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.�-�.
Z�4" 1�W �� rr;. �n �' I�
�� ��a�..�..t'a1� N� ..
Z "�a, A-p u, , .
zv �-r,'�:;� i.. �tY;,' � J z. �`,`i��
�, r`T' i'F F� N 6 RS
, p�+1 � � ; 2 ��.+� � iat ,
,4*LTL'f� U•dCi'�. Ct� !., � .�� � w,��D I N f�LAG E
GMrr 2 x .a, tJA► �:rz, � , �o `��uuG�4x%g ;
U€►��.. �tA� F�..a. �E., v: -, ',` iz�.F- �—J' 3
„'b. 11-�5i7n�� ��-� �N � �'N t- J T ` 1 ' �
WGYO�! SGiC..�.W,� �9 � � � . . , o ,. �
"� �" D, G . I I.a TC3 '�� I S'T'� � _ i ( �'J� G� � � ,� - . _ f
° ` r; � a �l . :: .3/zK 3 �o-rm ° �
�
. , b a�
� ° ' � ; 2 � ? � q �/�s� �-� � _ � l sT. FC.. .
�'oe.��u � �r.� � � N � � s. �� �rr� N
_._... . �
_,
_ �" �� a� � � � . _
� -
�. _ _. _ _ . _
, __ __ ,
, ; 4r '
, _� ;
jL� �- N °
1- 3p L.1 G� (�'- 5 �, ,(�, �`
:� %a x �,� a'- ► o Ul � �� , ;.. :_-
,� ' ;�_ -
� , > ; ,� ,_�
F � . ' ADD e�.o��t�iG. ' � : I�M av�...
, � r ,
� � '�'IGN-t"� 1l'�p�S -M , �1 � 3/y�3�L G�..� cM� f�T
, - , ,� ' ' a
,n.,,-t Pl4ua..�`1 �%T" P s-r
_ a ; : � --rn 2uD r=�, : �
,. . Yti. .r .-- 7C Q /� 3/S LJ.G SG'k�W
,� .�. )_.: �.. �.. ' _ . �r,� � i r7 � V1� �C�.i /"a �. � �
� j Gpt�sl.i, �. 54z��. w� _
_ _ �� , v�,p��. $aK �.� �, e � s,.a-�-
� _ , , � __
�
N , .
_.. � � . _ , ..
t _ , � ;:4_. �, �n�.`�; � ; r,.:-, � .�-�, �`''' �
�
--�--
�� � �'� I�_i� cEJ�1 G��' E. 51 NP r �� N D
� � �
� S�-r� �ssuH�7� .. `t. �-rEN �� �.3�i
� _ `,1 � � V�..tzr ��. sc��
3�zx ��� Po�-r � ; _ , = . _ '
� p"-t- ca� rZ�._.-
�i^G X I (jrr �wlv�- .G�.��UN E1.�-
� L..( G- ���I l., 3 �/ F�IF� �ev�D�-� t_t..� r.� �o�� S
��,, _ tr! �/ . TI-t �U C.I:C�?.t-aG• r'�, G-%a�'
s� �Tl���_ � '
( hereby certify thet this plan, specikcetion, or , � Z'
renort wes prepared by me or under my direcc 3'��� -� �'-'=���
super�ision and that I am a duly Registered
Profes.iona� Engmeer under the laws of the
• S of Minnesota.
. `" ' �r-�'
ote.�� 2i- IZ- _Reg. No. �J�$�
� 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