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PRE 2010 DOCSCity of Fridley, Minn. WELDING PERMIT Date: .. � � ... ... `. ............ Owner Address !�Kv. ..`.-r.� N® 3586 Builder . ............ Address............................................. LOCATION OF BUILDING Street ...... !' . No. .010 . .4. ...... Part of Lot ............................... Lot . SYf .ick .q:�.`.!�:®.�..... ditio. n or Sub -Division ....................................... Corner Lot ............ Inside Lot Setback .:3 =. ®... Sideyard................ DESCRIPTION OF BUILDING To be Used as: 4 v4�...... Front . ..y ®4� Depth .. .�0.: Height Sq. Ft. 11Y . Cu. Ft. ..................... Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ........ Type of Construction ................... haat. Cost..................... To be Completed ................... In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. ..... `�'?z� .. � l.. .........��. In consideration of thea ent of a fee of p ym $.. A4::—:., 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 with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ... ..P....�..... ............... Building Inspector NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspe or_ for eeparate permits for these Items. Date: City of Fridley, Minn. BUILDING PERMIT OCTOBER 7, 1966 N9 9046 Owner: M S • MYLO W. PARKS Builder SAME —� Address 1341 MISSISSIPPI ST. R.E. _ Address FR.IDLEY. MINNESOTA 55421 No. 1341 Lot --- Corner Corner Lot Sewer Elevation To be Used as: LOCATION OF BUILDING. Street MISSISSIPPI ST. N.E. Part of Lot PARCEL, #2020 Block — Addition or Sub -Division _ ��:J AUD . SUB - # 10 Inside Lot — X Setback --_ Sideyard ._._ Foundation Elevation DESCRIPTION OF BUILDING MOVED GARAGE Front 16' Depth 24' Height 10' Sq. Ft. 384 Ca Ft. 3,840 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction — FRAME Est. Cost ._..._...$250.00 ___ Tobe 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 wi ons of ordinances of the city of Fridley. In consideration of the payment of a fee of $-.A-- 00 , permit is hereby granted to_ MRS. MYLO PARRS 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. CLARENCE BELISLE Building Inspector NOTICE This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be core to see the Building Inspector for separate permits for these Mena. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING n NO. STREET co S PART OF LOT LOTBLOCK ADDITION OR SUBDIVISION 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. DESCRIPTION OF BUILDING To be used as; i f � FrontDepth elf Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction 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. DATE SIGNATURE i 6I (Schedule of Fee Costs can be found on the Reverse Side). / - - - - -rc -10, to Application fOr Power Plank and Heating, Cooling. Ventilation. E anon and Air Cenditioning S"ns 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.W i Replacement of Furnace 6.00 Repairs & Alterations—up to $500.00 6.00 $ Repairs & Alterations each add. $500.00 3.W $ 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) ...... 6.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x$ 2.00 $ Additional Fixtures x .711 $ Gas Range to 199,000 x$ 5.00 $ AIR CONDITIOIIfI11G YFSchadule e,1, CD FAN HEATING SYSTEM See VEI11TILATING SYSTEM —� ALTERATIONS & REPAIRS TOTAL FEE $_ ROUGH FINAL %� Dept. of Bldgs. Phone 5110-3490 , r City of Fridley: t 1 M The undersigned hereby makes application for a permit for the work herein speciflec agreeing to do all work in strict accordance with the City Ordinance: and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, #4nn i . 19 _ Kind of Building ._ Used as To be completed aboutl�" _'_ - 7 f O Estimated Cost, Old- ew. Building Permit No. Permit No. i DESCRIPTION OF WORK HEATING or POWER PIAiNT3—Steam, Hot Water, Warm Air—No Trade Name Size No_ CapacitySq. Ft. E.D.R BTU HP. Total Connected Load Kind of get BURNER — Trade Name'' Size No Capaci f Sq. Ft E.D.R BTU IMP. P By "� Business NO -- rr' -0 ' -0 a Cd-, (REMARKS—OVER) City of Fridley r AT THE TOP OF THE TWIN$ I , r rL-------COMMVNITY DEVELOPMENT DIV. I MOTECTIVE W1 ftCTIOIr OW, l i r CRY HALL FRIOLRY 064E 53 9m 53 -8b -S-915.51 SUD ECT PLUMBING, PERMIT APPLICATION Job Address - 0 2115/73 1 1 1 800 13111 N. E. Mississippi Street Owner Address one M. TnT, Parks Contractor ,,,,-;'1SC0 73? /.:'I :,,.. Address �,,,.,r.. `L�� Pone Kind or building Use Frame Res. Comp etion Datestimate Cost 5-21-7l, 10.00 Plumbing Fixture Rates: NO. RATE TOTAL I f I W ffII II 1 I Number Fixtures x $2.00 Future Fixtures x $1.50 srfll E I I New Fixture -old Open. x $1.50 •lddY I I O Catch Bastn x $3.25 8Yfl i 1 Water Heater -99,000 BTU x $3.00 •oslwl I I I � II i I i� Ground Run Old Bldg. x $3.25 sad, 'MNIraI I I i II m Elec. Water Heater x $2.00 8N18r8I t r N N�ir�l I ( w Gas Fitting Fees: IO c I I 3 u i a 1st 3 Fixtures x $2.00 w a O u Io.0 I saaMalg Additional Fixtures x $ .75 �OQ '1NOOdI VNIaa i Gas Range -199,000 BTU x $5.00 NSVMI I A I I Repairs & Alterations See f •�"ISI I I i I Description: Install Gas Grill Code 5.00 I IJ I I I State Surcharge .50 I I TOTAL FEE $ 5.50 son.I I I I I !The undersigned hereby makes application for a permit s-IrNIa° I I I I I for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and Tulin gI ■,e■on aaivs► I I I____�__ of the Department of Buildings, and hereby declare that all'the facts and representations stated in this application are true and correct. 'Signature qp� �IF.Date 01 SUBJECT RM City of Fridley 18911 AT THE TOP OF THE TWINS BUILDING PERMIT r R COMMUNITY DEVELOPMENT DIV. // r PROTECTIVE INSPECTION SEC. jj C� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY l 612-571-3450 910-F15 4/29/87 JOB ADDRESS 1341 Mississippi Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION ATTACHED DESCR. 10 Aud. Sub, #10 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mrs. Parks 1341 Mississippi Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Heath -Construction 2531 Marshall Street N.E. 781--0056 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 1 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 201 x 2V Garage and a 10' x 241- Breezeway Addition 9 CHANGE OF USE FROM TO .STIPULATIONS Firewall between garage and breezeway required. 14 foot maximum height on garage. 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $10,200. $5.10 DOES NOT PRESUME TO GIVE UTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF O HE TA OR LOCAL LAW REGULATING CON- STRUCTION O E RF A E OF CONSTRUCTION. $86.50 PLAN CHECK FEE TOTAL FEE .2i $91.60 GN T Ed C AC OR ORAUTHORIZED AGENT ID EI WHEN PROPERLY ALIDATED THIS IS YOUR PERMIT r INSP f SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEIBLDG DAT 01 NEW [ ] ADDN. [ ] ALTER. [ ] Construction Address: Legal Description:_. Owner Name & Address: Contractor: e4 Address: City of Fridley Effective 4/1/86 R-1 AND R-2 Building Permit Application 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:%sm Corner Lot j ] Inside Lot [ ] / Ft. Yd. Setback Side Yard Setback Type of Construction: /�-�'��PaT Estimated Cost: $ Approx. Completion Date: T Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: -�� APPLICANT: /`'li�� ciJ�/�"�� Tel. Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side 25% of Building Permit Fee $•50/$1,000 Valuation $525 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] ('%`rt E ta.a *-LA_ %C?Wjrt jQ C ArZ-Ae— C -4 %2e4r 14 ' *14)6 C)pj cc) , zibo 00 CITY OF FRIDLEY Effective May 1, 1990 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE QESIDENTIAL RATE TOTAL Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range a Gas Dryer • Air Conditioning (all sizes) All Others/Repairs and Alterations 10 of Value of Appliance or Work COMMERCIAL/INDUSTRIAL It of Value of Appliance or Work $ 20.00 $ $ 10.00 $ $ 10.00 $ $ la. 00 $ 9 $ 10.00 $ State Surcharge TOTAL M Reinspection Fee ($15.00) Rough Insp. Date Final Insp. 8_ /+ Date Approval for Permit $ .50 $ \ Spn $ 15Sb Job Address \SSS 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. 