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AF - 46966, City of Fridley, Minn.. _ � BUILDING PERMIT" N° 5s3o Date: ._ "" �.....__._....__._._..._..... '"!.`.'.�J.�.__.. , Owner: ' .�Q!"�.._ ._...�.""��.._�..,/_.. __.. Builder ..�._._ �.. _...._.._..�..._.__.---..__.__. ._... ° � _.. .�:. ._.._.. .. ._.._._._.. .._.._._ � �� , Address....._._:.._ _.�...__._..__r.._........_.._:___._....._._..._..__._......_......_.... Address _ _ . _..__._:_......__.�...�..._.._.�.:. . '. � , N O U NG . CATIO , , , �� , . _: � No a�G•.�•!�► St�et'. . _. _!� w... ..1. P of Lot ..._...7.__� � l5,�'..,.. , . ' ;. r , • Lot ._._:.�_..._.._..._ Biock _.__..._._:.:' ....._.....�,,,rAddition or Sub-D�visi , . - r� �w � . , Carner Lot .____......._.._.._ Insitle Lot .. ... �._.____.._...: Setback �lrr� .._...__.__ Sideyard _.....:_..w._.._._�.....��_:..._:.______�.� Sewer Elevati� _w_.__._._a_.__ .....__._.�.._.�.__._.._ Foundation IIevation _..__�_�.._..._.... , DES��"TION�� :Of BUILDING �; . � � v�; � 1 � � ,. . ,�' , ,,'.,' �� . _._ �t _�� Depth : ...j�..,,,�- Height �� . Sq. ��.� Cu. ' _.__.._..._____......._._.. __... _..:,,.,,.__._.. Depth t � Sq. Ft. . �� Gu. Ft. Type of Constructioa _ _ .,�!�`....._.. Es�. C'a��.:.._.�.-.�-..� .'o be Coanpleted�_....._ __.__.. ;a�� ,�' � � ., In consideratioa of the issuance to me of a permit to construct the i�uildinS described ai�ave, I agree to � the proposed work in accordance with the description above set forth and fn compliance with all p�o�vie�Ons o� ordinancea of the city of Fridley. yr .!'_..._..__ _— , In consideration of the payment of a fee of $a�......_..._.._., permit is hereby granted ta......... to construct the building or addition as described above. Thisp�� t is gra�af+ed tt�c�t �he express condition that the person to whom it is granted and his agents, employees anc� worimnen, in ail vvo�t drne in, around and upon said building, or any part thereof, shall c�nform in all respects to the ord�nanc�'o[ �'ridley, Minnesota re8�� location, conatruction, alterat�on, maintenance, repair and maviu8 c� buildi�! ordinanc�s. city limits and th�s perxuit xnaY be revoktad at anY �uPo��'vic�� anY aP t]'►e pravi�na e� seua _ I " aI/F,�!; 1 / . > . � ,. � ,.... ,.�..�._�._.,._ � ' - NOTiCE: `This p�emlf dws not eova d�� onsMreHon, instailallon fo� wirin�. :phrabino, yas h�Mieo► awin� or water. !� � fs sM th� dviidie� �lasp�ebr foe s�puat� p�rmits foe th� ituaa. � � ._ .._s � �4 . ,.r. . - APPLICATION FOR. BUZLDING PER�IIT CITY OF FRIDI.EY, NIINNESOTA Owner's Name Builder �k �\2�� Z-° �C�'�� 1 e t� lddress Address �� 1 ��v�..4c�� ._� � T______ LOCATION OF BUILDING No. `� �.d� ,� Street C\�V c,� 2�2 �� Part oP Lot Lot �l Block � Addition or Subdivision '� ^� � \ �` �� Corner Lot Inside Lot Setbaek Side-Yard SEWF� ELEVATION FOUNDATION ELEVATION �pplicant attach to thia form Certificate of Survey of Lot and proposed bui�.ding location. DFSCRIPTION OF BIIILDING io b� used as: �v.,.@�_ ` _� Front_ '�! Depth Height Sq. Ft. �� . Ft. F`ront Depth Height Sq. Ft. Cu. Ft. T;,rpe of Construction `�" Oti c� Estimated Cost To be Completed _� v� cr�n,� � The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declaxes tha.t all the facts and representations stated in this application are true and correct. DATE �� ,��, SIGNATtk�E (A Schedule of Fee Costa can 1�e found on the Reverse �ide.) � • _ .. d� I� A►pp�ice�'io� fio�' P�awer P�ants and He�eting. Cooling. Ventilation. Refrigerertio�n c�d Air Conditior�ing Systems and Device�s PARTIAL RATE SCHEDULE GRAVITY WARM AIR: Furnace Shell & Duct Work .......................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . . Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . . . MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTLT . . . . . . . . . . . . each add. 60,000 BTLT . ...................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . . RATE TOTAL s.oa $ 5.00 $ 5.00 $ 2.50 $ 8.00 $ (� , � a.00 � 5.00 $ 5.00 $ 2.50 $ STEAM or HOT WATER SY$TEM , Furnace Shell & Lines—ta 4Q0 sq. ft. EDR Steam ...... 8.00 $ ` Furnace Shell & Line—to 64Q sq. ft. EDR Hot Water ... 8.00 $ � Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . . 2.50 $ Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 $ OIL BURNER—to 3 gal. per hour . . . . . . . . . . . . . . . . . ... .. . . 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 STU) . . . . . . . . . . . . . . . . . . . . . . . 5.00 $ s � J � � GAS FITTING FEES: NO RATE TOTAL lst 3 Fixtures ...................... x$1.50 $ / S� Additional Fixtures .......'.......... x .50 $ Gas Range to 20a,000 BTU . . . . . . . . . . . x 2.00 $ AIR CONDITIONING $ FAN FiEATING SYSTEM See Fee Schedule VENTILATING $YSTEM $ ALTERATION3 8c REPAIRS TOTAL FEE $� REMARI43: 0 Dept. o# Bldgs. Phone SU 4-7470 Location �a �- � ' ��-�7 �ea-�./ � L.� •��+ � , City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of fihe Depariment vf Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. F4�idley, 1Vfinn. �` �� , 193'"� Owner `�"`�v — 195— Kind of Building _ �/�� 195— Used as �� 6�� `^�{j To be completed about Estimated Cost, $ � S�f � � '� Permit No. �'`?1 _�, <, � � DESCRIPTION OF WORK HEATING or P WER FLANTS�team, Hot Water, Warm Air—No.� Trade Name �� Size No. �/� LS' Z Capacity Sq. Ft. E.D.R. �'� � BTIT H,p, Total Connected Load � -3 a s� Kind of Fue BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R. BT°iJ H,p, 11 pOST 1M-12-58 Sign sy PERPECTION HEATING COMPANY, INC. B�§��S��Q�eA��' . • . MINNEAPOLIS $ �11�LIESOJA D�36 s s ` � � � • HFAT LOSS CALCULATiONS DEPARTMENT OF BUILDINCS �� Weatherstrips A.S.H.V.E, Conatruction No. Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof F1oor Kind Yes—No Yes—No 19.— ' FI.� `�/ � y Room Lengt �- fl Width f3 Height Fl.� Room 1 Windows a Doors—Crackage and Area Windowa and Doflra--Cr, � Width Height No. o[ Llneal f. Area Wtdth Halght No No. � ot pane oP pane tights ot crack aq. tt. � No. ot pane ot pane !i6 ! � o � z !v � / 3 � /e l' � / 9 Coef. Btu Infiltration �� t�.p L o -a Glass Z ,�"O Exp. wall � Q Net exp. wall / � o J 2s`� Int. wall Ceiling Floor � � � D � Total Btu. / o 0 Required sq. ft. E.D.R. or sq. ins. W.A. Lea r area Fl.� �� h Room ( Leng U- Width C Height Windows an Doors—Cracl�age and Area Width Hetght No. of Lineat 1t. Area No. ot pane o[ pane ilghts of crack sq. 1t. _ .2 / s� / b Coef. Btu In6ltration � '� (Q o caa� � 6 --o �, Exp. wall Z.. Z / ( Net exp. wall L v /c1 jQ V-�p Int. wal! Ceiling Floor Z/ S' � �/ Total Btu. 1 � Required sq. ft. E.D.R. or q. ins. W.A. Leader area Fl. � d oom ( Lengt Widt Height Windows an Doors—Crackage and Area Width Aeight No. of Lineai ft. Ares No. ot Dane ot pane Ughte ot crack eq. tt. � l � 3� � C z� zo Coef. Btu In6ltration ' c.tL p 6 0 Glass 6 �O �� o ' Exp. walt � G � Net exp. wall 2� b 2 c� Int. walt - Ceiling � loor �O /.i� � Z t7 Tota) Btu. 1 v�% (� o Required aq. ft. E.D.R. or sq. ins. W.A. I.eader area �— Infiltration v s' Hnr+rr�o�ts. �mmv. n . -_ Insulation Haw. AppGed Width �// Height aad Area neai ft. Araa 'crack sQ.ft. � b ,! ' c�$ss � 6 � � Exp. wall Net eap. wall �s / � Int, wall Ceiling Floor o L �(s� 0 1'otal Btu. �O Required sq. ft. E.D.R. or aq. ina. W.A. Leader sres Fl.l Room ( l.ength Vi►i�#h d He�ht Windows and Doors—Crackagt nd Ares Wldth HeSght No. o! Lfneal ft. Ares �No. ot pane orysn� lighb o! cr6ck W. tt . . . � / Infiltration � �o (� � o Glaaa �4 S"O Exp.:Wau :.S�o Net exp. wall � � �- n Int. wall Ceiling Floor D J� aJ� Total Btu. Required aq. ft. E.D.R. or aq. ins. W.A. Leader area F1.� _.�.�P Room I Lengt jl — Wic� f�L Height Windowa and Doora--Crackage and Area Width 'Helght No. of Lineal it. �Area .' No. ot pane of pane Ilghb ot crack sq, tt. % 3 2- / 2 l,S o L �3 (e -z,o ,_. � /S �? � Inhltration Glass Facp. wall o. Net exp. wall � Int. wall �wt.:3�� -�� 'F�� Ceiling Floor A 6 0 7'otal Btu. �p Required sq. ft. E.D.R. or sq. ina. WA. Leader ana D-S6 � s � � •: ~� HEAT LOSS EALCULA'TIONS DEPARTMENT OF BUILDINGS NIIM�iFr4P�LtS. 1�iN• A.S.H.V. , Weatherstrips Guide Construction No. Inaulatiom Windows ( Doors Reference Out. Wall Int. Wall Geiling Roof F1oor Kind How. Applied Yes—No Yes—No 19_ � FL� Room � Len l� Width c� Height FI.� Room Length Width Height Windows and Doors—Crackage and Area Windows and Doora—Crackage and Area . Nidth Height No. 01 Lineal ft.. Area Width Height No.-ot Llnealit. Atet� � �. . No. of pane of pane lighta ot crack aq. tt. � No. � of yane of pane IlQhta of crsek � eQ. �tt. 2_ �r Z.. .� 10 � � % .%` ` Coef. Btu Coef. : Btu In6ltration C� (Q � Infilttation Glaaa Z '� L? � ° Glaaa Exp. wall / �o Esp. wall Net exp. wall y l J �° Net eap. wall Int. wall Int. wall Ceiling Ceiling Floor ( 2.� Z� Z� Floor Total Btu. ��0 0 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required aq. ft. E.D.R. ar sq. iaa. W.A. Leat�r area Fl.� Room Length Width Height �,� l�OOm ( Length Wi�lth Haiqtkt S Windows and Doora-Crackage aad Area Windows and Doora—Cracka e and Area WSdth Helght No. of Lineal ft. Ares Wtdth Helght No. o! Lineai ft. Ares No. o[ pane ot pane lighte of crack eq. it. No. of pane oL psns Itghts of crack at. tt. Coef. � Btu Infiltration Glaaa Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. L,eader area Fl. Room � Length" Width Windows and Doors--Crackage and Area Wtdth Hetght No. ot Ltneai ft. Area No. of oane o[ pane � Ilghta ot crack ea. It. Coef.l Btu InFiltration � Glasa Exp. wall Net exp. walt ' Int. wall Ceiling Floar Total Btu. Required aq. ft. E.D.R. or sq. ins. W.A. l.eader area Infiltration Glaaa Exp. wall Net exp. wall Int. wall Ceiling I Floor � Total Btu. Required aq. ft. E.D.R. or aq. ina. W.A. Le�td Fl.� Room 1 Length W; Windows and Doora—Crackaste and Ana � Infiltration I Glass Eap. wall �.�� -� ��r ■�- ��. �� Coef. $tu, . iVet exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or aq. ins. WA. Learkr area I� . . ,� � City of Fridley App�ea�io� for P1�bing anc� Gtrs Fitting Pern�it DepY. af Bldgs. Phoae SU 4-7470 DESCAIPTION OF WORK Number, Kind and Lacation af Fixtures 3�`�,�di�-�m`�1I3��O�I�laalU�`<3`�U'<I�U'o:�(�90I FI NIGSTERELEC. Base f lst f � % ` 2nd 3rd 4th ` Futurs Connecfion Openings � New Fixture, Old Openings PARTIAL RATE SCHEDULE Sewer � Cesspoal f1 PLUMBING FIXTURE RATES: O. RATE T TAL Number FYxtures ....� x $1.50 $ ��C Future Fixture Opening ................ x 1.20 $ New F'ixture Old Opening . . . . . . . . . . . . . . x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTin . . . . . .,.L— x 2.00 $ �� New Ground Run Old Bidg . . . . . . . . . . . . . x 3.25 $ GAS FITTING FEES: NO. RATE TOT`A�. lst 3 Fixtures ..........................�_ x $1.50 $ -'S � Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU . ..... ... ..... x 2.00 $ REPAIRS 8c ALTERATIONS—Refer to Code Description ................................................$�—i TOTAL FEE $-,�, � •-= City of Fridley: r � � ! �� The undersigned hereby makes application for a permit for the work herein specified, agreeing to do ali work in strict accordance with the City Ordinances and ruling of the I?epartment of Buildings, and hereby declares that all the facts and representations stated in this applicatio�n are true and correct. Fridley, 1Vlinn. /�°�" e-� a? 7 � Owner C��'1 i -4�� -�c.e-�� '�o ,' 19— Kind of Building _ ��c -�yr2-2/ 19— , Used as ��e+ -c-e-C-�. �.� � To be compieted about Estimated Cost, $ Old New, ilding Permit No. �� - Signe C � � By Business Phone Na. ,�e�' = .� � ��1,�-' �6-Bo-�� -��y� 11 POST � M-t 2-sa Application �ot Powt�r �[�S and HaaNng. Cooling, Yentikttioe. R�iqt�+alioe and Air Condi�ioning S�st�ns c�d Devic�s PARTIAL RATE SCI-iEUULE GRAYITY WARM AIR: R1lT'� 'POTAL PUrnace She2I di DucE Work . . . . . . . . . . . . . . _ . . . . . . . . . . . $10.00 ; RepIacement of Fnrnace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.00 : Repairs & Alteraf.ions—up to �500.00 . . . . . . . . . . . .'. . . . . 6.00 � -- Repairs dL Alterations each add. y500.00 . . . . . . . . . . . . . .. 3.W � �cx. w� Arn , ; .. Furnace Shell da Duct Work to 1�0,000 BT[T . . . . . ... . . . . .$10.00 # � L � 28Cti 8(�C�. �Iiy00� S'1'U .......... ... ....... .. . 3.Dil � Replacement oi Furnaee . . . . . . . . . . . . . . . . . . . . . . . : . . . . : 6.00 �— Repairs dc Alterations--up to ;500.00 . . . . . . . . . . . . . . . . . 6.00 � Repairs & Alterations each add. ;500:00 . . . . . . . . . . . . . . 3.00 a STEAM or HOT WXTER SYSTEM F�rnace She�l & Lines-to 40Q sq. ft. EDft Steam ... $1Q.00 $ Furnace Sheli & Line—to fi40 sq. ft. EDR Hot Water 16.00 $ Each add. 200 sq. it. EDR Steam . . . . . . . . . . . . . : . . . . . . 3.00 �- Each add. 320 sq. 1t. EDA Hot Water . . . . . . . . . . . . . . 3.00 � OIL BLiRNER—to 3 gal. Per hour . . . .' . . . . . . . . . . . . 6.00 $ over 3 gal. per hour�ee Fee Schedule GAS BURNER (up to 199,000 BTU) . . . . . . . '. . . . . . . '. . . . . . : . 6.Ob ; . � --' over 199,000 BTU See Fes Sch�dul� GAS FITTING FEEB: NQ RATE TOTAL 1st 3 FYxtures ..... ................ x; 200 S - � Additional Fixtrires ................. x .7b = Gas Range to 199,NOt► . . : . . . . . zE`60� i AIR COIEDITIOIiIIfG ID FlIN HEA?ING SYSTEI�t � VEliTILXTIIiG SYSTEM ALTERAT'FOl�iB i� REPAIR$ iiEii.Taii �rtu, /D-3/- � � � � Se� � F� Sch�dnb i. ror�. � ;1 �' ' �= �"��L C /Z 1- C C1.-t_ � �:� � ,, ,�� L`�(.r-� c � _- Dspt. of Bldys. Pho� 880-3480 _, �, _.:.;� , � � /� %/� �. � City ot Fridtey: , The uadersigned hereby makes appiieation for a permit for the work hereir. specified, agreeing to do all work in strict accordance with the City Ordinanee: and ruling of the Department oi BuiIdings, and hereby declares that aI1 the facts and representations stated in tisis application are true and correct. F�idley, 11tinn i_�' f,� �'--- ,_ It� � Owner "•� � xind or $uilding "- �' Used as _—�,C .� 4 1`o be completed about — _� .. � , , > ' c ��' _�_�c. ! � / / _�_. / - _-, � ; - � % Z Estimated Cost, $ �' � �M�„ - � �/O� New. Building Permit 1�Io. Permit No. DffiCRIPTlON OF WORR HEATING or FOWER PLANTS—.Steam. I%t Water, arm Air; Na � / �— Trade Name . �, r � > « L � � =; , � E � Size No /7�F �1 � : 'a � � Capacitg Sq. F't. E.D.A i i[:' : �' <' �' BTU ii.P. _. ' �> ?,'_-r l' Total Connected Loaci—? L-.!-,� Rind oi Fue BURNER —liade Name Siu No- � CaPacity 34. Fk E.D R- BTU H.P. f i' � S` . / �-L •c. B� -� - �'.�- �.�; , �:_�� <<��-_ � ,,._ � , ` � , �. ,� �:`-? ;�P- .:� ��1..� % . �� B�siness ifione No- • � �— �f�_. _ � �� 4 ti-� t ,' - 't-�{_.�-Z C� l, .' _. _ (REMARKS-OYER) SUBJECT , City of Fridley ° 1216'7 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � RE . � `y _ ___ COMMUNITY DEVELOPMENT DIV. � /- �� PROTECTIVE INSPECTION SEC. �Q t , � � /"'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �"-"�'� ,�� 612-560-3450 910-F15 6/7/H73 � � JOB ADDRESS 5221 Buchanan Street N.E. 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ],], 2 Ma,rian Hills Addition SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE John Emerson 5221 Buchanan Street N.E. 3 CONTRkCTOR MAILADDRESS ZIP PHONE UCENSENO. Aquarius Swimming Pool Co. 16900 Cedar Avenue South 4 ARCHITECT OR DESIGNER MAI� ADDRESS ZIP PHONE IICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ AITERATION ❑ REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Install 16' x 32' Swimming Pool 9 CHANGEQFUSEFROM TO STIPU�ATIONS See attached Health Inspector's memo dated June 6, 1973, having 11 stipulations. SEPERATE PERMITS REQUIRED FOR �IIRING, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAI, PlUM81NG, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTqX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DO PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMI FEE SACCHARGE OVISIO OF ANY OTHER STA OR LOCAL LAW REGULATING CON- TR ON OR THE PERF MA CE CONSTRUCTION. � LZ.00 �� PLAN CHECK FEE TOTAL FEE70 R � SIGNATUREdFCONiRACTORORAUTHORIZEDAGENT (D T 1 HE PROPER�Y VALIDATE THI IS YOUR PERMIT ♦ � � SIGNATUfiEOFAWNERIIFOWNERBUILDERI IDATEI BIDG INSP � DATE ApPLICATION FOR RESIDENTIAL, ALTERATION, OR AllDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA . . aZ��. . .. . OWNER � S NAME :,Jor�/� �.�1 �,P S� N' BUILDER :_ /7C!L�A�P/// C' t.U//Yl �n�) I� Q. ADDRESS : �?02 / �(�Cf/ A�(1rA N ADDRESS :_ _ /�9(�Q �.�]A . ��0" � SC� . NO :. �o�a2 / S TREET : y�1(�C C/�IAlI/ A/�/ LOT: �� BLOCK: � ADDITION: %��',�j�� f�/LLS �D,�IN' ' CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Ztao Certificates of Survey of Lot and proposed building location drawn on these Certificates,. ^ �ESCRIPTION OF BUILDING To Be Used As; � a Jim • �l�l�� _ Front t �� Depth : �°� / Height • �`j' � � �� Squaxe Feet• Cubic Feet• Front: Depth• Height: Square Feet; Cubic Feet; Type of Construction; Estimated Cost; $ c�y/%Q To Be Completed; The undersigned hereby makes applicativn for a permit for the work herein apecified, agreeing to do all work in stiict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that a11 the fetcte and representations stated in this application are true and coxrect, DAT�: SIGNATURE: (See Revexse Side For Additional Inforu�ation.) � .1_J - �-K.� �,��C,�.�'JC.J /�Yk��x..L�'U � L.�il'1�1 ��k�:, -_"`.J �� , (P, lq�/�� // � �� a ` � � ��. �d � __ _ _ : ___ _ __ , _ , 8�tiaming Pool Stipul�tiona , Mr. John &nereon 3ZZI �thsnan Stzeet N.$. , . Fl�tn �et►i�it s i• The diving board i�hould be from �" to 11" abave the pool edge and not � "20" maximum as shawn. The board overhang should ba about 24" as a lainiunim. ;- A turnover of pool water e�very 1Z hours �s approved. However, wa are generally gettir.g from 7 to 9 houra for a turnwer. Your proposed 12 hour� turnwex vili b� aggrwed. 3. Pra�tide depth markets at edg� of pool, �. �qo iniats, one skiu,a�er, and one main drain ir� �eep end muat be pxovided. � 5. Paol or qard muat be fenced �ith a self �lo�ing �nd aelf iatching gate. � 6. Fravide e minia�um of s 3 foot c�eck arrncnd pool. T. �rwida 8 1�dder in the deep end of pool and step8 in ahallaw end. 8. Pravid@ a back siphona�e device on inaide of house to wata� Iine �ith outside apzgot if hose uaed to fill paol. You may provide a permgnent �i12 line under divir.g bosrd. Keep lip of �ill pipe at 2eaat 6" above adge of.poal. 9. 81e�trical �ork �st be inspected az}d appraved isy the $lectrica3 InspeCto�. IQ. Skimm�rs� filter, and pumP �st be N.S.F. approved. 11. Pxo�vide a teat kit and safety equipment. , PLAI3S EPPRtn/8D JUNB 6, 1973 : HARVEYJJ, I�CPHSE ii�ALTIi INSPECTQB q . , + , , � . . � � . . _ . .. . . . . . . � � . . � . . . � 4 .. � � , . � - . � . � � � . � . �. f ,._ �...,....._._..W.� . . �.,`:...,�....�. . ..,,... � ` L� ; .� � � ;,�., � �� , �r� .�: t p � � . .. . z 7�c; p i „� � y . �:p � � � � �� f � � f . . � �� . �^ + . � _ �'k�,�}� +� c, a l � .; ' e - � h.} . '� 4 �fi y. �. � . ' �L^�J ��4+$��"�"� ��' �;' • � , v � � ': P , . . . �y � r . � � V �� . .. `d �' � . F � � � � . .. � � � . . �d� . . � �� si � .��. � � . . . �' +ti ' ; � � , . � ,. � � '.� 'L A 4- . � . . � . . . - �' � ±. ey . $'�5 �+ j' .}:. � � � � . . . . . ' .. . , � � �. 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LL Q �l a � 0 W 0 J J � � � a � �u F � � U W ;� a w o� u�: �;�, U 2 � � � r� � r--N_ 7 1—� -� ?�-�-1 o a p p I•'�d' ^ I A1 M J < il.i W � 3 �� L11 $ Z o w� �0 0 po a I o O Uo 0 �y Z° 0 0 � z> � 1_ I � {I� A1 fv � j(1 �f �.. � � �� .� Q O O d' � wN I o V J � r Wo �� WO �n � ; � ; �n � u� a , � �� '� �9 � � � � � < � O a ti � � __ ..—. J 1 J � J .r�-� � 4 �-I I�-�"T L S Q I �� Q �� "i �� O �<` if- �� O W � � � uQ � � o o �-- � au � I o Y'"r J y� �? � � zy iWOv � w f o �— dLL ,, �� / 1� V , I o � � O a € � ,n� � � J � � Q � f m� � O LL a pi=1 o- 0 � �Nw m � '�N} _ y ,Q r � � � w 0 r � Z' O Q ��di s � �?z ; � p g00 0 � � J oa1 w ai3 0 '� u ip 0 � y1 w � '� a � ��a � � ��W r o QZ° ooa � 2 0 � Z w � D C 0 � 0 0 (a1 lp) -�� •. lil_ �� _ � =`�� %_-:^_:_. —— - �+s ' ' 'o�+o�iv�o� fan]lo� � 9.6 9n�O�b �� JNI�i ��'(� lUN 00 '�t�h d0 iSrO i.• 1� OOl 1i 011 - � (D) � � \ i c �o L. � o b�A�lo A O�s w 9� � A S _ y f a � Y .r Q u v y u a� <.r b u r� e� i�9 S Y e E�+ Y. .��t �+.r 7 6 �-..� d � ,., � . L 17 9 �C � e� � F -- A�9i— a---r � � '_._' .. .._..� �t }S I� � � ,. \ �--,--- — � {�. :: '�"� � �:., `y '8'�'{'' Y��i + � � � i,= 'r � � � � .r. �•. . � \• 4 � � •�`J� � . ; Nw a � � � \ �� .e� .. � � y '� ' �r .. - � ; :'�, S# " . I u ::i Y � �... � � r .+� � . t � '��`P' � O . . � � . . � . .. �: � ; "i �; -� , � � s �;� _ ,: � �. � t� i h S` f � I � � �� ( � ;.�'�; a � ::,1* a � ,�' .. : , , f . �:-�. ` ° .. � ' `,'�( s y � ��. ` � �+ ��` 3 �r 1^"�Ps.?C, � � /�' � . i� :'. � � --�--1 E 1 � . \\ I \\ � i \ \ _�.I__. , q � . ,, s � \ � � a j� + s ,}� d• it �!� ��G` �_ d�a0 w y� I! �a�a N t] ^ j✓�� aaiC , ', : � � ! ,i ��;;.,' , I N', -� a-ae;, -- h �1 ,: �� ' ; ,� �i� ^ - 7 �� J I � � „.. Y � � �� ,.f�` . �,: � ,. ,z �.��. �� , �Y � i , , ; �/'; ' � �. � i : � , .. . , ,:'�ri � m ; j:s.� - ,; -_. ,��' s�` > {� •Sc `,�.• —=--�'- -- ` .�` � � . `,C��Y OF FRIDLEY �,,,b�ALTH AND SAFET�Y I NSPECT I ON svszr�ss r�r� : n�� : _, ?,�S �'� OPERATOR: TEL. � ADDRESS : � � !'�I '"��,,�..��_„�,.,,,,,iT �PE OF BUS . : On this date, the health $uthority made an investigation of the subject facility. The deficiencies noted at this time and the necessary corrective measures are �iven below. If you have any questions concerning this matter, please feel free tto call on us at our o€ficea (City Hall, 6431 University Avenue N.E., Fridley) i�lephone No. 560-3450, Ex. 41. — - ..�_ - - � / �� i ,� . - - � �.. _a..... , � ..+7 r.i% ' �_ • /1 ,�.... /�- • P .w � July �, 1973 �ry. J��n �� 5�� Bu�hart� St�e�t �.�� F��.di�� e�a�a 5�4�� 3�� er�csra. 's'�.� �.et�e�t ��.�.1 �crnt�.�n t�ry �r; s�.t ar�4 �.�rv��y af ycc�nsr �c�a�€:£,xag �oc,�, �n 3u�,y 7, �97�. i ��'h �� ha�.k �� foz �� .mm� �nd cau�`t�sy du��.�.g � �.n� pec C�s�� . A�ep��t w�� ].�:�t with y��., azcd I�mp�Zasi,z�ci �tZe i�ngc�rt�ce o� ��c�v��x�� : b��lc�'1a�a �rev�ntei� r�n tt�� r�t�r l�.n� us�d tc� ti�.l. tt�e poc��.. i�cna �nay c�:l�, ��;e P�,um'�in� ��aspe�tar i.� ther� are �xy que��.ans �br�ut h�:�e Edt�V �.e4 � "�h+� fe�ce �ai�.3. b� repl�ced �:� th� so�t�rest cr�rnex. Th�� gaxtic�r� �a�� remc►�red t� �e� �quipx�� iratca C�he y��d, Ca�e� s�a�t b� �elf»cic��ag a�d s�%f � i.� ��hi� ; . P�.��.�a �e��. ��e� tc� ca�.�. �� h�r� ��c+� sny ��sti�n�. H�ilsz� ��.nce'��iY�, . ...-- ��t� c�� rid�.� :�:'VEi� ,�. �P�E� Publ3.c �alth S�nit�,Y�.�;re ;� � 97-8l,l�16051 ' � ' . CITY OF FRIDLEY ' : , • APPLICQTION FOR PUIMBING AND GAS FI�'1'ING F��tr >. tn u � • a� Water A �n �'� u c� m. o u� a w � Heater v a� .� � A H.+ a � H ro s� o, � '� U ° .S " .c '� c u v .� � � a u a�i v`�i J u � m � vi• .3� o u°. � g u oo a? � � � o As lec 1� . � . . ep 3ce Znd 3zb 4 ;.`i (Rl � Fv ture Connection opening (•) � New Fixture, Old Opening Connected with Sewer Water PARTIAL RATE SCHEDULE � PLUbiBING FIXTURE RATES: N0. RATB TOTAL tAutiber Pixturea x 53.00 S Fv ture FSx ture Openinq • x 52.00 $ ' Nev Pixture, Old Opening • X S2.00 $ . Catch Saein • x 55.00 • $ Water Heater - to 99,000 BTIJ x S5.00 $ 100,000 HTV to 199,000 8TV x$10.00 $ ' Katez Softener , x $7.00 $ � t7ew Czound Run Old Buildl� x $5.00 $ , Electzic Water Heater x $5.00 �'�$ GAS FITTINC FEES: � . I lst 3 fixtures x'$3.00 I1►dditional F�x tures x $1.00 Cas Ranqe to 199,000 81V x$10.00 REPAIRS �i ALTERATIONS Pizat 5100.00 . $5.00 each add. $100.00 or lraction 52.00 State Surcharqe � TOTAL FEE REZNSPECfION PEE tctn nn� S $ S $ S $ .50 s g.00 0 Job Addrese 5221 NE Buchanan � � � � � � .� � � � � � ,Department of Buildinqs . City of Pridley , Tel. N571-3450 The undersiqned hezeby makes epplication tor a permit for the wrk her�S,n apecified agrceing to do all work in strict accordance wiih the City Cbdea and rulings of the Department of Huildings. and hereby declares that all . the facts and representations atated in this applicntion ere true nnd corrx t " Fridley, Mn, 11-].� -7$ , 19 owrr�x EMERSON KIND OF BUILDING f2'antC ' • USED AS r�G _ - ' � y TO BE COMPLETED ASOUT � I.1-21-75 " ESTIMATED COST 20�00 � • OLD - N�W BUILDING PERMIT N0. PERMIT N0. �� a c9 � �E�' v"v� ' Company� ,� MiNNEGASCO Siqned By . • Tel. No. ROVGH INSP. Date � FINAL INSP. / - �� -�(� � Date APPRO'VAL FOR PERMIT �2�1:��` . � : , . .� . .� MINIMUM FEE FOR ANY PLVMBING PERMIT 23 S7.50 pLtig S.SO STATB Sp� � n 0 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE �ridley, MN 55432 572-3604 Effective On January 1, 1991 APPLICATION FOR PLUMBING AND GAS FITTINC PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLC)OR PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Btow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas NO. RATE TOTAL Gas Range Gas Dryer Back Flow Preventer Required ()Yes () No JOBADDRESS �7 `�"' °�' � �UCJ��JI/,�.,�j � � 7.00 The undersigned hereby makes application for a permit for the work herein ;� 4.00 specified agreeing to do all work in strict accordance with the city codes � 5.00 and rulings of the Building Division, and hereby declares that all the facts :� 7.00 and representations stated in this application are true and correct. :6 7.00 � 7.00 :0 7.00 9�10.00 :6 7.00 �;10.00 9�10.00 �;10.00 Type $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTEFiATIONS 1% of Value of Fixture or Appliance ' 0� State Surcharqe TOTAL FEE .50 $,�37� • i��..�a /Li � � � Building Used As Estimated Cost � � °�' � , 1991 PERMIT NO. �� PLUMBING COMPANY C.�LC�X��''«`' SIGNED BY TEL N0. °t'%�'� �� ! � Approved By Rough-In �ate Final Date l�� MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT iS $15.00 �/i�. PLUS THE �.50 STATE SURCHARGE ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 57Z-36U4 1+'AX: : 5221 BUCHANAN ST NE : 253024210055 : MARIAN HILLS : LOT 11 BLOCK 2 : BUILDING : RESIDENTIAL : WINDOW/DOOR REPL 571-12if7 _.�._4_..,-- � ..� PERM O.: 2004-01079 DATE ISSUED: 07/12/2004 VALUATION : $ 5,489.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENING5. REPLACE WINDOWS WITHIN EXISTING OPENINGS. STATE LICENSED CONTRACTOR 1 APPLICANT LIFETIME SIDING & REMODELING INC (1 355 21 ST NEWPORT, MN 55055- (651) 458-0844 OWNER EMERSON JOHN E& SHERRY L 5221 BUCHANAN ST NE FRIDLEY, MN 55421 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 ordina�lces governing this type of wor� 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. Ann1i�T.i� Date i I Bldg Ins��,�!'1�- Date BUILDING PERMIT FEE FIRE SURCHARGE STATE SURCHARGE, VALUE LICENSE SURCHARGE TOTAL PAID WITH CHECK # 46620 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 125.25 5.49 2.74 5.00 138.48 JUL-01-26�14 10 � 2�7 FRQP1 G I TY � FR I DLEY T0� 3%%3 NEVV [ l clrr 4F �Rt�t.�Y AD6iN [] 6431 llnivetsity Ave NE, Ft��l►, MN �5432 = q�,� �� StNGL,E �AAAELY AND DUF'LEXE51t-1 AND R�2 �UIL�iNG PERMlT APPUGATIDN C�I'�St1'UCt10� Addti.'S.S: ��' �. _ r _-.. r . . ��° �r i�l'M'14' $c �I�SS: 16514581865 P.H2iO3 Eft�fi+e d112{3174 {TB3} 672-360A B�g M�p (763} 579-4 Fax �� / � � ��[ � _, � 7 v •--- •�1 11S �iii�lOt'1, a Ci�ttl�lCr�� Of $UNG�► tYf � LSR, Inc. �� 'nstn�c#ion �irawn on it ta sc�le. �pYl l'14�- �'' � 21rt, MN 55055 �CR�''i1aN O� {111lPRQVENIENT Newpo L.IVING �AR�'�l: L�s�gth _._._.._..�.... Width Neigfit �.._ �1- F� _ -- width � �eight _ Sq• Ft GARAGE ARi�A: �.es� ______y___ - DEGIC AREA: �9� ___r�_.-- w�d�, __.___._.._._..� �� s�. F�. — - OTH�R: 2Et�i Cost �_ � �� - Coc�.�trudion Type: T pfir�vVay Curb Cu# V1f�dth Needed: Ft + fi�t = Ft x� _� — �� l �s� o�yy DATE�: / d APPL Tet. # � Ca�i (763j 572�6Q4 for P�rnit f ing in appliu�t+on. Faic to 783 5T1-1287 if using w�dit cae�f ar� we wi�l call yOn for card number. Cii'Y USE Ol'�1LY - Permit �ee P1an R�view �ire Surt�t�rge Sta�te Sur+charge SAC Charge u�ense surcharge Curb Cut Escrc�w Ervsion C►orrtral P�rk Fee $ern�r Main Ghargr� "CpTAi. W 1 ��r �� ^ � �� .�.-----� $ a � -.��.:-'�.� $ $ -�. C'C? �► � $ $ � � SLS�.�--� � /� f Fee Schedu� csn Reve�se Side fi5°�b of Fermit Fe� .Ot?1 af Permit Vaivatron {i /i 4#�+°lo) $.5a1�9,o0o vawa�ion �'i 350 per SAC Unit $5.OD (St�t� ��censed Re�iden�al Contractars) Alt. "A" or Alt. "B" Abave $45U_00 Canserv�tio� Pian Review Fee peterr�tineci by Engineerir�g A�reement NecessarY I l Not NecessarY � l STiPULATi jtilS: . ` , -f=�" �/ � CITY OF FRIDLEY BUILDING 1NSPECTION (i �/�o+� Effective 4/1/2004 6431 UniversityAve NE � V Fridley, MN 55432 763-572-36'b4 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning - All Sizes APPL{CAT{ON FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Fee Total JOB ADDRESS ' �2� Owner 1jj.l� $35.00 $ �� Building Used $10.00 $ $10.00 $ $10.00 $ $25.00 $ All Other Repairs or Alterations (List on Back) • 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater. on work less than $500.00 Commercial/Industrial/Institutional ' 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/Industrial/Institutional State Surcharge �OTAL FEE REINSPECTION FEE $50.00/HOUR • $ � /. ESTIMATED COS� � �d� PERMIT NO t DESCRIPTION OF FURNACE AND BURNER # of Heating Unj,ts / Cir�le One (Steam) (Hot Water) (Warm Air) Trade Name G�,�,ei�� Size No. BTU _�9,y%7 HP EDR Fuel � �T Total Connected Load 5�-� � T% �aya_'%� �� ..5�%�� , Burner Trade Name Size No. B7U KP " EDR The undersigned hereby makes application for a permit for the work herein specified agreeing to do aIV 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. $ .5� $�� *Air Conditioners can not be ptaced in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPIACEMENT FURNACE H EATI NG Si Tel #��Z ��!' FAX #��?� —� � Date � ^ � '"' � Approved by Rough-in Date Final Date FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMQN VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION - . When replacina an existin� furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, (ength, number of eibows and termination. Yes () The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. The existin� combustion air is sized and installed to meet the current codes and manufacturer's specifications. When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. No ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) When installina a new ventinu svstem, the undersigned hereby verifies that it is a listed assembly and meets the cur�ent codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. No ( ) Yes ( ) No ( ) Appliance Tvpe and Size/Common Vent and Vent Connector Information Appliance #1 Type �G/�� BTU Input 1'� Fan Assisted or Nat Appliance #2 Type BTU Input -�' OI'3 Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances �-, � Tdal Btu Input �� Common Vent Type Vent Height -��— Diameter � inches Appliance #1 Vent Connector Height ,�ft Length � ft Diameter in Type �_ Appliance #2 Vent Connector Height �ft Length �_ft Diameter in Type /� Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed B'y: G � �� 0 Date: 1/28/05 Revision Date: 1/28/05 Site Information Address 1: 5221 Buchanan St. N.E. Address 2: City: Fridley County: Anoka Application Information Business Name: Sharp Heating & A/C Inc Contact Person: Kevin Hanson Existing Construction: Pre 1994. Project #: Lot: Block: Subdivision: MN Contractor License #: Office Ph: 763-572-0459 Fax: Cell Ph: 612-743-9193 Address 1: City: State: Zip Code: Combustion Appliance Water Heater: Natural Draft Input BTUs: 40,000 Common Vent Furnace/Boiler: Fan Assisted Input BTUs: 88,000 Common Vent Make-Up Air '�a� . Up°Air Reqt�i�ed by Code Combustion Air , � Combustion �ir Requirements Met. � � �� Applicant Name (print): ��'v �� ture/Date: • p]S Code Official (print): Signature/Date: O 2004 CenterPoint Energy Minnegasco. 2004 Mechanical Code Guidelines. Page 1 Building Inspections 763-572-3604 DATE ( � � � SITE ADDRESS • alZ.\ THIS APPLICANT IS: PROPERTY OWNERI TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE TYPE OF WORK: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY ❑ OWNER �� STATE LICENSE # ADDRESS: -/ S� YOUR E-MAIL ADDRESS , PHONE `7�%�. SU3 !�C�S F� INGLE FAMILY/NEW CONSTRUCTION ❑ TWO FAMILY/NEW CONSTRUCTION ❑ ADDITION O GARAGE/SHE: ❑ BASEMENT FINISH ❑ ROOF ❑ DECK ❑ SIDING ❑ SWIIviMING P( ❑ I;iEW ❑ ADDITION ❑ MAINTENANCE/REPAII2 ❑ REMODELINC DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT NUMBER OF SQUARES �LL% GARAGES PROPOSED SIZE: PROPOSED HEIGHT: TH � HOUSE & GAR.AGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE Permit No.: �'1"fJf)S � Received By: Date Rec'd: �r � �� STAT�ZIP £XP DATE ��! �1 O b ` CITY c��-. �'s�5 s3 S � SIZE STORIES t ❑ WINDOWS ❑ DRAIN TILE ❑ OTHER )L � - a��c WIDTH HEIGHT AT�ZIP �1T3 �3 Ft. BASEMENT REMODELING SUBMIT: I. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and ptoposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS �Yes ❑No LOCATION OF WINDOWS 3. Ertergy Calculations OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED AIUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (LTSING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ ' OCCUPANCY TYPE Permit Fee Plan Review Surcharge Fire Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ -- $ $ $ $ $ $ $ $ $ �7 , .. . See Back Page for Fee Schedule 65% of Building Permit Fee (.0005) times the total job valuation — Minimum $.50 .001 x Permit Valuation (1/10%) $5.00 (State Licensed Residential Contractors) $ I450 per SAC Unit (Plans to MWCC for determination) ft+68= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclrnowledge 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 e it nd 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 whic r es view and approval of plans. SIGNATURE OF APPLICANT PRINT NAME 1'1W �Q��I�4lJ=� DATE I(/ ^ —