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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N? 3228 Date: ... .......... ..................... � E owner ....................................... Builder :1.:'�:. ....... .:::.....: ........... Address ...................................... Address ............................................. LOCATION OF BUILDING No. '.:. r.. Street' ...... .. ......... Part of Lot .............................. . r" Lot ...... Block ...... v:....... Addition or Sub -Division ...... . ..... .. Corner Lot ............ Inside Lot ............ Setback. �s..: Sideyard ::::.. ....:. .: �a 4 4 a ...... DESCRIPTION OF BUILDING Tg be Used as: ....... Front ..: ` :. Depth .....: Height .... a... Sq. Ft. ........ Cu. .................... Front ........ Depth ..... Height .... Sq. Ft......... Cu. Ft. ........ Type of Construction ................... Tet. Cost. �3..r® To 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 fgxkh 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 grantedupon the express condition that, the person to whom it, is granted and his agents, employees and workmen,-InAll'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. BVilding 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 Items. — -1. T-a-.�--- City of Fridley, Minn. BUILDING PERMIT N? 3785 Date: ............. ..................... Owner ..�� . .......... Builder ......................................... Address ...................................... Address ............................................. LOCATION OF BUILDING No. ..Sf ®l . Street .............. �: ... Part of Lot ............................... Lot ............ Block .................. Addition or Sub -Division ..................................... c � Corner Lot .......... Inside Lot ............ Setback.�r�..: �.. Sideyard ................... DESCRIPTION OF BUILDING U ed as: ...... yy' Front .� '� Depth :� Height . Al `�Sq. Ft. � .✓.6 . Cu. Fh� .................... Front ........Depth ........ ei ht . Sq. Ft. ........ Cu. Ft ........ Type of Construction ................. • Est. Cost....,. r....... To 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 and in compliance with all provisions of ordinances of the city of Fridley. .X. ., � ...................... 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, 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. �� I W--��l�' � W - - � � � 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. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name l ) ��� Builder Address Addressopt +... LOCATION OF BUILDING No. Street _ Part of Lot Lot-- Block Addition or Sub. • Di -7.. Corner Lot side Lot .Set Back -- Applicant:attach to this Porro Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as -• Front. Depth,,., Height Sq. Ft. Cu. Ft Front ______...;._Depth Height Sq. Ft. Cu. Ft.. 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 Ordinarices 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 Signature. (A!Schedule of Fee Costs can be found on the Reverse Side) 52-84-915.51 City of Fridley Appkatkia for N=dAng wed Gag Fi hnait Dept. of Bldgs. Phone NO -3480 DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $200 $ Future Fixture Opening ............ x $1.50 $ New Fixture Old Opening .......... x $1.50 $ Catch Basin ............... 6 .... 6 x $3.25 $ Water HeA9P WL 9&W, BTV) .... 1 x$3.00 $ 3.00 New Ground Run Old Bldg. ....... . Electric Water Heater .............. GAS FITTING FEES: 1st 3 Fixtures .................. Additional Fixtures ................. . Gas Range to 198,000 BTU.. . ... . ... .... REPAIRS 8: ALTERATIONS—Refer to Cede x $3.25 $ $2.00 s NO. RATE TOTAL 1 x $2.00 ; 2.00 x$.75 $ x $5.00 $ Description ............................. > .................. $ TOTAL FEE 5.0© �p O Fur c d f.ar�t}sn 6301 NE Quincy St. City of Fridley: The .undersigned hereby makes application for a permit for the- work 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 atilt the fact and representations stated in this application are true and correct Fridley, Minn Jular 27e 1971 18� Owner Vernon "ichards - Kind of Building fr. Used as res . To be completed about Aug. 2 Estimated Cost, $ 10.00 Old—New. Building Permit No. pppp ��yflPermit No. ed MILAN APOU 1A1 Business Ph No ROU®H 3` Y e e WATER NIR. GAS ELK. Base 1st il Ist411 r 11 2nd 3rd 44th ° Future Connection Openings Co * Near Fixture, Old Openings Sea ❑ V cesspool Cessp000l ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $200 $ Future Fixture Opening ............ x $1.50 $ New Fixture Old Opening .......... x $1.50 $ Catch Basin ............... 6 .... 6 x $3.25 $ Water HeA9P WL 9&W, BTV) .... 1 x$3.00 $ 3.00 New Ground Run Old Bldg. ....... . Electric Water Heater .............. GAS FITTING FEES: 1st 3 Fixtures .................. Additional Fixtures ................. . Gas Range to 198,000 BTU.. . ... . ... .... REPAIRS 8: ALTERATIONS—Refer to Cede x $3.25 $ $2.00 s NO. RATE TOTAL 1 x $2.00 ; 2.00 x$.75 $ x $5.00 $ Description ............................. > .................. $ TOTAL FEE 5.0© �p O Fur c d f.ar�t}sn 6301 NE Quincy St. City of Fridley: The .undersigned hereby makes application for a permit for the- work 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 atilt the fact and representations stated in this application are true and correct Fridley, Minn Jular 27e 1971 18� Owner Vernon "ichards - Kind of Building fr. Used as res . To be completed about Aug. 2 Estimated Cost, $ 10.00 Old—New. Building Permit No. pppp ��yflPermit No. ed MILAN APOU 1A1 Business Ph No ROU®H SUBJECT PER City of Fridley - 15.20 AT THE TOP OF THE TWINS _ B U I L D I N G PERMIT r . ECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 � � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 .910-F15 5/21/79 JOB ADDRESS 6301 Quincy Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 8 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Vern Richards 6301 Quincy Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be second but not third roof. Install ridged galvanized valleys.. SEPERATE PERMITS REQUIRED FOR WIM MEATING, PLUMBING AND SIM. 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 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 l 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. $1,000 $.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- $7.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $8.00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT v f l[ SrGNATURE,PF OWNER Or Y WNER BUILDER) )DATE) BLDG INSP OA TLE • CITY OF FRIDLEY • APPLICATION FOR RI'SII ENTIAL BUILDING PERMITS (NEW, -ALTLRATIns, ANITION'S, OR RCPAIRS) OWNER: //p c ;.� s DUILDBR: Address. ,(, U/ Q, �` ��./. s �, Gt�� l Address: -Tel. 14o.: -r-21- No. r -2/ -No.: Street: LOT: 9 BLOCK: � ADDITION: � (S 71 L �i U CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS: - Applicant attach to this form 7\vo Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front: Depth: Height: Square Feet: 20 � Cubic -Feet: 'Front: Depth: Height: Square Feet:* Cubic Feet: Type of Construction: Estimated Cost: $-iUo� To Be Completed: Alt. A Alt. B proposed Driveway Width If Beta 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 Dcpartment 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: c�_ - ,� �- 7 � SIGNATURE: Stipulations: • SUBJECT MI City ®f Fridley 26974 AT THE TOP OF THE TWINS BUILDING PERMIT r g COMMUNITY DEVELOPMENT DIV. _ _ r � � PROTECTIVE INSPECTION SEC. 1 . � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 A ,`, 612-571-3450 910-F15 8/3/98 JOB ADDRESS 6301 Q incy St NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 8 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE George H useby 6301 Quincy St NE 572-9548 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 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 Reroof house 12 S Tear—off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. 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 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. OWLG. 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 1000 $.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. 34.75 Fire SC $1.00 PLAN CHECK FEE TOTAL FEE 6.2 SIGN UREOFCON, CTORO UTHORI DAGENT IDATEI WHEN PROPERLY IDATED THIS IS YOUR PERMIT _I 81.INSP r�ATE NJ S,GNATUREOf,0%NER0F OWNER BUILDEFVr IDATEI r- NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: (,;7 �0 ( Legal Description: Effective 1/1/98 Owner Name & Address: t�7�®�9 e Jlj�CeSP6cr Tel. # 7.2- Contractor. �d MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE -AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: /PP f150-1 riese 11A Sx Construction Type: Estimated Cost: $ /0601 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: X'0 APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ J1 CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 [ J Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By. 763-572-3604 CITY OF FRIDLEY Da d;! % DATE1"6—0-7 YOUR E-MAIL ADDRESS SITE ADDRESS O / Q lJ ( A% THIS APPLICANT IS: ❑ OWNER IONTRACTOR PROPERTY OWNER/ NAME: aG a&gF s b(A^jZ M,4,eS y4,4 ADDRESS: G 30 ( Q Ui r4C-C-4 CITY ;E9/,9 L;C �e STAT&OZIP TENANT PHONE: CONTRACTOR NAME: g , & ICF= STATE LICENSE # o *;?2 EXP DATE �! SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 4� S— CITY/'/ f STAN/ZIP YO WITH APPLICATION PHONE %3 FAX 7ro-3 - S_S_ 7 ^ % PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH XtROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES OHOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: METACHED GARAGE 3. List of struchual members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DgCKS, ❑ 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: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ $• $ /."35 $ 5.60 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) $1675 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 oavable to: City of Fridlev 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 work whichl-e4uires review and approval of plans. SIGNATURE OF APPLICANT �/`"�f PRINT DATEy `�� ~✓ Building PLUMBING Permit No.: Inspections IESIDENT'IALAppLICATION Received By• 763-572-3604 CITE' OF FALL+ Y Da 'd: 763-502-4977 FAX EFFECTIVE 1-1-08 DATE -7 I ?-cl l0 YOUR E-MAIL ADDRESS SITE ADDRESS 3v ( �' ncy �� THIS APPLICANT IS: ❑ OWNER OCONTRACTOR PROPERTY NAME: t7, c-,, c_ -t OWNER/ ADDRESS: � CITY Y� I �Y STATE ZIP -55-Y? 2- TENANT PHONE: CONTRACTOR NAME: lOvn5 �4; { SUBMIT A COPY OF YOUR STATE STATE LICENSE # 3 I EXP DATE 1 3 i2- � � I O LICENSE, BOND AND OF STATE BOND # 7 EXP DATE t� CITY fo k(4aJ -PWk- STATE-o ZIP CERTIFICATE INSURANCE ADDRESS: G FAX '76-5- S10- 0- 6 3 5 . PHONE PERNIIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: 9[NEW ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK � d� lac !s,, A k— ,y` is2w�e✓�+ PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x .05 = plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $15.50. 1 )(BATH SINKILAV DRAINS _ WATER PIPING _FLOOR —SHOWER —_BATHTUB GAS PIPING (NEED CITY LIC) _SWIMMING POOL _ WATER SOFTNER ($35) CLOTHES WASHER ^_ KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREY. ($15) _ DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER —OTHER Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge 0 Number of fixtures @ $15.00 x $15.00 = $ OR Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ State Surcharge = $ .50 $15.50 (MINIMUM $15.50) Total = $ THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 on site; that the work will be in accordance with the approved plan in the casepa Ik which requires review and approval of plans. +t1_ % 1 Z 1�1® SIGNATURE OF APPLICANT PRINT NAMejC)A ldil< DATE APPROVED BY DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building /0q'5"J25- BUILDING Permit No.: qa Inspections of o S'/ RESIDENTIAL APPLICATION Rece' 763-572-3604 bi 56 CITY O F FRIDLEY Date eYAc 763-502-4977 FAX --A --7ff $ .0005 x Permit Valuation Minimum $.50 License Surcharge EFFECTIVE 1-1-09 $ DATE q YOUR E-MAIL ADDRESS LA /r#loCL a A/e SITEADDRESS iro 30I &,tojc9 ST NiF 0 F/Loote- THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: l IAA/ (769 MAtt g YA ADDRESS: 4301 &kl acl°I ST- AA CrrY F7L t/>t.a:7 STATENA/JZIP 7�2— TENANT PHONE: Gt S-9 — 9-er I4 CONTRACTOR NAME: a ft ' 4 lA�C . STATE LICENSE # EXP DATE 020 to SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS:LI&J TA41/— CU.45- STATE OIAIOZIP M67 INSURANCE PHONE FAX (0' — (PS - (o P PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE Make checks uavable to: City of Fridlev Attach Stipulations ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE DECK OTHER Su 0111j6 66!/}55 �c NG 13SIDW POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ JKREMODELING /MAINTENANCE/REPAIR. DESCRIBE WORK BEING DONE: /} ®OIAJG 14 Si 401A* 644, PDQ, +4 e4 At -0 ®CCIC-• SIZE OF IMPROVEMENT LENGTH tF WIDTH ISI R HEIGHT o2 / SQ FT /(00 ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HIMGHT: SIDING I e FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: ❑ Vinyl c�C� ❑Soffit C `V ❑ Aluminum ❑ Trim _ 2--Z �' �� 1. Site Plan/Survey showing the existing structures and proposed project. ❑ Other WINDOWS ❑ Fascia 3 C� L) C�c Q 2. Two sets of construction plans 4l _ 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: �p SING THE X97 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ CPQ U I , (0 0 "7 . iv® OCCUPANCY TYPE Permit Fee /0q'5"J25- $ x 3111(5 See Back Page for Fee Schedule Plan Review of o S'/ $ !,z LI, 11 65% of Building Permit Fee Fire Surcharge bi 56 $ -4 (0 .001 times the total job valuation Surcharge --A --7ff $ .0005 x Permit Valuation Minimum $.50 License Surcharge 5,6V $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Curt Escrow $ ft + 6 ft = ft x $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Char,.g_e/ $ Agreement necessary ( ) Non Necessary ( ) Total Due �s o��� 00 $ Make checks uavable to: City of Fridlev Attach Stipulations 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 on site; that the work will be in accordance with the approved plan in the case of all %I k which/requires review and approval of plans. ® Q SIGNATURE OF APPLICANT / 4A+� t e 4iINT NAME S +� L X/L it r DATE PLEASE NOTE: SEPXRATE PERMITS ARE REQUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK -I