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AF - 38639f��1 �'�1 City of Fridley, Min.n. 3 2 0� BUILDING PE�dIIT N°- . .�".�:- ��. Date: . . .. ..................... Owner ....................................... Builder .. �!'".�..� .�.. Address...................................... Address ............... .......................... � � L��ATIO OF �UILDI1m9�G �.. , ��..� ��.i�t-��.J-e� <"��,r-'",g� No. Street ..n :.:...::................�........... Part f Lot ....... ....... ........ Lot . . . . . �. �. . Bl . . . . . . . . . . . . . . . . . . Addition `or Sub-Division � . . . . . 4t.:�� e Corner Lot . . . . . . . � Inside Lot . . . . . . . .. . . . Setback .� �. . . . . Sideyard . . . . . . . . . �� . . �E� r DES�RIPTION O� BU[LD91iIG To be Used as: . . . . . . . F'rorrt . . .� � Depth . . . !� � Height . . . . � . Sq. Ft. �� Cu. Ft. . . . . . . . . � . . . • . . . . Front . . .��. Depth . .. . �.� H�i ht �.�. . Sq. Ft. � .� Cu. Ft. . . . . . . . . � Type oP Construction . . . . . . . . . . . . . . . . . . . Est. Cost. .!'�. .r�. �� . . . . . . . To be Completed . . . . . . . . . . . . . . . . . . . �� `i�c�� , o� � �. �� . � � � 3 (+ � 0 _ � �� In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. 0 .................................................... �'� consideration of the payxnent of a fee of $/. �.�� , pernut is hereby granted t '�' _� � . . . . . . . . . . . . . . . . . . . . . to construct the bwllding or addition as described above. This permit is grante upon � L �� express condition that the person to whom it ia granted and his agents, employees and worl�nen, in work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of �% � Fridley, Minnesota regarding locaiion, cons:ruction, alteration, maintenance, repair and moving of buildings with- in the city limits and this permit may be revoked at azy time upon violation of any of the provisions of said ordinances. � � . ,� . . . . . . . ,. • • � , • •��/.� : . : .�iiilding Inspector 1010TICE: Yhis perrnit does not cove� the constructlon, Installation or alteration for wiring, pluenbtng, gas heating, sewer o� water. Be sure to see the Building Inspeetor for separate permifs for these Items. o � `�� . O .� �� C � ' � �� C � � � V ,� H � N� G � � L .r � •.. C '0 v� C� �a d � � O � :- � � a 6 � � � � � a � oa 0 m A W J � W U H W � J H � a �� I � I � .�� ti� � �� F Gl � � w � �+ � .��,� � o �� .�� o� �� a�� o�� U v!� a� �� Q aa � �°`"� � a° .�� •� � �� y � y ��A� � �� o � � �� `�N, O � H .� �o o °o, °w � 00 W � CN : : : o . . . o . . O � , , � o " ' O � . .�,d . . �. .�d � +°� � o � � '� � � � � � � � � � � � � � m � � � � V � � �� a�� m °�n � 1 � r � w � � � o � � �i 5 o °o °o � °�c+ �� .� E� � � � •' �' r : z , � a � � � � z �d W O �. 0 � � i� � z � � � � , O � a-� u� � � � .� � � �� o � A w �w o � M ls'� O O �o � �� a � L� E° C =` O t�ce �, • • _$ � ri °o o � °w o o ��o, �� : ' ' : : � o�v � : ' o � o . ; $ g �i o . O . : O � � ' . � dl ,� �, : ,q � � ° � o � � '� � .� � � � � � � o � � � � �� °�� o � � � x �� o� a a � '� �� a, . � � � U] �' � � �' �' 0 0 �� r� w : 'g : : : � : � . � . : o � � ' � ,� o Qi D3 � � ° � o ,� 0 � ,� � � � M � .s � .� "' � a �a � g v � � � � � a � oo a o � � x z � � � A w � ri� � � z � � � � a ft1 U O ci' � � O '� O .� H m w � ....ti. � � � � � �� o�� o � a t� � � � � �a � . 0 v � � � 0 � � � � � q .� a � � � r� � � � 0 r. .r �, � �� City of Fridley, Minn_ BUILDING PERMIT Date: Jtane 2,. 1965 � Q�� / �! N° '7649 p�; Harr� �onald �oa B,� TJn3.que Home Construct3on, ?nc. A� 655� Clover Placte �. E. Ad� 11901 Crooked, Lake �l.vd. Goon xa.pids 55l�33 �esota LOCATION OF BUILDING xo. b55� s� C]�er Place N. E. Part oP Lot Lot � _ Bl�k Addition or 3ub-Divisian Cl�Vei' Le�F �dd. Corner Lot _ Inside Lot Setback Sideyard �wer IIevation — Foundation IIevation DESCRIPTIOIV OF BIJILDING To be vsed as: Front Depth Height Sq. F� Cu. Ft Front Depth i%ight Sq. F'k G�. Ft. Type of Constructton F�t. Cost �i7.��00..� To be Completed StOZ� Damage B�epsir In considerat[on oP the issuance to me of a permft to conatruct the building d�cribed above I agree to do the ProPosed work in acxordance with the drescrlption above set forth and in complianc+e with afl proviaions of ort]inancea of the dty of FrYcIley. _. � n,/ . In camsideration of the paqment of a f� of $�� ,�errmtt ia hereby granted to nn3�ne H�t ei ��n� • s��' to canstruct the buflding or addition as desdibed above. This �rmit is granted u�n the express candition that the peraon to whom ft is grantQd and his agents, e�nployees and worlmaen, in all work doae in, around and upon eaid building, or anypart thereof, shall conform 3n all respects to the ordinances of Fridley, Minnesota regaraing la:ation� conatr�action, alteration, maintenaace, repair and moving of buildings wltvin the dty limits and thia permit may be revoked at any time upon violation oE aay of the Proviaiona of said ordinances. A71en Jer�sen �� NOTICEs 'll�b pu�mB dws eo! eerer fln coaalweH�, tnstall�ton �er �rietne, plumbteg, pas 6ultee, sawr or wNar. B� surs to ss� tln Buildlug Impadee te� ap�rala p�rmhs for f6a� he�. �., 1 � .. APPI.ICATION FOR BOILDING PERN9IT CITY OF FRIDLEif, MIIQNBSOTA OWNER' S - �dti� BUILDEIi , - ' ' �� Ann�ss_ � �� s'� ��.�� Ann�ss J'� �od �� . . . � �� .. LOCATION OF'SUILDING ' No. ; � � � _Street �°' , ��Part of �;o _ LOT_�� BLQCK � ADDY�IOAT OR SUBDIVISION � Corner LoC�_Inside,LOT� Setback Side Yard � SEWEB �ELEVATIQN . FOUNi��iTIOA ELE�/ATION Applicant attach to,this form �wo Certif3cates og Survey of Lot �nd proposed building location drawr► oa these C�rtificates. - DESCRiPTiON �0�' BUILDIIITG To be used as.: � Front " tiept � fleight Sqs Ft.�, :. Cu. Ft. _ Frdrlt Depth � Heiglit , Tqpe of +Caizetructi To be completed. . ' Sq. �'C._�_ . , Cu. F.C. `=��'�-�.��aa�d C��ted Cos /' � �� ,� r� � , . The undereigned hereliy makes applicAtion-for"a permit for the work.herein specified, agreeing to do alI wo�k in strict accordaace wiCh the C3ty of Fridleq Ordinances and rulinge of ,the � Aepartment` of B�iildings, �and hereby declaree that all .the facta and representatioris atated in this application are true and eorxect: . DATE � r " �� `' (Schedule of �'ee Cpats can be �° . . ,,��'� . �� ` ��,��'� �� V ^ D t •• ! \ f'oimd on the . Reverse S ide ). ,• .. . ��o�� . . ��, = . . . o - G -_ , • . ' • / 1 �a 1 Y- 'A BDILDING PERNB,T �EE SCHEDULE SEG�'ION 2. The Inspector of Buildings shall, before iseuing aay permit for the ''. ere�ction of any building or structure, or for any addition to anq existin� build- ing or �tructure, or for any alterations or repaire to anq existiag building or structure, upon appl3cation.therefore, require the payment bq the applicant for such permit of fees to the amount herein below set forth and in the maaner herein provided to-wit; 2.1. For any such permie for the erection of any fire-proof building, other than a garage, warehouse, factory or grain elevator, or for the erection of any fire•proof addition, for aimilar occupancy, to any existing building, ehall be at the �ate of $1.4,0 for each one ehousand cubic feet, or fraction thereof, ia euch cubical contents. 2.2. � For any such permit for th+e �rectfon of any fire�p�oof gsrage, Watehouee, factory or grain elevator, or for th� erection of any fire-proof adc�3tion, for similar o,ccupancy, to any existing building shall be at the rate of $1.25 for each c�e thousaad eubic feet, classified as "fireproof" by Section 502 of the Niinneapolis Building Code. HOIISES __.___ . . 2� 3. For anq auch permit for the erection of any non•fizeproof buildiag, other than a garage, warehouse, factory or gra3.n elevator, or any non-fireproof additioa, for similar �cupancy, to any exiating building - permit $1.D0 for each one thousand cubic feet. GARAGES �� 2,�.�i. For auy such permit for the erection of any non-fireproof garage, warehouse, factorp or grain elevator, or for the erection of anq non-fireproof addition, for similar occupancy, to auy euieting building or for each such building or addition - ninetq cente ($0.90) for each ane thousand cubic feet or fraction thereof, ia the cubical contents thereof with the minimum of $4.00. For the purpoae of computing fees for building peranits, the cubical contenta of any building or addition to a uniform height throughout by multiglying the ground area covered from a point six (6) inches below the floor liae of the baeement os cellar to the average height of the upper surface or to the average height of the roof aurface of the main gable of a pitched roof. 2_;5. For repairs or alterations to an existing structure, the fee sha�l be ae the rate of $3.00 per each Five Hundred Dollars ($500.00) or fraction thereof in the cost of all proposed �aork. 2_ 6. In ao case shall the fee charged £or any permit as aet forth in Secti'on 2 be less than $4.00. ,� - � '� � ��. �. ._ e �, � City of Fridley, Minn. BUILDING PERMIT Da�; AUGIIST 11, 1965 �� ; No 8349 ��: HARRY D. NANSON ��r iJNIQUE HOME CONSTRIICTION', INC. Addr�s 6558 Clover Place A� 11901 Crooked Lake Blvd. Fridley 32, Minnesota LOCATION OF BUILDING N� 6558 s�t Clover Place p� of Lot I,ot _ Block Addition or Sub-Divlsion Corner Lot _ Inaide Lot Setback Sideyard Sewer Elevation Fo�mdation IIevation DESCRIPTION OP BUILDING To be vsed as: Addn. Fa�nily Roa�t 14 �� 20 ��t 10 �. � 280 �� 2, 800 F�nt Depth I�eight Sq. Ft. Gti. Fk Type of Conatruction F�t. Cost �4, 5 00. 00 To be Completed Ia con�deratlon of the isauance to me of a permit to construct the building described above I agree to do th� ProPosed work in accordance with the d�scrlptlon above aet�Q� and in crom,��ce wlth a'll provlsfons oP vrdinanc�ea oE the dty oP FrYdley. / I D.f� // �,� In cansYderatton oP the payment oP a fee of � 4. 00 � p�t is her�by graated to �� HOME CON'STR. INC . to canstruct the buflding or adciil3on as described above. Thia perrnit is granted upon the eapr� condition that the person to whom ft is �ranted and hia agenta, employees and workmen, fn all work. doae iq around aad upon eaid building, or anypart thereof, ahall conPorm in all respects to the ordinanc� oP Fridley, Minnesota g location, construction, alteration� maintenance, repair and moving of bufldinge within the dty ]imits�i� tbis permit may be revoked at aqy time upon violation of aay of the P��ons oP sa4d ordinances. ALLIIQ G. JENSEN Bufl�►S Ins�ctOr NOTICE: '�t pqe�f doa eo! eersr t6s eo�dlon, MstaQatioo for vrhin�, p1um6leg, 0a 6udee, aw�r er water. B� sun to � tM BoW11ne Im�etor tm aPa►at� p�m6a fer fh�a �mt. �� d. _ J APPLICATION FOR BIIILDING PERMIT CiT�i OF FRIUtLEY, MINNESOTA OWNER'S NAME �� _;� .? �,.a_= BUILD�R� r ��" ��,,,,� (�� c��;9'�°' ADDRESS �� (' �f� � ADDRESS �� Q�✓f (°. ,,T,�� p�Q LOCATIOAT OF BUILD�NG NU._ �� STREET ��-t��'�- �� PART OF LOT�� LOT BLOCR � ADDITION OR St1BDIVISION CORNER LOT INSIDE LOT � SETBACR SIDE-YARD SEWER ELEVATION FOUNDATIQN ELE9ATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building locaCion drawa on these Certificates. DESCRIPTION OF BUII. G To be used as; �. � -�`��`�''�'�"" � �� Front Depth �-�/ Height � � Sq. Ft. �� Cu. Ft. �� v Front � Depth Aeight Sq. Ft. Cu. Ft. Type of Construction Estimated C�� • �o To be completed The undersigned herebq makea application�for a perm3t far the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinancea and rulings of the Department of Buildiags, and hereby declares that all the facts and rep�Ceaentations stated in this application are true and correct. DATE � // � � .� g (Schedule of Fee Costs can be found on � _�. .. �. Reverae Side). _..a I� , ,_ �� U. - �_ _._ � � �, � \/ BIIZLDING PERMIT FEE SCHEDOLE SECTION 2. The Inspector of Buildings shall, before issuing any permit for the erection of any building or's�ru¢ture,'or�for anq addition to any exieting buildiag or �tructure, or for any alteratiions or repairs to any exisCing building or structure, upon agplieation therefore, require Che payment by the applicant �or such permit of feea to'the.amount hexein below �et,fo�th and in the manner herein provided to-wit; 2.1. �For any euch permit for the erection of any fire-proof building, othei tha a gara�e, warehouse, factory or grain elevator, or for the erection of gnq fire-proof addition, for eimilat occupancy, to any egisting buildiag, sha11 be at the rate of $1.40 for each one thousand cubic fe�t, or fracCion thereof, in auch cubical contents. 2.2 For any auch permit for the erection of any fire-proof garage, warehouae, factory or graia elevator� or for:�the erection of any fire�proof addition, for eimilar occupancy, to anp esiating building shall be at the rate-of $1.25 for each one thousand cubic feeC� classified as "firepraof" by Section 502 of the,Minneapolis Bu�Iding Cale. flOIISE$ 2.3. For any such permit for the erection of any non-f3reproof building, other than a gsrage, warghouso, factory or grain elevator, or anq non-fireproof addition, for e�ilar occupancy, to auy existing buildin� - permit $1.00,for each one thousand cubic feet. GARAGES � - 2 4., For aay suc�h permit for the erection of any non-fireproof garage, warehouse, factory or grain elevator, or for the ,erection of any non-fire-proof addition,,for aimilar..occupancq, to.any egist;iag buildiag or for each such �:: building or addition - ninety cent�s ($0.90) for each oae thousand c�bic feet or fraction the�eof, in the cubical contente thereof.with the minimum of $4.00. For �the purpose of.compuEing fees for bniTding permita, Ehe cubieal contents of any bui].ding or addition to a unifqrm height througt�out by. multiplying the grouad area covered fra� a point six (6) inches below the floor line -of the basemeat or cellar to the average h+��ght of the upger eurface or to the average height of the roof aurface of the main gable of a pitched roof. 2_5. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each' Five Sundred Dollars ($500.40) or fraction thereof ia the cost of all proposed work. 2.6. Ia no case ehall the fee charged for any permit as set forth in Section 2 be less than $4.00. , STORM REPATR DAMAGE �EES: � . Residential; Estimated Cost of work up to $500.00 -$5.00 . Estimated Coat of work over $500.00 -$10.00 Cou�ers�I; Estimated�Qst of wo$k up to $5Q�,00 -$1Q�0 Estimated .ost of work over $500.00 - $2(,. .J , . � ,.�Y.�. � � > � � � ot � .� . d •� �� v . � .� H� C _ � • �� u �a � � • � � 0 a � a � �� a � ov a A � 0 W � N W � J H � � �� h�Y � �� °�� '�.� b � d � � F id t+ � w 0� a�b� o�� , `v° u v; �° � �w ro R�Li .�' � ^�'V �� °"� �� .��p � .� 0 �� '� �° � N .�� A �n�� bo� � �� v 4' ;��a�i � E•� N U �,' � � N M � � �y O O O � � CD �q tt) N : : : � . : O C7 O � ' ' O � . . � 'L! ..�b w � � � o �� d u �� 4°�� v �� q �¢ � � � � a � � N � � 4 � a a a 0� � � rl � � � � I� a � � � o r � � � , o '� � �g' v O"�.c�' � I � v} �r O O O O � 00 CV 4hi �!] N E+ : : l. : GO . . : o o° : ' ° o : . ° u� N � � ' �' '� �� ;� � � o °' a '� � m � � � � � � � � � � �a °' '� iy �v�i� �°i �, �?3 � �, a a '� '� V � � a � � � � � a 0 � � H � � z i�, z � a �; � U � � d � z w O O w O d a c°�i a csr . � e�r c� O O O O O O t[J �[J 00 OD N N � � W m �° w � �� a'+ q 3 � N x� � o itl 4 � � . d . � "� O �x � � � ti N M � � W W z �a � � � � � O a : � � � � O O � . y : � : � : � : � . �1 . � � � � o ti � o �. � a � � a � � � °� M � � a o w � oG a � a 0 z .:� � b E� � � U � N � � � � � � � a V � � w� � J � � � � m � .� � � � � � 1�0 � .m ,� � U � � � , E �'? 1 � � � s�r �; � css �a e�r O �+ � � 6 � tt� � N : o�� -_� � 0 0 0 0 � 0 � W a � � � � � . . � � � o � � o N � � W � Y ��q� V, o � Z m � .. � E � � � w 4 � � H v� W � ,-��r. a � � � � � � � � O � � � �'ra' H E O �� O � V a 4 x a sw��s �l � O x � Q �� I� a �O � � vi � � � � n � �'� � � 0 � m a � � �, � �,, di (�- '�1 �� , o• � � O � � a w � ■ s 0 t� � �'a`' � d C � a v S a ,o 0 •� L C C � Q ��- •� � � � H . 0 C y L } � � � C � �' � %� � � � . W � O � C � : - ; C � .; m o m L Y � � � � � c _ � .�C V �• O � � � 3 0 � d 0� � � � � � . � � � �� 0 � � U O d .� � "d � � � � � .� � -. .°Y .,�Q, O � � , 0 � _I � ti � � � "J d � U d a � � � �I � � � � � . � � .� � 0 �� v U � d �.�o h � �� I � 3 .o � ,� a � � a � 0 � � � O � � � � O r� � w � �1 � � � o�i 2 0 � � � ti � �� •N � "d ,�° W `° ��o� ,� � U � .��a a� O� � O y � � `w� V � • � � � � � ,� ti •N Cl ��o� � � � � a�'N� � ��w o� � � o �� a � �� I�� .g� � ��N � . �d�� .� ,o y ,��oyr � ° �� , .� � w `C •N � 1� • O � VeJ � �� o�� . �� '� � , �� .� � '_I.j � •N a � �i � '� �� w� �� o o� � � � .s �� o °' � � �o o �o �';� � .� .� �� d � ��° U ��a�a � �� C ;� o � �,' � �� o ,z R' d °A � ��.�o .�� .� � � ,°,°,� .Q 0 a��N°o v � `N a � � � � � ��°�a, SUBJECT , City of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �� o r � � RECEIPT NO. � i y______ COMMUNITY DEVELOPMENT DIV. A�� PROTECTIVE INSPECTION SEC. 1 � � � , /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV DATE PAGE OF qVPROVEO B� �"""�� ,'' 612-571-3450 910-Fi5 5/18/95 � / JOB ADDRESS 6558 Clover Place NE t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 Clover Leaf Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James Hanson 6558 Clover Place NE 571-1916 3 CONTqACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Twin City F�teriors Co 9060 Zachar Ln N��'108, Ma. le Grove MN 55369 425-4737 2535 d ARCHITECT OR DESIGNEFi MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WOHK ❑ NEW ❑ ADDITION p ALTERATION O REPAIR � MOVE O REMOVE X 8 DESCRIBE WORK Reside Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE FEOUIRED FOR ELECTRICAL. PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED VGITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WOfiK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GAHAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION SURTAX AND ORDINANCES GOVEFNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �S�OOO �L.SO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION �%Z.00 Fire SC �S.00 PLAN CHECK FEE TOTAL FEE License SC $5.00 $84.50 SIGNATUAEOFCON'AACTOAORAUTF�OA�2EDAGENT IDATEI WNEN PFiOPE Y VALIDATED THIS IS YOUR PERMIT 'f((��6 C�/�/`� SiGNATURE OF OWNEF iiF OWNER BUILDERi IDATEi �, �" 8 G�NS�- 1 NEW ADDN ALTER il [) 1� Construction Address: �(, Legal Description: Owner Name �k Address: Contractor: � Address: $Y� _/U� C[TY OF FR[DLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Effective 1 / 1 /95 � � � �� Tel. # �r%I��9%�0 MN LICENSE # �Sv� � ��Tel. # ��,� �%3 r% Attach to this applicadon, a Certificate of Survey oti th� lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground OTHER: Sq. Ft. _ Sq. Ft. Sq. Ft. Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setb$ ac�cs � � Type of Construction: �f i/.�,� Estimated Cost• ��/��Y1 Approx. Completion Date: — o?y �S " � � � �� " , .�' +�'� a�,:� —� ' (Cost on Back) � Driveway Curb Cut Width Needed: Ft. + 6 Ft — Ft x$ _$ DATE: _,��APPLICANT: � Tel. # ya75 ` �% � Permit Fe� Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL 6�D $ $ $ D $ $ �06 $ $ $ $ $ s� CITY USE ONLY Fee Schedule on Reverse Side .GOl of Permit dalua�ion (1/14th�) $.50/$1,000 Valuation $850 per SAC Unit $5.(� (State Licensed Resident�al Contractors) Alt. "A" ar Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] STIPULATIOi�IS: ,_ � = ` ��r / :�� l8'�� u��.uirvc: E>1.�tMrr rr_r_ sc�ir_nur_r: �I"lu: (:lii;:t t�uilclinf; Ul�ticixl shall, lx;l'orc issuing per�nits tor thc crc;ction of any buildin� or stnicturc, ur ti�r any :+�lcliticm tu any cxistin�; buildin�; c�r structurc, or for any allcration ar rcpair tc� any cxistin�; (�uililing c�i x�ructure, u�n arplication thcrcforc, rcquirc thc paymcnt by d�c a�plicant f�r such rermit <�I� ti:c;s tc� the amount I�crcin t�cli�w st;t tc�rth anci in thc' manncn c�rcia Providc�,d tc�-wit: "1'U"1'A l.. V A I.17 l: , S 1 to $SOU �501 to �2,000 $2,001 to �25,OQ0 rr_��s $IS (Minimum l=ee is $15 plus surcharge).• $15 for Fust $S00 plus $2 for each additional $100 or fraction thereof, to and including $2,000 - $45 for fii�st $Z,000 plus $9 for �each additional $1;000 or Fraction thereof, to and incluiiing 525,000 ' - �25;001 co �50,000 • $252 for first $25,000 plus $6.50 for each additiona! $1,000 • or firaction thexeof, to. and iricluding $50,000 � $50,001 to 5�00,000 �100,401 to �500,000 $500,001 to $1,000,000' . $1,000,001 and up $414_SO for first �$50,000 plus $4S0 for each additional $1,000 or fractioa �ereof;. to and including $100,000 $63950 for first -$100,000 plus= $3_SO for each additional• $1,000 or fractioa thereof, to and includiug -$500,004 $2039:50 for t�e 5rst $500,000 plos $3 for each additi'vnal $1,000 or fractioa thereof, to and including $1,000,000 $3539.50 for the first $1,OQ0,000 plus $2. for each additional $1,000 or fradion thereof - DR[YEWAY DEPRESS�ON ESCRO'G�/ (Concrete Curt� Stireets Oaly) Alternate "A": � Removai and repiacement of curb aad gut#er �only - Dci�veway width plus 6 feet times S 13.50. Alternate ° Q": Removal and replacemecet of curb and gulter and install a 3 foot �vide approach with 6 inch depth - Dciveway width plus 6 feet times S 15.75. ' VLRIF[CA"f[ON Or FOUNDAT[0[Y !'ermits fur consliuction will be issued a minimum of 24 houcs from the time of appliption to allow for pr<�per rcvic;w oC ttic rropc�scd structurc and of thc co�uiruction site. A Ccrtit7c;:itc of Survcy of die.lot, stiowing the iocation of tlic founda[ion c�nce it t��.� it has i�ccri conslructe�i wil! tx: ce;yuired l�ef<�rc proceeding with lhe ftaming. R 7 � sue�ecr P c�ty of Fridley 2 7 63 6 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � T NO. � • COMMUNITY OEVELOPMENT. DIV. � j y �� PROTECTIVE INSPECTION SEC. � = i ( ��'� � CITY HALL FRIDLEv 55432 NUMBEF REV DATE PAGE OF APPROVED BY �----� • •'� 612-571-3450 910-F15 9/9/98 � � JOB ADDRESS 6558 Clover Place NE t LEGAL ��T NO. BLOCK TRACT OR ADOITION SEE ATTACHED DESCR. ],2 Clover Leaf Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PNONE Jim Hanson 6558 Clover Place NE 55432 571-1916 3 CONTRACTOR MAIL ADDRESS Z�P PMONE LICENSE NO. Master Remodeling Inc 32 lOth Ave S Hopkins 55343 932-9311 20012916 4 ARCNITECT OR DESIGNER MAIL ADOiiESS ZIP PMONE LICENSE NO. 5 ENGINEER MAIL ADORESS ZIP PHONE LICENSE NO. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION O ALTERATION � REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WOHK Reroof house & garage (38SQ) Tear-off 9 CHANOE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCV dROUP OCCUPANCV LOAD SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTII.ATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONIN(3 SQ. fT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR A9ANDONED FOR A PERIOD OF 120 DAVS AT ANY TIME AFTER WORK IS COMMENCEO. NO. DWLG. UNITS OFFSTFEET PARKING 1 HERE9Y CERTIFV THAT I HAVE READ AND EXAMINED THIS APPIICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION SURTA@X AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $3,256.00 y�1.C3 WITH WHETHER SPECIFIED HEFEIN OR NOT. THE GRANTING Of A PERMIT DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEL TNE pERMIT FEE SAC CHAAGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW HEGULATING CON- @87 � 2)r Fire SC �3. ZS STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. y' PLAN CHECK fEE TOTAL F Licen $5.0 $97.13 SIGNAIUREOFCONTRACTORORAUTMONIZEDAGENT IOATEI N P P ALIDAT IS IS R MI r � S�GNATUAEOFOWNEAUFOWNEABU�LDEFiI �OATE� BlD �NSP ryurE � 7 JUN-lb-1998 11�39 FROM C1TY UF FRIDLEY TO NEW � � ADDN [ ) CITY 4F FItIDLEY �-T� I l SINGLE FAM1�,Y AND DUPLEXES R-X AND R-2 BUILDTNG PERMIT APPLiCATION 9329316 P.01i02 Effecdve I/1/98 Consauction�►dc�rress: _ (o S,5` B G�D � e/t �lv9-c -e �,� �aal Description: Owner Name & Address: S�^� 1�—(,�-,� s o� Tel. # cS i/ a+ 1�'/ (� Contractor: �I`�R ItEA�OIDEI,IlITG 7NC. 1Vi1�T I,ICENSE #_p� �o I� 9/(� 2 T�nt v�nue Soutl� Address:_ � ��k�.,s, �►►,nesot� 653A3 Tel. # (61�ae�'�pgtication, a Certificate of 5urvey of the lot. with ihe proposed conswction drawn on it to scale. �'�� G� ��• DESCRIP�ION OF IMPROVEMENT 32 Ten4h Av�nue South hiopkins, Mi�nesoia 55343 �612) 932-93�1 LIVINf� Ait��: I.ength wadth Height Sq. Ft. GARAGE �TtEA: Length Width Height Sq. Ft. DECK AREA: Length Width HgdGround Sq. Fc. 01'HER: �X��v �. Construction Type: �c� �- �� . Estunaced Cosr. $ �� j dZc��° -o— -�- lFee Schedule on Back1 Driveway Curb C�t Width Needed: Ft. + 6 Ft = F $ _$ DATE: / � APPI.YCANT: �'�/ 'Tel. !t �� 9.3// Permit Fee Fire S�ucharge State 5urcharge SAC Charge Licease Sutcharge Driveway Escrvw Erosion Control Park Fee Sewer Main Charge TOTAL $ Z o2 �- �� r �O $ ..� $_�a� $ $ $ $ $ ,[3 CITY USE UNLY Fee Schedule on Reverse Side .Odl of Permit VaIuation (1/lOth°b) $.SO/$1 �000 ValuatiOA $I000 per SAC Unit $5.00 (5tate Licensed Residential Co�tractors) Alt. "A" or Alt. "B" Abvve $450.00 Conser'vation Plan Review Fee Determin� by Engineering Agreement Necessary [ J Not Necessary [] STIPULATIONS: i � �� . Building Inspections 763y5�2-3604 763-502-4977 FAX DATE� SITE ADDRESS _ THIS APPLICANT IS: ZD �� PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF INSURANCE PROPERTY TYPE BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTTVE 7-1-2010 YOUR E-MAIL ADDRESS !Y� `1 �' n a L- �� OWNER ❑CONTRACTOR �: �/Y'n e� � l� C�u 0 NAME: � STATE LICENSE # EXP DATE ADDRESS: CITY PHONE FAX INGLE FAMII.,Y SIZE ❑ TWO FANIILY/NEW CONSTRUCTION STORIES PERMIT TYPE � �DTTION ❑ GARAGE/SHED �WIIVDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAW TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMWG POOL TYPE OF WORK: ❑ NEW HOI� CONSTRUCI'ION � ADDITION � MAINTENANCE/REPAIR ,,'f4 REMOI2ELING DESCRIBE WORK BEWG ROOFING NUMBIIt QUARES'r GARA ES PROPOSED S :_� PROPOS IGH'f: SIDIIVG ❑ Viny( 0 A1 ' O r l' wnvnows IN EXISTWG OPENINGS ❑Yes ONo OR FOR NEVJ OPENWGS-DESCRIBE S1ZE OF OPENIlVG CHANGES 8c Q2 U�IV'�!L TYPE OF WINDOW TO BE INSTALLED�'�a� ALL FEES ARE BASED ON TOTAL JOB VALUATION $ -- Permit Fee Plan Review Fire Surchazge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Chazge i Total Due ❑ HOUSE ONLY ❑ HOUSE & GARAGE 0 ATTACHED GARAGE ❑ DETACHED GARAGE OSoffit ❑ Trim ❑ Fascia LOCATIO OF WINDOWS ��i,re� /�� i ,�( .�— NUMBER OF WINDOWS � � YeILL� V< $ $ $ $ $ $ $ $ Permit No.: F� �' f �� Received By: I�i�eci41� �►?�aJZrn s� ATE ZIP I� BASEMENT REMODELIlVG SUBMIT: 1. Exisdng Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. 8c PORCI�S SUBNIIT: 1. Site Plan/Survey showing the existing structures and proposed project 2. Two sets of conshuction plans 3. Enetgy Calculations FOR WINDOWS – PROVIDE U-VALUE AND MANUFACTURE STICKER ON WINDOW. INCLUDING THE COST OF LABOR AND MATERIALS: �997_U.B.0 _FEE SCHEDULE) ,-O Q OCCUPANCY TYPE See Back Page for Fee Schedule A e 65% of Building Permit Fee � 1 �`; j!j .001 times the t o t a l j o b v a 1 u a t i o n � e �! .0005 x Permit Valuation Minimum $5.00 $5.00 (State Licensed Residential Contractors) $2�00 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$24=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks �ayable to: City of Fridley Attach Stipu THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclaiowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case o orl w io ' s r " and approval of plans. � / SIGNATURE OF APPLIC PRINT NAMF�L�fY/d ��OUPC/ DATE d � d APPROVAL INSPECTOR SIGNATURE __ Page 2- Building Residential Application BUILDING PERNIIT FEE SCHEDULE The Chief Building Official sha11, before issuing permits for the erection of any building or structure, or for any 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 aznount herein below set forth and in the manner herein provided to-wit: VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to a11ow for proper review of proposed structure and of the construction site. A Certificaxe 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 � �� C �� r .� ` ' r� QV�t4c - g �� - ��uvH o � �G, C�o. �� ~ � c� G � �.�.�,IVai4� S �� e� � �S �� , S�c� c�� ti•� � �� 3to� z� t �C �5� � t-�z�l�� . �� -�� d 2X �'4s�� +n� ►N � � w�2�.t� lS aN ��Q �� Building MECHANICAL Pernut No.: �d � � t �� Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date �" �� 763-502-4977 FAX ��„�,,,�, , ,�,� STI'E ADDRESS _ THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBNIIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE L O YOUR E-MAIL ADDRESS OCONTRACTOR � Yr/�Gt C f`� o cc r STATE SE # EXP DATE SS: CITY STATE ZIP / PHONE FAX � SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: I � IvEw �PLACEMENT DETAILED DESCRIPTION OF WORK ❑ ALTERATION/REMODEL FEES ARE BASED ON $10.0{I PER FIXTURE, EXCEPT WIiEERE NOTED. FIXT'URES: (INDICATE TOTAL NUMBER OF EACH BELOV� PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK Equipment Installed MFG: MODEL: SIZElBTU A/C $25.00 AIIt TO AIIt EXCHANGEER $15 BOII.ER $35.00 CI-IDVWEY LINER $10.00 DUCT WORK $10.00 MFG: MODEL: MFG: MODEL: FIILEPLACE (GAS) $15.00 FIREPLACE (WOOD) $35.00 PLTRNACE $35.00 ,LGAS DRYER $10.00 /' GAS PIFING $10.00 SIZEBTU p SIZEBTU / GAS RANGE/OVEN $10.00 i P�n. GAS UNIT H1R $10.00 _POOL HEATER $35.00 VENTILATOR $I5.00 THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclmowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and wor 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 �es re d approval of plans. � SIGNATURE OF APPROVAL INSPECTORS SIGNATURE c',Z ar �,,:� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 �/ o �1 / 2P�/ D City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT . RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ 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 MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) � a. IMC Chapter 5 with MN Amendments MN Rule 1346 Sec. 501 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments 4. Hea.t loss & cooling load per room a. MN Rule 1322, Sec. N1104.4.13 5. Ventilation a.. Per MN Rule Chapter 1322. Sec. 1104 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be nsed for combustion and make-up air calculations. Building Inspections 763-572-3604 763-502-4977 FAX DATE �� srrE,�wnxESS l�o THIS APPLICAN'f IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND CERTIFICATE OF INSURANCE PERNIIT TYPE PLUMBING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECITVE 7-1-2010 'Z4/D ❑ OWNER YOUR E-MAIL ADDRESS ��°� `'� °� -[,¢-' �j � . OCONTRACTOR •r� CITY Permit No.: � � � Received By: �� ' � �% v n ii ��^L=fif a C�. STATE LICENSE # EXP DATE STATE # EXP DATE ADDRESS: CITY STATE ZIP PHO FAX TYPE OF WORK: I � ��'�' FAMII.Y DETAILED DESCRIPTION OF WORK 0 TWO FAMILY J�REPLACEMENT ❑ TOWNHOUSE FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOV�. MINIMUM FEE $35.50. .'