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PRE 2010 DOCSSUBJECT PERMIT NO. of Fridley ® 12804 AT THE TOP OF THE TWINS BUILDING PERMIT Ir?City 4.4 RECEIPT NO. _ COMMUNITY DEVELOPMENT DIV. v i%�G !� PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATEPAGE OF APPROVED BY 612-560-3450 910-F15 11/15/74 10B ADDRESS 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 3 SHEET Jim Lund Estates 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James Lund Construction, 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Same - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK t 9 CHANGE OF USE FROM TO STIPULATIONS. Provide a hard surface driveway. Provide a verifying survey before capping. SEWER LOCATION: 333' west of manhole (Inv. 892.99) extended 5' plus or minus into property. Wye Elev: 894.19 Top of Footing: 897.50 Minimum WATER LOCATION: East of sewer service in same trench. Service extended 5' plus or minus into property. cr-nFRATE PERMITS RE I FOP ,9�IRING, HEATING, PLUMBING AND SI SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 R-1 3020 19F.200 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION I 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, $24,052 12.03 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- $47.00 $300.00 STRUCTIO OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE 9.03 G ATUREOFCONTRACTOR bTrAUTHORIZED AGENT (DATE) HEN PROPERLY VALIDAT THI 1 YOUR PERN)IT LD T SP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) i APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME:James Lund Cons:,,Inc. _BUILDER:James Lund Const.,Inc. _ ADDRESS: 241/ 148tn Ave NE Anoxa ADDRESS:2417 148th Ave NE Anoka NO:. 1510 STREET: 73 1/2 Ave NE - LOT: 1 BLOCK: 3. ADDITION:Jim Lund Estates E -2U.50 CORNER LOT: INSIDE LOT: X SETBACK:3.,' SIDEYARD .W- 12 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: Single Finaily DwelFront: "&4' Depth: 40' Height: ling Square eet: 960' Cubic Feet: .�C &ASE Front: jt Depth: 221 Height: Square Feet; 572, Cubic Feet: K Type of Construction: Frame Estimated Cost;, $ 35.000.00 To Be Completed 2-1-75 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in st-kict 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. NATURE • � DATE: 10-31-74 SIG �— (See Reverse Side For Additional Informa'tltrn/.) V CERUMCATE OF SURVEY 30.59 5116.4 P' Q 5 ,(90I.5) cos32r d 3 N en > l=am o _ 12 24 I I 20 50 � `rC,JBri 2L %n 0 fit Proposed Elovst N O .D tf1 26 24 0e1 tV .•, 'r3rarna�e � Ui�ltf.y Easement (900 82.50 ° Denotes iron monument (900) Denotes Existing Grade Fg-00 Denotes Proposed Grade Proposed Top of Foundation -904.5 Note: Description invalid until plat is filed.:, Address: 151.0 732 Ave. NE DESCRIPTION: Lot ,, Block 3, Proposed JIM LUND ESTATES, Anoka County, Minn. �' � I hereby certify that this is a true and correct representation of a sure+•y of Joh No. �lown C" Country the buundar ws of the above described land and of the location of all buildings; 1-14 if arry, therfrorr, ,rnd Ill vrsiblra encroachments, if any• beim or on said land. •-�Q��°Q2Q�®®°� drink. ---I ,-qr, - �'veyrng • ".T(� Pljru,..„) As r.urvt-yed by 'Fw this - 14 �h day of 0CtC, i. 74 (� -68 r ^_rl iny,rrcrr;",� i.+'h 1(JTh• h. N tl 93 et Bu- av A Phnne r>3.? 7340 M,nn Reg. No.. . 10944_ _ j 3 Tor y9 9 /W S��ln e Tfee-YVG14 CECe x repoao E..o city of Fridl©y - Dept. of Bldgs. Phone 580.3450 DESCRIPTION OF VIORIt Number, Kind and Loee.tlen of Fixtures`' w Q j li 3 N .• Y 11 O r 1 Z1"10! g'3 r O i6 �3 V 7' Y 7< 0 a, N 7$ r (7 N WATE4 MR. GAS ELEG Base ZAS FITTING FEES: NO. RATE" TOTAL Ist 3 Fixtures ............ • • • • • • x $2.00 $ Z•�-� Additional Fixtures ............... x $ .75 $ 1st 1 2nd _ 3rd 4th Future Connection Oponinp Sower I * New Fixture, Old Ovenings Ccaspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ............ X$1.50 s 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 $ Electric Water Heater .............. s $2.00 S ZAS FITTING FEES: NO. RATE" TOTAL Ist 3 Fixtures ............ • • • • • • x $2.00 $ Z•�-� Additional Fixtures ............... x $ .75 $ Gas Range to 199.000 BTU . .... . . . . .. x $5.00 $ 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 Citi Ordinancc and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct Fridley, Minn Owner Kind of Building' �--� — Used as s > ' To be completed about `' l Estimated Cost, $ Old—New. Building Permit No. Permit NO.. �3 9,)—) Signed ��'�� , rl, �,) Business Phone No ROUGH FINAL "/—// — %S REPAIRS tr ALTERATIONS—Rofor to Code .50 State Surcharge Description ........................................ �j- 6). TOTAL FEE _ 16-10— '%36 xVeiE. 560-3450 cit3 O ric& ANOKA COUNTY 6431 UNIVERSITY AVENUE NE January 16, 1975 FRIDLEY, MINNESOTA 55432 James Lund Construction, Inc. 2417 - 148th -Avenue N.E. Anoka, Minnesota 55303 Re: Structural Finals on Hames in Jim Lund Estates Dear Mr. Lund: You have been requesting finals on the homes built in Jinn Lund Estates. Upon making these inspections, we have noted that there are no door closers on the door leading from the dwelling unit to the garage. This is a requirement of the Building Code and therefore you must install them. Make sure that they are capable.of completely closing the door assome that we have seen are not capable enough and do not close and latch the door. This is necessary to keep the integrity of the firewall between the house and the garage. We ask for your cooperation in getting these installed on all your homes prior to your requesting finals and those with people in and already finaled must be installed on or before February 71 1975. Upon your completion of this request, would you please supply us with the addresses of those installed in the homes that we have already make finals on so we can reinspect them. If there are any questions on this matter, please feel free to contact me at 560-3450. Sincerely, DARREL G. CLARK Community Development. Adm. DGC/mh PARTIAL TE SCHEDULE GRAVITY WARM AM: SATE TOTAL Furnace Shell & Duct Work ... ... -s10.00 Replacement of Furnace 6,00 Repairs & Alterations -up to S500.00 600 3 'Repairs & Alterations each add. 3,500.00 3-00 bmCI . WAam AM Furnace Shell & Duct Work to 120,000 BTU each add.. 60,000 VIV . ......... Replacement of Furnace ,Repairs & Alterations -up to $500.00 Repairs & Alterations each add. $500.00 STEAM ax HOT WATER 375TE€d ..$10.00 110 OLE - 3.U0 S 6.00 S 6.00 $ 3.00 $ Furnace Shell & Lines -to 400 sq. ft. FDR Steam $10.00 $ Furnace Shell & Line- -to 640 sq. ft. EDR Hot Water 10.00 S. Each add 200 sq. ft. EDR Steam A.00 S Each add. 320 sq. ft. EDR Hot Water 3.00 OIL BURNER -to 3 gal per hour 6.00 S. over 3 gal. per hour -See Fee Schedule GAS BURNER (up to M,0W BTU) 5.00 3� over 199,000 VW See Fee Schedule GAS PITTING FEM. 140 RATE TOTAL Int 3 Fixturesco X$ 200 S- = Additional Fixtures _ x ' .76 S-*___ Gas -_ - Gas Range to IMAM RB 15.0 $ State Surcharge .50 Tori E. F= $ _( 7 Dopt. of Bldsa phoew OW -M City of Flidley: The undersigned hereby makes application for a permit for the work herein specified. agreeing to do all work in strict accordance with the City Ordbiancev and ruling of the Department of Buildings. and hereby declares that all the f�'a and representatiuns stated in this application are true and correct. „ISZ Kind of Building Used as To be completed about, Estimated Cost, $ uilding Permit No. _-- permit No. HEA77NG or POWER P'I.ANTS-Stearn, Not Water arm No Trade Name Size -Capacity------ Sq, Ft. E.D.R �Cf � BTU Total Connected LoadS/fj� Kind of Flue ,r BURNER - Trade Nam ` �' Size Capadty Sq. lvt. EMIL-_SI7J ] t99awaaa-Ovsa1 City of Fridley r Applicavl®n for Piing and eas RWing Pemit Dept. of Bldga. Phone SED -3450 " DESCRIPTION OF WORK Number, Kind and Locelion of Fixtures Locate � / a 1r '� .N C S p M ,i S Y z 0► p N d V Q z - o �• V V a N � Z o V r . a WATE4 "Tn. ws nEc Base 1st 2nd _ 3rd 4th 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 tact and representations stated in this application are true and <acorrect* /J Fridley, MinnQ" Owner Kind of Building r I - - Future Conaoctioa Oponinrds a.vnu111-a+w -.rasa Sower ❑ Used as + Mew Fixture, Old OponLngs ccespool ❑ 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 $ Electric Water Heater .............. s $2.00 5 SAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures x $2.00 $ Additional Fixtures ............... x $ .75 $ Gas Range to 199.000 BTU ........... x $5.00 6 REPAIRS & ALTERATIONS—Roger to Code To be completed about Estimated Cost, $ Old ew. Building Permit No. P.r No. 5 5 Signed By Business Phone No 7-5- 7 ROUGH FINAL .50 State Surcharge Description ........................................ TOTAL Y= $ S"45-6 ING, SUBJECT P IT NO. City of Fridley 13022 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPTiq COMMUNITY DEVELOPMENT DIV. INSPECTION PROTECTIVE SEC. 1 � i 1l"'1 NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 e L'--- 612-560-3450 910-F15 6-16-75 JOB ADDRESS 1510 - 731g AVENUE N.E. FRIDLEY, MINNESOTA 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 3 Jim Lund Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE KIETH HOESCHEN, 1510 - 7332 AVENUE N .E., FRIDLEY, MINNESOTA 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. DACO CONTRACTORS 8701 JEFFERSON ST. N.E. MINNEAPOLIS MINNESOTA 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING FIRE DAMAGE - DWELLING & GARAGE —T-CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK DWELLING 24 x 40 x SPLIT FOYER GARAGE 26 x 22 x 10 9 CHANGE OF USE FROM TO STIPULATIONS PROVIDE HARD SURFACED DRIVEWAY gEPERATE .PERMITS REQUIRED FOR WI HEATING, PLUMStNG AND SIGNS. CALL BEFORE RECONSTRUCTION STARTS. di ng 011 gefor� EIECTit1C - GAS DO- iELEPHONE- JAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. 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 19,200 OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PA I 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 Q $7.50 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- $47.00 NO SAC STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE i (� �� $54.50 SIGNATURE OF CONTRAC ROR AUT (ZED AGENT ( TE) (DATED THIS IS YOUR PERMIT JUNE 16, 1975 a=UL BLDG. INSP DATE SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) ING, APPLICATION FOR RESIDL'NTIAL., ALTERATION, • OR ADDITION BUILDI\'G PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAIiE : -b1 e i) I1 � L S c® k'\ BUILDER : ADDRESS: I� I �Ia �V�° ,V-� ADDRESS : P NO:. f �ly STREET: 3 Z W LOT: i BLOCK: ADDITION : �y vvl I—LLU n CORNER LOT: INSIDE LOT:_ _SETBACK: SIDEYARD: Applicant attach t this fora Ttzo Certificates of Survey of Lot.and.proposeI building location drawn on these Certificates. DESCRIPTION OF BUILDING I fiz oavn lq6 ir, To Be Used As: FUJ I. Front : t% Depth : 6/0 Height : SPL i r 4•- &0 FO Y�Z(l , Square Feet:- Cubic . Feet : i�, 200,0 a }� -----Front: Depth: 2 Z Height: Square Feet; Cubic Feet: Type of Construction: FEZ fj7vtA rL_ Estimated Cost: $ To Be Completed: 3 lmo&m15. The undersigned hereby makes application for a•permit for the work herein specified, agreeing to do all work in stxict 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 Aeverse Side For Additional Information.)' 7 s �® �J I � � • . • Oma' S� U FE & CASUALTY Casualty & Surety Division 212 South 6th Street Minneapolis, Minnesota 55402 340-5000 September 15, 1976 Fridley City Hall 6+31 University Avenue N. E. Fridley, MN Attentions Mr. Leonard Eichmiller Electrical Inspector Dear Sir: OUR INSURED, HEDSTROM ELECTRIC INCORPORATED -- OUR FILE NO. S 37 LPP 235+25 RG -- CLAIMANT KENNETH HOESCHEN -- D/A 5-24-75 We understand that you have been contacted by Mr. T. Hammond, an electrical engineer in connection with the fire at the residence located at 1510 732 Avenue N. E. in Fridley. Since our insured has been called upon to pay for the fire damage as a result of that fire, we are interested in interviewing you relative to your inspection of the electrical work which was done at that residence. We have attempted to contact you in the past few weeks but have currently been unsuccessful. Could you please contact the undersigned at your earliest convenience so we may interview you? Thank you very much for your cooperation in this matter. Sincerely, C -G PaulG �IZ Sr. Claim Representative � PY' Jmj L -488-A ,Etna Life Insurance Company / The ktna Casualty and Surety Company / The Standard Fire Insurance Company SUBJECT P RMIT NO. City of Fridley 32694 AT THE TOP OF THE TWINS BUILDING PERMIT r RE . � ; � _�____ COMMUNITY DEVELOPMENT DIV. r ' PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV OATS 6/13/02 PAGE OF APPROVED BY 612-571-3450 910-F15 JOB ADDRESS 1510 73 1/2 Ave NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. X 1 Z 3 1 Jim Lund Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Schurr Handy Construction, 14415 15th Ave N Plymouth, MN 55447 20244357 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 612-850-6307 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK Cj NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK New siding, soffit, fascia, windows & doors 9 CHANGE OF USE FROM TO STIPULATION$ Per Section 1402, 1997 Uniform Building Code requires that a weather - resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions to this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in the application guidelines. Call for inspection of wrap before covering. Ventilation must meet State Building Code. Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulking and flashing for all exterior openings. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 $15,00.0.00 $7.50 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. $251.25 Fire SC $15.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE License $5. 278. 5 SAO ATURE OF CON-RACTOR OR AUTMORII rn AGENT 40ATE- TM IS Y UR P MRoptftFATED S�GNATUAE O� OW NEFt ��i OWNER Bu�LOER� iOATE� SLOG p o r�A1E NEW [ ] CITY OF FRIDLEY Effective 1/12002 ADDN (] 6431 University Ave NE, Fridley, MN 55432 (763) 5722604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: /s/o 73 f'2 Legal Description: Owner Name & Address: Ke: 0 Tel. # Contractor. CS:' nF �' MN LICENSE # ab'a,-A -A 3S 1 Address: \y�W5 Tel. # (al ). - Sgo•- 6 307 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:S . ha ,mai : c; A, w •„,�u "As Estimated Cost: $ iS4d o 0 Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: / 7 8 2 APPLICANT: Jo C/, Tel. # 4. 8S - 39':6 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 TOTAL �qktiIRF4110I2LWAI $ Fee Schedule on Reverse Side $ /<100 .001 of Permit Valuation (1/10th%) $ -7, ;0 $.50/$1,000 Valuation $ $1200 per SAC Unit $ S $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 [ ] $ 078, Z,5- STIPULATIONS: Building $ BUILDING $ Permit No.: I Inspections Surcharge RESIDENTIAL APPLICATION License Surcharge Received By: 763-572-3604 $ CITY OF FRIDLEY $ Date Rec'd: DATE U % YOUR E-MAIL ADDRESS $ SITE ADD SS /S/e� 73�� AytS N . 1Cr� e� 1�..1 `My, Total Due THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: K'_— n g k< 44 A %/ ►6c 1, R.'L/ ADDRESS: /5-/0 c ' 3 //X a VQ_ CITY STATS vILIP SS ya Q, TENANT PHONE: CONTRACTOR NAME; SC �n w wr �� gra n cI O STATE LICENSE # q V3 S- 7 EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE !o /a - fs 3 - S FAX PROPERTY TYPE 45SINCTEE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH �❑ROOF 13 DRAIN TILE 'MIDING � � e°^ ❑ DECK � °r ❑ OTHER ❑ SWIlvIMING POOL TYPE OF WORK: NEW ❑ ADDITION ANCE/REPAIR [3 REMODELING _AINTENDESCRIBE WORK BEING DONE: e P act So m t C, ; c� ,. o, n �- a r 1 o F 1 o v sA F—A 5c. A SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2• Existing Floor Plan 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 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 $ OCCUPANCY TYPE Permit Fee $ Plan Review $ Fire Surcharge $ V .010 Surcharge $ A001 (1 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$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks Davable to: Citv of Fridlev 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 requires review and approval of plans. TSSIGNATURE OF APPLICAN-,,&-:5.:ere.-� ; PRINT NAME -� es`P h Sc h.� �, r DATE 1^