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PRE 2010 DOCSBUILDING PERMIT Village of Fridley, Minn. ' $ � 2552 Date• ............................. Builder . 'i Address •� �... .aG: Address .................. ..................... i LOCATION OF BUILDING No.,'/....... Sfreet/jr,O,/!�.�r^,irl•:..!r,�'f'� r Part of Lot Lot ..... Block ....;F.......... Addition or Sub-Division . .... ,�, ........ Corner Lot ........,.... Inside Lot ............ Setback A*W' Sideyard ............. DESCRIPTION OF BUILDING To be Used as: ... ..... •� Front +o•,. Depth... Height Sq. Ft. Cu. Ft. .. .... Front . 140... Depth Height /#& .... Sq. Ft., . j1 J.—D, Cu. Ft........ . Type bf Construction Est Cost /4 a,...... To be Complt ted AI ... In consideration of the issuance to me of, a permit to construct the 'building des the proposed work in accordance with the description above set forth and in complian above, I agree to do with all provisions of ordin4nces of the village of Fridley. ..... a ., eration of the payment of a fee of $.,.'� .. , 'permit is hereby granted to to construct the building d addition Aexp4ress .. .. ..... . .. as described above. This con on that the personto whom it is granted and his agents, employees permit is granted upon d workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respecl Fridley, Minnesota regarding Iocation, construction, alteration, maintenance, repair and r i to the ordinances of oving of buildings with- in the village limits and this permit may, be revoked at any time upon violation of any f the provisions of said ordinances. . .. Building Inspector NdICE: Thls permit does not cover the construction, installation or alteration for wiring, I ifumbing, gas heating, sewer or,water. Be sure to see the Building Inspector for separate permits forthose Rome. iii City of Fridley 53-84-879.01 Application for Plumbing and Gan Rtting Permit Dept. of Bldge. Phone 560-3450 DESCRIPTION OF WORK 6351 NE. Monroe $t• Number, Kind and Location of Fixtures Location y G7 m 3 ' �F� x $1.50 ,i w x�^ 3� z�z o� �n -8z 8c �Z 5 Ox <3 J �°d (9 (�9 Sn Ute' Z �O • F • N WATER HTR. GAS ELEc Base 1st 2nd 3rd 4th • Future Connection Openings * New Fixture, Old Openings I Connected with Sewer ❑ Cesspool El 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: NO. 1st 3 Fixtures ...... ................... Additional Fixtures .................... Gas Range to 199,000 BTU .............. Replace (1) gas range REPAIRS & ALTERATIONS—Refer to Code x $2.00 $ x $1.50 $ x $1.50 $ x $3.25 $ x $3.00 $ x $3.25 $ a $2.00 $ RATE TOTAL x $2.00 $ x$.75 $ x $5.00 $ 3.00 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, A inn June 30 _ 3-97() 19_ Owner Wayne Whitehill Kind of Building frame Used as residence To be completed about 44Y 3, 1970 Estimated Cost, $10.00 O1dXNew. Building Permit No Permit No. ROUGH FINAL �l ! K Description ................................................$ TOTAL FEE $--- 3.00 42 7 SUBJECT PERMIT NO. City of Fridley 5 716 AT THE TOP OF THE TWINS B U I L D I N G P E R M I T t REC COMMUNITY DEVELOPMENT DIV. r i � PROTECTIVE INSPECTION SEC. t i � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/9/80 JOB ADDRESS 6351 Monroe Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15 7 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David M. Lenzmeier 6351 Monroe Street N.E. 574-9285 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. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK install basement (6 courses of block). under dwelling 9 CHANGE OF USE FROM TO STIPULATIONS WARNING SEPCRq r Beton digging call local utilities F-T00. t q f pE TELEPHONE - ELECTRIC - GAS Etc. Pt REQUIRED BY LAVA! B�N� ��RFp qND �© SIG�,SO l? %�Rw 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 ISTALLS 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 $1,00.0 $.50 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. $7.50 PLAN CHECK FEE TOTAL FEE ' 9 88 SIGNATURE OF CO TRACTOR OR AUTHORIZED AGENT (DATE) W N PROPE Y A D HIS IS\yYO�URR PERMIT CrTIN, f 000" 4�r_ f(0� SIGNATURE OF OWNER SIGNATURE OF OWNER I�OWNERB OERIDERI ATE) D INSP DATE 7 CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OWNER: _0b V'c d /q /I C K zm e— ADDRESS : 6, 3.!5;-1 go-,- ro e- -5,7/� TEL NO: b-,7-' - %� BUILDER: , 57�919? C- ADDRESS: . �. e - TEL NO: sAiyl e— Construction Location STREET NO: re3S STREET: Orve- T �� o LOT : /4 BLOCK . �_ ADDITION : Ch t /� �e, Corner Lot: Inside Lot: Setback: X Side -yards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. 'ALL DESCRIPTION OF CONSTRUCTION Front: v°Zf Depth:, C�,� 1 5 C� Square. Feet_ OL Cubic Feet: 0-L-vCjC/ Front: Depth: Height: Square -Feet: Cubic Feet: Height: 4Y% Type of Construction: Estimated Cost: $ i Wd To Be Completed: W Alt. A Alt. B Proposed Driveway width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET . 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 Stipulations: Pg_ -,.M 8 r. rD(_ • O V J q.gg SUBJECT PERMIT NO. City of Fridley 11=0 1987 AT THE TOP OF THE TWINS BUILDING PERMIT _ REC • ______ COMMUNITY DEVELOPMENT DIV. ~ -- PROTECTIVE INSPECTION SEC. r CITY HALL FRIDLEY 55432 NUMBER REV, DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/8/89 JOB ADDRESS 6351 Monroe Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 15 7 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David/Joan Lenzmeier 6351 Monroe Street N.E. 57479285 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 JJ ADDITION O ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 161 x 221 Addition to Dwelling; a 151 x 16' Garage Addition 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. Provide a hard surface driveway. 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 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 $15,400 $7.70 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $171.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $178.70 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLYALIDATED THIS IS YOUR PERMIT BLDG INSP CJ n TE SIGNATURE OF OWNER 0F OWNER BUILDERI IDATE) NEW [ ] City of Fridley Effective 5/1/88 ADDN R-1 AND R-2 ALTER [ ] Building Permit Application Ile ODnstruction Address: (�; 3,5-1 Legal Description: C h Ic Ig Owner Name a ODntr actor : Address: Tel. Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposoed canstruction drawn on it to scale. DESCRIFTIM OF IFIROVERM LMNG AREA. Length Width Height Sq. Ft. �J Zse GARAGE AREAgth _I� Width Height Sg. Ft. DECK AREA: Length Width Hgt/Ground Sul. Ft. MEL. Gbrner Lot [ ] I i Loth [ ' G Yd s k ��� sid�e�Ya hi �eeacs� '� Tripe of ODnstruction: )600Estimated Cost: Approx. Completion Date: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ t / Width + 6' See Back Page DATE : ` % 7 - � APPLICANT: Tel. # CLTY USE OMY Permit Free State Surcharge SAC Charge Driveway Escrow Park Flee Sewer Rain Charge TOTAL 3PIPOLMIDNS: 15calm d r P®C)a- saP PV.0t.'0A--L- 5 r)t.(-<)Fee Schedule on Reverse Side 5 0), 7z $.50/$1,000 Valuation 5 s95 per SAC Unit 5 Alt. OA" or Alt. "B" Above 5 Flee Determined by Engineering 5 Agreement Necessary I ] Not Necessary t ] ow Gb t2-C)C& �� c4l-X� I 1S, qoc, 0 RL'tj PURCHASE ORDERF 17285 ICIAIDEPARTIVI PURCHASED BY THIS NUMBER MUST APPEAR ON ALL CORRESPONDENCE SENT TO US THIS DOCUMENT GOOD FOR PURCHASES UNDER $1,000.00 ONLY SUPPLIER AVS LEa ZA Eju _ ADDRESS a e"o P -O �� 21 b Lk u A) �S _�� ` CITY OF FRIDLEY PHONE NO. � ` 6431 UNN. AVE. N.E. FRIDLEY, MN 55432-4384 CONTACT 612-571-3450 PAYMENT VOUCHER BY SIGNING THIS DOCUMENT BELOW I HEREDO AUTHORIZE PAYMENT AND THAT THE GOODS AND SERVICES HAVE BEEN RECEIVED OR RENDERED AND ALL CITY GUIDELINES HAVE BEEN FOLLOWED IN THE P EMENT OF THE BELOW STATED ITEMS. DATE D P E A DRIZE ACCOUNT OTY. UNIT PLEASE ENTER OUR ORDER FOR THE FOLLOWIN UNIT PRICE AMOUNT Oi f Qcv .5' Q AJOT dui - TOTAL y d 0 THIS AGENCY HAS AGREED NOT TO DISCRIMINATE IN HIRING PRACTICES ON THE BASIS OF RACE, SEX, COLOR, CREED, MARITAL STATUS, RELIGION, OR NATIONAL ORIGIN AND HAS AGREED TO TAKE AFFIRMATIVE ACTION TO RECRUIT MINORITIES AND WOMEN INTO EMPLOYMENT. IT ENCOURAGES FIRMS AND OTHER AGENCIES WITH WHOM IT PURCHASES PRODUCTS OR SERVICES TO DO LIKEWISE. EXEMPT FROM SALES TAX AS A POLITICAL SUBDIVISON OF THE STATE OF MINNESOTA CITY OF FRIDLEY NO. 8030301 WHITE, VENDOR - YELLOW, PURCHASING - PINK, ACCOUNTING - GOLDEN ROD, DEPT. HD. __1 NEW, ADM R-1 AND R-2 Effective 5/ Building Permit Application �/ (� / �Wtruction Address: 4egal Description: d1t 0 0 Wer Nam & Address: /) Toa k— Aen ?-/I, el ee- -Tel #_SDCI -%2 ps- Contractor: Attach to this application, a Certificate of survey of the lot, with the Proposed =Wtn=tiCn drawn on it to scale. '�) `* I , I zo , TO ,/ D. , I Livnc AREA: Iexqth Width Height Sq. Ft. GRRAGE AMM: Length Width Height Sq. Ft. DECK AREA: length Width 07HER: Hgt/Ground _ sq. Ft. Corner lot [ ] Inside Int Type of Construction: Approx. Ccnpletion Date: Ft. Yd Setback Side Yard Setbacks Estimated Cost: $ 13, Proposed Driveway Width If New Opening Is Desired: /)(-3 s $. Width + 61 See Back Page DATE: APPIZCAM: Tel. # Permit Fee $ State Surcharge SAC Charge Driveway Escrow $ Park Fee Si'IPUTATICNS: CPPV USE Fee Schedule on Reverse Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Rnineerjra sewer main Okirge Necessary trot Necessary 7 707AL Si'IPUTATICNS: AV I' Cz IVOYI-tA 1"q/ed 00- tvVCj1j whe�j C tj V b 4 //,Y _1F P te" 7 11 ws /0 ;w,e4es 4 13, pet, T), c v" p&r j, 011 SUBJECT P City of Fridley 27745 AT THE TOP OF THE TWINS BUILDING PERMIT r -RECOrT-NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. �/•f1(,lr� NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 9/14/98 JOB ADDRESS 6351 Monroe St NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15 7 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David & Joan Lenzmeier Same 574-9285 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house & garage (27SQ) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the 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 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 ISTALLS 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 $2,313.00 $1.16 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- $74.75 Fire SC $2.31 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEEFEE T07 $78.22 SIGNATURE OF CONTRACTOR OR AUTHORIZE AGENT IDATEI i EW THIS IS Rx IG• IqSO 0 AROPIVALIDA ZriATE SIGNATURE F OWNERoF OWNER BUILDERI ATEI 011 NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 4®� BUILDING PERMIT APPLICATION ConstructionAddress: -L� ,;�� Legal Description: Owner Name & Address: PjQILj �+�c0/9,yi e%,? r: -m e 1;ee- Tel. # Contractor: MN LICENSE # Address:��� �%G a1�a� �T�� Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF ENIPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. LengthWidth Hgt/Ground Sq. Ft. / p &rc Construction Type: Estimated Cost: $ c,)3J (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: J70- !y ` � APPLICANT: `: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side $ .001 of Permit Valuation (1 / 10th %) $ 1,16 $.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 [ ] g 178 - -;Ze2 suejECT P T�.O— city of Fridley 33025 AT THE TOP OF THE TWINS BUILDING PERMIT ` COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. RECEIPT NO. r E PROTECTIVE NUMBER REV GATE PAGE OF APPIIOVEO eY CITY HALL FRIDLEY 55432 763-571-3450 910 -FIS 8/29/02 JOB ADDRESS 6351 MOnroe Street NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. 15 7 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David Lenzmeier 6351 Monroe Street NE 574-9285 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 O NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct a 24' x 22' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARNING Before digging call for all utility locations 454-0002 REQUIRED BY LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAO 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 ISTALLS 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 $6,292 $3.18 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- $139.25 Fire SC $6.29 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE7148.69 AL FEE SIGNATUREOFCON-AACT-RRORATHORIZEO ENT iDATEi �ip EN PROP VALIQATfD THIS IS YOUR PERMIT 0 )r$-GNATUFIE OF OWNEAoF OWNER BUILDERS iDATE, BLD iN " r)ATE NEW (] CITY OF FRIDLEY Effective 1/1/2002 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction IV Construction Address: �3�� /'�/���r� �f(— Legal Description: Owner Name & Address: `�� Tel. Contractor. 0W h e y MN LICENSE # Address: 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 f' 317 DECK AREA: Length; ay—Width �� HgUGroundIrl2 "ZSq. Ft 5----�'� z3 OTHER: //��1 Construction Type: a" Estimated Cost: $ C oQ 5d Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ DATE: o Z APPLICANT: �' d ` en �/� e r Tel. # 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 $ �. CQ -j Fee Schedule on Reverse Side Fire Surcharge $ e g .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1200 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 [ J TOTAL 191/8-6-7STIPULATIONS: A BuildingBUILDING $ a,3J 5- `® Plan Review $ Permit No.: ` a Inspections Surcharge RESIDENTIAL APPLICATION License Surcharge Received By: 763-572-3604 $ CITY OF FRIDLEY $ D et'a4l I L 3 d'2001 DATE C-,�U 10 0( YOUR E-MAIL ADDRESS 4J5Ci--V\aa6 ari en(2J.[ DC • CZY1'1 SITE ADDRESS (Q -JS l Total Due THIS APPLICANT IS: ❑ OWNER ,60NTRACTOR PROPERTY OWNER/ NAME: ba �f1C� TENANT ADDRESS: �CITY STATE_ZIP 2 / `1 PHONE: Be 3 — S2- -52 ,S NAME: Renewal By Andersen CONTRACTOR SUBMIT A COPY OF STATE LICENSE #_ 1920 County Road "C" West YOUR STATE LICENSE ADDRESS: Roseville, MN 55113 r STATE ZIP WITH APPLICATION PHONE License #20130983 ❑ SINGLE FAMILY/NE1 PROPERTY TYPE ❑ TWO FAMILY/NEW G 651-264-4777 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.*'YN DjrArkO[n"� S �� N L 1� �r:' SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT* GAUGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used ❑SI DIN inyl ❑Soffit FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS & PORCHES SUBMIT• ❑ Aluminum ❑ Other ❑ Trim 1. Site PhudSurvey showing the existing structure ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ♦ i T --- ua. r cr o PU%M l6AArdJ IN VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 V1 B.0 FEE SCHEDULE) TOTAL JOB VALUATIONS f%PV1Tvswrry grvnv Permit Fee $ a,3J 5- `® Plan Review $ Fire Surcharge $3.- Surcharge $ („ License Surcharge $ 5, p p SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ t 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$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridlev Attar 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 i conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not permit 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 approve plan in the case of all work lich requm:= l of plans. SIGNATURE OF APPLICANT _ PRINT NAME _ _ &,CC