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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N? s 0:03:j Date: Owner: —Builder Addressef Address 1W 0 F BUILDING No. Street Part 9 1-0 Lot Block _Vddition or Sub-DivisIn, Comer Lot Inside Lot Setback Sideyard jz) Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To! ;U,=sed+ ILI A w FrontDepth I-I�g!t Sq. Ft. Cu. Ft.WV 4F I 'Depth I-191ght Sq. Ft "Cu. Ft. .0 Type of Construction At' '4" 0 9 '— 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 work In accordance with the description above set forth and in compliance with 21 provisions of =OQ= the city of Fridley. In consideration of the payment of a fee of $ JIL lw&F-- ., permit is hereby granted M -- 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 art thereof, shall conform in all respects to the ordinances of t ci? c Fridley, Minnesota regarding locatign, construction, alteration, maintenance, repair and moving of buildings within the city limits and this perralt may be revoked at any tim upon vidod% of any of the provisions of said ordinances. Building Inspector NOTICE nh pennh does not cover the condrudlon, hougaffins for vAdn& plinubIng, on heatht& saner or wder. Be sure to no t6 SWIft Inspeftr for aparift persubs for thus herrn. APPLICATION FOR BUILDING PMUM CITY OF FRIDLEY, MINNESOTA Owner's Name Builder �.. Address Address LOCATION OF BUILDING No. I� Street �3 - Part of Lot Lok Block Addition or Subdivision 02z-�� Corner Lot ___.Inside Lot ✓ Setback -Yard /o SEWER. ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: DESCRIPTION OF BUILDING L-1 r 14,7taht lam/ t 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. (A Schedule of Fee Costs can be found on the Reverse Side.) P�P City of Fridley of - Application for Plumbing and C"s Fitting Pentdt Dept. of Bldgs. Phone SII 4.7470 DESCRIPTION OF WORK 135 — 63rd, Way Number. Kind and Location of Fixtures Location y 3 �� vi N 3F Y ou Q z 8e E'c H t� ?C�ri � d 63 `a 6� c9 °d w z�z� t9oZ Z y�` d CSO • R • N WATER HTR. GAS ELEC. Basev 1 12 1 Ist 1 ]1 1 1 1 D1 o al 2nd _ 3rd _ 4th Future Connection Openings New Fixture, Old Openings I Connected with Sewer � Cesspool ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... 8 x $1.50 $ 12400 Future Fixture Opening ................ 2 x 1.20 $ 2.40 New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $-2c00 New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $_e50 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description................................................$ TOTAL FEE $ 1790 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. Fridley, Minn July Ill 19_L2 Owner Paul Schwartz Const. Go. Kind of Building Frame Used as Dwelling To be completed about Oct. 15.1962 Estimated Cost, 800.00 Old—New. Building Permit No a a e,-2 Permit Noe. Signe STANDARD PLUMBING & APIA CE C t By Basin s Phone No We 8 3589 ROUGH -7 ` I �? ` FINAL 42 2M 7-S9 Application for Power Plants and Heating. Cooling. Ventilation, ReMgeraflon and Air Conditioning Systeins 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 $ 8.00 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 $ Dept. of Bldgs. Phone SII 4-7470 Locatfoa 135 - 63rd Way 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 are true and correct. Fridley, Minn July 18 -• .. 19 -62 Owner Paul Schwartz Const. Co. Kind of Building Used as lies STEAM or HOT WATER SYSTEM To be completed about 8-18-62 Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Estimated Cost, $- 450.00 Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $� Old—New. Building Permit No. .-t'� 0 � Permit No. Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ i Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ DESCRIPTION OF WORE 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 $ 1.50 Additional Fixtures ................. x ,50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL $ See Fee Schedule TOTAL FEE $ 14.50 Plan - 1 On file HEATING or POWER PLANTS team, Hot Water, Warm Air—No 1 Trade Name Westinghouse Size No GUF1l00 Capacity Sq. Ft. E.D.R- B 100M H.P. Total Connected Load 45,631 Kind of Fuel Gas BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signed FRE® VOGT & CO. HEATING & AIR CONDITIONING By6630 Wesf take St. t uis Park, Minnesota �e�.4 z 2M 7_59 Business Phon 8 y9/)j-2-1 City of Fridley, Minn. N? 10 3 01 • BUILDING PERMIT Date: Jme 20,196969 owner: _ Curtis Teske Bider _,Ll Ps Lumb r (nmra.