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PRE 2010 DOCSCity of Fridley SUBJECT ®KNIT AT THE TOP OF THE TWINS P R M I T BUILDING E RECEIPT NO. 1 16U• COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. -13 1 � 1 � � NUMBER REV. DATE PAGE OF APPROVED BY CITY CITY HALL FRIDLEY 55432 �••-- i`•� �.J 612-560-3450 910-F15 9/14/76 JOB ADDRESS 5190 3rd Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Carlson's Summit Manor Annex 2nd Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James Lund Construction, Inc. 2417 - 148th Avenue N.E., Anoka 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 ❑ REPAGVISM *9%4"Mti.VMVE 8 DESCRIBE WORK AT, DRWEWAY OPENINGS, Construct a 24' x 40' Dwellinga 3 arage SEp"TR� . n I`f S . REQUIRED. FOR.:AIRING. 9 CHANGE OF USE FROM kEATt VWM91NG;SND SMN& STIPULATIONS Provide truss design. Provide vapor barrier in ceiling and call for insulation inspection before sheetrocking. Provide hard surface driveway. Provide sod in the front and side yards. Provide a verifying survey before capping. SEWER LOCATION (Approx. 8' Deep) 225' North of Manhole (Inv. 832.33) WYE ELEV: 832.78 TO POF FOOTING: 835.78 Minimum WATER LOCATION: 10' North of Sewer Service 10 CW or M om Not : G�I�AAMM T" Cat loll utilities �Ot! $ w VAYK 14000 4.0 AT► ?a AC401CY is son p�0 111 r AN: RLEMONE • ELECTRIC - GAS Etc. " "fk ma wo a VM no + p aioN REQUIRED BY AW J* rn an. 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 R-1 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. $32,275 $16.14 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- $g9.44 $350.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. F f f PLAN CHECK FEE $24.86 TOTALFEE $490.44 SIGNATUP,E CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY �THIS IS YOUR PERMIT �%VALIDATED / BLDG INSP DATE SIGNATURE OF OWNER (IF OWNER I ILDER) (DATE) N O. 3'755 t e ., AR.PL,ICAT ON FOR RESIDENTIAL, OR ADDITION BUILDING J ALTERATION, PERMIT CITY OF FRIDLEY, MINNESOTA , U OWNERS NAME: JAMES LUNO CONST., INC. BUILDER: JAMES LUND -CONST.,INC. ADDRESS: 2417 - 148th Avenue N.E. Anok DDRESS: 2417 - 148th Avenue N.E. Anoka, Mn. 55303 NO:. 5190 STREET: 3hd Street N.E. LOT: 1 BLOCK: 2 ADDITION: Cateou Summit Manors Annex 2dd Add. CORNER LOT: INSIDE LOT: SETBACK: 35' SIDEYARD: OSE S- 14' Applicant attach to this form Two Certificates of Survey of Lot and praf)c building location drawn on these Certificates. i i m DESCRIPTION OF BUILDING To Be Used As: Sn9te ►.l Front: 24' Depth: 40' Height: 1.5 AtoAieA dweZ.P,i,ng Square Feet: 960' Cubic Feet: Ganaae Front: 34' Depth: 241' Inctu �2" X 13' doyen. Height: Square Feet; 816 'tnc �ubic Feet: Type of Construction: name Estimated Cost: To Be Completed: Ndvembeh. 31, 1976 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: AaauAi 26, 1976 SIG (See Reverse Side For Additional formation.) r 1' 0 GrP e- Uppl-:111V- Ey FOR: Lund Cort,A-ruc- Jjon Inc. o ce-no-tt--s iron Morimen-t- Le-SoA Lot 15 Block 21 CARL.SOtiS SuMM1T MAW)?, AWEX SECOKD ADDIMON, ArtoEcct Ccun}yz �r ..IM RTANT-- Mrf THE HOLEY EN pW191+�M REtARiG CURB MOVAL AND Kft ACEMENT AT fR M WAY OPENING& Mirtneso�-ta.. NOT GYARI►N7E'G THE THE Ca p! fRI jW NOES ACCURACY OF tmuiY LOCAtiO AND ` t yAn AND YVA KING THIS ZWA IS FOR .p�OL"XION !URlOWS_ ONLY. 'lf�tSON9 L040R saw VMV VM CAD local utitibies ON 10E Sin. pool MM - On Etc. REQUIRED BY LAW hereby certify that this is a true and correct repr�!sentarion of a survey of Jab No. the boundaries of the above described lard and of the to= -Lion of all lsuHdinas, ioerS . F"-.��i�i�# if any, thereon, and all visible encroachments, if any, fro�:t or or, said [and. LAN! SY0°S INC- Eanb: - Page As surveyed by me this 1 5'i` day of 3"v30 HZ.—Sor Lane . 55441 1�r•+_.s�'�� .et . � 1 � /��°.�. Seth z . R � Minn. Reg. No. al, oarWCr velo -Sol lt m ilk "'Y IAJ, '16, i1qwill va ac Q-,- /cac,, Y® e of SBC 6096 4 Sy � t`3 J (ji rb $ r lnr� :v �y—�JG SV T.'s9t • • ;.:,'r'�''� ,i19 y Na -'WL" _ y. -� � lqq-.tv , it?rii •� 4 ♦ •�' �.: '." , {SR: 'S.�F' Y' * _ i ..W .. jrk.L :9cuare _c:3Z.of each. _�... 7 R, 'd' �_ ! i.L iv. -W�i '�.. Z � . . po: 5 , ft. .-. -• x- _�u:iAJ4 area (_. y r )e v.e ➢ y J 40 �• •, ; ,r• -, _. i I L L W u u 4 v e u O u O 0 e c♦ O a u O a o 4 u C o u O w O a O o O 4 O .......... `, .. �... `fL P _.�..�.. e��. _.. �vc._.._,.Jc?4.C'•ar`Zc�.'v:..`ov�o�.. >i of co o�acoa c'.�c.c .r�® .... ..�.,.. _-..._,... .. DrTv va ac Q-,- /cac,, Y® e Fes✓ ........ a .. :Ot3_ ... e o e w. a w• t°L.t q6,22. ��.q?? :$ it -cm V43 is the sane as, or less than ite-m ;rim you have met the intent of SBC 6096 t`3 J f �y—�JG SV T.'s9t • • ;.:,'r'�''� ,i19 y Na -'WL" _ y. -� � lqq-.tv , it?rii Fes✓ ........ a .. :Ot3_ ... e o e w. a w• t°L.t q6,22. ��.q?? :$ it -cm V43 is the sane as, or less than ite-m ;rim you have met the intent of SBC 6096 t`3 J ^^.,o.T+".'1. af-• .��e6••'-•—••—_.T'�sY�^' w 7 �y—�JG SV T.'s9t • • ;.:,'r'�''� .. R"_^"r'-....-.•rmr+...'."P'°4Z°'^'..�'b i y Na -'WL" _ y. -� � irW" _ 5 ' t' * _ '. � Z. � S i,. 0.Z' �� , •� 4 ♦ •�' �.: '." , {SR: 'S.�F' Y' * _ i ..W .. ' � �^' t i _�... 7 R, 'd' �_ ! i.L iv. -W�i '�.. Z � . . po: 5 , .-. -• ,. 0, 4 . , , _�u:iAJ4 `i�AT" Z GV: 101, Tota. exposed roof "ceiling area a.ea.................................. 1Ka Ll! :li 'De`/CC'llil5:a'i. 1Rs, arca (S'JC� _,o ........ 6 ._4 "li" Vatll;.. for CACtl ► O l S 1 04LI 4. . ............... ........... ToLal C.41, . - L...::: c. u , G d i G v v 1.:: C.1-1 �-C i.c Ct a1 En yI :< : al,:e, eL tab C,' c-. L-,, �'.- 7l3 %i?Ci i u: ._ Ji LC i'C�.`_ _ Ci„ 1��► \ IFJ111 940• ® 1!•197 ► O l S 1 04LI 4. . ............... ........... ToLal C.41, . - L...::: c. u , G d i G v v 1.:: C.1-1 �-C i.c Ct a1 En v __� . eyCLCW _ __ J`i :< : al,:e, eL tab C,' c-. L-,, �'.- 7l3 %i?Ci i u: ._ Ji LC i'C�.`_ _ .! :. L111 .' SU:a Gi ZSe CCdS L'_ c°'iC L' L_"OL% descr'\p4rt orn s Lo -r 15 Bl0c1•c 21 CARLSmtiS SUMMIT MAW)R AMEX SECOND ADUT\0%i `,tg0k , COUrc�-y9 Wnnesoko_ . ®L.a• ..kS — GALRIEL LAND Std.; EY0�S INC 3'OJ i~Sarbor Larne . Piyrnou,:h, AN 55441 hereby certify that this is a true and correct representation of a survey of fob No. the boundaries of the above described land and of the location of all buildings, X048 if any, thereon, and all visible encroachments, if any, from or on said land. Book -Page As surveyed my me this 1 St day of `-�p� . 4-k 1� Minn. Reg. No. 10944-. FOR: Lund ConsArrUC�lon Inc 118.14 ul, • - �s -- n I 2� I N � i I 00 i :y o 4 4 i 40 I � O o Deno+t--s Iron motnvn e -V& L_"OL% descr'\p4rt orn s Lo -r 15 Bl0c1•c 21 CARLSmtiS SUMMIT MAW)R AMEX SECOND ADUT\0%i `,tg0k , COUrc�-y9 Wnnesoko_ . ®L.a• ..kS — GALRIEL LAND Std.; EY0�S INC 3'OJ i~Sarbor Larne . Piyrnou,:h, AN 55441 hereby certify that this is a true and correct representation of a survey of fob No. the boundaries of the above described land and of the location of all buildings, X048 if any, thereon, and all visible encroachments, if any, from or on said land. Book -Page As surveyed my me this 1 St day of `-�p� . 4-k 1� Minn. Reg. No. 10944-. CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE A NO. RATE TOTAL N � ro $� u x x 0 New Fixture, Old Opening Water $2.00 $ Catch Basin la $5.00 $ Water Heater - to 99,000 BTU x N p 100,000 BTU to 199,000 BTU y p, W r. x Heater d •.� L d 14 ro $5.00 N c N E •A (du x +J W $4.c N k ro ►+ 0 W .0 1st 3 fixtures a`� fa $ 3• �! Additional Fixtures x $1.00 O ••r.A J�J �U) � N- 1 0 0 S 4 •W V N N $ each add. $100.00 or fraction Orj �+ n .q w ro «+ ro u o .e m ro d m m .{ ro " O as lec to U l 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 Fixturesx � $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 $3.00 $ 3• �! 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 $ .50 TOTAL FEE $ REINSPECTION FEE ( $3.0.00) Job Address � '•" ,T 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 fi�,r/ Fridley, Mn. 6" , 19 7 OWNER KIND OF BUILDING USED AS/ TO BE COMPLETED ABOUT ESTIMATED COST J OLD - NEW BUILDING PERMIT NO. PERMIT NO. % (�/A Company C©C P I / • i t�s ��/� f �?� Signed By Tel. No. �-� �✓ ROUGH INSP. Date FINAL INSP. % f -7- 76 Date j APPROVAL FOR PERMIT'"� MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE t1kVITY WARM AIR: RATE TOTAL Job Address _urnar_e Sell & Duct Work $12.00 $ Replacement nt of F urrace 7.00 7.00 $ $ Department of Buildings Repairs &Alterations -up to $500.00 4.00 $ City of Fridley Repairs & Alterations each add. $500.00 Tel. #571-3450 MECHANICAL WARM AIR: The undersigned hereby makes application for a permit for the work herein $12.00 $� specified agreeing to do all work in strict accordance with the City Codes F`arnace Shell & Duct Mork to 100,000 BTL' 4.00 $ and rulings of the Department of Buildings, and hereby declares that all the each add. 50,G00 SiJ 50,COce 7.00 $ facts and representations stated in tiis application are true and correct. r^.eplaeach t of Repairs & Alterations -up to $500.00 7.00 $ ridley, Minn. �' '- a 19 e: airs & Alterations each add. $500.00 4.00 $ STE_7%X OR HOT 'KATLR SYSTLU: OWNER Bailer S :inns p to 100,CO0 BTU ' $12.00 $ KIND OF BUILDING eae_h addn. 50,000 BTU 4.00 7.00 $ $ USED AS Boiler only up to 100,000 BTU addn. 50,000 BTU 6.00 $ / 17- 7 each TO BE COMPLETED ABOUT OIL BUR -NEER- to 3 gal. per hour $10.00 10.00 S $ ESTIMATED COST c o eac add. 3 gal. per hour g -BUILDING PERMIT NO. CUCu� ('.AS SURN-R- from 100,000 BTU to 199,999 BTU $10.00 $ I © 00 OLD PERMIT N0. " (over"199,999 BTU see Fee Schedule) $ C,.AS FITTING FEES: O ist 3 Fixtures x $ 3.00 $ DESCRIPTION OF FURNACE/BUR:dER Additional Fixtures x $ 1.00 $ • Gas Range to 159,000 BTU x $10.00 $ HEATING or POSER PLANTS, Steam, Hot Water, ar�Ai - No. 10"4--c AIR CONDITIONING � $ Trade Nam Size No.9 - FAN HZETING SYS: EIS See Fee Schedule $ / VENTILATING SYSTEMS $ Capacity Ft. EDR BTU N•? ALTERATIONS & REPAIRS S $ - State Surcharge $ .50 Total Connected Load 0,6 0 Kind of Fuel TOTAL FEE S D Q BURNER -Trade Name t .;�?• G_a� Size No. 've FEE Capacity Sq. Ft. EDR v/�� BTU HP ROUGH INSP. REI::SPECTION Date ($10.00) Compan* Date Signed By APPRZVAL FOR PERMIT %Z�G • Tel. No. FEE FOR ANY HATING PERMIT IS $7. SO sue�EtT w: of Fridley 9 5 AT THE TOP OF THE TWINS (EECity R M I T BUILDING PERMIT r `v _ COMMUNITY DEVELOPMENT DIV. � PROTECTIVE INSPECTION SEC. 1707 r � � 1 . � I = 1"'1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 91aFls 4/2/99 JOB ADDRESS 5190 3 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 1 Carlson's Summit Manor Annex 2nd SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Harriet 6wing 5190 3 Street NE 586-0923 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Lake State Remodelers Inc 6000 Bass Lake Rd #111, Crystal, MN 55428 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 20047291 533-1544 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION O ALTERATION Q REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof House & Garage (27 Sq) Tear -off 8 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. Permit Inspection Cards Will Be Mailed To Homeowner To Post 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 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 $1.16 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,313 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHAR PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $74.75 Fire $2.31 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL F E LiSAp e C $5 SIGNATURE OF CONTRACTOR OR AU1I.OR12E0 AGENT IOATE, NMOPEAL AT T $ IS Y P IT Ila ., .BLOts INSP FIATE S,GNATURE OF OWNER,IF OWNER BUIIOERI IDATEI NEW [ ] Effective 1/1/99 • ADDN [ ] CITY OF FRIDLEY ALTER [x] SINGLE FAMILY AND DUPLEXES R-1 AND R -B BUILDING PERMIT APPLICATION " ConstructionAddress: �0 Legal Description: p� Owner Name & Address: /'/ 17 %c0 - �� AJAe1. # Contractor: o C. MN LICENSE #// Address: 6006// `/ Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION ,OF EVIPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 35, Construction Typeg,�f-,a&�-mP16-w- Estimated Cost: (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. 6 Ft = Nt x $ = $ DATE:/ APPLICANT: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Tel. # CITY USE ONLY $ Fee Schedule on Reverse Side $ ,/ .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1050 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 [ ] w suB,IEtr PERMIT NO. City of Fridley 2 9 4 AT THE TOP OF THE TWINS BUILDING D E R A A I t 'r 1CEIPT NO. COMMUNITY DEVELOPMENT DIV. r � PROTECTIVE INSPECTION SEC 7Y l � NUMBER REV DATE vAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 4/7/99 / JOB ADDRESS 5190 3 Street NE I LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 I Carlson` s Summit Manor A ex 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO 4 ARCHITECT OR DESIGNER MAIL ADDRES PHONE LICENSE NO 5 ENGINEER MAIL ADDRESSPHONE LICENSE NO 8 USE OF BUILDING 7 CLASS OF WORK O NE O AD O ALTERATION REPAIR O MOVE O REMOVE 8 DESCRIBE WORK 9 CHANGE OF USE FROM T STIPULATIONS V c V/ V v SEPARATE PERM{ TS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING R AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZE!/ UTHORIZE IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK I SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AAFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING 1 HEREB/CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KN THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ODINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED 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 SIGNAT I E F CONTRACTOR AUTHORIZED AGENT iDD`AA-TEP WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT BLDG INSP - GATE SEOF OWNEROF OWNER BUILDER. 'u�TE� I NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & A dres Contractor: Address: 'K D d o Tel. # MN LICENSE # 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 GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground OTHER: -7,194 �,� Construction Type: Effective 1/1/99 Tel. # S .3 /S_41 �L Estimated Cost: $ ;),5 Sq. Ft. Sq. Ft. Sq. Ft. (Fee Schedule on Back) Driveway Curb Cut Width Needed: 2i6 Ft = x $ _ $ DATE:- �' APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $G' CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (State Licensed Residential Contractors)' Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] FROM :City of Fridley FAX NO. :7635711257 Jul. 31 2007 01:10PM P2 Building 13UIr.DWG Permit7or7 Inspections RESIDENTIAL APPLICATION Recei��7C -57 -3604 CITY : 4T+ C+ RIDL�EY DAtef 2 Q DAl'E' ' - .r ,�®. d,T YOLTR E-MAIL ADDIRMS SITE ADDRESS,, S IGNT I; TIi1S AITL ,A , ,:. 0OWNER GONTRACTUR _ PROPERTY TENANT DRESS, --4'1'!D . -- CONTRACTOR E• p _r e.,.. .._. TATE LICENSE 0 ,,�fi EXP.DATE r 3�1, , fl 1;g6 i STAT( ZIP � l SUBMIT A COPY OF YOUR STATE WCENSE PRESS: wrrviAPPLIt:A:f10N MONE PROPERTY TYPE G F 1 M6W N UCHON O FAMELYINEW CONMU ON STOkt S iP)E;RR'I1IT' TYPE SFl1� DOW5 PDASHMENTFINISHJK F❑ DRAIN TILE CK C3 SID( 0 0 OTHER A SWA+iMWG POOL TYPE OF YORK: 3NVWIa Aon1 ANCA PAM 0 REMODELING DESCRIBE WORK-BEINC1 DONE _ e� � � ��� . t v ;'j') o i.t 3 �F(7.. /"� -' SIZE OF IMPROVE A+IENT • LENGTH WIDTH HEIGHT Sq. Ft NUMBER OF SQUARES - 13 HOUSE Y 0 HOUSE & GARAGE BAS t RfAlODFJ.INQ SUBMIT: d A7TACFIED OARA 1. Existing Fiaor Ply 2 pmpmw fbor plan. PROPOSED SI1:E: . 0 DETACRED GARAGE 3. UBt of aquohtW MeatbW to be atxd PROPOSED RE10 r; !IUMInum FOR NEW CONSTRUCTION 113CLU131N© DECKS, d im 1. Site Plnitr5tarey showing the eahting strAMM and ptpaw pwiat. 0 OLhW VANDOWS IN MOSTING OPENINGS es a9ci!< Z. Two eels of corobvction Alnns Callo LOCATION OF WDMOWS .+L` 3'. EncruCa:culatlons OR FORNEW OPENING DESCRMESIZEOF ._ OPENING CHANGES & TYPE OF WINDOW TO EE IN LED V/II• L NUMBER OF VANDOWS ON VAI.UAT19F, i NCLUDINC, THE r-OSTW LABOR AND MATERIALS: ALL FEES.ARE BASED . (USING THE IM U.$.0 I= SCH11dULk) TOTAL JO>k VALUATION $ O o OCCUPANCY TYPE Permit Fee $ 2O •1? b See Rack Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharges 21 -OU— _ . •001 times the total job valuation Smmbarge $ .0005 x Permit Valuation Minimum $.50 License Surcharge _&.00 $ Tf 0D $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 per SAC Unit (Plans to MWCC far determination) Curb Cut Escrow $ _tt + 6 i4 R it x $21® $ Erosion Control S $450 Conservation Pian Review Park Fee $Fee Determined by Engineering Sewer Main Charge $ �...-_. Agreement necessary ( ) Non (necessary ( ) Total Due $ d $' Make checks a able to: Cq of Frift Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NUT VALID UNTIL FR.00ESSFD 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 cad codes of the City of Fridloy gad with the Minnesota Construction Codes; that T under -stand this is not a pertnit but only an applicat oil for a pe it and work is not W start without a permit; that the work will he in accordance with the approved plan in the caro of all work which r res ro�iv a d approval of plans. PRINT NAME._ 3® d S1GI3A rIJRE OF APPLIC _ _ ..._DATE $uiiding WATER OR SEWER Permit No.:' 6W 1; Inspections PERAUT APPLICATION Received 8 763-572.3604 CITY OF FRIDLEY : 763-502-4977 fax EFFECTM I_I48 APPLICATION DATE: 01 • • L)YOUX E-MATL ADDRESS: tr•1�����5+�, 1 Cr TW..S APPLICANT IS: CONTRACTOR, E3 OWNER i} r h e. JOB ADDRESS: NEW CONSTRUCTION PERMIT d (IF APPLICABLE): PROPER'T'Y NAME 10M UJ t n,!)% OWNED! ADDRESS: _ Wt •L _ CITY• , STATE: W ZT: TENANT PHONE: CONTRACTOR NANII: SUBMIT A COPY OF ADDRESS: ' STATE: 7.LP: YOUR STATE LICENSE PHONE: CELL PHONE: AND BOND STATE LIC: Y'ifti t1ND: Exi': PERMIT TYPE 0 SEWER CONNECTION PERMIT $50 ATER CONNECTION PERMIT $50 ❑(W:A>TFZ/SEWER LINE REFATR PERMIT $40 D ADD STA'T'E SURCHARGE S-50 ❑ SAC CHARGE _@$1825 TOTAL OTHER CHARGES (W APPLICABLE) PAY TO LITMITx BELLING NEW WA'T'ER METER COST SEE UTMITY BILLING SPECIAL ASSESSMENTS SPEFINANCE WATER TAP SIMENODMI RING NOTE: WATER METER REPAIR, INSP OR STOUT -OFF / weEXMDS & HOLIDAYS $125 I HOUR -BILLED TffM tS AN APPLICATION FOR A PERMIT NQT VALID UNTIL PROCESSPM I hereby apply for a water or sewer (new connection or repair) permit jwd I acknowledge that the informadon above is Complete and aC( ume; that the work will be in wrth � ordinaum and codes of the City of Fridley. I understand this is not S permit but only an application for a permit work is stagy without a permit. STCrivAT1:aRE OF APPLICANT: FRINT NAIL V'Q �L DATE;z --.... .......`_. DATE �y ���y v APPROVED Y ED B* . rl COPY ar C1� 1 o, * }� * �T�y+ V l iLITX '314L Nri City of Fridley Build%.g Inspections DeWtweut 6431 University ,Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 I& Zk U