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PRE 2010 DOCSDate: Owner: City of Fridley, Minn.. BUILDING PERMIT OCTOBER 5, 1966 Builder N9 9041 BRUCE HULBERT CONSTRUCTION COMPANY Address Address 339 - 97th AVENUE N.W. COON RAPIDS, MINNESOTA LOCATION OF BUILDING NO. — 1244 Street REGIS TERRACE __ Part of Lot Lot — I _ _..._ Block 3 Addition or Sub -Division __P Mi_QA 8* FIRST AMITION Corner Lot — X.____ Inside Lot _..— Setback — Sideyard Sewer Elevation _ 951-00Elevation _ 954.00 M TOP OF FOOTING DESCRIPTION OF BUILDING To be Used as: 4 x 14) JOG DWELLING Front 44 Depth 26 Height 20 Sq. Ft, 1.144 C�L Ft. 22,, 880 ATT. GARAGE Front 20 Depth 24 Height 10 Sq. Ft 480 Cu. Ft. 4,8 0 Type of Construction FRAME Est. Cost 24 x 0 00 To be Completed SEWER 80' West of Manhole at Regis Trail WATER LOCATION 69' West of Manhole at Regis Trail (11' E. of Sewer) 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 aft provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ 29.00 , permit is hereby granted to BRUCE A. HULBERT CONSTRUCTION GO- 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. CLARENCE BELISLE Building inspector NOTICE: 'This permit does not cover the construction, huhllatlen for whing, plumbing, gas beating, sower or water. Be sure to we the Building Inspector for separate permits for them home, APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA ADDRESS ADDRESS-7y�'— LOCATION OF BUILDING NO.STREET� s PART OF LOT P` LOT BLOCK ADDITION OR SUBDIVISION °` CORNER LOT � INSIDE LOT SETBACK SIDE YARD � SEWER ELEVATION FOUNDATION ELEVATION 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 ;14�y 1�1 c` Front DepthHeight.' Sq. Ft. �i��� Cu. Ft.=�� - k" A _n Front Depths Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost e ,�11 ® d a To be completed_ / /6 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__��� SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley Applicaflon for Plumbing and Cas Fitting Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK 0� Number, Kind and Location of Fixtures Location PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. s 12p �_ g x z $ N �QQ� z O� N G z m o 6 J °d i� �U' Z z �U' • R N WATER HTR. GAS ELEC. 3 3.25 �� " Water Heater (Up to 200,000 BTU) ...... U� x (�Y nK 0&1 x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 0' -� 0 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 Base Gas Range to 200,000 BTU .............. x 2.00 $ 1st /= / 2nd 3rd 4th • Future Connection Openings Connected with Sewer e New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ 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 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 0' -� 0 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ City of Fridley: The undersigned hereby .makes application for a permit for the work herei specified, agreeing to do aR 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, Minn — e/ �!� 19" Owner: Kind of Building Used as To be completed about .2 / V '' Estimated Cost, $ 104e Old -4a uilding Permit No 311 Permit No. Signe By— Business Phone No. % 5-5 ROUGH FINAL 42 Application for Power Plants and Bleating, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE 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 $ 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 640 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 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x $1.5o $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS It ROUGH FINAL a� See Fee Schedule TOTAL FEE $ J� Dept. of Bldgs. Phone 560-3480 r 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_ KOV, /4 , 19(2 Owner Kind of Building Used as✓t-��j To be completed about Estimated Cost, $ b 0 Old-(ENew. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or P WER PLANTS- s am, Hot W •, Warm Air—_No / %l Trade Name (6-46-e Size No C1 Capacity ,,Sq. Ft. E.DD..R 1�&e &VJ BTU / H.P. Total Connected Load 7" < / Kind of FuelL BURNER — Trade Name Size No Capacity. Sq. Ft. E.D.R BTU H.P. (REMARKS—OVER) RAY N. WELTER HEATING CO. Signe 46a!7 `r GHIE3AE36 AVE. By MINNF-^PCILIS 7. MINNESOTA 4 2 Business Phone No- J 6 7 ee,�' 4- U HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A'S'S°�°E° Construction No. Insulation Guide Windows I Doors Deference Out. Wall Int. Wall Ceiling Hoof Floor Kind I-I®ar �� .e —No a —No 19—. 5 I �To 7 Room 1, Length /-3 C Width /a eight , ' JI I Fl.p L [ e i ft Doom Length/ : Width ,g Windows and Doors—Crackage and Area Height of pane No. of lights No. Width of Dane Height of pane No. of lights Lineal ft. of crrjjac,k// Area sq. ft. G Ol /-7ay Coef. Btu Coef. Btu Coef. Btu Infiltration Coef. Btu Infiltration �f Glass Net exp. ,tvall ® 5 S GJ Exp. wall .5 >- Glass Ceiling 1 -7 e ✓� a a i Net exp. wall S� Ie 1;' D `- Int. wall Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 197 V / " Ceiling Net exp. wall �U Floor v Int. wall Total Btu. ,1 `~ Requi;., sq. ft. E.D.D. or sq. ins. W.A. Leader area Ceiling ® X ®"' Floor c Floor 3 7 Total Btu. (� Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.10g Aj Length Width Leight` - Windows and Doors—Crackame and Area No. Width of pane Height of pane No. of lights Lineal ft. of crack Area sq. ft. Lineal ft. of crack Area sq. ft. Area sq. ft. /-7ay Coef. Btu Coef. Btu Coef. Btu Infiltration -- 5 3 3r �f Glass Net exp. ,tvall ® 5 S GJ Exp. wall .5 >- C? Ceiling 1 -7 e ✓� a a i Net exp. wall S� "la `- Int. wall Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 197 V / " Ceiling Ceiling �U Floor Floor Total Btu. ,1 `~ Requi;., sq. ft. E.D.D. or sq. ins. W.A. Leader area 1 V71 I n ,,, 'IT •) r Rnnrn I Lengthy A' .- Width d') Height re - Windows and Doors—Crackatge and Area No. No. Width of pane Height No. of of pane lights Lineal ft. of crack Area sq. ft. Area sq. ft. /-7ay Coef. Btu Coef. Btu Infiltrations` Glass 777 v Glass -- 5 3 Exp. wall Exp. wall Z Net exp. ,tvall ® �,7 -F 7 - �� Int. wall Net exp. wall Ceiling 1 -7 e ✓� a a i r `� G° - Int. wall Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 197 V / " Ceiling �U Int. wall Floor Ceiling 5 Total Btu. Required sq. ft. E.D.D. or sq. ins. W.A. Leader area 2CD Windows and Doors---Crackage and Area No. Width of pane Height of pane No. of lights Lineal ft. Area of crack sq. ft. Lineal ft. of crack Area sq. ft. Coef. Btu Infiltration - 777 v Glass -- 5 3 Exp. wall Net exp. ,tvall ® �,7 -F 7 - �� Int. wall Ceiling 1 -7 e ✓� a a i r `� G° Floor A �� Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 197 V vi 1 P—m I I mnoth lCf C, Width /_- :�, Fleiaht Z r _- VWindows and Doors--Crackage and Area No. Width of pane Height of pane No. of I lights Lineal ft. of crack Area sq. ft. Coef. Btu Infiltration �; j �,7 -F 7 - Glass S"n r `� Exp. wall Com: i , , Net exp. wall / " �U Int. wall Ceiling 5 2CD Floor c Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Do -arae 9 Length Width ,� = F L9h-t 2 Lo Windows and Doors--Crachage and Area Width Height No. of Lineal ft. Area No. off pane of pane lights o+ff crack sq. ft. 151 7, 11 C �G Coef. Btu Infiltration -y Glass llp. Wall x c> Net exp. wall -2 0 Int. wall Ceiling /12- Floor 'LFloor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Bader area --F p lath I�d 7 Height a 9im6ws ad DCOM—Cmchase and Area WMW ­R-agght No. og me. of Pane 09 Fame light® Lineal IL of crack Btu Infiltration Cdaw Z-6 Esp. waI�, Not eats. wall LEE �L&_ _Zt —s - flat. wall -Ceiling I �_ j%e e w J5- '91 Floor o u Total Btu. Required sq. ft. EDA ®e sq. im WJL r afta CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Effective On January 1, 1991 Fridley, MN 55432 t►PPLIGATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Rate TOTAL Furnace Shell and Duct Work, Burner - Iso Replacement FurnahV40 $ 20.00 $.S0' C�2oQ-1S Gas Piping (Needed with new furnace) $10.00 $ Gas Range $10.00 $ Gas Dryer—� $10.00 $ * it Conditioning - II Sizes _Tii AA -0 $10.00 $ Lo b1 All Other epairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ Commercial/Industrial 1 % of Value of Appliance or Work $ State Surcharge $_50? o TOTAL FEE $ '5p% MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. JOB s The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and ruling of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct.` noa 1992 ,1991 BUILDING USED AS ESTIMATED COST hxam PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR ,chmond 9, Sons Elec., Inc. d"�"; HEATING -COMPANY G^Idcn Valley Htg. & Air Cd 5 c , -,es �roa Crystal, MN 55429 Signed By - c, 95.2000 Tel No. Approved B `� r Rough -in Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined 2. Is free from rust or deterioration 3. Has no foreign objects lodged within 4. Is securely supported S. Meets all current Code requirements for size and total BTU's connected 6. Has total heating BTU's of All other BTU's TOTAL BTU's Remarks List Alterations Being Done: HEATING COMPANY . e.,cnrr,enc t, Sons Elr;c., �n, Signed By Crystal, NIN 55429 Date Phone 51R.2ng® Yes ( m"� No ( ) �r Yes ( , °�° No ( ) Yes 1 No ( ) Yes No ( ) Yes ( ) No { ) Ob -32 -N2 - CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE es-eee%ow-PTar Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with now furnace) Gas Range Gas Dryer a Air Conditioning (all sizes) All Others/Repairs and Alterations It of Value of Appliance or Work COMMERCIAL/ INDUSTR I AL 11 of Value of Appliance or Work RATE TOTAL $ 20.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ State Surcharge TOTAL IFEE Reinspection Fee ($15.00) Rough Insp. Final Insp. Date ! Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 PLUS $.50 STATE SURCIU\RGE S!S) ico S $ .50 $ r6' 51� s Attach stack verification fors, with replacneent furnace permits *Air Conditioners can not Ix- placed in nid+• yard witl.out written Ixrnission frC" adtoininq mryldx)r. Job Addrea!12M c� Department of Buildings, 6431 University Ave. M.E., Fridley, MN S5432 City of Fridley Tel. 0571-3450 The undersigned hereby saked application for a permit for the work herein specified aqreeinq to do all work in strict accordance with the City Code• and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Z --�� p� Fridley, Minn. OWNER a M ��jG�i?CtW+tiy`(.�.� AXPAM QC KIND OF BUILDING USED AS IN<✓ q TO BE COMPLETED ABOUT ESTIMATED COST 900-- OLD v®-OLD - NEW BUILDING PERMIT NO. PERMIT 140. DESCRIPTION OF'FURNACE/BURNER HEATING or POWER PLANTS. Steam, Hot Mater, Mars Air- No. Trade Name site No. Capacity Sq. Ft. EDR BTU NP Total Connected load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU NP Company AjobL.L. lA c Siqned By Tel. No . _77 -C x®21 SUBJECT P E R City of Fridley 22155 AT THE TOP OF THE TWINS BUILDING PERMIT (f t 9 1 L COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. (� r t e PROTECTIVE U\ t NUMBER REYDATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 110/6/93 JOB ADDRESS 1244 Regis Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 3 Parkview Oaks lst Addition SHEET 2 PROPERTY OWNER MAIL ADDRES$ ZIP PHONE George Bukovich 1244 Regis Terrace NE 571-4350 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. J M B.ruggeman 420 E Co Rd D, Little Canada, MN 55117 483-5144 5359 4 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 ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 121 x 12' Addition and a 101 x 121 Deck 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. W O Before digging call for all utility locations 454-0002 REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 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 $10600 $5.30 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT r 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- $126.60 Fire SC $10.60 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. CHECK FEE TOTAL FEE rPLAN ©- o License SC $5. $146.90 SIGNATURE O ONTRACTOR OR AUTHORIZED AGENT IDATEI WHE O VALIDATED THIS IS YOUR PERMIT �� BLDG INSP �� + 0ATf SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI • NEW I ] 314 Effective 5126/93 ADDN CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2\` Building Permit Application �J Construction Address: Legal Description: Owner Nance & Address: A" Tel. Contractor: MN LICENSE # 6,,4-33-;P Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF DeROVEMENT LIVING AREA: Length /69�` 0___ Width /,I' Height 00 ' Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length , f d ` Width 1.2 Hgt/Ground / Sq. Ft. 42,p Corner LotU Inside Lot { ] Ft. Yd Setback Side Yard Setbacks 9 Type of Construction: w Estimated Cast. $ 6 Approx. Completion Date: /ice r JOS (Cost on Back) Driveway Curb Cut Width Needed: APPLICANT: 0;7 c Tel. #- 4. k ``�� CIT�t�SE�oNLY ., DATE: %x-/16- ,gY Permit Fee $ Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL Ft. + 6 Ft = Ft x $ A-26.00 Fee Schedule on Reverse Side $ /0, 60 .001 of Permit Valuation (1/10th $ —5-30 $.50/$Valuation $ $750 per SAC Unit _ $ h O $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ Conservation Plan Review $450.00 $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: v, i SUBJECT P City of Fridley M30518 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. � INSPECTION SEC. � PROTECTIVE 72A6r ` 1 CITY HALL FRIDLEY 55432 '•� NUMBER REV DATE PAGE OF APPROVED BY L.___�i 612-571-3450 910415 11/ 17/99 --- JOB ADDRESS 1244 Regis Terrace NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 3 Parkview Oaks, First Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Brakovich 571-4350 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Roncor Construction 10740 Lyndale Ave S Bloomington 55420 888-5578 2337 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 Yff REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reside house and garage; Replace trim - aluminum 9 CHANGEOFUSEFROM TO STIPULATIONS Call for building wrap inspection before covering. 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 CERTIFY THAT 1 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 $9468 $4.73 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- $181.25 Fire SC $9.47 TR TTION THE PERFORMANCE O,, CONSTRUCTION a PLAN CHECK FEE TOTAL FEE LiceUA4C $5,60 1 A200.45 SIGN E f CON'92CCTOR OR AUTHORIZED AGENT IDATEI N R P VALID Tyb THIS IS YOUPERMIT BLD )NSR ��AT E S,GNATURE OF OWNER p0 OWNER BUILDER) (DATE) i NEW'[ 1 Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: S Legal Description: Owner Name & Address: Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Tel. # MN LICENSE #� Tel. # w`/./&K��' Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT Length Width Height Length Width Height Length Width Hgt/Ground 9 1 1 '0 P .19 . ✓e O; Sq. Ft. Sq. Ft. Sq. Ft. Estimated Cost: $� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: APPLICANT:Tel. # CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ 161 a�g~ Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 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 [ ] BuildingPermit $ BUILDING No. - Plan Review $ 65% of Building Permit Fee Inspections $ RESIDENTIAL APPLICATION Received By: 763-572-3604 $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ CITY OF FRIDLEY Date Rec'd: SAC Charge $ DATE YOUR E-MAIL ADDRESS SITE ADDRESS / y �-�C,. T�-1 ✓ N� THIS APPLICANT IS: O OWNER CONTRACTOR PROPERTY OWNER/ NAME: &eor -e uj a J 1 TENANT ADDRESS: i X('ejiS ✓^iL�ITY/7 STATE-L✓LIP Park Fee PHONE CONTRACTOR NAME: , SIi-/iil-tf�/'i �✓S STATE LICENSE # Tri iS5/ EXP DATE 2007 SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: & Y I/ �c„� s � �� CITY /� �'� � STATE -- -ZIP ,ELY S. > WITH APPLICATION PHONE ?(o, .3—Y- 7 Ll -i3 % FAX 7C� 3 "�'©off — l✓ ��- PROPERTY TYPE Pt SINGLE FAMILY/NEW CONSTRUCTION SIZE 0 TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE 0 ADDITION 0 GARAGE/SHED 0 WINDOWS 0 BASEMENT FINISH PROOF 0 DRAIN TILE 0 DECK 0 SIDING 0 OTHER 0 SWIMMING POOL TYPE OF WORK: ONES' 0 ADDITION 0 MAINTENANCE/REPAIR 0 REMODELING DESCRIBE WORK BEING DONE: _ �� �� f- -;z_ 11c -J_ SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING 0 HOUSE ONLY 2L NUMBER OF SQUARES 0 HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES 0 ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: 0 DETACHED GARAGE 2. Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, 0 Vinyl OSoffit ADDITIONS_ & PORCHES SUBMIT: 0 Aluminum 0 Trim I. Site Plan/Survey showing the existing structures 0 Other O Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS DYes ONo LOCATION OF WINDOWS 3. Energy Calculations 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 $ Y-*P�= 3 1 Iq 3 6) 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 $ $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 $ 1l .00 Make checks payable to: Citv 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; that the work will be in accordance with the approved plan in the case of all work which requirer� eview and approval of plans. SIGNATURE OF APPLICANT �— PRINT NAME n� S C4!/1DATE -06