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PRE 2010 DOCSBUILDING PERMIT Village of Fridley, Minn. N° 2994 Date... cO , .. . ... ........—................... . Owner 4.14& ........... Builder .!� ........ ..... .... . �. Address 1.0. 67 -.. 7.. CO .................. Address � ..................... � aL�OCATION OF BUILDING No.. Z .. �....... Street ..... /. ....... ........ ....Dof Lot ..................... Lot .... 0... ...... Block ..... ........... Addition or Sub -Division art ................... ..... r � Corner Lot ............ Inside Lot.. . Setback .... Sideyard®' /l�4lPfv •.9� DESCRIPTION OF BUILDING To Used as: . ... llp ... Front .... Depth � l ' 6eight 4kn Sq. Ft. 0 : . Cu. Ft. ........ . ont ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft. ........ Type of Constructio Est. Cost �.T� 0'6 ....... To be Completed ... .. . W_ 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 village of Fridley. WM In consideration of the payment of a fee of $1(;7" permit is hereby granted to��,s ..... toconstruct the building or addition as described above. This p nted 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 limit, and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. 'A? /n i I e..vnoiig Inspector NOTICE: This permit does not cover the construction, installation or alteration for wiringMling, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for thes tems. City of Fridley, Minn. BUILDING PERMIT No 6�87 Date: Owner: — -� Builder Address OF BU1 No. Street Lot __ Block Addition do Corner Lot _ Inside Lot"' back Of Lot Ie Sideyard Server Elevation FQIKdation Elevation DESCRIPTION ,,OF ,BUILDING Front Depth Height Sq. Ft. Cu. Ft7 Depth Height sq. Ft Cu. Ft Type of Construction 'A. Est. `� 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 aft provisions of ordinances of the city of Fridley. 4t In consideration of the payment of a fee of $ , permit 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 reg location, construction, alteration, maintenance, re and moving of buildings within the city limits and permit may be revoked' at' any vi ono of the provisions of said ordinances. ��? Building Inspector NOTICE: fhb perrah don not cover the construction, huftWon for whb & pWmbin& gas heating, o wor or wabr. Be sun to see Ow Buihiin8 kqw for for separate ponnits for thea itenm APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name gv—f h� &1-3 Builder V rA"r Address /o S'= lS 7h If J,4 fJ,4 Address If LOCATION OF BUILDING �a No. d.� Street 7� Part of Lot AeAlk 91,9 -J'e.0ee Lot Block Addition or Subdivision Corner Lot Inside Lot Setback Side -Yard SE14HR ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To be used as: DESCRIPTION OF BUILDING Front d Depth Height Sq, Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost 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 0 (Schedule of Fee Costs can be found on the Reverse Side). SUBJECT PERM) City of Fridley AT THE TOP OF THE TWINS PERMIT' 1��q� r BUILDING IPT N `L -------COMMUNITY DEVELOPMENT DIV.��®� r � � PROTECTIVE INSPECTION SEC. 1 _ � NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-580-3450 910-F15 6/16/76 JOB ADDRESS 105 - 75th Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 Niemann Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Wn. H. Peters 105 - 75th Way N.E. 3 CONTRACTOR MAIL ADDRESS 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 Residential 7 CLASS OF WORK ❑ NEW Ij ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct porch addition off side of garage 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATiE PERMITS REQUIRED FOR WIRING, HEATING,-PLUM84NG AND SIGN& 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 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 $600. oo .50 