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AF - 46162City of Fridley, Minn. BUILDING PERMIT �v� s o 7 7 � .: - , , i �' � , . • • � - ., �...r. .� ! ..l .�e. - ._.. .i .�.._. � f''t.�M .,.. ' sF • .. � ATIO F U L ING No. - � Street � �� P ! Lot -� Lot _.._. ...r__ Block Addition or Sub-Division�� Corner Lot — Inaide Lot _� Setback �.�L�! � Sideyard �� Sewer Elevation �____ _ Foundation IIevation DESCRIPTION OF BUILDING T e Used " / �1 � . � Front .�� Depth �w� Height �� &1• Ft. +�' �f �`� C�. F��a��"� .•� /,�1� •"' Front � Depth FTeight � Sq. Ft. �� G�. F't. �„�.� Type of nstruction Fst. Co be Completed In consideration of the issuance to me of a permft to conatruct the building described above, I agree to do the proposed work in accordance with the descript3on above set forth and in compliauce with all provisions of ordinancea of the dty oP F'ridley. � In conaideral3on of the payment of a fee of $_�� , pera►it fs he�by granted to to construct the building or addition as described above. Thia permit is granted upon 'Che express condition that theperaon to whom it fs granted aad his agents, employees and worl�en, in all work dane in, around ead upon said buildiug, or any �art thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construchon, alteration, maintenance� repair and moviag of buildings within the dty ]im�its and this permit may be revoked at aqy upon violation oP aay of the provfsions of said ordinaacea � �t .� ��"""'� �� NOTIC� 'Ifib psrmt! d� nef wv�r ths coastrucHoe, Irotall�Hoa �oe �rMno. 'hnebtno, /n 6aNe�, s�w� or wahr. 8� sun fe s» th� Buildiee letp�eta� for qparat� p�rmlis hr f6�a Ihmt. S'. . R �_\ % \ � � � �� s, - r. APPLICATION FOR �#UILDING PERM[T CI�Y OF 7�RIDL�Y, M�TNESOTA R a Owner' a Name ��"= �� '`�� ! $uilder ."o�%� ��y�,��' �aa �-�2��,�'�,,c�-�' �`' , -� � � . Address ,� ��>�l��J � ��l,;�d .��-�� Address �� , ��'�� 6 f��.� ��,�.� �9"� ��n�. �j� � ` 9 {� o �: tr �7s'hs` P��-�%i.'� � H- p LOCATION OF BUILDING No. /�� Street ,��-��%�=�� P�-- Part of Lot 0 �� Lot �� Block �� Addition or Subdivision ��-��= ��- �1-�-1�`�.f` Corner Lot Tnside Lot �9 Setback Side-Yard � C SEi�ER ELEVATZON � � �� "'�- �`� �'OU�]DATION ELEVATION /�� =� � � �e ,— Applicant attach to Chia form Two Certificatea of Survey of Lot aad proposed building location drawn on tthese Certificates. DESCRI�ION OF BUTLDING To be used as: ,� � Front , � � Depth � - � Height � ��"'� -� �= ' %' ' � � � `� � ��- �/ � _ ' Sq. Ft. �.�!�'�� Cu. Ft. � !/ �� ,�-•_^� ' �-.�--� � � � � �� '.�- � , ` � , �-�a ` ��1-- ` Front `� Depth � , � Seight ��' --- �, . � � Sq. Ft. �'ii�'��°� Cu. Ft. ,� ,�',��`",,�''" -�-- �� Type of Construction ��,��-Z�� , Eatimated Coet, _�� E�� To be Completed -%:,�j� � r�J - � �' The uaderaigaed hereby makes application for a permit fos the work herein specified, a�reeing to do all cvork ia strict accordance with the City o£ Fridley Ordinances and ruliags of the Departmeat of Buildings, and hereby declares that all the faEts and representations �tated.in tiiia application are true and cvrrect. � ,�;� ,�� DATE �" i f� � SIGNATURE ��;t,��_rz�� a�.��, �?�� r � (Schedule of Fee Coets can be fouad on the Iteverse Side). - � d i� �'`� 0. c � c BUH,DING PERMIT FEE SCHEDULE Section 2. The Tnspector of Buildinga shall, before isauing any permit for the erection of any building or structure, or for anq addition ta anq egist- ing building or strucCure, or for any alteratfoas or repaira to any existing bu3lding or stcructure, upon apglicatioa therefor, require the payment by the applicant for such permit of feea ta the amount herein below set forth aad in the manner hereia provided to-wit: 2;1. Eor any such permit for the erecCion of any fire-proof building, other t�ian a garage� warehouse, factory or grain elevator, or for the erectioa of any fire-proof addition, for similar occupaacy, to any existing building �shall be �t the rate of $1.40 for each on� thousand cubic feet, or fraction thereof, in such cubical conteuta. , 2.2. For any auch permie for �he erec�ion of any fire-proof garage, warehouse, f�ctory or grain elevator, or for fhe erect3on of aay fire-proof addition, for s3.mil�r occupancy, to any existing building shall be at the r�te of $1.25 for each oae thousand cubic feet, classified ae °1fireproof" by Sec.tioa S02 of the Miane�polie Buildiag Code. - L�OUSES e 2.3. For any auch permft #or the erection of any noa-fireproof buildiag other thaa a garage, warehouae, factory or grain elevator, or any noa-fireproof addition, for similar occupancy, to aay exiating building - permit. $l.pp for each one thousand cubic feet. GARAGES 2,,.4._ For any such permi,t for the erecCion of any non-fireproof gara e warehouse, factory or grain �levator, or for the erection o£ an� non-f3re}�roof additioa, for aimilar occupancy, ec �ny existing building or for each such buildiag or addition _ niaet�y ceats {$D.90) for each one �housand cubic feet or fraction thereof, in the cubical conteats thereo€ �vith a minim�► of �4.00. For the purpose of computiag fees for buildi of szny buildin� or Qddifi,ion �o a un�.form heightpthroughouteby�multiplyingnthe ground area covered fram a point s3x (6) inches below the floo� line of the basement or cellar to the average height of the.upper surface or to the $verage height of the roof eurface`of the main gab7,e of a p�.tched roof. 2.5. For repa3rs or alteratfons to a.n existing structure, the fee shall be at the rate of $3.Q0 per each �ive iiuudred Dollars ($500.00) or frection thereof fn the coat of a11 proposed work. 2_.6. In no case aha11 the fee charged for any permit as set forth in Section 2 be less than $4.pp� �1 � --_� '. _ ° ;� , _ �. [and Plannin9 Lmrd Surveyii►9 Soi�s Testiny C�vil fr A�fuii�apeol E��9 . � � �s-H�yhwoy fcs u.E. Minieeo�o%s 2/, EN G I NEE R I N G, I N C. l��nnesofo SUnset4-6066 — En9ineers � Surveyors — ce:�ti�'icate o� s�ss�eT �o�,��c�A � �J �� ,��1:: �.P�__ z o, 3 � � , � , 3:� � .�rt••s r.-.� z0�0 ' f pI �% . /� ��I �u4'�� K.�'4�tl��'/ �-<�„��%� �'Y: � J y . � `,` / [% �7 � � 6�i� / i Ft F � I `�� ' � e ► 0 ' d�" A 4,,,,! �rdn � L.J + l-° sr � ._ :.: ._ . _., �r - - � ------ . . -�_. , . .. . : ._.. .�.2,.,_.�.,-.,__...--_�._ _ _ . . -�.- - � � �.�- . �. ..-c.�-.+r�.--°---- ". _ _ � _�- ° -� --�- -`-' - . -- - -. - - "'- _ — - - - . . "_ - -'_- -- - - __ . . f: �_ .-- - - - ,.�' .�rc i. t�, ��o- �, ,t rr r, a Q\X o' � N �� (\ i � Y a � �, Tron ..,�n..rr .��--�BI`�� '� � 6' l,� !�' �!P ; � r 1 �d �'�'r` �*`' t J � <' "3 �i ts� ti t{a�✓k�y ' T►.m ��,�� ,_ � - — �--y �"- � -.� ,. f� . � -- - ._ .�.._._� � _ "_ _. _.-._ _.__ , �b_��, 60,IJ -" Zc.c�� s..�� -�-- � i�/LL CR�ST� �DR�t�,� 1 r�n �� , A �'%I�U Np r,•� .: �� p` , e� ��'�u v..� � L Ul`0'[iG' y� `' .. �`_ �S � � r �`Q� ---_._ ___ , ��,�,� ° ^ -�� r.��r � ' / � � - � , $a^arr � r �d �Z C� . / -4a . Y J !/ p A� � . � / � � c� �% E-•4 �`••' � �,�. a � �� .��'/ce � � � �>-�� :�'' .. ,�. r� _l�i //.� � A s� c� !r �. �' o,,.Ail � t, �.. lh�rnl�y �rfi�y �!' �� o fi�e �rd mrr�cf rePrese�otrcn o�'a sr�rret� �'1br ban.,dorres �'!lre abo� d�Ged /aa�and o�'lIx ! n q�'oll drrri/dm�s , fl�crean , ard d/ ris�b/e uranvviinalfs ,��'an�. �irsn ar ar� soid /and. As surreyed by me tbs�=-+d�� 6 `� � A.O � SUB URBAN ENG/NEE2ING , INC. En�inc�s 6� sur.tyors , _-- - 5��-l� I„F y�,, ��M e� �`"� � �� . - - �� , � � � ti � � � � � p ��d : y 0 : � : � : ti : o � a . m °� : � : � � � G I N � � � � � � � w � � o � � .�j � � � o � �° fA � � N � o � o � : o . � � : x 0 � � � N � � 0 4 0 � � � H . y �It" � z � 3 m z� � z� z x � m rt � � n $ � � � � �" �� '� y � � a�� d ' O � � � � b . � � � � � ,� � . � a��. � : �_ � : ri, P� o� o � � : o¢a � : � : : • � . . . . : � : : : : 'i �o � � � � � � w N w �.. .. �' �O C�T p C�i� O O O � {fl {/! fA if� �fl ifl � y . y � �C'' � 0 Q x 1 { s � � � 00 c � y % � m D � i � � m � � 2 m C r m � • � � � �� a �� m � M �� I � � � a� a. R. p � � � � O M r � a � � o R � � G � � a � � � � �l ,� �,� �, ��;� � , �► �� aa� � � � p� ° ro `�°�►a� � �� D p � �4• � ��o � �' �. � `� �"'�.� bi b � �b :� ed � �p� � � p �' o � ¢ o p �'�,o �! � � � w 'CS � � � �`� R�� G ��►o! �� . � � � � � M � � fD .a. � � 3 `� � � �� x� a� aQ �rx & �°, p � M � � � a � � = �. ' � � �J �� °� �� d °' �- �b � � ;rt � M `� �. � o � � � � � � a � � \ `� M E� � a � x i < 8 � N � � � � � ID 0 � x r��M � x x � �,r�o Y x � z � � � o � `� '� x ��n '� � � �-..� . � � � o �C y F F m � � m b � � � � � � � � b c� p C � � 1� a- � � m n � D z � �' _ —,, _� � �� g� � C.`"� � � � � � < <jj � � m � � Z � � ' � m � r�-i b � b � � � � y � � � � � W � � � � � � o � � ,��, N k � o�0 O y � � : : � : : �E k D4 0 N � o en en ,� c o o � tn �n tfl � t O � r � o � � 0p � A H � m \ ,l 1 ��. , . ;. � 1 . • \\ `� \ � � 00 � � � � 0 � 0 0 � 0 0 � � 0 0 0 r on � ` I '' o w oa ``' w � m � �9 � ti � o � � o � � � �. � �. �: � �: w 0 0 � � � � P � H O � � O � � �� x O � � � � � � � �fD O � O � p7 jU � �� m m � � � ¢ � '° � x � � o H o °o G G � � � R° R° y �� 0 A o o � � � � � �� m � : � � : : � � � = x �d . � o � . . �,. : : � � . . y . � � � � 0 0 °o °o � �s 4» a � � Gi � � M � � � � � 0 0 a� � O � � g � � � �° ,� ,� � � ��'� � � � � � � � � � � � � °� �, � oo�� o� � Q �' R7 � � �' w 5' � �" � � ; � � o . � � S � : : ° 0 o . . . � o . . • : : : : �, w o� er ns ao 0 0 °o °o o° tn v� rw � a. � � O ro � � 0¢ , �� \ ,� �`! �` t , �� 0� ` \ \ l � ; �'` \ � � b b � � � m � �'�'� � � � t�t�� ,y �� ro R° � � � �d �n p � � y �, b � o a � � � � � : : � ° � : o g : . o . . � : : : � er vi oe � cn o 0 0 0 0 0 0 �n O t' � a�� w � °�a� �c ��'! �� M ro y�'R.