PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N® 3546
Date:.. � .. ...... �.......
Owner ....................................... Builder..... .......... .. .............
Address ...................................... Address ... ell
.......... .......... �....................
LOCATION OF BUILDING
No. .�. /... Street..� ` ......... Part of Lot ..........I'.... ..............
Lot ../-...... Block .......... TAddition or Sub -Division
.lQ:.`.�
Corner Lot ............ Inside Lot '�........... Setback �J` ..�.... Sideyard ................
DESCRIPTION OF BUILDING
To be Used as: l /� p
.. Front 41 Depth Depth a'ii� 1 i'�b Height I. ` Sq. Ft. �� Cu. Ft. 9? -0. P .074-�
.................... Front ........ Depth ..... Height ..... Sq. Ft......... Cu. Ft. ........
Type of Construction ................... Mgt. Cost.1.Q7,474.1v ' .. To be Completed ...................
In consideration of the issuance to me of a permit to
the proposed work in accordance with the description ab
ordinances of the city of Fridley.
degribed above, I agree to do
ompliance with all provisions of
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
i
ordinances.
F .. Building 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.
**z
City of Fridley, Minn.
BUILDING PERMIT
j
Date::......_._...__...�:^.._.-,....�.�':..._.._._..._._.__...__..__.....__.._..
6 �
Owner: ...:... ... s -r' .
Address
i
Builder
Address_ ........................... _...._..:_......_.:._._._.__.._.._......_.._.._.._..._......._......_.._.._
LOCATIO F BUILDING
No...P-c. _.._... Street ..._.. '" „r e_._..._..... Part of Lot .. -... _...._..._.._..._..._......_... - ._.._..._.._.._
Lot.............. Block....._..,..,.:,:_....:F.................. _........ Addition or Sub -Division ........................................ _...... _............. ..-------------- _......_.._.............
Comer Lot ..... . ............................. Inside Lot
Sewer Elevation
Setback ....._ ............._.._........._........ Sideyard
............ Foundation Elevation _................
DESCRIPTION OF BUILDING
To
red
..,mm
�c .... Front j ......__.. Depth :ra± ._-- Height ,r..: ._:. Sq. Ft. . I---
.--.... ........................ Front x Depth ....._ Heigh.................... .... Sq. Ft
Type of Construction..........
. .. Est. CZ/4-5.6.:............ To be Completed
Cu. FtL� - -
Cu. Ft-......................
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 thea
p yment 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
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. .+" AA I
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
4
d
K -
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Al
Owners
Builder
Address LAddress ,. �...�
LOCATION OF BUILDING
No. 6 7-,>- / Street ,42• 4�, Part of Lot
Lot Block Addition or Sub.Div,
Corner Lot Inside Lot Set Back Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used _4&t
JL---_ Front /(0 Depth �-- Height / C9
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft,
Type of Constructions_ 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 cor ct.
DATE' �' C, SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
=F,
VALUATION
ADD,
P=perty Line
Property Line
....................... ..... ............ . ...................... . ............................................................
.............. I ............................
. 1 4"!
010.4-t se
. 0
SUBJECT
PERMI
City of Fridley
12'786
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
PROTECTIVE -INSPECTION SEC.
���f
i---- A � CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
10/29/74
�.
JOB ADDRESS 6721 Quincy Street N.E.
1 LEGAL
LOT NO.BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
lO
5
Brookview Terrace SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
R. J. Aanestad 6721 Quincy Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Miles Garages 4500 Lyndale Avenue, Mpls.
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 Cg ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 9110" x 22.3' Addition to garage
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPERATE PERMITS REQUIRED FOR WRING,
HEATING., PLUMBING AND SIGNS.
