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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT iv?rfi�7)) Date: glo ,, er - Owner: Builder Address Address ;r CA 10 BUILDING No. —� Street F Lot — Lot _ Block Addition or Sub. Corner Lot � hack Sideyar Sewer Elevation ____ _ _ Foulfdation Elevation DESCRIPTION OF BUILDING Toas: Kir". Front _ Depth _+ Height a€ Sq. Ft. Cu. Ft. t DepthHei ht, zr Sq. Ft. Cu. Ft. Type of Construction Est.. Co _ To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $AWW_ , permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or anypart thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits ndht s permit may be revoked at any time upon violation of any of the provisions of said ordinanCe& a —,& Building Inspector NOTICE: This peemh don not ewer the construction, 6uta1lafion for v Wn& 'iumbino, gas bales, sawn or water. Be wro to we the BwMins kwecwr for separate parmht for thea home. f APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Nam ilder Address Address LOCATION Of BUILDIN Noy Street art Lot Block Addition or Subd vision Corner Lot Inside Lot '9ftb SEWER of Lot P Side -Yard 3 ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING T b us d as: Front v� Depth eight�!_�i Sq. Ft. Cu Ft.� Front Depth Height QSq. Ft. Cu. Ft. Type of Construction Estimated Cost 11.01 L-011 To be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. _ '_—� /9 (Schedule of Fee Costs can be found on the Reverse Side). - • - r BUILDING PERMIT FEE SCHEDULE Section 2, The Inspector of Buildings shall, before issuing any permit for the erection of any building or structure, or for any addition to any exist- ing building or structure, or for any alterations or repairs to any existing building or structure, upon application therefor, 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; 2.1. For any such permit for the erection''of any fire -proof building, other than a garages warehouse, factory or grain elevator, or for the erection of any fire -proof addition, for similar occupancy, to any existing building shall be at the rate of $i.40 for each one thousand cubic feet, or fraction thereof, in such cubical contents.. 2.2. For any such permit for the erection of any fire -proof garage, warehouse, factory or grain elevator, or for the erection of any fire -proof addition, for similar occupancy, to any existing building shall be at the rate of $1.25 for each one thousand cubic feet, classified as "fireproof1° by Section 502 of the Minneapolis Building Code. - HOUSES 2.3. For any such permit for the erection of any non -fireproof building other than a garage, warehouse, factory or grain elevator, or any non -fireproof addition, for similar occupancy, to any existing building - permit $1.00 for each one thousand cubic feet. GARAGES 2.4. For any such permit for the erection of any non -fireproof garage, warehouse, factory or grain elevator, or for the erection of any non -fireproof addition, for similar occupancy, to any existing building or for each such building or addition - ninety cents ($0.90) for each one thousand cubic feet or fraction thereof, in the cubical contents thereof with a minimum of $4.00. For the purpose of computing fees for building permits, the cubical contents of any building or addition to a uniform height throughout by multiplying the ground area covered from a point.six;(6) inches below the floor line of the basement or cellar to the average height of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. 2.5. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each Five Hundred Dollars ($500.00) or fraction thereof in the cost of all -proposed work. 2.6. In no case shall the fee charged for any permit as set forth in Section 2 be less than $4.00. - - r 6438 LFOXVUSUrg AV H� E yR%gLLr)T , m SOU 53421 560-34,50 Mr. Bruce Chrysler 420 Liberty St. N. E. Fridley, Minnesota 55432 December 13, 1966 as-* UVAULng Fermat Be. 6179 l as *ndo �cteber 9 + 19da Addy so For.. no. 41i*-- U., nQ i&&Q Siro Phis office hae been inforod by the City Aasessar that the work tlimed an the above captimed building Pa mit has not as yet been c=pjeted. As you know, a buiidimg pamit is vaBid for a me year sriod fres the date it waa issued. UWLY Bet in touch with this offico for rawma8 of this Pe mit before jamary 1, 19677. It any ch"gag of dtaign or eatent of work are pLamed, pteaae submit thin Infvrmstiop a1mg with estimated cost of lama acs that caul reeords will correspond with the City A®aea�s®r's o If there are any quepti@m with refereace to this msttcr® kindly catt this effict. Tours very truly, CBecks City of Fridley Application for Plumbing and Cas Pitting Penult DePL of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... .............. x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 F N WATER HTR. GAS ELEC. Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 O Additional Fixtures ... 1 ................ x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ Base 1st 2nd _ 3rd 4th • Future Connection Openings Connected with I -Sewer � New Fixture, Old Openings Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... .............. x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures ... 1 ................ x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS --Refer to Code Description ................................................$ - TOTAL FEE • a City of Fridley: a )2. The undersigned hereby makes application for a permit for the work herein specified, agreeing to do 411 work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Owner Kind of Buil inj� Used as To be completed about 4 Estimated Cost, $ Old—Adevr.–Building Permit No Pe N G 110 Sign ROUGH FINAL -OJEDOAR 2M 7-59 Business Phone N 19_ _/ ef`3�4 City of Fridley, Minn. 9572 BUILDING PERMIT Date: Dec. 4, 1967 Owner: Bruce Chrysler Builder Same _— Address 420 Liberty St. N. E. Address Same LOCATION OF BUILDING No. 420 _ Street .—_. Liberty St. � Part of Lot Lot 32 & 33 _ Block 7 Addition or Sub -Division . Spring Brook Park Corner Lot — Inside Lot — Setback --_ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Rear Entry Front _ _ 14' Depth 81 Height — 8 t Sq. Ft. Cu. Ft. Front Depth Height — Sq. Ft. Cu. Ft. Type of Construction Frame _Est. Cost_ $500.00 __ To be Completed 3/1/68 In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in complian with allprovisions of ordinances of the city of Fridley. �� f7 // _ In consideration of the payment of a fee of $ 5.00 , permit is hereby granted to_._. Bruce Chrysler to construct the building or addition as described above. This permit is granted upon j ress condition that, around anduMinnesota regarding location, construction, alteration, mainte/nva�nce, repair and moving of buildings e city limits and this permit may be revoked a t a�iv time u�� / $ of th provisions of said Official REPWW NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be euro to sse the Building inspector for separate permits for these Henm r r . 4 APPLICATION FOR BUILDING PERMIT CITY. QF, :FRIDIEY, MINNESOTA 00 OWNER'S NAME rose. ADDRESSIi3RESS vr_ +�,1 LOCATION OF BUILDING NO LOT13LOCK ADDITION OR SUBDIVISION..._. RR CORNER LOT INSIDE LO SETBACK 41 SEWER ELEVATION TOP OF FOOTING Applicant attach,to this form Two Certificates of Spivey of Lot and proposed building Atocation drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: deser- &P/ Z#- fe Front AV Depth,_„ Square feet %'jam Cubic Feet.- Front eet.. Front Depth Height Square feet Cubic Feet Type of Construction Estimated Cost To Be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE —SIGNATURE .•. (Schedule of Fee Costs can be found on the Reverse Side). a �f� 1 d CfiYOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 May 6, 2002 Michael Taylor & JD Penny 420 Liberty Street NE Fridley MN 55432 Re: Paved Driveways Dear Propery Owners: In 1997, the City Council adopted an ordinance declaring gravel driveways a public nuisance. They were declared a public nuisance for a number of reasons, such as: they can cause erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in the City's storm sewers and detention ponds. When gravel driveways were declared a public nuisance, the City Council gave property owners five years to have their gravel driveways paved. The five-year deadline is quickly approaching, which means all gravel driveways within the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002. If on December 31, 2002, your driveway hasn't been paved a citation will be issued and filed at the Anoka County Courthouse. A misdemeanor citation is a criminal offense and is punishable by up to 90 days in jail and/or a $700 fine. If you've already paved your driveways, Thank you! Please call me at 763-572-3595, so I can update our files. For your convenience, a brochure on the City's loan program has been enclosed. You can use this loan program to acquire financing for your driveway improvement project. Please call Jim Hesnik at 612-335-2651, if you have any questions regarding this program. Thank you for your cooperation! As you successfully complete your driveway improvement project, please call me at 763-572-3595, so I can do an inspection of your property and update our files. If you have any other questions, please feel free to call meat the above number. Sincerely, Stacy Str berg Planner C-02-53 CIIYOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY. MN 55432 - (763) 571-3450 - FAX (763) 571-1287 July 2, 2002 Michael Taylor & JD Penny 420 Liberty Street NE Fridley MN 55432 Subject: Paved Driveway Reminder Dear Propery Owners: This letter is a friendly reminder that all driveways within the City of Fridley need to be paved by December 31, 2002*. As you are aware, the City Council adopted an ordinance declaring gravel driveways a public nuisance. They were declared a public nuisance for a number of reasons, such as: they can cause erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in the City's storm sewers and detention ponds. When gravel driveways were declared a public nuisance, the City Council gave property owners five years to have their gravel driveways paved. The five-year deadline is quickly approaching, which means all gravel driveways within the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002*. If you've already paved your driveways, thank you! Please call me at 763-572-3595, so I can update our files. For your convenience, a brochure on the City's loan program has been enclosed. You can use this loan program to acquire financing for your driveway improvement project. Please call Jim Hesnik at 612-335-2651, if you have any questions regarding this program. Thank you for your cooperation! As you successfully complete your driveway improvement project, please call me at 763-572-3595, so I can do an inspection of your property and update our files. If you have any other questions, please feel free to call me at the above number. Sincerely, S om erg Planner If on December 31, 2002, your driveway hasn't been paved a citation will be issued and filed at the Anoka County Courthouse. A misdemeanor citation is a criminal offense and is punishable by up to 90 days in jail and/or a $700 fine. C-02-83 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 x631572-3604 FAX: (763) 571-1287 ADDRESS : 420 LIBERTY ST NE PIN : 033024310076 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GARAGE, DETACHED PERM O.:2004-01668 DATE ISSUED: 09/24/2004 VALUATION : $ 18,069.00 NOTE: CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. PROVIDE HARD SURFACE DRIVEWAY. SEE NOTATIONS ON PLAN. REMOVE EXISTING GARAGE. CONSTRUCT A 26'X 22' DETACHED APPLICANT TAYLOR MICHAEL & PENNY DELUCE- 420 LIBERTY ST NE FRIDLEY, MN 55432 OWNER TAYLOR MICHAEL & PENNY DELUCE- 420 LIBERTY ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating c6struction.gr tyle performance of constrgction. Insp. BUILDING PERMIT FEE 307.25 PLAN CHECK FEE 199.71 FIRE SURCHARGE 18.07 STATE SURCHARGE, VALUE 9.03 TOTAL 534.06 PAID WITH CHECK # 4014 SEPARATE PERMITS REOUIRLD FOR WORK OTHER THAN DESCRIBED ABOVE. AUG -16-2004 09:47 CITY OF FRIDLEY�'� _ �J,/ P.02iO3 1*4evv l) CITY OF FRtDL r 1� Ef dive 411/2004 ADDN 1 l 6431 University Ave NE, Fridley, MN 55432 (763) .3604 aft Iris ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) -1287' F�1X BUILDING PERMIT APPLICATION j Construction Address: L e . a Legal Description: 4 Lac Owner Name & Address: Tel. # Contractor. �� _ MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the bt, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length , Width _ Height n Sq. Ft 0_ DECK AREA; Width "' and Sq. Ft OTHER: ✓4 �s X Construction Type: Estimated Cost: $ /5 O r Driveway Club Cut Width Needed: Ft + 6 Ft = Ft x $ DATE: T— APPLICANT:.4 ATel. # �/_� � 1' D03 6W Call (763) 312.3604 for Permit Fees if mailing in a iication. Fax to 763-571-1287 if using credit card and we will calf you for card number. CITY use ONLY - Permit Fee Plan Review Fire %mfarge Statertum1 arge SAC Phai" License. 6urcharge Curb CutEscrow Erosion Control Park F'pq Sewer Main Cham Fee Schedule on Reverse Side 66% of Permit Fee .001 of Permit Valuation (1110th%) $.50/$1,000 Vakiation $1350 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 [ j Not Necessary [ ) TOTAL $ 53q, STIPULATION; Building $ BUILDING Plan Review Permit No.: o ®® -0/ Inspections Surcharge RESIDENTIAL APPLICATION (.0005) times the total job valuation — Minimum $.50 Received By: 763-572-3604 $ 001 x Permit Valuation (1/10%) CITY OF FRIDLEY $ Date Rec'd: DATE — YOUR E-MAIL AQD SS $1450 per SAC Unit (Plans to MWCC for determination) SITE ADDRESS $ ft + 6 ft = ft x $20 = $ THIS APPLICANT IS: f�9WNE ❑CONTRACTOR $450 Conservation Plan Review PROPERTY OWNER/ NAME: Fee Determined by Engineering TENANT ADDRESS: S CITY STATE, C U Total Due PHONE: 62i Al v Make checks payable to: City of Fridley Attach Stipulations CONTRACTOR NAME: --4\44) SUBMIT A COPY OF STATE LICENSE # EXP DATE YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE GLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHEDWINDOWS ❑ BASEMENT FINISH 11 ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW _❑gD01 ION ❑ MAINTENANCE/REPAIR MODELING DESCRIBE WORK BEING DONE: I SIZE OF IMPROVEMENT LENGTH WIDTH aq HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2• Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS KYes [No LOCATION OF WINDOWS baSZ wola 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED CJQffCA5 NUMBER OF WINDOWS ALL FEES ARE BASED ON VOILUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING, THE R97 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ ® OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $ (.0005) times the total job valuation — Minimum $.50 Fire Surcharge $ $ 001 x Permit Valuation (1/10%) License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary( ) Non Necessary ( ) Total Due $ v Make checks payable to: City of Fridley Attach Stipulations 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 or 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 work w 'ch require view and approval of plans. p c SIGNATURE OF APPLICANT ( PRINT NAME l DATE K - a 2 3 z O 3 p 1, V� c 2 3 z O 1, V� Ell 9-29-2005 2:24PM FROM LAW OFFICES 1 651 490 2904 ,P.ENNY DELUCE 420 Liberty Street N.E. Fridley, UN 55432 Telephone (763) 784-4926 Facsimile (651) 490-2904 September.' ), 2,105 City of Fridley Building Permit Division Fridley, NIN 55432 RF: Building Permit 0#2004-01668 Dear Sir or Nladam: This letter is to request an extension of my building penin for my garage. All 1 have rrmminino Arr• the c,grAge. and ,ervico doors. the cid)'nu and the f -k xrical. The , idinr i,,, beino delivered next week and the garage I would like a one month c:x cnsion to have all the work completed. I1' you have any questions, please feel free to contact Mi,. Sine lye oe" L ..J Penny J. Dt;1 ce P. 1 i2 -1�y ys- • ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIA I ,S: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 16`97. 4 Li 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 $ (—f $ J CCAS See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determinati , t) ft+6ft= ftx$21 =$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Ai t tch 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; hat the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; tht . I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in ace, ,i dance with the approved plan in the case of all work w 'Gh requ' e� r/evvie and approval of plans. SIGNATURE OF APPLICANT GJ/ 1�% PRINT NDATE_/IZ�8� I J BUILDING7 Permit Jo.: ReceiV d By. P s5 Building Inspections RESIDENTIAL APPLICATION 763-572-3604 CITY OF FRIDLEY Date R c'd: DATE YOUR E-MAIL ADDRESS SITE ADDRESS !� THIS APPLICANT IS: ❑ OWNER ONTRACTOR PROPERTY OWNER/ NAME: Gtl%I -- ADDRESS: = _ST TE ---ZIP TENANT PHONE: '%do G • �Sg `� CONTRACTOR NAME: r 111 .- — --- "�1 STATE LICENSE it VO L�� pry,, EXP DATE 5110 0 A i S-&1/7 "� : W, CITY ���r ' STAT SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS:I'1lim e r r =S - WITH APPLICATION PHONE /f6/- '9. FAX 6161- AO PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ 9ARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH 514ROOF ❑ DRAIN TILE ❑ DECK /❑ SIDING ❑ OTHER ❑ SWIMMING POOL —_ TYPE OF WORK: ADDITION MAINTENANCFJREPAIR REMODELING DESCRIBE WORK BEIN6 DONE: a.,? SIZE OF RAPROVEMENT LENGTH WIDTH HEIGHT_ _ Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODEL) 'G SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2. Existing Floor : in Proposed floor an PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structur, I members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCT ; >N INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS & P0RCW ` SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Surve showing the existing structures ❑ Other ❑ Fascia and proposed p ject. 2. Two sets of cot ; ruction plans WINDOWS 3. Energy Calcula ; >ns IN EXISTING OPENINGS OYes 13No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIA I ,S: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 16`97. 4 Li 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 $ (—f $ J CCAS See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determinati , t) ft+6ft= ftx$21 =$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Ai t tch 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; hat the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; tht . I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in ace, ,i dance with the approved plan in the case of all work w 'Gh requ' e� r/evvie and approval of plans. SIGNATURE OF APPLICANT GJ/ 1�% PRINT NDATE_/IZ�8� I J Building BUILDING Permit No.: � Inspections RESIDENTIAL APPLICATION Received By: , 763-572-3604 CITY OF FRIDLEY DaM (NOV 7 763-502-4977 FAX EFFECTIVE 1-1-08 DATE •— 1 0 YOUR E-MAIL ADDRESS SITE ADDRESS 1 C THIS APPLICANT IS: ❑ OWNER ReONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: !� CITY i �/ STATE /�=x"IP PHONE: NAME: r- P — / ADDRESS: d CITY P STATEJ!(%&_CQ�� CONTRACTOR SUBMIT A COPY OF PHONE G Zk �t ff f 3 FAX YOUR STATE LICENSE STATE LICENSE # c200> EXP DATE ? J/ —Z52 PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH❑ OF ❑ DRAIN TILE 13 DECK RIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ 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 3. List of structural members to be used. PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS, & PORCHES SUBMIT: ❑ Vinyl []Soffit 1. Site Plan/Survey showing the existing structures ❑ Aluminum ❑Trim and proposed project. ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & _ TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 UBC 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 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1825 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 payable 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; th9t 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 accord with a approv the case of all work which requires review and approvallf plans. 1 PRINT NAME Z 04 n /c �% P- I >^ DATd' _"� SIGNATURE OF APPLICA liV �. I log