-nv _ Address 13 5 -63rd Way N.E. Address LOCATION OF BUILDING No. 135 — Street 63rd Yhy N.E. Part of Lot Lot ... 16 __- Block ---2--- Addition or Sub -Division . 'iTs'k Rri nlrGnn giver Ms.-nor- Corner arnsr Corner Lot Inside Lot — X Setback -- Sideyard Sewer Elevation --- Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Garage Front 24 -_ Depth _ 2.2 __ Height 10 Sq. Ft. 52R . Cu. Ft. 5280 Front Depth _ _ Height Sq. Ft. Cu. Ft. Type of Construction Frame Est. Cost -$2.112 - -_ To be Completed Juin x • Paved Driveway • 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 ail provisions of ordinances oP the city of Fridley. F ,n34 In consideration of the payment of a fee of $r8 .gp , permit is hereby granted to Curtis Teske _ 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 andmoving of buildings wi n� city limits and this permit may be revoked at any time upon violation o of the provisions of said D (2- - 4'� � 2' — - -) -4 CLARENCE BELISLE NOTICE: This pormit does not cover the construction, Installation for wiring, plumbing, gas heating, sower or water. Be sure to we the Building Inspector for separate permits for these item. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER 'S NAME BUILDER /Wi /e S ADDRESS r f�/��r �G ADDRESS LOCATION OF BUILDING NO. / STREET C ¢ LOT /w BLOCK ADDITION OR SUBDIVISION i CORNER LOT INSIDE LOTbe"' SETBACK SIDEYARD SEWER ELEVATION TOP OF FOOTING 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: 0 e, Front Depth Height Square feet Cubic Feet -5a � Front Depth Height Square feet Cubic Feet Type of Construction �/�C//�� . 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 'U . /& 5' SIGNATURE �� (Schedule of Fee Costs can be found on the Reverse Side.) e ;ssociates Inc. F. C.JACKSON LAND SURVEYOR REGISTERED UNDER LAWS OF STATE OF MINhJEyJ � A LICENSED BY ORDINANCE OF CITY OF MINNEAPOLIS 3616 EAST 55TH STREET PA. 4 4681 &urbepor's tdertificatc ti e; J f 1 If Or. 7323 tt2'o1-20A s - _--- r I HEREBY CERTIFY THAT THE ABOVE If A TRUE AND CORRECT PLAT.OF A SURVEY OF a mortgoge survey Tot 16 Block 2.hva .1,rickson , hive.- Manor,hnoka County,'..'.inn, As SURVEYED BY ME THIS. 13ti.. DAY OF-. -.. Jail. A D _1966_ F C J11 KSCI a>�rA SEG 6TH.P:,,N Pio 3Ev>> SUBJECT City of Fridley 1900 CR AT THE TOP OF THE TWINS BUILDING PERMIT r COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 6/10/87 JOB ADDRESS 135 - 63rd Wa,y N. E. 1 LEGAL LOT NO. BLOCK TRA TOR ADDITION SEE ATTACHED DESCR. 16 2 Erickson River Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Curtis/Bonnie Teske 135 - 63rd Way N.E. 574-19846 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICEN E O. Advance.Home Products 3770 West Broadway N, Robbinsdale, MN 55422 � 52 -.211 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. i y 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION (2 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REOUIRED 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 S0. 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 $4,900 $2.45 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE A THORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE \FROVISIONSIOF ANY O HER TE OR CAL LAW REGULATING CON- $50.50 R HE P OR E OF NS RUCTION.L AN CHECKFEE TOTALFEE WCON 0 w $52.95 SIG ATUREOFC NTRACTORORAUTHORIZEDAGENT IDATEI WH PROPERLY V D TED THIS IS YOUR PERMIT G SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI BLDG INSP E NEW [ ] ADDN. [ 7 ALTER. [ Construction Address: 13 Legal Description: Owner Name & Address: ✓��� Contractor:.4LA" 14 J Address: .3 7Z� LIVING AREA: GARAGE AREA: DECK AREA: OTHER: City of Fridley R-1 AND R-2 Building Permit Application d ^0404; Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length Length DESCRIPTION OF IMPROVEMENT Width Width Width Height Height Hgt/Ground Effective 4/1/86 Tel. #- Tel. # - Sq. Ft. Sq. Ft. Sq. Ft. tbk Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Ya eae Type of Construction: �� s �� Estimated Co $ Y?®�0 CFO Approx. Completion Date: Z Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation DATE: APPLICANT: Tel. # Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ ��.50 Fee Schedule on Reverse Side $ 25% of Building Permit Fee s $�,Lf-: $.50/$1_,000 Valuation $ $ 525 per SAC Unit $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ 4clo 0 3)0G `Y. SUBJECT PER City of Fridley 00162 AT THE TOP OF THE TWINS BUILDING P E R M I T _ r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 I i CITY HALL FRIDLEY 55432 ".J NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 10/18/89 / f JOB ADDRESS 135 - 63rd Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 2 Eva Erickson River Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Curt Teske 135 - 63rd Way N.E. 574-9846 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO, Paulson Construction Inc. P.O. Box 247, Anoka, 427-0033 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 7 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct & lV x 20.' Addition with.zero clearance Majestic Fireplace 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan, Fireplace to be installed according to manufacturers specifications. '� SEPARATE PERMITS REQUIRED FOR � � WIRING, HEATING, PLUMBING AND SIGNS. Before digging call for all utility locations On all new roofs or tear-offs and replacement roofs, y 454-0002 State Code requires that 2 layers of 15 Ib. felt, REQUIRED BY LAW mopped together, be installed to a point 24 inches up from exterior wall line, or the use of other approved underlayment membrane. 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS 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 $18,850 $9.43 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 PR SIO S OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $198.00 CT O OR E PERFC?B�AANCE OF CONSTRUCTION. P PLAN CHECK FEE TOTAL FEE $207.43 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI WH PROP L A Ob THIS IS YOUR PERMIT tFLUU )NSP Tur SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) Neral [ ] Effective 5/1/88 ADLN [ ] R-1 AND R-2 ALTER [ ] BuildiM Permit Application Construction Address: legal Description: Owner Name & Address: CU iR i 7-S!C �eTel. # -9/ P y4v Contractor:J-11-ISO/O }�,��%-% - Tel. #0 700 L), Address: oZq -?��tJ©!C Attach to this application, a Certificate of Survey of the lot, with the prc osed cmwtn=ticn drawn on it to scale. DESCRTP17M CF II�H�Tr LIVIM AM: length /�_ Width oQHeight _ Sq. Ft. A6 GARS AREA: Length Width Height Sq. Ft. DDCR AREA: Width Hgt/Gmuxl Sq. Ft. Corner Lot [ ] Inside lot [ ] Ft. I Yd Setback Side Yard Setbacks Type of Construction: /rj /Q AQ4� Estimated Cost: $ Approx. CmPletion Date: W /B/&O-V Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page DATE: /(� ( APPLICAN!': Tel. # 11/a) ?UU -? 3 Permit Fee $ A . 00 State Surcharge $ SAC Charge $ Driveway F--=-a,a $ Park Fee $ Sewer Main Charge TOTAL Lis sTIP JIMCM: CITY USE ataar Fae Schedule cn Reverm Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee ined by IIhgineeting Ag - : I Necessary [ ] Not Necessary [ ] /a, CP,O 2 D a 6.s qs. 00 let ZOO CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENTIAL ` Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer RATE TO'T'AL Job Address / $ 20.00 $ 10.00 $ 10.00 $ 10.00 * Air Conditioning (all sizes) $ 10.00 All Others/Repairs and Alterations 1% of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 1% of Value of Appliance or Work Department of Buildings, 31 University Ave. N.E., Fridley, MN 55432 City of Fridley $ Tel. #571-3450 $ The undersigned hereby !akes application for a permit for the work herein specified agreeing to do 1 1 work in strict accordance with the City Codes $ and rulings of the Depar nt of Buildings, and hereby declares that all the facts and representations stated in this application are true and .correct. $ Fridley, Minn. OWNER KIND OF BUILDIIN��G USED AS $ TO BE COMPLETED ABOUT State Surcharge $ .50 TOTAL FEE $ . Reinspection Fee ($15.00) $ Rough Insp. Date Final Insp. Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. ESTIMATED COST OLD - NEW BUILDING PERMIT No. PERMIT NO. ti/ /n J 7 HEATING or POWER PLANTS, Trade Name Capacity Total Connected Load BURNER - Trade Name IPTION OF FURNACE/BURNER team, Hot Water, arm Air- No. / r' Size No.--3q5eAya-3&®76- Sq. Ft. FDR BTU ��b HP Kind of Fuel �%• Size No. Capacity Sq. Ft. EDR BTU HP Company Signed By \ Tel. No. Fill out back side for tack verification on replacement furnaces !Z CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes ( ) No ( ) 2. Is free from rust or deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes ( ) No ( ) �i ^,4 Maate all rij"inan+ r^,4- Yes ( ) No ( ) total total BTU connected 6. Has Total heating BTU's of All other BTU's TOTAL Rema rk s Company _ Signed By Date Building $ BUILDING Plan Review Permit No.: Inspections Fire Surcharge RESIDENTIAL APPLICATION .001 times the total job valuation Received By:.''