PRE 2010 DOCSCity of Fridley
AT THE TOP OF THE TWINS
SUBJECT
BUILDINGPERMIT
PE IT NO.
18003
r
Lu ______ COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
i ---.�/'-' �•� CITY HALL FRIDLEY 55432
L 612-571-3450
RE
NUMBER
910-F15
REV.
DATE
5/23/85
PAGE OF
APPROVED BY
JOB ADDRESS 1566 South. Bavarian Pass N.E.
1 LEGAL
DESCR.
LOT NO.
43
BLOCK
1
TRACT OR ADDITION SEE ATTACHED
Innsbruck North_ Townhouse Plat 4 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Darrel A. Farr Development 4600 Lake Road, Mpls., MN 55422 536-9936
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
11 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 42".x 351 Townhouse witlh._a Tuckundex Garage and.a 151 x 104 Deck
9 CHANGE QF USE FROM TO
STIPULATIONS Separate sewer & water services, are necessary. Permit issued contingent
upon letter dated May, 22, 1985 dor completion of concrete curbing and asphalt
driveways.
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
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DV/LG. 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
AND.ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
VALUATION
$62,400
SURTAX
$31.20
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STR TIO OR TH PERFORMANCE OF CONSTRUCTION.
$322.00
$425.00
As7
PLAN CHECK FEE
$ 80.50
TOTALFEE
1 $858.70
SIGNA U EOFCONTRACTORORAUTHORIZEDAGENT (DAT56
WHEN PROPER L VALIDATED THIS IS YOUR PERMIT
G L^
1:/8L -
BLDG iNSP. DATE
SIGNATURE OF OWNER OF OWNER BUILDER) (DATEt
SIGNATURE
a
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y
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AMnwOPd.s Marw*au 15432
S" OMica te0 6l10
[ wtl ► fMuanpf Eepwnsry • *d T.uar • Led Swswuy • Lwd Plorwnr ;I 1101 Cliff Road
i� 8. --Na MinnsWit 'A337
Certificate of Survey for OWMEL A, &w Owa. Coit?
x
41.00
'44 00
S'
o
C&T
2o.0
o `
4L �tfS4,
/ peo posfa A 8ld I W lN<q ° I
v-�is. 15.0• 1
L Is
o ^ Dendi5 imp monamed
e
Lo7-5-4-3 X44 . /3LOCK
)VO f/ To;�IVlqo4y!�C-Snfr ZE'O_
1 hereby certify that this Is a true and correct representation of a survey of the boundaries of the above Anoka described land, and of the location of all buildings tbvison, and all visible encroachments, if any, fro m+ or ow /�'nok
said land. As surveyed by me this day of A.D. 19I?d--
dURBAN,ENg1f11"ING, INC.yers
r'
NEW DQ
ADDN. [ ]
ALTER. [ ]
City of Fridley
�R-1 AND R-2
Building Permit Application
Effective 4/1/84
Construction Address: i$tesrb S" 6'a_U"kr"& // Peo's' / tt--
Legal Description: 1» " 'y 6k' IAA56lr,G/C
Owner Name & Address: Dustr+ne.n Tel. #
Contractor: 0AQA_4 °' Tel. # --
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: Lgnj�h Width . ► Height 26' Sq. Ft.
+o`40 ar
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Length!$ Width l0, Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [ ] Inside Lot LyC.7 Ft. Yd. Setback .ab Side Yard Setback
Type of Construction: wcuo dt. ��- Estimated Cost: $
Approx. Completion Date: ac.. /�
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation
DATE: APPLICANT:
i
Tel. #
CITY USE ONLY
Permit Fee $ Fee Schedule on Reverse Side
Plan Check $ ,sla 25% of Building Permit Fee
State Surcharge $ 111 $.50/$1,000 Valuation
SAC Charge $ wt1® $425 per SAC Unit '
Park Fee $ Wpm* Fee Determined by Engineering
Sewer Main Charge $
,® Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ m V
STIPULATIONS:
ra47 ��,g�?��,2fr'' 4b P °°.fF��'' mai•` > <E"y �,
,iyY yR'*.F''>z,.:- ft v;'�i'�$`yy� ��•'�'" t 3 'r� i``7 .5 ,�
S
w 1
�yy M1 1 t
t � l
� yV
� 1 ( �,✓ my R,., ,ir
f FF
_ 4 �
�► �b� tmf 3atiiah@d
kk
uld ;' A" tw , twre
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93�
".0M sr
t
3 .�
Effective Aug. 1. 1981
o. CITY OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
@ESYDE:t�TLAL
RATE
TOTAL
Furnace Shell and Duct Mork,
(Also replacement furnace)
S
20.00
$.9n nn
Burner
G Piping g
$
10.00
S10.00
(pipingneded with new furnace)
(piping
ange
Gas Range-
$
10.00
$
Can Dryer
$
10.00
$__
a Air conditioning (all sizes)
All Others/Repairs and Alterations
1• of Value of Appliance or Mork
COM7ERCIAL/INDUSTRIAL
11 of Value of Appliance or fork
$ 10.00 $
State Surcharge
Tom M
Reinspection Fee ISIS -00)
Rough Insp.
Date
Final Insp. 3—IS-Y6
Date
Approval for Permit
MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00
PWS $.SO STATE SURCHARGE
s
5
Attach •tack verification tort with replacement furnace permits
*Air Conditioners can not be placed in std• yard without
written "ission from adjoining neighbor.
Job Address 1566 South Bavarian Pass
Department of Buildings, 6111 University Ave. N.E., rridley, MN SS472
City of Fridley
Tel. 1571-2450
The undersiqned hereby waked application for a permit for the work herein
specified agreeinq 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.
Fridley, Minn. R -9n . 19,ga
ONNEa Farr Development
KIND or BUILDING frame
usED As -residen
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD - NEW BUILDING PERMIT ND. PERMIT NO. 902 -8 -
DESCRIPTION of rURNACE/BUaNER
HEATING or POMER PLANTS, Steam. Not Nater, Man Air- No. one
Trade Neve Carrier _ Sime No. �58-r,ens+
Capacity Sq. Ft. EOR +,_ n
Total Connected load Kind of rust gas
BURNER - Trade Name - Sise No.
Capacity Sq. Ft. EOR Bri Nf
co■p a able Ht &
Signed
Tel. No. 757-5040
HEAT LOSS CALCULATION ° fEMP. DIFF.
Customer Name Type Construction
City Windows Storm Sash -
Dealer Name. Walls : Ins.
Street __ Ceiling Ins.
City _ Floor
LuLea
Fl. Ii .� Room i Lenoth I � Width 9 Heiaht
Winffows and Doors-Crackage and Area
141 Width /6 -Height
th 1/e1ght No. of Linl ft. A►-
No Wp g
nf an* of gene Lights of crack q. ft.
C3- AO
Windows and Doors-Crackage and Area
No. Wath Hagnt No. of Lin -1 ft. Ar"
of enc of enc L hb of creek q. ft.
�-
Int. wall
Coef. Btu
Infiltration
G lass
Exp. wall'
-
Net exp. wall
Int. wall
Ceiling
Glass
Floor
Total Btu.
141 Width /6 -Height
y FI.I Roomll-ength Width
Height
Windows and Doors-Crackage and Area
No. Wath Hagnt No. of Lin -1 ft. Ar"
of enc of enc L hb of creek q. ft.
�-
Int. wall
Coef. Btu
Infiltration-
nfiltrationGlas
Glass
-
Exp, wall
Net exp. wall
Int. wall
Glass
Ceiling
F loon
F 1 I� F'Voom I L h
141 Width /6 -Height
Windows and Doors-Crackage and Area
Nn WtAeh H►ptht NO. O}
m sera. nt sane L is
Ltngl-h. Ar-
of crack q. ft.
3
Int. wall
Coat. Btu
Ceiling
Btu
Infiltration
141 , kl?.
Glass
Exp. wall
-
Net exp. wall
q
Int. wall
Coat. Btu
Ceiling
Floor
Btu
Total Btu.
FI -1 " , Room ILength 11 Width h Haight
Windows and Doors-Crackege and Area
No. widthNc6,ht No. of Lb" ft.. Ana
ofi1 Linhu of pW h•
No. width Height No. of Litncl h. Ara
ofPare-of none Lights of crack q. ft.
_
4
p
Coat. Btu
1 90
Coef.
Btu
Infiltration
Net exp. wall
Int. wall
Glass
Ceiling
Floor
Exp. wall
12 tit)
Net exp. will
& 61
Int. wall
Ceiling
Im--),
Floor
Total Btu. I
F I.l ak%oom l Length 1 4 Width H' t
Windows and Doors-Crackage and Arm 3
No. ^WiOtfi� .Hath.- ,k.%" .1 t. ssl1t.
Infiltration
Glen
Exp. wall
Net exp. wall
Int, wall
Ceiling
Floor
Total Btu.
n
Btu
Roofs I t_efseth A Width 7? Heieht
Windows and Doors-Cradage and Arm
No. widthNc6,ht No. of Lb" ft.. Ana
ofi1 Linhu of pW h•
Coat. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
I Total Btu. I Z R% i
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PLUMBING -FIXTURE RATES:
New Fixtures
Future Fixtures
RATE SCHEDULE
NO. RATE TOTAL
Old Opening, New Fixture
Beer Dispenser
Blow Of! Basin
Catch Basin
Rain water Leader
Hydraulic Valve
Sump or Receiving Tank
Nater Treating Appliance
Not water Neater
Gas Range
Gas Dryer
$ 5.00 $
S_ 3.50 $
$
1.50
$
S
>,
a
A
5.00
u
M
Y
$
Mater
,1
5.00
e
$
5.00
S.
c -4
a
ii
$
u
w
W
°
Heater
.ei
e
a
$
e
$
+ V
10.00
$
�w(
pw
a
8.Or
u
m
p
0
{�
a
C
email
•i
8
✓ m
u
U
�
ai
vi
o
vJ
w
u
s
�i
o
s
lec
fe
oti
w°
o�
lot
2nd
3rd
4th
(R) • Future Connection Opening
Connected with Sewer
(�) New Fixture, Old Opening
water
PLUMBING -FIXTURE RATES:
New Fixtures
Future Fixtures
RATE SCHEDULE
NO. RATE TOTAL
Old Opening, New Fixture
Beer Dispenser
Blow Of! Basin
Catch Basin
Rain water Leader
Hydraulic Valve
Sump or Receiving Tank
Nater Treating Appliance
Not water Neater
Gas Range
Gas Dryer
$ 5.00 $
S_ 3.50 $
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
It of Value of Fixture or Appliance
Reinspection Fee S State Surcharge
IS1S.001 TOTAL FEE
Ettecttve Aug. 1, lywl
Job Address /J�lp so Y 12 K
Department of Buildings
City of Fridley
Tel. N571-3450
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
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
a
, L Fridley, Mn. a — . 19
f�
OwNER 1,r LL dCY°P
KIND OF BUIIjLDINf/G r2 r• -C
USED AS (`cam v li f
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
000pany - ♦ ^
Signed By
Tel. No.
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE $.50 STATE SURCHARGE
$
1.50
$
S
4.00
$
$
5.00
$
$
5.00
$
$
5.00
$
$
5.00
S.
$
5.00
$
$
7.00
$
$
5.00
$ 00
$
10.00
$
$
10.00
$
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
It of Value of Fixture or Appliance
Reinspection Fee S State Surcharge
IS1S.001 TOTAL FEE
Ettecttve Aug. 1, lywl
Job Address /J�lp so Y 12 K
Department of Buildings
City of Fridley
Tel. N571-3450
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
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
a
, L Fridley, Mn. a — . 19
f�
OwNER 1,r LL dCY°P
KIND OF BUIIjLDINf/G r2 r• -C
USED AS (`cam v li f
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
000pany - ♦ ^
Signed By
Tel. No.
ROUGH INSP.
Date
FINAL INSP.
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE $.50 STATE SURCHARGE
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND CTAS FITTING PERMIT"
RATE -SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
- nr
New Fixtures
$
5.00
a
ie
3.50
$
Old Opening, New Fixture
x
1.50
Mater
S
4.00 '
a
slow Off Basin
$
5.00
0
..a
C
- $
5.00
mu
If
C
a
t
Hydraulic Valve
Heater
a
d
a
$
c
a
water Treating Appliance
M
gxac
7.00
$
Not water Heater _
$
G
$
Gas Range
$
10.00
$
Gas Dryer
$
10.00
$
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
11 of Value of Fixture or
Appliance
u
D L
Reinspection Pee $
v
$ , .50
y
TOTAL FEE
$
m'eu14
�n
g
lug
m
s
ow
w
moos
t3
�:
o
.as
Iec
lot
2nd
rd
-
4 th
(R) a Future Connection Opening,
Connected with Sewer
(6) - New Fixture, Old Opening-
- water
RATE -SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
New Fixtures
$
5.00
$
Future Fixtures
- $
3.50
$
Old Opening, New Fixture
$
1.50
$
Baer Dispenser --__._
S
4.00 '
S
slow Off Basin
$
5.00
$
Catch Basin
- $
5.00
$
Rain w•:tar Leader
$
5.00
$
Hydraulic Valve
$
5.00
$
Sump or Receiving Tank
$
5.00
$
water Treating Appliance
$
7.00
$
Not water Heater _
$
5.00
$
Gas Range
$
10.00
$
Gas Dryer
$
10.00
$
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
11 of Value of Fixture or
Appliance
S10,190
Reinspection Pee $
State Surcharge
$ , .50
($15.00)
TOTAL FEE
$
Job Address 11 -61 -
Department of Buil
City of Fridley
Tel. 1571-3450
The undersigned 1
specified agreeing
and rulings of the
the facts and rear
OWNER
KIND OF BUILDING
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST
s
by makes application for a permit for the work herein
do all work in strict accordance with the City Codes
artment of Buildings, and hereby declares that all
tations stated in this application are true and correct
f ridley, Mrd. 1
OLD - NEW BUILDING PERMIT NO. PERMIT NO. / V� 0q1
s
Company
Signed By
Tel. No.
ROUkii INSP.
Date
FINAL INSP.
Date
P
APPROVAL FOR PERMIT
A?/moo
MINIMUM FEE FOR ANY PLUMBING PERMIT IS
PLUS THE S.50 STATE SURCHARGE
l
SUBJECT
City of Fridley
31 1
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RiRWT NO.
COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC
4433
PROTECTIVE
CITY HALL FRIDLEY 55432
NUMBEDREV
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
7/14/00
JOS ADDRESS 1566 - 68 S. Bavarian Pass
T LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
4344
1
Innsbruck North Townhouse Plat 4 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Innsbruck Townhome Association 651-224-5482
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Garlock -French Roofing Corp., 2301 E. 25th St® ls., MN 55406 651-224-5482
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
00001423
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
NEW O ADDITION t] ALTERATION REPAIR O MOVE 0 REMOVE
8 DESCRIBE WORK
Tear Off and Reroof Townhome Building
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
Permit Inspection Cards
Will Be gaited
To Homeowner To Post
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
2
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
$8,639.83
$4.32'
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-
$167.25
F're SC $8.64
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEETOT
L FEE
,/
$180.21
SIGNATURE OF CONTRACTOR OR AUTMORiZEO AGENT tDATE.
EN ROP VALI AT THIS IS YOUR PERM
'ar
S,GNATURE OF OWNER,IF OWNER BU(LDERi iDATEj
ILI !�IV
BL INSo ,ATE
l
7-12-200 11:51AM FROM 6127229754
�j
NEW j ] �� Effec&e 1/1/2000
ADDN j ] CITY OF FRIDLEY- �/)rZ 72.3604 Bldg Insp
ALTER j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION -
Construction Address: 1 i- t le -10-S
Legal Description:
Owner Name & Address:
Contractor:
soG a.� q - 549
MN LICENSE # CW O! qQ3
N 55yOATel.# -7t2 5
Attach to this application, a Certificate of Survey of the
tot, 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 Wdth HgWround Sq. Ft
OTHER:
Construction Type: fzob.raEstimated Cost: $ 3 3
Driveway Curt) Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: (019-IDO APPLICANT: Tel.!!
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Change
TOTAL
STIPULATIONS:
Call (612) 572,3604 for Permit Fees If mailing In applicaUon
$ / Fee Schedule on Reverse Side
$ hoc .001 of Permit Valuation (1/10th%)
s:!-
$.50/$1,000 Valuation
$ $1100 per SAC Unit
$__=:::::: $5.00 (State Licensed Residential Contractors)
"A" or Alt. "B" Above
$ $450.00 -Conservation Plan Review
$ - Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ J
Building
$
BUILDING
Plan Review
Permit No.: -�
Inspections
Surcharge
RESIDENTIAL APPLICATION
(.0005) times the total job valuation — Minimum $.50
Received By:
763-572-3604
.001 x Permit Valuation (1/10%)
CITY OF FRIDLEY
$
Date Rec'd:
DATE '7"` `
YOUR E-MAIL ADDRESS
$1450 per SAC Unit (Plans to MWCC for determination)
SITE ADDRESS /S4Z �tc
®GQs��i�� SS
ft + 6 ft = ft x $20 = $
THIS APPLICANT IS:
❑ OWNER PCONTRACTOR
$450 Conservation Plan Review
PROPERTY OWNER/
NAME: .0,24 ° °
Fee Determined by Engineering
/ 6
ADDRESS: -fc CITY
STATF IP
TENANT
Total Due
PHONE:
Make checks payable to: City of Fridley Attach Stipulations
CONTRACTOR
NAME: 7®W Ile-
STATE LICENSE # 6C- 2, > 33.S-7-5�T EXP DATE 3 / / 6
SUBMIT A COPY OF
YOUR STATE LICENSE
-7//0
ADDRESS:7-® 6 CITY STR IP J 31�'
WITH APPLICATION
PHONE C 3 FAX
PROPERTY TYPE
SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK WIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:ez/R;//5,,W<c 1-4/4ln14e'e G e i
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT
REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1.
2.
Existing FIoor Plan
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
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ADDITIONS. & PORCHES SUBMIT7
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1.
Site Plan/Survey showing the existing structures
❑ Other
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and proposed project
WINDOWS
2.
Two sets of construction plans
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
3.
Energy Calculations
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION,$._ R0,V, - -- OCCUPANCY _ TYPE_
Permit Fee
$
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Surcharge
$
(.0005) times the total job valuation — Minimum $.50
Fire Surcharge
$
.001 x Permit Valuation (1/10%)
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1450 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $20 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
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.- �/ /lam
SIGNATURE OF APPLICANTC/f;je PRINT NAME (r—
,Z DATE_ — D�
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