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AF - 42390City of Fridley, Minn. BUILDING PERMIT .: - - � � � �• � � • � � - �... a1. .� .. : .J....� .. .. _ �lr,._, - ��...r.L�.[.. -�.. �. N° 6131 ,� � LOCATI B�I Q NG No. � Street ��'�� P Lot Lot .— �__ Block � ddition o Sub-Divis�to � � � Coraer Lot _ Ineatde Lot � Setback �.--_ Sideyard � Sewer IIevatian �— Foimda.tion IIevation DESCRIPTION OF BUILDING To vsea ,� / ,.- � , ��` '� � �� Front � Depth .�� Height _� Sq. F't,��;� Cu. Ft � Front ....---- Depth I�eig�t �,..3 Sq. Ft, G�. F't. �►pe of Conatruction _... r Es��.�!��;�!.. f� s""�~To be Completed In conaideration of the issuance to me oY a permit to construct the building described above I agree to do the proposed work fn accordance wlth the description above set forth and 9n compliance with a'll provisions of ordinanaes of the dty of Frldley. �1' .+� s Ea consfderal3on of the paqment of a fee of $�� , permit is hereby granted to to construct the buflding or addition as described above. This �rmit is granted upon the express condit%n that the person to whom it is granted and his agents, eniployees and worl�nen, in all work done in, around aad u�n eaid building, or any part thereof, st�all conform in all respects to the orciinances oP Fridley, Minnesota regardfng location, construcLion, alteration, mainteaance, � and moving of bufldings within the dty ]imits and this permit may be revoked at any time upon violation f aay of the provisiona of said ordinancea .�,. _ �. Building Inspector Nonc�: '16u ps�mlt doa eo1 eer�r fhs eoesfruetioe, InstallaHoe �e� �a �w�t�a �.. 6..x�a sww� or .►.�.r. B� sun fo sN t6� Boilding letp�ero� fo� aparaM p�rmili Poe t6a� tt�. ... _ �"q i'�"'� _ .,,o,, � .. : ' � � C � �. � � � p � . M : x :� ' M . ~ • O : � . m o� � : � � O N � � � �• � � W � � p @� � o � N � o � g � : o.. �� : �o � � � N � � 0 0 o y e� L*J H , y �l � � rq 3 b� � � w� m � � x e � � � � � � � � � � �' ^� a�� ' 'd � R' � � �°°��.��. . � . N. . � a : �� : u9 O . . . . 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Q ; � � R� p N � �' V _� � m � aa� �t] �� ° y �� o�� a C� �A'�'! � o�d�- y d�� . �, �� °� p p ��-''< eM ��0�p�� w �'y D� � b��'� �d ��!y� iTbn4 fWj n p� �� w �°'op �'^ f�D R, y �� a�� o��* �� f�DM �� o � �. � x � '° � �k � e �N D � i � �"� m � C) m v m �G M M be � b 0 � a � V A V O � '0 �� 0 � �1 � �O 0 � .7 0 0. �. � O = ;• 10 t� �� 3 0 � �� A � e� � A � e' 3. , 0 � 7s � � �• .i � � � � �� 0 � ^ ^ n Building ,Ic�,b �tepor# N°• � g 5 0 6 ADDRESS OWNEIt Buun�t uwrE �E —�— PERMIi Ne. DESCRIPTION ��•�/ � INSPECTION RECORD DATE REPOFtT I a ��P�D & APPROVED DATE -=��1. . 0 . _ e � �l �� City of Fridley, Minn.. N° 10458 BUILDING PERMIT � �� Date: ec�eb�� 31,.,—��19 p�Qr; Dave Kaliher g�d� Bond Builders ,�� 7866 Firwood SX Way �,d� 8312 Hopkins Crossover LOCATION OP BUILDING No. 7866 S�t Firwood Way N.E. P� ��t Lot �i- __ Block - 2 Addition or Sub-Division Pearson's Craig,�ay Estat�s 2nd Corner Lot — Inside Lot X Setback Sideyard Sewer IIevation — _ Fo�mndation IIevation DESCRIPTION OF BUILDING To be Used as: DPta�� Sa��e Front 20 Depth 22 Height 10 gq, �, 440 �, �, 4400 Front Depth fTeight Sq. Ft. Cu. F't. Type of Construction Frame �, �_ �1, 700.00 To be Completed 30 Days STIPUT,ATION: Hardsurfaced Driveway. In consideration of the issuance to me of a permft to construct the building described above I agr� to ctm the proposed work in accordance with the d�script3on abov orth ° pliance with afl provlsfons of ordinancea of the dty of Fridley. ��--r e�.--�-\.a In conafderatioa oP the gayment of a fee of $� , permit fs hereby granted to �ond Builders to constcuct the buflding or addition a� described above. Thispe rmft ia granted upon the express condition that theperson to whom it is granted aad Yus agents, employees and workmen, in all work doae in, around ead u�n said building, or anypart thereof, shall conform in all reapecta to the orc�fnance� of Fridley, Minnesota location, construction, alteration, maintenance� repair and moving of buflclings within the dty ]imfts�� perrmit may be revoked at ar�y time upon violation of aay of the provisiona of said ordineaice�. i>! 1__�, �' =�_ �, � �: .;t � �i?I �� - — `�� NOTIC� iids perm(t d�s ao1 eovsr t6s eamtrocHoe, ins�aqdloe to� wirtee, plumbtng, eo 6eaNeg, avr�r er w�tsr. B� sun to � tha Btrildine lesps�to� Po� aparafa parmtis fo� th� hw. e � .� .. J � q �� ` y; gPPLICgTION FOR BUILDING PERMIT . � • • ■� • � • a�• : � i , .. r /. �,_ : r � �• _ �.. � _ � �� _ �� ' f � � �` � �� 1 � � �i LOCATION OF B[TILDING NO o �a' �� S'�'RELTI' �� CI�.9� (oe..�;��/ �• �. , ._..r_ LOT BLOCK � �DDITION OR SIIBDIVISION ��l�SO�`� �j��Qr� f,cls4 y` CORNER: LOT INSIDE LOT�SETBACK Z�. ` SIDEYARD� :.�� T�� SEWEL� ELEV.�TTQN TOP OF FOOTIIVG - gpplieant attaoh to this form Two Certificates of Survey of Lqt an�. praposed buildita.g.location drawn on these Certificates. DESCR�PTION OF BIIILDING To Be Uaed �.s s ��, �,�c..��4� � o � F'xpnt 1, 2 Depth �3 Height 1 0 Square feet �� Cubic Feet �/�f �� Front Depth Height Square feet Cubic Feet Type of Cox�,stx�uction � Estima,ted Cost 9, '1 0��° To Be Completed � � � � " _n_ The undersi�ned hereby ma.kea application for a permit for th� work herein �pecified, agxeeing to do all work i.n atrict accordaa�.Ge w�.th the City of F�idley Ordinanaea and rulings o�° the Department of Buildings, and herebY declares tha,t all the facts and repreaentations ata�ed in this a��lication are true and correcte DATE � e5 — „� ! - / q' .., SiGNATIIRE l �1 c�e �i�_= � _"'�^ ^.e.. a F .(3cheduJ,e o� Fee Coata can be fouxid on the Reverse Sideo ) �`U � �` �1 . , � s� �� n .� Y r BIIILDING PERMIT�FEE SCFi�DIILE SECTION�2. The In�pector of Buildings aha,ll, before issuing per,mit� for the erection of any building or structure, o� for any addition to any �xistin.g etzu.cture or building, or .for any alteration or repa,irs to any exi�ting building or stsucture, upon applYCation therefore, requi,re the payment b�r the applieant for �uch permit of fee� to the amowa.t herein below aet forth and in the manner herein pro�rided to-wit: IIniform Buildin.� Code: Type 1, 2, & 4-�1075 for each one thous�.nd cubic feet, or fraction thereof, in such cubical c.�ox�.tenta. Type 3& 5- $1a50 for each one thoueand cubic feeto For the purpose of computing fees for �uildi.ng permita, the cubical �ontente of any'buildin�aor addition to a uniform hei�g`�it° �Yiroughout by multiplying the ground area cavered from a poin.t aix (6) i.nches below the floor line qf �he basement or the cellar to the avera�e height of the upper surface or to the avera.ge height of the roof eurface of the ma,in gable of a pitched roof . For repaira or alteratione to an existing atructure, the fee ehall b� at the rate of $3.00 per each five hundred dollara ($500.00) or fraction thereof in the cost of all proposed work. I.n no case shall the fee charged for any permit as se� forth in Sectiox� 2 be less than $5.00. NSSSD Connection Char�es based on location - 9rea 1 or 2. � • . � , �1 � � r . - � ,�. w < , � � � MINDER ENGINEERING CO., INC. ENGI NEERS AND SURVEYORS uND evavev�nro 301L9 TE3TIN� GIVIL 1r MUNIGIDAL ENOINEERING �.ANO PI�ANNINO � � . � 6418-scTM av�uE N. MII�INEAPOLtS 2T, MINN. KE ?