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AF - 37065� + Village of Fridley, Minn. BUILDING PERMIT N� 8� 3 Oifice of INSPECTOR OF BUII.DINGS � ��. �. tY �_ � Fridley. Diinn., � � , 19 �"_ LOCATION OF BUILDING �� l --y- No. � �,treet � t�((. i 2.-�� / Pazt of Lot -="�� X.1.� Y�• , � / " i�: .... � � �T�.�_. Lot Block Addttlon or SubDivision � DESCftIPTION OF BUILDING Fcont Depth Height Storfes__ Manner of Construcrion To be used as To be completed Esttmated Cost Permit is hereby granted to the butlding described in the above statement. Thie permit ia granted upon the express conditfon that the person to whom it is granted, and Lis agenta, employees and workmen, in all the work done in, around and upon said building, or any part thereof, ahall conform in all respects to the ordi- nances of Fridley, Minn., regarding the construction, alteration, maiutenance, repalr and mov[ng of buildings within the city limits, and thia permit may be revoked at any time upon violation of any of the provisions of said ordinances. oP Buildings. AGREEMENT AND SWORN STATEMENT In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of the above permit, I hereb,y agree to do the proposed work in accordance with the description above set forth and according to the provisiona of the ordinances of Fridley, and, being first duly swom, I hereby state and say that the facts stated by me and contained in the above permit are true as therein stated. Subscribed and swom to before me at F�idley, Minnesota, day 19—. • • / �I Jn o �I �� . � � \ �� • +, .'� � � � V � � �O . [ Fi C a � � N � o 0 T � � m N m � �p a a C � a � o' a c :o � k� �� d ]� 3I � �� u � • z '� j � . � w s��N,<o 'Q r� I a a y 3�r�vx i Q : I �4 W � O o 3a w• 0 b za O ,o F � a ab y k Q � A e� z f ^� \ N f�i .�'. U U 4 C � y � .a F � W t Y '� « 3 � A � �« r U L ' « u �. v v o « �. � � u « u � 3 v � � c �a, � w � � � o °' 9 � � G � � ro o �y � � ;� o y � c u �N'da ca� X 4 � �+ E3°y T^, � C v � � O $ d � r'� m m � Q f�� N L � �y N � � U Y N � �' U �O '�1 bp O y 7 � [ y v 'D a � W � � L vvv a ro m �aav r� naHSVm o�� 5Hi5VB HJlq snnaa ; saHHs iHno� 1NIMO SAVN1 HSYM $MNIS sNim seru H1W sivNinn s�sov b31VM I m � a; � GFi I I J � s. o I 3 c v O x � , ❑e ib V � "a [ M y� I � �i � ��og I � � a b �-- � O ° ti �. � M 7 I O U K I � u' � 6 0 y � 'LI nl w x (3 ^ �Q. ti Ni MI WI • 'µ I � � a A bq � � C �c v 'J Y � j O 5 a U � o b � °.,' n � � � b F w O w J � � W _ N lL� H Q � J H � a � � a 1 a p F F v> I v� I� Fn 4 0 0 0 �n o �n �[J N O N O N �' .y .-r .�-i M N M � xl x x x x x °z � � i I � F W po °o 'o c o �q N C d � 'O �,.� C Q � � a � ° o � � a� x � c� � v � w K � � � � kr. �" K " � o � A � [H � w C7 � � 3 w ; 3 z z w z � 3 z Rl � a a , � F F � i � W 4 0 0 0 V) Iry O ([ ti N df x x x °z � � � � O O 0 {�. O N ° k N � � � o W Y v W % G G ,^ W o NA V M W z �' '� w F ti 6 � F W N � r I I W 6 O F a o. F H Q �� ° 7- J 75' C�Y OF FRIDLEY � ' � � � Application for Installation of Water and Sewer Service This form to be completed before a tap is made to any existing water or sewe,r /line. P�R�/ �/ Lot _ 7� Block _ 8(v P Addition �/�iG�_ __ . ... .......:...3i"czZ� Address _ (¢ <o U... .... .. _[1' _. .. ..._ ... _ ...... _ . Owner ��/� .C/1./[,c21�> `,��i G/ �t!�Q- . Plumber �-� C� �t-�Y�r� _ Cl!c.�!-s�._. _l�wc� (this portion of form to be completed b�person requesting tapl CHARGES TO BE PAID BEFORE TAP IS MADE — WHERE ASSESSMENT HAS NOT BEEN LEVIED AGAINST P�20PERTY Sewer Connection fee . .. .._ ._ 'Street patch ........_ .. .. .._. ______. Water Connection fee Meter deposit . Materials used 'Street patch .. . ' Where applicable ' � The above applies for all regular residential size sen•ices � �� , e-o 5�p�� -a � e--�C� �l! „Z�AU IF LATERAL ASSESSMENTS HAVE BEEN LEVIED AGAINST THE PROPERTY, THERE WILL BE NO CHARGE5 OTHER TFIAN CONNECTION PERMITS AND METER DEPOSIT The City will furnish materials for water service and the plumber will bill the City for sewer, not to exceed $3.00 a foot or a maximum of $60.00. ASSESSMENTS TO BE LEVIED Water Lateral Credit for material Total assessment Sewer Iateral Credit for material $ ...��.__. $ . .. . .. _......._........... $. .. ._ ................_... 60.00 Total assessment $....._. ..-.—:.U._.'....... Clerk's signature / �(.�_:2 x�r. �:z .1.�--l.12CE-n-2:Q-Y/.�F �� I hereby authorize the above tap _ _ _. __ __ _ lst copy—Public Works Uirector of Public Works _.�=-E�- PERMIT NO. ��Citv of Fridlev 19497 �"��'°°°`r��rw'�s� �' gUILDING PERMIT � - � � AECEIPT NO. ' ' COMMUNIry DEVELOPMENT DIV r � y vROTECTNE �NSPECTION SEC I'Z�,Fj j i � � �""1 � GT'/ HALL fPIDLE� 55<72 �+uueeP AFV onrE e<eE o� acvq��.pc Br 1"'"�" �� 612-571-3450 g�0-Ft5 5/31/SS / / ioe nooaess 6600 - 04 Central Avenue N.E. 1 LEGAL ��T NO BLOCH TRACT OR ADDITION $EE ATTACHED oESCa 4G 2nd Revised Aud. Sub. #21 sHEET 2 PFOPERTYOWNER MAILADDRESS ZIP PHONE Gregg Hinz 6600 - 04 Central Avenue N.E. 3 CONTRACTOR MAI�ADDPE55 ZIP PHONE UCENSENO Anderson Exteriors 2910 - 118th Lane N.W., Coon Rapids 755-6531 d ARCHITECTORDESIGNER MAI�ADORESS ZIP PHONE LICENSENO 5 ENGINEER MAILADORESS ZIP PHONE LICENSENO 6 USEOFqUIL01NG Residential 7 CLASSOFWORK .., NEW �-� ADDITION C A�TERATION F� REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reside Ilaelling 9 CHANGE OF USE FROM TO STIPULATIONS SEPAFATE PERMITS ARE REOUIRED FOR ELECIRIGAL. PLUMBING, HEATING. T�PE OF CONST OCCUPANC� GROUP OCCUPANCV LOAD VENTI�ATiNG OR AIF CON�ITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTqUCTION ZpNING SO.FT CU FT AUTHOPIZED I$ NOT COMMENGED WITHIN 60 �AYS. OR IF CONSTRUCTION OR WOFK I$ $USPENDED OF ABAN�ONEO FOR A PERIOD OF 120 DAV$ AT ANV TIME AFTER WORK IS COMMENCED NO DWLG UNITS OFFSTFEET PARKING � HEREBY CERTiPV TMAT i HAVE READ AND E%AMiNED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LqW$ yq�UATIOF $URTA% AND ORDINANGES GOVERNING THI$ TYPE OF WOAN WILL BE COMPLIED $1�85� $�gg WrtH WHETHEA SPEQFIED HEREIN OP NOT THE GRAN�WG OF A PERMrt DOES NOT PFESUME TO GIVE AUTHORITV TO VIOLATE OA GANCEL TME pERMITFEE SAC CHAPGE PROVISIONS OF ANV OTHER STATE OR LOGAL LAW REGULATING CON- $43.00 R CTION R THE PEFFpqMA%N �JOF CONSTRUCTIpN ` �^ / / � PLANCHECKFEE TOTALFEE C� � ,� 3! �G $43.93 SiGV<t�PEOFCCNicp�iOPCA<�'r.pa�2E?