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PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT S® 4331 Date: --------._............._.. Owner: ---.._.................----------------•--...---.._............_-_..._...--_-••-._---..-.-.-_--.-_... Buder .........._....._..-----...._...._....__--•----. .......................... ..... __..........._:�....i.__..... Address ......................... _.......... ........- Address ....... ............ ................ _............ .__..__....._. LOCATION _ OF BUILDING No. 1-0 Street_.__ ....... v -.... _-- -. ----- .... ._ ............ ....._ Part of Lot - - Lot ..._.-- .................... Block .................... .................. Addition or Sub -Division Corner Lot ..... ............................. Inside Lot ....................---............... Setback ............................. _.............. Sideyard Sewer Elevation ....._............._......._.---.......---...-......................-------------------------- Foundation Elevation .................. DESCRIPTION OF BUILDING To be Used as: � c a c ar l _._..... _.._......... ........... Front ...f_....7..`� Depth _� Height.. Sq. Ft. l.../.... Cu. Ft.19.0..716 A�ce� .......... .. Front . Y:7..6 `Depth.®f .. .. fight ........................ Sq. Ft.. I... Cu. Ft. Sp p Type of Construction............................................................ Est. Cost......I 9 919 j7 To be Completed ................. ..._...................... -........ In consideration of the issuance to me of a permit to construct b the proposed work in accordance with the description above set fo'" ordinances of the city of Fridley. r �e , in I aa��''ee to do ovisions of In consideration of the payment of a fee of $..ice....._--......., 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. .1 _, , 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. Application for Power Plants and Hearing, CooUn . Ventilation, Rengoratton 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 do 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. IDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ I Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ s OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule $ AIR CONDITIONING GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ GAS PITTING FEES: NO RATE TOXAL 1st 3 Fixtures ...................... x $1.50 $. Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ REMARKS - h_ Dept. of Bldgs. Phone 0 -Al 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. Owner Kind of Used as To be completed about — Estimated Cost, $ VW—New. Building Permit -No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Name P Size No J�� EE 195- 195— Capacity. 'u Sq. Ft-. /E.D.R BTU H.P. Total Connected Loao�!/ G Kind of Fuel• BURNER — Trade Name- � Size No Capacity. Sq. Ft. E.D.R BTU H.P. Sign By e 11 POST 1 M -12-58f Business Phone No a Ary X VA 6X -O -c r fVp D-36 ,42 HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN. Weatherstrips A.S.H.V.E.H Construction No. Insulation Guide Windows I Doors Reference Glut. Wall Int. Wall Ceiling Roof T Floor 11 Kind How Applied Yes- iNd- Yes 19_ J M I //e -P - , 'AIR-- I r ---.k U a 111:.].i. I I Q Lr :.L• 'l, 1, _ _.L - .p ­----- Win ows and Doors—Crackage and Area r%oom I i.engtn 7 ytj Width .Height No. of Lineal f . Area No. of pane of pane lights of crack .q. ft., Width No. of pane rielght Windows and ; oors--Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Co;f.1 Btu Infiltration Btu 30�® Glass Btu Infiltration�''� Coef-I Btu Infiltration Net exp. wall " Int. wall Exp. wall 2 Ceiling Glass Net exp. wall Floor4 151, Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1 otal 13tu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I F1.1 L, t4 A')v Room I Lenath b J Width / IJ Heiaht 9 Windows and(boors—Crackage and Area r%oom I i.engtn 7 ytj Wath y Width No. of pane rielght Windows and ; oors--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. IL 96 Q e, Btu Infiltration Coef. Btu Infiltration�''� Coef-I Btu Infiltration Glass Exp. wall j Q336 Glass Net exp. wall 0 Net exp. wall Exp. wall Int. wall Ceiling Net exp. wall- 4(f Floor -" Int. wall Floor ".,. Ceiling Floor L y #17 Q 7qg 1 otal 13tu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I F1.1 L, t4 A')v Room I Lenath b J Width / IJ Heiaht 9 Windows and(boors—Crackage and Area wp.a. :1 r. - ..ro.. ,_" Width No. of pane Height No. of Lineal ft. Area of Dane Ilghte of crack sq. ft. 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 tights of crack .q. ft. Coef. Btu Infiltration Coef. Btu Infiltration�''� Coef. Btu Infiltration Glass Exp. wall j Q336 Glass Net exp. wall 0 Net exp. wall Exp. wall Int. wall Ceiling Net exp. wall 4(f Floor Int. wall Floor ".,. Ceiling ILL #17 Floor a 55 4 Total Btu. Required aq. ft. E.D.R. or sa. ins. W.A. Leader area e>� s ..1 M M 14 •www wp.a. :1 r. - ..ro.. ,_" Windows and Doors—Crackage and Area 1 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 tights of crack .q. ft. Coef. Btu Infiltration Coef. Btu Infiltration�''� Glass Btu Q Glass Exp. wall _ r; Exp. wall Net exp. wall 0 Net exp. wall Int. wall Int. wall Ceiling Net exp. wall ' Ceiling' Floor Q Floor ".,. Total Btu.) (,ll) Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 0) Fl.l.0 /1P z4 Room I Lenath 1 _� Width 6 Heiaht ,S�'' Windows and Doors—Crackage and Area m Room I Length / U,, Width Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. 1 Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane tights of crack .q. ft. Coef. Btu Infiltration 1 Glass Btu Q BAS Exp. wall _ Glass' Net exp. wall 0 ` Int. wall Ceiling Net exp. wall ' lq3 Floor Int. wall Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 JV.W. R m Room I Length / U,, Width 5 ® Height $\<L Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane tights of crack .q. ft. Coefa Btu Infiltration BAS _ Glass' Exp. wall Net exp. wall ' lq3 11' Int. wall Ceiling Floor Total Btu. pad -`.:y ffi� .� yh" 7' Required sq. ft. E.D.R. or sq. ins. W.A. Leader area D-36 —42 ' HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, 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 Yes—No 19_ I- F1.1 /VI---. #7 .Room I Length 1/1 Width 0� 9., Height ey 11 1a FI_I V -F� w Ranm I Length le- Width Heiah0 fes, Windows and Doors—Crackage and Area G� Width Hetght No. oL Lineal f . Area No. of pane of pane Ilghte of crack sq. ft. d ,ppane /b q Coef. Btu .Infiltration Coef. I Btu Infiltration Coef.1 '351 7,611 Glass D S. " Exp. wall G Glass Net exp. wall 9q hi 1 1639 Int. wall Exp. wall Net exp. wall Ceiling 12 m Ia. Floor �yq ±f Windows and Doors—Crackage and Area G� Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Width Height No. of Lineal ft. Area No. of pane of lights of crack eq. ft. ,ppane /b q Coef. Btu .Infiltration Coef. Coef.1 Btu Infiltration (s 31 q c G Glass 3 Ir Exp. wall Exp. wall Net exp. wall � tis 12 m Ia. Net exp. wall ko 4 OAT Int. wall b_ et Cl Al Jq Ceiling - 15-0 ; Floor Ceiling L 0 -�� Iq 1 otal Btu. IP' Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FIALm. n--Jfri vRoom I Lensfth 1'47 Width )G,,) Height ' T, Windows and , oors—Crackage and Area G� Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. 9. q Coef. Btu .Infiltration Coef. Coef.1 Btu Infiltration Infiltration 31 q Glass G Glass 3 Ir Exp. wall Y`l Net exp. wall � tis 12 m Ia. Net exp. wall ko Ceiling i _ty b_ et Cl Al Jq Ceiling - 15-0 ; Floor Ceiling 37- -�� �,=' 1 btal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area G� Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack I sq. fto 12— J woe 1A 0, 'L Coef. Btu .Infiltration Coef. Btu Infiltration . Infiltration 31 q Glass G �, 3 Ir Exp. wall ®s® Net exp. wall � tis 12 m Ia. Int. wall ko Ceiling ? b_ et Floor ?