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PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT N 4 6 2 7) Date: .,F r Owner: __.-- .�. - ° ; Builder _._...... .__. _...._...._._...__.._..._. ._._.....—...._ Address _ _ _ x.. ,. Address 1 NO.:: !._.., Street _: LOCATION..E a-e�nPart of . t ....._....._..__.._.._...__.._..._....._..._.._. Lot ....._........_........ Block ....._... ..'�"......_......._....._; Addition or Sub.ivison ?.�_..... Corner Lot ..... _........_........._...... _ Inside Lot ...-....................... _........ Setback -& de d ....._..(' �'" Sewer Elevation ........................ _...___._..._...... _._____.__._......__.._.._._ Foundation evation. .................................. _. DESCRIPTION OF BUILDING Tgo-U, ....... Front ___.. Depth .--.. _..._.: Height .-..-- Sq. Ft..- .. .......... Fro t .. ...:._.. Depth .._ / Height � �_.. Sq. Ft... � ...:.. 4� . cu. Ft.Tnstru on . , :dl� Lite_....... Est. Co� .�`� .."" .---------- To be Complefted.............. ................................... 5!", _-1 •"�._,- THIS PERP,41iT 1., i ORIZE VIOLAT. ION OFANY Y p ;i rf,;-E i AND''COVENANTS AND SUILDHf G RESTRICTIONS. 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 all provisions of ordinances of the city of Fridley. 1,._...._.._.._..._.. .7 e7 V 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 attd workmen, in all work done in, around and upon said building, or an"art 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 and4lus permit may be revoked at any timq upo } violation -of any of the provisions of said ordinances. .t w, 94 iA Building Inspector 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 items. 4 I. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name ' s 1 //6, /'= Builder J-1 r.__ Address 6 �� /���% o = 0 Address LOCATION OF BUILDING No. ? � Street %,JjFc< Fart of Lot ),3 Lot Block Addition or Sub.Div. Corner Lot t-- Inside Lot____, Set Back Side -Yard SEWER ELEVATION _ 7 FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUnDING a T��� be used as: ° Front`, f� s, Depth G� height Sq. Ft. Cu. Ft. Sq. Ft. Cu. Ft. Type of Construction L&,.2 b Estimated Cost C To be The undersigned hereby makes application foxy 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 Piat all the 7f7 and representa- tions stated in this application are true andr-- ct. SIGNAT �� 1��,'A � (A Schedule of Fee costs can be found on the Reverse Side.) . .- . r « . • City of Fridley, Minn. BUILDING PERMIT NN® 3536 Date: .1A .. R . 9 .:..:5� .......... . Owner....................Builder .. .... .. ....... .............. Address...................................... Address .......................................... FF LOCATION BUILDING No. 4P. /.. ! J • . Street / . F�:.......... Part of Lot ................ ........... . Lot ..l®...... Block ........ ........ Addition or Sub -Division iCl. .. ... Corner Lot ............ Inside Lot X ........ Setback'.—..76-.. Sideyard ........... DESCRIPTION OF BUILDING To_be Used as: ... ...... FroutY:.l.: Deptle?'$�'.I. Height Sq. Ft. `Q Cu. Ft.��1 ........... V....... Front ........ .Depth ........ Height ......... Sq. Ft. ........ Cu. Ft. ........ Type of Construction ................. lit. Cost./. 0296. 7.. '. To be Completed .................... O In consideration of the issuance to me of a permit to construct bed above, I agree to do the proposed work in accordance with the description above set f9ftV5YXante with all 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 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. !- / ../,� ... 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 Inspector for separate permits for these Items. PERMIT for Power Plants and Heating, Cool- ing, Ventilation, Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of ry' , Heating Plants to b ins lle ltered—repaired Make Oil fired ; Coal fired—L ; Gas fired__Y ; Gas Authorization No. Remarks Approved by Final Inspection Date , 19_ Inspector Permit N° 4806 Fee Office of the Inspector of Buildings City of Fridley City of Fridley, Minn. Owner C� A/D, Location Kind of Building --- How Occupied it_t) Ajk dd e% Work to be Commenced—, 19— To be Completed ,19_ Estimated Cost, $ �&ew, Building Permit No. Permission is hereby granted to -ZL , i r1aAA I e 1) 7DD7&X ) to install—erect—use the material and devices described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specifications et forth in the approved application for this permit on file in the office of the Inspector of Buildings. -e )AIL L � 94 APb �) , Inspector of Buildings 42 2M 11-67 V Original PERMIT for Power Rants and Heating, Cool- ing. Ventilation. Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of ® pleating Plants to be'nsta d ltered—repaired Make , Size &: � / -/ Q ® ; Oil fired �f , Coal fired—L, Gas fired; Gas Authorization No. Remarks _ ' 1' 1° . iU, O - Ce a d.., Approved Final Inspection Date , 19_ Inspector ,5-0 3e Pent Fee 46'76 $ /� L� Office of the Inspector of Buildings City of Fridley City of Fridley, Minn., M2AeL , 19.20 Owner g2 - -r-In . `T 4,A a .1je Location Co 7 4f ✓ ) USIA • Kind of Building JAAWA-Q, How Occupied Work to be Commenced ---L-19_ To be Completed—, 19— Estimated Cost, $ 3 9'4'® Old -New, Building Permit No. Permission is hereby granted to ZZ — % x124 �,2-���1.@I X y� J-2toinstall—erect—use the material and devices described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specifications set for h in the approved application for this permit on file in the office of the Inspector of Buildings.Q ll % � I Inspector of Buildings ,. 42 2M11 -67V 1� Application for Power Plants and Heating, 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 BTU) ....................... 5.00 $ e over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 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 a f ' V S See Fee Schedule $ TOTAL FEE $ 1.30 10 Dept. of Bldgs. Phone SM -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 and correct. jFridley, Minn 9 19 ZY Owner Kind of Building 0 Used as To be completed about Estimated Cost, $ Old—New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No / f 60 Trade Name Size No./7(_114' Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load Rind of Fuel As(�4ea-4 BURNER —Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS—OVER) Signed w� " ° J��04A&k_ By ax Business Phone No- 7 SUBJECT PER City of Fridley 21116 AT THE TOP OF THE TWINS BUILDING PERMIT i ? R . 1 06Y COMMUNITY DEVELOPMENT DIV. III � PROTECTIVE INSPECTION SEC. � 1 = � { CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY .j 612-571-3450 910-F15 10/18/91 JOB ADDRESS 6741 Monroe Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED 10 4 Brookview Terrace SHEET DESCR. 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Donna Olson 6741 Monroe Street NE 571-5908 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Viking Home Improvement 4832 - A Street NE, Mpls., MN 55421 572-1820 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 ❑ ADDITION j] ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Remodel bathroom 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 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. 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 $5,250 $2.63 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 $5.25 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE so. 88 SIGNATURE OF CONT RACTOR OR AUTHORIZED AGENT IDATEI WHE ROPERLY D T IS YOUR PERMIT -0 +' DATE SIGNATURE OF OWNER Off OWNER BUILDER) IDATEI IT "5f TA ADDN [ J CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: / `7 /I/jG V ko e !lj C Legal Description: Effective 1/1/91 Owner Name & Address: / 6 N dZA i�) /-( 0 AO Tel. # S 71-5-i6? -5-i4 Contractor: VI;6 �/a UQAA 0 1771 J' 4 Y.P Mf -v � Tel .# S^ 7-2 - 2 U Address: Z IVE �v S 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 _ Type of Construction: i�4t/ oa44 12,e -*,W o Approx. Completion Date: /i- I S = 9/ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Side Yard Setbacks Estimated Cost: $ f-ZJ 6. a v Ft x $ cooe m art) DATE: f a %� " APPLICANT: Tel. # r7 Z 2-D Permit Fee Fire Surcharge State Surcharge $ 9/,00 $,a $ SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary ( ] CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas Gas Range Gas Dryer Back Flow Preventer Required ( )Yes () No Type $ 7.00 -� 6- G6 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance _ State Surcharge $ .50 911211&wl�" 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 Building Division. and hereby declares that all the facts and representations stated in this application are true and correct. //- 5 - 0 199 Owner e��6 e fj Building Used As Estimated Cost PERMIT NO. PLUMBING COMPANY i���-�' SIGNED BY �'Zz ems' TEL NO. Approved By Rough- n Date Final Date MINIMUM FEE FOR ANY PLUFABING/GAS PERMIT IS $15.00 TOTAL FEE $ PLUS THE $.50 STATE SURCHARGE Water Closet Bath Urinal Tub Shower Wash Drink. Floor Sink Tray Fount. Drain Catch Auto. Basin Washer Gas Gas Ap 1. Range Misc. Fixt. Water Heater Stories Gas lElec Basemen Floor 1 J Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas Gas Range Gas Dryer Back Flow Preventer Required ( )Yes () No Type $ 7.00 -� 6- G6 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance _ State Surcharge $ .50 911211&wl�" 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 Building Division. and hereby declares that all the facts and representations stated in this application are true and correct. //- 5 - 0 199 Owner e��6 e fj Building Used As Estimated Cost PERMIT NO. PLUMBING COMPANY i���-�' SIGNED BY �'Zz ems' TEL NO. Approved By Rough- n Date Final Date MINIMUM FEE FOR ANY PLUFABING/GAS PERMIT IS $15.00 TOTAL FEE $ PLUS THE $.50 STATE SURCHARGE Bu ding BUILDING Permit Nm-'Peb 5 Inspections RESIDENTIAL APPLICATION Rec ' Py 763-572-3604 : CITY OF FRIDLEY DateJ�!C°fl: 763-502/�-4977 FAX EFFECTIVE 1-1-09 fl, if y ®n�YOUR DATE E-MAIL ADDRESS SITE ADDRESS Wi o F THIS APPLICANT IS: OWNER fICONTRACTOR'%� PROPERTY OWNER/ NAME:— AME:TEN TENANT ADDRESS: CITY STATE ZIP lv PHONE: CONTRACTOR NAME: ,?