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PRE 2010 DOCSCity ®f Fridley, inns BURDING PERMIT N® 7059 Date: ,� ` �- L�r� Builder --,-� �^-�' Address :F 3 ® LOCATION OF BUILDING No. + street -f --e ,e � A Part of Lot Lot . - 1 , Block Addition or Sub -Division _ j Corner Lot . _ Inside Lot Setback �_-_ - Side -yard Sewer Elevation Foundation Elevation 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 wi all provisions of ordinances of the city of Fridley. 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 reg location, construction, alteration, maintenance, repair and moving of buildings within the dty ]imitx ands permit may be revoked at any tin�upcgl� of any of the provisions of said ordinaacce. NOTICE: lids permit does not cover the construction, bisfdlmion for whu& phmbing, gas heating, sewer or wafer. Be core to see the Building kqm for for separaft permits for these atoms. City of Fridley Application for Plumbing and Gas Fitting Permit DESCRIPTION OF WORK Number, Kind and Location of Fixtures N ® Ul 7 F Z �n 3F- K Z� �LL s J at LLG 4< U �U' a Od, c (Z Z 6 a O ` F r N WATER HTR. GAS ELEC. Base lst �° 4 2nd 3rd 4th • Future Connection Openings New Fixture, Old Openings Connected with Sewer cv Cesspool PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 4-7470 Location A p t � -, r 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 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 jU 'A I qk' ' Owner -1 `12A Kind of Building' -- Used as% To be completed about Estimated Cost, $ Old—New. Building Permit No v G Permit No."�2.>— PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures .................. x $1.50 $ 2 " �� ° Signed 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 .00 $ '> c co s New Ground Run Old Bldg. ....... .... x 3.25 $ ROUC;H GAS FITTING FEES: NO. RATE TOTAL FINAL 1st 3 Fixtures .......................... 0 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ c REPAIRS & ALTERATIONS—Refer to Code Description ............................................... TOTAL IFEM By Business Phone No SUBJECT PER - City of Fridley 1290 AT THE TOP OF THE TWINS BUILDING PERMIT r RE IPT . `v COMMUNITY DEVELOPMENT DIV. r � PROTECTIVE INSPECTION. SEC. � 1 `CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 4/18/75 JOB ADDRESS 8275 Riverview Terrace N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 25, 26,pt 2 P Riverview Heights Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE chard Smith 8275 Riverview Terrace N.E. 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 N ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK Construct a 241 x 24' Second story to existing residende 9 CHANGE OF USE FROM TO STIPULATIONS per markings on plan SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIONS, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 R-1 576 6912 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. 5.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $10,000 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- $36.40 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $41.40 SIGNATURE OF CONTRACTOR- OR AUTHORIZED AGENT (DATE) WHEN PROPERLY THIS IS YOUR PERMIT ' V "UILIERI p /�VALIDATED CJl.k l�-�.K1v� 7 8 -2C DATE SIGNATU REOF NERD WNER (DATE) T APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAM: 1C 1+A0 Q— Sig jr#4 BUILDER : 9jQ4A 9Q SM ► rN ADDRESS: gjZ ADDRESS: ,)84- G iq�? NO:. 81-175 STREET: ? 1 U 15IZ 1j 1 L W TAr9A 6C& M,6 LOT: 1.5, 2. 6�BLOCI�: � ADDITION:. R I U N& V I 14616 n A0,QtT&*4J pkry ' a to 2 - CORNER LOT: INSIDE LOT: SETBACK: _ SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. AVOPCIGAVO+) t5 FOIE "r -"O St"y A10DIVOW 0ras1,7 w+T4 k)o C WA1u65 lU 5ET �A'►GICS OIL Stpor-jAro®• P1,A1iS A1ZW cou -t" AT flu®ut®/buG tjaSP DESCRIPTION OF BUILDING To Be Used As: SjgGowa SroOv AaptToaJ TO I' arXisr. �1015 V �Front • 1 1 Depth: Height- Square eight•Square Feet:�,(® Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: W&'V ' ' F1EAMP, Estimated Cost: $ To Be Completed: M 0VAE mj$g&/� � � '®,cam The undersigned hereby makes applicatian for a permit for the work herein specified, agreeing to do all work in staict 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: 4-11 S/'d 4 SIGNATURE! (See Reverse Side For Additional Information.) pro VA It ,. SAI L it . Boa. .,rw too 000 'W60/14(# It 6.60 9 Cii,/ �4 Eridlay Applicntlan for Plumbing cndj Gas I vHya; Perini? Dept. of Bldgs. Phone SM -3450 DESCRIPTION Oc WO111 Num�aar, Kind and Locr.2;on of Fixtures Loran � 2%F7 �1 t1��Vt�+�J Tt�� PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 3 (�O Future Fixture Opening ........... x $1.50 $ _. New Fixture Old Opening.....:.... x $1.50 N Catch Basin .................... WATER MTR. $ Water Heater 'Up to 99,000 BTU) - • • • x $3.00 $ New Ground Run Old Bldg......... x $.3.25 3 Electric Vlatar Heater... 3 V U U NO. BATE TOTAL GAS tIEC. � . Additional Fixtures ............... x $ .75 $ N �; ► O r x $5.00 r O V a V Base 1st _ _rd }} 3:d 4:h ars • Futuro Coe:.!en Oponinr�a �n =moi d �ri3ls Savor $ Xavr Fi::turm. Old Opomings Cczzpool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 3 (�O Future Fixture Opening ........... x $1.50 $ _. New Fixture Old Opening.....:.... x $1.50 $—._� Catch Basin .................... x $3.25 $ Water Heater 'Up to 99,000 BTU) - • • • x $3.00 $ New Ground Run Old Bldg......... x $.3.25 3 Electric Vlatar Heater... z $2.00 $ ZAS FITTING FEES: NO. BATE TOTAL 1st3Fixtures •••••••••••••••••• x$2.00 $ . Additional Fixtures ............... x $ .75 $ Gas Range to 1999,000 BTU ........... x $5.00 $ City of Fridley: The undersigned hereby makes application for a permit for the- work herei specified, a„recing to do all work in strict accordance with the C:ty Czvinance and ruling of the Department of Bufld:ngs, and hereby declares that all the fact and representations stated in this applcaaon are true and correct Owne Kind Used ; To be completed about -' a I J 7 Estimated Cost, $ Q® .�-- Old --New. Building Permit No. Permit No. Signed Z3 ROUOK P.EPAMS tt ALTERATIONS--Refor to Code .50 State Surcharge -Description ........................................ TOTAL FEE $ G' By _.. Business Phune No 8-7t--7-74-1 s ` CITY OF FRIDLEY INSPECTION DIV. Ma Effective On January 1, 1991 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES C11 f2_,100-�416-w JOB RATE SCHEDULE The undersigned hereby makes application for a permit for the work Residential Rate TOTAL herein specified agreeing to do all work In strict accordance with the Furnace Shell and Duct Work, Burner - city codes and ruling of the Building Division, and hereby declares Also Replacement Furnace $ 20.00 $ that all the facts and representations stated in this gnplicaAion are true and correct. Gas Piping (Needed with new furnace) $10.00 $ OWNER Gas Range $10.00 $ BUILDING USED AS Gas Dryer $10.00 $ 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) (Warm Air) Trade Name Size No. Commercial/Industrial BTU --71) 00 HP EDR 1 % of Value of Appliance or Work $ Fuel _1�! Total Connected Load State Surcharge $ .50- Burner Trade Name—kfl��Size No, BTU HP EDR TOTAL FEE $ Q (Z1 HEATING COM PAN1Y. MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 Signed Al Tel No. O PLUS THE $.50,"t!§URCHARGE s .,__.., ..... ..., 4:,.-.�,�,y REINSPECTION FEE $30.00 �j(� Approved By Rough -in Date Final Date l +l 7 '*Air Conditioners can not be laced in a side and without p Y Written permission from adjoining property owner. 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 Yes ( ) No ( ) 2. Is free from rust or deterioration Yes ( ) No ( j 3. Has no foreign objects lodged within Yes ( ) No ( j 4. Is securely supported Yes ( ) No ( ) 5. Meets all current Code requirements for size and total BTU's connected // Yes ( ) No ( ) 6. Has total heating BTU's of All other BTU's TOTAL BTU's, Remarks List Alterations Being Done: HEATING COMPANY Signed By Date a Building $ BUILDING See Back Page for Fee Schedule Permit No.: a, Inspections RESIDENTIAL APPLICATION Fire Surcharge Received By: 763-5723604 .001 times the total job valuation CITY OF FRIDLEY $ Da APR 13 207 DATE YOUR E-MAIL ADDRESS $ SITE ADDRESS g 7S I �.' 1�y $ w 'i- C R . A/ L SAC Charge THIS APPLICANT IS: ❑ OWNER CONTRACTOR $1675 per SAC Unit (Plans to MWCC for determination) PROPERTY OWNER/ NAME:TENANT ft + 6 ft = ft x $21 =$ ADDRESS: ADDRESS: g 7.57 A ® 1 t12 0 U7 e cj CITY / e� �t ` STAT —A PeIP S $ PHONE: 7 lv -3 % 9 / ?9 - $450 Conservation Plan Review 'CONTRACTOR NAME: p— /1M — ® U C M,cW) S STATE LICENSE # 0 _S 1 /46'7 EXP DATE Sewer Main Charge SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 4 L L CITY f A' / Q %-e ✓ STATE AZIP S -I 2 WITH APPLICATION PHONE �s eF 901 FAX l) 17 % PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION q GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISHROOF 13DRAIN TILE 13DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION I N1 MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: .ems. 0 f � o PYJ y� d F a T= /v 5y7L ' Me r� /yo r S 0 A,# 01 SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY •� G NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 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 DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other . and proposed project. WINDOWS ,Fascia 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑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 THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 3436! OCCUPANCY TYPE Permit Fee $ 7I' a See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 3.L/a- .001 times the total job valuation Surcharge $ j . 