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�.59029/ City of Fridley, Munn. 11295 6431 University Ave. N.E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: December 20, 1971 Owner: Robert Laugen Homes Builder Same Address _._.._._U6b__F i Rb Lake Rd - Clasen — Address Same LOCATION OF BUILDING No. 5550____ Street Matterhorn Drive N.E. part of Lot Lot --..10 _____ Block 4_ ____ _.__._. Addition or Sub -Division —Innsbruck North Addition Corner Lot ______ .___ Inside Lot X Setback 35 1 Sideyard 5 & 15 Sewer Elevation _ Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Log ___ Front 261 Depth 36' Height 20 Sq, Ft, 1172 Ca. pL23,00 . Garage _ Front 14' Depth 22' Height 10, Sq, Ft, 484 Cu. FL4840 Frame 28,000 April 1, 1972 Type of Construction __ Est. Costo 22,l rte._ To be Completed Maximum Slab Elevation 995 Street 989 (proposed Street E levation as per Sub. Eng. 12-17-71 Minimum bottom of ftg. E1. 991 In consideration of the issuance to me of a permit to construct the building described above, I agree tp do the proposed work in accordance with the description above set fo6?d'.'e compliance th all provisions of Ordinances of the city of Fridley. 3109 State Surcharges 53.00 Robert Laugen Homes In consideration of the payment of a fee of $ , 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 any part 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 and this permit may be revoked at any time upon violation of any of the provisions of said iirdinanoess. �ZSunding Inspector HANK zcH NOTICE: This permit does not cover the construction, installation for whine, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for these items. .- APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME oM e u BUILDER • ADDRESS : 36 & E r1s,( ADDRESS • m K 3&9 STREET: Mo- 4 e r- ,� o r n �-b t"'l v e. /v L LOT: / D BLOCK: ADDITION: 10 CORNER LOT: INSIDE LOT: X SETBACK: 35 / SIDEYARD: S" 1 �� Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. 3. 'L Z.41 —;;7 T DESCRIPTION OF BUILDING '�� 7� 4- To Be Used As: t Front: De th : 3 1-4 Height d Square Feet: 1 15 Cubic Feet: 2 3, e p Di Front: De� pth ._ Height • P� �' ,=e Square Feet;Cubic Feet:- 7 a ^J - Type of Construction: rz r,,% e- Estimated Cost_: 3y f To Be Completed: 9 ? A7� ti1705' 1N b The undersigned hereby makes application for a permit for the work herein / g L specified, agreeing to do all work in sttict 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 3, ` abare true and correct. DATE: S IGNA 2 - (See (See Reverse Side For Additional Information.) 1 19752-0 e 5-4 op GERALDT.COYNE 300 BRUNSWICK AVE. S. LOT SURVEYS COMPANY AYMOND A. PCH 869177 IDAHO AVE. N. GOLDEN VALLEY, MINN. LAND SURVEYORS BROOKLYN PARK, MINN. MINN. REG. NO. 4741 MINN. REG. NO. 6743 REOISTERED VNDER LAWS OF STATE OF MINNE50TA LIOENSED BY ORDINANCE OF CITY OF MINNEAPOLIS �rtt 34 4 7 5747 W. Broadway 533-9922 INVOICE NO. INDUSTRIAL — JUDICIAL Minneapolis, Minnesota 55428 F.B. NO. 137-45 COMMERCIAL — TOPOGRAPHICAL '10. CITY LOTS — PLATTING fourbeporg. Certificate SCALE I" _ �-� o 'denotes Iron o Denotes 'adood ROBERT LAU"1',N HOT.kj INC. Hub, set for excavation only 4. 1ew r '13 13 Lk J (ern p e7 Is kyr aj �'' j4. c•i Akk ° \"� k IL - -z) s �7 a Lot i U , Block 4, $� INNSDEiUCK NORTH NOTE: Plat not recorded at this date:. We hereby certify that this is a true and correct representation of a survey- of the boundaries of the above described land and the location of all buildings and visible encroachrrients, if any, W_ or�rm said land. Surveyed by us this 3 &O day of'y"� b �'~ 19 7 I Signed—*LOT SURVEYS COMPANY s oet a City of Fridley Applicuffm for Mmbing and Gn g t Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK 5550 Matterhorn Drive Number, Kind and LocaBion of Fixtuaea PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ . 7 x $Zoo $ 14.00 Future Fixture Opening ........... 2 x $1.50 : 3.00 New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater (Up to 99,000 BTU) .... x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Electric Wabr Heater, .............. 1 : $2.00 t 2.00 GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures z $200 $ Additional Fixtures ............... z = ,75 $ Gas Range to 190.000 BTU ............ x $5.00 i State Surcharge $ .50 REPAIRS A ALTERATIONS—Refer to Code _ Description .......................... , ................ A TOTAL FEE 8 19.50 City of Fridley: The undersigned hereby makes application for a permit for the^ work here! specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings. and hereby declares that all the tact and representations stated in this application are true and correct Fridley. Mina February 8. 1972 I9_ Oar Robert Lauclen Homes, Inc. Kind of Building Framed Used as nwo 114 ng To be completed about May 1072 Estimated Cost, $ i , i on, on Old—New. Building Permit No. Permit No.� ROUGH y�j FINAL G" Sign +.. ey Plumbing and HeatinesInc gy�Y/ Businew Phune No e a S e.1 A q WArEM "M. � art 31 Nail, T I � I t e 3 e N GAS [IEC. V O Base 1 1 1 2 1 1 1 1 X 1st 1 1 l 2nd _ 3rd 4th • Put=* Connection Openings Bawer s New Fixture. Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ . 7 x $Zoo $ 14.00 Future Fixture Opening ........... 2 x $1.50 : 3.00 New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater (Up to 99,000 BTU) .... x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Electric Wabr Heater, .............. 1 : $2.00 t 2.00 GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures z $200 $ Additional Fixtures ............... z = ,75 $ Gas Range to 190.000 BTU ............ x $5.00 i State Surcharge $ .50 REPAIRS A ALTERATIONS—Refer to Code _ Description .......................... , ................ A TOTAL FEE 8 19.50 City of Fridley: The undersigned hereby makes application for a permit for the^ work here! specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings. and hereby declares that all the tact and representations stated in this application are true and correct Fridley. Mina February 8. 1972 I9_ Oar Robert Lauclen Homes, Inc. Kind of Building Framed Used as nwo 114 ng To be completed about May 1072 Estimated Cost, $ i , i on, on Old—New. Building Permit No. Permit No.� ROUGH y�j FINAL G" Sign +.. ey Plumbing and HeatinesInc gy�Y/ Businew Phune No e a S e.1 A q Application for Pourer tents and Heart % Cooling, Ventilation. Refdgerwkn and Air Conditioning Sysfenis and Devices PARTIAL RATE SCHEDULE GRAVITS WARM AIR: RATE TOTAL Furnace Shell & Duct Work ......... . ................. $10.00 $ Replacement of Furnace 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ CH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............$10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & lines—to 400 sq. ft EDR Steam . .. .$10.00 $ Furnace Shell & Line—to 640 sq. ft. IDR Hot Water .. 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00,$— .00'$Each Eachadd. 320 sq. ft. EDR Hot Water ..... ........ ... 3.00 $ OIL BURNER—to 3 gaL per hour ... .:... ... .. ..... 6.00 $ over 3 gal. per hour --See Fee Schedule GAS BURNER (up to 199,000 BTL) ................... 8.00 $ over 199,000 BTU See Fes Schedule ; GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 200 $ Additional Fixtures ................. x .78 $ Gas Range to 199.000 ........... i$ &00 $ Am CONDMONINa WESTINGHOUSLO=30=2h ton$ 18.0 FAN BEATING SYSTEM 10 0 0 'FM See ' Fee Schedule VENTILATING SYSTEM : .50 SURCHGE ALTERATIONS & REPAIRS TOTAL FEE $ 18.50 Dept. Of BIdgL Phone 880-3480 Locea 5550 Matterhorn N.E. City of Fridley: The undersigned hereby makes application for a permit for the work hereic specified, agreeing to do all work in strict accordance with the City Ordinance. 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, Minn- Apr. 24, 1973 1s _ owner Larry Crable Kind of Building frame residential Used as To be completed about 5/15/73 Estimated Cost, $ 5 5 0.0 0 Old—New. Building Permit No. Permit No. 1<701573 DESCRIPTION OF WORK BEATING or POWER PLANTS -Steam, Hot Water, Warm Air—No Trade Name size No Capacity Sq. Ft. E.D R- BTU H.P. Total Connected Load Kind of Fuel BURNER — Trade Name Size No Capacity Sq. FL E:D.R BTU HP. ROUGH SALESMAN: Don Bell "FINAL !� _ ✓�' � ! (RMwaas—OVER) Signed B MERM `AIR C0hDRIONING Qi Ara • ft9-6767 &tri Pak Ilti■0110010 09426 53-84-s-915.51 City of Flaiey Applicalfon for PkmOft and Cvm RWI" Penn* -- Dept. of Bldgs. Phone SOD -3450 DESCRIPTION OF WORK 5550 N. E. Matterhorn Drive Number, kind and Location of Mtur� Logsdon-5550 'r"��' - -- a Y a 'Fill �M ■1�■ © - ON - ■ PARTIAL RATE SCHEDULE FLUMBINO FIXTURE )RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 S Future Fixture Opening ........... x $1.50 S New Fixture Old Opening .......... x $1.50 i Catch Basin .................... x $3.25 S Water Beater 'Up to 99,000 BTU) .. • • x $3.00 S New Ground Run Old Bldg......... x $3.25 5�-- Electric Water Heater .............. a $2.00 $ GAS FITTING FEEM NO. RATE TOTAL lot 3 Fixtures .......... • .. • • • .. x $2.00 $ Additional 112thim ............... x $ .76 $—�--- Gat Range to 199.000 BTU ............ x $5.00 $ State Surcharge $ .50 REPAIRS A ALTMATIONS— Ww to Codo - DucriVtian . .Install Gas Light & Grill ... .. 8.00 TOTAL FEE $ 8.50 Vass City of Fridley: The undersigned hereby makes application for a permit for the work here!' specified, agreeing to do all work in strict accordance with the City Ordinance and reeling of the Department of Buildings, and hereby declares that all the fact' and representations stated In this application are true and correct Fridley, 1liinn 5-3-73 ,19._ Owner H. L. Crable . Find of Building Frame Used as Res. To be completed about 5-10-73 Estimated Cost, $ 20.00 n Old --Building Permit No. pe No. / Signed ' I�IHL�EGASCQ By Business Phune No ROUGH FINAL l� /� s� SUBJECT PERMIT NO. City of Fridley 7 9 AT THE TOP OF THE TWINS BUILDING PERMIT Ir RECEIPT NO. COMMUNITY DEVELOPMENT DIV. 1 V PROTECTIVE INSPECTION SEC. r CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9/28/95 JOB ADDRESS 5550 Matterhorn Drive NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 10 4 Innsbruck North SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Laimonis Sprogis 5550 Matterhorn Drive NE 572-0964 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 13'2" x 15' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARNING Before digging call for all utility locations 454-0002 REQUIRED BY LAW, SEPARATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION I STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,693 $.85 DOES NOT PRESUMETO GIV AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF AN TH STATE OR LOCAL LAW REGULATING CON- STRUCTION OR T PERF RMANCE OF CONSTRUCTION Fire $ 1.69 CHECK FEE TOTAL FEE c�PLAN 491rr- $56.54 SIGNATURE OF CON' P/CTOR OR AUT ORIZEDAGENT '-YE) PROPERL ALIDAT D THIS IS YOUR PERMIT 4WHEN BLD INSP DA E SIGNATURE OF OWNERIIF OWNER BUILDER) IDATEI s� NEW [ ] Effective 8/1/95 �I ADPN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application i Construction Address: -.5's-5 0 - r -r 5P3 -z- Legal _ Legal Description: /l�/n/SB�P.u�� �kTN L o UC 4 �" �o R) z ,e Z4 3o Z¢ 4Z - o d ¢ 9 A/M&NI5 00 *7344Z Owner Name & Address: �L r., S�, r o -9 1• S Tel. # Contractor: r, �,,,�„ _ _ MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length <3 + Width /S Hgt/Ground s Sq. Ft. X7,5 r OTHER: c o _� . 9 ---*- ,y �''"^'" it f, 5 7 Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: 7,t cA•rEp W -00p f &'P,A Estimates Cost: $ Approx. Completion Date: tib-/, 0/1194�5' (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: o7--- tz r— APPLICANT: L'4 /Moll S S/'/e oG !S Tel. # OZ -0144 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ s�.sy CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $850 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 [ ] Not Necessary [ ] SUBJECT City of Fridley 2 6 3 6 7 AT THE TOP OF THE TWINS BUILDING PERMIT � + RECEIPT NO. COMMUNITY DEVELOPMENT DIV. I tr PROTECTIVE INSPECTION SEC. r � , NUMBER REV DATE PAGE Of APPROVED BY CITY HALL FRIDLEY 55432 �`' 612-571-3450 910-F15 6/26/98 JOB ADDRESS 5550 Matterhorn Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 4 1 Innsbruck North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Sprogis 5550 Matterhorn Drive NE 572-0964 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Renewal By Andersen 350 73 Avenue NE, Fridley, MN 55432 502-4777 20040630 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO, 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Q REPAIR X ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 15 windows in home with pocket insert windows 9 CHANGE OF USE FROM TO STIPULATIONS Install smoke detectors to meet the State Building Code - in each sleeping room and on each level of home. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $7,723 $3.86 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- Fife STRUCTION OR THE PERFORMANCE OF CONSTRUCTION, PLAN CHECK FEE TO AL FEE License $5.00 $153.83 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI EN OP VALIDA BL I SP E -THIS IS VOWR PER T GATE SIGNATURE OF OWNER0F OWNER BUILDER) IDATEI ITY OF FRIDLEY NEW [ ] ADDN j ] ALTLR ( ] ComstructionAddress: Legal Description; ` TEL: 612-571-1287 Mar 20.96 9:48 No.001 P.`01/02 CITY OF FRIDIZY SINGLE FAMMY.. AND DU MRXES R-1 AND R-2 Building. Permit. Application Effective 311/96- Owner /1/96 Owner Name & Address: �''11(. '`; Il , . p r 0n 1 -n ft ukx Tel. # -_o _ Contractor. � 1[�.� f� a ` 'n MN UC04SE # J Address: cx-' Tel. # -Ll ,:, Attach. to this application, a Certificate of Survcy of the lot. with the proposed construction drawn on it to scale. DESCRIPTION OF EWROVEAZENT LIVING AREA: Length Width Height Sq. Pt. GARAGE AREA: Length � Width Height Sq. Ft. DECK AREA,: Length Width _ _ Hgt/Ground Sq. Ft. OTHFR• , r Corncr i.ot [ ] Inside Lot [ ] Ft. Yd Setback Sidc Yard Setbacks Type of Construction: _ Estimated .Cost- $_ Approx. Completion Date: (Cost. oa . Back) Driveway Curb Cul Width Needed. Ft. +.6 pt!--= Ft x $ DATE: OLIN APPLICANT: Permit Fee Fire Surcharge Stale Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee ' . Sewer Main Charge TOTAL STIPULATIONS: cm USI,. Ori(LY $ %3 c -Schedule on Reverse Side $ �' 17,2 :001 of Pennit Valuation (1/10th!) . $ $.50/$1,000 Valuation $ . $900 per SAC Unit . 60 - $5.06 (State Licensed Residcntlat .Contractors) . $� Alt.. "A" or Alt. ' pB"-'Abovc $ $450.00 Conservation Plan Revim. - $ Fee Deftnined by Engineering. $ Agreement Necessary L i Not Nbedssary j ] Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604\ $ a��i� Surcharge CITY OF FRIDLEY DatR d License Surcharge $ 5,60 DATE—YOUR E-MAIL ADDRESS �j50,�a 6) $ SITE ADDRESS Sa (�(� $ THIS APPLICANT IS: ❑ OWNER CONTRACTOR $ PROPERTY OWNER/ NAME: Lck:,'mo n15 S Pc Qevi5 $ TENANT ADDRESSCITY STATE_ZIP Agreement necessary ( ) Non Necessary ( ) PHONE: -7U3 — 570-65(P4 NAME: Renewal By Andersen $ 5 CONTRACTOR SUBMIT A COPY OF STATE LICENSE #_ 1920 County Road "C" West YOUR STATE LICENSE ADDRESS: Roseville, MN 55113 r STATE ZIP WITH APPLICATION PHONE License #20130983 ❑ SINGLE FAMILY/NF PROPERTY TYPE ❑ TWO FAMILY/NEW C 651-264-4777 _ — ❑ ADDITION ❑ GARAGE/SHED 'WINDOWS PERMIT TYPE ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION .BCMAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: R10 QA4.[,Q I LA_� C13 SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUB IT• GARAGES ❑ ATTACHED GARAGE I. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2• Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING ❑ Vinyl ❑Soffit FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Aluminum ❑ Other ❑ Trim ADDITIONS 1. & PORCHES SUBMIT• Site Plan/Survey showing the existing structun ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations 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 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 1 a 1 to — OCCUPANCY TYPE Permit Fee $ 41,90 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ - to 1 .0005 x Permit Valuation Minimum $.50 License Surcharge $ 5,60 $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 5 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 i conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approve plan in the case of all work whicrequires r 'ew and approval of plans. ,n _ �j SIGNATURE OF APPLICANT �.t'RINT NAME 0dCk. )e y%4� y� DATE_ �z(l Vb W S & D Permit Service 9533 — 367`h Street; North Branch, MN 55056 Phone 651-674-1766 —Fax: 651-674-6190 To Whom It May Concern: I am an authorized agent by Renewal by Andersen to pull, pay for, and obtain their building permits. I have enclosed a self addressed stamped envelope for you convenience to mail the permit back to me. If there is a problem with this please feel free to give me a call at 651-674-1766. Thank you for you assistance, Kara Benson WS&D Permit Service 651-674-1766 — Phone 651-674-6190 - Fax