>GEh* � E� VyHEN PRO�EALY VHYfQGTE� THIS IS VOUA PEAMIT _ / _ - - � x< , � � � �; �._ ; �c_ � 3/ "<�t <%� s��.- -E . :.,:_ ._�F_ :� -- _> E - — � 2� [ 7 City of FYidley Effective 5/L88 AIJDN [ 7 R-1 AbID R-2 AL'1£R [ ] Wnstruction Address:_ I�1 Ti2SCI1j�1Q1• �C:d m,;�ding Permit Application , `i .: -C1� C_ �_ �� ' /r - ,.' f,� CY d <:_ Owner N�ne & Address: �� r�GG ��N .' � �� - �� r .,� �� Tel. # ! ` Contractor : � '� ��. � _>� -�✓ � �. �s�' r�r , r� �� - Tel. # �" � 1 � : �_,°i _ �. � � Address : ��-� � • � C < t . � � �,'� � i', i �. : : r:T;�TN : �_a,«: ; : �/Y.��: Attach to this appl ication, a Certif i.cate af �cvEy of the lot, with the proposoed construction drawn on it to scale. DESQt7PPI0N OF I!lPRWII�tdP Length Width Height Sq. Et. Length Width Height S�. Ft. Length �_ Width Hgt/Groimd _ 93. Ft. ,t� e' _ �� ,z:. Cbrrer Lot [] Znside Lot [] Ft. Yd Seth3ck Zj�pe of Construction: -,": � -� c f/ �. ApQrox. Completion Llate: Proposed Dciveway Width If New Opening Is Desired: _ Side Yard Setbacks _ '; J„ `' _ Fstimated Cost: S / c' �� Width + 6' � - � � � IY,TE : � 7 � G� cr APPLICp,Nf : ,��' 2-.� ✓ L � ,; _ � . - QTY USE Qd,Y Peffiit Fee State Surchazge SAC (hazge Driveway Escrow Park Fee Sewer !lain Chazge TOTAL . �. .� • . S "� ,�,�. S 7� S S & $ , - �,, i-� `/_ `/� .�� Alt. A Alt. B S See Back Page TP1. # -�)! � � �/ F�e Schedule on Reverse Side 5.50/Si,000 Valuation 5550 per SAC Unit Alt. 'A" or Alt. 'B" Above F�e Detecmired t� F}�gireering Agreenent Neoessary [ ] Not Neoessary [ ] �: il7 'i�i�. '�:w Y J `.«.ir�. 1 The Chief Building Official shall, before issuing permits for the erection of any t�uilding or structure, or for any addition to any existing building or structure, or for any altetation or repair to any existing building or structure, upon application therefore, require the g�ynerrt by tl�e applicant for such permit of fees to the amount herein below set forth and in the manner herein prwided tmwit: 'It�TAL VALUE S1 to 5500 5501 to 52,000 52,001 to 525,000 S?5,001 to 550,000 550,001 to 5100,000 5100,001 to 5500,000 FEES S15 Qlinimun Fee is S15 glus surcharge) S15 for first 5500 plus S2 for each additional 5100 or fraction thereof, to and including 52,000 S45 for first 52,000 plus S9 for each additional 51,000 or fraction thereof, to and including 525,000 5252 for first 525,000 plus 56.50 for a3ch additicnal 51,000 or fraction thereof, to and including 550,000 5414.50 for first 550,000 plus 54.50 for each additianal 51,000 or fraction thereof, to and including 5100,000 SQ9.50 for first 5100,000 plus 53.50 for each additional 51,000 or fraction thereof, to and including 5500,000 5500,001 to 51,000,000 52039.50 for the first 5500,000 plus S3 for each additional 51,000 oc fraction thereof, to and including 51,000,000 51,000,001 and up 53539.50 for the first 51,000,000 plus S2 for each additional 51,000 or fraction thereof �):ii��:�: � �• ; a • � � ^r:•t. . - - • . • Alterriate "A": R�nwal and replacement o� curb and gutter only - Dziv�ay width plus 6 feet times 513.50. Alternate "B": Renwal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width glus 6 feet times 515.75. �+��• • . � • i�. 1, � • �,� Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the wnstruction site. A Certificate of Si�rvey of the lot, showing the location of the foundation once it has been oonstructed will be required before proceeding with the franing. ! .��x�� Cit�� of Fridley � """E'°`°""E,""'"5 gUILDING PERMIT ; � . GOMMUHIIY DEVELOPMENT DIV r � � � PROTECnVE INSVECTION SEC , � , ; � -- �' �'-'1, � CITV HALL FRIDLEv 55a32 �+�,MeFn ` 612-571-345D 9t0-F�5 ioe nooaess 6601 Central Avenue NE RFv t LEGAL LOT NO BLOCN TPACT OR AODITION oesca 9-10 Dennis Addition 2 PROPERTVOWNER MAILADORE55 Ronald Ennis 6601 Central Avenue NE 7 CONiRAGTOR MAILADDFES$ 0>*E ✓e 10/16/95 � ZIP Same a ARGHITEGTOA�ESIGNER MAILAD�AE55 Z�P 5 ENGINEER MAILADDRESS Z�P 6 USEOF9WLDING Residential ] CLASSOFWORH . I NEW ., ADDITION Ci ALTERATION O REPAIR R 8 �ESCRIBE WOtiK Reroof House & 9 CHANGE OP USE FROM 21 Sa) Tear Off �PERMIT NO. � C E�N O , ��i �c n>vaaveo e. / $EEATTACMED SHEET 574—t105 PHONE UCENSENO VHONE LICENSE NO PMONE UCENSENO ❑ MOVE �"] REMOVE S�iPU�A710NS Underlayment must comply with the State Building Code. Trae oF co SEPAR4iE PEPMi'S AAE REOUIRED FOR ELECTRICAL, oLUMBING. HEA7ING, VENnLATiNG OA AIR GONDITIONING 'HIS vERMIT BECOMES NVLL AND VOID IF WORK OR CONSTRUCTION ZONING AuiHORIZED IS aOT COMMENCED WrtHiN 60 OAYS OF IF CONSTRUCTION OA WOFK i5 Sl�SPEN�ED OR ABANOONEO FOR A PERIOD OF 110 DAY$ AT FNV TiME aF1EF WOFN IS COMMENGED NO �WLG i NEREB'/ CERTIFV iHAT I HAVE REAO 4N0 EXAMINE� iH15 AGGUGATION 1 ANDNNOW THE SAME TO BE THUE PNDCORqECi ALL PROVISIONSOF LAWS yq�UATION 4Np ORDINANCES GOVERNING iN15 TYPE OF WOPN WILL BE COMPLIEO $1�6HO WITH WHETHER SPECIFIEO HEREiN OP NOT �HE GRANTiNG OF A PEPMIT OOES NOT PFESUME TO GIVE PUTHORITV TO VIOLATE OR GANCEL THE pERMIiFEE PRO'Ji$IpN$ O� ANV OTHER $TATE OR LOCAL L/+W AEGULATING CON� $54.�0 STRUCTION OR iHE PERFOFMANGE OF CONSTFUCTipN P�AN CHEC . ��iC�Ni'VRE(j!{/��.'uP'�'�:'�N(1qAV .Vi:f['�CGEN �I]f�lfFi . . WM �.cr/ 50 $iALL$ 0 CU FT OFFSTREET PniiNING IGAPAGE$ $.84 iAC CHARGE Fire SC $1.68 OTALFEE $56.52 �-}�-- Nr;w AUDN AL"1'GR Il II I� Construclion Address: Legal Description: CITY OI� I�RIDL,IiY SINGU: I�AMILY AND DUPLGXGS R-I AND R-2 [3uilding Pcrmit Applicatioo � ! � - , . �� .�'�, , , _ h. ��. i- I�.f3�c;ct;vc 8I119s � ,� Z ( Owner Name & Address: '� �-�� j � < � . � U � 7, �F h,:;`�TeL ti j �' ��j r . �n(� %� I) �,(�l'1 (:.,��iT:�_L Contractor. `,��, ��e _ MN LICENSE !