� � �� p �� a d H 4�' of�Dp"'� d doa°t� � �, ��; � , �' ��°� � � dp��e � �o�� m ~' M � w�� \ � � �. �' � � � ��b p � �� p� m s cyD�O� �. m p, o � y �� b �� . `° � �. �P p � � �oV �\ ��f�DH a:� ;+ � Ci . �� E �'�'! r► �. � ''' ' `° � rr � � � �' �Sk 5' D -_�-I r � -a m � 2 m C 1'17 b M � � :7' � � a � � V O '� � _ � 'o� � � � O � 1 � O �� O� � D = D �� NN� rt 3 � h 0 � 0.� v� �� i � �i 0 � vs � � �• � d � ��_ ��r�� . Compliments of North Central Public Service Co., �� 9 � �` i HEAT L08S CALCiTl.�ITIONS - , � �) � � DEPARTMENT OF UILDINGS V I LLAGE Weatherstrips A.S.H.V.E. Cons�uction No. Insulation Guide WfndoN DooN� ReferenCe Out. Wall IInt. Wall) C,eiling _I RooE Floor 'F�ind I How � � 1�?'... l� �— , Fl. p� Roam I Length �'�/ Width��/ Height �/ Fl. I ' Roam I I.en Width W dows Doors—Crackage and Area Windows Doors--Crackag and Area. Widttl Height No. oY Llneal ft. Area Width Height No. oP Lineal ft. Area No. oE pane o1 pane lights oP crack 8q. ft. No. oE pane of pane lights oP crack sq. ft. ' %.� r� � l � • �_ � �?� ?� � � � � z.� �' / �� o �'� ehf C!' / ' co�ef. stu coet.� Btu InSl'laation .�i Z� �p InfilYration f�? � �, Glass p Glass � ° Exp. wa11 Exp. wall I Net exp. wali '' p - Q Net exp. wall 6 O � 1��7 � I In� wall In�, wall Ceiling !l� �i !1 �01 � Ceiling - ,'%��. ' � �p � Floor Total Btu. Total Btu. Requfred sq. ft. E.D.R., or sq. ins. W.A. I.eader area � y Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ,�j Fi, � �m I Length Widfih Height FL � m I Lengtli �2/ Width i Height�� Windbws and Doors---Crackage and Area I Windows and Doors--Cra.ckage and Area. _ I I I c��. s� �nsl�tratton o26. / 20 � � Glags . ' _% 7 Z 7°— Exp. wau � Net �cA. wall , � / � In�. w'all ceiling Flaor Total Bht. Requirad sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. � m I Lengtlz AZ / Widt�h / Height �/ Windo . and rs—Crackage and Ar�- I Width I FielghC I No. of I Lineal ft. I Area � No. o! Pane oT pane _ lights oY crack sq. ft. � I I I I Caef. Btu In8l�tra.tion �i.� � � I� Gla� G� i ! E�c�,i. wall S' � � Net exp. �wall !� � � � In�. waIl � Ceiling �I � . � � Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area � � Infll`tration Gla�+ Exp. wall Net exp. wa11 Iri� vva11 �iling Floor Btu I � Total Btu. O Required sn. ft. E.D.R. or sq. ins. W.A. Le�a.der ar�a. Fl. � Room I Length � � Width / Height �� Windows d Doors--Cra.eka.ge and Area Width Height No. oY Lineal Pt. Area No. oE pane oE pane lights oE crack sq. ft. I�I D � �, � � � � � �� I caet. stu i InSltration � � � p Glass Exp, wall Net exp. wall Int. wall �Ceiling Floor Total Btu. IIRequired sq. ft. E.D.R. or sq. ins. W.A. Leader area i I Compliments of North Central Public Service Co., ��,3�� °• ' �T r.oss c�cvr.A�oxs - t� DEPARTMENT OF BU DIN�S V�E Weatherstrips A.S.H,V.E. Constructi�n No. Insulatlon Guide Wind N�s ( Doo�� Referenc'e Ou� Wall I� Wall I Ce3ling I Roof I Floor Kin I How Applied 19, .�..�.. v' Fl. R�m I Length ' Width �/ Height ,/ FL Roam I Length Widt3i Height W dows and Doors—Cracka.ge and E3rea. Windows and Do�rs—Crackage and Area W1dtt1 Height No. 01 Llneal Yt. Area Width Height No. oY Lineal ft. Area No. oY pane o1 pane lights o1 crack sq. ft. No. oP pane of pane lights oY crack sq. fk .