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AF - 45543sue�ecT PER - c�ty of Fridley � 13278 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T • i � � � REC IP�T NO. � `L ____ COMMUNITY DEVELOPMENT DIV. r j � PROTECTIVE INSPECTION SEC. °a � 1 ` , � /��'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ��'� � ,•� 812-580-3450 910-F15 10/24/75 � � JOB ADDRESS 1264 Hathaway Lane N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2rj 2 Parkview Oaks lst Addition SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Todd Gibbons 995 Lynde Drive, Apt. 18, Fridley 3 COPITRACTOR MAILADDRESS ZIP PHONE LICENSENO. Swanco, Inc. 6737 Camden Avenue North 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 X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 36' x 26' Dwellin and a 22' x 22' Gara e 8 CHANGEOFUSEFROM TO STI PU LATIONS Provide a haxd surface driveway. Provide a verifying survey before capping. Provide sod in the front and side yards. —��ia�� _5�� ?��` � ' NOTIFY T�1C FFE�LEY E�i�.��. :;��ERATE PER�iOTS R�t�UIRE� �=�R �Vl��lf�t�, �°`�asQON R��AR°�N� c�� REMOVAL AND RE�L�10Efi�tNi HEATING, PLUMBIiVG AIVD SIGIVS. AT QRB�lE)NAY OPEf�iPJ�S. ��'��'P� � �efore d�g�ing call Ioc�1 �iil;tif�. TELEPHOiVE - ELECTRIC - VA� E��. R��U�� v'� SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CON$T. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. OOCI F2'dIR@ THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R �. ].$].]. i- �H4 �.5� 232 �F 3S%2 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 COHRECT. 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 $28,650 ],L�.3�j DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � .,Sg,O.S9 �S`32S.00 PLAN CHECKFEE TOTALFEE $380.24 SIGNATUREOFCONTRAGTORORAUTHORIZEDAGENT �DATEI WHEN PROPERLY V�ALInDA-TED. T�HIS IS YOUR PERMIT " _ ', ,� � I � �� (' e2 �� SIGNATURE OF OV�NER IIF OWNER BUILDERI I�ATEI BLDG INSP� �AT � , � INDUSTRIAL ��bU51NE58 CITY 10T5 `��TOPOGRAPNIC MAPPIN6 I % i ��d�K -Z., PA�k�t�.ti►� � �aK� 'F11�`aT._AQ�1'°�'°�A1�1_ �. C. E. COULTER � LAND SURVEYOR REGISTERED WNDER LAWS OF STATE OF.MINNESOTA LICENSED BY ORDINANCE6 OF CITV OF MINNEAPOLIS 3300 LYNDALE AVE. SO. MINNEAROLIS 8, MINN. TAYLOR 4-0370 • �urbepor;�� (�ertificate v� � A-cu ��►� � L � PLATTING FARM SURVEYS LAKESNORE �uoicu� _ � ) n,•► — �,• , �� 01� '��0 � ` ' . . � �� I� a� � . � � �, �� ,, ,�,` � �� - � ��, ; � � � � t ;,.:? : •oob � �.�= � -T3 M� . -_ ym., ��,?i I� /iA�� 7� J�O� �z ry I � . i �i':: p � , : � a �Sno�} (� � . $LK,' _' , � q-;@! . ' ---- ,p �(y � t � I - �� J . d' ` tl td. � � � � � �_� __ _^�' � � . S�Yi"� , . , . . . I � �? �b � �ab SeAL� . �� = 30� . :� . � a �.7; ; ; �y�-,; ' . ... . � . k � �:. ' . � � _ I 4�¢ j � 7�e. � � * � � Y ' � k., �� I - � �►, � ' , , �� ORAIN�A6E $r UT1L,iTY _ � � � I �s � � � . � EASEM6NT . _ _ ' . ��: � � 15;0 ' ;:: ---,— , �;c . . �'iw'- ;�:; k I�hereby certify that the above is a true and correct plat of a survey of: �, . _ �»'; ��'.+Dt 25, Block 2, •PARKVIEW OAKS FIRSfi ADDIT�ON, Anoka County, Minnesota. r��.�� , �:�.;�s�rveyed;by me this 19th day of April 1960 A.D. . �� ,a4 . � ��,T_ �<•. � . . : s�, , � • . �� r;, � � ��'�� p� S igne d ��,.; � V Minnesota Registr�.tion No. 2584 - �, '� « �, : .� � ., �� . �- _ , � r,;. x� :>.� , y' , � f �,.. s' � e. � c :ti � - . ,; _;«. , ,. . M. , . , � d � � �` APpLICATION FOR RESIDENTIAL, ALT�R�ITION, OR AllDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER `S NAME :_ .��rz�-a` BUILDER : � s � � ADDR�S S : �� j ��z.-�-Q /.Ziitc� .��DDRES S : � %� % �'�?�',.��/iQ� �u- , /� ` ) ;�-y�.�/�'�� , �5 `f��- NO : . �� a � STREET : �i� Tfi`,� �� /l�� /v� �v LOT: �`J✓ BLOCK: � ADDITION: f�/f�� U/,�/.r/ �i�j s r� �%D�' GORNER LOT: INSIDE LOT:�_SETBACK: �� SIDEYARD: ��/S� �� i�iS', � � Applicant aticach :o this foxm Zt,�o Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As : � � �� i�i ��1� Front o ��s De th e Z(e Height : 5 �� I�j �.��ir� � Square Feet : (� Cubic Feet :� �, 3'=� ��(1� Front : �� Depth : Z.'� Height : � Square �'eet; Cubic Feet:_ _ ��`°�/ Zype of Construction: �� 1��j°�, Estimated Cost: $ ��"�'�. — To Be Comple�ted: _ � �_'�, �� The undersigned hereby makes applicatinn ior a permit for the work herein specified, agreeing to do all work in stsict accordance with the City of Fridley Ordinances and rulings of the Department of �uildings, and hexeby declares that all the facts and repxesentaLions stated in this application Are txue and corxect. S Gv��– �–� ��DATE : , � ��%.�S IGNATITRE : (See Reverse S3.de For Additional Informatior�.) P � ' � � �o.�g '� P �I � 3a' �� - � '°, c� � 3� de ��l R � tr � .�..�.. .• _� rd . ' . � $UILDING PEI2MIT F�E SCHLllUL� SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building ox structure, or for any addition to any existing building or structure, or for any alteration or repairs to any existing building or structure, upon appl�.cation thexefore, require the payment by the applicant for such pelcmit of fees to the amount herein below set forth and in the manner herein provided to-wit: UNIFORM BUILDING CODE: Type 1, 2�: 4-$2.15 for each one thousand cubic feet, or fraction thereof, in such cubical contents. Type 3& 5-$1e85 for each one thousand cubic feet. ADDITIONAL INFORMATION For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covexed from a point six (6) inches Uelow the floor line of the basement ox 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 stxucture, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00} or fraction thereof in �he cost of all proposed work. In no case shall the fee charged for any permit as set foxth in Section 2 be less than $5.00. VERIFICATION OF FOUNDATION NOTE: Permits for construction wi11 be issued a minimum of 24 hours f�ozn the time of application, to allow for proper �evie�a of the proposed stru.cture and of the construction site. A Certified �urvey of the lot, showing the location of the foundation, once ii: has been constructed, will be xequired before proceeding with the framing. CERTIFICATE OF OCCUPANCY Application for a Certificate of Occupancy shall be made ten (10) days pxior to the use or occupancy of any �tructure for which a building pexmit has been issued; and sai.d structure shall not be used or occupied until a Certifi.cate of Occupancy has been issued. �. . .. � � � ��'" � � 1 - , � y� i..,��lt�: �. �l #/� ; ; : � � _ � � =a - ;_1 _ '� : . ,. , ; _ � � . .. , . , . , �_ - ; I�.r� ' Z�• 3f. s "'i. "L�/" ; _ � � . , .