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PRE 2010 DOCSJ, City of Fridley, Minn.. No '10732 BUILDING PERMIT Date: July 1, 1970 , Owner: Ed Chies Builder Ed -Ray Builders Address 7651 Central &uanile N E Address 7651 Central Avenue N F LOCATION OF BUILDING No. 1402 _Street �Meadowmoor Drive _____ Part of Lot Lot — 8 Block 3 Addition or Sub -Division Meadowmoor Terrace Corner Lot. Inside Lot — X Setback _ - Sideyard mmwElevation 889.60 VPJ&WA9ffM 892.60 Wye 0 TOP OF FOOTING DESCRIPTION OF BUILDING To be Used as: Dwelling Front 32' Depth 6'_— Height 20 ' Sq. Ft 728' Cu. Ft. 14.560 ' Garage Front 18' Depth 24' Height 10Sq. Ft. 432' Cu. Ft 4, 320' Type of Construction - dram Est. Cost $17,500 _ __ To be Completed November 5, 1970 Hardsurfaced Driveway Verification of basement before framing WATER LOCATION: 11.5' East of Sewer SEWER LOCATION: 69.5' East of Manhole 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 f in compliance with all provisions of ordinances of the city of Fridley. �' V, /' : i i " In consideration of the payment of a fee of $ 35.00 , permit is hereby granted to Ed -Ray Builders 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 andmoving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. AL D. BAGSTAff NOTICE Thb permit does not cover the construction, instalWon for wirins, plumhins, gas he+fing, sewer or wafer. Be wre to we the Building hapector for separate permih for these item. 9 APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME:9;2 BUILDER: ADDRESS:— ADDRESS: NO /&O= STREET LOT: ADDITION: CORNER LOT: INSIDE LOT :b�-' SETBACK :,��5� S I DEYARD Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPT ON OF BUILDING To Be Used As: aC- e Front • �- Depth • Height Square Feet: Cubic Feet: 6 Front;Depth:_ 2 Height: Square Feet; Cubic Feet — IrJ Type of Construction: �P 7%�� Estimated Cost: T To Be Completed: j S-, Zy 7!) The undersigned hereby makes application for a permit for the work herein 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 are true and correct. Of DATE: SIGNATURE: (See Side Reverse Side For Additional Information.) f,el:P" -� Iand Plannmy(4a&tr6u1)L C875-llyhnvy'ef #E. [arid St rvey;y MreuruPo1,s72, Snrsresfnq ENGINEERING, INC. alim�sola Civi/ b- Ow/cipal _ SUm d ,1 066 Enyineers E Surveyors - ceir tslscate ON Survey for JUAROWSKI AMP CN/ES �I �yI HO�►sa: agRAoF i LOT 8 5' I 73 nioR rH BD•CN07ZS IRON DZ -MOMS Ur/1/TY 4 DRAIMAGC ZASl`/'► Z -Nr 1 �. Zo 3L 0 c K 1YcAA9owvooR 4 -,em c,4c- CO&Nry OA' AMOKA ! /rtr�by ar-1 Y fhat ,� a o h acrd OWMCf rep-eserd atian Viod !WWW eh* Gormalorr�es e* ad w �6ed rare, 4nd lacviiai a�'al/ br�idrir9s , N can , and d! PmAfr avavchmmh d . * t r w so d /md. As sra-myed 6t, fw flys — _ 0bf SEB_ A-Qr�d�• SUBURBAN MWNEERlN6, ,INC. Er veers fr 5w* ori %YCALE 40 r.. To(' i'6- w �2 tond Pla+mrcfa&"4fl1,L MS-ROMY OCS #1. L&d SWWYi 7y tifirraeew/02, Sotssfy ENGINEERING, INC. Cr"�,l � Al�a7pat Sl�h.�t 4 X066 EnIneers Sur veyors --- - cestiSscate of survey so: "u�xowsw Awo CHizs wM000 ryE--------- 1IN0R 7'H -75 IN H) %iDVSk Gg1o6.1 hh O V 32 / I LOT 8 5 75 1 cDENOTES IRON --- DENOTES (/T/L/TY e 40RA/N.4GE ZASEMENT Lor 8 Bt ocK 3 AcAoowwooR 469RA cz- COUNTY OA' AAVKA / b&Thy cavi& bat *6 is a hw and a red rrp rSW14m as o�'o SOWY q'lt bWdfftW $`!41 AJV d CMbrd ta►d, dr! a�fYt /a�vi ii Fall brsk/mgs , man, and d/ risible arxroarbmer fs , tf ma . farn ar d7Aid ANd. As 59NWyfd 6f OW Ai---- °by 4r. ��-e_ ,o.o.rs.64. SU8uR8AlV ENGINEMM7, INC. yrs � sw- � SCALA-, ' 40 AY 908 je MEMO FOR FILE Memo Date: November 19, 1970 Ed Chies called P.M. and said he had a man �14+1408 Meadowmoor Terrace:( ) with a pickup cleaning up the debris in the area. Cleaning should be completed in a few days. 7630 Bacon Drive (Basement): Ed Chies called and said this property now belongs to another person and.this person would be building on the property shortly. However, he did not give the name of the new owner. I el In AL D. BAGS Building Official -Inspector ADB/mh City of Fridley Application for P14mbbig and bar: ftmik Dept. of Ridge. Phone 960-3 DESCRIPTION OF WORK Number, Kind and Locaflon of Fixtures I.e 0& I S I Z = rl O Z V • • • N WATER HTR. GAS ELEC. Base�- lst L e - v " 2nd 3rd -t—. 