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PRE 2010 DOCSiI I; BUILDING PERMIT Village of Fridley, Minn N0 2181 It A Date ...... ........... Owner`. • Builder .. ..... . ................... Address dress ..... .. .. ......... .......... LOCATION OF BUILDING ` No. 1• . Street ?'...... Part of Lot .............. ...... . Lot ................. Corner Lot Block ............ .... Addition or Sub -Division r :':.. .. .. . . e ' ISideyard ...... Inside Lot ..... ack .. .. ..... .... DESCRIPTION OF BUILDING To be Used as: ... FrontDepth Height ii Sq. Ft......... Cu. Ft.. .... . Front Depth .. Height .. Sq.7t. Cu. Ft., ... Type of Constructio �a..- . Est. Cost .. 1 . ..... To be Completedf.,0A*-JP1Q . i In Consideration j of the issuance to me of a permit to construct the building ,described above, I agree to do the proposed work k ordinances of the vage i accordance with the description above set forth and In compliance with all provisions of of Fridley. nsideration the -:express conditionthat of the payment of a fee of $ t... , pie . 't is hereby graator. ,tn o construct the building ad. ad. n: as described above. This permit is granted 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 Pridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving, of buildings with - In the village limits end this permit may be revoked at any time upon violation y of the provisions of said ordinances. �� , • �, g 'inspector NOTICE: This permit Does not cover the construction installation or ti al er t a on fpr wiring, plum, bing,;gas heating., _ sewer or water. a sure to see the Buiilding Inspector for separate permits far these items. M , SUBJECT PE City of Fridley O 16564 AT THE TOP OF THE TWINS BUILDING PERMIT REC � L ------ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. �/ V -3r CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/7/82 JOB ADDRESS 5820 West Moore Lake Drive 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 4 IDonnay's Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Vernon Tuveson 5820 West Moore Lake Dr. Fridley 55432 571-6423 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO, 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USEOF BUILDING Residential 7 CLASS OF WORK ❑ NEW I$ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be second but not third. U TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Asphalt 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 R-1 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 $500`00 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $15. 00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $15.50 SIGNATURE OF.CONiRACTOR OR AUTHORIZED AGENT WHEN PPEF��V ALED THIS IS YOUR PERMIT 'elf e�"DATE1, S NA URE OF NEROF WNER BUILDER) BLDG )NSP DATE CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDENTIAL BUILDING PERMITS (New. Alterations, Additions, or Repairs) OWNER: oxl�7 5oAl BUILDER: 5' ADDRESS:.LKZ6 624' Ullrle� RA a ADDRESS: 1( TEL N0: .5''Z/ - / e so TEL 140: Construction Location • STRIZT NO: STREET: LOT: �� BLOCK: ADDITION: -/a./Aelk Corner Lot: Inside Lot: ` Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. Front: DESCRIPTION OF CONSTRUCTION Depth: Square.Feet: Cubic Feet: Height: Front: Depth: Height: Square -Feet.- Cubic Feet: of Construction: Type � .� Estimated Cost: $ Rb Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ ' $ SEE REVERSE SIDE OF SHEET . 'Zie undersigned hereby masses application for a permit for the %-nrk- herein specified, agreeing to do ,all wort: 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. .A D.7TE: /I ��� SIGNATURE: Stipulations: SUBJECT PERMIT NO. City ®f Fraley :�. AT THE TOP OF THE TWINS BU IL®INC PER 21248 i RECEIPT' COMMUNITY DEVELOPMENT DIV. fr PROTECTIVE INSPECTION SEC. r NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 3/31/92 / / JOB ADDRESS 5820. West Moore. Lake Drive NE 1 LEGALLOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED 5 4 Donnax t S Lakeview. Manor SHEET I DESCR. 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Tom/Mary Hlavinka 5820 .West Moore Lake Dr NE 571---7844 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Panel.Craft of Minnesota.Inc, 3118 Snelling Ave S''Mpls, MN 55406 721-6628 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 �J REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Residei.soffit & fa,s:ciai trio 9 CHANGEOFUSEFROM TO STIPULATIONS 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 $3 JQQ $1,75 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT G 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- $6.3000 Eire SC $3.550 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC $5.00 $73,25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) EIN P OP V LI T THIS IS YOU/V PEER `T 7� 91 nG 'NSP ATE SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI NEW [ ] ADIV [ ] ALTER [ ] CDnstniction Address: I VZTOr rte« r-= Effective 1/1/91 ® R-1 I Building t Application Attach to this application, a Certificate of Survey of the lot, with the proposed oanstn=tion drawn on it to scale. lavn1G AREA: length Width Height Sq. Ft. GMAM AREA: length Width Height Sq. Ft. DBCK AREA: length Width 07MM: Hat/Ground Sq. Ft. Permit Fee $ Fire Surcharge $ State Surcharge $ . SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ it. Umf e TOM $ STIPLUATIMS: 074� Cis „ CITY USE 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 [ J oil SUBJECT IT NO. City of Fridley 22782 AT THE TOP OF THE TWINS BUILDING PER I T t � COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIOLEV 55432 612-571-3450 910-F15 8/9/94 JOB ADDRESSMU 5820 West Moore Lake Drive NE t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 4 SHEET Donna s 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Thomas/Mary Hlavinko 5820 West Moore Lake Dr971-7844 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Custom Remodelers Inc 8729 Centra 784-2646 174 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 Cj ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct an 8' x 191 Addition 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. WARNUNG Before digging call for all utility locations 454-0002 R QDIRED BY LAW 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 I 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $17,252 PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIOOOF ANr OTHER STATE OR LOCAL LAW REGULATING CON- T UCTION R TH PERFORMANCE OF CONSTRUCTION. $ 189.00 Fire SC $17.25 TOTALFEE PLAN CHECK FEE o. `AE License SC $5.00 $219.88 =_N-9AePe"VAyyATED THIS IS YOUR PERMIT IG OF CONTRACTOR OR AUTHORIZED AGENT (DATEI BLDG INSP DATE SIGNATURE OF OWNER t IF OWNER BUILDER) )DATE) oil fir A'(4r1r' ADDN 07 TO GF F&IOULEY AL'ri-m i i SINGLE FAMILY AND DUPLEXES KA AND R-2 Int dding Permit Application r4t8; nimt-11cflunk jvss: '/!OE Dnri Owner Name & Addre-ss- A4N Lieri-KSru #> —el Attach to this application, a Certifkale'of Survey of the lot, with the prqmed construction di -awn on it to "e. 'DESCRIPTION OFIMPkOVEMiMT LIVING AREA: Length GARAGF. AR14.A,. ung", Width Hejgbt r. :4. Ft DRCK AREA; Length._ Width HgLIGround SQ. Ft. OTHER: Qxner W1 Inside Lot Ft. Yd Sdback Side Yard, Sefteks Tnx of Construction: Approx. Coml►jcti()n Date -- -2 (Co. -L- cri. Back; I i 6 1) IF RS DriveWay CUrbCut Width Needed: + x DAM �APPLICANT: Tel. 01 SE ONLY i Permit Fee Mrc',-,'urchar&c State Surcharge SAC Charge Liccnse. Surcharge $ 6-'o e) Driveway Kscrow Erosion Control Mark Fee .Soarer Main Cliargo TOTAL 911PULA-rIONS: Foe Sche(hile on Reverse Side .001 of Puralit N"Ahlaclon (11101;470) $.501$1,OW Valuation $800 per SAC Unit $5.00 (Stats~ I'lCefiscd Rcsiduil;al Ounitacious) Alt. *A" or Alt- "u" Above $450-00 Couservalion Plan Review Fee Determined by Foginezring Agi"imiat Neu I<* SLP IJ '94 15:3G FPQI,I CC 220 CP lya ata s6 fe IAA Smom sqw R.AM W -k-4- 1--t4- 5 led -- all ri-iuL . uu i itv** L L n- - API L n- - IT f W WSWI OT -OT 10600 'ON XVA 0093 zo:tl 20 40 CL L9 Ew IT f W WSWI OT -OT 10600 'ON XVA 0093 zo:tl CITY OF FRIDLEY INSPECTION DIV, Effective On January 1;1993 6431 Univershy'Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 672-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE JOB ADDRESS 94W,57eZ,0 W77gl moo•re 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 Fumace 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. 4®p 1199 Gas Piping (Needed with new furnace) $10.00 $ OWNERG r°i�'®- A A Gas Range $10.00 $ -BUILDING USED AS Gas Dryer $10,00 $ • _ ESTIMATED.COST �����n-� PERMIT NO, s �l *Air Conditioning — AH Sizes $10,00 $ All OthemlRepairs & Alterations (LIST ON BACK) DESCRIPTIONNQF FUR gg AN12 08_SUR bjER 1% of Value of Appliance or Work $4 No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. Cornmerclallindustrial BTU HP EDR 1% of Value of Appliance or Work $ Fuel Total Connected Load $tate Surcharge $ .60 Burner Trade Name Size No. BTU HP EDR TOTAL FEE $ 1 �57 C HEATING COMPANY__ &fzer'sr);'_v &e�5 MINIMUM FEE FOR ANY HEATING/C00L11SIGNENTILA1ION . REFRIGERATION/AIR CONDITIONING PERMIT IS X16,09 Signed By Tel No.7°7--7 j- Z_ PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 Approved B Rough—In Date Final Dated g *Air Conditioners. can not be placed in a side yard without written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION'ON REPLACEMENT FURNACE CHIIMY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: .1. Has been carefully examined Yes ( j No ( ). Z. Is free from rust or deterioration Yes ( ) No ( ) 3.•.Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes (.j 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 Remarks List Alterations Being Done• -Ck ------------- HEATING COMPANY Signed By Date y� �� P NO. SUBJECT City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT P /�'iJ/ � Ir? �• _____ COMMUNITY DEVELOPMENT DIV � V 1 � PROTECTIVE INSPECTION SEC. r 1 � � NUMBER REV DATE PAGE OF APPROVED BY ����1 CITY HALL FRIDLEY 55432 A" ,'j 612-571-3450 910-F15 9/6/96 / / JOB ADDRESS 5820 West Moore Lake Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 4 Donnay's SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tom Hlavinka 5820 West Moore Lake Drive NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Paul T Rains Construction 256 Egret Blvd NW, Coon Rapids MN 55448 767-0508 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 O NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reside Garage 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 THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,200 $.60 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 PROV SOF ANY R STATE OR LOCAL LAW REGULATING CON- ANC $40.25 Fire SC $1.20 S CTIO OR P RF OF CONSTRUCTION ,-,APLAN CHECK FEE TOTAL FEE A.4 %16h� - License SC "City" $42.05 IGNA URE FCON RACTOR OR AUTHORIZED AGENT ( ATE( WHEN PROPERLY ALID TED THIS IS YOUR P/ERgMIIIT 6BLD JNSP DATE S,GNATURE OF OWNERIIF OWNER BUILDERI IDATEI P NO. NEW [ ] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application I ConstructionAddress: $ alQ cc, Legal Description: Owner Nan Contractor: Address: 1 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # TENSE # Tel. # 7& 7'-6 -5 0 9" LIVING AREA: Length GARAGE AREA: Length Width Width Height Height Sq. Ft. Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ J Inside Lot [ J Ft. Y etback Side Yard Setbacks Type of Construction: iWO Estimated Cost: $ Approx. Completion Date: -7!f�. (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE:lq� APPLICANT: Tel. /�(� r2 S Tel. # CITY USE ONLY Permit Fee $ 1 _ Fee Schedule on Reversre Side Fire Surcharge $ e , ;Zr .001 of Permit Valuation (1/10th%) State Surcharge $ (; r; $.50/$1,000 Valuation SAC Charge $ $900 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 Z, $ STIPULATIONS: C SUBJECT P City of Fridley 28184-111, 57th .RHE TWINS BUILDING PERMIT r `y -------COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. �. I � � NUMBED REV OATS PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 91'0-Ft5 10/9/98 JOB ADDRESS 5820 West Moore Lake it Drive 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 4 Donna s SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE Tom Hlavinka 571-7844 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO L & M Roofing 593 Berwood Ave Vadnais Hgts 55127 484-9197 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 a REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage 19 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST, OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ' NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT 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 1628 .81 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- STRUCTJOhL O THE PERFORMANCE OF CONSTRUCTION $54.00 Firw sC $1.63 � PLAN CHECK FEE TOT FEE �� 1.44 SjdWATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI EN P O IMA IS YOUR PER AIT $-GNATURE OF OW NER �Ii OW NER BUILDERt IDATEI Ip SP i ATE NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: lot Legal Description: Owner Name & Address: f�� Tel. # Contractor: lLI—AVALP MN LICENSE # w"' .3 9'/ Address: G29 3 � r�,.��c>�� ��� �f� Se �� Tel. # , ' ad Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IMPROVEMENT Length Width Length Width Length / Width Height Sq. Ft. Height Sq. Ft. �Igt/Ground -Sq. Ft. v Construction Type: %� e d>tlemwEstimated Cost: $� �� U (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: ( APPLICANT:" - yr,"t-10Tel. # � -2 I TOTAL STIPULATIONS: CITY USE ONLY Permit Fee $ C) 0 Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $j / $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ i - o & $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 [ J TOTAL STIPULATIONS: