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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N® 3888 Date: ... ..... .... Owner ....................................... Builder C% .. ... ....��.. Address ...................................... Address .......................................... LOCATION OF BUILDING No. 10cV.. Street .... Part of Lot ................ '............ . Lot .... �..... Block .. ..... .. Addition or Sub -Division ... ... ...../.�!✓� Corner Lot ............ Imide Lot .. • • . r �....... Setback '�P ~ Sidegard .... .... . `.............. . DESCRIPTION OF BUILDING TbAe Used as: ..• p Q Front ;&.-10 Depth �?:�.� ..Height /I/1�..: �0 "Sq. Ft. /001 f Cu. Ft. dA -:7;V Front A? `t® "'Depth �� �� H /.02 ,11 Sq. Ft. � O.Y Cu. Ft alt0:! (P Type of Cons coon ................... F.st. Cost. be Completed ..............:.... In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description above set forth din compliance with all provisions of ordinances of the city of Fridley. ��pp In consideration of the payment of a fee of $...1..1, 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 city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. �" Buildipg Inspector 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 itema. V ' a APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name )� .Builder , Addx�:ess5.� Y'—A/l,Address. _ LOCATION OF BUILDING No-. Street G '-`' _ /Part of Lot _ r Lot, ,. Block Addition or .Sub. Div. Corner Lot, Ynside Lot Set Back .Applicant attach to this form.Certi,ficate of Survey of Lot'and proposed building location.; DESCRIPTION OF BUILDING To be used as -5P Front —3�)- Depth 5� Height Sq, Ft.Cu..' Ft. Front Depth Height Sq. Ft.. Cu. Ft. Type of, Construction, Estimated Cost To be completed �P The undersigned hereby makes application for a permit for the work 1aerein specified, agreeing to do.all work in strict accordance with the Ci, y 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. Date Z/ Signatures' s _ (A Schedule of FeeCosts can be found on the Reverse/Side) a Application far Power Plants and Heating, Cooling,Ventilation. Refrigeration and �S APP Air Conditioning System anDevices �' PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU 4-7470 GRAVITY WARM AIR: RATE TOTAL Location Furnace Shell 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 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ 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. IDR 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. IDR 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 PIPING (Up to 3 Fixtures) .......................... 1.50 $ (Add 50c each over 3) AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM ALTERATIONS & REPAIRS TOTAL FEE REMARKS: 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, Owner���yt�1 195— Kind of Building �� �E �) 195— Used as To be completed about Estimated Cost, Old- �-New�Buildina Permit No. d O DESCRIPTION OF WORK BEATING or PQTM 7 PLANTS—Steam, Hot Wa , Warm Air . No Trade Name.4 °� �j'- e' " c, Size No Capacity Sq. Ft. EM.R� 0� m—o �J BTU H.P. Total Connected Load Kind r Kind of BURNER. — Trade Name Size No - Cap I o Capacity Sq. Ft. EM.R BTU H.P. RAY N. WELTER HEATING 00. Signed 48jY — . By MINN`APOLIS 7. MINNESOTA 11 POST IM -8-58 Business Phone No- x- r 's,-' .:: ; '�# � r r _ . .F�- 'F.. - 3rd„ ..g` " r a yv x� '. -ux .a L '" s,�i,' - ' o= + ry t I m� 1 'L mow'. �+ "' `"x = 3p} f moi, ` t 1 11 {wy i , .. � �7 1 M1 rf' l M1 . - L.. - f }� i bit 1 L t �'' (. i { Cyt 4Y czt , �: 3 r� q J) CW'ftr- .EO 'Et. a a TT : f� 1 .s i bar t-• ry g } i fia It �+ r �t cl _ pf r V. "y ,.'f. &. _ f t s Ip- �A"3 L--Qy LM' -t - K.' 4 +- ; l.. YT f J4 arp __ �.e'[Zr�: a 1177 -�. c .:t tIq t a, F g .e �.,�rF- . pz sn. J' J•i••'}`, t �l .9 , w - ,_. � �? �' '�'?} �R" �4 r 1.; •.`F "'f t } I f5 ,r.x`. p 7 a t� y %C - :� U e Lam..1. 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City of Fridley SUBJECT P , btr ®1435 AT THE TOP OF THE TWINS P R M BUILDING E EIPT NO: `L �_____ COMMUNITY DEVELOPMENT DIV. r -I PROTECTIVE INSPECTION SEC. /'--1 CITY HALL FRIDLEY 55432 L---- ,'J NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 9/13/77 JOB ADDRESS 980 Overton Drive N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 5 Brookview Terrace 2nd Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ed Breitenfeldt 980 Overton Drive N.E. 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. B USE OF BUILDING Residential 7 CLASS OF WORK NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE �❑ X X 8 DESCRIBE WORK Conversion of existing arae to living area and construct a 36' x 24' detached garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. WMNING Betore digging cell foal utilities SEIFt-O" E PERMITS REQUIRO FOR WIRING, TELEPWONE- ELECTRIC -GAS Etc. !{EATING. PLUMBING AND SIGNS. REQUIRED 8Y LAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. wood Frame 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 $7,455.36 $3.72 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. $34.56 PLAN CHECK FEE TOTAL FEE $38.28 SIG URE OFCONTR OR ORAUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT 7�^ ■LIG INSP DATE SIGNATURE OFOWNER IIF OWNER BUILD I IDATFI• I CITY OF FRI,DLEY APPLICATION FOR RESIDENTIAL BUILDING PER14ITS (NEW, ALTERATIONS, ADDITIONS,.OR REPAIRS) OWNER: `c( gi -Q ,,'rev /--e !,( ;� BUILDER: S' /f -,-,4 Address: 91ro 0-- Address: Tel. No.. No.: 9 8-0 Street: 11 LOT: BLOCK: S ADDITION: 59 10 CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS: 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: G/a vsa Front: Depth: Height: �® Square Feet: Cubic Feet:) Depth: Height: Square Feet: Cubic Feet: . , S Type of Construction: &4,d o 4 Estimated Cost: $ D 0,-0 Q To Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ (SEE REVERSE SIDE OF SHEET) 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. See reverse side for additional information. DATE: q_ /-2 -- % % SIGNATURE: Stipulations: - 4j �� �( AGREEMENT owner of the property located at '?4/0 Qlue4�,e7;L, have no objection to the City allowing the construction of a to be located at f'Ga� - ��'- E without the required certificate of survey that the City ordinarily requires for all new construction. ILI Signature Address —,7 7 Date Witness I Mrd PlailoInq 37OMisms' si/►piJUE. I (4a&o4al7L wr"{ ti; r�yrir� °` Minneapolis 2l, in; „'eslrict ENGINEERING, INC. ti11nnciola Sllnref 4 6066 Fn yineers Sur vecyon5 certilicate of suirveyI s y v 'Sb 0 1 r i ! hereby cerhiy' lhat ibis is a b-ue and correct represenfofion or-, survey Fife boundaries el'Ae oborre /rcgfion ol'all trurldin95 , lheivon , x7doll risible encrodcbmenfs ,!f'ooy, from or ansoid /and. As surveyed me d ;. of " SUBURBAN ENGINEER � NO 1-ng;neers k� I �. (Aj I rL or,' r SUBJECT PE MI City of Fridley 16 7 6 7 AT THE TOP OF THE TWINS BUILDING PERMIT _ r RECEIPT NO. `y ______ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r 1 PROTECTIVE 1-5-00 t' CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 1910-F15 9/16/82 JOB ADDRESS 980 Overton Drive N.E. 1 LEGAL LOT NO. BLOCK RACT OR ADDITION SEE ATTACHED DESCR. 4 5 rBrookviewTerrace 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ed Breitenfeldt 980 Overton Drive N.E. 571-3033 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. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK t Gar&g.e Addition 9 CHANGE OF USE FROM TO STIPULATIONS A firewall is to be placed between the existing garage and the addition. MM FOR RME cl 100 dots �EPERATE PERMITS MU 41ac 601 X0 -Ec• PLUMBING AND SiG� �i E",0jjj, 8E-ATINGeEE QuotED TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 320 3200 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3,296 $1.65 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $44.50 PLAN CHECK FEE TOTAL FEE $46.15 GNATUR FCONTRACTO ORAUTH IZEDAGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT D �f` c N BLDG INSP f DATE SIGNATURE OF OWNER IIF WNER BUILDER) IDATEI r CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATI1V FOIL RESIDENTIAL BUILDIUG PERMITS (Rew, Alterations, Additions. or Repairs) OWNER: F -e ADDRESS: TEL 00: '5- 7 /— 3 0 3 -z BUI LDER : 5 ADDRESS: TEL 110: Construction Location . STRICT NO: q STREET:(� !� 0) -A P, L) LOT: "� BLOCK: 1=1) ADDITION: eC ee- 0•eJ F) . Corner Lot: Inside Lot: Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. /n,_ DESCRIPTION OF CONSTRUCTION 1� Abb o Front: Ja Square Feet: -30- Q Depth: / O Height: /6 Cubic Feet: Jabo Front: Depth: Nei Square Feet: Cubic Feet: ;ht: Type of Construction: Estimated Costa $ 0 Q - 7b Be Mrapleted: / a Alt. A Alt. B Proposed Driveway width If New Opening Is Desired: $ ' $ SEE REVERSE SIDE OF SHEET 'Mie undersigned hereby makes application for a permit for the »ork herein specified, agreeing to do,all work in strict accordance with the City of Fridley Ordinances and rulings of the Deplrtment of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: SIGNMIE: Stipulations: .''.; �rt,� � ��r��r/ � � S10d1ssrss!Pf%SINE. Alwnealv!l� W. ENGINEERING, INC. Enyincer-5 Sur veyor6 ciemtificate of surve 9 1,1n.5 is a f ue arid ewre-n7i -epre5rnl,-tion c bwn;birres "file abope v�yedf �,/ foe el.V�VXhmeW5 'eml. fmo W M;d !i7rd. A d'7q5, , lheiror, apdOd MQ or A. 0 ll_ SUB U28" LcNC7 [1,q;ne . . . . . . . . . . . . . 01 SUBJECT City of Fridley ('U21475 AT THE TOP OF THE TWINS ? BUILDING PERMIT B UV COMMUNITY DEVELOPMENT DIV. -REzGPIF5;6:::� _ ~ PROTECTIVE INSPECTION SEC. _ , CITY HALL FRIDLEY 55432 NUMBER REV PAGE OF APPROVED BY 612-571-3450 910-F15 [DATE 8/3/92 JOB ADDRESS 980 Overton Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 5 Brookview Terrace 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ed Breitenfeldt 980 Overton Drive NE 571-3033 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 �7 ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK bzNKxX 1KXX Reroof Dwelling (18 Squares) 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. ZONING SO. 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 NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. 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 $954,00 $.5o 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 PROVISIO S O ANY OTHER STATE OR LOCAL LAW REGULATING CON - $25+00 Fire SC $.95 . TR R H ERFORMANC F O TRUCTION. PLAN CHECK FEE TOTAL FEE $26.45 SIGNATURE OFCONTRACTOR ORA ORIZEDAGENT IDATEIWHE PR ERLY VAL ATED THIS IS YOUR PERMIT g_g- BLDG )NSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI 01 NEW [ ] Effective 3/1192 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: Cl " v �� m `� Legal Description: Owner Name & Address: Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: -e ; ICL - Tel. # MN LICENSE # Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Corner Lot [ ] Inside Lot j J Ft. Yd Setback Type of Construction: Approx. Completion Date: Driveway Curb Cut Width Needed: APPLICANT: Tel. # DATE: JIXT— ( -� Ft. + b Ft = Side Yard Setbacks Estimated Cost: $ -�16-7-1 `r6 (Cost on Back) Ft x $ = $ Permit Fee $ oo Fire Surcharge $ . ��- State Surcharge $ C� SAC Charge $ License Surcharge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: RIMMWIRWIM" Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $700 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary ( ) 3uilding $ BUILDING Permit No.: inspections $ q RESIDENTIAL APPLICATION Received By: 763-572-3604 $ CITY OF FRIDLEY Date Rec'd: )ATE 3Z YOUR E-MAIL ADDRESS Erosion Control ;ITE ADDRESSr, , $ HIS APPLICANT IS: DOWNER ❑CONTRACTOR Total Due PROPERTY OWNER/ Nom; r, ADDRESS: 0oz)PITY oG STATER S✓Z TENANT PHONE: ✓� �%f C3 �� CONTRACTOR NAME; STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE—ZIP— TATEZIPWITH WITHAPPLICATION PHONE FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILYINEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH XROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: Q NEW ❑ ADDITION DWAINTEN.ANCE/REPAIR, ❑ REMODELING DESCRIBE WORK BEING DONE: ®UC' >° C SIZE OF Rv PRO LENGTH WIDTH HEIGHT Sq. Ft. ROOFINGt HOUSE ONLY NUMBER OF SQU ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE 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: (USINGTHE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ e5 � , OCCUPANCY TYPE Permit Fee $ Plan Review $ Fire Surcharge $ q Surcharge $ I. aZ License Surcharge $ SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ a, CM See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach 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 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 wor ich requires revi w and approval of plans. __ `` i� SIGNATURE OF APPLIC7 PRINT NAME�yJ elU�f �� Xtf �zy-ATE