PRE 2010 DOCS.
SUBJECT
„.�..�
City of Fridley
32138
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEI O.
i VV -------COMMUNITY COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
572 �®
l�
1 . �
HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVEO By
,..J 612-571-3450
L 612-571-3450
910-F15
9/6/01
JOB ADDRESS 6031 6 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
12
1
Bonnie Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS,
ZIP PHONE
Chester/Jeanette May 6031 6 Street NE
763-571-5761
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Patio Enclosures Inc 2123 Hwy 8 NW, New
Brighton, MN 55112 651-631-1100 1676
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 Q. ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Construct a 11' x 13' Three Season Porch With Windows
9 CHANGEOFUSEFROM
TO
STIPULATIONS
See notations ON plan.
SEPARATE PERMITS
Before digging call for
locations
REQUIRED FOR:
all utility
454.0002
PLWIRING
I � NG
SIGNS
REQUIRED Y LAW
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING. HEATING.
TYPE OFCONST.
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 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. '
NO DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
@
$4, 794
$2.40
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 T PERFORMANCE OF STRUCTION
PLAN CHECK F
TOTAL FEE
`7
Licen S $5.
23.44
IGNATURE OF CON •RACTOR OR AUTHORIZED AGENT IDATEI
EN OP AL1 T THIS IS OUR PERMIT
.I
BLD INS qA�E
S.GNATURE OF OWNER,,F OWNER SUILDERI IDATEI Q►
i
NEW []
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
1.
Construction Address: w3I (Oe ✓,
Legal Description:
Effective 1/1/2001
(763) 672-3604 Bldg Insp
Owner Name & Address: tr 4, , ie c- Adam - Tel. # -745 - 5`71-S Ital
4031 (00V3l.NG
Contractor: �d�in �.��\o MN LICENSE # � e
Address:. \ Tel. # (051- b 3t- I 1 no
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
t 61-0-6 AJ
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length //;/ 511/ Width .3�3 Hgt/Ground8=6'Sq. Ft. 9
Construction Type: -�� Estimated Cost: $
d
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT:—Owy- qjn..'2�� Tel. # (oS&3�-
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 672-3604 for Permit Fees if mailing in application
$ !. S' Fee Schedule on Reverse Side
$ 4z 79 .001 of Permit Valuation (1/10th%)
$_ $.50/$1,000 Valuation
$ $1150 per SAC Unit
$ 4010 $5.00 (State Licensed Residential Contractors)
"A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ % Agreement Necessary [ ] Not Necessary [ ]
$ ,�3.
Buildim-
i P7UNIBI G j Permit No.
Inspectionsji�'T
_� �z y' Received BST :
763 -57? -3604
CITY IT O �IL-� Date � SEP 0 2 (6
I
j 763-502-4:77 Fri
EFFECTIVE mm
p
DATE D �?I 0 YOUR E-MAIL ADDRESS
SITE ADDRESS UO IO S s�lj
THIS APPLICANT 1S: Q OWNER. ONTRACTOR
PROPERTY
NAME:
OVR �
ADDRESS: V0*1 dD Se lu e CITY 441. 411 STA IpTEN
PHONE: UJI. �?� b'L74
CONTRACTOR
NAME: Ulf, GI i IrIA
SUBMIT A COPY OF
YOURSTATE
--E
STATE LICENSE # MXP DATE65-S-#�
LICENSE, BOND AND
STATE BOND4 EYP DATECERTIFICATE
OF
ADDRESS: 5!- 4O PsAQ4 SI Ne �✓q CITY - STATE l
INSURANCE
PHONE ��v�� ���� 2i�� FAX 7I�rU5 1Yq-
PERMIT TYPE
)6INGLE FAMILY ❑ TWO FAMILY [3 TOWNHOUSE
TYPE OF WORK:
❑ NEW YGEPLACEMENT
DETAILED DESCRIPTION OF WORK
PER MS 16B.665 the permit fee is a minizaum of 57.5.00 or 5% of the total cost up to WOO.^ whichever is greater, for the
improvement„ installation or replacement of a residential fixture, excluding the fixtures. '(This should reflect only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = 'plus SO surcharge
OR
FOR PROJECTS WHERE LABOREXCEEDS 5500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: CINDICATE TOTAL
NUMBER OF EACH BELOW). MINIMUM FEE $15.50,
_BATIK SINK/LAV FLOORDRAINS SHOWER WATERPIPING
—BATHTUB _ GAS PIPING (NEED CITY LIC) SWIMMING POOL .._WATER SOFI'NER ($35)
_
CLOTHES WASHER KITCHEN SINK WATER CLOSET PREY. ($15)
_ _ _BACKFLOW
_ DISHWASHER _ LAUNDRY TRAY _TWATER BEATER ($35) FOR IRRIGATION
WATER METER OTHER
,�i..�,veuuyrcwn.ram.e..ys �. ' .
{"..i��:�i�,�"s'���0w�.'�t491����.+��u������rir7c'1u.�, "' •• .
Permit Fee $
Number of fixtures @ $10.00 x$10.00=1
Surcharse .50
Number of fixtures @ $15.00 x $15.00 = S
OR Number of fixtures @ $35.00 x $35.00 = $
TOTAL DUE S
State Surcharge = S .50
(MINIMUM $15.50)
(MINIMUM 515.50) Total = $ '
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing permit and I acimowledge that the information above is complete and accurate; that the work will be in j
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
i
with the approved plan in the case of all work which requires review and approval of plans.
F SIGt4AT1J - OF :1 INT °PINT 7 JAMS. 1�iLk- CAIII t/� DATE /
PPROVCD 13Y
GATT
i
'PERIVIlTST RE' IrCI =-D FOR 3.UTI:DINQEL �: lCAL. D k-:-IEC:-TA'(, iC.1L.-,VA)
3ufia niz
�_---
-��-