PRE 2010 DOCS01
SUBJECT
IT
City ®f Fraley
12953
AT THE TOP OF THE TWINS
BUILDING PERM1T
RE .
. ------ COMMUNITY DEVELOPMENT DIV.���
INSPECTION SEC.
7
1 � � PROTECTIVE
1 �
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
= CITY HALL FRIDLEY 55432
IL
---- j%'. , ,'J 612-560-3450
910-F15
5/21 75
JOB ADDRESS
1 LEGAL
LOT NO.
BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR.
11
5 Shaffer's Sub. #1 SHEET
-F—PROPERTY OWNER MAIL ADDRESS ZIP PHONE
George A. Johnson 7358 Van Buren Street N.E.
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
❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a deck onto dwelling 10' x 15'
9 CHANGE OF USE FROM TO
STIPULATIONS
1-61--QUIRED Wit W09%
HEATING, PLUMBING AND SIGNS.
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
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.
$700.00
50
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$5.00
PLAN CHECK FEE
TOTALFEE
$5.50
SIGNATURE OF CONTRACTOR OR THORIZ DAGENT (DATE)
PROPERLY VALIDATED THIS IS YOUR PERMIT
X�6 � IQ �V
�HE%N�
•ate
^v"il VL — S—X2- f A
BLDG INSP DATE
SIGNATURE OFIOWNER IIF OVk4ER BIJILDtRI ATE)
01
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNERS NAME: d N7 S C ILDER: e ® 6-2 �' /�`1 ��`� n -s o G�
ADDRESS: % 5 U1A.1 ! )B UL VYan/ &kk ADDRESS; 7 3 tai d&n-e ��- �✓�� /�`�.
NO:. 7 S STREET: 0 G& r A n(
LOT: % BLOCK: ADDITION : , i� �, C v, JccA lci
CORNER LOT: INSIDE LOT:_SETBACK: SIDEYARD:
Applicant attach to this form 1%7o Certificates of Survey of _Lot and proposc-1
building location drawn on these Certificates.
To Be Used As:
DESCRIPTION OF BUILDING
Front • /0 Depth • / Height:_
Square Feet: Cubic Feet:
Front:
Depth: -Height:
Square Feet; Cubic Feet:
Type of Construction: AJoe)c4 Estimated Cost:
To Be Completed: 242:'2.
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stxict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
DATE: 22 �, (�_, SIGNATURE
(See Reverse Side For Additional Information.)
n 9tA
V
BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings 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:
UNIFORM BUILDING CODE Type 1, 2 & 4 - $2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. Type 3 & 5 - $1.85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
For the purpose of computing fees for building permits, the cubical contents
of any building or addition, is determined by multiplying the ground area
covered from a point six (6) inches below the floor line of the basement
or the cellar to the average heights of the upper surface or to the averagee
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.
VERIFICATION OF FOUNDATION
NOTE: 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 Certified Survey of the lot, showing the location of the foundation, once it
has been constructed, will be required before proceeding with the framing.
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior
to the.use or occupancy of any structure for which a building permit has been
-
issued; and said structure shall not be used or occupied until a Certificate
of Occupancy has been issued.
1.
97 -8b -X16051 APPLICATIO14 FOR PLUMBING AND GAS KITTING 1jE1
PARTIAL RATE SCHEDULE
PLUNBIN G FIXTURE RATES; NO.
RATE
TOTAL
h%= -hex Fixtures
b
53.00
u
.',
u4
$
Wator
x
$2.00
$
A
��
'A
.$5.00
m
h
a c
x
$5.00
$
A
x
$10.00
01
Water Softener
lieator
U
. u
New Grourd,Run Old Building
x
$5.00
w
Electric Water Heater
i
$5.00
$
�(
lit 3 fixtures
x
$3.00
$
3.ddicional Fixtures
x
$1.00
$
.Gas Range to 199,000,BTU
�b
$10.00
$
REPAIRS 6 ALTERATIONS
p
y
N
$
as
'LOC
c,
r u
$ 5o
TOTAL FEE
$ '10e50
o
rt •
r
1st
2nd
(R) Future Connection Opening
Connected with Sawor
)tow Fixture, 01d Opening
Wates
PARTIAL RATE SCHEDULE
PLUNBIN G FIXTURE RATES; NO.
RATE
TOTAL
h%= -hex Fixtures
x
53.00
$
Future Fixture Opening •
$2.00
$
Now Fixture, Old Opening .
x
$2.00
$
Catch Basin �r
x
.$5.00
$
i Nater Heater - to 99,000 BTU,
x
$5.00
$
100;000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.90
$
New Grourd,Run Old Building
x
$5.00
S
Electric Water Heater
x
$5.00
$
GAS FITTING FEES;
lit 3 fixtures
x
$3.00
$
3.ddicional Fixtures
x
$1.00
$
.Gas Range to 199,000,BTU
x
$10.00
$
REPAIRS 6 ALTERATIONS
first $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$ 5o
TOTAL FEE
$ '10e50
Job Address
� Department c
City of Frid
Tol. 0571-34
• The undersigned hereby makes application for .a permit for the work)
specified agraeing•to do all work in strict accordance with the City;
and rulings of the Departmont of Buildings, and hereby deelaxos that
the facts and representations stated in this application are true ar.
Fridley, Mrs J O 3-77 , 19
OWNER GEORGE HEM �OHNSON
KIND OF BUILDING frame
USED AS res.
TO BE COMPLETED ABOUT 10-;>Q- 7
ESTIMATED COST 10._00
OLD - NEW BUILDING PERMIT N0. PEf{jtIT
Company
'MINNEGAW6NLEGASCO
Signed By'
Tel, No.
ROUGE{ INSP.
Data
FINhL INSP.
Dato '
APPROVAL FOR PERMIT ,
MINIMUM FEE FOR ANY PLUMBING PERMIT 19 $7.50
WE
SUBJECT
IT NO.
City of Fridley
'
® 14563
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
•
1 L ��«�� COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
1 � �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
�.J 612-560-3450
910-F15
1/11/78
JOB ADDRESS 7358 Van Buren Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
11
5
Shaffer's Sub. #1 SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
George A. Johnson 7358 Van Buren Street N.E. 784-6264
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION C ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install a free standing fireplace (ICBO #2736)
9 CHANGE QF USE FROM TO
STIPULATIONS
SEPERATE Pkwmi l ,�) RUQUIRED FOR WI IiNG'�
HEATING PLUMBING AND SIGNS,
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 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 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$929
$.50
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.
$7.50
PLAN CHECK FEE
TOTALFEE
$8.00
SIGNATUREOFCONT CTOR AUTHO I DAGENT (DATE)
• WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
I -r/-27
BLDG INSP - DATE
SIGNAT O OWNER (IF O N R B LDERI IDATEI
WE
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: �C jCrc Ub/!/%S Op-- 13UILDEII:
Address: �jT�(1'�it%�P/!�' Address:
Tel. No . v`? .
No.:
LOT: //
CORNER LOT:
Street:
BLOCK: `� ADDITION: �� pin S4,C,6
INSIDE LOT: )_ SETBACK: SIDEYARDS:
Applicant attach 'to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
Front: Depth:
rlecW_ Square Feet: Cubic Feet:
Height:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction:
To Be Completed:o!G� S
Estimated Cost: $ /2' oz ? 47V
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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 Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct. See reverse side for additional irAormdtion.
DATE: % SIGNATURE:
Stipulations:
o U�
BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of buildings 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:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet..
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus .6 feet x
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x x/17-20
_ADDITIONAL INFORMATION
For the purpose of computing fees for building permits, the cubical contents of any
building or addition, is determined by multiplying the ground area covered from a
point six (6) inches below the floor line of the basement or the cellar to the
average heights 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 $7.50 plus $.50 state surcharge.
ERIFICATION OF FOUNDATION
NOTE: 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.
'.1
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building permit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
SUBJECT
IT NO.