- 3637 �lr�s��'�i� �I� � ��`IQ� � T,.��. �� C a� !, � \.. , � ,C±4 •, � `s �, ,�`��. /�k'oo _� a � �� '�. � _ '" �• ti� � ' : �.. ,� � ,• ; ° �� '4 �r l �� ✓.n - X \ . -L ,r i . `, �?' , � . , Y �.\ �' � ^,' �`� �f ..L7� �i�v ' . .a � �J � , f �x . % " � �^ - �r �`' �� \� \ �' e _ ,. �.` \ , , � ,� � ,� �� `� ,�' a e.. .:. , \ 1l � C ; `�, •�c� �.�r }t\ n�� .3 . _.. � � 's� � `'r�� s � ' �� _ � .s �. � ._.a �` � � lf,`��. � � / � �`�` � � /��\�` , � �J � �,, , ._ ti ,,f y�. / � \° i ",r c � � ,�'�._ ��.q( �'+� I ON ` '�H,C}`�; ?9 � � .. - .. � +� p " 1..� �. �,`',� i��. � ��::p: ._� Y�3"��i'�'� nZ'3''.�Wn�' �:�,z.aX.c� �.... h�jr±e _,�r. �. � r I '- i. ,_ , ._ ' �� J� �� / � � �a,J °�� ° � //�t�c.v �,� � � P. a a. • sueaecT / P N0. `` c��y of Fr�aiey ' � 14042 AT THE TOP OF THE TWINS g � I L D I N G P E R M I T ;, ,� . S �y_----- COMMUNITY DEVELOPMENT DIV. C� `-t'�� r � � PROTECTIVE INSPECTION SEC. 1 = � i_-_. A�'�h ,� CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPpOVED BY L � � 812-580-3450 910-F15 5/3/77 � � JOB ADDRESS �g66 Fi.rwood Way N. E. COT NO. BLOCK TRACT OR ADDITION 1 LEGAL SEEATTACHED DESCR. 4 �''� Pearson's Cra.i.gway 2nd SHEET 2 PROPERTY OWNER MAIL AODRESS ZIP PHONE David J. Kaliher 7866 Firwood Way N.E. 3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO. Leo O. Sanders 7813 Jackson Street N.E., Mpls. 786-2860 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION C� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install drain tile inside of basement- run line outside 9 CHANGE QF USE FROM TO STIPULATIONS SEPAFATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCGUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR 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 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 COMP�IED $]_ � 7OO yi` . sr'J WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PER�NIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS F ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTIO H THE PERFORMANCE OF NSTRUCTION. � $�-2.00 PLAN CHECK FEE TOTAL FEE Q � p $12.85 SIGNATUREOFCONTRACTORORAUTHOFIZEDAGENT IDATEI '�.. WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT � �' c�.,�� ' � �'%� SIGNATUREOFOWNERIIFOWNERBUILDERI IDATEI BLDG iNSP pATE CITY OF FkiDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS �NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OTnT�JER: � / i � '� L- / � � � Address : � � �/.� No. /�CoC� LOT: Street: .� BUILDER: � v . � F � Address: ��/ � �G�'� .' � %? � Tel. No. : %�� . � � � BLOCK: �� ADDITION: CORNER LOT: INSIDE IAT: SETBACK: SIDEYARDS: Applicant attach to this form Ztao Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: �,��.�i �J Front: Depth: Square Feet: Cubic Feet: Height: Front: Depth: Height: Square Feet: G�bic Feet: Type of Construction: 7.b Be Completed: Estiunated Cost: $�� D o o� Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ a �� ,�, ��Q�% ��ry�� (SEE REVERSE SIDE OF SHEET) �� z �� ,�,��-,� undersignec�'here y makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. See reverse side f additional information. DATE: �� ,� �' � � SIGNATURE: Q _ Stipulations: � j� �� U ,` �� ' � �'� _ � �f � � � �� BUILDING PER��IIT FEE SCHEDULE SECTION 2. The Znspector of Buildings shall, before issuing pexmits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repairs to any exis ting building or structure, upon application therefore, require the payinent by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic fee�. PLAN CHECK: 25 percent of building permit fee. DRIVEWAY DEPRESSION: (Concrete Curb Streets Only) Alternate A: Reraoval and replacement of concrete curb and gutter only; Driveway width plus 6 feet x$11.75 Alternate B: Removal and replacement of concrete curb and gutter and install a 3 foot wide approach with 6 inch depth; Driveway width plus 6 feet x$15.40 ADDITIONAL INFORMATION For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determi.ned by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the _ average heights of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. In no case shall the fee charged for any permit as set forth in Section 2 be less than $7.50 plus $.50 state surcharge. VERIFICATIO� OF FOUNDATION NOTE: Permits for construction will be issued a minimiun 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 been constructed will be required before proceeding with the framing. CERTIFICATE OF �CCUPANCY Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a building pe mtit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. 0 1�7 SUBJECT rcn�r�� v. City of Fridley 2� 3 3 2 r AT THE TOP OF THE TWINS g � I L D I N G P E R M I T _ � � . � � COMMUNITY DEVELOPMENT DIV. �' PROTECTIVE INSPECTION SEC. � ` _ � __ % ��.�� r ; -- -; � _ , � /�"\ � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY �"""� � ,'� 612-571-3450 9t0-Ft5 5/13/92 � � JOB ADDRESS 7866 Firwood Way NE t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. L� 2 Peaxson � s: Cx^aigway Estates 2nd Addn e SHEET 2 PROPERTYOWNER MAILADORESS 2�P PHONE David Kalihex 7866 Firwood W�y NE 571�8343 3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO. 5 ENGINEER 8 USE OF BUILOING Residential 7 CLASS OF WORK 8 DESCRIBE WOHK MAII ADDRESS ZIP PHONE LICENSE NO. ❑ NEW ❑ ADDITION ❑ ALTERATION �7 REPAIR O MOVE ❑ REMOVE 9 CHANOE OF USE FROM TO STIPULATIONS Undexlayment zgus:t cozqply~ Htith....�� Sta,te. Building Code, TYPE OF CONS SEPARATE PERMITS ARE fiE�UIRED FOR ELECTNICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK Ofi CONSTRUCTION 20NING AUTHORIZEO IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOH A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. U I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION �" AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS VAIUATION AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPUED $7L�2 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- tij`21 e QQ STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ' PIAN CHECK I IG ATURE OF CONTRACTOP � AU HORIZED AGE T IDATEI W E� t //�/ �� // � � �"�� L `--t .Y � � _ Y �C�si - PANCYLOAD CU. FT. OFFSTREET PARKING STALLS GARAGES SU RTAX $��JQ SAC CHARGE Fixe SC $.74 TOTALFEE $22.24 ��T THIS IS YOUR PERMIT � � J��-9Z riaT� �W [ ] AnDN I l �.'rER [ ] Construction Address: Lega1 Description: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application � Owner Name & Address: Coniractor: � � Address: Effective 3/1/92 LIVING AREA: GARAGE AREA: DECK AREA: � t� , Tel. # � � � � .5�� MN LICENSE # Tel. � � � r �j � � Attach to this application, a C,ertific�te of Sorvey of the kit, vvith the proposed co�strucdon drawn on it to scale. DESCRIPTION OF IIVIPROVEMENT T �..:..i —� � m:x� � �. o.� $ Ft. LC�1�U�7 '�-- --�awa— f r��. �� Q. Length Width Height Sq. Ft. Corner Lot {] Inside Lot [) Ft. Yd Sstback Side Yard Setbacks Type of Constiuction: ��`; e�- � 1� SS Estimated Cost: $%5�� "—c Appmx. Completion Date: Driveway Curb Cut Width Ne�ed: DATE: �_�! � �PLICANT: Permit Fee $ � o. � � Fire Surcharge $ • �'� State Surcharge $ � � � SAC Charge $ License Surcharge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL $ °` �� (Cost on Back) Ft. + b Ft = Ft x$ _$ Tel. # � � � $� �.� � i Fe� Schedule on Reveise Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $700 per SAC Unit $5.00 (State Licens� Residential Conttactors) Alt. "A" or Alt. pB" Above Fee Determii►ed by Engineering Agreement Necessary [ ] Not Necessary [ ) STIPULATIONS: � _ .� BUII.DING 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 bnilding or structure, or for any alteration or repair to any existing building or structure, upon applica.tioa therefore, require the payment by the applic,ant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $540 $501 to $2,000 $2,001 to $25,0� $25,001 to $50,000 $50,001 to $100,000 $10(?,q01 to $5�,� $5�,001 to $1,OQ0,000 $1,OOQ,001 and up FEES $15 (Minimum Fee is $15 plus surcharge) $15 for first $500 plas $Z for �ch additional $100 or fraction 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,Q00 plus $6.50 for each additio�l $1,000 or fiaction ther�f, to and including $50,000 $414.50 for first �50,000 plus $4.50 for eacb additional $1,000 or fraction ther�f, to and including $100,000 $639.50 for first $i�,00U plus $3.50 for each additional $1,000 or fraction ther�f, to and including $500,000 $2039.50 for the first $5�,000 plus $3 for e�ach additional $1,000 or fraction thereof, to and including $1,�0,� $3539.50 for the first $1,�,0� plus $2 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW _ (Concrete Curb Streets Only) Alternate °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 fa�ot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. YERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the consh-uction site. A Certificate of Survey of the lot, showing the lr�ation of the foundation once it has it has been conslructed will be required before proceeding with the framing. sue��tr P IT NO. ��'� City of Fridley 3 0 2 4 2 AT TME TOP OF TNE TWINS g U I L D 1 N G P E R M I T i � � � � ; v_�� COMMUNITV DEVELOPMENT DIV. p� v r � � PROTECTIVE INSPECTION SEC. �a � i = i � �'�'1 � CITY HA�L FfiIDLEv j�132 NUMBER REV DATE PAGE OF APVROVED 8� �---•�' �•' 612-571-3460 s�aF�s 9/20/99 / / JOB ADDRESS �g66 Firwood Way NE t LEGAL �07 NO. BLOCK TiiACT OFi AODITION SEE ATTACNEO DESCR. L�, 2 Pearson's Crai a Estates 2nd Addn. SFIEET 2 PROPERTY OWNER MAIL ADDRES$ ZIP PHONE Nancy Kaliher 571-8343 3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO Owner d ARCHITECT OR DESIGNEp MAIL ADDRESS ZIP PNONE LICENSE NO. 5 ENGINEER MAII ADORESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION � REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reside house and ara e 9 CHANGEOFUSEFROM TO STIPULATIONS Call for building wrap inspection before covering. SEPARATE PERMITS ARE REQUIREO FOR ELECTFICAL, PLUMBING, NEATING, TYPE OF CONST OCCUPANCY GROUP OCCUPANCV �OAO VENTI�ATING OR AIR CONOITIONING. TMIS PERMIT BECOMES NULL ANO VOID IF WORK Oii CONSTRUCTION 20NING SQ. FT CU fT. AUTHOfiIZED IS NOT COMMENCED WITHIN 80 DAYS, Ofi IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DW4G. UNITS OFFSTqEET PARKING I HERE9V CERTIfY 7NAT I MAVE READ AND EXAMINEO THIS APPLICATION STA�LS GARAGES ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PqOVISIONS Of LAWS VA�UATION SURTAX AND ORDINANCES GOVERNING TMIS TYPE OF WORK WILL BE COMPLIEO WITH WHETMER SPECIFIED MEREIN Oii NOT. THE GRANTING OF A PERMIT .�SOOO .�Z. SO DOES NOT pRESUME TO GIVE AUTMORITY TO VIOLATE OF CANCEL THE pEqMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULA7ING CON• STRUCTION OR TNE PERFORMANCE OF CONSTRUCTION .�I.],]..ZS Fire SC S.00 PLAN CNECK FEE OTAL F 11 5 S�GNATUAE OF CON'AACTOA OA oUTMOp�ZED sGENT �D�TEi N OPER IDATE S IS PE� ��.- c K�, , � S�GNOTUAE O� OWNEA��F OWNEABU�LDERi �D�iE� g� G�tiSV � r�a1E r�w � � ��2'[l a��R � Effective 5/10/99 CITY OF FRIDLEY SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2 BUII.,DING PERNIIT APPLICATION Construction Address: "? !� (a (P -�°� � �� l,Jct� ti] � Legal Description: �� aN� � Owner Name & Address: N�u�j �L-�' �'?�((�,(� �y,,,,�,� �,�y�,,J� Tel._# Cp /�-S� I- 83�3 Contractor: MN LICENSE # ` Address: ' � Tel. # Attach to this application, a CerCificate of Survey af the lot, with the proposed construction c�awn on it to� scale. LIVING AREA: GARAGE AREA: DECK AREA: OTI�R: Length I:ength DESCRIPTION OF IlVIPYtO�EMENT Width Height Width Height ) Wid �Igt/ i F' S � �� . �c.c S F � ( � � Sq. Ft. Sq. Ft. Sq. Ft. Construction TYPe: _ "��?? . Estimated Cost: $ s4� 0. C� � Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: `�'i- c�-Gei APPLICANT: �.�, C'. �a� Tel. # �ol�--S % /-$��/3 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ l//,�2 S`� � � o� $ �- �� $ $ $ $ $ $ w $ � V CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1050 per SAC Unit $5.00. (State Licensed Residential C�ntractors} Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] BUII.DING PERMIT FEE SCHEDULE � _ ,,t 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 existi.ng building or structure, upon application therefore, �equire 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,OQ0 $2,001 to $25,000 $25,001 to $50,000 $50,(�1 to $100,Q00 $100,001 to $500,(?00 $500,001 to $1,000,000 $1,000,001 and up FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $1OU or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,OQ0 or fraction thereof, to and including $25,000 $391.25 for first $25,400 plus $10.10 for each additional$1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,0(}0 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fracrion thereof, to and including $1,0OO,OQO $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1, 000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15 .50. Alternate "B": Remo�al and replacement of curb and gutter and ins�all a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. 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.