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pre 2010 docs'Miger of Fpldl" Mhao eY9 SUBJECT ER City of FridleyIN 17 219 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. e: ------ r PROTECTIVE INSPECTION SEC. i NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 / / 3 JOB ADDRESS 6240 Sunrise Drive N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 30 2 Sylvan Hills Plat 1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Walter 7embal 6240 Sunrise Drive N.E. 571-5388 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. L. R. Tabor & Sons Inc. 1800 Central Avenue N.E. 788-6665 4 ARCHITECT OR DESIGNER MAILADDRESS 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 X 6 DESCRIBE WORK Reroof E:xistinq Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. Install ridged galvanized valleys. 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 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING TYPE OF WORK WILL BE " 6 �5 WITH WHETHER SPECIFIED HEREINIOR NOT. THE GRANTING OF AOPERMIT 4.000 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE j. c34.41a SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT E BLbG I P � 4. SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE),,, CITY OF FRIDLEY . Effective Aug. 1, 1981 APPLICATIO'1 FOR RESIDERTIl1L BUILDIt:G PEW-1IT$ (New, Alterations, Additions, or Repairs) ONINER:rA j— Z4 -M @ � L BUILDER: L ,'e. J�� ADDRESS: 42 YO e5u",-LS:0 ADDRESS: /e-6© cyff � Atj='ti� TEL A0: ��/ ,�''� _ TEL 110: 29,9-46,9 Construction Location STREET NO: to 2 STREET: -S t-: n' %L (—S jP— LOT: BLOCK: ADDITION: Corner Lot: Inside Lot:., Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF COINSTPUCTION Front: Depth: Height: Square feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: y Type of Construction: c I 1EY1 S T / A) (!�N Estimated Cost: 4b Be O mpleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE PEVF.R�L' SIDE OF SiIEE:T Me undersigned hereby makes application for a permit for the %:,ork herein specified, agreeing to do .all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Build' s, and hereby declares that all the facts and represen titiens stated in this applica are truq-azLd correct. Stipulations: t a",?. 0 /,()0 The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure or for any alteration or repairs to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: $1.00 to $500.00 $501 to $2,000.00 $2,001 to $25,000 $25,001 to,$50,000 $50,001 to $100,000 Fees $10.00 (Minimum $15.00) $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,000 $32.50 for the first $2,000 plus $6.00: for each additional $1,000 or fraction-,.-' thereof, to and including $25,000 $170.50 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $50,000 $281.00 for the first $50,000 plus $3.00 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 and up $433.00 for the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof Plan Check: 25 percent of building permit fee. Driveway Depression Escrow: Concrete curb streets only. Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50 Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75 Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. .e 4 SUBJECT City of Fridley 2 6 � 1 � AT THE TOP OF THE TWINS BUILDING P E R M I r *RUEIPT NO. COMMUNITY DEVELOPMENT DIV. COMMUNITY �L - ---- PROTECTIVE INSPECTION SEC. A/' `]' 560 r NUMBER REV DATE PAGE OF APPROVED BY ,.� CITY HALL FRIDLEY 55432 L 612-571-3450 910415 7/24/98 JOB ADDRESS 6240 Sunrise DR NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 30 2 Sylvan Hills, Plat 1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Walter Zembal 6240 Sunrise DR 571-5388 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. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION V REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage 22 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. 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 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 1834 .92 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. $59.50 Fire SC $1.83 PLAN CHECK FEE TOTAL FEE 62.25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT MATEI WHEN PROPERLY • ° BLDG INSP VALIDATED THIS IS YOUR PERMIT GATE SIGNATURE OF OVVNj ILRLDEAj IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION z ConstructionAddress: Legal Description: Owner Name & Address: bi4LECE ? 1:3MER-C- 42gb ScAo r(%�e Pt Tel. # Contractor: -� �-> ( MN LICENSE # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE -AREA: Length Width Height Sq. Ft. DECK AREA: r - Length Wid Hgt/Ground Sq. Ft. OTHER: Q c` S 2 r `Cd Construction Type: >Q Estimated Cost: $ (CJ3 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: / LAPPLICANT: Tel. # CITY USE ONLY Permit Fee $ S c7 -SO Fee Schedule on Reverse Side Fire Surcharge $ 183 .001 of Permit Valuation (1/10th%) State Surcharge $ „� _ $.50/$1,000 Valuation SAC Charge $ $1000 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 [ ] TOTAL $ STIPULATIONS: It BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $21 (Minimum Fee is $21 plus surcharge) . $501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. SITE ADDRESS THIS APPLICANT IS: D OWNER CONTRACTOR PROPERTY NAME: %3 O r t 14 v L D P n b'L C_ V- OWNER/ ADDRESS: feo2`it0 SLanAIS^s L)'r' SJE CITYSTATEQ'le1ZIP �- TENANT*PHONE: -7 63 _a 5-71- � -3 CONTRACTOR COMPANY NAME: _RL v 0_ s CLQ b.k e` C-`^ � e � g � SUBMIT A COPY OF CONTACT PERSON: EXP DATE YOUR STATE STATE LICENSE # M� 5 SLl�� LICENSE WITH ADDRESS: & qi b � a -L -1 � � � CITY STATE ZIP APPLICATION PHONE -76-1 '7S(4 -3tu4 FAX PERNUT TYPE SINGLE FAMILY D TWO FAMILY D TOWNHOUSE TYPE OF WORK: D NEW WkEPLACEMENT D ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK F AP_P A%, + *A- At Q' 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 510.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) SIZE/BTU Equipment Installed MFG: MODEL: MFG: MODEL: SIZE/BTU MFG: MODEL: SiZFJBTU A/C $25.00 ,_FIREPLACE (GAS) $15.00. GAS RANGE/O,VEN $10.00 -AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRII,L $10.00 BOILER $35.00 X FURNACE $35.00 —GAS UNIT HTR $10.00 CHIMNEY LINER $10.00_GAS DRYER $10.00 —POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 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 r x $25.00 = $ �S• Number of fixtures @ $35.00 # x $35.00 = $ ag State Surcharge = $ SO Total = $ 6 D ; 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. DATE PRINT NAME SIGNATURE OF APPLICANT C' � � <. � � � 4� __ �'at City ®f Fridley Building InspeetiOns Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977