PRE 2010 DOCSCity of Fridley
SUBJECT
®14157
AT THE TOP OF THE TWIN
IT
i �
DVLDAGD[Rv
COMMUNITY DEVELOPMENT DIV.
r 1 PROTECTIVE INSPECTION SEC.
1 "1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF APPROVED BY
612-560-3450
910-F15
6/13/77
JOB ADDRESS 5686 West Bavarian Pass NE.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
1
Innsbruck Villages
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Darrel A. Farr Development Corp. 7286 - 72nd Lane North 560-8110
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICE 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
Construct a 24' x 35.5' Townhouse and a 20' x 23' Garage
(Sunnenheim Model)
9 CHANGEOFUSEFROM TO
STIPULATIONS
PERMITS REQUIRED FOR WIRING,
Wmmo
,SEpMTE
®d ift dig0mg call local utiIR
HEATING, PLUMBING AND SIGNS.
-MLERt1ohE- ELECTRIC -GAS Etc
REQUIRED BY LA
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Wood 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
1800+460
22,936 Total
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.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$30,375
$15.19
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.
$91.74
$375.00
PLAN CHECK FEE
TOTALFEE
$22.94
$504.87
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT - (DATE)
W E, P PERLY VALIDATED THIS IS YOUR PERPAIT
BLDG. INSP
®�
f6ATE
SIGNATURE OF OWNER (IF OWNER BUILDERI (DATE) •
J
10.:SIJ)I;N'J'ItiJ,, A1,11:1,1ATIO )
OR ADI)ITIO; Y,Uf LI)ING I11:1ZIMIT
CJTY OF ]:RfJ)LI-:Y, .JIN ;J;SOTA
UtTINE'R' S NA1-1E :A4A_ to 41 A210-k-Dem.�, BUILDER: .�a��
ADDIR'ESS :7A 8& W":4 Lase. Aowf4 ADDRESS: !� . �_��•�"� ��-� �
LOT: BLOCK: _� ADDITION:- k°°A 9 L11,d— s
COMER LOT: INSIDE LOT: Pelo, SETBACK: SIDEYARD:
Applicant attach to this form Wo Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To .Be used As:
/,�',�i;,A-o se_ Front: - Depth: 3C. �� Height:
t
Square Feet: Cubic Feet:
Front: Depth • Height:
Square Feet; 490 Cubic Feet: o
tt��� Ca,
Type of Construction: ()00 �-91M� Estimated Cost: $
To Be Completed:.
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all Pork 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.
DATE:
(See Reverse Side For
P612(A r r
PLA ab
90
SIGNATUM:
Additional Information_)
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Number Fixtures
x $3.00
$
Future Fixture Opening
x $2.00
m
Water
N
49
.ml
Catch Basin
m
$
E.
b
m
$
m
0, $4
W
W
Water Softener
$eater
$
o
New Ground Run Old Building
x $5.00
$
a
Electric Water Heater
x' $5.00
o
$
GAS FITTING FEES:
M
1st 3 fixtures
x 43.00
$
Additional Fixtures
x $1.00
$
Gas Range to 199,000 BTU
x $10.00
$
REPAIRS & ALTERATIONS
W
V W
°�
$
m
each add. $100.00 or fraction
$2.00
$
u1
ro .a
U
s+
D
ro
Pq
cy
PO
�+
N
ro
S
N o
q W
a
W
W
ro ro
U M
a m
RC 3
C7
ro
(9
O
lec
d
1st
2nd
3rd
4th
(R) - Future Connection Opening
Connected with Sewer
{*} - New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Number Fixtures
x $3.00
$
Future Fixture Opening
x $2.00
$
New Fixture, Old Opening
x $2.00
$
Catch Basin
x $5.00
$
Water Heater - to 99,000 BTU
x $5.00
$
100,000 BTU to 199,000 BTU
x $10.00
$
Water Softener
x $7.00
$
New Ground Run Old Building
x $5.00
$
Electric Water Heater
x' $5.00
$
GAS FITTING FEES:
1st 3 fixtures
x 43.00
$
Additional Fixtures
x $1.00
$
Gas Range to 199,000 BTU
x $10.00
$
REPAIRS & ALTERATIONS
First $100.00
$5.00
$
each add. $100.00 or fraction
$2.00
$
State Surcharge
$%,.J50�\
TOTAL FEE
$
7 / • S (J
REINSPECTION FEE
($10.00)
Job Address 5 (0 `�
Department of Buildings
City of Fridley
Tel. #571-3450
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 Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Fridley. Mn. ® , 19�2 -7
OWNER DC1—
KIND OF BUILDING�A
USED AS
TO BE COMPLETED ABOUT
ESTIMATED COST
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company �- Y 4I UY �tlbfUCt c����% �C-f� �I IV)
Signed By-'-ee
Tel. N �q.;2,15 e- fl_S
ROUGH INSP.
Date
FINAL INSP. %/-/ 7 - 77
Date
APPROVAL FOR PERMIT �RB�
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE
d, CI1Y OF FRIDLEY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND J z 3 d'�
AIR CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
ism 3 Fixtures
x $ 3.00
$
�.
Additional Fixtures
x $ 1.00
L, (a% 3
If 4
;RAI"ITY WARM A1R:
RATE
$
TOTAL
Job Address 110 c 1s
✓/
Furnace Shell & Duct Wort
$12.00
$
See Fee Schedule
$
Replacxx nt Of :i:rnace
7.00
7.00
$
$
Department of Buildings
Re_ airs & :.iterat:o.^.s-up to $500.00
State Surcharge
City o£ Fridley
.50
P.etairs & Alterations each add. $500.00
4.00
$
),S--S-v'
Tel. ;`•571-34501
IECHUNICAL WARN AIR:
The undersigned hereby makes application for a permit
for the yrozk herein
Furnace Shell & Duct Work to 100,000 BTU
$12.00
$
f v` `�`�
specified agreeing to do all work in strict accordance
with the City Codes
4.00
$
and rulings of the Department of buildings, and hereby
declares that all tee
each. add. 50,000 BTU
7.00
$
facts and representations stated in this application are
true and correct.
Retlace»ent of Furnace
7.00
$
F.e-airs & Alterations -up to $500.00
4.00
$
Fridley, Minn.
J , lg_
Re airs & Alterations each add. $500.00
;TF OR HOT WATER SYSTI31:
OWNEi.
-A:.'
`
Bailar & Lines up to 100,000 BTU
$12.00
$
KIND OF BUILDING
each:. z~.. 50,0000 BTU
4.00
$
//�
Boller only up to 100,000 BTU
7.00
$
USED AS �/9 �•
each addn. 50,000 BTU
6.00
$
.7
TO BE COMPLETED ABOUT
)IL BURNER- to 3 gal. per hour
$10.00
$
each add. 3 gal. per hour
10.00
$
ESTIMATED COST � ,.Sv 4.7
$10.00
$
l a. 00
OLD - BUILDING PERMIT ,:0. PER<IT
::0. �,1�Q�
AS BURNER- from 100,000 BTU to 199,999 BTU
(ever 199,999 BTU see Fee Schedule)
$
3AS FITTING FEES:
ism 3 Fixtures
x $ 3.00
$
�.
Additional Fixtures
x $ 1.00
$
Gas Range to 199,000
BTU x $10.00
$
'SIR CGNDZTIONI NG -1!
/-9,-, A_ 7--,J
$
I1N HEATING SYSTEMS
See Fee Schedule
$
i-NTZLATZNG SYSTEMS ,
$
1LTERATIONS $ REPAIRS_%
$
State Surcharge
$
.50
TOTAL FEE
$
),S--S-v'
Date
F=AL I.,S?. "
Date
'r
1PaZ.7t iv FOR PERMIT
REINSPECTION FEE
(.$10.00)
XLX'XQ4 FEE FOR ANY RZATING PERMIT IS $7.50
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, F.ot Water, Warm Air- No.
Trade Name /V 1,— a _,1 Size No. e,/-/- '
o v .�
Capacity Sq, Ft. ED9 BTL' :?
Total Connected Load -2 7 7 5Kind of Fuel d
BURNER - Trade Name
Size No.
Capacity Sq. Ft. EDR BTU HP
Company
^0-�5r`•0sl By o
_ re.
`Tei. No.
aB ��
HEAT LOSS CALCULATIONS H EATI & AIR
Weatherstrips
A.S.H.V.E.
Guide
Reference
�g
Construction No.
Insulation
Windows
Doors
Out. Wall
int. Wall
Ceiling
Roof
Floor
Kind
How Applied
Yes -No
Yes -No
FI. V- C'- Room I Length X IrWidth ® Height
FI
Room Length® Width ✓ Height
Windows and Doors—Crackage
and Area
Lineal ft. Area
of crack sq. ft. ,•
f
14 91
Windows and Doors—Crackage and Area
1(
No. Width Height No. of
_ of pane of pane lights
No. Width Height No. of Lineal ft. Area
of pav5ne of pane fights of crack sq. ft.
Coefj Btu
Coef Btu
Infiltration
Infiltration
Glass x'°60
Glass (.
Exp. wa I I
Exp. wa 11 (/
Net exp. wall d & 0 S
Net exp. wall
,�
Int. wall
Int, wall
Ceiling
Ceiling
Floor /
Floor
Total Btu.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Room Length jef Width
Height
Q FI &I. Room I Length/!rWidth /a Height
Windows and Doors—Crackage and Area
j o
Windows and Doors—Crackage and Area
Noghts Width Height No. of Lineal ft. Area
of paneof pane lights of crack sq. ft.
/ 3� 7- -Z. `s7 7- 31
No. Width Height No. of Lineal ft. Area
of pane of pane ❑of crack sq. ft,
N��"
- I
Coef Btu
Coefj Btu
Infiltration
Infiltration 7
Glass
Glass
Exp. wall
Exp. wall
Net exp. wall ev _
Net exp. wall
Int. wall
Int, wall
Ceiling
Ceiling_ /�� e�s� 41 0
Floor
,� �-
Floor
Total Btu.
Total Btu.7Cv
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI. Room Length Q ILWidth /4 Height &
Q FI. (� ),(, om I Length Z4r®` Width Height
Windows and Doors—Crackage and Area
Windows and Doors—Crackage and Area
No. Width Height No. of Lineal ft. Area
of pane of pane lights of crack sq. ft.
No
v: nth Hr qht No. of Lineal ft. Area
of pane of pan'. L t_s_ of crack sq. ft.
Coef B to
jCoefj
Btu
Infiltration d
Infiltration
Glass
Glass
Exp. wall
Exp. wall
Net exp. wall ,
Net exp. wall
Int. wail
Int. wall
Ceiling
Ceiling
Floor
®
Floor — -
Total Btu.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Weatherstrips
A. S. H. V. E.
Guide
Reference
19
Construction No.
Insulation !-
HEAT LOSS CALCULATIONS
HEATQ G & AOR
CONDIRTOM92 n nn
MINNEAPOLIS, MINN.
Weatherstrips
A. S. H. V. E.
Guide
Reference
19
Construction No.
Insulation !-
Windows
Doors
Out. Wall
Int. Wall
Ceiling
Roof
Floor
Kind How Applied
Yes—No
Yes—No
FI g Room Length Width
Windows
Windows and boors—Crackage and Area
// Height
FI./_ RoomWidth
Windo s and Length
and Area
��j' Height
No. Width Heignm
of pane of pa
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack sq. ft.
Btu
Coef Btu
Infiltration
Glass
��
Infiltration
Glass 1610sill/3
2,27
0�
Exp, wa I I ` ,
Exp. wa I I
Net exp. wall
6
Net exp. wall
f
Int. wall
Int. wall
Ceiling 1�
°�
Ceiling
Floor
Floor
Total Btu.
Total Btu.
Required sq. ft. E.D.R. or sq, ins. W.A. Leader area
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
IYL
FI. Room Length Width
Height
FI. Room Length Width
Height
V'dind s and Doors—Crackage and Area
Windows and Doors—Crackage and Area
No. Width Height No. of Lineal ft. sq.
of pane of pane ghts ofme
crack q. ft.
Widrh Height No. of Lineal ft. Area
No.of pane of pane lights of crack sq. ft.
Coef BtuCoef
Btu
Infiltration
_ �
Infiltration
Glass
to
Glass
Exp. wall
Exp. wall
Net exp. wall
evo
Net exp. wall
Int. wall
Int. wall
Ceiling I
Ceiling
Floor
Floor
Total Btu. Z.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Fl. Room
Length Width Height
Fl. Room Length Width Height
Windows and Doors—Crackage
and Area
Windows and Doors—Crackage and Area
No. Width Height
of pane of pane
No. of Lineal ft. Area
lights of crack sq, ft.
Wath He Qi No. of
No. of pane of pane lights
Lineal ft. Area
of crack sq. ft.
Coef Btu
Coef Btu
Infiltration
Infiltration
Glass
Glass
Exp. wall
Exp, wall
Net exp. wall
Net exp. wall
Int. wall
int. wall
Ceiling
--
Ceiling
-- Floor
Floor
Total Btu.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
City of Fridley
SUBJECT
IT NO.
14 N .
AT THE TOP OF THE TWINS
r
BUILDING
D 'v C
U I L D I N G PER M I
N
'_RYGIE_WT
' • COMMUNITY DEVELOPMENT DIV
r E PROTECTIVE INSPECTION SEC.
E �
1
�'--1 CITY HALL FRIDLEY 55432
,.j
NUMBER
REV
DATE
PAGE OF
APPROVED By
612-571-3450
910-F15
3/28/97
JOB ADDRESS See Below - Multiple Buildings
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Columbus Exteriors Inc 2131 111 In, Coon Rapids MN 55433 868-9195 3509
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Townhouse Buildings
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION 1 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside 11 Buildings
9 CHANGE OF USE FROM TO
STIPULATIONS
Install.building wrap and have inspection of same unless manufacturer's
specifications state it is not required.
5600,5602,5604,5606 North Innsbruck Ct; 1511,1513,1515,1517 North Innsbruck Dr;
1510,1512,1514,1516 Trapp Ct; 1531,1533,1535,1537 Trapp Ct; 1511,1513,1515,1517
Trapp Ct; 5610,5612,5614,5616 W Bavarian Pass; 5621,5623,5625,5627 W Bavarian Pass;
5631,5633 5635 5637 W Bavarian Pass; 5651,5653,5655,5657 W Bavarian Pass; 5680,
5682,5684: b86,Zst Bavarian Pass; 5691,5693,5695,5697 West Bavarian Pass
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
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
$232,000
$116.00
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
$1,547.25
Fire SC $232.00
PLAN CHECK FEE
TOTAL FEE
Lj,9,,ej4 SC 5.00
$1,900.25
S1GNA EOF CON'.RACTOR OR AU HORIZED AGENT iDATEi
�PERLY V (DATED THIS IS YOUR PERMIT
S,GNATURE OF OwNEP„F OWNERBWLDER� (DATE
17
LDG � SP gAtE
SUBJECT
P -
City ®f Fridley
6 2 5 7
AT THE TOP OF THE TWINS
BUILDING
PERMIT
i
RECEIPT NO
COMMUNITY DEVELOPMENT DIV.
r 1 ~ PROTECTIVE INSPECTION SEC.
1
NUMBER
REY
OATS
PAGE OF
APPROVED BY
i CITY HALL FRIOLEY 85432
o ��
J 612-571-3450
910-F15
6/16/98
JOB ADDRESS 5686 West Bavarian Pass NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
1
Innsbruck Villages
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Raymond Rrech 5686 West Bavarian Pass NE
574-0613
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
Skilcraft Industries Inc 1601 N Innsbruck Dr #126, Fridley, MN 55432 8107
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
572-0913
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
8 USE OF BUILDING
Rebuild 24' x 8' Deck
7 CLASS OF WORK
NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR
❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Construct a 24' x 8' Deck
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan
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 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
$1 722
$.86
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.
e
PLAN CHECK FEE
TOTAL FEE
G p
License SC $5.00
$64.33
SI TURF WCONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPERL VALID TED THIS IS YOUR PERMIT
BLOd INSP
MATE
SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY 0 0-�61
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 3cj�
BUILDING PERMIT APPLICATION
ConstructionAddress: j� �� Gia 9,,401,,1/1 i,rfA-)
Legal Description:
Owner Name & Address: (&)ZZyca4 k;ecc-// Tel. # j779/ -0C/ -T
Contractor:<®z Cd -'4 F -r- ���-���®,Je. MN LICENSE # eia 7
Address: 1601 /0- !%w. a �2! o z Ez Tel. # -1-.7z -o
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: Le 2 y' Width Hgt/Ground _ Sq. Ft. / 9 z
OTHER: % 064k.fl "
Construction Type: Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: 6 c Age APPLICANT: Pa u,4c 9 Tel. # jr- 7z -® S /.?
TOTAL $ �%
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$ 2
.001 of Permit Valuation (1/10th%)
State Surcharge
$_
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ C
$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: