Loading...
PRE 2010 DOCSSUBJECT PER City of Fridley 2 0 515 AT THE TOP OF THE TWINS ? BUILDING PERMIT r RECE1RLN0---_ _ COMMUNITY DEVELOPMENT DIV. ~ PROTECTIVE INSPECTION SEC. y y/6 3 r s CITY HALL FRIDLEY 55432 / NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 8/9/90 JOB ADDRESS 124 - 711� Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 2 Riverwood Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jerry Tollefson Construction 311 Sunrise 427-7745 3 CONTRACTOR MAIL ADDRESS IP PHONE LICENSE NO. Same 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 X0 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ayfismACEMOVE 8 DESCRIBE WORK Construct a 66' x 26' Dwelling and a 20' x 32' Garage Before digging call for all utility- locations 454-0002 9 CHANGE OF USE FROM TO REQUIRED BY LAW STIPULATIONS Minimum walkout elevation equals: 856.5 feet. Erosion control required along retention pond and rear yard. Provide sod in`the front and side yards. Provide City with. copy of verifying survey before capping. Provide a hard surface driveway. See notations on plan. Paid $1,500 Park. Fee. SERVICES OFF 71 1/2 Way SEWER LOCATI.ON, 140' E. of M.H. at Alden Circle. ISO� WATER LOCATION; 4' -81 E. of Sewer Service DRIVEWAY DEPRESSION: 16' + 6' -- 22' x $13.50 = $297.00 THE CITY OF FRIDLEY DOES NOT GLIA>'ANTEE THE �,�,�� 00 ACCURACY OF UTILITY LOCATIONS AND ::i.E:►A;,ONS,THIS DATA IS FOR ON PURPOSES ONLY. FTHIS AINFORMATION AND PERSONS USING SHOULD VERIFY IT ON THE SITE, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $87,150. $43.58 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SACCHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $55855.550 Credit from School STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE 9.08 + PF & DW WHEN ROPER Y V ED IS S YOUR PERMIT SIGNATURE OF Co TOR OR AUTHORIZED AGENT IDATTTEI �J{ BLDG INSP DATE SiGNA OF IIF MNER BUILDERI IDATEI NEW ( Effective 1/1/90 ADDN [ ] R-1 AND R-2 ALTER [ ] Building Piermit Application Cmwtr u.'tion Address: legal Description: Owner Name & Address: Contractor: T rr� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to sole. fIPTIC�1 OF Il- l�VEI+�TP LT71M AREA: length Width o9 b Height f _ Sq. Ft. , GARAGE AREA: length a o Width 36, Height oP Sq. Ft. DEM AREA: length Width wit/Ground Sq. Ft. ORKER: Corner lot [X Inside lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: WOOD Fri vti a Estimated Cost: Approx. Cmpletion Date: /yoy 3l __ 9Z) Proposed Driveway Width If New Opening Is Desired: 16Ft. $ -1e r 7b W Width + 6� See Back Page DATE: - (9 - /PO APPLICANT: / Tel. # CITY USE ONLY Permit Fee State Surcharge $ �3 SAC Charge emr. c Driveway Escrow $ 'r^n ,j,) a Park Fee $ 15,06 160 Sewer Main Charge $ Tt7M$ . a Liss 3t. 00 S1'IPUTATIMS: (� t I v is (I) MIJ cru frLtC®car cz, q&goW& C4.vP%AjAw �rArl- Ypto4 Fee Schedule on Reverse Side $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] Eau PIL RJL�'�UN 903997G.&A Ana BAYM IM40 -PR©PO DATION FOR TOLLEPSON CONSTRUCTION Before digging do for all utility lOCatiOTME CITY OF FRIDLEY DOES NOT GUARANTEE THE ns ACCURACY OF UTILITY LOCATIONS AND ELEVATIONS, 454-0002 THIS DATA IS FOR INFORMATION PURPOSES ONLY, f?EQU4RED BY LAW AND PERSONS U'SINfs THIS INFORMATION SHOULD VERIFY IT ON THE SITE. 71 112 WCjy Ae .l iaclr = AW le �i�g t w dao o VI p�, h ®� CAUTION 1 9.� l ie,- •-_� „' - a "VISION SAIFETY COPITPOL ZONE,- OO, �12T o od"& ® P fdT c�R P/ FI_AGF AfdY. Op j/ ty P oy4� �1 Pg�B 3 0 7s iia•: C5 1N THIS AREA WITHOUT AP. 9 qt PROVAL OF THE CITY OF FRIOLEY. Drainage & Utility sem nt o 9�x 5 0 ®o 30 DAY NOTIVCE 74D OT -1 DIV. a.?. ky1'0°^lA L AND D -'•J I RI VEWo,.Y OsPENUNGS, Lot 6, Block 2. Riverwood Park, Ano!ia County, Minnesota. Elevations shown are assumed and for drainage concept only HOUSE LOCATION ONLY — NO FIELD SURVEY PERFORMED I hereby certify that this survey, plan plat, preliminary plat or report was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota. Reg. No. Date Job No. Book No. Spy cvicg-s -7/ �2 v 0 F 1�� &-f - ld?fy,lcl�f; . s 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 �Z� �' L lJ� -RESIDENTIAL RATE TOTAL Job Address Furnace Shell and Duct Work, goo 20 Department Buildings, 6431 University 55432 Burner (Also replacement furnace) $ 20.00 $ of Ave. N.E., Fridley, HN v o City of Fridley Gas Piping $ 10.00 $1C9 Tel. #571-3450 (piping needed with now furnace) Gas Range $ 10.00 $ 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 Gas Dryer $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. • Air Conditioning (all sizes) $ 10.00 $ Fridley, Minn. 1970 \\ C1-5� cr-11— All Others/Repairs and Alterations OWNER O�l� v� li of Value of Appliance or Work S KIND OF BUILDING COMMERCIAL/INDUSTRIAL USED AS 1 li of Value of Appliance or Work State Surcharge TOTAL P'EE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. /0 `� — To Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00- PLUS 15.00PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. E $ .50 TO BE COMPLETED ABOUT ESTIMATED COST -),( 0 V OLD - NEW B ILDING PERMIT NO. PERMIT NO. 1� V DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water,rm A``i. �� Trade Name WnfJS}e�,/ Size No. �V &YII oo Capacity �T Sq. Ft. EDR BTU HP Total Connected Load S Z Ss (D Kind of Fuel PC,? LTA 9 BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company a 1 -e p T- Signed By&�— ^-� Tel. No. 434 ^ ! -7 Fill out back side for stack verification on replacement furnaces 0 CHIM14EY 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 ( ) 5. Meets all current Code requirements for size and total BTU connected Yes ( ) No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL Rema rk s Company Signed By Date .� R0U TS-FA:`Y!(.TGA! COMPANY MEAT LOS CALCULATi NS _ Weatherstrips A.5.H.V'E. ; - Construction No. Guide -idows Boor. Reference Out. Wall I Int. Wall I Ceiling I of I Floor 1—No I Yes --No 1 19 1 I I Fl.l 14,7— Room I Length Width Height inflows anC Doors—Crarkage and Area Width Height No of Lineal It Area f, of Dane 1, is a! crack sq ft 7 I ? / Infiltration Coef. I Btu (filtration .3 Z Btu d �2 S' lass V 4 l v 7 (% S 1 c' Itp. wall Glaze Z 9-40 fl et exp. waif Li,-, b v - A. wall ='"' / It. wall Net exp. wall eil.or floor S"' - otal Btu. � d equired sq. ft-E.U.R. or aq. ins. W.A. Leader area W1 ; Rnnm I l_enath - Width Height indowa and Doors—C.rackage and Area %%* dth Height No of Lewin 1t. of pane at pane fights n( crack I Area q (t 40 Coef. Btu Infiltration Coef. Btu Glass Coef. Btu Coef. Btu filtration V 4 Int. wall 9v GS 70 lass Glaze Z 9-40 fl [p. wall Li,-, b v - et exp. wall ='"' / It. wall Net exp. wall %(e S"' Int. wall .J -.r Annr :)tat Btu. -1 7 squired sq. &E. D.R. or sq. ins. W.A. Leader area I.; Room I Length Width Height indows and Doors—Crackage and Area Width Hnght No of Lineal It. Area of pare cfpane lights of crack act It. Coef. Btu filtration 110 ?- C lass F.P. wall et exp. wall t. wall ?,1&1 3 1 tt :il. or floor In 3 ts )tat Btu. squired sq. ft.E.D.R. or sq. ins. W. A. Leader area ' .S6 Kind MIN NEAPC-t. . Insulation How .aprlied F1.1 Z "~ry Room I Length Width Height_ _ Windows and Doors—Crack ire and Area Width eight No of l.eneal ft. Ara No. of pane of pane lights of crack q k. %L tdth Height No. ofLineal fe. Area No o/ffpane o_f)Pam lights oIcraack q 1t 40 Coef. Btu Infiltration Coef. Btu Glass Coef. Btu Infiltration Net exp. wall V 4 Int. wall 4, ? Exp. wall Glaze Z Net. exp. wall Li,-, b v Exp. wall Int. wall ='"' / Net exp. wall %(e S"' Int. wall - s7y 3 24z Ceil. or floor?Y Total Btu. % = u 11 1", Required sq.ft. E.D.R. or. sq. ins. W.A. Leader area 1- -m I R-.^, I I math Width Height Windows and Doors—Crackage and Area Width eight No of l.eneal ft. Ara No. of pane of pane lights of crack q k. Coef. Btu Infiltration Coef. Btu Glass Exp, wall Net exp. wall Int. wall Exp. wall Z Total Btu. _ Required sq. ft. E.D.R. or sq.ins.W.A. Leader area FI 1 01,3---.-4- Rnnm I l-entrth Width Height Windows and Doors—Crackage and Area idch Hnsht No of Lineal ft. Area No of pane of parte lights of auk q ft. Coef. Btu Infiltration Glass Exp. wall Z Net. exp. wall Int. wall ='"' -TT, C--il_ er floor - I e% Y r Total Btu. % J' Required sq. ft. E.D.R. or so. ins. W.A. Leader area I ' 5-7 S-6' � `7 � "T - r CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: NO.RATE aq New Fixtures ( >. m Future Fixtures p 3.50 U Old Opening, New Fixture x N $ Water sy m y [ey+ $ 5.00 M Fyy c —6i m p g u p, R. 1w Hydraulic Valve Heater $ 5.00 $ Sump or Receiving Tank $ 5.00 S Water Treating Appliance " = $ u 8 'aq=� . Gas Gas Range d $ 10.00 S Gas Dryer $ 10.00 S Back Flow Preventer Required. . . Yes ( ) No eYye Type pM S r.- It of Value of Fixture or Appliance U p State Surcharge ay y Reinspection Fee $ w H a9 U 4 3 FEE $ r. 06 O as lec r~i► ql IA i (1. ql l7 c7 R 1 R I let 1 2nd 3rd 4th (R) " Future Connection Opening connected with Sewer (•) - New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO.RATE TOTAL New Fixtures ( S 5.00 S ,3S ,00 Future Fixtures 3.50 $ Old Opening, New Fixture S 1,50 $ Beer Dispenser S 4.00 $ Blow Off Basin $ 5.00 g Catch Basin $ 5.00 g Rain Water Leader S 5.00 S Hydraulic Valve $ 5.00 $ Sump or Receiving Tank $ 5.00 S Water Treating Appliance S 7.00 $ Not water Heater ' S 5.00 S 5 - Gas Gas Range $ 10.00 S Gas Dryer $ 10.00 S Back Flow Preventer Required. . . Yes ( ) No ( ) Type $ 5.00 S ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance S State Surcharge S .50 Reinspection Fee $ (515.00) TOTAL FEE $ r. 06 Effective May 1, 1990. J. Job Address ' F —7 / Z K/Ry Department of Buildings City of Fridley Tel. 0571-3450 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 rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct J Fridley, Mn. — Jr , 19-2-0 OWNER /v ll�$�• KIND OF BUILDING G✓pyp� -�..�� USED AS ICGS•�ae TO BE COMPLETED ABOUT ESTIMATED COST OLD - N W ILDING PERMIT NO. PERMIT NO. /OL7-3.1 Company Signed By Tel. No. ROUGH INSP. Date FINAL INSP. /® —15— ^ <? Date APPROVAL FOR PERMIT !1INIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE CINOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MN 55.132 • (612) 571-3450 • FAX (612) 571-1297 October 18, 1990 Jerry Tollefson Construction Inc. 311 Sunrise Lane Champlin, MN 55316 Re: Final Inspection at 124 - 71 1/2 Way N.E., Fridley Dear Sirs: A final inspection was conducted on October 18, 1990 of the above address and the following items must be completed before the structure can be finaled: 1. Provide sod in the front and side yards by May 15, 1991. 2. Provide City with verifying survey by November 10, 1990. We will expect these items to be completed by the scheduled dates and a reinspection called for. If you have any questions on this matter, please feel free to contact me at 571-3450. Sincerely, "2aLf D -IML G. CLARK Chief Building Official DGC/mh suBdEcr PE RMI _ City of Fridley 2132_ 3 AT THE TOP OF THE TWINS BUILDING PERMIT r ' , R NO. I COMMUNITY DEVELOPMENT DIV. ;,.------, r � PROTECTIVE INSPECTION SEC. 3cf 910 � NUMBER REV. DATE PAGE OF APPROVED BY ---1 CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/7/92 JOB ADDRESS 124 71;1 Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 2 1 Riverwood Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jackie Lindahl/Doug Rasmussen 124 711-2 Way NE 571-2051 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Custom Dimensions: of MN RT Ir Box 142 Cokato 5282 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 Cj ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Construct a 12t x 26t,Deck Addition 9 CHANGEOFUSEFROM TO STIPULATIONS S•ee notations on plan, Deck must be anchored. to ground. Provide guardrail for deck over 30 nches.above grade. Provide smoke detectors in dwelling if not already provided: WARNING Before digging call for all utility locations 454.0002 REQUIRED BY LAW ; , TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2f243 $1.12 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $54.00 Fire SC $2,24. STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE --v License SC $5.00 $62.36 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI EN -R Y LI ED THIS IS YOUR PERMIT DG IN SP GATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW [ j Effective 3/1192 ADDN [ ] CITY OF FRIDLEY ALTER[ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: 12-4 7 / i Legal Description: Lc) `r &,, & • � 0 ,�- rZ ? o o '0 1422 a Owner Name & Address: �c k l y I C A,45,Li US .s' Z"✓rJ Tel. # :C :Z I - 2. (95-1 Contractor: (, Ij Z2, -j 111, Yj E_A15I o.6v C)C � Al MN LICENSE # O0d SZ eZ Address: AI / Ay C 0,k4 id /'I ,-y Tel. # 2,2y -s329 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 / 2- ' Width Z �' Hgt/Ground Sq. Ft. z 9 �. [11W10 Comer Lot [)4 Inside Lot [ ] Ft. Yd Setback _ Type of Construction: /2 F/+ Approx. Completion Date: d `� Z Driveway Curb Cut Width Needed: Ft. + b Ft = Side Yard Setbacks Estimated Cost: $- 22-13` (Cost on Back) Ft x $ = $ DATE: 6" 9 Z APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow $ r' Park Fee $ �-- Sewer Main Charge $ TOTAL $ Z ® O 'g, STIPULATIONS: m, w a, e 0 CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $700 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ) Not Necessary [ ) 1 q v � :n lcl0 140 J 4 FM w e4 I� 3 � O � 7.X�d JotS1, 1 q v � :n lcl0 140 J 4 FM w � O � `O M �C 3 � An ywi C -A aC L[1 O M �ur� w w 3 � � J O C -A aC L[1 4 w CL s J V\ A;M7.D,) RAVO 1-Ww,4,, Existing Foundation Location for Tollefson Construction. 71 1/2 �4y 0 A/0 lett r $ r LV/ Ly 1 o n• Ki��r�J ao�- .2 .0?rm °® �' 61� ♦ rama' e 8 Utilt t Lot 6, Block 2, Riverwood Park, Anoka County. Minnesota. I hereby certify that this survey, plan plat,preliminary plat or report was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota. l0,33 2. �lG Z, ll �� /t'l �"/ &�- Li t Reg. No. Dqt—e P Job No. Book No. o •` , O 0 00 > h 30 Lot 6, Block 2, Riverwood Park, Anoka County. Minnesota. I hereby certify that this survey, plan plat,preliminary plat or report was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota. l0,33 2. �lG Z, ll �� /t'l �"/ &�- Li t Reg. No. Dqt—e P Job No. Book No. Building $ BUILDING See Back Page for Fee Schedule Permit No.: , ' Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604Date t �e . Iiia CITY OF FRIDLEY Rec'd: 7 '� DATE - -7—(2(- YOUR E-MAIL ADDRESS .0005 x Permit Valuation Minimum $.50 SITE ADDRESS $ $--OO THIS APPLICANT IS: ❑ OWNER CONTRACTOR $ PROPERTY OWNER/ NAME: ,A r oe Curb Cut Escrow TENANT ADDRESS: �.7 `I 7/ �� �-� `3 y CITY STATFA IP - Erosion Control PHONE: -2% CONTRACTOR NAME: W, r $ STATE LICENSE 1! ® �2 O o EXP DATE "-'P7 ! h -7/ _ SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 79 `,< c-/,, ;r- CITY 0 STATZ11/I1' S� WITH APPLICATION PHONE 7C-- - % y 6 FAX 7 ( 78 v 3 PROPERTY TYPE ❑ SINGLE FAMILYNEW CONSTRUCTION SIZE ❑ TWO FAMILYNEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: ' '1 �� ' ass �✓� o/d� a •� �� h �` S SIZE OF IMPROVEMENT LENGTH"WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES BIZUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SID ^ / FOR NEW CONSTRUCTION INCLUDING DECKS. Vmy�j IOSofrl — ADDITIONS. & PORCHES SUBMIT: ❑ Aluminumn 1. Site Plan/Survey showing the existing structures ❑ Other ascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOBATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF/ Ocgr- bqj n m e- F OPENING CHANGES & V1 TYPE OF WINDOW TO BE INSTALLED n NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B. ® FEE SCHEDULE) TOTAL JOB VALUATION $lv O ZDd - OCCUPANCY TYPE Permit Fee $ 2 (-:z, .1!; See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ t �e . Iiia .001 times the total job valuation Surcharge $ 3.0 Ci .0005 x Permit Valuation Minimum $.50 License Surcharge $ $--OO $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 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 $ G1 tf da Make checks payable to: City of Fridley 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 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 w h requires review and , pproval of plans. SIGNATURE OF APPLICANT ,d �% PRINT NAME rl DATE