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PRE 2010 DOCSBUILDING. PERMIT Village of Fridley, Minn. No Date...... .................... Owner ...... ...... Builder Address . J.........��.: .dv+'. .... ' .. Address i 2975 / LOCATION OF BUILDING No. .O ..... Street ... V . �. . Gf!�............. Part of Lot ....................... Lot ..... ✓�.......... Block .... ...... Ad on or Sub -Division .. . 4!. ... Corner Lot ............ Inside Lot ............ Setback `s!...... �Sideyard DESCRIPTION OF BUILDING To be Used as: Cr . P OIUA4 � Front _91. Depth 4 f... Height ... Sq. Ft. YP Cu. Ft. .................... Front ........ Depth ........ Height ......... _ Sq. Ft......... Cu. Ft. ...... O® •� /� Type of Construction .......... Est Cost .� � To be Comp leted ✓LT 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 compliancewith all provisions of ordinances of the village of Fridley. In consideration of the payment of a fee of $4K t is hereby granted to ..... . ....................... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. din Inspec NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing,gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. W IN0Wft6XA' e'"" C. E. COULTER I��, I PLATTING BUSINESS �I FARM SURVEYS CITY LOTS LAND SURVEYOR LAKESHORE TOPOGRAPHIC MAPPING REGISTERED UNDER LAWS OF STATE OF MINNESOTA JUDICIAL LICENSED BY ORDINANCE OF CITY OF MINNEAPOLIS 3300 LYNDALE AVE. SO. MINNEAPOLIS 8, MINN. TAYLOR 4.0370 �• �urcr$�c9.t'�e iirrti#ir� ! 67 m y C I 1 I � I hereby certify that the above is a true and correct plat of e survey of: Lot Seven (7), Llock Five (5), RICE CREW PLA,',A SUM ADDIL 01,', Anoka County, V.innesote. As surveyed by use t.Iis 1st day of !gay 1956 A, D. Signed ,$ y�r Ninne:3ota t, Registration IUC. 2584 City of Fridley, Minn. BUILDING PERMIT N° 6 0 9 7 Date: Owner: Builder eZ,,. L J Address Address TION jOF BUILDING No. Street _ r Cl Part. Lot _ ___0, W—Y'—V� __ _Block Addition or Sub -Di Corner Lot _ Inside Lot I tback Sideyard —_ Sewer Elevation __._ FowAtion Elevation DESCRIPTION OF BUILDING .� 0� . Front Depth Height Sq. Ft ! +r:► Cu. Ft Front: Depth �. Height Sq. Ft. Cu. Ft Type of Construction � Fast. Cc§i_ """ To be Completed In consideration of the issuance to me of a permit to construct the building described above I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ , permit is hereby granted to JF— 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 reg location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any tide upon violatfo`i� of any of the provisions of said ordinances. -"'� .4'A . / NOTICE: Thio permb does net eowr the eonatruetlon, hm taWon for wking, phrmbk& pe haNeg, aw.r or crater. Be sen to we the Building Wpocter for aparata pormka for thea Noma. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA AddressOwner's Name Builderl,/_.e_��., / Address_ I LOCATION OF BUILDING No. Street 9 ate •_Part of Lot Lot %' Block .g— .Addition or Subdivision Corner Lot Inside Lot 4-:- 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. To be us ed- as DESCRIPTION OF BUILDING Front / (, Depth Height j9 Sq. Ft. !� Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type ,of Construction -Estimated Cost %�v _ l - _._ 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). - . ._ 1 0 0 1 . . r 0 1+ 01 SUBJECT City of Fridley .� AT THE TOP OF THE TWINS BUILDING PERMIT Ir RECEIPT NO. � ; COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. I �! r I CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 4/25/96 JOB ADDRESS 240 67 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR, 7 5 1 Rice Creek Plaza South SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Terry/Barb Clint 240 67 Avenue NE 572-0635 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Quality #1 Plumbing & Remodeling 1670 132 Ln NE Blaine 55449 755-5198 7640 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 1� 8 DESCRIBE WORK Construct a 10' x 12' 19= Addition to Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 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 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 $6,945.60 $3.47 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- CON- $124.75 Fire SC $6.95 STRUCTION THE PERFO CE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE C.r �! 2 S' (o License SC $5.00 $140.17 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI VALIDATED THIS IS YOUR PERMIT �W�HENPROPERL YRSv �� a 6L INSP GATE SIGNATURE OF OWNER 0F OWNER BUILDERI IDATEI 1+ 01 NEW [ ] ADDN [) CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: Z e-1 o 6P7 f Legal Description: vZ N115- Effective 3/ 96 1 Owner Name & Address: T•erL24 � Gajz r3 GL-i..i r Tel. # S 72 a6 �S Contractor:j!�jPoi+t, j, 1+1 PI.��,S,..sao�c�P� MN LICENSE# 7(oy0 Address: 1(,70 / ,32-.o Tel. # '7SS- - SI 9 P Attach to this application, a Certificate of Survey of the D C lot, with the proposed construction drawn on it to scale. DESCRIPTION OF E"ROVENWM LIVING AREA: Length 10A Width /2- Height Sq. Ft. I L. O GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: s',u a r-,94 1,1 (z e s. Estimated Cost: Approx. Completion Date: 9 (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft. = x $ _ $ DATE: 1Y -r 9 - 9 APPLICANT: r Tel. # ;7 S'S` - 5-/ 9 CITY USE ONLY Permit Fee Fee Schedule on Reverse Side Fire Surcharge 4.qs $ .001 of Permit Valuation (1/10th%) State Surcharge 3. y j $ $.50/$1,000 Valuation SAC Charge $ $900 per SAC Unit License Surcharge $ S DD $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Pian Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary j ] Not Necessary [ TOTAL $ STIPULATIONS: INDUSTRIAL BUSINESS CITY LOTS TOPOGRAPHIC MAPPING C. E. COULTER LAND SURVEYOR REGISTERED UNDER LAWS OF STATE OF MINNESOTA LICENSED BY ORDINANCE OF CITY OF MINNEAPOLIS 3300 LYNDALE AVE. SO. MINNEAPOLIS 8. MINN. TAYLOR 4-0370 �'vk'Y=r Fes.<,' t`,;� 's�'. ��•�•;'' ��rtrr��.r'a �igrtit�rure 6 m I N � 13$ •!1 I\ \d PLATTING FARM SURVEYS LAKESHORE JUDICIAL I. i 9i 4 I hereby certify that the above is a true and correct 1-11at of a ;urvev of-, Lot Seven (7), Block Five (5), R1C1: c;FzELK ULa`jA SuTTV, ADDIT101., Anoka County, D''innelaots. As surveyed by me t.lis 1st day of f�',ay 1G58 A. aJu" t.inne.scta,. Registration No. 2584 SUBJECT P2 City of Fridley 2 4 AT THE TOP OF THE TWINS BUILDING PERMIT Ir RECEIPT NO. • _ COMMUNITY DEVELOPMENT DIV. v PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV - PAGE OF APPROVED BY 612-571-3450 910-F15 IDATE 5/30/96 / / JOB ADDRESS 240 67 Avenue NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 5 Rice creek Plaza South SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Terry Clint 240 67 Avenue NE 572-0653 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO D & D Home Improvement Inc 7401 Central Ave NE, Fridley 55432 784-7543 4840 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 X 8 DESCRIBE WORK Reroof House & Garage (19 Sq) Tear-off 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 SQ. FT. CU. FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS I 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 $.76 WITH WHETHER SPECIFIED HEREIN OR. NOT. THE GRANTING OF A PERMIT $1,520 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIOANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTI HE PERFOR OF CONSTRUCTION $51.25 Fire SC $1.52 NOR CE PLAN CHECK FEE License SC $5.00 TOTAL FEE $58.53 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATr1- WHEN PROPER VALIDATED THIS IS YOUR PERMIT 33 SIGNATURE OF OWNER OF OWNER BUILDE RI IDATEI aLCAV INSP GATE NEW C ] ADDN [ ] CITY OF FRWLEY ALTER [ ] SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress:� Legal Description: Effective 3/1/96 *'�) ��_5z Owner Name & Address: �,��� ��/�/ Tel. # 7;1 _ Contractor: D & D Home Improvement, Inc MN LICENSE # a R a n Address: 7401 Central Ave NE Fridley, MN 55432 Tel.# 784=7543 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF HNAPROVEMENT 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 Setbacks _ Type of Construction: Wig) -Estimated Cost: $ 1& 20 Approx. Completion Date: 7TAW .(Cost on Back) Driveway Cuyb Cu Width Needed.: Ft. + Ft = Ft x $ _ $ DATE: APPLICANT: Tel. # CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ / S .001 of Permit Valuation (1 / 10th %) State Surcharge $ $.501$1,000 Valuation SAC Charge $ $900 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On January 1, 1997 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS_ 4410 ip %' A V, /V C, New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the fads Blow Off Basin $ 7.00 and -representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 &ZOIL.1998 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 - Owner �4 7 7r6"Y Y-,�/�A�/ Water Heater -Electric $ 7.00 Water Heater - Gas** l $10.00 Building Used As Gas Range" $10.00 Gas Dryer** $10.00 Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMPANY76� Reinspection Fee $42.00/Hr SIGNED BY TEL N0.o�%`�� l �t ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Facture or Appliance Approved By Rough -In Date Final Date -4 State Surcharge $ .50 G TOTAL FEE kgl D PLUS THE $.50 STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ INCHES. Building Inspections 763-572-3604 763-502-4977 FAX SITE ADDRESS oC' t I THIS APPLICANT IS: PROPERTY OWNER TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE PROPERTY TYPE PERMIT TYPE TYPE OF WORK: DESCRIBE WORK BEING Di SIZB OF IMPROVEMENT BUILDING Permit No.: RESIDENTIAL APPLICATION. Received By: CITY OF FRIDLEY YOUR E-MAIL ADDRESS -il F, ❑ OWNER NTRACTOR NAME: ADDRESS:CT a4 •o —( �, PHONE: 7W 5 —7a - (o s 3 NAME ADDRESS• 1 PHONE — q6p STATE LICENSE # /? +SINGLE FAMII,Y N S: ❑ TWO FAMILYINEW CONSTRUCTION S ❑ ADDITION ❑ GAI2AGP/SFIED ❑ BASEMENT FINISH ❑ ROOF D DECK ❑ SIDING ❑ SWIlVIlAING POOL ❑ NEW HOME CONSTRUCTION ❑ ADDITION WMAIN1`ENANCE/REPAIR ❑ REMODELING ROOFING NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other WINDOWS ✓- IN EXISTING OPENINGS ikes ❑No OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE EXP DATE Z ❑ DRAINTILE ❑ OTHER ❑Sofrt .I- 3ji;& - L-� Rxx-) C4,11 ra*'Vo ❑ Fascia 3 _ � ' �../► �'O-� LOCATION OF WINDOWS W —Na _ nmu ff i, SQ FT a I3ASEMENT REMODELn'40 SUBMIT: L Existing Floor Plan . 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDMONS & PORCHES =. I. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Enargy Calculations I r rn vr. W uvLV W I V .= mail,AU.&D NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING� 1997 UBC FEE SCHEDULL) DOTAL JOB VALUATION $ Q�. OCCUPANCY TYPE Permit Fee $ /.5, Aly See Back Page for. Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ Q _ .001 times the total job valuation Surcharge $ -3-90 .0005 x Permit Valuation Minimum $.50 License Surcharge $' 15.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Curt Escrow $ ft + 6 ft = ftx $21— $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ &Make checks Dayable.tw City of Fridley Attach St3unlatinac THIS IS AN APPLICATION FOR A PEUdIr 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 codas of the City of Fridley and with the Mimtesota nstnrction Codes; that understand this is not a pannit but only an application7�f f permit and work is not to start without a permit on side; that the work will in acco ce the approved m the case of all work which requires h``'aw [� / J SIGNA 0 PRINT NAME �Jl�i DATE (• l [o f D Building BUILDING $ Permit No. a O Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 $ .001 times the total job valuation Surcharge $ CITY OF FRIDLEY Date Rec'd: 763-502-3604 FAX e�( $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) EFFECTIVE 1-1-2010 $ ft + 6 ft = R x $24 = $ �9 J/ /�} DATE '<! ' ! V YOUR E-MAIL ADDRESS $ SITE ADDRESS c9�D Park Fee THIS APPLICANT IS: ❑ OWNER CONTRACTOR Fee Determined by Engineering PROPERTY OWNER/ NAME: Ir'Sj C�UM+ — necessary ( ) Non Necessary ( ) TENANT �/► ADDRESS: 2YC l0 - 04,,,, CITY Col r' -'A STATE /hy✓ZIP PHONE: CONTRACTOR NAME:Cyr-►,..a..-, SUBMIT A COPY OF STATE LICENSE # Q �O EXP DATE " Z401 7- YOUR STATE LICENSE �- AND CERTIFICATE OF ADDRESS: CITY (-in, +-. L, lc t STATE ,,)ZIP� .5VLf INSURANCE PHONE (03 - YLIS - ((0'5q FAX -7(-3 - 7 m - l d3 PROPERTY TYPE O$INGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION GARAGE/SHED ❑ WINDOWS �❑ ❑ BASEMENT FINISH P!9ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAIINTENANCEIREPAIR REMODELING DESCRIBE WORK BEING DONE: IC 2 I Luh SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING 17 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, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other ❑ 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: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ D See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ _�'� 0005 x Permit Valuation Minimum $.50 License Surcharge $ e�( $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = R x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $Agreement — necessary ( ) Non Necessary ( ) Total Due $ Make checks Davable to: Citv of Fridlev Attach Stiuulations 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 fo 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 whi require view and approval of plans. ,j SIGNATURE OF APPLICANT PRINT NAME i� &,C<J I DATE /0 l D