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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT S? 4106 Date: ............ ............ .. Owner: "..Ouilder 4eO..._...._....---...._..._... .......................... . — ------ Address;�?, 'e Address ....................... .......................... . .................................. ..... . ..................... . ....... LOCATION OF BUILDING No. ' Street Part of Lot ..--------•--•---•----.._. _............ ... ............... Lot ....._....% ............ Block ..... . ................... -D ............. Addition or ComerLot .......................... Inside Lot ...X...................... Setback -------------------- - ...................... Sideyard ............................................................. .. SewerElevation ........................... ............ ........ . ..... ..................................... ......... Foundation Elevation .................... . ............................ . ....... ............................ ........ DESCRIPTION OF BUILDING To be Used as: A. 22Front ..... .......... e- DepthZfi?. 4-0. Height Sq. Ft. k.6-'I?4F Cu. FL.�.- ........... .............................. . .............. Front ..............................Depth ................. .. Height ........................ Sq. Ft . ...... ................. Cu. Ft . ............. Type of Construction Est. .......... To be Completed . .. ......... ot, 9-e-4LA-1. V 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 all provisions of ordinances of the city of Fridley. ......... . �-. In consideration of the payment of a fee of permit is hereby granted ..-- - . ................................................ 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. Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water: Be sure to see the Building Inspector for separate permits for these items. HUN ING. AHVIU L.UAKLbUN th 3200 FRANCE AVE. O. 3rd. STREET N. E. {flP 1 A 5044-A, 24 1. cl Ch w. r cbw. 40, 7- 7- 26 2-7 r -i E 25 28 La -- YO 24 70 ol I'LL Vrr' A 21 LANE4; Z5 IQ 16 SO.9 'v51 2-0 4 15 fz — 17 14 Is 6% wj --45 6% -77, 1Z 19 13 -- lo 12L J J 8 Li ry 0& �7L 40 'u.f lid a P. 0. 4.2 12.1a AA r73 , 5069 505 zz 5031 5 017 1 JAIL d1l Af '9Q Al CLEARVIEW STREET SUBJECT,.�—!l�n„a, N City of Fridley 0 1844 AT THE TOP OF THE TWINS BUILDING PERMIT i � COMMUNITY DEVELOPMENT DIV. 1 L INSPECTION r PROTECTIVE SEC. i j CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 5/22/86 JOB ADDRESS 5084 Topper Lane N.E. 1 LEGAL DESCR. LOT NO. 18 BLOCK 5 TRACTOR ADDITION SEE ATTACHED Carlson'!s Summit Manor South SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE 572-8721 Virginia Rorwick 5084 Topper Lane N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE ENSENO. Landgraff Construction 521 - 53rd Avenue N.E., Fridley 55421 572-90�I � 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 Cj ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 141 x 161 Addition to Dwel;Lng 9 CHANGEOFUSEFROM TO STIPULATIONS Install products of combustion fire alarm in hall leading to sleeping area.. PERMITS REQUIRED Before 1�alSEPgRAiE TECFp N°NE yfilrtip,w►RoNG, -Cot! FOR HEqr'v � 1l�UrV1,011NG AND SIGNS. BY L 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 FORA 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 $4.98 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $9,950 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- TRU TION OR THE PERFORMANCE OF CONSTRUCTION. $80.50 J a p PLAN CHECK FEE TOTAL FEE $20.13 1 $105.61 SIGN URE OF CONTRACTOR OR Aur RIZED #GENT (DATE) WHEN PROPERLY J BLDG INS, VALLIDATED THIS IS YOUR PERMIT / DATE SIGNATURE OF OWNER OF OWNER BUILDER) ---(DATE) NEW [ ] City of Fridley Effective 4/1/86 ADDN. [ ] R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: 3-t)F a&e- Legal Description: Owner Name & Address :V Qin/ ®%'L,1�% 7'� ,��% �ci&e Tel. �'%�'��o�� Contractor: L. �. �✓'�/� �A, cd •�.$'%B Tel. AddressS7 LI - S-3 �^ ��J" V_eB 'v 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: RADAnV ADVA. DECK AREA: OTHER: �r� ` [/ ® �( Corner Lot [ ] Inside Lot Ft. Yd. Setback Type of Construction: LAMe��16d Approx. Completion Date:e'`�` B Length'�a-° " Width_' 6 % ® Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Proposed Driveway Width If New Opening Is Desired: Side Yard Setback Estimated Cost: $ Alt. A Alt B See Back Page for Explanation B DATE: ® APPLICANT:9�&67 r Tel. #S72-- 9'014o CITY USE ONLY Permit Fee $ R®oho Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ 14, Cie $.50/$1,000 Valuation SAC Charge $ ' $475 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge TOTAL �$ Agreement Necessary [ ] Not Necessary [ J 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 Valuation Fees $1.00 to $500.00 $10.00 (Minimum Fee is $15.00) $501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,000. $2,001.00 to $25,000.00 $32.50 for the first $2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and including $25,000. $25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $50,000. $50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each additional $1,000 or fraction thereof, to and including $100,000. $100,001.00 and up $433.00 for the first $100,000 plus $2.50 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 been constructed will be required before proceeding with the framing. 9'5�0 o C) W .Civ °6z) ENERGY CONSERVATION SUPPLEMENT TO BUILDING PERMIT APPLICATION PLANNING AND INSPECTION DEPARTMENT CITY OF FRIDLEY, MINNESOTA This supplement is provided to assist the applicant in computing EXTERIOR ENVELOPE AVERAGE "U" FACTOR INFORMATION. This information is required so the BUILDING OFFICIAL can determine that submitted plans comply with the ENERGY CONSERVATION DESIGN CRITERIA of the STATE BUILDING CODE (Section 6000). It is the APPLICANT'S responsibility to accurately compute the data; reflect the proper DESIGN CRITERIA in the plans; submit product specifications, if needed to support the "R" and "U" factors used; and to assure construction is per approved plans. JOB LOCATION: wya t._ p J. 'OWNEWCONTRACTOR: ADDRESS I P _ �� E�� ,,A PHONE: A. Determine the Total Exposed Wall Area as follows: 1. Total wall window area �e res 2. Total door area 3. Total sliding glass door area 4. Total fireplace wall area 5. Total wall framing area (average..10 0) 6. Total net wall area ,above floor (average 90%) 7. Total rim joist area Subtotal: Total exposed wall area above floor 8. Total foundation window area 9. Total net foundation area above grade Subtotal: Total exposed foundation area GRAND TOTAL EXPOSED WALL AREA Olt B. Multiply. the GRAND TOTAL EXPOSED WALL AREA X .17 = Item I �_�-�<�� C. Determine the Total Exposed Roof/Ceiling Area as follows: sa.rq 10. Total skylight area 11. Total' roof/ceiling framing area (10%) 12. Total net insulated roof/ceiling area GRAND TOTAL EXPOSED ROOF/CEILING AREA D. Multiply the GRAND TOTAL EXPOSED ROOF/CEILING AREA X Item II `m E. Determine the "U" value of each segment (1 -9) -and multiply by the area as follows: ,y-- 1. Add Item I ° 1._ X fluff n _ 77, � i �9 6 J. Add Item III 't ) - + Item IV 3 J ^ e d ft A V B ..•. J r l V i- IV are less -. 4. X lout. Code for total envelope system. 5_ o ? X nut° d — 6. X "U" %. 6 r R teastuff 9. x "uto _ ADD 1-9 FOR TOTAL WALL SEGMENTS ITEM IIIa�o- F. Determine the "U" value of each segment (10-12) and multiply by the area as follows: 10. X ttutt C,) 11. ,—� �, e � ,, X Dean � � :a �° � � rl _ � i �� `�"� t � C J yy s 12. ` ,_ x ttutt Z 9 ADD 10-12 FOR TOTAL. ROOF/CEILING SEGMENTS, ITEM IV ' G. If Item III is the same as, or less than Item I, you have met the intent of State Building Code 6006 (c) 2. H. If Item IV is the same as, or less than Item II, you have met the intent of State Building Code 6006 (c) 1. , ,y-- 1. Add Item I + Item II '_ _ 77, � i �9 6 J. Add Item III 't ) - + Item IV ` L K. If the sum of Items -III and IV are less than Items I and II,. you have met the intent of the Code for total envelope system. The undersigned, as applicant for a building permit, hereby affirms the above information has been prepared and submitted by himself or under his direction, hereby acknowledges the information to be correct and accurate; and hereby presents the information with required plans in support of the building permit application. DATE: �' �--= SUBJECTNO. City ®f Fridley',qr 276;53 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. i VL r PROTECTIVE INSPECTION SEC. 1 I NUMBER REV DATE PAGE Of APPROVED BY i CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/9/98 JOB ADDRESS 5084 Topper Ln 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 18 5 Carlson's Summit Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Stanley Roust Same 572-8.721 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Seasons Four famm Roofing & Remod A 7930 Univ Ave NE Fridley 795-9410 20138 80 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 C3 REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house & garage (23SQ ) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the 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 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 $1,971.00 $.98 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- $62.25 Fire SC $1.97 RU TI OR TH ORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOT;E 00 eq IWMA�e / License SC $5.00 -.-% $70.20 -I --- SIGNATURE OF CONTR OR OR AUTHORIZED AGENT (DATEI P OPER Y IDAT ' BLD INSR A S IS R PERM) DAVE -� SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI - _ .. _- -- N u1ne & Address: CITY OF FRIDLEY SINGLE, FAMILY.AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 0 - —Tel, 16 lKes Zrll al".4 MN LICENSE —Tel .# Effective 1/1/98 "Attach .ro supplication,- a Certificate of Survey of the lot, with the".propos " ed, construction drawn on it to scale. . ,ADESQRIPTION OF IMPROVEMENT .'Width Height Sq. Ft. Length AREA: Lerigth,!' Width Height Sq. Ft. 9 Sq. Ft. �,:K' AREA: ng. Width H t/Ground It: enugjo, Ll Oil Type: Estimated Cost: (Fee Schedule, on Back) 4. $ li� ee t ..,.y Curb Cut.Widt 6 Ft _Ft x all) A4 rI- Tel. A.PPLIMM 5:1 ZCITY USE ONLY �Ivllkll W1111 Surcharge:.,, C Charge $ Surcharge -way Escrow- p 11 Control Main Charge TOTAL . . . . . . . . Fje .`Schedule on Reverse Side ,OOI I ,of Permit Valuation (1/10th%) I ., � $'�'501U',0()0 Valuation 'Q- A SAC Unit $5,00. (State Licensed Residential Contractors) 4 ,A "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering greement Necessary Not Necessary Building $ q i . `s BUILDING Permit No.: U Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 .001 times the total job valuation CITY OF FRIDLEY Date Recd: DATE l O ` c) O -' d YOUR E-MAIL ADDRESS $ ® SITE ADDRESS�- SAC Charge $ THIS APPLICANT IS: 0 OWNER CONTRACTOR $ PROPERTY OWNER/ NAME: A0P r Il ANinCiCaA a�ta.ls S $450 Conservation Plan Review ADDRESS: °TO RP ex CITY [ ® STATFeVZIP2U I TENANT $ PHONE:'? i Tntal Due $ ®-) _0 CONTRACTOR STATE LICENSE # QQ ---' C 9 EXP DATE ® O SUBMIT A COPY OF 3 Li `i' �� CITY STATii'�IP� YOUR STATE LICENSE ADDRESS: J 6 WITH APPLICATION PHOS f0 FAX PROPERTY TYPE GL8 FAMIL SIZE TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE 0 ADDITION �E/SHED 0 WINDOWS 0 BASEMENT FINISH,ROOF 0 DRAIN TILE 0 DECK 0 SIDING 0 OTHER O SWIMMING POOL TYPE OF WORK. 0 NEW 0 ADDITION ❑ MAINTENANCE/REPAIR 0 REMODELING DESCRIBE WORK BEING DONE:- QF -P ?