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PRE 2010 DOCS• Village of Fridley, Minn. BUILDING PERWr N° 7918 Office of INSPECTOR OF BUILDINGS owner. i"`t + Architect Fridley, Minn. `A «; 19 4� •^, Builder LOCATION, OFF BUILDING No. Street moi)2 Part of Lot Lot ,%� �� 1,.. � ',� Block ,Addition or Sub -Division { DESCRIPTION OF BUILDING 1--' -*. Front, Depth Height Stories Manner of Construction - To be used as To be completed Estimated Cost I i , Permit is hereby granted tai •_° . _ c r:..#' .� w°. -,� .•- %:�-a ;,_ -i? yx _• :« i the building described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, Minn., regarding the 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. Inspector of Buildings. AGREEMENT AND SWORN STATEMENT In consideration of the issue and delivery to • me by the Inspector of Buildings of Fridley of the above permit, I hereby agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Fridley, and, being first duly sworn, I hereby state and say that the facts stated by me and contained in the above permit are true as therein stated. Subscribed and sworn to before me at Fridley, day of a r, z r.,._ t ,M, , A.D. 19 Minnesota , thi "�' ` City of Fridley, Minn.. N9 9644 BUILDING PERMIT •Date: —. March 26, 1968 0 E Owner: J. Sinigaclio Builder Strand Const-,CQ,� Address _ _47 5 3rd St. N. E. Address 9240 Lvnd_aJ—e Ave , Sguth LOCATION OF BUILDING No. 4715 Street _ 3rd St. N. E. _ Part of Lot Lot 18 & 19Block 8 ____ Addition or Sub -Division ._ Plymouth Addn. Corner Lot —_ Inside Lot ._ Setback --- Sideyard Sewer Elevation __ Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Garage Front 24' Depth —24' Height 10' Sq. Ft. 576 Cu. Ft. 5760 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction — Frame Est. Cost _—.$3..,000 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 foo^ ,andin compliance wi1 provisions of ordinances of the city of Fridley. / In consideration of the payment of a fee of $ 9.00 , permit is hereby granted to Strand C ons t . C o . 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. f' r� ding Inspector arence Belisle a. NOTICE: 'fids permit don not corer the construction, hutallatton for wiring, plumbing, gas heating, sower or water. Be sun to no the Building inspector for separate permits for thus hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MUMSOTA OWNER'S NAME C*40*004940BUILDER- ; r ev ADDRESSF�® �. r4 ro, Jo ADDRESS _�_ LOCATION OF BUILDING NO. STREET 1, OT; �P / BLOCOK _ ADDITION OR SUBDIVISION, CORNER LOT INSIDE LOT SETBACK SEWER ELEVATION TOP OF FOOTING Applicant attach•: tp•;*this form Two Certificates of Survey . of Lot and proposed building location'drawn on these Certificates: '1 DESCRIPTION OF BUILDING ,. To Be Used As t Front� � � Depth t Hdight_ Square feet �!�! Cubic. $ee;� r.:f Front Depth ... fleiglit' Square feet Cubic heat Type of Construction Estimated..,gost To Be Completed��6m� 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, t DATE ®� ® �® SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side. 53-84-S-915.51 City of Fridley AppkoMm for Pkmbbg and Gos Dart_ of BWkpL n%om 960-390 Macalmon or WORK x • Kid mi Loce� eat MAB 4715 N. E. 3rd. Street PARTIAL RATE SCHEDULE VLVAOMQ rUCTUM RATM wo► BAre ?Or,13. K"I ................ �� E sm iN . ...i...... : Vie 6 . ON C%wni.. o ....... Nm '4 I IM i / . .�.�. . ........ W& (V.p to 0 BMf !V b fleas Gnmmd slue CW Bth.......... z S&Z 4 w&tw .............. -a an i m3 CYt . . . . . . ..... .. . . . .. Zan ..............• S $ M t an ftw fo mon ..........M -s no State State Surcha ne .50 ► f it.'rQ►?ZCMD-AV W b Gia p ........ Install�Gas Light....�..�...� 5.00 TCWAZ.= S 5.50 Chi" W Surcharge .500 City of Fridley SUBJECT PE 13'76 •CEIPT AT THE TOP OF THE TWINS BUILDING PERMIT i ` NO. ______ COMMUNITY DEVELOPMENT DIV. L r PROTECTIVE INSPECTION SEC. 1 � LLUJJ ` CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 9/16/76 JOB ADDRESS 4715 - 3rd Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 18,19 8 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Joe Sinigaglio 4715 + 3rd Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Miles Garages 4500 Lyndale Avenue North 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 J NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ EMOVE mammal - 8 DESCRIBE WORK INSUPW Construct a second accessory building (32' x 24') 1Utnw" T,ELEPNONE • ELECTRIC =S M 9 CHANGE QF USE FROM TO REQUIRED STIPULATIONS Garage is not to be used for a home occupation. Garage to be compatible with the existing house as far as exterior appearance. SNYN$ Special Use Permit approved by the City Council on August 16, 1976. SEPERATE -PERMITS REQUIRED FOR ISI O% HEAT , ' PLUM81NG AND SIG . --IM ORTANT— • WM Y THE FRIDLEY ENGR, CIMSION REGARDING CURB REMOVAL AND REPLACEMEN AT`MIV&VAY OPENING') TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, 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 R-1 768 7680 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION I 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. $5,683 $2.84 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- $22.73 STRUCTION OR THE PPPFORMANCE OF CONSTRUCTION. /,w m PLAN CHECK FEE TOTAL FEE $25.57 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PR PERLY VALI ATED THIS IS YOUR PERMIT y' 9-1� BLDG INSP DATE SIGNATURE OF OWNER (IF OWNER BUILDER) (DATEI ut i i ur rru.uLr.r APPLICATION FOR RESIDENTIAL ALTERATION, ADDITION, OR REPAIR BUILDING PERMIT OWNER'S NAME : d O r ( / c= BUILDER: ADDRESS: '® NI ADDRESS: NO • C,"`7 i S STREET: Aj L 1. LOT: BLOCK: ADDITION: N CORNER LOT: INSIDE LOT: SETBACK: SIDE71ARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To B Used As: Front: 3:2 Depth : .? i Height: Square Feet: 168 Cubic Feet: ��&(;I() Front: Depth: Height: Square Feet; 763 Cubic Feet: Type of Construction: Estimated Cost: $ S'%Tota 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. ' 4 DATE: F� ` SIGNATURE: (See Reverse Side For Additional Information.) ' aLfS� Dr10� s , Jnr r0 ,�, �tc�xSEe �4s Fk, hS €x-re-ef0Z 1)Wcqk'ANC6_• a,, 370 - 0,56 City of Fridley SUBJECT ® AT THE TOP OF THE TWINS BUILDING PERMIT � R • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION r SEC. 1 . � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-680-3450 910-F15 12/5/77 JOB ADDRESS 4715 - 3rd Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 18,19 8 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Joe Sinigaglio 4715 - 3rd Street N.E. 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 ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 6 DESCRIBE WORK Renewal of Building Permit #13,762 for construction of second garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. WARNING Before digging call foal utilities TELEPHONE - ELECTRIC - GAS Etc. REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, 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 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ] 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. $5,000 $1.42. 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- $11.36 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $12.78 A SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) + WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT LOG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) • CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER: J ds� I M 1 G_ 13UILDEII: Address: �% /�'� �(�( Address: Tel. No. No.: Street: LOT: I� , a BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS: 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: � gpmC" Front: I Depth: Height: �Q / Square Feet: Cubic Feet: Front: Square Feet: Cubic Feet: Depth: Height: Type of Construction: (.J608 F-P-Aa(f To Be Completed: Estimated Cost: $ 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. DATE: -,S - '% SIGNATURE: Stipulations: ?aj o{J' E 4 im Z�Kk FlqC-, M SUBJECT PE City of Fridley ®14965 AT THE TOP OF THE TWINS BUILDING PERMIT ' REC€IP-T-NO. • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION r � � SEC. 1 � = �l---1 CITY HALL FRIDLEY 55432 NUMBER --fRIEV* DATE PAGE OF APPROVED BY 612-560-3450 910-F15 10/18/78 JOB ADDRESS %!S 3rd Street N.E. 1 LEGAL LOT NO. BLOCK TRA CT OR ADDITION SEE ATTACHED DESCR. 18-19 $ Plymouth SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Joseph Sinigaglio 4715 - 3rd Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. 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 8 DESCRIBE WORK Construct a-32' x 24' Second Garage 9 CHANGE OF USE FROM TO STIPULATIONS Renewal of permit issued 12/77. Provide hard surface driveway. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Wood Frame 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, $3,960 $1.98 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- $30.72 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $32'.70 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN P OPERLY VALIDATED THIS IS YOUR PERMIT BLDG )NSP DA E IGN TURE OF O E F OWNE BUILDER (DATE) M • CITY OF FRIDLEY APPLICATION FOR RESMENTIAL BUILDING PEMAITS (NL" -W, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER: 6gek !S j" � BUILDER: Address: 'g7lj 11-S_,+T 14F Address: Tel. No.: No.: Street: LOT : % r L 9 BLOCY.: F 'ADDITION: �!%� G!►� CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS: 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: /l • � Front: Depth: _ �„�,_ Height: Q Square Feet: Cubic Feet: �G 'Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: — �ve� �°�—_� Estimated Cost: $ kwz�✓$� �• �', 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 iation. -ZZZ� DATE: � Q r-! % � SIGNATUP.E: Stipulations: �P - 396&r I -32,2'0 SUBJECT PMIT NO. i City of Fridley 0877 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. _ _ _ r PROTECTIVE INSPECTION SEC 1 � NUMOER REV OATE PAGE OF APPROVED By = CITY HALL FRIDLEY 55432 612-571-3450 910 -FIS 4/28/00 JOB ADDRESS 4715 3 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DES CR. 18,19 8 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Joseph Sinigaglio 4715 3 Street NE 572-8896 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION ❑ ALTERATION Cj REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (25 Sq) 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 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 1 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 @ $2,185 $1'09 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 TOT FEE $86.53 S.GNATURE OF 'RA ORORAUT ORiZEDA•GENT 1DATE, N ROPEY ALIDA E THIS IS YOUR PERMIT 9l iN P GNASLTUR O N BW DE i iOATE� NEW [ l Effective 1/1/2000 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 41 3 (2-`�) (, 1 l Legal Description: Owner Name & Address: aD&d' SIV1'-�4k�LCri`J�5-3STGIE Tel. # 617—S72- Wim.& Contractor: MN LICENSE # Address: Tel. # 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/Groun Sq. Ft _ OTHER: _ / :mow '/ - - We v a ; `l) W Construction Type: 12ag -f- Estimated Cost: $ 40 — lOd Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: � G� APPLICA T: Tel. # i�-12- S-72WIZ CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ 83.-S Fee Schedule on Reverse Side Fire Surcharge $ c1,19 .001 of Permit Valuation (1/10th%) State Surcharge $.50/$1,000 Valuation SAC Charge License Surcharge Driveway Escrow Erosion Control $_$1 100 per SAC Unit $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ _ $450.00 Conservation Plan Review Park Fee $ Sewer Main Charge TOTAL STIPULATIONS: $ 481� -&3 Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] r1 ALL FEES ARE BASED ON VALUATION, INCLUDING TtM tt:US-r Ur- JUADUK AIN" 1y1A r JN"mL' ' (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ BUILDING Permit No.: Building Inspections Fire Surcharge RESIDENTIAL APPLICATION Received By: 763-572-3604 $ SU CITY OF FRIDLEY Date Rec'd: DATE �/f ®�D YOUR E-MAIL ADDRESS SAC Charge SITE ADDRESS�- Curb Cut Escrow THIS APPLICANT IS: OWNER ❑CONTRACTOR Erosion Control PROPERTY OWNER/ NAME:--Te-60[t Park Fee TENANT ADDRESS: 6a/ -V--3 R -0S f J E CITY � [ t'i A _STAT) IKZIP css�Z/ $ PHONE: :Z 3 - Ja eej�w Trtal Due CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE -0 -SINGLE FAMILY/NEW CONSTRUCTION SIZE TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE -SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING '?.OTHER— [3 SWIMMING POOL Jct TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY 13 HOUSE & GARAGE BASEMENT REMODELING SUBMIT I. Existing Floor Plan GARAGES El ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ❑Vinyloffit ADDITIONS &PORCHES SUBMIT: Aluminum Trim 1. Site Plan/Survey showing the existing structures and project. ❑ Other ❑ Fascia proposed 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 sR TTT7 AT Q. ALL FEES ARE BASED ON VALUATION, INCLUDING TtM tt:US-r Ur- JUADUK AIN" 1y1A r JN"mL' ' (USING THE 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 $ `i lD .001 times the total job valuation Surcharge $ SU .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 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 ( ) Trtal Due $ L(. Make checks payable to: City of Fridle 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 andork is not to start without a permit; that the work will be in accordance with the approved plan in the case of all w tc ie and pproval of plans. AN���, SIGNATURE OF APPLI T PRINT NAME//�'t/�/G�1 r //!�%%�J�G10 DATELO �IP7496