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PRE 2010 DOCSI VMage of F1r.Idley, MojL j N? 483 Office of INSI?FMOR O.F BIT"INGS :7ch eriteo Fridlej, Miran_-- tAWAIL I illl Buildsr ai+r��i I LOCATION F BUILDING No. Part of Lot Lot BlockAddition or Sub -Division DES-CrUPTION OF BUILDING Front-_ De th + r p Neight--lid_Storie°_./_ Manner of Construction + r I1t% To be used as To be completed t6V Es ted Cost 1irfJG�s "" ISI I Permit is hereby granted to. eae=W rr to &W4 the building�sp described in the above statement. upon the express conditi that the person to whom it is granted, and his agents, employi the work done in, around and upon said building, or any part thereof, shall conform in nances of Fridley, Minn., regarding the construction, alteration, maintenance, repair ai within the city limits, and this permit may be revoked at any time upon violation of any ordinances. his permit is granted and workmen, in all respects to the ordi- moving of buildings the provisions of said I, ' Spector of Buildings. AGREEN +'T�t+ AND SWORN STA T.FMENT I In consideration of the issue and delivery to me by the Inspector of Bus �tiangs of Fridley of the above permit, I hereby agree to do the proposed work in accercTence BW the description above set forth and according to the provisions of the ordi --aces of Fridley, ' d, being first duly sworn, I hereby state and say that the facts stated by me and contained in t e above permit are true as therein stated. Subscribed and sworn to before me at Fridley, Minnesota, day -A.D. 19 . ii 1 SUBJECT MIT�NO�. City of Fridley 170 05 AT THE TOP OF THE TWINS BUILDING PERMIT JjERC rp IPT •i� _ ��_ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r � PROTECT VE 77 1 i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED By 612-571-3450 910-F15 I I 6/15/83 JOB ADDRESS 1390 Onondaga Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 Walnut Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Ed Karn 1390 Onondaga Street N.E. 784-7410 3 CONTRACTOR MAIL ADDRESS ZIP PHOI1fF LICENSE NO. Midwest Fence & Manufacturing Co. 525 E. Villaume Avenue 55P75 455-2221 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHOE 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 X 8 DESCRIBE WORK Construct a 201 x 24' Second Accessory Building 9 CHANGE OF USE FROM TO STIPULATIONS SP #83-02 approved 5/16/83 (Second Accessory Building) 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 SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN BO 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 $5,126 $2.56 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 OVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $56.50 S R TION OR THE PERFORMANCE CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $59.06 SIGNATURE OF CO TRACTOR ORA ORIZED AGENT tDATEt WHEN PROPERLY DATE THIS IS YOUR PERMIT BLDG 'NSP SAT SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE' 1 CITY OF .FRIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDtNTIAL BUILDING PEPjfITS (New, Alterations, Additions, or Repairs) OWNER: e BUILDER: /0l ADDRESS: ��(, �/�/U/saiCJi�6r-4 ADDRESS: -moo .57�z, �� L TEL n0: % y� �7 �� TEL NO: Construction Location STRI•TT NO: / n STREET: C-4 f] LOT: .�� BLOCK: —� •— ADDITION: L1� r67J Corner Lot: Inside Lot: Setback: Sideyards: Ap,pliczmt attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION Q1�eAG& Z4�,b Front: ' Depth: ` Height: l� C�Vb Ate. &L&,, Square Feet: 48® Cubic Feet: 400C3 Front: Depth: Height: Square Feet: Cubic Feet: _ Type of Construction : ,s`/�'� Cf �"'�� Estimated Cost: $%� (0 • `t 6 Rb Be Corapleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE PEWME SIDE OF SHEET . 9.5ie undersigned hereby makes application for a permit for the tvrk herein specified, agreeing to do.all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DI%TE: 'v/ " -P� SIGNATUIE :✓/� ' n v i Stipulations: l o I SUBJECT PERMIT NO. City of Fridley 8 4 AT THE TOP OF THE TWINS BUILDING PERMIT _198 RE E I • COMMUNITY DEVELOPMENT DIV. 1u_____ r 1 PROTECTIVE INSPECTION SEC. 1 � = CITY HALL FRIDLEY 55432 1.j NUMBER REV, DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/9/89 JOB ADDRESS 1390 Onondaga Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 5 ] Walnut Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. AMRE 3700 Annapolis Lane, Plymouth, MN 553-0020 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 0 MOVE ❑ REMOVE X 8 DESCRIBE WORK Cover soffit/fascia/window wra s 9 CHANGE OF USE FROM TO STIPULATIONS 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 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 $41900 $2.45 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- $72.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $74.45 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI WHEN PROPERLY BLDG INSP ALI DATED THIS IS YOUR PERMIT OA7 SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) Prepaid Plan Check $ Effective 5/1/88 Estimated Cost $ CITY OF FRIDLEY Receipt # R-3, OMMEPJ siL & MUSTRIAL Building Permit Application Construction Address Legal Description Property Owner/Address Tel.# am,RA=R & Ammss a�e 6d Tel. #c, -3 OD,t U Architect & Address Dai Ile Reg.# Engineer & Address Reg.# Zoning TYPE OF WORK [] New [ ] Addition [ ] Alteration -Describe 04Ule 16--,&1a- Applicant Signa % Tel �c.�OD�?o Date/ BUIMn G DIlMENSIONS Length Width Height Sq. Ft. # of Stories OFC. AREA: length Width Height Sq. Ft. WHSE AREA: Length Width Height Sq. Ft. OTHER AREA: Length Width Height Sq. Ft. BION Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) Sq. Ft. x $ Cosa/Sq. Ft. = Valuation $ -- ._ Sq. Ft. - - x $ Cost/Sq. Ft. = Valuation- - $ Building Use Construction Type Occupancy Group Air Conditioning []Yes []No Fire Protection Provided []Yes []No Performance Bond Amount $. See Reverse for Schedule Received []Yes Permit Fee $ V,4D Plan Check $ State &a -charge $ .� SAC Charge $ Park Fee $ Spec. Assessments $ Driveway Escrow $ TOTAL []NO See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side $.50/$1,000 Valuation (See Sched. for > $1 Million) $575 per SAC Unit Fee Determined By Engineering Agreement Necessary [] Not Necessary [] feet x $13.50/foot d SUBJECT PER City of Fridley 2209 6 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. ` t r I~ PROTECTIVE INSPECTION SEC. 11 J NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/9/93 JOB ADDRESS 1390 Onondaga Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 Walnut Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ed Karn 1390 Onondaga Street NE 784--7410 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D & B Home improvements 1568 Ballentyn Ln, Spring Lake Park 55432 784-0922 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (:21 Squares). Tear-off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with. th.e. State Building Code. Provide adequate attic ventilation. Provide smoke detectors as per UBC 1210 adjacent to all sleeping areas and in basement. 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 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 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 $2,730 $1.36 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- $54.00 $2.73 Fire SC STRUCTION OR THE RFORMANCE OF CONSTR TION. PLAN CHECK FEE TOTAL FEE p ^ License SC $5.00 $63.09 SIGNATURE OF CONTRACTOR OR ORI ED AGENT V IDATEI WH§nrO E VALIDATED THIS ISYOUR PERMIT BLDG INSP �lA E SIGNATURE OF OWNER IF OWNER BUILDER) IDATEI NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: Legal Description: Owner Name & Address: Contractor: P�lb Address: % 4 ' /n X LIVING AREA: Length GARAGE AREA: Length DECK AREA: Length Effective 5/26/93 --- Tel. # 7e 7 MN LICENSE # -7 Tel. # Attach to this application, a U"ticate or survey or lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. -� / C. ,2 f . Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: 2e- Estimated Cost: $ % Approx. Completion Date: - / - %3 (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ 4 $ DATE: 2- �- APPLICANT: Tel. # 2'!-OPa?P Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ $ CITY USE OMM Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $ / • („ $.50/$1,000 Valuation $ $750 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ Conservation Plan Review $450.00 $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] 22 STIPULATIONS: SUBJECT PERMIT City of Fridley("'2 8 04 0 AT THE TOP OF THE TWINS ? BUILDING PERMIT i -%R4CzWz_NCr_ : COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY 1 /'�'1 • CITY HALL FRIDLEY 55472 612-571-3450 910-F15 9/30/98 JOB ADDRESS 1390 Onondaga Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 1 Walnut Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Edward Karn 784-7410 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Renewal by Andersen 350 73rd Ave NE Fridley MN 55432 502-4777 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 7 windows in home with ocket inserts 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling. 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 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 COMPLIEO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 3865 $1.93 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $87.25 Fire SC $3.86 PLAN CHECK FE�+E//�� TOTp AL FEE Lic ense Sl, • 90. 04 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATEI WHEN PgOPERI BL,4G INSo - ALIDA ED THIS IS YOUR PERMIT ' r,AtE S-GNA tURE OF OW NERi6 OWNER BUILDER, IDATEI NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Legal Description: Effective 1/1/98 Owner Name & Address: ESN O'KCA �4-" l'�`1.0 0 na end a or, Tel. # —79L4 - 7 H 10 Contractor: 350 - -1 Y N C , N\C MN LICENSE # aOo Ll OU Address: f�na L,�� N\K ( `eA�a Tel. #S8a- y -l"17 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT V 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: Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: �}L-� APPLICANT: Tel. # �9-gSt/ CITY USE ONLY Permit Fee $ gl - aS Fee Schedule on Reverse Side Fire Surcharge $ 3 'KID .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ C5.00 $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 $ S3.0� STIP TIONS: % 1/It SuBjECT PER City of Fridley 8 8 8 3 AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. E 1 ; , NUMBER REV DATEPAGE OF APPROVED BV CITY HALL FRIDLEY 55432 612-571-3450 910415 2/2/99 JOB ADDRESS 1390 Onondaga Street NE 1 LEGAL LOT NO. BLO TRACTOR ADDITION SEE ATTACHED DEscR. 5 1 I Walnut Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Edward Karn 1390 Onondaga Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO New Haven Construction 4208 83 Ave N, Brooklyn Park, MN 55443 566-5225 20077950 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 O ALTERATION Q. REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof House & Garage (19 Sq) Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 1 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,628 $.81 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE RGE SACreSC PROVISIONS OF A O HER STATE OR LOCAL LAW REGULATING CON- TRUCTI NOR PE FORMANCE F CONSTRUCTION E $54.00 F $1.63 PLAN CHECK F T AL EE Lic e $5. $61.44 $IGNA-FCON'RACTORORAUTHOAIZEDAGENT IDATEI HE PRO ALI THIS IS YSUR PERMIT S,GNATURE OF OWNER,IF OWNER BUILOERI IDATEI BLjfG INSP J�77 PATE NEW ADDN ALTER ConstructionAddress: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �^ _ B jILDING PERNIIT APP-ICAT�JNj- Effective 1/1/99 f� �P Q8$3 Legal Description: "� Owner Name & Address: �G�G�a�� Tel. # Contractor,4/9,O &AtadZ, � � C-. MN LICENSE # ?-e d 77 Address: 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: Construction Type: QGci' e ¢ Height Height Hgt/Ground Tel. # Sq. Ft. Sq. Ft. Sq. Ft. ep 4!10 Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = DATE: 5APPLICANT- (Fee Schedule on Back) Et x $ = $ Tel. # S -4p d--.s�aa� TOTAL $ `� STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ , lv .001 of Permit Valuation (1/10th%) State Surcharge $ $.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: 4 FROM :City of Fridley Building Inspections 763-572-3604 SITE ADDRESS THIS APPLICANT IS; OWNER/ TENANT SURMrr A COPY OF YOUR STATIr LICENSE WrM APPLICATION PERMIT TYPE FAX NO. :7635711287 Dec. 20 2005 12:50PM P3 MICEUN'ICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL 0 OWNER OCONTRACTOR Permit Received 13y: Date Rec'd: ADDRESS:_CITY___STATE ZAP COMPANY NAME:.b CONTACTPERSON: STATE LIC1 PE #, FAMILY 0 TWO FAMILY TYPE OF WORK: � ONEW XR6LACENF.K 0 TOWNHOUSE 0 ALTERATION/REMODEL -1 ao DETAILED DESCRIPTION OF WORK PER MS 16B.665 the permit fee is R minimum of $15.00 or 5% of the total cost up to $500.00, whichever is 1pater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. ('This should reflect only the cost of labor ) cost under $300 = $15.00. Labor oost between $300 to $500 =cost of labor x .05 = FOR PROlEsCTS WHERE LABOR EXCEMS $500, FEES ARE RASED O�OjjN®®$10.00 PER FrAT11RE, EXCEPT WHA NOTED. �JRBS: (INDICATE TOTAL NUMBER OF EACH BELOW) MFt �l:k �/�MODEL: (" - 4 SIZE/BT 101 Eq�pment Installed MODEL: , — SIZEIBTU MFG; 517 U MFG: MODEL: A1C $25.00 FIREPLACE (GAS) 515.00 GAS RANGE10VEN $10.00 TO AIR EXCHANGEIIR S 15 _�IREPL ACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOILER $35.00 _FURNACE $35.00 _GAS I]E HTR $10.00 CHIMNEY LINER $10.00 GAS DRYER 510.00 P001. I>FATBR $35.00 euCT WORK S10.00 _ ,GAS PIPING $10.00 _VENTILATOR 515.00 Permit Fee $Number of fixtures @$10.00 _ x $10.00 = Sumbargo $ .SQ Number of fixtures 0 $15.00 x $15.00 = $ TOTAL DUE $ Number of fu bnu Q $25.00 x $25.00 = $ Number of fixtures @ $35,00 . _ x $35.00 = $ State Surcharge " $ Total 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 wiU be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction C ; that .I understand this is not a permit but only an 'on for a perm and work is n start without a permit; that the w ill in accordance with the approved plan in the k which r v ew R oval of plans- ans- SIGNATURE OF APPLI / DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 RAY- 761-50_4977 S