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PRE 2010 DOCSCity of Fridley, Minn. BUELDING PERMIT N���Z MUM, Address ..................................... N® 3421 Builder .... .. A -An -42-e. ............ Address.... ............................... LOCATION OF BUILDING No. ..6.1.9. Street .. .mfr... ... .. d. .. Part of Lotr ............ .. .............. /� Lot ... / ....... Block .. ............. Addition or Sub -Division 6W4e .. Corner Lot .. �4 ....... Inside Lot ............ Setback w�.�. �a— c! Sideyard . .............. DESCRIPTION OF BUILDING To be Used as � P 0 4 . `........ ..) Front��� Depth Height ��..®f Sq. Ft� Cu Ft.5-: �5� Front ........ Depth ........ Height ........ Sq. Ft......... Cu, Ft. ........ f� 0-4. Type of Construction ................... lkt. Cost..4. ; ........... To be Completed ................... In consideration of the issuance to me of a permit to construct the building desribed above, I agree. to do the proposed work in accordance with the description above setfo a��pliayxce with all provisions of ordinances of the city of Fridley. / , ..:..,,.rs.v.s......................... 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 with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. -:� %JP6 7 City of Fridley, Minn. N° 8286 BUR DING PERMIT Date: July 293 .1965 Owner: PAUL YAGU Builder J. E. DU00S Address 6r, Rice Creek Terrace Address 1909 Rice Creed Road Fridley, Minnesota New Brighton, Mimesota LOCATION OF BUILDING No. 617 Street RICE GREEK TERRACE Part of Lot Lot lra _ Block 2 Addition or sub -Division RC Terrace Plat #7 Corner Lot _ Inside Lot _ Setback Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Front Depth Height Sq. Ft cu. Ft Front Depth Height Sq. Ft Cu. Ft Type of Construction Est. Cost _ 22 2 000 *00 To be Completed Storm Rebuild In consideration of the issuance to me of a permit to the proposed work in accordance with the description abo ordinances of the city of Fridley. I above I agree to do with a�l provisions of In consideration of the payment of a fee of S 10:00 _ _ _, permit is hereby granted to J, E, RU -00S 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 aII work. done in, around and upon said building, or any part thereof, shall conform in aII respects to the ordinances of Fridley, Minnesota gg location, construct�Ton, alteration, maintenance, repair and moving of build�sg� w city ]imits�anthis permit may be revoked at any time upon violation of any of the provisions of said ALLEN G. JENSEN Building � I i or NOTICE ihb pgm* don no eewr the eondmdlon, hutdbdon for whb& phmbk& gas huem& nww w water. Be are to no tiro SuMns fir. for aparato pamdts for thea hams. APPLICATION FOR BUILDING PERMIT CITY OF FRIDL*Y, MINNESOTA OWNER'S NAME/%AfL A1s2Sy �. VA / (I BUILDER�r h � � 110 S ADDRESS 0/7 G 6 199e T�/P/ZADURESS �01 91 LOCATION OF BUILDING N0. STREET PART OF LOT LOT C3 C- BLOCK T o ADDITION OR SUBDIVISIONW_1V CORNER LOTINSIDE 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 Certif cater. 641A 19 DESCRIPTI0N OF BUILDING To be used as; Front Depth Height Sq. Ft.Cu. Ft. Front Depth- .Height Sq. Ft. Cu. 'Ft. Type of Constructions E Estimated Cost���� To be completed 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. (S Cie1dule o ee Costs can be foyPnd gxf the Reverse Side', 0 R I H SUBJECT PERMIT NO. City of Fridley o 8 AT THE TOP OF THE TWINS BUILDING PERMIT r TNO. • COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. VECEIP� fffJ PROTECTIVE 1 � � "t CITY HALL FRIDLEY 55432 NUMBE REV. DATE PAGE OF APPROVED BY 612-571-3450 91b -F15 5/18/88 JOB ADDRESS 617 Rice Creek Terrace N. E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 2 Rice Creek :Terrace Plat 7 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ellard Briesemeister 617 Rice Greek Terrace N.E. 571-3614 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 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 Reroof Dwelling (22. Squares ) 9 CHANGEOFUSEFROM TO STIPULATIONS Roof can be the 2nd layer but not the 3td. Install ridged galvanized valleys. On all new roofs or tear -offs and replacement roofs, State Code requires that 2 layers of 15 Ib, felt, mopped together, be installed to a point 24 inches up from exterior wall line, or the use of other approved underlayment membrane. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 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 $1 $.55 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT F100 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 TOTAL FEE $27.55 AT F TRACTOR OR AUTHORIZED AGENT - (D WHEN PROPERLY (DATED T IS IS YOUR PERMIT DATE) �d � i ! ��g BLDG (NSP siG ATURE OF OWNER IIF OWNER BUILDER) ATE( NEW [ ] City of Fridley Effective 5/1/88 ADDN [ ] R-1 AND R-2 ALTER [ Construction Addri rl Description Building Permit Application Owner Name & Address:_ &,t74c�2 37 Tel. # v%i 3 Contr actor : Tel. # Address: Attach to this appl icat ori,:;,:a ;4 a of ic:ate o_ f , ,Survey of the lot, with the proposoed. bo" Yistyruct on -drIawn on it to scale. DESausTioa dF IMPROm+mr LIVING AREA: Length Width Height Sg. Ft. GARAGE AREA: Length Width Height Sg. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. -Kr- Y,®®#='f/'1/'�" -21 ;?- Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ I100 Approx. Completion Date: Proposed Driveway Width If New Opening Is Desired: 1 $. Width + 6' Alt. A Alt. B $ See Back Page DATE: !� �� APPLICANT:.2�, ���z L�-7 Tel. # CITY USE COY Permit Fee $'� �'� Fee Schedule on Reverse Side State Surcharge S $.50/$1,000 Valuation SAC Charge $ $550 per SAC Unit Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ 7 TOTAL STIPERMIONS: w CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDEI4TIAL RATE TOTAL Job Address_ �/� Furnace Shell and Duct Work, Burner (Also replacement furnace) $ 20.00 $ qp .QQ Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Gas Piping $ 10.00 $ Tel. #571-3450 (piping needed with new furnace) Gas Range $ 10.00 $ The undersigned hereby makes application for a permit for the work herein Gas Dryer $ 10.00 $ specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. * Air Conditioning (all sizes) $ 10.00 $ Fridley, Minn. _ p7, 19 All Others/Repairs and Alterations _�%' OWNER 1% of Value of Appliance or Work $ KIND OF BUILDING X-�Lai COMMERCIAL/INDUSTRIAL USED AS 1% of Value of Appliance or Work $ TO BE COMPLETED ABOUT -- ESTIMATED COST 3! , � State Surcharge $ .50 az TOTAL F=OLD $� - NEW BUILDING PERMIT NO. PERMIT NO. Reinspection Fee ($15.00) $ Rough Insp. Date Final Insp. —.3— y — Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00, PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission frcm adjoining neighbor. DESCRIPTION OF FURNACE/BURNER 410-5& ?60-Q 3-6 HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No.7�fJ Trade Name Size No. i Capacity ��/ Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel i BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company . Signed By Tel. No. Fill out back side for stack verification on replacement furnaces SUBJECT city of Fridley 971 AT THE TOP OF TME TWINS BUIL®ING PERMIT NO. __ _ COMMUNITY DEVELOPMENT DIV. e m `v ------ INSPECTION SEC. 7�6 6 r PROTECTIVE 1 � = 1 it CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY j 612-571-3450 910-F15 10/20/98 JOB ADDRESS 617 Rice Creek Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 1 Rice Creek Terrace Plat 7 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Briesemeister 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Advance Alum. Supply Inc. 7701 Main St NE Fridley 55432 571-3440 7983 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 O ADDITION ❑ ALTERATION Rk REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage (21 Sq) Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlaymen¢t must comply with the State Building Code. 