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PRE 2010 DOCSCity of Fridley, Minn. BUELDING PERMIT Date: ... JAg.24s.195.9................... owner....................................... Address...................................... N® 3968 Builder 137M.® ��II .. Address ............................................. LOCATION OF BUILDING No.. 36..... Street ... ?' Oe . Stt. if . A* ............... Part of Lot ............................... Lot .... 7 ...... Block ......... 3 ....... Addition or Sub -Division .. PM*F , T..3rA , 94R— Comer Lot ............ Inside Lot .... g...... Setback3%!9p ...... Sideyard ... ,10 Wo ................. DESCRIPTION OF BUILDING To be Used as: . ,VWel.UDg ....... Front . %+�.�ia� Depth .25W. Height 19V. Sq. Ft. . IM. Cu. Ft. ..X25 .................... Front ........ Depth ........ Height ........ Sq. Ft......... Cu. Ft......... Type of Construction ................... Est. Cost.....*1.Aj,9.64AQ... 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 ompliance with all provisions of ordinances of the city of Fridley. �—� a 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 ro 'ions of said ordinances. ding 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. Application for i Certtiicate o! uccupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued;. and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. jb Ad- 0 0 -up/a/ a� el Edam, Pawnsw fl hl Ov PW,6j.1da,,ay! x Poold hfflq AWiMl LW.7.WW.' 10%iau�ss�y!, jq!sIA //0 '1wvx1;%ftP'MPaq'xjrOP awep pul _,qjjP s.,uqpumq AaAjns-,v"# ua,1,v1uOSa& aqljll v pw Vjl 0 sl rqL F_ Nx 7 40 //v A 7- AaAxns Uleorl ase ;x0 - 9JOAOA in gJaOul 51001-P 0 PNII 91 N' 1 1 "R. N I E) N' 02 sYa'A'Ouw-Y z� /S'L'uDld PU07 7L119"_4P PZ rJAIM G7Y0F FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 . (612) 571-3450 • FAX (612) 571-1287 October 13, 1992 Dawn Locker 6856 Monroe Street N.E. Fridley, MN 55432 RE: Property at 6856 Monroe Street N.E. . Dear Ms. Locker': This letter is to confirm the information which I provided to you in our recent telephone conversation. At that time, we discussed the regulations pertaining to home occupations permitted in residential district*. I have enclosed a copy of this portion of the Fridley Zoning Code for your review. As I indicated in our conversation, Fridley City Code 214 (copy enclosed) limits signage in residential districts to one wall sign up to a maximum of 3 square feet in area. Presently, you have a sign located near the curb advertising your daycare. In accordance with the Code requirements, it is important that this sign be removed immediately. f"-;- During ayDuring our discussion, you indicated an interest in applying for a variance to permit your existing signage. I have enclosed a variance application form along with the schedule of upcoming meetings. If you wish to pursue this option, please complete the application. form and return it with a check for $60.00 (non- refundable fee) to process the application. Feel free to contact Michele McPherson at 572-3593 if you have questions about the variance process. I will be reinspecting this property on or shortly after October 21, 1992, at which time full compliance is expected. Please call me at 572-3595. if you have questions or wish to discuss this further.. Thanks for your cooperation. Sincerely, Steven Barg Planning Assistant SB:ls CE -92-507 DATE: May 31, 1996 6 �N MEMORANDUM HOUSING DIVISION TO: Lori Manzoline, ACCAP FROM: Grant Femelius, Fridley HRA SUBJECT: Dan and Dawn Locker Today Dawn Locker stopped by our office to obtain information concerning the City's fence and driveway regulations. During her visit, she alerted me to the fact that the contractor, Traditional Tile & Remodeling, failed to obtain a building permit for the rehabilitation work. I informed her that the contractor was responsible for obtaining a permit. I also stated that his failure to obtain a permit may result in additional fees or penalties. Please notify the contractor of the permit issue. Due to the contractor's negligence, I believe he should not be reimbursed for any permit fees or penalties related to this project. Also, because the scope of work for the driveway will be less than originally bid, I would ask that the contractor provide a revised cost figure. If you have any questions or comments, please feel free to call me at 572-3591. cc: Dan and Dawn Locker ,Ron Julkowski, Chief Building Official ST AL SUBJECT P City of Fridley 24262 AT THE TOP OF THE TWINS BUILDING PERMIT f RECEIPT NO. • ______ COMMUNITY DEVELOPMENT DIV 1 V PROTECTIVE INSPECTION SEC r 1 NUMBER REV DATEPAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/12/96 JOB ADDRESS 6856 Monroe Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 7 3 I Brookview Terrace 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dan/Dawn Locker 6856 Monroe STreet NE 571-6486 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Traditional Tile & Remodeling 110 132 Ave NE, Blaine MN 55434 755-6386 6862 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 ❑ ALTERATION ❑ REPAIR X ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (18 Sq) 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 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 $1,485 @ $ 74 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT • DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE Inv. Fee SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $4850 $48.50 Fire SC $1.49 STRUCTION OR T E PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE �- License SC $5.00 $104.23 SIGNATURE drcONTRACTOR OR AUTHORIZED AGENT L I ATE) WHEN PROPERLY LIDATE THIS IS YOUR PERMIT 1-00 - BLD INSP r e, to I, DATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY ALTER [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: J 7— Legal Legal Description: Owner Name & Address: />G� /�� js(�/��i� Tel. # Contractor: Zy?�e7err(jyU1AC "-le Ir MN LICENSE # ®®o Address: SCO " f 3 ,� N -L -Z v)L6e, Tel. # Attach to this application, a Certificate of Survey of the Lot, with the proposed construction drawn on it to scale. DESCRIPTION OF R"ROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: ` ,,, �'i4r xGP i^ /V 7 z-oew "Z.or, Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction:, , rm ?czVr �/mc Estimated Cost: $ a i Approx. Completion Date: 5— (Cost on Back) Driveway /Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: C� APPLICANT: �_ Tel. # 1 10 CITY USE ONLY Permit Fee $ 7 Fire Surcharge $ 1 State Surcharge $ SAC Charge $ License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge STIPULATIONS: Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $900 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 [ ] SUBJECT NO. City of Fridley 30973 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r 1 PROTECTIVE 1 ; � CITY HALL FRIDLEV 55432 NUMBER REV DATE PAGE OF APPROVED By 612-571-3450 910-F15 5/23/00 JOB ADDRESS 6856 Monroe Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. 7 3 Brookview Terrace 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dan/Dawn Locker 6856 Monroe Street NE 763-571-6486 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 ❑ ADDITION ❑ ALTERATION] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace windows 9 CHANGE OF USE FROM TO STIPULATIONS 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 $500 $ ro 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 TOTAL FEE $24. 0 N6,GNATUPA OF COWAACTOROR AUTHORIZEO AGENT (DATE. ENP OPERLY IOATED TH S YOUR PERMIT V TUR WNt1 )WNERIFUILDERI IDATEI NSP gAtl NEW [] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Effective 1/1/2000 (763) 572-3604 Bldg Insp C /\` Arol Legal Description: Zoo- % z31 ,ocle c3 Owner Name & Address: ay f 04w,v z®C`E/L Tel. # 763-S71-6 Contractor. 'E Aif 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 DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: Construction Type: Gc!l%v,Ovr•J ce z,P'-1T Estimated Cost: $ 50yi-IcAc Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: APPLICANT: Tel. # CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ �2 3o5® 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 $ $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 $ Q.4Ia J STIPULATIONS: RMIT NO. SUBJECT City of Fridley E 9, AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • _____ COMMUNITY DEVELOPMENT DIV. L - PROTECTIVE INSPECTION SEC 3 gl r 1 � � NUMBER REV DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/30/97 JOB ADDRESS 6856 Monroe Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 3 Brookview Terrace 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dan Locker 6856 Monroe Street NE 571-6486 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Durabilt Assoc Inc 7343 Ann Court, Eden Prairie, MN 55346 938-9350 3004 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 WORKXQ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 36' x 24' Garage 9 CHANGE OF USE FROM 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 $15,828 @7.91 W 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- $ 237.25 Fire SC $15.83 STRUCTI OR THE ERFORMANCE O CONSTRUCTION PLAN CHECK FEE TOTALFEE d License SC $5.00 $265.99 SIGNATURE FCONTR Ct OR AUTHORIZED AGENT RATE WHEN�PRRO/PERLY LID TED THIS IS YOUR/PERMIT BLD INSP GATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI ' RMIT NO. NEW ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: _ Legal Description: Owner Name & Address: Contractor: (� Address: -73 q-� A L OS6 Mom . �4 )4�,) Nw,) -IO Z- Effective 1 / l /97 Oct 39 �1 d �-f �ovu Tel.#__�-(��8�p MN LICENSE # 3�Te1. # 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. 112 - GARAGE AREA: Len / �� c?, � 3 Width � Height �' Sq. Ft. - i�'�z--X Ir DECK AREA: Length Width Hgt/Ground Sq. Ft. = 7" OTHER:LV Construction Type: Wa)d` �� Estimated Cost: $ 9) (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = S DATE:APPLICANT• - Tel. #� Permit F X31% ,S Fire Sur harge /.56.3 State S charge 9 SAC harge Lice e Surcharged Driv ay Escrow Erosi n Control Park Fee Sew r Main Charge jT TAL STIPULATIONS: X71 CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $950 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 2C 5" n [ ] $ ,Z W. SUBJECT PERMIT NO. City of Fridley 32047 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. `COMMUNITY DEVELOPMENT DIV. v______ r PROTECTIVE INSPECTION SEC. 572-3604 NUMBER REV DATE 7/31/00 PAGE OF APPRO ED By CITY HALL FRIDLEV 55432 L 612-571-3450 910-FIS JOB ADDRESS 6856 Monroe Street 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DescR. 7 3 Brookview Terrace 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dan & Dawn Locker, 6856 Monroe St., Fridley, MN 55432 763-571-6486 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Dan &Dawn Locker 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 Basement - 3/4 bath 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 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 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 $1950 hM WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $.75 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- $54.00 Fire SC $1.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE $56.25 SiGNATUREO CONTRAC OR AU RIj DAGENT iDATE� W�HENJ�p`ROPER%LY�VALIDATED THIS IS YOU PERMI J 7-P-1-0i / / -PL1 - 0/ $,GNAT E O_ OWNEF ,OQ BUILOERI iDATEi SLOG iNSP OA E W. NEW I l Effective 1/1/2001 ADDN [ J CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: Contractor. Tel. #-7(o 3 Jr/2Z_ (a M G 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. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: WSOW7 Construction Type: 4!.Estimated Cost: $ 1.5-00 ®® Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ =$ DATE: APPLICANT: CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $—' CO Fee Schedule on Reverse Side Tel. # Fire Surcharge $ ,,�;C .001 of Permit Valuation (1/1 Oth%) State Surcharge $_ $.50/$1,000 Valuation SAC Charge $ $1150 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: .A CpTY OF'FRIDLEY INSPEC•I1UN DIV. 6'W University Ave NE Fridley, MN 55432 763-572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RAwov wu IRADCO nC CIVTI IOCO Tn GC IAICTAI 1 FI1 nN GoP_N 1=1 f1PAR Effective On Jan 1, 2001 PLUMBING FIXTURE RATES: NO. RATE TOTAL 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 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 PRA1.111P Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 0� 1.5% of Value of Fixture or Appliance State Surcharge $ -50 TOTAL FEE $ 3Z,50 JOB ADDRESS �o � YM ZW,2 Ok S i 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. 