` t- - Total Btu. I / 0 14, Required sq. ft. E.D.R. or sq. ins. W.A. Leader area .1? Fl.l /k `-%' n Room I Length R" Width �'' Heightq v,. Windows and Doors—Crackage and Area G� Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of cracksq. ft. 3 q q r0 Z /� i I Coef. Btu .Infiltration Glass Coef. Btu Infiltration Int. wall 3,' Glass ®s® , r � tis 12 m Ia. ko Net exp. wall ., 0 Ax Ceiling d _ L, Floor Q Sc 9 Total Btu. I (' Required sq. ft. E.D.R. or sq. iis. W.A. Leader area Fl.1 Room I Length Width Height Windows and Doors—Crackage and rea G� Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Coef. Btu .Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor 1 otal Btu. Required sq. ft. E.D.R. or sa. ins. W.A. Leader area City of Fridley Application far Plumbing and Gas Fitting Permit DESCRIPTION OF WORK Number, Kind and Location of Fixtures �j F: ^ v ,�7 w (a9 �U' ? u1z aU' • R N N WATER HTR. GAS ELEI ei viC 4. C U m U' K O Base 1st 2nd _ 3rd 4th • Future Connection Openings Connected with Sewer E] New Fixture, Old Openings Cesspool ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE 67 Number Fixtures ...................... A 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 BTL) ...... x 2.00 New Ground Run Old Bldg. ............ x 3.25 Dept. of Bldgs. Phone SU 400 -7747 i_n 44— d /t �[)D 4V'i 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 applicatipn are true and correct. f Owners Kind of Building Used as To be completed about l Estimated Cost, $ Old New Building Permit No- !� Permit o. TOTAL $ ® Signe&A' $ BY s $ Business Phone No 6 $ ROUGH FINAL GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ 06 51D Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description $ TOTAL FEE $ �`Q e a 2M 7-59 Furnace Shell & Duct Work ...........................$10.06 $ Replacement of Furnace ...........'.................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ 11tH. WARM AER Furnace Shell & Duck Work to 120,000 BTU ............ $10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace 6.00 $ Repairs & Alterations --up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam .... . $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 10.00 $ Each add. 200 sq. ft EDR Steam ............... :...... &00' $ Each add. 320 sq. ft. EDR Hot Water ..... ........ ... 3.00 $ OIL BURNER to 3 gal. per hour ... ::... ... ... I ..... 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 109,000 BTU) .......................... 6.00 $ over 189,000 BTU See. Fee Schedule GAS FITTING FEES. NO RATE TOTAL 1st 3 Fixtures ..... I ................ u$ 200 $ Additional Fixtures ................. x .75 $ Gas Range to 189,000 ........... s$ 8110 $ AIR CONDITIONING $' FAN HEATING SYSTEM See Fee Schedule ATING SYSTEM $ ALTERATIONS & REPAID TOTAL M $ UGH City of Fridley: The undersigned hereby makes application for a permit for the work hereie specified, agreeing to do all work in strict accordance with the City OrdinanceE and ruling of the Department of Buildings, and hereby declares that an the facts and representations stated in this application are true and correct. Fridley, 112inn MAY 24 19ZI 1S Owner�°e 2 ,� . tol:04"E m "y Kind of Building Used as To be completed about r' ?- 9 7/ Estimated Cost, $ OP New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Name ��� �✓" ��•• Size NoAI/41!�'z 13% - capacity 2 e' � Sq. Ft E.D.R. BTU ZZ ®� H.P. Total Connected Load Kind of Fuel s BURNER — Trade Name Size No— Capacity—,Sq. o Capacity .Sq. Ft. E.D.R BTU ILP, Slue Fla rne Contractors, Inc. 6959 Washington Ave. So. Edina, Minn. 55435 no s zz Business Phone No (REMARKS -OVER) 11 SUBJECT PER City of Fridley 1819? AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. p/ r � � PROTECTIVE 1 � i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9/10/85 JOB ADDRESS 210 Rice Creek Terrace N.E. 1 LEGAL LOT NO. 2 BLOCK 3 TRACT OR ADDITION Rice SEE ATTACHED Creek Plaza South SHEET DESCR. 