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PRE 2010 DOCSCity of Fridley, NUmn. 6431 University Ave., N. vve ,N. E�., Minneapolis, Minn. 55432 BUH-DIN Owner: Viewcon, Incorporated Builder Same Address _..59.01_..Brooklyn Boulevard Address Same No..__. L.. 5.514 Street – s t Bavarian. Pass Part of Lot Lot ._ _ .... _. Block _ _____ ._..._ Addition or Sub -Division i.sb=ck North Ms. Site Corner Lot _._ __ _ Inside. Lot ._ X Setback I Sideyard Sewer Elevation Foundation Elevation _._....... Rnidua divl Townhouse 1hLttFront 24_' Depth 31 _ Height 28 _ Sq. Ft. 748 Cu. Ft. 2.0 a. L -Garage _ _ Front 20' Depth __22 ` Height 101 Sq. Ft. 4401 Cu. Ft. .► Type of Construction Wood Frame Est. Cost X24.610.56 To be Completed Jan 15,-1972 Stipulations: Provide 10 foot wide plato at elevation 857 for future walk around the lake. All parking lot and j street grades must be greater than .6%. Area to be platted and filed before occupancy of units. In consideration of the issuance to me of a permit to construct the building described above I agree tq 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. 12 _ 1 State Stsr`'harge , In consideration of the payment of a fee of $ 7.00 , permit is hereby granted to %Viewcon, Inc. 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 building�ss Within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. � f s �� � � Building inspector HANK MUHICH NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or seater. Be sure to leo the Building Inspector for separate permits for these items. If ("D" Unit) APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: VIEWCON. INC. BUILDER: VIEWCON, INC. NO:. 5514 STREET: West Bavarian Pass LOT: ;Z BLOCK: 11 ADDITION: Innshruck North TQkjQhgWFe site CORNER LOT: INSIDE LOT: X 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: Individual Townhouse Unjt Front: 24' Depth: 31' Height: 28' Unit: 748 — 1 97.1(( -Lo 16,,Z(, ,-Lo `---�) Square Feet: FID: 1496 Cubic Feet: 20.944 Qa.r'Q9Q Front 20' Depth: 22' Leight: 10' 1 Z`1 'Z_0 ---� Square Feet; 440 Cubic Feet: 4,400 JG -(Ar— Type of Construction: wood frame Estimated Cost: Z--Z-4-4,10s-66 SCVG.P � To Be Completed: 15 January, 1972 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declarea that all the facts and representations state is applicajtiot are true and corrects 1011% _ IF Ir1 I'kl DATE: 1OZ14121 SIGNATURE (See Reverse Side For Additional Information.) -?/ -/�, e - /-/7 r� r F Application for Power Plants and Heating, Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ........................... 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 ............ each add. 60,000 BTU ....................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 ................. Repairs & Alterations each add. $500.00 .............. 8.00 $ 2.00 $ 5.00 $ 5.00 $ 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam .... 8.00 $ 10.00 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 $ X GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ X 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 $ 17 -•5Q -- ROUGH 7 Dept. of Bldgs. Phone SU 4-7470 Locafion c;q14 W_ Bsygr ag Pass 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 December 13. 1971 , 19 — Owner Viewcons Inc. Kind of Building Frump Used as Residence To be completed about jana€ary, 1,972 Estimated Cost, Old—New. Building Permit No. Permit No. vv 5! DESCRIPTIONOF WORK BEATING or POWER PLANTS --Steam, Hot Water, W Air- No 1 Trade Name Bryant Size No 393-80 Capacity Sq. Ft. E.D.R $C) 000 BTU HY Total Connected Load 44, 100 Rind of Fuel Nat. gas BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU HY (REMARKS—OVER) Signed Ad3myced .Cond. U �! r 786-4881 City. of Fridley Application for Plumbing and Cas Fitting Permit DESCRIPTION OF WORK Number, Kind and Location of Fixtures 6� , k N WATER HTR. GAS ELEC. 3 e9 ? ; F C •C 3 C�'1 q C�'J .[ O R Base 1st ` rl 2nd 3rd 4th Future Connection Openings Connected with I Sewer New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TO AL Number Fixtures ....... .............. U x $2.00 $ --240- O�® Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ...... ..................... x $3.25 $ Water Heater (Up to 99,000 BTU) ...... ( x $3.00 $ LN -0 New Ground Run Old Bldg. x $3.25 $ Electric Water Heater a $2,00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $200 $ Additional Fixtures x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ Dept. of Bldgs. Phone 560-3450 11 ss��l Location — -?c '/4t -CleA- b',14 City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the facl and representations stated in this application a7ee and correct.Fridley, Minn- Owner ���-J r D r� J , .467 el j . Kind of Building -,6 C1,0722i Used as To be completed about �� �, 7, Estimated Cost, $ 4 Old--(!eD Building Permit No Permit No. S7 Signe f By Business Phone No. 83 ROUGH FINAL n REPAIRS & ALTERATIONS—Refer to Code9 ' Description ................................................$ TOTAL FEE $ az -M f 53-84-s915.51 PARTIAL RATE SCHEDULE PLUMBING FIXTURE BATES. NO. RATE TOTAL Number Fixtures ................ 1 x $100 : . 00 Future Fixture Opening .... a ...... x $1.50 $ New Fixture Old Opening .......... x $1.50 i Catch Basin O. .. 0 ......... D p. p .. x $3.25 IL— Water Beater ''Up to 08.000 BTU) • p • • x $3.00 S New Ground Bun Old Bldg. p . D • D D .. x $3.25 S Electric Wates Heater........ p D .... a $too $ GAS FITTING FEES. NO. RATE TOTAL 1st 3 Fixtures ............ • . • , • • 1 x $2.00 Additional Fixtures............ • ... x $ .75 $ Gas Range to 1.000 BTU ............ x $5.00 $ State Surcharge $ .50 Description 0 0 0 0 p 0 0 D O D O D 0.O O p A. . 0 O p .•, . p e. • A .O• • a p� TOTAL YKE City of Fridley: The undersigned hereby makes application for a permit for the work hereil 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 presentations stated in this application are true and correct Fridley, Minn 8/14/7;) Owner Darrel Farr Dev Corp Find of Building Frame Used as Res. 7'o be completed about 8/19/72 Estimated Cost. $ 10,00 Old -Anew. Building Permit No. —pe Signed By MINNEGASCO Business Phune No ROUGH FINAL i —.� i `f 53-84-x915.51 City of Fridl®y " Apidicaffm for Pig end c as RMi.9 ftm* Dept. of Bldgs. Phone 5 DESCRIPTION OF WORK 4 i Number. Kind and Location of Fixtures 551��Bavarian Pass • Future Connection Openings I waa.cwa wua + Near Fixture. Old Openings Sewer 13 a PARTIAL RATE SCHEDULE PLUMBING FISTU RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ............ x $1.50 am= New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 MIN Water Heater :Up to 99.000 BTU) . • • • x $3.00 Wi New Ground Run Old Bldg......... x $3.25 $ Electric Water Heater .............. : $2.00 $ GAS FITTING FEES: NO. RATE TOTAL ist 3 Fixtures ............... • 1 x $2.00 $ 2.00 Additional Fixtures .................. x $ .75 $ Gas Range to 199,000 BTU ..... iGas •Grill x $5.00 $ Install 1 3.00 .MEMO MIMMEMIN NEE • Future Connection Openings I waa.cwa wua + Near Fixture. Old Openings Sewer 13 a PARTIAL RATE SCHEDULE PLUMBING FISTU RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ............ x $1.50 $-- _New New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater :Up to 99.000 BTU) . • • • x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Electric Water Heater .............. : $2.00 $ GAS FITTING FEES: NO. RATE TOTAL ist 3 Fixtures ............... • 1 x $2.00 $ 2.00 Additional Fixtures .................. x $ .75 $ Gas Range to 199,000 BTU ..... iGas •Grill x $5.00 $ Install 1 3.00 REPAIRS & ALTERATIONS—Refer to Code Description ............................................ $ ,TOTAL FEE $ 5.00 (SURCHARGE $ _.50) City of Fridley: The .undersigned hereby makes application for a permit for the, aeork herei specified, agreeing to do ell work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that alk the fact and representations stated in this application are true and correct Fridley, Wren 9/21/72 19® Owner Darrel Farr Del Kind of Building Frame Used as Res. To be completed about 9/26/72 Estimated Cost, $ 10.00 Old—New?CBuilding Permit No. —Permit No. Sign By MINNEGAsm Business Phone No ROUGH FINAL SUBJECT PERMIT NO. City of Fridley AT THE TOP OF THE TWINS K U I L I PERMIT BUILDING 2 i V RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 � ''j 612-571-3450 910-F15 5/18/94 JOB ADDRESS 5514 West Bavarian Pass NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 11 Innsbruck North Townhouse SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Dicks Fire & Storm 864 19 Ave SE, Minneapolis MN 55414 78j-6170 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 ❑x REPAIR [IMOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Garage (Tear-off); Install gutters 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. 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 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 $2109 P $1.06 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 $2.11 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. . PLAN CHECK FEE TOTAL FEE License SC $5.00 $62.17 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI OP LY VALIDATED THIS IS YOUR PERMIT SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI - BLOG INSP MATE NEW ( ( Effective 1 / 1 /94 ADDN CITY OF FRIDLEY ALTER ( SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: 5514 - West Bavarian Pass --- Legal Description: — Owner Name &, Address: Tel. # Contractor: Dicks Fire and Storm MN LICENSE # 2481 Address: 864 - 19th AVe S E , Mp1s , Mn 55414 Tel. # 7g1 -6 70 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: Remove and replace roofing on garage Install g„ttPrG Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Roof i n g /gutters Estimated Cost: $ Approx. Completion Date: C 4 - Ba k) Driveway Curb Cut Width Needed: DATE: _ g/ 15 / 9 4 APPLICANT: I os on c Ft. + 6 Ft = Ft x, $ Dicks Fire and Storm 2,109.00 Tel. # 781-6170 TOTAL $_ STIPULATIONS: CITY USE ONLY Permit Fee $ �, P Fee Schedule on Reverse Side Fire Surcharge $ J) .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $800 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 FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Furnace Shell and Duct Work, Burner — Aiso Replacement Furnace (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning — AnIzes All Others/Repairs &Alterations (LIST ON BACK) 1 % of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Effective On March 1, 1996 JOBADDRESS ��'6aw"La 1 Iq The undersigned hereby makes application for a permit for the work herein Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and 0 0 rulings of the Building Division, and hereby declares that all the facts and $ 30.00 $1 -k representations stated in this application are true d correct. $10.00 $ 11996 OWNER lVQ-i;Il PA2)(elr eil $10.00 $ < . BUILDING USED AS $ 10.OQ $ ESTIMATED COST PERMIT NO. $ 25.00 $ DE§CR(PTION OF FURNACE AND OR BURNER State Surcharge TOTAL FEE 50 $ , '50 MINIMUM FEE FOR ANY HEATINGGICOOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. No. of Heating Units 0 Circle One (St Trade NaMe 7 BTU GV HP am) (Hot Water) �n Size No. 330 V Dllac D EDR Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR HE AT G COOM NY Approved By FILL OUT BACK SIDE VOR REPLACEMENT FURNACE BLAINE HTG. A/C & ELECT. INS 1. 13662 CENTRAL AVE. N.E. Tel No. �5 -)— &'O Rough—In Date STACK VERIFICATION ON Final Date CEM%MY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined 2. Is fine from rust or deterioration 3. Has no foreign objects lodged within 4. Is securely supported 5. Meets all current Code requirements for size and total BTU's connected 6 Has total heating BTU's of o d /--,) All other BTU's l e6z> TOTAL BTU's ,� `) b a Z T 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: —7&,u) T -k i �Tk List ALTERATIONS Being Done: HEATING CO: Signed By: Date: BLAINE 14TH. A/C & ELECT. INC 13582ANOKA,RMN 5530AL 4N Yes No ( ) Yes W No ( ) Yes ( ) No bJ Yes N No ( ) Yes ( ) No N Yes W No ( Yes .W No ( NEHEATING AIR CONDITIONING AND ELECTRIC, INC. .f/ /,Ir1A4V7 Ae HOUSE HEATING TEST RECORD W OCCUPANT HEAT LOSS DATE HTG. INST. r SOLD BY Electrical Work By TYPE OF HEAT GA FA HW STEAM® SPACE HTR.® GAS DESIGN MAKE Model 3, da V 0 Y.2 offb Serial L( INPUT_�� CONTROLS THERMOSTAT Ake— Heat Plug Valve Limit Limit Setting Fan Setting APT. FLOOR CITY ZSUBURB OWNER i / j aj INSTALLED BY Gas Line By UNIT HTR. OTHER CONVERSION MAKE OF BURNER Model Max. BTU Rating MAKE OF FURNACE Model Vent Size KIND OF LINER SIZE NONE Draft Hood Regulator Fitters Size `a D Number Chimney Location Inside Outside Pitot Type Chimney Construction Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing Draft Test Tag L. W. Cut Off Door Pressure Lighting Inst. Pressure Percent CO, Date Tasted d Input CFH 6 , Percent Os Company Testing r` Stack Temp.,Percent CO Name of Tester Form 235 • SUBJECT 0. Cityof Fridley 31043 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT F F COMMUNITY DEVELOPMENT DIV. _ __ r �' �� �� PROTECTIVE INSPECTION SEC. 7. 2�6 F F � NUMBER REV DATE PAGE OF APPROVED BY E 1 CITY HALL FRIDLEY 55432 %'j 612-571-3450 910415 6/8/00 JOB ADDRESS 5502, 06,10,14,18, 22 W. Bavarian Pass I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ,,1-6 11 Innsbruck North Townhouse Site SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Innsbruck...Townhome Association 651-224-5482 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Garlock -French Roofing Corp. 2301-E. 25th St...Npls., MN 55406 612-722-7129 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 00001423 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING "=Residential 7 ,, CLASS OF WORK O NEW O ADDITION O ALTERATION XE7 REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof Building 9,, . CHANGE OF FROM TO rE STIPULATIONS Underlayment must comply with the State Building Code. Permit inspection Cards Will Be Mailed To Homeowner To Post TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE°PERMITS ARE REOUIREO 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 1 HAVE READ AND EXAMINED THIS APPLICATION 6 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 $16 674.56 $8.33 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- $279.25 Fire SC $16.67 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE 304.25 SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT (DATE, HENR P VALI AT D THIS IS YO�� PERMIT Bl ,NSP MATE S,GNATURE OF OWNERI,F OWNER BUILDER, (DATE, BuildingBUILDING $ � .. See Back Page for Fee Schedule PermitNo.:�5 Inspections RESIDENTIAL APPLICATION Fire Surcharge Received By: 763-572-3604 .001 times the total job valuation CITY OF FRIDLEY $ Date Rec'd: l0 1S .0005 x Permit Valuation Minimum $.50 License Surcharge $ J' ('rD $5.00 (State Licensed Residential Contractors) SAC Charge SITE ADDRESS r � � � va $1675 per SAC Unit (Plans to MWCC for determination) THIS APPLICANT IS: ❑ OWNER `CONTRACTOR PROPERTY OWNER/ NAME: $ TENANT $450 Conservation Plan Review Park Fee $ ADDRESS: CITY STATE ZIP Sewer Main Charge PHONE: CONTRACTOR NAME: $ SUBMIT A COPY OF STATE LICENSE # EXP DATE 3" YOUR STATE LICENSE ADDRESS: 5220�2CITY STATWIPs� 3 WITH APPLICATION PHONE Q :), sfel FAX PROPERTY TYPESINGLE FA -YNIEW CONSTRUCTION SIZE c3 TWO FAMILY/NEW CONSTRUCTION STORIES PEi RIMn TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ OTHER ❑ SIDING WIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR WREMODELING :DESCRIBE WORK BEING DONE: -� e SIZE OF IMPROVEMENT I ip.WnT 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. WINDOWS 2. Two sets of construction 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 MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ i� F) /) n OCCUPANCY TYPE Permit Fee $ � .. See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ Ce -61z) .001 times the total job valuation Surcharge $ ',tea ,Gfj .0005 x Permit Valuation Minimum $.50 License Surcharge $ J' ('rD $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 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 ( ) Total Due $ ?-3_ Make checks payable to: City of Fridley 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 workw,jh�' h r qu' es[view and approval of plans. �( % / SIGNATURE OF APPLICANT PRINT NAME,Z - 1`t' -t /I�t �� DATE �'Ilmlffll