Loading...
P - 48529Building Inspections 763-572-3604 763-502-4977 F DATE � . % �!?/ /�� �— SITE ADDRESS �zJ THIS APPLICANT [S: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTNE 1-I-2011 YOUR E-MAIL ADDRESS ❑ OWNER / 'ONTRACTOR � ' PROPERTY OWNER/ NqME:__�,��17n��r� ' ��� TENANT ADDRESS: �G�'I � Il ��� ��;. /��_CITY PHONE: �� f� � �� '— !� % CONTRACTOR ' SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF INSURANCE PROPERTY TYPE PERMIT TYPE TYPE OF WORK: NAME: � I��4 � J����G/ �L STATE LICENSE # ? �_ ADDRESS: ���% � �I � � �L,�G� PHONE — _lDI � — 'ZJ!%% _' �j ��-� �INGLE FAMILY/� C.'O�dsT-�'ii�C�'1�ON ❑ TWO FAMILY/NEW CONSTRUCTION ❑ ADDITION ❑ GARAGE/SHED ❑ BASEMENT FINISH ❑ ROOF ❑ DECK ❑ SIDING ❑ SWIMMING POOL ❑ NEW HOME CONSTRUCTION ❑ ADDfTION ❑ MAINTENANCE/REPAIR �EMODEL DESCRIBE WORK BEiNG DONE: SIZE OF IMPROVEMENT ROOFING NUMBER OF SQUARES �-• GARAGES PROPOSED SIZE: � j %� PROPOSED HEIGHT:M�� SIDING ❑ Vinyl ❑ Aluminum � j 3� - ❑ Other N't �� WINDOWS IN EXISTING OPENiNGS ❑Yes ❑No OR FOR NEW OPENINGS-DESCRIBE S1ZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED 0 LEAD CERT NUMBER CITY ////e Permit No.:�'( Received ByC�� Date����a� �.,; ec'd: � '��� �� � !� i — °— � " --- , STATE ZIP_ i � � � ` � /a'��TATE!%A Z FAX �/�� ' S1ZE �f.2�'l ��G�`- STORIES � , ❑ WINDOWS ❑ DRAIN TILE �THER � LENGTH WiDTH ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia LOCATION OF WINDOWS NUMBER OF WINDOWS HEIGHT FT BASEMENT REMODELING SUBMIT: I. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION �NCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: I. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction 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: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $� j�.,J `=�-=- OCCUPANCY TYPE Permit Fee $ j 10��. Z� See Back Page for Fee Schedule Plan Review $ �, I � 65% of Building Permit Fee Fire Surcharge $ ��ST; .001 times the total job valuation Surcharge $ ,�{ );� .0005 x Permit Valuation Minimum $5.00 ��, License Surcharge $ �.,uL� $5.00 (State Licensed Residential Contractors) ' SAC Charge $ � $2230 per SAC Unit (Plans to MWCC for determination) ' Curb Cut Escrow $ ft+ 6 ft= ft x$25= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary O Non Necessary O Total Due $ �i �"� ( Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICAT]ON 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 C�.{�y of Fridley and with the Minnesota Construction Codes; that I understand this is not a pennit but only an application for a permi a w�rk�� s not t start without a permit on site; that the work will be in accordance with the approved plan in the case o� work whic r'� u�`es�ev�kw � approval of pla s. y�, � �, SIGNATURE OF APPLICA��'"'� fr, „ F��/- -�- P 1 T NAME '/ -' �DATE :,��r / APPROVALINSPECTORSIUAI.� � `� � �' ` � ���L---"�� �'' � ` — �- �� � �� PLEASE NOTfi: SEPARATE PERMITS AR�,�� QU ' D OR PLUMBING, ELECTRI'CAL AND MECHANICAL WORK _ ✓ �� `JNIl340YV321 fW 1H`JR1Ad0� 0 tOZ N`JI53O 3FLL j0 S1N]W313 ONV S3�VdS j0 NOI11SOdW0� ONV 1N3M3'JNVNl1V 3H15tl ll3M SV YdfiOj'1lVN3h0 3H1 Ol �311WI1 lON SI 1f18 530fIl�Nl NOLL�310Nd SIHL t/�IN3 WV j0 531tl15 0311N(13 HL j0 SMtl11H`JliiAdO'J 3FLL A8 031�310i1d SI �31VLONdO�NI `JNIl3OOW3N fW A8 N91S3O SIHl • �� ��_ �t n �/ a'�/ • �� � w �� � � � U�,� � � � � � � �.n s Z£�b'S�' NV� `6ra�pE.�� � c p�ena�rao� �aa.�� a��� LZ5 �, � �° r ��� uo��a �� a��aposa� ������� � ' ' 0 rou qo( �6uw }oa(ad �au6isaa � , �� � L � � •N � �d w � �, � / = N � � J ,' o� � � �C a� ar � � C �L.L 0 O L� II. N % � Q. N (V N � v'� �,' A wr � �L� N N (0 � I� � � ; �o�;_� �a � � ` � o M ! � O.N 1 U U � Y . � h 1 ?� N X U }� � -4-�j O a W� � _� � �N� �� �� t �� a>w �m �. s = .�l di _ i •� _ � � � Y. � N � � � "�� � � ` � � � � W ` I�Fr � � � � �. ��- � _ � —Q � k ���� �� � �� ��� �� � ^ _ c ( J� � � � o c � w ` r � , � �" �� ---� " �' ° _� �/ U = � y o �0 °' � O U I � Z o f 'i lE � —� �.L .t1 L . � . _... .. . �' � �.-.:.:_.:-.�..-._.�.-_..--' V „o-,gz a C � @ C - U •� � om o f � �U - w 3 �n 0 0 Z � ---- y - . �� � ,_ _ � — � � � _ °R w ' i t i, �� ' I � _t �� ` ��� ��� ��,� — � �- � �- � --�b - - ,.- —` � - I � � i� M _ �J a � �. N � ��, {, ,� � � T � � �� � �� 1 '� � { / �i _. � :�: - , , __ , c-- � - - � C!�'I . _ _ _ _ '� . . .. .. „���,.�.� . _. _. . ... _ �^ �� t-�i7r � � � � n-� � ;' ,:� rn � � ::� e O � � c v �:r 0 m �� �� <-, ,r; � � � � a° J � � +� � �� I.� n �� � �' � ,� } �,,� �n �;' u� � � � c� � U � a � 1�� �� � � � ���� i✓� �`����� �� �� � i �/���� �� � � ���� � �,����� � � � . ��� ��-� ��� �� �xi�� � �f���l�� ������� �r � ��`= ��� ��� �-- � l�l� v�jf� � �l� � ' ��,- �� � �� ,���z��� �'�� ��' � �i. ;�r. � � ID � �. �� � �� � ;- e o� O 0 Y�/ � • .� u� �;� , r�i �o p N � � o � � � � � Ul e" Cp aoza 11'-6", �� � �, �� - i7 i t�) �� . f.' " A A W cri A O I� ii'' i � I-� . .t'. . . ._. .. _ �.: '_ .... _ .. - n � J� � �� � ' ;x� �; �1 � G �; ° L �_ ��5 W n' �� _ !N M — , - _- –� , � ' 10�,�.� �� � �� �- --�- � � � � � i _ ___ � . z � ; �°, • __ � -�-- � �� v �' �6 � � � � Q 4v � 7• n (Q � � � � 2#�'-C)" Vl-� __--_. : � V _ __ _ Q 15'-7"' �� r V' �— � � � �, , ��� , � �� � � � � 0 � Ir � � � x 5-�— � _ � � � M �� � L P� � s., �— � �p � � , M !�-^ � � � ��� � � � ! � I I� � ( � � ; n�� v � �� � O � i9�"�lA�� ���SS���Ce Designer project mngr job no. �: � � B. Bverson xxxx � 521 Rice Creek Boulevard � � �rid9ey, 9UIfV 55432 • (:l CJ1 �� � � N f � ' �� r� �-- m � G � n/1 � �� d � G�1 �r jv� 'M� �� DESIGN BY MJ REMO�ELING INCOPRORATED IS PROTECTED BY iHE COPYRIGHT L4WS OF 7HE UNITED STATES OF PMERICA THIS PROTECTION MCLUDES BUT IS NOT LIMITED TO iHE OVER,4LL FORM AS WELL AS TNE ARR/WGEMENT AND COMPOSITION OF SPACES AND ELEMENTS OF THE DESIGN 2010 COPYRIGHT MJ REMODELM