� � y � Z � � � 6 � v . CaeP. Btu Caef.l Btu In81trat3on � � Gla� S Exp. wall Net exp. wall �� Int wall Ce911ng ,� Fl�r Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area. ` Fl. Room I Length �a / Widt�h � Height s Windows and Doors--Cracka.ge and Area Widt11 Helght No. 01 Lin it. Area No. oi pane o! pane lighta o1 crack sq. ft. � / � � �.� i � Co�ef. Btu InSltration � � G� /�/� F.�cp. wall p rret exn. wau ( � � Tn�. wall � � v Floor Total Btu. Required sq. ft. E.D.H. or sq. ins. W.A. Le�der ard, F1, I Roam I Length �� Width, / Height - Windows and Doors--Crackage and Area � In$1'trdliOA Gla.ss Exp. wall Net exp. waII In�. wa11 Ceiling Floor Total Bta Required sq. ft. E.D.R.. or sq. ins. W.A, I.eader area Btu I Infil`tration � Glass Exp. wall Net exp. wall Int. wall Ceiling f� %� �� Floor I I Total Btu. Required sq. ft. E.D. . or sq. ins. W.A. Leader area Fl. I Length r Width "/ Height �� Windows and oors—Cra.ckage and Area. � � , Tnfil'tration Glass Exp. wall Net exp. wall In� vvall �g Floor � Btu _� i �,� �� Total Btu. Required sq. ft. E.D.R, or sq. ins. W.A. I.eader ar�a Fl. I Room I Length VVidth Height Windaws and Doors—Cracka.ge and Area. Width Height No. oE Lineal ft. Atea No. of pane oE pane lights of crack sq. ft. CceP. - - - Btu Infiltration I _ �s� Gla:ss Exp, wall 3�� Net exp. wall Int. wall � ��g FIOOP �� Total Btu. IRequired sq. ft. E.D.R, or sq. ins. W.A. Leader area � rn � n m � m Z -a � c � z n m � � � n � � �� .-"C_, � � 3 � o � 3 � n O `o m � � � A -�a a v � �u � � �� a � � 0 c �. �o m Z � -o rn � 0 Z m � � Z ,aD v� a � � �! < n. i � � � � �° �� o ! �� i � D � � � � i � o � � c � � � � , �� , � � � j � � i � ' a i � � � � � o � m � � _ _ �' � �, . � � �� r O � -� -► � � � c � rn � . c� � � � � W � �c� � � ; � � z �/ m � � � � � � z � � o �m v � . -' o � 3 0 °. 3 �� C A � � o = AM• q. 'b C zs t� � �' � 0 � O x ER J � o � �. m � � � °. m �� A � m � ° o � � N O � � N � O Z W n 3 �� 7 W .-�i Z c � m 0 _c� o 3 `� �, � � cQ � � _ � -� � 0 A � � 'n � 0 3 � � � � � � ��• � � 3 Q'�o = 0 � � � � b � � -� � fl. O � S � 1 � � m � � v � � � � � c� �' � tG � m a � � � 7 a� A :� �� C N � � � a � �: �• � � 3 � � .�► Q. -� v c ID � � o x � c � N I <n � � � � 0 0 0 0 � � °o °o � g o° �'. � � {� tsl � � � � D c� O � -a }J �1 � -� m �o � 0 � � ls� f�3 W v z � C a� rn v � � , F!9 lfl � 0 � Q � ^ v► -I Zt�"D� �.� � m �' � a ��m � ° °° � �- �� a� a � � � � Q�°m � s°o� � y' m � � N � � � �=o� � �• Q 3 '�O � � ? � � y � � � � � � � h a � ��o� � � � � a.�m� �� s -'� � � a ��m � Sv � � � `^ � o z � .\ ? � Q-�� 3 � � a cfl co w �� w� t� . i � O ao v v � m � � W � � � �� W rC � � �Z�� v �� < N m Z Z m� rn � 2 � < � � 7D my - -� -�'-t O OZ 2 'q Z � a � D �7� C� � v� _' Z zN ��Z �a u� _ rn �Z z� an �O r mZ �� m Z � � 2 � � 0 � L � 3 c � � � W CHIMN$Y AND STACR VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes O No O 2. Is free from rust or deterioration Yes () No ( j 3. Has no foreign objects lodged within Yes () No () 4. Is securely supported Yes () No () 5. Meets all current Code requirements for size and total BTtT's connected Yes () No () 6. Has total heating BTU's of . All other BTLT' s � � ' TOTAL BTLT' s . Remarks List Alterations Beinq Done: e HEATING COMPANY Signed By Date sue�ecf • PE . City of Fridley 2 9 084 � AT TME TOP OF TME TWINS g U I L D 1 I� G P E R M I T � � R . � `L _ COMMUNITY DEVEIOPMENT OIV. �� r � � PfiOTEGTIVE INSPECTION SEC. 1 .' � L-_-.