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PRE 2010 DOCSVillage of Fridley, Minn. 30 6 BUILDING PERMIT N? Date: ... //• • • ... ....... .... . r a "" Builder .. ..?. '.......... . . Owner .. Address...................................... Address ........ �"....... ........ !� 0 LOC TION OF BUILDING No.../7 .. Street . ........ .. . .. 2................ Part of Lot Lot ..... ........ Block ................ ddition or Sub -Division Corner Lot ........... Inside Lot ........... Setback .A; ..... Sideyard !. ® ....... DESCRIPTION OF BUILDING To Used as* . .......... Front . Depth .. Height q. Ft. � ... Cu. Ft. ........ ..................... ont ........ Depth ........ Height......... Sq. Ft. ........ �j e/ Type of Constructio ...... Est. Cost ... ,1./..�l . To ®Conipld 57 4 -a 1 0 �. L 71 c t C 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 village of Fridley. Cu. Ft. ........ 6 ............ Ar I * I I I I I I * I * * * * * 09 --- In consideration of the payment of a fee of $.le....., 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 village limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. rt .. g�►spe for 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. City of Fridley, Minn. BUILDING PERMIT No 26 Date: Owner: ...... Builder ...to, .,:...__:_.._.__._.._..._..._.. __.._.__._._..__..._____._ Address °� Address LO TION OF BUILDING C�._. No....._. ___._ _ Street_. _ , .:... ��,�_._.._..._..... Part of Lot ...__.._...---..__...._....__...._. ....... _........ ........ _..__ Lot....._ .....................:_........ Block .... _...... ......---...._........... _........ ddition or Sub -Division .... _.......... ......................... .. Corner Lot .................................... Inside Lot .....__ ............. Setback ....._............._....... ............ Sideyard .... ....._...: . Sewer Elevation ...._..---_-----------_--__.._..__ ----- -.............___.._..._...._....._ Foundation Elevation DESCRIPTION OF BUILDING To �be Used as: °�... rz+� ....n Depth ..= .•:=•. Height ...:.� . Sq. Ft. .a, t=�:....:: _ S.x...... Front .. Cu. Ft. �-- --- --'� _..... -- - - ._... - ....._..... Front ..................... Depth ............Heigh � ............ Sq. Ft. ...................... Cu. Ft. ..... _................. Type of Construction . ._ l& , r • & ..:.--.. Eat. Cost .. F .....:. _..--- To be Completed .... _.......__.._.._.-•---.._. 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 the payment of a fee of $. ..__`�"''_.._..y 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 within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. r'"; 1 P r —) I Building Inspector NOTICE: This permit does not cover the construction, installation for will , plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name Builderr LOCATION OF BUILDING No. ®`1 % 3 StreetCj- 4U a Part of Lot Lot Block Addition or Sub.Div. Corner Lot Inside Lot A--' Set Back Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: DESCRIPTION OF BUILDING Front A Depth®® Height A® Sq. Ft. e Cu. Ft. y,' ga 9' Front Depth Height Sq. Ft. Cu. Ft. gr Type of Construction 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 Ordinances and ruling of the Department of Buildings., and hereby declares that all the facts and representa- tions stated in this application are true and correct. DATE__Y ' S� • �® - G SIGNATURE ��,�. � ..,,�.. (A Schedule of Fee costs can be found on the Reverse Side.) City of Fridley, Minn. N° 7690 BUILDING PERMIT Date: dune 3, 1965 Owner: BOnedict Shutray —Builder Same Bbnedict Shutrop Address 14.73 inondago Street N. E. Address 3473 Onondago Street N. E. LOCATION OF BUILDING No. 1473 Street Onondago Street N. E. Part of Lot Lot 2 Block 1 Addition or Sub -Division . Hi tZ@M Corner Lot Inside Lot g Setback Sideyard Sewer Mevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Frame Est. Cost a 10-00- 00 To be Completed Dett. Garage Storm damage repair In consideration of the issuance to me of a permit to construct the building theproposed work in accordance with the description above set forth and in co ordinances; of the city of Fridley. -.j A , Iprov=isio s off In consideration of the payment of a fee of13-x- 0 _—, permit is hereby granted toBenediCt Shutrop 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 thereoiy shall conform in aIl respects to the ordinances of Fridley, Minnesota regarding location, ao�ostructfon. 