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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: February 16, 1971 Owner. Tom Swanson Builder Y:n, l to teak $u i 1 dQ..rs, Inc Address _, 5114 Long Lake Road Address 3114 Long Lake Road o.�_4iF76— '1®931 LOCATION OF BUILDING No. - 5550 Street ,_, 6th Street N.E_,.,,_ _ . — ._.._..,., part of Lot Lot .2s Nz4 __ Block 7 Addition or Sub -Division . Hamilton's Addition to Mech'ville Corner Lot , Inside Lot _ _ X Setback 35'___ Sideyard — 10' slow Elevation 851.40 _ 854.40 (Approx..) Wye Top of Footing DESCRIPTION OF BUILDING To be Used as: 10 14.5 Dwelling Front 26 Depth 30 Height 20 Sq. Ft. 920 CtL Ft, 21+200 Garage Front ___4 _ Depth 20 freight 10 Sq. Ft. 280 Cu. Ft. 21,800 Type of Construction _ Frame Est, Cost _ `a.__15, 000 __ To be Completed May 1, 1971, Provide verification survey before proceeding with framing. Provide hard surface driveway. WATER LOCATION: 107' South of Manhole SEWER LOCATION: 94' South of Manhole Garage w1m floor elevation 864.00 (Spike in tree at top of garage floor, 12 inches above street.) Determined by Engineering. In consideration of the issuance to me of a permit to constqct the building—described building—describedabover4vidy I agree to do the proposed work in accordance with the description above o and in plian with of ordinances ofthe ty of Fridley. In consideration of the payment of a fee of $ 40-00 ., permit is hereby granted to Th nma c Swar a^n 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 regardinglocation, 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 /Building Inspector HANK MMCR NOTICE: ?his psenit does not cover the construction, Installation for wiring, Plumbing, gas heating, sewer or wafer. Bo wrs to iso the Building Inspector for separate permits for these items. oj! ROY J.' 4WANSEN Spring 13907 Lake Road ��� r.Su^'ey°r AND PLAT O F SURVEY � Hopkins, Minn. 85343 Civil Engineer * - Telephone 99&5678 OF PROPERTYXXX_f nr White Oak Builders �, Z LOCATION 5550 6th St. N.E.' Fridley, Minnesota. DESCRIBED AS FOLLOWS Lot 3 and the North 1/2 of Lot 4, Block 7. Hamilton t s Addition to Mechanicsville, Anoka County,q Minnesota. KAJ \h �k \,A` d` UQ Y i i I" a hh N4 s 1 n I� V Id -C /30.;23P/af J /30. ewrore m A>tAcq�i I 3S' — - YA �PI1` ®�p ( Al'® 4 "'r TL 30 {� 4 scd/e : / �ifcif 30 Av., f 0 iron X/a.Ed! CERTIFICATE OF LOCATION OF BUILDING CERTIFICATE OF SURVEY I hereby certify that on—. --19— I hereby certify that on�0-7 19?�— I made a survey of the location of the building(s) on the above I surveyed the property described above and That the above plat described property and that the location of said building(s) is is a correct representation of said survey. correctly shown on the above plat. ROY J. HANSEN, REGISTERED SURVEYOR NO. 6274 . APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: ADDRESS :-3"W#� � �, ,,��ce /to� ADDRESS:, -3--//z/ 1a�-fail ` NO:.�"L5'0 STREET:_ LOTJWZ BLOCK:_ ADDITION: ic di CORNER LOT: INSIDE LOT:x X SETBACK: 3.5 SIDEYARD: /D 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: ' '"� Q/6-7,qa / `'' x /' ,-,4' 1aFront • �` & Depth: 3 0Height Square Feet: 0 Cubic Feet: Front 9 •�_ Depth : `� ,-�� Height: � Square Feet; �, V 'r a Cubic Feet: -3. a r' 0 a ' Z3Pe of Construction: Estimated Coat: �e vU To Be Completed: The unders Zeby k s application or a permit for the work herein specs ed, agreeito do all work in sttict 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 : • )—/7- 7/ SIGNATURE: (See Reverse Side For Additional Information.) } uP spy „ �, �J � d f�},,.., per" � �'"� Y� •� I Apoicafto dor Power Pkuft ane! Heating, Coding,, VemAladon, R n and Air C®n0loning S"em and Devic PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ..........................$10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ............. .. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECIL WARM AIR 6 C) Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 ' each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam .$10.00 $ Furnace Shell & Line—to 640 sq. ft. IDR Hot Water .. 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 ' $ Each add. 320 sq. ft. EDR Hot Water ... ........ .. 3.00 $ OIL BURNER—to 3 gal. per hour ..... 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTL) ........................ 8.00 $ ! over 199,000 BW SeeFee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ..... ..... x$ 100 $ �` , ® 0 Additional Fixtures ................ x .78 $ Gas Range to 199,000 .. — ...... it 5.00 $ AIR CONDT1iONING FAR BEATING SYSTEM VENTILATING SYSTEM ALTERATIONS do REPAIRS ROUGH FINAL 5-13 % s See Fee Schedule TOTAL FEE $ Dept. of Bides. Phone 980 -MM 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 Ordinance; and ruling of the Department of Buildings, and hereby declares that an the facts and representations stated in this application are true and correct. owner sffl�j Kind of Building Used as To be completed :ed Cost, $- ew Building Permit No. Permit No. 'Y 7 HEATING or POWER P'LAN7 --Steam, Hot Water, Warm Air—No Trade Name- Size No- CILl® Capacity Sq. Ft. E.D.R BTU d H.P. Total Connected Loa02) — Kind of Fuc BURNER — Trade Nems Size No Capacity Sq. FL E.D.R BTU H.P. (Ru"AKs–OVER) SL'.'RWlUM MIN WN!M1"' 141 0. Signed 8419 CHM MhE By Business Phone N� City of Fridley AppificcNogn fec- pjumping cilld Gas pjj-, kitsg pc,_ nE3C111PT10jj Or WORIC Dept. of Bldga. JPhor%G 560-3450 Numb--, Kind and Locallon of riturem Locatio 5 c5u r, T?4 4 P A A L RATE S C 'rED U L E PMJ) C -M: -� *-!----S: Fixtur, 1'-1:--1e to lc1.) 11TIJ RZPAMI '- M. TrnATIC!; �--Tlc for to Codo T'-*-, Sewer ce.-spo'01 rl RATE TOTAL 14 ou x T2.00 - x $I.So 03.25 S ---- v oo x t-3.25 52.00 < F�l RATE TOTAL R $2.00 • -T, I- Ti` X $1.00 P A A L RATE S C 'rED U L E PMJ) C -M: -� *-!----S: Fixtur, 1'-1:--1e to lc1.) 11TIJ RZPAMI '- M. TrnATIC!; �--Tlc for to Codo T'-*-, Sewer ce.-spo'01 rl RATE TOTAL 14 ou x T2.00 X1.50 x $I.So 03.25 S ---- v oo x t-3.25 52.00 RATE TOTAL R $2.00 .75 X $1.00 TOTAL nX ItY of Fridley: The undt-i-jrr,,t:(j IW -b; rmk("S;jPP11C,'I1jun !(r j,:Tnjt f,,r I;, to (11? -Il %-.()rk m strict "Ith aiid rule,,,, ()r jil, 111k.11t ()f iri,, 01c NJ - 'Ind (.11 Irl -Iry tlul- Ownvr K;ncl of 13W1,jirl4 U, -( .(l a--, 0 F:.*;-, zit, --d CL,.t. ROUGH______ <!tb A a City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING PERMIT P 15549 rp � COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 `.J 612-571-3450 RE 9 7 NUMBERREV. 910-F15 DATE 1/5/79 PAGE OF APPROVED BY JOB ADDRESS 5550 - 6th Street N.E. 1 LEGAL DESCR. LOT NO. 3, Pt. 4 BLOCK 7 TRACT OR ADDITION SEE ATTACHED 1 Hamilton's Addn. to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dennis Sando 5550 - 6th Street N.E. 571-2832 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Hogar Construction 1061 - 109th Avenue N.E. 755-6600 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 X 8 DESCRIBE WORK Construct a 24' x 24' Detached Garacre and r-onvert Existing Attached Garage to Living Area. 9 CHANGE OF USE FROM TO STIPULATIONS Existing attached garage door must be removed before final inspection on detached garage. Side yards to be maintained at 3 feet with survey to be submitted. provide hard surface driveway. WARNING Before digging call utilitiesSEPERATE PERMITS REQUIRED FOR WIRIN. �TELEPHONE - ELECTRIC - SAS Etc, HEATING, PLUMBING AND SIGNS. REQUIRED BY 14 SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. TYPE OF CONST. Wood Frame OCCUPANCY GROUP OCCUPANCY LOAD THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ZONING SQ. FT. 576 CU. FT. 5760 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $4,821 + 2,000 SURTAX $1. 00 + Wl DOES NOT PRESUM TO GIVE UTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SACCHARGE PROVISIONS OFOY� OTHER T TE OR LOCAL LAW REGULATING CON- STRUCTION OR TERFOR A CE F ONSTRUCTION. $23111104 + 12.00 PLAN CHECK FEE TOTAL FEE x $38.45 SIGNAWJRE OFCONTRACTO -RAJTHO IZEDAGENT (DATE) IT WHEN PROPERLY V IDATED THIS IS YOUR ER7EF ZILJL BLDG INSP 0 SIGNATURE OF OWNER I IF OWNER BUILDER) (DATE) CITY OF FRIDLEY APPLICATION FOR RESIDLNTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OWNER: fv" -S S /t/ve 0 ADDRESS: _SSS® tff54 TEL NO: � BUILDER: ADDRESS: ZQ61 Axf-el-Ale-11116 TEL NO: Construction Location STR12T NO: �(J STREET: 4 t 1 5'�c IV LOT: /'� �- BLOCK: -7 ADDITION: Corner Lot: Inside Lot: "✓ Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION 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 her decla es that all the facts and representations stated in this application are ru and oZ� rr ct C DATE: U ✓ SIGNATURE: Stipulations:Y4, bL Fi � Y4, lA1J �r W 1 r�zf 'Sc _e_'Lj 2 �a Qa a-�� I x��►,��► 0,CN�6 � _X002 us— � J7,NAL r,uSP����v►J 6.0 1► Acr1L02A�L - 38 qs- Front:-( Depth: Height: `V Square. Feet: 51-7 Cubic Feet: 0 G�} t d Lm Front: Depth: Height: Square - Feet: Cubic Feet: 1 Type of Construction: Estimated Cost: $ �GTo Be Cbmplete6: ' v 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 her decla es that all the facts and representations stated in this application are ru and oZ� rr ct C DATE: U ✓ SIGNATURE: Stipulations:Y4, bL Fi � Y4, lA1J �r W 1 r�zf 'Sc _e_'Lj 2 �a Qa a-�� I x��►,��► 0,CN�6 � _X002 us— � J7,NAL r,uSP����v►J 6.0 1► Acr1L02A�L - 38 qs- ROY J. I- ANSEN 13907 Spring Lake Road Lend Surveyor PLAT O F SURVEY Hopkins, Minn. 35343 AND Telephone 938.5678 Civil Engineer OF PROPERTY= fnr White Oak Builders LOCATION 5550 6th St. PI.v., Fridley, Minnesota. DESCRIBED AS FOLLOWS Lot 3 and the North .Z2 of Lot 4, Block 7, Hamilton's.Addition to Mechanicsville, Anoka County, Mintesota. 1'z ods sMeasurF� /30,.2'�P/af iso' - \ 6 1,41 o,— ho O �Ci �iC /hi// /a fOG1,4 WW2 41 cornFit i. M h _=4o (� I V *'4 30' f .Se..71e , / A'e-4 e .?0 /rNe,' 0 Vei701"es icon xlfallc a CERTIFICATE OF LOCATION OF BUILDING CERTIFICATE OF SURVEY �PrgoOsed 1 hereby certify that on—. _1?_ F 19,— I hereby certify that on_�' 191�— I made a survey of the location of the building(tT on the above I surveyed the property described above and at the above plat described property and that the location of said building(*) is is a correct representation of said survey. correctly shown on the above plat. n R J. HANSEN, REGISTERED SURVEYOR NO. 62 �i ,.,v n F�--"+cr* T; w!s, vv • := g :r' _ "� "^*n'.' t >r� n +ap,r � � "w ` t, . 7 r.� r. r 000 OGAR CONSTRUCTION, INC. 1061 109th Ave., N. E. CEMENT WORK ORDER MINNEAPOLIS MN 55434 755.6600' Permit Number Date Promised Salesman 61 Cement Man Cement Supplier Fill Supplier Date 1 A Garage Side /-7 X 2"� Apron, Detached ❑ Attached 0141remesh ❑ 112" Rods EjyCondult Pipe Ix 7'5 Overhead Door Si zq Offset 6 � , Lo r"plc Service Door Location 6A1 Old .Garage Removal By Old Cement Removal By� D�Ivevray Size i Blox Size and Location Waterproof Backfill Excavation By - _- Gradual Steep Grade Flat Slope Slope__ f SUBJECT PERMIT NO. City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT 27915 RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. i = , 1 1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE O: APPROVED BY "'j 612-571-3450 9t0-Ft5 9/22/98 JOB ADDRESS 5550 6th St NE 1 LEGAL BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ILOTNO. 3, N$4 7 1 Hamilton's Addn. to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Elaine Sando 571-2832 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Solomon & Sons 12211 Olive St NW Coon Rapids 55448 754-5875 20055664 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 :0 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house, garage & shed (23S Tear -off 8 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 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 $1,971.00 $.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 - Fre SC $1.97 ST OR THE PERFORMANCE OF CONSTRUCTION OR PLAN CHECK FEE TOT EE License $5.00 $70.20 SIGNATURE OF CON TRACTOR OR AUTHORIZED AGENT IOATEI EN ROP VALID THIS I�OUR PERMI IN P ryA TE SIGNATURE OF OWNER,IF OWNER BUILDERI IDA TE -1' f NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �-iel te ConstructionAddress: 55-5-0 61" Ste- kL Legal Description: Owner Name & Address: �.rr, o� s Tel. # Contractor: ,91) 0 ✓ ? So y- MN LICENSE # Address: // O ice If-- e&W 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 OTHER: V- � Wt. ' Construction Type: Estimated Cost: $ I97 ) (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT:–� `'� –"—� Tel. # CITY USE ONLY Permit Fee $ o2S Fee Schedule on Reverse Side Fire Surcharge $ 1, G% .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: g D•�?0 Building $ BUILDING Permit No.:' [1 — -3;f6 Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION Received By: 763-572-3604 Surcharge $ �, 7S .0005 x Permit Valuation Minimum $.50 License Surcharge CITY OF FRIDLEY 2)4 Date Rec'd: g mss - 763 -502-4977 FAX $ EFFECTIVE 1-1-2010 �� Curb Cut Escrow DATE �3�/�r% YOUR E-MAIL ADDRESS PIW,, SITE ADDRESS _ _ S� �_ -, Arg THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS:_7 CITYSTATE &P Agreement necessary ( ) Non Necessary ( ) PHONE: CONTRACTOR NAME:�� SUBMIT A COPY OF YOUR STATE LICENSE _I -D �'] J J %( EXP DATE '3 / STATE LICENSE #/zO �% AND CERTIFICATE OF ADDRESS&D3CITY 'SP !lam F,V. STA IP INSURANCE PHONE B Z 6/ OO FAX i 17--2—Zft OZ/1 PROPERTY TYPE OLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEJSHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK 9SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION R MAIAITENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE:_ IZ 21- J'1 12 SIZE OF IMPROVEMENT Z Z S LENGTH WIDTH HEIGHT SQ FT ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY ❑ 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 ❑ 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 FOR WINDOWS – PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPINING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING/ 1997 U.B.0 FEE SCHEDULE) COTAL JOB VALUATION $ 9P ® 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 $ �, 7S .0005 x Permit Valuation Minimum $.50 License Surcharge $ :;;etPV— $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ftx $24 = $ Erosion Control $ $450 Conservation Plan Uview Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $— P;so Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the 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 c=0f,,ork�yv ' h uires review and approval of plans. SIGNATURE OF APPLIC�/ PRINT NAME_ �i0264C,' C� ,�tr Z ATE J 2