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PRE 2010 DOCSBUILDING PERMIT Village of Fridley, Minim., N° 2523 _ I Date.r " :, "" .................... Owner " ......... Builder ..... ......... ... . Address"'Address ... ................... LOCA`T'ION OF BUILDING No. jw.. Street,.-. ' Part of ',Lot ...... .. ....... Loi,/ $lock . . , Addition or Sub -Division , , , , , , , Corner Lot ...... Inside Lot ... .. Setback S deyardl /42.,44f . . , , DESCRIPTION OF BUILDING To be Used as j Front Depth A . Height • , , Sq Ft.! /0%14Cu. Ft........ . .... . .. . ...... .. .. Front ........ Depth ... , ... Height ....... _ Sq. Ft.::....... Cu. Ft...... . Type of Constructiol •... E t . Cos o f ,.Ot! ....... To be Completed I 1 II I a r In consideration f the issuance to me of aermi p t 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 vM ge of Fridley, ............... ...........»...... I In consideration of the payment of a fee of $. ., .. , permit is hereby granted to ° ....... . jun to construct the building or addition as described above. This permit is anted upon expres con at the person to whom it is granted and his agents, employees and workmen, in all work done m, around ansaid building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota re ding location, construction, alteration, maintenance, repair d moving of buildings with - an an g g In the village limits this emit may be revoked at a pe Y .f Of the provisions of said ordinances. any.time upon violation of any Building inspector NOTICE: This permit doe not cover the construction installation i or alteration for wiring, plumbing, as heating, }� g, g g, sewer or water. Be ure to seg the Building Inspector for separate permits for these Mems. City of Fridley, Minn. BUILDING PERMIT Date: ,; A"o Owner: �r -, Builder Address _ _ __ ___ Address 1401 L CTI OFI f.G - �I No. Lot ' _ Block ; _ - ddition or Sub -Division Corner Lot ___ Inside Lot _ Setback _ Sideyard Sewer Elevation r _ _ Foundation Elevation CRIPTION' OF BUILDING T, . � Front, Depth Height .....� SQ. Ft..� CU. Ft..��: Frbn Depth Jeipt Sq. Ft. '� Cu. Ft. Type of Construction =, Est. +Cofit _ _ o be Completed I I 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 prdinances of the city of Fridley. I 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 regarding location, construction, alteration, main , re and moving of buildings within the city limits and this permit may be revoked a t anybx� o� any of the provisions of said ordinances. NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure Mace the Building Inspector for separate permits for these hems. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name G��®,�/���� Builder S�`�� Address "-L-11/1iegT Xl Sl / CAddress LOCATION OF BUILDING No. ,F�� Street �.�'S�/�C1T / 17 /%,- Part of Lot Lot Block Addition or Subdivision Corner Lot Inside Lot Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: DESCRIPTION OF BUILDING %Sl / Denth �/O 9W P- 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 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 G (A Schedule Schedule of Fee Costs can be found on ,:�z %/ 16 City, of Fridley, AUmn. N? 8092 BURDING PERMIT Date: July 1, 1965 Owner: I,eRor Willman Builder Same Address 6835 Washington St. R. E0 Address LOCATION OF BUILDING No. 6835 StreetTashington Street N. E. Part of Lot Lot 19 _ Block Addition or Sub -Division Rice Creek Terrace Corner Lot _ Inside Lot Setback Sewer Elevation To be Used as: Type of Construction Sideyard Foundation Elevation DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Front Depth Leight Sq. Ft. Est Cost MP50MO To be Completed Sto m Damage Repair Cu. Ft Cu. Ft 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$ innpliance with ail provisions of ordinances of the city of Fridley. /�// /f ✓ ��i> In consideration of the payment of a fee of10 S !00 ...., permit is hereby granted to LeRoy AL 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 au work da a in, around and upon said building, or any part thereoty shall conform in all respects to the ordinances of d1eY, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildiaga wiord:cea city limits and this permit may be revoked at any time upas violation of aay of the provisions of said Allen Jensen NOTICE: Uh peraft does not cover d w construdtion, hmealhMton for whing, phanhin9, gas heating, eewoe or water. as wra to no do Baliding bqm ter for »perste pormNa for them acnes. 0\11 �(� APPLICATION FOR BUILDING PERMIT k CITY OF FRIDLEY, MINNESOTA OWNER'S NAME 411ZZ,/04-Z� BUILDER ADDRESS_�� S = ��S//o �1/� o'i�✓ ST, Flo. Z:ADDRESS LOCATION OF BUILDING Street®-�5 is ✓'� Part of Lot LOI'�""-� F, ADDITION OR SUEDIVIk0M x p' aL�- Corner Lot fnsfde LOT Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATrON_ 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 7 Depth - Height Sq. Ft. /O -5 e Cu. Ft. ,ly�sT® „Front— Depth S � Height Sq. Ft. /�W Cu. Ft. Type of Construction GV0011 Estimated Cost � , ..5�®�• 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 rulings of the Department'of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. (Schedule of Fee Costs can be found on the Reverse Side). PARTIAL RATE.SCHEDULE PLU�LBING FIXTURE RATES; NO. GATE 1.%=c.r FLxtutee x $3,00 Future Pli tura 6paning 1 $2,00 New Fixture, old Opening x $2.00 Catch Blain • x $5100 t.water Haater - tD 99,000 BTU x $5.,00 100; 000 'BTU to 199,000 BTU .___.._ x 510.00 Nater Safconer Nev Ground ittn Old Buildlry x $5.00 Electric Water Heater - _T x $5,00 GAS FITTING FEES; ' x $3.00 x 11,00 - _ x $10,00 13t 3 fixtures M ditio nal Tixturem :Gs5 Range to 199,000 BTU REPAIRS & ALTERATIONS First :100.00 each acd. $100.00 or fraction State Surcharge TOTAL FEE TOTAL i $5,00 5 $2,00 5 50 97-8h -416o5i Job Addr000 , . 6835 Washington S reet NE Department of Baildingo City of Fridley I Tal, #571-3450 Tho undersigned hereby maker application for A pormLt for the wo specified agruaing•to do all work in strict accordance with the Ci and rulings of t1to Department of Buildinge, and hereby daclaroe th the facts and roprgoontationj stated in thio applicati0n are true Fridley, M,,, 1-3-78 , OWNER LEROY WILLMAN. ' KIND, OF BUILDING , fx%me . USED AS rQs• TO BE C014PLETED ABOUT 1 -Ll -78 � 20.00 ESTIMATED COST OLD - NEW BUILDING PERMIT NO, NtI�IT 110, , Company M1NPM'A�( QAscO Signed Dy' Tal, Not pml ,INSP. Date Data ' APPROVAL FOR PERMIT MIIIIMUM PEE FOR A11Y PLUMBING PERMIT 19 i7.50 u water Lp A '� A t+ ,u w �' w o, Haator u~r�� J G' C •N M x" FAA ..L1 b .0 U p 0 ' C .. �. A G ..4 N A w4 22G W 0 b S H N &j W N N C� +J t, U' ti ai •c x ti o ae loc Ist • , 4 2std • . ee l.ac e 'ra nge ' artTl' 1 « .--= ' (RJ - FVture Connection Opening Conn -octad with Suwor 1.1 - 11ow Futuro, Old Opening Water PARTIAL RATE.SCHEDULE PLU�LBING FIXTURE RATES; NO. GATE 1.%=c.r FLxtutee x $3,00 Future Pli tura 6paning 1 $2,00 New Fixture, old Opening x $2.00 Catch Blain • x $5100 t.water Haater - tD 99,000 BTU x $5.,00 100; 000 'BTU to 199,000 BTU .___.._ x 510.00 Nater Safconer Nev Ground ittn Old Buildlry x $5.00 Electric Water Heater - _T x $5,00 GAS FITTING FEES; ' x $3.00 x 11,00 - _ x $10,00 13t 3 fixtures M ditio nal Tixturem :Gs5 Range to 199,000 BTU REPAIRS & ALTERATIONS First :100.00 each acd. $100.00 or fraction State Surcharge TOTAL FEE TOTAL i $5,00 5 $2,00 5 50 97-8h -416o5i Job Addr000 , . 6835 Washington S reet NE Department of Baildingo City of Fridley I Tal, #571-3450 Tho undersigned hereby maker application for A pormLt for the wo specified agruaing•to do all work in strict accordance with the Ci and rulings of t1to Department of Buildinge, and hereby daclaroe th the facts and roprgoontationj stated in thio applicati0n are true Fridley, M,,, 1-3-78 , OWNER LEROY WILLMAN. ' KIND, OF BUILDING , fx%me . USED AS rQs• TO BE C014PLETED ABOUT 1 -Ll -78 � 20.00 ESTIMATED COST OLD - NEW BUILDING PERMIT NO, NtI�IT 110, , Company M1NPM'A�( QAscO Signed Dy' Tal, Not pml ,INSP. Date Data ' APPROVAL FOR PERMIT MIIIIMUM PEE FOR A11Y PLUMBING PERMIT 19 i7.50 SUBJECT P M City of Fridley ® 19986 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. 7y r PROTECTIVE t � _ I CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY %.j 612-571-3450 910-F15 7/10/89 JOB ADDRESS 6835 Washington Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 19 1 Rice Creek Terrace Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE LeRoy/Regina Willman 6835 Washington Street N.E. 571-3728 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 E2 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 121.x 20' Shed 9 CHANGE OF USE FROM TO STIPULATIONS Shed must be securely anchored to ground or slab. Use treated Wood on floor if slab•.not used. 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 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 $1'8Q0 $.9O 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- $41.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. a <PAN�HECK FEE TOTAL FEE $41,90. SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY VA ATED THI IS YOUR PERMIT Q U SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEi BLDG INSP t)AT NEW [ ] Effective 5/1/88 ADM [ ] R-1 AND F-2 ALTER [ ] Building Permit Application Construction Address: legal Description: Owner Name & Address: —� ��p'i,,�,4 ��t c X .ti Tel. #_-5�/-,37a Coaractor: �,Ll'�1� 7` ,v .v ?u� L OGS S Tel.. � Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LTV= AREA: length Width Height sq. Ft. GUM= AREA: length Width height Sq. Ft. DBCR AREA: length Width Hgt/amund sq. Ft. Corner Int [ ] Inside loot K] Ft. Yd Setback Side Yard Setbacks Type of Construction: Zjdcr .gyp Esdmted Cost: $ /F®0• °i AMrox. Cmpleticn Date: ,;7-- /6 -� Fr 2 Prgmsed Driveway Width If New opeU g Is Desired: Ft. $ $. Width + 6' See Back Page HATE: 7- IC)— f9 APPt aM: �d � Tel. � s 7 s - 3 7;,L Permit Fee $ 4).®® State Surcharge $ �(7 SAC Charge $ Driveway Escrow $ Fork Flee $ sewer Main charge $ � �s,� as .- r�rf�✓ CI'PR DBE Qi�II,Y Fee Schedule on Reverse Side $.50/$1,000 valuation $575 per SAC Unit Alt. "A" cr Alt. "B" Above Fee Determined by Agreement Necessary [ ] Not Necessary [ ] /go u.vo /3�2 SUBJECT E City of Fridley ®� AT THE TOP OF THE TWINS ?RECEIPT BUILDING PERMIT r ' , I • _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. mmrr i , l CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L.«_� ' '•, 612-571-3450 910-F15 6/18/91 / / JOB ADDRESS 6835 Washington Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 19. 1 Rice Creek Terrace Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Leroy/Regina Willman 6835 Washington Street NE 571-3728 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 8 DESCRIBE WORK Reroof Structure (24_Squares) 9 CHANGE OF USE FROM TO STIPULATIONS ,r or tear-offs and replatoment roofs, On all new roofs that 2 layers of 15 lb. felt, State Code requires mopped together, be installed to a point 24 inches up from exteripr wall line, or the use of other underlayment membrane. approved TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 7 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1 25Q $.63 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT r PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $31.00 $ Fire SC $1.25 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. LAN CHECK FEE TOTAL FEE $32.88 I7 A UTHORIZED AGENT IDATEI WHEN PROPERLY LIDATED T IS IS YOUR PERMIT / �TCONTRACTOR / / BLDG INSP qAT S,G ATU F OWN E R OF OWNE R BUILDER ATEI NEW [ ] Effective 1,/1/91 ADEN [ ] R-1 AND I-2 ALTER [ ] Building Permit Application Construction Address: C!� E::��5 �✓.�' S� ,��-a �/ ST i✓ �/�� 1? �1" ✓ 5��/� Legal Description: Owner Name & Address: Attach to this application, a Certificate of Survey of the lot, with the proposed constriction drawn an it to scale. OF II+DVII►�Tr LIVnrx AREA: length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DEM AREA: Length Width Hgt/Gras ri Sq. Ft. Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ Approx. Completion Date: Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page DAZE: APPLSCANT: Tel. # Permit Fee $ C' Fire Surdharge $ State Surcharge $ SAC Clharge $ Driveway Escrow $ Park Fee $ Sewer Main Charge TOTAL $ CP s-rIP MAMICNS: 0 USE OHLY Fee Schedule cn Reverse Side .001 x Permit Valuation (1/10th $) $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Ergine Tg Agreement Necessary [ ] Not Necessary [ ] j2sz S-60 3j SUBJECT P City of Fridley 21104 AT THE TOP OF THE TWINS BUILDING PERMIT r 1 0 ______ COMMUNITY DEVELOPMENT DIV. 1 ~ � PROTECTIVE INSPECTION SEC. 1 � 1 . � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 10/7/91 F/ / JOB ADDRESS 6835 Washington St NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 19 1 Rice Creek Terrace Plat 4 SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Leroy Willman 6835 Washington Street NE 571-3728 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Minnesota Exteriors Inc. 295 Hwy 55, Hamel, MN 55340 478-6252 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 j] ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Soffit & Fascia 9 CHANGEQFUSEFROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $21970 $1.48 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $54.00 Fire SC $2.97 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $5 45 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN P OPER VA4 A ED H I OUR PERMIT BLDG )NSP nATE SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI NEW [ ] Effective 1/1/91 ADCN [ ] I-1 AND R-2 ' ✓ 7 / r A= [� Building Permit Application Construction Address: baa E K 2Gh na n �f Legal Description: Owner Name & Address: Le- 1-0 V me- _ Tel. # % / -S 726 Contractor: \ .o rs Erzs _ Tel. # q "78-6252 8'62 Attach to this application, a Certificate of Survey of the lot, with the proposed oonstxuct'.icn drawn on it to scale. ."; L NIM AREA: Length Width Height Sq. Ft. GRRAGE AREA: length Width Height Sq. Ft. DBM AREA: Length Width Hgt/Gro u d Sq. Ft. OTS• Corner Lot [ ] Inside Lot ] . Yd Setback Side Yard Setbacks Type of Construction: -� Estimated Cost: $ Approx. C u pletion Date: 10-20-91 (� Proposed Driveway Width If New Opening Is Desired: Ft. $. $. Width + 6' See Back Page DATE: 0-4-C11 APPI aw:00raw'-,Tel. # -7'"g�92S2- Permit Fee $ 54.00 Fire Suxrharge $ .9 State Surcharge $ . L SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ CITY USE OMY Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th �) $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] TOTAL $ f. STIPUTATICNS : CITY OF FRiDLEY INSPECTION DIV, Effective On January 1;1993 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 672-3604 REFRIGERATION AND AiR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 3 RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Bate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — vv _ rulings of the Building Division, and hereby declares that all the facts and Also, Replacement Furnace $ 20.00 $ 2 representations stated in this application are true and correct /11171 ,1993 Gas Piping (Needed with new furnace) $10.00 $ OWNER Gas Range $ 10.00 $ BUILDING USED AS �� s S•, °' Y � ` �`"" Gas Dryer $10.00 $ ESTIMATED.COST©G PERMIT NO. *Air Conditioning — All Sizes $10,00 $ /"�' ` • DESCRIPTION OF FURN6CE AND 08 BURNER All Others/Repairs & Alterations (LIST ON BACK) ( / / 1% of Value of Appliance or Work $ No, of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name a4/7 .e Size No, Commercial/Industrial BTU eD,1 'HP EDP I% of Value of Appliance or Work $ Fuel f Total Connected Load O State Surcharge TOTAL FEE $ MINIMUM} FEE FOR ANY HEATING/COOLINGNENTILAIION REFRIGEROON/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.63TATE SURCHARGE REINSPECTION FEE $30.00 *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 HEATING COMPANY Signed By Tel No, f� Approved By Rough—In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE i CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney! or stack: .1. Has been carefully examined Yes (,i) No ( ) Z. Is free from rust or -deterioration Yes ( ) No ( i 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes (1) No ( ) 5. Meets all current Code requirements for size -and total BTU's connected Yes {) No { ) 6. Has total heating BTU's of All other BTU's TOTAL BTU's Remarks List Alterations Being Done: HEATING COMPANY Signed By Date CITY OF FRIDLEY INSPECTION DIV, Effective On January 1, 1993 6431 University Ave NE "Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE JOB ADDRESS 6S35 LA_)LA�&yr .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 $ 20.00 $ representations stated in this application are true and correct. I � ,1893 Gas Piping (Needed with new furnace) $10.00 $ OWNER v Vim`\�\ Gas Range $ 10.00 $ BUILDING USED AS Gas Dryer $ 10.00 $ . ESTIMATED COST (>�O PERMIT NO, bi *Air Conditioning — All Sizes $10.00 $ • QESCRIPTION OF FURNACE ND OR BURNER All Others/Repairs.& Alterations (LIST ON BACK) 1% of Value of Appliance or Work $ E.C� No, of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. Commercial/Industrial BTU HP EDR 1% of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge .50 Burner Trade Name Size No. BTU HP EDR TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATIONIAIR CONDITIONING PERMIT IS X15.00 PLUS THE $.5o STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. HEATING COMPANY FRED VOGT & COMPANY 32,1011GORHAM AVE ST LOUIS PIC 55426 Signed By� Tel No. 929-6767 Approved By Rough—In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE :..............,... ..... ..., _. .....,..........__.. -.. _._�. ....�,...... .... .....,..,-�.......Wd ..,:,:a:avw.c,3av:avat.. ,:�o wi.nx�.wxia,..n,: �;,:W<.ot.. .......v..e ...... CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes NO 2. Is free from rust or -deterioration Yes No 3. Has no foreign objects lodged within Yes No 4. Is securely supported Yes No S. Meets all current Code requirements for size and total BTU's' connected Yes No 6. Has total heating BTU's of All other BTU's TOTAL BTU's List Alterations Being Done:' HEATING COMPANY FRED VOGT & COMPANY Signed By Date SUBJECT PEAAA ' City of Fridley 6] 2227 AT THE TOP OF THE TWINS BUILDING PERMIT EIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. %���` J NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 12/29/93 JOB ADDRESS 6835 Washington St NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 19 1 Rice Creek Terrace Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Leroy Willman 6835 Washington St NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Giertsen Co; 860 Decatur Ave N, Golden Valley, PIN 55427 546-1300 1796 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 O ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Repair fire damage; Sheetrock, egress window, joist in basement 9 CHANGE OF USE FROM TO STIPULATIONS Call for inspection after removing all damaged materials. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, F'%,UMBING, HEATING, VENTILATING OR AIR CONDITIONING. F ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED$5F 000 $2, 50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- Fire SC $5.00. STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $72,00 PLAN CHECK FEE TOTALFEE License SC $5,00 $84.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PRO RLY VALIDATED THIS IS YOUR PERMIT IL 3®-93 DG Asp DATE SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI NEW [ ] Effective 5126/93 ADDN [ ] CITY OF FRIDLEY ALTER SINGLE FAMILY ANDDUPLEXES R-1 AND R-2 Building Permit Application Construction Address:�o�� �� �� ��c� u� ��� - Legal Description: �� L /2 Owner Name & Address: L� (zoo �, .y�-�� �, �� Tel. # Contractor: `� � �� C®. J MN LICENSE # \- l Address: ''8c oco �� ���--� . ,6 .0 - �s�Z1 Tel. 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: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width HgtlGround Sq. Ft. OTHER:l\-*) Corner Lot [ ] Inside Lot [ ] Type of Constriction: Approx. Completion Date: asem �X-'r J FL Yd Setback Side Yard Setbacks. Estimated Cost: $ sem" (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: APPLICANT: \ , �_ Tel. # -\--Soo CITY USE ONLY Permit Fee $ 77 Fee Schedule on Reverse Side Fire Surcharge $ S - .001 of Permit Valuation State Surcharge $ $.50!$1,000 Valuation SAC Charge $ $750 per SAC Unit fCf License Surcharge $ $5.00 (State Licensed Res Driveway Escrow $ Alt. "A" or Alt. "B" Abol, DENNIS FISHER General N COM OANY Erosion Control $ Conservation Plan Review 24 -Hour Number (612) 546-1300 Minneapolis Office Park Fee $ Fee Determined by Engine FAX 546-0623 860 Decatur Ave. Car 723-4742 Golden Valley, MN 5 55427 Sewer Main Charge $ Agreement Necessary [ ] - TOTAL $ 5 U STIPULATIONS: IJ SUBJECT PE City of Fridley 29988 AT THE TOP OF THE TWINS BUILDING PERMIT q �e COMMUNITY DEVELOPMENT DIV. __-_-_ r PROTECTIVE INSPECTION SEC. � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEV 55432 612-571-3450 910415 8/4199 1013 ADDRESS 6835 Wa On St=k-Plf- NF 1 LEGAL LOT NO. BLOC TRACTOR ADDITION SEE ATTACHED DESCR. 19 1 Rice Creek Terrace Plat 4 SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Leroy Wellman 571-3728 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Vern Jurek Const. 7329 SE Cty. 23 Becker MN 55308 261-4776 - 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 &x REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garakre 27 SO 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2360 $1.18 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- STRUCTIO OR THE PERFORMANCE OF CONSTRUCTION 83.25 Fire SC $2.36 PLAN CHECK FEE TOT "�- T Licens 5 0$9,71719 SIGN A TUBE OF CON- RACTOROR HORIZED AGENT IDATEI EN OPE ALIDATE IS IS PERMIT SIGNATURE OF OWNER SIF OWNER BUILDER) IDATEI BLO )NSP gAtE IJ NEW[ ] Effective 5/10/99 ADDN [ l CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 R BUILDING PERMIT APPLICATION 0 Construction Address: 3 �`- Legal Description: Owner Name & Address: ,( Cd/ l Tel. # -9'-7t- Contractor: S`'7t-Contractor: V e. -r- vo w ^4k MN LICENSE .# Address: °7 3 Q L C'_�i` ls' �� /t� -30Q' Tel._ # 77 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: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: -)fi S/uav'ar Construction Type: Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: $ Q APPLICANT: Tel. # Co (� TOTAL STIPULATIONS: CITY USE ONLY Permit Fee $ J 83 • �s Fee Schedule on Reverse Side Fire Surcharge $ :;-36 .001 of Permit Valuation (1/10th%) State Surcharge $ /. / $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: CITY OF FRMLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763) 571-1287 PERM NO.:2004-00931 DATE ISSUED: 06/17/2004 ADDRESS : 6835 WASHINGTON ST NE PIN : 143024120006 LEGAL DESC : RICE CREEK TERRACE PLAT 4 : LOT 19 BLOCK 1 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 300.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL A FEBCO 765 BACK FLOW PREVENTER. # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE 0 # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS 0 # GAS DRYERS 0 # GAS RANGES 0 # OF NEW FIXTURES 0 # WATER TRMT APPLIANCES 0 APPLICANT CEDAR PLUMBING 2445 VIKING BLVD NW CEDAR, MN 55011 [411AWI M WILLMAN LEROY D & REGINE P 6835 WASHINGTON ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regula ' ons ction or the performance of construction}. ADnlicant 1 Date [ I PLBG PERMIT MINIMUM FEE 15.00 PLBG FIXTURES (NEW OPENINGS) 0.00 PLBG FIXTURES (EXIST OPENINGS) 0.00 WATER TREATMENT APPLIANCE 0.00 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 0.