� . , . . , . . . .. , . _ . � - : { , i � Z s' �' x$ Q r} a.,,. � ' ,, _ . . , - :. , . ,, _ :.. . � i _ ; � ?i ° � �'� ' _ .-_ � �, � .� u.'� *Z. :'4"' � � � � '� w. ��7 � +w.� � . " - �� i ��',1 � i ., ' � , '' � :_:r�� ; �-. � -. l�. � '� 00 , , - -� �► , � -a�.1 � _ '�S �� d ��c��: �a - - � � �� d �' �� F � _ � _ - � �.. . _ _ '=� � - _ �� , `� * �:;� fi-: . - � � '"'�s� •�' ► , � 7 "�- '` � �;� � _ � .� _ �} - � �� . - - J; . - "�, , � _ - � _ - � , _ �� , - `�, _ - �,� . � .. � � __ - � ,� ¢ ,� _ ,: . . ; . .. . . , _ ,� , , _ f.. . - � ,_ , , . . . .,..� :._.. . . .,- . . . .;..- -. ,- 1:. � . . ...... . . . _ .. . �� ' Q�ocK �., PARK`��E�f 0��:� F1RS'i` AI�D1'T��3t� �� '' C. E; COULTER �& ASSOGIATES, lN�. JOHN A. PETERSON FRANK R. LENZ JR. ";; � � � �;:� PROFESSIONAL REGISTERED SURVEYORS � � REGISTERED IN MINNESOTA 6 WISCONSIN UCENSE� IN CITY OF M(NNEAPOLI8 3300 LYNDALf AVE. S0. MINNEAPOLIS, MINN. 55408 �' �• � TELEPHONE � 612 - 824 - 0370 �- � ;_ � �'�b� �AiNAVVAY �ANE � _ � � 15.p ��' � ', . = � ' � � _ f ,, m °�'°, $ � �- fi — �1 �^ p, - � � �� ,� �,� �� . , � T�-7- - -- _ , ., . �_ �� 3(v.2 2.p 2 .I v (1� . ( _g_ S ` r�l �j UNDER - ' ; - - � 12 4g � M � � ConISTR UcTlOnl N F� ' '• 21 2 a.' 1 � ; �� 3rn.2 . --- l3- Q � � ,'1 � .° r a�,` �' � ' �1 +i � 1—S—F . UO -�' �` � �g /2� . •- � o � ' � 1,..., 0 1 � �7 , � , . � ,�� .r � r. . r +� ' O . . O , � aRait�AC� � u-r��trr . - - �ASEN1E1•1T 15.0 Legal Description: ' Lot 25, Block 2, PARKVIEW OAKS FIRST ADDITION, Anoka Gounty, Minnesotaf Subjec� to easements and restrictions of record, if any. I HEREBY CERTIFY THAT THIS SURVEV, ME OR E MY DIRE T SUPE SION LAND URyE R Ul�� THE�S O� �� OR REPORT WAS PREPARED BY 1AT AM A DULY REGISTERED OF MINNESOTA. REG. N0. `�' �`''°` � CLIENT �j�/��jCO �NC. JOB N0. °/�i'b� _- � SCALE 1�! = 30i ^- BK./PG. LL 33�� (OGo I SNEET � OF 1 �-'� •4 1�1 • a� P a�, • 1.� ;r 1„�� ►," 00 1 ' � ' � t'� � � � l o. a � � � �S[orlcs .9 x � � . 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Fixt � N Gas fiange a ` � �i �ther v�s 'r�, w p rr r � K n � O M H� y � � O H � d d � n �1 t1 O N � d � 0o n H t�1f H p y d H � � 0 M y � � w O y :J w b O � W • O a K . C1 'C � � i � � � � ro M s H H ' z 0 ,0 ; w c� � 7'O � w n O cD G � 7 %"' ,� � � N C ro� � O n � y n. D "O "O � c� a -� 0 Z T 0 � -O � � s —i W -'G C+l O �-t D Z ty T � � ""' D t� cn r m T -�G -1 "'� Z � �--s_„ HOUSE HEATING TEST CORD`�� ADDRESS APT. FLOOR CITY SUBURB—___, OCCUPANT OWyER HEAT LOSS DATE HTG. INST. SOLD BY ' INSTALLED BY Eleehieal Work By Gas Line By TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER MAKE� Model Serial _ INPUT THERMOSTA Valve Limit � Limit SeHing Fan Setting _ Pilot Type � Pilot Make — GAS DESIGN CONTROLS �eat Plug CONVEFtSION MAKE OF BURNER_ Model Max. BTU Rating _ MAKE OF FURNACE �flodel Vent Size . � � -KIND OFi#NER StZE NQNE � Drah Hood �_Regularor � Fi Iters Size Number Chimney Location Inside �� Outsi Chimney Construrtion � �.�. Pilot Model Smoko Bomb Wiring � Pflot Timing � '�¢�/�/ Droft Test Tag �_ L.W. Cut Off Door Pressura Lighting Inst. �� Pressuro �'� ��_Pereent COZ � Date Tested � Input CFH �� C�^ d Pereent OZ Company Testing Stack Temp. �rj � Pareent C Idame of Tester Form 235 L 7 y r�- n A rR+ � n � G m r� r � H O � X w � < A o r. � d w �p � m 3 O W �o a `� o�y r• 'C 9 v m � � WR � N' S r• � �a A 'J• �p � a n � � � d R C M r' C 0 � c � r m 'o �D � n m bH N3 y3 o '*� N � H �� N b � �C A �_ [�7 �Z G'� ��p 3 M N � r O O O � � � ~ � w o °' �'e m b � � O h+ � ~ m v O � � M � � � K R� R � � 4 � � �. � c � � � � n $ � � m � r p ►- Z � i � � � � � � A � A A � Z � 77 C m � b a 'G . � A � R N r► � �°o •n � i � � s cv !� n '�+� p �' O C �n r� � $ ��a.�°�� ' � � g " e �r • S � � ti �o m ►� 7 m 'O n f'► r- � � A � N r � 0 O � � � d �R � � y G M Q ? � �o � H N N � � � o 0 ►� �I [9 M A a e�+ r m v M C � � '� � r w � � h V vr N O (A1 � t�ir � � � v � � � � o � e � � N�+ O y H � � � H � ►� � O e � � O � � . F~+ M �K O M IP G C m R G � � m 'O � O M M �I m O �m ~ W � � fp m � p r M ff O 7 M m ii' N r O 0 O T ��Z. O p ;�. �. � � n c� ae �o � m m�p� MM O�q � �i �� M � y � �y.1 M fC �� S [' m lp � or K~ r � � � � � � �g N R f* � G � O V a x � ' N N N fA 0 0 0 0 � . . y 0 0 o O m O o O O N N N f/! � � .e 0 m ~c� � m r a��.� � � .�O N n .Oa A �G ImC S � O. R � � S R � O M 7 N O �C m g m fC ��" }P r► 7 � +7 Yr r► m r ��'�C �°e o � � � � �am d r r n n � m � r O �pO t0 R 7 r O Or O ►� � f1 M ^ � � O `� m � �� e �. s `� r r� � � 7 M O � � � O o O O � S r � a��x • F( r R r � o '�° :r ~ o s � s ° 5 � � ► � ~� m : o n � M � r 'q � 1 �1 R aao v� r ►n � `� % C � O� P 7 < � n m � Z ;� � G r O � � � � a N t� 0 Q a O� M A m m � n x d rC t'�'I � � r A D 1 0 �. T O � � O � m a n r� � D f"1 � O N Z o a -� v o x � > �S � z N G'1 < � N �i C"1 �n O 3 O v+'r O � t� t m m < � n m S H .�.. 0 z 70 m � .'O � m a D � O Z D 2 O c"� � � O T T � O r � � .s � < � a � � m r HEATING HOUSE HEATING TEST d�ECORD �� AIR �ONDITIONING AND E C IC. INC. ADDRESS � � OCCUPANT HEAT LOSS DATE HTG. INS . SOLD BY Electrical Work By TYPE OF HEAT GA FA HW STEAM SPACE HTR. GAS DESICiN Model Serial INPUT NTROLS THERMOSTAT � l{.i _` Heat Plug Valve �� Lfmft � �erp,� Limit Setling � %Ci Fan Setting Pflot Type Pflot Make Pilot Model Pilot Timfng L. W. Cut Off Pressure Percent CO, Input CFH +�'°� Percent O� Stack Temp. ° Percent CO � Form 235 APT. FLOO � SUBURB OWNER INSTALLED BY Gas Une By UNR HTH. OTHER CONVERSION Modal — 6Sex. BTU Rating IdAKE OF FURNACE Model L at Vard Slze V KIND OF LINER g�� NONE Draft Hood 0 Regulator Flitare Sizo /�� % Number Chimney Locetion Inside Chlmney Construction Outelde Smoke Bomb Wlring � DraR Test Tag / Door Pressure UphUng In�. 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(n A1 o � 3 °- v o " � • _ 0 � � ov � � 3 � D \ m � � � v C� O � 69- �� 'D m � � _� Z O ( s. /��-% � �.�s m c v z � c � m v � � � 2 a � � � � � m 7�0 � � � a � °��c� � � 3m w � o m � cs� � � W � � y • 7 Q �. � 3 a� ° m � � �o� � ? N � � y O � !y ? O m o;�� CZ � ��-a �/1 � ? �'* �• � m "� � � c3 � .. m `� A 3 � � �D a O C n m �, �, � � � o � °' r. 'D 3 A s O ,.�• S -�i. 1 � � 0 � ~ � � s � m n j � 2 n � � y n � � � Q � m � a a, m � y �' 3 Q n _ m C L 0 � D v v � m � � N Q. � � J � w `< C O ��< �' zm � � � � � N � � zZ m � � rn -� O z � < m � �� ma � � -Di O 0 z Z �1 z � v� D O � � � � Z � v� �z o� z cn z� � �v _ �� z� v C� c0 mZ �� C rn z � � � Z m � � c�o O \ D , c cfl c � � � � � N ( ) ort 4, �x � � OH � �� r� 1(i Op£Sg NY1 `hiONr � '3'N '�Ad ltlH1N3� Z9S�t '�NI '1�313 ! �/V 'p1H 3Nttl18 :�EQ -�8 ��j$ �O� JI�II.Ld�H .auaQ iag I�IOI.LH��'IN . :s�.retvag .T2�E3Lj 12�EAA 10� �piAO.Id II� .IIE UOqS[l(�WO� SE�j 1�EJt� iA;EM .I03 P2P�AO.I(I II2aQ .IBiIii E SR�j � (�a� � � � �� %� ��o S.n�g �y.�o� � S�nis � i� 3Q S�f1.Lfl .g 'L 0 () o1�I �/) sa� _. paa�awo� s�flsg T��uE � azis io3 s�uauiannbai apo� �uaun� IiE�� L�i ' S () oN � sa� x, i , paa.i�ns �jam�s si •� M•6 i )� o1�I � ��C mLj�TM �3�POI Sj�2CQ � ��ao� ou seH . ' £ �� C'd�y:,. () oN ( sa� uor��oualap io �s:r� -�luo.g aai3 s� •Z r� � � ( ) ol�i �) �J� pau�wexa �Ci� �'�� uaay seH � � � � :��e�s io �Cauw►u� �uilsixa a� �E� sayuan � pau�is�apun ay�, � � � �� l.Ld�I�R1�A �t V.L (II�Id A� W1H� sue�Ett p p. , City of Fridley 3 017 3 AT THE TOP OF THE TWINS g U I L D i N G P E R M I T � � � RECEIPT NO. COMMUNITY DEVELOPMENT DIV. � �� r � y � PROTECTIVE INSPECTION SEC. � = i i-._.� ��"' `•i CITY MAI,L FFIOLEV SS132 NuuBER NEV O�iE vAGE OF APPROVED 8r t 612-571-3450 9t0-F15 9/3/99 � / JOB ADDRESS 1264 Hathaway Lane NE t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACMED DESCR. 25 2 Parkvi.ew Oaks lst Addition SNEET 2 PROPERTY OWNER MAIL ADORES$ IIP PMONE 1Ted Thompson 571-9163 3 CONTRACTOF MAIL ADDRESS ZIP PMONE LICENSE NO Renewal by �fAndersen 350 73rd.Ave NE Fridle 55432 502-4777 20130983 1 ARCHITECT OR OESIGNER MAIL AOORESS ZIP PMONE LICENSE NO 5 ENGINEER MAIL AODRESS ZIP PMONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WOFiK O NEW O ADDITION O ALTERATION � REPAiR O MOVE O REMOVE B DESCRIBE WORK Replace 12 windows and 1 door in home. 9 CHAN(3E OF USE FROM TO STIPULATIONS Install smoke detectors to meet the State Building Code - in each sleeping room and on each level of the house. �ermit ��+spection C�r�s �V�11 Ro nllalled �o �am�owner To P�s� SEPARATE PERMITS ARE REQUIRED fOfl ELECTFICAL, PLUMBING, HEATINa, TYpE OF CbNST OCCUPANCV GROUP OCCUPANCY LOAD VENTILATING OR AIq CONOITIONING. TMIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONS7RUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 OAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDEO Ofi ABANDONED fOF A PER100 OF 12p DAYS AT ANV TIME AFTEii WORK IS COMMENCED N0. DWI.G. UNITS OFFSTREET PARKING 1 MEREBV CERTIFY TMAT 1 MAVE READ ANO EXAMINEO THIS APPLICATION STAIL$ GARAGES AND KNOW TME SAME TO BE TRUE ANO CORFECT. ALL PROVISIONS Of LAW$ ypLUATION SUp7AX ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO WITH WME7NER SPECIFIED MEREIN Ofi NOT. THE GRANTING OF A PERMIT 12 000 6.00 DOES NOT PRESUME TO GIVE AUTHOqITY TO VIOLA7E OR CANCEL TME pEqMl7 FEE SAC CMARGE PROVISIONS OF ANY OTNER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR TME PERFOfiMANCE OF CONSTRUCTION 209. ZS Fire C i2 . OO PLAN CNECK F TOTAL EE Lic S 5.0 .25 S�GN4TUaE O� CON'aACTOp OA sUTNOA�2E0 eGENT �OATE� EN ROP LIDA E IS IS PE T t S�GNAlU�7E O� OWNEA �� OWNEp BU�LOEp� tDI�fE� el0 �N$� �p�E NEw� � - ADDN AL1'ER [l [-�� onstruction Address: Legal Description: ' Owner Name & Address:`%�� Tel. # J�7/ � `�/(03 Contractor:��,�.�'LQ /� �.�n ,Q�, _ Nnv �cErrsE # a��3o�8 � Address: 3`� • i�,� Effective 5/10/99 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-i AND R 2 r 1�, BUII.DING PERMIT APPLICATION , , \1 � �" ' •�� ,�.Q LIVING AREA: GARAGE AREA: DECS AREA: OTHER: Construction Type: �� Attach to this application, a Certifica�f'e of Survey of the lot, witli the proposed construction drawn on it to scale. DESCIZIg''�CI.�N UF ��4�IEli�NT _ Tel. � ��']�� Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Wlidtli Hgt/Ground Sq. Ft. T . .n _ . � . . . n . �a��a cost: � ia� pUp � Driveway C�ttb Cut Width Needzd: Ft. + 6 Ft =_�Ft x$ _$ . DATE: g�a? �`�� APPLICANT: Tel. # 8SL/'`a-�SZ-/ CITY USE ONLY Permit Fee Fire Surctiarge State Surcharge SAC Charge Lic�nse Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ ao9 • aS $ 10l . c�fl $_l� . 0 O $ � S�,v� $ $ $ $ � a3a . as Fee Schedule on Reverse Side .OQl of Permit Valuation (1/1(3th%) $.50/$1,000 Valua.tion $1050 per SAC Unit �5.00 (State L�censed Residential Contractors) Alt. "A" or Alt. "B" Above $450.OQ Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] - �,.. BUII.DING PERNIIT FF�EE SCHEDULE 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: r.�pair to any existing building or structure, upon application therefore, require the payment by the applicant for.:such permit:af fees to the amount_herein below set forth and in the manner herein provided�to-wit: - - TOTAL VALUE $i to $500 $501 to $2,000 $2,�1 to $25,000 $25,(�1 to $50,000 $50,�1 to $1Q0,000 $1�,001 to $500,(1Q0 $500,�1 to $1,000,000 $1,0�,001 and up --- FEES $23.50 $23.50 for first $500 plus_ $3.Q5 for each additional $100 or fraction thereof, to and _inclnding .$2,Q00 $69.25 for first $2;QQ0. plus $14.00.fQr eac� additional $1,�J00 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,Q00 or fraction thereof,. to and including $SU,000 - $643.75 for first $SO,Ot� plus $7.Q0 for each additional $1,�0 or fraction thereof, to and including $100,000 $993.75 for first $100,0(}0 plus $5.60 fo�r each additional $1,�0 or fraction thereof, to and 'mcluding $SOO,OaO $3,233.75 for the first $SQO,OOO plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,Q00,�0 plus $3.15 for each additional $1, �0 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concretz Curb Streets only) Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "B": Removal and repl�cEment of eurb and gutter and:in�tali a 3 foot;wide °° �. approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIF'ICATION OF FOUNDATION Permits for construction will b� issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been �o��sl vvill be required before proceeding with the framing. Building Inspections 763-572-3604 DATE�� "1 J SITE ADDRESS� THIS APPLICANT IS: TENANT CONTRACTOR BUILDING RESIDENTIAL APPLICATI4N CITY OF FRIDLEY O OWNTER PHONE: SUBMTf A C4PY OF �ArE YOUR STA1E LICENSE ADDRi WITH APPLICAT[ON p ONE PROPERTY TYPE IN� Permit No.: R�eived By: YOUR E-N1AIL ADDRESS V ICA%� (� Q��(o P�'r' �y�f ��^i �(�l ➢'F� � �� 1-�r� PERMIT TYPE O nnDrr[Ox Cl BASEMENT FINISH O DECR �r�rn� oF woRK: ��► ❑ n�tAwT�nrar,c�a DESCRIDE WORK BEING DONE �'�Z�— S1ZE OF IMPROVEMENT xun�� o� sQun�.c 1�_ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING O Virryl O Al�inum E! Other wc�v�ws IN EXIS'FING OPENIIVGS �Y� fllvo OR FOR NEW OPENING5-DESCRIBE SIZE OF OPENING CHANGFS & I 1� EXP DATE .� � 1-L� % �i1 S-� �l f CITSC�, � Fax��,��1-7%l�_� liUCTTON SIZE CfION STORIE$ O GARAGFJSHED � WINDOWS �LOOF ❑ DRAIN TILE �SIDING O 071�R O SWIMMING PC�L o xousE e� ��xncE O ATfACHED GARAGE Q DETACFIED OARAQE ❑Soffit or� ❑ Fascia LOCA170N OF WII�IDOWS _ ANMBER OF WINO ALL FEES ARE BASED ON VALUATION, INC ([ISIIy,� THE 1997 JOB V, Pernrit Fee Plan Review Fire Surchatge Swcharge License Surcharge SAC Char�e Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due � '�'E me��'�fJ ss`�' Ft. BASEMENT REMODELAIG SifBMIT: l. Existing Floor Plan 2. Proposed floor plan 3. List of struamtal members to be used FOR NEW CONSIRUCI'ION INCLUDING DECKS, ADDI770NS. dt PORCHES SUBMIT: l. sice Plan/s,rtvey sanwing rhe existiog strucnues and Prol�� ProJ� 2. Two sets of construaion plans 3. Energy Calculat�ns THE COST OF LABOR Ai�1D MATERIALS: UA7'inN $ _ � - ; �l� I ��UPANCY TYPE $ �� % See Back Page for Fee Schedule b5°10 of $uilding Percnit Fee .00i times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) � 1550 per SAC Unit {Plans to MWCC for determination} ft+6ft= ftx$21=$ 5450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( } Non Necessety ( ) $ �_ - I ? Make checks pavable to: Citv of Fridlev Attac TH[S IS AN APPLICATTON FOR A PERMIT-NOT VALiD UNTIL PROCESSED I hereby apply for a building pezmit and i acimowledge that the information ebove is complete and accivate; that the wark wiil be in confom�ance with the ordinances �d codes of the City of Fridley and witb the Minnesota Cons�uction Code� that I nnderstand this is not a pemdt but only an applicati n for a pernri d work is not to start without a perrnit; that the work will be in accardance with the approved plan in the case of all wo hich requires ' w d'approval of plaos. ° � �� .��I�Q� SIGNA7URE OF APPLICANf " PRIIV'P NAME �1 � pp -