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PRE 2010 DOCS
City of Fridley, Minn.. Date:WELDING PERMIT N? C523J o wn - Address LO TI N F BUILDING No. �s7Street .. _ ._ Pari g4Lot Lot —, —.__ Block —Addition or Sub-DivIsionkc ` Corner Lot Inside Lot 000'Setback Sideyard –-' --- Sewer Elevation ____ - [ Foundation Elevation DESCRIPTION OF BUILDING To Usedn }} , Front Depth Height �_ Sq. Ft. . RCa. Ft. "".�,/ rront Depth Height Sq. Ft. Cu. Ft. Type of Construction Est.i� 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 ah provisions of ordinances of the city of Fridley. 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 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. — ,. /_7 Building Inspector NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to as the Building Inspector for separate permits for these home. 4 h APPLICATION FOR BUILDING CITY OF FRIDIEY, MINNESOTA Owner's Name Builder (�4" n�� Address Address l If LOCATION OF BUILDING No. 911 r Street Y1 , AJ L" Part of Lot Lot J -V Block v Addition or Subdivision s, Corner Lot Inside Lot Setback 31' 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: 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 Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this gapplication are true and correct. I tet, DATE l ' d SIGNATURE lJ — (A Schedule of Fee Costs can be found on the Reverse Side.) 40 40 City of Fridley Applilcation for Plumbing and Gas Fitting Perndt Depf. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORLocation., -' Number, Kind and Location of Fixtures Locatio , PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ ' G Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ ® U New Ground Run Old Bldg . ............ x 3.25 $ = r Z � �n Q� Z � Z O = � WU' Z • • WATER HTR. 3� ��F w �4y 3� p eLL v4y ti'c S S7 a3 �� U°d i?Z USc a t90 R N GAS ELEC. Base 1st 2nd 3rd 4th • Future Connection Openings Connected wfth I Sewer New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ ' G Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ ® U New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE /TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $� City of Fridley: The undersigned hereby .makes application for a permit for the work hereil specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this applicatigpeare tWe and correct. Kind of Used as To be completed about Estimated Cost, $ Old—New. Building Permit No Permit No Si P B Business Phone No '.a7 C7 ROUGH �d '• 7 FINAL O_. APPficathm for Pawer Pkmts and Heating. Cooling. Ventilation..Refrigeration 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 ............................. §.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 $1.50 $ /i 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— OUGH FINAL— FINAL Dept. Dept. of Bldgs. Phone SII. 4-7470 ! Location .5- d ;z � O z 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. i Fridley, Minn- � � �® 19 6 / Owner .A s Aa Kind of Building 4z Used as To be completed about Estimate Cost, $ :2J'0"� Wrwilding Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PL -ANTS -steam, Hot Water, Warm Air—No Trade Name -21 A2 - - - - Size No- 'e whow e -b Capacity. Sq. Ft. E.D.R _ M_ BTU H.P. Total Connected Load Kind of Fue BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H P. (REMARKS—OVER) i a. .$rZ .59 Business '..ni r 42 HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E. Construction No. Guide ows I rs Reference Out. Wall Int. Wall. Ceiling Roof Floor 1 No es No 19— O Kind Fl.� (tea iAr Room I Lengt / Width 11941 Height r FI Room Windows a dDoors—Crackage and Area Windows and Doors -4 Width Height No. of Lineal tt. Area width Height ] No. of Dane o[ ane lig to of crack eq. ft. No. of Dane of Dane 1 I otal Btu. Requir f .D.R. or sq. ins. W.A. Leader area Fl.j% 1'A' Room j Length Width /moi / Height Win ows and boom--Crackage and Area of Infiltration Glass �' ' �?g• � N d t1.0 1. e2® A D, a I' 1.4 /s.7' /vii § `✓ f O , Coef. Btu Infiltration Glass 191090 Floor ©g 50 Exp. wall ,�� Required s :K Net exp. w Net exp. wall Heiaht Int. wall ` ('� Int. wall Floor EE Ceiling 3 / %D ze Floor / I otal Btu. Requir f .D.R. or sq. ins. W.A. Leader area Fl.j% 1'A' Room j Length Width /moi / Height Win ows and boom--Crackage and Area of Infiltration Glass �' ' �?g• � Exp. wall / O"V !1 / • - �. Q Net exp. wall 8'(� Int. wall Btu Infiltration Ceiling ew, 70 191090 Floor ©g Total Btu. Exp. wall Required s E.D.R. or sq. ins. W.A. Leader area Net exp. w Room 1 Length -- Width/ Heiaht Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Width Height No. of