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AF - 38012City of Fridley, Mirm.. BUILDING PERMIT Date: �ec. i.�� 1".>f�� Owaer: �i�an �i�k Buiider ��-��,r��a, Tn4. Adaress �,d�H 4411 �: �n t r�- L v�. . td .�. N° 10063 LOCATION OF BUILDING No. ��'33 Street �cna��ri:c� CunTe Part of Lot Lot � _ Block � Addition or Sub Divfsian Mel�'�d� I�=it��r 3�'ci �.�lc�ra . Corner Lot Inaide Lot � Setback ��' � — Sideyard i•� ' i� e Sewer IIevatitton � � -`` • �4 i�ot�niiii�.1�� 883 .(i0 ( '^,PPr�x) TcglJ �af g� pr��1� DESCRIPTION OF BUILDING To be Uaed sa: C�v�e 11 i.�t� �t �(J' �p� 25' Height �� Sq. Ft. 1 C�flU Cu, Ft �•'.0, i1ti0 ��.r, ��e Front �2 � Depth a3 � fTeight 1� e Sq. Ft. �� Gu. Ft ��yo "� Type of Construction r�Tt�°e Faat. Cost —��6 @ O(i� To be Completed rI''SF�.�' �.l�E��.°��i� @?,t� �'a3t f+�F T�t�'A�aCa�.�. 1�,�� ':i�;� �,t�t;;` TI��' S;.' .�es� �i �i,,;nii::>1: In consideration of the issusnce to me of a permft to construct the building described above I agree to 80 the Pruposed work in accordance with the descrlption above set forth and in compliance with afl provIsions of crrdinances oP the dty oE Fridley. ,,� .. �-` - ;�lat�.�� e�a�� Connectioa �h�r�e �:� . �`y.i �le�+zc►�, �nc . In camsideration of tt►e payment of a fee of $ , permit ie hereby graated to to construct tt►e builcling or addition as deseclbed above. Th3s �ermit is granted upon the expresa condition that the person to whom it 3s granted aad his agents, employees and worl�nen, in a11 work done in, around and upon said building, or anypart thereof, shall conform in all respects to the ordinance� of Fridley, Minnesota regar8lng lacaiion, construct�Ton� altera.tion, maintenaace, repafr and moving of buflciings witbin the dty ]imits and this permit may be revoked at any time upon violation of aay of the provisions of eaid ordinancea Suil�7in8 Inspector G'�.�iGiLC@_' Pi'4.'ZIE�i�: NOTICE: 1hH permk d� eot eowe t6e construeHoe, iestaQaliee �e� �rirtao, pinmbiee, gn 6adeg, aw�� ee wwr. B� sun to n� fM Boildtag le�eto� for ap�rN� p�rmiM for th�n itenn. � �.�_ - �"\ G /� � - - a APPLICAI'I4N FOR BUILDING PERMIT � � �� r ��` � �� . , i- , , �.- :�r � ' ._�/,� °i/. �_- T � y: ✓�:!/ . .. .t .v �� . . . /, � � � � � , i • ,� � � .� � 1�..: J�./�%�� .�`�j / LOCATION OF BIIILDIDTG NO„ � � ,�,�,� STREET �e'• t� � ��2 �d �� ,s� ART OF LOT LUT BLOCK ADDIIZON OR St1BDIVISI0IW� i� CORNER LOT INSIDE LOT� ACK �5 � SIDE-4 ,/.� °°C? �/� -� SEWER ELEVATION ��AT�� 0�� Applicant attach to this form Two Cert3ficates of Survey of Lot and propoaed building location draFSa on these Certificates. DESCRIP7.ZOR OF BUILDIftG To b used as; . � � � ! � Front �� Depth �`5 � Height �—O , Sq. Ft.1`�� Cu. Ft. � Front �� Depth�Eeight � —� Sq. Ft. J�'� �/ Cu. Ft. .� �� Type of Construction Estim�ted Coat ��, � Q� ��% To be comp].eted The under�igned hereby makea application for a permit for the work herein specified, agreeing to do a11 work in strict accordance with the City of Fridley Ordinances and rulings of the Departmeat of Buildiags, and hereby dec�ares that all the facts attd representat3ona stated in this application are true and correct. � � _ " � .,� j (Schedule of Fee Costs can be found on the Reverse Sid�). �� ,� , eJ� l� � � .� 8 _ ., �,,.� � � - � � - �-- � �`� � n ^� ' � , �; � � �� --� �, ;� �, � � �� ,�� . , �-- �, c� �, l� > � � �.. � �� -� °�," � � � U� � �� BIIILI?ING PERNRT FEE SGHEDOLE SECTION 2. The Inspec�or of Buildings �hall, l�efore issuing any permit for the'� erection of any bui�.ding or'structure, or for any addition to any existing building or s�tructure, or for any alterations or repairs to any existing build3ng or atructure, upon applicatiaa therefore, require the paymeat by the applicant for auch permit of fees to the�amount�herain beiow set forth and in the manner herein provided to-�ait; 2.1. For any such permit for the erection of any,fire-proof building, othei tha a garage, warehouae, factory or grain elevator, or fox the erection of any fire-proof additioa, for similar occupancy, to any esistiag building, shall be at the rate of $1.40.for each one.thousand cubic feet, or fraction thereof, in such cubical couteats. 2.2 For any such perm�Lt for the erection of aay fire-proof.�arage, warehouse, factory or �rain elevator, or for the �erection of any firepproof addition, for similar occupancy, to.�ny exiating building shali be at the rate of $1.25 fc�r eacti one thousand cubic feet, classified ae�"fireproof" by Section 502 of the Mianeapolis Buildiag Code. ., HO.. USES 2.3. For any such permit for the ezectian of auy non-fireproof buildiag other than a garage, warehouso, factory or grain elevator, or any non-fireproof addition, for similar occupancy, to any e$isting building - permit $1.00 for each one thousand cubic feet. GARAGES 2.4. For any such permit for tho erection of any non-fireproof garage, warehouse, factory or �rain elevator, or for the erection of any non-fire-proof additioa, for aimilar occupancy, to any�esisting buildiag or for each such building or addition - ninety centa ($0.90) for each.one thousand cubic feet or fraetion thereof, in the cubical contents thereof with the minimum of $4.00. For the purpose of computing fees for buildiag pe�its, the cubical contents of any buildin� or additioa to a uaiform height throughout by multiplying the. grouad�area covered from a point s�x (6) inches below the floor�line af the basement or cellar to the average hoight of the upper surface or to the average height of the roaf.surface of the main gable of a pitched.roof. � 2.5. For repairs.or alterat�ons �o an eaisting �tructure, the fee s?�P11 be at the rate'of $3.00_per,each Five Sundred Dollars ($500,00) or fractivn thereof in the�cost of all proposed work. 2.6. . In no case�shall the fee charged for any permit as set forth in Section 2 be less than $4.00. ST'ORM REPAIR DANIAGE FEES : Residential; Estimated Coat of work up to $50�.�� - �5.!?� Estimated Coat of wozk over $� �:::. �-�� ..� y, �, �:p Commercial; Estima.ted �st of work ��c �::, �`, ,:_,.`:, ��,� ,�� _ � Estimated st of wo�:� u��r ��i;i;�i�;; .. �•� ,� ?- :;.:i.,_� aENERa.L CONTRACTORS CUSTOM BUILDERS OF HOMES APARTMENTS COMMERCtAI BUILDINGS YOUR PLAN WE TRADE OR OURS REAI ESTATE BROKERS LET US SELL YOUR HOME APARTMEPIT BUILDING LAND OR LOT ALL TYPES OF FINANCING AVAILABLE ._ 701 COLUMBIA BLVD. MINNEAPOLIS, MINN. 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A A��, �y�� '�'� ti �, �o��. � � b y ?� � � � A �' �,�.�� o �� ' � � "' �o � �'�' � M � � � � O � A p b A� � � � � S � , O r. � O t`�o' � a � , y 'ti � �'�, o �,o, a� C � � � � �� 'n � c� � b o o� � � � � � �`' `z �, �o�' o ��'�ob � � � bCl A� A: b � � � �. � � �. � � �� 0 � � � � b � �. � � 0 0 � 1� 1��1 0 �c ,��,; �+ O �� Q � c�o o �' '�''' �Sct'' O �e' � �i � R' � �1'+ W � � � � � I � �, � � J H � .� °p� � �� , �' �' �' a� g p � �+ a, � � �� , �. � �a �ro w~ �� 0 �II• � a� �� o �. M �� . �, �« .�, 0 M �ro � �. � a 0 �. � HOUSE HEATING TEST RECORD ADDRESS ,�� '�-� �,��'-�� APT. R SUBURB.�� O,�CU PANT OWN E R �� , HEAT LOSS DATE HTG. INST. GAS C0. METER BA # `' SOLD BY INSTALLED BY � – Elsetrical Work By Gaa Lins By TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER cc�.� GAS SIGy,..,�� CONVERSION MAKE /a,�.� �� r� MAKE OF BURNER Modsl �� Of.� �/�% Model Ssria l �� 7� Max. BTU Rating INPUT ,��' �� MAKE OF FURNACE Model CONTROLS Zc THERMOSTAT J��eot p�� Vent Size �� _ Valve KIND OF UNER �` � �Z � NONE Limit � Draft Hood Regularor Limit Sstfieg –�'r�'�' FilTers Size ►�u�ber Fan Setting �� " C�imney Loeation Inside �'� Outaide Pilot Typa Chimney Construefion Pilot Make B Pilot Model �,p �� Smoke Bomb Wiring �° L� Pilot Timing ��"�–� Draft �,�� Test Tag L.W. Cut Off �o�r Pressure— Lighting Inat. Prossure .�,� � Pere nt CO � a ��Teated — Input CFH ,`� � Pe�� LCompany Testing '� Stack Temp. Psreenf CO � �� Name of Teater Form 235 SUBJECT P ML�-H1E��: c�ty of Fridley 21314 ' , AT THE TOP OF TNE TWINS g � I L D I N G P E R M I T ECEtP . r � � � • COMMUNITY DEVELOPMENT DIV. i LV �� f � � PROTECTIVE INSPECTION SEC. � j � � �'�'1 � CITY HALL FFiIDLEY 55432 NUMBER qEV. OATE PAGE OF APPROVED BV �""� � �'� 612-571-3450 910-F15 4/30/�2 / / JOB ADDRESS �433 Concexto Curve NE t IEGAL ��T NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. G 3 Melody Manor 3xrl Addn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZiP PHONE Glenn/Haze1 Vick 7433 Concexto Curve NE 786�6135 3 CONTRACTOR MAIL AODRESS ZIP PHONE LICENSE NO. Custozrl Remodelers Inc. 8729 Central Aveniae, . S1a3ne MN 55434 784-^2646 1748 4 ARCHITECTOROESIGNER MAILADORESS ZIP PHONE IICENSENO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Res i.denti�, l 7 CLASS OF WOHK ❑ NEW ❑ ADDITION � ALTERATION C� REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroo� Dwelling (�6 �quaxesl Te�r��';� 8 CHANGEOFUSEFROM TO STIPULATIONS Underla�tment m�ast com�l� w�.''th. S:tate. B�ailding Code4 TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANOONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT..ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMPLIED $1 � 378 $• 69 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUM TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OTHER TATE OR LOCAL LAW REGULATING coN- $33.00 k'lY'e $�C $�.�35 RUCTIO R T P F ANCE OF CONSTRUCTION. � PLAN CHECK FEE TOTAL FEE Licexise SC $5.OQ $40.07 SIGNAT E FCONTRACTOR AU MORIZEDAGENT IDATEI HEN RO LY VA ID ED TNIS IS VOUR PEFiM1T ' � / � �. SiGNATURE OF OWNER iIF OWNER BUILDERI �DATEi LOG INSP �ATE � - � NEW [ ) Effective 3/1/92 ADDN [ ] CITY OF FRIDLEY �-� �� ! _�, ALTER [�(j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Constiuction Address: Legal D�scriptioa: 3� l_c�Kc � Owner Name & Address: � c � Tel. #%" �-l� �-3..i Contractor: iawc _..0 MN LICENSE #�60 / 7�� Address: g�c� � ��'r�,�[ a. �l4 � k.e � �/�% SS��3 � Tel. # <�/a�.?�'� a,� �,� T� Attach to this application, a C�rtificate of Survey of the lot, with the propos� coastruction drawn on it to scale. DESCRIPTION UF IMPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: Length Wi�h Height . DECK AREA: Length Width Hgt/Grotmd OTHER: Corner Lot [] Inside Lot [] Ft. Yd Sexback _ Type of Construction: Approx. Completion Date: Sq. Ft. Sq. Ft. Ft. 5�, Side Yard Setbacks Estimated Cost: $� � 1 �� %��%�'i (Cost on Back) I?riveway Curb Cut Width Ne�ed: Ft. + 6 Ft = Ft x$ _$ DATE: 30 � APPLICANT: � Tel. 6� �� f �ITY USE ONLY > Permit Fee S �3- 0�. Fe,e Schedule on Reverse Side Fire Surcharge $ l. � o .001 of Permit Vatuation (1/lOth%) State Surcharge $ . �% $.50/$1,Q00 Valuation SAC Charge $ $700 per SAC Unit License Surcharge $ a�, d O $5.00 (State Licens� Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Pazk Fee $ Fee Deternuned by Engineering Sewer Main Charge $ Agreement Ne�essa�y [] Not Necessary [] TOTAL $ L/d , O'% STIPULATIONS: �� a� � s� —� l�— /� �U r � �' (, 5" 0 BUII.DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the er�tion of any building or structure, or for aziy addition to any existing bnilding or structare, or for any alteration or repair to any existing building or structure, upon applicatiori tiierefore, require -the paymern by the applicant for such permit of fees to the amount herein below set forth and in the manner herein pravided to-wit TOTAL VALUE . $1 � to $500 $501 to $2,000 $2,001 to $25,0� $25,001 to $50,OD0 FEES $15 (Mirumum Fee is $15 plus surcharge) $15 for first $500 plus $2 for each additional $100 or fraction thereof, to and including $2,U00 $45 for fit� $2,000 plus $9 for each additional $1,000 or fraction thereof, to and including $25,000 $252 for first $25,000 plus $6.50 for each additional $1,OOQ or fraction there�of, to and including $50,000 $50,001 to $100,(�0 $414.50 for first $SO,OOU plus .$4.50 for each additional $1,000 or fraction thereof, to and including $1�,000 $100,�1 to $S�,OQO $500,001 to $1,0�,0� $1,OQU,001" and up $639.50 for first $100,000 plus $3.50 for each additional $1,000 or fraction theareof, to and including $500,000 $2039.50 for the first $500,000 plus $3 for each additional $1,000 or fraction thereof, to and including $1,(�)0,000 $3539:50 for the first� 51,000,000 plus $2 for e,ach� addifional $1,000 or fraction thereof DRIVER/AY DEPRESSION ESCROW _ (Concrete Curb Streets Only) Alternate "A" : Removal and replacement of curb and gutxer only - Driveway width plus 6 feet times $13.50. Alt�ma.te °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 $15.75. VERIFICATION OF FOUNDATION Permits for constiuction will be issu� a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the constivction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. sue�ecr PE . City of Fridley 2 6 7 6 4 . AT THE TOP OF THE TWINS g U I L D i N G P E R M I T ; � o. � ; L ��_�� COMMUNITV DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. �� 1 . � � � � j /"'1 � CITY HALL FFiIOLE� 55432 NUMBER REV OATE PAGE OF APPqOVEO BY �----� � �'' 612-571-3450 910-F15 7/22/98 � / JOB ADDRESS 7433 Concerto Curve t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 3 Melod Ma.nor 3rd Addn. SNEET 2 PROPERTY OWNER MAIL ADDRES$ 21P PNONE Glen Vick g - 3 CONTRACTOR MAIL ADORESS ZIP PHONE LICENSE NO. Four Seasons Roofin & Remo e 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION � REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof 24 S Tear-off 9 CHANOE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL. PLUMBIN(i. HEATIN(i, �PE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCE0. NO. DWLG. UNITS OfFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLtCATION STAILS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE Of WOqK WILL BE COMPLIED WITN WHETHER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT �ZOOI 1.00 DOES NOT PR UME TO GIVE AUTMORITY TO VIOIATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS F ANY STA E OR LOCAL LAW REGUTATING CON- STRUCTION R THE PER A E OF CONSTRUCTION. �]�{.7S Fire SC �Z.00 PLAN CHECK FEE TOTAL FEE � � License SC 5.00 $82.75 IGNATUiiEOiCON7RACT ORAUTMOR12EDAGENT DaTEi WNEN PROPER ALIDATED TNIS IS YOUR PERMIT s ^ 4 � S�GNATUREOFOWNEFUfOWNERBUILDERi IDATEI B G�NSP qpTE r 3 � NEW [ ] Effective 1/1/98 ADDN [ J CITY..OF FRIDLEY � ALTER [] j SINGLE FAMILY �AND DUPLEXES R-1 AND R-2 �q � - : BUILDING �PERMIT APPLICATION , , - �� " �� conscru�tionAaaress: � '7 � 3 3 C.c� n �e.r--�l—� Cc� �-✓e.. � � . � , Legal Description: Owner Name & Address: � �.�n V l eJ�C Tel: #, �%g(o —� /�j� Contractor: Fv u r S easan s�oc�i r� a d f�em o cic,%h,, LC. C, 1��IN LICENSE # c� ��3�� Add�'ess: %?� 4 [ / ,� � � , �-� �'l,/�o �U . � Fr ► c-� I �, c.� Tel. # r% 9.5-- �� / d ' � � Attach to this application, a Certificate of Survey of the � lot, with the proposed construction drawn on it to scale. . DESCRIPTION OF IIVIPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length � Width Height Sq. Ft. DECK AREA: L�,ngth �idth �� Hgt/Ground Sq. Ft. OTI-�R: Construction Type: {�p�YL,pV �2,C�.,�� Od� Estimated Cost: $ ��%� � � �-�� - - ' (Fee Schedule on Back)�`f Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ �— . . DATE:. �� 3 � APPLICANT: TeL �'l �JS- 9�i�0 CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Pazk Fee Sewer Main Charge TOTAL STIPULATIONS: $. ~ . .�� $ . OC� $ l��U $ � �. �b $ $ $ $ . � $ ��.7s Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1� per SAC Unit � $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering r Agreement Necessary [ ] Not Ne�essary [ ] . BUII.DING PERNIIT FEE SCHEDULE : `� . � . The Chief Building Official shaU, before issuing permits for the erection of dny 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 amaunt herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $SQO $501 to $2,000 $2,001 to $25,000 $25,001 to $SO,Q� $50,001 to $1�,000 $100,001 to $500,000 $500,001 to $1,O�,Q00 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fracdon thereof, to and including $2,000. $62.25 for first $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.OU for each additional $1.0� or fraction thereof, to and including $50,000 $574.75 for °first $50,000 plus �$6.25 for each addidonal $1,000 or fraction thereof, to and including $100,(}00 -$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 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. Alterna�e "B" : Removal and replac�ment 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 constiuction 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 construction site. A Certificate of Survey of the lot, showing the locadon of the foundadon once it has it has been constcucted will be required before proceeding with the framing. � �. _ , * � D � �� O '� � m Q: � _r 3 0 y' 7 N � O N � n -,. � O � 3 � 0 a� 0 �• � �• � Oq n fD a °' o � � �' �N � � o � � � � Q . � � � a c � � rn Z N � m n _-i O z � m m � �P V O 0 \ 2 � a A � � x °`� � m � � U. � I ( � � � 0 c oa ? � � a1 t�D � � � 0 � � �� Jl � � � � � � r � n r-+ p � � � � o � G1 � � fD p. C O N D _ � d -� �' � n m 0 < 0 � o h � D N r N m � m �. N Oq lD � � � � o �I 2 � � y � � � �' CD 3 � � � � � y � - � � � �D fD � o Q � n � � � y O ? � � aq' y W �, N N C• � Q. � � � � 7 O � a� a � > >�o�� .+ <. °1 � � �; y c' � � � o N / � � N � � �_•Q='� i � � N — � �. � n . 1 D � � •n-► =- Q O P "i n� � � � i m ma�-* rr � 0 � �c � �-� � � � � � a � N � � � ''� � t� n�i � � o r«��, 1 � 0 � � rF 1 � � � � � S ^� S � � " � i:l � � 0 y O � �, a � m �a y m � _. � D rr _ � � � � <� N y � m m '� O � D '� a �' a � o�' D m � O �; �O � O N �� 0 Z W � c� v D n O a 0 � � Oq D � N m N G) � N � m � G� G� A '�'I e�D U1 N N '� N � � � '� n � � � N-o m = � �� d � = z � � m � � � � � Q . � o Q-�T� —c -�o_� O� � � � � � � � � W � o � � n � � ~` v �.'�i � W � � � � m � Ef� �H9 i�9 4f� {� N �--� � �--� (N (J1 O O O O °o °o o° °o °o � m fA 4A b9 t�i if� {�i � � 0 � � �' W W � fD � -� � Q m z � N 2 � � N fD z m � :Ll "n � --I Z m C � ° °- o N .,ti � z 2 � � � � m � 04 ` �c N � _ o � c� � A n � O � � � � fp fD .n+ ^ m N a �� r N ar"z3 0 � o = �O � � �� rF r\ � � � � W ,� c D � Z rn � � C � o � � ` � rn � � z O � �!v `�, � � "'� m N c� x m v c r m O �- c,� O � � � � � � rn � 1� � �" � � � � � V � � n dl a W �--� v(p i""' � cn `-� C � wz� � � �� w < � N m Z zN m� m C7 � 0 z � C � a � � z � r �� O � Z R1 � a� �� O� Z� Z 7mo v .� a� � ON vz .� v o= zm a �Z �A O mp Nr Z a� v< v "' z <� c� � yO Z � m n < m O � L � � c d � � N O O N THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMnN VFNT� VFNT GnNNECTOR AND nM8l1STI�N AIR V RIFI .ATION Wh211 r� I�.ing an eYictin� f�i ran�p, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes �j' No () �l The venting system is plastic/PVC and meets all cuRent codes and manufacturer spec�cations including sizing, length, number of elbows and termination. The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufa�turer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The pYic_t_in�, _emb �� en air is sized and installed to meet the current codes and manufacturer's specifications. When required to in�tal� a n w_ome ��on air�it wi11 be sized and installed to meet the current codes and manufacturers specifications. Whet1 inc allin� a n_w v_n in�iy�, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( ) No(�' Yes �j No ( ) �� Yes� No ( ) Yes� No ( ) Yesl� No ( ) Yes�No ( ) _ • � . � ' . � ' . � • ' � 11 II • � ' � . � � - � � 1 � ' M � 1 � tll . ( • � Appliance #1 Type BTU Input �' � a v an Assiste r Nat � Appliance #2 Type BTU Input o o�v Fan ssisted o at _-- - Appliance #3 Type BTU Input Fan Assisted or Nat, �� Total Appliances c�_ Total Btu Input % 0 a�d � l.:c ,�� _ Common Vent Type Vent Height a C1 Diameter e ° inches , Appliance #1 Vent Connector Height ft Length ft Diameter in �ype :�� Appliance #2 Vent Connector Height ft Length ft Diameter in ?ype ' Appliance #3 Vent Connector Height ft Length ft Diameter in Type � � y : � �•. .�- ..- HEATING CO: Signed By: Date : � � a B�ilding � Inspections 763-572-3604 DATE Y — C� �O SITE ADDRESS 7 � THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE TYPE OF WORK: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS �C��^ � r �<- ,�WNER ❑CONTRACTOR �z�e % �/� � ADDRESS: % �.� � �o�. ��° � C � �✓CITY. PH�NE: ��— z O Co — ��'r STATE LICENSE # EXP DATE Permit No.: Received By: Date Rec'd: '�� ADDRESS: CITY STATE ZIP, vr�rn� FAX _ � SINGLE FAMILY/Ni ❑ TWO FAMII,Y/NEW ❑ ADDITION p BASEMENT FINISH ❑ DECK O NEW ❑ MAII� DESCRIBE WORK BEING DONE: SIZE OF NUMBER OF GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other WInDOWS IN EXISTII�TG OPENINGS OYes ONo OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED �-�OOF �� ❑ SIDING ❑ SWIMMING POOL ❑ ADDITION pAIR ❑ REMODELING LENGTH ❑ HOUSE ONLY i�IOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE L]Soffit ❑ Trim ❑ Fascia LACATION OF WINDOWS ❑ DRAIN TILE ❑ OTHER WIDTH HEIGHT Ft BASEMENT REMODBLING SUBNIIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of strucwral members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDTfIONS. & PORCHES SUBMIT: 1. Site Ptan/Survey showing the existing structures and proposed project 2. Two sets of constrvction plans 3. Energy C;alculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $��f S� OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surchazge License Surcharge SAC Charge Curb G�t Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ Q`3�a5 _ $ $ �� 5 $ 1 �17 $ / $ $ $ $ $ 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) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( Make checks payable to: City of Fridley THIS IS AN APPLICATION FOR A PERMTT-NOT VALID UNTIL PROCESSED Attach 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 Cons�uction 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 wluc r'�S ��w proval of plans. SIGNATURE OF APPLICANT � p�NT NpMg�/ v�G � `— v DATE R _ � � 4 � Page 2- Building Residential Application BUILDING PERMIT FEE 5CHEDULE 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: 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 includin $2,000 $2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional$1,000 or fraction, to and including $$25,000 $25,001 to $50,000 $391.25 for 1�` $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 ea.ch additional $1,000 or fraction to and including $500,000 $500,001 to $1,d00,000 $3,233.75 for the 1� $500,000 plus $4.75 for each additional $1,000 or fraction to and includi.n $1,000,000 $1,000,001 and up $5,608.75 for the 1�` $1,000,000 plus $3.15 for each additional $1,000 or fraclion 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 proceedi.ng with the framing. New Houses Onlv City of Fridley Building Inspections Deparlment 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fa�c: 763-502-4977