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PRE 2010 DOCSx2v"A� -11F6AI- City of Fridley, Minn. N° 10512 BUILDING PERMIT Date: November 21,E 1969 Owner: H. S. Peterson Builder Sussell Company Address 6112 Pierce_ Street_1N.E Address LOCATION OF BUILDING No. 6312 _Street Pierce Street N E _ __ part of Lot Lot l4 -4--L5--- Block Corner Lot Inside Lot Sewer Elevation Addition or Sub -Division .Mooxe Lake High lands First Addn. Setback _.__ Sideyard —_ Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Detached Garage Front 22 1 Depth 22 Height 10' Sq. Ft 484' Cu. Ft. 4840' Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Frame Est. Cost $2.2D -O Q.Q_.......__ To be Completed 90 daY s Provide hardsurfaced driveway. Ce�tif4ed0SZ D,�'the/lot, �wi ng Zec&a o of�th� fquryQYa o e. h ben ,�ona/tr� c ed w l l e e ire c d t g• In consideration of the issuance to me of a permit to construct the building described above, I agree to do =Wan= work in accordance with the description above set orth and in complianceZall provisions of ordinances of the city of Fridley. Inconsideration of the payment of a fee of $ , permit is hereby granted to Sussell Company 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 andmoving of buildings within the city limits and this permit may be revoked at any time upon violation of of the provisions of said ordinances. Wr 'tUaECE BELT -SLE p NOTICE: This permit don net cover the construction, hntallatioa for airing, plumbing, gn heating, swrer or water. Be sure to ate the Building Inspector for separate permits for then hone. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER IS NAME �z �'� �e� - .� .o BUILDER ADDRESS ;'3 /a %`SOP c � �f A�& ' ADDRESS LOCATION OF BUILDING N0. LOTBLOCK ADDITION OR SUBDIVISION jM00R-e, LAAhI tCetf 'swINS CORNER LOT INSIDE LOT SETBACK SIDEYARD �c esT' SEWER ELEVATION TOP OF FOOTING 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: ae-40-LoLa�i a- Front . Depth Af Height Square feet -le t/ Cubic Feet `elfl-% Front Depth Height Square feet Cubic Feet Type of Construction �a Estimated Cost 2- OCs V—�L— To Be Completed 'go e��x -5 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 A,,— ?/- /9(o .(Schedule of Fee Costs can be found on the Reverse Side.) NOTE: A Certified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before Rroceedint� with the framing. SUBJECT PERMI City of Fridley "'C21423 AT THE TOP OF THE TWINS BUILDING PERMIT r ______ COMMUNITY DEVELOPMENT DIV. ~ PROTECTIVE INSPECTION SEC. �! r T NUMBER REV, DATE PAGE OF APPROVED BV CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/29/92 JOB ADDRESS 6312 Pierce Street NE 1 LEGALLOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 14, Pt. 15 Moore Lake Highlands lst Addn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lori Stinger 6312 Pierce Street NE 574-2509 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Columbus Exteriors 2131 111th. Ln NUT, Coon Rapids MN 55433 868-9195 3509 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 ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 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 $4000 $2.00 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 PR VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $63.00 $4.00 T UCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC $5.00 $74.00 SIGNATOR OF CONTRACTOR OR AUTHORIZED AGENT IDATEI r HEN RO RL�ID D THIS IS YOUR PERMIT 6-Z% tALOG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE) NEW [ ] Effective 3/1/92 ADDN [ ] CITY OF FRIDLEY ALTER [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: 6 312 -, e /,--I e Legal Description: Owner Name & Address: �y�� S% eC5 ca S41t.E-4" Tel. # Contractor: alum J ies Ex f P /- I o - J _ MN LICENSE # 0 6o 3S o !y Address: / /// �� LAS %i S S Y 3 3 Tel. # P4 6) - fl f 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: Length Width Hgt/Ground Sq. Ft. OTHER: 5c-"� J ^tet Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Type of Construction: Approx. Completion Date: Driveway Curb Cut Width Needed: Ft. + b Ft = _ Side Yard Setbacks Estimated Cost: $ fn�� (cost on Back) Ft x $ = $ DATE: " ,36 — %2 APPLICANT: MTel. # �! Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Park Fee Sewer Main Charge $ TOTAL STIPULATIONS: CITY USE ONLY 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 [ ] City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING PERMIT 526(TIPT r • _____ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 5432 j 612-571-3450 ' NO. /� 36, I NUMBER 910415 REV DATE 7/14/97 PAGE OF APPROVED BY JOB ADDRESS 6312 Pierce Street NE 1 LEGALLOT DESCR. NO. 14, Pt 15 BLOCK TRACTOR ADDITION Moore Lake SEE ATTACHED Highlands 1st Addn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Thomas Buirge 6312 Pierce Street NE 586-0875 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 Ek ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 32'5" x 12'6" Addition 9 CHANGE OF USE FROM TO STIPULATIONS See notations an plan. wAR14ING tEPIARATE PERMITS REQUIRED FOUR WIRING, HEATING, PLUMBING AND SIGNS.454.0002 Before digging call for 211 utility locations REQU I RED BY LAIN 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 AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SQ. FT. CU. FT. OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION NO. DWLG. UNITS 1 OFFSTREET PARKING STALLS 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 $35,647 SURTAX $17.82 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PERMIT FEE $ SAC CHARGE PLAN CHECK FEE TOTALFEE $502.22 SIGN TUREOFCONTRACTORORAUTHORIZEDAGENT IDATEI /. WHEN PROPERLY V I ATED THIS IS YOUR PERMIT B60G SP qAT SIGNATURE OF OWNER uF OWNER B DERI ID T I T JUN -11-1997 08:23 ' ADDN pC] ALTER C J ConstructionAddress: CITY OF FRIDLEY 612 571 1287 P.01i02 CITY OF FRMLEY SINGLE FAMILY AND DUPLEXES R -I AND R-2 BUILDING PERMIT APPLICATION] Legal Description: Owner Name & Address: 1 'POW1A S -C--' - t&IeNE (s3(2 ?15Ar NE Tel. # &tZ G SQ -0$"7S Contractor. Z_ _MN LICENSE # Address: Tel. # Z Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF Il61PROVEMENT �r LTVYNG AREA: • Length ' �� Width l z� ��t HeightrZ Sq. Ft. GARAGE AREA: Len Width _ `�.(P $ Height Sq Ft �_ � � l DECK AREA: Length Width Hgt/Ground SQ- Ft. •� �C9 OTHER.- Construction THER: Construction Type: Driveway Curb Cat Width Needed. Ft. + 6Ft = DATE: 8 i(q-71 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow _ Estimated Cost $ 2�. 00. O O • (Fee Schedule on Back) Ft x $ _ $ ATTPLICANT: (nrY►F�S (2.�(.l i ��,'� Tel. # (Q l S8 - O 8-]1S Cr Y� USE ONLY Fee Schedule on Reverse Side .001 of Permit: Valuation (1/10th%) $.50/$1,000 Valuation $950 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Erosion Control $ • $450.00 - Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge . $ Agreei3i6nt' Necessary [ J ' Not Necessary [) . TOTAL $ STIPULATIONS: 106/11/97 WED 08:17 [TX/R1 NO 51231 IJ001 -CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On January 1, 1997 PLUMBING FIXTURE RATES: NO.. `Q 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** Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type RATE TOTAL JOB ADDRESS �C7rCC A� $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated In this application are true and correct. 1997 Owner �Jl14S ;F95&,1W` 5 76 Building Used As Estimated Cost ^ �/(N PERMIT NO. / / / / PLUMBING COMPANY ll/M lg] ��qqr O � SIGNED BY TEL N0. X06 & 7 5 6111 Approved By / Rough—In Date Final Date $ .50 MINIMUM FEE /QR ANY PLUMBING/ $� PLUS THE $.50 STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. SUBJECT M City of Fridley E27993 AT THE TOP OF THE TWINS BUILDING PERMIT - r` COMMUNITY DEVELOPMENT DIV. INSPECTION SEC, r : PROTECTIVE E , NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 810-Ft5 9/29/98 F JOB ADDRESS 6312 Pierce Stree 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 t. 15 M 1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tom Buir e586-0875 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO New haven Const. Co -5225 20077950 ARCHITECT OR DESIGNER MAIL ADDRESS ZI PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ilk REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage (33 Sq) Tear-off 9 CHANGEOFUSEFROM 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2828 $1.31 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 $74.75 Fie SC $2.82 PLAN CHECK FEE AL FEE License,4C$5-0 783.88 SIGNATURE Of CONTRACTOR OR AUTHORIZED AGENT IDATEI EN R P Y VALI THIS IS LIR IT BLOt INSP e )ATE S[GNATURE OF OWNERIIC OWNER BUILDER[ IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: _ Owner Name & Address: Cry og/lam Tel. #'r �f Contractor: 14) MN LICENSE # Z007 qS'() Address: ��A? Z3Tel. # .5-(Dja' 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: Length Width Hgt/Ground Sq. Ft. OTHER: mlld o—AT-z--f- e 23 Construction Type: Tom"' �� /��V 0 � Estimated Cost: $ Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: & IZ-! S APPLICANT: ' 'W 40) � Tel. # S-&& -S-N S' Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ 211,7L5— Fee Schedule on Reverse Side $ of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1000 per SAC Unit $ 4 jam, &-5 0 $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 [ ] $ '33. W 4 sue�EtT ERMIT NO. City of Fridley32796 AT THE TOP OF THE TWINS BUILDING PERMIT r R C IPT O. COMMUNITY DEVELOPMENT DIV. -� INSPECTION SEC. r PROTECTIVE CITY HALL FRIDLEY 53432 I NUMBER DEV DATE PAGE Oi APPROVED AY 612-571-3450 910-F15 7/17/02 JOB ADDRESS 6312 Pierce St NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 Pt 15 Moore Lake Highlands 1st Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tom Buirge, 6312 Pierce St NE, Fridley, MN 55432 763-586-0875 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Tom Buirge (same as above) 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 ❑g NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Install new pool 9 CHANGE OF USE FROM TO STIPULATIONS Follow all pool stipulations 1-10 on handout. WARNING Before digging call for all utility locations 4540002 SEPARATE PERMITS REQUIRE® BY LAW, REQUIRED FOR: WIRING HEATING SEPARATE PERMITS ARE REOUIRE0 F 9MEWIRT. IN M61NG. 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 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 COMPLIED5 175,00 @ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT W2.59 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. 125.25 Fire SC $5.18 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOT FEE - 133.02 S�1 NAT ON' ACT OR UrHOR1ZED AGENT HE PROP VALID THIS IS YOUR PERMIT ZTE, '71 AOF OWNER BUS Ri E� BLAG -NSP GATE NEW (] CITY OF FRIDLEY ADDN [ J 6431 University Ave NE, Fridley, MN 55432 ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Effective 1/1/2002 (763) 572.3604_ Idg Insp 401 tom' Legal Description: Owner Name & Address: `259166 452 �C�Ge � Tel. #763. 50 -OS-76- Contractor. S MN LICENSE # Address: Tet. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: 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 Wdth Height Sq. Ft Width Hgt/Ground Sq. Ft Construction Type: Estimated Cost: $ 5(�� Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: 11,2 O0— APPLICANT: /%� S ��' i� Tel. #� Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - $ o? 05 Fee Schedule on Reverse Side $ 5 .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ 9$1200 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by'Engineenng $ Agreement Necessary [ ] Not Necessary [ ] $ J C1, ur STIPULATIONS: ct-, 4'75R P SUBJECT0: City of Fridley (' 3 4 0 4 8 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. tr -------COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. b5ql r E 1 ; P NUMBER REV DATE PAGE OF APPROVED Br CITY HALL FRIDLEY 55432 763-571-3450 910-F15 12/9/03 JOB ADDRESS 6312 Pierce Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14, pt 15 Moore Lake Highlands 1st Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tom Buirge 6312 Pierce Street NE 763-586-0875 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 ❑ ADDITION 1 ALTERATION ❑ REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Basement alterations per plan 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. 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 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 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 @ $5,000 $2.50 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. $111.25 F SC $5.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION e PLAN CHECK FEE I/T51AL :$118.75 $� GNAT URS OF CON• CTOR RAUTHORIZeD AGENT ��t4' TE Q H P LY VALID D THIS IS QUR RMI Y m l� !!��J� NATURE OF O R ,jF NER BUILDDATEi OG PE P NEW [ ] CITY OF FRIDLEY Effective 1/1/2003 ADDN [ j 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ j SINGLE FAMILY AND DUPLEXES R4 AND R-2 (763) 5714287 Fax BUILDING PERMIT APPLICATION Construction Address: �� I �� S Legal Description: Owner Name & Address: t cLC,� �,3�2 �� Tel. # 58(-" 08-7RS Contractor. oCa�N'e�c_ MN LICENSE # Address: 1st z_ ' l& -6e__ S+ Tel. # � 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: Length Width Hgt/Ground Sq. Ft. OTHER: F7/72 Construction Type: g:, Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: ' b� APPLICANT: iAI l`�h,! 112��L Tel. # Call (763) 572-3604'for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ `c)57 TOTAL $ Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1275 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 [ CITY OF FRIDLEY INSPECTION DIV. 6431 Univerpity Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Effective On Jan 1, 2003 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR JOB ADDRESS r� 3<'G Awe c(- tic- icNew Urinal :I�: ll: Shower : o��..t�� ::::::: Wash Tray € :::::>;» Floor >:.::.:::.:.:::` Drain �#�?�r..�< :::>::::>: :..:. 13altf:.... AUtO. Wa Sher r`aS:::s::<::: as ::: ' => =< Ran e Il;L' Water Heater a EI >...... Gas ec Stones :.:Iffly=>< ��5�: Basement �'�' specified agreeing to do all work in strict accordance with the city codes Beer Dispenser '�• $ 5.00 �� Blow Off Basin $ 7.00 I F o0r1 and representations stated in this application are true and correct. Catch Basin `® $ 7.00 n Rain Water Leader -rte $ 7.00 Floor 2 Sump/Receiving Tank <3� $ 7.00 Water Treating Appliance '0 $10.00 Owners I F o0 r3 -9 $ 7.00 Water Heater- Gas"" � $10.00 Building Used As Gas Range" Range" Floor 4 $10.00 Gas Dryer""'XNo $10.00 Estimated Cost �� PERMIT NO. Back Flow Preventer Required ( )Yes PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS r� 3<'G Awe c(- tic- icNew S y� NewFixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture -P $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser -0' $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin `® $ 7.00 n Rain Water Leader -rte $ 7.00 ZZ , 20 v-? Sump/Receiving Tank <3� $ 7.00 Water Treating Appliance '0 $10.00 Owners Water Heater -Electric -9 $ 7.00 Water Heater- Gas"" � $10.00 Building Used As Gas Range" Range" $10.00 Gas Dryer""'XNo $10.00 Estimated Cost �� PERMIT NO. Back Flow Preventer Required ( )Yes Type $15.00 PLUMBING COMPANY Q(,/NeryL- s8.� Reinspection Fee $47.00/Hr SIGNED BY Gam-^ � , TEL NO.a ALL OTHERS AND/OR REPAIRS AND ALTERATIONS. 1.5% of Value of Fixture or Appliance �i . Approved By Rough -In Date Final Dat State Surcharge $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.0 TOTAL FEE $ 021 S -D PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THd BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When relain an _xie in0 f gran . _, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes( ) No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No ( ) The axk ina r-nmhi ,noon air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No( ) When required to install a now comhunfinn air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When inlinn! a new ventinnsyc _m, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) Ar reliance Jypp and S➢7e/ nmmnn Vent and dent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type Al T RATIMS- ccdbe) o,,z Oii ef 46�� ..� �/Nem `/L/ � LI.N.° �/�GrGYQ !�/,�C�'ii✓ y�Z F K- ��'Pf�� G✓9S HEATING CO: add -e`er Signed By: A Date: /3 FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 June 8, 2004 Mr. Tom Buirge 6312 Pierce Street NE Fridley, MN 55432 Re: Final Inspection at 6312 Pierce Street NE Contractor: Homeowner Dear Mr. Miller: A mechanical permit and a plumbing permit were issued on December 3000, 2003 to install ductwork, an exhaust fan and three basement bathroom fixtures at your address. According to the 1991 Uniform Mechanical Code and State Plumbing Code a final inspection shall be conducted on the work authorized by these permits. As of this date the inspections have not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Codes. We will keep your permits open for another 30 days and if we do not hear from you within this time to set up the inspections, we will mark the permit "no inspection called for by homeowner after notification" and the permits will be expired. To set up the inspections or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. Sincerely, Effective January t, 2003 CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1287�c�( 1/� JOB ADDRESS �n�2 SfC6- l� (`� RATE SCHEDULE OWNER -Tba) ll,i�!-�/� Residential Rate TOTAL Furnace Shell and Duct Work, Burner - BUILDING USED AS Also Replacement Furnace $ 30.00 $ (Side Vent - Fill Out Back) ESTIMATED COST PERMIT NO. = r Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Gas Dryer $ 10.00 $ Trade Name Size No. BTU HP EDR *Air Conditioning - All Sizes $ 25.00 $ Fuel Total Connected Load All Others/Repairs & Alterations (LIST ON BACK)' Burner Trade Name Size No. 1% of Value of Appliance or Work $ 560 ' BTU HP EDR Commercial/industrial 1.25% of Value of Appliance or Work $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and TOTAL FEE representations stated in this application are true and correct. $ SSZ� DATE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO c eK_ REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 �. r PLUS THE $.50 STATE SURCHARGE Signed TEL # �� _0` G�'rS FAX # REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final Da written permission from adjoining property owner.d THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED AND OMMIRTION AIR VERIFIr`ATION Fan Assisted or Nat S`n6 M0N trNT. tFtiIT CQNNFCTQR When renla i an axictinn furanne, the undersigned hereby verifies that the BTU Input venting has been examined and is free from rust, deterioration, obstructions, Appliance #3 Type and is securely supported and firestopped where required. Yes (i No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer Total Btu Input specifications including sizing, length, number of elbows and termination. Yes( No() The undersigned also verifies that the replacement unit is a listed assembly Diameter inches and meets the current codes and manufacturer's specifications. This does ft Length include AGA-GAMA Category I Central Furnace Venting Tables for fan Appliance #2 Vent Connector Height assisted and natural draft appliances. Yes () No ( ) The pY nti r-nmh -conn air is sized and installed to meet the current codes ft Length and manufacturer's specifications. Yes () No ( ) When required to inatall a now aernhustinn air- it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( No( ) When Inctallonn a naw yanting -r—pte , the undersigned hereby verifies that it is'a listed assembly and meets the current codes and manufacturers specifications. This does include AGA -LAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances _ Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type N Al TFRATIl7NS• ( ) S7- HEATING CO:/�� Signed By: l Date: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 763) 572-3604 FAX: (763) 571-1287 ADDRESS : 6312 PIERCE ST NE PIN : 133024310049 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : HEATING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION PERM O.: 2004-0156 DATE ISSUED: 09/13/2004 - VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL PIPING FOR A GAS FIREPLACE. # A/C UNITS 0 VALUE OF APPL OR WORK 1100 # FURNACES 0 # GAS DRYERS # GAS RANGES 0 VALUE (FOR MINIMUM CALL) APPLICANT FIRESIDE HEARTH & HOME 2700 N FAIRVIEW AVE ROSEVILLE, MN 55113 1WOhL BUIRGE THOMAS R & LINDA J 6312 PIERCE ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application 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 does not presume to give authority to violate or cancel the provisions of anther state or local law regulating constructio the perf ance o onstructio . Applicant7 Date�� Bldg HEATING PERMIT MR41MUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 112653 SEPARATE PERMITIB'REOi11RED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 1100 25.00 0.00 0.00 0.00 0.00 0.00 0.50 25.50 CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed.'with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.00 $— $10.00 $10.00 $$10.00 $ $ 10.00 $ $ 25.00 $ State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE C50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. .50 Effective On January 1, 2002 JOB ADDRESS_ 3 OWNER UkS'�i C CU2lkLrr, IVjf1r\ @J, BUILDING USED ASS_+ ESTIMATED COST I (Ly • DO PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER C—j r' -e plu cA. No. of Heating Units,.__I Circle One (Steam) (Hot Water) (Warm Air) Trade Name lie r * g ULo Size No._(L�T2,�� BTU_ 3D I c-,cx HP EDR Fuel ltd - LoCw,--j. Total Connected Load Burner Trade Name Size No._ BTU HP ED The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and Ccorrect. Allied Firesid® DATE dba Fireside Hearth & NOW Wanes 1120090811 HEATING CO 2700 N. Fairview Ave. RuNvIlto, MN 551 13 851/833-2581 _ Signed TELA# FAX # Approved By Rough In Date Final Date THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When replacing an exacting f ,ran . _, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The exit i g _omh ,conn air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new enmhnstion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When inc alfing a new venting,system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) Appliance Type and sisemommon 11pot and Vent Connector Informs ion Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: Signed By: , Date : cllaw Building WELDING Permit No.: L Inspections RESIDENTIAL APPLICATION Received B 76.A; 57Z-3604 CITY OF FRIDLEY an Dale Redd: f DATE ZDo YOUR E( -MAIL ADDRESS %U L f Q e g 0 0 k" S h• e-0 01 SITE ADDREss 3 2 T. AfF $1550 per SAC Unit (Plans to MWCC for determination) THIS APPLICANT IS: i(QWNER ❑CONTRACTOR $ PROPERTY OWNER/ NAME: — ovK Fee Determined by Engineering ADDRESS: 3 LZ I %c—t2c.� 5T ��Cr CITY "� GF (ey STAT*IP ssSF�Z TENANT PHONE: 71`S-5 S%�O�ZS CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE FAX PROPERTY TYPESINGLE FAMILY/NEW CONSTRUCTION SIZE TWO FAMILY/NEW CONSTRUCTION STORIES PERNM TYPE ❑ ADDITION ❑ GARAGE/SHED 0 WINDOWS ❑ BASEMENT FINISH ❑ ROOF 0 DRAIN TILE DECK ❑ SIDING ❑ OTHER ❑ SWD4KI VG POOL TYPE OF WORK: 1 17 NEW PLADDITION Tia 0 MAINTENANCE/REPAIR 0 REMODELING DESCRIBE WORK BEING DONE: C' Aw0tJ4&- POOL. SIZE OF IMPROVEMENT LENGTH WIDTH ..`; 4'0' HEIGHT " 410 Sq. Ft. R00MG ❑ HOUSE ONLY NUMBER OF SQUARES ❑ 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 1. Site PhWSurvey showing the existing structures 0 Other ❑ Fascia wand propos projecL 2. w1wo sets of construction plans WINDOWS IN EXISTING OPENINGS ❑Yes ONo LOCATION OF WINDOWS 3. Isee M� 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: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB V Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Dae aZKalBly $ 25.25 See Back Page for Fee Schedule $ 101 , 65% of Building Permit Fee $ S SS .001 times the total job valuation _ $,'1 _ �•-�' .0005 x Permit Valuation Minimum $.50 $ $5.00 (State Licensed Residential Contractors) $ .Ps $1550 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ $450 Conservation Plan Review $ y, Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $T L q' I Make checks payable to: City of Fridley Attac 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 work whicl r elres t e/v�l w nd approval of plans. �j/ SIGNATURE OF APPLICANT i� /G PRINT NAME !!�/c�►1tAS I