4th • Future Connection Openings # New Fixhm. ON Openings Connected with Sewer � Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE //TOTAL Number Fixtures ................ _ x $2.00 $ Future Fixture Opening ........... x $1.50 $ _ 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 Water Heater .............. s $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 0 0 1st3Fixtures •.••.••••••••••. x$2.00 Additional Fixtures .................. x $ .75 $ Gas Range to 199,000 BTU ............. x $5.00 $ REPAIRS S ALTERATIONS—Refer to Code Description ............................................. .O TOTAL FEE t A /° City of Fridley: The .undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the Cite Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this appHca4 onvre true and correct Owner Kind of Used as To be completed about Estimated Cost, $ d Old—New. Building Permit Signed e, By— Business Phune No ROUGH Application for Power Plants and Healing. Cooling, Ventilation, ReMgeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ........................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ NECK. WARM AIR 16, 66 Furnace Shell & Duct Work to 120,000 BTU .........�.. $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ..... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .. ........... .. 2.50 $ OIL BURNER—to 3 gal. per hour . 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ ' GAS FITTING FEES: NO �WA4E TOTAL 1st 3 Fixtures ..................... x .r0 $ �L Q 0 Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $� ALTERATIONS & REPAIRS TOTAL FEE $/:z ROUGH Dept. of Bldg& Phone SU 4-7470 UV Locatio++ 1402 Meadownoor Drive City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all 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, Minn_ _/`� 1974) Owner Mario June Kind of Building Frame Used as '.�w`1 To be completed about Estimated Cost, $ Old—New.XBuilding Permit No. Permit No. r19 DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm AOLNo 1 Trade N e AFCO Size No GB 1203—OHD Capacity Sq. Ft. E.D.R_ 60, 0 0 0 BTUH.P. Total Connected Load 38,359 Kind of Fuel Nat. Gas BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signed Mill City( Heating Co. Q Business Phone No 544-1501 SUBJECT PER O. City of Fridley - 17 3 2 6 AT THE TOP OF THE TWINS BUILDING PERMIT R PT N0. I.r � • _ COMMUNITY DEVELOPMENT DIV. �.: - ---- r i � PROTECTIVE INSPECTION SEC. A3 5-OP 1 � { CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 N 11/8/83 1 1 10B ADDRESS 1402 Meadowmoor Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 3 Meadowmoor Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Walter Lizakowski 1402 Meadowmoor Drive N.E. 784-4303 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 Install free-standing fireplace and construct a 12' x 20' Shed 9 CHANGE OF USE FROM TO STIPULATIONS s 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 1 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 $1,500 $.75 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- STRUCTION OR THE PERFORMANCE Or CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $25.75 SIGNATURE OF CONTRACT O R OR U HORIZ AGENT (DATE) WHEN PROPERLY V,4rAj ATED TOM IS YOUR MIT rRE BLDG INSP ATE SIGNATUREOFOW NERIIFOWNE 8 ILDERI (DATE) CITY OF FRIDLEY . Effective Aug. 1, 1981 APPLICATIM FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OWNER: 1'Z)4L-7-9Vt ADDRESS: % Q,CZ,� �- !L TEL K0: BUILDER: A) 44-? Ez TEL 110: aLV, 2! -?-5 Construction Location STRDCT NO: D STREET: 1::Zj &a4gk-) LOT: BLOCK:�— Corner Lot: Inside Lot: Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION 1 A &08 Front: Depth: Height: Square Feet: Cubic. Feet: Front: o Depth: Height: Square Feet: Cubic Feet: Type of Construction:A41,rgstimated Cost: 4b Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ , SED PEVF:R;L' SIDE OF SHEET Zine undersigned hereby makes applicaticn for a permit fcr the %:ork herein specified, agreeing to do.all work in strict accordance with the City of Fridley Ordinances and rulings of the Del-.irtment. of Buildings, and hereby declares that all- the facts and represe..-titiens stated in this application are true andocorrect. DATE: ! i — - / — e:9"J SICNATUM Stipulations: km SUBJECT PER City of Fridley �'2 AT THE TOP OF THE TWINS BUILDING PERMIT R E C E I `v ______ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. S 1 , dc6 I CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY •� 612-571-3450 910-F15 6/5/85 JOB ADDRESS 1402 Meadowmoor Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 3 Meadowmoor Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Walter Lirakowski. 1402 Meadowmoor Drive N.E. 784-4303 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 X 8 DESCRIBE WORK Construct an above ground swimmiPool _ 24' Round 9 CHANGE OF USE FROM TO STIPULATIONS See letter dated 6/5/85 with stipulations. SEPARATE PERMITS REQUIRED FORANINIVA Before diggng call local utilites WIRING, HEATING, PLUMBING AND SIGNS. TELEPHONE! ELECTRIC -GAS Etc. REQUIRED 0Y LAVA' SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 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 $l/5Q0 $.75 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- $ 25. QQ STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PAN CHECK FEE TOTAL FEE $25.75 IG ATURE ONTRACTOROR UT ORIZEDAGENT (DAM WHEN PROPERLY LIDATED THIS IS YOUR PERMIT SiGNATURE OF OWNE (F O E I E I (DATEI BLDG INSP O E km y� CITYOF FMDLEY CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450 June 5, 1985 Mr. Walter Lizakowski 1402 Meadowmoor Drive N.E. Fridley, MN 55432 Re: Swimming Pool Construction at 1402 Meadowmoor Drive N.E. Dear Mr. Lizakowski: This letter is to make clear this department's requirements for the swimming -pool construction at the above address. 1. As indicated, one (1) skimmer approved by the National Sanitation Foundation will be provided. 2. As indicated, one (1) inlet of approved design for fresh and/or repurified water will be provided. 3• As indicated, a main drain of approved construction will be provided. 4. The filter and pump shall be approved by the N.S.F. and be of sufficient capacity to provide a minimum turnover of at least two (2) times in 24 hours. This department recommends a turnover rate of 6 - 8 hours. 5. A deck of at least three (3) feet wide, measured from the pool waters edge, shall be provided which extends completely around all private residential pools. Above ground private residential pools may be provided with decking of a minimum size of 4 feet by 4 feet at pool entry points and provided that such decking has the approval of the City. 6. Fencing or other effective means including but not limited to walls or buildings, acceptable to the City, shall be provided to positively control all access to public and private residential swimming pools. Fending shall meet the following criteria: (a) The fencing shall prevent the entrance of children and be without hand or foot holds that would enable a person to climb over it. (b) The fencing shall be at least 6 feet high and entrances shall be equipped with self-closing and self -latching gates capable of being locked. (c) Self-closing and self -latching devices shall be placed at the top of the gate or otherwise inaccessible to small children. (d) The opening between the bottom of the fence and the ground or other surface shall be not more than four inches. June 5, 1985 Mr. Walter Lizakowski Re: 1402 Meadowmoor Drive N.E. 7. An automatic chlorinator should be provided with a suitable test kit. Page 2 8. All electrical and plumbing installations shall be inspected and approved by the City Inspection Department. 9. All overhead electrical lines must be a minimum of 10 feet horizontally from the pool surface, and 18 feet straight line distance from the waters edge. An alternative is to bury said lines. 10. The pool fill spout must be protected by a vacuum breaker or air -gapped. 11. Suitable safety equipment to include but not limited to a ring buoy and rope that is 1-1/2 times the pool diameter and shepherds crook pole must be provided and maintained with the pool at all times. Furthermore, these and any other requirements must meet the provisions of the Fridley City Code, Section 115, Swimming Pools. The building permit is approved contingent on final inspections and approval of the City. If any questions or problems arise from this letter, please feel free to contact me at 571-3450. Sincerely, aloso, -..' DARREL G. CLA Chief Building Official DGC/mh NEW [ ] City of Fridley Effective 4/1/84 ADDN. f R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: a ngtj1j _%? AJ Legal Description Owner Name & Address: �S�/%`� <� G A-Aff�'�-vc roc' Tel. # % .4- Contractor: ! 