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PRE 2010 DOCSCity of Fridley, Minn. BUILDING P T N° Q69i) f f i�r Date: owner: W- :f Builder Address Address _--- -- -- — L®C�TI®N BUILDING No. street _ __-+ - r • Part o Lot --- Lot _ __ Block Addition or Sub-Divisio� �? Corner Lot - Inside Lot �__ Setback -f — ____ Sideyard Sewer Elevation _ _ ____ _ Foundation Elevation _ -- DESCRIPTION OF BUILDING Toy Used" . Front' Depil Height .>_�__ Sq. Ft. Cu. Front ___ ___ Depth _ _I�ght Sq. Ft. ___ Cu. FL Type of Construction __'`' "' _ Est. Cosi ;� �'.---__'moo be Completed 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 Co— 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 coffiorm 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 violA#Gq of any of the provisions of said ordinances. _ A A. � I �� Building Inspector NOTICE.- This OTICE;This permit does not cover the construction, installation for wiring, plumbing, gas beating, sewer or wafer. Be sure to see the Building Inspector for separate permits for these items. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY# MINNESOTA Owner's Name Builder„_ Address Address M LOCATION OF BUILDING S17Street D' �fi of Lot Z ata&, Lot Block v Addition or subdivision �C Corner Lot Inside Lot Setback,Side--Yard /0'+ /J- ` SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: FrontDepth Height sq. Ft. Cu. Ft. Front Depth Height sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be Completed 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 ruling of the Department of Build- ings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE ll' -j"j' (,C SIGNATURE (schedule of Fee Costs can be found on the Reverse side). d, r ---mown City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number. Kind and Location of Fixtures Location- 0 ocation PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE T9OTAL Number Fixtures ...................... x $1.50 $ X ° O Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... Z x 2.00 $-2 , New Ground Run Old Bldg . ............ y�0 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... Z x $1.50 $ Additional Fixtures .................... Z6 Z W x 2.00 W L7 ? .Z R N WATER HTR. GAS ELEC. �0 Base 1st 2nd _ 3rd 4th • Futures Connection Openings Connected with Sewer Iq New Fixture, Old Openings Cesspool In PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE T9OTAL Number Fixtures ...................... x $1.50 $ X ° O Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... Z x 2.00 $-2 , New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... Z x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description.........................................$ ..... TOTAL FEE $Z,:P—� City of Fridley: The undersigned hereby makes application for a permit for the work here! 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 application are true and correct. Fridley, 1Vlinn- �� 19� Owner Kind of Building _ Used as To be completed about Estimated Cost, $ Ol Ne . Building Permit ROUGH � " A 3 - y Z�/ FINAL By— Business Phone No _ S Application for Power Plants and Heating, Coodng. Ventilation, .R�ic,�raFion and Air Conditioning Systems and Devices a PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU .... . .................. 2.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 .... •............. 5.00 $ Repairs & Alterations each add. $500.00 1— .........1 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $� GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL Dept. of Bldgs. Phone SU. 4-7470 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, Minn Owner _ Kind of Used as To be completed about Estimated Cost, Old—New. Building Permit No. 4�E Permit No.—,z DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No— / Trade Name ��if� Size No D -d Capacity Sq. Ft. E.D.R �/, BTU H.P. Total Connected Load 1 � Kind of Fuel BURNER — Trade Nam, Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) - 0" 4�g' --- Signed By y Business Phone No. 2M 7-59 i i Fj D46 79 HEAT LOSS CALCULATIONS �°® ' DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E, Construction No.. Guide ndows oors Reference Out. Wall JInt.WalI I Ceiling I Roof I Floor s No I e No 19— 2 ° ao FI.1 / d Room I Length°' 1 Width YW-` Height <c ® II Windows an oors—Crackage and Area ®� ` 14-.3 '®+ Width Height No. of Lineal P . Area No. of pane of pane lights of crack sq. ft. a 2 a J 200 0 2J 6 �`/�'4e#`�� ® APS �a p P�p aG � �lSi � t•� ! 0 • � a Z Y Infiltration �' k o 14q, Coef. Btu Infiltration �� 0 2- 3,1-0 -Exp. wall 3 j s Glass Exp. wall Net exp. wall S'0 Exp. wall — Exp. wall 2 O Net exp. wall Net exp. wall Ceiling �j 2 i 0 Int. wall Floor $i i * r .� Total Btu. Ceiling 73 104+36 3 07 10 070 Floor Width 17 Height P ° TO 3 7 2 fa Total Btu. Required sg,.I E.D.R. or sq. ins. W.A. Leader area Room ( Length 71 Width/2 Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane light. of crack .q. ft. 2 �.-2 j1,_ /,R , � / 7.9 If Windows and Doors—Crackage and Area ®� ` 14-.3 '®+ Width Height No. of Lineal ft. Area No. of pane of pane lights of crack�jJ sq. ft. 6 Coef. Btu Infiltration �' �' Coef. a f 7 a Glass ® �� 0 2- 3,1-0 -Exp. wall Glass /J Net exp. wall S'0 Exp. wall — Exp. wall 2 Int. wall Exp. wall Net exp. wall Ceiling 66 2 ® B d z ®�''� Floor $i i * r .� Total Btu. Ceiling 73 104+36 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area A Room I Length � Width 17 Height P ° Windows and Doors—Crackage and Area l2 " Width Height No. of Lineal ft. Area No. of pane of pane lights of crack�jJ sq. ft. 6 Width Height No. of Lineal ft. Area No. ofpane of pane of crack sq. ft. ^^llgights . 2- 1 Coef. Coef. Btu Infiltration ® Btu I 6 Y f Glass It 71? /J ®0 S'0 Exp. wall — Exp. wall 2 7 Exp. wall Net exp. wall 66 d 0 Int. wall Int. wall Y i- 40 Ceiling %'�� Ceiling 73 1,1 f 0 Floor Ceiling 119 1 Total Btu. 0 p Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Insulation Kind F1.I aW Room I Length/1'6 `Width l2 " Height V Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. ofpane of pane of crack sq. ft. ^^llgights . 2- 1 Coef. Btu Infiltration Btu Coef. Btu Infiltration s Y8 It 71? Glass p Exp. wall 2 5- 0c0 Exp. wall Net exp. wall ® 1.9f Int. wall Y i- 40 Ceiling %'�� `� 73 Floor 17- r Total Btu. 0 42 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area or _ 1 Room I Length ,di Width / jz ` Height 9 ° Windows and Doors—Crackage and Area Width Veight No. of Lineal ft. Area No. of pane 'of pane lights of crack sq. ft. 32- 6 :289 e Coef. Btu Infiltration Btu 29? 11.7 Glass 3Y qiro Exp. waR p Net exp. wall 5- 0c0 Exp. wall Int. wall Ceiling Y i- 40 Floor a Int. wall -),p Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area d F1_I 9,, 0 / Ronm (Length `7 2 Width $?' Height V Windows and Doors—Crackage and Area Width Height No. of -Lineal ft. Area No. of pane of pane lights of crack sq. ft. -7. /6 21, /sem 3 I. Coef. Btu Infiltration 3Y it 7 a Glass p .r 5- 0c0 Exp. wall Net exp. wall ® a Int. wall Ceiling 1 i 0 Floor 46 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area . ,? v3sy City of T BUHDING PERNUT ' e 3 - 6 V Date: `� of Owner: V A Zjf er Address Address — _ LO TION O F B D No Street ,Pal of Lot Lot _ - __ Block Addition or S7= — Corner Lot Inside Lot — Sotback Sideyard , Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING n Front Depth Height Z4 Sq. Ft Cu. Ft Depth �Teight _ _ Sq. Ft Cu. Ft _.. Est. be Completed 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 ce withallrprovistons of ordinances of the city of Fridley. In consideration of the payment of a fee of $ , permit is hereby granted to 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 regardinglocation, construction, alteration, maintenance, repair and moving of buildings within the city limits and permit may be =on at any time upon violaiof any of the pmvislons of said ordinances. NOTICE: Sk penin does not cover the construction, installation for wiring, plvmbiee, gas heating, "War or water. Be sure to we the Building Inspector for separate pontis for these heam Date: May 3, 1967 Owner: ..... V. Fuechtmann Builder Address 5872 Washington St. N. E. Address No. 5 872 Lot 3 Street Vern Fuechtmann LOCATION OF BUILDING Washington St. N. E. part of Lot Block 2 Corner Lot . Inside Lot Sewer Elevation Addition or Sub-Divisic Setback N® .9217 Lyndale 7thA n. Sideyard Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Garage_ Front Front 2 Depth 22 Height 10 Sq. Ft. 24Z'Cu. Ft. Type of Construction Front Depth Height Sq. Ft. _ __ Cu. Ft. Frame1800.00 June 1967 ..... Est. Cot_. ....._..