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AF - 45046/ �/ � Village of Fridley, Minn. BUILDING PERMIT �!�'j �� Date: �!..�. �.�..! ............. ..... Owner /�J��Y�""'�f`4a,.'' � Ad�iress . �y .� ./ /. . . � . . . . . . . . . . . . .':�,��L/ � �T° �� $�'8r. I�'V -.._ Builder .... ......l......✓ .. ... ............ .a.... � Address . . . . . /�. b ,�. .`�. . .� . . . . . . . . . . . . .�� J LOCAT[ON OF BUILDING �TO. �. . �.� l. . . Street `4�'��. . i"" �� . . . . . . . . . . . . . . . . . Part of Lot . . . . . . . . . . . . . . . . . . . . . . . . . . . � !_ � � c ' Lot . . . . �. . . . . . Block . /j . . . . . . . . . . . . . . . ddition or Sub-Division . . , . . . . �'��'t`Y��. . r � �,A , �!��✓ . . . ; . . . . . .� . �r �/ . . Corner Lot . . . . . . . . . . . Inside Lot . . . . . . . . . . . Setback . .��. . . . Sideyard . `� . . . . .� . .��. �: � �"%��;� A�L-�O.n .ii.Ot:�.� DESCRIPTION OF BUfLDING " To e lised a � � ' �- � i /% . . . . . . . � ,! . . . . Front .�� Depth . . . . �.4� Height . ./ . q. Ft. F • �./. � i � � ��I4;G�G�� . . . . . . . . . . . . . . Fr nt .l �� Depth .�'�.�.� eight . . .o.t�. . q. Ft. �/ � . S . ..... ype of Construction . . . . . . . . . . . . . . Est. Cost . . . � � .��' To be Completed � `?.�..... .... /: C�%a�— � � Cu. Ft. ........ Cu. Ft. ........ �? .. ........... � Tn 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. 1." � �� . . . . . . . . : . �.�-.v . .� . . . . . . . . . . :� . . . .w.�;,. . . Tn consideration of the payment of a fee of $. . 1�.o ,�it is hereb gy ranted to .��?!1'�.'¢x:��' `• -• . . . . . . . . . . . .. . . . . . . . . . . . . to construct the builciing or addition as described above. This permit is gr�('nted upon the express condition that the person to whom it is granted and his agents, employees and worlanen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, iVIinnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. �� ..s..•�..V � .if�l..�..... NOTICE: � This permit cfoes not cover the construction, installa,tion or alteration for wiring, ing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. �� C l� `� CITY OF FRIDLEY INSPECTION DIV. � j� L� I; ,��-�j�j�J� 6431 University Ave NE ��,,��'[ i ti'�.� Fridley, MN 55432 (�j V� � APPUCATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 � MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On March 1, 1996 - �U6 � �, � PLUMSING F{XTURE RATES: NO. RATF_ TOTAL New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater —Electric Water Heater — Gas** _L Gas Range** Gas Dryer** Back Flow Preventer Required ()Yes () No Type $ i.00 $ 4.00 $ 5,00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $1Q.00 �i-�� $10.00 $10.00 $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5°� of Value of Fixture or Appliance State Surcharge TOTAL FEE .50 _��Tt;iF-��+ �r�i�h`. �_.��1�_i� _ ... ) i'{�yjrl�� I . . 1..:�.! .��=j�.�'�T? lt��.-.'.�.�. 1'T1' JOBADDRESS �,�� a_` S�'� , �O i� _i�l i ��_SP:,' j. 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 Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. �Z� , 1996 Q Owner � �` OQ �� Building Used As �? N'� Z -� iZ a� Estimated Cost PERMIT NO. ��j �- a PLUMBING C�MPANY � ��,�L-:�� p�,(,j'4( /lJG . : Q��Q t) SIGNED BY Approved By Ol. � Rough—in Date $ t� J,. ,� MINIMUM FEE �bR ANY PLUMBING/ PLUS THE $.50 STATE SURCHAF,�� J �Q W m (� � TEL NO.� ' �� n-`- Z> �� {- !`��° � � � O _ Final Date � 'ERMIT IS �20.�T�� **COMBUS110N AIR SHALL BE PROVII�ED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 S� INCHES. ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 57Z-3604 r'AX: : 6211 ALDEN WAY NE : 153024430030 : NLI-ANN ADD : LOT 4 BLOCK 1 : BUILDING : RESIDENTIAL : ADDITION/ALTERATION 571-1"Lif7 _�_ _._ _ _ ..... „ .A PERM T NO.: 2004-00887� �__.._...� _,� DATE ISSUED: 06/10/2004 VALUATION : $ 1,968.00 NOTE: UNDERLAYMENT AS PER STATE BUILDING CODE. REROOF HOUSE & GARAGE (17 SQ) TEAR-OFF. STATE LICENSED CONTRACTOR 1 APPLICANT HASTINGS RICHARD CONT (4051) 6331 RIVERVIEW TER NE FRIDLEY, MN 55432 OWNER STOREVIK CAROL A 6211 ALDEN 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 work 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 construction or the performance of construction. Applicant Date Bldg Insp Date BUILDING PERMIT FEE FIRE SURCHARGE STATE SURCHARGE, VALUE LICENSE SURCHARGE TOTAL SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABUV�;. 69.25 1.97 0.98 5.00 77.20 NEW ADDN ALTER [ ] CITY OF FRIDLEY [] 6431 University Ave NE, Fridley, MN 55432 [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 6 Z Effective 4/1/2004 � 1 (763) 572-3604 Bidg Ins (763) 571-1287 Fax ��_��4�� Legal Description: " Owner Name 8� Address: C6� �o L s�e 6�� f� �� Tei. # Contractor: r` �c �, �ZS� �S�i l�CG S MN LICENSE# �f� S� , Address: � 3,� 1 `� �. � t�=- iZ `? � t.= c.J -C''t= 2 Tel. #. S' 7�C �' g l� 6 LNING AREA: GARAGE AREA: Attach to this application, a Certificate of Survey of the bt, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height DECK AREA: Length OTHER: Width HgUGround Sq. Ft. Sq. Ft. Sq. Ft. Construction Type:��2- � � � `� R� �D`o � Estimated Cost: $ � ��r � Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: � CI APPLICANT: � Tel. #� 7�E � l��.G 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. Permit Fee $ t�� . v1 s� Plan Review � Fire Surcharge � State Surcharge $ SAC Charge � � . �'� License Surcharg�J $ Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ $ $ $ � � $ ��. CITY USE ONLY - 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 MECHANICAL Permitrlo.:��-�� y'G'� � Inspections RESIDENTIAL APPLICATION Receivect By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 1� �' � DATE�/ / SITE ADDRESS � THIS APPLICANT IS PROPERTY OWNER/ TENANT SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: YOUR E-MAIL ADDRESS ❑ OWNER NAME: � ADDRESS: � PHONE: 7 •7� � -� COMPANY NAME:_ CONTACT PERSON: n STATE LICENSE # � EXP DATE ADDRESS:�,�I ��.i�^�I�PS� E• /�I.E, CITY ��,��STATE�ZIP� PHONE ��SZl,t=vTS Q T FAX SINGLE FAMILY ❑ TWO FAMILY ❑ NEW DETAILED DESCRIPTION OF WORK ❑ TOWNHOUSE ❑ ALTERATION/REMODEL 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 WI�RE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOV� Equipment Installed MFG: M�DEL: SIZE/BTU MFG: MODEL: SIZEBTU �r,; MODEL: SIZEBTU I p/C $25.00 _FIREPLACE (GAS) $15.00 GAS RANGFJOVEN $10.00 —AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOILER $35.00 LFURNACE $35.00 GAS iJNIT HTR 510.00 CHIMNEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 t DUCT WORK $10.00 _GAS PIPTNG $10.00 VENTILATOR $15.00 Permit Fee $ Number of fixtures @$t0.00 1 x$10.00 =$ f0- �11 Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @$25.00 � x$25.00 =$ Number of fixtures @ $35.OU � x $35.00 = $ State Surcharge = $ 50 Tota1= $� THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTII- PROCESSED I hereby apply for a building permit and I aclaLOwledge 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 r a rmit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case o all wor hi equires review and approval of plans SIGNATtJRE OF APPLICANT � PRiNT NAME ^V I N /J• �SB/v _ DATE � �7Y�� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPUCATION HVAC ❑ NEW HOMES/ADDITIONS EXISTlNG HOME ❑ MAKE-UP AtR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) . a. Oil or soIid fuel IMC Chapter 7 with MN A�endments b. Natural Gas or.Propane/IFGC Chapter 3 wi.th MN Amendments 2. Make-up Air (5ee note below) a.. IMC Chapter 5 with MN Amendments 3. Venting ' a. Gas appliances ]FGC Chapter 5 with MN Amendments b. Fuel other than gas ]MC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction TMC 1346.0312 5. Ventilation . a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations Building Inspections 763-572-3604 DATE l I I SITE ADDRESS _ TMS APPLICAM IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WTTH APPLICATION PERIVIIT TYPE TYPE OF WORK: DETAILED ,.. MECHA.NICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS O OWNER ADDRESS: COMPANY NAME:_ CONTACT PERSON: Permit No.: Received By:_ Date Rec'd: � � � STATE LICENSE q EXP DATE ADDRESS: I J�J�.f,�/li� I`l�� /N� CITY ��. STATE�ZIP �..—�.•�,c PHONE �� J"' �Ci7' jp� � FAX O�GLE FAMILY ❑ TWO FAMILY p NEW 0 REPLACEMENT OF WORK ❑ TOWNHOUSE ❑ ALTERATION/REMODEL 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 ]abor x.OS = 1 y� �v FOR PROJECTS WF�RE LABOR EXCEEDS $500, FEES ARE BASED ON $]0.00 PER FIXTURE, EXCEPT WHERE NOTED. FlXTURES: (INDICATE TOTAL NUMBER OF EACH BELOVI� Equipment Installed . MFG: MODEL: SIZEIBTU FJB'I1.T A/C $25.00 AIR'I'O AIR EXCHANGEER $15 BOILER $35.00 CHIMNEY LMER $]0.00 DUCT WORK 510.00 Permit Fee Surcharge TOTAL DUE MFG: MODEL: �G: MODEL: FIREPLACE{GAS) $I5.00 FIREPLACE {WOOD) $35.00 FURNACE $35.00 GAS DRYER $10.00 GAS PIPING $10.00 SIZ SIZFJBTU GAS RANGE/OVEN 510.00 NEW GAS GRILL 510.00 GAS LJNIT HTR $10.00 POOL I-�ATER $35.00 VENTILATOR $15.00 $ Number of fixtures @ $10.00 x $10.00 = $ $ .50 Number of fixtures @ $15.00 x $15.00 = $ $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Tota1= $ THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UN7'IL 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 aU w k which requ' s review and approt�al of plans. SIGNATURE OF APPLICANT PKINT NAME �"� �` �Ld� DATE (�/J o� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 � Building Inspections 763-572-3604 DATE I ��`,V �1 SITE ADDRESS THIS APPLICANT IS: PROPERTY NpME: OWNER/ �D� TENANT _____ CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WTTH APPLICATION PERNIIT 'i'YPE TYPE OF WORK: DETAILED DESCR] A- MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY O OWNER COMPANY NAME:_' CONTACT PERSON: YOUR E-MAIL Permit No.: Received By: ` Date Rec'd: lj " STATE LICENSE # , EXP DATE -z`� ADDRESS: ��iJr �1 v� 1�'U� ��ITY Y�-o--�Lr�. STATE�ZIP ��ll � PHONE _ FAX �S�PIVGLE FAMILY ❑ TWO FAMILY IC p NEW ❑ REPLACEMENT OF WORK � TOWNHOUSE ❑ ALTERATION/REMODEL 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 = �� d� 5Q• � �" FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW} Equipment Installed MFG: MODEL: SIZEBTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGEJOVEN SI0.00 • AIR't0 AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _NEW GAS GRILL 510.00 BOILER $35.00 FURNACE $35.00 _GAS UNIT HTR $10.00 CHIMNEY LiNER $10.00 _GAS DRYER $] 0.00 _POOL I-�ATER $35.00 DUCT WORK $10.00 _GAS PIPING $10.00 _VENTILATOR 515.00 .. . .._. ,.�, . Permi? Fee $_ 35 . Number of fixtures @$10.00 x$10.00 =$ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $�_. J(� Number of fixtures @$25.00 x$25.00 =$ 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 requ' review and approval of plans SIGNATURE OF APrL]CANT / ��, /i� �� rRINT NAME ✓i �l L7'��! � DATE `�I �G6 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 /a