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AF - 43187� City of Fridley Application for P"lumbing and Gas Fitting Perm�t Dept. oi Bldgs. Ph� SU 4-7470 f1 DESCRIPTION OF WORK �' `� �� Number, Kind and Lxation of Fixtures Locafion � / ��'e�-� U' WATER NTR. � � �� x�, � '� x} iz '� 8�z uz ox � i� Z • • 3 l� j �5 � � in ;� o� � u� U� < 3 U�' c(�9 n U�' O F N� GAS ELEC. Base � 10� lst � � 2nd 3rd 4th ' Futu:s CoanecYfon Openings * New Fix3uze, Old Opeaings PARTIAL RATE SCHEDULE 3ewer Cesspool PLUM$ING FIXTURE RATES: NO. RA'i'E TiOTALG Number Fixtures . . . . . . . . . . . . . � x $1.50 $� G . � Future Fixture Opening . . . . . . . . . . . . . . . . � x 1.20 $ °z ° Q New Fixture Old Opening . . . . . . . . . . . . . x 1.00 $ Catch Basin .... . .................. .. x 3.25 $ Water Heater (Up to 200,000 BTfn ......—� x 2.00 $ a�� New Ground Run Old Bldg. . . . . . . . . . . . . x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL„i� lst 3 Fixtures ..........................� X $1.50 $ �r S Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTiJ . ............. x 2.00 � REPAIRS 8c ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE ��Q City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application,are true and correct. Fridley, Owner Kind of Buiiding Used as To be completed about / 0 19`O�� Estimated Cost, $ Old— wl�uilding Permit No. �� Permi o. �� °�� Signe By � Business Phune No C�' �"��3 ROUGH FINAL az 7M City of Fridley, Minn. BUILDING PERMIT x , �, . : � ,', s ,��`°' �� , . . , � <:�-,� I '� ,� � :� ..�!'',wl�`� , .� w..- � ' LOCATION ING Na � ,' , : Street ._._.. �� -�.., p `��.�. "�"__.�._' Lot y��.� Block _. . Adaitton or Sub-Divi4ta� , Corner Lot � Inside Lot _,;.�'_'.� � �S�tback _.�� '�._ Sidryard ..�� Sewer Elevatian. _._..:.....�._. ' � ' " Foundatiasc Elevatioa � , ,,, . . � r ' `, . �ESCRIPTIOI+t1° 0F ` BUILD�NG , ; . ; � ,.;{�� "�`�.� . � " ,�' '- •�� : � ' U . .. . , �� To _.. .>,; , •., ,- . ,/�� : : : . ,.° � :.. ` I+"t�t .�%� Depth _. ./r� - -�ieiSht .�� &1• 1�'t. Cu. P't � " � f,� • . �� " . t �q. Ft. C�. F!. � -.�.+�.-r- Type of ction . 'F.s� : n _.. o be (�OOapleted . ;� � f �t �: '�` .t..� .7 � 6 � .... . ' . 5i . . . . , k._. . 3 .. . ' . . •. �.AM'� ' . _ . ... � . . � . �.:. . . . . .. . . . . . . . i Ill CORS$�C�CT8�033 OY ti1C �SSi39AO2 t0 Ille �$ pBTIY1it't0 C�ISfTl1Ct. '� b11�if�i1$ f�CBCPI 'UE.'d 8�10M1►E' ��;'� �' tha propo�ed vcrork in accordance with the d�scription abave�� set forth and in cosnpliance wlth a�i .p�t � o r 8 i n a acea o i t h e city of FMdley. � �� ,� In ca�sideratfoa� of the PaYment oP a fee o! �...:.., Per�nit is herebY S�� --- to construct the buiiding or adrliticui as d�cribed a�ove. �e t is gia�tted. �a the exPress condition that the to whom �t fis; BTeated and his aS�ts, �P�yees ��'�, �t ali�WO�k. done in, around and u� sai�ding, or any�� thereof, shatl confo�i ia all z�c�peats to the QE FridleY, Minnesota regarding location� aaa�ltx�uct�o�, alte.�atios�t mainten�nce, repe�i�r. end mtivi�g o� witt�in the city limits and ttws Pernqit inay be revbked at ar�y ,t�ne upon: ',, of any o� the p�vL� qE" ordinances. � ;" .. f � /- � �, , ; ,; , , ' r �%� � NOTICE: �,,� 'Ihb p�rmh doa not eowr fw eos�Iroallou. t�MaqNiee for wi�. �r. N� MrNy, �ww a� �rahu N awr N� f6� 6oiWfey in�p�elor for s�raf� p�rsils for 1M» iNep. • � . :•. • � . ... ,;, _ :-' +P OWNER' S PIL�t� ADDRESS APPLICATION FOR B�ILDING PERMIT CITY OF FRIDLEY, MINNESOTA BUILDER ADDRESS LOCATIOPi OF BUILDING No. Street Part of Lot Lot Block Addition,or Subdivision Corn.er Lot Inside Lot Setback Side-Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. To be used as; DESCRIPTIOld OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be Completed The undersigned hereby makes application for a permit for the work herein specified, a;reeing to do all work in strict accordance with the City of Fridley Ordinances anci rulings of the Department of.Buildings, and hereby declares that aIl the facts and representations atated in this application are true and correct. � n.��E � � czcr�n�� ---------______-- -- ' �� (SchQdale o.f Fee Costs cea be found on the Reverse Side). . � . > � • � .. - No. of. Origmat � PERMIT for Power lants and Heating� Coot- ing. Ventilation� Refrigeration and Air Conditioning System�s and Devices aESCRIPTION OF WORK eating Plants to be installed--altered—repaired Make � , Sixe � � � ; Oil fired ; Coal Remarks Approaed by ; Gas fired � ; Gas Authorization N Final Inspcction Date , 19_ Inspector `f �`7C£�� Permit �TQ � � O C F� � '.7 � .t�� , OfFce of the Inspector of Buifdings City of Fridiey City of Fridley, Minn.,�ldm�_, 19� Owner �/��n ��g-�'Z�� Location iOg 7 �� Kind of Building v 1 How Occupied Work to be Comrnenced �' y ,19� To be Completed � � � ,19� Estimated Cost, $ �� d`�% Old-New, Building Permit Permission is hereby granted to '° v� to install—erect—use tlae material and devices described in tlie above statement. Th.is permit is granted upon t e express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of tlae deaices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of tlae devices herein name ,�and to the specifica ions set forth in the approved application for tlxia permit on file in the o f j`ice o f the Inspector o f Buildings. • , Inspector of Buildings <Z sM »-a� v � `' f- GRAVITY � Furnace Replace Repairs Repairs MECH. WA �v afl 3 � ON. � �O Iv nm �� . C � -ni 7 O Y � Z �o � �1 � �'UT113Q j v c � Replac Repaix Repaia 3TEAM o� � a- ��a '�:�Z � �zrna D Z � rn Each � � D � o ° O C '^ Each N' �o a OIL BUR cn cD N7 G � GAS BU] � � � GAS FIT Z . � lriiJ uaa.ba. �.. �__„ ' AIR CONDITIONING FAN HEATING SYSTEM VENTILATING $YSTEM ALTERATIONS 8c REPAIRS ROUGH FINAL 3 � n� -�. S;�„ C p -Ni � v�i � � O — O O -+ ' n �C tD � W 3 O�p � C lD tn N � p � � fD �' � a a < � � � c'o °- � ° �D ° -. — o uN+ u�i � o � 0 . N —. Q -F < C� c � �c o � � I y � �- 7 O — S . � � T � N � �F � y • '+ T D 7 N tn � � � � � �, � v 0 0 1 � 3' (G 7 T N 3 n � °, c J < � N (/i � � o c� �' ai °' o -. � � S � p c tp �u "'•�' � ° � fD �- ��°�� m � � O (�D <C� N � � � � �n = c �• -- -► cu c '� � � �c a o .� 0 �o • � � � N v �' ° � _. � � ry f1 S � 0 'p H .�,� � o -� � a n �p o \ .,; �n 3 O � � � m � -�+ � � a � -*� o� v�i ' f1 N C �' .0 .� = O � ' () � � See Fee Schedule � TOTAL FEE � � V c� o Q s N � W o a � �. � � -�i� � � � 0 � D c S Z 0 CI] � W W N � ,� �ating. Cooiing, Ventilation. Refrigerarion and � ;ng Systems ond Devices � Z Z rn D � � r N �ii D N n 0 � � Z -C � r-- � �— � jTAL F� Dept. of Bldqs. Phoae 560-3450 Location � � / y �^ � � �i C � � I City of Fridley: The undersigned hereby makes application for a permit for the work hereir. specified, agreeing to do all work in strict accordance with the City Ordinance: and ruling of the Department of Buildings, and hereby declares that all the fact� and representations stated in this application are true and correct. Fridley, Minn. � ! � � , 19 � ` Owner � � '" \ � 4 � � �!'� � �l /J" �1 Kind of Building /� �'✓ ' C L`I Used as � � _l � �� To be completed about � �' � � � � / �__� � �� Estimated Cost, $ Old—New. Building Permit No. Permit No. '�%d�� DESCRIPTION OF WORK HEATING or P R PI.ANTS-�team, Hot Water, azm Pii � No. Trade N ame ;, J� �� Size No. Capacity Sq. Ft. E.D.R. BTU �� H,p Total Connected Load Kind of E�el f�' /� � BURNER — Trade Name Size No. Capacity Sq. Ft. E.D.R. BTU g,p, (REMARKS—OVER) 42 � � Sign � sy Business Phone No- g_ 2�� 7`�� sua�ECT PE . City of Fridley 18407 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ' ' RE � � . � ; y_____._ COMMUNITY DEVELOPMENT DIV. r � � PROTECTVVE INSPECTION SEC. �Q �9 � i � , ' ' /'��1 � CITY HALL fRIDLEv 55432 NUMBER. REV. DATE PAGE OF APPROVED BY �'"""�"� ,�' 612-571-3450 9t0-F15 5/2/86 � / JOB ADDRESS 687 �ver Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. �.% ��.$ V Riverview Heights SHEET 2 PROPERTY OWNER MAII AODRESS 21P PHONE George Korich 687 Dover Stxeet N.E. 780-1550 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE IICENSE NO. 6 USE OF BUILDING Residential 7 CIASS OF WOHK ❑ NEW ❑ ADDITION Cl� ALTERATION O REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Draelling 9 CHANGE OF USE FROM TO STIPULATIONS Roo� can be 2nd layer but not 3rd. Install ridged galvanized valleys. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID If WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOfi A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING { HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 STAL�S GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VA�UATION SURTAX AND ORDINANCES GOVEFiNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GfiANTING OF A PERMIT yS`rJ' OO $.SO DOES NOT PRESUME 70 GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OFi IOCAL LAW REGULATING CON- STRUCTION OF THE PERFORMANCE OF CONSTRUCTION. $).rJ.00 PLAN CHECK FEE TOTAI FEE $15.50 i ATUAEOFCON'RACT R AUTHORIZEDAGENT IDATEi WHEN PROPERI.Y IDATED THIS IS YOUR PERMIT � r � � � '" SiGNATURE OF WN iIF OWNER BU�lO R� IDATEI BLDG �NSP ATE N� [] City of Fridley Effeetive �/1/86 ADDN. L] � R-1 AND R-2 i pLTER. [ 7 Building Permit Application Construction Address: __ `p�� 9 v �ir � �' � Legal Descript�on: ,p Owner Name & Address : `-�f< a�`� � � � ��Cl�` Tel . � ` v v� �'��d Contractor • �� l� Tel . � Address • �� N� Y�� ST N'� � Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROYEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: DECR AREA: OTHER: Length Width Height Sq. Ft. Length Width Hgt/Ground $q. Ft. Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setback Type of Construction: ��—�� 7 Approx. Completion Date: � �� Estimated Cost: $ �d ° Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: �r � � �� APPLICANT: ��'k-�' Tel. # ��v� �5�� CITY IISE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: � /s : oa $ $ ,�`�� $ $ � $ l�-S O Fee Schedule on Reverse Side 25� of Building Permit Fee $.50!$1,000 Valuation $�75 Per SAC Unit Fee Determined by Engineering Agreement Necessary L 7 Not Necessary [) CITY OF FRIDLEY APPLICATION FQR POHlER PLANTS AND HEATING� COOLING, VENTILATION, REFRI AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE 4ESIDEIQTIAL Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer * Air Conditioning (all sizes) Al1 Others/Repairs and Alterations 1� of Value of Appliance or Wor}: COMMERCIAL/INDUSTRIAL 1$ of Value of Appliance or Work RA.TE TOTAL S 2a. oo $ $ 10.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ 10.00 $ $ . State Surcharge TOTAT, FEE Reinspection Fee ($15.00] $ .50 S 15 . SO $ Rough �nsp. **Installing one (1) Carrier Date 38EN024/24 2 ton air conditioner Final Insp. Date Approval for Permit ��`T7'°`�— MINIMUM FEE FOR ANX HEATING PERMIT IS $15.00� PLUS $.50 STATE SURCHARGE Attach atlsck verification Forn► wilh. replacc�nent furnace pexmits *Air Conditioners can not be placed in side yard without written permission fran adjoining neig or. Job Address 6$� DOV Department of Buildings, 6431 City of Fridley Tel. H571-3450 The undersigned hereby make specified agreeing to do all and rulings of the Department facts and representations sta OWNER George Korich I KIND OF BUILDING Frame usEO As Residential TO BE COMPLETED ABOUT ESTIMATED COST �1.300.00 OLD - NEW BIIILDING PERMIT NO. _ Effective Date May 1, 19II8 TIOP! ANL� St. NE ty Ave. N.E., Fridley, N,id 55432 application for a permit for the work herein rk in strict accordance with the City Cedes f Buildings, and hereby declares that all the d in this application are true and correct. dley, Minn. July 18 , 19 g8 PERMIT NO. �' � DESCRIPTION OF FURNAC£/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Wazm Air- No. Trade Name Size No. Capacity Sq.. Ft. EDR BTU Hp 1bta1 Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. �DR gTU gp Company � Dependable Heating and A/C • Siynecl BY �t'C�Ci�Y�C� C• �,� ^ (� ° �0.� Te1. No. 757-5040 SUBJECT City of Fridley 2 5 5 5 4 AT THE TOP OF THE TWINS g � I L D I N G P E R M i T r REC IPT NO. � � /� � • COMMUNITY DEVELOPMENT DIV. � � ; V �� , . r � •� PROTECTIVE INSPECTION SEC. 1 ' ��1 � CITY MALI FRIDLE� 55I32 NUMBER REV DATE PAGE Of APPROVEO 8V !"""�� '' 612--571-3450 910-F15 9/30/97 / � J08 ADDRESS 670 Dover Street NE LOT NO. BLOCK TRACT OR ADDITION 1 LEGAL SEEATTACHED DESCfi. ZG, 25 W Riverview Heights SHEET 2 PROPERTY OWNEFi MAIL ADORESS 21P PHONE James Clobes 670 Dover Street NE 280-8885 3 CONTRACTOR MAI� AODRESS ZIP PHONE UCENSE NO $11Il2 d ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE UCENSE NO. 5 ENGINEER MAII ADDRESS ZIP PHONE IICENSE NO. 6 USE OF BUILOING Residential 7 CIASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION � REPAIR O MOVE O REMOVE 8 OESCRIBE WORK Reroof House (15 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROl1P OCCUPANCV IOAD SEPARATE PERMITS ARE REOUIRED FOA ELECTRICAL, P�UMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BEC�MES NUII AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. fT. AUTHORIZED IS NOT COMMENCED WfTHIN 60 OAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED ON ABANDONED FOq A PERIOD OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFfSTREET PARKING 1 HEREBY CERTIFY THAT I HAYE REAO AND EXAMINEO TIi1S APPLICATION 1 STAILS GARAGES AND KNOW THE SAME TO BE TRUE AND CORFiECT. ALL PROVISIONS Of LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TVPE Of WORK WILL 8E COMPLIEQ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRAN7ING OF A PERMIT �1,251 �.63 DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHAqGE PROVISIONS OF ANY OTHER STATE OR LOCAI LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �43.00 Fire SC �I.ZS PLAN CHECK fEE TOTAI FEE $44.88 S�GNATUREOFCON�AACTORORAUTHOA�ZEDAGENT IDATEI WHEN PROPERLV ATED THIS IS VOUR PERMIT �� -� .��t cExl�(� C.t�t�° � � �C( `i � — A7URE OF OWNEA i�F OWNEA BU�I EA� i�ATE� _ Bt�DG NSP ��FTE Ncw [ ) ADDN [ � ALTER [ J ConstructionAddress , . .. s :..; C[TY OF FRIDLEY S[�TGLE FAMILY AND DUPLEXES R-1 AND R-2 BUiLDING PERMIT APPLICATiON ^7 d i� o � e�- Effective 1 / 1 /97 ��.��-� Legal Description: La �}-,2c.( � 5 ,�j L o�� W �� J e.� v t e� � c.r�S ----� Owner Name & Address: .J � m � ( a b .e� TeL /f � �U � � � � Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: Attach to this application, a Certificate of Survey of the (ot, evith the proposed construction drawn on it to scale. Lenath I.ength L.enath DESCRIPTION OF IMPROVEMENT Width Height Width Height Width HgdGround . , ��,r � � — �� _ Sq. Ft. Sq. Ft. Sq. Ft. OTHER: . � �a�� Construction Type: � �{� �}.Q �;� �,, Fstimated Cost: $ � s S c�{�( Cc v'-e S (Fee Schedule on Back) Driveway C�ub C�t Width Needed: ` Ft:` + . 6 � Ft = ` .'" Ft x $ .; - .. ; _ � � . , �. . . DATE: % 6 GI7 APPLICANI': � p�'p p��, � C(� �p � Tel. # s� O p� (' 7S � Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charae TOTE1 L S"1'CPULn"('[ONS: $ 3� � w �y�� 0 3 $ $ $ $ $ $ $ � `'( ' i� � C1TY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Vaivation $950 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ) Not Necessary [ ] Building lnspections 763-572-36tM ; �A�___�� STk .'1�DRESS i � 'E'HIS APPLiC�1:VT IS� �---^--- ; PROPERTY OivV � TEN.'�N7' SUBb�IT A COPY OF YQiJR STATF LICENSE WITH APPLZC'AT(4N Frpm: Clty ot Fndley To: 952-54a-0882 Pege: 4/5 Date: 12l181':t006 12:� �:Q3 PM BU�LriYNG� RESIIyENTIAi, APPi,�CATIaN CITY OF F��,�1'' C] OVVNER N�� w� �7DAESS: �B� nH;�KE;_� � NAAi�:�Qr ° _ .. i 3TATE LIC:E:d56 �+ I AI7DRESS:��'i� �=`-�.-�,..�,� ,er�5]T� CiLE; F.4Mlt,Y/1�T1 I � �CWC� FA1r1TLY'NE� C] A C�OITIQN ,_._...._,_. � J �ASc:�f�NT �'T?JT5?i � 7 DE(:il i TYP� O�' WORI�; ;❑ r�� ; ._ . . ._. . __ ..... .. ...... . _ I. � b•tAl vTEtv.?, I U�S�::?�.i�E WvTtI� BEIIti'3 U��NB� � __ $QI:nRFS i.? ,�_ 1'ermis Na. R�ceived By: _� Date Rec'd: �,2 ,� -- YCiUR E-MAL' ADDRESS ,............��.._.._ ..�........ __....._..--- -- �O:�TRACTOR T,...••,•-- ----- .— .� � L ��___.—��.._.._._, -�_�...__.._._ ------- �m---•,- �_. .. ..�,,.��- s� N�.��. �;.��.�._y.....,._...._ _ . sT�� . . �sy� 7 $ �(�,l0 53,_„ [� f72fi�CU EXF' D.4TE � FA7( r7`' � I� fTRUQTiQN s12 �L�CTi4N 3T� 0 o.a�c��sx�n �i00F O 5IDING ❑ S1�1:MM1NQ PU(iL __ �❑ DITI�N fOD�GING � hovs� �. c+!�Rao£ CITY �,�w.r,�STATfi�LIP�„'�,�,� ❑ DRAtld TlLE ❑ GTHER W T17T iaf,r ; • ■ � �: �. rt. /' �cyC� � ' C3 ATTAGHBD C.4R.SC7E , j?RO�PO.S�7 SI7.F,;��-�,1 I] 17F.T,4('HF.n C�iRA(iF. � 2. Pmposcd f1o,u pl�n Pt2��P:1SF�i HEICrH^'' 3 Llb'l Of �tl'UCSUI'dl �ril01bCfS l�t �t 4flS! j -- • . I�Ct � FUTt h'EW GGNSTRUC':1GN iTi�1.UMVC� D:CI:S. �❑ Virryl C7Soffit ADDiTI�I�:i, Bc DOR(`}iFS 3i�SM(T: I�°.!��ur,inum G Trim i 1 Site PIao�Surve�� siu�ing the rciscin,� atrucwrss I❑ Artlet S7 FNecia ! en�i }uopueeJ �u1ec1. Iw'Il�D� K� � 3 'nvo sets af ccw��vaian pfars R+� F.XISTJ�Q OPSNINQ9 C7Yes OtJ� LQCATtO'J OF TN]T11X;WS � 3 Ener�• C�tculttlons j�R 1=C7� Z.fE•W Qp$NLNd3-DE5CRlS& SIZE OF �__ � � I JFLiJTNG CtiAN'G�a 1ti — -----•----- � TYPE pF U4NpOli' Ti13E It35TALLEC NUMBER OF l�'L�"DpCV$ I AL�. �'�E$ ARE BASED OV VALLiATION, rNCLL''UXiV'G THE COST OF LABOR A�TD MATB�IALS: � �� M� (t?Si1vG��I�F�19$'! [:.B.0 FEE SCY�i)'[iT..�) � ToTAI. JUH Z'wL�UA'�IOli' S �l�l� � p��Y°pp�TC`l' TYPE _ �ernut r aa Pten Rcview �ise Snroharge 9uroher�e License Surcharga sAC cts�� Curb c'_�ut �;s�row Eroaic� Con[rel Park Fee $eaer Main l;har�e $ _ See �aek Pr�ge fn_ Fea Schedule _ 65aio pf Building PermitFee _ .fJ01 times the tptal )pb vahiatien .OU05 x Permit't'aluatian lMi�ut�urn S.SO � $S,CQ iState T.icensed �tesidential c".ontractorsj $1550 p�r SAC l'.Jnit fPlens to MtiVCG for determination'1 t}+fift� Rx�;:! -� $456 ronservar,ion Plan Raviaw -�^_T- _ Fee Aetermined by Engi�iearutg _ A�'eemantnecassary( � NunNecnssaryf. � � TI�iE3 IS AN APPL1C�lTION FOR A P:��f[i-*TOT �'qLIA i1NT[L PRQGESSE� iZ horo�+y apply for a building perntit and T ecknowledge thet the �!'ermation abor•e ia crmplete and eecurnte; that the wark v.ill be iri i eonformanee �rich the ordu►ances e�+d codes of the City of Fruilty �o vcirh the I�4;nr►escrta Consrruccian �odes; thet f understand this ia nat a { permir but oni,• am ap}�lication for e nermit and work ia nat to atart witk+olrt. fl normit; that. the wark wili be in accan�3ance tivith the appra��ed i pia�� in the caso of all wor which re uiros :ew and approvel of plans, � 3fUN,�SJR$ OF �'PLlC:AU�,�� --- pEiilVT A'AMfi ��e6� DAT£_�� „- ' _ .,�.,....._.__�. __ _..�_—•--Y ��._..� ...---- -- Wd £6�OO�Z6 900Z/0Z26 :a}�0 bl£ :a6�d Z880bti9ZS6 :�o�� Building Inspections 763-572-3604 DATE SITE ADDRESS ,�, TMS APPLICANT IS: PROPERTY OWNER/ TENANT �. MECHANICAL RESIDENTIAL APPLICATIQN CITY OF FRIDLEY t Permit No. Received By: YOUR E-MAIL ADDRESS �/ �D y✓ C� �vwt �G C..v�.e.r��r�-�•-� �.� �CONTR.ACTOR w�� ADDRESS: Cv �S / /�JvvC ✓ J � Pxor�: -76 3- 7ff y- c� 1 6 fs CONTRACTOR COMF Home Energy Center SUBMIT A COPY OF CO� 2415 Annapolis Lane N#170 YOUR STATE sTAT� plymouth MN 55441 LICENSE WITH r�D�63-476-1990 fax 763-476-1143 APPLICATION pHON. PERNIIT TYPE TYPE OF WORK: �Sl SINGLE FAMILY ❑ TWO FAMILY p �W �7 REPLACEMENT �,r,��,Q 1 G�/_STATE}11� ZIP�S 4 30�1. T-- �ATE CITY P�Ymouth STA7'E MN ZIP 55447 •476-1143 ❑ TOWNHOUSE ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK �'� PER MS 16B.665 the permit fee is a minimum of $15.00 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. (This should reflect only the cost of Iabor ) Labor cost under $300 =$I5.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOV� /,,,,�,,,�i �� MODEL: l M��5 S�Z�raTU ��'� �'r'O— Equipment Installcd MFC'� "_"" MODEL: S��TU MFG: SIZEBTU J,�G: MODEL: A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGFJOVEN 510.00 AIR TOAIR EXCHANGEER $IS FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOILER $35.00 ,�FURNACE $35.00 GAS IJNIT HTR 510.00 CHIMNEY LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.00 _GAS PIPiNG $10.00 _VENTTLATOR 515.00 DUC7 WORK $10.00 __ .. , _ �.�r, ,, ..,,��.._. m� �.��:,�;w��..�;a,-�;��r��r*�c+.�r�r'r�:a3�'e'rri 11'#�4�'ti'.t%:�1i'IJ,J„�'.Ls3J. [;a�>�n v.�,��j.rs.a�.:u+,.,.vv cw;ar .x:�-.; , i.. .-...-.t- r . :..,--::. .__..�.....: �..._..-__. __ . . . -- Permit Fee $ Number of fixtures @$10.00 x$10.00 =$ Surcharge $ .50 Number of fixtures Q$15.00 x$15.00 =$ TOTAL DiIE $ 3 • D Number of fixtures @$25.00 x$25.00 =$ Number of fixtures @ $35.00 � x $35.00 = $,�� State Swcharge = $ .5�' Tota1= $�J. TH1S IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I herehy 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 Minnescta Consm:ction Codes; that I understand this is not a permit but only an applicatio or a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in th case of all wo�c ich requires review and appro��al of plans. SIGNATURE OF � NAMF `� q'� (L DATE �—/� s o City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977