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PRE 2010 DOCSDate: June 3. 1968 City of Fridley, Minae BUILDING PERMIT Builder C l emron , Inc. Address Address 701 Columbia Blvd. LOCATION OF BUILDING No. 7386 Street __.. Memory Lane —_ Part of Lot N9 Lot Block Addition or Sub -Division _ Me] orl y Mance 3rd - Corner Lot — Inside Lot __._ X Setback 35' —�_ Sideyard _.. 15' & 15' Sewer Elevation —.._ _ $72.5 _ _ ._ _ .._ __ 875.57 (App-rox.) Top of Footing DESCRIPTION OF BUILDING To be Used as: Dwelling Front _301 Depth 241 Height 201 Sq. Ft. 1440 Cu. Ft Att. Cara.gP _ _ Front 201 Depth 231 Height --10' Sq. Ft. X60._ Cu. Ft. Type of Construction Frame Est Cost _j24_&00.00 __ To be Completed 6 Months SEWER LOCATION — 121' S.W. of Manhole WATER LOCATION — 110' S.W. of Manhole V3 --21-k 91%2 In consideration of the issuance to me of a permit to cons a building describe eve, to do the proposed work in accordance with the description above o and in cc ` with all rovlsions of ordinances of the City of Fridley. G $100.00 Sewer. Connection Charge In consideration of the payment of a fee of $ AQ. 00_._.., 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 Ordinances. d' CLARENCE BELISLE NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Bronx. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA ffw�xOWNER'S NAME " Al BUILD ER ADDRESS ADDRESS::4ZZ//�-14L LOCATION OF BUILDING Nd. �, �� STREET PART OF LOT LOT �� BLOCRADDITION OR SUBDIVISION i' CORNER LOT INSIDE LOT_ _ SETBACK C �� SIDE -Y �j`��1� ��u '79 SEWER ELEVATION �� . i 8 l � ' � % (�P pox. o ��� Applicant attach to this form Two Certificates of Survey of -hot and proposed building location dra+*m on these Certificates. .. �.L 4 Nw-lol� DESCRIPTION OF BUILDING �' To be ed as ; Front ,0-6 Depth „1yLgsHeight ddE=:Z Sq. Ft. Iwo Cu. Ft. r Front�Q Depth eHeight ld Sq. Ft. Cu. -Ft. 00 Type of Construction4 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 this application are true and correct. 00, DATE 5� /40�� SIGNATURE (Schedule of Fee Costs can be found on the Reverse Of— �3-52) 6, r �j 879.01 City of Fridley Application for Plumbing and Cas Ming Perm Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number, Kind and Location of Fixtures $ — x $1.50 y5� — x $1.50 12 �° YF Z Z — x $3.00 C Z Z <_ O� J w O �nS Z z �O • F • N WATER HTR. GAS ELEG Base 1st Instal 2nd 3rd 4th • Future Connection Openings New Fixture, Old OpeningsSewer I Connected with El Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ............................ Water Heater (Up to 99,000 BTU) ...... New Ground Run Old Bldg. ............ Electric Water Heater GAS FITTING FEES: — x $2.00 $ — x $1.50 $ — x $1.50 $ — x $3.25 $ — x $3.00 $ x $3.25 $ _ s $2.00 $ NO. RATE TOTAL 1st 3 Fixtures ...... ................... x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. 1 x $5.00 $ 3.00 REPAIRS & ALTERATIONS—Refer to Code Description ................. ..............................$ TOTAL FEE $—, -& Location 7386 Memory Lane 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 fact and representations stated in this application are true and correct. Fridley, bUnn_ NOV 2 2 1968 19_ Owner Clem -Ron Builders Kind of Building F'ra= Used as Red dance To be completed about NOV 2 9 1968 Estimated Cost, $ O1dX-New. Building Permit No Permit No. Signe MINNEAPOLIS GA CO. Business Phone No ROUGH FINAL ---L/ / - ?i O - 7 y 42 City of Fridley Application for Ph=Wng and Crm Ming Perndt Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK -3 Number, Kind and Location of Fixtures Location / -7 PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... .............. — x $2.00 $ 110-00 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 $ 3 • o G New Ground Run Old Bldg. ............ �S$� $ cc z $200 $ GAS FITTING FEES: NO. RATE TOTAL Yn8 x $2.00 Z Z ,�lj,��l�� $ w ? �o • P • N WATER HTR. GAS EIEC Base 1st 2nd 3rd 4th • Future Connection Openings Connected with I sewer ❑ New Fixture, Old Openings Cesspool ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... .............. — x $2.00 $ 110-00 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 $ 3 • o G New Ground Run Old Bldg. ............ x $3.25 $ Electric Water Heater z $200 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ 02. V Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE O 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 fact and representations stated in this application are true find correct. / Fridley, Mnn_ ® —, 1969 G Owner (P 1-5e Kind of Building Y -Ze� ° Used as To be completed about Estimated Cost, $ Old—New. Building Permit No Permit No. Signe r . By Business Phone i ROUGH FINAL /& 42 Application for Power Plants and Healing, 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 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 BTL) ....................... 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE T0�5AL 1st 3 Fixtures ...................... x$ 2.00 $ Additional Fixtures ................. x .75 $ Gas Range to 199,000 ...... ....... x$ 5.00 $ JUR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL $ See Fee Schedule TOTAL FEE Dept. of Bldge. Phone 560-3450 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 g_4d correct. Fridley, Owner [ �a�G�� ®•—.� ✓U�' Kind of Building / Used as To be completed about i� Estimated Cost, $ S� Old-4.V�v . Building Permit No. ��/ a Permit No. &- !29— DESCRIPTION OF WORK HEATING or POWFA PLANTS -Steam, Hot Water, Warm Air No Trade Name �' Size No. Jzjle� Capacity Sq. Ft. E.D.RAZI!5��'70'Z7 BTU H.P. Total Connected Load �?/ © Kind of Fuel - BURNER — Trade Name 07% a Size No — Zaz Capacity Sq. FL E.D.R BTU H.P. (REMARKS—OVER) sR" N. WELTER HEATING CM 4637 CHICAsO AVE. By MI <e Business Phone No- ` d D•56 2 5 CJE7--7 -/-1 HEAT LOSS CAL//CULATIONS ,. `DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E, Construction No. Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Roof I Floor e No I&I—No 19_. Room Length �b Width / - Height - II J Fl.l ,t Windows and Doors—Crackage and Area Coef. I Width Height No. of Lineal ft. Area Noe of pa of p e lights of crack sq. ft. Infiltration ? J' 20 qO t zog. 3 3 Glass Coef. Btu Infiltration Exp. wall 2 / X - 37 il Glass Net exp. wall Int. wall 5� Exp. wall Ceiling y Net exp. wall Net exp, wall Int. wall Floor / 2 ac % Z Ceiling Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area % Fl. V, d • '.t rg Room I Length %,- Floor ?.o X It -- Height Windows and Doors—Crackage and Area WidthHeight No. of Lineal ft. Area No. of pane ofpane lights of )crack sq. ft. f S C) Total Btu. Required sq, ft. E.D.R. or sq. ins. W.A. Leader area F1.1 /;,-L oom I Length Width - Height S' = Windows and*Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Exp. wall 2 N' Net exp. wall Int. wall Ceiling Floor I Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area .> MINN.Jai Insulation [Sind How Applied `Room I Length ,/ Width P" Heiuht i Windows and Doors—Crrckage and Area r Coef. I Btu Infiltration ? J' Lineal ft. Area of crack sq. ft. 77T% 3 3 Glass a �� Exp. wall 2 / X - Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length �Width ?'& Height0l , Net exp. wall Int. wall Coef. Btu Ceiling Net exp. wall Floor / 2 ac % /0-3 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area % Fl. V, d • '.t rg Room I Length %,- Width// -- Height Windows and Doors—Crackage and Area WidthHeight No. of Lineal ft. Area No. of pane ofpane lights of )crack sq. ft. exp, wall (G� C ef.1 Btu Infiltration sl Z �( 7 b Class Ceiling 5-0 v A 5-0 Exp. wall 2 N' Net exp. wall Int. wall Ceiling Floor I Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area .> MINN.Jai Insulation [Sind How Applied `Room I Length ,/ Width P" Heiuht i Windows and Doors—Crrckage and Area r Glass Width No. of pane Height No. of of pane lights Lineal ft. Area of crack sq. ft. a G ,.I t; Ceiling r Floor - Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length �Width ?'& Height0l , Glass5- Coef. Btu Infiltration Net exp. wall Glass Ceiling Exp. wall _-fNet Floor exp, wall (G� Int. wall Ceiling Floor 0 3 ac' Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area -2- F1.113a 4971 Room I Length Width -7 - Heightrl�, Windows and Doors—Crackage and Area Wldth HelghI Nc. of Ltneal ft. Area No. of pane of pane lights of crack sq. ft. Infiltration r Glass f U Exp. wall bf;;� 1, Net exp. wall Int. wall Ceiling r Floor - Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length �Width ?'& Height0l , Windows and Doors—Crackage and Area Width Height No. of Lineal ft. No. of pane of Fane tights of crack Area sq. ft. • � �� � G r'� i t{ Coef. Btu Infiltration 3 Glass5- Exp. wall / L^ „,.< e Net exp. wall Int, wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq, ins. W.A. Leader area ••� 1 u n Room' Levegth jZ.�E Witith C? r Height Windows and Doors—Crackage and Area 6✓ Width Height No. of No. 1 of Dane of pane lights Width Height No. of Lineal ft. Area No. of of pane lights of sq. ft. crack iptan/e7 °t Coef. Btu Coef. Btu Infiltration Coef. 0 g .? Glassf— „- Zi Q 1 Glass Exp. wall 19 Exp. wall j , "` Int. wall Net exp. wall Ceiling Ceiling ,1! (( Int. will "-'y2. Floor ® -O a .0 r. Ceiling y Floor - --� v r - -- - --- 1 ----v--- - -- ----- Windows and Doors—Crackage and Area - ---v--- 6✓ Width Height No. of No. 1 of Dane of pane lights Lineal ft. Area of crack eq. ft. 0 °t Coef. Btu Infiltration p Coef. Btu Infiltration .? ` - - „- Zi Q 1 Glass Exp. wall 19 Net exp. wall Net exp. wall Int. wall Int. wall Ceiling Ceiling ,1! (( Floor "-'y2. Floor ® -O a .0 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area °,, F1 °U j4. Room I Length // -' Widifi /() -! Height 9 Windows and Doors—Crackage and Area "Y ,. Width Height No. of Lineal ft. Area No. of pane of Dane Ilghts of crack sq. ft. a .IU 6 Coef. Btu Infiltration p Glass I .? a Exp. wall Net exp. wall Int. wall Ceiling ,1! (( "-'y2. Floor ® -O a / & r. 6, Total Btu. ft. E.D.R. or sq. ins. W.A. Leader area SUBJECT PERMIT NO. City of Fridley 28442 570-3=4 THE TWINS BUILDING PERMIT RECEIPT NO. `v ______ COMMUNITY DEVELOPMENT DIV. SEC. 79eRA r PROTECTIVE INSPECTION � 1 . � L CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED Br 612-571-3450 910-F15 10/28/98 JOB ADDRESS 7386 Memory Lane 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 18 3 IMelodyManor 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Heidi Ferdinand 780-5558 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Ea leview Const. Inc. 2937 2 174th Ln NW Andover 55304 753-5469 20076043 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION a REPAIR 1:1 MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 22 S Tear-off 8 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED 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 80 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 1885 .94 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 OF CONSTRUCTION $59.50 Fire SC $1.88 PLAN CHECK FEE TOTALFEE 67.32 / GNATURE OF CON'RACTOR OR AUTHORIZED AGENT IDATEI n WHEN PROPE MVAC DATED THIS IS YOUR PERMIT L,G% S,GNATURE OF OWNERJF OWNER BUILDER) IDATEI BL G )NSP fjAT( NEW [ ] Length Width Height Sq. Ft. Effective 1/1/98 ADDN [ ] Width Height Sq. Ft. CITY OF FRIDLEY Length ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Type:� 7 Q Estimated Cost: $ ConstructionAddress: (Fee Schedule on Back) Driveway Curb Cut Width Needed: Legal Description: DATE: A47 APPLICANT: Tel. # Owner Name & Address: CITY USE ONLY Permit Fee Tel. #��� Contractor: Fire Surcharge $ MN LICENSE# DOO7Coy'-�3 Address: 7 iy' ` $.50/$1,000 Valuation 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 Width Hgt/Ground Sq. Ft. OTHER: Construction Type:� 7 Q Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: A47 APPLICANT: Tel. # CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ "%`1 $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ -j , �' $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 to TOTAL $ rA 11 SUBJECT City of Fridley =115 AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. (,o�/ r PROTECTIVE I = , 1 ".-Ii CITY HALL FRIDLEY 35432 "'j NUMBER REv DATE PAGE OF APPROVED BV 612-571-3450 910415 12/13/00 JOB ADDRESS 7386 Memory Lane NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 18 3 Melody Manor 3rd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert & Heidi Ferdinand 7386 Memory Lane NE 763-780-5558 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Panelcraft of MN Inc 3118 Snelling Ave S, Mpls., MN 55406 612-721-6628 2179 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 O ADDITION O ALTERATION Cj REPAIR O MOVE O REMOVE B 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. House numbers must be on structure before the final inspection is made. 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 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 $10,294 $5.15 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 OF CONSTRUCTION PLAN CHECK FEE TOT FEE Lice e)SC $5.0 $ 5.69 SIGNATURE OE CONTRACTOR OR AUT ORQEI O AGENT IDATEI HE PROP VALIDATED HIS IS YOUR P MIT 10 ` 11- BLD ,NSP ' DATE S,GNATURE OF OWNER Of DINNER BUILDER, IDATEI rA 11 a i.-. 6, 9 NEW [ ] Effective 1/1/2000 ADDN [ ] CITY OF FRIDLEY 612-572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction: Address: -73 L h Legal Description: Owner Name &Address: _ ,�2 /� eh� f7e-i a'i zo�e7 /­ O'/i-7g 'e7 d% Tel. # Zk3 - 7S'0 -,55.58' Contractor y_qn e 1 C o" tv t f e/ 10,44 jr e MN LICENSE # -2179 Address:_,3 / /8 Sn e Ili .ng y t. 6. 1n,016 MA; 55 q O bTel. # &/a -7 A / - % 6,a 8 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:_ v �O/« �' Estimated Cost: $ / "T E Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ =$ DATE: APPLICANT: Tel. # CITY USE ONLY - Call (612) 572-3604 for Permit Fees if mailing In application Permit Fee $ / ��, a.5 Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1100 per SAC Unit License Surcharge $ 57, D D $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 $ e--? /It) 1 STIPULATIONS: Building BUILDING Permit No.: ZM Inspections RESIDENTIAL APPLICATION Received By r�6 763-572-3604 CITY OF FRIDLEY Date"D: AUG 1120 1 763-502-4977 FAX EFFECTIVE 1-1-08 J DATE C a YOUR E-MAIL ADDRESS r r-1 Cs c ( ! Corn G t^o � SITE ADDRESS 3g [Q M�3 0r ULANI 1 lL C n LEY P1 II 5 71 e THIS APPLICANT IS: WNER ❑CONTRACTOR PROPERTY OWNER/ NAME: ' TENANT ADDRESS: ? r` CITY — I (,E STATEZIPsS9 32 PHONE: -7 (o3 m '7 9- 9 j NAME: ADDRESS: CITY STATE ZIP CONTRACTOR SUBMIT A COPY OF PHONE FAX YOUR STATE LICENSE STATE LICENSE # EXP DATE PROPERTY TYPE OINGLE FAMILY/NEW CONSTRUCTION SIZE-0 00 SF TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED JKWINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: R(Z'n1QCR,, Diwt4ci tndaw w&,OO SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. 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 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No OF WINDOWS �LO�C�ATION OR FOR NEW OPENINGS-DESCRIBE SIZE OF('hi 1 W ra 1?00 NA OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED ' NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: a ®�T THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due 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) R+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks oavable to: Citv of Fridlev 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 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 on site; that the work will be in accordance with the a proved plan in the case of all work which requires review and approval of plans. SIGNATURE OF7KMICANT PRINT NAME(� rl FQ,� Ino, nC) DATE APPROVED BYDATE —( (`� PLEASE NOTE: SMARATE PERMITS ARE REQUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK