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P - 48576Building BUILDING Ins,�ections RESIDENTIAL APPLICATION '763-572-3604 CITY OF FRIDLEY 763-502�4977 FAX EFFECTIVE 1-1-2012 DATE Z�' Z 7� I Z YOUR E-MAIL ADDRESS i�� D� G 1 A h� SITE ADDRESS _ � �h0 �/�Ic V1 �� /t/�'GT�' THIS APPLICANT IS: �i OWNER OCONTRACTOR PROPERTY OWNER/ N�:�i TENANT �D�ss: Pxoi•rE: �A CONTRACTOR N�:� SUBMIT A COPY OF gTATE LIC YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS: INSUREINCE oun�rc � :sxi ... �. 1 r ���- ������, I � - -� i `� �, ;'�• -��� : � ! 1 � # LEAb CERT NUMBER EXP: PROPERTY TYPE I�,s�GLE F�l.Ym�w corrsTxuC�ox � TWO FAMILY/NEW CONSTRUCTION PERMIT TYPE TYPE OF WORK: DESCRIBE WORK BEING ❑ ADDITION ❑ BASEMENT FIDIISH O DECK � NEW HOME CONSTRUC'I'ION � MAINTENANCE/REPAIR ❑ GARAGE/SHED ❑ ROOF ❑ SIDING ❑ ADDITION I�REMODELING '�S STATE ZIP ❑ WINDOWS ❑ DRAIN TILE $(3THER ► K�♦Gr1 tM► rtw�od c 1 JtOOFING vv! !�/%l� � ` 0 HOUSE ONLY NUMBER OF SQUARES �Y�p �l�jfh] ❑ HOUSE 8c GARAGE . GARAGES ❑ ATTACHED GARAGE PROPOSED SIZE: ❑ DETACHED GARAGE PROPOSED HEIGHT: SIDING ❑ Vinyl ❑Soffit SIDING/SOFFIT/FASCIA ❑ Aluminum ❑ Trim REMOVED? C] YES ❑ NO ❑ Other ❑ Fascia WINDOWS IN EXISTING OPENINGS �Yes ONo LOCATION OF WINDOWS ORFORNEW OPEIdIN('sS-DESCRIBE SIZE OF OPENII�tG CHANGES & FiNK�S ,�1 �r�,�<�r� _ i., BASEIvffiNT REMODELING SUBMIT: l. Existing Floor Plan 2. Proposed floor plan 3. List of shuctural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS_ & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations FOR WINDOWS — PROVIDE U-VALUE AND MANUFACTURE STICKEROI�t WINDOW. ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: ING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $.� .l a c� OCCUPANCY TYPE Permit Fee Plan Review Fire Surchazge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Due $ , k See Back Page for Fee Schedule $ .�/ �-a � 65% of Building Permit Fee $ . 0 .001 times the total job valuation $ � (Q .0005 x Permit Valuation Minimum or .50 $ �-- $5.00 (State Licensed Residential Contractors) $ --- $2365 per SAC Unit (Plans to MWCC for determination) $ t'j �_ft+6ft= � ftx$25=$� '� $ ---� $450 Conservation Plan Review $ — Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary (!�) checks navable to: Citv of THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowiedge that the information above is complete and accurate•, that the work will be in conformance with the ordinances and co f the C' of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application far a permit w is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of o ' r review and approval of pl sicrraTU� oF arPLicarrT iurrT Nan��oSS ���R h Da�_ ?•% � APPROVAL INSPECTOR SIGNA PLEASE NOTE: SEPARATE P ARE REO IRED FOR PLUMBING. ELECTRICAL AND MECHANICAL WORK ` , Job No.: Sheet; � OF 2 �� ��� ��� -� CONSULTING STRUCTURAL ENGINEERS Project: �I�E-�N ��5.-NF�/ Ft-o�2 � MINNEAPOLIS I DULUTH I PHOENIX gy; ,J�M Date: 2�Z7-IZ �%J � � OO ^.�`'i '�_' ' I �V�! �1/�3 x 1 e -------�-- - , A 36 -��s. C � � ' _—__.--._._._ ��--� �1_ _-:� ��_ :.:�. a �� , � � � e� : � _- ----------,--.------____ ____ � 3��j VJ Pa . ST►r- rJ�'�� C-�.°�Ght I D� l�?�1 f� l�i� �Zl���=- ���� _�� � J � j- u- c� [L � : �s-- 2 tL � ��� 1 i' , ...... ... . ....�; ;..._ Q � IZ�GMU �"]`_ � �j�� ���F_21 �Y) — I F D ht F3E Lo�N _ i� L o N V 1 EV�/ -�1 D�' �.vo �. � %. �� _ I'- o" I S CLLL.�. : �1 a 0 0 p� d �� � � � � s-n � lY� +� �l� � �1�2x4- �-rvD �r� � c_ TH�s �08 CaPY s���.�_ p� j avat�a��� o�� r��E �o� � s�TE FoR T�-�� F�a� ����.t:; � AND F(f��t. �f�S�EC?��<�l�S_._1 `��=— WG�3b o�. PLJ���TIG SNIM S EbGI-E JOI ST - G �uE IN R►.A�E �o�►�. L4 x4-x %e x3�z 2-� x 3'f�-i�1.�s 'rr� ���'1(fl R�pl.'t- s, ' 2-�z x 3 �;�� �ws 'r� j� sT ���Z ��A �s i;,zrzby certify that this plen, speciHcation,_ or yyc 3 c-l-/�.h'1 T fe�,o�i was prepared by me or under my direu ��s � I�� y;;,+-..� H�, �(- CoNt�! � 3uperviS�pn and that I am a duly R�gistered �F.. ,�i ra�:� �/4� �c 3'TiT�_W P�ofE:c:�or�at Eng�neer under the laws of the I-1 D SGr?`=v'.4 � I Iti�-t� �a'��.�c':. �• . oi f��in esota. �,�,`'� �,�,` F_�u z co�f� ; w rrt� coNC, � 4584 � E, �ca7- F�-Ot.�E GOJRSE.. ):�te 2- Z.7'� 2—Rtg. o. ---•-- �h , p,� �'F L.� W � �"�'T' �----�_. �ZiiGi�il.� �"u�� D�TI`,i! -- � -�. � � � 1 � s�.�!..�.�: �"- I'O �J.. ,� � IVI�3�1, � CONSULTING STRUCTURAL ENGINEERS MINNEAPOLIS I DULUTH I PHOENIX k � �� ( �� �, _�. N W8� 1 r`� s� t-r� s�r.� �� � Go� ►� �.��r-� � � �z"a,e. � � Job No.: Sheet: � o t= Z Project: �P Fr�s.l�tJ ��-S .-^11�.v�� FLOC�R E�tx1. By: -� �� Date: 2- Z 7-) Z. _ _ _ ' __ _ . _ _._._.. _ ._ d1:. _ \ � �1 O ZNT� r.�-�. 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No. �J�$� � ou� x��t , t�' " �� � S IM�c(/� . �aivs t�oo�s � � � ` � G � ��uwc� � �'l�N D�ScR.I�'I'IoN = 1'�AN v��'w of K►r�NL� sNowiNy I�t�w �ND b�D wA� PRo�E.C,T: 7�(�o A�GD�N WA�� NE f� 11'cHEN REMob��- pwN�'�ZS = �'aSS �J�D PA-/��'1-,�- PNEc�t-�I �'t.�� i�RE PA��D Sy = R�s 5s pJ� �L�4�1 D A�7� � 2� �� f!2 .� ` Coat closet (no door) To Garage ...--- � � '� 1.1`1 ��z�,�j 'S� �E. � i V�c�vl/t (� _ � I� �f� c�J �Z:.�t �� v g' a-1 �� ��� _ ' s-�-�.- S� � -�� .`�" � ���� �� Bookcase `— Window seat Y Wine Coo er — New partition wall ' C�M iC� �t �I Cabinet (J �, � �� ��r��� si � �m f¢ � 2 . . � Ca'binets w�th averhanging counter for seating Cabinet i' — New partitio wall Down to basement - ,� � i 4 ,� , .- , r'' Wall-oven — Gas coaktop -J New partition wall --' Bui1t-in Frig and Freezer Preo � t J�.��N Pantry 1—��. icrowave — ` 7�� �V, ��� i island % - Island ��u •�-�TZ � 6 New partition walls —' ., � 5ink !�- Dishwasher Cabinets CODE P4 �N�-���c��� � P c.�N v� � � pRa� �.T � 7s� �r.,��� w�-Y �� N Pantry 2 Existing Bath raom �`� I c� 17L �3f�'r J R-�.. Up to l�uel 2 �. Cabinets � Coat -n,. � Upper Cabinet °� Ic►�'cN��V �'�NtoD�L. !'SI Tc.�NN,�'� �'�/�1aA,�L.. CjWN�R.S � RoSS A�1�D Ai}iN�L�- PN,�L�¢/1J t�� P���.��� By � h�oss ,p�,�"l�n� �7A�1� ; z,.12���z- P To Dining Room - To dining room Door