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PRE 2010 DOCSAPPLICATION FOR BUILDING PZF4QT CITY OF FRIDLEY, KWWOTA' Owners Name .�^ ®9 s ��` Address -ter— Address __ _�--------.--__ LOCATION OF BUILDING No. Jt -® _Street Part of Lot Lot -' Block. Addition or Sub.Div. Corner Lot Inside Lot -,4 Set Back Side -Yard SEM ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: Front Depth Height Sq. Ft. Cu. Ft. Front ga 4c -r- Depth `ight Sq. Ft. Cu. Ft. Type of Construction 06 Estimated Cos �t 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 Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representa- tions stated in this application are true and correct. � DATA `� r�-l"v� `� - � ti SIGNATURE (A Schedule of Fee costs can be found on the Reverse Side.) City of Fridley, Albm. BUILDING PERMIT N°4 8 s s Date: Owner: ... .. Builder Address Address s.� W-, �N�/''OF�UILDING190. �y .. Street -_..�_".'�..:......_.._._.__._ Part of I' , .._� Lot.....=..1.. Block._.._...-.._....®�......_........ Addition or Sub-DivisionqSl"'f` Corner Lot .......................... _........ Inside Lot ....._..... .............. Setback ....._------...._._---.._..._._----_. Sideyard Sewer Elevation....._............._.._.........___.._.__-...._._._....__..._......._...._........ Foundation Elevation _..._........... DESCRIPTION OF BUILDING To Used as: ,r _2 ........:............ _....----.............. Front _.. Depth° ..:.. ......._.. Height ...... ._.. Sq. Ft..... :. Cu. Ft. _.._.............. ..... ................. _.............. Fro - -.. Depth ...................... ght ............. .- . Sq. Ft. ---•--............._.. Cu. Ft. Type of Construction ........-----.-.. :.....�•-..-- Est. Cost -1 .......:.-........ 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 $–.,� 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 violation of any of the provisions of said ordinances. '—."07A Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be su a to see the Building Inspector for separate permits for these items. LAT - a THISMIT DOES F , ION#�Y PRIVATE LAND -C(;) Nqt TSAND BI'ILDING RESTRICTIONS. City of Fridley, Minn.. =5545,, BUILDING PE T N° Date: Owner: Builder Address Address -- --' LO ON OF BUILDING No. Street °` —T—_ _ _ Part op Lot Lot —IJ --4— Block Addition or Sub -Division _ Corner Lot Inside Lot _ _ - Setback — Sideyard Sewer Elevation To be Used as: Foundation Elevation DESCRIPTION OF BUILDING Front -- Depth — Height Sq. Ft. Cu. Ft. Front Depth _ _ ,e" Relot, Sq. Ft. Cu. Ft. , left Type of Construction Est. 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. tl. In consideration of the payment of a fee of $ w — , permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that theperson 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 11m1is and this permit may be revoked at any time upon violation—of any of the provisions of said ordinances' "� suiliiaf,' Inspector NOTICE This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate pen db for these Ilona APPLICATION FOR BUnDING PERMIT CITY OF FRIDIEY, M7DMOTA Owner's Name _/' , Builder Address LOCATION OF BUILDING No. Street J! 4'/i Part of Lot Lot Block Addition or Subdivision Corner Lot Inside Lot 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: Frontpth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. ��— Type of Construction Estimated Cost gLi - go 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 Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in tis application are true and correct. 101 DATE i (®� SIGNATURE .%?��/il (A Schedule of Fee Costs can be found on the Reverse Side.) . A% City of Fridley, Minn. N° 8642 • BUILDING PERMIT • • Date: DECEMBER 28, 1965 Owner: Builder HOM6DALE BUILDERS- Address U, DERSAddress Address 3017 L) dale -Avenue South Minneapolis 55408,Minnesota LOCATION OF BUILDING No. 5609 Street _ 5th Street N. E, part of Lot Lot 18 and 19 Block 2 Addition or Sub.Division — Hiltons Ad—da. to Mechanicsville Corner Lot _ Inside Lot _._. X Setback Sideyard _. 7 and 12 Sewer Elevation — — Foundation Elevation DESCRIPTION OF BUILDING To be Used as: 37 DWELLING Front 31 Depth 24 Height 20 Sq. Ft 888 Cu, Ft 17,760 GARAGE Front 24 Depth 24 Height ._._._1_Q_ Sq. Ft. 576 _ Cu. rt 5.7 0 Type of Construction EB= Est Cost —$12,5120 To be Completed In consideration of the issuance to me of a permit to construct building described above I agree to do the proposed work in accordance with the description above set f in comp ce ail provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $_Z4. 00 , permit is hereby granted to HOMEDALE BUILDERS 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, Minnesotaarding location, construction, alteration, maintenance, repair and moving of buildin— within the city limits and this permit may be revoked at any rim upon violation of any of the provisions of ted ordinances. ALLEN G. JENSEN Building Inspector NOTICL 1'hia permit don not en r the eonsh uMan, butallation far wiring, plumbing, ga bating, tan or water. Be an to as the Building impostor for aparafo peraft for tbaa hu. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA E BUILDER ADDRESS ADDRESS LOCATION OF BUILDING NO, -6-;15 ® STREET x. &, A PART OF LOT LOT, BLOCK ADDITION OR SUBDIVISION P CORNER LOT INSIDE LOT__�­SETBACKSIDE YARD / _ f SEWER ELEVATION FOUNDATION- ELEVATION 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; t Front 1 Depth�Height Sq. Ft. Cu. Ft. Front Depth_2-� Height / 13 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 f SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side) Land Planning Land Survey'ly Solis Tesh;�y ENGINEERING, INC. c/w/ 6- A funinpal Mllkt 444060 Enjif terriny Engineers Sur vepr.5 ce2ptu-ficate Of S-Ml2ve""Ir E.M! 157,Z7'" kl, and wrred repreMnWionOrI7.5urvey e,*e b— o flue 00060 "1", ssai eq qq - - - - — . ou Application for Power Plants and Healing. Cooling. Ventilation. ReMgerafion and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ..... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ --- GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x $1.5o $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM ALTERATIONS & REPAIRS TOTAL FEE ROUGH FINAL Dept. of Bldgs. Phone 560-3450 City of Fridley: 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. Owner Kind of Used as To be completed about 9 Estimated Cost, $ �� L Permit No. —2 Permit No.— DESCRIPTION OF WORK HEATI`_ =: ; :' PLANTS Hot Wa, Warm Air— / Trade Name-��� £ 1 S2 Size No f� Capacity Sq. Ft. _E/.D.R Z -) � BTU H.P. Total Connected Load '3� s �` Y -V Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R, BTU H.P. RAY N.WELTER HEATING CO. Signe By MibibJEAPOLI® 7. MINNESO 42 Business Phone No -' Z drl (REMARKS—OVER) 3 /1'/ '/ City of Fridley, Minn. N° 8930 • BUILDING PERMIT Date: JULY 19, 1966 • • Owner: HOMEDALE BUILDERS Builder A.B.C. BIACRTOP 90 Address 7000 HUNIBOLDT AVENUE NORTH Address 1308 Nim? STET N -E— MINNEAPOLIS, MINNESOTA EMNEAPOLIS, MINNESOTA LOCATION OF BUILDING No. 5609 Street 5TH MEET T? _ F. - -- Part Of Lot Lot 18 and Vock 2 Addition or Sub -Division HAMn.TONS Ann>v _ TO MF.C!HA'NICSV LE Corner Lot _ Inside Lot Setback — Sideyard Sewer Elevation _ Foundation Elevation To be Used as: ASPHALT DRIVEWAY Front Front Type of Construction DESCRIPTION OF BUILDING Depth Height Sq. Ft Cu. Ft Depth Height Sq. Ft. Cu. Ft Est Coat _.$153,55_ _ 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 s compliance with 21 provisions of ordinances of the city of Fridley. an i_� In consideration of the payment of a fee of $-A. 00 v permit is hereby granted to A.B.-C. BLACKTOP COMPANY 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 tinge upon violation of any of the provisions of said ordinances. NOTICE: M permit don not oaver the construction, huda0tlion for w1riao, phrmhing, on heating, awer or water. Be sure to no the BuiMilog hupeator for aparste penWb for thea it=& APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME BUTS,. -DER ADDRESS ADDRESS LOCATION OF BUILDING N0,� ® �' STREET ''� ��` T• PART OF LOT C'j LOT L/ X �BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT SETBACK SIDE -YARD SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To be used as: DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth 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 g SIGNATURE (Schedule of Fee Costs can be found 0/the Reverse Side).. �` C. SUBJECT PERMIT NO. City of Fridley , 19242 AT THE TOP OF THE TWINS BUILDING PERMIT _ r R -------- COMMUNITY DEVELOPMENT DIV. P-6 �� r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV, DATE PAGE OF APPROVED BY j 612-571-3450 910415 10/13/87 JOB ADDRESS 5609 - 5th Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 18, 19 2 Hamilton's Addn. to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRES$ ZIP PHONE Donald Swanson 5609 - 5t'h.Street N.E. 572-9001 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. American.Remodeling 3700 Annapolis Lane, Plymouth 553-0020 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 ❑ NEW ❑ ADDITION ❑ ALTERATION C$ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside 9 CHANGEOFUSEFROM TO STIPULATIONS 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 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 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 .7,000 $3 r,0 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOESNO ME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVI ONS OF NY OTHER ATE OR LOCAL LA REGULATING CON- $62.50 ST CTION TH ERFO NCE OF CO RU ON. PLAN CHECK FEE TOTALFEE $66.00 SIG ATUREOFC NTRACTOROR HOR12EDAGENT (DATE) WHEN PROPERLY LI ATED T IS IS YOUR PERMIT BLDG INSP f1ATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI NEW [ ] City of Fridley Effective 4/1/86 ADDN. [ ] R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: �`6Gy •f S� �U Legal Description: Owner Name & Address: &Lo*1V �W�'��'� JDOF 5'i '' NE Tel. # `S 7°2 Contractor: ,�/1?.E�'���� /P9wr?®0401 IjI& Tel. # Address: 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: Corner Lot [ ] Inside Lot [ ] / Ft. Yd. Setback Side Yard Setback Type of Construction: Approx. Completion Date: �� /5-'i'= Proposed Driveway Width If New Opening Is Desired: a 11� C/o Estimated Cost: $ 1 ;A�(y Alt. A Alt B $ $ See Back Page for Explanation DATE: � APPLICANT: Tel. CITY USE ONLY Permit Fee $�� s� - Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ $•50/$1,000 Valuation SAC Charge $ $ 525 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ pj Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: suB,,ECT IT NO . , City of Fridley 26599 AT THE TOP OF THE TWINS BUILDING PERMIT r 1 ` RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 17/14/98 JOB ADDRESS 5609 5th St. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 18 & 19 2 Hamilton's Addn. to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Don & Be tt Swanson 5609 5th St. 572-9001 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, 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION T3 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 28 S • Repair siding 2 sides • Repair fac & trim 3 sides 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Call for building wrap inspection before covering. 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 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2935 $1.47 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. $74.75 Fizon SC 2.93 PLAN CHECK FEE TO L EE 1S SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI N P OP Y ALID THIS YOUR PER 1W BLD I;SP MATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 t, BUILDING PERMIT APPLICATION ConstructionAddress: .-\ .� `' Legal Description: E -®f vC �1 L® �= �— NIP qASM, 1 N&. s 4 ��► Owner Name Name & Address: kA.c2© Tel. # Contractor: rj a UL e 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 BIPROVEMENT LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Length Length Length Driveway Curb Cut Width Needed: DATE: (- � APPLICANT: Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Groumd Sq. Ft. Estimate& dost: $ (Fee Schedule on Back) c Ft. + 6 Ft = Ft x $/ = $_ If Wrtln Tel. # STIPULATIONS: CITY USE ONLY Permit Fee $ �w Fee Schedule on Reverse Side Fire Surcharge $ - .001 of Permit Valuation (1 / 10th %) State Surcharge $ $.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: 1�C"/_-_ 66" Building -3--UlAl-lli "JML U14 LABOR AND K&Tti:RIA7 S: SIl��G THE 1997 UBC FEE SCHEDULE) BUILDING $ Permit No.: Ab -16-190 Inspections $ RESIDENTIAL APPLICATION. Plan Review Received By: 763-572-3604 Fire Surcharge $ / .001 times the total job valuation Surcharge $ 7,90 .0005 x Permit Valuation Minimum $.50 CITY OF FRIDLEY $ Date r�d� F 763-502-4977 $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ *FAX Erosion Control EFFECTIW 1.1-08 $450 Conservation Plan Review Park Fee ' Fee Determined by Engineering Sewer Main Charge DATE U YOUR E-MAIL AD S Total Dae SITE ADDRESS O / Sem �-) C Make checks a able.toe_City of Fridley Attach Stivulations THIS APPLICANT IS: 0 OWNER 'CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: �D 9 Z✓ CITY yArz>PS 2� PHONE �74;,Z S7a — 9d6) CONTRACTOR NAME. ADDRESS- STATPD/IZIP Ul SUBMIT A COPY OF YOUR STATE LICENSE PHONE -/_ � !� FAX f9-1 STATE LICENSE EXP DATE / / PROPERTY TYPE ZTINGLE, FAMILY pN SUE ❑ TWO FAMELY/NEW CONSTRUCTION STORIES PERMIT TYPE 0 ADDITION 0 GARAGLSM AgIVINDOWS O BASEMENT FINISH 0 ROOF 0 DRAIN TILE 0 DECK 0 SIDING 0 OTHER O SWIMMING POOL TYPE OF WORK: 0 HOME CONSTRUCTION 0 ADDITION �ANCFJREPAIR 0 REMODELING DESCRIBE WORK BEING DONE: _ SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT RO 13 HOUSE ONLY NUMBER F SQUARES 0 HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES C3 ATTACHED GARAGE I. . 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: PROPOSED HEIGHT: 0 DETACHED GARAGE 3. List of structural members to be used SIDING _ FOR NEW CONSTRUCTION INCLUDING DECKS, 0 Vmyl OSoffit �^ ADDPIIONS & PORCHES SUBMIT, 0 Aluminum 0 Trim � ` �` 1. Site Ph m/Survey showing the existing si uct ues 0 Other 0 Fascia _ g and proposed project. WIINDOWS / GVu�'S �1�rr� — a 2. Two sets of construction plana IN EXISTING OPENINGS dyas ONo LO TION O�i�l a+ OR FOR NEW OPENINGS -DESCRIBE SIZE OF 3. Energy Calculations OPENING CHANGES & TYPE OF. WINDOW TO BE INSTALLED NUMBER OF WINDOWS ATT 12WWO ♦"WT ♦(.111T A1T �Y vT ...w•..�. ... %� -3--UlAl-lli "JML U14 LABOR AND K&Tti:RIA7 S: SIl��G THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ 5 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ / .001 times the total job valuation Surcharge $ 7,90 .0005 x Permit Valuation Minimum $.50 License Surcharge $ ,$ • $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 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 Dae $ �-) C Make checks a able.toe_City of Fridley Attach Stivulations THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a building pmmh and I aclmoWledge that the on above is complete and acomft, that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction ; that I understand this is not a permit but only an application fo a permit on site; that the work will be ce widt plan in the case of all work which lana* permit and work is not to start without a requires 'ew an of SIGNATURE OF APPLIC PRINT NAME LL ✓Vl DA l ®464 ff Building $ BUILDING Plan Review Permit NO.: a'i0' ©o-3 Inspections Fire Surcharge RESIDENTIAL APPLICATION .001 times the total job valuation Received By: 763-572-3604 .0005 x Permit Valuation Minimum $.50 License Surcharge $ 1 $5.00 (State Licensed Residential Contractors) 763-502-4977 CITY OF FRIDLEY $2100 per SAC Unit (Plans to MWCC for determination) Dat d y FAX ft + 6 ft = ft x $24 = $ Erosion Control $ ` Park Fee $ EFFECTIVE 1-I-2010 Sewer Main Charge $ DATE Off/' �� Flo YOUR E-MAIL ADDRESS �'� (0-P 14okouvl_ kCPAd3; .cowl SITE ADDRESS 5'601 s-� �?I'• -rG THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: Octty SwaNfd" TENANT ADDRESS: 5*0q CITY r-4hy STATE AK ZIP 1J-971 PHONE: CONTRACTOR NAME: NObte-t ate e�"t t,t koj SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # ;-0 6 71149 48 EXP DATE AND CERTIFICATE OF ADDRESS: F1 114 doµ' AAa. S . CITY P - O STATE 1e KZIP Oy417 INSURANCE PHONE 614' !P76- $71F- FAX 617, - O-ZA 003 PROPERTY TYPE ➢+SINGLE FAMILYINEW CONSTRUCTION SIZE 17-00 ❑ TWO FAMILY/NEW CONSTRUCTION STORIES A PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED KWINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK 6SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR 'N REMODELING DESCRIBE WORK BEING DONE: �✓�'^% �KeQew S fte,vcq {-�/'�•u^ SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: I. 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 J9 Trim 1. Site Plan/Survey showing the existing structures ❑ Other PLFascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS 2l,Yes ❑No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & pp TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS 1 ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ I4,Gli�- OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ 1 $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ , v Make checks vavable to: Citv of Fridlev 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 and 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 work which quires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME r 57 "-A 6e0-'4Hd'4?- DATE