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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