___._..._._.._ To be Completed 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 compiz de with ovisions of ordinances of the city of Fridley. r ` a % 6 In consideration of the payment of a fee of $ 7.00 , permit is hereby granted to._._. Vern Fucehtmann 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 peons of said ordinances. CLARENCE BELISLE Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sower or water. Be sure to we the Building Inspector for separate permits for these Items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME BUILDER ADDRESS ` -� ` ADDRESS LOCATION OF BUILDING N0. � '' STREET �'' ,' a `f,F=`-a PART OF LOT C1rw A— LOT BLOCK - ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT SETBACK SIDE -YARD SEWER ELEVATION TOP OF FOOTING Applicant attach to this form two certificates of survey of lot and proposed building location drawn on these two certificates. DESCIPTION OF BUILDING To be Used as: .a Front ° ;12 Depth '' Height / ® Sq. Ft. il A) _� Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft, Type of Construction ° Estimated Cost '�',��e, e° To Be Completed 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 ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. f DATE �;°,; SIGNATURE r �_ (Schedule of Fee Costs can be found on the Reverse Side). rl SUBJECT PE City of FridleyIr ®12311 AT THE TOP OF THE TWINS P, BUILDING PERMIT ` RECEIPT NO i `L _ __ COMMUNITY DEVELOPMENT DIV. r -- PROTECTIVE INSPECTION SEC.to �� t /- 1 a I /'-'1 + CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �""j4,," �j 612-560-3450 910-F15 9/5/73 JOB ADDRESS 5872 Was hin ton Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 2 Lyndale Builders 7th Addition SHEET 2 9ROPERTY OWNER MAIL ADDRESS ZIP PHONE Fuech.tmann 5872 Washington 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 7 CLASS OF WORK ❑ NEW IX ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Patio Deck 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Frame 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 1 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 250.00 $.50 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. $5.00 PLAN CHECK FEE TOTALFEE $5.50 SIGNATU ;OFLCONTRR OR AUT zED NT (DATE) *^ P V*SIIGNATLIRE 1/1/ N PROPERLY VALIDA - H IS YOl{R PERMIT I OF OWNER IIF OIAPI rl ® City of Fridley a^�rECT Y Permit No. ^ AT THE TOP OF THE TWINS BUILDING PERMIT APPLICATION Receipt No. I V ------ COMMUNITY DEVELOPMENT DIV. t PROTECTIVE INSPECTION DZPT. CITY HALL FRIDLEY 58432 %.j 812-800'3450 to ER REV, DATEGE PA OF APPROVED 8v • 91910--F140 73 1 1/15/73 1 1 800 Job Address: Legal Lot No. Block Tract or--Adtition% See Attached Descr. , Sheet Property Owne Addresfi Zip Phone ontractor Address Zip Phone License No. Ar-cEitect or Designer Address Zip Phone License No. Eng neer Address Zip Phone License No. Use of Building Class of Work []Remove ❑ ❑ ❑ ® New Addition Alteration Repair Move Describe Wor o / D(f CA' Change of Use From To SPECIAL ASSESSMENTS: If lateral assessments have not been placed on this property, an agreement nrust be signed, agreeing to assume such lateral assessments before a permit will be issued Agreement Necessary: Agreement Unnecessary: Finance Director OUTSIDE UTILITIES: J z Sewer Elevation: Water Elevation: 0 Stub Location: Stub Location: w BUILDING INSPECTION } h- Plumbing H.V.A.C. Electrical Fire Insp. V Signature & - Date Approved 0 U- Registered Engn. Stamp. Legal Description Check Exterior Devel. Check Performance Bond Check Easements, R/W, Special Agreements' Final Approval Date Certificate of Occupancy P Date DIMENSIONS: Length: Width: Accessory Buildings: FOR CITY USE ONLY Height: Sq. Ft. Cu. Ft. Cu. Ft. Length: Height: Width: - Sq. Ft. VALUATION: Sq. Ft. Q X CosfjI Sz4 OL= Valuation ) Total Valuation Basement X Cost = Va uation ) PERMIT FEE: Residential Total Valuation Fee $1.00 to $500.00 $501.00 to $2,000.00 •$23,001.00 to $25,000.00 $25,001.00 to $50.000.QO $50,001.00 to $100,000.00 PERMIT FEE: Commercial and Industrial Total Cu. Ft. X $2.15/1,000 sq. X PLAN CHECK:. $5.00 $5.00 for the first $500.00 plus $1.00 for each additional $100.00 or fraction thereof, to and including $2,000.00. $20.00 for the first $2,000.00 plus $3.00 for each additional thousand or fraction thereof, to and including $25,000:00. $0.00 for the first $25,000.00 plus $2.50 for each additional thousand or fraction thereof, to and including $50,000.00. $151.50 for the first $50,000.00 plus $1.50 for each additional thousand or fraction thereof, to and including $100,000.00. ft. Permit Fee _ Take one half of permit fee = STATE SURCHARGE: Valuation X $.50/$1,000.00 =. X $.50/$1,000.00 PERFORidMCE BOND VALUATION Blacktop 1.50/sq. yd. Curbing 2.00 lin. ft. c Sod 0.40 sq, yd. Fencing 2.00 lin. ft. . Bushes and Trees 5.00 - 30.00 SUBJECT PE1 City of Fridley ®13449 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIP ___ __ COMMUNITY DEVELOPMENT DIV. 1 L <� r , PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 4/12/76 JOB ADDRESS 5872 Washington Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 2 Lyndale Builders 7th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Vernon Fuechtmann 5872 Washington Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 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 X 8 DESCRIBE WORK Reroof and screen deck 9 CHANGEOFUSEFROM TO STIPULATIONS PERMITS REQUIRED FOR WIRING SEPERATE HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 R-1 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $400.00 .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. $5.00 PLAN CHECK FEE TOTAL FEE $5.50 c IGNATUR'OF "O TRACTo ORAUTHORI ENT IDATEI ' WHEN PROPERLY- VALIDATED THIS IS YOUR PERMIT BLDG INSP DATE SIGNATUREOF OWNER IIF OWNER B ILDERI IDATEI APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA C� OWNER ` S NAME • �'' Vo i d� BUILDER • ), ADDRESS:, `�0 �� a) ft L. /) - /V , - ADDRESS :��J /1.2 NO:g=_ STREET: LOT: BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD:, 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: Ci._� Fron t : � � Depth • / � Height: Square Feet: Cubic feet: Front: Depth: Height: Square Feet; Cubic Feet: �L Type of: Construction: Estimated Gost:-•,� �� To Be Completed: 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 :: d° `- S IGNATURC (See Reverse Side For Additional Information.) `7 4 M I Building Permit Fee BUILDING Plan Review $ Permit Nd: - Inspections Surcharge RESIDENTIAL APPLICATION License Surcharge Received By: __ 763-572-3604 $ CITY OF FRIDLEY $ Erosion Control $ DATE - q- G !E� YOUR E-MAIL ADDRESS d UI {\J19S a 111Me 1; A O4 • (O Yln SITE ADDRESS W_sk!S h 1_n Aen � THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME ,ey-ej TENANT ADDRESS: !S!J 72i r��1 CITY Jv A A p STATE IP �Z PHONE: (o I Z ®j � 1(a/mi 1 CONTRACTOR NAME:) !e A) ' n 0 Iu !, �o re i, i.t -e ?r? r) STATE LICENSE # `7-0?, F5 SS61 ! ' EXP DATE 3-2j \ - () a SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS156 41 fDcu+Y, Sha vP r, UP CITY 1)1 rg w o u'rh STATE IP2i WITH APPLICATION PHONE FAX PROPERTY TYPE M SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED WS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK:t1E13 NEW ❑ ADDITION MAINTENANCE/REPAIR B'kEMODELING DESCRIBE WORK BEING DONE: k k I h4 rrA&4M0"&X SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. 3. Proposed floor plan 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. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS t�Ces ONo LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF `'rrflo rv-o OPENING CHANGES & J 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) TOTAL JOB VALUATION $ C7 Permit Fee $ Plan Review $ Fire Surcharge $ e- a Surcharge $ License Surcharge $ !Z #o SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ v i '-Z' - e OCCUPANCY TYPE 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+6ft= 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 requires review and approval of plans. SIGNATURE OF APPLICANT d Al �Q,tAp r �Civ� PRINT