��' $ATH SINK/LAV % FLQOR DRAINS ,L $HOWER I WATER PIPING ��ATHTUB GAS PIPING (NEED CITY LIC) SWIMMING POOL WATER SOFINER ($35) / CLOTf�S WASHER HITCHEN SINK � WATER CLOSET � _BACKFLOW PREV. ($IS} _ DLSHWASHER � Z LAUNDRY TRAY �LWATER HEATER ($35) �� FOR Il2RIGATION • ,� WATER METER� A _ � �,! _ OTf�R THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I aclmowledge that the information above is complete and accurate; that the work will be in conforma.nce with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand ttus is not a permit but only an application for a permit and work is not to stazt without a permit on site; that the work will be in accordance with the approved plan in � 11 wor��l ' h r eview and approv o� plans/.' SIGNATURE OF APPLICANT-��'�� T NAA��/p �/ 2-�%� v� DATE APPROVAL INSPECTORS SIGNATURE ' 6\C1A/�. T City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building BUILDING Permit Ivo.: Inspections RESIDENTIAL APPLICATION xeceived sy: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 763-502-4977 FAX EFFECTIVE 1-1-2010 DATE �7 O 3 2O I i� YOUR E-MAIL ADDRESS {� �-�/ lr /1 � G�L/ y �'LGt b Ou v e c1 i STfE ADDRESS �' . � . �i" �✓'' i� � THIS APPLICANT IS: O OWNER OCONTRACTOR PROPERTY OWNER/ Nq�: � � TENANT ,,�DRESS: _/r% V�-%?.i� CiTY STATE ZIP PHONE: CONTRACTOR N.41�: SUBMIT A COPY OF STATE LICENSE # EXP DATE YOUR STATE LICENSE AND CERTIPICATE OF ADDRES • CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE SINGLE FAMII,Y/NEW CONSTRUCI'ION SIZE . O 71�V0 FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ �DITION ❑ GARAGE/SHED �dINDUWS ❑ BASEMENT FIWISH ❑ RQOF O DRAIN TILE ❑ DECK O SIDING ❑ OTHER • ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION o Ma,nvTnvnxc�nuz o xE�on�r.IIVc DESCRIBE WORK BEING �NE• �S' -I- K( TG C e I) � 4'%�� SIZE OF IMPROVEMENT LINGTH WIDTH HEIGHT S Ff �2QOFING �7 HOUSE ONLY �qSEMENT REMODELING SUBMIT: NCTMBER OF SQUARES O HOUSE & GARAGE 1, Existing Floor Plan GARAGFS 0 ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members W be used PROPOSED HEIGHT: SIDIIVG FOR NEW CONSTRUC'!'ION INCLUDING DECKS, 0 Virryl OSoffit ADDIT[ONS_ & PORCHES SUBMIT: O Aluminum ❑ Trim l. Site Plan/Survey showing the e�cisting structures ❑ Other O Fascia and proposed project 2. Two sets of construction plans WIlYAOWS 3. Energy Calculations IN EXISTING OPENINGS �Yes ONo LOCATiON OF WINDOWS FOR WINDOWS — PROVIDE U-VALUE AND OR FOR NEW OPININGS-DESCRIBE SIZE OF MANUFACTURE S77CKER ON WIN�W. OPEMNG CHANGES 8c TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS .�wi. r�.�.� Aicr; isa�r,L VN vALUA11V1v, 11vC:LULIIrI� l�riL C:U��I� Vr' LA13VK ANll MA'1'EKIALS: TOTAL JOB VALUATION $ r� �('� ...� HE 1997 U.B.0 FEE SCHOCCUPANCY TYPE Permit Fee Plan Review Fire Surchazge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Chazge Total Dae $ �2 C.L� ,� � See Back Page for Fee Schedule $ 65% of Building Permit Fee $ /� � .001 times the total job valuation $ � .0005 x Permit Valuation Minimum $.50 $ ' $5.00 (State Licensed Residential Contractors) $ $2100 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$24=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) _$_ �,�;�— Make checks payable to: City of Fridlev Attach THIS IS AN APPLiCATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work ' ot to start without a permit on site; that the work will be in accordance with the approved plan in the cas k which u ev�e and approval of plans. SIGIdATURE OF APPLI ANT PRINT NAME �y��a ��u v`� DATE �� [ a Page 2- Building Residential Application 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 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: VERIFICATION OF FOUNDATION 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 location of the existing foundation will be required before proceeding with the framing. New Houses Onlv City of Fridley Building Inspections Departanent 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 Buildin�` � Insp�ct�c,:is 7�3-�'2-3604 763-502-4977 FAX DATE / � % ZD / O SITE ADDRESS _ THIS APPLICANT IS: PROPERTY OWNER/ �' CONTRACTOR SUBNIIT A COPY OF YOUR STATE LICE E AND CERTffIC E OF INSURANCE BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 7-1-2010 _ �L O t/�!✓ Permit No.: Received By; . , ;: ; � , , ,,, ' . � . YOUR E-MAIL ADDRESS ��' ��2�4 @%Y1 �Y�'LQ LJ B ct t�'cy , Cdyvi P`Q G E. �GJWNER OCONTRACTOR E: � r � r r1 c� o u RESS:_ �$�{ C� Cd �PyL �. �� c�/� / � f� �� C STATE LICENSE # EXP DATE ADDRESS: CITY_ PROPERTY TYPE GLE FAMILY/NEW CONSTRUCTION SrzE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE TYPE OF WORK: DESCRIBE WORK BEIIVG SIZE OF IMPROVEMENT ROOFING rfLT F SQUARES _ GARAGES PROPO IZE: PR OSED HEIGHT: SIDING ❑ Vinyl 0 A�i`mum �� wwnows IN EXISTIIVG OPENINGS ❑Yes OR FOR NEW OP S-DESC OPENING C S & TYPE OF W TO BE INS7 ❑ ADDTTION ❑ GARAGE/SI�D ❑ WWDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ �RAIN TILE ❑ DECK ❑ SIDING �TI�R ❑ SWIIvIMING POOL O NEW HOME CONSTRUCTION ❑ ADDITION � MAINTENANCE/REPAIIt �'REMODELWG i: ,ClrGi�►� �'12/�i., h u� ./?2�i2 -S°`ioL!/Pti . � l l.t�� ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia DATo LOCATION OF WINBOWS :IBE SIZE OF N z� s'�4� z ATE ZIP FT BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used caeE 1.�,; FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. 8c PORCHES SUBMIT: 1. Site Plan/Survey showing the e�cisting structures and proposed project 2. Two sets of construction plens 3. Energy Calculations FOR WINDOWS — PROVIDE U-VALUE AND MANUFACTURE STICKER ON WINDOW. ALL FEES ARE BASED ON VALUATION, INCLUDING TI� COST OF LABOR AND MATERIALS: TOTAL JOB VALUATION $�D U�SING THE 1997 U.B.0 FEE SCHEDULE) OCCUPANCY TYPE Pernut Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Chazge j Total Due $ �3••..�'o $ $ $ $ $ See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuarion .0005 x Permit Valuation Minimum $5.00 $5.00 (State Licensed Residential Contractors) $2100 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$24=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridlev Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclaiowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; tha.t the work will be in accordance with the approved plan in the case of all wo � �vhich rec ' es r ew and approval of plans. / SIGNATURE OF APPLICANT _. v__ ��PRINT Np►vIE /YI y rn a l�ou r u� DATE l0 � Z�� - 4aCe I Page 2- Building Residential Application � �, . $ BUILDING PERMIT FEE SCHEDULE � �' The Chief Building Official sha11, before issuing permits for the erection of any buildi.ng or structure, or for any addition to any existing building or siructure, 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: TOTAL VALUE FEES $1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for 1�` $500 plus $3.05 for each additional $100 or fraction, to and including $2,000 $2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional $1,000 or fraction, to and includin $$25,000 $25,001 to $50,000 $391.25 for lg` $25,000 plus $10.10 for each additional $1,000 or fraction, to and includin $50,000 $50,001 to $100,000 $643.75 for 1�` $50,000 plus $7 for each additional $1,000 or fraction to and includin $100,000 $100,001 to $500,000 $993.75 for 1�` $100,000 plus $5.60 for each additional $1,000 or fraction to and includin $500,000 $500,001 to $1,000,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each additional $1,000 or fraction to and includin $1,000,000 $1,000,001 and up $5,608.75 for the l�` $1,000,000 plus $3.15 for each additional $1,000 or fraction VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to a11ow 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 Buildi.ng Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 ...� s (�. �ti�� ` `� ' ( � ��_p F P V ..� ��C.. � � �-� _ �� fV�'� M � � L� , ��--� c n �- L� ` 1�� t�t� � �cSSS` �� '�- B �' c, I �t!' --� s � � `' — '��! Zl �� v�. �� c� -s--� , n �� ,_ ,,; , ,, ,, , , ,. � - — ,� �� M�� r ?�o �1 '�.�J ��` .� ��t�2r ��-�U �'� l�c�vc..� / � _ � �.s �N �.� �� 51��,� � � � �� Z � d �lt �10��- � IUI � � S . �� c. , S . �q,-� �� ,�l�S� �V1 �t� l � 1 � , � `�." E � L � �� Z9� �� `�� ' �� ln �` � lL� �. � � 1!i K ! �� _ � �� pf� Building Inspections 763-572-3604 763-502-4977 FAX DATE � ! SITE ADDRESS THIS APPLICAIVI' IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERNIIT TYPE MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY COMPANY Permit No.� o �ft �3 Received By: � Date ' 10 � ' - � � • %Lc// �—� �- /L.� ' � � � l' : '.Y:. � _i1�1 ! ■ � •� � 4 �� % � � ,- � , �g�� 3z A ICENSE # EXP DATE �ss: ct� sTa� z� [O FAX ^ SINGLE FAMILY ❑ TWO FAMII,Y ❑ TOWNHOUSE TYPE OF WORK: I❑ t�1Ew �'x�PI,�,CEMEtv'r ! DETAILED DESCRIPTION OF WORK ❑ ALTERAI'ION/REMODEL v1 FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WI�RE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOVI� PROVIDE HEAT LOSS CALC'S PER MAN[1AL J 2�6 ASHRAE HANDBOOK. Equipment Installed MFG: MODEL: SIZFJBTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU A/C $25.00 FIItEPLACE (GAS) $15.00 _GAS RANGFJOVEN $10.00 AIIt TO AIIt EXCHANGEER $15 _FIItEPLACE (W�D) $35.00 NEW GAS GRILL $10.00 BOILER $35.00 _FITItNACE $35.00 GAS UNIT HTR $10.00 CI-IDVWEY LIIVER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 _GAS PIPWG $10.00 �VENTILATOR $15.00 THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which re uir review and approval of plans. SIGNATURE OF APPLIC PR1NT NAN� /'�`9'r'1�I. �du�'-�-j DATE 7 ` d i AiSPECTORS SIGNATURE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERNIIT RESIDENTIAL PERNIIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS � EXISTING HOME ❑ MAI�E-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) � a. IMC Cha.pter 5 with MN Amendments MN Rule 1346 Sec. 501 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments 4. Heat loss & cooling load per room a. MN Rule 1322, Sec. N1104.4.13 5. Ventilation a. Per MN Ru1e Chapter 1322. Sec. 1104 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be ased for combustion and make-up air calculations.