5-21 i"' Tel. # Address: 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 Sq. Ft. OTHER: Corner Lot [ ] Inside Lot Ft. Yd. Setback Side Yard Setback Type of Construction: I fj). oa e I L Estimated Cost: $ Approx. Completion Date: C /J,'t. - — /V,?"X77 Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: w- Y- S APPLICANT: Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: Tel. # CITY USE ONLY $ Fee Schedule on Reverse Side $ 25% of Building Permit Fee $ $.50/$1,000 Valuation $ $425 per SAC Unit $ Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] $ PA*- -54-A),b F/ L--W� —p,&7m.A, AkAt A) Loc -T -.j GIS SUBJECT City of Fridley 7"6�" AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. __--� COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. Y3 JOy � � 1 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEV $5432 612-571-3450 910-F15 9/8/98 JOB ADDRESS 1402 Meadowmoor Dr NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 3 1 Meadowmoor Terrace SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Walter & Sondra Lizakowski 1402 Meadowmoor Dr NE 55432 784-4303 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 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 O MOVE O REMOVE 8 DESCRIBE WORK Storm damage - Deck (256SQ) / Redo Utility Shed (from 10 x 20 to 10 x 16) / Replace Rain Gutters 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 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 $1.58 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3,160.00 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- $87.25 Fir SC $3.16 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTA *E //,$91.99 GNJ TTUU/RREE W N, I RAC409 OR AU R RI AGENT IDATEI N Row4pff RowVALIDAJEqpfHIS IS P IT w ! B-LEX INS PATE LVVIS.GNATURE OF OWNER OF O NER BUIL RI - IDATEI NEW [ ] ®`Qqj ective 1/1 8 ADDN [ ] CITY OF FRIDLEY �}� (,�� ALTER SINGLE FAMILY AND DUPLEXES R-1 AND BUILDING PERMIT APPLICATION I ConstructionAddress:L— Legal Description: Owner Name & Address:O %Lc:-�-416P . �� Tel. # Contractor: �� Al �-�/C_ MN LICENSE # �L Address. Tel. # �y Attach to this application, a Certificate of Survey of the ri lot, with the proposed construction drawn on it to scale. 3 JC DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width �� Hgt/Ground Sq. Ft.— OTHER: _ Construction Type: %� Estimated Cost: $ % (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: J APPLICANT:On _Tel. # %� CITY USE O Y Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge TOTAL STIPULATIONS: Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 [ ] Building Inspections 763-572-3604 DATE i an / — e SITE ADDRESS /D z THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION BUILDING " RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL. ADDRESSwe— OWNER ❑CONTRACTOR NAME. ADDRESS: CITY ZA punNF- /— STATE LICENSE EXP DATE t No.. Received By: Date Rec'd: ADDRESS: CITY STATE ZIP PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION ❑ TWO FAMILY/NEW CONSTRUCTION SV -h STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT ROOFING NUMBER OF SQUARES d GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other WINDOWS IN EXISTING OPENINGS ❑Yes ❑No OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED LENGTH WIDTH HEIGHT ❑ HOUSE ONLY (HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia LOCATION OF WINDOWS OF BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used Ft. FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ $- $ "493 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 determination) ft+6ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary Make checks payable to: City of Fridley THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED Attach 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 pe d work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all w view and pproval of plans. SIGNATURE OFAPPLIC PRINT NAM !S / L '(, L DATE