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AF - 47285City of Fridlep, Minn.. 6431 Univeraity Ave. 1�. E., Minneapolis, Minn. 55432 BUILDING PERMIT ��; _ Julv 8. 1971 py�; _ Brad Baldwin g�d� Tri.-Co Bui� ders Inc � Address �555 U.� Bu�esi. ��o�o � . LOCATION OF BUILDIIdG N'o �� Street �� Jackson, p� �� ypt 20 g;�k 4 Addition oa Sub-Divisian - M� Mannr �,-A Cornex Lot Insiide Lot Setback Sideyard � g�ya,�q� _ R71 _ 7 R IIevation 874 _ 7 8 „_ Wye Ton of Footing DESCRIPTION OP BUILDING To be Used as: House �nt 40 �p� 28 Height 20 Sq, �, 1082 �, �•�, 21,640 Gara�e �nt 20 �p� 24 Hei�ht 10 Sq, �•t, 480 �, �, 4, 800 '1`ype of Construction Frame �, �� 19, 000. To 1� Completed 11/1 71 No walkout without engineering approval. Hard surface driveway. Verification survey required. � Elevatioa miaimum 18`0 above centerline of street. Sewer - 54' South o£ Sanitary manhole. Water 44' South of Saaitary manhole. In cons4dera,tion oP the issuance to me of a pertnit to eonsfruci the building described above, I agree ta do $he proposed vaork in accordance with the de�criptio bove forth and in complisnce with all provisions oE Qrdihances of the dty of Fridley. �� - � ,-,- �� ,�r SC S4_96 Ia consgideration of the payment of a fee of $..�..�SL, permit is hereby granted, to Tri-Co Bl rs . Inc . to construct the building or addition as described aUove. This permit is granted upon, the express condition tliat the person to whom it is granted and his agents, employees and worl�nen, in all work dOne in, around and upon said building, or any part thereof, shall conform in all res�cts •to the ordinances oi 1�`rfdley, Minnesota regarding local3on, construction, alteration, maintenance, repair and moving of bwllc�tags ��th�e dty ]imits and this permit may be revoked at any time upon viola.tion of any of the provisions of s9afd P - Builcling Inspector HANK M[TEIICH � Q� RIOTICE: This permlt does not cove� fhe eonstruefion, installa4ton for wiring, plumbin8, gas heafing, sswer or wefer. Be sure to sas f6e Building Inspector fo� separete permits for fhese hems. . f^ k,.'. ' . ` �!" � ��.:� � � ..� �'7 � ��0fU71� � , ��'�J� �.� � ��#�� NG i htE�Ri NG, 1 : �tvrl' �r �.l�linp�ll � . �� — �rt�ineers � Sut�verJors -- � . ; _� �+e��;�a�cate o�' sus�re �� : : --h � � 6� � I �I t Q7 ?� • � I � � 1� .� . .� � ��. i _ • 1�2 � I 00 . � e�� C G � �� m Q � � � � � tii2 �I � �� rsH��s�� M�r�ls 3�. � �. 1l�r�tneso% Stkite� el-IQOdii ., � c�,� �� ' �. . t�t�1R7'N a CENOTES tRON"—'OENOTES OQAINAGE. AND l�T1L.ITY EASEMENT L�?��. BL+OCK.�_MELOD7 MANOR 3RD AODITION ANDKA C�UNr�f Ji�ebt� ce�'iyl'tl �htf# Ihi� �s a frue Qr�J eaori°tct �e�tessitl�!'ron o�'a survte� �N1r 6�amdarres qC �ne obort a�cr�6er1 /ar►�,ond �i'Y�s /ar�Ori aJ'QIl �iartdrrr�s, ffman , ad ol� nsib/� oxrnvdimenfs ,�!'may, {�rri o,r an am� la�d. As surreyed � rr� fl�s �_ c� �__ � .� ,�,�� A.D 1�J'rz.B . °Y`�"' SU8U28AN ENG/NEER/NG, INC. S F° ,St +�f:��I°y � � Scate: tp�d0 �, _��. _ _.r�� C��/�..._�.��-� .: ! . v � � �� . .� ,� �� vL L �"/1 � �� r � � ��-- �`z`- � �� l� �� f � �/ S � �� - �,�. Z �" 7 � ��i �� , � � �- y�� Ss� � .�� % � - �.� �7 _ �%�� . . � r w .s -• � 9PPLIC�TION FOR BIIILDING PER1�T CITY OF FEIDLEY, MINNESOTA OWNEEt'S NAME /°°G�q � ^�� - ,�, e � BIIII�DER � / — , , _ � �' �� v� Cu �a� �,4 ��" ee �nD�S �D�sS �5� ss �� "�� LOCATION OF BIITLDING No oZ,��,s�r �d �. l� � � �/ � L0�' � BLOCK ADDITION OR SUBDIVISION ��e �� '��,� � �� ' CORNER L0�' INSIDE LOTT SE'I'BACK SIDEY�D�� SEWEE[�.. ELEP,A.TION TOP OF FOOTING � Appli;cant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificatea. DF,SCRIPTION OF BUILDING �'o Be Uaed As: , , . �. ��-� F'�cont `'� � Depth - i'� ,��! Height � � Square feet �(� � � Cubic Feet �� -` � „ � � � ��r�✓� Fr t �� D th c� � Hei ht �� 0 on ep g � e�i 61 Square feet �� Cubic Feet ��=" `- �P '_'` =`� ' �� , �r � . �.��x-�;.�:�....._. w. r �, C F � - Type of Conetruction ��° �' �€ �'1 � Estimated Coat ,� yn r�' �'�� . � '�� , � To Be Completed � �`-�� +�� .1 � ��9� �� ,��. The undersigned hereby ma.kea application for a permit for the work h�rein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulinge of the Department of Buildings, and hereby decl,area that all the facta and representations etated in this application are true and correcte ,� DATE � �� R.,,� ��/� SiGNAT'ORE � �,�'.�^^�`�° 'f�- °�i' �. ,�� '_ , � � (Schedule of Fee Coats cas�, be fouzid on the Reverse Sideo ) �� ! �� , , . � � { // �j .,.• w L�r -+n e� �l�� .�.•�t^• ,�,�`` d ;J � �J� ,' ,r�„ � .