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PRE 2010 DOCSCity of Fridley SUBJECT P 17 2 8 3 AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. J r PROTECTIVE INSPECTION SEC. r P.). 1 CITY HALL FRIDLEY 55432 L J\ NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 10/'11/83 JOB ADDRESS 6530 Oakley 610�blm_ N. E. 1 LEGAL LOT NO. BLOCK TR ACT OR ADDITION SEE ATTACHED DESCR. N. 811 8$ Second Revised Aud. Sub. #21 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Burns 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Tekton Inc. 9516 Tyler Street 786-9315 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 I NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 42' x 26' Dwellin g and a 24' x 24' Garage 9 CHANGE OF USE FROM TO STIPULATIONS AGREEMENT signed 9/29/83. Paid $500 Park Fee (Rec. #10970) 9/29/83. Provide a hard surface driveway. Provide sod in the front and side yards. Provide City with copy of verifying survey before capping. SERER LOCATION: Approx. 8' Deep In Streets 711 N. of M.H. (Inv. 866.28) Wye Elev: 866.00 TOP OF FOOTING: 869.00 Minimum WATER LOCATION: 65' N. of M.H. DRIVEWAY DEPRESSION ESCROW: Surmountable Curb but recommend additional depression. - CIT1' OF FRIDLEY HOES NOT GUARANTEE yft �� G ACCURAC"' OF UTILITY LOCATIONS AND ELEVATIOPi , digging call local 'i"ks DAIA IS FOP INFOWv%ATION PUI;POSES ONLY ANDBefore utilities PERSON: G M USING MOULD VERIFY THE INFORMATIQU TELEPHONE - ELECTRIC - GAS Etc. ,-M THE sITL REQUIRED BY LAW 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 $59,100 $29.55 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- $313.00 STRUCTION OR THE PERFOP�OCE O CONST UCTION. $425.00 PLAN CHECK FEE TOTAL FEE �%e&j ^ $845.80 SIGNATURE OF CON ACTOR OR AUTHORIZED AGENT IDATEI v WHEN ROPERJY V. D EDTlj3j IS YOUR PERMIT 'GSP' nATE SIGNATURE OF OWNER 0F OWNER BUILDERI (DATE) 01 CITY OF FRIDLEY APPLICATIVI FOR RESIDENTIAL BUILDING PEFU41TS (New, Alterations, Additions, or Repairs) OWNER: e-Z4� ADDRESS: TEL N0: STREET NO: 6'6 /G STREET: Effective Aug. 1, 1981 BUILDER:70- 2;V ADDRESS: :LI'6 %�Z-e/2 TEL 110: i VS f. Construction Location A/ 8i LOT: BLOCK: ADDITION: A a� ' erilYa d �?� Corner Lot: Inside Lot: Setback.: Sideyards: Ap,plicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRI�TIQR OF Front:- COI-ISTPIJCTION Depth: Height: Square Feet: Cubic Feet: Front: � Depth: Height: Square Fent: Cubic Feet: _ s�.`a /o iX,$.6�= 91aS.3z-+ lto(v)e39.4t �i3,&sz.v t sxx 41 Type of Construction: A100A a2��A?e Estimated Cost: $ Tb Be Clompleted: Alt. A Alt. B Proposed Drivet;ay Width If New Opening Is Desired: SEE ISVF.RSE SIDE OF SHEET 2be undersigned hereby makes application for a permit fcr the r.,ork herein specified, agreeing to do.all work in strict accordance with the City of Fridley Ordinances acid rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. D,%TE- 9 /;Zo/s� S��IGNATUIE: Stipulations: �� / GCo �'AJ 313. oo \ �-ee`d 16990 /��j Ty o9.cr 'all C)•. .S M 1 I 1 C)'nSZ, o LP N 14 ry (� U+ l.Jl .5-- r. e4 r C'j i N cppn to {i�l 0 S r CA �� J I- D N �� ♦� 0.0 •�-L Pa^a? I�Ilogr5 got►pnb ss "INuO%sa io-1 va aull tb-d CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PLUMBING FIXTURE RATES: RATE SCHEDULE NO. New Fixtures Future Fixtures 18 Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Hydraulic Valve Sump or Receiving Tank Water Treating Appliance Hot Water Heater Gas Range Gas Dryer RATE $ 5.00 $ 3.50 $ 1.50 $ 4.