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PRE 2010 DOCSCity of Fridley, Mm. � �7`3,6 BURDING PERMIT N® -7402 Date: Owner: Build Address Address LO I O ILDING No. /� Street ® Pa=oLo+- Addition or Sub -Di 0 7 Corner Lot _ Inside Lot _ Setback Sideyard v Sewer Elevation e 3 n Elevation 11V N'Potins. �A DESCRIPTION OF BUILDING Front Depth Z Height sell! �.�/f✓ .1 Depth Height Type Of etion A6 --To be- Completed r r In consideration of the issuance to me of a permit to construct the build the proposed work in accordance with the description above set foam in ordinances of the city of Fridley. �� . In consideration of the payment of a fee of ��permit is by granted to I agree to do provisions of 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 anypart 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 uponviolin of any of the provisions of said ordinances. _ A)V Building Inspector NOTICE: We pormb does not cover the construction, bstsMan for wh%g, phmubtne, an hearing, sewer or water. Be sum to sec the Badding lespector for sopmte permha for tbese items. Application for Pourer Plants and Heating, Cooling, Ventilation. ReMgeration 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 $ NECK. WARM AIR Furnace Shell & Duct Work to 124,000 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 $ -491-90 GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ �S U 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 $ �� Dept. of Bldgs. Phone M-3450 Location L� �I[�� e &P 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-�'� y 19 6-,2 Owner Kind of Building Used as To be completed about N Estimated Cost, $��)- Old New. Building Permit No. Permit No. v e DESCRIPTION OF WORK BEATING orPO R PLANTS -steam, Hot��Water, Warm Air—,�No p Trade Nam es i6 eit� Size No-' d `" d d� Capacity]' 2 Sq. Ft. E.D.R BTU H.P. �✓ Total Connected Load d of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS—OVER) Signe -��42 Business Phone No- 9 GRATIM WARN AIR: DATE TOTAL Furnace Shell & Duct Work .810.00 0 Replacement of Furnace 0.00 Repairs & Alterations—up to $500.00 6.00 Repairs do Alterations each add. $500.00 3.00 — MECIL WARM AER $� _--- Furnace Shell & Duct Work to 12000@ BTU 510.Eeach add. 60. ........ 3.UO _ Replacement of Furnace &00 a Repairs & alterations --up to $500.00 &00 $ Repairs & Alterations each add. .00 &W -- Furnace Shell & Lines—to 400 sq. ft. FMR Steam $10.00 - Furnace Shell & Line—to 640 say. ft. EDR Hot Water 10.00 Each add. 200 say. ft, EDR Steam 1.0n � Each add. 320 sq. ft. EDR riot Water 3.00 $� _--- ®1L BURNER—to 3 gal. per hour 6.00 �— - over 3 gal. per hour --See Fee Schedule GAS B (up.to MM8 BMTU) &00 � over 190,WO FM see Fee Sei"Aule GAS FITTING NO RATE TOTAL 1st 3 Fixtures --- - — AS 2_00 Additional Mxtures x .75 -- Gas Range to 199, / xS _ AIR I9'E®i!1 t/ State Surcharge .50 FAN HEATING S VEN LATING SysTng ALTERATIONS & REPAIRS >FINAl6 _l- f®= 7_6" es Dept. of S-7 , - a' "�/C- %3 , City of Fridley: The undersigned hereby makes application for a permit for the work hereh specified, agreeing to do all work in strict amwdance with the City QMhMm and ruling of the Department of Buildings, and hereby declares that an the facts - and representations stated in this application are troy a" carrecL Fridley, ARann �s /� 19 % owner_ nn3rs�-4�`-�0 Kind of Building Used as a To be completed about � % Z�erffi' 7 3 Estimated Cost, a — �� Uid New. Bolding Permit No. permit No._• 'al_� C___P"DrBOw or WORK HEATING or FOSot Wates. Warm Air—No Trade Sbe No �/ i, )e 2— Capacity-- ------ Sq. FI. E.D.R gI°C e-� Total Connected Load--- Kind of F9et BURNER — sift x0 Capacity---- Sq. Ft. F,.D R BTU l� (REMARKS -OVER) I 0 suejEct PERMIT NO. City ®i Fridley 8 139' AT THE TOP OF THE TWINS BUILDING, PERMIT iL10 COMMUNITY DEVELOPMENT DIV. _ _ r : PROTECTIVE INSPECTION SEC. NUMBER REV OATS PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 L.__.R ' '•, 612-571-3450 910-F15 1017198 JOB ADDRESS 571 Rice Creek Boulevard 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 2 I Holiday Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Elyse Raner 571-2058 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Bo's Construction 2218 22nd Ave S M is MN 55404 709-5037 20100656 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 ®x REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (26 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2228 1.11 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION THE PERFORMANCE OF CONSTRUCTION $74.75 Fire SC $2.23 A -7-f PLAN CHECK FEE TOTAL F Licens 5.00 83.09 S NATURE CONCRACTOR OR AUTHORIZED AGENT iDATE, P OPER LIDATE T, S IS YOUR S�GNATUAE OF OWNEROF OWNER BURDERi 40ATEi el INSP 1).1E 0 NEW L ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY AT L ] SINGLE FAMII.Y AND DUPLEXES 1"1 AND R-2 BUILDING PERMIT APPLICATION �1 �0 ConstructionAddress: 5-71 Legal Description: Owner Name & Address: Tel. Contractor: &S MN LICENSE # A ®I 00 65",l Address: 2�a s, Alols IMP .-SL%OL-( Tel. # 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 Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Al� 5A IA - Construction Type: t ex Estimated Cost: $ 3 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: b - � q5 APPLICANT: Tel. # ?®Cj- 503 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge $ TOTAL 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 [ ] CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 WIM111L R W►V.qiwillu 1 a W-16 ADDRESS : 571 RICE CREEK BLVD NE PIN : 143024210015 LEGAL DESC : HOLIDAY HILLS TOTAL : LOT 1 BLOCK 2 PERMIT TYPE : ELECTRICAL PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION PERMIT NO.: 2004-01673 94S DATE ISSUED: 09/27/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. SERVICE UPGRADE. 1;1 APPLICANT SCHAFF ELECTRIC INC 2081 122 LANE NW COON RAPIDS, MN 55448 - OWNER GEORGE BIGALOW 571 RICE CREEK BLVD NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date ELEC AMP SERVICE FEE 30.00 ELECTRIC FORM FEE 1.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 31.50 PAID WITH CHECK # 5900 SEFAKA"TE FERN TI"S REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Building MECHANICAL Permit No.:a0U2-o/&60 CtV- Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY mcnp DATE _I" r YOUR E-MAIL /ADDRESS SITE ADDRESS_ J -I �eQ e ��e e k �10c(• NE. THIS APPLICANT IS: ❑ OWNER ]CONTRACTOR PROPERTY NAME: �-_ \ ,e r - OWNER/ ADDRESS: J -1 % � ® a e Q_fe-e k-ytCITY TATE MIUZIP 5 `5C/3a TENANT PHONE: '626 `5 `7 l - Cl LA 3 CONTRACTOR COMPANY NAME: CENTERPOINT ENERGY CONTACT PERSON: JOANN 7INKEN SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: 9320 EVERGREEN BLVD STE BITY -COON 'RAP.IDS sTATEMN zrp55433 APPLICATION PHONE 763 — 757 -- 6202 FAX 763--757--6701 PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY 17 TOWNHOUSE TYPE OF WORK: 0 NEW PfREPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK Zvi icy. t PER MS 1611.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) ���,,��--�� Equipment Installed MFG: ��e a MODEL: �o ^ ®� SlZki(13"1U —1 � C•O MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU _A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 _AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _BOILER $35.00 FURNACE $35.00 _GAS UNIT HTR $10.00 _CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 $10.00 GAS PIPING $10.00 VENTR ATOR$15.00 _DUCTWORK Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 t x $35.00 = $ 3%. O� State Surcharge = $ .50 Total = $ 5 , O 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. n SIGNATURE OF APPLICANT ® Rh. � NAME ROGER HOFFHEIN DATE 04 "S ' �� Al City of Fridley Building Inspections' Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building PLUMBING Permit No.: O-) -Q 3 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 D Q' 0 V 200 CITY OF FRIDLEY a DATE_�/ 'T:�� %% YOUR E-MAIL ADDRESS SITE ADDR S 2 SE� THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY NAME: ADDRESS: ITY��O STA�ZIP TENANT PHONE: CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS: CITY STATE ZIP LICENSE WITH PHONE FAX APPLICATION PERMIT TYPE SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: ❑ NEW REPLACEMENT s DETAILED DESCRIPTION OF WORK r PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) _ BATH SINK/LAV DRAINS SHOWER _ WATER PIPING _FLOOR _ GAS PIPING a&o cirrucmm) SWIMMING POOL WATER SOFTNER ($35) —BATHTUB _ _ _ _ CLOTHES WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($15) _ _ _ DISHWASHER LAUNDRY TRAY HEATER ($35) FOR IRRIGATION _ _WATER WATER METER OTHER y�•+y Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ 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 whi a y'res r ,view and approval of plans. �/ 1 SIGNATURE OF APPLICANT( /' ' `%� &) /40/t TE G`� - :•' PRINT NAME .` ROTI' City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building N BUILDING i q,573 Plan Review PennitNo.: 7-009-0 05,;!,�- Inspections ' Fire Surcharge RESIDENTIAL APPLICATION .001 times the total job valuation Received By: 76S-572-3604 .0005 x Permit Valuation Minimum $.50 CITY ®F FRIDLEY $ � 0 4 2 09 ©' ® Cl $1550 per SAC Unit (Plans to MWCC for determination) DATE YOUR E-MAIL ADDRESS R + 6 ft = ft x $21 =$ SITE ADDRESS -1�;, iE r of S. THIS APPLICANT IS: ❑ OWNER 936ONTRACTOR Fee Determined by Engineering PROPERTY OWNER/ NAME: �) �✓ S P� CAS Agreement necessary ( ) Non Necessary ( ) TENANT ADDRESS: '�) K \ Co— �f e -e F- �3 1 OCITY STATF Z]P &' �- PHONE: -7b-3 - 2%,,\- - 3 5 % .� CONTRACTOR NAME: Wel ( POIq - hyl,7 1/ 'i d (3 0.) -f- SUBMIT SUBMIT A COPY OF STATE LICENSE #_ d V q' EXP DATE YOUR STATE LICENSE ADDRESS: X13 b{ ©1L CITYStjjj STAT* �5 � WITH APPLICATION PHONE sa -" 3-(p3®O FAX S� a: - 3 - ®� PROPERTY TYPE UrSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED IirWINDOWS aa ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE J ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ ANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: I=2 Q IAS IY��tiL 0 C�� (� ,�(�2 sJ S ' �t 5-I ;`/���p S SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2• Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. WINDOWS2. Two sets of construction plans IN EXISTING OPENINGS Q4:` s ❑No 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 997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ J/t aSee 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 $ R + 6 ft = ft x $21 =$ 1 Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 3, ( (o Make checks payable to: Citv 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 confornance 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 he case of all work which equires review an approval of plans. / j j SIGNATURE OF APPLICAN PRINT NAME �w eS� U 1 DATE Building BUILDING Permit No.31 Ins-pections RESIDIENTLAL APPLICATION Received. By: r) yk 76S-572-3604CITY DaACO'cPEC 2 2009 OF FLE �! DATE Q - I IO I YOUR E-MAILADDRESS � SITE ADDRESS � 6 I CP- ueelv_'&yCQ �^ tiE.i'V v� 1 ► r / ✓1 fi� _. THIS APPLICANT IS: DOWNER 6CONTRACTOR � PROPERTY OWNER/ NAME: G• - TENANT ADDRESS: S% / , tv. 6 e -e -,e 81 CITYy / adlA-, STATAZIP PHONE:6J,-) 76-3 9 f/ �5 - d J 6 CONTRACTOR NAME: r STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS:,393W l &1.QGg4o-7 1b),,f30 � CY /: CITY �T / _ [yl,S P STATB�/�ZIP ss�I WITH APPLICATION PHONE /! S4 - 93 `9J ` 3 ®6 FAX - 3 - % PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED WININDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ O ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ DITION ❑ MAINTENANCE/REPAIR ODELING DESCRIBE WORK BEING DONE: - SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2• Proposed floor plan PROPOSED HEIGHT: 3. List of structuFal members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS, & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGSes ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF -0 a OPENING CHANGES & D .� TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS a ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 74Z D U 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 $Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ r 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 phan in the case of all work which requires revieR and pproval of plans. j PRINT NAME SIGNATURE OF APPLICANT( .rp �-a �a n P_ 7 c DATE UV(1,� i