- $�– Pclr�T= SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING �® NUMBER OF SQUARES. 0 HOUSE ONLY AHOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES 0 ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: 0 DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, 0 Vinyl OSoffit ADDITIONS & PORCHES SUBMIT: 0 Aluminum 0 Trim I . Site Plan/Survey showing the existing structures 0 Other 0 Fascia and proposed project 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS OYes ONo LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AAM 1viA I V KJ--- a; (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ e 31 cl3— OCCUPANCY TYPE Permit Fee THIS $ q i . `s See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 3. i .001 times the total job valuation Surcharge $ 10 .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Tntal Due $ ®-) _0 ti ulations Make checks payable to: CIV of Fridle 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 whi ii s review and approval of plans. SIGNATURE OF'APPLICANT PRINT NAM�� ' �, j� DATE Zj2� — Page 2 - Building Residential Application 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 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for 1" $500 plus $3.05 for each additional $100 or fraction, to and including $2,000 $2,001 to $25,000 $69.25 for 1' $2,000 plus $14 for each additional $1,000 or fraction, to and including $$25,000 $25,001 to $50,000 $391.25 for 1R $25,000 plus $10.10 for each additional $1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for IR $50,000 plus $7 for each additional $1,000 or fraction to and including $100,000 $100,001 to $500,000 $993.75 for 1s` $100,000 plus $5.60 for each additional $1,000 or fraction to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the 1- $500,000 plus $4.75 for each additional $1,000 or fraction to and including $1,000,000 $1,000,001 and up $5,608.75 for the I' $1,000,000 plus $3.15 for each additional $1,000 or fraction 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 proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 Building See Back Page for Fee Schedule BUILDING 65% of Building Permit Fee Permit No.: 5 Inspections $ RESIDENTIAL APPLICATION $ Received By. -MAI 763-572-3604CITY $1675 per SAC Unit (Plans to MWCC for determination) OF FRIDLEY ft + 6 ft= ftx$21=$ D DATE 04/28/08 YOURE-MAILADDRESS estherd@probui1tam. Com SITEADDRESS 5084 Topper Lane Fee Determined by Engineering THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR $ PROPERTY OWNER/ NAME: Bob Jones TENANT ADDRESS: same as Site CITY STATE_ZIP PHONE: 763-571-2289 CONTRACTOR NAME:ProBuilt America STATE LICENSE # BC -20356847 EXPDATE U-3/ Uy SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 2211 i itn Ave h CITY North Stn STATE ZIP b b 16 WITH APPLICATION PHONE 651-770-5570 FAX 651-770-0495 PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: Replacinq 3 window, not changinq sizes 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 Floor Plan Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & 3 TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TUT. Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due 67/11lilt19_9Loicib rigLum $ See Back Page for Fee Schedule $ 65% of Building Permit Fee $ .001 times the total job valuation $ .0005 x Permit Valuation Minimum $.50 $ $5.00 (State Licensed Residential Contractors) $ $1675 per SAC Unit (Plans to MWCC for determination) $ ft + 6 ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ Make checks payable to: City of Fridley Attach 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 requt s review and approval of plans. SIGNATURE OF APPLICANT %� E _ PRINME �s` ler Dahl DATE 04/28/08 :wilding $ BUILDING Permit No.: -nspections $ RESIDENTIAL APPLICATION Received By: /63-572-3604 $ CITY OF FRIDLEY Date Rec'd: �+3 ATE DV$ YOUR E-MAIL ADDRESS Q f s w Q (y e b1 ' P .