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 7.00 $ 5.00 $ 10.00 $ 10.00 TOTAL ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 18 of Value of Fixture or Appliance $ State Surcharge $ .50 Reinspection Fee $ ($15.00) TOTAL FEE Effective Aug. 1, 1981 Job Address 6-5-3e 0i fC %sf Department of Buildings 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, Mn. I-(/. y • 17 , 199!�F OWNER O `"' 0 111 4 e o C KIND OF BUILDING 1� USED AS TO BE COMPLETED ABOUT ESTIMATES COST OLD-(NEGI/BUILDING PERMIT NO. PERMIT NO. 0/19/ �� Company h. //6 h 62✓✓L �c , Signed ByCV Tel. No. '211- 7 2 7 ROUGH INSP. Date FINAL INSP. ll -;7- I' ` U'-3 Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE X m Water w a� ��, 1q M 8 , u 1 w w �C°y Heater 4 G e t N .0 4i 0M1 04 M 0 3 4 o 49 g v 3 o lec v�l u a ani u a t3 s R R RI lat 2nd 3rd 4th (R) - Future Connection Opening Connected with Sewer (*) s New Fixture, Old Opening Water PLUMBING FIXTURE RATES: RATE SCHEDULE NO. New Fixtures Future Fixtures 18 Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Hydraulic Valve Sump or Receiving Tank Water Treating Appliance Hot Water Heater Gas Range Gas Dryer RATE $ 5.00 $ 3.50 $ 1.50 $ 4.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 7.00 $ 5.00 $ 10.00 $ 10.00 TOTAL ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 18 of Value of Fixture or Appliance $ State Surcharge $ .50 Reinspection Fee $ ($15.00) TOTAL FEE Effective Aug. 1, 1981 Job Address 6-5-3e 0i fC %sf Department of Buildings 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, Mn. I-(/. y • 17 , 199!�F OWNER O `"' 0 111 4 e o C KIND OF BUILDING 1� USED AS TO BE COMPLETED ABOUT ESTIMATES COST OLD-(NEGI/BUILDING PERMIT NO. PERMIT NO. 0/19/ �� Company h. //6 h 62✓✓L �c , Signed ByCV Tel. No. '211- 7 2 7 ROUGH INSP. Date FINAL INSP. ll -;7- I' ` U'-3 Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE Effective Aug. 1. 1981 CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE � �� LK/PSS �/�• RESIDEtrTLAL RATE TOTAL Job Address ffJ Furnace Shell and Duct Work, Burner (Also replacement furnace) $ 20.00 $ vC7<®� Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Gas Piping $ 10.00 $�G,�� Tel. #571-3450 (piping needed with noir furnace) Gas Range $ 10.00 $ 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 Gas Dryer $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. • Air Conditioning (all sizes) $ 10.00 $ Minn. AcIvo 3 /Fridley, 7d k" /7� SCh cae� All Others/Repairs and Alterations OWNER li of Value of Appliance or Work $ 7/h e KIND OF BUILDING of COMMERCIAL/INDUSTRIAL USED AS _ 1t of Value of Appliance or Work S TO BE COMPLETED ABOUT State Surcharge TOTAL FEE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 PLUS $.50 STATE SURCHARGE S .50 Attach stack verification fozm with replacement furnace permits *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. ESTIMATED COST OLD NEW ILDING PERMIT NO. PERMIT NO. 860 �2 DESCRIPTION OF FURNACE/BURNER 1 HEATING or POWER PLANTS, Steam, not Water, Harm Air- No. tk4�101 e2 C� Trade Name IV� r 117e o/ size No. Capacity ®/ ®®® Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuels �• �3 S BURNER - Trade Name 500"e Size No. Capacity Sq. Ft. CDR BTUiU HP Company i `' "� H o �✓�y e Signed By �f Tel. No. Y Z -7 FRIDOF LEY CIVIC CENTER • 6431 UNIVERSITY AVE. N.E., FRIDLEY. MINNESOTA 55432 • PHONE (612) 571-3450 August 2, 1984 Mr. John Hitchcock Tekton Inc. 9516 Tyler Street N.E. Blaine, MN 55434 Re: Final Inspection at 6530 Oakley Street N.E. Dear Mr. Hitchcock: A final inspection was conducted on July 17, 1984 of the above address and the following items were noted which must be completed before the structure can be finaled out: 1. Complete the installation of the house numbers. 2. Install guardrail and handrail on stair from garage to house basement. 3. Install fire alarm in basement. 4. Cover strofoam insulation in basement with 1i inch sheetrock. 5. Install joist hangers on deck joist. 6. Secure telephone wire to house. We will expect the above items to be completed by August 20, 1984 and a reinspection called for to determine compliance. If you have any questions on these items, please feel free to contact me at 571-3450. Si ncer , 0 , DAR CLARK Chief Building Official DGC/mh SUBJECT P City of Fridley ` s 9HE TWINS �-19' • ____ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. ---,•j CITY HALL FRIDLEY 55432 l 612-571-3450 BUILDING PERMIT 8 2 8 2 4 4 NUMBER 910-F15 REV DATE 10/14/98 PAGE OF APPROVED BY 10B ADDRESS 6530 Oakley ;$)$Drive NE I LEGAL I LOT NO. N 811 BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. f 8H I I Sec. Revised Aud. Sub. #21 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jerry & Bonnie Burns 571-3817 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Ron Miller Const. Inc. 953 Mississi i St -Fridley - 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 Rx REPAIR ❑ MOVE ❑ REMOVE ❑ NEW ❑ ADDITION O ALTERATION 8 DESCRIBE WORK >j Reroof house and garage 23 S Tear-off; Reside house and garage 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. Call for building wrap inspection before izHx-ix covering. 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 AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SO. FT CU FT 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED VALUATION SURTAX WITH WHETHER SPECIFIED HEREIN OR NOT THE GRANTING OF A PERMIT 5171 $2.58 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- PERMIT FEE SAC CHARGE STRUCT N OR THE P FORMANCE 9F CONSTRUCTION $112.25 ire S 5.17 AM PLAN CHECK FEE AOTA;LFp 1 .00 SIGNATURE Of CON' OR AUTH 2ED AGENT IDATEI NMOP�= Bl0 IS YOUR PERMIT Tl E SIGNATURE OF OWNER,lf OWNER BURDERI iI)ATE, NEW (] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Q�e� ConstructionAddress: Legal Description: Owner Name & Address: Jle rr / Tel. # `S-)/- 3971 i J Contractor:�` /�j, / py (Ir�� L �� ,� ,�/ MN LICENSE # Address: �,' il�l�rlff�d° �J i�Jly Tel. # 7/-3.�7�/ 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: f _ Construction Type: Estimated Cost: $ C' �44- (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: - - APPLICANT: ,1�� L 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%) $.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 [ ] 1 SUBJECT , City of Fridley 30989 AT THE TOP OF THE TWINS BUILDING PERMIT r � RECEIPT NO. � `� ______ COMMUNITY DEVELOPMENT DIV. SEC. �T[ r PROTECTIVE INSPECTION 1 . � CITY HALL FRIOLEY 53132 NUMBER REV OATE PAGE OF APPROVED By L 612-571-3450 910-F155/30/00 10B ADDRESS 6530 Oakley Drive NE 1 LEGAL LOT N0.BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. N 81' of Second Revised Auditor's Sub. #21 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gerry Burns 6530 Oakley Drive NE 763-571-7341 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Betz Construction 371 Julep Ave N, Lake Elmo, MN 55042 651-735-4330 20095268 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 Construct a 16' x 20' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. V Before digging call for all utility locations 454-0002 IRA E Q U I R E D B11 IF LAW SEPARATE PERMITS ARE REOUIREO 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDI NCE: GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $3,008 $1.50 WITH WH T ER SP "ED OR NOT. THE GRANTING OF A PERMIT O GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE HER STATE OR LOCAL LAW REGULATING CON•$97.25 Fir SC $3.00 FORMANPLAN MNATURE CHECK FEE TO AL FEE Lice C $5. $106.75 CTORORAUTNORIZEDAGENT tDATEi 1. HE P 0 P VAL10 T THIS I�R P RMIT B G iNSP gAtE S-GNATURE OF OWNER,a OWNERBU4DER1 tOATEi 1 73 ILv ls-t�le NEW [ ] Effective 1/1/2000 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 rn BUILDING PERMIT APPLICATION CP Construction Address: DCe iC/p c !�' y °J Legal Description: Owner Name&Address: Gerry &,ns ln5-3G Gcelcleg &-. &c1tec4Tel.# (7-6 41 Contractor. h&A-r. RP tZ MN LICENSE # _Z609;5 -,?1g Tr Address: 37 U4 p Au AV / a Ice aftwo ✓ ,,'- 5TQ ZZ Tel. 4C V) 7- 3S 5,334 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 /�h>,, Width 20 Hgt/Ground S . Ft. �o�q OTHER: +7 - Construction Type: Estimated Cost: $ "-Zo Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ -=$ DATE. M" 12Z� APPLICANT: Tel. # a S ) CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee Fee Schedule on Reverse Side Fire Surcharge .001 of Permit Valuation (1/10th%) State Surcharge $ / ��`� $.50/$1,000 Valuation SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ $1100 per SAC Unit $ 5-40 $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above d $450.00 Conservation Plan Review $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: $ ap "7S �3s-y no SUPPLEMENT TO DECK PERMIT APPLICATION Plans and all of the following information are required with deck permit applications. a. Size and depth of footing IN2 Type of footing forms (i.e. cardboard tubes) Sef JM55 5ij!. Size and spacing of posts 44 POSE-• L, , <50acA d. Type of lumber G 4- F Ram I I% c� e. Size of beams ea �X V f. Size and spacing of joists �c f oc g. Is the deck off a cantilever? Yes No X If Yes, how will joists be supported? h. Type of floor boards —37/1 (I- edaf i. Height of deck off ground j. Height and design of guardrail 0 e k. Size of deck 1. Distance to property lines Side 1 'x) Plus Side 2 NOS Rear �� I I VS Other Q:\Data\Building\WP\Web\Deck Requirements -21d Page Building $ ?j BUILDING Plan Review $ Permit No.: Inspections $ RESIDENTIAL APPLICATION Surcharge Received By 763=572-3 04 License Surcharge CITY OF FRIDLEY $5.00 (State Licensed Residential Contractors) SAC Charge Date Rec'd: DATE YAR E-MAIL ADDRESS $ ft + 6 ft = ft x $21 =$ SITE ADDRE klfl $450 Conservation Plan Review Park Fee THIS APPLICANT IS: ❑ OWNERCONTRACTOR Sewer,.Main Charge $ PROPERTY OWNER/ ,s NA r $ Make checks payable to: City of Fridley Attach Stipulations TENANT ADDRESS: CITal Z�41STAT P PHONE: CONTRACTOR N STATE LICE SE # EXP DATE /I SUBN HT A COPY OF CITY E P NE FAX aE PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE TWO FAMILY/NEW CONSTRUCTION STORIE PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHEDWINDOWS ❑ BASEMENT FINISH ❑ ROOF RAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTE ANCE/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 I. Existing Floor Plan PROPOSEI) SIZE: ❑ DETACHED GARAGE 2• Proposed floor plan PROPOSED 14EIGHT: 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 OPENINGSes ❑No LO I O � 3. Energy Calculations OR FOR NEW OPENINGS- ESCRIBE 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: (USI 7 >�T:VEE SCHEDULE) TOTAL JOB VALUATION $ (, oCOCCUPANCY TYPE Permit Fee $ ?j See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ S .0005 x Permit Valuation Minimum $.50 License Surcharge $ S00 $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer,.Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 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 applic ti for a permit 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 as r andr�jo/vjal of plans. �/� SIGNATURE OF APPLIC " t/ `--I�RINT N TE �l1