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 1799 $.90 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 $56.75 Firs SC $1.80 PLAN CHECK FEE TOT FEE LIce e SC 5. 0 .45 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEi O Y VALIDA E HIS IS YOUR PERMIT QP SIGNATURE OF OWNER OF OWNER BUILDER, IDATEi B OgAtE NEW [ ] ADDN [ ] ALTER ] S 612 571 2260 ADUANCE ALUMINUM CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION .577/--/ -&-e7 Effective 111/98 ConstructionAddress: 61 7 /C / G c L: �z�!ir T.� .-i /�:�'c •r Legal Description: Owner Name & Address: /�,�?.,�/ /,�jp /��,r-/L Tel. # Contractor: ,.t.,r c.v,., wG.,.., vP�c, i-,. MN I..ICENSE # 79113 Address: 70 w /ia1,4 2e Tel. # S�' / — 3 yy® 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: Construction Type: Estimated Cost: $_ /221 `21 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 17t = Ft x $ _ $ DATE: V �.j g APPLICANT: Tel. # S7/-3j�'yt> TOTAL $�q.7�;- STIPULATIONS: �� 03 CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ , .001 of Permit Valuation (1/10th%) State Surcharge $ 90 $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $. O ® $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 $�q.7�;- STIPULATIONS: �� 03 SUBJECT PE O. City of Fridley 2 4418 AT THE TOP OF THE TWINS BUILDING D C D A A I T Ir r GR'Y1 RECEIPT NO. � .v ___�__ COMMUNITY DEVELOPMENT DIV. J PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED SY 1 612-571-3450 910415 5/7/99 10B ADDRESS 617 Rice Creek Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Rice Creek Terrace Plat 7 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ellard Briesemeister 617 Rice Creek Terrace NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Advance Aluminum Supply Inc. 7701 Main St NE, Fridley, MN 55432 571-3440 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 CX REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reside house; trim 9 CHANGE OF USE FROM TO STIPULATIONS Call for building wrap inspection before covering. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $8,000 $4.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC C GE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $137.25 F SC $8.00 PLAN CHECK FEE TOT EE Lice e SC $ $154.25 SIGN TORE OF CON'RACTOR OR AUTHORIZED AGENT IDATEI WHE P D R L 2oudr.00� B OG INSD . THIS IS V 45 i /- 7117 OAiE SIGNATURE OF OWNER IIF OWNER BUILDER, -.DATE. iv= VYL J ADItN ( ) ALTFR ( ) Description: $ 612 571 2260 ADURNCE ALUMINUM CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES It -1 AND R-2 BUILDING PERMIT APPLICATION Llitective 1/ 1/98 81 Name & Address: 4 A D 14, el yd ,*.4; y ,�2 Tel # ;tor: dA,o` /_zec. MN LICENSE # 720 Tel.#_S /-3y'YD Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF1T4PROVEMENT LIVI 4G AREA: Length Width Height Sq. Ft. ! GAR kGE AREA: Length Width Height Sq. Ft. DEC AREA: Length Width Hgt/Ground Sq. Ft - j OTH R: Constriction Type:. Estimated Cost: $ 10oy (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATES % APPLICANT: Tel. #�/— CITY USE ONLY Permit Fee $ )37>c�r Fee Schedule on Reverse Side Fire St rcharge $ . ®6 .001 of Permit Valuation (1/10th%) State S rcharge $ $.50/$1,000 Valuation SAC C arge $ $1000 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Drivew2Ly Escrow $ Alt. "A" or Alt. "B" Above Erosior Control $ $450.00 Conservation Plan Review Park Fi e $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ) TO AL $ STIPULATIONS: I 11 suejEcr P MIT NO.' City of Fridley 31030 AT THE TOP OF THE TWINS P, BUILDING PERMITr y RECEIPT NO ` COMMUNITY DEVELOPMENT DIV. - ------ i PROTECTIVE INSPECTION SEC. " 1 , = CITY HALL FRIDLEY 55432 NUMBERREV DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 6-5-00 JOB ADDRESS 617 RICE CREEK TERRACE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Rice Creek Terrace Plat 7 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ellard Briesemeister '617 Rice Creek Terrace 571-3614 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 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 O ADDITION O ALTERATION j] REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Repair Existing Deck 9 CHANGE OF USE FROM TO STIPULATIONS For stipulations see attached plan. 