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PRE 2010 DOCSCity of Fridley SUBJECT - P , 14454 AT THE TOP OF THE TWINS UILDING 'PERMIT BUILDING Ir? RECEIPT NO. COMMUNITY DEVELOPMENT DIV. ti. r PROTECTIVE INSPECTION SEC. NUMBER REV.. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 IL L''-'jk�., ,f %.J 612-560-3450 910-F15 11/2/77 JOB ADDRESS 1414 - 76th Avenue N.E. 1 LEGAL LOT NO. 6 BLOCK 1 TRACTOR ADDITION \ SEE ATTACHED Meadowmoor Terrace 2nd \ DESCR, SHEET 2 PROPERTY OWNERMAILADDRESS ZIP \PHONE Marvin Burns \\ 3 CONTRACTOR MAIL ADDRESS ZIP PH NE LICENSE NO. Gar ac Construction(,81 No. Highway #65 Cambridge 689-2200 4 ARCHITECT OR DESIGNER MAIL_ ADDRESS ZIP PHONE LICENSE NO. � T }{ 5 ENGINEER MAIL ADDRESS ACCURtACY OF :�� S cvA�,�9f'�c ,, THELICENSE NO. LOCAnONPOE THIS AND 6 USE OF BUILDING PERSONS USING; R SHOULD R !NFORIMIFION p,� ly Y THESES Residential ON TTHE siTr-VERIFY THE 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 38' x 46'8" Dwelling and a 208" x 21' 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. Provide sod in the front and side yards. Provide a verifying survey before capping. Provide truss design before capping.., SEWER LOCATION: (Approx. 10' Deep In Street) 69.5' E. of Manhole (B_. Inv. 887.14) WYE ELEV: 887.42 TOP OF FOOTING: 890.92 Minimum WATER LOCATION: Approx. 12' E. of Sewer Service DRIVEWAY DEPRESSION COST: Alt. "a" 16' + 6' x $11.75 $258.50 WARNING Before digging call loch ���;�:;`- SEpERA'i'E PERMITS REQUIRED FOR �IIRI G® TELEPHONE - ELECTR iC, GAS EIC. HEATING., PLUMBING AND SIGNS. REQUIRE® BY LAYV 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 OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 1030 + 504 25,304 Tots ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION j 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 $34,995 $17.50 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 R THE PERFORMANCE OF CONSTRUCTION. $101.22 $375.00 PLAN CHECK FEE TOTAL FEE 01-111. z 25.30.02 SIGNATURE OFC RACTOR OR AuoRIZEO AGENT (DATt) * HEN PROPE Y VALIDATED THIS IS YOUR PERMIT BLDG. INSP DATE SIGNATURE OF OWNER(IF OWNER BUILDER) (DATE) t c� v 1 dmi MUSUROAN Certificate of Survey for t� -f�a rl%r -- —1 CZ SCAGE : / " 30' AVG. W& -1 -;50 _ ON— .r v` I— l � dolts iibn manU�nP!!i &OCK coun� I hereby certify that this Is o true and co ct representation of o survey of the boundaries of the above described land, and of the location of all ildinps, thereon, and oil visible encroachments, if any, from or on sold land. As surveyed by me this day of ' A.O. 107, r SUBURBAN ENGINEERING, INC. Ineinew sby Svr.iyeyor• F Not PublishM- All Rights Reserved ., Id )�-- cl�eljg)e6 3 0,47) y® co 7 5` A, 4,t)yf �5 G 4 G� �-of • Of: 6- 4qrltw)9 (, PL) � P/U) plel— P com me7,5 r. 4 CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER: �.dtd1y'�1/ I ��R �$ EUILDER: e&7xic vf� b Address: Address: AID, &kzl (,r CIA M dA 1A4E Tel. No.:66 No.: ��� Street: �% �!ly� /1.� r3 - LOT: LOT: BLOCK: _�ADDITION : M °p a d Q vv � 06� 'TP ir.�f/ �P � /G0 CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS: "j-4-1 -b' 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: 138 8 Front: 42 r2r: Depth: Height: oio Square Feet: /0_ Cubic Feet: 07 6, p (0.41 nc r -A2 ACy Front: �y �� << Depth: 101 Height:, /®i 76'74 L Square Feet: � Cubic Feet: Type of. Construction: Ed,4 ^1,C- Estimated Cost: $'996— To Be Completed: TA or/, -/ I Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired 16 $ $ (SEE REVERSE SIDE OF SHEET) 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 representa ions stated in this application are true and correct. See reverse side £o dditional information. DATE: SIGNATURE: Stipulations: /. A*tee,- tl/hv w , v 6L.r If 1411-22 / 21 5-6 1/9, d2 -),I, UV.4o 4 iITY g ''�rr�{S��}__}�'�[ �/�)�p }�,� ,a ,���r} }� �rW+.^ y�y ��Jpy�y�?1�. 1}�, yy��`+e yr��j■�►{ /J}/ ;. d- - y-�• 5 r!V �F�' `V i��. f_All�Li��F tl' ■ ."RAG!�..1. �A �� .. +��4/� � iy "i6�rV�T(�• /� �'(` ,�-` V . 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A7/1.., J .�.. rG , y h fl �Jr y� - 9t /. ! :5 V i' 4I t�7w�h rFi.Y.�....n y('�►-.(tea N- h l• ■ ! ri i� y ',}r tit.�rtOl, a, -.„ 4y • � � t 1 -,A. � V �TM'.y�� � - ,+ �1r 17NVI,'t•'}','w�y...,riw+r�,,,«_�.r..,�, i �'J� .] 7 s �Y nu ;3 ° R E ti a j[� ` tyr�j, ]�(y���1� ��4'yAJ ,.. a' 11,�„(/0i}1311ti 1Nv«.. �'`ax. l Y (- ✓BI µ4 2`" r �'w�, :�lcak- * G tl�c� ai w 1 -tis . tY; if ra ft % P ft" 1 J.r• jr"E �# y Gi-Qr1e, u-.ry� +�'•Yt� X • L ti a ..u.sai►. ..++.ra .-- Ii�sLS7� �Ip#� ;,�i�a7f row, ttpp pL,, y V FiG15r` TL lgi �+ �i t}}� �'-,, s' __ `(� +' t • .ir++„r,� +mow i r i% a �iP3i ' it S b p F) 1 . Jt.'♦ �q�yFys�4.s. 4 !r 6 ,.`. 116 d� .a � � a � �, -? E � Y i� G �. A r,� .% ,/� r► '�'o-TA 7 kor, ca �I�k t�AL� �{ a�,, tJIM tltatl 'e:'er et�reeI, rvswq. .... �>; , x s+ ��.( •r.`rt�. (�.i[ap,,) a9 �y `. ��+ Jvfi iT ♦ 'd Y}/ Utacrii di P+ i t�ji. k, i ' �a t - 'Jro. -��: i� 4!! (�T ��'craf rtL� 4t)9 �3ng • "°illl RD$� " "I,gr�r f` . l �1/: R 9 '�' r x sq. ft • ,.,,,n FF f 17 k�►`�.d'sr�.; +��,tt .C}5i' VGt►.�.MiC •I`Oo$^7"'l./a�i141'e%I�'"':., . fi � +z � wY s , t,;. � Y `,'. , � tr - 't t i, P� `{"' -stn � -.�: ' r u � ,_.a ' - oT F `� x 13 t'• � ,t ; r - f s1,�' � � �� 3'Tk � t a � r itl` � � ��r(rt �%p �6 {. !t F�,"•�31k, "� ,rti e'' ! (Fu'• fit}`},�.§ 4J * M? �+ ,� !!f L '`{fir u� a `� �"�y . Jeff / •per i ( �+�h,A� 1.�• ^��/*�Je1_ OI' ICO:' tF i• Ii D it if+l cep u s wall area foY s • ra ch• Construction 2. ♦t�►r�ar air fiL� [� 5B ., • Z. 3 inches soft i, . •�" �. irw•g lune.• A k"e♦+'!•Ih+rf IePY ,y�..�iw1Rw. d �' �` 4i , S. . e 1C . 6. Extexior `air film g� �r*�. t4 f ; Ilk- C � N 1. Interior ai.i. ri114 sal t 5 1 2. 1 S. • x} 6. EiitQrior air film a • v, ,a r , � + �- + - �• _� ♦ .�y� I r r-:: '' T • �• nteri V4 8.1.r'�ii�i� ' ..�•{,7G► f '.1 3. Site !AlA �1 '-�---�eew �• 6. Exterior air filmmom fttal •4�*`• • ��w • r`. - ' r. 4 l A L s ••YL `/a t I F r i imp s ' ♦. 4r , 1. Interior air film3 geo �1[ •' i s { • D 4 t A �} 1�'�+r� •"�* Ft` r.,_ w•���Ir•♦ . �. Exterior air, fiiza _ t���{"I a 7// j�' Mo 71j..'..'� ter►'.y r 5t, •t's.. >�f j i. -+ ••f ♦/y,' SLAB ON GPADE r�r 3T. 7sr r fey l.:: �',' 'R- ._ • •' - •-� � �� - ay � � �^ � �'�� � � � `, � 4.. �(�. �" �(( V i • t rpt � •' e �F u ,rrhtj� r • , l .'{�P ,1 r FIG. . �*°`"1 t� .� ' �.. ♦ NE: ° indicate type. MaM,,dep► i�irrG'ts �1 • " • placelsentr of insqUti• k r `' •� • • v + _r1: 131 i -.b i v U; i-KiLL'cr APPLICATION FOR PLUMBING AND GAS FITTING PEF14IT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Number Fixtures Future Fixture Opening New Fixture, Old Opening Catch Basin Water Heater - to 99,000 BTU 100,000 BTU to 199,000 BTU Water Softener New Ground Run Old Building Electric Water Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS $ ALTERATIONS First $100.00 each add. $100.00 or fraction NO. RATE TOTAL of $3.00 $ �2900 x m $ i� $2.00 u x k N x Water $ 5:'.vy X $10.00 $ x $7.00 $ x $5.00 $ x $5.00 $ x '$3.00 $ Job X $1.00 �e X $10.00 $ [y wW Heater w n .i r. Am x41 y 3Mu�a q0 t - 13 u 14 m W .u m ed U o as lec�W 1st 2nd 3rd 4 th (R) - Future Connection Opening Connected with Sewer M - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Number Fixtures Future Fixture Opening New Fixture, Old Opening Catch Basin Water Heater - to 99,000 BTU 100,000 BTU to 199,000 BTU Water Softener New Ground Run Old Building Electric Water Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS $ ALTERATIONS First $100.00 each add. $100.00 or fraction NO. RATE TOTAL _9 x $3.00 $ �2900 x $2.00 $ X $2.00 S x $5.00 $ x $5.00 $ 5:'.vy X $10.00 $ x $7.00 $ x $5.00 $ x $5.00 $ x '$3.00 $ Job X $1.00 $ X $10.00 $ $5.00 $ $2.00 $ -- State Surcharge $ .50 TOTAL FEE $ �� REINSPECTION FEE ($10.00) Job Address Department of Buildings City of Fridley Tel. #571-3450 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 Fridley, Mn. OWNER KIND OF BUILDING> �) ;✓ USED AS (� TO BE COMPLETED ABOUT 0 ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. Com an r Signed By — Tel. No✓ / ROUGH INSP. Date FINAL INSP. _ Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SUFE CITY OF FRIDLEY APPLICATION FOR P(WER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Job Address c , Furnace Shell & Duct Work $12.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Department of Buildings Repairs & Alterations each add. $500.00 4.-00 $ City of Fridley i Tel. #571-3450 MECHANICAL WARM AIR: The undersigned hereby makes application for a permit for the work herein Furnace Shell & Duct Work to 100,000 BTU $12.00 $ specified agreeing to do all work in strict accordance with the City Cod" each add. 50,000 BTU 4.00 $ and rulings of the Department of Buildings, and hereby declares that all the Replacement of Furnace 7.00 $ facts and representations stated in this application are true and correct. Repairs & Alterations -up to $500.00 7.00 4.00 $ �,y/,� Fridley, Minn. 19� Repairs & Alterations each add. $500.00__.. $ STEAM OR HOT WATER SYSTEM: OWNER _ l Boiler & Lines up to 100,000 BTU $12.00 $ KIND OF BUILDING each addn. 50,000 BTU 4.00 $ Boiler only up to 100,000 BTU 7.00 $ USED AS each addn. 50,000 BTU 6.00 $ TO BE COMPLETED ABOUT OIL BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ ESTIMATED COST 2 GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 /I $ BUILDING PERMIT N0. PERMIT NO. �G (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: let 3 Fixtures x', $ 3.00 $ DESCRIPTION OF FURNACE/BURNER Additional Fixtures xi $ 1.00 $ Gas Range to 199,000 BTU x $10.00 $ HEATING or POWER P , Steam, Hot Water, Warm Air- No. AIR CONDITIONING $ ' Trade Nam � size No. FAN HEATING SYSTEMS See Fee Schedule $ VENTILATING SYSTEMS S Capacity Sq. Ft. EDR BTO HP ALTERATIONS 4 REPAIRS $ State Surc e $ .50 Total Connected Load Rind of Fuel , TOTAL BURNER - Trade Name Size No, p' ROUGH INSP. REINSPECTION FE Capacity Sq. Ft. EDR BTU HP Date ($10.00) ,w �'s; FINAL INSP. Company Q' Date"01; Signed By r� APPROVAL FOR PERMIT Tel. No. MINIMUM FEE FOR ANY HEATING PEkaT IS $7.50 pLUS $.50 STATE SURCHARGE 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE ( 812)571-3450 January 23, 1978 Mr. Gary D'Aigle Gar Jac Inc. 681 North Highway #65 Cambridge, Mn. 55008 Re: Final Inspection at 1414 -76th Avenue N.E. Dear Mr. D'Aigle: A final inspection was made on January 20, 1978 of the above address and the following items were noted which must be completed before the structure can be finaled out; 1. Provide vapor barrier in laundry room by February 1, 1978. 2. Provide sod in the front and side yards by June 15, 1978. 3. Provide a hard surface driveway by June 15, 1978. 4. Provide permanent posts with frost footings for deck support by May 1, 1978. We will expect the above items to be completed by the scheduled dates when reinspections will be conducted to determine compliance. If you have any questions on the above items, please contact me at 571-3450. Sincerely, 0-nms(�Z, DA G . CLA Community Development Adm. IGC/mh • KIND OF DUILD1110 _ frame PLUNMING• FIXTURE RATES: NO, RATE TOTAL I,L:.b1X FLxtutes •• K $3,00 $ Nture !'-•aura Opening C, $2.00 Nater U X ,ro $ _� Catch Basin • A D� C 5 t.Nator Haa%er - to 99,000 BTU,' `' In ,U so �� j •a X 110.00 ' O J O .2df 57,40 rU !N M X c b S X N 5 �_ H v' n '•'r A a w ++ a .� N o ae 1ee a' c� t� isc r pl as fang e ._� 77- . (R) - Future Connection Opening Connected with Suwar I•) - Haw rix w re, Old Opening Natur • • PARTIAL RATE.SCHEDULE KIND OF DUILD1110 _ frame PLUNMING• FIXTURE RATES: NO, RATE TOTAL I,L:.b1X FLxtutes •• K $3,00 $ Nture !'-•aura Opening ri $2.00 $ _ New Fixture, Old'Oponing X $2,00 $ _� Catch Basin • X $5,00 5 t.Nator Haa%er - to 99,000 BTU,' `' X $5.,00 �� j 100; 000 'ETU to 199,000 BTU X 110.00 ' Nater Softener x 57,40 S ' 11e -p Ground' Fun Old Building X 55.00 1 �_ Eloec.rie Nater Heater - X $5,00 5 �_ -CAS FITTING FEES: 1st 3 fixtures x $3,00 $ _ 3Jdicicnsl rixturei -,x 51,00 3 �� ,Cas Range to 199,000 BTU x $10.00 REPAIRS E ALTERATIONS rich 5100.00 $5.00 1 each xed. $100.00 or fraction $1,00 $ +� State Surcharge $ .50 TOTAL FCC B,oO 1414 76 Ave 1 , Department of But dinge City of Fridley I Tal. 1571-3.150 � , W The tindersignod hereby makes application for •a permit for the w spooified agruoing•to do all work in strict accordance with the C and rulings of the Department of Buildings, and hereby doclaras t the fa0te and roprgeantations stated in this application aro trod Fridley, Mal 1-•25-78 ONNFR _ M_ 13UHM KIND OF DUILD1110 _ frame ' USED A9 res TO BE COMPLETtD ABOUT 2-1-78 ESTIMATEO COST 20.OQ OLD - NCN uUILDn1G PERMIT 140, YE(y1IT 110, Compo MIPJWCANMASCO ' Signed By' Tole No, ROUGII INSP, ' Date FINI.L INSP. Dato ' APPROVAL FOR PERMIT MINIMUM YEB FOR A11Y PLUMBING PERMIT 19 17.50 ' MA SUBJECT City of Fridley (74 2 `� 3rAT THE TOP OF THE TWINS P, BUILDING PERMIT - _ RECEIPT NO. ' • _______ COMMUNITY DEVELOPMENT DIV. 1 L PROTECTIVE INSPECTION SEC. r NUMBER REV DATE P AGE OF APPROVED By ' -i CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/28/96 JOB ADDRESS 1414 76 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 1 Meadowmoor Terrace 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jeff Tatus 1501 78 Ave W, Brooklyn Park MN 55444 566-9923 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Advanced Home Improvements 1501 78 Ave W, Brooklyn Park MN 55444 566-0233 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20017269 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (20 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must )XX comply with 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 $1,600 $.80 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF NY OTHER STATE OR LOCAL LAW REGULATING CON- Fire SC $1.60 TRUCTMNR PERFORMANCE OF CONSTRUCTION $51.25 jPLAN 6 CHECK FEE TOTALFEE $5.00 Li se SC $5 5 S16NOAURE OF CONTRACTOR OR AUTHORIZ AGENT IDATEI PAOPE LIDAT D IS YOUR PERMIT . INSP je- 6- MATE _ SIGNATURE OF OWNER 0F OWNER BUILDERI IDATEIG MA NEW [ ] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: IVY 2( & ?L�` ` � tc- , Legal Description. Owner Named Address: ; -7 e 11et V? w Tel. # .-L6 — 97 Cy,,( s Contractor: ,,,,,x -7-7., /�'�-pve w.4e r 41 MN LICENSE #- 6 4-), -7 a t� 9 Address:/ J. 7 e-fh 4 ,,-e I-/- r ! G, ns� �� s sZ� Tel. #—I -Z. G �-c► �-1� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING A: Length Width Height Sq. Ft. GARAGE Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: _ �C.� _S .c Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction:, Estimated Cost: $ Approx. Completion Date: Icy (Cost on Back) Driveway Curb Cut Width Needed: Ft. + _6 Ft = Ft x $ _ $ DATE: 4' 6 APPLICANT:r `--'-� Tel. # S6 G ©� ?-3 f CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ / G) .001 of Permit Valuation (1/10th%) State Surcharge $ �'C� $.50/$1,000 Valuation SAC Charge $ $900 per SAC Unit License Surcharge $ OCA $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ ��- STIPULATIONS: Building Inspections 763-572-3604 DATE SITE ADDRESS THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE PLUMBING RESIDENTUL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS Permit No Received By: ATEA NLIP5�543 NAME: 1 , m !so V\ 01 STATE LICENSE I2_®1 EXP DATE l O 2� ADDRESS: a-3 C� �7�� Q r CITY S e STATE► " ` ZIP, SS�o y` PHONE '�D .3 _ S 7 I 0145A FAX - Z%61 SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE ITYPE OF WORK: ! o NEW 3(REPLACEMHNT DETAILED DESCRIPTION OF WORK PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to 5500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor q�jo - x .05 = p FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Surchar a .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $35.00 BATH SINKILAV FLOOR DRAINS r SHOWER _WATER PIPING — GAS PIPING MED =UCU44 _SWIMARNG POOL —WATER SOFTNER ($35) —BATHTUB CLOTHES WASHER _ KITCHEN SINK WATER CLOSET ! BACKFLOW PREV. ($15) DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION _ WATER METER —OTHER Permit Fee $ ��. ®� Number of fixtures @ $10.00 x $10.00 = $ Surchar a .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ 50 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 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 requir s mvieNy and approval of plans. jj SIGNATURE OF APPLICANT PRINT NAME 10 _DATE 1 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 RAY. 741_1;0')_AQ77 Building OCCUPANCY TYPE BUILDING Permit See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Inspections $ RESIDENTIAL APPLICATION Received By: 763-572-3604 .0005 x Permit Valuation Minimum $.50 CITY OF FRIDLEY Date Rec'd: 763-502-4977 FAX EFFECTIVE 1-1-08 $ DATE i YOUR E-MAIL ADDRESS til f SITE ADDRESS )) toy v $ $450 Conservation Plan Review Park Fee $ THIS APPLICANT IS: ❑ OWNER CONTRACTOR Sewer Main Charge PROPERTY OWNER/ NAME: Total Due 14 L -L %'`L` �1ele� CITY STAT ZIP 432 TENANTADDRESS: PHONE: NAME: ' r -I �j ZIP !%_0G CONTRACTOR ADDRESS: CITY h STAT SUBMIT A COPY OF . PHONE Co - . `'"J FAX (05V �I • 3 YOUR STATE LICENSE STATE LICENSE # Z03�l.�JD'SS EXP DATE 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 MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: f " SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ 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: — FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS. & PORCHES SUBMIT: ❑ Vinyl ❑Soffit 1 Site Plan/Survey showing the existing structures ❑ Aluminum ❑ Trim and proposed project. ❑ Other ❑ Fascia 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 VALUA'nuN, iNCLUDiNG THE w3l Ur LADun P-4 LP I --i Li. t riiciNG TNF 1999 TTRC FF.F. SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ 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 $ otoo $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 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 $ 9 Make checks payable to: Ci 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 on site; that the work ill be in accordanc w e approved plan in the case of all work which requires revie nd ap val of plans. SIGNATURE OF APPL CA PRINT NAME DATE — A /. APPROVED BY DA PLEASE N ARATE PERMITS ARE REQUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK 11