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. $6.00 PLAN CHECK FEE TOTALFEE $6.50 9 SIGNATURE OF CONTRACTOR 0 IGNATUREOFOONTRACTORO AUTHORIZED AGENT (DCATE- ) ji s Y�JI.IEWHdE�N PROPERLY VALIDATED THIS IS YOUR PERMIT UnAJ t-l&-a 1 BLDG. )NSP DATE SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: (o') J"( z2t BUILDER: Z"/)/, ADDRESS: O �� - % y Lv ADDRESS: r, NO:_._ ® �� STREET • r LOT: S BLOCK: ADDITION: CORNER LOT: INSIDE LOT: 4/ SETBACK: SIDEYARD: 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: "_A14�"Front: //- / % � Depth: � � Height: Square Feet: Cubic Feet: Front: Depth: Square Feet; Cubic Feet: Height: Type of Construction: ft� Estimated Cost: $ G 4 G , O d To Be Completed: 'R &)161 4 , 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:— A:=_ 2z�'�_ (See Reverse Side For Additional Information.) l ti �U y C9 . 0 CIlYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 - FAX (612) 571-1287 September 23, 1991 Bonnie Born 105 - 75th Way N.E. Fridley, MN 55432 Subject: Lot 8, Niemann Addition; 105 - 75th Way N.E. Dear Ms. Born: The above referenced property is located in Zone C of the Federal Emergency Management Agency's flood plain map, which is considered to be "areas of minimal flooding". Enclosed please find a copy of the FEMA map with the general area of the property outlined. The map number is 270013 0003 B, with an effective date of March 2, 1981. If you have further questions or concerns regarding this issue, please contact me at 572-3590. S i nc ere J 4`ILI� Barbara Dacy, AIC Community Development Director BD/dn C-91-317 -FZ 'AA c SUBJECT �7 City of Fridley 22 8 9 3 AT THE TOP OF THE TWINS B U I L D I N G P E R M I T' r RECEIPT NO. � `y COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9/9/94 JOB ADDRESS 105 75 Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. $ Niemann Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Michael/Bonita Born 105 75 Way NE 574-0801 3 CONTRACTOR MAIL ADDRESS 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 Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑X REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof House (16 Squares) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Provide smoke detectors adjacent to all sleeping areas and in basement. 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 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 $.60 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,200 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- $29.00 Fire SC $1.20 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE $30.80 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WH I PROPEROJ LDG INSP VAL194TED THIS Ij_X0LM PERt IT DATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI c NEW [ ] Effective l/ 1 /94 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 ��3 Building Permit Application Construction Address: Legal Description: Owner Name & Address:1u1 i e h n P , i a- �o n�ka l� o n Tel. # ;j y - v 90 I Contractor: Se 1 MN LICENSE # Address: 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: iR. C"nrl hni oCP , /A -.rte Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Type of Construction: Approx. Completion Date: Side Yard Setbacks Estimated Cost: $ 1 "10 C), c (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ $ DATE: 9 / q / 4 y APPLICANT: & n ; +Q -&,-n Tel. # O Rv I Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $0�'6)C) $ /too $ S $ �`6b 3z) Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $800 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 [ ] M SUBJECT City of Fridley 24692 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC.45-637 1 � � ---\ CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 10/16/9 JOB ADDRESS 105 75 Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. I 8 1 Niemann Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Michael Born 105 75 Way NE 574-0801 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Panelcraft of MN 3118 Snelling Ave S M ls. MN 55406 721-6628 2179 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 1i ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside House; soffit & fascia, trim 9 CHANGE OF USE FROM TO STIPULATIONS Install ventilation to meet 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $7,890 $3.95 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- SC $7.89 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $137.25 Fire PLAN CHECK FEE TAL FEE Licens SC .00 $154.09 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) PRO Y V ATED THIS IS YOUR PPERM/���fJJJ��/j BLDG INSP r)ATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATEI '" - M NLW (( ADDN (( CITY OF FRIDLEY ALTER It SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: /45r -7-5- h 1 '9'�76) LllecUve 1/1/94 Legal Description: Owner Name & Address: /%f�1 L�0�/I% �s � 460yc-) Tel. # S-7�1-,ITO/ Contractor: RA1Ve1-6rC-,4Fr �i� //V MN LICENSE # Address: _/� �Jn✓EL �-� by e/ s / "%S /%N !�;6-�& 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.- t.DECK DECKAREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot Inside Lot Ft. Yd Setback Side Yard Setbacks Type of Construction: TFC ZIC 6�510eF Z Estimated Cost: $ %,F%V - l7t,2 Approx. Completion Date: So �Fl (Cost on Back) Driveway Curb Cut Width Needed: Ft. + G Ft = Ft x , _ $ _ DATE: /D 5 APPLICANT: �� Tel. # CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $_ .001 of Permit Valuation (1/10th%) State Surcharge $_ 3, 7_5�_ $.50/$1,000 Valuation SAC: Charge $ _ $800 per SAC Unit License Surcharge $ .506 $5.00 (State Licensed Residential Contractors) v Driveway Escrow $ _ Alt. A or Alt. B Above Erosion Control $ --, $450.00 Conservation Plan Review Park Fee $ —° Fee Determined by Engineering ID _ Sewer Main Charge $ ---- -^� Agreement Necessary I I Not Necessary I 1 TOTAL /,'� $ 16 o y STIPULATIONS: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 763) 572-3604 FAX: (763) 571-1287 ADDRESS : 105 75TH WAY NE PIN : 103024120037 LEGAL DESC : NIEMANN ADD : LOT 8 BLOCK PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING PERMIT .:2004-00683 DATE ISSUED: 05/11/2004 VALUATION : $ 1,042.00 NOTE: UNDERLAYMENT AS PER STATE BUILDING CODE. REROOF GARAGE (9 SQ) TEAR -OFF STATE LICENSED CONTRACTOR 1 APPLICANT CARLSON ROOFING & REMODELING 533 79 AVE NE SPRING LAKE PARK, MN 55432 OWNER BORN MICHAEL W & BONITA K 105 75TH WAY NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort, will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating ction or,the�performance of construction. ADDIIC �/ Date5-11 v Bldg lnsp �(�,( �� Dated % (I BUILDING PERMIT FEE 41.80 FIRE SURCHARGE 1.04 STATE SURCHARGE, VALUE 0.52 LICENSE SURCHARGE 5.00 TOTAL 48.36 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW (] CITY OF FRIDLEY Effective 4/1/2004 ADDN (] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address:Tel. # ContractorG 0 ci- )CA, MN LICENSE # ©,y -t.3 3 3 Address: SV3 -7 9 -/A « v /.' 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 i9 Height Sq. Ft. DECK AREA: _ Length Width Hgt/Ground Sq. Ft OTHER: -9 f� as n (' � e- rc> 07e o� O(e fa C iQAi a r de_ a sc> ( e 10/-1C Ga of w0.�dConstruction Type: �Estimated Cost: $ Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ —=$ DATE: 5- r` ' a y APPLICANT:E 4r Tel. #1'i Call (763) 572-3604 for Permit Fees if mailing In application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL S S s Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 [ ] STIPULATIONS: Building TOTAL JOB BUILDING U.&C FEE SCHEDULE) M6 Permit Fee permit No.• -0 Inspections Plan Review Fire Surcharge RESIDENTIAL APPLICATION 65% of Building Permit Fee Received By: 763-572-3604 .001 times the total job valuation License Surcharge $ is .0005 x Permit Valuation Minimum $.50 SAC Charge . GO $ CITY OF FRIDLEY Curb Curt Escrow D=1t DATE SITE ADDRESS V- YOUR E-MAIL ADDRESS 1(1e C� q 5 pp �u r S G oyh ft + 6 ft = ft x $21 = $ $450 Conservation Plan Review Park Fee Sewer Main Charge THIS APPLICANT IS: 0 OWNER CONTRACTOR Total Dne PROPERTY OWNER/ NAME: 1 A - TENANT ADDRESS: CITY STAT>%IP�a 7 PHONE:—IU3 CONTRACTOR NAME: 2r. X tri o g .Lhc , SUBMIT A COPY OF STATE LICENSE # –q EXP DATE YOUR STATE LICENSE WITH APPLICATION ADDRESS:.O'l r r S -A ( CITY PHONE 1�?i- - 3 I¢ $ -) D L' ✓I STATEN ZIP SS30 3 — PROPERTY TYPE FAX Ln 5 L IL W CONSTRUCTION srzE PERMIT TYPE O FAMILY/NEW CONSTRUCTION STORIES 0 ADDITION 0 GAR,4GE/SHED 0 WINDOWS 0 BASEMENT FINISH PROOF 0 DRAIN TILE 0 DECK 0 SIDING 0 OTHER TYPE OF WORK: 0 SWIMMING POOL 0 NEW 0 ADDITION INTENANCE/REPMR-0 REMODELING DESCRIBE WORK BEING DONE: 6eLk! - SIZE OF IMPROVEMPWT T T..,,..,.., NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT - SADING 0 Vinyl 0 Aluminum 0 Other OW IN EXISTING OPENINGS OYes ONo OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & 13 HOUSE & GARAGE 0 ATTACHED GARAGE O DETACHED GARAGE OSoffrt 0 Trim 0 Fascia LOCATION OF WINDOWS BASEMENT REMODELING SUBWr• 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, 1. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: TOTAL JOB (USIN997 VALUATION $_I U.&C FEE SCHEDULE) M6 Permit Fee $ OCCUPANCY TYPE See Back Page for Fee Schedule Plan Review Fire Surcharge $ $ ( 65% of Building Permit Fee Surcharge $ .001 times the total job valuation License Surcharge $ is .0005 x Permit Valuation Minimum $.50 SAC Charge . GO $ $5.00 (State Licensed Residential Contractors) Curb Curt Escrow $ $1675 per SAC Unit (Plans to MWCC for determination) Erosion Control $ ft + 6 ft = ft x $21 = $ $450 Conservation Plan Review Park Fee Sewer Main Charge $ $ Fee Determined by Engineering Total Dne Q � � –., � Agreement necessary ( ) Non Necessary ( ) _ _ _ _ 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 'ch requires revie val of plans. SIGNATURE OF APPLICA PRINT NAME �� , DATE_ Building Inspections 763-572-3604 DATE,_ ► L—L SITE ADDRESS ____ THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH PERMIT TYPE TYPE OF WORK: PLUMBING Permit No.: /,d In`9A�_ )tL' Received By: RESIDENTIAL AI" PLICATION Dates :. I 2 2a CITY OF FRIDLEY YOUR E-MAIL ADDRESS 0 OWNER IPCON"CKAUIUM NAME: l + )A' STA' crrY f,DnREss: Q d PHONE: ...,...... (00l -00a -I0 -W STATE LICENSE # �XP DATE •••� ��+2M M9 CITY STATE ZIP ADDRESS: F PHONE y FAX SINGLE FAMILY ❑ TWO FAMILY 0 TOWNHOUSE _ 0 NEW 16 REPLACEMENT DETAILED DESCRIPTION OF WORK eater, for the PER MS 16B.665 the permit fee is a minimum ofd$n5..0 0 or e�excluding of hetotal the fiup xtures. ut so $500 Thisshould reflect on0, whichever is ly the cost of labor) improvement, installation or replacement of a rest x .05 = _— Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor (INDICATE TOTAL FOR PROJECTS WHERE OR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FDaIME, EXCEPT WHERE NOTED�FIXTURES: NUMBER OF EACH BELOW) SHOWER WATER PIPING BATH SINK/LAV FLOOR DRAINS — SWIMMING POOL — WATER SOF n MR ($35) GAS PIPING R� cm'L►� BACKFLOW PREV. ($15) — BATHTUB .