`' z-9 ' '''''� � _ ` �`�(��C �� a � ��,7 / � '� /� ( , r 3� , �c'�Led�ie�a -_._�� /--,r� :A '�� FA - - �- � � ., - � � � ��,� ,� _ ,� � � �� t� ,. , �� a r�� .� � r .; �0 4� e _ , �,�� o @`� � / � Y � ,.�� , �� c � ,� � � �' � �� ' �...� e `✓' � � � jf,ce �t' � ,, �: ��: f1 :-' -- ��_., -_ � � 7i�� rv'-� �� , - .;' � � '�'� �.> 7 ��' , � � � �, � � � � � � -�-_� � � � � �� r;��;«,G� . �3 � A � iS'R��j A r��a�m.- (/ f ( � � � / a� � � p --�� .,�_'�.� _ , �`��l D �.�' � e .' ,� BIIILDING PERMIT�FEE SCHEDULE SECTION 2o The Inspector of Buildinga shall9 before issuing permits for the erection of any buildin.g or �tru.cture, or for any addition to any �xi�tin.g structure or building9 or.for any alteration or repairs to any existing building o� atructure, upon application therefore, require the payment by the applieant for �uch perm.it of fee� to the amovsnt herein. below set forth and i.n the manner herein provided to-wit: Uniform Buildinm Codee Type 19 2, & 4-$1075 for each one thous�d cubic feet , or fraction thereof , ir_ auch �ubical c.ar�.tente . Type 3& 5- $1050 for each one thoueand cubic feeto For the purpose of computi.ng fees for buildin� permita, the cubical c'ontenta of any`buildin�'br addition to a unigorm heig�it°thr�u�hout��y� multiplying the ground area covered from a point ai.x (6) inGhes below the floor line of the basement or the cellar to the avere,ge height of the upper surface or to the average height of the roof sur�.ace of the ma,in gable of a pitched roof. For repairs or alterationa to an existing structure, the fee sha.11 be at the rate of° $3.00 per each five hundred dollars ($500.00) or fraction thereof in the coet of all proposed work. In xao case shall the fee charged for any permit ae set forth in Sec�ion 2 be less than $S.00o NSSSD Connectioz� Charges baaed on location - Area 1 or 2. .� .w , �. � a �G��?� � tand ?lanoing �u�u/L�n 6875 Highway No.65 N.E. lohd Snrva � • �/�, �• Minneo olis boiis Telti 8� ��PiGIlG�, r'nc� Mina. 55432 Civii.Ebginearieg Telsphone 784-8066 Municipal Ertgineer►ng EIIg�II882'B & Surveyors Area Code 612 � Mortgage Loan 3urvey for ��' 4� �u �� V�� _ � �'"` �" �� -�- �� . � � �:. � � � � � � � _..�...� -�.. � vr ol � � .� Q � `��,V �Y�.�: � 1)J . .� � �a'� W L.lJ � V" � � � � � S�al@' �.''� `3�� Loi 24� �..�C� � � �E �ol� �'�� ,�� l�n�.i�c� ot.r�, � This is o tr�e ond correct representation of o survey of tl�e 1iaYAdpciBS of tha land above deseribed oad of the IOtpti0�1 OI pl) bYi�dIi195� if anr�� fhereon� aed oll visible eneroaehmenri� if anr�. from o► on said land. This survey is mnde onlr in conneetion with o mo�tgoge toan new being ploced on the pcoper�y and no liobilitr is dssumed eacepf to �Ae holder of avch mertgage or onr other interest acquired by the rooson of suth morfgaga. It is Ynderstood o�+d bgreed no monun+ents have been ploced for tha purpose. of astablishing IA� �Op@s ar 6oundary cornen. Dared �his��'�lo�r of Su �u__ _ A. D. 19],� � ' SUBUBRAN ENGINEERING, INC. �� Engineers ua,,r'_e�rors �,,y,�. �+r . �,��.;� �t-�....� �5 g�4 1 m � � � � :: '"' O x � u�� I" C: j i � � N � � w � p � l)'1 � � i �"i � O F� r�� H x x � �r��y �' �' x x x � � � � o � � � � �� rA � � � o � � � m � fs <N � � � � r F-� f� r- �� r �y � � � rt i�i O . � M � 9 m y � ¢ � � � � W � p � � ,� c�o °•'-• M Ch o � � N N � ti o � c y °o � � . . � : : � � � x k �! k � N � Q O O � {!> iA {F� � 0 r � � W � � x � 0 � 0 0 0 0 O m � cn O O ffl 0 t� W � C � � I w � W �� w ro � � � � � .�'� y O .x � O V1 y m � � fD • �: a �: �. en O O H! m � o w w � � y cL � � � � � � � a � 'z] z � o � � � � � 0 w � � � � � .°r � � a fi G� � � m n i � fi W A N � �t � � � o � � Z by o N h� 0 O 0 y w a�+ � � � � � O m m a � � � x � � O N o m m ""� 0 0 � � � � � � � � �� i �i � � � ��s�-� 0 f`�'D O O � �. � � � � � � M ►�j � � y� . . eb � � � x � . . o � . . � : : � � . . y . 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Z � �� =° �t � .7� � � � � 90 � � � � D O. 0 � � �`s �v �� f� . 1�'1` 1.� CA WeatherUrip� Pl� �+i��• I � aad 1 � ot � III6Ii�ihOD Glaa . E�cP•'—�l Net esp. wall •-�--- lat. aU Ceiliag � Floor i ' 7' Bt� and I e 1 s[ � ' In6ltradon 1 � i �,p�p PARTiNENT F NSPECTIONS , • G�aE 1 � Coastruction . ; ,, Etekreau � Out. �la lntc Wall Ceiling Roof '�'Floor 19____ �th Width i8hc Fl.� � � �rackagc nd Area Windowa and No. at Llneal t. ♦rea VVldtb 1 Ilshts o! cr� tq,j�• No. p e � � �l , o sq, �ne, W.A, der area h �Width m eackaae and Area . Glaa Eap. wall � Net eup. wal! In� w q r--- Ceilmg ' Floor �- T Btu. Requircd aq. k. E.D.R. o Iasps�tor°s �tes in�. W.