� ��',.� CITY HALL FRIOLE� sS�J2 NUMBER pEV OATfi pAGE O� AVPROYED BY L 612-57�-3460 s�aF�s 3/25/99 / / JOB AODRESS 1346 Hillcrest Dr ve 1 LEGAL ��T NO. BLOCK TRACT OR AODITION SEE ATTACHED oescR. 16 3 Moore Lake Hills SFIEET 2 PROPERTY OWNER MAIL ADpR�S$ ZIP PHONE Paul Tumms 13 illc e t e E 571-9573 3 CONTRACTOR MAIL ADDRESS 2�P PMONE LICENSE NO Walker Roof'n C - 4 AiiCHITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILOING Res dential , 7 CLASS OF WORK 0 NEW O ADDITION O ALTERATIAN p� REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WOI;K , Reroof House & Gara e 44 S Tear—off 9 CHANGEOfUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. permit inspection Cards Will Be Mailed To Homeowner To Post SEPARA7E PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, NEATIN6, TYP� OF CONST. OCCUPANCY GROUP OCCUPANCr LOAO VENT�LATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOIO If WORK OR CONSTRUCTION 20NING SO. fT CU FT. AUTMORIZEO IS NOT COMMENCEO V�1ITHIN 80 OAYS. Ofl IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO fOFi A PER100 OF 120 DAYS AT ANY TIME AFTER WOHK IS COMMENCED NO DWLG. UNITS OFFSTREET PARKtNG I MEREBV CERTIFV THAT I HAVE READ ANO E7(AMIN�O THIS APPLICATION 1 S7AL�S GARAGES ANO KNOW TNE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAW$ yp�UAT10N SURTAX ANO ORDINANCES GOVERNING THIS TYVE Of WOqK WI�L QE COMPUEO $3 � 77O � l. 88 WITM WMETHEq SPECIfIED MEREIN OR NOT. TNE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE Op CAMCEI TNE pEqMl7 FEE SAC CHARGE PROVISIONS OF ANY OTNER STATE OR LOCAL LAW REGULATING CON• 87 � 2r, Fire SC �3. 77 STRUCTION OR 7NE PERFOfiMANCE Of CONSTRUCTION � PLAN CMECK FEE TOTAL FEE License SC $5.00 $97.90 S�GNGTUpE OF CON7i7ACTOA OA oUTHOp�ZED AGENT ipatE� WMEN PqOPE V VALIDATEO TNIS IS �OUR PERMI7 _ c�/ � _ r�i —�� $�GNATUqEOFOWNEp��OWtiEABU4DEA� iO�iE� s,. � - b �p5o � � qatE NEW [ ] ADDN [ ] ALTER � ConstructionAddress: / CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION � Effective 1/1/98 0� � U� �� 1 Legal Description: �' ��/�(c� ��3 -sl�� Owner Name & Address: ;�� `�� y Tel. # a�f —�� Contract� Address: LIVING AREA: GARAGE AREA: DECK AREA: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Length Width Length Width � ENSE # �%�� Tel. # �� Height Sq. Ft. Height Sq. Ft. Hgt/Ground Sq. Ft. OTHER: 4 �• � ,Je��al�►e Construction Type: -� Estimated Cost: $ `�`� � 3 � � '� (Fee Schedul e on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �'Z �j' � g APPLICANT: __ Tel. # /� p��o� � Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ �7�� $ � �-7� $ I�� $ $ S, DO $ $ $ $ $ -�.�(� CITY USE ONLY Fee Schedule on Reverse Side .t�01 of Permit'Jaivation (1/lOth%} $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] . ._ BUILDING 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 building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require 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 $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $SO,OQO $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for �the first $SOO,OQO plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRE�SI�N ESC:Id,OV� _ . _ (Concrete 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 approach with 6 inch depth - Driveway width plus 6 feet times $15.75. 