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PRE 2010 DOCSVillage' of Fridley, 'Minn. .................... owner ! . .... . Address................. .................:.... 'N° 2366 Builder ..' ... .... .. _ ... .. . Address ......................................... Building Inspector NOTICE: LOCATION OF BUILDING No. ...... Street ..r .. sem: K .......................... Part of Lot ....................... Lot .......... . .. .. Block .... . ... . ; . Addition or Sub -Division iDi e . ........ . Corner Lot :..... ..... Inside Lot /!�';....... Setback ..... ... Sideyard .......................... DESCRIPTION OF BUILDING To be Used as: a n ` . ...... � ...... Frond: � � .T...... ;Depth Height .1.$.. Sq. Ft. .. � � Cu. Ft........ . l .... Front • •'L" . ..... :'Depth . Height ......... Sq. Ft......... Cu. Ft........ . Type of Constructi rsr, ..Est. Cost ' .......... To be Completed . r"/. f' it �f In coissiderati of the i uance to we 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 i illage of Fridley. I� ........................................... In consideratic a of the payment f a fee of .•.'".'. ; permit is hereby granted - ME .I., ..................... to constructthe building or addition as described above. This permit is granted upon the express conditi that the person to whom it is granted and his agents, employees and workmen, in all work done in, around an I upon salbuil , or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding „locatio 2, construction, alteration, maintenance, repair and moving of buildings with- in the village isms and this permit be revoked at any time upon violation of any of the provisions of said ordinances. Building Inspector NOTICE: ° This permit does not cover tlie construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure 4 see t e Building Inspector for separate permits for these items. • City of Fridley, Minn. BUILDING PERMIT Date: AUGUST 20, 1965 N° 8394 Owner: JAMES G. SMEDEMA Builder THOMAS % S=S Address 6070 - 7th St 1q- F Address 6020 Wynnwood Road Fridley 21, Minnesota Minneapolis, Minnesota LOCATION OF BUILDING No. 6070 Street 7th Street N. E. Part of Lot Lot 1 _ Block 1 Addition or Sub -Division .___ _ 11 onny Add i ion Corner Lot ___X_____ Inside Lot _ _ Setback Sideyard Sewer Elevation Foundation Elevation 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, 000.00 _ To be Completed REBUILD HOME FROM CAP UP – STORM DAMAGE 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 fo and in compliance with ;hprovisions of ordinaacres of the city of Fridley. �- In consideration of the payment of a fee of S 10.00 permit is hereby granted to THOMAS S - STINIS 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, Minnesotalocation, construction, alteration, maintenance, repair and moving of buildings limits within the city mits permit may be revoked at any time upon violation of any of the provisions of said ordinances. ALLEN G. JENSEN Building Inspector NOTICE: Ibis permit den not cover the construction, hataUdion for whhm phmubing, gra hosthkg, sewer or water. Be sere to we the WOWS hapector for separate permits for these t -ems. OWNER'S APPLICATION FOR BUILDING PERMIT CITY OF FkMEY, MINNESOTA BUILDER AMUVOC LOCATION OF BUILDING No. � � ���street Part of Lo LOT BLOCK ADDITION OR SUBDIVISTONiF.=V.,e2:K Corner LotInside LOT_ Setbaick 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 d as ; Front Dept 3'0 Height / O Sq. Ft. Cu; Ft. Front Depth Height'-; Sq. Ft. Cu. Ft. Type of Constructitimated Costt To be completed / The undersigned hereby makes applicationrfor`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 here y declares thst all the facts and representations,,stated in this application are a and correct, yo_! of Fee Costs can be found on the Reverse Side). r SUBJECT City of Fridley ® 128,�,� AT THE TOP OF THE TWINS BUILDING PERMIT r � ECEIPT NO. • ______ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. "1 CITY HALL FRIDLEY 55432 NUMBER REV. .: OATS''")` PAGE OF APPROVED BY 612-560-3450 910-,15 3/7, 75 JOB ADDRESS 6070 - 7th Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 1 Bonn iAddition SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE e Euciene Kazmierkoski 6070 - 7th Stteet N.E. Fridley 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. i B & L Construction Company t - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. I 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. I 6 USE OF BUILDING u 7 CLASS OF WORK ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install paneling in basement i I 9 CHANGE OF USE FROM TO i STIPULATIONS I l I 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 R-1 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 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. $1,000.00 .