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. Allen Jensen Building Inspector NC' L% Ibis pump den rm sown the coedmd1m, hutsl Wm for wkb& phimbiAe, Bn hedht& www w wdw. Be sore to we 60 sumins h"ador hr sep"aft pwnft for thew Moms. r . . . ll OWNER'S NAME APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING No._ Street, of Lotr LOT eZ BLOCK / ADDITION OR, Corner Lot�_Inside LOT SetbackZ,-ff Side -Yard' 1619 SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as - Front. Depth3Height Sq. Ft,. Cu. Ft. l' Front Depth Height Sq. 'Ft,. Cu. Ft. Type of Construction_ Estimated Cost 0,2 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 true and correct. (Schedule of Fee Costs can be found on the Reverse Side). �� 7 2- City of Fridley, Minn. N° 8700 BUILDING PERMIT Date: March Us 1966 Owner: Ben Shutrop Builder Taylor d RP.ms Address _ W3 Onondago N.T. Adm 1562 - 15th St. '' LOCATION OF BUILDING No. x4+71_.___ Street Onandam N-Ef Part of Lot Lot Part of _8 Block Addition or Sub.Division AUDITOR IS SUBDIVISION 129 Corner Lot _ Inside Lot -- Setback _ _ _ Sideyard Sewer Elevation __ _ Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Remode 1 Front Depth Height Sq. Ft Cu. Ft RasaWnt Front Depth Height — Sq. Ft Cu. Ft. Type of Construction Est. Cost _ 5M- _ To be Completed 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 and in pliaace with afl provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ 15- , permit is hereby granted to Ta;l or .TIM d $nmPS . to construct the building or addition as described above. Thisrmit is granted upon the express condition that the person to whom it is granted and his agents, employees anaworkmen, in all work done in, around and upon said building, or any thereof, shall conform in aII respects to the ordinancg Of des0off Fridley, Minnesota regarding >��,� � alteration, ttaany t'me�upon violation of any of and ththeeproovisions, of said ordinance. city ]units and tide NOflCS i T16 pm* don not con► tho condrudion, hutapation for wMhg, plumbing, gn ho dng, s wor or wdw. Be wn to ao the Building haps for for apmft pormih Por thea Nunn. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME /7 y i -o t? BUILDER A, /7 pie A�6ay�s ADDRESS / �, ADDRESS ZS"6 ,2- 1.5-,4 .5,),L LOCATION OF BUILDING 11 J NO, y ,Z3 STREET PART OF LOT LOT BLOCK ADDITIO OR SUBDIVISION CORNER LOT INSIDE LOT SETBACK SIDE -YARD SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as; &k,,f cc-s� e e , Ls 7L Front Depth Leight Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost ,'®a,:D 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 true and correct. DATE 3 ' f/ �,�� SIGNATURE (Schedule of Fee Costs can be found .on the R verse Side). City of Fridley AT THE TOP OF THE TWINS SuBjECT BUILDING PERMIT RMIT NO: 25596 �• COMMUNITY DEVELOPMENT DIV. - r � PROTECTIVE INSPECTION SEC. 1 � I CITY HALL FRIDLEY 55432 L J` 612-571-3450 RECEIPT NO. NUMBER 910415 REV DATE 10/15/9 PAGE OF APPROVED By JOB ADDRESS 1473 Onondaga Street NE 1 LEGAL DESCR. LOT NO. pt g BLOCK TRACT OR ADDITION Auditor's Sub #129 SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRESS Cliff Cote 1473 Onondaga Street NE ZIP PHONE 717-4327 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 O NEW ❑ ADDITION ❑ ALTERATION [A REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof Garage (10 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS 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 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $834 SURTAX $.50 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. $32.00 Fire SC $.83 PLAN CHECK FEE OTAL FEE 1� / /f $33.33 SIGN T RE FCONTRACT OAUTHORIZED AGENT IDATEI HE PRO V VAL ATED THIS IS YOUR PERMIT • 8 OG IN �/1 ��'/��/ MATE S)GNATU O O INEROF OWNER BUILDER) IDATEI NEW [ J Effective 1/1/97 ADDN [ J CITY OF FRIDLEY R ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION` ConstructionAddress: Legal Description: Owner Name & Address: 014 Cole, Rzi dP,_P&4A�g Tel. Contractor: ---` ` MN LICENSE # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE A Length Width Height Sq. Ft./000 DECK AREA: th-Width Hgt/Ground Sq. Ft. OTHER: V L,;- 7, �­1 r�� Construction Type:, — si't f%7,i r, rr�0 Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut .Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: /D / 5 /�2 APPLICANT: 0-11-p/ O&-% Tel. # `71 _ - f ,� iTlPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ �� $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above rosion Control $ -$450.00 Conservation Plan Review ?ark Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ iTlPULATIONS: SUBJECT -' PER `-� City of Fridley 9 5 8 3 AT THE TOP OF THE TWINS BUILDING PERMIT r ` RE `� -------COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. f PROTECTIVE j � f CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BV 612-571-3450 910415 3/1/99 10B ADDRESS 1473 Onondaga Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. Pt 8 Auditor's Subdivision #129 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Cliff Cote 1473 Onondaga treet NE 717-4327 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Midwest Construction Services Inc PO Box 442, Litchfield, MN 55355 20101426 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. (320)693-3620 5 ENGINEER MAIL ADORES; ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION J7 REPAIR ❑ MOVE O REMOVE B DESCRIBE WORK Reroof House & Garage (29 Sq) Tear -Off; Reside House & Garage; Replace 9 windows 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. Install smoke detectors to meet the State Building Code - in each sleeping room and on each level of the dwelling. Call for building wrap inspection before covering. 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 E.0 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW.THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $7,185 $3.59 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 - STIR CTION THE RFORMANC OF CONSTRUCTION $137.25 SC $7.18 PLAN CHECK FEE FEE Lic S $5 0&153.02 SIGNATURE OF CON'RACT OR AUTHORIZED AGENT (DATE, EN ROP SOUR PER S,GNATURE OF OWNER,,F OWNER BUILDER, IDA TE I ! O BI B G INSP pAtE NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress7 �i Legal Description: Effective 1/1/92 Owner Name & Address:/19 Tel. Contractor: MN LICENSE#fib/ ri(0 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 Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. Hgt/Ground Sq. Ft.BS _ DECK AREA: Length Width OTHER: "h `� add x l •� `� I _%Ob Construction Type: Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ 11% 7 loo -C 1/���S DATE: " "' APPLICANT: 4g �7� Tel. CITY USE ONLY Permit Fee $ 12 7 c) -S Fee Schedule on Reverse Side Fire Surcharge $ % /S .001 of Permit Valuation (1/10th%) State Surcharge $ 3..5-% $.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: L SUBJECT PER O. City of Fridley i 793 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. Ir? L `y _____ COMMUNITY DEVELOPMENT DIV. r - - PROTECTIVE INSPECTION SEC. 572 -3604 36,P I = 1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/3/01 JOB ADDRESS 1473 Onondaga Street NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. pt $ Auditor's Subdivision 4129 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Cliff Cote 1473 Onondaga Street NE 763-717-4327 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 8 USE OF BUILDING Residential 7 CLASS OF WORK NEW 0 ADDITION O ALTERATION 0 REPAIR O MOVE IR REMOVE 8 DESCRIBE WORK Remove existing 12' x 25' Deck; Construct a 25' x 16' Deck 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. r„WAKIN ' Before digging call for SEPARATE PERMITS all utility locations REQUIRED FOR: 4540002 WIRING HEATING REQUIRED BY LAW PIAIMBINd AND SIGNS 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 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 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED @ @ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4,400 `1'2.20 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 - 111.25 Fire SC $4.40 TION TION WPLAN CHECK F E'41 TOT FEE z4mg 17.85 AGENT [DATE, HE PROP VALID D THIS IS YOUR PERMIT 00, �• S,GNATURE OF OWNER,If OWNERSUILDERi aOATEI Bl NSP - OATE L NEW [ ] 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 J -7 -P On on AA!aij S4 • i)% E Legal Description: Owner Name & Address: (%) i TT 0-p-�e, 1 Xgi-k .51, AiTel. # 70 --7r7-OF � Contractor: Ok,�h GY` MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the L L q4' lot, with the proposed construction drawn on it to scale. f" f4_ DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: L ng Width &Z i Hgt/Ground Sq. Ft. OTHER: EMo o� - 7-"A.)6 /a k --f Construction Type: Estimated Cost: 'Woo Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$ DATE: 5& 2 -LOO APPLICANT: �_7 j�t C � Tel. # CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application $ Fee Schedule on Reverse Side $ U .001 of Permit Valuation (1/10th%) $ off•,70 $.50/$1,000 Valuation $ $1150 per SAC Unit $ $5.00 (State Licensed Residential Contractors) "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] e,APPROVED PLO ri TO E1ELD Building Inspections 7.63-572-3604 DATE 1� THIS APPLICANT i3: PROPUTY OWNER/ TENANT SUBMIT A COPY OF YOUR STATE LICENSE WrM APPLICATION PERMIT TYPE • MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIODT1EY O OWNER COMPANY NAIVE - 1 -CONTACT PERSON: STATE LICENSE $_ PHONE LE FAMJLY YOUR S -MAIL ADD /'-t e� 1/ 1 1! ,.^ill 3 RI . ; . i ITTEMN OVER 0 TWO FAMILY Q TOWNHOUSE TYPE OF WORK: I 13NEW XREPLACEMENT DETAILED DESCRIPTION OF WORTC jac6L D A13 ERATION/RSMODEL permit No.;� Received By: Date Recd:-- --A6 6e A PER MS 165.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to 5500.00, whichever is grearer, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (71:is should refect only the cost of labor } Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 - ARE RASED ON 510.00 PER FIXTURE, EXCEPT WH W NOTED, FDa URE4: MiDICATE TOTAL FOR PROJECTS WHERE LABOR EXCEEDS SS00, FEES NUMBER OF EACH BELOW) EgWpm=d hz%I1ed MFG: MODEL: SIZE/BT"[T MFG: MODEL: � SIZ MTU A/C $25.00 �.�.— FIREPLMODEL. MFG ACE (GAS) $15.00 - - SIZEMTU_,�.._ _GAS RANGEIOVEN 510.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) 535.40 j FUitNACE 535.00 NEW GAS GRILL 510.00 UNIT = $10.00 BOILER 535.00 CHIMNEY LINER $10.00 ftTT -r Wnr�rr vnm GAS DRYER $10.00 GAS PIPING $10.00 ,,,_GAS POOL I1fiATER 15.00D YENM ATOR$15.00 _..._. Permit Fee $ _ Number of fixtures @ $10.00 -j— x $ = Surcharge 50 Number of fixtures 0 $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 0 x $25.00 = $ Number of fixtures @ $35.00 = x $35,00 - $ State Surcharge - S .50 Total T $ o TMS IS AN APPLICATION FOR A PERMT - NOT VALID UNTIL PROCESSED I hereby apply for a building permit ajad I acImowledge 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-Constluctlon Codes; that i understand this is not a permit but only an ap tas, 'on 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 f a1�1 work wh requires r/e and approval of p SIQNAnME OF APPLIC DATE City of Fridley Building Inspections 1Departmelat 643I University Avenue NE, Fridley, MN 55432 763-572-3604 �5