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PRE 2010 DOCSDate I Owner .. Address BUILDING PERMIT Village of Fridley, Minn. N° 2253 ................. :...... '..Builder ........................................... RAWW .. ........................ Address ............... ----------------- - Lu • I LOCATION OF BUILDING. No...... ....III Street ... ,$T' .� Part of Lot 7 ..�...� ...... ......................, Lot ......'i :.... if Block :... / ......... Addition or Sub -Division t J Corner Lot ........ ... Inside Lot ............ Setback '... Sideyard ! ............... ji II DESCRIPTION OF BUILDING To be Used as: • � .... I , Front '. . Depth �.,�. F+ �s" .... Sq. F't......... Cu. Ft. ........ PHeight►�.�� ...................t Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft......... I Type of Construction .. W.. .. Est. Cost .. /zoo ..... �... To be Completed .� . In consideration I it I III Ili i�f 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 vill�ge of Fridley. .... ............. ............................. In consideration 11f �Ito the payment of a fee of S...�r .. , permit is hereby granted to Mea construct the building/oddition as described above. ThisCr xaitd upon e eat done in, around and t the person to whom it is granted and his agents, employees and work work pon said building, or any thereof, in Fridley, Mmnesota re''Jarding part shall conform all respects to the ordinances of location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits aid this permit may be revoked at any time upon violation of any of the provisions of said III ordinances. I 1 .1. Building Inspector I - NOTICE: This permit dd sewer or water. 6@ il les not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sure to see the 9uilding Inspector for separate permits for these Items. h Lu • I SUBJECT City of. Fridley FE 1254'7 AT THE TOP OF THE TWINS BUILDING PERMIT \JRr ECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 1 � NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-560-3450 910-F15 JOB ADDRESS 560 - 57th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15 10 Donnay I s Lakeview Manor Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roger Harold 560 - 57th Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Sussel Company 1850 Como Avenue St. Paul 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 IX NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 24' x 22' Garage 9 CHANGEOFUSEFROM TO STIPULATIONS Provide a hard surface driveway SEPERATE PERMITS RE QUrREp FOR WIRING, HEATING, PLUMBING AND SIGNS, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 R-1 528 5280 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 1.39 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,798 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. $10.00 X A&&,--,i� - PLAN CHECK FEE TOTALFEE ' SIGNATURE OFCONTRACTOR O AUTHo ZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOURPERMIT ( .2 l 91 BLDG. INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: BUILDER: ADDRESS: -_f_6 ® _ 7 '`.�'` /� e �� ADDRESS: /"V 6*1_111 .7/ &_9 NO:. STREET: LOT: BLOCK: CORNER LOT: INSIDE LOT: ADDITION: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: b.�_ �0-J-tc&—A— Front: a Depth: /o Height: Square Feet: �-2 ?-) Cubic Feet: 6:28 d Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: Estimated Cost: $ -�%9c9-q0 To Be Completed: %® s 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 r (See Reverse Side For Additional Information.) SSE, WORK ORDER HE SU SEL COMPANY NAME `e 0'3&-& H APA Lb PHONE 1850 Como Avenue St. Paul, Minnesota 55108 612 645 0331 JOB ADDRESS fes; Permit by S,' <AS— ❑ Legal Description ❑ Lot ❑ Blk ❑ Add'n ❑ Value Type Const Slab: n- In XBy Sussel O By Owner Approx. 2•STAIITINGS POINTS ONLY r S.P.L. S.S.P,L. R.P.L. Alley House F. Street Other Square With G v F ❑ Rods W Mesh Sod Rem. -By` Cl 5 Haq Mix G1 6 Haq Mix LI Tamp tiq No Tamping, t. A.B.U.6 Cx, Grade Point CONDUIT O.H. Dr. Offset ie- S.D. S.D. Location >� Windows p IPA AC Existing gaiage: No ❑ Dri,,:hed ❑Attached Yes ❑ Sire of existing:-- x Existing garage will be: ❑ Left as is O Converted to L.S. - By owner ❑ Removed By: Owner ❑ Sussel ❑ Junk Most Be Removed By Owner Specify other removals by Sus- sul or owner - trees, bushes, etc. ❑ Show approx. dist. garage to house and all prop. lines Stakes visible - Cl Yes ❑ No Survey available - FI Yes I7 No $"pecial in%uctions from %111110- Ac i ri1sid •t 0 A I I C -- I b I C BLDG CODE AREA Eel b Lt Y SALESMAN CONTRACT DATE& -2.c 7 IZE _,' `% X" Am—FOR OFFICE USE ONLY CONTRACTOR °tom e-lus / JOB # —4;2 ;IJS SF L .JOB # x`20`CONTRACT # 05P � ` lil� Z-ZI P R ® t hl r/ /Zr, - H -t - - � i t I TR' IC --L-. PSR OF CONT # __ � _ �_.L_:_ - p P --y 97-84-116051 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUINI$ING FIXTURE RATES: NO. RATE TOTAL Number Fixtures M 9 $ u x $2.00 $ New Fixture, Old Opening a o+ Catch Basin Water Cd 0 In.0 x $5.00 $ 100,000 BTU to 199,000 BTU x $10.00 +� Water Softener yyw� A N •°i ro k ri w� u� x $5.00 $ Heater m b x $3.00 C m x $1.00 y Gas Range to 199,000 BTU O U o s.01 O O C -4 4 L � 4 N �! G C 01 C C •rl 'a $ O O .Oi � N J.". 4J 0 N 'N N y U a ca W 3 aw w c�caa3 U 0 as lec 1st 0 51 e, 2nd g it 3rd 4th (R) - Future Connection Opening Connected with Sewer (�) - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUINI$ING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water Heater - to 99,000 BTU x $5.00 $ 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x $3.00 $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ 8.00 REINSPECTION FEE ($10.00) Job Address 560 57 Ave. NE Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facL•s and representations stated in this application are true and correct Fridley, Mn. 6 -6 -?9 19 OWNER HARALD KIND OF BUILDING frame USED AS res. TO BE COMPLETED ABOUT 1- 6-13-79 ESTIMATED COST 40 -nn OLD - NEW BUILDING PERMIT NO. / DPER14IT NO. �60 1 Company MINNEQASCO Signed By Tel. No. ROUGH INSP. Date FINAL INSP, l `�!o - V Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE SUBJECT PER City of Fridley 018479 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. INSPECTION J� r PROTECTIVE SEC.0 1 I ` CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 6/9/86 JOB ADDRESS 560 - 57th Avenue N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15 10 1 Donnay'e Lakeview Manor Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roger Haraold same 571-0250 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Twin City Storm Sash Co 927-6534 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION IX ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Aluminum siding 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 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 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 $5,000 2,50 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. $50,50 PLAN CHECK FEE TOTAL FEE 53,00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEY PROPER VnG INSP V LI AT T IS IS OU PERMIT i GATE SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI NEW [ ] ADDN. [ ] ALTER. [�] Construction Address Legal Description City of Fridley Effective 4/1/86 �R-1 AND R-2 Building Permit Application A jV Owner Name & Address: ROQ -e- lc' AaIC O'� A V Tel. #-M-036-T_ Contractor: �i��h ���Y S'�C"fyw A c,S%y% �' b• Tel. # Address: &W 46U 4S; ar. /9l0' Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback '00 V Q.0 l4 I 1 Type of Construction: 1 vO. S"J"' �'�w+ Estimated Cost: $ .fir 00, Approx. Completion Date: P 1-rpI6 Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: 6 A-, �f_-'L Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: nn APPLICANT: r Tel. # ° CITY USE ONLY $ Fee Schedule on Reverse Side $ 25% of Building Permit Fee $ a �Sd $.50/$1,000 Valuation $ $475 per SAC Unit $ Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] U v au L�QQLL-- y 6 SUBJECT P City of Fridley 2�84 AT THE TOP OF THE TWINS BUILDING PERMIT � RECEIPT NO. F COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r I { CITY HALL FRIDLEY 55432 NUMBER REV DATE RAGE OF APPROVED BY 612-571-3450 910-F15 5/11/93 JOB ADDRESS 560. -- 57th Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15 10 Donnayl's Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roger Harald 560 - 57th. Avenue NE 571-0305 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Gates Roofing 4640 Ximines Ln N, Plymouth.MN 55442 550-0043 6793 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 ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof House C17 Squares) Tear-offr 10. Squares 2nd Laver on Garage 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 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 VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1, 458 $,73 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE A THORITY TO VIOLATE OR CANCEL THE PROVIS F ANY OTHER S ATE OR LOCAL LAW REGULATING CON- $35.0.0 lore SC $1,46 THE PERFORM CE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE (1 $42 ,18 rSTT;1050R /j' / — "� GNATUREOFc ORORAUTHORIZED AGENT (DATE) WHEN PROP Y VA DATE THIS IS YOUR PERMIT LDG INSP DATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/93 ADDN [ ] CITY .OF FRIDLEY'( ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: Legal Description: Owner 1 Contract Address: MN LICENSE # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length GARAGE AREA: Length DECK AREA: Length OTHER: Corner Lot [ ] Inside Lot [ ] Type of Construction: Approx. Completion Date: DESCRIPTION OF IMPROVEMENT Width _ Width Width 17 5e4 Aao5 c - Ft. Yd Setback Height Height ucX. ®ue- fe- Sq. Ft. Sq. Ft. Sq. Ft. T �Osr Side Yard Setbacks Estimated Cost: $ . (Cost on Back) Q v0 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $/of �v DATE: 1 3 APPLICANT: Tel. # Permit Fee 60 $ 36.00 Fire Surcharge $ 1. State Surcharge $ . 7S SAC Charge License Surcharge $ $ r O O Driveway Escrow $ --�� Park Fee $ Sewer Main Charge $ '& TOTAL $ Z• STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $750 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] WE 3uilding BUILDING Permit No.: - nspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Recd: )ATE : ✓�''r�� fo YOUR E-MAIL ADDAE SS ;ITE ADDRESS �- /� HIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: ADDRESS: cS-� © -4-7 L7 t� CITY a ST TENANT PHONE: CONTRACTOR NAME; ® /- tk STATE LICENSE # EXP DATE 1039'1,�Q�I ��' /f �'i_ST4 414ZIP S �3 SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: �'�'N S J� �� CITY WITH APPLICATION PHONE V —'5 7 & 7 FAX PROPERTY TYPE D SINGLE FAMILY/NEW CONSTRUCTION SIZE D TWO FAMILYINEW CONSTRUCTION STORIES PERMIT TYPE 0 ADDITION D GARAGE/SHED O WINDOWS D BASEMENT FINISH SMOOF 0 DRAIN TILE D DECK SIDING D OTHER 0 SWIMMING POOL TYPE OF WORK: D NEW O ADDITION O MAINTENANCE/REPAIR REMODELING DESCRIBE WORK BEING DONE: ►'r�El%� �d? <— Src�r ® FJ ro5 `/1 SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFINGHOUSE ONLY NUMBER OF SQUARES �— BASEMENT REMODELING SUBMIT: GARAGES �0 ATTACHED GARAGE I. Existing Floor Plan 2• Proposed floor plan PROPOSED SIZE: 0 DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, 0 Vinyl OSoffit ADDITIONS & PORCHES SUBMIT: ❑ Aiumin D Trim I. Site Plan/Survey showing the existing structures 0 Other It C e 0 Fascia and proposed project T+' 2. Two sets of construction plans WAVDOWS 3. Energy Calculations IN EXISTING OPENINGS DYes [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 1997 U. C FEE SCHEDULE) TOTAL JOB VALUATION S =CCUPANCY TYPE Permit Fee $ l l l ,a4` See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ S .001 times the total job valuation Surcharge $ .TJ .0005 x Permit Valuation Minimum $.50 License Surcharge $ 15'_00 $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 $ 1 p 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 appli on 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 w k hi req ' es r vtew and approval of plans. / SIGNATURE OF APPLICANT PRINT NAME ��O y W� G DATE 3uilding $ BUILDING See Back Page for Fee Schedule Permit No.: U01 'Enspections RESIDENTIAL APPLICATION Received By: 763-572-3604 (, CITY OF FRIDLEY Date MAY -)ATE '5110110 YOUR E-MAIL ADDRESS rt D d I s X I l Q 1 /' l Oats. to /i 1TE ADDRESS G O 'S 7 "% ie, A(6 V "'HIS APPLICANT IS: ❑ OWNER "UCONTRACTOR $5.00 (State Licensed Residential Contractors) PROPERTY OWNER/ NAME: P/311 o 11 Q' I) TENANT ADDRESS: '5 1. O $ 1 MdA v/V F CITY Fri a'jl STATE_ZIP_�5 S'Ll 3 7 $ PHONE: -71,3 s i' R-977 R + 6 ft = ft x $20 = $ CONTRACTOR NAME:_ THD At- Home Services, Inc. Jodi & Gd c t J o to S $450 Conservation Plan Review STATE LIC 2690 Cumberland Pkwy, Ste 300 q f at l 3 Y5 - L O Y 7 SUBMIT A COPY OF Cumberland Office Park ewer Main Charge YOUR STATE LICENSE ADDRESS CITY STATE ZIP WITH APPLICATION PHONE Atlanta, GA 30339-3913 %qsINGLE Lic# 20268257 Ph. 763/542-8826 LE PROPERTY TYPE ❑ °'O FA _ .'ORIES PERMIT TYPE CIADDITION ❑ GARAGE(SHED WS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION '5 MAINTENANCE/REPAIR ❑ REMODELING !}ASCRIBE WORK BEING DONE: IWIAffOL4/1)60.1411141 IZE OF IMPROVEMENT LENGTH WIDTH IGHT 'Sq. Ft. DOFING ❑ HOUSE ONLY "UMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: ' ARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan '? OPOSED SIZE: ❑DETACHED GARAGE 2• Proposed floor plan 3. List of structural members to be used ,�DPOSED HEIGHT: Tn ING FOR NEW CONSTRUCTION INCLUDING DECKS, 'Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: 7 aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures I Other ❑ Fascia and proposed project 'TNDOWS 2. Two sets of construction plans d EXISTING OPENINGS (Odes ❑No LOCATION OF WINDOWS 3. Energy Calculations -R FOR NEW OPENINGSCDESCRIBE SIZE OF L / U l A h %I 0 0 !q PENING CHANGES & i'PE OF WINDOW TO BE INSTALLED fiQ 1) I NUMBER OF WINDOWS_ Q ALL FEES ARE BASED ON -VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 2f b O OCCUPANCY TYPE 'ermit Fee $ S-3.2; See Back Page for Fee Schedule Ian Review $ 65% of Building Permit Fee urcharge $ (, (.0005) times the total job valuation — Minimum $.50 ire Surcharge $ .001 x Permit Valuation (1/10%) ;cense Surcharge $ 4 Do $5.00 (State Licensed Residential Contractors) AC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) Irb Cut Escrow $ R + 6 ft = ft x $20 = $ rosion Control $ $450 Conservation Plan Review ark Fee $ Fee Determined by Engineering ewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) 'otal Due $ Lj,'�, p u Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in Dnformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a srmit but only an application for a permit and wftk is not to start without a permit; that the work will be in accordance with the approved tan in the case of all work which requir re .ew approval of plans. / 'GNATURE OF APPLICANT PRINT NAME I �� A4 �I 1� DATE '7 (l O �l O