7� .208% Building Used As 1A om 'e_ — Estimated Cost e*mPERMIT NO.__L:3 :3 / /?C) - � PLUMBING SIGNED Approved By Rough -In Date Final Date COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE i3 " ':< ::y {:yr�`z•,r•;:.. Wash :::<>:: �.�. <,:::>:>{>:: Floor :�::.}•.}:. Auto. ;:a#{ 'mss;:»::.�.:..: Gas ;Water Heater +wUrinal 111-ag-1.1 vvy; 'i`:} : Shower :}}'• JFI{ :';< Tray .l�����•�•�'•�'••••',•,if ii„�.:Y•yr,{�: Drain I#itir... �:: Washer ` :: Ran a > ti .Stories Gas Elec .., a.✓.•Fr :::?;ir: .}.,.... ��}• Basement :{her:::•}: 4:{{:•Y.:eN::•}W. :: rF. •?•.v::: '•:'•::v.::::.r.:::::•::::. :: ..•{,vv;:i: ii;: •.. ri :.: :,'s-'i,'•itii n:F:.:•:.:::.:..:.ice; FloorI-<.....:...-r d.. ii iQ{L:;�}ii: ..}/v,{ is:::::::iii;::: Floor :::.:::.::<.:.v: :.:R . i :.:....::...... Floor 3 :::•:.}:..:....::.:: ::.r..........r..: Vii:•»:•}}}}:{{•i:•:•: v::: •:}:.: Floor - PLUMBING FIXTURE RATES: NO. RATE TOTAL 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 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 PRA1.111P Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 0� 1.5% of Value of Fixture or Appliance State Surcharge $ -50 TOTAL FEE $ 3Z,50 JOB ADDRESS �o � YM ZW,2 Ok S i 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. 7� .208% Building Used As 1A om 'e_ — Estimated Cost e*mPERMIT NO.__L:3 :3 / /?C) - � PLUMBING SIGNED Approved By Rough -In Date Final Date COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When installing a new ventina system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height _ Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date: G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 November 26, 2001 Mr. Dan Locker 6856 Monroe Street NE Fridley, MN 55432 Re: Final Inspection at 6856 Monroe Street NE Contractor: Standard Heating & Air Conditioning Co Dear Mr. Locker: Permits were issued on June 21 and July 31, 2001 to install a furnace, air conditioner, and three plumbing fixtures at your address. According to both the 1991 Uniform Mechanical Code and the State Plumbing Code, a final inspection shall be conducted on the work authorized by these permits. As of this date, no final inspection has been called for. The permit fees that were paid cover the inspections to make sure the work was completed according to the Codes. We will keep your permits open for another 30 days and if we do not hear from you within this time to set up the inspection, we will expire the permits and no further action will be taken. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh CITY OF FRIDLEY-INSPECTION DIViSION 6431 University.Ave NES Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 763.572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner Also Replacement Furnace (Side Vent Fill Out Back) Gas Piping (Needed with -new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning All .Sizes All Others/Repairs & .Alterations (LIST ON BACK) 1% of Valueof Appliance or.Work Commercial/Industrial 1.25% of Value of Appliance or Work JOB ADDRESS Effective 0n'January 1, 2001 ti OWNER_ L�� Rate TOTAL BUILDING USED AS Oe S"tP C""� $ 30.00 $.-�: ESTIMATED COST PERMIT.NO. $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ No.:of Heating Units Circle One (Steam) (Hot Water) �rA' $ 10.00 $ Trade NameL Size No. �J3 BTU HP EDR $ 25.00 $� ®� Fuel Total Connected Load Burner Trade Name Size No. $ BTU HP EDR State Surcharge TOTAL FEE MINIMUM FEE FOR ANY,HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ . .50 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 an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correctDATE: 5TANDARA FI.TING A AIR CONDITIONING CO. HEATING CONil 410 WEST LAKE STREET -2998 Signe 824-2656 TEL # Approved B Rough -In Date Final Date 'li® 01?_ BACK SIDE MUST BE FILLED IN ON VENT SIZE, VENT CONNECTORS AND COMBUSTION'AIR VERIFICATION COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes-( ) No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( No( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes O No ( ) Is the common vent and vent connectors. sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes ( )No(') Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date: March 30, 2006 TO WHOM IT MAY CONCERN: DAWN LOCKER AT 6856 MONROE ST i I SUSAN TREUCHEL GIVE DAN AND G�LTRFAC RIDLEY, MN X5432 PERMISSION TO ADD A HARD�D ME TO THE F E FOOT EASE TO EXTENSPASS THE THREE PROPERTY LINE ON THE NORTH SIDE OF THEIR HOME. � �1� t 3uilding BUILDING Permit No.:JRQ lad Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: )ATE ,�[- /Q .O(p YOUR E-MAIL ADDRESS JTEADDRESS i#PLAZA. fY►®nrlfte,gr— A .HIS APPLICANT IS: OWNER PROPERTY OWNER/ NAME: bp I ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR -,Na ADDRESS: � - 5� CITYf m..� STAiO ZIPgcJ� TENANT TOTAL JOB VALUATION $ OCCUPANCY TYPE PHONE: 1(4:4:1 $ See Back Page for Fee Schedule CONTRACTOR NAME: 65% of Building Permit Fee Fire Surcharge STATE LICENSE # 1AA EXP DATE Surcharge SUBMIT A COPY OF STATE LICENSE Ul%vYOUR ADDRESS: $ CITY STATE ZIP WITH APPLICATION PHONE FAX Curb Cut Escrow PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE Erosion Control $ ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS $ ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE 1512 Make checks payable to: City of Fridley Attach Stipulations ❑ DECK ❑ SIDING OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR A REMODELING DESCRIBE WORK BEING DONE: 1',U �r C &P L' SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia WINDOWS IN EXISTING OPENINGS ❑Yes ONO LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS I ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ 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 $ $15 0 per,§AC Unit (Plans to MWCC for determination) Curb Cut Escrow $ Z�Z —' ft _ J Z ft x $2p = $ t52 Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 1512 Make checks payable to: City of Fridley Attach Stipulations 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; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT bU.liP I) _ PRINT NAMEbN_%I i DATE:g )�Jve� U-6 At Building $ BUILDING Permit No.: 0U_X Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION Fire Surcharge Received By: ►'-Q 763-572-3604 CITY OF FRIDLEY $ Date Rec'd: G!� —®� License Surcharge $ DATE" — 7 YOUR E -Mr ADDRESS SAC Charge SITE ADDRESS $1550 per SAC Unit (Plans to MWCC for determination) o THIS APPLICANT IS: WNER ❑CONTRACTOR �� �- ft + 6 ft = --- ft x $21 = $ X IZ X PROPERTY OWNER/ NAME: ) & e_ Y, $ TENANT ADDRESS: I& ,Ela _ Sr" CITY STATE L0P $ PHONE: U CONTRACTOR NAME: Agreement necessary ( ) Non Necessary ( ) STATE LICENSE # EXP DATE Total Due SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE—ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used 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. 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 ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ 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 e-0 License Surcharge $ $5.00 (State Licensed Residential Contractors) ye �%��" SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) o Curb Cut Escrow $ �� �- ft + 6 ft = --- ft x $21 = $ X IZ X 7 = Erosion Control $ $450 Conservation Plan Review AV Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks pavable to: Citv 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; that the work will be in accordance with the approved plan in the case of all wor hich requires review and approval of plans. SIGNATURE OF APPLICAN PRINT N DATE 6- From: City of Fridley To: 586-0617 Page: 213 Date: 8/141200611:23:43 AM Building BUILDING Permit NO Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604CITY OF FRIDLEY DateRecd: 1.4 DATE—`tSl�l YOUR E-MAIL ADDRESS -Def/.. Ilr-Ad.. SITE ADDRESS '� THIS APPLICANT IS: \# OWNER EiCONTRACqOR PROPERTY OWNER/ NAME: C)AkN 4- ADDRESS:I09su CITYz�, dl,,_ STATILWZIP, L TENANT PHONE - CONTRACTOR NAME: STATE LICEN EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE—ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE kl SINGLE FAMILY N SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN ME ❑ DECK 11 SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK- ❑ NEW ❑ ADDITION MAINTENANCE(REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: �� �/ o a%t2'A=" Veoft o, n;a SIZE OF IMPROVEMENT LENGTH 2 WIDTH Il., ' HEIGHT % . Ft. ?% ROOFING O HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2. Existing Floor Plan Proposed floor Plan PROPOSED SIZE: O DETACHED GARAGE 3. List of sauctnral members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ADDITIONS. & PORCHES SUBMIT: 13Alumirmm rTj: 1. Site Pkn trvey showing the existingstructures1P Other scia and Proposed Project. 2. Two Stas of construction Plans VOWS 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 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 -�?®®C OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Dae $ log -Z:5- $ Z5$ do $ $ $ See Back Page for Fee Schedule 650/6 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 navable to: Ciitv of Fridlev Attach THIS 1S 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; that the work will be in accordance with the approved plan in the case of all wo quires review and approval of plans. SIGNATURE OF APPLICA PRINT NAME DATE _DATE/�n 3uilding BUILDING Permit No.: inspections RESIDENTIAL APPLICATION Received By: 763-572-3604yCITY OF FRIDLEY Date Rec'd: )ATE/G YOUR E-MAIL ADDRESS ;ITE ADDRESS 1UlN V-C,e_ < At e4t. HIS APPLICANT IS: "J� OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: C-asw&�. i W— —Q / ADDRESS: 4::&L." Imm r se -5 CITY /%`-�� fLAo STATE IP TENANT PHONE: 1017,:5711 a- re 7110 CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE—ZIP— TATEZIPWITH WITHAPPLICATION PHONE FAX PROPERTY TYPE INGLE FAMILY/NBW CONSTRUCTION SIZE TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED DOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWDVIMWG POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR 9 REMODELING DESCRIBE WORK BEING DONE:S\ r e *_-,a r l ya 5s dmjyL L,aa)6p 3 SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS IN MaSTI NG OPENINGS WYes ❑No LOCATION OF WS 3. Energy Calculations OR FORNEW OPENINGS -DESCRIBE SIZE OF % l3%} X10 OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS uX ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ '?iQtf' 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) $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 Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information 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; that the work will be in accordance with the approved plan in the case of all wor ich requires review and approval of plans. ' � SIGNATURE OF APPLICANT PRINT NAME i Xad-y L Zr'UI DATE 0019( / 6® FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 BUILDING PERMIT APPLICANT: PROPERTY OWNER I - oE understand that the State of Minnesota requires that all residential building contractors, remodelers and roofers obtain a state license unless they qualify for a specific exemption from the licensing requirements. As the owner of the property ate�b,� �� Fridley,I am exempt from the state licensing requirement only if I am not building or improvin this property for purposes of resale. By signing this document, I attest to the fact that I am improving this house for my own use and do not intend to sell it. I hereby claim to be exempt from the state licensing requirements because I am not in the business of building or remodeling on speculation or for resale and that the house for which I am applying for this permit, isl the first residential structure I have built or improved in the past 24 months. I also acknowledge that because I do not have a state license, I forfeit any mechanic's lien rights to which I may otherwise have been entitled under Minn. Stat. 514.01. Furthermore, I acknowledge that I may be hiring independent contractors to perform certain aspects of the construction or improvement of this house and I understand that some of these contractors may be required to be licensed by the State of Minnesota. I understand that unlicensed residential contracting, remodeling, and/or roofing activity is a misdemeanor under Minnesota law, and that I would forfeit my rights to reimbursement from the Contractor's Recovery Fund in the event that any contractors I hire are unlicensed. I have also been informed and acknowledge that by listing myself as the contractor for this project, I alone will be responsible to the City of Fridley for compliance with all applicable building codes and city ordinances in connection with the work being performed on this property.