�� 763-572-3604 .0005 x Permit Valuation Minimum $.50 CITY OF FRIDLEY $ DAMAC;T 14 200 763-5-02-4977 FAX $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ EFFECTIVE 1-1-08 $ $450 Conservation Plan Review DATE 6 g 1 ®� YOUR E-MAIL ADDRESS 144 Fee Determined by Engineering SITE ADDRESS 13 1W� $ Agreement necessary ( ) Non Necessary ( ) THIS APPLICANT IS: ❑ OWNED Rfe6NTRACTOR $ PROPERTY OWNER/ NAME: j?? u r r GC ADDRESS: 3 i,�a v CITY r STATE IP TENANT PHONE: CONTRACTOR NAME: o ADDRESS: to I OLL., A -Ac A10 CITY ���i<< ''I STAT04A/ZIPSry SUBMIT A COPY OF PHONE % 3 — 2-3 F "�'�� �-- FAX YOUR STATE LICENSE STATE LICENSE # q0 EXP DATE p PROPERTY TYPE OffNGLE FAMILYNEW CONSTRUCTION SIZE ❑ TWO FAMILYNEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION❑ G�GE/SHED ❑ WINDOWS ❑ BASEMENT FINISH PROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE:C°lr ©f4 -r Peso ®� SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HPeSE ONLY & GARAGE BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES OUSE 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: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS & PORCHES SUBMIT: ❑ Vinyl ❑Soffit 1. Site Plan/Survey showing the existing structures ❑ Aluminum ❑ Trim and proposed project. ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes [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 MAI LRtALS: (USING 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 $ ,1 .001 times the total job valuation Surcharge $ (p .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 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 Sti ulations 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 w!#h the approved plan in the case of all work which requires rev/yew and a proval of�tans. SIGNATURE OF APPLICANT PRINT NAME �°�` e �0 ^ `j 1t` DATE /L9//Y/OS APPROVED BY — DATE Building BUILDING $ Fire Surcharge Permit No.&S3 _J Inspections RESIDENTIAL APPLICATION CTO Received By: 763-572-3604 Curb Cut Escrow CITY OF FRIDLEY Erosion Control $ Date Recd: 2 763-502-4977FAXEFFECTIVE Sewer Main Charge $ Total Due $ % I-1-08 S DATEo� YOUR E-MAIL AD $ ''_,, 11 "nE J ' SITE ADDRESS (, THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: --e- TENANT ADDRESS: I.3S- & CITY STATE/ zIP 3 7 PHONE: / [pct / 8 L NAME:_ CONTRACTOR ADDRESS: `7 C �� //,�,, STA'V /ZIPa4l SUBMIT A COPY OF PHONE 0 7 —: -o 14A, FAX YOUR STATE LICENSE / 3 Z2 U STATE LICENSE # / / EXP DATE PROPERTY TYPE GLE FAMII ION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED :ff;WiNDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION -eMAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 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: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS. & PORCHES SUBMIT: ❑ Vinyl ❑ Aluminurn ❑Soffit 3 -Iw 13 Trim 1. Site Plan/Survey showing the existing structures G Other ❑ Fascia 1 )�� 2. and proposed project. Two sets of construction plans SOWS 3. Energy Calculations IN EXISTING OPENINGS Z0 6 ❑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: ING� 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ Jam'. D - OCCUPANCY TYPE Permit Fee Plan Review $ Fire Surcharge $ Surcharge License Surcharge. CTO SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ % See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1825 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary to: Citv of THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and 1 acknowledge that the information a e is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minn onstruction Codes; that I un rstand this is not a permit but only an application for a permit and work is not toYIQ 'thout a permit on site; that the work will be in rdance a approved plan ' e of all work which requires ew d approv f p SIGNATURE OF APPLICANT NAME DATE3/D APPROVED BY DATE MINNESOTA DEPT. OF LABOR & INDUSTRY Construction Codes and Licensing Division 443 Lafayette Road N. St. Paul, MN 55156-4344 CUSTOM REMODELERS INC 474 APOLLO DR LINO LAKES, MN 55014 Address: 474 APOLLCI -.D ; , LINO. LAKES, AAi� .55i I4' MB4�W:��l9m.,ffi -tructure:: TION ITER 31/200,9'