/qV oil t -J f6 4 /r; SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # S'3 ! 9 EXP DATE AND CERTIFICATE OF ADDRESS: 9y / 1&e4� C'(,?-1MA- IFAI� CITY f1'?) 67240Y STATRW19-LIP INSURANCE PHONE Gr ,3' &'-;;' uz-S%O 3 FAX PROPERTY TYPE #SINGLE FAMILYNEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED XWINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK SIDING �� �`' ��,e .� ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION MAINTENANCE/REPAIR MODELING DESCRIBE WORK BEING DONE:_ SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT so FT ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY ❑ 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 11 Fascia and proposed project. 3 X �✓� Coifs rr 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS Yes ❑No LOCATION WWINDOWS % OR FOR NEW OPENINGS -DESCRIBE SIZE OF 5C> � '% (S xo OPENING CHANGES & TYPE OF, WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: TOTAL JOB VALUATION $ (USING SING THE 1997 U.B.0 FEE SCHEDULE) OCCUPANCY TYPE Permit Fee $ �r See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $10-150 , Make checks payable to: City of Fridlev Attach Stiaulations 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 approved plan in the case off 11 work y/vhi b)y requires review and approval of plans. SIGNATURE OF APPLICANT 1` PRINT NAME iJ� /G /� S jr DATE L7 SUBJECT P T NO. City of Fridley 2 9 330 AT THE TOP OF THE TWINS BUILDING PERMIT r � NO. COMMUNITY DEVELOPMENT DIV. - INSPECTION SEC. MaCEIPT r � PROTECTIVE _ CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF V APPROVED BY 612-571-3450 910415 4/28/99 JOB ADDRESS 6741 Monroe Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 4 1 Brookview Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE TrAvis/Cindy Story 6741 Monroe Street NE 574-2263 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Central Contracting ffi 10609 Meadow Lane, Brooklyn Park, MN 55443 5163 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 427-7787 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO e USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Cj REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof House & Garage (25 Sq) Tear-off; Install Bay Window 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 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 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 $7,912 $3.97 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. $ 137.25 Fie SC $7.94 T UCTION THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE Lic e SC $/-00 TO l FEE $154.1 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI HE PR V LI THIS I$ Y R BuBG INSo OaiE I S)GNATURE OF OWNERJF OWNER BUILDER) IDATEI L7 NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: _ Owner Name & Address: Contract Address: N J -I Effective 1/1/99 Tel. MN LICENSE # w �,6� ��7:2Tel. # p 7RD Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EUPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: '- A /Y2. Construction Type: A&7 tond,- Estimated Cost: $ 2' (Fee Schedule on Back) .Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: Y APPLICANT: �-�,_ �, ��✓ - Tel. U CITY USE ONLY Permit Fee r $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ 3 % $.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 Permit No:: h Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: I— — 763-5p0�2-4977 FAX EFFECTIVE 8-19-09 DATE i' � 52 � � YQll-MAIL A,?bRESS SITE ADDRESS L/0- %DTHIS � / THISAPPLICANT IS: ('OWNER `j- OCONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: c76 / lel<CF CITY l�i� i STATE SLIP S��3a PHONE: 763 S9 8Y0 CONTRACTOR NAME: SUBMIT A COPY OF y STATE LICENSE # c3 oZ /� EXP DATE 14 lb/0 YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE 0 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 ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH Al WIDTH 1 HEIGHT e9 S FT ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY ❑ 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, ❑ Virryl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other El Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE 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 1, 15 4- OQ')2;5 OCCUPANCY TYPE Permit Fee $ 5'7 o b _ See Back Page for Fee Schedule Plan Review $ Q 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ '� .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ G( (0 Make checks savable to: Citv of Fridlev Attach Stiuulations 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 approved plan in the case of,,all work w,4ich_Wyuires review and approval of plans. SIGNATURE OF APPLICANT L,y,�� �(/�Lffi'` PRINT NAME OP D"O A116'" DATE // `� _ 9