Loading...
P - 36805B.uilc�ing Inspections 763-572-3604 763-502-4977 FAX BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 1-1-2011 Permit No.: Received By: � . , ,�i DATE '����� �'j/� YOUR E-MAIL ADDRESS ��¢/�S � �,��e2'<�/AAqIG�RiCiIGt �`.tC'[// >'S SITE ADDRESS fO���,���n,f� L�i�L it,%t= � i,p/�.•�j 'G�o�'J THIS APPLICANT IS: ❑ OWNER C+]�ONTRACTOR PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF INSURANCE TY TYPE PERMIT TYPE TYPE OF WORK: NAME: °T��r`��yl/� at�'.��' ,��iJA�,�T ADDRESS: /pf�Le yAC-��'/A.c! L'i CITY ���1�9 STATE,�fJ�iZIP-��- PHONE: .�v �j a-�J� !Jf �'J �rL_ NAME: �/ln _t' / ,� � `�� � �� >'G �. �ivG STATE LICENSE #_ a. �fL,� LEAD CERT NUMBER �/�¢T '-��}i�)�-% ADDRESS: �/� �jX /� 3 CITY ��.�j,�J STATF�[P�� PHONE ��� "_ ya �% � `�S7a S� FAX �%lO � — �/�'7 — �/�/.� c ' fid'SINGLE FAMILY/NEW CONSTRUCTION ❑ TWO FAMILY/NEW CONSTRUCTION ❑ ADDITION O GARAG ❑ BASEMENT FINISH ❑ ROOF ❑ DECK ❑ SIDING ❑ SWIMM ❑ NEW HOME CONSTRUCTION [B�MAINTENANCE/REPAIR SIZE ❑ ADDITION ❑ REMODELING ❑ wirrDOws O DRA[N TILE I�OTHER DESCRIBE WORK BE1NG DONE: [oRiCA� ��iG ,fi�rG s/�' /.�,�gN SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT ROOFING NUMBER OF SQUARES _ GARAGES PROPOSED SIZE: PROPOSED HE[GHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other WINDOWS IN EXISTING OPENINGS DYes ❑No OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED O HOUSE ONLY ❑ HOUSE & GARAGE O ATTACHED GARAGE ❑ DETACHED GARAGE OSoffit � Trim ❑ Fascia LOCATION OF WINDOWS NUMBER BASEMENT REMODELING SUB T• 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 FOR WINDOWS - PROVIDE U-VALUE AND MANUFACTURE STICKER ON WINDOW. ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) fOTAL JOB VALUATION $��j (o�' `�—' OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Chazge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ $ See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $5.00 $5.00 (State Licensed Residential Contractors) $2230 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$24=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: Cityo uf Fridlev Attach lations THIS 1S AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and co es f the ' of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permi nd k is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all k w' r i review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME �)vE �,rJTd % DATE �//$�i APPROVAL INSPECTOR SIGNAT E �. � `c �. . _� �`` � � � �� � ,� � �� �� �� �: < � � �� � � � �� � � � � � . �� � � �� � � � � ,n�ys �� .w,. �r, r� � � �� � e o. � *:. �� � � � � : � `� � �. .� �<, t � Z � � � � �Q �� '� c �������X� � �'l �. ����vR��. � �� 11� �� � �� _��. � �� ��� � ���� �, � � � � , � �: � R. ��'�Fy � � '��„ \ � � ��, ' N ` � �� � � � �� � ��� �,� � c�� �� .�. � � � , � 3 M �1� t� • � . �.,1 � �,, �V I , ? � : . � � �� � � �" . � �� � � �. ...y °�' rM+ �'��--.'F ��„ '� yq'ss �� t+ �� � i� � Y � �'1p ik� � � �� � � �K ' .�. � � �.. � � ,'� , {}, `Y � �e. �" 1l,} 'Y �. i 5,:. ��+� '� � � � �' W f+Z� �.Y3 � v�� � � �'�t u�'3' � ` � � � � � 1 � � � � v. *: � {�` ``• f: � `` � � �� _ � � � t� °`` �, � .,. � � � � � � � `,! � � � � �:: �"`�� � ---- �. � �a � A � ��o --� s n�� � � � � �� � � .� � � � d � : � � 4 t� � � � � �� �� �� �� �„� �°' , � �. �� � ��, �� : � 4� � �� � • � � �� � � c.i, � � '°'`. � � � � T � � `i} 4 .n ; 3 y i � ���fl ; �� � . � �� G'� „?. . � :� �W¢� � �: � � ,`� z .� � � � � ��� � � � ��� � � ..i � � � � � � „ � �` � '�\ �. r� 9` � � � i � � � , � � . �� �� �