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,000.00 $.50 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- Fire SC STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $38.75 $1.00 PLAN CHECK FEEL TO A FEE $40.25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATEI WH PROP Bl INSP VALID T D TBHIS ISP T �� TE S.GNATURE OF OWNER OF OWNER BUILOERi IDATEI I 11 NEW [] ADDN [] ALTER [ ] Construction Address: Effective 1/1/2000 CITY OF FRIDLEY (763) 572-3604 Bldg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 r1 BUILDING PERMIT APPLICATION �,v q Legal Description: Owner Name & Address: 4ELp-D 45;- 7255C Tel. # 7./ Contractor:41l'o'/ MN LICENSE # Address: Tel. # 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. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Construction Type: it 0 Estimated Cost: $ ,/ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: Ic"f APPLICANT • Tel. # CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application STIPULATIONS: Permit Fee $ %� Fee Schedule on Reverse Side Fire Surcharge $ l C,) 0 .001 of Permit Valuation (1/10th%) State Surcharge $.50/$1,000 Valuation 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 [ ] C TOTAL $ -'a - STIPULATIONS: Building BUILDING Permit No.: Li ' Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Da d• DATE 1 A f 105 YOUR E-MAIL ADDRESS tA.*Y50.�C1S— SITE ADDRESS l- " zrt cl -f za (a cj THIS APPLICANT IS: 0 OWNER CONTRACTOR PROPERTY OWNER/ NAME: I I 'Q S C'i' 1rYC t ADDRESS: n CITY STATE P ZI TENANT a � PHONE: IUJ–�7 T +CLI y NAME: Renewal By Andersen CONTRACTOR SUBMIT A COPY OF STATE LICENSE #_1920 County Road "C" West YOUR STATE LICENSE ADDRESS: Roseville, MN 55113 t STATE ZIP WITH APPLICATION PHONE License #20130983 0 SINGLE FAMILY/NE` 651-264-477% PROPERTY TYPE 0 TWO FAMILY/NEW C 0 ADDITION 0 GARAGE/SHED 0 WINDOWS PERMIT TYPE 0 BASEMENT FINISH 0 ROOF 0 DRAIN TILE 0 DECK 0 SIDING 0 OTHER 0 SWIMMING POOL TYPE OF WORK: 1-101 NEW 0 ADDITION MAINTENANCE/REPAIR 0 REMODELING __� cc�� DESCRIBE WORK BEING DONE: aS �^�'/ -M bh �HOEIGH�TS SIZE OF IMPROVEMENT LENGTH WIDTH Ft. ROOFING 0 HOUSE ONLY BASEMENT REMODELING SUBMIT• NUMBER OF SQUARES 0 HOUSE & GARAGE 1. Floor Plan GARAGES 0 ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: 0 DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, 0 Vinyl 0 Aluminum OSoffit 0 Trim ADDITIONS 1. & PORCHES SUBMIT: Site Plan/Survey showing the existing structure 0 Other 0 Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS OYes ONo LOCATION OF WINDOWS 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 $ 8 SSS OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Atta( 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 conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not 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 approve plan in the case of all work vhich require eview and approval of plans. t SIGNATURE OF APPLICAI, RINT NAMEOI 1 { , y -,5e i1�7 DATE LV $ �— $ See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Atta( 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 conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not 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 approve plan in the case of all work vhich require eview and approval of plans. t SIGNATURE OF APPLICAI, RINT NAMEOI 1 { , y -,5e i1�7 DATE