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 PROV SIO OF ANY OTHER STATE OpLoCAL LAW REGULATING CON- $6.00 STRU TI N R THE PERF ANCE CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $6.50 SI ATUREOFCONT OR OR UT ORIZEDAGENT (DATE) WHEk PROP RL V ID T THIS IS YOUR PERMIT ==D P DATE r SIG TURE OF OWNER (IF OWNER BUILDER) (DATE) APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: Ca jeNe. KgZ`"nedOSKZ BUILDER: ADDRESS: 60-70— 74t Al,� . ADDRESS: �' d 3 F [ K I NO:. OSTREET: LOT: BLOCK: / ADDITION: P-xlp� �3 Ti U CORNER LOT: % INSIDE LOT: SETBACK: SIDEYARD: 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: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: T4rve,( •'4/ j F4Seme.04-Estima.ted Cost: $ 411000. 0 To Be Completed: AIQr ; l S — ) `� 7� '�go�d' ►71�� er,'a (S The undersigned hereby makes application for a permit for the work herein specified, agreeing to 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: 3— ( 7, SIGNATURE: (See Reverse Side'For Additional Information.) 1 • 5�-�1 -9915051 CR4it{�� A�a�^•.}1C;`i VU for PIf14ii n .`� =,QGin= • ,_,�,_„_ ,_.,_... Dept. of Bldp. Phono S:'D-3" . DESCRIPTION 0: 4,'Orr. 6070 7tvn Street rW,. I:uzzS.:. KL:i d aad Loc:!10a of Fixtares . City of Fridley: L t 7 •: I$ o u z wATrI -T*, Tu OAS t. ' The undersigned hereby crakes application for a permit for the vor>c her the Cit? Ordirs:" ; 3 M �a _ �v s u u d to specified, aCr eeing to do all work !n strict acco:Cance with that a:I the 1: N is iS and ruling of the D+:pa:.r•:ent of Build.'agr, and hereby declares Estr I and represertations stated in th.s application are true and co.reti-t' ins to 1 g ril ... 5-10-76 19. z'ridley, Zaaa 2:.d rugQne Kazmierkoski — Owner 3rd • Kind of Building Frame — S .y • FLr._e Cc�L:t.cn C?:.z! ::� ucaaz❑ res. Used as t i{av Fir:•aro. Old O—,,s-..:--•ss Cc=2col ❑ 5-17-76 To be completed about . Estimated Cast, $ 10 CO PARTIAL RATE SCHEDULE � Old-MMw. Duilding Permit No. — rarest: o. Lv^AMIC rIXTU?E RATES: NO. RATE TOTAL Sizr;cd A' rr.ber Fixtures . . . . . . . .... . . . . . �-- x 52.00. g _ Fv:ur a Fixture Opening ........... .�— x 51.FA S -• By MITGNASCO Business Phone No %cw Fixture Old Oyerung........ • • _______ x S1.50 $ _.. _ . , Catch Basin .... x $3.25 $ - Water Beater 'Up to 9.3.000 BTU). • • • ------ x $3.00 $ ROUGH . New Ground Run Old B!dg....:... • _---- x :3.25 S . 3 E!.ctr-c Y.a:.r H.atar. .....:........ _._..__ a .$,2.00 FINF►L ,PO s1.S ;'ZTTING FEES: NO. R^*TL' TOTAL , $ - Ist3Fixtures •••••••••••••••••• -----x$2.00 kddlUonal Fixtures ............... ---- x C .75 G:s R.:: Ze to 199.000 BTU ........... ----- x $5.00 ,'►�----- . grill 5.00 . .50 State Surcharge p„c•? l::'3 is ALTERATIONS—R&UT !o Cod* ' TOTAL. l;'T• :. r �— CITY OF FRIDLEY INSPECTION DIV. dG� 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On January 1, 1997 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 ,0® $10.00 $10.00 $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 TOTAL FEE $gA, -< 0 JOB ADDRESS.607C) -7 Sf- The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. .2 % / !' 72 1997 '71' YZ s'2. Building Used As Estimated Cost ® PERMIT NO. :Z L-1 Rough -In Date PLUS THE $.50 STATE SURCHARGE TEL N0. I ' Final Date_ **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SO INCHES. SUBJECT P City of Fridley 28468 AT THE TOP OF THE TWINS BUILDING PERMIT r 114. DEVELOPMENT DIV. SEC. �cvJ r PROTECTIVE INSPECTION 1 � ` CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 10/29/98 JOB ADDRESS 6070 7th Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 1 Bonn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Rosemary Hinsverk 571-4252 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO New Haven Constr. Co. 4208 83rd Ave N Brooklyn Pk 55443 566-5225 20077950 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 O ADDITION ❑ ALTERATION is REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof house and garage (20 Sq) Tear -off 9 CHANGE OF USE FROM 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 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 TRUED CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING T IS TY OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED MER OR T. THE GRANTING OF A PERMIT 1714 $.86 DOES NOT PRESUME TO E UTHO 1 V TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PR IONS OF ANY OT ATE R LOCAL LAW REGULATING CON• STR TION OR THE PER O NCE F CONSTRUCTION $56.75 Fir SC $1.71 PLAN CHECK FEE FEE - 1zld ' icen C 5 0 ;70AL .32 SIG10 ATURE CO'. TO RAurtl RILEOAGENT IOATEI EN PR V LI THIS I$ YOUR P RMIT V / S-GNATURE OF OWNEROF OWNER BUILDER. (DATE. BLO INSP Z OA fE NEW [ 1 Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ��� � ConstructionAddress. -7'0 5�r -e e �E Legal Description: Owner Name & Address: �Cos e IV Ikls ✓e r'i2— Tel. # Contractor-,-/�e, MN LICENSE # -?-o a 7 7 9S- o Address • ��� S� `-"r ,%z'e6i ice /�trY Tel. Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF ZIPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 0., [Zonstruction Type • Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x $ _ $ DATE: /-0 - ;)-s - S k APPLICANT: Tel. # X76& 'ermit Fee 'ire Surcharge ►tate Surcharge ;AC Charge .icense Surcharge hiveway Escrow irosion Control 'ark Fee $ ewer Main Charge TOTAL TIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] Building PLUMBING Permit No.• Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 5 DATE OG YOUR E-MAIL ADDRESS SITE ADD -SS THIS APPLICANT IS: O OWNER S iCONTRACTOR PROPERTY NAME: +CIII KC 7i, ADDRESS: CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR NAME: STATE LICENA # c e a( EXP DATE CITY l ow STATE/9 "ZIP 3 SUBMIT A COPY OF YOUR STATE ADDRESS: LICENSE WITH PHONE 7c 3 6trot-V4116 FAX e7rot-40a G APPLICATION PERNIIT TYPE f4SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: "SEW 0 REPLACEMENT G� �ry`sr/�er�` j�✓r��1''�`'�� DETAILED DESCRIPTION OF WORKell PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, 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 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINKILAV FLOOR DRAINS _ SHOWER _WATER PIPING _ BATHTUB GAS PIPING pam crrruc.Eh" _ SWIMMING POOL WATER SOFTNER ($35) _ _ CLOTHES WASHER KITCHEN SINK_ WATER CLOSET ,BACKFLOW PREV. ($15) _ _ DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION _ WATER METER —OTHER Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 6 x $15.00 = $ 157 CW TOTAL DUE $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ 50 Total = $ i 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; that the work will be in accordance with the approved plan in the case of a k which requires review and approval of plans. �';�� PRINT / ~ h/nNAME * DATE �OeO� SIGNATURE OF APPLICANT C� /G��i'Ydy—� �. NINE,, %.. City of Fridley ]Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 FROM :City of Fridley From: unknown Page: 2/3 Date: 8/1/2007 9:02:49 AM 11.1 1. FAX NO. :7635711287 Jul. 25 2007 02:16PM P2 c7ee.: $11A . ,.rin O VA 610 4-f 1A RN Building S JJs,.5 BUILDING Plan Review Permit No.: - Inspections Fire surchesge RESIDENTIAL APPLICATION .001 times the total job valuation RwOlvod By: 763-572-3604 .0005 x Permit Valuation Minimum $.50 CITY OF FRIDLEY _ $ aad Q DATE/"`"j��] - L, --... -- YOUR WMAIL ADDREg.9 — $1675 per SAC unit (I'larlm to MWCC for dctcrminedun) SITE ADDIMN th �'Y R 1 6 ft= R x $21 n$ •rrus APIn C"T 19: © OWNER Nl•AALTf_tR 5450 Conservation Platt Review PROPERTY OWNEW NAME, Fee Determined by Engineering TRNANT ADDILESS:L,076 '1'0 t84lrf'_.k•:- NJ f CrrY rlrriljjt t3fATF.M*11'—§fi4 Agreement necessary ( ) Non Necessary ( ) PHONE: -716,;r -3$G,- Icta3 $ / a0 AYi } CONTRACTOR NAND , Sd-Y1L`e i - rS sUlatv>rT A corY of STATE IXFXRE a �1,�. . EXT' DATE alaij.,hos YOUR 9TATF.LIICFNS , ADDRF45:.2 1 _ Jy clnr ply Caraur r,►� i 1P 9 WITH APPWCAIIUN PJRONli TO-, 2 QCXa ~-Jjob' of PROPERTY TYPIR 13 UNCLE FAMTLY/NEW CONSTRIX-11 1N STA TWO F Mit YffiPW CONSTRUCT! N STORIRS PERMIT TYPE 11AWff1ON 0Q%M0WIICD 0 VANDOWS El BASEMENT FrKTSFT 13 ROOF D DRAIN TILL E3 DF4X WWING 10 OTIE R 13SWNMMG POOL t0 NRW MADOrnow TYPE OF WORK: lQ4AINMANCEIREPAIR. O RL MODLTdNa DESCRIBE wURK BP.i O r.)UNR; LENGTH WIDTH HEIGHT sq. rL SIZE! OF IMPROVEMENT RQQMG EJ HOUSE ONLY NU1 lXX OF tit2UARES C3 HOUSY & GARAGE RA 10=mnrar.Twa atnim OARAQ8 0 AYfACHUD GALLKOU 1. 1*ft9 Floor Plpn PROPOSED .WE;. . G T)ETACFMI) GARAGE 2. Proposed floor pion PRO1N1 U) IIIslGiff- 3. LiqL Of 61 raauel mambsn a be aced FOR WV CONSTRUCTION 1N(,-jAMrNCi DEM% D lunmlum g9orFic q Trim AD.DrrloN.c_ 1. & Pc>I99M AVWTP Site Pfoal/Survoy showing the exlsBag s>�ros lwhor_Hardie 13 Fulciu and proposed prgjaar, s 2. Two sea of oonmwilon pTww .ter. IN IW$TTNG OpFWC.S ❑NO i.00ATiOIv OF WrNDOWS 3. Energy 0deulalfons OR FOR Ni,wOPRWWMNr,3-riP CitiFTASM. OF OPE MG CHANGES TYP>: OF WTNDOwTf) ti$ TN T'ALLFD N1IMRPR OF WINDOWS r.L.I \`.J�d7 itfil`. ngatev �.I l\ ♦AIr�/M al 1V1\'Iryl:LII UII\�tl Ili l!: �:ll�l UK 4A11VK APIU mnen:l'L�jK�Al,`�': (USING TRE 1997 VAC iFEE SCHEDULE) Permit Fee S JJs,.5 Seta Back Page for Fee SehcdWo Plan Review $ _ 65% of Building Permit Fee Fire surchesge '-, .001 times the total job valuation surcharge • '1. .0005 x Permit Valuation Minimum $.50 License Surcharge _ $ _ $S.00 (State Licensed Residential Conwidors) SAC Ciera $ $1675 per SAC unit (I'larlm to MWCC for dctcrminedun) Curb Cut Escrow $ R 1 6 ft= R x $21 n$ Erosion Control S 5450 Conservation Platt Review Park Fee $ Fee Determined by Engineering Sewer Main Chame $ Agreement necessary ( ) Non Necessary ( ) Total Due $ / a0 AYi } Md4s nAanka .�etu�r�la fin/ f91v n0 li rill w eFMn 1'1113 IS AN APPLICATION %OLt A PERM -Myr VALID LTNTTL PROC:RSSRD I hereby apply for a bui ing permit and I acknowledge that the information above is complete and aceu=o; that the work will be in eonforlmalee with the ord xiances And cod of the City of Fridley and with the Minnesota Construction C)dds; that I undt rstsnd thin Is not a Permit but only an applic alon for it and ark Is not to start without a pta'n k; that the world will bo in accordance with the approved Plan in the cage ofoll wnr • whi requires rev' and approval of plans. SIONATUItsOFAPPLICANT __ _PRIN•rNAML• �••��d) F44,._ It11'IS__. 7��./wry, 3uilding BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY D CIA' ' )ATE / I "f / I ;ITE ADDRESS I7iIS APPLICANT IS: YOUR E-MAIL ADDRESS y"Z 7 sem' ❑ OWNER WONTRACTOR PROPERTY OWNER/ NAME: - TENANT ADDRESS:— ' 6— CITY I STATE, PHONE:/ V5 ---- SO 1P a CONTRACTOR NAME: S STATE LICENSE # I tLo y EXP DATE 1'31190) 0 SUBMIT A COPY OF 1 ,, 6 �IP X509 YOUR STATE LICENSE ADDRESS: CITY STAT>� WITH APPLICATION PHONE 7 / FAX PROPERTY TYPE SINGLE FAMIL ON SIZE ❑ TWO FAMILY/NEW CONSTRUCTION SIO PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHEDWINDOWS 13 BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ADDITION 13 �t �G � ANCEMEPAIR REMODELING !M I DESCRIBE WORK BEING DONE: SIZE OF NUMBER OF SQUARES _ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other WINDOWS IN EXISTING OPENINGS es ❑No OR FOR NEW OPENINGS-13ESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED LENGTH WIDTH - 1 HEIGHT ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia LOCATION OF WINDOWS NUMBER OF BASEMENT REMODELING SUBMIT: I. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used Ft. U FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U. .0 FEE SCHEDULE) TOTAL JOB VALUATION $ ;LV OD. OCCUPANCY TYPE Permit Fee $ 2K3.9 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ g-20 .001 times the total job valuation Surcharge $ 1 .3ZP .0005 x Permit Valuation Minimum $.50 License Surcharge $ 5k $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 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 Due $ . �- 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; that the work will be in accordance with the approved plan in the case of all work w equire feyiew and approval of plans. SIGNATURE OF APPLICA] PRINT NAME DATE 10