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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT No 4100 Date: . -...__.......-..L..... - ..._.. - Owner: ..... -....... -......................... _...................... ................................... _.................... Builder....._......................_...._....._...._........._.._......._ . _. __.. __......._. __.._. Address Address LOCAATI 0-01.0F BUILDING No.... Q._. Street... ............- - ...........-......._..... Part of Lot ...... ............. -............ _.._._....._.------_...._.---------- Lot ..../10- .................. Block ....._.............._................. Addition or Sub -Division � ... ..._-- -- ......��G'......_�l Corner Lot ...... ............................. Inside Lot . k ......................... Setback ... a ..... Sideyard ..Z.A4 -t4.'� . --............. _........ ........... _.. Sewer Elevation ...... ........................................... _..................................................... Foundation Elevation DESCRIPTION OF BUILDING To be Used as: s' - FrontL....:. .. a Depth Height .l..._.7.. Q . P y` .............. Front .��_.*Height Depth ..®�.'.® Height �..._O (/ Type of Construction ........................... ................. ............ _. Est. Cost e\� c Sq. Ft.��%//� yy. Sq. Ft...7......1....�.. To be Completed Ca. Ft..9....��,��+�� CU. Ft..l...._.C9 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. In consideration of thea p yment of a fee of $Z� .................., permit is hereby granted ..... __._......................... I ........... ........._......1. to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. 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 Application for Power Plants and. Heating, Coding. Ventilation..ReftigenWon tod Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, 4 Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ ,r .each add. 60,000 BTU ....................... 2.00 ; Replacement of Furnace .............................. .0.00 $ Repairs & Alterations—up to $500.00 ... ............ 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam....... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ S'• P 'O ($AS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ....... x $1.50 $ 4 iP Y Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING 4,5o FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL Dept. of Bldgs. Phone SU, 4-7470 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. Fridley, Minn_ Zzg lam' 5 / , 195 Owner �✓+rsr/y��—�t� ops Kind of Building Used asL To be completed about Estimated Cost, $ Old—New. Building Permit No. Permit No. /'0// DESCRIPTION OF WORK HEATING or P9FM PLANTS -Steam, Hot Water, Warm Air—No Trade Nam Size No- day Capacity �+-0--r2 Sq. Ft. E.D.R Zo-_� BTU H.P. Total Connected Load ✓� Kind of Fuel BURNER — Trade Name g�� Size No Capacity Sq. Ft. EM.R BTU H.P. (REMARKS -OVER) Sign Crw424M 7.59 Business Phone No yoy 9 f Suburban Rumbugg Suuppl.* Co. WHOLESALE PLUMBING AND HEATING SUPPLIES 6215 West 36th Street St, Louis Park 16, Minn. Wh' iffier 0298 SHIP SHIP VIA -CUST. No. TERMS QUANTITY ITEM -T- LIST DISCOUNT NET /` ✓., Pot FW i 115- / g��� R�� 12.E ®o Go SALES ORDERy` Q ..p �I® � V City of Fridley Application fow Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SU 4-7470 l DESCRIPTION OF WORK Location—6 ® D 4 A L Number, Kind and Location of Fixtures dl RATE TOTAL Number Fixtures ...................... �NO. � —L_ x $1.50 e-0 $ /Te-0 Future Fixture Opening ................ y 1.20 $ New Fixture Old Opening .............. x 1.00 H Catch Basin ............................ x WATER HTR. $ Water Heater (Up to 200,000 BTU) ......—� x 2.00 $ ' New Ground Run Old Bldg . ............ x 3.25 $ zp GAS FITTING FEES: _, 4n ~� $m 5¢ �a `aZ �d F N GAS ELEC. Gas Range to 200,000 BTU .............. x 2.00 $ oLL N LLO a3 �< e� coo Base / 1st 2nd 3rd 4th Future Connection Openings Connected with a° New Fixture, Old Openings I Sewer E] Cesspool ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: RATE TOTAL Number Fixtures ...................... �NO. � —L_ x $1.50 e-0 $ /Te-0 Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ......—� x 2.00 $ ' New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. BATE TOTAL 1st 3 Fixtures .......................... x $1.50 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL F1 :3 - s® 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. Fridley, Minn F P 5 r� , 19 Owner `— 14 1('4 /, 4,41 P 113 ILD A 5 19 Kindof Building 14'z 19— Used as cv To be completed about % s G Q Estimated Cost, $ Old—New. Building Permit No signerLONDDN PLUMC:NZ C By Business Phone No Connection Permit No . ....................................................... Water SEP 2 3 1959 ROUE j sewer 11 IM -8-58 Meter Deposit Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: Furnace Shell & Duct Work ........................... Replacement of Furnace ........................ Repairs & Alterations—up to $500.00 .................. Repairs & Alterations each add. $500.00 ............... MECK. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ each add. 60,000 BTU ....................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 ................. Repairs & Alterations each add. $500.00 .............. STEAM or HOT WATER SYSTEM RATE TOTAL 8.00 $ 5.00 $ 5.00 $ 2.50 $ 8.00 $ 2.00 $ 5.00 $ 5.00 $ 2.50 $ Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 8.00 $ Each add. 200 sq. ft. EDR Steam . .................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water ......... ........ 2.50 $ OIL BURNER—to 3 gal. per hour ... 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x $1.50 $ Additional Fixtures x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL Dept. of Bldgs. Phone SW -3480 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. Owner Kind of Used as To be c Estimat Old—New. Building Permit No. c� �' Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS -Steam, Hot Water, Warm Air—No Trade Name Size No Capacity Sq. Ft. E.D.R BTU g p Total Connected Load Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU Hy. (REMARKS -OVER) Signe By <2 Business Phone No ,=:?y2 -7C-) City of Fridley, Minn. N° 8186 BUILDING PERMIT Date: July 14jo 1965 Owner: En=TT Td2 MCCARTHY Builder Zff9M Address 680OAMM MM Address 6495 PIERCE ST. Fridley 21, Minnesota Fridley 21, Minnesota LOCATION OF BUILDING No. 6830 Street Oakley Drive . Part of Lot ,at 10 _ Block 3 Addition or Sub -Division Brookview Terrace 2nd Addn. Corner Lot _ Inside Lot _ _ Setback Sideyard Sewer Elevation Foundation Elevation To be Used as: Type of Construction DESCRIPTION OF BUILDING Front Depth Height Sq. Ft Front Depth Height Sq. Ft. Fat Cost $18, 000.00 To be Completed REPAIRS DUE TO STORM DAMAGE In consideration of the issuance to me of a permit to e the proposed work in accordance with the description above ordinances of the city of Fridley. CU. Ft CUL Ft. I above I agree to do vq�,th ;Jl provisions of In consideration of the payment of a fee of S 10.00 , permit is hereby granted t , EVERETT MCCARTHY 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, Minnesotang location, construction, alteration, maintenance, repair and moving of buildia� within the city limitsand this permit may be revoked at any time upon violation of any of the provisions of ssaaiid ordinances. A1JZX G. JUSEN Building Inspector NOTICE 'lids permit does not emu t6 constmWo, bataffiNan for wiring, phmbing, gn ban&& nww or water. Be sore to ass t6o BWMl r for sepwats pwmhs for these bmw APPLICATION FOR.BUILDING PERMIT. CITY OF FRIDLEY, MINNESOTA BUILDER OWNER'S KANE �►SS ADDRESS. LOCATION OF BW;DING No. Street Fart,.of Lot. Lot s, Block 'Addition ;.or..Subdivisiont if Corner LotInside Lots etback Side -Yard. SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location. drawn. on these Certificates. : DESCRIPTION OF BUILDING To be used as: i' - .fa . , ! P Frost ,51 _ J1 . Depth �� Sq.. Ft. Cu., Ft. Front Dopth Height CU., 1t . Type of Consiructioa � � r Estimated Cost; To be Completed The undersigned hereby makes application for a permit-for.the work.herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department.of Buildings,.,and hereby declares.that.all the facts and representations stated in this application are trueeand correct.. j Schedule of Fee Costs can be found on the Reverse Side). ,It CITY OF FRIDLEY INSPECTION DIV. Effective On August 1, 1995 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $�, representations stated, in this application are tru and correct. (Side Vent — Fill Out Back) ,1995 Gas Piping (Needed with new furnace) $10.00 $ I� OWNER &Ly rte- � oC /� S 7 y ' l6 7 Gas Range $ 10.00 $ BUILDING USED AS Gas Dryer $ 10.00 $ // ESTIMATED COST Ldp I PERMIT NO. *Air Conditioning — All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work $ No. of Heating Units ( Circle One (Steam) Hot ater (Warm Air) Trade Name S%alcJ� Size No. /:2 a - 000 laic Commercial/industrial BTU 1 %0 &-a m HP EDR 1.25% of Value of Appliance or Work $ Fuela(n 0 _ Total Connected Load State Surcharge $ .50 Burner Trade Name Size No. �� C �_ BTU HP EDR TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. HEATI N Signed Approved Byid Rough—In Date Final Date FILL OUT BACK SID FOR STACK VERIFICATION ON REPLACEMENT FURNACE . CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes ( ) No ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1993 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Urinal b >..:.:: Tray . . rWash FIoo DrainStories . ...Auto ` `Washer .A> ` Gas Range j .......Water H ate r as Elec Basement m nt J 0 Flo r 1 I r F o0 2 Floor o 3 Floor 4 PLUMBING FIXTURE RATES: 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 NO. RATE TOTAL JOB ADDRESS 69-30 O H k k E y S7. $ 7.00 The undersigned hereby makes application for a permit for the work herein $ 41.00 specified agreeing to do all work in strict accordance with the city codes $ 5.00 and rulings of the Building Division, and hereby declares that all the facts $ 7.00 and representations stated in this application are true and correct. $ 7.00 Gas Range Gas Dryer Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 to .OV $10.00 • $5.00 Reinspection Fee. $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance State Surcharge _ V .-.;Q , 1993 Owner MAP -it ?Sgg&COG/L Building Used As 146 -A6 Estimated Cost /50 �d PERMIT NO. PLUMBING COMPANY_n,'S SIGNEDBY TEL N0. Approved By Rough—In Date Final Date $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 TOTAL FEE $ ) S.Su PLUS THE $.50 STATE SURCHARGE SUBJECT 4WERMIT NO. City of Fridley 25731 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. `y _ COMMUNITY DEVELOPMENT O PROTECTIVE INSPECTION SEC.. r � � 1 � ` CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 12 / 15197 10B ADDRESS 6830 Oakley Street 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 3 Brookview Terrace 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mark Babcock 6830 Oakley St., Fridley, MN 55432 574-1672 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Lloyd's Home Improvements, Inc., 1012 42 1/2 Ave, Col. Hts. MN 55421 788-5602 1798 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Dwelling 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION CX REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Re -roof (second layer) . 34 Sq 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. 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 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 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 $2,130.44 $1.07 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 $2.13 STRUCT ON OR TH; PE FORMANCE OF CONSTRUCTION f'3 -q - PLAN CHECK FEE Lice 5.00 TOTAL99E $82 5 SIGNATURE OF ONfRACTOR OR X'UT)4ORizEb AGENT IDATEI ENP OPE ALIDAT 1$ IS YOUR PERMIT ` BLO INSP �t s /+ </ OATE/' S,GNATURE OF OWNERoF OWNER BUILDERI IDATEI NEW (] / l 7 Effective 8/l/95 ADDN [ ] 1 CITY OF FRIDLEY ------ ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application` Construction Address: 6830 OAKLEY ST. N.E. - Legal Description: Owner Name & Address: MARK BABCOCK Tel. #__514-16U 672 Contractor: LLOYDS HOME IMPROVEMENTS, INC. _ MN LICENSE # 1798 Address: 1012-422 AVE.. NE., COLUMBIA HEIGHTS, MN. 55421-3159 Tel. # 7ss-s6o2 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 GARAGE AREA: Length Width DECK AREA: Length Width OTHER: Corner Lot [ ] Inside Lot j ] Ft. Yd Setback Type of Construction: REROOR 34 sq. Approx. Completion Date: Driveway Curb Cut Width Needed: — DATE: APPLICANT: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Height Height Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Side Yard Setbacks Estimated Cost: $ $2,950,0 (Cost on Back) Ft. + 6 Ft = Ft x $ Tel. # CITY USE ONLY $ 75 Fee Schedule on Reverse Side $ /.S .001 of Permit Valuation (1110th%) av,$ d $.50/$1,000 Valuation $ $850 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 [ ] "a . //I+ti ie' Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY mate Rec' YOUR DATEE-MAIL ADDRESS 2, � SITE ADDRESS Q C THIS APPLICANT IS: 0 OWNER de6NTRACTOR PROPERTY NAME: Z ADDRESS: 60ri L:iQ_ STATEjYj41Pf rVL3ZI OWNER/ TENANT PHONE: 2 S 4;4;21 f r CONTRACTOR NA1i,M: STATE LICENSE #1 l Q ! EXP DATE 2 ! r - STATE�ZTf z SUBMIT A COPY OF YOUR STATE ADDRESS: l CITY LICENSE WITH PHONE FAX APPLICATION PERMIT TYPE GLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: E3 NEW &IrEPLACEMENT DETAILED DESCRIPTION OF WORK PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINIULAV FLOOR DRAINS —SHOWER _ WATER PIPING _ BATHTUB PIPING Mm rnTLICE A _ SWIMMING POOL —WATER SOFTNER ($35) —GAS — CLOTHES WASHER KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREV. ($15) _ DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION _ —�.yey.y,, WATER METER —OTHER .q�.{�y�g�. P �.1; ,."-0.3'. Permit Fee $ Number of fixtures @ $10-00 x $10.00 = $ Surchar a .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED IBhereby 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 w ' ires review and approval of plan i SIGNATURE OF APPLICANT PRINT NAME DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Al.ding .spections x3-572-3604 CITY OF FRIDL.EY permit No.: r—(� B•[� MDIN APPLICATION Received By: RESIDENTIAL VS -6 nwe Roca.: cb CI'T'Y OF FRIDLFY YOUR E-MAIL AADS • , . • �;ir7B���s�s STATE LICENSE ��'� y N iV DATE. SUBMU A COPY OF 10MSTATE LICENSE ADDRESS: _ wim Appur-A 10N Pte. -- FAX cry :ESCRME WORK BE NG A VLNG 3 vinyl 3 Alumimulm HYNDOWS N F�QSTIi� r4 O GS EMS ONO 3R pop, M Y OPM4N0S-DESCRMZ WE OF 3PR4D* CHANGES & 1 -M OF WRMM TO BE I rALLM ARE DAM) ON t AL JOB V'ALUATXO ■Y.1 ��rsc 0- ❑ HOUSE & GARAGE O ATTACHED GARAGE O DETACHED GARAGE FL BASMOM 1. Existing Fbor Ph= 2 %t mbeto ba w d 3. FOR NEW CONS1'11'.UCMNINCLUDINGOEM' m & 0SQffd Trio► T Site Pte Y sb the s II Fascia aid P�wd ��' Z. Two scb of Oft uchm Plans 3. Faera Calc"M LOCATION OF WINDOWS 1997 U.B.0 COST OF LABO1<R AND 65% of Building Permit Pee Plana Review $um S.54 Surcharge $ � • ��i ,,,- (.0405) tunes the total job valuation - l+�ini» $ .QU1 x Permit Valus ion (I/14%) Five Surcharge - License St d $5.00 (Sense Licensed Residential Couftaaon) SAC Charge $ $1450 per SAC Unit (Plans to MWCC for dofto nation) Orb Cut Esa0w grosion C,.onnual S $450 Conservation Plan Review park Fee S Fee Determined by Enguaeermg Sewer Main Charge $ AV Bement necessary ( ) Non Necessary ( ) Total Axe $ Make chi � Mable to: of Fridley Attach St' nlatlons THIS IS AN APPLICATION FOR A PERM T NOT VALID LWM PROCBSSW I y apply a bundioag P=* and I ackmowledge #Mt the information above is complete and acctuate; that the work will be in conformance, with the ordinanm and codes of the City of Fridley &ud with the Minnesota Co struc.iion Codecs 1hu i understand this is not a permit but only an application for a permit and work is not to start without a Permits t the w �o srk will be in accordance with the approved plan in the case of all work wb!clt��view d approval of plans- Jl ;:. , _ %0�. _ . _, ,,., C /4//W7 SIGNATURE OF APPLICANT IV