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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT No 45 Date: .. 60/ Owner: �,�'_,�'--!...__ .. _. — ._ Builder A�� ;. �o Address ___.._..._W_...__ _ _ _ _. Address LO TIO F BUILDING No. - Street' _ `f ..�__.......__._.._._. Part of Lot Lot ...._.. ' R' --.-...... Block ....._ ..............:........---.....-........ Addition or Sub -Division ' - y - .. __....._.:. ...... Inside Lot--------...�+'` _. Setback ..... .._..._ r Corner Lot ....._..:..............-• ------ ---... ..._.._..._. Side and ....._.: !!:.:.. Sewer Elevation ..._------- ------ ----------- _•---_._._..-------------- _..._._.......... _._ Foundation Elevation DESCRIPTION OF BUILDING To �se�d/ _ ........... ..... Front f a _.. Sq. Ft. e'. aF..00. _.......�`. Depth Height Cu. Ftoly- -.................. ....... :......_..:....... ......... ,FroL►t ....::........r. Depth Height Sq. Ft _:.._ _.. Cu. F't.....:_:........... ... Type of Coin struA'xi ir°d :-. Est. Cos �. ..�...... _....! To be Completed ....._ ............._............._. 110 f r- VIOLAT- `u I lIS PER IT r,C,,:yeP OT AUT LAND CC;VEi'Ir',f 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 $ "'"°_'"-:.., 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, repaq and moving of buildings within the city limits and this permit may be revoked at any timo -ups violation of any of the provisions of said ordinances. ,�°` d+' r/� -. Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for these hems. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name / f- ®�' �� Builder_ L a k _, e� Y✓ - �(eA ! � i Address Address LOCATION OF BUILDING No.---=-��Street ®y f r�f� d V i'art of Lot Lot Block '! Addition or Sub.Div., wed Ve terof f e- Corner Lot_Inside Lot Set Back Side. -Yard 3- w -� SEWER ELEVATION � js e FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: ✓ 42 s ✓ Front ° Depth '-,r Height Sq. Ft.2,, Cu, Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction,,22�� 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. °' SIGNATURE DATE "- ( Schedule of Fee costs can be found on the Reverse Side.) ° City of Fridley AppIlication for Plumbing and Gas Fitting Pennit DESCRIPTION OF WORK Number, Kind and Location of Fixtures ry� NO. RATE TOTAL x $1.50 $ O'�U �.. €� $ z �� sip�0 Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 0 2 z a • F • N WATER HTR. GAS ELEC. �� x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. o2 $ M REPAIRS & ALTERATIONS—Refer to Code Description................................................$ TOTAL FEE $ 11 " Base 1st 2nd _ 3rd 4th • Future Connection Openings Connected with Sewer � New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Number Fixtures ...................... NO. RATE TOTAL x $1.50 $ O'�U 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. RATE TOOTA�L�, 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 FEE $ 11 " Dept. of Bldgs. Phone SII 4-7470 Location 2 a z /53e ,4 r - r - City of Fridley: 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 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. A Fridley, Minn. MAY 9 1960 19__. - Owner Kind of Building Used as To be completed about Estimated Cost, Old ew. Building Permit No 1- J-/ Pemsit No. SignedD101DQN PLUMBING CO. Business Phone No ROUGH MAY 12 1960 FINAL 4 a 2M 7-59 City of Fridley, Minn. �2&" )�6 BUILDING PERMIT N° .7274 Address Address LOCATIO F UILDING No. Street P f Lot Block Addition or Sub- an . Corner Lot._ Inside Lot __ Setback _ Side, -- dation Sewer Elevation — Fo Elevation DESCRIPTION OF BUILDING B: 97 — Front Depth Height Sq. Ft. LW Cu. Ft.�r9-� Depth 'gei t _,_�____ Sq. Ft. Cu. Ft. Type of Constructio _ . _ Est t i To be Completed In consideration of the issuance to me of a permit to construct tbe building described above I agree to do ::i= he proposed work in accordance with the description above set fo and in compliance with aft provisions of ordinances of the city of Fridley. 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 reg int location, construction, alteration, maintenance, repair and moving of buildings within the city limits and t]s permit may be revoked at any time upon violation of any of the provisions of said NOTICE: M permit dont not corer the constwcHon, huh nflan for wkhgb phmhing, ea headne, sewer or water. Be sons to as the BulkUns Inspector for separate permits for these Homs. OWNER'S ADDRESS No APPLICATION FOR BUILDING PTIMIKET CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING Lot Block Addition or Subdivision Corner Lot Inside tot �etback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION of Lot Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location drawn: on these Certificates. OF BUILDING To be used as: Front rapth Height ✓P` Sq: Ft. Cu. Ft .\S r a - Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cos n---�'-��'_— 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 r4ue.and correct. DATE S (Schedule of Fee Costs can be found on the Reverse Side). 53-84-S-915.51 City of Fridley _ APplieallm for g wd baa R"I" 4 - Dept. of Bldgs. Phone 9®0-3450 DESCRIPTION OF WORK TAM 961 No E• 07erton Drive Number, Kind and Location of Fixtures �• Qs g � ►� O� s N it O V 6 � 3 V� did- V - y lJ V . I . WATER MTA. Base 1st Inst an P rt b1a ra it 2nd 3rd 4th • Future Connection Openings saw" ❑ * New Fixture, Old Openings Cesspool ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ....... • • • • . x $1.50 $ New Fixture Old Opening ....... • • • . x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater (Up to 99,000 BTU) • • • • x $3.00 $ New Ground Run Old Bldg. ........ x $3.25 $ Electric Water Heater .............. s $2.00 $ GAS FITTING FEE$: NO. RATE TOTAL 1st 3 Fixtures ........... • • • —x$100 ; —x$.75 $ Gas Range to 199.000 BTU ............. x $5.00 6 REPAIRS & ALTERATIONS—Rotor to Coda Description ......Portable,11„ .00 ..... TOTAL FEE $ 5.00 City of Fridley: The .undersigned hereby makes application for a permit for the- vwrk herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct Fridley, Minn 6-15-71 -, 19— Owner Donald J. Beaudette Kind of Building Frame Used as Fes. To be completed about 6-22-71 Estimated Cost, $ 10.00 New. Building Permit No. Perini o. s L Si c By - - Business Phone No ROUGH FINAL 2 - -z-1- '7 1 16 SUBJECT I City of Fridley ?4182 41 2 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. •COMMUNITY DEVELOPMENT DIV. yyy r � � PROTECTIVE INSPECTION SEC. 10 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 �""��� �•� 612-571-3450 910-F15 5/16/96 JOB ADDRESS 961 Overton Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15 4 1 Brookview Terrace 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Donald Beaudette 961 Overton Drive NE 571-5682 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 X REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside house; Soffit fascia 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 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 $3 6OO $1.80 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. S PLAN CHECK FE FEE �p i$92.65 c2"O(. o�rr/-�% �611A rTAL SIGNATURE OF CONT ACTOR OR AUTHORIZED AGENT N PR LY VALID D THIS IS YOUR PERMIT DG INS MATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI 16 NEW C ] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: Legal Description: Owner Name & Address: Tel. # 6 %/ Contractor: MN LICENSE # Address • C�j�- - - ) V e ° — �T; Vt ,--' Tel. # _ Attach to this application, a Certificate of Survey of the 0 lot, with the proposed construction drawn on it to scale. DESCRIPTION OF 1WROVEN[ENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: S , Cl S So — %� Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks . YP r 1 �'1 �l ! s i C/ , 7 Estimated Cost: $ 0 � � 4 Type of Construction: � � � d Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: DATE: APPLICANT: Ft. + 6 Ft = Ft x $ _ $ Tel. #c671 Ur 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 $ $900 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 $ .6✓ STIPULATIONS: 01 SUBJECr PERM City of Fridley 26252 AT THE TOP OF THE TWINS ? BUILDING PERMIT Ir -RfiGfiW4-Wr.-_ _ COMMUNITY DEVELOPMENT DIV. rr PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 "'j 612-571-3450 910415 6/16/98 JOB ADDRESS 961 Overton Drive NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 15 4 Brookview Terrace 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Donald Beaudette 961 Overton Drive NE 571-5682 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Quality Contracting 11412 West River Rd, Champlin, MN 55316 427-7733 7035 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 Reroof House & Garage (26 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 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 ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2,168 $1.08 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 O HER STATE OR LOCAL LAW REGULATING CON- $74.75 Fire SC $2.16 STRUCTION TH F RMANCE F CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC $5.00 $82.99 SIGNATURE OF(CONTRACTOR OR AUTHORIZED Xft NT IDATEI HEN PROPERLY IDATED THIS IS YOUR PERMIT BLDG N! GATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI 01 NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION a� I/_ 33 ConstructionAddress: Ly - Legal Description: Owner Name "ddress: ® _ffe Tel. # Contractor: Llua_ 'y a MN LICENSE# Address: (Z (b Tel. #7� 73 3 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: a gth, Width Hgt/Ground Sq. Ft. OTHER: leq 6^ �,r ffS -P 6� q f/` .�L 5; -QR ,�, ��� �' Construction Type: �Pct�'' P-e"OCLEsthnated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: APPLICANT: Tel. # STIPULATIONS: CITY USE ONLY Permit Fee $ .. Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ /,06 $.50/$1,000 Valuation SAC Charge $ $1000 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 [ J Not Necessary [ ] TOTAL $ STIPULATIONS: al y SUBJECT City of Fridley 797120 AT THE TOP OF THE TWINS BUILDING PERMIT r ` T NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. ��/ E NUMBER REV DATE PAGE OF APPROVED BY _ /-'-1 CITY HALL FRIDLEY 55132 �---'�' I'' 612-571-3450 910-F15 6/21/99 JOB ADDRESS 861 Overton Drive NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 27 5 Brookview Terrace d SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roger Plessel 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Premium Roofing 6680 Lucia Lane #11 Fridley 55432 571-3971 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 KX REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 25 Sg) Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OF CON T. 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 $2185 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,09 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 License SC $5.00 1$91.53 SIGNATURE OF CON'RACTOROR AUTHORIZED AGENT IDATEI WHENPROPERffl VALIDATED THIS IS YOUR PERMIT Bl G IN$D DATE S,GNAYURE OF OWNER„F OWNER BUILDER, IDATEi y NEW [ l Effective 5/10/99 ADDN [ J CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: (l &,6e6V J)fol0,!�- Legal Description:,P(/jF� Owner Name & Address: Di 066- i � 5 "�-- Tel. # Contractor: ,t,, Flu,' MN LICENSE Address: egl lro ZA" // Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EM PROVEMENT 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: j C6z_.G 6 4,P.z-2- Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: - G• APPLICANT: �/� Tel. # Permit Fee $. o(�/ Fire Surcharge $ State Surcharge $ �, o SAC Charge $ License Surcharge $ Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ 9/,2 STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 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 [ ] mA 30ding Inspections 763-572-3604 ;ITE ADDitE.SS! WS APPLICANT IS: PROPERTY O'W TENANT CONTRACTOR CITY OF FR I DLEY BMDING Permit No.. � RESIDENTYAL APPLICATION Received gay: � CI'T'Y OF FRIDLEY Date Recd, _ YOUR E -MAL ADDRESS ntn Dr O ADDRESS_ -� CITY STATE ZIP PHONE:� c d J 2I �� — SUBMIT A COPY OF STATE YOUR STATE LICENSE ADDRE WITH APPLICATION PHONE PROPERTY TYPE °'IN( PERMIT YPE or, DESCRIBE WORK BEING SIZE i GAi2AGES PROPOSED SIZE — PROPOSED HBGHT_ .JWING 0 vmyl 0 Aluminum 0 Other,, w ■ . ■ I . • . ■ 'i`.l�.s it ••�• --- O HOUSEOMY O HOUSE & GARAGE 0 ATTACKED GARAGE D DETACHED GARAGE DSQM 13 Trim ❑ Fascia 22W--W� iN EXISTING OPENINGS Oyes IINo LOCATION OF WINDOWS OR FORNEW OPfiNMGS-DESCRMZ SIZE OF OPENING CHANGES & TYPE OF WINDOW 710 BE INSTALLED NUMBER OF VMMOWS ALL FEES ARE BASED ON vALuATM, 1NCLUDJ.NG THE COSI' OF (USING THE 1997 U.B.0 FIFE SCHEDULE) TOTAL JOB VALUATION $ —,n -W 1q- OCCUPANG ral SFmwr RghgU2Z2Q SUMT., 1. Existing Floor Play 2 Proposed floor p1W 3. List of sun■asurai members to be wed FOR NEW CONSTRLIGMN INCLUDING MMS. ADDITION& & 1. Site pIp4wvey showing the aaseit; strucMa and proposed projoc. 2. Two sots of aonstruction plans 3. Energy Calculat OW A" Permit Fee See Back Page for Pee Schedule Plan Review $ 65% of Building Permit Pee Surcharge $ (.0005) times the total job vahmion – mk imum $.50 Fire Surcharge $ .001 x Permit Valuation (1/100/0) License Surcharge $ gait( Pesidential fort odetenaainst;on) SACCharge $1450(SAC lans o MWCCContractors) per CutCtEEscrow $ 6 ft a ft x $20 — $ Erosion Control $ $450 Conservation Plan Review Park Fee S Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) - Total Due $— Make checks bye to: Ci of Fri Attar THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTILL, PROCFSSW I hereby apply for a buildiurg permit and I acknowledge that the information above is complete and accurate; that the worts will be in conformance with the ordinances and codes of the City of Fridley and with the Mbwesota 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 whi review and approval of plans_ SIGNATUREOFAPPLICANT ��- — PRINTNAME 21, L AATET�I�i---O