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. � 0 � � 7 O4 '� 0 � m � � m 0 � 0 n � v a < a � � 0 c 3 3 v � m � � v v � m � m z � � n -_I � Z � m rn � � 0 0 � _ O c z � 3 i-' 3• tNn 3 0 c o � -h � � � C cD (n �' $a a o � � � � o � o d � � � o � � � a r � rt � � 1 m c� °� o � �� s � v � � � C�' C' � � � m � � � � � U, 1 7' x � z � v � a m � N m � I� 0 _ N rt r�+ � Q � � N N � a � �± 0 � � � c m cii � n 0 � m � 3 3 o D � � � — • o � o � � �. � � � � N 'rl � N � N O � ?� D N N �, cn a o rn � oi D �• ° �D n��i ma � � o m a o �' m � � � � � �,+ °� o o � � � o � -�+� 0 � �, m `° � c o. °' fD o� � m � �D� a � 1 Q � O � N � O �D � � � � � � rt � o � a � � �� . r�r �' � a rn � c� � � o � � � �° �D m � D N � � o ,�� Q � O 7 7 � D �° G� � z v � f�D L� � N � a � OZL Z � c � � m _n m v v m � m � 07 c � o � �i � � a a � � �ii S !'�,F � � 01 fD � 7 � a c ° 3 � � md � 0 � ov c � m � R� � m � n x m v c r � w � � N W � � �P � � w tn � ►;� � � � ,�'p C) a J �G �' '� c � �. O � � � N � v z I�rl m _� � r Z �i± �T V m � 0 z � n � o 0 o c�''i, � � r °o o °o 0 0 � D �r � � � � �, D O �� —� Z • � I° Z O �' � v o v� � m � W � m -, � d a m Z � � 2 � u� I N m v o � • c°°�� cn �ca°, � x z� m rt _ >��I � C �� O (p � = O o � �D � � N � '� � � Q � 0 w = Q' O m N � � � d o ' � D � � � 3 � m v O � . h� � � m � 3 � z O W c a � ma C � a � � � E °D O '� d'�/ ° 0 Z � � � � 0 / � V' � Z D �Z �v _ � '^ � m Z � � L� n �Z O � ° z v� �. � c� m � � �"� � Z FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacina an existina furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and flrestopped where required. The venting system is plastic/PVC and meets all current codes and manufacturer specifications including s'izing, length, number of elbows and termination. The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. T�ie exi�ti� combustion air is sized and instaHed to meet t�e currerat �des and manufacturer's specifications. When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specific�tions. When installina a new ventina svstem, the undersigned hereby verifies that it is a listed assembly and meets the current codes and r�anufacturer's specifications. This does include AGA-GAMA Category 9 Central Fumace Venting Tables for fan assisted and natural draft appliances. Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes ) Yes No ( ) No ( ) Yes� %� No i ) Yes ( ) No ( ) Yes No ( ) Yes (� i� No ( ) ( Yes/� No ( ) Aapliance TVpe and Size/Common Vent and Vent Connector Information Appliance #1 Typ V1G�C� BTU Input �Q �O�b. Fan Assisted or Nat X�� Appliance #2 Type � BTU Input �� 1 C�C� Fan Assisted or Nat � Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Tatal Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height �ft Length �ft Diameter,�in Type � Appliance #2 Vent Connector Height if Length ft Diameter �� grpe Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING Signed By: Date : �