2 PROPERTY OWNER MAILADDRESS ZIP PHONE George Johanson same 571-0562 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Covenant Construction Co. 7716 67th. Avenue N 55428 535-5.101 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING R-1 7 CLASS OF WORK ❑ NEW ❑ ADDITION ER ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys. 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 THE $1,788 $ WITH WHETHER SPECIFIED HEREIN OR NOT. GRANTING OF A PERMIT a .89 DOES NOT PRESU O GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS O AN OTHER STATE OR LOCAL LAW REGULATING CON- $29.50 STRUCTIO T P MANCE ONSTRUCTION. PLAN CHECK FEE TOTALFEE /�-pr $30.39 SIGN CONTRACTOR OR AUTHORIZED _ IDATEI ,WHEN PROPERLY VALIDATED THIS IS YOUR PT M _ (7/ //fERp/ BLDG ]NSP DATE SIGNATURE OF OWNERIIF OWNER BUILDER] IDATEI 11 NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ ] t R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: -2 Z :7 P Legal Description: C22 ��l 2 Zr (!�ni 0 z�� }� - Owner Name & Address: 414P , L4 r -T.e9 4-1 Tel. # Contractor 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 Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: to 0,-Y, � c' .l Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: Estimated Cost: $ Approx. Completion Date: z7—/':F— 5�=> _ Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: APPLICANT. Tel. #-�S'���� CITY USE ONLY Permit Fee $ Z47a 50 Fee Schedule on Reverse Side Plan Check $ 25$ of Building Permit Fee State Surcharge $ ?)9 $.50/$1,000 Valuation SAC Charge $ $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Hain Charge $ TOTAL $ 0.3 c, Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS• �y SUBJE& PER City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT 27992 � � 1 L COMMUNITY DEVELOPMENT DIV. r F PROTECTIVE INSPECTION SEC. 1 CITY HALL FRIDLEV 55432 612-571-3450 CEIP E 63 NUMBER 910-F15 REV DATE 9/29/98 PAGE OF APPROVED BY JOB ADDRESS 210 Rice Creek Terrace I LEGAL DESCR. LOT NO. 2 BLOCK ; 3 TRACTOR ADDITION Rice creek Plaza South SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mai Dao 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Top Gun Inc. 5014 Parrish Ave42A-4S59 2012R211 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Jac REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage 25 S Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING. HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING 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 ZONING SO. FT CU FT 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL RE COMPLIED VALUATION SURTAX WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2142 81.07 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 OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOT L FEE $82,196 SIGNATURE OF CONTRACTOROR AUTHORIZEDAGENT iDATE, Ezm,4�&7 SLO INSP. 7--c= S-GNATURE OF O%NNEROF OWNER BWLOM IDATEI ' NEW 1 1 Effective 8/ 1 /95 _ ADDN 1 CITY OF FRIDLEY ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 CO - Building Permit Application �R ConstructionAddress: 4-10 R4u CAtt k T. 00 i — Legal Description: — Owner Name &Address:�2 Tel. # Contractor: 7-0P GV 1J A)C B 1L/I®aA-4[SJ1Q)'C 0 _ MN LICENSE # ZWf-M2l ! Address: /zcS� M"? 553-74 Tel. # AlW–q,56 . Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IMPROVEMENT Length- Width Height Sq. Ft.' Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Type of Construction: Approx. Completion Date: Side Yard Setbacks Estimated Cost: $ (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft.= Ft x $ _ $ DATE: �®�/ 79 _ APPLICANT: Tel. # �:�� 069 CITY USE ONLY Permit Fee $ 1 Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ ® $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit License Surcharge $ $5.00 (ate 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: