PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT N°5 0 5 s� ,'
Date:
q
Owner: udder
Address Address
O TIC OF BUILDING
No. Street Part gr Lot —
Lot __ Block • _ __ Addition or Sub-Divisio.. _ �L•
Corner Lot — Inside Lot "'-o Setback Sldey''�ard
Sewer Elevation _ __ _ _ Foundation Elevation
DESCRIPTION OF BUILDING
To Used
Front � Depth _ Height Sq. Ft. ' IZWQL Ft.cW&
Front Depth t Sq. Ft. cu. Ft.
Type of Construction Est. Cost 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.
In consideration of the payment of a fee of $ 5: _ , 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. - `""
(;
4,"116 Building �
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewor or water. Be sure to we
the Building Inspector for separate permits for these hems.
s w 0 4 ..—
a -
APPLICATION FOR BUILDING PERMIT
CITY OF FRIQLEY, MINNESOTA
Owner's Name arm! a54- 4 Builder
Address Address
LOCATION OF BUILDING
No.S` G Street 5 y �- 19�'X Part of Lot
Lot Block % Addition or SubdivisionT��"���
Corner Lot Inside Lot v Setback 7 G Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
64
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 application are true and correct.
DATE SIGNATURE
(A Schedule of Fee Costs can be found on the Reverse Side.)
City of Fridley
Application for Plumbing and Gas Fitting Pennit
Dept. of Bldgs. Phone SU 4-7470
DESCRIPTION OF WORE —S -S'4.0 S /4/
Number, Kind and Location of Fixtures i'°ca3l°n
a)m
0
RATE
TOTAL
Number Fixtures ......................—�
x
$1.50
$
Future Fixture Opening ................
�
1.20
$
�U'
�U'
Z
�U'
+
N
WATER HTR.
GAS
ELEG
$
;
x
� �
$
New Ground Run Old Bldg . ............
; �
[�QQ�jj
c S
$
i -i
U
< 3
d
of
O
$1.50
$
Additional Fixtures ....................
x
.50
$
Gas Range to 200,000 BTU ..............
x
2.00
$
Base
/
1st
/
b
0
2nd
_
3rd
_
®
_
4th
• Future Coanectioa Openings
Connected with
Sewer �
New Fixture, Old Openings
Cesspool E]
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:NO.
RATE
TOTAL
Number Fixtures ......................—�
x
$1.50
$
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
$
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 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.
AUG 141961
Fridley, Minn 19—
Owner /4 L �'a,+ A/ /j7'G',0 RZ 40 IV 5
Kind of Building �2
Used as
To be completed about / _'' /.-
Estimated Cost, $ y
Old—New. Building Permit No,\V� Permit No. O
LONDON PLUMBING CO.
Signe p
By ��/l�. �•�
Business Phone No
ROUGH
FINAL
da 2M 7.49
Application for Paver Plants and Healing, Cooling, Ventilation, Refrigeration and
APRT 9 g �
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 $_8.0—
each add. 60,000 BTU ....................... 2.00
Replacement of Furnace 5.00 $
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. IDR 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 $ 5.00
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
$
AIR CONDITIONING
$
FAN BEATING SYSTEM
See Fee Schedule
VENTILATING SYSTEM
$
ALTERATIONS & REPAIRS
TOTAL FEE
$14
REMARKS:
Dept. of Bldgs. Phone SU 4-7470
Location 556 54th Ave. N. E.
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 aretrue and correct.
Fridley, Minn. 1/4/62 195—
Owner-_AMa1gaTma l efl 195
Kind of Building fr 195—
Used as r e S
To be completed about
Estimated Cost, $.951D . 00
Old—New. Building Permit No.
DESCRIPTION OF WORK
8
HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No-
Trade
ir—No Trade Name Chrysler Size No4208
Capacity Sq. Ft. E.D.R 81. 250 BTU_H.P.
Total Connected Load 36, 000 Kind of Fuer gt4s
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
Si gn Larson -Mac company
,¢
By v
11 POST IM -]Q-58 Bu ess Phone No± a 7 7 32 3
City of Fridley, Minn.
r
BUILDING PERMIT
40
d;
Vr- r. r7t 77 WORM
y22)
N° _6436
Builder ---•—
Address
L N
BUILDING
No. Street Part of Lot
Lot —__ Block Addition or Sub -Division .Was
Corner Lot _ Inside Lot _ _ aback —_ SIAard
Sewer Elevation —_ _ _ _ _ _ _ Foundation Elevation
DESCRIPTION OF BUILDING
ToA U
Front �-x Depth Height �� Sq. Ft. Cu. Ft.
Fro Depth Height Sq. Ft. Cu. Ft.
Type of Construction Est. " Fie ® __ 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 forthand in complivodeforewith g11 provisions of
ordinances of the city of Fridley.
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 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 Tlr f any of the provisions of said
ordinances. A/ 1
• NOTICE:
7Ms permit does not corer the construction, hutaMon for wiring, Plumbing, gas heating, sewer or water. Be sore to see
the Building hApector for separate permits for thus Menu.
SUBJECT
PERMIT N
City of Fridley
0 17410
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
CEIPT NO.
tr ------- COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
� �
S CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
2/17/84
JOB ADDRESS 556 - 54th. Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
5
1
Temple Terrace 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Robert Jurek 556 - 54th Avenue N.E. 572-9028
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Mirmesota Exteriors 295 HIgn Highway 55, Hamel 478-6001
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 Ej ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside, insulate and add trim
9 CHANGEOFUSEFROM TO
STIPULATIONS
SEPERATE PERMITS REQUIRED FOR WIRIN
HEA THNG, PLUMBING IRNA 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
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
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
$3,412
$1.71
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
ROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON -
TIO OR THE PERFORMANC CONSTRUCTION. il
$44.50
PLAN CHECK FEE
TOTALFEE
$46.21
SIGNATURE OF CONTRACTOR OR AUTHORIZFOAGENTATEI
WHEN PROPE Y LI DA ED THIS IS YOUR PERMIT
I( (
-
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
BLDG INSP rE
CITY OF FItIDLCY Effective Aug. 1, 1981
'
APPLICATIM FOR RESIDENTIAL BUILDING PERMITS
(Rew, Alterations. Additions. or Repairs)
OMIER:
ADDRESS:
TEL N0: 7 :2`
STRICT NO:
STREET:
BUILDER:
ADDIESS:
TEL 110: 0/
Construction Location
LOT:
BLOCK: /
ADDITION:
Corner Lot:
Inside Lot:T_
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
Front: Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: -dam ' �° ` - -�-►-- Estimated Cost: S � �-
Rb Be Completed:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE PZVF.RSE SIDE OF SHEET .
Mie undersigned hereby males applicaticn for a permit fcr the %:.,ork 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 appli
DATE: �� � � � SICNATum
Stipulations:
/ • W
a r �
9
City of Fridley
AT THE TOP OF THE TWINS
sueaEcr
BUILDING
PERMIT
PER
17919
• ______ COMMUNITY DEVELOPMENT DIV.
r i L PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
.-_.
L J-ItIt 612-571-3450
ECEIPT NO.
a A ��
I/p s
NUMBER
910-F15
REV.
DATE
4/19/85
PAGE OF
APPROVED BY
JOB ADDRESS 556 - 54th Avenue N.E.
1 LEGAL
DESCR.
LOT NO.
S
BLOCK
1
TRACTOR ADDITION SEE ATTACHED
Temple Terrace 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Robert Jurek 556 - 54th Avenue N.E.
572-9028
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Minnesota Exteriors 295 Highway #55, Hamel, MN 55340 478-6001
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 DESCRIBE WORK
Reside Garage and add trim
9 CHANGE OF USE FROM TO
STIPULATIONS
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
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
ZONING
SO. FT.
CU. FT.
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
AND.ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WWHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
VALUATION
$2,300
SURTAX
$1.15
DO N T PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PRO ONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRU THE PERFORMANCE ONSTRUCTI N.
$38.50
AN CHECK FEE
TOTALFEE
$39.65
SIGNATURE OF CONTRACTOR OR AUTHORIZE GENT IDATEI
WHEN PROPERLY V DATED THIS IS YOUR PERMIT
BLDG )NSP
OATE
SIGNATURE OF OWNER OF OWNER BUILDER) (DATE)
NEW [ ] City of Fridley Effective 4/1/84
ADDN. [ ] R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address: ✓� `{
Legal Description:
Owner Name 6 Address:
Contractor
Address
Tel. # S -J - '7096'
dl
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
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 Width Hgt/Ground Sq. Ft.
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction: _ Pv-�-Estimated Cost: $ O -Z
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
• L{�lG/-���.(►V�%v-c✓�e Tel.
DATE: APPLICANT.
CITY USE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Fee Schedule on Reverse Side
25% of Building Permit Fee
$•50/$1,000 Valuation
$425 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
suejEcr
R M I T NO.
City of Fridley
30037
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
�(_Rfiev5T-NO.
-� -------COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 �
= � CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
L 612-571-3450
910-F15
8/10/99
10B ADDRESS
556 54th Avenue NF
I LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
5
1
Te le a
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Robert Jurek
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Suburban Exteriors 9701 Penn Ave S Ste 107 Bloomington 55431
8 9
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 99x REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 27 S Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIREO 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
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
$2360
$1,18
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 PERFORMAN E OF CONSTRUCTION
$83,25
jFire SC $2,36
PLAN CHECK FEEOTAL
F Ek
Licen 5.00
9 9
S4GNA TUBE OF CON" R AUTHORIZED A ENT IDATEI
N P OPE51�PkIDATED
,NSv
SIS R PE IT
5'
i iAtl
S.GNATURE OF OWNER,IF OWNER BUILDER, IDA rEI
NEW [ ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY 1
ALTER [ SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�u
Construction Address: 5 j
Legal Description:
Owner Name & Address:
ythQA.1e
Contractor: � MN LICENSE #
Address: 9)0/ 'PkPAjyA CLA,-9 Tel. # EQ 3
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA.-
OTHER:
REA:OTHER: E
DESCRIPTION OF EMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length �� �
/
Width H Ground Sq. Ft.
Construction Type: Estimated Cost: $ P
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: -R -0/ 9 APPLICANT: � At�, Tel. # a 8-/ - 9- a 3Q
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
rLl - z4f2.
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1050 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 [ ]
:— q1. gs
Building BUILDING Permit No. i ` 0--CU`'?�
Inspections RESIDENTIAL APPLICATION. -Received By{
763-572-3604 CITY OF FRIDLEY Da
763-502-4977/FAX. ml"X nm 1 -1 -as V
DATE • % • lU YOUR FrMAIL ADDRESS
�-
SITE ADDRESS �:) Q !�Q a `f -- CZAA,2 7-1
THIS APPLICANT IS: 1 ❑ OWNER "NTRAgOR
PROPERTY OWNER/
NAME:
TENANT
ADDRES : 5S_1P_ �•
.
PHO 3 S
CONTRACTOR
NAME:
ADDRESS -
SUBMIT A COPY OF
PHONE
YOUR STATE LICENSE
STATE LICENSE #
V TYPE SINGLE FAMI Y
❑ TWO FAMII Y/NEW CONSTRUCTION
TYPE ❑ ADDITION ❑ FW G
❑ BASEMENT FINISH ❑ ROOF
❑ DECK ❑ SIDING
TYPE OF WORK. I ❑ HOME CONSTRUCTION
ANCFJREPAIR
DESCRIBE WORK BEING DONE: h 1�/.rte t�ru e
ROOFING
NUMBER OF SQUARES
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ vinyl
❑ Aluminum
❑ Other
wnvn_owS
IN EXISTING OPENINGS ❑Yes ❑No
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
❑ ADDITION
❑ REMODELING
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
❑Soffit
❑ Trim
❑ Fascia
LOCATION OF WS � n
/I
❑ DRAIN TILE
❑ OTHER
BASEMENT REMODELING SUBM
I. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS &PORCIrac crinNrrr.
1. Site Plau/Stuvey showing the existing struchm
and proposed project.
2. Two sets of construction plane
3. Energy Calcuhnions
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND 1MIATERIAT c;
S THE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION 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 $ .0005 x Permit Valuation Mmimnm $SO
License Surcharge $ Iq .dD $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1825 per SAC Unit (Plans to MWCC for deternunation)
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 Dae $ blake checks payableto:City of Fridley Attach St3onlat3ons,
THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the inf above is complete and acmunte; that the work will be in conformance with the ordinances and codes
of the City of Fridley and with the Minnesota Construction Codes; I understand this is not a permit but only an application a permit and work Is not to start without a
permit on a* that the work in cc wilb the plan in the case of an work whichnevi and of lens.
SIGNATURE OF C /' PRINT NAME � h'1 DATBo
APPROVED BY Y DA