11 .0005 x Permit Valuation Minimum $.50 License Surcharge $ 5,0—D $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 $ l) 17 % 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 which requires review and approval of plans. ,. SIGNATURE OF APPLICANT rC.L� m..� PRINT NAME U( C w, *A- DATE_V / 3 �D Building BUILDING Permit No. M9 011 -ONO Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 $ CITY OF FRIDLEY DaiR cQCT 0 2000 713-502-4977 FAX EFFECTIVE 1 -1 -08 - DATE �U 6 41' ®E '2 d YOUR E-MAIL ADDRESS SITE ADDRESS OZS ll� V I (k' V (1- rz- THIS APPLICANT IS: )0OWNER OCONTRACTOR PROPERTY OWNER/ NAME: ._ 1 G L-1 A, rz-io �7 TENANT ADDRESS: A2,75 lel u (�av(L'w '� t4Z _CITY �'� Is 5 Y STATEDOZIP 5510-L PHONE: :Z aJ -7 Or, 6, - L Q NAME: ADDRESS: CITY STATE ZIP CONTRACTOR SUBMIT'A COPY OF PHONE FAX YOUR STATE LICENSE STATE LICENSE # EXP DATE PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED INDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION X&AINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: i Pc, Adtr_ 0 11 L -L / �k�I -�`7 1� tuxf wn k% V&L4-�? SIZE OF IMPROVEMENT N LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used. PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS. & PORCHES SUBMIT: ❑ Vinyl ❑Soffit l . Site Plan/Survey showing the existing structures ❑ Aluminum ❑ Trim and proposed project. ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS es 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 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ b O OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $�1 $ Igo $ ar 91 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) $1825 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 savable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit acknowl dge that info tion 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 innesota C n io odes; th I unde tand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be n accord wl prov in the ase of all work which requires review and approval of plans. SIGNATURE OF APPLICA PRINT NAME 9 L G P%W 5" t T14 DATE 1 6 ®8 APPROVED BY DATE Building $ 20-150 BUILDING Plan Review Permit No.: Inspections Fire Surcharge RESIDENTIAL APPLICATION .001 times the total job valuation Rec ;'y�,.,By� . , 763-572-3604 .0005 x Permit Valuation Minimum $.50 CITY OF FRIDLEY $ `' Dat d:AY *Z ON 763-502-4977 FAX $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ EFFECTIVE 1-1-09 $ $450 Conservation Plan Review DATE' �i C fL, Z C9� YOUR E-MAIL ADDRESS $ SITE ADDRESS Z 5 t2 Iy tggy t C w T L—; 12 Fcz i 0 L,6?1 $ 4,5e-- ,5ZTHIS THISAPPLICANT IS: XOWNER ❑CONTRACTOR $ a4 it Z5 PROPERTY OWNER/ Nps: t GI4--m7--0 GJ V-A L r7 TENANT ADDRESS: Z Z S d2 I V UVe-, V I (: U-eITY I I n, STATEM UZIP 157� 47-Z PHONE:®�- CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED XWINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION INTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE:_ W I ktV Occ> 1Z LeC0re-4=?l/Wb7,L4- SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim l . 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 'es ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF. WINDOW TO BE INSTALLED V I I1 Y L NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: SING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ A T OCCUPANCY TYPE Permit Fee $ 20-150 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ t0 .001 times the total job valuation Surcharge $ C-2 .0005 x Permit Valuation Minimum $.50 License Surcharge $ `' $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ a4 it Z5 Make checks navable to: Citv of Fridlev Attach Stiaulations 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 ordingpe and odes he City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an appli ton for a it nd ork is not to start without a permit on site; that the work will be in accordance with the approved plan in the a of all w�^he it s re iew and approval of plans. SIGNATURE OF APPLIC PRINT NAME I C- t4ft*ZQ 41M I n- DATE :5/ 12- 1 2-cocf