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AF - 40714sue�ecr PERM . City of Fridley 142'7 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T • r � � ECEIPT NO. � ` _.__ COMMUNITY DEVELOPMENT DIV. i f � y ; PROTECTIVE INSPECTION SEC. `�C-!'�, � � � /"'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE � PAGE OF APPROVED BV �""� � ,� 612-�0-3450 910-F15 8 5 77 � � JOB ADDRESS 5557 East Danube Road N.�'i. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 1 Innsbruck Nort,h 2nd Addn. SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE DaVerne Qorporation 1393 - 16th Avenue N.W., NEw Brighton 631-1213 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Same 4 ARCHITECT OR DESIONER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 OESCRIBE WORK Construct a 34' x 30' Dwellin and a 24' x 24' Gara e NG 9 CHANaE OF USE FROM TO AND SIGNS. STIPULATIONS provide a hard surface drivev�ay. Provide .sod in the front and side yards. Provide a verifying survey before capping. Provide City with copy of truss design before capping. SEWER L�ATION: (Approx. 13' Deep In Street) 130' S.W. of Manhole (Inv. 946.74) WYE ELEV: 948.48 TOP OF FOOTING: 951.48 Minimtun WATER LOCATION: 3' S.W. of Sewer 5ervice DRIVETnTAY DEPRESSION COST: N/A 1 � �: EI `�.� �'^' � Tki t�lY Of PRIDIEY DOES NOt Gt►AR�,NTEG n�e �efore dig�ir�g call i�cKi utilities AGG�IRACT OF UTIl11Y tOCATIONS AND E�iv�,TIONS, TELEPHrOI'aF - ELECTFiC -�a!',� E���,e THlS OATA t3 FOR 111�ORMATION ►Ue�OSES Oh�LY AND ��s u�rvc rt s�o�nc v��r n� a�o�u►r�t ����.��� �� �`� �,���A - c� n�+� s�te '� TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, W� Frame 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 R 1 ]_�]./� + 576 38,104 Total OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUFTAX AND ORDINANCES GOVERNINC3 THIS TYPE OF WORK WILL BE COMPLIED $��215 �•32.11 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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. ' S1S2.42 $375.00 - . �1_` PLAN CHECK FEE TOTAL FEE �(,� �l�,�ylA_, ���+L,C�XCJ S 7 $38.11 $597.64 SIGNATUREOFCONTRACTORORAUTHORIZEDAGENT lU rEi WHEN PRO.ERLY VALIDATED THIS IS YOUR PERMIT � ` � � ` `C-��i� �� '`�' SIGNATURE OP OWNER IIF OWNER BUILOERI IDATEI BLDG iNSP DATE � �I OS�JIZLR: Addres::: - l.l I i UI 1 ttlllLLT APPLIC/1TICi1 FOR RESI))E�lTI/1L Bt11LDING PER��IITS i�`�LW, /iLTLEZATIU�JS, /�DDITI0�1�, UR ��EP/�IRS) IIUILDLl2: �(�. (/j��°l� � Address: Tel. Na.. � No. : ,�jJ J%��_ Street: � -���•� LOT: c3 BIACY,: d RDDITIOPJ: ��bf4� � CORNER LOT: IPJSIDE LOT: Y S,?TBACK: SIDEYARDS: Applicant attach 'to this form ZWo Eertii'ica�es of Survey of Lot and proposed building location drawn on these Certificates. DESCRI PTION OF BUI LDI NG �. To Bsed As: _ . • �� � Front: � � Depth: �� Height: Square Feet: � 7/� Cubic Feet: .�-�� �`�� � Front: � � Depth: °� � � Height: �� Square Feet: ��f� Cubic Feet: ��� � Type o� Construction: W Estimated Cost: $ P� ���� � To Be Completed: Proposed Driveway Width If New Opening Is Desired Alt. A Alt. B % � $ �- $ (SE� REVERSE SIDE OF SHEET) The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and r ect. See reverse side for additional infozmation. DATE: v � SIGNATURE: Stipulations : G��� � ���. �� P` � .� ��, � / '� �. . ;.. � � /� ��° ���� �.�� J.' f �� • e � �32•�/ �,� ,c� � � �/e�y E Y\I.._�f./I11�• i L1�� �a � �•• .�..��.�...,�... SECTIOt4 ?.. 'rhe Insper,tor oE }3uildit���s shall, Lefoic J.JJUlI�� T�ermit� for thc. cr.cctioti Uf clfl� �iUJ.�_I�JII:f Ci1" :;t_]'LCf.IlYf•� UY rC�l' �.1)f ilCjr�lt]C�1-t t'C) Z]tl'� ('i'.l.^.tlll�j t�l]11.(�l,l�� C)T" `;i:Yll[:t.�lr�'� nY 1C)J" �tIi`f i11.1..C1":1i:.1.Ut1 U2- 1_tr}�itll::% i:O c7l�f C'l.J.';Ll.l]�J ���ll.lcllll`j UY ::trucLur�� Uj)UIt �lj�j7�_]�7:tt.]��11 thereiurc, rec�u.�ru LYie ��riyment }�/ tiir_� �����licanC fur ::uch F�cr.ui.it oi iecs to the amuu►,t hcr.�:ir� },clow seC forth at�d iii thc manncr Yicrc�iii l�r.ovic3ea La-wit: ?;EW C.OtISl'ItUC7'IO;J: :;inglr, r'��mi�.y tiome� and Garages: $4.UU/1,OOU cubic £eet-. PLJ1td CIILCY.: 25 percent of. t�uildinq E�eizni:t fee. vRlVrt•7t�Y Df�I�P�L•'SSIGP]: (Concr.ete Curb Streets Only) Rl.te�'��tite A: 1?�moval. and rei�lacement of concrete curb an�l yutt�r anly; Driveway width ��lus 6 fcet Y.$11.75 Altc:rnatc A: Iterric�vai and re��la�•ement af cor�crete curb at;cl guttcr and install a 3 foot wide approach with 6 inch depth; Lriveway width F�lus 6 ieet x$15.��G �DDI T IOf�/1L I PdFOR��IAT I ON For the purpose of comput�ng fees for building permii:s, the�cubical contents of any building or addition, is determined by multiplying the ground area covered from a point sir. (6) inches below ttie floor line of the basement or the cellar to the average heights of the upper surface or to the average height of the roof surf.ace of the main gable of a pitched roof. Eor repairs or alterations to an existing structure, the fee shall be at the rate of $3.Q0 lier each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. In no case shall the fee charged for any permit as set forth in Section 2 be less than $7.50 plus $.50 si:ate surcharge. VERIFICATION OF FOl1NDATIOf� NOTE: Permits for construction will be issued a minimum of 24 hours from the time of application to allo�o for proper review of the proposed structure and of the construci:ion site. , A Certificate of Survey of the lot, showing the location of the foundation oiice it has been constructed �aill be required before proceedir.g with the framing. Ct2TIFICATE OF OCCUP9NCY Application for a Certificate of Occupancy shall be made ten (1G) days prior to the use or occupancy of any sti-ucture for �aiiich a builcling perniit iias been issued; and said structure shall not be used or occu��ied until a Certificate of Occuganc}• has been issued. � CERTIFICATE OF SIJR�/EY �"o�.• Da Verne Co. v oP � ti �� P� O 5� �P / / r s��/: .�r,�o' �Deootes Iro� �� � ��' v � �af 3, B/oe�F 1, /NNSBf�U�'!( NORTff Z"'O ADD/T/ON, .4�oko Coa�fy, /Lli�r�esofo- We hersby certify that fhia ie o frue and corroct ropreeentation of o surver of the troundariae of tAe above deec►ibad land ond of the locotion of all buildin8s, if ony, thereon, and all vieible ancroachmenle� it any, from or on eaid land. E. G. RUO & SONS , INC. �' S'e � �� Dated this .�T day of �° t9_' br ,��,. �'�p""'� Sio%yo.d .f'e,�6vc�.F iervsed' 9•90.77 Minn. Rea. No. E. G. RUD 8� �OIUS, INC. LAND SURVEYORS 3847 155th Avenue N. E. Anoka , Minneso#a 55303 Tei� 434- 5505 1-si �3- 3.2 V � .� L`���°ri���e or� .39��v�y f�r.. ��`�t'� �,��.s�"Ao � i� ' ,'� 1 i 'j� P� o / � � � / �� �¢ ��e �, v � � �� J�F�J � �� / e � flo9 ��� 4 -, � � % D / '¢ �� ����.° .�==3D� � D�.�a��°s Trorr 1�iE CIT'e° OP �RBD�E� Dp�S Npp CUARA E EC:,URAC� OF �l�ILB� d��A�'90PdS A�p E� TIONSE ,:3 DA�� eS FOR IP9FpRM,��I�Pg ��pRPOSES O y A�� Pe�SONS USIPIG 1� SMOULD VE1�8�1' TFi� ASdP�B�AATI�PV ON i�lE SITE �� � -'.�,,� '1N��I����G `�� Before digging call Ie�al utiYities TE�EPHONE - ELECTRIC � GA� ��� `���IR�� ��' ��fV � Z� -o" _ . . , r' � ; o ; , o ., ; ' �s � i� ��\ ' °O Lo� .� .8/oc°.�r 2,� /��,s�6�-vc.� /1'�orfh .?'Q'D �la'o�i�io�� ,4r�o.�o Cov.��y� /1/ii�.��so�'`�: �/ ` .-; e�k /� hr Se� j ��� �1,���� � � / o� e � ��. ��9/ ��a` / �.�-� _ / ���`� � �� i hf�r�&rv ��ir�y tha� �i� �u�eq+, DOa�, �� ��po�t �ras k�p���'�r�a�J �y m@ a� �sPtd�p r�y a�v� su��a+is¢esn st� Y�w� �:�:�� s�9ulb R��ost��� �aarao:+ 5�srv�EN�r aanda�r eh� ���r� ti,' 1�`�cti �Dk' ��� e0� �1��0 � G��2e , !7 _�,n.��'�.,7 % s ��e� .. ����.,_..K. a. �.. 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JN � V� t Y �+t�e` �t.,c� ��.'*'�„�' ��'�x t � "�� t¢� _ s � �'���i �+`�`' r +�( � �r� t*X �� �� � �� F; �� � \ w t 3 t %, � ' �' h sr ,�,K w �T�, � ; � `� ;s . $� y s'. �.'�r R� �� a,,�� �p ?,��,� a 'v x., `i 'Y � �„'�, g ,..+ � � f,M1g .k A ..3� ��a" 1 � .• ��,. . 'v� � � .. Y _�' ���e � ���'�`"�,i'� � �.�,zs .€, '} T�' rP:��,' � 4 ��� .{; � � .�5�,�� - ;� ., � _ �,`�. r S i � t A � G , � _ M�IRMl4� +�-t�' : r r ` ���°'���������� �������`' ����� : ������'���� 1925 Oakcrest Avenue Roseville, Minnesota 55113 (612) 636-7744 220 - 20th Avenue North St. Cloud, Minnesota 56301 (612) 253-3451 REPORT OF DENSITY TESTS FROJECT: BLOCK l, LOTS 3, 4, AND 8 EAST DANUBE ROAD INNSBRUCK NORTH, SECOND ADDITION FRIDLEY. MINNESOTA . GEC JOB NO: 1419 REPORTED TO: DaVERNE CORPORATION 1393 16TH AVENUE NW NEW BRIGHTON, MINNESt3TA 55112 CC: CITY OF FRIDLEY BUILDING INSP�CTI�N DEP ATTN: MR. RON HOLDEN DATE: 2, 1977 Eight field density tests were conducted at the ref�renced site on July 29 and August 2, 5, and 12, 1977. The tests were done using the Density of Soil in Place by the Sand Cone Method procedure (ASTM D 1556). � One Standard Proctor Density Test (Moisture-Density Relation of .� Soils using a 5.5 lb Rammer and 12 inch Drop, ASTM D 698-70), previously reported in GEC Job No. ].379 and identified as Proctor No. l, was used. Three Modifiecl Proctor Density Tests, numbered 2, 3, and 4 (Moisture-Density Relation of Soils using a l0 lb Rammer and 18 inch Drop ASTM D 1557-70}; were also conducted. Relative density was then computed by dividing the field density by the Proctor density, expressed as a percentage. The results of the field density tests are as follows: Cr•�-L� � L�� ` � � �, ��,.v-�•c i . .:. � , t�- f� " ( `��o ��y � ' \� � r J.—� tto � � � 4 `J � �' � -f �` ' � ' ��° 7 � tw r i' E� �, ,�/ LQ � n € ���i. �' �� � „�� °� / � - J C��4`'� rI � y; � �/ � J HYbROLOGY • SOIL AND FOUNDATION ENGINEERING •'FEST BORINGS MATERIALS TESTING • PERCOLATION TESTING • ENGINEERING GEOLOGY • CONSTRUCTION IPISPEGTION 1 i �� i � ..� � . GEC #1419 - Page 2 FIELD MOISTURE REI,,ATIVE I'EST TEST DE.NSI�'Y CONTEL�7T pRpCTOR DENSITY JOi DATE LOCATION DEPTH cf) % NUMBER. % 1 7/29 Block l, Lot 4. 1/3' below grade 107.7 20.8 4� 90 Rear Frost Footing 2 7/29 Block 1, Lot 4 1/3' below grade 104.3 18.8 4 g�i Rear Frost Footing North Side 3 8/2 Block 1�t__3� �' below grade 120.6 4.9 � 1 104 Rear Frost Footing � 4 8/2 Block l, �ot 1/3' below grade 134.8 6.6 2 108� I3ouse Cen - 5�8/5 Block 1, Lot 8 1/3' below grade 122.6 10.5 2 99 South end � � � 6 8/5 Block 1, Lot 8 1' below grade 125.8 8.9 2 101i North end 7 8/I2 Block l, Lot 8 1/3' below grade 122.7 8.5 4 L�103 Frost Footing-SE . 8 8/12 Block 1, Lot 8 1/3' below grade 121.1 3.8 3 104 Frost Footing-NE 1 2 3 4 The results of the Proctor tests are as follows: . , OPTIMUM MOISTURE M1�XIMUM DRY SOIL�DESCRIPTION CONTENT (%) DENSITY, (pcf) S�, medium grained, brown (SP) 12.5 116.0 - SILTY AND SANDY CLAY. brown fCL; 17_R l�d_1 SAND, fine grained, brown (SP) SAND, fine grained, brown,(plastic�SM) 12.2 13.4 Based on the results of the field density tests, it is our 116.2 119 . 3-� conclusion the soil was compacted in a suitable manner and will provide adequate structural support for single family dwellings. 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Wall Int. Q/all C.eilmg ee I�o I Y— �0 19_ .� Room Lengch Widch Hei�hc Window� and Dooro---Crackage and Atea tVldth Ha1�Al No. ot Lln��l [t. Are� fe. of Dane o! D�na Ileht• ot craek p. tt. 7. � � u'' �-- '7vZ r1 v� � �� � / / 1_ dl Ge -� � :�- % ' ,� 3 ' C� coe�. �ea� lofiltration ��. �'' �e' :lau 3 L �;� �p. wal! ;jn" Vet e:p. wa01 / � � � � nt. wall �eiling r � �a �C.�' � loor CoLI Btu. / tequired sq. k. E.D.R or aq. mi. QIA. Leader area Room Leagth Width Height Qlindows aud Doors--Crackage and Area Wla A He1�At No. o! Llneal tt. Arq r0. 0[ pans e[ am Iltot� o[ enck p. ft. I � Q � (�, � • � � ��� � "�'� � / � � � � e;� s'�' 3 � L 3 caE. ee� a6laataa ' G ✓Z �-� �,.. � " s v S'v :�. wall �et e:p. ws0 nt. ws11 :eiling Floor Potal Btu. Zequired aq. h. E.D.R. or sq. wa. WA Leader area Room � l.eRgch '3 � 9v�dch ..� Windowa and Doori—Cratkage and Area Wldth Hel�at No. et Llaeal tt. Ares fa ot p�n� ot psn� Ilfet� ol enek W. tt. , �� . � G, L a. � �� 2- � U S/ � o6ltrat�n �_ ilau �p. wall Vet �p. waq nt. wall �eiling � loor tetal Bt�; � 2eq,�ired �q.�f� ��v or tq. ini. WA. Leader are� 5 Btu C� -_ �� � � �` ,t�s�'���3% - �� B��`��gV�� VILLAGE OF CHANlPLIN r. �ulaeion Roof IFlosc Kind ��'ai>/' o�/tr`"�''E%om�0.� �°ieedoaas aAd Doors--�rae wia�h t7•�set No. � Na ot pena of paae ISfAI � c., Z �3 .z / In6lcratioa �� �sp, evall N�t e�. w.0 ln� wall H�r ' Qli�th Area e. wr.. r �. te. � C"" � 3 � � �' S � rc�� lu�) � �cu l,rZ C% Ceiling Floor ' � . .7% / � % � �% y L° Total �tu. R�uir�d w. k. £.D.R. or �q. in�. WA l.eadec arca '(� � Fl.) Room I l.en�th QVidth Height Windowe `nd Dooes--Craelcage and Area WIdtA SN�Dt No. ot Lfa��l [t. Aroa Ne. o! pano ot p►n� Ilsets ot craek �v. tt. Ia6ltratioa GI... Esp. wall � Nec ezp. wall lnt. wall Ceiling Floor I"fotal &u. Required sq. k. ED.R. or sq. ins. QY.A. L.eader area Fl.� Room I L.ength W�dth Windov►n •nd Doon--Crackage aad Ans �W�IdtA HsI�At Na ol Lleul tt. Ara� Ne. I o[ o�o� oY pan� Il�ht• o[ erael[ �p. tt. Heeghc CoeE. Bcu lnfiltration Glaa �. w.0 Nec e:p. wall Int. wall Ceiling Floor Total Btu, Rs�uired �. ft. E.D.R. or aa. ies. WA Leader area BROOKI�N ►RINTING L ADV. CO ��� �,�r ��� ; r� �;` �,� ' ' y� �r°� � � �f: �� � � �` � 4 � ,��.:.:' f P• ., _ ;''t,. �t � ° : '� - .`: ty 16r 1978 �ve Ficek DaVerne Corpprati.on 1393 - 16th Avenue N.W. New Brighton, Mn. 55112 ���� �� ������� 8431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 Res F'inal Inspection for 5557 East Danube R+�ad N.E. Dear Mro Ficek: TELEPHONE ( 612)67'1-3450 A final inspection was made on January 16, 1978 of the above address and the following it�s were not� w3lich must be completed before the structure can be finaled out; 1. 2. 3. 4. 5. 6. 7. Provide sod in the front and side yards by July 15, 1978. Provide anchor bolt nuts in garage by January 22, 1978. Insta].� three paxatanent steps in garage by January 22, 1978. Insulate and fixerock hole in garage firewall by January 22, 1978. Complete roof flashing by January 22, 1978. Install garage door closer by January 22, 1978. Install f�ost footings for deck by July 15, 1978. We will expect the above items to be completed by the scheduled dates when reinspections wi11 be made to deteanine compliance. If you have any questa.ons on these itens, please feel free to conta.ct me at 571-3450. Sincerely, ImN HOLDEN Building Inspector RH/mh W �.J A � LL Ll.. O � U l � I �, I I I A Z Q Z 0 F � W c� � LL W � z 0 �y ►• U > -n�- , ca Z Q .. 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New Brighton, MN 55112 TELEPHOIdE ( 612)5T9-3450 Re: Reinspection For Final at 5557 East Danube R�ad N.E. Dear Mr. Ficek: A reinspection was made on July 28, 1978 of the above address and th.e following items were noted which must be completec3 before the structure can be finaled out; �i 2. 3. 4. 5. 6. 7. Repa.ir closer on gaxage fire door. Replace broken block.in north. wall of garage. Inerease deck footings to 42 inches helow grade. Patch cracks in northwest corner of the basement wall. Install heavy gua.ge metal strap over cut in top plate near furnace. Caulk exterior around all openings. Install 5/8 inch "plyvaood" box beam tXpe reinforcing above garage door header where top plate is sagging. We will eacpect the above items to be completed by August 15, 1978 when a reinspec tion will be made to determine compliance. If you have any quss tions on the above items, please contact me at 571-3450. Sincerely, �N HOLDEN Building Inspector RH/mh CC: Patricia Freeburg 5557 East Danube Road N.E. a ��I � � r � .� � ..: : , ,,�. � ��. : , ; . � ,�;: " ; October 5, 1979 CI'�l� O� �FRIDL�Y 8431 UNIYERSITY AVENUE N.E.� FRIDLEV� MINNESQiA 6643� . TELEPHONE ( 812)571-3450 Ms. Patricia Freeburg 5557 East Danube Road N.E. Fridley, MN 55432 Rs: Final Reinspection of 5557 East Danube R�ad N.E. Dear 2�.s . Freeburg: In response to your r�uest for a written report on our coanpletion check list sent to your contractor and dated July 31,1978, we list the following as a re;port; , l. Repair closer on garage fire door (complete). 2. Replace broken block in north wall of garage (area ha.s been repa.ired) . 3. Increase deck footings to 42 inches below grade (cor.�plete) . 4. Patch cracks in narthwest corner of the basement wall (unenforceable by Building Code) . 5. Install heavy guage metal strap over cut in top plate nea.r furnace (complete) . 6. Caulk exteri.or around all openings (openings visible from grade have been completed). 7. Install 5/8 inch plywood Yaox beam type reinforcing above garage door header where top plate is sagging (unenforceable - the Code requirement of two 2x14'�s as a daor header has been met) . If you have any questions in regard to these items, please feel free to call me at 571-3450. Sincerely, DARItE G . CZ�ARK Chief Bu' Official DGC/mh CC: DaVerne Corporation 1393 - 16th Avenue IJ.W. CITY OF FRIC�LEY � r , � a � � W � � � � Z � � � � x m � � a � � v � < > � 2 � � �� 2 � } Q N O •� `� � ��� o��� N :.± � LL t^l� U d � 2 O � 0 �- � W m � Z � � � .� � TEL: 612-571-1287 Sep 29,95 1�:38 PJo.00� P.02ip2 � tl3 w a� � � Q w O H a � O Z d a w � � z � � a c ��� � � � .� � � �� ''' O ��� .� r ~ � � � � � ���5' ���� r���a � ��� � .� p .�+ a � � � Y Q � � � � � .s��� t�~�c m � c � Q Qi � ~ � � � � °' `�.�'� '� 'c7 a � 2 �' ���� i ` T � � � � � m � C � � �. � ` � U � � U � 2 � � a ggg88gg$8$$S S t� st tn A h 1� h O � O O O �ff ������������ � � � � � � t � � �� � 1? t .. �i - : >- � '� .� � Y � .� + � LL .�i ... +� � 3 ����� � ¢� W � Z d � R� p� { f � � � C •� C � .0 C � � � t � � 'C o. .. � C� •� � � b (� I-- � � � � � CI 3 g t �,��� � � 3 ��� a: °� � a� � c'�i E- � O�� U o c c�n ��'3 �7 t� a`� >-' m m -o Z � � � � v� � � � h � 0 a � . .Q �' � � � $ �� `o 8 °� � ��� � Q ti �z � d m 3 O Q � :. � �x o � o N O � ii Q � � � � � 4r'' � r�i N � W V z � �, � � � Z � < I � � r Ga Q ¢ � � 0 F- � U � � � O w Q 0 a w m � N OC d O � � V s � SUBJECT PE . CitY of Fridle - �-�-� AT THE TOP OF THE TWINSy g U I L D I N G P E R M I T ����� r � � � �• COMMUNITV DEVELOPMENT DIV ' �v _-___-� r � � PROTECTIVE INSPECTION SEC `�� � � � � � /" '1 � CITY HAL� FRIDLE� SS432 NUMBEF pEV DATE PAGE OF APPROVEO Bv �---'�' �'' 612-571-3450 910-F15 6/5/96 / / JOB ADDRESS 5557 East Danube Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADOITION SEE ATTACHED oesca. 3 1 Innsbruck North 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Patricia Freeburg 5557 East Danube Road NE 571-6041 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same A ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION � REPAIR ❑ MOVE � REMOVE 8 DESCRIBE WORK Reroof House (28 Sq) 2nd layer 9 CHANGE OF USE FROM TO STIPULATIONS , Roofing can be the 2nd layer but not the 3rd. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING. VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, Ofi IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTHEET PARKING I HEREBY CERTIFY THAT I HAYE READ AND EXAMINED THIS APPLICATION 1 STALLS GAFAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED @ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT � 1, 736 '1' • 87 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OF THE PERFORMANCE OF CONSTRUCTION. �.56.%.5 Eire .SC �1.73 PLAN CHECK FE O AL FEE $59.35 SI ATUFlEOFCON'AACTOAOAAUTHOA�ZEOAGENT IDATEI PfiO VALD THIS IS YOUR PERM f �� �� I ' • �_� �Q-Q� �,� ,L ,., NA UF7E OF OWNEA i�F WNER BU�LUEF7� � ATEi OG INSP �itiTE r�w ADDN ALTER C] [l [l CITY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R 1 AND R-2 Building Permit Application Effective 3/1/96 �a� �� ConstructionAddress: _�" �� j � G �,r-� � � � � � � Legal Description: Owner Name & Address: '°� n �! ^ -� 5 T 1. # / ( � U� T i � C i C� , r I��- ��. 1tJ � R�- C .� / L C �-i I Contractor: _ u-r.u�,��-- MN LICENSE # Address: � ��_- Tel. # n ��;� �N LIVING AREAs GARAGE AREA: DECS AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction dra.wn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height Length Width HgtlGround Corner Lot [] Inside Lot [] Ft. Yd Setback Type of Construction: Approx. Completion Date: Sq. Ft. Sq. Ft. 5q. Ft. Side Ya.rd Setbacks � / az Estimated Cost: $ % (� (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: I � �i L APPLICANT: , r - � ��-u;; ' 2_ Tel. # � 7 / — � � =f I CITY USE ONLY Permit Fee Fire Surcharge Staxe Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Pazk Fee Sewer Main Charge TOTAL � s�-7� $ l� �%� $ � C,� % $ $ $ $ $ $ ^' Fi e � �r� � � � � Fe� Schedule on Reverse Side .QOl of Permit Valuation (1/lOth%) $.50/$1,�0 Valuation � $9� per SAC Unit $5.(� (Sta.te Licensed Residentia.l Contractors) Alt. "A° or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] STIPULAI'IONS: _� , .- BUII,DING PERIV�IT FEE SCHEDULE The Chief Building Official shall, before issuing �rmits for the erecrion of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing builcling or structure, upon applica.tion 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 $1 to $500 $501 to $2,000 $2,001 to $25,0(� $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up �� : . $21 (Minimum F� is $21 plus surcharge) $21 for first $5� plus $2.75 for each additional $100 or fraction ther�f, to and including $2,OQ0 $62.25 for first $2,0(� plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each addi.tional$1,0� or fi�ction thereof, to and including $50,000 $574.75 for first $50,(�0 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100, 000 plus $5.00 for each additional $1,.000 or 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 $1,0OO,OQ� plus �2.75 for each additional �1,Qf10 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Ci�,rb Streets Only) Alternate "A" : Removal and replacement of curb and _gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construcrion will be issued a minimum of 24 hours from the time of application to allow for�proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the lacation of the foundation once it has it has been constructed will be required before proceeding with the framing. _ _ ` SUBJECT �: i---�.,,, City of Fridley 2 6 0 21 ' , AT THE TOP OF TME TWINS g � I L D I N G P E R M I T O � � �` _���� COMMUNITY DEVELOPMENT DIV. r � v � PROTECTIVE INSPECTION SEC. �� �� i � 1 . � i---. w�'�',.j CITY HALL FRIDLE� SS432 NUMBER REV DATE CAGE OF APPROVED BY t '� 612-57�-3a6o s�aF�s 5/5/98 / / JOB ADDRESS 5557 East Danube Road NE t LEGAI LOT NO. BLOCK TRACT OR ADDITION SEE ATTACNEO DESCF. 3 1 Innsbruck North 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADORES$ 21P PHONE Pat Freeburg 5557 East Danube Road NE 571-6041 3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO. Fey's Construction Inc 13270 Jay St NW, Coon Ra.pids, MN 55448 755-4438 1904 4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO. 5 ENOINEER MAIL AOORE33 ZIP PMONE LICENSE NO. 8 USE OF BUILDIN(i Residential 7 ' CLASS OF WORK � NEW ❑ ADDITION �1 ALTERATION ❑ REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Ritchen remodel 9 CHANOE OF USE FROM TO STIPULATIONS See notations on plan. 5E�'ARA'1'� PERI�ITS REQUtRED FOf� V�iRdr��, HEATING, PLUMBIN� A�va �f�NS, TYPE OF CONST. OCCUPANCY OROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBIN(i, HEATING, VENTILATING Ofi AIR CONDITIONING. TMIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCEO WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. N0. DWLG. UNITS OFFSTREET PARKING I MEREBY CERTIFY TNAT I MAVE REAO AND EXAMINEO THIS APPLICATION 1 STALIS GAHAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl PROVISIONS Of LAWS yALUATION SURTAX AND ORDINANCES GOVERNINCa THIS TYPE OF WORK WILL BE COMPLIE� WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �LO�OOO �LO.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEpMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTI OR THE PERFORMANCE OF CONSTRUCTION. �L8]. LS Fire SC �ZO.00 � PLAN CHECK FEE TOTAI FEE License SC $5.00 $322.25 SIGNATUREOFCONT ORORAUTMORIZEDAGENT IDATE� WHEN PROPERLY LIDAT D THIS IS YOUR PERMIT S�GNATURE O% OWNEA ��F pWNER BUILDERi �DATE� BLD iN�r! � p°iE ♦ NEW [ ] Effective 1/1/98 � ADDN [ ] CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 ��� 6 BUILDING PERMIT APPLICATION � �,� � ConstructionAddress: _�����,� � �5 � Od�l���� 0�_ . _ _ _ Legal Description: Owner Name & Address: Pd � ���2P%,�i �� Tel. # �%� ���� Contractor: S �p�� �'ric. MN LICENSE # l��„� Address: 13� %� ,/�,e..3f. .G!�Gi _ G�h �a�. c1s _ /�� . ��G`�� Tel. # 7�S"�� � Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type:1{.7�ih�l7 �/i��( Estimated Cost: $ �QOl�O (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _ $ DATE: �'i ���I� APPLICANT: � Gd �.,�c�- Tel. # %�'S'��� � Permit Fee Fire 5urcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL . STIPULATIONS: $ � �� 2� $ ' (� `'� $ �(�� � CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $ $1000 per SAC Unit $ � `'� $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.Q0 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [] Not Necessary [ J $ ZZ� Z;� ���� ���� BUII.DING 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 buildi�g 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 $1 to � $500�' $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $SO,QO1 to $100,000 $100,001 to $500,000 $500,001 to $1,000,0� $1,000,001 and up FEES $21 (M'�inimum Fee is $21.plus surcharge) , . $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,aao $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,OQ0 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $10.0,D00 $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 $SOO,OQO plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,0� plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only} Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15. 75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. � A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will b'e required before proceeding with the framing. �. j. �4': �'� • 32 �! , .: JS��Y� � u-;��. �,•t...�; .-. • . , . ,- ,. �-4- Q A��' 7�P� �P• .PoGKET , �.� �, ' t � 1 , _ 1• V _� � .'l �� r� �'w'� � ,T �`e7,• "�i�'� , _ � � � .��-� P�x�rr ., y � r �; . . . . ' d i�.`.�j�1�t� : r t .�- . . ,;�: .,..` �.......:.....r.i� . !�'.1�.' �i P , ° r � ,; ' ' : ; '�1 `,.�-_a . . ... O�`THt�7'.�.. ',� � .� �, � , . �'' � ' —�r` , ` `�'� . � , . � ' . � � . �' �-i4 f . _-�--( � �:-to�._ o� 't � 1. .• . �. j 2�. '` � ar . 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RT�aL E�T��bR _E�����'1Ur� ,�4;�: �,_� t� 0 . . o � _____- _____ .� ,- � o°fi � � C '�7 C 0 Z d W � � � Z O U N w z Z �'j Q rNi 0 •� � LL � g o O � � � d U � ti u�i �./ � � � � � � 1` tv^ ) V 0 � W Q 0 � m � � O H � 0 z w � w � X z m � J a � N � � o `' � m � � . � � � i � � 1 +�+ L � � 3 °' � m � i . � � : � a � � v � i � m i t tSv! � c ; . � i . c c � o � O N � Z � 3 0 ! � rn � , o c.� v � j o m , � i , � d � � 'a� � ? � � o � � � � ; : � C I I y= 2 � , � �p , N l0 � rn rn � � � _ U � , � � �� � 1� � �1 � H � � w a � . J � W � � � O � � � � .� N m UN � � � c . t� � v E � •� W m f � � � Q a � U (7 Z m � J a 0 O � 0 0 0 0 0 0 0 0 0°o, °o °o, °o, 0 0 0 0 0 0 0 r� v ui ��: � t� o� o 0 o u� � � � � � � � � � � � � � �I I.I I I I I I I I. I I� I . � � v v d m m � � � � � � c • *� '- 3 � �i � a � C7 � W m � � Z� � � c p� I I ` u, c��'�+ ���m � m m*s�# a �� N � � � ` 3 �' � m � o � � a�i H�p�t3��=x � Z`LL°, m u, °'o t3 0.� � ..�pY a y '� a�i � � � � � � m � � � F� zommvo�u�333c��7� � �ri � � O Z � m w z � � � z O � w � �Z � a = N a 2 Q � � `o °o � � � � ° o LL � m � � W � � o �' O � J � � � � � � � C LLL � � � � � ' I - t -p Cf � � 2 e C C u u u � u m ' � i o � a 7 Q � 0 � � m rn � U 7 N � � 9 � '� w � � O W _ U z O � � w N � � � � � a �o J a ►r- 0 Q a O � z 0 F w � U � � w a 0 W 0 2 a m � _ � Q a Z O F � � U s SuBJEGi . C;ty of Fridley 3 2 9 4 9 AT THE TOP OF TNE TWINS g � I L D I N G P E R M I T � � ` NO. � ; y ��_�� COIV�MUNITY DEVEIOPMENT DIV. ��� � r � � PROTECTIVE INSPECTION SEC. 1 i � � �"'1 � CITY NALL FRIOLE� 35�32 NUMBEa pEV D�TE P�GE Oi •PPROVED Br �----�" �'' 763-571-3450 9t0-Fts 7/30/02 / / JOB ADDRESS 5,557 East Danube Road NE 1 LEGAL LOT NO. BLOCK TiiACT OF ADDITION SEE ATTACHED DESCR. 3 1 Innsbruck North 2nd Addition SNEET 2 PROPERTY OWNER MAIL AOORESS ZIP PHONE Pat Freeburg 5557 East Danube Road NE 763-571-6041 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Fey`s Construction Inc 13270 Jay St NW, Coon Rapids, MN 55448 763-755-9438 4 ARCHITECT OR OESIGNER MAIL AODRESS ZIP PHONE LICENSE NO. 1904 5 ENGINEER MAIL ADDRESS 21P PNONE LICENSE NO 8 USE OF BUILDING Residential 7 CIASS OF WOFiK ❑ NEW C� ADDITION 0 ALTERATION ❑ REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Remove existing deck; Construct a 12' x 14' Deck 9 CHAN(3E OF USE FROM TO STIPULATIONS See notations on plan. �1RNIN� ' ��forr� di��►��� ���I f�r �II utili�[yy I���N�ns 4�4-00�2 �E��►r��� �� L��v TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV IOAD SEPARATE PEFiMITS ARE fiEOUIRED fOR ELECTfiICAL, PLUMBING, MEATING. VENTILATING OR AIR CONDITIONING TMIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENOED OR ABANDONED POR A PERIOD OF 120 DAYS AT ANY TIME AfTEF WORK IS COMMENCED. � NO DWLG. UNITS OFFSTREET PARKING I MEREBY CERTIFY TMAT � HAVE READ AND EXAMINED THIS APPLICATION 1 STA�LS GARAGES AND KNOW THE SAME TO BE TRUE ANO CORRECT. AlL PROVISIONS OF LAWS yALUATION SURTAX AND ORDINANGES GOVERNING TMIS TVPE Of WORK WILL BE COMPLIED @ WITM WME7MEp SPECIFIED HEREIN OR NOT. TME GRAN7ING OF A PERMIT W1,932 �•97 DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OF CANCEL TME pEqMl7 FEE SAC CMARGE PROVISIONS O: ANY OTH fi STATE OR LOGAL LAW REGUTATING CON- Tii CTIO TME PERF R E OF CONSTRUCTION �69.25 Fire �J'�,' �1.93 � PLAN CNECK FEE TOTAI PEE Lice C $5.0 $77.15 5 NATUAE OF CON"AACTOp NOA�2ED AGENt �DATE� HE PROp VALIOAT TMIS I�OUFl PER IT - -dy S�GNSTUAE O� OWNEa��� OWNEp BU�LDEp� IDATE� NSo ���TE a • NEVV (] CITY OF FRIDLEY Effecctivve 1/12002 ADDN [] 6431 University Ave NE, Fridley, MN 55432 (763) 572�604 Bldg Insp � ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R 2 BUILDING PERMIT APPLICATION : "'��"'�� r �, Construction Address: ���� ��� � ��/� �� �LG< � Legal Description: Owner Name 8 Address: /�l� ��.�c�� Tei. #,7�'3°���° � �Contractor. S � � MN LICENSE # ���� Address: � 3 � ��� Tel. # ��� �s° i��� �1��- � LMNG AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Ce�tficate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft Length � Width � HgUGround Sq. Ft C�J� Construction T pe: ,}c, �'- Gi� Estimated Cost: � �� �� Y Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$ DATE: �.��ii�`O� APPLICANT: Tel. #%�� �SS' ���� Call (763) 572-3604 for Pertnit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you tor card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge $ ras $ $ � $ $ cC� $ � $ $ Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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 [ ] TOTAL $ � STIPULATIONS: BUII.DING 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: TOTAL VALUE $1 to $500 $501 to $2,OW $2,001 to $25,�0 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,(?00,001 and up FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.(� for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50, 0� $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $SOO,Q00 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,0(�,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION.ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $17.00. Permits for construction will be issued a minimum of 24 hours from the time of application to �.11ow for proper review of the proposed structure and of the construction site. � VERIFICATION OF FOUNDATION A Certificate of Survey of the lot, showing the location of the elcisting founda.tion wilY be �equired before proceeding with the framing. New Houses Onlv F � - D�y� P��` �r�bv� sss� �'osf ���� �d fr�`��yj ����`�� ��,,��'�'�,� � ��o� - � . .. , s���� r� ,���� ; � n � �b �� G�+�i . �� a` ' L 'O fC_ � . � ����� / E An� ,�dr *v 3��� � � �f,g�a���Gv .��►��or,� � �en d�`�� r � �� � y�yPat�srQ��� �r�a. ���„ N�� F� t•'�s. � � ��,�.'� 'r" "�,,,� o � � �i����V,� � 3 - ,� /� � � /r � - �,� �'� 1 y � � t, "� Sor�� 7�vd�s -f6 �� M`� �/`�1.�l��u2G/�°�i ��X �� � s � �,. , n �'� .oh�.� �'Q�� �� F�. sf•� 6�� �. ,'�scS a6ar�G�cc� Go�� G � !� x � Trer��-/ ;�d��'�''` �°'S`'`s ' c !i!'1!/� ����iv , ,� „� � lo >r-�a►� ✓�• 5 5 /l �• . � � �:�� �� �o��V �� � � G� ` �c� S � �'� � 7 '� s fj�� T�,�� �� "—` . ,.� ,��,�-,�s C�S�f �•d•�/d �1( � X � C ��PY Guc�/�d � � � ,� . �*o �� �-v G ud� �za. � 3 Q6D6�?i�G � I�pQ�✓f ��v � ,� f p �' � � j�.e��.ers � ryP Z'�� � x �� �"�� s�D6� -►, c��txu,! 1� � � G ��� k� � ��f�� � �/ �� ��Pm�`s , � ��,� � ° � ."--�.^�^�--�-v JUL-22-2082 ,10�37 FROM CITY OF FRIDLEY ���r���aTE � s���Y For. . �Da �Verne Co. O a�" \ . � �� � � ��' ���J � E�g6 �i 5� �, / �G� ° � � TO ��� .��� J�.�`' ``�o 7553?19 P.01/01 • � �• � � : '�` ' . :� , ,�'�"a/ : .���D . N . QD�.�vfts Ire.w . : � � . . � . �, 2� � . 1 ✓ ��� �. � . -.d � � . /. � � � . Lof 3, ,9/oc�F �, �N�vs,�i�Uc�k NoRT.y 2�' .�,Od/T/oN.•d�a�v C"oa�,fy, �in��.r� - . . . �•.. � . � .� W� .d�by �erft�y �hot this os a tru� ond ca�rea� reprosenlatioa, o� e sur+►ay ot •tt�e ' E. G, R�D �. �7���'l%' �esi�a o� +�+ abew dss�tb�d la�d ead �I M+� 100oti0e ef au a�i�at�, tf an�►, L.ANO. 'SUR•Y�'���� �'�' :i: thanen, ead alt risibla �r��+0►oohe►�+t�, ii ao�r; t�om or a► sn�d {arid. , 384T .!fi6#b ��'►e, 'S�•�; � � �. s. auc � s�. �o�s. ��ac. ��� ��:.�: �.. `. ��� s � �� . _ . . :���ti ..��� -�:•. Ostid fbt� .�.� aay +� �'_. � .-19_. • � '�- �► . � • . . . . . T.t�f' .�t��'�: '.c�i�rilt .r:-= �"�.� ...': . •. .. . . . _ �...� TOTRL P.01 �IE1N [ ] ADDN [] ALTER [ j Construction Address: : � I I�€�� p � �. � ' � � � '� � �— �� ' � ��S �� CITY O� FRIpLEY fi431 Universily Ave NE, F�idley, MN 55432 SINGLE FA�AILYAND DUPL�7(�S�R'��AND R-2 BU1LDtNG PERMIT APPl1CATION �#.2�� ��i,� (7C3) 572-Si6Q4 Bldg U�sp (7G3) 571-1287°Fax � SS:� � �.��'����,�, ��� �� Legal Description: Owner Name & Address: �� ��'� � �� . y � , Tel. #� �"7� ° �° � � — Contractor: ��` � G`�� i��� t�e.�� �.� ��� �.� MN LICENSE # � `� Address: �` � � �� �. � � et,� Tel. # �! � . �2� -- � LMNG AREA: GARAGE AREA: Attach to this applicafion, a Certificate of Sun►ey of the bt, with the proposed cor�truction drawn on it to scale. DESCRIPTION O� UNPROVEMENT Length __ Width �_ Height,_,__ SQ. Ft. _ Length � �dth _ Height Sq• Ft DECK AREA: Lengtl� • wdth _,^ Hgt/Graund Sq. �t , QTHER: Construction Type: Q �-- � � � � _ Estimated Cast: $ � �� �� � Drivew2y Cur'b Cut Wldth Needed: Ft + 6 Ft = Ft x$ �_$ DATE: �° l� ' �� APRLICANT: Tel. #��.�?- f.2%° �J y� Call (763) 572-3604 tor Permit �ees if mailing in appliaation. Fax to 7635i1-9287 if us➢ng credit carr! and we will call you for card number. CITY US� ONLY - Permit �Fee Plan R�view Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL � 3 � o ���' $ Q L •r $ 1���3�/_ $ $ �� $ $ � $ Fee Sch�lule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1450 per S/�C Unit $5.Q0 (State Licensed Residenfia) Contractors) Alt. "A" or Ali "B" Above $450.00 Conserva�don Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary ( ] $ �,3 e o � STIPULATIiDNS: S0�Z0 ' d Jl3-1Q I 21� �0 rtl I � Sti : Z ti S00Z-S0-�Idd BLT�DING PE�iT FEE SCHEDTJLE The Chief Bui1dffig Official sb�all, before issuiag permits for the e�tion of any buiiding or structure, or foz' any addition to a�y existixag bu�ding or stzucture, or for any a�teration or repair to any existing buiJ.ding or structure, upon appUcati.on therefore, require t�e pa�ent by the applicant fox such permit of fees to the amount biexein below set forth a�td in the manner herean provided. to-�vit ' TOTAL V,E'�LUE $1 to $500 $501 to $2,�0 $2,�1 to $25,�0 $25,001 to $50,0� $50,�1 to $10Q,000 $100,001 to $500,0� $5�,�1 to $1,000,000 �� $23.50 $23.50 fo�c first $500 plus $3.45 for each additiot�al $100 or fraction thereof, to and Yncluding $�,000 $69.25 for fizst $Z,000 plas $�4.00 for each addiuonal $1,� or fract�on t�er�f, to and iu�ctudin� $25,000 $391.25 ;fox first $25,�0 Plvs $10.10 for each additio�al $1,� ox fraction thereaf, to aud including $SO,U00 $643.75 for f�cst $50,� plus 57.00 �o� each additional $1,0� ox �raction t�reoF, to a�i including $1�,000 $993.75 for first $100,000 plus �5•b0 fox each additio�l $1,� or fractioa ther�of, to and i�luding $500,000 $3,233.75 for t,��e frrst $500,400 plus $4.75 for each addido�al. $1,OQ0 or fxaction thereof, to and i�ciuding $1,000,000 $1,000,001 aud up $5,608.75 for the fust $1,�00,000 plus $3.�5 for each additio� $1,000 or fractioaa thereof DRIy�WAY DEPRF�5YON ESCROR' (Concr�te G�irb Stree�.s O�ly) Removal and replac�ment of curb and guiter only - Driveway vc►idth plus 6 feet tmaes $17.00_ V'EYtIFICATION OF FOUNDATION Permits for constructaiom will be issued a minio�tum o� ?A hrnus from the time of application to allow for proper revie�ev of tiae proposed structure a�. of the cox�srinlction site. A Cera�ficate o� S�rvey of tt�e lot, showing the location of the founda�on once it has it has been consaucted will be r�ui�t� be�ore pmceeding with the framing. �Tew House.s Onl S0�£0 • d A3�Q I 21� �0 l�1. I � Sti : Z ti S00Z-S0-?�dH ���� : 16 � 37 C I TY OF FR I DLEY p,�,�p3 City �f Frkiley Buliding lnspections Rept. Ph: 783-572-3604 FAX: 763-571-1287 6439 Univers�y Ave NE Fridley MN 55432 MeCh�11ic81 Permu o# �'� � � �� ��� Residential Application � J �� �' City vf Fridley Sae Back Side Por Re4uired Informa�on Date �� l 0 C1 f, Site Owne� �� City: �<r ,� I ��- _. S�' m� �� Ga11: - Fax: MN Bond# & F�cp Date Type af WorK (cfrcle one): tdew ReWacen�ern fuceranorvKerrpaei _ Oetafled Description ot worlc: Equipmerd Installed: MFG: nnooe�: �¢er�s, u: MFG; ' Model: S1ze/BTU: MFG: Model: Slze/BTU: Piease check all tnat apply: ,,,_�ireplace (gas) $15.00 New Gas Grill $10.00 �A/C $25.00 ,_Firepiace (wood) $35.00 _G� UnR HTR $10.00 _Airto Air exchanger $15.00 „_Fumace �36.00 Po01 Heater �35.00 Boiler 535.00 Gas Dryer $10.00 _Verrtitator $15.00 _Chimney Uner $10.00 _Gas Piping $10.00 Duct Worlc $10.00 Gas Rande/Oven $90.00 __ Pemtit Fee � �-S �� (Total from abovo-Minimum fee $35.00) Total D ee $ �s --5� �ake check payable to Ctty Of Fridley This is an applitxtion for a permit• not valid untq processed i hereby epply for a meot►ar+led Permit end ��dCnowled90 lh�t th� it�tormatlon above Is eomplete end mcourate; 8,at the wodc wi11 b� in eonformpnao with the ordinaroes and eodes oi 1he City oi Fridley end with thw Mlnnesota CoristrueUon Codes; tha[ i tr�ders�d thts Is not e permit but atlY an appGcation far a permit and work fs no� to start wltfiout a p�rtnit; ihet ths worlc wilt be in aoeordanee with the �Proved plan in oa� ot e0 work whioh requiros r�iow and approval of p(anc. Signature of Applfpnt: -��-r " Date: � � '� Approval Inspeclur Sigr�atu�e: �8�� PiP.AS9 NOt@: Senarate aermits are �eQUired for Building, Plumbing, and Eiectrical work AUG-03-2a� 16�37 CITY OF FRIDLEY P. ai0'+ REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLlCA1'!ON HVAC ❑ NEW HOM�SJADDITIONS � EXI5TIId� HOME ❑ MAKE-UP AIR RE�UIRED FOR NEWIF�CISl'ING HOMES • r• 1. Corx�bustion Air (See note below) � a. Oil or solid �el IlMC Chapter 7 with MN Amendmcfnts b. Natiu�al Gas or Propane/IFGC Chapter 3 with MAT Ameadments - - - �. ?�Ia�e.-ap-Air�S�cmotehelow) - - -- - - - ---- a. IMC Cl�ter 5 witb� IvII�T Amgndmeats 3. Venting a Gas appliances I�GC Cbapter 5 with 1VIIV Amenc�me�ts b. Fuel other than gas fi�IC Chapter 8 with MN Amendme�nts REQUIR�D FOR NEW HOME9- . 4. �Ieat loss 8t woli.ng load pea� room � a. Requir�d oa new construction IMC 1346.0312 5. Veutilation a. Per MN Ene�rgy Code 7670 or 7672 6. Duct Dcsign Per IMC 1346.d603.Z a. AGCA Maaual D NOTE: Cente�oint Energy Mechanica! �ode Guidelincs softvvare may �e as� �or cambushon and make up afr caltulatfions TOTAL P.03 NEW [ ] ADDN [ J ALTER [ J Constrvction Address: Legal Description: _ Owner Name ddre Contractor. Add�ess:�(�� � � � �'` / ��1 � � �� � � i CITY OF FRIDLEY Effective 1/1/2003 6431 Universit�l Ave NE, Fridley, MN 55432 (763) 572�604 Bidg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Tel. # ��� ��/ �ca S// MN UCENSE # � �� "' el. # l"5� �/S � - Ce �.s° Attach to this application, a Certificate of Survey of the lot, with the proposed constn�ction drawn on it to scale. DESCRIPTION OF IMPROVEMEIVT LIVING AREA: Length �dth Height _ Sq. Ft. GARAGE AREA: Length �dth _ Height Sq. Ft. DECK AREA: Length Width HgUGround Sq. Ft. OTHER: Construction ��✓ Estimated Cost: S ���5 Driveway Curb Cut Width Needed: �:--�, Ft = Ft x$ _$ � / �_ ` � DATE: I °I � �G'�V APPLICAN'I''-:- ' Tei. # Call (763) 572-3604 for Pertnit Fees if mailing in application ax to 763-571-1287 if using credit card and we wiil call you for ca�d number. CITY USE ONLY - Permit Fee Fire Surcharge State Surrharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ /�- �� $ '� ,`ZZ _ $ ��3� $ S�C� $ $ $ $ $ Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th°/a) �.50/$1,000 Valuation $1275 per SAC Unit $5.00 (State Licensed Residential Contrac�ors) Alt. ��A�� or Alt. ��8�� Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] TOTAL $ 3- 3� ,STIPLI ATIONS� TQO sasnoH nsaN •�unu�� aq� �im 3utpaa�oid aio�aq pannbai aq �inn uop�puno3 �uqsnca a� 3o uor�raoj a�i �uinno�s `�oi atp 30 �anms �o aa�t ,�a� �► I�iOI.L�Qi�f l03 301�tOI.L�'�L�I?I� •a�is uor�naqsao� a� 3o p� am�n�s pasodoid a� 3o nsainal iadoid io� nno� ol uo�ildde �o amq aqa �o.� smo�{ �Z �o mnmmnu � panss� aq �nn nop�n�qsuo� io3 s��ad '00'LI$ ��l ��3 9 �Id �PTnn �Ensant.ip - �Juo iaun� p� qm� 30 �uatua�da.r puE �nomag (�IQO ��AS qm� �ia�uo�) ASOZL7S3 J.fl� �Nfl� 3oalaql uoq� io pQp ` i$ �aoAippE ��ea io3 Si'£$ �Id 000`OOD`I$ ls.n3 aqj io3 SL'809`S$ 000`000` i$�PnI��? P� ol `3oaia� uoq� io p�` I$ TeaoulppE ��a io3 SL'b$ �Id U00`OOS$ lsn� aq� l03 SL'�£Z`£$ 000`OOS$ �Pnt�? P� �`3oaia� uo� io ppp ` i$ I��RtPP� �T� Io3 09' S$ �Id 000 `OOI $�s.n3 �03 SL' £66$ 000`OOI $�PnI� P� �`3oaia� uo�ag io ppp ` i$ I�aourppE q�a io3 00'L$ �id 000`OS$ ls.n� Io3 SL'£b9$ OQO`OS$ �Pni� P� � `3�ja� IIop� �o 000` I$ l�opTppE ��a jo� OI 'OI $�Id 000`SZ$ ls.n� io� SZ' I6£$ 000`SZ$ �PnI�I puE rn`�oaiaql uo�� io 000`I$ I�ouippE q�a io3 00'bi$ �Id 000`Z$ �sn3 io3 �'69$ 000`Z$ �Pnl�m P� � `3oaia� uou� io �I$ I�o?�1ppE q�a l03 SO'£$ �id OOS$ �S�31o; OS'£Z$ OS' £Z$ 5333 � P� I(}0`000`I$ 000`000`i$ 01 I00`OOS$ 000`OOS$ � I00`Opi$ 000`OOi$ ol I00`OS$ QOObS$ � I�`SZ$ OQO`SZ$ � I00`Z$ 000`Z$ � lOS$ OOS$ � I$ 3n�n -�.LOi :1tn�-o� papino�d uiaia� iauuEm atg m pue t�o3 �as moiaq maia� aunomE a� ol saa3 �0 1�lad u�ns io3 l�ridde aq� �fq luam�iEd a� annbai `aio�aia� uop�iJdd¢ uodn `ami�ru4s Io �urp�nq �m3snca �uY ol �dal io uo�Yaa1� �� io� lo `aml�n�s io �utPimq �misrxa �uE oa uou1PPE I�IIE 10� 10 `am��n�s io �atp�rnq �ue �o not�aia a� io3 s�ttu.iad �mnssr aio;aq `�qs ���p Surp�rng 3a� a�J,I, �'Il1Q'.��S �3 J,II�1i��d �I�IIQ'IIl1g 3uilding [nspections 763-572-3604 753-502-4977 FAX �ATE / — r7 —O 3ITE ADDRESS c� .J `7 / �✓ I'HIS APPLICANT IS: ❑ OWNER PROPERTY OWNER/ TEAiAl'i`Y' BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 1-1-08 _ YOUR E-MAIL ADDRESS e .. �'7/� � o � - � . �±•lti—�� • - - - . : �L'�,�L �, :,�r,�r��, _ �• • � � . 'ATE %�o%LI P�� 1VA��lL. � Y• -• � �� � CONTRACTOR �,DDxESS: '; Z ��1 �e /dlr)P CI� /� �t�9oC9sTArsi�.Zrn v��� SUBMIT A COPY OF pHp� 6�f '�,3R' $— 7� 7' FAX YOUR STATE LICENSE STATE LICENSE # �� c� �7 3�3 EXP DATE � 7 PROPERTY TYPE p�SINGLE FAMILYRJEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES_� PERMIT TYPE � �DITION u ��� ❑ BASEMENT FINISH �ROOF ❑ DECK ❑ SIDMG ❑ SWIMM TYPE OF WORK: �.O NEW HOME CONSTRUCTION DESCRIBE WORK BEING OF R��� 3� NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING � Vinyl O Aluminum ❑ Other wnvnows TN EXISTTNG OPENIAiGS �Yes ❑No OR FOR NEW OPENINGS-DESCRIBE STZE OF OPENING CHANGES & 'r'w� nF urmtpOW TO BE WSTALLED ❑ ADDITION o x�MOn�. ❑ HOUSE ONLY �1i0USE & GARAGE f,81 ATTACHED GARAGE ❑ DETACHED GARAGE O DRAM TILE ❑ OTHER FT BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used, FOR NEW CONSTRUCTION INCLUDING DECKS, ,ADDITIQNS & PORCHES SUBMIT: �Soffit I, Site PIan/Survey showing the existing structures ❑ Trim and proposed project ❑ Fascia 2. Two seu of construction plans 3. Energy Calculations LOCATION OF WINIIOWS NUMBER OF ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: ,.. R1�ING THE 1997 UBC FEE SCiIEDULE) COTAL JOB VALUATION S Permit Fee Plan Review Fire Surcharge Surcharge License Swcharge SAC Chazge Curb Cut Escrow Erosion Control Pazk Fee Sewer Main Charge Total Due _ $ `�{' � doG'� $ $ $ ol $ ��_ $ $ $ $ � $ $ �0 ANCY TYPE See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the tota.l job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contra.ctors) $1825 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) ' Make checks pa�able to: City of Fridley Attach 'THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I 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 nstruction 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 accord with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME ���ul� ��'��1 DATE /'��7"v � APPROVED BY DATE i� Page 2- Buildi.ng Residential Application s , F�, . BUILDING PERNIIT 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 applicaxion 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 consixuction will be issued a mini.mum 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 found.ation 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 Faz: 763-502-4977 Frcm: City of Fridley� T3: 35� 48�4022 �age: 2!3 D�te: 1' /4/2�8 11:09 25 AM Bd�ilding ' 1VIECHAlti7I�AL, Inspections � ��IDENT'I�L Ai'PLICATI�N 763-572-3604 j �'I�l�Y (��� � �I�L�Y 763-502-�97! Ft1X � rrr���-nvr ;-i-ux ll,� r�__ \ l �� 1'OU1Z �-R1AIL r�;JDR�:SS _--, ^— Sll'E AUllIt6SS �^ ���.�—���— �----- — TH1S APPLICaNT IS: ❑ C)N'NEIt Va�'nNT12ACT(�!i PROPERTY Nm��:_ �o��� G � 0. yZ e e b ��°�. OWNER/ auuxtss C� Yl l,t '�- �' � C1T1 ��� Ci TENANT —�------ - /�� PriCiNt: 1'—���_� � �D U—T 1 j Permit No.: �' � F.eceived By:� I 1' ! D���IOV � P l.. sr� P � -- — CONTRr1CTOR l'DMP4N°' NAME�� ��_`��e _ e�� il�--- ----------------.__---- NOTE.: __�� _ `____ ---- �� S�.PAItATE ClT'i' +�ONTAi:T PEIiSON: U� �----� ��.----.-----__------ :.�C'ENStJ �1Kt I �T.4T� :.Il'tV�N ;! EX? ll.a, k�'— �c�t REQI 1R�ll HtIN. C;A'S ------- -- — -- --- yy� �%i. .. �JJ `� ARU HVAC. ! AUURtSS: C'ITl s"� ��'� � 1TAT!' � �' su��w: � conv c�H �on;c I ryor�r-�2V �.�c�� �"��e-�:�x �..�Y1�-----��-�_.—���b – S� � ANll 1NiUJ2.�N�k: PERMl7' TYPE I�'��'LL ^�MILY �� rwo r�nsiL� I�YP�, t)F� «`URl�l I ❑ NEII' ;,YK�PL4C'E.y16NT DETAILED DES�.RIPT[ON OF' 4VORK � ❑ Tt�WNHt)l.".+E C .�LT�IiA"fil);r�K�!�tOJEL _� ��� t?-�1_C�_CSZ. --------- PF.R'btS 16B.�ifi5 4hc. �crmit fcc i� ,3 minRnum� oT:515.00 or 5% of tlee tot�xl cu�t up t� �500.(1(1, tit•hi�l������� �;rc�3mr. for thc �r.�rovcriunt, insteli�ti�yn or renl;�cr•n;ent ef a nsidantial fi�ct�irc. ��xcl•adi.n� thC rixYar'.'t,. {TE:i:; shu.zid r.f.ect ��r,t;ti� th� cest �,f 1�'x�r ) OR L.al.or cust undce $300 = S lSAQ. LaY�or cost bct.va:n :fi+3f�Q iu $�QU – rn�t �f lsbor _________ x.US =_____ F'fJItPKCJI�I��'4'H�lZt_.4kiOR�XCtEUS��00.F'�tSARfEAlcJ(]!N`�lUiIGP�'riL'th7.�12E;'c:i�cPf'�4'He:Lt(h^'Itll I-3\'f'L'It::� �INJI�Ai�'1^1'.:_ NL!11H�R C�F tACH dtLC)1A ) ry��/► l�y - �`^ ' 4� C�D� � �(� 1 C�O� Equi�nnent Instatied n�r•r: w� ' � --- �i�. , ti1JUEL: __ ^ 51L6r8Tl, --- Mb'G. ti1t�J�L: S1�::HTU . , ^ , ;�;'L�,'f3"fl, ._`_'- 11�1F(i. — �lUilEk[ _ A•C $2�:00 � !'1hEN!_SC� 1GA�} S;j �iG ' ----- CiAS 1L4hGE t71�'EN $fu.Ul! AlR TO .�11R EXCHANG�L•R $]5 I�11tc,PLnC i: i�'� t�.C,Di S�'.��0 `L�V Gr�S f;l'�1LL."b IL�.t�� HOILtiR�35.U0 �NiRhAC,��i35.GU - GhSUNiTHTIt$1�iGU !(;H@7.'Vtl' LIN�R$l0 GU CA3 URYhk blf!.Q(i PC)1�:._H�.4Trlt i;5.U;1 llUCT 41'OkK $IU.O+� ,, - =liA� PiPllvii SIL.Oi} _VEN71LAPn{:SI S.Gt! Pcrmit Fcc Surchargc T'OTAL DL'E „ . �..,.. � '_411N1h1ti11 SiS._SO OR . ..... ;.,P��4�1 L::�'�� kfiJ:k�t YHE;CJ:J:�4, titi':tiJ<at �ki ��U!#: htmbcroif�:turc�res;Slf1.OQ x$1UA�)=g. R'umbcro:'fxt��rc� ra�. $1.5.UG x $15.00 = S N�:mbcr of fi�:ti�r�� �as S25AU ` x�2g.0i� _$------ Niimbcr c�.' f xturc.� {u�. $35.Ut� x$35.U+1 = 5 � Srdtr Surchargr = �i' .50 !�111�IR9t?AI $15.50 Total = $ __ �.� THIS 1S Av APPLI(:.�T10N }'ON. A P�RP.�1I-NOT VALIll UNTI! PR�Ck:SSEll 1 here�y n�+iy fnr a nxchanical perrnit and ! acknowledgc that the ���f�an:tlion arn?�e �, �oruple!e ane acc�rcate; ;hat the werS; w�i�l �e in confi�nnan.x with the on'inances an•J codes ��f the t.ir; '>>' F:id;e} ar,o with the M:r,rms��ta Gonstmction Cc�des. :hai 1 unJeistan�l ��i< is jiet a, ��er.i:i: :•ut unly an ap�^l�ca�io.: for a�:ni�t and •aoek is n:,t [�� .tirt s� ithcn�t.a pcnnit: that tl�e �aora u il� bG in acc:ui�xrn;e with nc� aPprooeu �n� i!� tLe c.:�ac cP.etl itio:� '.s i�h �eiji�ir � rer�iew arnl.ap�sro�el uf la �a. , i _ , _ _. ' �(� _ -�– S1i1NATURE OF APPUC 4 _ -_,: ��!✓1 .--__PRINT [YAS�'E "�_�� ����� LpATE I (_� 3.l � APPRO�'�U BY _. . ; . , 1)ATF. " " Citv ui E'ridlew' � , Bullding Ins�ecttons Deprartm�,vat t � G�31 Ur.'i����itv .A��unuc NE; Fridl�y> TViN i�33?. ?b3-�72-3fi0-1. ,F.4.7{; 7c;3,50�-a9;?