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PRE 2010 DOCSDate: — Dec. 13, 1967 Owner: _ Homedale Blders Bider Address 5217 Wayzata Blvd. Address Same Same LOCATION OF BUILDING N9 = 9578 No. 7528 Street _ Tempo Terrace —_ part of Lot Lot _ _ _ 3__ Block 3 Addition or Sub.Division _ Melody Manor 4th Corner Lot Inside Lot _._.X Setback 35' Sideyard 10'- 5' Sewer Elevation — 880.66 883.66 Ton of Footing DESCRIPTION OF BUILDING To be Used as: Dwelling Front 46Depth 24/28 Height 20 Sq. Ft. 1152 Cu. Ft 23,120 � Garage Front 20' Depth 24' Height 10' Sq. Ft. 480 Cu. Ft. 4800 Type of Construction Frame F:st. Cost _1191000 _^ To be Completed SEWER LOCATION - 82' West of Manhoike WATER LOCATION 12' East of Manhole In consideration of the issuance to me of a permit to couc building described above I agree to do the proposed work in accordance with the description above °set and in con fiance with a'll pr � ordinances of the city of Fridley. _07._ / � � 9 9 $100.00 Suer Connection Charge In consideration of the payment of a fee of $ 42.00 , permit is hereby granted to Homedale Blders . 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. Official Building NAMW JAN GASTERLAND NOTICE: This permit does not cover the construction, Installation for wiring, Plumbing, gas heating, sower or water. Be sero to no the Building Inspector for separate permits for these Nems. O OWNER'S NAME ADDRESS APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA BUILDER ��---- - ADDRESS LOCATION OF BUILDING NO. STREET PART OF LOT LOT �� BLOCK ADDITION OR SUBDIVISI CORNER LOT INSIDE LOT SETBACK ft SIDE-YARD1:e:� SEWER ELEVATIpON S P • TOP OF FOOTING SoS� - "���• rd Z97`• ApplicantP1 attach to this form' two certificates of survey of lot and proposed building location drawn on these two certificates. DESCRIPTION OF BUILDING To be Used as: -- Front `` Depth Height Sq. Ft. Cu. Ft. Lh Front Depth Height dx Sq. Ft. Cu. Ft. Type of Construction Estimated Costa To Be Completed The undersigned 1�4reby 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 ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). e BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building of 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: - Uniform Building Code: Type 1,2, & 4- $1.75 for each one thousand cubic feet, or fraction thereof, in such cubical contents. Type 3 & 5 - $1.50 for each one thousand cubic feet. For the purpose of computing fees for building permits, the cubical contents of any building or addition to a uniform height throughout by multipluing the ground area covered from a point six (6) inches below the floor line of the basement or cellar to the average height of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each Five Hundred Dollars ($500.00) or fraction thereof in the cost of all proposed work. In no case shall the fee charged for any -permit as set forth in Section 2 be less than $5.00. NSSSD Connection Charges based on location- Area I or 2. V Application for Power Plants and Heating. Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE 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 $ MECH. 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$ 200 $ r� 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 $� Dept. of Bldgs. Phone 560-3450 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, M Owner Kind of Building%��� Used as To be cc Estimated Cost, $ e52t)" e ' I Old uilding Permit No. ✓ °' Permit No. DESCRIPTION OF WORK HEATING or POWEA PLANTS—Steam, Hot Water, arm Air o Trade Name-° Size No-Aj VI -O'45 Capacity Sq. Ft. E.D.R BTU----- Total Connected Load Kind of Fuel A6 9 BURNER. — Trade Nam �� Size No. Capacity Sq. Ft. E D R BTU H.P. RAY PSI. W EI_TER HEATING CO. Signed 4637 61H(BAGG AVE. 1. By #AINNEA►POL113 7. MINNEBOTA as Business Phone No- (REMARn 60VE City of Fridley Application for Plumbing and Comas Pitting Permit Dept. of Bldgs. Phone 560-3 DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL to Number Fixtures ...................... x $2.00 zrL Future Fixture Opening ................ �Z $ S® pini i uU �U' (9 Z O N WATER HTR. GAS ELEC. O x $3.00 $ I�(�9 x $3.25 $ Electric Water Heater a $2.00 $ GAS FITTING FEES: QQZ 1st 3 Fixtures .......................... °d $� Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 rn Base 1st 2nd 3rd 4th ° Future Connection Openings Connected with e New Fixture, Old Openings I Sewer Cesspool ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $2.00 $- Future Fixture Opening ................ x $1.50 $ S® 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 $ Electric Water Heater a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $� Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................ It TOTAL FEE $ 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 applications are tt e and correct. Fridlev. Minn_ ® / A Kind of Used as To be completed about ) 9 ROUGH FINAL 52-84-5915.51 City of Fridley Application for Plumbing and Gas F'ini'ng Permit Dept. of Bldgs. Phone 560-3480 DESCRIPTION OF WORK 7528 Tempo Tarr Number, Kind and Location of Fixtures Loaati°n ye rn 12 Y c Z 8o G Ua5 < U�' w (�9 Sa Z (�y0 • F • N WATER HTR. GA$ ELEC Base 1st 3- 2nd 3rd 4th ° Future Connection Openings New Fixture, Old Openings Connected with Sewer � Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ..................... Future Fixture Opening ............... New Fixture Old Opening ............. x $2.00 $ x $1.50 $ 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 $ Electric Water Heater a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. 3' x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do al1 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, nn_10–E38 Mi19_ Owner Kind of Building Used as Homedale Bldrs frame To be completed about E Estimated Cost, $ 10.00 Old—New. Building Permit No Permit No. 9� Si By Business Phone N ROUGH FINAL Description ................................................$ TOTAL FEE � a z HOUSE HEATING TEST RECORD ADDRESS T. ---,F OR - OCCUPANT OWNER HEAT LOSS DATE HTG. INST. GAS CO. METER SOLD BY INSTALLED BY _ Electrical Work By Gas Line By TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER GAS J SI� d MAK l' MAKE//� Model .d` 1� 4� �. &— Model Seria l 2x_= Max. INPUT ��444 MAK CONVERSION E &259:2 OF BURNER BTU Rating E OF FURNACE Model CONTROLS v THERMOSTAT f' Heat Plug Vent Size 44 7 Valve y KIND OF LINER/11&4= NONE Limit �6�.� Draft Hood JC�Regularor Limit Setting �� Filters Size ►umber Fan SettingChimney Location Inside Outside Pilot TypeChimney Construction Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing ���� Draft �-- Test Tag t-,-, L.W. Cut Off Door Pressure— Lighting Inst. !1! Pressure Pent `� 6te Tested Input CFH /60-_ mpany Testing ' Stack Temp. �Percent CO ,�e Name of Tester 235 -+.. a � w 4 l +,, t '� z .,- �y M, ' A4 b -_ +.. �, ry,t Y d c'"- f "`a ..� .. .. 'R M .+ ��'d �V _i1 ''4 'L: \- '°+ i 'Y T � � � �y4 � �. ..� -, 4 �4 .. ,' - .. -+.. a � w 4 l +,, t '� z CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1997 6431 University Ave NE Fridley, MN 55432. APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 0-444 RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ - representations stated in this application are true and correct. / (Side Vent — Fill Out Back) orb ,199F Gas Piping (Needed with new furnace) $10.00 $ OWNER. Gas Range $10.00 $ ' BUILDING USED AS /L Gas Dryer $10.00 $ 0 PERMIT N0. ESTIMATED COST, *Air Conditioning — All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work State Surcharge TOTAL FEE $ No. of Heating Units Circle One (Steam) (Hot Water) Trade Name Size No. BTU HP EDR $ Fuel g-0 tal Connected Load MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Burner Trade Name Size No. BTU HP EDR 0 HEATING COMPANY,Z1 /® Signed By e Tel No. 70 �i `V` 9/ Approved By6 Rough—In Date Final Date 1-26—F6 FILL OUT BACK SIDE F R STACK VERIFICATION ON REPLACEMENT FURNACE TOTAL BTU's 7. Has a liner been provided for water heater Yes () No 8. Has combustion air been provided for water heater Yes No ( ) Remarks: . List ALTERATIONS Being_Done. HEATING CO: Signed By: Date: CuM%INEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes (P f No ( } 2. Is free from rust or deterioration Yes (Lf No ( ) 3. Has no foreign objects lodged within Yes( ) No 4. Is securely supported . Yes (vj No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes (1,f No ( ) 6 _ Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No 8. Has combustion air been provided for water heater Yes No ( ) Remarks: . List ALTERATIONS Being_Done. HEATING CO: Signed By: Date: SUBJECT City of Fridley 26586 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. _ COMMUNITY DEVELOPMENT DIV. ®�� PROTECTIVE INSPECTION SEC. P/ I . 