�1, L,eader area � Iu�ulation How W'�dth � � I�rea lAfl��i8�t011 Glau Esp. wall � � Net e:p. wnll Iae. w Q Ceiling Floor � 7o Btu. Reauired sa. h. E.D.R. or sq. ina. WA. Leadea area ight �.I Room I Windows and Doon—� �Wldth Hdsbt r No. I ot was ot pam 1 Widtb and Ares ae�llt. Area lcraek la.lt Infiltration I GIaN Esp. waU Net e:p. wall Iat. wall Ceiling �'loor Tot�l �tu. Reauired ma. ft. E.D.R. or eq. iee. W.A. � � F� i �.�:� �� :,a L��-riuRas �� v��rrs�� .. � � 4 r- ;. 1� :'...�. i�T�. Weat�eescrips � �',uide � �n�truction No. '+�nsul�tion ' W' owa a E�eference �t. Wall Int. Wall Ceiling Roof �'loor Kind I-Iore� Applied Y�a No Ye @ 9_ � - Fl.� R m l.ength Widch a—fleighe FI.� / Room Ltngt6 —�Widch � H��h� Windoews and s—Cr�ckage and Area Windows and Doors--Craekage and Aeea tVldth Heig . ot Llaeal tt. Area Width Helgdt No. ot Llncal tt. Area Na. p of a I ta ot ceack ap. ft. No. o[ D$ of D ne Ughta o[ enek eq. ft. �. ! � ! lllfl0i��1�� C� /-� Glase F�p. wall Nee e�sp. wal9 Int. wmll Ceilin� r � Floor j 7° 1 �tu. Requir�d sq. $t. �. .R or sq, ena. W.A. ader area �1. in I L.ength -�Vidch Q I-Ieight e»do�a+� ffi v eac�age and Aroa wi� �.i�b �e Llnenl tt. Area IHo. m! o L■ n[ cr�c@ aa. tfm � In6ltr�tio� ti Glaae Fap. ,vail � rlet e$p. r�al! r Int. �a u Ceiling F�� ,--- � e Toc Bcu, equired sq. ft. E.D.Et. or rq, ena. R%.A. E.eader area Inape�o� aaot• a �� ,j �� / �,� /�- � _ �� ; --- � °' Inhltration � �% Glass � Exp. wall � Net e:p. wall � Int. w�l! Ceiling Floor ,s � To Btu. Windows and Door Width Hel�ht No. ot panl of pape or aq. ins. W.A. Leader area � f Length Width --Cracicage and Are� No. ot Lineal tt. A�ea llthes oi crack eo. rv► Infiltration °� Glaea F�cp. wall ,� / � Ne� e:p. wall �''� Int, w ll Ceiling �oor 6 , To Btue Required aq. ft, E.D.R. or eca. iris. W.A. l.eader �rea �� ,�� d'` __— _� �._,�,_....- --L� � .� � '..� C' t � � � �' � � Q r � � •� O ;�� • , /1� �.1 M '`�o •�� : h� .� , � : � � � , i w S � � � � � � � n � � � � i.n O ~e, : : � r � oe � � � e d x � � � W x �; � g � �' � n �' ~ � =' '° $ � �o � " � � � A m � � � M p 5 w C � � � pp � y ee � A � k � � � C • � � e~e 'Jtl � � py o N m ' � 0 0 • 'd � ' M • . , i� � . B. � . � i . . � v . .� � . : � . � � . . . . � . . . . . . . . �"J O O � a " �a x x x �e �t � O � O� G � O � O u,� �h N! M N tn d) d► � i M► N y O °� � I r � � � x C � � a � � � � a � � � D � r � � ff7 N1 _ m C r m 0 �� o �� c�D. � n '� � '' � �' �o g � ■■..1 � : �� , L ��1 ■ ■. ■, • • ■■■'■, � �..■' �� a � $ c. a � � � � 00 � , � � � � � � � � � Q � � r c ti � � � � �; h m � w�tu� � �� uTM � �wss�s :�H� wewi iMK DRINK. FOUMT. sMw�s. oauNs u.a sA5iN5 uno w� G� MVL cns au�c� � OPENINGS • • Y • N � a � � � �. � � a a� �� „c, a �t � � �. '�B. �'�' 0 � �� o� �� M � � � � � b � � � � d p • � � � �� ~ ��m � � O. E 8�� ti �� o � �° n � .. � 3 '� �- Z � � d m �� a0 �z �t � p � M � � � � � � � � �, � �' i � � m � � �' � � � � v O � b � � w � � � � � � � C'�' • m � w � � � � � � - . n� �• K � M > � �� w �• � � � "o' `� � n � � o n a� °• ro �• a � a �• � N W K fD o�i a 0 G rt 0 c c+ Q' w � � � o: m � 0 � � r+ � n < m � � a � 0 � 0 � � m � O� � � m � � -n c � � a � (D N m r O � � z n a w o r �' c ~ � m o ro ro n � ro n � rt w `� rt m � cu S � a � w i+i w � �� y I � M M (D cao m � z a z � S ro a ';a � . �n A y '� � � � � H � K ' °z O O K7 ri '9 7° a �C rt !A M T' w �o N � �m a � �C m a �y o `� � O M �J M � C � ~ �-y O � � x � ro z � a � ro m n rt r• 0 � � � N � r � 0 0 H � �a rt m t� G �� w m � � � � 'V " O � 0 � � an �J M (] w r�+ � � � m o a M [A ro �'� �a O � K 0 t1 � �tn � � r �• F� �o � 0 r°n � a �7\0 0 �ro w r°,, M� w � `� w �w ~ 'a F-' N� �rt � O� Krt O � 7C � �fA � 0 0 0 � � .�/ � � o � G � � ~ t+7 � 'A �8�� C g ��d+ C C O t1 � '�'' � y � � �' o � � � � � o � ► �y N �3 0 � � � c� c� o� �n w N �ro� nn v d �ro� �� w M fD �W y�' r mm � o � �r W � � aa 0 � �� M rtrt � �O o � y �x � � iA iA iA� i/l ►� � r n� % 0 0 o c y . 0 0 0 o tjJ 0 0 0 0 tn �n tn � O � � .�✓ roW m Hf]�1 rt aF{� � ~� a y C M� �k O GF w rw �nroa � A' w� m i' r�s r�+� r4 m a rs w r• M M fnD W O(D M �°��a a �� ro°" w � � o � N � � m � r 7C � w � iu o �d � r � aMxb � C � � w � w � p � � �t w rt � n ro � rt � C � rwao o a n „ z i� w� wroryry ."7 fD � M �J I W'C f�D W K a � ~ M � � a � K � m m � � � � W C� N � � BK�X w � N � a x � c� ��n �'�� m U a' W H N N N v � � � r .. m � N � _ °z � T � O � O f m z a� z O N Z t7 D -� C O S ►+ D � � Cn GZi � � y -m-I C'� 3 O �+ r t7 � m m < �n m � � -� 0 z � � 1 m -� � � m z D '�i O z D Z G I�$� n � O T T � � t7 r � m � -n m � � < (D O a � _ � `� . � � �� CHIM�JEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes (�) 2. Is free from rust or deterioration Yes (J) /` 3. Has no foreign objects lodged within Yes (�C) 4. Is securely supported Yes (�;) 5. Meets all current Code requirements for size and total BTU connected 6. Has Total hea ti ng BTU' s of �� ,�� A11 other BTU's �}�, u�� TOTAL �'Z� �� Rema rk s a �� No ( ) No ( ) No ( ) No ( ) Yes (,() No ( ) Com pa ny , _.�. L -- - - - - - Signed_By_- � Da te SUBJECT ity of Fridley AT THE TOP OF THE TWINS g � I L D I N G P E R M I T i � � � COMMUNITY DEVELOPMENT DIV. � � PROTECTIVE INSPECTION SEC. � � -- r � �; � _ �' '1 � CITY HALL FRIDLEY 55432 NuMBER REV DnTE �""'� � �� 612-571-3450 910-F15 6/18/92 �os nooRess• �340 Jackson Street NE t LEGAL LO NO. BLOCK TRACT OR ADDITION DESCR. 2O 4 Melody Manor 3rd Addition 2 PROPERTY OW ER MAIL ADDRESS Bradley Halc�rin 7340 Jackson Street NE 3 CONTRACTOR MAILADDRESS Same 4 ARCHITECT O DESIGNER MAIL ADDRESS 5 ENGINEER MAILADDRESS 8 USE OF 8UIL01 G Residen ial 21P ZIP PAGE OF � � r�!�s•.n� �.v. E ,.- 2140� T NO. �7 � �� APPROVED BV SEE ATTACHED SHEET PHONE 786�5068 PHONE LICENSE NO. PHONE LICENSE NO. PNONE LICENSE NO. 7 CLASS OF WO K � N� ❑ ADDITION ❑ ALTERATION � REPAIR O MOVE O REMOVE 8 OESCRIBE WO K Reroo� House & G�age C23 Squaresj Tear--Q�f 9 CHANGE QF U$E FROM STIPULATION TO Underlayment � must comply vaith the State Bui.lding Code. SEPARATE PERMIT ARE REQUIRED FOR ELECTRICAL. PLUMBIIdG, HEATING, VENTILATING OR IR CONDITIONING. THIS PERMIT BEC MES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORI2ED IS N T COMMENCED WITHIN 80 DAYS, OR IF CONSTHUCTION OR WORK IS SUSP NDED OR ABANDONED FOR A PERIOD OF 120 OAYS AT ANY TIME AFTER ORK IS COMMENCEO. I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SA E TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER S ECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESU E TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE PROVISIONS OF A Y OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR TH PERFORMANCE Of CONSTRUCTION. SIGNATUfiE OF ONTRACTOR OR AUTHORIZED AGENT IDATEi '� i�.�� Cv /�� l S 9 Z -- --..-'-_ .......,.�� , nca� IDATEi OF �. �� JATION $1 �219 MIT FEE $31.00 dROUP IOCCUPANCYLOA SQ. FT. CU. FT. OFFSTFiEET PARKIN( STALLS IGAFAGES � a �71 AC CHARGE Fire SC $1.22. OTAL FEE .�JZ a 83 THIS IS Y UR PERMIT � /g �� naTE �W i l ADDN [ ] ALTER [ ] construction Lega1 De.scri� Owner Name Contractor: LIVING � GARAGE DECK Al � �� , Effective 3/11�2 CITY OF FRIDLEY SINGLE FAMiLY AND DUPLEXES R-1 AND R-2 Building Permit Application ��: �7 3 yo ��sa� s'�� N� , ��T zo , �La�K �I 1 f�'1tLcDy /i1l�Na� ��e �D�, Address: � R%�D �. � y l.J �� L�(,J t �v Tel. #� 8� - s�l� 8 � � � �, � /y) E y � -�- � Gv A% �'lZ MN LICENSE # Tel. # Attach to this application, a Cerdficate of Survey of the lot, with the propos� construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT . Length Width Height Sq. Ft. A: Length Width Height Sq. Ft. Length Witith Hgt/Ground Sq. Ft. (�ERoFF f-}o�sE -+ C'�42/-tG.E' �� 54Sa -d- TFR2 OFF Corner Lot [] Inside Lot {] Ft. Yd Sexback Side Yard Setbacks Type of Consbru 'on: Estimated Cost: $ C��/ °�� Approx. Comp 'on Date. (Cost on Back) Driveway Curb t Width Needed: Ft. + 5 Ft = Ft x$ _� DATE: 1 � %�_- APPLICANT: �/�� c Tel. # �8� "S� � �' Permit F� Fire Surcharge State Surcharge SAC Charge License Surctiarg Driveway Escro Park Fee Sewer Main C TOTAL STIPULATIONS: $ �o o � $ l �� $ � �/ $ $ $ $ $ �� , - CITY USE ONLY F� Schedule on Reverse Side .001 of Pemut Valuation (1/lOth%) $.50/$1,000 Valuation $7(� per SAC Unit $5.00 (State I,icensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary j] Not Necessary [] BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the er�tion of any building or structure, or for azty addition to any existing bnilding or strucdue, or f� any alt�ration or repair to any existing building or stcucture, u�n application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manaer hereiun provided- to-wit $1 TOTAL VALUE �'�, �� $501 to $2,0� $2,001 to $25,� $25,001 to $50,000 $50,�1 to $100,� $l0i?,001 to $500,000 $S�,QO1 to $1,�0,� $1,�,001 and up FEES $15 (Minimum Fe� is $15 plus surcharge) $15 for first $500 plus $2 for each additional $100 or fi�action ther�f, to and including $2,000 $45 for fust $2,000 plus $9 for each additional $1,�0 or fraction ther�f, to and including $25,000 $252 for first $25,000 plus $G,50 for each additional $1,000 or fra,ction ther�f, to and including $SO,alO $414,50 for first $50,� plus $4.50 for each additional $1,000 or fra�ion thereof, to and includiag $100,IX?0 $639.50 for first $1�,0t10 plus $3.50 for �ch additional $1,�0 or fraction thereof, to aad including $500,000 $2039.50 for the first $500,000 plus $3 for each additional $1,000 or fraction thereof, to and including $1,000,� $3539.50 for the first $1,�,0� plus $2 for �ch 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 f�t times $13.50. Alternate "B": Removai and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the progos� structure and of the construction site. A Certificate of Survey of the lot, showing the l�ation of the foundation once it has it has been constructai will be required before proceeding with the fiaming. .� �- � � � � sue�ett � PERMIT NO. ity of Fridley 3 2 6 4 8 � AT TME TOP OF TME TW�NS g u� L D I N G P E R M I T � � RECEIPT NO. • COMMUNITY OEVELOPMENT OIV. (�'•� r � � � PROTECTIVE INSPECTION SEC. �� i . � � � /' '1 � CITY NAL,L FRIOLE� SS�,2 NUMBER pEV OAT@ PAGE Oi AVPROVED BY ��-�� '' 612-57�-345p siaF�s 5/30/02 / / r JOB ADORESS 7340 Jackson Street NE 1 LEGAL L0 NO. 9LOCK TRACT OR AOOITION SEE ATTACMED oescR. 20 4 Melody Manor 3rd Addition SNEET 2 PROPERTY OW ER MAIL AQ�RES$ 21P PMONE Joseph rou�h 7340 Jackson Street NE 763-755-4509 3 CONTRACTOR MAII ADDRESS 21P PHONE LICENSE NO Standar Water Control 5337 Lakeland Ane N, Crystal, MN 55429 763-537-4849 4 ARCHITECT O DESIGNER MAIL ADORESS ZIP PHONE IICENSE NO. 1522 5 ENGINEER IMAIL AODRESS ZIP PNONE LICENSE NO 8 USE OF BUILDI G Residen ial 7 CLASS OF WO K O NEW O ADDITION � ALTERATION 8 DESCRIBE WO K Install draintile system 9 CHANGE OF US FROM TO STIPULATIONS SEPARATE PEIiMITS RE FiECUIREO FOR EIECTRICAL, PLUMBING, HEATIN(i, �� VENTIIATING OF AI CONOITIONING THIS PERMIT BECO ES NULL AND VOID IF WORK OR CONSTFiUCTION ZONING AUTHORIZED IS NOT COMMENCED V�IITHIN 80 OAYS, OR IF CONSTRUCTION � OR WORK IS SUSPE OED OR ABANOONED fOfi A PERIOD OF 120 DAY$ A7 ANV TIME AFTER W RK IS COMMENCED. ' NO. DWLG. UI 1 HEREBV CERTIFY TMAT I HAVE READ AND EXAMINED TMIS APPLICATION 1 AND KNOW TME SAM TO BE TF1UE AND COpRECT. ALl PiiOVISION$ Of LAW$ VALUATION ANO ORDINANCES OVERNING TNIS TVPE OF WORK WIIL 9E CpMP�lEO @4 32O WITH WHETHER SPE IFIED MEREIN Ofi NOT. THE GRANTING OF A PERMIT `�' � DOES NOT PRESUM TO GIVE AUTMORI7V TO VIOLATE OR GAMCEL THE pEqMITfEE PROVISIONS F AN OTHER STA7E O(i LOCAL LAW REGULATING CON- �111.25 � UCT�ON R THE PE FORMAN F CONSTRUCTION � � P�AN CMECK F Lice SiG A UA OFCON'aACTOpOAAUTHOA4EDAGEN� ID�fE� ME oTUAE O� OW Ep��f OWNEp BU�IDEpi iDATE� . ' � � � ❑ FiEPAIR STALLS $�• ❑ MOVE � REMOVE CU f T OFFSTREET PARKING IGARAGES SUFTAX $2.16 SAC CHARGE Fire SC $4.32 TOTALFEE 1 �122.�3 0 THIS IS VpUfi PERMIT 0 ��'S�//��7 NEW ] CITY OF FRIDLEY Effective 1/1/2002 ADDN ] 6431 University Ave NE, Fridley, MN 55432 (763) 572�604 Bldg Insp ALTER ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMITAPPLICATION Construction ddress: / � � d �CX 'L(�Spl� �S t / V � Legal Descrip ion: Owner Name Address: � Tel. #_�� 5.� �S� % Contractor: �Ol.� 0� �� u-� MN LICENSE# ��, Address: , � l� ,5.5 �/vZ Tel. # 7./0. � �.�% �c��/� LIVING AREA: GARAGE AREI DECK AREA: OTHER: Construction T� 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 Height �Sq. Ft. Length Length i�'�l i r� �f', i Wdth Height Sq. Ft. Width Hgt/Ground Sq. Ft. Estimated Cost: $ -�` �� lJ �s Driveway Curb Cut Width Needed: Ft: + 6 Ft = Ft x$ _$ � c 4 f n� DATE: c�C, APPLICANT: __1/�[�(.� �J �� Tel. # Call (763) 572-36 call you for card Permit Fee Fire Surcharg State Surchar SAC Charge License Surch Driveway Esc Erosion Contrc Park Fee Sewer Main CI TOTAL � for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will e e CITY USE ONLY - � �l �� $ � 02 $ •/ $ $ _ � C�(� $ $ $ $ � /�a. � Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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 [ ] STIPULATIONS:� .� . BUII.DING PERMIT FEE SCHEDULE The Chief Building Off'icial 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,OQ0 $100,001 to $500,000 $500,001 to $1,000,000 $1,400,001 and up FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,0(}0 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 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 $100,000 plus $5.60 for each additional $1,0{� 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 fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,000 plus $3.15 far each additional $1, 0� or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) � Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus b feet times $15.50. 