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PRE 2010 DOCS• City of Fridley, Minn. ■■ Date:BURDING T N? 6679 i Address -. Address ON F BUILDING NO. ��� Street ,ot 00. Lot Block Addition or Sub-Divisi Corner Lot ._ Inside Lot _ _ _Setback 2 52 Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING T U Front Depth Height Sq. Ft. Cu. Ft Fro Depth Height p��_�D Sq. Ft cu. Ft Type of Construction �-Est Id4 °`'o 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 fo d comph'ap�ce with all provisions of ordinances of the city of Fridley. �� e O 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 Id persononearound and upnd builddley, Minnesota regalocatiowthecitylimits and permit may be revoked at a�/ABY do of aay of the provisions of said ordinances �Y Building inspector NOTICE: M permit does not corer the construction, hutallalion for whing, phnnhing, gas heating, sewer or wrier. Be sora to we the Building hjspadtor for separate pomits for these liana. — . r APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME ADDRESS ( ADDRESS LOCATION OF BUILDING No. Street: Part of Lot Loth Block 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 build- ing location drawn on these Certificates. DES9KPTION OF BUIL%DIN To be used as: �%�rc✓ 0. 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 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). ,r • is 0 • s City of Fridley., Application for Plumbing and Gas Fitting P Dept. of Bid Phi S 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Locatio 3 �� o� 80 5 < (�'Jg 3 �U' z �p R N WATER HTR. GAS ELEC. Bas ,at 2nd 3rd 4th • Future Connection Openings e New Fixture, Old Openings Connected with Sewer Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... .............. x $1.50 G ^� Future Fixture Opening ................ x 1.20 $ Q New Fixture Old Opening ............... x 1.00 $ Catch Basin ...... .. x 3.25 $ Water Heater (Up to 200,000 BTU) ......—�lx 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 snakes applicatio for a permit for the work herei specified, agreeing to do all work h strict a yordance with the City Ordinance and ruling of the Department of Buildings, d hereby declares that all the fact and representations stated in this appli are true and correct. Fridley, Owner Kind of Building Used as To be completed about Estimated Cost, $ Old ew uilding Permit ROUGH 74— 0 FINAL -Ow4z 2M Business Phone 1913 City of Fridley, .Minn.. • BUILDING PERMIT r� U Date: OCTOBER 52 1965 ROBERT W. ERICKSON Builder Address 565 - 57th Avenue N. E. Address Fridley, Minnesota 55421 No. SAME LOCATION OF BUILDING 565 Street 57th Avenue N. E. Part of Lot Lot 20 _ Block 8 Corner Lot _ Inside Lot . Sewer Elevation N° 8513 Addition or Sub -Division ____ Donnav's Lakeview Manor —. Setback — Sideyard Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Car Port Front 17 Depth 25 Height 10 Sq. FL 425 CtL Ft 4, 25 0 Front Depth height Sq. Ft. Cu. Ft. Type of Construction Est. Cost _ 1,000-00 To be Completed VARIANCE REQUEST GRANTED BY COUNCIL OCTOBER 4, 1965 FOR SIDE LOT VARIANCE FROM 5' TO 3' FOR CONSTRUCTION OF CAR PORT. 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 Zolwith 21 provisions of ordinances of the city of Fridley. o In consideration of tate payment of a fee of $_ AM , permit is hereby granted to M W_ ERICKSON to construct the building or addition as described above. This permit is granted upon the express condition that theSbuil n, ffi all workdone in, aroundand upon saiing, or any part thereof, shall conform in aII respects to the y, Minnesota ithe citylimitsnt may be revoked at any time upon violation of any of the provisions of said ordinances. ALLEN G. JENSEN Building Inspector NOTICE: Uls permit den net eowr the condrudlon, houlldion for wbiag, Plumbing, as bsetlng, s wrsr or water. Be am to an tbo sawl" imp"ier for "pude pwmhs for done Nems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME S BUILDER ADDRESS r- ADDRESS LOCATION OF BUILDING No. ��" Street�7Part of Lot r LOT BLOCK 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. DESCRIPTION OF BUILDING To be used as: ,�lvl 04-A' ► Front /7, Depth Height / Sq. Ft. # X_ e1— Cu. Ft. Al )_,("__ 6: Front Depth _Height Sq. Ft. Cu. Ft. Type of Construction �/_ �l�i ''�, Estimated Cost 1 = 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 — 6?�` 6•,( SIGNATURE_2 (Schedule of Fee Costs can be found on the Reverse Side). ?4" 1,4 r . t � S!Jo%aArns pvo sWauI6u3 'SNI "9Nf? XMIDN3 NYSM17S s VAV %1.M�ua0q-V %/o/ &gs%yclsa15 esc��nd ayf �! p�a� uaar �eoy s/�aurnunuao� paaJ�pua pone _; r s I� l paten /sa-afu/ ✓aylo �i,�a` -V db4jaw cpns�o f it fsaara paum-re -v kIllmotl ou pr�n Awl coo/ aba6f✓oui d i�r uo�la�uo� to �uo apnty sr hdn a1s sr�l puD/ pros ua ,io uro� '%1ua,fi ' sluamtraanua afgisra YD OLO 'sbr p/mq fpJc uw f°'o/ 1"141 pu° pagw7sap a oqa puo! -,ql ), s;v 1opunoq dgjjv' ktuns o,,# uo, fn fuasa�da, pa -1 /x, 'Ovo .7 (-7 ZO YL 9JC aA✓ns 3 s�aau�,�u� 6u�Jaau��u� 9909D'/asu/1S 7Dd0/unjy i 11A1 'l Esgadvauui`y IuIARA.mSPW7 �n S9�'y�N-S189 6uluuDld puD7 (jeamiomftalty Co. 6441 University Avenue N. E. Minneapolis 21, Minnesota _75-1 5' U.T[9liy 4 Did -A I N AGE F -P'S, I Real Estate Industrial and Commercial Sites Residential Lots Custom Homes INSURANCE Commercial and Persgnal Sunset 4-4395 Ijb�>,I*&�— 1061 v PNor,P Gt)u, jwv U Application for Power Plants 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 $—BQ—'— Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MEC*. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ 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 NO RATE TOTAL 1st 3 Fixtures ......... ......... Furnace Shell & Lines—to 400 sq. ft. EDR Steam ..... 8.00 $ * $ Gas Range to 200,000 BTU ........... Furnace Shell & Line—to 640 sq. ft. IDR 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 $� 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 FINAL Dept. of Bldgs. Phone SII 4-7470 - 6r.., X/ 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. (JL Fridley, Minn 1963 Owner an . _ n Kind of Building r Used as To be completed about?� Estimated Cost, $ Old—New. Building Permit No. _ Permit No. o2- DESCRIPTI OF WORK HEATING or PO PLANTS—Steam, Hot Water, Warm Air—No Trade Nam Size No 100, '-Capacity Sq. Ft. E.D.R BTU H.P. uelBUTotal Connected Load 7S Kind of Fuel- BURNER RNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU A.P. (REMARKS -OVER) • Signed By SUP11-1Z.41114"', 8419 .42 2M susinessfVl�6��!!�f°CILIS 32, MINNESOTA k ��VCV HEAT LOSS- CALCULATIONS DEPARTMENT OF. BUILDINGSX g 3 Weatherstrips A. Guide E. Construction No. Guide WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind Yes—No Yes—No 19— F1.1 Room I Length ` Width Height ja / II 1 Fl.l _ _ Room I L Windows ana Doors—Crackage and Area . Coef.1 Btu Width Height No. of Lineal ft. Area No. of pane of pane lights oo{f crack sq. ft. D- Y� f / r / r Pro /r jw, 1, 0 Infiltration Glass Exp. wall Coef. Btu Infiltration DO Glass d Exp. walllea a -- Net exp. 'wall Int. wall 4a /zzo Ceiling Ayh Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1 F1.I MXoom I Lensfth tel/ /idth it/64 Heiaht 010 Windows and Doors--Crackage and Area . Coef.1 Btu Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 2 .o 0 f / r / r Pro /r jw, 1, 0 Infiltration Glass Exp. wall Coef. Btu Infiltration &I Glass d Exp. wall Net exp. wall Int. wall a -- Ceiling gj;_ Floor Total Btu. Required sq. ft. E.D.R. or sq. ins.;, W.A. Leader area . / Fl.l 7:1 -7- _ Rnom I LenQtlt �c s'"� �lidth l% ".1 HeiQltt P Windows Ad Doom—Crackage and Area . Coef.1 Btu Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. f / r / r Pro /r jw, 1, 0 Infiltration Glass Exp. wall 12 Net exp. wall &I Int. wall Ora Ceiling O 0 Floor ITotal Btu. Required sq. ft. E.D.R. or sq. ins.yWJL Leader area No. of pane IF Vi? Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Insulation How 'd Width /"d Height and Area meal ft. qeea crack e. A Btu Fl.l ngth / D ! Width 41 / Height �# Windows and MoiszXrackage and Area Width' Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration 1 X� Glass Ora Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W Leader area FI -1 A*V- _ m I Length A /w Wldthl y A Heutht �� Windows and rs—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of -pane lights of crack sq. ft. Coef. Btu Infiltration Glass. Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. p Required sq. ft. E.D.R. or sq. ins. W.A. Leader area City of Fridley, Minn. N° 10660 BUILDING PERMIT Date: - May 22, 1970 Owner: Rnbext !ret Rri eksnn Builder Robert Johns= Cc=.=_QQ. Address 96 - 57th Avenue N.E. Address _5801 Lyndale Avenue LOCATION OF BUILDING No. 565 Street 57th Avenue N.E. _ _____, part of Lot Lot 2n Block S Addition or Sub -Division .—Donna Manor Corner Lot _ Inside Lot _.._ % Setback —_ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Basement Addn. Front _ _ Depth . _ Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Masonry Est. Cost $1200. _ To be.Completed 30 days 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 mpliance wi all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $9_DIl__ , permit is hereby granted to Robert W. Erickson 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. �y Building Inspector HANK N RICH NOTICE: ibis pormit does not cover tbs construction, instaQation for wiring, plumbing, on beating, sewer or water. Be sure to we the Building inweetor for separate penmhs for these amm Lond,Plonning Minneof oAi 32. &-0 Surwieyl�y '01"nesola Soils TesMy E"NGINEE RINGS INC. slbwT d -COC -6 Civil b -Municipal I Surve E,7 —Enyineers f F,420srtgage Loan Survey �®� D IV it )q ,Y, yep, rsen Ta lion fj s ur wy.5f Me h oundol -,e 5 " 6e knc( ebo xe &Jcrib cd Of& tlleon ' / but/dins, -al6WIdS, ;fdny, f077 on-W&/rid. rJ51ryey'i Ma�w5A7 avznedyil* a flwr97eloaq nog; , --ed except IS The holder dfsA;770j4je or p7Y, Alper inlered OWNiedb ra4f "T , ThepurposeA qbk��74` h 1,;,e5 or -0 - - , APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S. NAME:�obe_� Li, E.i-ICXS !) sal BUILDER:. \o bt Jo h ".S ® !J Ce*n6,VI/- ADDRESS:-Q,5- `-ADDRESS:- QS S7 t4 &e A C ADDRESS:. Be)/ �_)ehj nde_ tie - NO:. STREET: -' % LOT.. ® BLOCK: ADDITION : _Do !6J A/ A /y/ * )Ji- 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. DESCRIPTION OF BUILDING To Be Used As: B se_Me,A�`_ Front: Depth: Height: Square Feet: Cubic Feet: Front: —Depth: Height: Square Feet; Cubic Feet: Type of Construction: Estimated Cost: To Be Completed: 30 0,14 y/ 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: .s-- c2 g 7v SIGNATURE: (See Reverse Side For Additional Information.) 17J y r F9°. • `ti .- • ►y y . . r Building BUILDING Permit No.: t Inspections RESIDENTIAL APPLICATION Received BY -2 763-572-3604 CITY OF FRIDLEY Date Rec'd:46 DATE 5"--745-0(0 YOUR E-MAIL ADDRESS G V -D l.(�!6@9(„�� 'n. AWT SITE ADDRESS ,56S S "] t'='y t � 121'lp1_ er,1 THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: �, 'J^%"f . V E CITY �Q I D Com/ � STATE Z 7 PHONE: / 3 — S% 2-- O (O CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE—ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE -)MINGLE FAMILY/NEW CONSTRUCTION SIZE� ❑ TWO FAMILY/NEW CONSTRUCTION STORIES ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS PERMIT TYPE ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK )KSIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR REMODELING DESCRIBE WORK BEING DONE: 1UPIPLaCrEw SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2• Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl *Offit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminumb Trim � 1. Site Plan/Survey showing the existing structures Other r 1 � c E1'i L-j.E r J,6121 Fascia and proposed project WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS es ON, LOCATION OF WINDOWS 3. Energy Calculations 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 $ 7G®® 00 OCCUPANCY TYPE Permit Fee $ ( ?a ;LT See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ -7-00 .001 times the total job valuation Surcharge $ ,lj. .0005 x Permit Valuation Minimum $.50 License Surcharge $ $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 $ q! 715 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 which requires rev ew and approval of plans. SIGNATURE OF APPLICAN O PRINT NAME��E Ce DV ISL 1� DATE S� L��-D Building $ BUILDING Plan Review Permit No: -2,0t0 -0 U0- Inspections Fire Surcharge RESIDENTIAL APPLICATION Received By %' 763-572-3604 $ d L10 .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge CITY OF FRIDLEYerdE B 19 2010 763-502-49/77 FAX $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review EFFECTIVE 1-1-2010 $ Fee Determined by Engineering ' _/(0 — $ DATE Z6 YOUR E-MAIL ADDRESS $ SITE ADDRESS 4 j�5— �I U THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: �v CITY f ✓7 `i STATE PHONE: �-�� 2— <C9 %ri � fS CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE � SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK SIDING ❑ OTHER. ❑'SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: (n SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ VinylSoffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum t' Trim l . Site Plan/Survey showing the existing structures ❑ Other_ V1 Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION S A OCCUPANCY TYPE Permit Fee $ i 1 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ L ` (. .001 times the total job valuation Surcharge $ d L10 .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 1 1 y 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 on site; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT C----� C� PRINT NAME ( R 6 I/L'v;5t&_. DATE t? 116