Lineal ft. Area No. of pane of pane ligh/ts of crack sq. ft. / O"V !1 / • - �. Q Coef. Btu Coef. Btu Infiltration Exp. wall' Net exp. wall 8/ le/9 Glass /15V Ceiling Exp. wall Floor Jam_ Net exp. w Int. wall Ceiling Floor EE 3 Tbtal Btu. /, Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Infiltration Glass Exp. wall Net exp. ;all Int. wau Ceiling Floor Total Btu. pyyf/ FRIDLEY, MINN. Insulation How Applied Width Height -1 and Area teal ft.I Area crack aa. ft. Btu Required nit or sq. ins. W.A. Leader area • '� --am,: Fl. i Room I L.enath /` Width /44-' Heigh Windows and Doors--Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. AM Coef. Btu Infiltration Glass /7 Exp. wall' Net exp. wall 8/ le/9 Int. wall Ceiling 15 - Floor Jam_ % Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1Zjjj%Room I Length — Width Windows and Doors—Cracks and Area Width Height No. of Lineal tL Area No. of pane of pans lights of crack eq. tt. / I 16.;t 1 Aice 116.13 IV5, Infiltration L38 Glass Exp. wall Net exp. wall /® Int. wall Ceiling Floor 7 Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area Btu i City of Fridley, Minn. BUILDING PERMIT Date: Owner: Builder Address Address a-75;?�i N? '7429 -LO T ON OF ILDING No. _ Street Part of Lot � Lot ._ _ .._ Block Addition or Su - Corner Lot _ Inside Lot _ . Setback deyard Sewer Elevation Fo tion Elevation DESCRIPTION OF BUILDING Used as:_� Front Depth Height Sq. Ft Cu. Ft l 'ren; DepthHeight Sq. Ft. Cu. Ft. Type of Construction ( )-To be Completed ti 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 a'll provisions of ordinances of the city of Fridley. r 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 confo respects to the ordinances of Fridley, Mi:mesota regarding location, construction, alteration, main ce;aIll pair and moving of buildings within the dty limits and this permit may be revoked at aqy time u violaof any of the provisions of said ordinances. , -11 NOTICE: This permit does net cover the construction, InstaMen for wMhm plumbing, gas hating, sewer or water. Be sera to no the Buihiing hnpeetor for separate permits for these Nems. City of Fridley, Minn. 'N9 9385 BUILDING PERMIT • Date: August 7, 1967 0 • Owner: Vernon LeRoy Anderson Builder Same Address 5825 7th St. N. E. Addams Same LOCATION OF BUILDING No. 5825 Street 7th Street ---- Part ofL�Jo�t Lot_ 12 Block 2 Addition or Sub -Division _____ T �. i=j.."'da1€e.'"ra 7th Adm - Corner Lot — Inside Lot Setback —_ Sideyard Sewer Elevation ___ _. Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Garage Front 24 r Depth 22' Height 1 t Sq. Ft 5 28 Cu. Ft. .5280 Front Depth __ _ Height Sq. Ft Cu. Ft Type of Construction Frame Est, Cost u_.$1500 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. �r In consideration of the payment of a fee of $ 8.00 , permit is hereby granted to Vernon Anderson 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 limits and this permit may be revoked at any time upon violation of any of the provisions of ald ordinances. CLARENCE BEL,ISLE Biding motor NOTICE: This pomit doss not cover the construction, hmft#Won for wiring, phnnbing, gas heating, sewer or water. Be core to see the Building Inspector for sepereie permits for these hone. A_''i'361C.MrXi FO;t B?JI1,D,1'ZG M s LT CI' `i OF, FTc'i'X,27' risNNESOTA OWNER'S NANE 00W A ADDRESS ADDRESS LOCATION Or BUILDING NO. � STREET S B PART OF LOT LOT_ BLOCK a2-, 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. DES,04RIPTION 07 BUILDIN To Be Used Ad: 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 SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). SUBJECT PERMI . City of Fridley AT THE TOP OF THE TWINS PERMIT BUILDING RECEIPT NO. COMMUNITY DEVELOPMENT DIV. INSPECTION r � � PROTECTIVE SEC. t � �. I CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 11/2/73 JOB ADDRESS 5825 - 7th Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 2 Lyndale Builders 7th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Vernon L. Anderson 5825 - 7th Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑X ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBEWORK Install Fireplace 9 CHANGE OF USE FROM TO STIPULATIONS PERMITS REQUIRED FOR WIRING, SEP ERATE HEATING, PLUMBING AND SIGNS. 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 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 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 $600.00 .50 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. $6.00 PLAN CHECK FEE TOTALFEE 6.50 SIGNATURE OCONTRACTOR ORAUTHO IZEDAGENT (DATE) ^y WH N PROP RLAL ATE HIS IS YOUR PERMIT G NSP DATLI i SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) APPLI::ATION FOR RESIDENTIAL, ALTERATIlDN, OR !1i DITION BUILDING PERMIT CITY OF I -N I DLLY, MINNESOTA NNESOTA S&01 -?-?n OWNER'S NAME:Oe��l�- P) BUILDER: Ll YA -N ,, n1 C ADDRESS Ma-- 2[Q I U . C ADDRESS: NO'S . �g�, T STREET • 9 +�, ', - M � C_ , LOT -BLOCK: J, ADDITION : L, % A V 1 �� CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed buildiaig location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: �lAQ° a Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Square Feet; Cubic Feet: Height: Type of Construction: M P Estimated Cost: $ �� To Be Completed: �(J _T q_ The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stfict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that -i11 the facts and representations stated in this application are true and c orrve t . 1. � ! � e. • 111. 1�% � si � (See Reverse Side For Additional Information.) �.sd SUBJECT P IT NO. City of Fridley 26251 AT THE TOP OF THE TWINS BUILDING PERMIT 1 , O COMMUNITY DEVELOPMENT DIV. 1 v PROTECTIVE INSPECTION SEC. 93�� r NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/16/98 JOB ADDRESS 5825 7 Street NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. L2 2 Lyndale Builders 7th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lee Sadowski 5825 7 Street NE 571-3014 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 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 D ❑ NEW ❑ ADDITION ❑ ALTERATION X REPAIR X ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (26 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 REOUIREO 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 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 $2,168 $1.08 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 $77.99 A O CONTRACT ROR UTMORiZEDAGENT (DATEP WHEN PROPERL ALIDATED THIS IS YOUR PERMIT AM ICCAIZ Bim iNSP GATE NATURE OF OWNER OF OWNER BUILD ) IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION T ConstructionAddress: 9�z-s �' f)' 6 Legal Description: Owner Name &Address:C in� Tel. # Contractor: MN LICENSE # Address: Q�20-4 R --r- Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: �TE—�>� ('»--'ef HG Sy . Construction Type: Estimated Cost: $ (Fee Schedule on Back) Driveway Garb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: lv �! ` APPLICANT: 4Tel. # 1 '1 CITY USE ONLY Permit Fee $ %S� 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 $ l Y q . STIPULATIONS: Building $ % S' $ BUILDING Permit No.: Inspections (.0005) times the total job valuation — Minimum $.50 RESIDENTIAL APPLICATION Fire Surcharge Received By: 763-572-3604 CITY OF FRIDLEY $ -,5400 Date Rec'd: DATE t! � l cl�®S YOUR E-MAIL ADDRESS f �� $ SITE ADDRESS S_02_S7y- $ t — THIS APPLICANT IS: ❑ OWNER JbCONTRACTOR ft + 6 ft = ft x $20 = $ PROPERTY OWNER/ NAME: L�9— e— 5aA0 �1 $ ADDRESS:S-g2_5"- Tf` 5 � CITY_ r t (may STATE4IP S q3,f:— TENANT $ PHONE: 76 zi S 7 ( 3G l �l CONTRACTOR NAME: C) 5 L7�'t V 5 5 At c- Agreement necessary ( ) Non Necessary ( ) STATE LICENSE # 2 0 O EXP DATE 3 lr 3 / °%Z N STATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: a c) CITY ./110 WITH APPLICATION PHONE 6/a- 73 ?'7 vZ a FAX 2 '6 -5 ; 5 5, 6 PROPERTY TYPE MINGLE FAMILYINEW CONSTRUCTION SIZE 1 000 5r- ❑ TWO FAMILY/NEW CONSTRUCTION STORIES / PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH �dOOF ❑ DRAM TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR NELUMODELING DESCRIBE WORK BEING DONE: Y -t) e0 `r� SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ❑ HOUSE ONLY a NNUMBERR OF SQUARES Iq HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Exisung Floor Plan GARAGES ❑ ATTACHED GARAGE DETACHED GARAGE 2. Proposed floor plan3. PROPOSED SIZE: List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS. ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: O Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other 0 Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Epergy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION S . 3 ( In OCCUPANCY TYPE Permit Fee Plan Review $ % S' $ See Back Page for Fee Schedule 65% of Building Permit Fee Surcharge $ 1 t (.0005) times the total job valuation — Minimum $.50 Fire Surcharge $ ; 3a .001 x Permit Valuation (1/10%) License Surcharge $ -,5400 $5.00 (State Licensed Residential Contractors) SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due - $ 1671 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 pe it and ork is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which re s e an approval of plans. L SIGNATURE OF APPLICANT �� PRINT NAME6Q&(1)-\ �� 5 �` "`y DATE