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P - 44453
Building BUILDING Permit No.: Oi(}� I �� Inspections REi SIDENTIAL APPLICATION Received By: 4 763-572=3604 CITY OF FRIDLEY �at � �'`' ��� 763-502-4977 FAX EFFECTIVE 7-1-2020 ��. DATE YOUR E-MAIL ADDRES S al � I Leyt'�Y .3 G� 2C�C S� Cc� "2 C� .:i �, ��Z:�_ SITE ADDRESS �� � c....�C,1+C t.�.te7c:+� /"%� .�, c� .— THIS APPLICANT IS: ❑ OWNER '�EONTRACTOR —. _ — PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF INSURANCE ADDRESS: �t_� Q� �-°�u� �2O`n°"�CITY ��"�� ��<y STATE �P PHONE: 1�/� —�� �" �� a i J NAME: �/ GcJ�^. � Za±C-j STATE LICENSE # c�G=bC� .3 '�' � EXP DA,/T�E� � J 3/ /�-- ADDRESS: 3Z� ��'E`�� �� 'a� CITYO �+�'z4�7.f'+�� STATFi�'�J_3ZIP�� PHONE 1� .3�+^ �S/ FAX :OS 1�03 /^— / Si 9 PROPERTY TYPE � SINGLE FAMILY/NEW CONSTRUCTION ❑ TWO FAMILYMEW CONSTRUCTION PERMIT TYPE O BASEMENT FINISH ❑ ROOF O DECK ❑ SIDING ❑ SWIMM STORIES ❑ wirrDOws ❑ DRAIN TILE ❑ OTHER TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING SIZE OF IMPROVEMENT ROOFIN NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia WINDOWS IN EXISTING OPENINGS DYes ONo LOCATION OF WINDOWS OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF \ � .�, F1' BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of swctural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDTfIONS, & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing shvctures and proposed project. 2. Two sets of conswction plans 3. Energy Calculations FOR WINDOWS — PROVIDE U-VALUE AND MANUFACTURE STICKER ON WINDOW. ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: SING THE 1 97 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ ��"��! �� OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee ' Sewer Main Charge � Total Due $ $ See Back Page for Fee Schedule 65% of Building Permit Fee .001 tirnes the total job valuation .0005 x Permit Valuation Minimum $5.00 $5.00 (State Licensed Residentia[ Contractors) $2100 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$24=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks navable to: Citv of Fridlev Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; that the work will be in conformance with the ordin codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an appli on for pe it and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the cas of all w c ires review and approval ofp,jaus--+�'1r�1� SIGNATURE OF APPLIC PRINT NAME `, C�3" ••�C�t�(e�ct/ DATE ��1 � A DDD/1V A i T.TCDC!"�TAD Qi!!LT A Ti iD� -- � � . l�il-Ways Decks, lnc. 310 Wexford Heights Dr. New Brighton, MN 55112 License #20003805 JOB ADDRESS � �e-� � i.� ;^,�-,1 S S�� ��� �ao� ���d � 1�`rl c� ie.� � ►'� ii��/C b��l�i'.� _ . rkk��P ' _� c' : _ � - �.. � w�+ C�c� _ � -� t�+�: t,�,-�, � � L �C� .� ,, . � : , - �o�� � � (� .z �� a�, l �. _ . ry . � � . __._...�.��.---.....,� _ � _ _ �.� _ _ .��) z��r� �� _ , _ �_�.�,.e,�.p� _ i _ 1$ . _ —' _ * _ 2-��� _� �� . rJ� ��� C2�c �c `t 'u `�� = _ � _ -....._.:� _ .� - __..._.:. _ rt ' _ —' , _ __ _ _ C.���r-�� _ _ . �r► � t•.3 _3�0 _' �-�; �' Z : �. � � �,�. .� �. c �� ApP yEp PLANS ' _ � _. . , p SEC R1 3,1 � _. _ �C,� 1� .�� c.ry���_ . ; ' ' _ �i? t�'1 _ ; c, O+II�� � _ _ ��1�� _ _ g tNSPE 0 � ! 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