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 PLBG REPAIR/ALTERATIONS 0.00 STATE SURCHARGE, PLBG FLAT 0.50 TOTAL 15.50 PAID WITH CHECK # 12058 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY INSPECTION DIV. Effective April 1, 2004 6431 gniver`sity Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 3 (763) 572-3604, FAX (763) 571-1287 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $10.00 Old Opening, New Fixture $10.00 Beer Dispenser $10.00 Blow Off Basin $10.00 Catch Basin $10.00 Rain Water Leader $10.00 Sump/Receiving Tank $10.00 Water Treating Appliance $35.00 Water Heater -Electric $35.00 Water Heater - Gas'" $35.00 Gas Range" $10.00 Gas Dryer" $10.00 Back Flowp eventer Re uired� )Yes () No Tvoe 7"L'ij ��S $15.00 et Reinspection Fee $50.00/Hr r%� ALL OTHERS AND/OR REPAIRS A D ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge TOTAL FEE JOB ADDRESS C 3 WCki nr:4 TQ Y -V S� The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. OWNER �_ BUILDING USED ESTIMATED COST PLUMBING DATE: r_'200y 3 pU1-`- 1",)II-. PERMIT NO. =_7,a PL'0&- SIGNED BY / a /r G TEL N0. Approved�By Rough -In Date Final Date l MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "PROVIDE COMMON VENT INFO ON BACK SIDE .4 FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS When replacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes (b No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes ( No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes O No( ) Appliance #1 Type BTU Input Fan Assisted or Nat_ Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat �e Total Appliances Total Btu Input Common Vent Type Vent Height Appliance #1 Vent Connector Height ft Length ft Appliance #2 Vent Connector Height ft Length ft Appliance #3 Vent Connector Height ft Length ft HEATING CO: Diameter inc es Diameter in Type Diameter in Type Diameter in Type Signed By: Date : Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: ,,dyJt6 763-572-3604 Plan Review $ CITY OF FRIDLEY -9 DATE YOUR E-MAIL ADDRESS i� SITE ADDRESS S ( License Surcharge THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR SAC Charge PROPERTY OWNER/ NAME: Ile 1;�(o j Ql Curb Cut Escrow TENANT ^, ADDRESS: CITY STATE—ZIP- TATEZIPPHONE: $ PHONE: NAME: Park Fee CONTRACTOR Renewal By Andersen $ SUBMIT A COPY OF STATE LICENSE !R_ 1920 County Road "C" West $ YOUR STATE LICENSE ADDRESS: Roseville, MN 55113 / STATE ZIP WITH APPLICATION PHONE License #20130983 PROPERTY TYPE ❑ SINGLE FAMILY/NEI ❑ TWO FAMILY/NEW G 651-264-4777 ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS PERMIT TYPE ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: O NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH IN HEIGHTFt E3 HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENTREM- OD i IN 1BMIT@ GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2• Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING ❑ VinylFOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Aluminum ❑ Other 0 Trim ❑Trim ADDITIONS 1. & PORCHES SUBMIT: Site Plan/Survey showing the existing structure ❑ Fascia and proposed project. WINDOW( 2. Two sets ofconstruction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations 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 AND MATERIAi,C! U.B.0 FEE SCHEDULE) 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) $1550 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: Citv of Fridlev Attar 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 h conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not. permit but only an applicatio or a permit and work is not to start without a permit; that the work will be in accordance with the approve( plan in the case of all work w 'ch requires iew and approval of plans. Q SIGNATURE OF APPLICANT NAME �t� DATEO?0 (J (USING THE' -1"7 TOTAL JOB VALUATION $20) S Permit Fee $ , Plan Review $ Fire Surcharge $ Surcharge $ /01 License Surcharge $ �5- 00 SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ 756-1 U.B.0 FEE SCHEDULE) 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) $1550 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: Citv of Fridlev Attar 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 h conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not. permit but only an applicatio or a permit and work is not to start without a permit; that the work will be in accordance with the approve( plan in the case of all work w 'ch requires iew and approval of plans. Q SIGNATURE OF APPLICANT NAME �t� DATEO?0 (J