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 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,
$1200•00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
.60
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMITFEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$9.00
STRUCTION OR THE PERFO ANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
-. -
$9.60
P --(()1.1'Y1-7C1
SIGMA EOFCONTRACTORORAUT DAGENT (D E)
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
BLDG. INSP DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
. 0
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
9 J �SOWNER'S NAME: �
ADDRESS : ®2 L^ Q AADDRESS : t 5 ( % y /1' y4 � 'e
NO:. a % STREET:
r ,/
LOT:
d BLOCK: ADDITION V poo 'fvi 14 4G`P
CORNER. LOT: INSIDE LOT:�SETBACK: SIDEYARD:
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:
Addal0- ✓I 4,0 SAOrvt, r /()Depth: a d -3 Height:
Square Feet: Cubic Feet:
Front: Depth: Height.-
Square
eight:Square Feet; Cubic Feet:
Typ-. of Construction: &o �4M4r Estimated Cost: $ /
r
To Be Completed: l �'
/0 e
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: [ l SIGNATURE: cC�<
(See Reverde Side Fdr Additional Information.)
'THE JOW J_RYAN CO...
SCALE: , f INCH FEET ' 1602 sELay "ENUE. ST. PAULS510.4
SU
7ELEPHONEs 040.6858.,
i
CERTIFICATE OF LOCATION OF BUILDING
I hereby certify that on $ m a r t?- 19 aa
I made a survey of the location of the building(s) on the
above described,, property and that. the location of said
buiidLwA:3) is correctly sho on the ab.QYO gist.
CERTIFICATE OF SURVEY
I hereby certify that on _ __I_*_•'
I surveyed the property described above and that the above;
plat is a correct representation of said survey.
SUBJECT
P N _.
City of Fridley
® 18304
AT THE TOP OF THE TWINS
BUILDING
PERMIT
COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
/9®
r PROTECTIVE
0.?-
i � CITY HALL FRIDLEY 55432
NUMBER
REV,
DATE
PAGE OF
APPROVED BY
--_-
612-571-3450
910-F15
12-2-85
JOB ADDRESS
6721 Quincy Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
10
5
Brookview Terrace
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Robert Aanestad same
571-3483
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
D and D Homes. 7401 Central Avenue Fridley 55432 784-7543
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Home
7 CLASS OF WORK
D-
❑ NEW X ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
3 season porch 14 X 14
9 CHANGE OF USE FROM TO
STIPULATIONS
room can no be heated except with wood burner unless the exterior envelope is
brought in energy code compliance.
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
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 COMPLIED
1.85
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-
44.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
�'JrJ
11.13
57.48
SIGNATURE OF CONTRACTOROR AUTHORIZED AGENT IDATEI
WHEN PROPER Y V I ATED HIS IS YOUR PERMIT
LOG INSP
GATE
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
G'
SUBJECT
RM
City of Fraley
2 0 0 4 4
AT THE TOP OF THE TWINS
BUILDING PERMIT
' ,
R
______ COMMUNITY DEVELOPMENT DIV.
r y -I PROTECTIVE INSPECTION SEC.
- q
d
NUMBER
REV
GATE
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
.-._ d �v��',•j
L J� 612-571-3450
910-F15
10/23/90
/
JOB ADDRESS 6721 Quincy Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
10
5
Brookview Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Robert Aanestad 6721 Quincy Street N.E. 571--3483
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
8 DESCRIBE WORK
Install egress window and add wall in basement
9 CHANGE OF USE FROM TO
STIPULATIONS
Install smoke detectors on both.level of dwelling. Egress window to
meet State requirements. See notations on plan.
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
$21000
$1.00
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
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$45.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
Fire $2.00
48.00
IGNp, TUURE OFTMORIZ DAGE T (DATE)
_ v WHEN ROPERLY V I T D IS IS YOUR PERMIT
=NTROR
/p
Q
BLDG P GATE
SIGNATURE OF,NEFWF OWNER BUILDER) IDATEI
G'
NEW [ 7
ADL [ ]
ALIS [ 7
1-1 AND R-2
Building Permit Application
Effective 8/16/90
Legal Description:
Owner Name & Address: 2K,M A C/Z s o-"£ •�, .4. ,mf- Tei. # -7 ` 3'e ef?
Contractor: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
imm G AREA: Length ] Width Height Sq. Ft.
MUUM AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
i..-...
Vi: (WC hj ?-A' Y �O.A- x ! 6V tU( &o 10 4O
Corner Int [ ] Inside Lot
Type of Construction:
Approx. Completion Date:
[ ] Ft. Yd Setback
Side Yard Setbacks
Estimated Cost: $A-e9ff9O . oz,
Proposed Driveway Width If New Opening Is Desired: Ft. $ $
+ 6' See Back Page
Wf
DATE: r� Z�� APPLICANT: Tel. #
CITY USE QTLY
Permit Fee $ ` G' Fee Schedule on Reverse Side
Fire Surcharge .001 x Permit Valuation (1/10th o)
State Surcharge $ 400 $.50/$1,000 Valuation
SAC Charge $ $600 per SAC Unit
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ l
7UM $ � oe)
+� z0 E07�
-
SUBJECT -
O. �-
City of Fridley
27880
AT THE TOP OF THE TWINS
BUILDING PERMIT
1 �
• COMMUNITY DEVELOPMENT DIV.
♦� V ------
INSPECTION SEC.
r PROTECTIVE
1 �
REV
GATE
PAGE OF
APPROVED By
� CITY HALL FRIDLEY 55432NUMBER
612-571-3450
910-F15
9/21/98
JOB ADDRESS 6721 Quincy St NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
10
5
1 Brookview Terrace
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Bonnie Aanestad
571-3483
3 CONTRACTORBecker MAIL ADDRESS ZIP
PHONE LICENSE NO
Richard Z. Construction 12231 Flintwood St NW Coon Rapids 55448 755-4682 20118341
a 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
O NEW O ADDITION O ALTERATION C: REPAIR
O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house & garage (24SQ) Tear -off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the 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 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
$2,056.00
$1.03
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 COW
$P 74.75
Fire SC $2.06
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
`
qq
PLAN CHECK FEE
TO FEE
V.V
L c e SC . 00
$82.84
SINATURE OF CON' ACTOR ORAUTHORIZED AGENT iDATEi
EN R P VALID T
THIS IS Y UR PERMIT
_
BLD INSP
J � a
DATt
$,GNATURE OF OVVNER,IF OWNER BUILDERi (DATE,
01,
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �d
BUILDING PERMIT APPLICATION
ConstructionAddress: 7� 1 mss_ , e .
Legal Description: v
Owner Name & Address: z® N u i e, Tel. # S%/- 3
Contractor: a rj MN LICENSE # Zoll 8 3 l
Address:f Z Z � f -1�/r �J Lv ®a� S_* R P W . 0_'R. M L'It' . Tel. #
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
Length Width
Length
Width
Height
Height
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: 004E n q Estimated Cost: $ 0?0S-Zo
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: I- Z)- 9 B
APPLICANT: Tel. #755-- 1�0 Z,
Permit Fee $ 1 z 7, Sr
Fire Surcharge
$ 0? 6 (.'
State Surcharge
$ 1.03
SAC Charge
$
License Surcharge
$ Do "
Driveway Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge $
TOTAL $ o°
. STIPULATIONS:
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 [ ]
From: City of Fridley To: 651-203-0554 Page: 4/5 Date: 7/26/200612:02:13 PM _ 1�L� 4c)
Building
$ ,
BUILDING
Permit No
Inspections
65% of Building Permit Fee
RESIDENTIAL APPLICATION
Received By o
763-572-3604
Surcharge
CITY OF FRIDL EY
DatJe'Rlr`��d:
DATE �$1 I is ICR
YOUR E-MAIL ADDRESS
$5.00 (State Licensed Residential Contractors)
SITE ADDRESS G(
CN I A�.� 4-75.
$1550 per SAC Unit (Plans to MWCC for determination)
THIS APPLICANT IS:
❑ OWNER CONTRACTOR
ft + 6 ft = ft x $21 =$
PROPERTY OWNER/
NAME' ?;:)[A-10% P CA n f- `-
$450 Conservation Plan Review
ADDRESS: 2ci Q CITY
STATE ZIP
TENANT
Sewer Main Charge
PHONE:_ 7
Agreement necessary ( ) Non Necessary ( )
CONTRACTOR
NAME: 9 Q euj v v nAkANK Six %— AAa UtCCA
Make checks payable to: City of Fridley Attach Stipulations
STATE LICENSE # 2k MAZLS- EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
`
ADDRESS 4Q �� vic! ' CITY nll�/a�
s STATE P 2f (J
WITH APPLICATION
PHONE Q,.Dl-�3 l fLP?,L rgC1 FAX
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHEDINDOWS
13 BASEMENT FINISH ❑ ROOF DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
E3MAINTENANCF/REPAIR MEM@BEL-iid'G 6
tQV
DESCRIBE WORK BEING DONE: If 4J0XCn t `U/1C i C-1. 1/VVYlr(tnn,�
SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT
REMODELING SUBMIT:
1. Existing Floor Plan
GAP -AGES
R
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
SID NG
FOR NEW CONSTRUCTION
INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1. Site
Planisurvey showing the existing structures.
