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PRE 2010 DOCS!* City oFridley, Fridl, Minn BUILDING PERMIT No 4035 Date:..... ........ 7._-._...6 ... . ............. 16 Owner: ..... ..................... ..................................... ................................... -.................... Builder 11!59; ..... AddreAddress ss....._............._......._...._...._...._......_.__...... _ _.._......._....._......... Address .--- _....----------------...------......_..-_......._......._. LCMTOF BUILDING No.......-..-�.-p...... Street ....._ ............._............. ............ ... .... Part ^'of' Lot ................................... _..... _ ...... _....... _.... _...... _..._ Lot �a.....:/a..: Block ..... _....... ...................... Addition �Sub-Division e4+.. ..... ._.... Corner Lot .................................... Inside Lot .._ ............................ Setback ._3j.._ 4.......�....__~.............._........... ........... yar Sewer Elevation ..... . ............. _............ --............. -............. -............. ............... ......... Foundation Elevation DESCRIPTION OF BUILDING To be Used as: �% �/ r v ry e P� .............. Front ...%.. ®:_ ®Depth .....°f....L...� ®Height ...1/..._Q.®Sq. Ft. !../®..1.®. Cu. Ft. �} ...... Front _ .............. Depth .. .'..k Height ../...®' -� Sq. Ft. .....4 �........ Cu. Ft.t�7 �.. Type of Construction ................. -....................................... Est. Co ,[eJ..�..4�..IC�R.. .._...... 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 thea r3� p yment 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 upon violation of any the provisions of said ordinances. ��'�...._..._... r --....... Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. SUBJECT P City of Fridley 1989 AT THE TOP OF THE TWINS BUILDING PERMIT r RtCkIPT 1 ••ti------- ICOMMUNTY DEVELOPMENT DIV. r � � PROTECTVE INSPECTION SEC. ---,,� CITY HALL FRIDLEY 55432 i NUMBER REV. DATE PAGE OF APPROVED BY ----� L 612-571-3450 910-F15 5/12/89 JOB ADDRESS 21 - 6531 Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 18 18 5 Edgewater Gardens SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Elwin Boldigheimer 21 - 65� I[J= Way N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Richard Hastings Contractor 6331 Riverview Terrace N.E. 574-9966 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION 1 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling (24 Squares) 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd layer but not 3rd,.Tnstall ridged galvanized valleys. On all new roofs or tear -offs and replacement roofs, State Code requires that 2 I..?ers of 15 lb. felt, mopped 'together, "e inS'aflir'd to a point 24 inw'aes up from exterior wall line, or the use of Ow approved underlaymeclt 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 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 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 $1200 $.60 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 PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $29.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $29-,60 SIGNATURE OF CONT RACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLYYj DATED THIS IS YOUR PERMIT BLDG )NSP �Loj! SIGNATURE OF OWNER I IF OWNER BUILDER) IDATEI NEW [ ] Effective 5/1/88 ADDN' -' [ ] R-1 AND R-2 Building Permit Application Construction Address: L 1 - / 5 �z (J A, Legal Description: owner Name & Address: % win So c� I z A '�;7 �" .n: � � Tel. # Contractor: !R` C- � Ft P, D /4A, -,-t Tel. Address: 6 331 i? L U P- U i a= L--) 1Z Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. IPPI�T OF II�VF1�4�T1' LIVIM AREA: Length Width Height Sq. Ft. CMUM AREA: length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Groind Sq. Ft. 07HER: Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yazd Setbacks Type of Construction: rE A r2 o FF -- Z e A aoF Estimated Cost: $ Approx. Completion Date: Gl1.� e7 Proposed Driveway Width If New Opening Is Desired: Ft. $ $ � Width + 6' See Back Page DATE: S '/ j'Z APPLICANT: Tel. # Permit Fee $ Z 1. 0-0 State Surcharge $ -(00 SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ $ z91 (00 sTI Aff-ATIMS: CITY USE ONLY Fee Schedule on Reverse Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Effective On January 1, 1991 Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace Gas Piping (Needed with newGfurnace) Gas Range Gas Dryer Rate TOTAL $ 20.00 $ ') 0 0 $ 10.00 $ $10.00 $ $10.00 $ *Air Conditioning - All Sizes $10.00 $ All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ CommerciaUlndustrial 1% of Value of Appliance or Work $ State Surcharge $ .50 TOTAL FEE L S MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. JOB 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 ruling of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. `f� ,1991 BUILDING USED AS ESTIMATED COST 14,26) PERMIT NO. ��`� DESCRIPTION OF FURNACE AND OR BURNER No.. of -Heating Units --L— Circle One (Steam) (Hot Water)arm Air Trade Name 7�- rp- �` -� Size No. ti,L,6 jc-77v - BTU '2s�, a u HP_ EDR Fuel > a Total Connected Load Burner Trade Name Size No. BTU HP EDR HEATIN Signed Tel No. �' 5 7— H','P/ Approved By � — Rough -in Date Final Date ® �e FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes (L -f No ( ) 2. Is free from rust or deterioration Yes (✓) No ( ) 3. Has no foreign objects lodged within Yes (A4 No ( ) 4. Is securely supported Yes (Vf No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes No ( ) 6. Has total heating BTU's of %S, D ® O All other BTU's y TOTAL BTU's 5 a U 6) Remarks List Alterations Being Done: HEATING COMPANY Signed By Z' Date 9 -,;2 lls;� 2-- CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner . Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning . All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Effective On May 10, 1999 JOB ADDRESS— OWNER DDRESSOWNER TOTAL BUILDING USED ASS.'% ESTIMATED COST PERMIT NO. �� DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units / Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name WlPtI Size No. BTU HP EDR $ Fuel Total Connected Load Burner Trade Name Size No. $ BTU HP EDR $ 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 an $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are'true and correct. Rough -In Date i 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 3. 4. 5. 6 Has no foreign objects lodged within Is securely supported Meets all current Code requirements for size and total BTU's connected Has total heating BTU's of Yes () No ( ) Yes () No ( ) Yes () No ( ) Yes ()No() All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes () No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: ®r suB,Etr P City of Fridley(_30204 AT THE TOP OF THE TWINS BUILDING PERMIT RE EIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 = � CITY HALL FRIDLEY 55432 NUMBEP REV DATE PAGE OF APPROVED BY 1'' 612-571-3450 910-F15 9/13/99 JOB ADDRESS 21 65 1/2 Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 18A -18B 5 Edgewater Gardens SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Elwin $ Irine Boedigheimer 574-7377 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO R Miller Const. Inc. ilifix1al'kXiix Fridley 55432 571-3514 635 4 ARCHITECT OR DESIGNER MAIL ADDRESS 6-316 7)4aft ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION I@( ALTERATION 29X REPAIR 0 MOVE 0 REMOVE 8 DESCRIBE WORK Construct basement walls for family room; Reroof house and garage (26 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS See stipulations on plan. Provide smoke detectors in all sleeping rooms and on all levels of the house. Underlayment must comply with the State Building Code. WPARA E PERMITS REQUIREp FOR WIRING, NEATINC>r, PLUMBING AND SI GAt& 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 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 1 HAVE READ AND EXAMINED THIS APPLICATION 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $8772 $4.39 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW $167.25 Fire S STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $8.77 PLAN CHECK FE TOTAL F E _Zrn Licens SC $5.00 $1 .41 SIGNATURE OF ACTOR OA AUTHORIZED AGENT (DATE, N ROP LI ATE IS I R�IT BLOC NSP v ✓ UAlk S-GNATURE OF OWNER,IF OWNER BUILDER, IDATEI ®r NEW [ ] Effective 5/10/99 ADON [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 2 / 6S '/z we N/ Fr i1J. le - Legal Description: Owner Name &Address: F -Lw i rq 'f - f_; ry6_ �e Tel. # J'_'74- 937 Contractor: MN LICENSE Address:, j �3 %� ��-{�d�� Tel. #- 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: DECK AREA: OTHER: Construction Type: DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. &_se_Pncd I�JQ"ti�S T�� vy,�y Vbo� oI c - m off- Estimated Cost: $, ? % a Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: APPLICANT: �oy,� .�� Tel. # S ?/-,3 .S% Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ IC 7, ;.Fee Schedule on Reverse Side $ Z65:, 4/ .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 [ ] BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE $1 to $500 $501 to $2,000. $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. I S L" fC f� A -S Z"N(5 ,Fs� rsrl� o �b b � w C-1 VV o -r4 ers X"1 -Y 000 1%0111� rrea.ke.CL beihlo le .0)1 ZXy W r� �0. iK, Loo Conrsf ZIA; X3= VW4 LAS WNZy � h& v t� r..T--V:PS 4-60 G tL NEW [ J CITY OF FRIDLEY Effective 1/1/2002 ADDN (] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATIONS 3 X Construction Address: ✓` �� t-. H / Legal Description: 'X owner Name & Address: F-'Olu'/lu 'Q � P- Contractor. Tel. #'263 -�->y73>> Address: Tel. # 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: Construction Type: Estimated Cost: $ �( Driveway Curb Cut Width Needed: o22Ft� 0 0 + 6 Ft = o�c� Ft x $ "7 = $ a G� S 7 -73i DATE: %"� � — 'Z—APPLICANT: Tel. # � 7 Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge 'E; CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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 [ ] TOTAL $ STIPULATIONS: BUII.DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $17.00. Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. VERIFICATION OF FOUNDATION A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only Building ` AY Inspections eV 763-572-3604 DATE C o LJ SITE ADDRESS THIS APPLICANT IS: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY ❑ OWNER YOUR E-MAIL ADDRESS Permit No.: Received By' Date Rec'd: PROPERTY OWNER/ TENANT NAME: 6191 n 6O e I Gi ki$ ADDRESS: C9( C� S- n,�,, CITY �/ l `_�STA7 6,m� S-5 4 hj a• �t PHONE: CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION Nom: U 0 STATE LICENSE #CSC ' IR 04 13 0150 EXP DATE 3 0-7 ..,,,,1 ADDRESS: CITY O STATR 411` 5�.� 4 d PHONE -1 (P-7 ®' 9 9 59 AX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION ❑ TWO FAMILY/NEW CONSTRUCTION SIZE STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ BASEMENT FINISH ;.ROOF ❑ DECK ❑ SIDING ❑ SWIMMING POOL ❑ WINDOWS ❑ DRAIN TILE ❑ OTHER TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: lY - f 0 0 4" SIZE OF IMPROVEMENT_ NUMBER OF SQUARES�C 0 GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia WIDTH HEIGHT Ft. BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project. 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 MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ a L<�P Q) OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge 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) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach 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 Ian in the case of all work 'ch requires review and approval of plans. .: r r.- • 1,•. _. ��i ' �I ice. 90ri IEli 0 IMP Building $ BUILDING Permit No.: 7--6/ (a0 Inspections • $ 4-'� y- RESIDENTIAL APPLICATIOIiT Received By: 763-5723604 $ 5, up SAC Charge Dari I U L 1 2007 Curb Cut Escrow $ CITY OF FRIDLEY $ DATE 7/11 ® YOUR E-MAIL ADDRESS U N OF F O A ^, Sewer Main Charge SITE ADDRESS Z• I �5 Z t; -.,A -( N 6 Total Due THIS APPLICANT IS: ❑ OWNER WNTRACTOR PROPERTY OWNER/ NAME: C-- L, w 1./-i 9b t: n 1 6� 1 r-� E 2 TENANT ADDRESS: z- w A `t tyE CITY 0 Ig—% STAT96WZIP 3 `r 3 -Z- PHONE: PHONE: CONTRACTOR NAME:Lt�'c�'T 10, STATE LICENSE #6L- (�7 H 3 Z5-0 EXP DATE W�-*4 did SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS:_ t% - fa Cot:!=L LTJ A-($ rJc- CITY Ey=� 0 Le7Y STATEtftIP 55743` WITH APPLICATION PHONE --(--7&J) 61 -70 -9 -?F) FAX (-R,"7(o1-17-2-9 PROPERTY TYPE SINGLE FAMII.Y/NEW CONSTRUCTION SLZE ❑ TWO FAMII.Y/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE DECK ❑ SIDING ❑ OTHER r ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAWTENANCE/REPAIR RREMODELING DESCRIBE WORK BEING DONE: I N�AL-L I A. F0EL-I ov s r7, ., C -x %5T L-:., PAT+ SIZE OF IMPROVEMENT K 7-3' LENGTH Z WIDTH 19' HEIGHT 1 .5 Ft. ROOFING ❑ HOUSE ONLY _Sq. 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 ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project WINDOWS 2. ' Two sets of construction plans IN EXISTING OPENINGS ❑Yes []No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WIDOW 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 $ $y,Zqoo?rjOCCUPANCY TYPE Permit Fee $ Plan Review $ ��• 3/ Fire Surcharge $ 4-'� y- Surcharge $, License Surcharge $ 5, up SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ /1qt1-. qA 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) $1675 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach 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 re ices review and approval of plans. SIGNATURE OF APPLICANT -Y PRINT NAME iaE H ®FFw�Ar�1 DATE 7 �r l csi -i, 11 �71 11 INDUSTRIAL COAVURCIAL CITY LOTS TOPOGRAPHICAL LAKESHOU PLATTING Andrew Hohn CERTIFICATE OF SURVEY i NORMAN C. 14010M UVW $0-*yor,_, 7100 t*,tSb MlI�INRrkP01l�' �i� /i1fi+IF1: 13�p1,i�6�•'1 ['�c�� Scale / "f,10.. " JJGr✓J .4I6/ I hereby certify that this is a true and c orreet plat Of a survey of 4 Lots 18A and 18B, Block 50 EDGEWATER GARDENS, Anoka County, Mimesota As surveyed by me this 30th day of April, 1959 A.D. Signed >