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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N© 6092 Date: Owner: Buil c� Address Address 10 F L ING No. r Street . P of Lot Lot Block Addition or Sub-Divisi p Corner Lot _ Inside Lot Setback iSidey M Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING Front Depth Height' s Sq. Ft. Cu. Ft. ' V gE4,j% AF Depth eight Sq. Ft. Cu. Ft. Ty;,(f Construction _ _._ Est. 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 aJl provisions of ordinances of the city of Fridley. 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 paw thereof, shall conform in aII respects to the ordinances of 7whin 'theme dty ]imitsand g location, construction, alteration, main repair p�visions of said this permit may be revoked at any viola on of inanece. — Building Inspector NOTICE: Ibis permit don not cover the conatruction, huhilation for Whiao, phnahing, gas hemi& moor or crater. Be sure to as the Building Inspector for separate permhs for those hens. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name Builder J, 4N Address Address 7 _ LOCATION OF BUILDING No. %3/ Street A,143( -W 1>lilt Part of Lot Lot /.� Block Addition or Subdivision!!* I ry Corner Lot Inside Lot etback S ! Side -Yard ,p �qL c SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To b used as: Front Depth Z,` V- Height �0 Sq. Ft, 7 Cu. Ft. CCS Front 2-0 f Depth/ Height /b Sq. Ft. q�7b Cu. Ft. Type of Construction j64d=&1 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 t s.application are true and correct. DATE % � 6 Y SIGNATURE Ak (Schedule of Fee Costs can be found on the "Reverse Side). City of Fridley Application for Plumbing and Gas F'ini'ng Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures q yCC.77� m y, _Z 12 �, Z� � � Z � Z °C O W J () 0 Z �0 � R t N WATER HTR. GAS ELEC. Base 1st 2nd 3rd 4th • Future Connection Openings ' I New Fixture, Old Openlags Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE Number Fixtures ...................... x $1.50 Future Fixture Opening x 1.20 New Fixture Old Opening .............. x 1.00 City of Fridley: The undersigned hereby makes application—fbr a permit for the work herei 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 fact and representations stated in this applicatio are true and correct. „ Fridley, Minn_ Owner �. i L", Kind of Building r Used as To be completed about Estimated Cost, $ / Cg Old New Building Permit No. �,'ermit No. T TAL $ 6/ 9� Signe $ By $ Business Phone No Catch Basin ...... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ g? , 0 New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 It 'Ay Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ......................................$ TOTAL FEE $ ROUGH FINAL 42 2M Application for Power Plains and Heating, Cooling. Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIA: HATE TOTAL Furnace Shell & Duct Work ......... . . . . ... . .......... 8.00 Replacement of Furnace ............................. 5.00 $ Repairs ,& Alterations—Up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $50000 ............... 2.50 $ MEC*. WARM AIR Furnace Shell & Duct Work to 12,000 BTU ............ 8.00 $ each add. 60,000 BTU ..... :................. 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—W to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or *OT 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 RATE TOTAL 1st 3 Fixtures ......... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ......... - . x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL See Fee Schedule TOTAL FEE DepL of Bldgs. Phone SII 4-7570 a> - 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 a and corre®ct. �1�Fr' ey, < 19Owner C Kind of Bhidling/''�J n. n Used as To be completed about a -o Estimated Cost, $ Old New. uilding Permit No. Permit No. L➢ DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, armAir o_ Trade Name -a Size No Capacity Sq. Ft. EM.R- BTU H.P. Total Connected Load !1�f 4 Kind of Fue �� ff BURNER — Trade Name Size No Capacity Sq. Ft. EM.R BTU H.P. RAY N. WELTER HEATING CO. Signe 4b37 L;HIL;AUU . By MINNEAPOLIQ 7. MINNESOTA .kF.W42 2I► Business Phone No j (REMARKS -OVER) j Date: Coity of Fridley, Minn. BUH DING PERMIT AUGUST 17, 1965 Owner: GERALD GLEN BUILDER Bider SAME Adams 1202 Hathaway Lane N. E. Address Fridley 21, Minnesota LOCATION OF BUILDING -:5C N° 8372 No. 7331 Street MELODY DRIVE N E Part of Lot Lot 15 _ Block 3 Addition or Sub -Division MET -OW MANOR. 