PRE 2010 DOCSAPPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, M.1MMOTA
OWNER'S NAME �`- >`I 1 k j 1 BUILbER
ADDRESS ADDRESS
.�.s .rte..... ..
LOCATION OF BUILDING
NO. j'� �� STREET PART OF LOT
LOT 09 BLOCK 0, ADDITION OR SUBDIVISION 4 k
CORNER LOT INSIDE LOT '� SETBACK .�a� , SIDE -YARD A
SEWER ELEVATION ===ON ELEVATION' -7
App 77
scant attach to tvi f Two Certificates of ulzey of Lot.And proposed
building locationrawn on these Certificates.
DESCRIPTION ,OF BUILDING
To Be Used Ad:
Front 96 ` Depth Height o'z
Sq. Ft. / 5�U Cu. Ft.
FrontDepth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost. ;
To Be Completed
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City of Fridley Ordinances
and rulings of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
DATE & og o 6
(Schedule of Fee Costs can be found on the Reverse Side).
City ®f Fridley, Minn. N9 9 3 05
BUH DING PERMIT
Date: June 9, 1967
Owner: Chaikin Builder Rodney Billman
Address Address 3000 36th Avenue N. E.
LOCATION OF BUILDING
No. 1539 Street _Windemere Dr, ____, part of Lot
Lot __ 19___T_ Block 2 .—... Addition or Sub -Division .--Innsbruck 5th Addn.
Corner Lot _ Inside Lot — X Setback 35' Sideyard _ -10'-25'
Sewer Elevation — _ r 985.57 988.57
Top of Footing
DESCRIPTION OF BUILDING
To be Used as:
House Front 50' Depth 31Height 20' Sq. Ft. 1550 Cu. Ft
Garage Front 22' Depth _.._.22 ' Height . _ Sq. Ft. 484 Cu. Ft.
Type of Construction Fri Fst. Cost _. $28, 000 __ To be Completed
SEWER LOCATION - 6' West of Manhole
WATER LOCATION - 10' East of Sewer at property Line
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 se rth and in mpliance with all provisions of
ordinances of the city of Fridley.
$100.00 SSSD
In consideration of the payment of a fee of $ 47.00 , permit is hereby granted to Rodney Billmar .- 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 buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
CLARENCE BELISLE Building Inspector
NOTICE:
Ibis permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sun to no
the Buihiing Inspector for separate permits for these Items.
Application for Power Plants and Heating. Cooling, Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE Dept. of Bldga. Phone 560-3450
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work ..........................$10.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 .................. 6.00 $
Repairs & Alterations each add. $500.00 ............... 3.00 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $
each add. 60,000 BTU ....................... 3.00 $
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations—up to $500.00 6.00 $
Repairs & Alterations each add. $500.00 .............. 3.00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $
Each add. 200 sq. ft. EDR Steam ...................... 3.00 $
Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $
OIL BURNER—to 3 gal. per hour ........................ 6.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 199,000 BTU) ....................... 5.00 $
over 199,000 BTU See Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures x$ 2.00 $ a'60
Additional Fixtures ................. x .75 $
Gas Range to 199,000 1 .......... x$ 5.00 $
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL
See Fee Schedule
TOTAL FEE 9t
Location 1539 Windemere
City of Fridley:
The undersigned hereby makes application for a permit for the work hereix
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, OMinn 19
°_
Owner �� +� P &L'-.1 00od
Kind of Building
Used as
To be completed about
Estimated Cost, $ Y60
1c
Old New. Building Permit No. Permit No. � -I!;- 7
DESCRIPTION OF WORK
BEATING or POWER PLANTS -Steam, Hot Wate ,Warm Air o
Trade Name— Size No
I ABP
Capacity Sq. Ft. E.D.R.12W ®SCD H.P.
Total Connected Loader %-P ! Kind of Fuel a'
BURNER — Trade Name ZAANW Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
Signe
By
c4ftb42 Bas ines ane Nn-
Cityy of Fridley, : 1 204"t
_
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUHDING PERMIT
mate: -_ Februajy 26,. 973
Owner: Robert E. Spangler Builder Same
.Address 1539 Windemere Drive N.E. Address Same
No 1539 Street
Loot 19 Block
LOCATION OF BUILDING
Windemere Drive N.E. Part of Lot
2 Addition or Sub.Division Innsbruck X4 5th
Corner Lot — Inside Lot x Setback — Sideyard
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
- Q b H a sam oT, t• Front Depth Height . — Sq. Ft. Cu. Ft.
Front Depth Height, Sq. Ft. _-.._.___._:._.. Cu. Ft.
Type of Construction Paneling Esti Cost 500. To be Completed May 1
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
wdinances of the city of Fridley. -A _ _ /
In consideration of the payment of a fee of $_2.00 Robert E. Spangler
p , 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
Irridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
Vithin the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
&'�
Building inspector
Darrel Clark
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
4'
APPLICATION FOR RESIDENTIAL, ALTERATIONS
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEYj MINKSOTA
flo�_L�}--O Is �: _BiJILDBR:e� &=.' '
,.�.� �I/
" DRESS : �`� � � ADDRES :.
r „m
/-5 9
ZZ
I / ,5� BLOCK 3 TION i�;� 5
C4MXER LOT: I IM LOT;, �SETBACK; SIDEYARD:,���
Afflicwmt attach to this form Certificates of SuxveY of Lot and proposed
.1d location d on these Certificates.
DESCRIPTION OF BUILDING
To Be Ua A*: i `2
1*40" Depth: Height:
Square Feet; Cubic Feet;
Front.' Depth; Height:
Square Feet; Cubic Feet:
7'
Ty{e of Constructions ��7 Estimated Cost:_1 ALZ�
To Be toted; �
The uadavoiSned hereby fies applicaCiva for, a permit for the work herein
spealfie44 agreeing to do all work In sttl.ct accordance with the City of
41AY 0r4Uances an4zutiap p£ Oe Department, of BuWi W, and hereby
d lace* all the facts avA representations stated in this application
axe true and correct,
PAU; - �. 6TGNA: �. e
(04m Reverae We For Additional Information.,)
o'�). "� -5,
ti�
SUBJECT
-PERMIT NO. '_
City ®f Fridley
22725
AT THE TOP OF THE TWINS
BUILDING PERMIT
�
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
✓� f/
r PROTECTIVE INSPECTION SEC.
�;? lGl�1/C®6a
NUMBER
REV.
GATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
7/18/94
JOB ADDRESS 1539 Windemere Circle NE
I LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
19
2
SHEET
Innsbruck 5 Addition
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Norm DUFresne 1539 Windemere Circle NE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Marquis Inc 1556 McClung Dr, Arden Hillq MN 631-2315 84*39
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 O MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 141 x 14' Addition to Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan. Inform homeowners that smoke detectors are
required adjacent to all sleeping areas and in basement.
�e�ore dlggln$ call for
l0raX10"S
all utility
454-®0tv
LAVA
F{EQUIRE
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
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
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
$20,000
$10.00
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-
$207.00
Fire SC $20.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
L cense SC $5.00
$242.00
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI
WH P RLY LIDA D THIS IS YOUR PERMIT
l_
SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI
BLDG INSP BATE
ti�
NEW [ )C Effective 1/ 1 /94
AriDN () rt OF PRIIDI.E'Y
ALTER [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application J�
Construction Address: I ��
Legal Description: L®T 19 Vts K 6M A--Mri,n+
Owner Naive & Address: NSM, i5;4ma: Acpajo5, Tel. # F2 71 Zz85''
Contractor: n ip. L C.,- MN LICENSE # 0 00
Address: 15;510 W-6w�q ��IJ�- egg WLLLs Tel. # to3t - 23rd
z--
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LBnNG AREA: Length ( — O Width - D Heights Sq. Ft. l Q !p
GARAGE AREA: Length Width Height Sq. Ft.-
DECK
t.DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [ ) Inside Lot N . Ft. Yd Setback _ . Side Yard Setbacks
Type of Construction: \,&Az p y,:�— Estimated Cost: $ a o t 000
Approx. Completion Date:
(Co t on )
Driveway. Curb CutWidtheeded: Ft.Ft = x $ _ $
DATE: PLICANT: Tel. #692_21
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTtl"
STIPULATIONS:
$ . ®® Fee Schedule on Revere Side
$ .001 of Permit Valuation (1/ 10th%)
$_� `' , $.50/$1,0oo Valuation
$ $800 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "E" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Neces► [) Not Necessary [ )
is
3 o a 11 voGG
y
SUBJECT .-'PERMIT
City of Fridley
23393-"
AT THE TOP OF THE TWINS
BUILDING PERMIT
t
_
RECE?P I N��
COMMUNITY DEVELOPMENT DIV.
L PROTECTIVE INSPECTION SEC.
r
S
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
AP ROVED BY
612-571-3450
910415
5/25/95
I
JOB ADDRESS 1539 Windemere Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
19
2
Innsbruck 5 Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Norm Dufresne 1539 Windemere Drive NE 571-2285
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Marquis Inc 1556 McClung Dr Arden Hills MN 55112 631-2315 8439
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
R
8 DESCRIBE WORK
Construct a 430 square foot deck
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
Before digging call for,
all utility locations
45+4-0002
REQUIRED BY LAVA
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
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 EREIN OR NOT. THE GRANTING OF A PERMIT
$3,504
$1.75
DOESjIOT PRESUME TO GIV AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVO S F ANY O HER S ATE OR LOCAL LAW REGULATING CON-
Fire SC $3.50
STRU THE PE O A CE OF CON TRU TION
$63.00
�tiJ'L
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$73.25
A dlp
AUTHORIZE DAGENT IDATEI
WHEN PROP LY VALIDATED THIS IS YOUR PERMIT
PiNAiTU�REOFCONT
JfLOG INSP DITE
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
I
NEW [ ] Effecti4/95
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: t'5 -37-
V
Legal Description:
Owner Name & Address: K)Ore _6 J�y t -f2� O E Tel. # X71 - ZZO S -
Contractor: (/-j��t5 , I PC— MN LICENSE #
Address: �C�e,L ti9 "��- Tel. # (� 3 [ 23 l S^
_ Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
L
G _ AREA:
DECK ARE
OTHER:
DESCRIPTION OF IMPROVEMENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
Corner Lot [ ] Inside Lot [ ]
Type of Construction:
Approx. Completion Date: _
Ft. Yd Setback Side Yard Setbacks
Estimated Cost: $
(Cost on Back)
Driveway Curb Cut Width Needed: FtV-L Ftk=jF x $ _
DATE: o ('� - ! APPLICANT:
pr�-F- - (j
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ ?�,6 Fee Schedule on Reverse Side
—�
Sq. Ft.
Sq. Ft.
X30
$ 3 5®
Tel. #
$ _ .001 of Permit Valuation (1/10th%)
$ ( $.50/$1,000 Valuation
$ $850 per SAC Unit
$'. $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$
p^+t
'
71
s ! a YAkliW50/rr
`
s mly.ENGINEERING, IN
E En Ifl ears Sur veyorS
cer ti'AiCa,f@ ti 9 'V e der oxine 81l �D ':
o /
i
LUT - 15
Lolr 91 BLOAoornoW
ANoKA Col wore
01Lsz-P•1:7
llwv6y a-ftCy #W lh/.s n a h-ue avrcl brred reprrsenfufmn o/'a swveq er'fflx lramdorres �l'Ae 464W 4rld,071d
o�'1ht ! ayr'a� duitds , h'rtnr ,and o!! rr>rble e�xrvodin�tn�s , rI any,n yr arr card lar/rd. As survet'� nme llu► . dy
�ti�gY A.0 11.0
x' SEJOVRB ENOIIV�tgl)VG, aINC.
r
F
9395
SUBJECT
ERMIT NO.
City of Fridley
27313
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
e �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
� CITY HALL FRIDLEY 55432
612-571-3450
910-F15
18/20/98
JOB ADDRESS
1539 Windemere Drive
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
19
2
1 Innsbruck 5th Addn
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Norm
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
American Roofing & Constr. Inc. 23624 St Francis Blvd
t Fr n is 55070 753-7451
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 JEc REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 26 S 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 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK ISMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY TH 1 HAV READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
AND KNOW THE SAM OBE TRUE AND CORRE . ALL PROVISIONS AuWS
VALUATION
SURTAX
AND ORDINANCES OVERNING THIS TYPE O WORK WILL B b4PLIED
WITH WHETHER S ECIFIED;HEREIN OR NOT. H ANTIN OF A'PERMIT
$216$
1.08
DOES NOT PRE ME TO ;GIVE AUTHORITY VIOLAT R CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY O 'ITER STATE OR CAL LA REGULATING CON-
STRU NOR HE PFORMANCE OF CONSTRU
$74.75
Fire S�'. $2.16
PLAN CHECK FEE
TOTAL FEE
$82.99
SIGNA RE OFCONTRAC7pR0RAUT O DAGENT (DATE)
WHEN PROPERLY
BLDG INSP
VALIDATED THIS IS YOUR PERMIT
GATE
SIGNATURE OF OWNER OF OWNER SUILDERI (DATE)
9395
NEW
ADDN [ ]
ALTER [ ]
ConstructionAddress:
Legal Description:
Owner Name & Address:
Contractor:
Address: %.� �� 7
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R -Z
BUILDING PERMIT APPLICATION
7 AA&4C(me� C �C4
Effective 1/1/98
Tel. #
MN LICENSE # 2�e) % 0
Tel. # _f2 f2=:2/
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:
Fee Schedule on Reverse Side
Fire Surcharge
$
h, Construction Type: Estimated Cost: $
.001 of Permit Valuation (1/10th%)
a ule on Back)
Driveway Curb Cut Width Needed:
;(Fe
Ft. + 6 Ft = x
$.50/$1,000 Valuation
SAC Charge
DATE• - qj APPLICANT:
Tel. # — 7 c-Cf7
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
r !
f `! %�s
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$
C1c°�
$.50/$1,000 Valuation
SAC Charge
$
$1000 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:
Building
Permit Fee
BUILDING
Plan. Review
Permit No.:,,�667 -_W3 qq
Inspections
RESIDENTIAL APPLICATION
Surcharge
Received By:
763-572-3604
$ $5.00 (State Licensed Residential Contractors)
CITY OF FRIDLEY
$ $1675 per SAC Unit (Plans to MWCC for determination)
Da aJ- U L 7
DATE 7_
YOUR E-MAIL ADDRESS
$ $450 Conservation Plan Review
SITE ADDRESS
$ Fee Determined by Engineering
Sewer Main Charge
THIS APPLICANT IS: E123.0
❑CONTRACTOR
$ Make checks payable to: City of Fridley Attach Stipulations
PROPERTY OWNER/
NAME:
o
conformance with the ordinance and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
TENANT
ADDRESS: ��`
�� (��ti �� ;� ra k t C
STATZIP,L� /
'u PRINT NAME ® iV' DATE 1
PHONE:
CONTRACTOR
NAME:
STATE LICENSE # EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS:
CITY
-STATE ZIP
WITH APPLICATION
PHONE
FAX
PROPERTY TYPE
WISINUIE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION❑
❑ WINDOWS
NOW
❑ BASEMENT FINISH ROOF ❑ DRAIN TILE
❑ DECK
❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW✓
❑ ADDITION
CE/REPAIR ❑ REMODELING
a
DESCRIBE WORK BEING DONE:�L,
SIZE OF IMPROVEMENT
LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFINGJO❑
NUMBER OF SQUARES JO
HOUSE ONLY
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1.
Existing Floor Plan
PROPOSED SIZE:
❑ DETACHED GARAGE
2.
3.
Proposed floor plan
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
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 QF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ _ � OCCUPANCY TYPE
Permit Fee
$ See Back Page for Fee Schedule
Plan. Review
$ 65% of Building Permit Fee
Fire Surcharge
$ 309 .001 times the total job valuation
Surcharge
$ /_W .0005 x Permit Valuation Minimum $.50
License Surcharge
$ $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
$ 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 ordinance 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 f r a permit an�°%Work is not to start with�t ape it; that the work will be in accordance with the approved
'
plan in the case of all w ik w
h requires rev' "w and approval of plans; A
SIGNATURE OF APPLICX
'u PRINT NAME ® iV' DATE 1