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PRE 2010 DOCSDate r Owner Address BUILDING PERMIT Village of Fridley, Minn. N? 2267 kmsil ........... `.................. No. ...$�... Lot ....... li A .... Corner Lot ... $ ... To be Used as: .' ,)111..--��.� . . ................... Type of In consideration the proposed work i ordinances of the vi] Builder....... ....................... ....................... Address......................................... 4LOCATION OF BUILDING . ► .r` Street... ...................... Part of Lot ....,.,,..,., .�.L........... . j Block .. ./........... Addition or Sub -Division . �1r''.�r!"���°� ...* .... , , . , , f... Inside Lot . �"". ` ...... Setback SW! Sideyard ... ��` �+ .............. DESCRIPTION OF BUILDING Front : l.% — Depth . 4 +fit :4'lieight *9Sq. Ft......... Cu. Ft. ........ Front ........ Depth ........ Height ........ Sq. Ft:........ Cu. Ft........ . Aso Est. Cost -A ": 00 ............. To be Completed if the issuance to me of a permit to construct the building described above, I agree to do accordance with the description above set forth and in compliance with all provisions of .ge of Fridley. _ ................... ,%%��In_ oo eration �f the payment of a fee of $.. �i .. , permit is hereby granted to r�.'(4CA41..�...... )!'r:'... , ... to construct the building or addition as described above. This permit is granted upon the express conditiothat 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 with- in the village limits,and this permit may be revoked at any time uviolation of any of the provisions of said ordinances. * F V.Aguilding Inspector NOTICE: Ji This permit dies not cover the construction, installation or alteration for wiring; plumbing, gas heating, sewer or water, Be sure to see the Building Inspector for separate permits for these Items. 0 Village of Fridley, Minn. N° 2331 Date ..: s............................. 0 0 ..��! ..ABuilder ."� ... �. ...................... . Owner il¢lj *.(A 444. , Address ....... ..... Address ...................................... LOCATION OF BUILDING No... fes':' : f .... Street 40 ................. Part of Lot ....... ............ . �� ..... Addition or Sub -Division Lot .... ........... Block.. .:..,,�,,,,..... Corner Lot .... A ..... Inside Lot ....... I .... Setback J41*ow.. Sideyard /tf **4.w.;':"`........... . To be Used as: Type of DESCRIPTION OF BUILDING Front '�l' Depth Height ... Sq. Ft. Cu. k'i... ... . ff: Front ...... Depth ......... Height ......... Sq. Ft.... ... Cu. Ft........ . ... �.l... Est. Costes...:..;.. To be Completed T' In consideration 4 if 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 viII go of Fridley. ........................................... aider the payment of a fee of $. %" permit is hereby granted to . ..... .......... to Construct the building, or' ad dition as described above. This permit is granted upon the express co clition t the person to whom it is granted and his agents, employees and workmen, in all work done in, around and n said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota r g location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits w id this permit may be revoked at any time u nvio n of any of the provisions of said ordinances. r . , . Building Inspector NOTICE: 1- This permit does not oover the construction, Installation" or alteration for wiring, plumbing, gas heating, sewer or water. Bc sure to see the Building Inspector for separate permits for these Items. City of Fridley, Minn. BUILDING PERMIT N?57s • ..rrr.r+'Builder a Address Address ,r+ LO ION OF BUILDING No. , Street G - �''. ___ _ Part of Lot ,�. Lot _ _ J .__ Block Addition or Sub- ivisi7i _ Corner Lot _ Inside Lot Setback _ _ _ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING Toe as: Front Depth _.;— Height Sq. Ft. Cu. Ft. Depth Height Sq. Ft. Cu. Ft. Type of Construction _ . i P Ft. • 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. A 4I 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 whorh 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. _ .4 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 Inspector for separate permits for these items. - J 4 -- - -" APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA owner's Name Builder Address �. 0 No. LOCATION OF BUILDING 4- ZLy- U art 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. To be used as: DESCRIPTION OF BUILDING pront1�. Depth -2 -1 -Height l Sq. Ft. � ,�Pu. Ft. 3 Front -„_Depth Height Sq. Ft. Cu. Ft. Type of Construction 2---/.� Estimated Cost To be 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 ruling of the Department of Build- ings, and hereby declares that all the facts and representations stated in this application are true and correct. 1�, DATE 9 — % sIGNATUl2E ­ZZ�� (Schedule of Fee Costs can be found on the Reverse side). • n LJ City of Fridley, Minn.. BUILDING PERMIT Date: July 20, 1965 Owner: ARDEN L. EBERT Builder GENERAl CONTRACTOR Address 6011 — 6th St. N.E. Address Fridley* Minnesota LOCATION OF BUILDING No. 6032 Street 6TH STREET N. E. _ Part of Lot Lot 10 _ Block 1 Addition or Sub -Division _ Bonney Addition Corner Lot , Inside Lot Z Setback 35 Sideyard Sewer Elevation _ Foundation Elevation N° 8244 DESCRIPTION OF BUILDING To be Used as: Front — Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Est. Cost $15,000900 To be Completed REPAIRS DUE TO STORM DAMAGE REQUEST FRONT S'TBACK VARIANCE OF 35 to 32 ft on GARAGE APPROVED BY COUNCIL ON JULY 199 1965 In consideration of the issuance to me of a permit to construct the building described above I agree to do theproposed work in accordance with the description above set forth and in compliance with a'll provisions of ordinances of the city of Fridley. —�,.. In consideration of the payment of a fee of 1 10.00 , permit is hereby granted to SEN L. EBERT 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 �gg location, construction, alteration, maintenance, repair and moving of buildings within the city limitsns permit may be revoked at any time upon violation of any of the provisions of sJd ordinance. ALIEN G. ffiVSEN Buildmng inspector NOTICE Se pun* den not ewer the condroc8oe, intelhdlen for Wbing, plumbing, gn henthl% rawer er water. Be sun to ne the Bugdh* l gmftr for sepm to pormifs for thea hoar. V � ` 82APPLICATION FOR BUILDINO„PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME A 13 C R 7—BUILDER ADDRESS 1�, ® l( e t �� ADDRESS // LOCATION OF BUILDING No.. 40*STREt PART OF LOT LOT ) BLOCK ADDITION OR SUBDIVISION' CORNER LOT INSIDE LOT 1, SETBACK S 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. DESCRIPTION OF BUILDING To be used as: S �' �� 4D Type of Construction To be completed - Front Depth Height, Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Estimated Coste'l , J6� 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_ SIGNATURE 1 (Schedule of Fee Costs can be found on the Reverse Side). c. 7— NEW [kj Effective 8/16/90 ADAN [ ] R-1 AND R-2 . 3-1 (0 cc) ALTER [ ] Building Permit Application dll Construction Address: (f �� I lQ G�/� , G Leal Description: `` / Name & Address: ��l�i� ( ZZ: �L L n L�ll/� Tei. # J �� Contractor: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed constriction drawn on it to scale. 0 LTVn G AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Bgt/Ground Sq. Ft. 07HER: Corner Lot [ ] Inside Lot [ ] Type of Construction: 1t' Date• Ft. Yd Setback Side Yard Setbacks Estimated Cost: $ Approx. Ccanp a ion Proposed Driveway Width If NewDesired: Ft. $ IM'. $ Ri + 6 See Bac Pa 1 7 / /S ,DATE: APPLSCANr: Tel. # Permit Fee $ Fire Surcharge $ State Surcharge $ SAC amrge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL $ CITY USE ONLY Fee Schedule on Reverse Side .001 x Permit valuation (1/10th �) $.50/$1,000 valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] SUBJECT PE City of Fridley 200 AT THE TOP OF THE TWINS BUILDING PERMIT _ r • _____ COMMUNITY DEVELOPMENT DIV. r � PROTECTIVE INSPECTION SEC. � 1 � , i " ,`� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED UT •-_. �� L 612-571-3450 910-F15 8/18/89 JOB ADDRESS 6011 - 6th. Street N.E. 1 LEGAL LOT NO.BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 10. 1 Bonny Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Leslie Coleman 6011 - 6th Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Richard Hastings Roofing 6331 Riverview Terrace N.E. 574-9966 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 3 REPAIR ❑MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling 18 Squares.). 9 CHANGEOFUSEFROM TO STIPULATIONS Roof can he 2nd layer N11IEN but not 3rd. Install ridged galvanized valleys. On all new roofs or trfr-RffS a~� ren!a�ement roofs, State Code requires th J 2 1,­-'CTC cf 15 IIJ. felt, mopped together, fe ins'.alled to a point ?_'1 inches up from e,:terior V12T line, or the use of other underiayment membrane. approved 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 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 $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- $23.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $23.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY V LIDATED THIS IS YOUR PERMIT BLDG )NSP / qAT SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI NEW [ ] ADCN [ ) ALTER [ ) R-1 AND R-2 Building Permit Application Effective 5/1/88 Construction Address: L E z t r'e C. o L 4/V 6 0/( � rA X571• N - S, Legal Description: Owner Name & Address: L g s j i r` <-o L cm ,a ,yam Tel. � Contractor: R, c,4 A j2,0 4A 5t ; N c S Tel. # 5 I 9wz Address: 1331 'R i V E 2 u t E Lj -rE& . Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. 1zqr9!9MgTT OF err LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Lex h Width Hgt/Ground Sq. Ft. oma: Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard SP tbacks Hype of Construction: i, E Ttoo F Estimated Cost: $'� , Approx. Completion Date: 9/> s jr i IE S F. Proposed Driveway Width If New opening Is Desired: Ft. $ $ Width + 6' See Back Page DATE: V—/ 8 �y APPLSCANT: p - Tp1. #_ 572 j! '-qF W Permit Fee $ QL1, ou State 3urrharge SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Qurzrge $ To►rAL $'�u b'rIPOIATIONS: G'LTY USE OIaY Fee Schedule on Reverse Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by NAY [ ] Not Nary [ ] 966.00 s76c,— SUBJECT P NO• City of Fridley 27362 AT THE TOP OF THE TWINS BUILDING PERMIT r 1 , O ' • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. -1d r 7 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 58432 612-571-3450 910-F15 18/24/98 JOB ADDRESS 6011 6th Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1U 1 Bonn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Les Coleman 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Premium Roofiniz 6S71-3971 20097688 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 3g REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 18 S 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION I 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 1501 PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.FireASC $1.50 PLAN CHECK FEE Licen e C 5.00 T07A EE 5 0 ® 90 SiG—TURE OF CON � RACTOR OR AUTHORIZED AGENT (DATEI EN 7PRPER 9L S LIDAT $ I$ y��q�R P R OATS SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI NEW L ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: ��%� ���_ ✓�� Legal Description: Owner Name & Address: Ze!!��ZcA, I i A,) Tel. # Contractor: /'re;'�MICe.��� MN LICENSE# Address:'�lo b'C,a G 4 ��,V �z�/U� 2� Tel. # , Si/ -3 r 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: Construction Type: POU ►= / V�, Estimated Cost: $ ,'l'� IS -6 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: 9 --)L `/ -q 5� APPLICANT: Tel. CITY USE ONLY Permit Fee $ �� o?S� Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ PJS $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ . Ulf $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: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2003 k Y/ t/7 COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE 6612 ' 4 cw PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS >/ New Fixtures $ 7.00 The undersigned hereby makes application for a p rmit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Water Leader $ 7.00 �� 20d- 0dSumRain p/Receiving Tank Sump/Receiving $ 7.00 Water Treating Appliance $10.00 Owner Water Heater -Electric 7 $ 7.00 geg Water Heater - Gas** $10.00 Building Used As Gas Range** $10.00 ) 2 Gas Dryer** $10.00 Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMPAN Reinspection Fee $47.00/Hr SIGNED BY TEL N0._ i ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough -In Date Final Date State Surcharge $ .50 411 MINIMUM FEE ANY PLUMBING/GAS PERMIT IS $20.00 TOTAL FEE $ C22 s4 PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED rpMMQN VFNT- VENT rYINNFC_TQR AND COMBUSTION AIR VFRIFICATION When ralarin n As in0 furan _ _, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The Px1 ting rnmhi ichnn aor is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to ennfaIl a now cnmbuction airrit will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When in ming a naw y _ntingyystam, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) A*r urian Tyne and S07P/Gammon Vent and Vent Cannertgr Information Appliance #1 Type Appliance #2 Type Appliance #3 Type Total Appliances _ BTU Input — BTU Input _ BTU Input Total Btu Input Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: Signed By: Date : //-)--70 Building iaaac. Drag" v11 V AJULIKILVAP INN Ul711vW THE COST OF LABOR AND MAITMA1 C: BUILDING (USIM THE 1997 UBC FEE SCHEDULE) TPermit No.: Inspections OCCUPANCY TYPE RESIDENTIAL APPLICATION. $ Received By: 763-572-3604 $ 65% of Budding Permit Fee Fire Surcharge $ 3.56 .001 times the total job valuation Surcharge CITY OF FRIDLEY 7a .0005 x Permit Valuation Minimum $.50 License Surcharge 763-502-4977 FAX S • D 0 •$5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Curt Escrow EFFECTIVE 1-1-08 ft + 6 ft = .ft x $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee DATE ' l 1 6 YOUR E-MAIL ADD Sewer Main Charge SITE ADDRESS �� Total Due THIS APPLICANT IS: ❑ OWNER NTRACTOR PROPERTY OWNER/ N TENANT ADDRESS:// O J CITY STATIN' os PHONE.7(o3 eO R —D CONTRACTOR ADDRESS: � •ASD/ SUBMIT A COPY OFPHONE �e SO � —o`tCB FAX YOUR STAT$ LICENSE STATE LICENSE #—___Z % EXP DATE D PROPERTY TYPE 1NGLE FAMILY SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED EVWINDOWS ❑ BASEY2M FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SW &,CNG POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION 0'1 aIN'TENANCEIREPAIR ❑ REMODELING "DESCRIBE WORK BEING DONE: _. PW SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFIN 0 HOUSE ONLY NUMBER F SQUARES ❑ HOUSE & GARAGE BASEMUM REMODELING SUBMTf GARAGES ❑ GARAGE 1. .ATTACHED 2. Ex isting Floor Plan Proposed floor plan PROPOSED SIZE: PROPOSED HEIGHT: ❑ DETACHED GARAGE 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit AI)_DD XS z onyr•vne ertas rrr. ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other ❑ Fasciaand — � � 2. proposed project Two WINDOWS i — YV\ �.�,, IN EXISTING OPENINGS Pfes 3. sets of construction plans Energy Calculations ❑No LOCATION OF WINDOWS r OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF. WINDOW TO BE INSTALLED NUMBER OF WINDOWS A i i IMMIC a WW r A..- �...a. ,•.., •.� iaaac. Drag" v11 V AJULIKILVAP INN Ul711vW THE COST OF LABOR AND MAITMA1 C: TOTAL JOB VALUATION $ 3,500 (USIM THE 1997 UBC FEE SCHEDULE) OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Budding Permit Fee Fire Surcharge $ 3.56 .001 times the total job valuation Surcharge $ 7a .0005 x Permit Valuation Minimum $.50 License Surcharge $ S • D 0 •$5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Curt Escrow $ ft + 6 ft = .ft x $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $i:Z&Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks payable.to: City of Fridley Attach Stduuu lations 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 Fri and with a Construction Codes; thall 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 wr be' rcla th the ap, rove pan the case of all work which review d f p SIGNATURE OF APP PRINT NAME V l/L DATE1V"./ A3U 11 APPROVED BY DATE