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 $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a�nimum 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. New Houses Onlv w � * * � D � � � o v � � o N• 7 y. � o N � n � � o � 3 � O a� � Q� 0 �- � �• a� aQ � fD '� fl. � _. � � � y � Q O � � � c�o Q . � i-r � 0 c r. a � a 0 < m 0. W � � 0 c oq � � � _n � n� . � a� �m � � � � rn z � 'D m � O z -n m rn {�9 �A V 0 0 \ 2 -. a �'• x °� � � � � � m --� - - � J � � Y � r p :)'1 � �R co o � d � � c�u c. c O y D � a d �a, — � n - m 0 � � O � o � �I � CD r N rn � � m s - - � 00 � \ � • � O o. �- _r� � < -� a� N � m � � o � D -• � N v Qo n�' D m � O .-► �O � O N � �"" � -� 0 z � n � D C� 0 Q � � D N m N � � H 0 � -1 G� G� D�e�D Ol O/ y � � d �� -6, v_? c� � ... � � � � � d Q^C�� fD � � � � a� � Q . > > O �p .n .-r O. � a _ � p v—c � O � cci n � � n � � W�° . � � n � � -� � v � � � C cnD � � � � � � N F-� 1--� 1-+ (Ai � � � � � b o 0 0 0 � O o 0 0 0 � Efl 6� 69 69 69 �6A � 0 D r _ �� N--i o0 00 -n oo --i z m m fD �� s -1 c �-� '• o cn a � �'c fD �� ca -� Z m � � � c"�o �n °. � � a z= � '.'. O Q. �p � °� c�i m ('� � rt C1 N � p 3°� �• Q- cp '-*. 0 I N W�?. co Z � I'*f O � N_, � Q c� C N cn �Q � � � rt C� -i � O � H � a � a. � � � �•po� �� bvm s `!' On2 � � o � -i � 2 0 � O �z G� �°' � c� � ai � -a �'a�� n � � y O z�Ci °� � .� �� z •� � a 'n'��D � � � o ,.��,� .. m a a� .� � N � � s m-�I m c�D a n -� �i p. " m� c"� o � r- N� � m n � a� °- °1 . _ o n°� rn `D � 0 �L ��_� �-oZ -�� ' � � �� •°^ '� Q. � � � .. . .� . . O C z. ,� _ O.. �� o : � � m._s�. °;- . � rtsm � :. �-. . . � � ('� , � . v . . _:. , i '� � � �G O -_ _ � , ��•�� rt n � .... � �' a^J � d Q' (?p � �V Q N � D � � �� v � W c r- � z � C N m 0 � � m N n _ m v C r 0 z rn •�•-n61(� W Q w � � cn � c � V � n�3�•-n WZc�u � � N � � �' � m w<� ' N m Z Z � m �° m C� -� � Z � C � a � � z � r � -�i �O L� Z � � a� �� O � ZO � Z� v� a� � Z ON vz .� v o= � Zrn a°o z -Di D � Z � N� :�i N m0 � 3 r� L--_ .� a Z J� � � � v< 9 � mz � < � � n � y0 � Z t. . m � � m � � <' ' � -. .. O � - ---- -.. . ` � . � C N . � . • � O N 0 THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPUCATION WILL BE RETURNED S:nMMnN VFNT, VENT GnNNEGTnR AND CnM6l1STIC)N /.11R VERIFICATIC)N � When tt��a��ng an Y�,c+ing furance, the undersigned hereby verifies that the � � � venting has been examined and is free from rust, deterioration, obstructions, � _ and is securely supported and firestopped where required. Yes () No () The venting system is plastiGPVC and meets all current codes and manufacturer specifications including sizing, 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 indude AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. � The pY�p _omh ,�t�en air is sized and installed to meet the cuRent codes and manufacturers specifications. When �equi�ed to inetall a new cemb�stien air�it will be sized and installed to meet the current codes and manufacturers specifications. Yes ( ) No ( ) _Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) When inctallinA a new ventin9 cv�,�m, the undersigned hereby verifies that it 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. • Yes () No () Is the common vent and vent connectors sized and installed correcdy after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No () A�nliance T� e and S'�p/Cemmen Vent and Vent Gennecter Ir�fermaiien Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input � Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or N�at Total Appliances -� Total 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 ft Length ft Diameter in .Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ,_,� ,7�.- C'�.+11lVG 1114'. N/V GLGV1.� !�.�v� - - HEATING CO: ��6? oEKA MN 55 0 N�� ' � "U Signed By: e�. �. � - Date :� l � � D � �. � O � � N fl- � �« 3. � � � y. � O N � A � � O � � 0 � � n. � `o_ �"� �• ci oa � m � n' o �� ' `G fl- O � � � c�u Q � � � 0 c � D � � 0 < � a � � rn z N 'D m � O z T m m EJ9 � v O 0 \ 2 � � � � _ a � Z G� � c � � ? � � � � � � � �� , � � + � � � � � , �, n � o �� fD � o �. d � C � 'c. C O N D _ v °—' �' � n fD 0 � 0 � � "�' D lD r � m � � m � � � 00 cD � � �n9 � � o � � N � a �•m c�o m � m � a � o Q � � r, � N oc�u��' N W � � N —• �� fl' ,� aa � ��o� a- a Q �•vo� ..+5°1� � y� � � y � O N � � N � � � � �•a�a � � � ci D � m � °' � � � �' � m ma�� A p O p/► c � Q- c� �� a� � � m � � N � � �« � � C') � � rr O � 3 —w '~ p> O � � _ r« � fD — �- ,� �sm �- <D Ci fD �+ � o y O � � �' l�D acD '� m � _. � D r - � Q �� < � � � y m m � O � D '� -� N 'p Qo �� D m � O r�r, � o � � �� Z W D c� � tfl W W c� � m � � � � cD z � m 2 � � N cD Z O m' � � D f� O � a O � � OD D � N m N � � N � �G m -t � f,� D 'n � N N N � N � ��n � � 'p. (n fD �p r► m � � m cn °� � � z � � m r'� �-� �, � Q . � � o � T.� a -� �- — � � —c � � � � � � s � � � � � W � o � � A �T. � �� .�i � W � _ � � � � m � � � � N � ►-+ cn O O o° o° °o fa �► O O °o °o � m � � � � "n � --I Z � --� �, o c� o � � � °� m � aQ C � �-r N _ � O � C� � n n � o p > > � � m � ^ c� � � �� I— N � Qmzv 0 � o = oQ o G � v ,, � D � � o � n ,�, r � m � � D � m 0 n 0 � � � � � � m :O � Z � �`� � � � c r= v z G� C N m v O z � � m N ci x m v C r ^'�701C W Q' W -< � Cn =� C � V 7 N�c'�"t w Z m � O� N C � �' � m W C � N m Z z� m �° m C7 � � Z � < v� a � � 'O r �� O �Z � � a� -� � O� Z� Z � v� a� �z O� ZD v_z �v o= Zm W Z� D � Z o. NGi p �.. � c� N 1'�i� � O � �I a Z � v< `C v Z � �� n S � yO � Z m N � < � O � L N � c a� `�G N O 0 N THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED CnMM�N VFNT, VENT CnNNECTnR AND G�MF3lISTInN OIR V RIFI .ATInN When �, In acine� an _xic ing �ran _, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes � No () The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No (� The undersigned also verifies that the replacement unit is a listed assembly and meets the cutrent codes and manufacturers speciflcations. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The pY�g _emb ��en a�r is sized and installed to meet the current codes and manufacturer's specifications. Whe� �eqUi�ed t0 inc_±all a new cem6�c_tien air�i{ �II be sized and installed to meet the current codes and manufacturers specfications. When ir,�� a new ventinA cv�, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufa�ture�s specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Is the cflmmon 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 �j' No ( ) Yes� No ( ) Yes� No ( ) Yes(�' No( ) Yes � No ( ) �.. .� - �.- .�. - .��.� -� .�. -� .��-«. � ..��.�.� Appliance #1 Type ��__ BTU Input �� Appliance #2 Type �•�� c�r�,�,�'fU Input ��o�� Appliance #3 Type BTU Input Total Appliances �_ Total Btu Input o� Common Vent Type �s L v e Vent Height �� Fan Assisted or Nat �a� ��s�% Fan Assisted or Nat Fan Assisted or Nat : � � ., �, �. f�_ ';, , � �� .;-� Diameter � - : �ir�ahes , - -, ; ; ;�- - Appliance #1 Vent Connector Height ft Length ft Diameter in Ty �,e _� Appliance #2 Vent Connector Height ft Length ft Diameter in Ty ,e � Appliance #3 Vent Connector Height ft Length ft Diameter in T, e"> '��T �f �g� � ; _'�A�'�; e� r�onrin�ic. /1'1n�wril�s\ �OAnAL^,�� 1li�� 0 6� �Y d.a��.1 �_.`.�' // // ` a HEATING CO: � � � Signed By: e� Date : � Building Inspections 763-572-36 DATE �'° SITE ADDRESS _� THIS APPLICANT IS: PROPERTY OV TENANT SUBMIT A COPY YOUR STATE LICE WITH APPLICAT] BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY E-MAIL ADDRESS � Received By:� D��°�PR 2 �fit G /L's'�'K �f' � - �--' 0 OWNER �ONTRACfOR N�: se � �n s: S' r . i(i �� crrr i� �'i i.[/ � s� PHONE: — %S�- S�� ,�: ;� . G. e STATE LICENSE # ' E3� DATE ADDRESS: ` � CITY � PHONE � S` j %J ' � � � FAX �� / � 7� % . �G� � � LQ �� PROPERTY TYP � �GLE FAMILYMi O TWO FAMII.Y/NEW PERNIIT TYPE 0 �DITION � BASENNIENNT FII�IISH FII II O DECK TYPE OF WORI : � ❑ DESCRIBE WORK E1NG I SIZE OF IMPROVE T NUMBER OF SQUARES GARAGFS PROPOSED SIZE: PROPOSED HEIGHT: _ SmING O Vinyl � Aluminum ' ❑ OFher . WIlVDOWS IN E3QSSTING OPINII�iG! Q OR FOR NEW OPENIlJG OPEA]ING CHANGES & TYPE OF WINDOW TO 1 ALL FEES Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Chazge Curb Cut Escrow Erosion Control Pazk Fee Sewer Main Charge Total Due �� 1tOOF ❑ SIDING ❑ SWIMMIIVG POOL LENGTH �'HOUSE & GARAGE J�ATTACi�D GARAGE 0 DEfACHED GARAGE �Soffit ❑ Trim ❑ Fascia DYes ONo L�ATION OF WINDOWS DESCRBE SIZE OF ❑ DRAIN TILE ❑ OTHER HEIGHT �Gs�? ATE�IP Ss'4'3 T �z� .S S` D BASE REMODELING SUBA�Il'1': I . Existing Floor Plan 2. Proposed fl�r plan 3. List of structwal members to be used Ft. FOR NEW CONSTRUCTfON tNCLUDIIVG DECKS, ADDITIONS. & PORCHFS SUBMIT: 1. Site Plan/Survey showing the existing swctures and proposed pmject 2. Two sets of conswction pians 3. Energy Calculations INSTALLED NUMBER OF WINDOWS � E BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING E 1 U.B.0 FEE SCHEDULE) IB VALUATION $ O, O� OCCUPANCY TYPE $�3, - See Back Page for Fee Schedule $ 65% of Building Permit Fee $ � G�� .001 times the total job valuation $ � ��J .0005 x Permit Valuarion Minimum $.50 $ �d (�(� $5.00 (State Licensed Residential Contractors) $ - $1675 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�ayable 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 aclrnowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a pemvt but only an ap lication for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all ork w ich requires review and approval of plans. � /� p� / SIGNATURE OF APPLIC � a.-��e �. �—`— -� PRINT NAMR (� o'� : � /� P!A N P ne� �/_ 7 f/� -� Page 2- Building Residential Application BUII..DING PERNIIT FEE SCHEDULE The Chief Building Official shall, before issuing permifs 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: VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to a11ow for proper review of proposed structure and of the conslruction site. A Certificate of Survey of the lot, showing the location of the existing founda.tion will be required before proceeding with the framing. New Houses Onlv City of Fridley Buitding Inspections Deparhnent 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fa�c: 763-502-4977 Building Inspections 763-572-3604 DATE � / '�D � srrs,�wnxESS '1 � �. TI-IIS APPLICANI' IS: PROPERTY OR'NE� TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENS; WITH APPLICATION PROPERTY TYPE PERNIIT TYPE �rE oF wox�c: DESCRIBE WORK Bl SIZE OF IMPROVEM NUMBER OF SQUARES _ GARAGES PROPOSED STZE: PROPOSID HEIGH7,': _ SmIIVG Yiny1 ❑ Aluminum ❑ Other . WWBOR'S IN EXISTIIJG OPENINGS OR FOR NEW OPENINGS OPENII�iG CHANGES 8c TYPE OF WWDOW TO B ALL FEES A Permit Fee Plan Review Fire Surchazge Surcharge License Surcharge SAC Cherge G�ub Cut Escrow Erosion Control Pazk Fee Sewer Main Charge Total Due BUILDING Permit No:� � RESIDENTIAL APPLICATION Received By: 1.� CITY OF FRIDLEY Da��Y YOUR E-�au. ,�DxESS (� d4-� �O � � � L r� a�r� �"a � �� h � � � oV L ❑ OWNER �CONTRACI'OR N�: �`n E � Ro c,( nnnxESS: / a� S r1 7'AY �or ' cI� PHONE: %�.� —� S S"�I S� I w�: �o v��e+�v. �. V`�s � � Y�.e P STATE LJCEINSE # o�I d D q� y l� F.3g� DATE ADDRESS: l� S�"' .! D � ��' 7 � C run�? `� I 3 � °� `T � - � � � el Fax � �L�n � O TWO FAIvID.Y/NEW CONSTRUCTIOId ❑ ADDTfION ❑ GARAGFJS ❑ BASENlENT FIIQISH ❑ ROOF O DECK `�SIDING i7 SWDvIlvIIIdC ❑ r�w o ,AnnrnoN ��a,�c�r�x o �oD� � Do1�: j��e` 5��. e�v ` G° i� y LENGTH O HOUSE ONLY _ ❑ HOUSE & GARAGE � ATTACHED GARAGE 0 DEfACHED GARAGE OSoffit O Tricn O Fascia ONo L(�ATION OF WMDOWS :RIBE SIZE OF A�V 2001 3� �—��'� � crrsr � �i v�� srA�!� `�Sy�� ❑ DRAIN TILE ❑ OTHER l � �S �. ua,u�°�e 9JIDTH HEIGHT Ft BASEMIIJT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed fl�r plan 3. List of structival membecs to be used FOR NEW CONSTRUCfION INCLUDING DECKS, ADDITIONS. & PORCHFS SUBMIT: 1. Site P1anlSurvey showing the existing structures � P�P� P%I� 2. Two setc of construction plans 3. Energy Calculations STALLED NUMBER OF WII�IDOWS I BASED ON VALUATION, INCLUDING TIiE COST OF LABOR AND MATERIALS: (USING TIiE 1997 U.B.0 FEE SCHEDULE) � VALUATION $ OCCUPANCY T�PE $ j See Back Page for Fee Schedule $ 65% of Building Permit Fee $ 3 7 j .001 times the total job valuation $_ / L Gf °, .0005 x Permit Valuation Minimum $.50 $ ,�, L`� $5.00 (State Licensed Residential Contractorsj $ $1675 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Detemnined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ /? $. /% Make checks aayable to: City of Fridle_y Attach THIS LS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a b ilding permit and I aclrnowledge that the information above is complete and accurate; that the work will be in conformance with the o dinances and codes of the City of Fridley and with the Minnesota Construcrion Codes; that I understand this is not a permit but only an app cation for a permit and wark is not to start without a permit; that the work will be in accordance with the approved plan in the case of all w rk w' l�requires re i w and approval of plans. �^ �y ^�� R _ / SIGNATURE OF APPLIC PRINT NAME�� I( D�'S� r{ DATE Page 2- Buildin.g Residential Applica.tion BTJILDING 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 struciure, upon applica.tion therefore, require the payment by the a.pplicant for such permit of fees to the amoun.t herein below set forth and in the manner herein provided to-wit: ' VERIFICATION OF FOUNDATION Permits for constiuction will be issued a min;mum of 24 hours from the time of application to allow for proper review of proposed structure and of the conslruction site. A Certificate of Survey of the lot, showing the location of the existin.g founda.tion will be required before proceeding with the framing. New Houses Onlv City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977