Loading...
P - 48486Building Inspections 763-572-3604 763-502-4977 FAX UILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 1-1-2011 DATE �'��� I Z Z �� I YOUR E-MAIL ADDRESS SITE ADDRESS 9� I (� �� i� (� �eP IC 7�C��1`6�P �Y; �G � y� J THIS APPLICANT IS: ❑ OWNER `�CONTRACTOR PROPERTY OWNER/ N,�v1E: wh (G � •CY'�'�' ,SwaHalv��' TENANT ,qDDRESS: / � [ f (� le PHONE: '�" CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF INSURANCE PROPERTY TYPE PERMIT TYPE TYPE OF WORK: DESCRIBE WORK BEING ROOFING NUMBER OF SQUARES _ GARAGES PROPOSFD SIZE: PROPOS�D HEIGHT: SIDIN � ❑ Vitiyl ❑ Aluminum ❑ Other STATE LICE� # V,S L(p �` ADDRESS:_ < U, `� ZZZ; PHONE "'��3 %,j 2 � �SINGLE FAMILY/NEW CONSTRUCTION ❑ TWO FAMILY/NEW CONSTRUCTION Permit N Received By: Date Rec'd: ATE ZIP ,� CERT NUMBER CITY �r� I.0 �� STATE�ZIP �3 // FAx 63 GtzS Ia6K SIZE STORIES ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE �DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING E: /% x 1.6 �l.c. WINDOWS IN EXISTING OPENINGS ❑Yes ❑No OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED O HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia LOCATION OF WINDOWS NUMBER OF WINDOWS WIDTH /� HEIGHT FT BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION MCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: l. 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: (U ING HE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ "2 1 C� F� 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 $ � i� • GS $ ��'• � � $ a Qd $ •�t0 $ $ $ See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $5.00 $5.00 (State Licensed Residential Contractors) $2230 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$25=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( Make checks pavable 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�c owledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of th City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a it and ork i not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all w hi require re ew and approval of p �/ � Z 1� SIGNATURE OF APPLICANT i, PRMT NAME �G/�,a' ��InY+ h,-✓� DATE � APPROVAL INSPECTOR SIGNATU !� ` ` ;� ! ♦ ��,' � � 0 � _ m � � x O � m � � � O m � m z � _ D Z � � � m � � � D � m � � � � m � � m m � � m � � n m -n � v r m � � c� b m � A 11 O 0 � � � � vV '1� . � � �"' � � � ! � v a� � � � ► / (� � V � �� � � -•-- '- � c. � � G I � � �''�� M QJ -�.1 � c ,- �-- � � � � �� -n � c5= � '�r � ��/' V � �— � � �1i � (1 ,� N �l .._ � r � _�._ � �A, `V � � L r ' o -� _ m � x 0 � m � -o O m � m Z � � � � � � � m � � � D � m � � � J � � A Q m - � m m � � m �° c� m . � � v r -mG � n D r m � � i�i 0 � i i i i � � • ,� �,> �,, � , � �o��o � m___� �? I/ Z N li o �- o - � � x � � IvA n� . h� 1 h � � n � � � ."�..7 v � ao. � O � _ m � ti x O � m � -o � � � m z � � s D Z � � -� m � � � � D � � m � � m � � � n m � � m m � � m � � n m � � v m � � n D r m � � � i�' 0 �� _, . , . _ .._- --�–�- f4nr�P/a�`rnrng ' �.S-H'�tn�'�`�� �t�. Carxf Surr�yrn9 M;rm�opaJ,� �l, .: , ' ,�iFs T�estrn�: . E�'�' � ��� �' � �.7 � ( �' �. A�li�rnesofa Civrl bM�,v�'�apa�! � Silnsef4�6066 E�yirreeFmy —� En ineers � SurvecJors 9 ����ic��te o� su��e �or � - � c, � �� �� �;��� �� ,� ��- �ce � � . `� ar,� � � .. �� �, � �( �� �v `' '� f '� � s , �``%'' �, . v y � . -, -'� a °� ' ��, -� � t/ �/� �\ � ���`��� � �� i ' �'� ��� . �' �. / . � A � n �1.` ��'� -.. � . . �-�;=;��F� � '� 'r�rt �i _ hi; �, � � � ''� � ,", ) ` t �/ •. '� �. � i I i � �� . �,�--- � . , ,, ' � , \ � ���:. � Y'� / ' -, , r� ia t�� p� y J !c / Sc. � �. e i�: _?;, � `h ` � �'� �`�.. � � � �/ �y' .�,i °..� � � � \ �. / > � �,, ! ° - � � ,� � � ' ,r' i i' � f� /�-��. �a\ `� 5 ...!'�_j��, �v �) N 1��� � �� J�� � �� � � l ��s } J l- `' � 01 �. �` 10+. d�. 1 � F � ----- t ,Ci/ � `-� i � � ,.f� `� � ��lQ���i�.�' � ��.¢.���. 1�, o _- --- -------- — (��� ` � Z��f ��l��TI��J E' ��`� �"-o � � �.��"�„�. - 1r•� ��;� �;�, \ � l h�by ca�+�i�'c� � Ih�s ts a�rue ard mr�-rcf rrpresenfofion o�'o surrey �'1hr bamdories ,i' � aba►� �rib�d f� a�rd o�'" f%� i� l o r a i i �n o�'al l I w r A d,ir9s ,�r�on , a� d' d/ rrsi� e a a r r o� c l r m a n f s ,��' a r� y, {� r n ar an sa:d %nd As surve y�d 6, r, f m�e flu3_+�:. a b� t � ��'�� A.� �. SUBURBAN ENC/NEE21NG , INC. : E���3 �r s�r��yo�s �, r � �� � �� �:�.���.�.-���.�.�. ���' , � ���, � - �--�' _ ., _� : ; �, � �. _.�:� ,