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PRE 2010 DOCSDate: Owner: Address Oct. 10. 1968 Vern Johnson City of Fridley, Minn. BUILDING PERMIT Builder Clemron, Inc. -V-Ve u N° 9976 Address 4411 Central Ave. N. E. LOCATION OF BUILDING No. 7380 _Street Memory Lane _ _ ._._... Part of Lot Lot Block 3 Addition or Sub -Division .____Melody Manor 3rd Addn . Corner Lot __ Inside Lot X Setback 35' _ _ _ Sideyard 10' & 5' Sewer Elevation -- 871.9 9 874.99 Top of Footing DESCRIPTION OF BUILDING To be Used as: Dwelling Front ^ 48' Depth 25 ' Height 2 0' Sq. Ft. 1200 Cu, Ft, 24 , 000 Garage Front 20' Depth 24' Height 104 Sq. Ft. 480 CtL Ft, 4800 Type of Construction Frame Est. Cost -- 8, 000 __ To be Completed SEWER LOCATION - 11' S. W. of Manhole WATER LOCATION - 0' from Manhole In consideration of the issuance to me of a permit to �onset a building the proposed work in accordance with the description aboort and iid cc ordinances of the city of Fridley. II II // I agree to do provisions of In consideration of the payment of a fee of $ 43 !00., "t is hereby granted to Clemron, Inc. to construct the building or addition as descri above. This permit is granted upon the express condition that the person to whom it is granted and his ag , employees and workmen, in all work done in, around and upon said building, or any part thereof, shall co orm in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, main ce, repair and moving of buil within the city limits and this permit may be revoked at any time upon violation of any of the provisions idsik ordinances. NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to no the Building Inspector for separate permits for these Item APPLICATION FOR BUILDING PERMIT CITY -OF FRIDLEY, MINNESOTA LOCATIONBUIL E ADDRESS ADDRESS • NO.STREET PART OF LOT LOT BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT /,�' SETBACK O SIDE Y 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 be used as: ( I Front- DepthgS(� Height_ 0 Sq. Ft. Cu. Ft. Front �-- Depthgy- LHeight Sq. Ft. Cu. Ft.. d O G� Type of Construction Estimated Cost -101 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 SIGNATUREzo 0 (Schedule of Fee Costs can be found on the Reverse Side). f City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK {% P -o Number, Kind and Location of Fixtures I'O�hOn ! 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 all the facl and representations stated in this application are true and correct. Fridley, Minn �12- lk le Owner 06t Ivo`'' - Kind of Building (2c"-�s I • Future Connection Openings wnneciea wun Sewer [] Used as # New Fixture, Old Openings Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: W TOTAL I IA Z Z�-K�3: I <K Z ON C Z 1 I J <* O I 7 M J &7 q 0 Z 0 < 0 Z Z a o'a •R •N WATER NTR. GAS ELEC. Base 3.00 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 0o 1st 3 Fixtures ......2-. ................. x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ 2nd _ 3rd - — 4th - - 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 all the facl and representations stated in this application are true and correct. Fridley, Minn �12- lk le Owner 06t Ivo`'' - Kind of Building (2c"-�s I • Future Connection Openings wnneciea wun Sewer [] Used as # New Fixture, Old Openings Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures .... . ... .......... / x $2.00 $ 2 .0 v Future Fixture Opening .. ......... . x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin .... I .. ........ x $3.25 $ 3.00 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 0o 1st 3 Fixtures ......2-. ................. x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description.................................. .............$ TOTAL FEE $ To be completed about WAMA Estimated Cost, $ _ Old—New Building Permit No �l 1 Permit No. Signe By ? - Business Phone No ROUGH FINAL .2 ti �tt Application for Power Plants and Heating. eating, Cooling. Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY 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 $ MECH. WARM AIR GAS FITTING FEES: NO RATE 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. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 $ Each add. 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 BTU) ....................... 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAI, 1st 3 Fixtures ...................... x$ 2.00 $ _� Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL See Fee Schedule $ TOTAL FEE $— Z Dept. of Bldas. Phone 560-3450 City of Fridley: The undersigned hereby makes application for a permit for the work hereir. 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. . 4 r0( Owner Kind of Building `�/�✓� Used as � X44111 1 To be completed about Estimated Cost, W. Old— e : Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWE TS --Steam, Hot Water, —No / Trade Name C�2 Size No Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load- 1� Kind of Fuel®� BURNER — Trade Name !� `G fi. —Size No- Capacity Sq. Ft. E.D.R �' BTU H.P. (REMARKS -OVER) RACY N. WELTER HEATING on - Signed 4637 CHICA1313 AVE. B &M&AMMs li T — « Business Phone No- ' n_"e� CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer * Air Conditioning (all sizes) All Others/Repairs and Alterations 1% of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 1% of Value of Appliance or Work Reinspection Fee RATE TOTAL $ 20.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $16-oo $ 10.00 $ State Surcharge TOTAL FEE ($15.00) Rough,*Insp. Date Final Insp. Date Approval for Permit r MINIMUM FEE FOR ANY HEATING PERMIT IS 4.00 PLUS $.50 STATE SURCHARGE $ Attach stack verification form with replacement furnace permits *Air Conditioners can not be placed in side yard without written permission frcm adjoining neighbor. Job Address 7380 NE Memory Lane Ettective Aug, 1, 1981 Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn. 19 Aug88 , 19_ OWNER HaX-3.2n 03rcm 8784-2476 KIND OF BUILDING Frame USED AS Res TO BE COMPLETED ABOUT 19 Aug ESTIMATED COST 300, OLD - NUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name Capacity Size No. Sq. Ft. EDR BTU HP Minnegasco #342-5'J. Compan 700 W Linden Avenue s ea p. 0. Box 1165 Minneapolis, MN 55440-1? Tel. No. SUBJECT PERMIT NO. `-"', City of Fridley 22732 AT THE TOP OF THE TWINS BUILDING P E R M .F0"r COMMUNITY DEVELOPMENT DIV. _ L PROTECTIVE INSPECTION SEC. 077(,/,L CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By 612-571-3450 910-F15 7/219/941 JOB ADDRESS 7380 Memory Lane NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 3 SHEET Melodv Man 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Harlan Olson 7380 Memory 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Metro Siding Inc 2750 Nia r 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. B USE OF BUILDING Residential 7 CLASS OF WORK ❑� ❑ NEW ❑ ADDITION ❑ ALTERATION X REPAIR O MOVE ❑ .REMOVE X B DESCRIBE WORK Reside House & Garage 9 CHANGEOFUSEFROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. 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. I 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $6,500 $3.25 PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHE ATE OR LOCAL LAW REGULATING CON- UCTIOIR OR THE PERFORNARISE OF CONSTRUCTION. $90.00 Fire SC PLAN CHECK FEE TOTAL FEE $5.00 License SC $104.75 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WPROP Y VA ,d�ATED THIS YOUR PERMIT N BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ j Effective 1/ 1/94 ADDN [ J CITY OF FRIDLEY ALTER SINGLE FAMILY AND DUPLEXES R -I AND R-2 Building Permit Applicationa777 Construction Address: / 3VO /We o 9 �- 'Legal Description: Owner Name & Address: ,�„ Q /S�nI Tel. # Contractor.:' d' cl; MN LICENSE # liz Address: �.SZ� t� 'r'c'� � Tei.. # �S.�'7 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 Setbacks Type of Construction: U `Kcjt Si'J,`kq GLw\ Y°M Estimated Cost: $ Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: 20-i c Ft. + 6 Ft = Ft x $ _ $ ST DATE: 7- APPLICANT: R�� Tel. # 7 CITY USE ONLY Permit Fee s $ C� C'e C,� Fee Schedule on Reverse Side Fire Surcharge $ �� �' .001 of Permit Valuation (1/10th%) State Surcharge $ _�,2--� r $.50/$1,000 Valuation SAC Charge $ $800 per SAC Unit License Surcharge $ L' L" $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 $ /Of . STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1997 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOBADDRESS 39 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, Burner – rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ representations stated in this application are true and correct. (Side Vent – Fill Out Back) 6cf- (s - 1997 Gas Piping (Needed with new furnace) $10.00 $ OWNER. oa.,.. ®��, �� �l - � Y7b Gas Range $10.00 $ BUILDING USED AS Gas Dryer $ 10.00 $ ESTIMATED COST _ 5� ��, ao PERMIT NO. *Air Conditioning – All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs R Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ No. of Heating Units_ Circle One (Steam) (Hot Water) it Trade Name — Size No._3m.4 Commercial/Industrial BTU- H EDR ✓� 1.25% of Value of Appliance or Work $ Fuel _ Total Connected Load . State Surcharge $ .50 Burner Trade Name Size No. r BTU TOTAL FEE ?s$ 5, MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining. property owner. HP EDR HEATING COMPANY ST o Signed By_, Tel No. Approved By Rough–In Date Final Date FILL OUT BACKSIDE FO STACK VERIFICATION ON REPLACEMENT FURNAC 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 ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CHIMNEY AND STACK VERIFICATION 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 ( ) 5. 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 ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: SUBJECT PERMIT NO. City of Fridley 28448 AT THE TOP OF THE TWINS BUILDING PERMIT ' ,23694 RECEIPT NO. CDMKAUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. I S CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY j 612-571-3450 910 -Fl S 110/28/98 JOB ADDRESS 7380 Memor Lane 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 1 3 IMelodyManor 3rd Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Harlan Olson 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Scharacon Construction 16700 N Hillcrest Ct Eden Prairie 55436 949-8668 20103863 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION JEk REPAIR O MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage (23 S Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 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 2471 $1.24 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 TH& PE ORMANCE OF CONSTRUCTION $83.25 Fire SC $2.47 _�� PLAN CHECK FEE TOTALFEE ZtFio_is nse SC 5.00 91.96 SIGNATURE 67ON7RAZIefttYR AUTHORIZED AGENT IDATEI WHEN PROPERLY V LI DATED THIS IS YOUR PERMIT � INSP pA(E SIGNATURE O. OW NERiIF OWNER BU4DERI IOATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: O E Legal Description: F Owner Name & Address: Tel. # Contractor:,�'!•{C.T' vAl MN LICENSE # Zd I OS Stp3 Address: 3 /y10 Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT 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: Do-rf Estimated Cost: $ 2 Y ySQ� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: APPLICANT: Tel. # TOTAL $ �y STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ 2 y $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ cep $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 $ �y STIPULATIONS: Building BUILDING Permit No.: R � 4 Inspections 763-572-3604 RESIDENTIAL APPLICATION Received B . CITY OF FRIDLEY �"c;P Z009 763-502-4977 FAX EFFECTIVE 1-1-08 DATE - � YOUR -MAIL ADDRESS SITE ADDRESS D g7 THIS APPLICANT IS: ❑ OWNERCTOR PROPERTY OWNER) NAME: TENANT ADDRESS: 73 ?4 CITY STA T$�'�'/ t'I.ZIP / PHO V - o� NAME: CONTRACTOR ADDRESS: q74 CTf / STATLyinZII'/ SUBMIT A COPY OF PHONE , 'J —a �L FAX YOUR STATE LICENSE STATE LICENSE # `T 3 EXP DATE PROPERTY TYPE ❑ SINGLE FAmILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION 13 REMODELING �,AgN"CE/REPAIR - DESCRIBE WORK BEING DONE: /1.�1dZc.Ol-C,Q 1A2 ¢�.t.Z - VW SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S FT ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: I. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 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 I. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia 2. and proposed project. Two sets of construction plans WINDOWS i��-C•�-�^ ^„7 3. Energy Calculations IN EXISTING OPENINGS Xes ONo LOCATION OF OWS —� ,�� /� 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: 2 USING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $3i S66 • OCCUPANCY TYPE Permit Fee C Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due 7r�7 $ �'`7 • Sa _ 3 r�o $ l�"1S $ 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= Rx$21=$ $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 ve 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 eustarud 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 ' with the approved pl =this of all work which requires vuew an apprVX SIGNATURE F LIC RINTNAME DATE q' r' / APPROVED BY DAT'- 13 ©