Loading...
PRE 2010 DOCSCity of Fridley23173 SUBJECT (� 41EVUff W&. AT THE TOP OF THE TWINS BUILDING P E R M I T f RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC r � ��--1 CITY HALL FRIDLEY 55432 ,'j NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 2/1/95 JOB ADDRESS 5713 Matterhorn Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 1 1 Totino Grace Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Olympio_ Construction Co Inc 2105 Long Lake Rd, New Brighton MN 55112 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 633-4515 2138 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 a NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 6 DESCRIBE WORK Construct a 42' x 57' Dwelling; a 22' x 34' Garage' and a 12' x 12' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Provide a hard surface driveway. Provide sod in the front and side yards. Provide City with copy of verifying survey before capping. SEWER & WATER: Available from Matterhorn Dr. Might have to be tapped under the street Development Company may have provided services to each lot when utilities went in. Check with developer or utility contractor on job. WARNING Paid park fee of $1,500.00. Driveway Curb Cut Escrow: 16' + 6' = 22' x $15.75 = $346.50 Before digging call for all utility locations SEPARATE PERMIT'S REQUIRED FOR ABY WRGT HE HEATING, RE UIRED Q PLtPJG a�N �SIG�}Sa A, 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 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX Fire S(' AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $146,423.60 $73.21 $146.42 DOES NOT PRESU�E O GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY O HER STAT LOCAL A TING CON- $850.0 STgUCTION HEP RFORMANCE F CON N.$804.00 PLAN CHECK FEE TOTAL FEE Lice e SC 1. 878.63 + PF & DW siG Ar of CONTRA TOR OR AUTNO ED AGENT DAT W EN PROPERLY VA IDATED THIS IS YOUR PERMIT 6LDG INS- p o 1A -Y!7 GATE _ SIGNATURE OF OWNER of OWNER BUILDER) iDATEi V NEW Effective 1/ /95 ADDN [ ] CITY OF FRIDLEY ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address:'] Legal Description: /r T Owner Na & Address: Tel. # Contract r. ru o �/STj�l,�C%/oiPJ �o c MN LICENSE #/ t� Address: �,,.v �.�� %��W ��, /r�T.r��/�� 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 312_ Width 5-,7 `` Height / 7�7 Sq. Ft. GARAGE AREA: Length Width 3'S' Height / Sq. Ft._ DECK AREA: Length /-:2- Width Hgt/Ground Ft. �o OTHER: - Corner Lot [ ] Inside Lot Ft. Yd Setback -?f" Side Yard Setbacks Type of Construction: /44V - p Estimated Cost: $ eon Approx. Completion Date: ,,,e6.e (Cost on Back) Driveway Curb Cut Width Needed: joFt. + 6 Ft = AZ Ft x $ /S� _ $ DATE: / APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control $ rjq, O-- $ 1-161,17, $ -73,1.1 $ X Sd! c° $ 5,vo $ 3 -rO CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1 / 10th %) $.50/$1,000 Valuation $850 per SAC Unit tl5lmc-1413, f),,,r X /C• K '01W.&I UAOCIA1 Sswr : �`4I, J7sF 002.1 q y - c6 fzx s /23,` 3`1 /V614123, 60 $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Park Fee $ ) 5 C,)® . G 0 Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary (��✓ TOTAL $ -� 1-3 STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1995 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater —Electric Water Heater — Gas Gas Range Gas Dryer 0 Back Flow Preventer Required ( )Yes NO. RATE TOTAL JOB ADDRESS — '13 /s- $7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 l4LL iD The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. l©. dv Type $5.00 eE!44too a Reinspctio1 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance State Surcharge .50 ,199 5 Owner(— Building Used As Estimated Cost W101W PERMIT NO. PLUMBING COMPANY l/ SIGNED BY _ TELNO. Approved By Rough—In Date Final Date TOTAL FEE $ V -.S1) PLUS' THE $.50 STATE SURCHARGE MINIMUM FEE FOR ANY HEATING/COOUNGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. HEATING Signed By, Tel N Approved By Rough -in Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 199.x' 6431 University Ave NE Fridley, MN 55932 AP CATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOBADDRESS 6_g13 RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Bumer - rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 20.00 $�� representations stated in this application are true and correct. (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace) $10.00 $ 1 D. OWNER ��I u�.) )m )j2 Gas Range $10.00 $ BUILDING USED AS Gas Dryer $10.00 $ 4 1 I`a.CC PERMIT N0. �✓C � *Air Conditioning -All Sizes $10.00 $ ®� ESTIMATED COST ;� DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Afterations (LIST ON BACK) 1% of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) arm Air Trade Name Size No. - /0Q Commercial/industrial BTU HP EDR 1 % of Value of Appliance or Work $ Fuel^ QbIl- L Total Connected Load State Surcharge $ .50 Burner Trade Name Size No. TOTAL FEE BTU HP EDR MINIMUM FEE FOR ANY HEATING/COOUNGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. HEATING Signed By, Tel N Approved By Rough -in Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE NOTE: #1 through #8 required when using a side vent furnace. CHIMNEY AND STACK_ MMFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely supported Yes () No ( ) S. Meets all current Code requirements for size and total BTU's connected Yes () No 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( ) S. Has combustion air been provided for water heater Yes () No ( ) Remarks: HEATING CO: Signed By: Date: I SUBJECT P City of Fridley C 23293___1 329 AT THE TOP OF THE TWINS BUILDING PERMIT 0. _RECETprTrr COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. , r r CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 4/19/95 JOB ADDRESS 5713 Matterhorn Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 1 Totino Grace Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Olympia Construction 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Fireside Corner 2700 N Fairview Ave, Roseville MN 55113 638-3304 1068 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 C ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install gas fireplace 9 CHANGE OF USE FROM TO STIPULATIONS 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 ] 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 $1,100 $.55 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $27.00 Fire SC $1.10 PLAN CHECK FEE TOTALFEE License SC $5.00 $33.65 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROP Y VALIDATED THIS IS YOUR PERMIT A VOG INSP % - 71 MATE SIGNATUREOFOWNERIIFOWNER BUILDERI IDATEI I CITY OF FRIDLEY TEL: 612-571-1287 Feb 16,94 17:14 No.016 P.02/03 'NEW Effective 1/1/94 ADDN [ ] CITY OF FRIDLEY. ' ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 A`ND R-2 Building Permit Application Conswuction Address: Legal Description: Owner Name & Address:Tcl. f! Contractor: FIRESIDE COAER MN LICENSE # Address: Tel. Attachto 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 Su. Ft. GARAGE, AREA: Length Widths Height, Sy. Ft. DECK WAI €.efoh _ Width Hgt/Ground.. ...5g. Ft. Corner Lot [ i Inside Lot [ j Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ - Approx. Completion Date: (Cost on Back) Driveway .urb Cut Width Needed: K + 6 Ft Ft x $ _ $ DATE:' APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY $ Ile CZ Fee Schedule on Reverse Side $ .001 of Permit Valuation (Moth%) $ $.50/$1,000 Valuation $ $800 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 ZbLU5 STIPULATIONS: 060 SUBJECT %3 City of Fridley ((72 4 62 AT THE TOP OF THE TWINS BUILDING PERMIT r • _____ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC, ;2;3 r 1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 6/15/95 JOB ADDRESS 5713 Matterhorn Drive NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 Totino Grace Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Olympia Construction Co Inc 2105 Long Lake Rd, New Brighton MN 55112 633-4515 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 O NEW 1 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 16' x 14' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARNING Before digging can for all utility locations 454.0002 REQUIRED BY LAIN 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 SQ. 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 $•91 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 1,825 DOES NOT PR. ME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF NY OTHER STATE OR LOCAL LAW REGULATING CON- Fire SC $1.83 STRUCTI OR ERF CE CONSTRUCTION $43.00 � PLAN CHECK FEE TOTAL FEE icense 00 $50.74 u F c N. R AUTHORi2ED A DAATETEi W PROPERL AL1 AT THIS IS Y0QR PERMIT LDG INS—W FIA TIE SIGNATURE OF OWNER of OWNER BUILDER) IDATEI 060 NEW [ ] Effective 1/ 1/95 ADDN . � [ ] - � - --CITY OF FRIDLEY• - ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: Legal Description: Owner Name & Address: Contractor. � v Address: 2/D -5" Tel. #. MN LICENSE #%� 5 •{.9�f� ���ry �Cvs',,zlTel. #(L/a) 6 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 % Width Hgt/Ground S — Sq. Ft. ZR OTHER: Corner Lot [ ] Inside Lot Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ Approx. Completion Date: 6 - i4' .a �x (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: APPLICANT: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: IL CITY USE ONLY : Fee Schedule on Reverse Side Tel. # .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $ $850 per SAC Unit $ g', $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 [ ] i CIiYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MN 55432 • (612) 571-3450 • FAX (612) 571-1287 August 7, 1995 Olympia Construction Co Inc 2105 Long Lake Rd New Brighton, MN 55112 Re: Final Reinspection at 5713 Matterhorn Drive NE, Fridley Dear Sirs: A final reinspection was conducted on August 7, 1995 of the above address and all corrections/completions have been finaled. If you have any questions on this matter, please feel free to contact me at 572-3603. Sincerely, L BARR RIESCH Building Inspector Building $ BUILDING See Back Page for Fee Schedule Permit No.:4-- l Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Surcharge c l DATE E-MAIL ADDRESS License Surcharge SITE ADDRESS ``'Y'OUR t a ' r LN kL� N� $5.00 (State Licensed Residential Contractors) THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ N 0f L= J $ TENANT ADD S: S? 13 MATtEkP6W Q 0 IF- 'CITY DLA v STATEN►;IIP 5503:Z Erosion Control PHONE: 5 �— CONTRACTOR NAME: 9kC k Z5(7 -S $ SUBMIT A COPY OF STATE LICENSE # s26S% 33 &-7 EXP DATE � 2 I b YOUR STATE LICENSE ADDRESS: 1 Z 4(b i 1 (-- ho'p-> CITY P40TDS STATE_ 1P Zeff+.z WITH APPLICATION PHONE L-3 " 6 "' � l FAX _ $ PROPERTY TYPE ❑ SINGLE FAMILYINEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH 20ROOF ❑ DRAIN TILE ec,per �- ❑ DECK ❑ SIDING ❑ OTHER , h ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: S12E OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES 3 ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ 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•WNDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 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 Fire Surcharge $ .001 times the total job valuation Surcharge $ /S .0005 x Permit Valuation Minimum $.50 License Surcharge $ , u L $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 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 _ _ $ 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 applica 'on for 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 ch r es review and a proval of plans. SIGNATURE OF APPLICANT PRINT NAMETS°�K) —?SJ—1 DATE 4)-0 d Building BUILDING Permit No.. / Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DATE YOUR E-MAIL ADDRESS SITE ADDRESS 5713 M!�� RIVIL f0 ► -i- THIS APPLICANT IS: ❑ OWNER )CONTRACTOR PROPERTY OWNER/ NAME: -1--f JAASi_►t3G TENANT ADDRESS: 6-7 1 -5 %>y�AA-M A?-eC(W M Lf- . CITY F(Zt DLJ -Y STATF_k0nP-5"3-2- 5"3ZPHONE:7& PHONE: -7&- �tC��a✓a CONTRACTOR NAME: SsSH�R� �LK'T�6zIbRS STATE LICENSE # 205T�3 3 -%,-7 EXP DATE 3 "' 3 f - C*3 SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 0 1-7qD I I b Mt M22, �;y M ldd CITYCap,.> RA P tr1 S STATFANLIP eZ WITH APPLICATION PHONE !a3 --7 - FAX -7&-5 PROPERTY TYPE I*SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES -2- PERMIT PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED J,WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK 16 SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: PLNEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: RyPt1tcf- hZ, W r,A-S Si `ES yt -RSI Q SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. FL ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, wvinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project VANDOWS 2. Two sets of construction plans IN EXISTING OPENINGS AYes ❑No LQCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED H NUMBER OF WINDOWS t°1 ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 21 t 100 OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ /5 .001 times the total job valuation Surcharge $ lb, -5� .0005 x Permit Valuation Minimum $.50 License Surcharge $ 5VD $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 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 $ :;3 S,5 ..G/n 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 for 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 whichequ es rev wand approval of plans. 2 SIGNATURE OF APPLICANT__ e?3 � PRINT NAME ►bAOI& T, 6AP-V, DATE " Q —0-7