— KITCHEN SINK _WATER CLOSET —FOR IRRIGATION _ CLOTHES WASHER '—' TRAY `` WATER HEATER ($35) DISHWASHER — t WATER METER —OTHER - �iir'�ta✓.a3�Yh'ms'0.LE $ ��' � $ State Surcharge Numberoffixtures @$10.00 x$10.00= Permit Fee Number of fixtures @ $15.00 x $15.00 = $ Surcharge.. SU Number of fixtures @ $35.00 x $35.00 = TOTAL DUE 1 --� Total = $ 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 t I erstand this is conformance with the ordinances and codes of the City of Fs not o start ridley and lwithou a permit; that the work will be in th the MinnesoConstruction Codes; a accordance dwith the not a permit but only an application for a permit and work I approved plan in the case of all work which requires review and approval of plant. /1 071 ®soli c /l VYl � �, City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 l �� FAX.: 763-502-4977 OCT -27-2009 11:50 AM DAN.HORBUL 715 646 2796 P.01 From: City of Fridley To: 171504VM,,,6W12 Pllge: 213 Dift:10127t=16:54:57 AM wilding s BUILDING Fire Surcharge PerrnitNo.: Inspections S RESIDENTIAL APPLICATION R=eived $y 763-572-3604 S1 $5.00 (Stato Licensed Residential Contmetars) CITY OF FRIDLEY -S ,OCT 0 763-502-4977 FAX tFFECTIVE 1.1.09 fe + 6 f4 = ftx S21 -S EMS10n Control DATE„ IO.+�► 7-,09' YOUKB-MAILADORMSS 8450 Conservation Plan Itawiew SITEADDRESS S THIS APPLICANT IS: DOWNER NTRACTOR s PROPERTY OWNER/ NAME: & AJA!_`! m®RN S TENANT AD0r0*%S: i0 ... '7�fA t t3/4CITY Y✓:[�Lr.i STATE '�LIPS,Sy3:i THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROC7W'C4ED PHONE: CONTRACTOR NAME:- .., -__... RI)SMIT A COPY OF Ynt)R STATE LICENSE U`' STATE LICLNSE #_.._ 4O..i $O 7? &9 _ _ EXP DATE _ 7�+� "' - �`l A�v CITY�ju�ti2��5TPTi�G1 ADDRESS!_`% AND CERTIFICATC INSUREWCE � f �`i PHONE t FAX 776 PROPERTY TYPE C91NOLEFAMILY/NhWCONSTRUCTION TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ADD'-'ON ARA FtiJ WINW * BASLME.NT FINISH G ROOK U DRAIN TILL: G DECK O SIDING G 0THER C SWIMMING POOL TYPE OF WORD.:� NEW HOME' CONSTRUCTION O ADDITION AINTENANCgREPAIR 17 REP400 UIVC DESCRIBE WORK BEING, IICINUQ + SIZE OF IMPROVEMENT LKNGTH WIDTH HEIGHT SQ 17 D SING G HOUSE ONLY }CASEMENT REMQ RLI,NCI SUBMIT: NUMBER OFSQUARES O HOUSE &GARAGE I. Existing FI Plan Q`UCRg PROPOSED SIZE: O ATTACHED GARAGE XDETACHL'D GANAOI! 2. IlImp+utti floor p6n 3 LRt of RifncfiRal »tettttaea to bs Im W PROPOSED HEIGHT: KA NEW CONSTRUCTION INCLUDING DECKS. HIDING ADIDITIOt &POIRCHESSUHMIL' QViny l CSofiit 1. Ciro PIndSur ey*hawing the etMng alnwnuaa O Alauraowa O Trint and proposed project. U Other D FFACis 2. Two Beta of eoNstroelinrt plana WINagwS 3. line +CaleuMarta M RJOMNG OPENIN09 ❑Yea MNc LWATION OF WINDOWS OR MR NEW OPENINCIS-DESC7iISE SIZE OV OPENING CHANGES A TYPE OF WINDOW TO BE INSTALLED —NUMBER OF WINDOWS ALL. FEES ARE BASED ON VALUATION, INCLUDING TIIE COST OF LABOR AND MATIEJ IALS: (USING THE 1997 MILC FEE SCHEDULE) Plan Review s 0% of Building permit Foe Fire Surcharge a •001 tlmos the total. job valuation Surcharge S jj .0005 x Parmit Valuation Minimum S.SO Lieonso Surcharge $ S1 $5.00 (Stato Licensed Residential Contmetars) SAC CIMCC -S 52000 per SAC Unit (Piams to MWCC for detcmination) Curb Cut Er4row S fe + 6 f4 = ftx S21 -S EMS10n Control S 8450 Conservation Plan Itawiew Peck FCC S Fee Dotonninad by Engineering err Main Charge s ASMOmont nooemary ( ) Non Necessary (' ) Taltal Due S on (I Malta cheeps Dilyablt: to: City of Fl idler t_a THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROC7W'C4ED 1 bmvby apply for a building permit and l acknowledgo that the information above is complete and accurate; that the Wolk will be in conformance with the ordinsna:s and codes of the City of Fridley and with the Minncsots Consttuction Codes; that I understand this is riot a permit but only an application for a permit and work is noW start without a poRnit on Mite; that the work will be in accordance with the approved plan in the cam ofall rk whi require rev d approval of plans. SICINATURdOFAPPLICANT PRINTNAMEg6!! Z DATE 16.27 67 OCT -27-2009 11:51 AM DAN.HORBUL 715 646 2796 P.02 e s -60 y ep ; y a a1 K �®P l.r REVIE D FOR CODE C'G Wi�/► Lv1s X /© 977 c ! ,ps k",ds N,