1 NUMBER REV DATE PAGE OF APPROVED BV i / -1 CITY HALL FRIDLEY 55432 � 1'd 612-571-3450 910415 7-13-98 JOB ADDRESS 7528 Tempo Terrace 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 32 3 MelodyManor 4th SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mabel Overlie 786-6827 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Quality Contracting, 11412 W. River Rd, Champlin, 55316, 427-7735, 7035 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION 11 REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Tear-off & Re-roof (25 Sq) 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 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 $2,087 $ 1.04 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF A HER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR E PE NCE OFC WSSTRUCTION. $74.75 Fire SC $2.08 PLAN CHECK FEE TOT ,FEE LicenseAC $5. $82.87 -SIG ATUREOFCONTFACTORORAUTHORIZEDAGENT (DATE1 N OPE ALID THIS IS YOUR PERMI - SP-.01 9.�� SIGNATURE OF OWNER IiF OWNER BU4 DERt IDATEI NEW [ ] ADDN [ ] ALTER [ ] ConstructionAddress: CITY .OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION .-_� (r e� EN Effective 1/1/98 Legal Description: Owner Name & Address: - �=�=-P / ou� l l c C Tel. # Contractor: (f®Cc P c� MN LICENSE # 70SY Address: 14 12, C.3 e -e10 Tel. # i_/ 2_7— 77 S S Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IlAPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Z 5-1�r =A&_ eloeZ 66 Construction Type: Te- ' t- V"evo Estimated Cost: $ (Fee Schedule, on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 7/0 7yAPPLICANT: Tel. # 7` 77 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park' Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ 21AK%3- Fee Schedule on Reverse Side $ ` DA .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 [ ] $ g, BUILDING PERMrr 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 $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 forfirst $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $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. SUBJECT MIT NO, City of Fridley 26894 AT THE TOP OF THE TWINS BUILDING P E R M I T r REC NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 NUMBER REV DATE PAGE OF APPROVED BY ` I "'1 CITY HALL FRIDLEY 55432 612-571-3450 910415 7/29/98 JOB ADDRESS 7528 Tempo Ter. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 32 3 1 Melody Manor 4th SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mable Oberle 786-6827 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Quality Contracting 11380 W. River Rd. Champlin 55316 427-7733 7053 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 F,] REPAIR ❑ MOVE Cl REMOVE 8 DESCRIBE WORK Window replacement 9 CHANGE OF USE FROM TO STIPULATIONS 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 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 0 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS O ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION R THE ANC F CONSTRUCTION.Fire SC .50 A-11""Z 71.5 � FEE TOTALFEE - -- SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI jA;2N4Cd;HECK TArPl3-qP-%C tS-On /A S27A P OPERL ATED THI IS YOUR PERMIT BLDG NSP 17ATE SIG NATURE OF OWN E R I IF OWN E R BUILDE RI IDATEI NEW [ ] Effective 1/1/98 ' ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 / BUILDING PERMIT APPLICATION ConstructionAldress:�� / •C C/� (/` Legal Description: Owner Name & Address: (a re (L` -- Tel. # Contractor: c� C ¢ cti CX -C— r�� MN LICENSE #®� Address: 3 K0 CA-). . Tel. # 7,!; Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EWPROVEMENT LIVING AREA: Length Width, Height Sq. Ft. GARAGEAREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: / rE3� Construction Type: i V,40 eU) ���(C'���u� r'c_e'� Estimated Cost: $ a2 ` bqs-e tics OL -1- '(Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft — Ft x $ _ $ DATE: �1 `APPLICANT: C� Tel. # 7_717-5t STIPULATIONS: 7 CITY USE ONLY Permit Fee $ C�) l v �1 Fee Schedule on Reverse Side Fire Surcharge $ .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 [ J Not Necessary [ J TOTAL $�` STIPULATIONS: 7 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.