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PRE 2010 DOCS,,:,2 //'7 7 City ®f Fridley, AE ;OCA N PF BTI G NO. StreetAAAP art t Lot _ _ _ _ __ Block Addition or sub -Division Corner Lot Inside Lot Setback 9 Sideyard Sewer Elevation Foundation Elevation DESCRIPTIONOF d10 H ei ei lit ii; r Depth HP Of on 2q�� Fat el F*'To be Completed ---- 1W I In consideration of the issuance to me of a permit to construct the building descri , I agree to do the proposed work in accordance with the description above set f tin c 4 o all provisions of ordinances of the city of Fridley. i J/1 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 within the city limits and this permit may be revoked at any time u vio ordinances. la ' of any of the provisions of said Building Inspector NOTICE: 7hb permh don not cover the construction, humMHon for wiring, phinhhing, ®es heneme, server or wabr. Be sure to we the BWldbg hapeetor for separate pormits for these hems. Cify of Fridley 52_84-5915.51 APplicafion #or Plug and Gas Dept. of Ridge. Phone NO -3490 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Location 5720 Regis Dr. PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $200 $ Future Fixture Opening ............ x $1.60 $ New Fixture Old Opening .......... x $1.60 $ Catch Basin.......... asin. .. ...... • • • • install lites'(25� x $3.26 $ 6,00 Water Heater (Up to 99.000 BTU).... Iasi New Ground Run Old Bldg......... x $3.25 $ � a $200 $ SSR � 1st 3 Fixtures ................ ssJJ 7 i� • • N WATER NTR. GAS fLEC. Base 1s< 2 ites 2nd kd 4th —491 ° Future Connection Openings Connected wllh * Now Fixture, Old Openings I BMW Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $200 $ Future Fixture Opening ............ x $1.60 $ New Fixture Old Opening .......... x $1.60 $ Catch Basin.......... asin. .. ...... • • • • install lites'(25� x $3.26 $ 6,00 Water Heater (Up to 99.000 BTU).... x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Electric Water Heater .............. a $200 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ................ 1 x $200 $ 2 , 00 Additional Fixtures .................. x $ .75 $ Gan Range to 199,000 BTU ................ x $6.00 $ REPAIRS & ALTERATIONS --Rates to Code Description ............................................ f TOTAL FEE $ 8.00 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 Cita Ordinance and ruling of the Department of Buildings, and hereby declares that as the fact and representations stated in this application are true and correct. Fridley, Wnn July 26, 1972 , 18, Owner Alan Eke Kind of Building f r . Used as res. To be completed about July' 31 Estimated Cost, $ 20.00 Old—New. Building Permit No. Permit No. 1Z ROUGH FIN1lL �� i� SUBJECT PERMI City of Fridley - 17 613 AT THE TOP OF THE TWINS BUILDING P E R M I T r R � � _ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. f 1 I � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/16/84 JOB ADDRESS 5720 Regis Dr. N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3 5 Parkview Oaks First Add. SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Doug Strong 5720 !Regis Dr. N.E. Fridley 55432 571-5920 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Dolphin Pool and Patio 3405 N. Co. Rd. 18 Plymouth 542-9000 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 Install an 18' X 371 in ground sviming pool. 9 CHANGE QF USE FROM TO STIPULATIONS See stipulations on ., letter dated July 12, 1984 from the City Environmental Officer. TYPE OF CONST. OCC PANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Metal/vinyl THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. T. 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 R-1 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STA LS 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 $6, 000. O $3.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $56.5 i PLAN CHECK FEE TOTAL FEE A. $59.50 SIGNATURE 67 CONTR OR LTRAUTHORIZED AGENT (DATE) WHE ERLY ED THIS IS YOUR PERMIT 8G INSP I It DATE SIGNATURE OF OWNER 0F OWNER BUILDER) (DATE) i� NEW [ City of Fridley Effective 4/1/84 ADDN. [ 1 �R-1 AND R-2 ALTER. [ ] Building Permit Application t ^tion Address• '5,7.20 /eEe/S b)( Cons ru Legal Description. &1 3 45Z04- S 1A�/�W OA45 X4t A�-Or Owner Name & Address: ,Dom' NANcc 5y6/''/t, Tel. 571-64740 Contractor: ,(' pl.I�-fIh/ /�OOC —Tel. # Address 310S No. 60, /W- /8 .tel o'cn 'Ally -.SS 0.1 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. Length Length Length l8' x 37'� DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. Width Height Width Hgt/Ground S^40% 44' 13 Side Yard Setback No'W .77 yo&sEX C Lot [ ] Inside Lot J&. Mo. Setback O Sq. Ft. Sq. Ft. orner i� l40V L 4P12 Estimated Cost: $ Type of Constructions p IL Approx. Completion Date: /s /?a r Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation DATE: 7 l �� APPLICANT : Tel. # CITY USE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ 9 Q 4� n Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $425 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ C[TYOF FRIDLEY CIVIC CENTER - 6431 UNIVERSITY AVE. N.E.. FRIDLEY, MINNESOTA 55432 - PHONE (612) 571-3450 i July 12, 1984 Dolphin Pool & Patio 3405 No. Co. Rd. 18 Plymouth, MN 55441 Be: Swimming Pool Construction at 5720 Regis Drive N.E. Dear Sirs: This letter is to make clear this department's requirements for the swimming pool construction at the above address. 1. As indicated, two (2) skimmers approved by the National Sanitation Foundation will be provided. 2. As indicated, three (3) inlets of approved design for fresh and/or repurified water will be provided. 3. As indicated, a main drain of approved construction will be provided. 4. The filter and pump shall be approved by the N.S.F. and be of sufficient capacity to provide a minimum turnover of at least two (2) times in 24 hours. This department recommends a turnover rate of 6 - 8 hours. 5. A deck of at least three (3) feet wide, measured from the pool waters edge, shall be provided which extends completely around all private residential pools. Above ground private residential pools may be provided with decking of a minimum size of 4 feet by 4 feet at pool entry points and provided that such decking has the approval of the City. 6. The diving area will be acceptable provided there is no overhead obstruction. 7. Fencing or other effective means including but not limited to walls or buildings, acceptable to the City, shall be provided to positively control all access to public and private residential swimming pools. Fencing shall meet the following criteria: (a) The fencing shall prevent the entrance of children and be without hand or foot holds that would enable a person to climb over it. (b) The fencing shall be at least 6 feet high and entrances shall be equipped with self-closing and self -latching gates capable of being locked. (c) Self-closing and self -latching devices shall be placed at the top of the gate or otherwise inaccessible to small children. (d) The opening between the bottom of the fence and the ground or other surface shall be not more than four inches. I Dolphin Pool & Patio July 12, 1984 Re: 5720 Regis Drive N.E. 81 -An automatic chlorinator should be provided With a suitable test kit. Page 2 9. All electrical and plumbing installations shall be inspected and approved by the City Inspection Department. 10. All overhead electrical lines must be a minimum of 10 feet horizontally from the pool surface, and 18 feet straight line distance from the Waters edge. An alternative is to bury said lines. 11. The pool fill spout must be protected by a vacuum breaker or air -gapped. 12. Suitable safety equipment to include but not limited to a ring buoy and rope that is 1-1/2 times the pool diameter and shepherds crook pole must be provided and maintained with the pool at all times. Furthermore, these and any other requirements must meet the provisions of the Fridley City Code, Section 115, Swimming Pools. The building permit is approved contingent on final inspections and approval of the City. If any questions or problems arise from this letter, please feel free to contact me at 571-3450. Sincerely, r0 ST N J. OLSON, R.S. Environmental Officer SJO/mh CC: Mr. Doug Strong 5720 Regis Drive N.E. SUBJECT PE, IT No City of Fridley ® 1.9400 AT THE TOP OF THE TWINS BUILDING PERMIT _ ' ' RE COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. �g r PROTECTIVE o2�/i- 1 i � CITY HALL FRIDLEY - 55432 NUMBER REV, DATE PAGE OF APPROVED BY 612-571-3450 910-F15 4/21/88 JOB ADDRESS 5720 Regis Drive N.E. 1 LEGALLOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED. DESCR. 3 5 Parkview Oaks First Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Doug Strong 5720 Regis Drive N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO, The American Handyman Contr. Inc. 1202 Hathaway Iane N.E. Fridley 571-2655 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 X] ADDITION Ek ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Install Bay Window and add a 444 square foot deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. SEPARATE PERMITS REQIJIRED FOR WIRING, HEATING, PLUMBING AND SIGNS., �z Q is call local BOOM digging ELECTRIC - CSS Et� i'ELEP�40NE � 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 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 $3,050 $1.53 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 OV IONS OF ANY OTHER STATE OR CAL LAW REGULATING CON- $44.50 ST TION ORT RTPERFORMANCE OF NSTRUCTION. PLAN CHECK FEE TOTALFEE � $11.13 $57.16 U ORIZED AGENT (DATE) SIGNATURE OF CONT ACTOR OR Au/0 WHEN PROPERLY A (DATED THIS IS YOUR PERMIT 1 �• BLDG INSP DA SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI NEW [ ] City of Fridley Effective 4/1/86 ADDN. R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: S /ft Legal Description: �/t Owner Name & Address: 4Z444iTel. # Contractor: /-�,oc,��cc4ell Tel . # Address:_/� 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 GARAGE AREA: Length Width DECK AREA: Length 11gev'- - Width OTHER: 7' Cso Corner Lot [ ] Inside Lot ] Ft. Yd. Setback Type of Construction:✓�P Approx. Completion Date: ,ZI�. J Height Height Hgt/Ground 0LA2j a')0' Sq. Ft. Sq. Ft. 1, Sq. Ft.r 1 Side Yard Setback Estimated Cost: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: y -;o ✓ APPLICANT: L G , Tel. CITY USE ONLY Permit Fee $30 Plan Check $ State Surcharge $ �•s SAC Charge $ Park Fee $ Sewer Main Charge $ ad TOTAL $ r STIPULATIONS: Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $ 550 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 11 Iv S t 010 coo-, gq.sd ��s.riss C. E. C O U L T E R CITT MOTs LAND SURVEYOR E OR ••�� u..tr• TO�Oa��••'IC �•�•`wa REGISTERED UNDER LAWS OF STATE .OF MINNESOTA l�.�a'►o�c I.CIM10 •• O•C..%&%CCS O► C'T► Or M hhl A►OLIS LiDICU1l 3300 LYNDALE AVE SO MINNEAPOLIS B MINN TAYLOR 4-0370 Burbepor's Certhfitatr ' V Scs►L� �" n to ASO s'i • I_-0 e, t P,r•r I 6 �.77 - t:Qm ►.St,GE A►JD 1 3 �� 1)�'1l.�TY E��aF.►�E tJT I i:areblr certify Liia' the abcie .s a tr;:e arx! ccrrect plat of a survuy c:: 14t 30 -rrck S. . ,j _ 11110,1 A.^Gka Ccur As surveyed by this ,h da;; c: Kay I°64 A.J. `1259 M:�C�AEL 0 gA�,tJO�J r on ofl i : a. J IA 3I" /Uzwhl „ 4 Lij 13" - d, ISO I i:areblr certify Liia' the abcie .s a tr;:e arx! ccrrect plat of a survuy c:: 14t 30 -rrck S. . ,j _ 11110,1 A.^Gka Ccur As surveyed by this ,h da;; c: Kay I°64 A.J. `1259 M:�C�AEL 0 gA�,tJO�J r CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1995 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS —77 . RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes ar Furnace Shell and Duct Work, Burner —rulings of the Building Division, and hereby declares that all the facts and 3®yep—c� �so Replacement Furnace $�8-A6 $ representations stated in this application are true and correct. (Side Vent — FIII Out Back) 199 Gas Piping (Needed with new furnace) $10.00 $ OWNER Gas Range $10.00 $ '�► BUILDING USED ASs Gas Dryer $10.00 $ / z) ESTIMATED COST ! �� PERMIT NO. *Air Conditioning —All Sizes $10.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) arm Ai Trade Name _ 'f,.� �- Size No. Al U G fn Commercial/lpolastrial BTU 7� ®� �/ HP EDR 1 % of Value of Appliance or Work $ Fuer ® Total Connected Load % P State Surcharge $50 Burner Trade Name Size No. _ BTU HP EDR TOTAL FEE > s HEATING COMPANY ` :o MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $16,00 Signed By Tel No. 5.3 7 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 Approved By i1v Rough—In Date Final Date *Air Conditlonem can not be pi aced in a side yard without written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE NOTE: #1 through #8 required when using a side vent furnace. CHIMNEY AND STACK VERIFICATION[ The undersigned hereby verifies that the existing chimney or stack: ' 1. Has been carefully examined Yes { No ( ) 2. Is free from rust or deterioration Yes() No ( ) 3. Has no foreign objects lodged within Yes(-) No { } 4. Is securely supported Yes (-/) No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes { 'f No ( } 6 Has total heating BTU's of `%S, ®O d All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater HEATING CO: Signed By: Date: Yes () No ( } Yes (} No/�- SUPERIOR_CONTRACTOnS INC City of Fridley Building Inspections Dept. 6431 University Ave NE Fridley MN 55432 Mechanical Ph: 763-572-3604 FAX: 763-571-1287 Residential Application City of Fridley See Back Side For Required Information 31' oW abj tl" -Permit # ! ' ,40 Date Site Address: k The applicant is: (cirlce one) Owner ontrac r Property Owner: Address: 574 City: State: 11-W Zip: 5,0.3d Phone: Cell: Fax: Contractor Information Company Name: Contact Person: (✓ Address: / City: &,rA Stater Zip: Phone: 7fs3'ZdO®_ Cell: Fax: Email: MN Bond# & Exp Date Type of Work (circle one): New Replacement Alteration/Remodel Detailed Description of work: Equipment Installed: MFG: Model: Size/BTU: MFG: Model: Size/BTU: MFG: Model: Size/BTU: Please check all that apply: _Fireplace (gas) $15.00 New Gas Grill $10.00 _AIC $25.00 _Fireplace (wood) $35.00 _Gas Unit HTR $10.00 _Air to Air exchanger $15.00 _Furnace $35.00 _Pool Heater $35.00 _Boiler $35.00 _Gas Dryer $10.00 _Ventilator $15.00 _Chimney Liner $10.00 _Gas Piping $10.00 Duct Work $10.00 Gas Range/Oven $10.00 Permit Fee $ (Total from above -Minimum fee $35.00) Surcharge $, Total Due $ 3�s 0.50 Make check payable to City of Fridley This is an application for a permit- not valid until processed I hereby apply for a mechanical 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 case of all work which requires review and approval of plans. Signature of Applicant: Date: �-AoVl Approval Inspector Signature: Date: Please Note: Separate permits are required for Building, Plumbing, and Electrical work Revised 6/14/2005 Building $ BUILDING See Back Page for Fee Schedule Permit No.: a7X7— W1A9 Inspections RESIDENTIAL APPLICATION Fire Surcharge Received By: 763-572-3604 .001 times the total job valuation CITY OF FRIDLEY $ Dated: l License Surcharge $ DATE YOUR E-MAIL ADDRESS SAC Charge SITE ADDRESS ^� ® S n r, Af THIS APPLICANT IS: ❑ OWNER CONTRACTOR $ PROPERTY OWNER/ NAME: , -5-u 5c I S Erosion Control TENANT ADDRESS: ✓ -I'cs -, / 1 r, A,12CITY /' STATE"fP6 $450 Conservation Plan Review PHONE: $ CONTRACTOR NAME:,5 Sewer Main Charge STATE LICENSE # EXP DATE G �,� u 1 d� �7 D% k L ADDRESS: % - , STATE SUi3MIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PHO C / �'-,�Ic/-O& -�P FAX $ PROPERTY TYPE EPSINGLE FAMILYNEW CONSTRUCTION SIZE ❑ TWO FAMILYNEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION❑�'iARAGE/SHED ❑ WINDOWS El BASEMENT FINISH ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: Rei U4' SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING �- 11HOUSE ONLY NUMBER OF SQUARE ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES 13 ATTACHED GARAGE I . 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DB,,CKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. 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 ,,--1LL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) _TOTAL JOB VALUATION $, i OCCUPANCY TYPE ermit Fee $ !/!. 7 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ < t .0005 x Permit Valuation Minimum $.50 License Surcharge $ 7.0-0 $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 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 $ 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 wh'��equ es revie �d approval of plans. �i r SIGNATURE OF APPLICANT �e ' ' L�%�'�''`�,'-I PRINT NAME 05 /� D f' f � j �1 Q � il�n cA E � � � C