/ Address LIVING AREA: GARAGE AIZEA_ nECK AREA OTHER: Attach to this application, a Certificate of Survey of the lot, with the proEwsed conswction drawn on it to scale. DLSCRIPTION OF IMPROVEMENT L,ength Width Height _ Length Width Height _ Length Width HgdGmund 5�-_ . , r� �� ,:: . ,.. �� , .. i , _ Comer Lot �] Inside L.ot [] Ft. Yd Setback 7'ype of Construcdon: Approx. Completion Date: Tel. �i Sq. Ft. Sq. Ft. Sq. Ft. Side Yard Setbacks Estitnated Cost: $ � '� ; '�' . � (Cost on Back) C)riveway Curb Cut Width Needecl: Ft„_} 6 Ft = Ft x$ _$ :ATE: APPLICANT:'��?J?;/� Tei. N '�y � /��I��'LCC�I?�- CITY IJSE ONLY :'ermit Fee t�ire Surcharge 'itate Surcharge 5AC Charge l.icense Surcharge :�riveway L'scrow 3rosion Control ?ark Fee :iewer Main Charge TOTAL ST[PULA1'IONS: $ �`l. C�` $ l. l� ;' $ �:�� $ $ $ $ $ $ $ y �' ., j � Fee Sc6edule on Keverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $850 per SAC Unit $5.00 (Shate Licensed Residenual Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Ptan Review Fee De[ermined by Engineering Agrcement Necessary [ ] Not Necessary [ ] �r,�: cl /.i'1/i: � . / I3UILDING PGRMIT �EE SCHEDULE The Chief Building Official shall, before issuing permiLS for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair [o any exisdng building or struc[ure, 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 provideci to-wit TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 aud up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $S00 plus $2.75 for each addiuonal $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 oc 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 $574.75 far 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 eac6 additional $1,000 or fraction thereof, to aud including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additiooal $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fractioa thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach witli 6 iach depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for pmper review of the proposed structure and of the construction site. A Certi6cate of Survey of the lot, showing the localion of the foundation once it has it has been consiructed will be reyuired before proceeding with the framing. soenn PERMIT NO. � City of Fridley 2 5 3 7 2 ^"�E'°'°F'�E'W'NS gUILDING PERMIT �'�RE�E�PTNo r � �• GOMMUNITY DEVELOPMENT DIV /�// � � � PFOTECTNE INSPECTION SEL 7�� . � � � �"'1 � GITV HALI fRIDLE� 55�3I NUMBFP AEV D�*f v�pE O� •�oAOVED B• �'""�" �� 612-571-3450 9t0-F�5 $�14/97 � � �oa noor+ess 6601 �l[% Central Avenue NE t LEGAL LOT NO BLOCK TRFCT OR AODITION SEE FTTACHED DESCR 9, 10 Dennis Addition SHEET 1 PROPERTVOWNEH MAILAODRESS ZIP PMONE Ronald/Shirley Ennis 6601 Central Avenue NE 574-1105 3 CONTRAGTOR MAILADDRESS Z�P PMONE LICENSENO Same a qRCMrtECTORDESIGNER MAILADDRE55 ZIF PMONE LICENSENO 5 ENGINEER MAILA�DHESS ZIP PHONE LICENSENO 6 USE OF BUILDING Residential 7 CLASSOF WORK C NEW G ADDITION ❑ ALTERATION � REPAIR G MOVE C REMOVE 8 OESCRIBE WORK Reside House 9 CHANGE OF USE FROM TO STIPULATIONS Install building wrap and have inspection of same unless manufacturer's specifications state it is not required. 7YPEOFCONST OCCU�qNCVGROUP OCCUPANCVLOA� SEPARATE PERMITS nRE REOUIREO FpR EIECTRtCAL. PIUMBING. MEATING. VENTiLqTING OR AIR GONDITIONING THIS PERMrt 9ECOMES NULL AND VOID IF WOFK OR CONSTRUCTION ZONING $O FT CU FT /•UTMOR4E0 IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK I$ SUSPENOED OR ABANDONED fOR A PERIOD OF 120 DAV$ AT ANY TiME AFTER WORN IS COMMENCED NO DWLG UNI75 OFFSTPEET PARNING I MEREBY CERTIFV TMAT I HAVE READ ANO E%AMINED THI$ APPLICATION 1 $T4LL5 GARAGE$ AND KNOW THE SAME TO BE TRUE ANO CORREGi 4LL PROVISIONS OF �AWS yq�UATION $URiq% ANp OFDINANCE$ GOVEANING THi$ TYPE OF WOFN WiLL BE GOMPUED $1 8OO �.JO WItM WHETHER SPECIFIED HEREIN OP NOT THE GRANTING DF q pEFM1T ° �OES NOT PRESUME TO GNE P.UiMORITV TO ViOLAiE OA CANCEL iNE pERMITFEE $ACCHARGE PAOVISIONS OF ANY OTMER STATE OA LOCAL L/+W REGULGTING CON� �S6.�S F1L0 SC �L.HO STRUCiION OP TNE �ERFORMANCE OF GONSTRUCTION PLAN GHEGNFEE T TnLFEE 59.45 sicm4luaEp�cOm"a>f.ioPOaa�iMOAVFDSGE�+* �o�rE� EN R V VAL ED iHiS IS Y UR GEPMI � • �.L L i-,w— . �` ' /''' � � � � � 5. N daFO�OwN P,aOW�EABV�IDFa� �D��Ei gi _ 1\�LYY ADllN nL�rt.iz I I II II ConstructionAddress:_ 1_egal Dcscription: Owner Name & Addmss: Contracror: Address: � LIVING AREA: GARAGE AREA DECK AREA: OTHF,K: CI"CY Ol� I�RIULI�;]' SING1,1? I�Ai1�lI,Y ANll DUPI,I'sXFS R-1 M�D K-2 I3UfLllING PIiRM[7' APPI,ICi1'1'ION �� C dl't .rtt I � �= � �'�i H l�o l 2�� F.ffccti�-c 1!U97 �P�`�53 � � ,l� I -`, Tel. # .S 7�—//�_F� MN LICENSE # Atlach lo U�is application, a Certificate of Survey of the lot, with the proposed coostruction drawn on it lo scale. Lcn�di Length L.ength I)ESCRIP'1'ION OF IMYROVEMrNT Widttt Width Width Tcl. # Height Sq. Ft. Height Sq. Pt. Hgt/Ground Sy. Pt. �'� �;��"/� �/ � Construction Type:�_ S,��C � rt P_stimated Cost: $ �p�— (Fee Schedule on Back) Driveway Curb Cut Width Necded: _Ft. + 6 FI = Ft x$ _$ nAT�: _ �:'S� �� nrrLrc.a��rT: `� ��r� �-�� 'rei. a57y�-1/05 Permit Fce Fire Surcharge S[ate Surchar,�e SAC Char�c , License Surcharge Driveway Gscrow Erosion Control Park I�ce Sewer Main Charge �r��rni 5�rii�� i.,,��i�>��s: <- f ,, - � -� �- i_S � i , �`{� $� $ $ $ � - -- � `� — ; .Sj l�- CITY USE ONLY Fee Schedule on Reverse Sidc 001 of Pennit Valuation (1/lOth%) $_50/�1,000 Valuation $950 per SAC Unit $S.pO (State Licensed Residcntial Contractors) Alt "A" or Alt. "I3" tlbove $450.00 Conscrvation Plan Revicw I�ee Dcterniincd by Enginecring A��rcemcnt Neccssary � j Not Neccssary � � � iiui�.��i�vc ��i�;iz��rr F�.