Loading...
PRE 2010 DOCS*City oFridley, f FMinn.. BUILDING PERMIT N° 4228 Date: ....._..- - .'- v._ .. --- _-------------------- ----- Owner: ................... Builder ............_............... ... ._......._.... ........ _.._........_.._......_.._ ___...._ Address..... -............ .... _..... _................ -- --... _._._.-.--------------- Address _._.. LOCAT� OF BUILDING No. ..•� Street .............. ............- ._............... Partof Lot .....------------------ - ... Lot ..........�................. Block ...... ....... .......... ,7......................... Addition or Sub -Division ...fir ✓ r _.......: ................... Corner Lot ......._ ........................... Insiidd Lot .)(. ._................._...... Setback : .'.. ..__........ Sideyard .. pQ.` /��_ ..........-__-.......--.....__ Sewer Elevation ...... .........1.1.....�44 ...........................--------. Foundation Elevation......���.r..�.L............._....... DESCRIPTION OF BUILDING To be Used as: OF r r� .._._�.._........... Front .2. Depth g..d...-' Height /Z f 4L ...` Sq. Ft. /.�a.7 Cu. Ft.-. -5-7,fZ °7 � .. � Front [- -® Deptho?.4..:� Height Q.---0 Sq. Ft. V!- 3 Cu. Ft..7�./.�� tt!d/ Type of Const tion............................................................ Est. CXl.-,ar5��. To be Completed ............. ....... ............................... In consideration of the issuance to me of a permit to construct th 'building described above, I agree to do the proposed work in accordance with the description above set f and in compliance ovisions of ordinances of the city of Fridley. l iI n 1 In consideration of the payment of a fee of $..v<.(C._�....:. permit is hereby granted ..... _............ ................................................... 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 an a provisions of said ordinances. _ 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 hems. 4 C, Application for Power Planus and Heating. Cooling. Ventilation. Refrigeration and Air Conditioning Systems and Devices 10 PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 4-7470 GRAVITY WARM AIR: RATE TOTAL Locatl— -7y � 0 -7® Furnace Shell & Duct Work .......................... 8.00 $ City of Fridley: Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ The undersigned hereby makes application for a permit for the work herein specified, agreeing to da all work in strict accordance with the City Ordinances Repairs & Alterations each add. $500.00 ............... 2.50 $ and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. MECIL WARM AIR Fridley, 11Rinn_ � � �L � 195k Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ eachadd. 60,000 BTU ....................... 2.00 $ �� Owner;!� `�' ' � . 19 Replacement of Furnace ... .. .. .. P ... .......... 5.00 $ Kind of Building i'�«� Oi 18.s Repairs & Alterations—up to $500.00 ................. 5.00 $ >� Repairs & Alterations each add. $500.00 .............. 2.50 $ Used as ,A' �� To be completed about STEAM or HOT WATER SYSTEM Furnace Shell & Lines --to 400 sq. ft. IDR Steam ...... 8.00 $ Estimated Cost, Furnace Shell & Line—to 640 sq. ft. IDR Hot Water ... 8.00 $ PM -New. Building Permit Nn_ Each add. 200 sq. ft. IDR Steam ...................... 2.50 $ Each add. -320 sq. ft. IDR 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) ....................... GABS PIPING (Up to 3 Fixtures) .............' ......... . (Add 50c each over 3) AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS 8c REPAIRS REMARKS: See Fee Schedule $ TOTAL FEE $ ' -- 5.00 $—°�• 1.50 ® " HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No Trade Name e9� Size No Capadty Sq. Ft. E D.R ✓ ®0-5:� BTU H.P. Total Connected Load 70 e9 7z 6 Kind of el ZZ2! BURNER — Trade Name.—s�r� � Size No r Capacity Sq. Ft. EM.RA-0& 0L--4 BTU H.P. , 9 1 e T. �-' *-- X61' q Signed✓ �` P Business Phone No- 11 POST W-8-58 k.Yi -• � � -.x�. ��.OA t y� � . l�� si` S!'a M _�..� 3;'�G�q -ss��•' C� � �.� "i � j�9 t'Tib �j 7 r y Tl-� � � �. ` Jl_ "� � ��- ..W C7 _ �x � s ��'r�' `�2 � � � ` shit �' �• � t Df ot trIt 41 k.t '{E;-,V�i K lU h �r ai 7bW.afl 40 ne— Ti vz ' ,,.. '-. � eke � •� +��> ' 4'@.- ..' 4G'.-�`..'� .11t� ;!f� >� � �. 3. , � .fa. :' -ai .�,�• e �. r � �.. '•-,.. � i -c1 P'' � ', a r — s •x ,+. _ �`-�,-s�'w_� e -' R r t f• a�''r� ? t �:�, �_s sa_• �`. J � �' �,:.'_ _ r.. � 3 � o'�ki i"rp�'�''•a�'--�� r_� y .: -,^� �C�?�w . ��.w�;s�.� �_.. _•�,.�>',?� ..._s..�:_�4 .�� � il:_ ,_� .<Q�F,..,-���i�_!<�"2 --;�w r�,:x�`�'lr<,�.i.,n, _ �.- Sri, .{ sz w,� ��.,� �^ � � r( �' �S• it r � '� k� -r > +',µtiff r ra� ?.�' itis s. �s� t '"� _� �i ,' � � �!}e t �[ ,� _ r -�r. p-S-S`i''�� M fri �i •5 a EgPut' _ �. XZ 4 ¢J ,k-�S- .a+-i`r -• } - }r Ti t;sFz Kc" J� ,� '3'�s,S'ii ;},-r• � �w 1 z t sT t r } t`.F Fr � �n i 1 zF >ti r ��.r;� ANOKA HEATINr61M C1X1D !TONING HEAT LOSS CrA&LATIONS AR,(_ Zv7� �� 327 VAN BUREN, ANOKA, MINNESOTA WeatherstripsS, A..H.V. Construe on No. Insulation Guide WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes—No Yes—No 19— / F1.I j Room I Length / Width $ Height Windows a Doors—Crackage and Area Coef. Width Helght No. of Lineal ft. Area No. or pane of pane lights of crack eq. ft. AS /pa PlIft ® (� Btu Infiltration Q Glass Coef. Btu Infiltration 2 X 3g j Glass 3a Exp. wall Net exp. wall 530 6 Exp. wall v X X x / b Int. wall dry Net exp. wall X Z21> // / S -2� . Int. wall X y X x / Ceiling 72- /2— 66 Floor Y V )f A Total Btu. I®G e� Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / 1`11 Room I Length / -2 / Width / o s Height X'/ Windows and Doors—Crackage and Area i - Width Height No. of Lineal ft. Area No. of pane of pane llghts of crack sq. ft. .'fie d '-t0 L , Coef. Coef. Btu Coef. Btu Infiltration Q Glass 7.2 1 LLe� 9a Glass X x , Net exp. wall 3a Exp. wall Net exp. wall 530 Int. wall 6x 16 zjr// v X X x / b Int. wall 6X /y X Floor x Ceiling Floor k X A yIt t� x Total Btu. 1 '5�/ 3 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I I M I Q. 7 A R...,,.. II anott, 4/ W;Jth 7' i$.t®hf _v/ Windows and Doors—Crackage and Area i - Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. [t. ZZ / 8// 113 L , Coef. Coef. Btu Infiltration �3,� 38° Q Glass 7.2 1 LLe� 9a Exp. wall X x N YX Net exp. wall 3a / 530 Int. wall Y v y x la Ceiling 6X /y K70 Floor k V k X Tbtal Btu.�/� jc . _ LyD 12 '.4/ ®----'---1 -- f, IT r%D -- -- '-- lff A I ---t-- ---- _•a--_ v - a e.l 6—le— Windows and Doors--Crackage and Area Windows i - Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. it. / 4/13/o14 L , Coef. Coef.1 Btu Infiltration 10,3 38° 626 Glass / 9a Exp. wall X X i >e Net exp. wall 3a // 17p Int. wall X Y Y v )f Ceiling b Z Z 876 Floor X it k )e 2f Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I / pi_I Q � _P Room I Length j_� Width / z Height S' Windows and Doors—Crackage and Area Width Height '41o. of Lineal ft. Area No. o[ pane of pane fights of crack sq. ft. 2 • L , Coef. Btu Infiltration Infiltration Glass / O Exp. wall k x Net exp. wall Int. wall X X 92D V x v Ceiling /Z 3a Floor x:! 17p De '/ iK Total Btu. I Required sq. ft. E.D.R. or sq. his. W.A. Leader area i p1I /3 — _,P Rnnm I Length / > Width / 2—Height 5;,, Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of vane of pane llghts of crack ft. !!e//q. L , Coef. Btu Infiltration 8 • /® Glass 2J.Y_ p Exp. wall Y y jr Y' Net exp. wall // 17p Int, wall X 7( X X )( Ceiling Floor b /Z X ,>`® yxy Total Btu. I C' 6'va Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ANOKA HEATING & AIR CONDITIONING HEAT LOSS CALCULATIONS # co _ 70 % W -v- 327 VAN BUREN, ANOKA, MINNESOTA Weatherstrips A.S.H.V.E, Construction No. Insulation Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes—No I Yes—No 19— I E l PH Room I Lenath fit/ Width 0® Heiaht -9® II a F1.1 X'RAn Room Length /% Width G Height? Windows and Doors—Crackage and Area Coef.1 Btu Width Height No. of Lineal ft. Area No. of Dane of Dane lights of crack sq. ft. l . �a 6 Glass Exp. wall 272 X '! X X Coef. Btu Infiltration Int. wall S( I y e. p Glass ge-4, All Rao Exp. wall 52 X X X A Net exp. wall Z a /! 1 130 Int. wall x C k X v Ceiling ' S 2 Floor Floor 111A4 1 4/ v x y Total Btu. 137,520 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Room I Length ale Width /,3 Height g Windows ad Doors—Crackage and Area width Helght No. of in Leal ft. Area No. of pane of pane liahta I of crack I sq, ft. � F���"5In�I.✓"* Windows and Doors—Crackage and Area Coef.1 Btu Infiltration SP Btu 6 Glass Exp. wall 272 X '! X X Net exp. wall jag_- // 2 - Int. wall S( I y y u v Ceiling 7.3 — g o--vP Ae—p-s • 3 2- a Floor Total Btu. X x X k /a, e(Q Required sq. ft. E.D.R. or sq. ins. W.A. Leader area -370 ,B Fl. I p" Room ILength Width -kit. wall NA,; Height Windows and Doors—Crackage and Area Width Height . No. of Lineal ft. I Area No. of pane of pane lights of crack sq. ft. .?S- a Ps // 40 Windows and Doors—Crackage and Area Coef.1 Btu Infiltration % 3 , j g Glass Infiltration l/ 6 p Exp. wall — g o--vP Ae—p-s • / j{ X x X 41k exp. wall / -370 Int. wall -kit. wall NA,; I )e k v y // 40 C . '.I" 511 A9r7 ;1 0 3V6 Floor Floor 111A4 1 4/ # 96 Tbtal Btu,�_NV AAC. rr .5' Windows and Doors—Crackage and Area Width I Height No. of Lineal ft. Area No. of pane of Dane lights of crack sq. ft. Coef. Btu Infiltration 31° .T/a Glass Exp. wall 1 / X if `/ Net exp. wall 2 / / -370 Int. wall X I )e k v y Ceiling 40 X )e %P- *Floor Floor ;1 X Total Btu. fi = /Yo=- a Required sq. ft. E.D.R. or sq. ins. W.A. Leader area R P1 I 17-- Rnnm I Lenath /L Width ;`2—Heiaht 7 Windows and Doors—Crackage and Area Width Height fo. of Lineal ft. Area No. of pane of pane fights of crack sq. ft. Coef. Btu Infiltration 10 2- 3% a Glass C y/ 30 Exp. wall e, 2 / X K X Net exp. wall ,e mo d --Ew wall e� 40 )e %P- *Floor Ceiling ;1 X Floor Total Btu. Required sq. ft. E.D.R. or sq. iris. W.A. leader area b t:1_I A"- Rnnm I Linath /t Width / ® Height 7 Windows and Door—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights I of crack eq. ft. C 7ef. Btu Infiltration rr 6,96 Glass / , / Y36 Exp. wall - 9– X k x )e Net exp. wall le —IR. wall, c, mo fog Ceiling X )e %P- *Floor Floor Total Btu. Required sq. ft. E.D.R. or aq. ins. W.A. Leader area 1,3p 3 Q 11 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area C/® M ' ANOKA HEATING & AIR CONDITIONING HEAT LOSS C ULATIONS-4 - 7 > �Y 327 VAN BUREN, ANOKA, MINNESOTA Weatherstrips A.S.H.V.E. �, Construction No. Insulation Guide WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes—No Yes—No 19— R Fl.l/� _ w Room I Lensfth 2 Width ?tel Height y II F1.1 Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area Noa of pane of pane llghts of crack sq. ft. / 3a 'Pw Coef. Btu Coef. Btu Infiltration ,3e, e Glass Int. wall Ceiling Exp. wall 17�® X.x Ceiling Floor Net exp. wall �, f=ix �:. m / , 6®, art. wall � � •o ®. � Int. wall Floor 0 �O Total Btu. /B S7d Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l Room I Lensith Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Area eq. It. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Infiltration Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack sq. ft. Area eq. It. Coef.1 Btu Infiltration Glass Exp. wall Infiltration Net exp. wall Int. wall Ceiling Floor Exp. wall Tbtal Btu. Required so. ft. E.D.R. or sa. ins. W.A. Leader area Windows and Doors--Crackage and Area Width Height No. of Lineal It. Area No. of pane of pane tights of crack eq. ft. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area P1 I Rnom I Lenfrth Width Height Windows and Doors--Crackage and Area Width HeightAio. of Lineal ft. Area No. of Dane of pane (ighte of crack sq. ft. Area eq. It. Coef. Btu Infiltration Glass Exp. wall Infiltration Net exp. wall Int. wall Ceiling Exp. wall Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1_I Rnnm I Lenoth Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. No. of pane of pane lights of crack Area eq. It. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area y YT, 41 v�j YN..,yy�j, � T/ s, F City of Fridley Application for Plumbing and Gas Fitting Permit Dep:. of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures go 3 .. � N 8 �U' Z R • N WATER HTR. GAS ELEG � 0 am $ < °d (�'� 0 Base l 1st 2nd _ 3rd a — 4th ° Future Connection Openings Connected with Sewer * New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... (_ x $1.50 $—u� Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... t x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS PITTING FE S: 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 $ 1�• a 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, Owner Kind of Building Used as�a'-�' To be completed about Estimated Cost, fffP—' New. Building Permit ROUGH FINAL dz 2M 7-59 19-!�--b By c.v Business Phone , CITY OF FRIDLEY os) k> APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE GRAVITY kAR\t AIR: RATE TOTAL _..mace S' -ell & Duct Work $12.00 $ Ra acemen t of Furnace 7.00 $ Repairs e Alterations -up to $500.00 7.00 $ Repairs & Alterations each add. $500.00 4.00 $ MECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTL' $12.00 $ each ad.:. 53,000 BTU 4.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Re_ -airs & Alterations each add. $500.00 4.00 $ STaa.%t 02, HOT WATi:.R Sl'STLM: . Boiler S Lines up to 100,000 BTU $12.00 $ eazr, ad n. 50,000 BTU 4.00 $ Boiler only up to 100,OOQ BTU 7.00 $ each addn. 50,000 BTL' 6.00 $ OIL BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 (over 199,99S BTU see Fee Schedule) GAS FITTING FEES: ist 3 Fixtures x $ 3.00 Additional Fixtures x $ 1.00 Gas Range to 199,000 BTU x $10.00 AIR CONDITIONING FAX HEATING SYSTEJIS See Fee Schedule VENTILATING SYSTEMS ALTE2ATIONS $ REPAIRS - State Surcharge TOTAL FEE ROUGH INSP. FINAL INSP. REINSPECTION FEE Date ($10.00) WA— APPROVAL SLCAPPROVAL FOR PERMIT MINi%lUM FEE FOR ANY HEATING PERMIT IS $7.50 $ /0, 00 Job Address r)U — Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application fora permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn. OWNER L "_ P" KIND OF BUILDING my _^Q — IAA, USED AS l TO BE COMPLETED ABOUT 10 /6 -sof // ESTIMATED COST / 6 S© s OLD - NEW BUILDING PERMIT NO. PE04IT NO. $ `'�� DESCRIPTION OF FURNACE/BURNER $ HEATING r POWER PLANTS, Steam, Hot Water, Warm Air No.. g $ Trade Name (.;,��e/�(p7/y Size No. 0b $ $ Capacity Sq. Ft. EDR BTU HP $ pp $ .50 Total Connected Load 60,002-1 Kind of Fuel go'7 S $ + So/� J ©/ BURNER - Trade Name l "o I P. {IYjaLy Size No: ch Capacity. Sq. 11Frrt. EDR BTU 160,0Q0 HP -L �, C N r S ��?d' �L T�• Company Signed By "C01- ��loofi Tel. No. Ba 01 SUBJECT P of Fraley _ 28550 ?City AT THE TOP OF THE TWINS BUILDING PERMIT r L,572-3604 COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 173 NUMBER REV GATE PAGE Oi APPROVED BY "'1 CITY MALL FRIDLEY 55432 612-571-3450 910-F15 11 19198 JOB ADDRESS 80 70th Wav NE I LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. g 4 Ostman's, 3rd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Joe Pietrzak 571-2785 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Advance Alum. Supply Inc. 7701 Main St NE Fridley - 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 O NEW O ADDITION ❑ ALTERATION :R REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage (27 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment 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 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 2310 $1.16 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 $74.75 Fire SC $2.31 PLAN CHECK FEE TOTAL FEE 22 SIGNATURE OF CON 7PAC TOR OR AUTHORIZED AGENT IDATEI WHEN PROPERL ALIDATED THIS IS YO R PERMIT e SIGNATURE OF OW NER qF OWNER BUILDER. IDATEI Bl0 IhSP T1ATE 01 E 612 571 2260 ADURNCE ALUMINUM 01 NEW 'j ] 297 Eff6ctive 1/1/98 ADDN ) CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES: R-1 AND R-2 BUILDING PERMIT APPLICATION V) n 1 ConstructionAddress: 141/ Legal Description: Owner Name & Address: % f� Tel. # Contractor: 6 p v,9 - C 4 .� e.vM �^�✓ �z� '- �� � MN LICENSE 5✓i�'!t� � Address: 7 ' C> / /f'! a 7- Tel. Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: D$CK AREA: OTHER: DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. . Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. ��?�� Construction Type: Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: 9 APPLICANT: G� ' Tel. # .571-5YqO CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge $ `��%'/S Fee Schedule on Reverse Side $ / .001 of Permit Valuation (1/10th%) $ $.501$1,000 Valuation $ $1000 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 [ J TOTAL STIPULATIONS: M