1 19 OWNER KIND OF BUILDING M `f USED AS TO BE COMPLETED ABOUT ESTIMATED COST O C -D `U OLD - NEW BUILDING PERMIT NO. PERMIT NO. lac -IW DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. ON JUAV Trade Name Size No. MIAAegasco #342-5326 900 W. Linden Avenue Capacity p. 0. Box 1165 Total Connected load Minneapolis, MN 55440.1165 BURNER - Trade Name MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in ride yard without written permission from adjoining neulhbor. Sq. Ft. EDR BTU HP Kind of Fuel Size No. Capacity Sq. Ft. EDR BTU HP Company �f Te L. MWNEQA&C0 Fill out back side for stack verification on replacement furnaces CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes (,) 2. Is free from rust or deterioration Yes ( ) 3. Has no foreign objects lodged within Yes ( ) 4. Is securely supported Yes ( ) 5. Meets all current Code requirements for size and... total BTU connected Yes ( ) 6. Has Total heating BTUSs of All other BTU's TOTAL Remarks Company Signed By Date No ( ) No ( ) No ( ) No ( ) No ( ) SUBJECT PERMIT NO. City of Fridley k r19 4 3 -AT THE TOP OF THE TWINS BUILDING PERMITEC • COMMUNITY DEVELOPMENT DIV. ��, PROTECTIVE INSPECTION SEC. 0_0r � � t NUMBER REV DATE PAGE OF APPROVED BY i CITY HALL FRIDLEY 55432 IL-'"'� �'' 612-571-3450 910-F15 6/29/93 JOB ADDRESS 1341 Mississippi Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt. 13 Parcel 2020 Auditor's Subdivision #10 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE C Parks 1341 Mississippi Street NE 571-4135 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. American Remodeling 3700 Annapolis Lane, Plymouth MN 55447 553-0020 2406 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 Q. REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Install smoke detectors as per UBC 1210, adjacent to all sleeping areas and in basement. 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 80 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 1 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 $6,000 $3.00 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- $81.00 Fire SC $6.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE License SC $5.00 17 $95.00 L SIGNATURE OF CONT RACTOR OR AUTHORIZED AGENT IDATEI WH=OPER ALIDATED THIS IS YOUR PERMIT C ? L 13 UOG 540 OATS SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/93 ADDN [ ] CITY OF FRIDLEY ALTER[ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address:-- �J.0 �� i��O�o�i��O��- S Legal Description: Owner Name Address: -ice Tel, # Contractor:: 0'p -A MN LICENSE # Addressc.A ee Bu7TZ # 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. T DECD AREA: Length Width Hgt/Ground Sq. Ft. T OTHER: Comer Lot [ ] Inside Pt [ ] . Ft. Yd etback Side Yard Setthh�cks Type of Construction: AV /0"et-i-q ( " Estimated Cost: $ Approx. Completion Date: Driveway Curb Cut Width Needed: Ft. + 6 Ft = - " r z C� DATE: 4� ��5 -9:3 APPLICAN . CITY USE ONI Permit Fee . $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ ,00 $.50/$1,000 Valuation SAC Charge $ $750 per SAC Unit License Surcharge $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $_ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ 9, STIPULATIONS: za V"3 / ��'a C410-lf /'�' -A'r- cz�V-3 P, s SUBJECT PE RAM City of Fridley 29139 AT THE TOP OF THE TWINS BUILDING PERMIT ` RE T NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1715 1 CITY HALL FRIDLEY 55432 %'j NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 4/2/99 JOB ADDRESS 1341 Mississippi Street NE 1 LEGAL LOT N0. BLOCK TRACTOR ADDITION SEE ATTACHED DEscR. Pt 13 I Auditor's Sub. 410 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Camilles Parks 1341 Mississippi Street NE 571-4135 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 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW 0 ADDITION O ALTERATION .0 REPAIR 0 MOVE 0 REMOVE 8 DESCRIBE WORK Reroof House (20 Sq) Tear-off; Reroof Garage (8 Sq) 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Roofing can be the 2nd layer but not the 3rd. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 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 @2,229 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT W 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. 74.75 Fire $2.22 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL F $ .08 OF CON'RACTOR OR AUTHORIZED AGENT P P R L/I/QA/T/fE/J M IS Y PER IT ////•�/SIGNATURE ' LIDATTJEI S-GNATURE OF OWNEROF OWNER BUILDERI IDATEI SLOG NSP' TIATE� NEW [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY AL'T'ER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 c\ BUILDING PERMIT APPLICATION � !� ConstructionAddress: Legal Description: Owner Name & Address: Y K s 6,1 art e Tel. # Contractor: ®IV41 6—'Y MN LICENSE # Address: LIVING AREA: GARAGE AREA: ,,DECK AREA: OTHER: Construction Type: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length Length DESCRIPTION OF IMPROVEMENT Width Height Width Height Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = (Fee Schedule on BackT-�oc �9 Ft x $ = $ \// DATE:. —'L q7 APPLICANT: ITe1. # 61,2 �f/� �� — - CITY USE ONLY Permit Fee $ !'/I 'S Fee Schedule on Reverse Side Fire Surcharge $ c72 .001 of Permit Valuation (1/10th%) State Surcharge $ 1- $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ $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 $ STIPULATIONS: Building $ BUILDING See Back Page for Fee Schedule Permit No.: Inspections RESIDENTIAL APPLICATION urcharge Received By: 763-572-3604 (.0005) times the total job valuation — Minimum $.50 CITY OF FRIDLEY $ DWCbc'0. ATE / t 1 o YOUR E-MAIL AADDRESSS� ,k d i 5& t ( d t r wy s. e U /n �!TE ADDRESS Li / ! M / S 51 S / 51 / Y 5.00 THIS APPLICANT IS: ❑ OWNER nCO CTOR $ PROPERTY OWNER/ NAME: r urb Cut Escrow TENANT ADDRESS: 13Y 1 / " I / S S . SIL. CITY �% I 11 %1 S S /( i V STATE ZIP 3 rosion Control �n 7 PHONE: 1 3 J S O'2 - b 497 _ CONTRACTOR NAME:_ fHD At- Home Services, Inc. Jodi Bl F(d c r J o n4 S STATE LIC 2690 Cumberland Pkwy, Ste 300 g y A l 3 itS - G 0 t SUBMIT A COPY OF Cumberland Office Park YOUR STATE LICENSE ADDRESS CITY STATE ZIP WITH APPLICATION PHONE Atlanta, GA 30339-3913 'Q SINGLE Lic# 20268257 Ph. 763/542-8826 =E PROPERTY TYPE ❑ TWO FA ORIES PERMIT TYPE ❑ADDITION ❑ GARAGE/SHED WINDOWS I ❑ BASEMENT FINISH ❑ ROOF DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER - ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW 0 ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING )ESCRIBE WORK BEING DONE: I tj / n e -1-0f! n / S ( l D�l %I JZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. tOOFING ❑ HOUSE ONLY TUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 'ARAGES❑ATTACHED GARAGE 1. 2.Proposed Existing Floor Plan floor plan ROPOSED SIZE: ❑ DETACHED GARAGE 3. 3. List of structural members to be used ROPOSED HEIGHT: EDING FOR NEW CONSTRUCTION INCLUDING DECKS, 3 Vinyl ❑soffit ADDITIONS. & PORCHES SUBMIT: I Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures 3 Other ❑ Fascia and proposed project WINDOWS 2. Two sets of construction plans 4 E)asTING OPENINGS iMYes ❑No PCATION gF WINDOWS 3. Energy Calculations ,R FOR NEW OPENINGS -DESCRIBE SIZE OF LlyMq, P&4 -h. We) ' lr,?If hl o ,PENING CHANGES & YPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION S -7 L 0 (. OCCUPANCY TYPE =3it Fee $ I'S 3. P See Back Page for Fee Schedule [an Review $ 65% of Building Permit Fee urcharge $ 3 . 8 Y (.0005) times the total job valuation — Minimum $.50 ire Surcharge $ 7 . G 9, .001 x Permit Valuation (1/10%) icense Surcharge $ 5.00 $5.00 (State Licensed Residential Contractors) AC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) urb Cut Escrow $ ft + 6 ft = ft x $20 = $ rosion Control $ $450 Conservation Plan Review ark Fee $ Fee Determined by Engineering -wer Main Charge $ Agreement necessary ( ) Non Necessary ( ) otal Due $ Q. 7 Qr Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in mformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a trait 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 an in the case of all work which requires re e and approval of plans. GNATURE OF APPLICANI� ( � PRINT NAME (/ %� J t h 1 J) /c DATE 6 (� b