City of Fridley
i 7
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
• __ _ COMMUNITY DEVELOPMENT DIV
' �L ------
PROTECTIVE INSPECTION SEC.
r �
6
1 �
�
CITY HALL FRIDLEY 55432
NUMBER
REV
DATEP
AGE OF
APPROVED BY
L 612-571-3450
910-F15
9/10/96
JOB ADDRESS
7358 Van Buren Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
11
5
Shaffer's Subdivision #1 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
George Johnson 7358 Van Buren Street NE
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Brian Hill Construction 2645 207 Ave NW Cedar MN 55011 753-2268 2277
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 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage (20 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
@
$.87
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,732
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
$56.75
Fire SC $1.73
PLAN CHECK FEE
T L FEE
Li se C
$
$64.35
I ATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
PRO
OG INSDO
VALIDA THIS IS YOUR PERMIT
DATE
SIGNATURE OF OWNEROF OWNER BUILDER) (DATE)
NEW [ ] Effective 3/l/96
ADDN [ ] CITY OF FRMLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
ConstructionAddress: )-35V 06 n S G, r P P\ -
Legal Description:
Owner Name & Address: 6eofyg JaG►nSan 23-1'r UR,, Tel. #
Contractor: 19 f o a n /V, / / MN LICENSE # aao d_-2 ?'7
Address: '20 2 '4yP. Ne✓ eed a ✓', `yl'y, 5-ro 1 J Tel. # 253 -da 41
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EUPROVEMENT
LIVING AREA: Length
Width
Height
Sq. Ft. _
GARAGE AREA: Length
Width
Height
Sq. Ft. _
DECK AREA: Length
Width
Hgt/Ground
Sq. Ft.
OTHER: Re
'Ra-rc cS E
�', lq ie-46
�-4W
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback
Type of Construction: 0i
Approx. Completion Date:
Side Yard Setbacks t� `' 3 X F,, �0
Estimated. Cost: $ .3 6 d S. a o --.14:2 32, ;O
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = 4 Ft x $ _ $
DATE: 1-49— e? & APPLICANT: Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ arC>
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$900 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 [ ]
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
i
$2,001 to $25,000 2' $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 itwhAs been constructed
will be required before proceeding with the framing.
SUBJECT
P
City of Fridley
3 1 6 5 5
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
�
RECEIPT NO.
- ______
� ; COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
�/��
r 1 -I PROTECTIVE
'w(
1 ; i
1 I CITY HALL FRIDLEY 55132
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
2/27/01
JOB ADDRESS 7358 Van Buren Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
11
5
Shaffer's Subdivision #1 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Joy Johnson 7358 Van Buren Street NE 763-792-9414
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Minnesota Rusco Inc 5558 Smetana Dr, Minnetonka, MN 55343 952-935-9669 2173
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 0 ADDITION 0 ALTERATION REPAIR 0 MOVE O REMOVE
8 DESCRIBE WORK
Replace 1 bay window in existing openings
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code.
Permit Inspec on Cards
IN191 Be
TO Homeowner To Pam
SEPARATE PERMITS ARE REOUIREO 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
@
$4,688
$2'34
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-
FireAC
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL E
License §,G-)$5.00
23.28
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
N7P�OPER V IRATE T IS IS YOUR PE IT
_
d� oZ % D
S,GNATURE OF OWNER IIF OWNER BUILDERI IDATEI
BI OG hSP 9 fQAtE
NEW []
ADDN [ ] CITY OF FRIDLEY
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address:
Contractor.
LIVING AREA:
GARAGE AREA:
s
Effective 1/1/2000
612-572-3604 Bldg Insp
Tel. # MJ -!7
MN LICENSE #
Tel. # ��� p �•��" ��
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
Length Width Height Sq. Ft
DECK AREA: Length Width Hgt/Ground Sq. Ft
OTHER:
Construction Type- l Estimated Cost: $'rjd A18
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: ®Z3 APPLICANT: (6' ,t <L, � ��� Tel. # ZLi V35 OWY
CITY USE ONLY= Call (612) 572-3604 for Permit Fees If mailing In application
Permit Fee $ /A i�_ Fee Schedule on Reverse Side
Fire Surcharge $ Ci 619 .001 of Permit Valuation (1/10th%)
State Surcharge $.50/$1,000 Valuation
SAC Charge $ _ $1100 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: