P - 48508Buildi�Y'g BUILDING Permit No.:� � d0
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY
763-502-4977 FAX EFFECTIVE 1-1-2010 ����e�
DATE �V/;�t� IC� YOUR E-MAIL ADDRESS 7 t) rob %�'1/ �i,,b 7�7�G1 �(( � C6y19
SITE ADDRESS % �. �� / f I� � . /i/a Tt�11 �/Z. T
THIS APPLICANT IS: ❑ OWNER (,�CONTRACTOR
PROPERTY OWNER/ NAME:
TENANT ADDRESS: CITY STATE ZIP
PHONE:
CONTRACTOR NAME: � S '�n,�.�� " �L�
SUBMIT A COPY OF STATE LICENSE #�O 1ooZ C��j �, EXP DATE
YOUR STATE LICENSE 'I �Q �cxo ��Ip S�D�,�'
AND CERTIFICATE OF ADDRESS: 1�-l' �D �_�1 '�' �v�, cITY ��n STAT
INSURANCE pHONE % S S I FAX
PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
� TWO FAMILY/NEW CONSTRUCTION STORIES�
PERMIT TYPE ❑ ADDITtON O GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
�'DECK ❑ SIDING 0 OTHER
❑ SWIMMING POOL
TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR � REMODELING `
DESCRIBEWORKBEINGDONE: Y�r►1•fl �X�S}7iz�J ��L� vuidO, 2G /lt�ti✓ 6fI�5 L�7� 5��,5 � ,O
SIZE OF IMPROVEMENT LENGTH i� WIDTH � HEIGHT S FT
ROOFING p HOUSE ONLY BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan
GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan
PROPOSED SIZE: ❑ DETACHED GARAGE _�I 3. List of structural members to be used
PROPOSED HEIGHT: r_ � _ J� , �y,l
SIDING �� (�� � FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl ❑Soffit `� ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum ❑ Trim � 7 l�' �� � 1. Site Plan/Survey showing the existing structures
❑ Other ❑ Fascia and proposed project.
2. Two sets of construction plans
WINDOWS 3. Energy Calculations
IN EXIST7NG OPENINGS ❑Yes ONo LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U-VALUE AND
OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USI G THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ �3 3� OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Chazge
Total Due
$ 7�� ��.��✓ See Back Page for Fee Schedule
$ S� 65% of Building Permit Fee
$ � 3 .001 times the total job valuation
$ .0005 x Permit Valuation Minimum $.50
$ $5.00 (State Licensed Residential Contractors)
$ $2100 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 aayable 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 acknowledge 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
permit but only an application for a permit and work 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 work which re uires review and approval of plans.
SIGNATURE OF APPLICANT C�^-t�� PRINT NAME�1`,�1/f I l ✓C��%i�Z�n DATE 1�/���(%
, � � R 1012812� � t�
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, *** Take this sheet to the Building Materials desk to purchase your materials. ***
You selected a 1 level deck with: '�
Pressure Treated Framing Material � Below is a section of the railing style ar��
4 x 4 Framin Posts � options you have selected for our ec�
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5�4 x 6 Pressure Treated D�ck Boards ,, _,. a ,---i, -,: -
Poured Footings 8 Tube 4 deep , �-� ', ;, !
Premium Gold Combo Drive Screws �, ' i;;
Galvanized Framing Fasteners � , !' � , ;
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Handrail selections
36" Spindle T Railing
2"x2"x42" Pressure Treated Spindles, Beveled 1 End
4"x4"x48" Pressure Treated l�top Notched Railing Posts
2"x4" Pressure Treated Hand Rail
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Spindle placement is approz. 4" apart depending on st4� ..
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You may buy all the materials or any part at low cash and carry prices. Because of the wide variable in codes, r
Menards cannot guarantee that materials listed will meet your code requirements. Check with your local municipality
for plan compliance and building permit. These plans are suggested designs and material lists only. Some items may vary
from those pictured. We do not guarantee the completeness or prices of these structures. Tax, labor and delivery not included.
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Illustra te�ded to show general deck siz shape.
So�ne options se ec n or picture clarity.
i'oda 's cost for materials estimated in this design with options:$$66.90
Y be base rice includes; 40 PSF deck live ioad, AC2 treated - horizontal 2z6
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deck boards, 4z4 posts, 2x8 joists and beams, galvanized framing fasteners,
AC2 treated 36" Vertical handrail to joist without posts, and premium screws.
*(BASE price); $622,77
'�Monthly BIG Card Payment would be: $24,35***
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ilocofion pf oll b��id�ngs, �f ony� Ihereon� ond oll visible entroathmen�t� if pny� {roin or on soid land. This S�rvey is
made only in connec�ion w�th a mortga9e loan now being pinced on the proPe•ry �nd no liab�lity is assumed
except to fhe holder of such mortgnqe or ony olher interest acqui�ed by tha��reason of such morigoge. It is
understood ond agreed no manumenrs have been ploced for rhe p�rpose of/esroblishing lo� lines or boundary
corners. Dated ehis �°<����doy of_��r�i A.D. �9�8. -
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*** Take this shee� to the Building Materials_desk_to purchase your materials. ***`
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Toda 's cost for ma�erials estimated in this design with options:$866,90
Y he base price includes: 40 PSF deck live load, AC2 treated - horizontal 2z6 *(BASE price); $622,17
deck boards, 4z4 posts, 2z8 joists and beams, galvanized framing fasteners,
AC2 treated 36" Ve�tical handrail to joist without posts, and premium screws. ***Monthly BI� Card Payment would be: $24.35*y*