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AF - 35649� C � BUILDING PERMIT Village of Fridley, Minn. Date • • 'r • • � ��. .%��. . . . . . . Owner . . �. . �� . �;'o?`.'?�/, , , .v0- . . Address �t ,�. �J . . .�� . . . . Builder Address N° 294y � ,G �'' , � . ,� r � ✓ L TIO OF BUILDWG � No. � 5!. ��. . . . Street . . ��a�"!� . . . . . . . . . . . . . . . . Pa of Lo ��'o'ti"' � t .......r Lot . . . . . . . .. .. . . .. . Block . . . .�. . . . . .. . Addition or Sub-Division !.!t!�'�!��:'!��/. W� / �y�' Corner Lot . . . .. . . . . . . . Inside Lot . .. �. Setback �`�! . . . . . . Sideyard`! To be Used as: Type of Constructionj DES�RIPTION OF' BUILDING ��a� • e ./� i � ��/��,� / � - Front � . . Depth � � . !�. .— I Ieigh . . Sq. Ft. � � r�. . � Cu. Ft. . . . . . // �/ +6r / Front /. L► .lK. Depth �.!�'. . . Height . . rr.�:. .. Sq. Ft. �� Cu. Ft. . .. .. . 1 ��.'�'` Est. Cost �J . k+� . �� . . . . . To be Completed . .� . . . . . . . . . . . . . . . �.��.��.�� In consideration of the iesuance to me of a perrnit to construci the buiIding described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions oP ordinances of the village of Fridley. ...... ..............__...�.........�.......... 7n consideration of the payxnent of a fee of $�� ermit is hereby granted to ,� �. .��.... ,.�.h. .�'. .�:! ... .. tn constxuct the buiIding or ad dition as described above. TI� permit is granted upon the,express condition that the person to wham it is granted �nd 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 Iimits and this permit may be revoked at any time upon vioIation of � of the provisions of said ordinances. //J Inspector NOTICE: �. ° This permit does not cover the construe4ion, installation or afieration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. ____ _ ____....� �__.. _ � -� - . . 7NTER-DEPARTi�IENT WORK ORD�R REQUEST i�v` _K _..� ; t �.� ;` ; Dept. Kequest- llate 1 S� ing Work ��/ ' � Dept. to do ' Name , _ the Work �. �.�� , (,�1 �j�, '; Job S ite ,(� � 5J� � i?> �,,,.�. � . Work to be done�,- - � r,�,-� 1,� rr�ti, I. c, � , ('�t,..�. � i � „Q,G' .�i� . t .h ! i.tit L l �i_.E' �C-v � ' �� Work to be done by: Date ; Charge to: Acct. .�� Progr �� I� - ---------------� --------------------/]'� - � Comments: ('��-� `� i � o ; x l Time taken care of , / � ' Date taken care of � � { � ^ � � �; � S igaed e,�` ' �` � 0 0 , . .. � , - �� , , � ; �. ��: � .�� .:.� ., � {rr. ;� i�iniY.a..i:�. . . . � . . .. � .�.' .:�� '�� 9� '' ¢.- 6431 U�iIYERSI7Y AVENUE N.E., FRiDLEY, MINNESOTA 55432 :r � � � y� ,� . TELEPHONE ( 612)571-3450 ,� �� `�' -.a�: '� �w�` c'�`= July 16th, 1976 =:a _ $.. �. . � . FV' . � . . .. . . . . .. . .. . . . . � ��^C�� .. � � � ,,; 6351 At�l . Strc�Pt NF�`� 'dley� tMt 55432 Dear Nfr. Stevenson: On Thursda.y, July 17th, you had a telephone conversation with our office regarding your sandpoint well proposal. You were informed that the City issues pennits, which, impose ceriain restrictions relating to the ruies and regutations af the Minnesota State Board of Health. Enclosed please find a copy of the permit pxesently in use and enforced by the City of Fridley. In the event tha.t your well does not meet the 'requirements of the enclosed permit the City taill require you to either: A. Abandon the we11 or, B. Upgrade the we11 to conform with the restrictions and requirements set forth an the permit - camplete ; the permit form and submit to the City for approval. _ . If you have any questions or comments, please feel free to call me or Mr. Tom Colbert, our Assistant City Engineer at 5i1-3450. Sincerely, �: f= , ��'� ` �'� ' ' C de V. I�ravetz it CVM/grs : Enclosure , . . �n ' � y . . . � � . .. � .. . � . .. . . . . . .