PRE 2010 DOCSSUBJECT
P
City of Fridley
3245 8 '
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
`
RECEIPT NO.
_ 1 COMMUNITY DEVELOPMENT DIV. ;.: -----
INSPECTION SEC.
�10-7
I � PROTECTIVE
I �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
=
I---1 CITY HALL FRIDLEY 55432
' 612-571-3450
910415
3/12/02
JOB ADDRESS 137 Pilot Ave NE I
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
30
.2
Carlson's Summit Manor, South SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Jewel Defour, 137 Pilot Ave NE, Fridley, MN 55421 763-502-6917
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Merit Building Co Inc, 3029 Coon Rapids Blvd #311, Coon Rapids, MN 55433 20271430
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP 763P ON 7363LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Dwelling
7 CLASS OF WORK Cjj NEW O ADDITION O ALTERATION X REPAIR O MOVE O REMOVE
B DESCRIBE WORK
xxx =a= = overhead garage door, vinyl insert windows, 2 exterior doors
9 CHANGE OF USE FROM TO
STIPULATIONS
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.
Caulking and flashing for all exterior openings.
SEPARATE PERMITS
REQUIRED FOR:
�LUi���G gNi'ING
Sift
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
SQ. FT
CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. `
NO DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
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
$10,945.00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$5.47
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
$10.94 Fire SC
PLAN CHECK FEE
TO;TACEE
3 -I2 -o -L
$5.00 ase
6.66
SIGNATUREW CONTRACTOR OR AUTHORIZED AGENT IOATE,
NP PER LIOA'LEDfrAIS IS YOUR PERMIT
SLOG. 1A5 /// OATEE
S.GNATURE OF OWNER „F OWNER BUILDER, IDATEI
03/12/2002 08:29 FAX 7633237464 Merit Building Co. Inc.
NEW CJTY OF FRIDLEY
AWN 1 1 6woi niver 4NE, Fridley, MN 53432
ALTER SINGLE I AMILYAND DUPLEM R-1 AND R•2
OL ILQJJ ` HERMIT APPLICA not4
Cbnsfruttion Address:
Legal Description:
Owner Name $ Address:
Contractor: C r)1' r j*+
COOn tZyp)t1-5, m f� 5.5
Attach to this app,'
lot, with the propos
.0
2004
Ef ecom If! 121c?
(713) �2:ssi iajaa !c—
r
Iv
Tel. # 7&5 -50 2-1 q 17
MN UCENSE # ZAZ7 I �1 (
ion, a Certificate of Survey of the
construction drawn on it to scale.
OFIMPROVEMENT
I.# X03 -32,,x -7,3& 2j
G (012-L1i2-0K57
WING ARElt_ Length Wght_ Sq. Ft.
I
GARAGE AREA: Length Width i_Height Sq. Ft
DECK AREA: Leng5 Widfli Ngt/Ground Sq. Ft
OTHM
Construction Type: &+b -Qq n 0,jerhgord C=race D -.ErAmated Cost: S
V;ny) 1pser wirldov�s; `
boorg
Driveway Curb Cut Width Needed: __Ft + 6 Ft = Ft x
DATE: 3 -1 1-Q Z APPLICANT: _C-�G..� ['�ffjrr - %1. '7ln -323
Call (763) 672-3604 for Permit Fees if mailing in epplieation or Fax to 763471-1287 if using credit card and we will
call you for card number.
Permit F'ee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway (Escrow
Erosion Control
Park Fee
Sewer Main Charge
.TOTAL
CITY USE ONLY -
$ 1,122l e! . 6 C- STIPULATIONS:
@N
W..asM
Fee Schedule on Reverse Side
$ /0.
.001 of Permit Valuation (1110th%)
$ 157
$.50/$1,000 Valuation
$1200 per SAC Unit
$ a v
$5.00 (State Licensed Residential Contractors)
$
Alt. "A" or Alt. " S" Above
$
$450.00 Conservation Plan Review
$
Fee Determined by Engineering ,
$
Agreement Necessary ( ) Not Necessary [ j
$ 1,122l e! . 6 C- STIPULATIONS:
@N
W..asM