�, sc►�c��.i�: l�lic Chiel 13uilding Ul�ici:il shall, be�i�re issuing permits for the ercction ��(' any buildim� or structurc, or i��r ainy additiun to any c�isiini, buildfn� ur structurc, or for any ahcration or rcpair to any cxisting buildine �>r suuccure, upon applicatiun ihercfore, require the paymen[ by Uie applicant t�x such permi[ of fees to the amount hcrcin belo�v set I'or�h and in the manner herein provided to-wit: TOTAL VALUIi �1 to $500 �� [O �2,�� 2,00] to $25,000 $25,001 to $50,000 $�0,001 to $100,000 S100,001 to �500,000 �500,001 to $1,000,000 51,000,001 and up PEGS $21 (Minimum Fce is $21 plus surcharge) Y $21 for first $S00 plus $2.75 for each udditional $100 or Craction thereof, to and including $2_000 $62.25 for firs[ $2,000 plus $12.50 tbr 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 $574.75 for first $50,000 plus $6.25 for each additional �1,000 or fraction thereof, to and including $1p0,000 $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 first $500,000 plus �4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,000 plus �2.75 for each additional $1,000 or fractioo thereof DRIVEWAY DEPRESSION ESCRO�b' (Concrete Curb StreeLS Only) Altcrnate "A": Removal and replacement of curb and gutter only - Drive�vay width plus G feet times $L.�O. Alternate "B": Rcmoval and replacement of curb and gutter and ins[all a; foot H�idc approach with 6 inch depth - Driveway width plus G feet times $]SJ�. VER[rICA'fION OI� EODNDAT[ON Pcrmits tor const�lictiun nvill be issued a miniinum of 24 hours from the timc of ap�lication to allow tbr pro;�.r rcvicw of tite ��r��>osed strucWre and of the construction si[e. �A i_'c�tiliauc u1 tiun�ry nl�;li� I��i, shou�[ng thc I�icaUon uf (he ti�unda[i�m ��icc it has it has I�c�n cnnstru.'� ! �ti : h:� rcyuir�:�l h.•In;;� „r,�i ��.liu�� v.iih Ih�:� fr.imim�. .. . SoB�EC* .� City of Fridley 2 5 8 3 9 A"HE'°`°"�ETW'"5 gUILDING PERMIT , RECEIPI NO. • COMMUNITY DEVELOPMENT DIV �) r � � �ROTECiIVE INSPEGTION SEC Q/ / � � ( J � � � ��1 ' CITY HA�� FRIDLEY SSa72 NUMBEA AEV O>iF P�GE O� OGVRO�E� BY �'""�'' '� 612-571-3450 9�0-Ft5 3/10/98 � � ioe aooaess 6600-6604 Central Avenue NE + LEGAL �OT NO BLOGK TRApT OR �DDITION $EE nTT�CHEO oesca 4G Auditor's Subdivision 1121 2nd Revised sMeer 2 PROPERTYOWNER MAILADDRES$ ZIG PMONE Greg Hinze 571-1552 ] CONTRAGTOR MAIL ADDRESS Z�P PHpNE UCENSE NO Ace Construction 6230 218 Ave NW, Elk River, MN 55303 323-3019 20001884 a ARCNITECT OR DESIGNEP MpIL ADDRE55 ZIP PNONE LICENSE NO 5 ENGINEER MAIL ADORE55 ZIP PMONE LICENSE NO 6 USE OF BUILDING Duplex 7 CIASSOFWORK C NEW C ADDITION ❑ ALTERATION I�, REPAIR G MOVE C REMOVE B �ESCRIBEWOHK Reroof Structure (29 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TVPE OF CONST OCW�ANCV GFOUP OCCUPANC� LOAD SEPARATE PEFMR$ APE REOUIPED FOR ELECTRICAL P�UMBING, HEATING. . VENTILAiING OR AIR GONDITIONING iH15 PEPMIT BECOMES NULI AND VOIO IF WORN OR CONSTRUCTION ZONING SO. FT LU :T AUTHORIZED �5 NOT GOMMENGED WITHIN 60 DAVS, OR IF CONSTRUC�ION OA WORN i5 SUSPENDED OR ABANOONED FOR A PER100 OF 120 OAYS AT ANV tIME AFTER WORh IS GOMMENGED NO DWLG UNIT$ OFFSTREET FARNING I NEAEBY CERTIFV TMAT I HAVE REGD /ND E%AMINED TMIS APPLICATION Z STA��S GARAGES AND KNOW THE SAME TO BE TRUE ! NDCORFECi ALL PROVISIONS OF �AWS yq�UATION SUA�R% 4N0 ORDINANGES GOVERNING iM15 TYPE OF WORK WILL BE COMPUEO @ WITH WHETHER SPEGFIEO HEREIN OR NOT THE GRAN�ING Oi A PERMIT y+2.��IIH �1.21 �OES NOT PFESUME t0 GIVE AUTHORITV TO ViOIATE OR CANCEL THE pEqMIiFEE SACCHARGE PaOVi510N5 O� ANY OTMER $TATE OR LOCAL LAW REGULATING CON- @ S�RUCTION OR TNE OERFOAMANCE OF CON TiON �74.75 F1T0 SC p2.�i2 ��cc /��C�� O vLANCNECKFEE TOinLFEE � � C L'cense SC $5 00 $83.38 cip.�nr,pE.� CC�•�"��+CrO4DAe��CA:EU>GEn* 0 E� yyNEN GRO�EAL1' LIOATED THIS IS VOUA PEAMiT) SiGNa•lIqE0�01NNfP�tOWNfPBU�L�EF' i�1lE� �/ ��I a�o �ns� �_-__ NEW ADDN ALTER [ � [l [l C1TY OF FRIDLLY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/98 ,i� ;'��t1k'I ConstructionAddress: � �C� ' (,. 4. C'� � ' �� ' - � /-i NC� i�C - L.egal Description: Owner Name & Address: �-��, z r TeL IJ ,-7� - i s; 2 Contractor. j� << ( �,� �`S f _MN LICENSE t! ,�r^� �: - /k 5' `� Address: (. �'c 3�k �"` �� L l[� l�.e - ,,.. Te1.11 3>z ;.i i- S.� 3 Attach to this application, a Certificate of Survey of tl�e lot, with the proposed conswction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: I,ength I,ength Length DESCRIPTION OF IMPROVEMENT W idth Width Width Height Sq. Ft. Height Sq. Ft. Hgt/Ground _ Sq. Ft Construction Type: � �,�c �,- o �-� � �-� . ,, 5 �c Estimated Cost: $ � �� - � � 7 �� (Fee Schedule on Back) Driveway Curb Cut Width Needed: _Ft. + 6 Ft =_Ft x$ APPLICANT: ii��% �. -�'�/�:-c ��... ;` TeL N i,13 �:�i � DATE• ;/ :�n �—T Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ �/� ! :'� " : $ �. �i,l $ /.�/ $ $ S C��' $ $ $ $ $ CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conserva[ion Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 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 aiteration 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 manncr herein provided to-wit TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for firs[ $500 plus $2.75 for each addi[ional $100 or fraction thereof, to and including $2,000 $62.25 for firs[ $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 $574.75 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 frac[ion thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction [hereof, to and including $1,000,000 $5012.25 for the first $1,000,000 plus $2.75 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 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper teview of the proposed struc[ure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been cons[ructed will be required before proceeding with the framing. ; n b n. � v � y 1 �� = W � N ' � � � � + IU N � �'LL � g . I � � N C R m U QI . ; — I ..., �. C v. P� � � � d � � O . C� Q i J I LL N U � w I N W C 3 i z O � 'N � I W m r � U m) J '— �' i C9 O r Z � � �y ❑ I W.�...� 1 .:. m s �i O � pl I W a tL� � �–_— _ .. . . ... .. � F L x tn T – N N LL�� o. � �, t W�, m � � z 3 Y � ¢ L � � �� ._ 1 r...J-..�. I � C I � � N � m� i N C1 UI_� � �. — � E � c� c� v N o ro o 0 0 0 (n �1 lL LL ll lL � � w Q � � ¢ m 0 � � � N � d d � t � � y O � O. T : � U � « � i � 1 O y t c 3 : E �, < N U � d C < � �0 l a • o `o � U C U � O m 1 N � T U f Q � � d C � n N y 'j Y � ' � 3 � E m i T � � � � I � � . � � L � -p C : N p� C � � I N � I d � � � i C � � �U N N � i Q I F a � � m m U � � \ `o_ U a C m d � _ � m� 0 �io �:1 I U � � �o. a N w 1 Y I C n � I � a � N � C i O ' � � C 1 � n v a � d 1 � 1 � 3 Q �., � ` �R N � � � N Z ll � J I � 0 Z � ` � Q W a \ N � � N 0 a U � a � � C cS � E � N m W � Q-.., , . a � � U � } Z m m � � W � Z J � G � �► � 0 0 0 0 0 0 0 0 0 o a� o 0 0 0 0 0 0 0 0 0 0 0 0 0 W r� 'v �n r� n r � o � o 0 0 � Qt» vi tA tn tA t» fn en � vi Ni �n � Q � I I Z N % � � d w � Q � d Q V Q1 Q K y C U Q m ' Q LL N d U ro d � 3 �, � a °' �ry � d w a, X. Z� � m� m I I � LL y � � � � � � C J 'pZj ' a U1 N � n. m tn p`� U i0 itl m X Q N� m c0 Q F== ro �` � N � Q LL � � 0 L� a N N N�� U 2 � 3�°' o� � E m m m � a z O m m U� c�n 3�� C7 (7 m N m � _ O1 O Q � � m � w > 0 d d Q .`� o �� , �� Z � � G � u w W ~ L J Q � C � U L ~ Q � U O [n _ J � d � Q d W a a �s 0 w `o in o � v � c� O x � O °' Z LL � Q `o LL � � ] U W � _ � O O C J 3° 2 Q ^ _ _ CIiY OE FRlDLEY FRIDLEY btl,'tiICIP�.L CEYTER • 6d3I Utif�'ERSITY' AVE. �.E. FRIDLEY. �iti 55-t_'_ • �763) 571-3�1�0 • FAX (763) 571-1'_37 May 6, 2002 Ronald & Shirley Ennis 6601 Central Avenue NE Fridley MN 55432 Re: Paved Driveways Dear Mr. & Mrs. Ennis: In 1997, the City Council adopted an ordinance declaring gravel driveways a public nuisance. They were declared a public nuisance for a number of reasons, such as: they can cause erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in the City's storm sewers and detention ponds. When gravel driveways were declared a public nuisance, the City Council gave property owners five years to have their gravel driveways paved. The five-year deadline is quickly approaching, which means all gravel driveways within the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002. If on December 31, 2002, your driveway hasn't been paved a citation will be issued and filed at the Anoka County Courthouse. A misdemeanor citation is a criminal offense and is punishable by up to 90 days in jail andlor a$700 fne. If you've already paved your driveways, Thank you! Please call me at 763-572-3595, so I can update our files. For your convenience, a brochure on the City's loan program has been enclosed. You can use this loan program to acquire financing for your driveway improvement project. Please cali Jim Hesnik at 612-335-2651, if you have any questions regarding this program. Thank you for your cooperation! As you successfully complete your driveway improvement project, please call me at 763-572-3595, so I can do an inspection of your property and update our files. If you have any other questions, please feel free to call me at the above number. Sincerely, Stac StYombe��SLB " Y 9 Planner C-02-53 _ _ Ct11' OF F'RtDLEY FRIDLEt' SIC`ICIPAL CE�TER • 61±1 C�IVERSITI' AVE. ti.E. FR[DLEY. �IV >�J3'_ • t?631 �71-3�350 • F?.X (76?) 571-1_3? July 2, 2002 Ronald & Shirley Ennis 6601 Central Avenue NE Fridley MN 55432 Subject: Paved Driveway Reminder Dear Mr. & Mrs. Ennis: This letter is a friendly reminder that all driveways within the City of Fridley need to be paved by December 31, 2002`. As you are aware, the City Council adopted an ordinance declaring gravel driveways a public nuisance. They were declared a public nuisance for a number of reasons, such as: they can cause erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in the City's storm sewers and detention ponds. When gravel driveways were declared a public nuisance, the City Council gave property owners five years to have their gravel driveways paved. The five-year deadline is quickly approaching, which means all gravel driveways within the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002". If you've already paved your driveways, thank you! Please call me at 763-572-3595, so I can update our fles. For your convenience, a brochure on the City's loan program has been enclosed. You can use this loan program to acquire financing for your driveway improvement project. Please call Jim Hesnik at 612-335-2651, if you have any questions regarding this program. Thank you for your cooperation! As you successfully complete your driveway improvement project, please call me at 763-572-3595, so I can do an inspection of your property and update our files. If you have any other questions, please feel free to call me at the above number. Sincerely, Stacy St mberg Planner 9f on Oecember 31, 2002, your Criveway hasn't been pavetl a citaticn will be issued and filed at the Anoka Counry Courthouse. A misdemeanor citation is a criminal offense and is pumshable by up to 90 days in jail andlor a 5700 fne. C-02-83 BU1�Ci117Q Inspections 763-572-3604 DATG (1 '- :X•. SiTE .ADDRESS THIS APPLIC.AI��T IS PROPERTY OWNER/ TEnA�T COVTRACTOR BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL .ADDRGSS _c✓}-l�ck Fu'L ❑ OW?IER �CONTRACTOR �1Jh i:a+.�e�5 �-' `I� ESS CITY ,� F;,�s— f;�i —'��R � Permit Received By: Date Rec'd: SUBMIT A COPY OP STATE LICENS-Et d EXP DATE 1'OUR ST.4TE LICENSE ADDRGSS: , 1%�O r�0 vv1ViV1 Rc� CITY i.�; �(.. S7ATE%�LIP i�� R'ITHAPPLIC.ATION PHO�E /;�r;l"F-��`?'�OFJ�Z F.4J( PROPERTY TYPE � st1dGLE Fnt��u.vrNEw CoNSTxUCnc �TWO FAMILY'/NEW CONS'fRUCTION NERVi1T TYPE ❑ 6.4SEMEKT PINISH ❑ ROOF ❑ D�Ck ❑ SIUING ❑ SA'IMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAI\TH�ANCEREP.41R � REMODELNG DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT ROOFI\G NUM19BER OF SQUARES GAR,IGES PROPOSED SIZG PROPOSED HEIGHT: SIDI�G ❑ Vinvl ❑ Aluminum ❑ Other ❑ HOUSE 8 GARAGE ❑ ATTACHED GARAGE ❑ DETACHED G.VtAGE ❑Soffu ❑ Trim ❑ Fucia �i7NDON'S IN ESISTNG OPL-'�(IdGS �'es ONo LOCATION OF R'I'JDOWS OR FOR NE�i' OVENIVGS- ESCRIBB SIZG OF OPENMG CHANGES & n , , ❑ DR.�Ut< TII.G ❑ OTHER WIDTH � HEIGHT � S . Ft. BASEMENTRL-MODELMGSUBbIIT�. 1. Existing Floor Plan 2. Proposed floor plan 3. Lis[ of swc[ural mcmbers ro be used FOR NEW CONST'RUCTION MCLUDMG DECKS, .4DDITIONS & PORCHES SUBMIT�. 1. Srte PIaNSurvey showing Ihe ezistine swc ures and proposed project. 2. Two sets of cons[ruction plans 3. Energy Calculations .4LL FEES .4RE BASED ON VALG.4TION, INCLUDING THE COST OF LA (US �G THE 1997 U.B.0 FEE SCHEDtiLE) TOTALJOB VALUATION �;�i CC�� OCCUPANCY Permit Fee Plan Review Surchar�e Fire Surchar�e License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Chzree Tocal Due $ . See Back Paee for Fee Schedule S 65°ro of Building Pertnit Fee � .• (.0005) times the total job valua[ion - Minimum $.50 $ . .001 x Permit Valuation (1/10%) $ ls , QQ $5,00 (S[ate Licensed Residen[ial Contractors) $ �1450 per SAC Unit (Plans to MWCC for determination) $ ft+6ft° fix�20=$ $ i450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Von Necessary ( ) $ f �:� ?%l "'!ake checks oavable to: Ci[v of Fridlev Attach TH15 IS AN APPLICATION FOR A PERMIT VOT V.4LID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will te in conformance �vith the ordinances and codes of the Cip- of Fridley and with the Minnesota Construction Codes; that I understand this is ��ot a pennit but only an application for a permi[ and work is not to start without a permit; that the work will be in accordance with the appn>ved plan in the case of all work whi!ch requires re ew and approval of plans. SIGNAT�RL-UI�APPLICAI��T �ur�� PRItiTNAME I�� '��TU4()I DATE U�c�}Jy�L,_ Page 2- Building Residential Application . BtiILDING PERAIIT FEE SCHEDULE rhe Chief Building Official shall, before issuing permits for the erection of any building or structurc, or for any addition to any existing building or structure, or for any alteration or repair ro any e�isting building or structure, upon application therefore, require the payment by the applicant for such pem�it of fees to the amount herein below set forth and in the manner herein proaided to-� it: VERIFICATION OF FOL'NDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot. showing the ]ocation of the existing foundation will be required before proceeding �ith the framing. New Houses Onlv Ciry of Pridley Building Inspections Department 6431 University Avenue NE Fridley, MN �5432 763-572-3604 Fax: 763-�02-4977 � �) � � . � � � vl Jti � � , � ` .._� �� w v ' i_i 1 .. �pz a� ��// w v � w0¢ °- �� C V`� � i ti ' � ---�' I ' � ` � �� o � � � M � � . . _ 4/ �i' ti-_� � -�-�` ,�-��-�'�-------- ___ ------------- � � � � v� �-;� _�'� __ ----- - - __. - � -- .---- � �--�-�--►� - -�--- �- — - ,, �� f J � �- -------- - - ----?-"--- � � 2 0 �- -�7 �r- h ✓� `.� �V'I � .,'� � -� - ----- X — -��-- -----3=� � n � �_ � ---- -- —�-----�-- � — � � ►, - --'� - , _ ._____ __� __ _ �� -_ _-_�_- --^� �- _� _ _ - ---- ___- - � ._ _ _ ___- __--_ ---__ _ _ ---=r-- _ ��-- -� -�—! ! � _ �--'�'-- � =� - -� . �� _�,--�- _-� �o � ; � ► -� 10 y d M � � O� � � � �� -� W �' �� 3 � �'� � � �� =,. � .� --- :s� � �—`''— C�— �� . 6 Buildi�ig � Tnspections 763-572-3604 SiTE ADDRESS THIS.4PPLIG4]<TIS. PROYERTY OWNER/ TENANT CONTRACTOR S1JI3�1IT A COPY OF S'OUR STATE LICENSE ��'1l'H .4PPllCAT]OV PROPERTY TYPE PERMIT TYPE 'I'Y"PE OF WORK: BUILDING RESIDENTIAL APPLICATION v 6U � Ok'�EA NAh1E: ADDRESS' % PHO`�]E-. 6 /r� raME STATE LIC6NSE k ADDRESS: PHO\E CITY OF FRIDLEY E-MAIL .4L Ce,� �CO'.4TRACTOR ❑ TN'O FAMIL}'�'NEW CONS'CRUCi'ION �2 S FAX E�P DATE �BASEMENT FI:41SH ❑ ROOF ❑ DECK ❑ SIDING ❑ SN'IT9Mf!4G POOL DESCRIBE \�ORK BEING DONE SIZE OF Ib�IPROVEMENT 4+'2 ROOFI�G tiliMBER OF SQUARES GARAGES FROPOSFD SIZE�. PROPOSED HEIGHT�. SID ING ❑ Vmvl ❑ Aluminum ❑ Other _ '(niF LENGTH ❑ HOUSE ONLl' � HOUSE & G.4RAGE ❑ ATTACHED GAR.AGE ❑ DETACHED G.4R.4GE ❑Soff�t ❑ Trim O Fascia N'[NDOW'S RJ EXISTING OPENMGS �Yes �NO LOCAiION OF 0.'INDOWS OA FOR rEW OPENI'.JGS-DESCRIBE 5[ZE OF OPENRJG CH.4NGES & o iv s(� �v Permit No.:� Received By:_ Date Rec'd: � c�sf. �'ve _CI7Y STATE_ZIP ES i7 V.'INDOV.'S ❑ DR4RJ T1LE O OTHER � Si e5 0 J �y�^^�n- TH HEIGHT S . Ft. BASEMENT AEMODELRJG Sl;BtvllT: . ]. Existing Fluor Plan ' 2. Proposed floor plan � 3. Lis[ of svuc[ural members lo bc used FOR I.'EW CONSTRUCTION RvCLUDNG DECKS, ADDITIONS & PORCHES SUBMIT� L Site Plan/Survey showing the existin� stmctures and proposcd projec[. 2. TH�o seLS of construction plans 3. Energy Calculations ALL FEES .ARE BASED ON VALUATIOV, I:VCLtiDING THE COST OF LABOR .4ND DIATERIALS: (USIN THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ ,SOl7✓ OCCUPAM1CY TYPE Yem�it Pee Plan Review Surchargz Fire Surcharee License Surcharge SAC Char�e Curb Cut Escro�v Erosion Control Park Fee Sewer Main Charge 7'o[al Due � �� i. as $ � ^ — � � $ ` \..,1 $ � � Q� $ $ $ $ $ See Back Pa�e for Fee Schedule 65%of Buildine Permit Fee (.0005) times the to[al job valuation — Minimum 550 .001 x Permit Valoation (1/10°i6) $�.00 (State Licensed Residential Contractors) �1450 per SAC Unit (Plans to MWCC for determination) ft+6k= fta520=� �450 Conscn•ation Plan Re��iew Fee Determine�d by E�gineeriog Agreement necessary ( ) Non Necessary ( ) THIS IS .AN APPLICATION FOR A PLAD1IT-NOT VALID UTTIL PROCESSED 1 hereby apply for a buildin, permit and 1 acknowledge that the informa[ion above is complete and accura[e; tha[ the �a�ork will be in conformance with the ordinances and codes of the Ciry of Fridley and with the Minnesota Construc[ion Codes, that I understand this is not a permit but only an application r a pe � an ork is nnt to start without a permit; that the work µ�ill be in accordance with the approved Flan in the case of all �a•ork w i�Ch requi re ew and approval of plans. �n �1d q� � SIG'��ATUREOFAPPLICANT PRINTN.M1E �nMeS T /n`�✓e'QSDATE [ � U Page 2- Building ResidenYial Application BUILDING PERI�7IT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for an� 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 TOT.AL VALIIE $1 to $500 $501 to $2,000 $2,001 to $25,000 $2>,00] to 55QG00 S�0,001 to 5100,000 S]OO,OOI to $SDQ000 $�OO.00I to 51,000.000 $1,000,001 and up FEES (Minimum Fee is ] 00 or fractioa to and 56925 for 1" $2,000 plus $14 for each additional �1,000 or fraction, to and including ��25,000 $39] 25 for 1" $25,000 plus $]0.10 for each additional 51,000 or fraction, to and includin� $50,000 �643.75 for 1" i50,000 plus S7 for each additional $1,000 or fraction to and including $]00.000 5993.75 for 1" $1OQ000 plus $5.60 for each additional $1,000 or fraction to and includine $500.000 $3,233.75 for the 1 fraction to ac�d incl $5,60895 for the 1 frac[ion �wu,wu pms a4. n tor eacn aaamonai �i,uvu or ling S1,OOQ000 $1;OOQ000 plus �3.li for each additiona] $],000 or VERIFICATION OF FOUNDATION Pem�its for construction will be issued a minimum of 24 hours from the time of application to allow 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 before proceeding with the framing. New Houses Onlv City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 , _-__.—._"_—______--___'_ —_arr--__'_. _ � , �. ... ...___ ' - -_. " ' _._._-�—�_-.._—_'_ Y ! _.._ ' "___._" '- . i 1 �-_' � � —`�_ _ ��r-_— ��... :— � _- i._'a' _ _ - II I . . _ \ ' �.. � � % ., A � L'I �V �i � i i � �� - d-S:..r' � C 7 __t_� _ . '_,rl �. _:_ � � _ _ _ _ � i.�� „/ I ; 1 y� ' •,T II/ W I 7. I t.,, �� - I� � . I i. I S - L �: � � ' � ' i � A ' �_� V � i � f _ . - , ��\ I �_.,J.., _ _r _�_II �"'. 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I `._-� . .. � _ . .s. _ _' . �_. _.�_��--� -�-- - _ L_�+---�- �--�-`_�, � ,- � - � � � --r -f_ __ _ � ---_ �- _ -- - � ' - - � -a--� - � �--�- � -�- - I -- . � 1 �- � - _ - -�- -�- � � , , , , -� _ _ _ _ _ - . _ L_-.- �- �-- - � - = , -6-- l _`- ' ' ' - � _ , i , _ _ . .._.. - �- � r---�� __�_ .-- - -�-- � --�--,� _ r- PLUMBING RESIDENTIAL APPLICATION City of Fridley �o� - �� Pertnit Number Received By Date Received NOTE: IF PROPERTY IS NOT OWNER/OCCUPIED- A LICENSED CONTRACTOR MUST OBTAIN THE PERMIT. DATE �� G�� YOUR E-MAI ADDRE S ��v'S ` D/�'I C� S/ ./Ll' / SITE ADDRESS �� iI �7 ' O� �C��/ �R•4I THE APPLICANT IS: (CIRCLE ONE) OWNER CONTRACTOR PROPERTY OWNEW TENANT N,nMe J �M d CITY PHONE 7�� ve,�s n� .P�4 / STATE 9 �—S"� ZIP NAME o I.L RI �'-I� LICENSE # ADDRESS CONTRACTOR � - CITY STATE ZIP IPHONE # FAX# PERMIT TYPE TYPE OF WORK I ❑ NEW FAMILY J" TWO FAMILY � REPLACEMENT TOWNHOUSE � � � • • � • • - ��LCTi7�1�ti�11�ZSti!S3ii1��t.JJlli%� � v_ . � FEES ARE BASED ON $'IC � FIXTURES: (INDICATE TO' �BATH SINK/LAV �, _BATHTUB _CLOTHES WASHER _DISHWASHER PFR FIXTURE, EXCEPT WHERE NOTED �NUMBER OF EACH) _FLOOR DRAINS GAS PIPING (Need City License) �KITCHEN SINK } _LAUNDRYTRAY �SHOWER j _SWIMMING POOL _WATER CLOSET _WATER HTR ($35) _WATER METER _WATER PIPING _WATER SOFTENER ($35) _BACKFLOW PREV. ($75) FOR IRRIGATION �OTHER Permit Fee $ �' C. C� MINIMUM: $15.00 or 5% of cost of the improvement-whichever is Plan Review $ greater on work less than $300 Surcharge $ .50 TOTAL DUE $ C� � L Make checks payable to: City of Fridley THIS IS AN APPLICATION FOR A PERMIT - NOT VALID UNTIL PROCESSED I hereby apply for a piumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance wiN the ordinances and codes of the City of Fridley and with the MinnesoW Construction Codes; Ihat I understand ihis is not a pertnit but only an application for a pertnit 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 requires review and approval of pi I/ NAMEOFAPPLICANT._ �M ��VP�S �-, DATE !I`�i /V� lea type or SIGNATURE OF APPLICANT PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR BUILDING, ELECTRICAL, AND MECHANICAI WORK 6431 UNIVESITY AVENUE NE, FRIDLEY, MN 55432 (763)572-3604 Building Inspections 763-572-3604 SITE ADDRESS _ THIS APPLICAM IS�, OWNER/ TENAAIT SLBMIT A COPY OF YOURSTATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY ;vU 0 �OWNER NAME: M n.�Dx�ss: 6G v v PHONE: ' � � COMPANYNAME:_ COMACT PERSON: _ STATE L]CENSE M_ ADDRESS: PHONE (� e.v 7-��.9 � ❑CONTRACTOR L<' v � ADDRESS �/"�v> 'P,f' S ✓�CITY� EXP DATL- .__ ❑ SRJGLE FAMILY �TWO FAMILY ❑ p7pW ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK Fl�X ❑ TON'NHOUSE �ALTERATION/REMODEL 1- <-o� r+,.� Permit No.: aS�L'� � Gi��n� Received By: Date Rec'd: N7 L S' _ /Ji? STATC!� ZIP�� PER MS 16B.665 the permit fee is a minimum o( 515.00 or 5% of the total cost up to 5500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (Thi�� ould reflect only the cost of labor ) Labor cos[ under $300 =$15.00. Labor cost betu��een $i00 to S500 = cost of ]abor �� x.05 = FOR PROJECI'S WIiERE IABOR EXCEEDS 5500, FEES ARE BASED ON S10.U0 PER FIXTURE, EXCEPT W HERE NOTED. FIXTURES: (INDICATE 70TAL NUMBER OF EACH BELO� MODEL: SIZFJBTU Equipmcntlnslallcd MFG: ��. MODEL: SIZFIB'N MFGt MODEL: SIZEBTU A/C 525.00 FIREPLACE (GAS) f] S.UO _GAS RANGE/OVEN E10.00 .41R TO AIR EXCHANGCER $l5 FIREPLACE (WOOD) 535.00 _NEW GAS GRILL 510.00 BOILER 535.00 _FURNACE f35.00 _G.AS UNIT HTR 510.00 CHI!.�f7JEY LINBR $10.00 GAS DRYER S10.00 _POOL HEATER E35.00 � DUCT WORR SI0.00 _GAS PIPING SI0.00 __VENTILATOR 515.D0 ___ . ....:.................T� �..� �...mzv c�nn . ` '' ;' .'. PERMITFEEEORPROJECTS OVER:$50 'uirnnii�v�a.w.,...••.. --- ... Permit Fee � C_' Numbcr of fiatures @ S 10.00 _ s 510.00 =� Surcharge S 50 Number of fixtures @$15.00 _ x$I5.00 =$ 7OTAL DUE $� Number of fixwres @ 525.00 _ x$25.00 =$ Number of fixtures @ 535.00 _ x$35.00 = S State Surcharge = $ 50 Total = S THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNfIL 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 appli�n for mit and work is not to stari without a permit; that the work will be in accordance with the approved plan in the case of U Wo w�ich requires review and approval of pla� / SIGNATURE OF APPLICANT� L � , ewi.rr NnMe �Ji ^7 �/r � V�'�S� �.4TE / ��3/ U� City of Fridley Building Inspections Department 6431 University Avenue N�, Fridley, MN 55432 763-572-3604 FAa: 763-502-4977 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMESIADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a Oil or solid fuel IMC Chapter 7 with ?vII�1 Amendments b. Natural Gas or PropanelIFGC Chapter 3 with ?vII�i Amendments • 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter S with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR 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 Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines sofhvare may be used for combustion and make up air calculations RUI�C{Itl� }3L!�j.��jG PemulNu.� �� lnspections RCSIDENTIAL APPLICATION xe�e��eas>:_� � 763-572-36U4 C1TY OF FRIDLEY od,exe��d 5" 763-502-4977 FAX r Frn;�•ri�i:i-i-nx U\II�. �'l�c��1�,7 �'�(j'l.� � ti01'R1��1\Il..\UURE�ti ... 1(i � .; �} � (�.�� -- tii u �ui,r.c�,a _ _ _ IIIIt V'I91�-.AAfti ❑ON'6L.R �['Oi�IR.Af`fOR ' b PROPERTYOWNER/ -�Np. �YZI�G-�� Ky�^' -- - .. - -. -.__. --- TENANT I, �vuar.tti ��,oy �,{r�-E /�< N c-irr ��((iy Sr.�rnH!� zm .SS-y�C _ VIIONIi: N1MIi .� [_ �. �u� r) 'nl UC 1�., _ c'OVTRACTOR �ui>Rr•:ss: �J.�, w;�-l�.i�,� �{. ..__ i�rv f✓N_��a-__ti�r:��i�ur�la lr suitmn'.ACOPVOI r��o�c %S1 �SJ� `IO?L -- - r�� -�S-J-(ri1�/__ — YOIIR tiTATE LICICNtiI? — - - - -- - - ST.{TF.IAC9'.ti�G= c'.��(r`i�`r.. . F'_CPD.\7"Id . 3"U j ____. PROPERTYTVPE �NC�.��:r.�uu.r;vraw4•o�s�ra�rc-noN sv.is ❑ 1'li'O F.1MI I,Y hER' CONti fRl Y'fiON SI'ORI IS . . PERMITTYPE ❑.annrnrn �.aa.�cFSi�i�a> ❑��i!�i�ws ! o � �si:�nevr ti��s�� {{aooF ❑ us.�r: ni.e ❑ uFd-F: ❑ S�DI'.�c ❑ on�liR ❑ tiR'MViI;:(: f'On[. TYPEOFWORK: ov�;wn��r,covs�ixuc�nov ❑.�uurnon ❑M.UV'17iN.\K(TRIiP.\IR ❑RHMOUkl.ltit3 UlisiRllilt R"o2I: R6:I�G D0Ati� � <'�'.., c�, � . -f _ �� - �Z1i — - . - - SILIIOPI\IYRO\'li�lb:\i' I.1:\G'17I R7D171 IILIGiff 5 FP RlN)F'IVG �� ❑1101!tiliD\LY R.UF:�11:�7' RF,MODGLNG SI �RW f: Nctiiai�:KOi=s�c.�a�c, _SS �tionsr.�,c.aa.acr. — I fa�stmg Floor Nlan G:\N:1C:F:5 ❑.\1'I'.\('111iD IiAR.I(31i 1. 1}�poFed Ilarr plan PR(1Pf1Cl(U SII.G-. � U4�1'.\(91F.D GAR.1l3I! i. I.i.l of'.fructmal m.mhcre m Fe w:cd PROI'f�tiliU I IIi1Gf IT ; )\(' FOR I:IiN' ['O\S7R1'(`f10V IK('I.1 ��ITG U8('Ati. ;F�, l'iml �Snliil .\DDI170�ti S, }�F['k1liti ti1;I3Vf1T-. ❑ \lummmn ❑'1'nm 1. tii¢Plantiun�nehowmythecuxtingaWi:wrex ❑ fnlwr ❑ Fhrda anJ pmponcd projul. 2. I'wo :cU ni cnnxvuctmn plvu \Vl\UUR'S -. I[n r4� t'alculalinnn IAil.AItiTIAGQPL-.SI':U� Opv; OAo 1.0('.A170'�OFN'!ADO�Iti _. OR F(�I: ]G\l OYIi\I]Gti-I)fSi RIf3IC 51/Ji �1P OPIi\I\G/'ll.\\i31:C t 1..iPIinP\PISUn\1� If1RP:l�tiT:\I.I.IiU VI!MR1dROF\Pltil�\l:ti :11.1. F'F',Eti :�RF: B.\SED ON V�Ll�.�"1'ION. INCLI'UIVG 1'IIF. COST OF I..U30R AYU SIA'I't:Rl \LR: JOB VALUATION S Pcrnitl Pcc Plan Iic� �e�c Pirc Sttrch:uge Surch+�rge L�ccn.c Sivchat�c S.�C Churgc Curb Cul 1{xrow h:rosion l'nntrol Park Pec Scn�cr Main Ch.vgc Q'SINC'Pllli 19`l7l':H(' FF:F: SCIIEDI�I.N:) OCCUPANCY S�r Back P�ge �i�r Pee SchedWe G�°%ni Ruildmg Pennit Fec 901 limcs tlie urial �ob veluatton .00U� � Pcrmit Vxhialinn Minimwu $SU $ $5 00 ;S��te I.icenu;U Residential C��ntraclorsl $ $I RZS per SAC UnA (Pl�ms l�� MWCC li�t detetm�neUOn) � ft+6tt= Its$21=$ $ $�50 Cn�i<cnauon Plan Rc�'iew $ I�eellclenninedh� laigmc,crir� .$ Agrecmenl nece,av� ( ) Non N�ce,.:in� ( ) $ , O Make chrckx pacabir tu: Cih uf Fridlcv At[ach Ililti Iti .\\ APPIJt'.�'IIOK FOR A PIiRVII f-\OI� \'.\I.IU I lti IIL PRQ'HtiSP:D I herch� apph lnr a huJding p rmrt and I acAnnwlcdgc Ihat We mlonnaliun abm'u is enmpktu and accwate. �hat tl�e wmk x dl Ae in contotmanec w dh �M1e ordinanees and mdw rl W� t l) n( F�dl c anJ wilh W�.lmnenol:W ' . .� / oJ �� ial 1 undet:WnJ Uiis ix nol a pennil but onk an appii�elion lor a permil and wmk ix nol N xLitl withoul a pun�n on xde: Oml tl�e wnrA wJl F mTeqtdan c/pNi �he ap rov m in tho w.e ol all wnrk wh¢h rcqwtue revii�v and epproval of plmx. SIUNAI"IIRLUFNR'TTC�M ��'! �� PRiKfNAMIi� Kr��`^'' __UA7T � Z ` / � Q �PI'Ri)V1iU BY _ _ �� , O/�. DATP/ � YLI;ASG NU I'li: ��p 'I �P I'.IJ?CTRICAI. AND M}iC{IAMCAL Building Inspections 763-572-3604 763-502-4977 FAX snt,�nnxess I7IIS APYI.iG1NT 1$: ILRTY OWN&R/ TENANT From: 7634326069 Page: 2/2 Date� 9/19/2008 8:38:58 AM BUILDING RESIDENTIAL APPLICATION ❑OWNE% CITY OF FRiDLEY �•outt rernrit Received By�:y n��: S E P � .�' coNTRACTOx ,woaess: c}10 w Mca..w ri, � cm ur.. p K sr,a�� 7/ SUBMIT A I;OFY OF p�� S1' � TY �6FFt-2- FAY 1�— YOUR STATE LICENSF - — - _ _ s7�ret�casa. 2o�l�AeS�74 �Dare 3 -fl9 PROPERTY TYPE -[NU� p.vNU,y xEw apxsrnnrnnu cnc TYPE OF DFarmm� q�p}�; � MR.�FR OF SQL�.�RLS (:ARApiC PROPOSEn SI7E RtOI'OSPD F�!(HiT: O (Mhc 0 TR'O FAA41,Y NEW CON.S'1'RUC7YON ❑.1DD17iON D4'.UL1 O B.1SF2�.�Nf FII.7SII G&OOP O DECG df5mna o r�w aon� coxsraircnox NCE RFPAiR .. PAw -f�d �(- A➢ � HOlf.S80NLY ❑ F10USE et GARAG6 ❑ ATTACNP.D GARAtiC O DETA(IIF.D G.1R,1C,F. OSoffit �'fn° RFuoa WIMInWS INL"CLSI1Nl;OPIIJQJl;S OYe �1io 1A(',\770NOFWWDOWS OR NOR NF W OPt7dMlig-pESCRIBE S7ZE OF orr�rmvic eauxcr•s ee ��ee TION Permit Fee Plan Review Fve SiQChatge Surcbugc Licease S�achazge SAC Chxrge Carb Cut F�crow Erosion CoMrol Park Fm Sewer Mein Chazgc wnmox (USING THR ]997 UBC FBR SCHF.pULE) $ S �.i �' � $ a $ a d ne,�w rn.e 0 o�e B CpN@dC D 1 Mt: pg[dj(� 1. F.iiqcg Ploor Plm 2 Propoeed5rorplm 3. !iR oFstroc�al membe, b be ued FnA NEW CANSIRtrf,710N INC7.UDING DECSB, I. Sib flau Svaroc �bwiug mc �tiDg �trodort.e +mP�Pa^dP�°J� 2 1bo ecb oF conehoctiun plapy 3. Faag�� GlcAatiw, AI�ID See Back Pege for Pee Scheduie GS°.G of Btilding Pami[ Fce .001 bmes the tutal job valuation .WOS xPeimit Vatuation Minunum 5.50 55.00 (Stete Liceosed Resiclentad Coottactots) 318Z5 per 3AC Unit (Plsa� tu MWCC Fm cktecmrontiun) ft+6ft= ftx521 =S $J50 Conaetvation Plari Revicw Fee Determired by Fn8��N2 Ageement necessery� ( ) Non Nxeysmy ( ) Make checks oavabk to: Cilv of Frldkv wttae IHLS LS,�N APPLIG170N FOR A PPR WT-NOT �'AIID [RTIIl. PRDCLRSID t he�ab�'+ppl� !vr a 6u��Wmg pe�mt and 1 ac�ori�ye WLL tLe id'oim�tiv� abave s compleb and eerua45 4al Wn wak wiY be m eodamaurs v� ihe admm�e md coJet of Wo CM1r of Ftullq aod wAh �c Mmnada Co 4uUioa � I wMaahnd mu e mt a pu�t Wt onh an appliufion fvc a pum"t md wod is mt m wn �imoot t pnmit oe Ne, Wat me work will bn m accor n a pr pIm n tLo use o[ a0 woetwhch mq�a review aod appmval M'pta�. SIGNATURE UF APPLIC PRINT Npl�q;_�.,(�_/l,/ :� w DATE.�� 9/0l T APPROVID BY r.e�rc