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PRE 2010 DOCSN°4'74 Builder C34,4A -----�— ® ION. BUILDING No._Street 7_ d:_..:� _ P of Lot Lot _ Block ®.. Addition or Sub. Division Corner Lot _ _+ Inside Lot ___ ._ Setback -- Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING T Used Front Depth Height Sq. Ft.='. Cu. Ft. Fro _ Depth e t _ Sq. Ft. Cu. Ft. Type of (;onstructjon Eat.^ Cost _""� ' To be Completed 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 ordinances of the city of Fridley. In consideration of the payment of a fee of $-71!f- -., 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, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon viola ' f any of the provisions of said ; , ordinances. A A 11 Building Inspector NOTICE: This -permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspedor for separate permits for these Rams. 4 APPLICATION FOR BUIIDING PERMIT CITY OF FRIDLEY, MINNESOTA � .: : �� • �. . � � rte._' • .S W ..� _ � • �,. • Address 4524 - 2nd St. N. E. Address 2940 Nicollet Avenue South Minneapolis 8, Minnesota Minneapolii 21, Minn. LOCATION OF BUILDING No. 4524 Street 2nd. Street N. E. Part of Lot -arrangemen o Lot Outlot #1 Block s 13, 14, &15- Addition or Subdivision Re -arrangement of Plymouth Corner Lot Inside Lot x Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: Porch Enclosure Front 12 Depth 14 Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Redwood Estimated Cost To be Completed 11 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 8/9/61 SIGNATURE HARRIS CONSTRUCTION COMPANY BY (A Schedule of Fee Costs can be found on the Reverse Side. SUBJECT 'PERMIT City of Fridley 14692 AT THE TOP OF THE TWINS BUILDING PERMIT r CEIPT NO. `t.--__ --- COMMUNITY DEVELOPMENT DIV. p r � � PROTECTIVE INSPECTION SEC. NUMBER REV. DATE PAGE OF APPROVED BY --1 CITY HALL FRIDLEY 55432 "-'A f %.J 612-660-3450 910-F15 5/11/78 JOB ADDRESS 4524 - 2nd Street N.E. 1 LEGAL LOT NO. BLOCK TRACT -OR ADDITION SEE ATTACHED DESCR. Outlot 1 3 rearrang. of Blks 13-15, Plymouth SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ivan Ficenko 4524 - 2nd Street N.E. 560-1748 3 CONTRACTOR MAILADDRESS 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 ❑X ALTERATION L1REPAIR ElMOVE ElREMOVE B DESCRIBE WORK Reroof dwelling 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 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 $900 $.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 SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $7.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $8.00 SIGNATURE OF CONTRACT08.QRHORIZED/A�GENT (DATE) '!J <UY�n P ✓ W.I.ROPERLY VALIDATED THIS IS YOUR PERMIT c .SIGNATURE OF OWNER (IF 0 (DATE) INSP 0ATE - CITY OF FRIDLEY APPLICATION FOR RESIDIENTIAL BUILDING PERMITS (NEW, ALTERATIoNs, ADDITIONS, .OR REPAIRS) OWNER: � �� � P710 10 BUILDER: Address: " 1��� - Aj AJ, Address : PA Tel. No. ��o ® /?418 No. �� Street: �2A.fQ �J. . LOT: BLOCK: •3 ADDITION: j®L y rnuc.t� CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS: Applicant attach to this form T+oo Certificates of: Survey of Lot and proposed building location drwwn on these Certificates. DESCRIPTION OF BUILDING -To Be Used As: o uS� Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: Estimated Cost: $ 9y0 To Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) 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. See reverse side for additional information. C o DATE: ` l%" '78 SIGNATURE:t, _ 6dwl-` � Stipulations: CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE .USIDENTIAL Furnace Shell and Duct Mork, Burner (Also replacement furnace) Gas Piping (piping needed with now furnace) Gas Range Gas Dryer 6 Air Conditioning (all sizes) All Others/Repairs and Alterations 1t of Value of Appliance or Work COIMERCIAL/INDUSTRIAL It of Value of Appliance or Work Effective Auq. 1, 19"1 RATE TOTAL Job Address S 20.00 $ Department of Buildinq %, 6411 University Ave. N.L., Fridley, NN 55472 City of Fridley $ 10.00 $ Tel. 1571-1450 $ 10.00 $ The undersiqned hereby saked application for a permit for the work herein specified agreeinq to do all work in strict accordance with the City Codes $ 10.00 $ and rulinqs of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Cle $ 10.00 $ Fridley, Minn. d (,�� , Igo-)OWNEa— S RIND OF BUILDING USED AS State Surcharge TOT11L !EE Reinspection Fee ($15.00) Rough Inep. Date Final Inep. 3-31-K j�2 Date -31- ete Approval for Permit MINIMUM FEE FOR ANY HFATING PERMIT IS $10,00 PLUS $.SO STATE SURCRARGE $ TO BE COMPLETED ABOUT U % 0 ESTIMATED COST C 0LD - NEW BUILDING PERMIT MO. PERMIT NO. $ Attach stack verification, form with replacment furnace permits *Air Conditioner% can not M• placed in %ads• yard without written purmission Fran adjoining w igldx,r. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS. Steam, Rot Mat r, Warm Air- No. ®O/ Tirade Name Bias No. Wa6-lelQ 6P Capacity Sq. Ft. LDR BTU HP Total Connected Read 4 Rind of Fuel BURNER - Trade Name Size Mo. Capacity Sq. Ft. EDR BTU HP Company Y-0 r.+ Signed By T(- I. No. e--3 CITY OF FRIDLEY APPLICATION FOR HEATING REPLACEMENT CHIMNEY AND STACK VERIFICATION THIS FOR14 MUST ACCOMPANY STANDARD APPLICATION FOR HEATING PERMIT FORM. LOCATION �� ` '/ DATE OWNER ADDRESS The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined 2. Is free from rust or deterioration 3. No foreign objects are lodged within 4. That it is securely supported S. That it greets all current Code requirements for size and total BTU connected 6. Total Heating BTU All Other BTU TOTAL REMARKS HEATING PERMIT 0 C7;2 if SIGNED by Address:� - fs Telephone ,-� -�3 Fridley City License ./ d 11 SUBJECT PERMIT City of Fridley G 19873 AT THE TOP OF THE TWINS BUILDING PERMIT r � RECEI i L _ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. ;�2 Y® 1 � i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/4/89 JOB ADDRESS 4524 - 2nd Street N.E. 1 LEGAL DESCR. LOT NO. . OutlOt 1 BLOCK 3 TRACTOR ADDITION SEE ATTACHED Rearrange. of Plymouth Blocks 13,14,15 SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Marie Ficenko 4524 - 2nd Street N.E. 572-1703 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. lst landmark Builders 611 South Snelling Avenue, St. Paul, 55116 699-3135 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 20' x 20' Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. W NILN,G Before. digging call, 10cif SEPARATE --+ERM'1T&-REQf j;RED utilities TElEPH0:1V - .ECTRIC-GAS Etc. W[RfNG, KEATING, PLUMBING A,ND SIGNS , ��, REQUIRED BY LAIN SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 ISTALLS 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 $5848 $2.92 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. PLAN CHECK FEE TOTAL FEE $83.92 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLYLIDATED THIS IS YOUR PERMIT =THIS BLDG )NSP qA SIGNATURE OF OWNER (IF OWNER BUILDERi (DATE) 11 NEW [ ] ADDN [ ] ALTER [ ] Construction Address: legal Description: a R-1 AND R-2 Building Permit Application 415 V .-2 4d 577' �I F - Effective 5/1/88 r(eae, y Owner Name & Address: /��'r�yY a Tel . # % 3T a-o6�,worr�f� d6e-t E���S Tel. # Contractor: a- Address: . C L 5S/1l1i Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. =CK OF III �ROVE M LIVIM AREA: Length Width Height Sq. Ft. GiMM AREA: Length A ® width ,Ap Height -� Sq. It. DECK AREA: length Width Hgt/Grrnmd Sq. Ft. 07HER: Corner lot [ ] Inside Lot [X], Ft. Yd Setback Side Yard Setbacks Type of Construction: cp a&C.e 41-& -te- Estimated Cost: $ Y 7e-ae` Approx. Completion Date: - 6? Proposed Driveway Width If New Opening Is Desired: Ft. $ $ I ST L use K %width + 6' See Back Page DAM: 5--3 - APP'LICAN'T: /�2 Tel. # b `l Y - 3 3 5 Permit Fee $ E /. C) C) State Surcharge $ 0.79.2 - . 9.2 -SAC SACCharge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ STIPULATIONS: //,6 -9..) - CITY USE ONLY Fee Schedule on Reverse Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] FIRST LANDMARK BUILDERS 699-3135 Permit by Legal Description WORK ORDER HOME PHONEf��' 0 61— NAMF�aC 2 -- BUS. PHONE: JOB ADDRESS* a% ,24 2� �� �' i BLDG CODE ARE 11.7 Blk Add'n SALESMAN CONTRACT DATE SIZE Value Type Const. SLAB: Eltv First Landmark ❑ BN Owner Approx. ; t ;.. ;- ,... 0 I ..... - { 4. 2-STARTINl JOINTS ONLY S.P.L. i ! '- • P. RPL. _ F.., } Y ..... Alley House / S F. Street at. Other r .t 'r ❑ Square With ❑ Sod Rem. - BY j ' +- ., +_ ❑ A.B.U. ,.. j , { 7 ❑ 0 Grade Point i 1�-tt locks: ❑By Owner EE` FLM O Wtr.proof: ❑By Own. ly FLM C ❑ []By ❑By r i. 1fi Backfill: Own. FLM ❑ Maintain 8' Total Wall Height { Including Blocks OR._. a ..... . ❑ Maintain 8' Wall Height on t , Top of Blocks Block Size (Top course) t - ------- ------------ Wall Heig t other than 8' ; i_ • Frame with full wall height sold OR ❑ Cut studs as required for OHD clearance JO.H. or Offset ULS.D. Location ; t _i... 9 Windows r a ❑ Att Gar Roof Tie-in Drawn on attached pictures f Existing garage: No ❑ ❑ Detached 11AtachedA, Size of existing:x Existing garage will be: ❑ Left as is } ❑ Converted to L.S. - By owner EVSCmoved By: Owner O ' First Landmark; Junk Must Be Removed By Owner ❑ Specify removals by Landmark Owner - trees, bushes, etc. ❑ Show approx. dist. garage to house and all prop. lines Stakes visible - ❑ Yes Uo Survey available - ❑ Yes ❑ Special instructions from owner: PURCHASER'S FOR OFFICE USE ONLY at. I _4._ PURCHASER'S FOR OFFICE USE ONLY ROOF: GBL REVERSE GABLE HIP EAVE OVERHANG:FIRST / �r .LANDMARK RAKE OVERHANG: f` BUILDERS SEAL DOWN SHINGLES WITH PLYWOOD OR OXBOARD ROOF SHEATHING AND 15 LB. FELT Roof Sheathing Manufactured Trusses --­' 2" x 4" Double Top Plate Manufactured trusses engineered:tti'mrifi-rnum.- 40# live load per sq. foot. Seal Down Shingles �} t NOTE: 1�1 Roof approved by Minn. State Building Dept.-"eeting:Minn. State Code Req irem.ents of 30, Ib..snow load.. 2) Hip 'twbofs consisf df -2" z 6"'•raft'ers, 2"�x 6"'i;i=brt ties 4$" 6.C., 2" x 8" hip rafters and no plywood gussets areqs d. RAFTERS: Trusses @ 24" O.C.2x6 16" O.C. 24" O.C. STUDS:2"'x4" X1,0" O.C. 24",O.C. - WALL SHEATHING: fC O SIDING: OVERHEAD DOOR -HEADER: ou e ' x-12" o Glue am beam` ; . x t Slab on grade construction approved per Minneora State Code"Refer to.State Building Code Letter Number 11. s SLAB: 4" WITH MESH 6" x 6" a10 6,,adge 4 Trim Fascia 1x6 Rabbited Soffit Redwood �W' Cove 2" x 4" Studs Siding yz.' x 7" Anchor Bolt i- 2" x 4" Treated Bottom Plate v Grade 45 f 4 Trim Fascia 1x6 Rabbited Soffit Redwood �W' Cove 2" x 4" Studs Siding yz.' x 7" Anchor Bolt i- 2" x 4" Treated Bottom Plate v Grade SUBJECT E City ®i Fridley 2728 6 AT THE TOP OF THE TWINS BUILDING PERMIT r T COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. /p ��Jj �� r `.! 1 . � NUMBER REV DATE PAGE OF APPROVED BY i CITY HALL FRIDLEY 55432 .--•/'�',•� 1 J`� 612-571-3450 910-F15 8/19/98 108 ADDRESS 4524 2nd Street NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. Outlot 1 3 13 14 15 Pl outh A ditio SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Carla Paarmann986-0735 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Midwest Roofing & Siding 18979 Gladstone Blvd. Maple Grove 5531.1 416-4804 20010277 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 Jk REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house (19 S Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply withi the State Building Code. CALL FOR ICE & WATER AND FINAL INSPECTIONS. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1584 S.79 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. 151.25 Fire SC $1.58 PLAN CHECK FEE TOTAL FEE License SC $5.00 1$58.62 SIGNATURE OF CONT RACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLYYALIDAZED THIS IS YOUR PERMIT BLD -INSP 0 SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI 1�Tr 1�a@F3� F. A I r ate•' ensaaa,Jer o.idc 3CL air r.rur NM [ ADDR ALM[ R [ } F cbmwawn"doem ncl fq /V E - ! !r" .fa 90-11M�; 'Jit v ..._.... _mow_ .__..win 1 l ti.'.f' � I, d't 4''.: '. -'.. 'T(�• �•�pf` :�}1f �.::)`-... afl'-r' )1 Z:' .-1„-'.���-• t. ... } .'ter=: ,C.$'"ltYFlow "til.Kno: 2�6 C�O\ Building BUILDING Permit No.: i 0) Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DateA0 J U L ZOO 763-502-4977 FAX EFFECTIVE I-1-09 Q DATE YOUR E-MAIL ADDRESS — SITE ADDRESS �oZ-/ u r7 ryc N ST AJ,` THIS APPLICANT IS: ❑ OWNER >eONTRACTOR PROPERTY OWNER/ NAME: DO-13A PA SAN TENANT ADDRESS: `-l�dY ��"��-- . NC'" CITY �^2►�LL� STATE LIP PHONE: r%%3 -- O jo^ 0 % CONTRACTOR NAME: J>VA 1C Oe S 1G6-'i Co,us�-R LrrA STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS:14,089kM 71 At/ CITY STATE LA91P� INSURANCE PHONE --zb " V 3 + of I FAX PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILYNEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION 1>R&AINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES C;20 HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. 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. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 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 $ 56 0. n -e ` Q 31 OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due 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) $2000 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$22=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks Davable to: Citv of Fridlev Attach 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 e City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application foran-.' work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all r quires review and approval of plans. ^� SIGNATURE OF APPLICANT PRINT NAME �1 O t'`� � ter- 0-7 DATE / t ` DQ Building BUILDING Permit No.: -0 0 3 Inspections RESIDENTIAL APPLICATION Received By: , 763-572-3604 CITY OF FRIDLEY 763-502-4977 FAX Dat $ EFFECTIVE 8-19-09 .001 times the total job valuation Surcharge $ --;D DATE :F—.:l 5--0') YOUR E-MAIL ADDRESS $ SITE ADDRESS . y 50;L y , ;,ii�'� �jT /J c $5.00 (State Licensed Residential Contractors) THIS APPLICANT IS: ❑ OWNER *ONTRACTOR PROPERTY OWNER/ NAME: C'AQ" PAA,94--hN $ TENANT ADDRESS: l{ S0 Y S T >y,c CITY /-R4,0Lam`% STATE IP Erosion Control PHONE: CONTRACTOR NAME: Pe*r- ACS I bKJ 5P- S T�vt °r7 o til $ SUBMIT A COPY YOUR STATE LICENSE STATE LICENSE C �/ 13 EXP DATE 3 -31-/ U AND CERTIFICATE OF ADDRESS: -//6 0 gni Jgrg A -L) CITY fjI r LA c A STATF/�/I�LIP INSURANCE PHONE ,? O — — FAX p -11 T PROPERTY TYPE )iPSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION RMAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: R FS 110 gc— Ho U S -C O N L SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING MOUSE ONLY NUMBER OF SQUARES / ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. 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 gTrim vXO f,eT 1. Site Plan/Survey showing the existing structures Pd Other �_ .2 p s o, Q Fascia iJ and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS AILJ, FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: n (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ " / e5D 0. ©Zl OCCUPANCY TYPE Permit Fee Sj� a 5 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 400 .001 times the total job valuation Surcharge $ --;D .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks vavable to: Citv of Fridlev Attach Stimulations 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 pe It work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all w.prlit i moires review and approval of plans. SIGNATURE OF APPLICANT /.�fl� v PRINT NAM<�%/ " "v DATE