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PRE 2010 DOCSN° :R Village of Fridley, Minn. BUILDING PERM" Office of INSPECTOR OF BUILDINGS Architect t�� h Frid'_ey, Minn. Builder B LOCATION OF BUILDING No. ` Street_i J;s °tea °x� / 7 Part of Lot Lot Block Addition or Sub -Division I II DESCRIPTION OF BUILDING Frond)—'20— Height Stories_, Manner of Construction To be used as �� .+. - F To be completedk-'l r. ^ r Estimated Co 2i ,�'a,i��rb'���` ,.�'...,r°, ae� � °v ..,s �0 a�:.� ,�'�n,��,,.��;-j �P' !��,�y ✓`.>� �,:;.rA s`e ��:E.�i�'.;�i «{ � 4�" .�f!�N`4 ''�',a° J��;�.._ +• id'.Ju '§� �'�`l YG" + e INS � � ��'� Permit is hereby granted to t to the buildinJ r described in the above statement. This permit is granted upon the express co4ditioa t4at they' arson to �'*hom it is granted, and his agents, employees and workmen, in all the work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, Minn., regarding the 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. Inspector of Buildings. r. u AGAFEMi N'�' AND SWORN STATEMENT In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of the above permit, I hereby agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Fridley, and, being first duly sworn, I hereby state and say that the facts stated by me and contained in the above permit are true as therein stated. _ Jo �o Subscribed anvil sworn to before me at Fridley, Minnesota, this— day his day of ) 2.. 'ti "dl, 42.2 A.D. 191_ 0 0 City of Fridley Application for Plumbing and Gas Rtting Perndt Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK 3 Locg�n2 © �l� c�•�e � �B Number, Kind and Location of Fixtures J C y y Z ww O5 <3 J �� O Z Z • • WATER HTR. GAS EIEC Base 1st 2nd 3rd 4th Future Connection Openings New Fixture, Old Openings Connected withI Sewer � Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $2.00 $ Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ............................ x $3.25 $ Water Heater (Up to 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg. ............ x $3.25 $—"4,26 Electric Water Heater a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the facl and representations stated in this application are true and correct. Fridley, Iff nn 1 19_ c Owner Kind of Building Used as To be completed about Estimated Cost, $ Old—New. Building Permit No Permit No. Signe , ROUGH FINAL (-� Description ................................................$ TOTAL FEE az By Business Phone No /33®-619 01 SUBJECT City of Fridley ;R 13840 AT THE TOP OF THE TWINS BUILDING PERMIT r ` RECE COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 91393 1 i � NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 IL ,`J L"" 612-560-3450 910-F15 10/25/76 JOB ADDRESS 1330 69th Avenue N.E. (1330 County .Read H) 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1$ A.S. #10 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mr. Aasland 1330 - 69th Avenue N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Franzen Construction Co. 4250 5th Street N.E. 788-4071 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 fx]' ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 12' x 20' Garage Addition 9 CHANGE QF USE FROM TO STIPULATIONS Provide a hard surface driveway. Use douglas fir for rafters. SEPERATE PERMITS REQUIRED FA WIRING, HEATING, PLUMBING AND SIGN& SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood Frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 24.00 OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 240 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 $1,776.100 $. 89 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- $9.60 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $10.49 SIGNATURE OF CONTRACTOR ORf1dRIZEDAGENT (DATE) WH N PRO ER ID D THIS IS YOU—^Rl PERMIT BLDG )NSP BATE SIGNATURE OF OWNER 0F OWNER BUILDER) IDATEI 01 CITY OF FRIDLEY APPLICATION FOR. RESIDENTIAL BUILDING PERMITS (NEW, ALTERATI ONS, ADDITIONS, OR REPAIRS) 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: << �1--et c � Gi9` {� Front: Depth: Height: Square Feet: Cubic Feet: a �- Front : Depth: a Height: Square Feet;_. Cubic Feet: -'li114 Type of Construction: 11y / :-"Ari' Estimated Cost: .*To Be Completed: M6. 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: (See Reverse Side For Additional Information.) PK V C�, vs� u4c4z F2 � roR A s OWNER' S NAME : //4' S IeH BUILDER: �ce t ( 7 e`( A�--r.s✓ C � ADDRESS: 13&D 61V' "/% , /V ADDRESS: �14 5'67 6:!"9/-/ TEL. NO. NO: /,? J C STREET: �`9 r Al' c , LOT: /� BLOCK: ADDITION: CORNER LOT: INSIDE LOT: C SETBACK: SIMARD: 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: << �1--et c � Gi9` {� Front: Depth: Height: Square Feet: Cubic Feet: a �- Front : Depth: a Height: Square Feet;_. Cubic Feet: -'li114 Type of Construction: 11y / :-"Ari' Estimated Cost: .*To Be Completed: M6. 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: (See Reverse Side For Additional Information.) PK V C�, vs� u4c4z F2 � roR A s AGREEMENT 64�yoL-.-�. , n`5P , owner of the property locatedat h;t,� , h y� ���, n! �-/_, have no objection to the City allowing the construction of a ,;r�s�. ���/,'.�;,�,., to be located at 6 q,} r, e, without the required certificate of survey that the City ordinarily requires for all new construction. Vv � P n -Y - Signature. �— 1-39 C) - CLQ cyL ct i-rnnt, S��t3a Address Date - ® S � 1Nn Q A Qb Rs � k G'1 4 LA 'j �i qTT 00 I smg Z(2 zzfv kA 7�1 - t77,311 ABANDONED WELL RECORD 1. LOCATION OF WILLI MINNESOTA UNIQUE WELL N0.1 I County Name (leave blank If net ketmm) Anoka Township Name Township N Range Number Section No. Fraction 4. WELL DEPTH (completed) gate sealed p E % % of h Fridley -40 s 24 W 1.4 NE NW 24 fs. 8/21/90 Numerical Street Address and City of Well Location or Distance from Road S. DRILLING METHOD (if known) Intersection ID Cable tool 40 Reverse 7Q Driven 10[3 Dug 1330 NE 69th Ave. 2p Nel low Rod 50 Air go Bared 11[] Show exact location of well 30 Rotary 60 Jetted g0 Power Auger (in section grid with •X•) Sketch map of well location N 6. OBSTRUCTIONS Wali obstructed r—I Yes 0 No W Obstructions removed [3 Yes ❑ No If obstructions cannot be moved. contact MON E�� before sealing. T 7• y Ni. �mestic 40 Monitoring 013 Heat Loop I 2Q irrigation U Public gQ Industry IL 30 Test Well 60 Municipal Ito Commercial �---1 Ni69th ve. 7[3 Air Conditioning 11(] 2. PROPERTY OWNER'S HANE MSTI g cess if different then property address indicated above B. CASINGS) l�Black 4[3 Threaded 70 Lois Aasland 2L]Galy. 10 Welded 30 Plastic 60 Stainless Steel 1n. to ft. HARDNESS OF 3. FORMATION LOG COLOR FORMATION FROM TO If not known, indicate formation lag from new well or nearby well, in. to ft. 9. SCREEN Screened well from _ ft. to _ ft. (It known) Open Role from _ ft. to _ ft. 10. STAT WATER LEVEL jt.V below E3 above land luAaco Date Measured 11. WELLHEAD COMPLETION 10 Pltless Adapter 40 Found Buried XBasement offset 30 Well Pit 16. REMARKS, ELEVATION. SOURCE OF DATA - CASINGS REMOVED. CASINGS PERFORATED. ETC. 12. GROUTING INFORMATION ANeat Cement 21j Bentonite 30 2" well, 241 deep in basement offset Grout material 'Portland from 0 to24 ft. cu. yds 13. NEAREST SOURCES OF CONTAMINATION feet direction type Well disinfected before sealing? 0 Yes 14. PUMP .CRemoved 3KNot Present Type: 1Q Submersible 30 L.S. Turbine 50 Reciprocating 20 Jet 40 Centrifugal 60 IB. EXISTING WELLS (Please sketch locations of abandoned and N active wells in remarks section or on back.) Other unused wall(s) on property? 0 Yea 10 No Abandoned: 0 Permanent 0 Temporary ❑ Not sealed w 17. WATER WELL CONTRACTORS CERTIFICATION This well was sealed under my jurisdiction and this report Is true to the best of my knowledge and belief. A-TATelI., Inc. 02484 Licensee Business Name License No. Address 772A. Take Dr. F Lino Lakes M. Signed Oate Date Nome of Driller FFiCIAL ABANDONED WELL RECORD (May be used for Property Transfer) nuotrugre rrslr Nr2w am sulliky City of Fridley 305,154 AT THE TOP OF THE TWINS BUILDING P E R MI I T IPT NO. COMMUNITY DEVELOPMENT DIV. � /� / r PROTECTIVE INSPECTION SEC. �[( /vsn 7 NUMBER NEv DATE PAGE OF APPROVED BY "...1 CITY HALL FRIDLEY 55432 L J` 612-571-3450 910415 11/30/99 10B ADDRESS 1330 69th Avenue NE 1 LEGAL I LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 18 (Parcel 320) Rev. Auditor's. Subdivision #10 SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Paul Kelly 571-5057 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Tabor & Sons Inc. 10547 Terrace Rd Blaine 55434 789-1902 20014248 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION XX REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof house (15 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlaymen.t must comply with the State Building Code. 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 SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW TME 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 $1311 $.66 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $50.95 Fire AC $1.31 `� 0 3 59 PLAN CHECK FEE 70TAL Licen C $5.0 $57. 2 SIGNATUREOFCONTRACTORORAUTMORIZEDAGENT (DATE, N P OP ALIDATE T IS Y�PER LIT t S,GNATURE OF OWNERi1F OWNER SUILDER�'DATE' BLOC NSA gAtE NEW [ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �h 1� Construction Address: _1 J 3 30 Legal Description: Owner Name &Address:-` ,�n//,i Tel. # 57/ -Yd5'9 Contractor: Z f6Q / !' Sam MN LICENSE # Address: /d 4ry .7 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: 2 �,, �. � „09= Aum, Estimated Cost: $ to 5,7 a!r2 re Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: - a S 5' APPLICANT: � Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $5-9, 9� CITY USE ONLY Fee Schedule on Reverse Side .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 [ ] CITY OF FRIDLEY INSPECTION DIVISION �h-��3C�� Effective January t, 1003 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR DOWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1287 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 JOB ADDRESS L c> f 0'5'1 Rate TOTAL $ 30.00 $s5e) BUILDING USED AS � Tj c ESTIMATED COST PERMIT NO. 0� $10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ / No. of Heating Units ( Circle One (Steam) (Hot Water)Warm Air $ 10.00. $ Trade Name--17'6LJ/1 C_ Size No. C�16 BTU 30, CTM lip EDR $ 25.00 $/9S_ Fuel 20- 3 Total Connected Load State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.SO STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air.Conditioners can not be placed in'a side yard without written permission;from adjoining property owner. $ ' .50 $ 5-S " 5v Burner Trade Name Size No. 13TU _HP EDR The undersigned hereby makes application for a permit for the work herein specified agreeing to do till work in strict accordance with the City Codes an rulings of the building Division, and heFeby declares that all the facts and representations stated in this application are true and �cco7r e�ct. DATE d V HEATING CO Sign FAX Appr FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED [`nlL MOKI VFNT� VFNT MNNFGTOR A gn CC)M ISTim AIR VFR1RC!AT1QN Wh�n7plai_ino an exicfin ,ran _ , the:undersigned heverifies that the venting has.:been examined and is free from:rust, deterioration, obstructions, and is-seauely supported and firestopped wheiL Tequired. Yeo ( ) The venting system is plasticJPVC and meets all current codes and manufacturer specifications including sizing, length; -number -of elbows and termination. Yes( No() The undersigned also verifies that the replacement unit is a fisted assembly and meets the current codes and manufacturer's specifications. This does indude AGA -LAMA Category I Central Furnace Venting Tables for fan assisted and natural draft -appliances. Yes ( No( ) Thep cflnn _nmhuctinn air is sized and installed to meet the current codes f and manufacturer's specifications. Yes ( No( ) When required to Inctall n npw cemhi,ctinn air d will be sized and Installed (" to meet the current codes and manufacturers specifications. Yes No( ) When in�ctallinn a naw venNnQsyjam, the -undersigned hereby verifies that it is'a fisted. assembly and meets the current codes and manufacturers spedfications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. -Yes P No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes §ONO ( ) Appliance #1 Typ BTU Inputgd. Fan Assisted or Nat,_ Appliance #2 Type BTU Input ` Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total, Appliances -Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Diameter L in Type cl „ft Length Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type At RATiC)NS� (�eecriliel 11 a PERMIT# / �, _133� bg FUSE HE G TES7mzd/ /e 4ADDRESS I ' , l OCCUPANT OWNER HEAT LOSS DATE HTG. INST. INSTALLED BY ELECTRICAL WORK BY TYPE OF HEAT GA _ FA HW _STEAM SPACE HTR. UNIT HTR OTHER GAS DESIGN / MAKE SERIAL 1 MODEL INPUT(BTU) CONTROLS KIND OF LINER SIZE NONE FILTERS SIZE LIS I, NUMBER I PRESSURE, PERCENT CO2 7,0 INPUT CFH PERCENT 02 INPUT ®,, '6 o o _ (00% STACK TEMP ffP? COMPANY TESTING, '13 o r`',J NAME OF TESTER Building BUILDING OCCUPANCY 'I YPE Permit No.: . (ala v C. Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Fire Surcharge Date Rec'd: 763-502--}4977 FAX Surcharge $� .0005 x Permit Valuation Minimum $.50 License Surcharge EFFECTIVE 1-1-2010 $5.00 (State Licensed Residential Contractors) iwtib DATE / Y/OUR E-MAIL AQ RErSS/ $2100 per SAC Unit (Plans to MWCC for determination) ' SITE ADDRESS 13 6�/ " �yL` %' (i d /Q.� . //vr /(j 5 rf THIS APPLICANT IS: OWNER ❑CONTRACTOR Erosion Control PROPERTY OWNER/ NAME: r Ke -61"e-7_ Park Fee ADDRESS:_ 1 -3 -Se /-/ - le, STATE IP TENANT $ PHONE: Woo - 57/-!2&77 Total Due 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 ❑ MAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: ���D✓® s /� owe iPJ ®7/� f� Q !! ' SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT S-5 ROOFING p HOUSE ONLY C� BASEMENT REMODELING SUBMIT: NUMBER OF SQt:�RES _ ❑ 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 1. 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 S OCCUPANCY 'I YPE Permit Fee $ ?jam C 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 $ $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 $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 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 fora 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 wAk vikic�i gegPire"yiJRv and approval of plans, SIGNATURE OF APPLICANT v/ I<