Loading...
PRE 2010 DOCSCity ®f Fridley, Address E Address L ICAT1 OF UI DING No. Street ` Part t Lot _ ___ Block Addition or Sub-Divisia`n Corner Lot _ Ineatde Lot — 9 Setback 315___. Sideyard --- Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To U:V� I Front Depth Height Sq. Ft. Cu. Ft. Fr t Depth Height _ Sq. Ft. Cu. Ft. Type o Constructio ` Est.- Co ��I'o be Completed 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. k In consideration of the payment of a fee of -o, 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 uordinanvi of any of the Provisions of said Building Inspector NOTICE. fids permit don not cover the construction, Imtaflation for atria plumbing, gas heating, sewer or water. Be core to see the Building Inspector for separate paeft for these Rena. APPLICATION FOR BUILDING PMUW CITY OF FRIDIEY, MMNESOTA Owners Name Claude J. Little Builder AMro d . E. Callson _ & son. Ind Address 6821 - 7th Street N. E. Address 3200 Fence Ane= South LOCATION OF BUILDING No. 5690 Street Regis give Part of Lot Lot 1 Block Addition or Subdivision Parkview Oaks First Corner Lot K nside Lot Setback ,__j,5 Side -Yard 16 SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: Resi encs Front 52 Depth [Z Height 14 Sq. Ft. 1268 Cu. Ft. gQ,;000 FrontDepth Height Sq. Ft. Cu. Ft. Type of Construction Frame Estimated Cost $209000.00 To be Completed May is 1964 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the gity Ordinances and ruling of the Department of Buildings, and hereby declares that1 the facts and representations stated in this application are true and correct. F i August 29. 1963 (A Schedule of Fee Costs can be found on the Reverse Side.) 10 City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SU 4-7 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Location 4l V1 K A N ? 3 Y F- C I/j y 8C Z u. O N Q Z_ U < U�' w �U' a ? O • P • N WATER HTR. GAS ELEG Base 0 ist 2nd 3rd 4th • Future Connection Openings e New Fixture, Old Openings I Connected with Sewer ❑ Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... .......- x $1.50 $ Ay -s -(O Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 1 New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE 1st 3 Fixtures .......................... x $1.50 Additional Fixtures .................... x .50 Gas Range to 200,000 BTU .............. REPAIRS & ALTERATIONS -Refer to Code x 2.00 TOTAL $ $ Description_ ................................................$ TOTAL FEE $ice 4v2 -v 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 all the fact and representations stated in this application are true and correct. Fridley, �AUnn. j 19 Owner xC"1.� ( Kind of Building `s "�`� ,� Used as-`�°evg-e-,''/A.)e To be completed about /� / -4!�- Estimated Cost, $ Ar�� Old ew uilding Permit No. Permit No. Signe By Business Phone No- ROUGH o ROUGH FINAL 42 2M - Application for Power Plants and Heating. Cooling, Ventilation, Refrigeration and ' Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU 4-7470 GRAVITY WARM AIR: RATE TOTAL, Furnace 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 $ e 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. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 840 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ ` Each add. 320 sq. ft. EDR 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 $ -5- "0 GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ /-J' Additional Fixtures . ............... x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH - FINAL $ See Fee Schedule $ _ TOTAL FEE $- Locatfon 'Ta g b Ra Gey S 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, Minn 19 Owner 140.ysa C. r A at-3®AJ o aV Kind of Building 'FA 4 en or Used asy eye ar P_ L_ o ;V 6, To be completed about Estimated Cost, $ Old—New. Building Permit No. c Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air No� Trade Name 0 ZA-) Size No /// 7®� Capacity Sq. Ft. E.D.R ®per BTU H.P. Total Connected Load �'r iEt r -(j = Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU I H.P. Signed— By 'GEO. SEDGWICK HTG. & AIR-COND. CO 4 z 2M Business Phone n No - 1001 Qg A - - Xm ►1sa—�'. 6; Minneapolis 16, Minn. (REMARKS—OVER) I.I. 54611 I 40?vib C'AkLSbru C,7km q-5-9 369 Do, ,i 9 �F3AiTeP"si---NJ% HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS, MINN. Weatherstrips A.S.H.V.E. Construction No. Insulation Guide WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes—No Yes—No 19_ F1.1 /-A1/,V& Room l Length Width 13 Heiaht -?' II / Fl.lz---4jrjev x mAoom I Length /-7 Width / Height A;"' Windows and Doors—Crackage and Area Width Height No. of Lineal f . Area No. of pane of pane llghts of crack sq. ft. ;/ P-- 6 Coef. Btu Infiltration & e� Glass --® Exp. wall / e 3 -F Net exp. wall Exp. wall a ® y Int. wall Ceiling 0 2 Floor Ceiling / M X / ® 1 otal btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / F1.1 6 Room I Length / Width C/7 Heiaht P Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu COef.1 Btu C041 Btu Infiltration 3 F Glass 3 -F Glass Exp. wall a ® y Int. wall Exp. wall 0 2 Floor Ceiling / M X / ® Net exp. wall z 6 Flgor 5 Int. wall Ceiling / -_7 y Floor Total Btu. I r._ Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / F1.1 *1; r -s_ m a- A; Room I Length i -A- Width / o Height P Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu COef.1 Btu Infiltration d -a 3 F Glass S-0 Exp. wall a ® y Int. wall Net exp. wall Int. wall 0 2 Floor Ceiling / M X / ® z 6 Flgor Total Btu: 1 -5 '-,, Required sq. ft. E.D.R. or so. ins. W.A. Leader area T Windows and Doors—Crackage and Area Width Height No. of Lineal ft Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration 7 r - Glass 3 if ,S' Exp. wall Net exp. wall Int. wall Ceiling p -7 X 0 2 Floor Total Btu. / 2-1 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area /° Fl.l s Yqa- n Room I Length a q Width /4/ Heiaht r Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration 7 r - Glass ® ® 0 Exp. wall X Net exp. wall VC Int. wall Ceiling cl ®[�! 0 2 Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / F1.1 W a aq tz n Room I Length r R Width I Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration 7 r - Glass ® ® 0 Exp. wall 2- Yr Net exp. wall Int. wall Ceiling / Floor Total Btu. Required sq. ft. E.D.R. or so. ins. W.A. Leader area f, D,56, 9 I HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS, MILAN. Weatherstrips A.S.H.V.E. Construction No. Insulation Guide WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof! Floor Kind How Applied Yes—No Yes—No 19— F1.I P a l;aa ii Room ILenstth / Width ®Height el Il...zAz. Fl.l m..,4uv. LrvzRoom ILensath Width `2- -Height7. Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 30 36 G :_3 0 3 Coef. Btu Infiltration Coef.1 2, Glass Btu I.SID Exp. wall 3 Glass Glass Net exp. wall 2-0 -3 Int. wall Exp. wall Ceiling y - 2_ Net exp. wall Floor Exp. wall Total Btu. 3AS 36 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area !' F1.I��. v i'; �a-R6om I Length X/ Width A --Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 30 36 G :_3 0 3 / Coef.1 Btu Infiltration Btu Infiltration //1/0 Glass Glass Ceiling 2-0 -3 x-000 Exp. wall d L r Net exp. wall Net exp. wall Exp. wall 7x c ® 2. Int. wall Net exp. wall Ceiling Ceiling /% x Floor Floor _�' o e_1 e-_1 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area asFl.I- c m D Room I Lensath Width 19 Height ?_ .�r Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of Bane of pane lights of crack sq. ft. 3 / Coef. Btu I Coef. Btu Infiltration //1/0 Glass Ceiling /S__ -3 Glass k,S d L r Net exp. wall Exp. wall 7x v) Net exp. wall Ceiling Floor Int. wall _�' o e_1 e-_1 Ceiling Floor d �. Total Btus ., Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ® --- Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. �0 Coef. Btu Infiltration Coef. Btu Infiltration Exp. wall C) Net exp. wall //1/0 Glass Ceiling /S__ Floor Exp. wall 7 k,S d Net exp. wall Int. wall Ceiling Floor �� _�' o e_1 e-_1 Total Btu. I r Cy Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. his. W.A. Leader area F1.1 Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane orpane lights of crack sq. ft. I I I I I I Coef.I Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I suB�Ecr PER City of Fridley -- 2 3 5 AT THE TOP OF THE TWINS BUILDING PERMIT Ir �• COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC.047 1 � NUMBERREV DATE PAGE OF APPROVED By = 11 CITY HALL FRIDLEY 55432 612-571-3450 910-F15 8/9/95 JOB ADDRESS 5690 Regis Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oescR. 1 4 Parkview Oaks First Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Frank/Mary Plant 5690 Regis Drive NE 574-1607 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Stan Hanson Homes Inc 12249 Lily St, Coon Rapids, MN 55433 422-3942 8453 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 CX ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct a 15' x 16' Porch Addition; S airway; Remove 1/2 of existing Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARNING Before digging call for all utility SEPARATE -PERWS REQUIRES FOR WIRING, HEATING, PLUMBING AND SIGN& R,EQUIRO BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 1 1STALLS 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 $69392 $3.20 WIT ER SPECIFIED EREIN OR NOT. THE GRANTING OF A PERMIT DO S PRESUME TO IVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PR V SI S F ANY OT ER STATE OR LOCAL LAW REGULATING CON- $124.75 Fire SC $6.39 ST C N PE ORMANCE OF CONSTRUCTION. / PLAN CHECK FEE TOTAL F E • License SC 5.40 9.34 S EOF T A TO AUTHO IZEDAGENT DAT HEN ERLY VAL A ED HI I YOUR PERMIT BLDG SP OArE iG UREOFO N Rt 0 NER BU4DER1 iD TEi NEW [ ] Effective 8/l/95 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address- 0 Legal Description: ?tel 1 E Owner Name�-& Address: I�[�I d2Tel. # AgPntractor: c LICENSE # � Address:\ N f Tel. #� �---- Attach to this application, a CertAicate 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: �C / 1L I Comer LotA] Inside Lot [ ] Ft. Yd Setback 50-c� —1— Side Yard Setbacks- ��= �� ; /2, If Type of Construction: 1 (%z rn Estimated Cost: $ 7� __ kk O Approx. Completion Date: �(� P' 30-- qS %� f (CpsV on Back) Driveway b t Wi tb Needed: Ft. J t Ft =$ DATE: APPLICANT: Tel. #4- :E 1 CITY USE ONLY Permit Fee $ e 7jr Fee Schedule on Reverse Side Fire Surcharge $-6,,Y9 , .001 of Permit Valuation (1/10th%) State Surcharge $, z,D $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: 4 CIT{ OF FRiDLEY INSPECTION DIV. Effective On January 1, 1997 6431 UniversityAve NE hridley, MN 5532 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VMTILATION, d 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DIES JOB ADDRESS r a RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residentlal Rate TOTAL specified agreeing to do all work in. strict accordance with the City Godes and w Furnace Shell and Duct Work, Burner - rulings of the Building Division, and hereby declares that all the facts and m Also Replacement Furnace $ 30.00 $ representations stated in this application are true and correct. (Side vent — Fill Out Back) /0 / 9 /J 1c' ,1997 Gas Piping (Needed with new furnace) $10.00 $ OWNER �10,,LZ Gas Range $10.00 $ BUILDINGUSEDAS¢� Gas Dryer $10.00 $ � ESTIMATED COST / qcn, cio PERMIT NO. 133 b "Air Conditioning -All Sizes $ 25.00 $ m DESCRIPTION OF FURNACE AND OR BURNER \ A50thersJRepairs & Alterations (LIST ON BACK) �— J 1% of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Wf ,u rop Size No, r - Commercialpndustrial BTU Y& ago HP EDR 1.25% of Value of Appliance or Work $ Fuel_ a!�L Total Connected Load o State Surcharge $ 5Q Burner Trade Name Size No. BTU FP EDR TOTAL FEE $ HEATING COMPANY 3 't'V�r-Luv MINIMUM FEE FOR ANY HEATING/COOUNGIVENTILATION w REFRIGERATIONIAIR CONDITIONING PERMIT IS $25.00Signed By u u� � l- Tel No. 03 PILUS THE $.50 STATE SURCHARGE A REIV5PECTION FEE $42.00/Hr Approved B Rough -In Date Fina! Date (� -° m r 'Air Coalitioners can not be placed in a side yard without FILL OUT BACK SIDE F R STACK VERIFICATION ON N written permission from adjoining property owner. REPLACEMENT FURNACE u SUBJE& IT NO. City ®f Fridley 3 0 8 28 AT THE TOP OF THE TWINS B U I L D I N G P E R M I T ` REMI PT NO. `v COMMUNITY DEVELOPMENT DIV. "_"_" r PROTECTIVE INSPECTION SEC. a 1 1 a NUMBER DATE PAGE OF APPROVED By = CITY HALL FRIDLEY 55432 612-571-3450 910-F15 j,::j 4E 14/00 JOB ADDRESS 5690 Regis Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 4 Parkview Oaks First Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Frank/Mary Plant 5690 Regis Drive NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Stan Hanson Homes 7611 Hwy 95, North Branch, MN 6S -Oz 242-1381 8453 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 B DESCRIBE WORK Reside House & Garage; Replace windows 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. I 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. DWLG. UNITS OFFSTREET PARKING I HEREBY C IFY THAT I AVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNO HE AME TO TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND OR INANC GOV NING THIS TYPE OF WORK WILL BE COMPLIED $16 000 00 WITH W ETH ECI I D HEREIN OR NOT. THE GRANTING OF A PERMIT , $8 • DOES OT UM T GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVI IO F THER STATE OR LOCAL LAW REGULATING CON- $265.25 Fire SC $16.00 STRUC TH P FORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE L e e SC $5.00 $294.25 SI ATURF bF CO 'R CTOR OR AUTHORIZED AGENT IDATEI MEN PROP LY LIDATED THIS IS YOUR%ERMIT _I le C S-GNATURE OF OWNER.IF OWNER BUILDER, IDATEI SLOG SPA O 1E u NEW [ ] Effective 1/1/2000 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION nf� Construction Address: Legal Description: Owner Name & Address: Contractor: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Tel. # 69L_' f 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 P Width Hgt/Groun 751 __t) W K Construction Tvpe:e_�/ Pn-IL Driveway Curb Cut Width Needed: F . + DATE: 5 X APPLICA Sq. Ft Estimated Cost: $� Tel. CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application�.�S %e-- 6'(1() Permit Fee $ (0� jQ Fee Schedule on Reverse Side 6 �d Fire Surcharge .001 of Permit Valuation (1/10th%) � <<� State Surcharge $ /3 a $.50/$1,000 Valuation1— SAC Charge $ $1100 per SAC Unit License Surcharge $5.00 (State Licensed Residential Contractors)' Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: Building $ BUILDING PermitNo.:�� Inspections $ RESIDENTIAL APPLICATION Received By: 763-572-3604 $ CITY OF FRIDLEY Date Recd: 411 Op DATE 4— ti —L'& YOUR E-MAIL ADDRESS SITE ADDRESS 56, 9 o p dl 15 Ck'`w— $ THIS APPLICANT IS: ❑ OWNER CONTRACTOR I SAC Charge PROPERTY OWNER/ NAME: >cRl�NIC PLANT $1550 per SAC Unit (Plans to MWCC for determination) ADDRESS: 51,'70 EAgj S DK v -q— CITY fid(© STATFIVOJZIP -SS -07- 0ZPHONE: TENANT ft + 6 ft = ft x $20 = $ PHONE: $ CONTRACTOR NAME: Mil ep . C'onSt�'��-1, a�1 /NC. Park Fee STATE LICENSE # 01009'739D EXP DATE :'i -31-07 Fee Determined by Engineering SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: PD &g q5 7 CITY 0A-rF-RRTnt,'trl 5TAT00%ZIP-(�388 WITH APPLICATION PHONE 0412- Zlo -"78q-L-FAX ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE Total Due PROPERTY TYPE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ W ❑ ADDITION MAINTENANCVREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 'T�20-C - o f � Nf-.�Z RP- - nt�®6 SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING NUMBER OF SQUARES 3 D GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other WINDOWS IN EXISTING OPENINGS ❑Yes ❑No OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED ❑ HOUSE & GARAGE ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia LOCATION OF WINDOWS NUMBER OF BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 5-800-00 OCCUPANCY TYPE Permit Fee $ ,g5] 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) I SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $1 Make checks payable to: Ciq of Fridle Attach Stipulations 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 whigth requireq review and approval of plans. SIGNATURE OF APPLICANT Z6 PRINT NAME ,)OL4 3-F6L5DGKW DATE q1) - 0