage by August 7, 1987.
4. laepair broken floor truss (5572 Unit) by August 7, 1987, .� p
5. InstalZ 2" x 6" lateral bracing in floor truss system by August 7, 1987. ��
6. Fill open cores in brick ledge on block walls of garage by August 7, 1987.Q�
We will expect the above items to be completed by the scheduled dates when
reinspections will be conducted to determine compliance. If you have any
questions on these items, please feel free to contact me at 571-3450.
Sincerely,
DARREL G. CLARK
Chie€ Bailding Official
DGC/mh
�
_
CITYOF
FIZtDLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
August 31, 1987
Mr. Kent Roessler
Kenco Construction Inc.
10666 University Avenue, #105
Coon Rapids, MN 55433
R�: Final Reinspection at 5570 - 5572 Fillmore Street N.E., Fridley
Dear Mr. Roessler:
A final reinspection was conducted on August 19, 1987 on the above units
to determine compliance with our letter to you dated July 20, 1987. It
was noted during this inspection that all items had been completed except
f or the f ol lawing :
Provide City with copy of verifying survey of the sites.
We wiil expect this to be completed by September 15, 1987. This survey
was stipulated on the building permit and must be completed and submitted
to our office.
If you have any questions on this matter, please feel free to contact me
at 571-3450.
Sincerely,
K
Chief Building Official
DGC/ath
�� ., —�..�-���-�- �
SUBJECT .
City of Fridley o 19424
AT 7HE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
� � •
COMMUNITY DEVELOPMENT DIV.
r � v � PFiOTECTIVE INSPECTION SEC. ���_� �
� �
1 S �
l.---� �'��1•� CITY HALL FRIDIEV 55432 NUMBER REV. DATE PAGE OF APPHOVED BV
i ' � 612-571-3450 9�0-Ft5 4/28/88 / /
JOB ADDRESS 5572 Fi.11more Street N.E.
1 LEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACHED
o�sca. Par�el A 1 IWPTl Terrace SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Mark Jensen 5572 Fillmore Street N.E. 571-2718
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIC,NER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS 21P PHONE LICENSENO.
8 USE OF BUILDING
Residentia,l
7 CLASS OF WORK
0 NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Oonstruct a 2Q` x 16' Deck & 6 sided Gazebo lus connectin deck
9 CHANGE QF USE FROM TO
STIPULATIONS, ,
.+� �
See natations on plan
�' : ' ' �`�
�,efcr� dib� cat11. ;��
�°��'� �- ��pARATE PERMITS REQUIRED FCR
. �IEC���.. � � ,
�CEtEP���j�����,�� �� ��iRl�v�, HEA�TfNG, PLUMBING A�D SIGNS.
,���UI _ �, : .: : :.
SEPARATE PERMITS ARE HEQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCV GROUP OCCUPANCY IOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID FF WORK OR CONSTRUCTION ZONWG SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCEQ,S.NtTHIN � DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD.OP 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCE0. NO. DWLC�• UNtTS OFFSTREET PARKING
1 HERE9Y CERTIFY TMAT 1 HAVE READ ANO EXAMINED THIS APPLICATION ]_ � STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUFTAX
ANO,ORDINANCES G�VERNING THIS TYPE OF WORK WILL BE COMPUED
W�TH WHETHERSP�CYf�ED MEREIN OF NOT. THE GRANTING OF A PERMIT $3,4�0 $l,%O
DOES NOT PRESUME ��O"G1VE AUTHpRITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHAfiGE
PROVISIONS OF ANY 87NER STATE OR L.00AL LAW REGULATING CON-
STRUCTION OR THE PEpIFQRMANCE OF CONSTRUCTION. $44. rJO
` PLAN CHECKFEE TOTALFEE
$11.13 $57.33
SI AT' CONTRA OR ORIZEDAGENT IDAIEI �
�. WHEN. PROPERLY UDATED T IS IS YOUR PERMIT
��g- � ��
� SiG ATU OfOWNER�IF NE UILDERi iDATE� BLpG WSP � qp7E
N� [] City of Fridley Effective 4/1/86
ADDN. [K �R-1 AND R-2
AL,TER. I � Building Permit Applieation
Construetion Address: 5 7 � � / �"� � � �
Legal Deseription: �� � U��L � ♦�.,�,,� r C e�
T�► �+ r• %l J -e k S �' �"c.. s � Z � �� � � � � r % / ?�
Owner Name & Address : �'-�-� �
Contraetor: D�Lt!1 � N� Tel .� f a �'
Address • '`^ L� 's'i� -�' ^—
Attach to this application, a Certificate of Survey of the
lot, with the proposed construetion draWn on it to seale.
DESCRIPTION OF IMPROQEMENT
�LIYING AREA: Length Width Height Sq. Ft.
�GARAGE AREA: Length Width Height Sq. Ft.
% DECR AREA:� Length �� Width �_ Hgt/Ground ��Sq.�Ft• Z'D �
I , OTHBR: ��CG�� 1!� 2� G.�`� , p��-$a '�e��•e �/� X�y = S 4��
��
�lg�x �•.5�.-= 3'��G.�� .�...
Corner Lot [] Inside Lot � Ft. Yd. Setback Side Yard Setbaek
.
Type of Construetion: !.V d t� — Estimated Cost: $ .��v i
Approx. Completion Date: ��! � �� � � � �
� �� �T
�t
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
�
DATE: �� APPLICANT: Tel. #�J� Ig
CITY IISE ONLY •
Permit Fee $ `7�•� Fee Schedule on Reverse Side
Plan Cheek $ 1 �.�� 25� of Building Permit Fee
State Surcharge $ �:i a $.50/$1,000 Valuation
SAC Charge $ ���� per SAC Unit
Park Fee $ Fee Determined by Engineering �
Sewer Main Charge $
%�� Agreement Necessary [] Not Necessary [ l
TOTAI. $
STIPULATIONS•
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Building
Inspections
763-572-3604
763-502-4977 FAX
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
DATE �� �" v 8 YOUR E-MAIL ADDRESS
SITEADDRESS �7�%i; �jl�'!r�'L � N�i
THIS APPLICANT IS: ❑ OWNER �ONTRACTOR
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
DESCRIBE WORK BEING D(
SIZE OF IMPROVEMENT
FIN
NUMBER OF SQUARES _
AG RAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
S�AING
O Vinyl
O Aluminum
� Other
/Ci
PHONE:
K
Permit No.
Received By:
Da��'d� �
(' ���tij STA1'EL'J1_h.ZIP ��3 '2.�
ADDRESS: CITY STATE ZIP
PHONE � FAX
STATE LICENS�#, EXP DATE � 3' ��` ��I
,._ . . 1►A1J 1 k� �t1�159r�i'1 £ . -
8'SINGLE FAMILY/NEW CONSTRUCTION
O TWO FAMILY/NEW CONSTRUCTION
❑ BASEMENT FINISH ❑ ROOF
❑ DECK � SIDING
❑ NEW HOME CONSTRUCT'ION
❑ MAINTENANCE/REPAIR
:• � i�l:'�+�! .�1Llti
STOR S
JSHED �3'WINDOWS
C] DRAIN TILE
❑ OTHER
NG POOL
❑ ADDITION
❑ REMODELi
�X � ��� --�
WI �i E
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
❑Soffit
❑ Trim
❑ Fascia
WINDOWS
IN EXISTING OPENINGS OYes ONo LO�A'fIpN�F ��OWS /
OR FOR NEW OPENINGS-DESCRIBE SIZE OF ��o�� . I Cti �r✓
OPENING CHANGES 8c I/'
TYPE OF WINDOW TO BE INSTALLED !� NUMBER OF WINDOWS
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
�1DDIT10NS. & 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:
(USIN THE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION $�d O� OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surchazge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$
$
$ �., i
$ �V p o
$
$
$
$
$
See Back Page for Fee Schedute
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1825 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$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 acknowl ge that th nformation above is complete and accurate; that the work will be in conformance with the ordinances and codes
of the Ciry of Fridley and with the Minnesota ction es• that I understand this is not a permit but onl an application for a permit and work is not to start without a
permit on site; that the work will be in accord the ro n the case of all work which requires iew and ap ov of plan I
SIGNATURE OF APPLICANT T NAME I�"r�� �k�l�,.JpATE S�'�J�
APPROVED BY DATE