9 -no Add i t inn Corner Lot _ Inside Lot Setback Sideyard Sewer Elevation _ Foundation Elevation To be Used as: Type of Construction DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft Front Depth Height Sq. Ft. Cu. Ft. Fit. Cost � 15 000.00 — 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 21 provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $10.00 permit is hereby granted to GEMU GLEN BBUILDER 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 location, construction, alteration, maintenance, repair and moving of buildings ordinances. city limits permit may be revoked at any time upon violation of any of the provisions of said ALLEN G. JENSEN Building Inspector NOTICE: rab pormh don not carer the condrudlon, hatdlatton for wkb& p1 mbing, on huHae, eswsr er wow. Bs can to ue Na Building I wer for ssparde p mWft for thus henm APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME UILDER ADDRESS LOCATION OF BUILDING N0. STREET�PART OF LOT LOT /'�.�` BLOCK -3 ADDITION OR SUBDIVISION d CORNER LOT INSIDE LOT SETBACK SIDE YARD_ SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these.Certificates. MI -J -P ° DESCRIPTION OF BUILDING To be used as; Type of Construction To be completed Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Estimated Cost % ��, 6 �r 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 `(� ,S� SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). . .�0 City of Fridley Appicalion for P wnbing and Sm RMiq Pemb Dept. of Bldg*. Phone 980-3490 DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ lip s7��<{�lt�ja`5�Sis 1 12;� New Fixture Old Opening .......... � i $ u1 O �n V ` 3 (7 < u12 ( V • -I • N WATER wTR. GAS ELEG Base GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .................. x $2,00 $ 2.00 Additional Fixtures .................. x $ .75 $ Gas Range to 199,000 BTU ............... x $5.00 $ install (1) gas grill 3.00 1st 2nd 3rd 4th • Future Connection Openings + New Fixture, Old 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 .............. z $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .................. x $2,00 $ 2.00 Additional Fixtures .................. x $ .75 $ Gas Range to 199,000 BTU ............... x $5.00 $ install (1) gas grill 3.00 REPAIRS & ALTERATIONS—Refer to Code Description ............................................ 4 TOTAL FEE s 5.00 53-84-S915.51 Loam= 7331 NE. Melody Drive 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 City Ordinance and ruling of the Department of Buildings, and hereby declares that aA the fact and representations stated in this application are true and correct Fridley, Ilii., May 10. 1972 l9, Owner William F arvianen Kind of Building frame Used as residence To be completed about .• Liu 150 1972 Estimated Cost, $ l(],()() OldK-New. Building Permit No. per='`q Signed MINNEGASCO By - Business Phune No ROUGH FINAL 'A" Surcharge .500 SUBJECT PERMIT NO. City of Fridley'- - AT THE TOP OF THE TWINS BUILDING PERMIT 22545 i � RECEIPT N � • COMMUNITY DEVELOPMENT DIV. r,: ---•--� PROTECTIVE INSPECTION SEC. + ��� r � � 1 � 1 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 5/18/94 JOB ADDRESS 7331 Melody Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15 3 Melody Manor 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Phyllis Parviainen 7331 Melody Drive NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. George Johnson Contractor 5410 Girard Ave N, Brooklyn Center MN 55566-2351 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 1016 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof House & Garage (26 Sq) 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be 2nd layer but not 3rd. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. 1 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $13-430 $.72 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $35.00 Fire SC $1.43, STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE License SC $5.00 $42.15 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI ERLRL V THIS IS YOUR PERMIT _ L BLDG INSP DATE SiGNATUREOFOWNERdFOWNER BUILDERI IDATEI ,�. NEW ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: 7 j 3 " IV41-/ } Legal Description: Owner Name & Address: Contractor: Address: Effective 1/1/94 ="I g s4 Tel. # MN LICENSE # / o Tel. # rj-74 7� 3 Attach to this application, a Certificate of Survey bf the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground OTHER: Sq. Ft. Sq. Ft. Sq. Ft. Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: i %�(J R (yt a t -PI , Estimated Cost: $ Approx. Completion Date: 914 (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE:10 APPLICANT: Tel. # CITY USE ONLY Permit Fee $ D5 , Fee Schedule on Reverse Side 6 � Fire Surcharge $ , � -).001 of Permit Valuation (1/10th%)6` State Surcharge $ 7�2 _ ��-$.50/$1,000 Valuation ��3© SAC Charge $ — $800 per SAC Unit License Surcharge $ `j , nL-i$5.00 (State Licensed Residential Contractors) . � 3 Driveway Escrow $ Alt. "A" or Alt. "B" Above ) a� '� Erosion Control $ $450.00 Conservation Plan Review O Park Fee $ Fee Determined by Engineering �� Sewer Main Charge $ Agreement Necessary [ ] Not Necessary TOTAL STIPULATIONS: SUBJECT City of Fridley 2 516 AT THE TOP OF THE TWINS BUILDING PERMIT r I � COMMUNITY DEVELOPMENT DIV. L ------. PROTECTIVE INSPECTION SEC. -loll NUMBER REV DATE 7-8-98 PAGE OF APPROVED BY /---1 CITY HALL FRIDLEY 55432 612-571-3450 910-F15 JOB ADDRESS 7371 Melody Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 19 3 1 Melody Manor 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 784-7829 Y>.1C� Curtis Courne a 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Four Season Roofing & Remodeling, 7930 University Ave, Fridley 55432 795-9410 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20138780 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION It REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Remove and replace roof - (31 Sq) - tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. 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 1 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 $2,585 $1.29 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 PRO SIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- ST U TION R TH FIFORMANCE OF CONSTRUCTION. $74.75 KXM Fire SC $2.58 PLAN CHECK FEE TOT FEE (S4�r Licen Sc $ .00 $83.62 S NATUREOFCONT CTOR ORAUTHORIZED AGENT IDATEI N ROP VALID40T§b THIS IS YOUR PERMIT D a INSP BATE S,GNATURE OF OWNER I iF OWNER BUILDERI IDATEI NEW [ l ADDN [ ] ALTER [ J CITY, OF FRIDLEY SINGLE FAMILYAND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: -73-7 Effective 1/1/98 Legal Description: Owner Name & Address: 0 u r4:%s Cou.rnet, ca 137/ mefdb, Qr N,E, Tel. # 78i 7W 7 Contractor: Fou or Seas® �o�: ►� Re vn e%h� L . [. C a MN LICENSE # Address: _N30 U n,yrr S J', A,)e No 1=. Tel. # 795-7VIO Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DE1. SCRIPTION 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: RV Mo u t * IC 101400 o 0 je S Construction Type:kemoo'c'%leplace- Estimated Cost: $ U (Fee Schedule. on Back) - Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: �— Tel. # 715 - 1S`CITY CITY USE ONLY Permit Fee $ `7l Fee Schedule on Reverse Side Fire Surcharge $ �. S .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $�_c��� $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ J TOTAL $ STIPULATIONS: SUBJECT P City of Fridley 32614 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. v -------COMMUNITY DEVELOPMENT DIV. r E PROTECTIVE INSPECTION SEC. 1 ; CITY HALL FRIDLEY 55432 It'-"'11.� �'� NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/20/02 10B ADDRESS 7331 Melody Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15 3 Melody Manor 2nd SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE P Parviainen 7331 Melody Drive NE 763-784-0441 3 CONTRACTOR MAIL ADORES S ZIP PHONE LICENSE NO Minnesota Exteriors Inc 8600 Jefferson Hjq PO Box 266, Osseo, MN 55369 2877 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 391-5514 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION O ALTERATION n X REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reside House & Garage 9 CHANGE OF USE FROM TO STIPULATIONS Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions for this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in their application guidelines. Call for inspection of wrap before covering. Caulk and flash all exterior openings. Permit Inspection Cards Will Be Mailed SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF S R UPANCr LOAD 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 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 @ @ $7, 180 $3.59 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. 153.25 Fire SC $7.18 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTALFEE License C $5.0 0 169.02 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI PROP VALID ED THIS IS YOUR PERMIT J�E S.GNATURE OF OWNERJF OWNER BUILOERI IDATEI G IN So gA1E NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address:L�i Legal Description: Owner Name & Address:Tel. # 76 Contractor: �0MN LICENSE # 66 — d' Address: # 3 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: Construction Type: C- Estimated Cost: $ Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: -:�X, 0 d- APPLICANT: Tel. # J f Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fee Schedule on Reverse Side Fire Surcharge $ - / .001 of Permit Valuation (1/10th%) State Surcharge $ S-5 $.50/$1,000 Valuation SAC Charge $ $1200 per SAC Unit License Surcharge $ e;Za $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ (v - 0 STIPULATIONS: