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PRE 2010 DOCS-C/j3a 7 City of Fridley, Minn. N9 9724 BUILDING PERMIT Date: May 10, 1968 Owner. Gordon Murray Builder Rodnvy Billman Address Address 151 Silver Lake Road New Brighton, Minnesota LOCATION OF BUILDING No. 5 25 0 — Street S t . Imier Part of Lot Lot _ 5 _ Block 2 Addition or Sub -Division .__ Innsbruck 5th Addn. Corner Lot --- Inside,.ot X Setback ___ .35—'-- Sideyard Sewer Elevation _ 960.25 #SMRW 963.25 Top of Footing DESCRIPTION OF BUILDING To be Used as: Split Entry Dwelling Front 65 Depth 26/2 Height Sq, Ft. 1752 �, Ft, 34.554. Tuck Under Gar. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Frame Est, Cost --A2-7--.-0—%L- Q To be Completed -1UlY 15x___196 SEWER LOCATION - 9' South of Manhole WATER LOCATION - 12.5' North 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. . h'9'oe e'' i In consideration of the payment of a fee of $ - 5 2. 00 , permit is hereby granted to Rodney Billman, Inc. 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.Inspector ) CLARENCE BELISLE NOTICE: This permit does not cover the construction, installation for whin#, plumbing, gas heating, sewer or water. Be mre to me the Building Inspector for separate permits for them Nems. 11 i APPLICATION FOR BUILDING PERMIT CITY .-OF FRIDLEY, . -NINNESOTA OWNER'S NAME T:DER ADDRESS _._ ._ ._1DRESS� LOCATION OF BUILDING N0. '-s__ STREET . °? �� a . rnz LOT 33JLOCK 2 ADDITION OR SUBDIVISION - -k CORNER LOT INSIDE LOT � SETBACK 3r .SIDEYARD ...� SEWER ELEVATION TOP OF FOOTING Applicant attach .to this form Two Certificates of Survey of Lot and proposed building location .drawn,on:these Certificates DESCRIPT>�ON OF BUILDING To Be Used As: � J f. Ute. La t Front�C ®� Depth ��' ZfH" eight Square feetX WCdbic Feet Square feet Cubic Feet Type of ConstructionEstimated Cost;,�"�, bra To Be 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`Buildngs, and hereby declares that all the facts and represe ations stated 1wthis applicati u-) are tru an correct. ,t.•�' DATE _� Gz2'�� SIGNATURE (Schedule of Fee Costs can be found the Reverse Side). C. City of Fridley Application for Plumbing and Gas Fating Pennit DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ............ . ......... Z "--/ x $2.00 $ 2 !FG ® 0 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 $ 2- 4 New Ground Run Old Bldg. ............ x $3.25 $ Electric Water Heater x $2,Q0 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .................... x $2.00 $ 2" & Additional Fixtures .................... —x$.75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE e .13,C)C., Dept. of Bldgs. Phone 560-3450 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 facl and representations stated in this application, are true and correct. Fridley, minn_ T ✓ 7 19_ Owner Kind of Building J � Used as To be completed about"'` Estimated Cost, $ / Old-6ew. Building Permit No Permit No. Signed 70C By Business Phone C, ROUGH FINAL �^ zl 6 Y� d2 •y/j}e // ��V y a F gZ � Cz iQTjZ UN' Z • R N WATER HTR. GAS ELEG 3 7 �P�p � rn Base I 1st 2nd 3rd 4th _ • Future Connection Openings Connected with New Fixture, Old Openings I sewer El Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ............ . ......... Z "--/ x $2.00 $ 2 !FG ® 0 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 $ 2- 4 New Ground Run Old Bldg. ............ x $3.25 $ Electric Water Heater x $2,Q0 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .................... x $2.00 $ 2" & Additional Fixtures .................... —x$.75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE e .13,C)C., Dept. of Bldgs. Phone 560-3450 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 facl and representations stated in this application, are true and correct. Fridley, minn_ T ✓ 7 19_ Owner Kind of Building J � Used as To be completed about"'` Estimated Cost, $ / Old-6ew. Building Permit No Permit No. Signed 70C By Business Phone C, ROUGH FINAL �^ zl 6 Y� d2 •y/j}e // ��V Application for Power Plants and Healing. Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldga. Phone 560-3450 GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ............... , .......... $10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ , Repairs & Alterations each add. $500.00 ............... 3.00 $ NECK. WARM AIR Furnace Shell & Duct 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 ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water . ............. .. 3.00 $ OIL BURNER—to 3 gal. per hour 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ....................... 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 2.00 $ Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH'- FINAL OUGH'FINAL 5-- '2- 3 r � SR 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 , 19 — Owner U Kind of Building Used as To be completed about A-IXAJ /4,17 - Estimated Cost, $ 3�,�® Old—New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No Trade Name I 0/X -A-" lelk lS d ba Size No_.3 `x,'042 Capacity 1,710 6Y" Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fue BURNER — Trade Name Size No (REMARKS -OVER) Application for Power Plants and Heating. Cooling. Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldge. Phone 560-3450 GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ........................... $10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ 13;epairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AIR Flumace Shell & Duct Work to 12.0,000 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 rurnace 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 ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $ OIL BURNER—to 3 gal. per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ....................... 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 2.00 $ �-- Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL See Fee Schedule $ TOTAL FEE $ , '— Location J `� 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 � N 19 6-b Owner �FD a 111L-1-1�—A F-1.tj Kind of Building Used as t NA kz—� To be completed about Estimated Cost, $ Old—New. Building Permit No. Q7 Permit No. �/Ly HEATING or POWER PLANTS team, Hot Water, Warm Air—No v A� Trade Name— 9'A�%J '=- Size Non"" &Q Capacity Sq. Ft. E.D.R W (n BTU 1 Na_n H.P. Total Connected Load Kind of Fuel C� n BURNER — Trade Name 3 PM.v!EE- Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) C411&.42 Business Phone No M SUBJECT - RMI City of Fridley ig18070 AT THE TOP OF THE TWINS BUILDING P E R M I T r R EIPT NO. COMMUNITY DEVELOPMENT DIV. v SEC. p 1 70 r PROTECTIVE INSPECTION 7 1 � ` 1 1 CITY HALL FRIDLEY 55432 NUMBER REV. DATEPAGE OF APPROVED BY j 612-571-3450 910-F15 6/18/85 JOB ADDRESS 5250 St. Infer Drive N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 5 2 Innsbruck 5th Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Gordon Murray 5250 St. Tinier Drive N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. 1 Brovold/Larson Builders 1161 - 79th Avenue N.E. 780--4533 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 Ek ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Cover. soffi.t/fa,scia with. 4luminumf Paint Trims X= Add styrofoam on block wall in rear/ Finish. terith Stucco 9 CHANGE OF USE FROM TO STIPULATIONS 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 $4,000 $2,0.0 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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- $44.50 TRUCTION OR THE PERFORMANCE OF CONSTRUCTION. A P AN CHECK FEE TOTAL FEE $46.50 SIGNATURE OF CONTRACTOR ORAUTHORIZED AGENT (DATE) IDATE PROPERLY O THIS IS.YOUR PER IT ,,/;WHENA BLDG INSP ATE SIGNATURE OF OWNER (IF OWNER BUILDERI IDATE) M NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ ] R-1 AND R-2 ALTER. Building Permit Application Construction Addr4 Legal Description Owner Name & Address: 016s'✓ �� " v Tel. �fr�� Tel. Contractor: � Address: # .6-7/-- 7�� 71'®-��3� 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. �j /FsniS�. OTHER: l avey Semi4agS.� 19 Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: Estimated Estimated Cost: $ e-0 Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: & APPLICANT:./�� . Tel. # CITY USE ONLY Permit Fee $ `��Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ 'io d $.50/$1,000 Valuation SAC Charge $ $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ /_ Agreement Necessary ( ] Not Necessary [ ] TOTAL $ STIPULATIONS: RSUBJECT City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT • __ __ COMMUNITY DEVELOPMENT DIV. " ' �" INSPECTION SEC. 3 y G3 r PROTECTIVE ">;.� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 8/16/89 JOB ADDRESS 5250 St. Tmi.er 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 55 2 Innsbruck 5th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE ordon Murray 5250 S.T. IMIER 571--7944 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Superior Roofing 2317 East 32nd Street, Mpls., MN 55406 869-6852 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 j2 REPAIR 0 MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling (26 Squresj 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 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 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 $� $° 6S WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT X300 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OT ER STATE, OR LOCAL LAW REGULATING CON- $31.00 STRUCTION ORT�STRUCTION.FORMAN OFC LAN CHECK FEE TOTAL FEE l!v $31.65 ATIJRE OFC ,FACTOR OR AU HORIZED AGENT IDATE WHEN PROPERLY BLDG )NSP VA DATED THIS IS YOUR PERMIT 7 qAT SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) NEW ADEN [ ] AIT [ ] R-1 AND R-2 Bui.ldiM Permit Application Effective 5/1/88 Construction Address: �-® �— r� ; cl) VIL , Legal Description: Owner Name & Address: _ C� CS V- 0 C) " Ir- Y� Cxv Tel. # !S�- '� C - i C, <4 Contractor: S u D ei^ i o d` b 0'�� i e Tel. Attach to this application, a Certificate of Survey of the lot, with the proposed stnx;tion drawn on it to scale. �SCRIPPION OF IIMPROVEMM LrM G AMM: Length Width Height Sq. Ft. GMAM AREA: length Width Height Sq. Ft. �Dy�ECCK�K AREA: length Width ,gs H�gyt/Ground Sq. Ft. wi[3ER: Corner Lot [ ] Inside Lot [ lV Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ lawit /30c) Approx. CmTpletion Date: 1 Proposed Driveway Width If New Opening Is Desired. Ft. $ $ Width + 6' See Back Page DATE:/ a'% APPLICANT: Tel. # S' Permit Fee $ _ State Surcharge SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main aku-ge $ STIPULATIONS: urz a= USE OI�II,Y Fee Schedule on Reverse Side $.50/$1,000 valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by MV;neeriM Agreement Necessary [ ] Not Necessary [ ] m I /S ,W `c dd -' SUBJECT 1PETQw_ City ®f Fridley (rr28206 5?VH &&HE TWINS BUILDING PERMIT CE o ` • COMMUNITY DEVELOPMENT DIV. _ r PROTECTIVE INSPECTION SEC. 6 q l 1 � � 6 Y NUMBER REVDATE PAGE OF APPROVED BY CITY HALL FRIDLEY 53432 612-571-3450 910-F15 10/13/98 JOB ADDRESS 5250 St. Imier Drive 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. rj 2 Innsbruck 5th SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Ivor571-1662 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Custom Remodelers Inc.M4-964A 174R 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 Jk REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside house and garage - vinyl 9 CHANGE OF USE FROM TO STIPULATIONS Call for building wrap inspection before covering. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REOUIRED 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 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 5300 $2.65 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- STRUC ON OR T PERFORMANCE OF CONSTRUCTION $112.25 Fire SC $5.30 o PLAN CHECK FEE TOTAL FEE License SC $5.00. 1$125.20 SiGNAiU OF CONTRACTOR OR AUTHORIZED AGENT iDATE� WHEN PjR�OOPERLY ALIDATED THIS IS YOUR PERMIT f % SIGNATURE OF OWNER of OWNER SU4DER1 iDATE) 81,02L -NSP OA �E NEW [ J Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: �� ,�® �/ /i z Legal Description: Owner Name & Address: � l�hi� �!/®��'j �� iV1 q Tel. # Contractor MN LICENSE #�� Address: 741-j 4 L12 ,did zyo ox/- Tel. # 0) 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: -e il/ Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: /0 /✓a APPLICANT: Tel. v 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 INSPECTION DIVISION Effective On January 1, 2001 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 763.572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS RATE SCHEDULE OWNER 1JX/ Residential Rate TOTAL I Furnace Shell and Duct Work, Burner - t BUILDING USED AS t Also Replacement Furnace $ 30.00 $ � (Side Vent - Fill Out Back) ESTIMATED COST PERMIT NO. Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of Heating Uni s Circle One (Steam) (Hot Water) (Warm Air) Gas Dryer $ 10.00 $ Trade Name - 6--l� Size No. BTU HP EDR *Air Conditioning - All Sizes $ 25.00 $ Fuel Total Connected Load All Others/Rep irs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR Commercial/Industrial 1 1.25% of Value of Appliance or Work $ 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 an State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. TOTAL FEE _ $ DATE Zei `-7-P —c' / MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. &S5e5` ynv.s�3G HEATING CO 41/ A-- "S-e.S"c Signed I=1 TEL # Approved By Rough -In Date Final Date / )_yk BACK SIDE MUST BE FILLED IN ON VENT SIZE, VENT CONNECTORS AND COMBUSTION AIR VERIFICATION COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( ) No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type _ Appliance #2 Type _ Appliance #3 Type _ Total Appliances Common Vent Type _ BTU Input _ BTU Input _ BTU Input Total Btu Input Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date : V SUBJECT City of Fridley 33854 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ,� RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 1 f fJ�J NUMBER REV DATE PAGE OF APPROVED By i CITY HALL FRIDLEY 55132 763-571-3450 910-F15 9/4/03 JOB ADDRESS 5250 St Imier Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 2 Innsbruck 5th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO P K Construction PO Box 296, Taylor Falls, MN 55084 651-335-3532 20388270 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 n O NEW X ADDITION O ALTERATION O REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a XXXR n 8' x 14' Deck and a 12' x 14' Porch 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARNINU BOOM digging call f®ir 811 utility locations 454-0002 Uka.RC LAW REQ 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 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 $6,199 $3.10 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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- $139.25 Fire SC $6.20 STRUCTIO PERFORMANC OF �C4I,NSTRUCTION 3 HECK EE TOTAL FEE Licen SC $5.00 $153.55 SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT IDATEI W EN PROPERLY VALIDATED THIS IS YOUR PERM 8 DG -NSP f1AT S-GNATURE OF OWNER,IF OWNER BUILDER, (DATE, V JUL-28-2003 13!04 FRIXI CITY OF FRIDLEY TO 6515832802 P.02/04 ti NEW 17 CITY OF FRIDLEY Effective 1/1/2003 ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg in! ALTER t } SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 871-1287 Fax BUILDING PEF4MITAPPLICATION bN-' no Construdon Address: 5- � 50 S- 0 Legal Description: Owner Name S Address: Tel. # Contractor: l C r� e i�,` o MN LICENSE # 903 89 Address: PO 130 f �9(q4 T y/ r t/r Al ' s -6 - 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 Weight Sq. Ft. 19 GARAGE AREA: Length Width Height Sq. Ft, Ih- DECK AREA: Length i Width//,, HgVGround t� ` Sq. Ft. a,� / � �/ 39�A D 9 OTHER: T61- I �^ /d � /7z "/(6608. /10 Construction Type: C0do- stec(c LW111 Estimated Cost: $ Driveway Curb Cut Width Needed= Ft. + 6 Ft = Ft x &/`Mai � DATE: APPLICANT: /�Z� Tel. # ��, %�S'�r 3� Call (783) 572-36Wfor Permit Fees if mailing In application. Fax to 763471.1287 it using credit card and we will call you for card number. CITY USE ONLY - Kermit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erasion Control Paris Fee Sewer Main Charge TOTAL $ ® ' ti � SIML.rATIOM WRMCATfON OF FOUN13AnON A. Certificate of Survey of the tot, showing the location of the existing foundation wall be required before proceeding with the frandag. New Houses Only Fee Schedule an Reverse Side $ O .001 of Permit Valuation (1/10th%) S /n $.50/$1,000 Valuation $ $1275 per SAC Unit _® $e 00_ $6.00 (State Licensed Residential Contractors) $ Aft. "W or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Nems+ I ] Not Necessary [ ] $ ® ' ti � SIML.rATIOM WRMCATfON OF FOUN13AnON A. Certificate of Survey of the tot, showing the location of the existing foundation wall be required before proceeding with the frandag. New Houses Only I iodsTcstu� EE R'�f iraid- En inc --Ur veyors -- �ate of . Mednto 10 9 }"4 s is � t t i Y�•v1 d ef `�e4 ., 4, �' ht4"il 1 �r Ci V 3 q i ajbsM1.M d f 10 ' d dry r I i � �4�?, � � � �R v S C • _ � � � ;i i f4 +m3•c� �bk �'{� HR �,}�Ja••r$ ��.0 e ��. '} { r , I ' � .� cam. ,/�P Y ? 5 � �t;'Y � I"�'•d � d%''�'.y 'a,), d'.�y h y$'- t � r .' • i d++ti;: ,, M ,..' � {' fA � F. �,i'Y,r+�,".�+¢ SNb }�1 yy n 1 , \e�v`'1.. @ r r V M S e., ,a i 3 e"r •k t E pr i 161 � T � g+l Et,} ., s i �" t 5 y . m • iw e`�� '1 L „fit" a•T 'h � t s 1' a '. ` vy .4 ., �' -i U < � N � .a•Tt" ^>st d'S :F 3 v >" , � n+ 4 �, t b �' 4 ,r�i^ �1 � "?'x^a•"^-.—h.a 4:,: �. i4� • � � ,1, v � r ''fa2't "k �`tS ` tror - '�'�,'�T pg� ". M, I. 1., i II �y S i � .� � -Yr. 4 ¢ �q`�. ,�°3+.* �, W'^•�' 1 $ 14 k i ,�► FLOGK /ri►14� ' � � ; Z,�� 'n1�"� :, 1ti21Csh; ` ,'�'� ,....�».•-- •-.(;y t,lt��tiS URAtZ�tA�-►C At+�t 4i11LI'K1' $ r x, .: ;x2V 3 !brit i f►�" fi�i Phis! rs o bve d� repr�►senPafi o�'a +fey gf' ' Al a ° � � � �' � �•rtar' �d d! nsidvt azrov�b�►�h • r��'y • �'! ar arr sad /awd A3 stv`►�` �f, , �k twu .., r 'u .,SU�tIRBAN; �NGiN��2tl�J�� IJ�G� IL ME It✓L � 1 �4,',. (��• s �w� ~ .. •fir • iia, � REQUEST FOR ELECTRICAL INSPECTION Minnesota oa`�` Uof Electricity ��58=391 1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104 } k�' (851) 842-0800 TTY/MFIS 1-800-827-3529 / www.electricity.state.mn.us #-6160 0 I EB -00001M13 7I M1000 Identify the work covered by this request: /„ l D 1 rl ❑ NEW EIREMODEL ADDMON O REPAIR GENERAL FEES Outdoor Lighting Standard @ $1 SERVICES / POWER SUPPLIES Traffic.Signal Standard ® $5 0 to 400 Ampere 0 $25 Supplemental Fee ® $20 401 to 800 Ampere @ $50 Transformers up to 10 KVA ® $10 Above 800 Ampere @ $75 Transformers over 10 KVA @ $20 CIRCUITS / FEEDERS Transformer / Power Supply for Signs / Outline Lighting @ $5 0 to 200 Ampere ® ,0JZ•d P40Occupant t �{ ONE & TWO FAMILY DWELLINGS, EACH UNIT Includes the Service and/or Power Supply up to 500 Amperes, Ali Circuits and Two Inspection TripsEach Dwelling Unit @ $80 Above 200 Ampere @ $10 1 ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING CIRCUITS, CIRCUITS OF LESS THAN 50 VOLTS Additional Inspection T' @ $20 Each System Device or Apparatus @ $.50 Irnesti alive Fee ADDITIONS TO THE GENERAL FEES Rei 'on Fee ® $20 MULTIFAMILY DWELLINGS PER UN TOTAL FEj 4b� (minimum total fee is $20 Contractor'Lice— Number V 3 to 12 Units @ $50 Per Unit Halling AdLdrJess (Contractor, P0 Each Additional Unit ® $25 Authorized store (Co wn usrEcron use My 1 hereby certffy that I hispected the electrical Installation described herein on the dates stated: OTHER ADDITIONAL FEES Lighting Retrofit ® $.25 per Fbdure Center Pivot Irrigation Boom 0 $40 Manufactured Home Park Lots @ $25 Recreational Vehide Park Sites 0 $5 1 W IN DATE — Separate Bonding Inspection ® $20 301 Special Inspection @ $30 per Hour tj I FM fS"ECTIcn ' DATE Special Inspection @ $.31 per Mile 1 HIS INS 1 ALLA IION MAY 13E ORDERED DISCONNECTED IF NOT GUMPLETED WITHIN 18 MONTHS FOR OFFICE USE ONLY lilllllllllllllllllilllllllllllllilllllllllillllll y�� 50 Requ ate: Rough -in Inspection Required? es ❑ No Inspection Other Than Rough -In: ❑ Ready Now m Cam CtIzZ®3 You must cam the Inspector when ready) I Date Ready: I cert that I am the NrLICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at: Job Address (Street, Box, or Route No.) 2S0 15"r. -Z CZip LEY Code Section Township Range Fire No. County BB /V oKA P40Occupant t �{ WOLP �} Phone qr / 6Vv_ 80�5r Power SupplierAd Electrical Contractor/ Co�m`4wgjAlome h'tJvW -dpi Contractor'Lice— Number V Master License Number Halling AdLdrJess (Contractor, P0 tion) (amu Authorized store (Co 1. n) Phone 0 BOARD OF ELECTRICITY COPY NISTNu(iTION%i uN eAuK ur Ttl uw uw— Building Inspections 763-572-36 DATE v SITE ADDRESS THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: r MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ❑ OWNER PHONE: '09 al - COMPANY CONTACT 410 Permit No.; Received By: Date Rec'd: STATE LICENSEtI MINN pk§, MN 55408 2. 24 STATE ZIP, ADDRESS: PHONE 4'SINGLE FAMILY ❑ TWO FAMILY ❑ NEW REPLACEMENT DETAILED DESCRIPTION OF WORK FAX ❑ TOWNHOUSE ❑ ALTERATION/REMODEL PER MS 16B.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) MFG: MODEL:_ SIZE/BTJ Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: FIREPLACE (GAS) $15.00 SIZE/BTU GAS RANGE/OVEN $10.00 A/C $25.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 FURNACE $35.00 NEW GAS GRILL $10.00 GAS UNIT HTR $10.00 BOILER OHIMNEYj5.00 LINER $10.00 - GAS DRYER $10.00 _ POOL HEATER $35.00 $15.00 ^DUCT WORK $10.00 GAS PIPING $10.00 _VENTILATOR 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 @ $35.00-7—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 onjyAu application fo it and work is not to start without a permit; that the work will be in accordance with the approved plan in a work 'ch eq ' es review and approval of ans. SIGNATURE OF RI1.1't �_L_eQ ATE � 1 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley,. MN 55432 763-572-3604 FAX: 763-502-4977 REQUIRED INFORMATION NEEDED TO PROCESS PERMKw- RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTIN0 HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propan&UGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a_ 1MC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new constriction BMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 - a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations 2.59 Property Inquiry Detail: 25-30-24-11-0052 9191 FE3 If�rcfhl�� F'Ct �"f..9.. h "If'I( %J.{!L '`U we'±� �,.. r , �., vdw.. � � ,�^. r 1 r �%{ f 4 '� t Y:�5�5 fir ✓N" 3H P� (I Y } 25-30.24.11.0052 �i l� "�� '�� lW�y ^, .� 3stpayG.� Owr�arf 1 r�laQO dQ�41.1► JQAh� TnJ '3 hk �(T ID t�En F1 .f �r�f� 4�NI ' ( •• X 4• { 1 .) d� (+ { k"> / M(Ag ccapany 00 CITI fORTGA ,{ ' J BELLE HQ$t3�] t�ETNibtST H{ L 17F;; E 100: R4 F ¢ ; „95 e �� { 4 } } dK 'f,� 1 �{j l � `a t I ? :i/p- ��-'' � -(F tr• 1 � �'J t 49 i -.:!"� f �. ,� 0 y .f ?aryl: L �N %ff .... [. t i �:�'lY T N 'fy. % % AY„% } 4�'i, ✓; I! tal* yda�'' �.r+ 't 1 M g <'�'i'^x'r } k �r,l'v �'p !, h5„�t,. � � �f S z+ r' f a { , ;�� J�i,�' ,�4rr ',}r p .$'k. �f � 4°`� 1��§ � 7 t � 711✓ �f 5'” � A '� 71�` 4� ! � �� n� I �' r 9 4 °� � / i �I�S i; ✓/ / .3 L g t �.0 ✓6 z ,.T a p _ ', „ su r �* ' ! L 1 � f� 4 ` � � �' . iu, I, : . 4 : � , �.. ( Ff�� i* Y r.� ..:�`.',, � � 'r,+t t f,:,'-�,e'y �/� 'ear 71 TtT � � �"� � T � .q .,, .rm '`�r2 t .:✓tbr lri e, ,r_a.y la 1 t! �� y J _f h (�'-, .F ,. ,,,' x y � f � ~�k% � � c;,. ,fu,/l - , ��r,. � �, §� .t' ✓. 1i �,�, �j (k, �s�: �p �,, 4.�� .,��{ � s. rn, �a� .. I'i�'�� m .'"'�.rf�,. �- .4 J i F. > 5 � �� J d' >` - :� ';d ., ,. ,,.W.,,.•:e.. �.."..f,?.,'.,v..,:r:�,u.� .:'1c....,.,>:,,..7;.r'`>E'.: X,5 .cn�;�,.. ,:7i ..Zo �.:;J�w - f'. � � 5 "`s','F ky'Fwi? P 1 y 4'£✓yp f.�i SNI �`e, ife s tt r� AUG -15-2005 09:13 CITY OF FRIDLEY P. 02/02 wilding $ BUILDING PermitNo.-.;�X % 77 Inspections $ 'R P1. 1� Td /A L_ Received By: 4, 1 763-572-3604 $ CITY OF FRIDLEY Date Recd: DATE 6 107 YOUR E-MAIL ADDRESS SITE ADDRESS .001 x Permit Valuation (1/10%) TENANT - - - Suite No. PROPERTY OWNER NAME: Erosion Control ADDRESS: ZId F,)V' CITY STAT]k\4Z' $450 Conservation Plan Review ARCHITECT NAIL: ADDRESS: CITY STATE ZIP Fee Determined by Engineering CONTRACTOR NAME: ADDRESS:-10EKd�IQK CI U, T1 X94 -urb Cut Escrow PHONE: c1 1 5 -7FAX `NOTE: CITY LICENSE REQUIRED FOR MULTI FAMILY/COMMERCIAL/INDUSTRIAL JOBS PROPERTY TYPE O TOWNHOUSE ❑ COMMERCIAL/INDUSTRIAL ❑ INSTITUTIONAL //- , _1_7 ❑ MULTI -FAMILY PERMIT TYPE ❑ ADDITION W CONSTRUCTION ❑ OTHER 13 REMODEL O SWB04ING POOL ff0OF PLEASE SUBMIT: 1.4 SETS OF DRAWINGS 5. CONTRACTORS LICENSE OR 6. SPECIAL INSPECTION 2. SURVEY/SITE PLAN LICENSE APPLICATION SCHEDULE 3. LANDSCAPE PLANS 7. PERFORMANCE BOND 4. ENERGY CALCS AMOUNT $ BUILDING TO BE USED AS: OFFICE sF WHS SF OTHER SF TOTAL SIZE: STORIES FIRE PROTECTION (Y/N) AC(Y/N) DETAILED DESCRIPTION OF WORK 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 SIGNATURE OF APPLICANT which requir revieW and ap rov of plans. r1r INTNAUJE B DATE 4f 00 ALL FEES ARE BASED ON VALUATION Sq. ft.—x $ Cost/sq. 1= Valuation $ Sq. fi. x $ Cost/sq. ft. = Valuation $ Sq. ft. x $ Cost/sq. ft. = Valuation $ TOTAL JOB VALUATION: $_ (1—USE OCCUPANCY TYPE ?ennit Fee $ x/53. d-�_ See Back Page for Fee Schedule ?Ian Review $ 65% of Building Permit Fee Surcharge $ `3 Id (0005) times the total job valuation — Minimum $.50 ?ire Surcharge $ `f 5 .001 x Permit Valuation (1/10%) 3,Ac ktarge P-65, 1,0 $ ,(j7� $1450 per SAC Unit (Plans to MWCC for determination) Erosion Control $ $450 Conservation Plan Review ?ark Fee $ Fee Determined by Engineering Special Assessments $ Agreement necessary ( ) Non Necessary ( ) -urb Cut Escrow $ ft + 6 ft = ft x $20 = $ notal Due _ $ //- , _1_7 Make checks payable to: City of Fridley Attach Stipulations TOTAL P.02