� 0 i ITE ADDRESS �' b a 5' t r 4 n .c .001 x Permit Valuation (1/10%) THIS APPLICANT IS: ❑ OWNER lieONTRACTOR '5.00 PROPERTY OWNER/ NAME: 5ivol&U g ( C $ TENANT ADDRESS: a s '5' 7-bpaer 01 CITY -ri 1 d lQ STATP 1P 5"19 Y 7 $ PHONE: -71s 1 'F-7 y- 74 O ft + 6 ft = ft x $20 = $ CONTRACTOR NAME:_ The Home Depot A.H.S. Inc. bd U7 dt int S SUBMIT A COPY OF STATE LIc 3200 Cobb Galleria Pkwy. 9 52/ t(7 YOUR STATE LICENSE ADDRESS: Atlanta, GA 30339 CITY STATE ZIP WITH APPLICATION PHONE 763-542-8826 ER -SINGLE TFLicense #20268257 .ORIES PROPERTY TYPE PERMIT TYPE QADDITION ❑ GARAGE/SHED ❑WIDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION D-MA-INTEAANCE/REPAIR ❑ REMODELING ?I,SCRIBE WORK BEING DONE: ldtn d vt„J t (.[ ifit n Q r l S / tl< ?TZE OF RvIPROVEMENT LENGTH WIDTH HE GHT Sq. Ft. OOFING ❑ HOUSE ONLY TUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: >ARAGES ❑ ATTACHED GARAGE I. Existing Floor Plan 2. Proposed floor plan 'ROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used :OPOSED HEIGHT: TDING FOR NEW CONSTRUCTION INCLUDING DECKS, I Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: I Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures I Other ❑ Fascia and proposed project 'MOWS 2. Two sets of construction plans i EXISTING OPENINGS &fes ❑No CATION OF WINDOWS 3. Energy Calculations R FOR NEW OPENINGS -DESCRIBE SIZE OF Ll U t 11 Ar 1b QA 1.0 It IV) >PENING CHANGES & (T YPE OF WINDOW TO BE INSTALLED '✓ NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 199 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 11 3T OCCUPANCY TYPE 'ermit Fee $ 1 / t'. ? See Back Page for Fee Schedule tan Review $ 65% of Building Permit Fee urcharge $ a . / 8 (.0005) times the total job valuation — Minimum $.50 ire Surcharge $ 11.3 1. .001 x Permit Valuation (1/10%) icense Surcharge $ '5.00 $5.00 (State Licensed Residential Contractors) AC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) :urb Cut Escrow $ ft + 6 ft = ft x $20 = $ ,rosion Control $ $450 Conservation Plan Review ark Fee $ Fee Determined by Engineering ewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Iotal Due $ / P R • 7 9 Make checks savable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in Dnformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a zrmit but only an application for a permit and w rk is not to start without a permit; that the work will be in accordance with the approved [an in the case of all work which requires review pproval of plans. :GNATURE OF APPLICANT PRINT NAME " L 5c he A t DATE � D Page 2 - Building Residential Application 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 miy 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 $23.50 (Minimum Fee is $23.5.0 plus surcharge) - $501 to $2,000 $23,50 for ? $500 plus $3.05 for each additional $100 or fraction, to and including $2,000 $2,001 to $25,000 $69.25 for 1' $2,000 plus $14 for each additional $1,000 or fraction, to and including $$25,000 $25,001 to $50,000 $39125 for 1" $25,000 plus $10.10 for each additional $1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for 1a $50,000 plus $7 for each additional $1,000 or fraction to and including $100,000 $100,001 to $500,000 $993.75 for 1a $100,000 plus $5.60 for each additional $1,000 or fraction to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the 1' $500,000 plus $4.75 for each additional $1,000 or fraction to and including $1,000,000 $1,000,001 and up $5,608.75 for the 1"$ 1,000,000 plus $3.15 for each additional $1,000 or fraction 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 proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977