❑ Other
❑ Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
IN EXISTING OPENINGS l es ❑No LOCATIO OF WI DOWS-10 4i kle
3. Energy Calculations
OR FOR NEW OPENINGS -DESCRIBE SIZE OF v • cu
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AN.D MATE:K A LN:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ '• 0 W - 00 OCCUPANCY TYPE
Permit Fee
$ ,
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
_
$ t
.001 times the total job valuation
Surcharge
$ �i ors
.0005 x Permit Valuation Minimum $.50
License Surcharge
$ -fes
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1550 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $21 =$
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$ 12, 424 Q
Make checks payable to: City of Fridley 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, that the work will be in accordance with the approved
plan in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLICANT ®JXz,-J,c - �l PRINT NAME460 5 ( .r'p DATE_������_
Building
Permit Fee
BUILDING
! !� See Back Page for Fee Schedule
Permit No.: - `ll 'I r
Inspections
65% of Building Permit Fee
RESIDENTIAL APPLICATION
Received By: 11'1
763-572-3604
Surcharge
CITY OF FRIDLEY
.0005 x Permit Valuation Minimum $.50
Date I�
763-502-49y77 FAX
�� , $5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2100 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
EFFECTIVE 1-1-2010
ft + 6 ft = ft x $24 = $
Erosion Control
a — D- 01 0
$450 Conservation Plan Review
�1
DATE ^ l
YqO� -MAIL ADDRESS
Fee Determined by Engineering
SITE ADDRESS
$
Agreement necessary ( ) Non Necessary ( )
THIS APPLICANT IS:
❑ OWNER *ONTRACTOR
Make checks payable to: City of Fridley Attach
PROPERTY OWNER/
NAME:
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
_
ADDRESS: (,7 a,L�y 1A� A ° AECITY � STATE VlVZIP Sad 3
TENANT
PHONE:26 ��— 5- (t " g3lq
CONTRACTOR
NAME: Toy -o Com -s -Ho Vi LL
SUBMIT A COPY OF
i
STATE LICENSE # of 0 (O 3 S EXP DATE '37-3) - 2011
YOUR STATE LICENSE
AND CERTIFICATE OF
�{
ADDRESS: OL &y25"� -� ,rLlie[e�`S U �'e1'i
p�
CITY RUMd Vgll STATE INV ZIP 55,-il
INSURANCE
_I
PHONE -w �;9'+ r 0 FAX
, S�
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS
❑ BASEMENT FINISH ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCEIREPAIR "MODELING
DESCRIBE WORK BEING DONE: E 0 I IAS' S®
S el'(k
SIZE OF I MENT
LENGTH WIDTH
HEIGHT SQ FT
OOFING �j Q HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
PJ ❑ HOUSE & GARAGE
1. Existing Floor Plan
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED
3. List of structural members to be used
PROPOSED HEIGHT:
SIDING.
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑ Aluminum
Soffit (� t
trim
ADDITIONS_ & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing structures
13 Other
Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS ❑Yes ❑No L DOWS
FOR WINDOWS - PROVIDE U -VALUE AND
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
j (USING THE 1997 U.B.0 FEE SCHEDULE)
'OTAL JOB VALUATION $ l(��(a— OCCUPANCY TYPE
Permit Fee
$
! !� See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$��'
�� , $5.00 (State Licensed Residential Contractors)
SAC Charge
$
$2100 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $24 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
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 on site; that the work will be in accordance with the
approved plan in the case of wo whic7,11,
uires(�reeviiew and approval of plans.
SIGNATURE OF APPLICANT l P Wll 1 � PRINT NAME AAPL V � a APO � DATE q 3010