� � . . �..�� . . � � . . . . . . � . � . . . n. . . � . . . . . .. . . . . . . . , . � . : . � � � . . . . �. . . . � � . . � - . . � .. � PLU��IBING PER,�ITT ," FOR (S.4ND POiNT IRRIGATION NELLS In accordance with the City Code of the City of Fridley and pursuant to the Minnesota State Building Code, permit is hereby authorized to carry out the plumbing work specified below on the following destribed property, tiaith the expxess understanding and condition that all work shall be performed in accordance with the City Code and the rfinnesota State Flumbing Code, Chapter 13. I hereby declare that alI the facts and representations stated i.n this apglication are true and correct. - - CQNTRAG"TOR: PHOHE # LOCATION OF 1VORK: OWNER: • . OWNERS ADDRESS : ��IONE # ' Residential � Comm�rcial � Industra,al � �� All wark shall meet, but no� be.limited Lo, the requiremen�s of the • - plumb�.ng inspector's check'`Iist on the back of th3_s form. The proposed depth of the well? - Issue Date: :. � Fermit Fee: $1S�Q0 • � � The owners hereby release, acquit, and discharge the City of Fxidley, � and all officers, agents, ancl employees af the CiL•y, �'xom a].7. liabxI.ity � and damages consequenfi upon, resulting fxoms growing out of, or i�z any manner connected wi�h the instalZation, opexatian, ox remaval, of the well.s by any and al l part�es, including specifically, . az�y and all J a.ability . i.n- •, curred by the consumption of the well water by any human t,x animal. SIGNATURE.OF PROPERTY OWNER PLUMBING AND HEATING INSPECTOR ' COA•1�1UNITY DEVELOPb1E�1T ADMINISTRATQR Permit is hereby granted and receipt o£ $ is hereby �cknowledged. r INSPECTOR'S CI-iECK L7ST Logged depth of the taell ft. � 1. All faucets connected to the water lines from th� sand point well are labeled prominently: "NOT FIT FOR H(3►rlAN CONSiNiPTION." � 2.: The ttel.l is loeated a minimum of 25 feet from the primary structure an the property and a minimuin of 3 feet from any permanent stxucture; is terminated above ground, ivith a hose bib. � _� 3. The hose bib is a�iinimum of 5 feet from the.pxoperty lines. � ` 4. There�is no� direct or indirect connection to the plumb�.ng system. : � . . 5. The well is at a higher elevation and is located at certain distances from possible sources of contamination. � ' a. The well site is no�;subject to flooding. . � b. The well is located"at`least 2 feet high�r and SO feet � from a high water mark of stream, river, Iake, or im- poundment. - � c. The surface drainage is diverted away f'rom the well. � d. T#�e weil is a minimum of 50 feet from a buried sewer � or" septic tank. - � e. A minimum 20 feet fxom a buried cast iron sewer, with tested, watertight joints. f —�t t.._� f. A minimum 150 feet £rom the nearest cesspool, leaching � pit, dry well, or seepage pit. ._ � g. A minimum of l00 feet from a subsurfac� disposal field. � b. The well is located a minimum of 15 feet from a gas Iine o R h d � over ea ele�ctric lines. � 7. The well i5 locatsd a minimum of 25 feet from an overhead electric liner (more than 50 KV or unknown voltage.� � ; 97 -8l,-l�16051 , , CITY' Or FRIDLE°� � � . APPLICQTION FOR PLlJMBING AND GAS FIiTING P�RMIt a m 1� b C�.Qi �n o � .-� .xi a, Water a, w g Heater � � b .e ..°i °' �c '� " a� s� .e c � a�', a 'ay w .� � ro 01 � M�u o� g ro M p ro ro N N ,�1 m u � w c� rn 3 o w �n w u a� Q a c� � c� o as lec lst 2n3 3r3 4 t`s (Xi A Yuture Connection Opening Coru�ected with Sewer t*) = New Flxtuze, Old openinq wa,ter PARTIAL RATE SCHEDULE PLU:�IBING FIXTUP.E RATE�: N0. RATE TOTAL Nsntses Fixtures FLtuze Fixture Opening hev Fixture, Qld Opening Catch Basin Hatez Hea:er - to 99,OOQ B2+1 � 240,000 BTU to I99,000 8TU Water Softener rer+ Grou^.d Pun Old Suilding E2�cGric hater. Heater GA5 FITTIVG FEES: lst 3 fixtures Add.itional Fir.tuzes Gas Ranqe to i99.000 BTU REPAIRS f, ALTERATIONS • Fizst $100.00 each add. $100.00 or fzaction x 53.00 x S2.00 x $2.00 � x 55.00 x $5.00 x $I0.00 x $7.00 x $5.00 x $5.00 x '$3.00 x $1.�0 x S10.00 , $5.0� 52.00 Stnte 3�rcharge TOTAL FEE F�IISS?E';:"*I!'i:1 i'Y.E S S S S $ S S S S . S S S $ S $ .50 S 8.W Jo�b Addresa 6351 NE Able Street ''''�' �� Department of Buildings City of Fridley , , Tel. #571-3450 The undersiqned hereby makes application tor a pesiait for the �+ozk herA,^ apecified agreeing to do all work in strict accozdance with the City Cb3es and rulings of the Depaztment of Buildings, and hereby declares that a21 . the facts and representations stated in thia application nre true and co�zxt ' Fridley, Mn, 6-�.6-?8 , 19 owrr�R �TEVENS ION KZND OF BUILDING fI'31Tig USED AS r.p�_ � • TO BE COMPLETED ABOUT _ (��,n� �? � ESTIMATED COST 20.00 OLL� - NEW BUZLDING PERMIT N0. PERMIT NO. �_�2� ' . -„ L7hti�fi''C'r , o`� - (,fi� •�, . �,- : .._ (.bmpany Signed Sy Tel. No. ROUGIi INSP. Date , � FINAL INSP. %�- '�J � % � ' Ddte APPROVAL FOR PERMIT df�� MINIMUM FEE FOR ANY PLUM82NG PERM2T IS 57.50 Py�tg 5.50 STATS SZ1�gf,'L 97-8LG-416o51 � CITY 0� FRIIILEY � . APPLICaTION FOR PUJMBING AND G�tS FI�1'ING PERMIt � d tr c '� •°i ,,,� �. d, water Job Address 6351 NE Able �--.. d i .�i � m ��.�i �°! � m'�ro W pA', w � Heater • Department o£ Buildinqs w adi � -.�+ rc ''� G 3 �' 'G �� x � ti d City �of Fridley � .° .� � m � ro ►�. b� .� g a ro � ro � q +'� . y u a w a� y r o w w w u ra �¢ 3� � i� O as lec Tel. #5?1-3450 - TYie undezsigned hereby mttkea applicatioa fos a permit !or the work hereia specified agreeinq to do all work in strict accosdance with the Cfty Cbdes lst ri 1 and rulinqs of the Department of BuiSdings, and herelay declazes that all : the facts and representations stated in this application are true and corrcjct 2nd Eridley. Mn. 82--78 , 19 3rd at.n (P.) a Future Connection Opening Connected with Sewer (*).� New Fixture, Old Openinq Watex PARTIAL RATE SCNEDULE P;,UMBING FIXTURE RATES: N0. RATE TOTAL :�6er Fixtures x S3.40, $ I�ture Fixture Opening x $2.00 S New Fixture, Old Openinq , x $2.00 � $ Catch Basin x SS.00 $ water Heater - to 99,000 SRV x $5.00 $ 104,000 BTU to 199,000 BTI7 x$10.00 $ � h�ater Sof tener x $T. 00 S New Ground iatn Old Building � x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: . . lst 3 fixtures x 'S3.A0 $ Additionai Fixtures x SZ.00 $ � Gas Range to 199,000 BTp x ST0.00 $ REPAIRS fr ALTERATIONS First $100.00 ' $5.0� $ each add. S100.00 or fraction 52.00 S State Surcharge S .50 ' �� $ 8.00 REI2iSPECTZON FEE (S10.00) �R STEV�NSON xixn oF svTr.uixc fr�me osEn as res . ' • To as cor�r.e�n aeocrr 8-9-78 ESTIMATED COST ZO.OG OLA - NEW BUILDING PERMIT NO. PERMIT NO. �(� r , Compang Signed By _ MI{�:=cv�k�8 Tel. No. RIDflGH INSP. Date � FINAL INSP. %6 - 1�� - 7 `�'J ' Date 1°►PPROYAL FOR PBRMIT y��-�— . MII�IIMUM FEE FOR ANY PLUi�IDINa PEI�lIT IS $7.50 pyVg $,SO 3TAT8 80�[iARGg sue�ecT PERMIT N_n_, City of Fridley ,� � ,� }., 7 AT THE TOP OF THE TWINS g � I L D I N G P E R M I T � r ; � RECEIPT NO. � COMMUNITY DEVELOPMENT OIV. ' j b----�--� �Q D � r � � PROTECTIVE INSPECTION SEC. ; 1 � ( � �'��1 � CITY HALL FRIDLE� 55432 NUMBER pEV DATE PAGE O� APPROVED BY �'"""�" �'� 612-571-3450 910-F�5 4/24/96 � � JOB ADDRESS 6351 Able Street NE 1 IEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 22 2 Moore Lake Highlands SHEET 2 PROPERTV OWNER MAIL ADDRESS ZIP PHONE Mark/Darcy Williams 6351 Able St NE 571-8142 3 CONTfiACTOR MAIL ADORESS Z�P PHONE UCENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PNONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION � ALTERATION O REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Tnstall egress window and replace sheetrock 9 CHANGE OF USE FROM TO STIPULATIONS Egress window must meet Che State Building Code. TYPE OF CONST. OCCUPANCV GROUP OCCUPANCY LOAD SEPARATE PERMITS AqE REOUIRED FOR ELECTRICAL, PLUM8ING, HEATING, VENTIIATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORI2ED 1S NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAVS AT ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UN17S OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GAqAGES AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL PROVISIONS OF LAW$ VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED @ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT W75O �.SO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEfiM1T FEE SAC CHARGE PFiOVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- @ STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. y�29. LS Fire SC �. %S PLAN CHECK fEE TAL FEE $30.50 S�G TURE OF CON�cAACT R OR12ED AGENT IDATE� j� P �Y V L TED THIS IS YO PERMIT � y�yi � ' �?S - QL �GNa RE Of O NE WNER BU�LDERI iDATE� DG i P qaiE NEW [ ] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY � ALTER �] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �*"" l�� Buiiding Permit Application ConstructionAddress: (0,3,$ / �%�.Q ��- j(/� Legal Description: Owner Name & Address: ark r�rc�� .,,,.,, ,,,��ve.� Tel. # 5 �l -$1�1,2 Contractor: �/a„Q MN LICENSE # Address: Tel. # Attach to this applicatioa, a Certificate of Survey of the lot, with the pmposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTI�R: DESCRIPTION OF IlVIPROVEMENT Length Width Height Length Width Height Length Width Hgt/Ground � , t. I , , t t Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot [] Inside Lot j� Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ Approx. Completion Date: (Cost on Back) �� Driveway Curb Cut Width�Needed• �� Ft. + 5 Ft��y— � Ft x$ � � =� $��• DATE: APPLICANT: - '- Tel. # Permit Fee Fire Surcharge State Suncharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STII'ULATIONS: CITY USE ONLY f i $ o'i•�� "Fee Schedule on Reverse Side ` $ , 7� .001 of Permit Valuation (1/lOth%) $ , � $.SO/$1,000 Valuation $ $900 per SAC Unit :: . . $ $S.IX? (State Licensed Residential Contractors�) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary' [] Not Necessary j] $3 � d � The Chief Building Official shall any addition to any existing buil� structure, upon application therefi herein below set forth and in the TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,OOlto $50,000 $50,001 to $100,000 v �� 2 � � �� /�� 2� `6 • � ti��S 2� � $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up Alternate "A" : Removal and re� Alternate "B" : Removal and re� approach with 6 Permits for construction will be i review of the proposed structure A Certificate of Survey of the will be required before procee BUILDING PERMIT FEE SCHEDULE , before issuing permits for the erection of any building or structure, or for iing or structure, or for any alteration or repair to any existing building or �re, require the payment by the applicant for such permit of fees to the amount manner herein provided �to-wit: , FEES . $21 (Minimum Fee is $21 plus surcharge) $21 for fust $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for fust $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.�5 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $10U,000 $887.25 for fust $100,000 plus $5.00 for each adc�itional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional "r : ,; $1,000 or fraction thereof, to and including $1,000,000 '- -"`. .'; $5012,25 for the first $1,0�,000 plus $2.75 for each additional $1,OW or fraction thereof )RIVEWAY DEPRESSION ESCROW (Concrete C�ub Streets On1Y) , cement of curb and gutter only - Driveway width plus 6 feet times`$13:50. : cement of curb and gutter and install a 3 foot wide : -= '"' ch depth - Driveway width plus 6 feet times $15 . 75 . VERIFICATION OF FOUNDATION aed a minimum of 24 hours from the time of application to allow for proper -� nd of the construction site. , ,, showing the location of the foundation once it has it has been constructed with the framing. � { ; , .., I sue�ecr MIT NO. ; City of Fridley 2 6 3 6 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � ` RECEIPT NO. � ` �� COMMUNITY DEVELOPMENT DIV. 1 � L � PROTECTIVE INSPECTION SEC. % � � � / � i � � � /'��1 � CITY HALL FRID�E� 55�32 NUMBER REV DATE PAGE Oi APPROVEO BV �""'�'� �'' 612-571-3450 9t0-F15 6/26/98 / / JOB ADDRESS 6351 Able Street NE t LEGAL LOT NO. BLOCK TRACT OH ADDITION SEE ATTACHED oescR. 22 2 Moore Lake Highlands SHEET 2 PROPERTY OWNER MAIL ADDRESS 2�P PHONE Williams 6351 Ab1e Street NE 571-8142 3 CONTRACTOR MAIL ADORESS ZIP PHONE LICENSE NO. Steve Bodinski Construction 2215 135 Ln NW, Andover, MN 55304 754-8917 d ARCHITECT OR OESIGNER MAIL A�DRESS ZIP PHONE LICENSE NO. 20019069 5 ENGINEER MAII ADDRESS ZIP PMONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION O ALTERATION G� REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof House & Garage (24 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCV GFOUP OCCUPANCV LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. TIi1S PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED W17HIN 60 DAYS, OR IF CONSTRUCTION OR WOiiK IS SUSPENDED OR ABANDONEO FOR A PERI00 OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STAILS GARAGES AND KNOW TME SAME TO BE TRUE AND CORRECT. All PROYISIONS OF LAWS VALUATION SURTAX AND OFDINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �2sOOO �I.00 DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEqMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL lAW REGULATING CON- STRUCTI R THE PERFO CE OF CONSTRUCTION. �62.25 Fire SC �Z.00 PLAN CHECKfEE TOTAI E =..�_. �`�� License $5. 0 0,25 � SIGNATUfiEOFCON7RACTOpOR�AUTHORIZEDAGENT � IDATEi N O E A�IDAT IS I$ VOUF! P RM T / i SiGNATUf7EOFOWNERUFOWNERBU4DER� � iDATE� "' 8L �NSP ��FTE NEW ADDN ALTER [l [l [l ConstructionAddress: Legal Description: Owner Name & Address: Contractor: �vc° Address: , o�'�?/ >` / : CITY OF FRIDLEY 5INGLE FAMILY AND DUPLEXE5 R-1 AND R-2 BUILDING PERMIT APPLICATION �� 7 ` ,�� f�', �j1� � %/; �.K rr , ��i(i ��' S �: f ' O,-, s�. �� /�i,..e' ��, /T�4�fi Effective 1 / 1 /98 . �C� b0 �� Tel�. # �� "�l�i�� MN LICENSE # ��d �% 6�e 1, �', �-7�7 • 5 S"1 C y Tel. # 'T Sf� �T � � 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 GARAGE AREA: Length Width Height DECK AREA: Length Width � Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. OTHER: �/- 5��:•-. Construction Type: ��r ' /�c' �1oa� Estimated Cost: $ � �� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �� 9 APPLICANT: � Tel. # �� % �� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL . STIPULATIONS: CITY USE ONLY $ �.i.� Fee Schedule on Reverse Side $ �. (,S�l� .001 of Permit Valuation (1 / l Oth %) $ � Q� $.50/$1,000 Valuation $ � $1000 per SAC Unit $ �� $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450,00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ D.� .. y � • a s BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $574.75 for`first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the �rst $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1, 000,000 $1,000,001 and up $5012:25 for the first $1,000,000 plus $�:�5 for each additional $1,000 or fraction thereof , DRIVEWAY DEPRESSION ESCROW . (Concrete Curb Streets Only) , � Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus G feet t�sz:es `�3^.50; Altemate "B": Removal and replacement of curb and gutter ai�� i:�:1�'. �".��.� .F'� aPProach with 6 inch depth -�J:'1V��r�,� . �,._ ��. - VERIFICATION l'��# y� �� Y�_°1 x' �: j�. Permits for construction will be issued a minimum of 24 hours from the time of application to a11ow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once ,�t has it has b�en constructed will be required before proceeding with the framing. . . .. � Building Inspections 763-572=3604 DATE y �J-G, °"�%�% 51TE ADDRESS %3� THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WIT�I APPLICATION PROPERTY TYPE PERMIT TYPE TYPE OF WORK: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY Permit No.: Received By; �, � �;•; :, r YOUR E-MAIL ADDRESS �..f/� L(/r � c/��/„/l-�fSO�i ��-O/n � OWNER �CONTRACTOR ADDRESS:_ _ G 3 S�/ fZ�l/ ST CITY PHONE: 7L 3 ��S.Y–L,//9l� NAME: �iff11� STATE LICENSE # EXP DATE A7'Fl�.li�IP 5�5�3� ADDRESS: CITY STATE Z[P PHONE FAX ❑ ADDITION ❑ GARAG ❑ BASEMENT FINISH O ROOF O DECK ❑ SIDING ❑ SWIMM DESCRIBE WORK BEING DONE: '�,vs y,� SIZE OF IMPROVEMENT �� ' � y� `� R FIN TiUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SI�IIVG ❑ Vinyl ❑ Aluminum ' ❑ Other . WINDOWS IN EXISIING OPENINGS ❑Yes ❑No OR FOR NEW OPENIl�TGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINt�OW TO BE INSTALLED :� O HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE OSoffit O Trirn ❑ Fascia LOCATION OF WINDOWS NUMBER OF SIZE ❑ DRAIN TILE ❑ OTHER HEIGHT BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used Ft. FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: t. Site PlanlSurvey showing the existing suvctures and proposed project. 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE SASED 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 Surchazge Surchazge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Pazk Fee Sewer Main Charge Total Due $ �'L� $ /. DC� $ $ $ $ $ $ $ `/;�i,�J 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) $1675 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 pa_yable to: City of Fridley Attach THIS IS AN APPLICATiON FOR A PERMIT-NOT VALID UtdTIL PROC£SSED 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 ' not to start without a permit; that the work will be in accordance with the approved plan in the case of all work whic requires rev' approval of plans. ,� SIGNATURE OF APPLICANT PRINT NAME /!�/A��/�rffl�if�''+1' DATE �% �ti —DD7 Page 2- Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided io-wit: VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to a11ow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required hefore proceeding with the framing. New Houses Onlv City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, NiN 55432 763-572-3604 Fa.�c: 763-SU2-4977 Building MECHANICAL Permit rto.: �7 � :�? � Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date ��: _ 7 DATE '�'" �' (U �7 YOUR E-MAIL ADDRESS �•C.�;�� %-i5��if�ilS4�f/• Co.� __ SITE ADDRESS /. 3� %l S % THIS APPL[CANT IS: O� OWNER ❑CONTRACTOR PROPERTY NAME: ^ S OWNER/ qDDRESS: G�.S^/ �/JlP S%— CITY /Ji STATF�/.�LIP .%�'/3� TENANT pHONE: 7G �-�r�- �i9� CONTRACTOR COMPANY NAME: SUBMIT A COPY OF CONTACT PERSON: YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH qpDRESS: CITY STATE ZIP APPLICATION pHONE FAX PERMTT TYPE �SMGLE FAMILY O TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK' �EW ❑ REPLACBMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK LJP.uJ �►,q-S FirttP.Ft'P 2�.t1S`l.�Cl d �%1'�v� ,c,� 32 oC � Ty PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, 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 x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE iVOTED. FIXTURES: (RJDICATE TOTAL NUMBER OF EACH BELOW) . Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.0(1 _AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00 BOILER 535.00 FURNACE $35.00 GAS LtNIT HTR $10.00 CHIMNEY LINER 510.00 GAS DRYER $]0.00 POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 Permit Fee $ 5.'� Number of fixtures @$10.00 x$10.00 =$ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ /,5 .� Number of fixtures @ $25.00 x $25.00 � $ Number of fixtures @ $35.00 x $35.00 = $ State Surchazge = $ .50 Tota1= $ 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 oniy an application for a permit woric is not to start without a permit; that ihe work will be in accordance with the approved plan in the case of all rk bvhi�h s review and approval of plans. � SIGNATURE OF APPLICANT �. PR[NT NAME/�7ff../�C G7/lG! /i¢!NS DATE ,�' F"Y� % City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS 0 EXISTING HOME 0 MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or PropanelIFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) • a. IMC Chapter 5 with MN Amendments 3. 'Venting ' a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FUR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manua1 D NOTE: Centerpoint Energ,y Mechanical Code Guidelines software may be used for combustion and make-up air calculations. Building Inspections 763-572-3604 763-502-4977 FAX PLUMBING R�SIDENTIAL APPLICATION CITY OF FRIDLEY y� _ DATE �Cd-i S �C�GI YOURE-MAILADDRESS " SITE ADDRESS �� S I � L'� �V�G THIS APPLICANT IS: ❑ OWNER fZ`CONTRACTOR PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOURSTATE LICENSE, BOND AND CERTIFICATE OF INSURANCE PERMIT TYPE TYPE OF WORK: ADDRESS: �S � CITY, PHONE: �_� � %�I % �I � f i� , Permit No.�'�'�� ;� Received By: Dat��et��N 1 ( �W� ATE ZIP, STATE LICENSE #! River City PI mbina Cn EXP DATE STATE BOND # 8290 Ma111 St N E�#�9 EXP DATE ADDx�ss: Fridley. MN 5s4�� CITX STATE ZIP pxorr� (763) 754-2199 Fax (763) 754�908 FAx ❑ SINGLE FAMILY ❑ NEW ❑ TWO FAMILY ❑ TOWNHOUSE �tEPLACEMENT DETAILED DES.CRIPTION OF WORK _�V1 S� I�,o .�q,� �� /�' W�`'� - FEES ARE BASED,ON $10.00 PER FiXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER• OF EACH BELOW). MINIMUM FEE 535.50. BATH SINK/LAV FLOOR DR.4INS SHOWER WATER PIPING BATHTUB GAS PIPING (NEED CITY LiC) SWIMMING POOL _ WATER SOFTNER (S� CLOTHES WASHER KITCHEN S[NK WATER CLOSET BACKFLOW PREV.�SI� DISHWASHER LAUNDRY TRAY _�3LATER HEATER ($35) ^ FOR 1RRIGATION �� — WATER METER ^ OTHER THIS IS AN APPL(CATION FOR A PERMIT-NOT VALID UNT1L PROCESSED I hereby apply for a plumbing 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 will be in accordance with the approved plan in the case of all wor which requires review and approval of plans. _ �j _L � SIGNATURE OF APPLICANT PRINT NAME /(�% G�-- ��DATE �o l�-d � �aty of �ridleg� �uilding Inspections :�epartmc;nt 6431 Jniversity Avenue NE, Fridley, MN 55432 763-�72-3604 FAX: 763-502-4977 From: Cib� of Fridle� Tc: 763?54290� Paqe: 2/4 Uate: 4" 6/200U 11:00:09 AN: 3uiidin� _ _ lr►�EC��.�TIC�4L. inspections ' T � ��h' �� .� �PP�.�� Q��: ?6;-�7�-3b0� ��' C��' ��,��' 763-502-49? % F� �rr��c�T�v�: _-��_o�, UAT� G _!q SIT� ADllR�SS G THlS APPLICANT IS PROPERTI OVVNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR 5TATE LICENSE WITH APPL[CATION YOUK E-MAIL ADDRES5 ❑ 04VNtR NAM t:_ _r��" �j j�(,, a11A S ADDIZESS: S M�VV�� CITY' PHON�:_�5 � I � 7 �I � � �'armi� ?vo.: Receiveci B�-: COMPANY N E: CONTACT P�� : e • STAT� LIC�1C'3C� �n ' ' �� : DAT�. ADllRESS: r� eye CITY rHOn,t ��}-,2199 F---�?��9`y�Ct-2cx18 - PERMIT TYPE � SINGL�, NAMILY ❑ TWO HAMILY TYPE OF WORK' � NtN' `J�RtPLACtM�NT . � DETAILED DESCRIPTION OF WORK � TOWNHOUS�. ❑ ALTtRAT10N%REMOU�.L STATE 'LIP ATE 'LIP, Fr,L�'S AfiE BASL�'D OV $10.00 PN:R FIX"fURN., ' CCL�'P1' WHEIiF. VO'fN;D. F1X7'URL�'S: (1V UICA7'E "f0'1'AL VUr1BN;R UF EACH BN;;,U� } �quipment lnstalled MFG: .�� MOUEL: �] S PY�VCQL� S1ZY./BTU �C MNG: �iyVILL MOD�L: ��% �� SI'L�/BTU � � �A/C $25.00 AIR 70 AIR �XCHANGttR $ I S BOIL�R $35.00 CHIMNEY LINER$10.00 DUCT 4VORK $10.00 MFG: MOUEL: NIREPLACE (GAS) $ I5.00 NIRtPLAC� (WOOD) $35.00 � U RNAC�. $35.Op GAS DRY �.R $10.00 GAS PIPING $10.00 S 1 "Lt:/BTU GAS RANGF�'OVEN $10.00 ~NtiW GAS GItILL $10.00 GAS UNIT HTR $10.00 AOOL H�:AT�1Z $35.00 �VENTILATOR $15.00 TH1S IS AN APPLICATION FOIZ A PBIiM1T-NQ'I VALIll UNT1L PIZOC�SS�.11 I hereby apply for a building permit and I aeknowledge that the information above is eomplote and aceurate; that the work will be in conformancc with thc ordinanccs and codcs of thc City of Fridlcy and with thc Minncsota Construction Codas; that I undcrstand this is not a permit but only an application for a permit and work is not to start without a permit; that thc work will bc in accordancc with thc approvai plan in thc casc of all r which �•quires rcvicw and approval of plans. SIGNATUR�, ON APPLICANT PR1NT NAMt �,�r],S K•y OO _ DATt G'I S�/ City of Fridley Bailding Inspections Department b431 University Avenue NE, Fridley, MN �5432 763-572-3604 FAX: 763-502-4977