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AF - 40863� r s� �..�J Job Ad .� ner • B lumbi C�L Kind o . City of �ridley 4T TN� TOP 0� TME TM�IN� ""�� COMN�NITT DEV[LAPMENT OfV, � MmCCTIVq IqfI�gCTi9�1 p�K, � C�rv ►u►�� rai06�r �os�R i___`«� iri'6e0'3�0 ss � � �. Contra �ctor �L1 � l�L��C, uilding piJ �-e;��>�)� omptetion � ��; I � I I � _ , --- W I � ; �� f ► � aoHra� I � � � erfl i •�e�H i •saa� j '�nNiva Im ,, I sN�ere I� H�11/7 N ,O o BNrvaa 3 [ aoo�� I 0 ;w�. I ,� ulsa3MONs �o!-� S , fy q '1Nff0l1 �� NNItlGI UQ v� p'� s�vai A� MSYM Y�NISI z I ��NIQK9I � I I ��.� � I � eirNirnl I I I �1i801D� I I I. Y�lYM � � � I � I '� 1 i� �� ! ' i I �I� a �; O � i � �' i � � I O � w I 'a � � i � •��[GT - • • , Permit No.� PLUMn I �Jr, PERP9I T,qPPL I�AT I�►d ,aaress ress se stimate ost e �ne Plumbing Fixture Rates; Np, RATE TOTAL Number Fi.�ctures x $2.00 �_ Future Fixtures� �_ X.$1.50 New Fixture-0ld Open. x $1.50 Catch� Basin x $3.25 Water Heater-99,000 BTU x $3.00 Ground Run Old Bld —� g • / ,_ x $3. 25 � �5� Elec. Water Heater __ X $2,00 Gas Fitting Faes: lst 3 Fixtures �_ X $2,00 Additional Fi.xtures �— . X $ .75 Gas Range-199,Q00 BT[1 x $5.00 ..� I I �.� Repairs &-Alterations I � I See I , Description; Code ( � II � State Surcharge 50 i I I B I T�T� FEE $ �? %7� _____ ! �!The undersigned hereby makes appl'ication for a permit Ifor the work herein specified, agreeing to do all work I— � in strict accordance with the City Ordinances and ruling of the Department of Buildinge, and hereby declare that „ — all�the facta and repreaentationa etated in thia ffi � application are true and correct. tb � � e8 M �v � �'��/I//,; �,,.� e� . , � ��"� /�v , � 'Signature � ate . 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' N_\r �. �o �' . � r �� ° ., � ap � �Q � . � r� 1 � �. , W � ;' �t', _ � , ��.� 0 �; � � ( � � �� ,,. � :t �� , � ;� / % � � i �� . , � ! �� / j� � �� f 1 �'' `� !i�� .�r;;,. : � / / .` �,` �/�' �� ,� ��.:�� /, J � / �� . � u: r •' C% i .�— � / �J' � �r1 i» ' r�i % j f.� . r � �/� %' Ir :'�; f � / � ! ��. . ;_; ,, �� . `� . : , r� � j/ ; � . i � ;,/, �` !i, ' � ' : . ,� ,� �,�� ,� . .� ;.; ,, . ,. : ; ,��. � . .,, .; 1 ,� , 1 , �1 , 1 ��o r�` \ �� . ,� � � ro �o �- � � . � � �;� C7 . � c a C � � � `� � . � a � .� � \ � � �m �� r �, M � � � � W � 0 � ► �n � � i �, ��-,�--1 ��. � -� � r z � o p �� i� �'' i � °' ; � � � � � � �' � �� `�, � ,;,_ I � ��i �� . �� ' c� � �d� � � �� . �� r: c'� � � � __�----- � i_ ,. -s� ,� „_._- �-,, , �_�-� � �3 '� � : � � � �,,� �, ; � `,� G� �� .�,�.- ! `� r;t � ; ��> � F"" .. � ;�� . � �C� . � ..t r . � t' i .. , �� 'i c,� l" � sus�ecr e PERMIT City of Fridley � 6 6 5 9 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � r � � REC . � `L ______ COMMUNITY DEVELOPMENT DIV. r j � PROTECTIVE INSPECTION SEC. �� ; ��1 ' r'��1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV �----� • •�' 612-571-3450 910-F15 7/1/82 � � JOB ADDRESS 6664 East River Rd. 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION DESCR. SEE ATTACHED 8 Subdivision #23 Revised SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P pHONE 6664 East Ri.ver Rd.. Frid��e 55432 572-0728 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING 7 CLASS OF WORK 0 NEW �] ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 12' X 7' 8" dormer and remodel di.ning roo�n. 9 CHANGE pF USE FROM TO STI PU LATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. WOOCI FYaIIIe 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 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 SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED y�`2�000.00 y��..00 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. $32.SO PLAN CHECKFEE TOTALFEE $8.13 $41.63 SIGNATUREOFCONTRACTORORAUTMORIZEDAGENT IDATEI WHEN PROPERIY V L ATED THIS IS YOUR PERMIT �. `�-i `% i p`��i � - -'�_.._� �SIGNATUREOFOWNERIIFOWNEfiBUILDERI 1- IOATEI OG �NSP DaTE � CITY 0� FRIDLCY Effective Aug. 1, 1981 APPLIGIITI�:J FOf; RCSIDCf�TItt� DUILQIf�G PCRt�iITS (N�►l, Alterations� Additions, or Repairs) � 0�lt�ER: �/W� ✓ lIA►u�11'GI l3UILDER: S�WI�L°,. . � ADDRESS: �o�o�p� .�• i�1VeY' �• IIDORCSS: TEL �10: 572-•O%2� TEL f�0: Construction Location • STI2ITT NO: �� STItEET: �'• ��/' � . LoT: $ BLOCSC: ADAITION: �UE3D1Vl�$�/j�Jl1/ �'�3 J�/j�= Corner Lot: Insiiie Lot: � SetbacY.: Sideyards: Ap�licant attach to tliis fozm two Certificates of SUrvey of lot and proposed buildinq location drawn on certificates to scale. DESCRIPTI01� OF CO�JSTP,UCTIO�a i �r%�°:�� Front: ! �Z. � Depth: � Height: Square. Feet: Gtibic Feet: _��pp�,. �w , Front: Depth: Height: �o� Square� Fest: Cubic I'eet: Rj►ge of Cor,struction: ��,� Estimated Cost: S ��• � T Zb Be Oonpleted: Alt. A Alt. B Proposed Driveti�ay Width if New Opening Is Desired: $� $ . , SE� REVERSE SIDE OF SiIEET T'iie undersigned hereb}► ma3;e� application for a permit for the �2ork� herein specified, agreeinq to do ,all work ir, strict accordance r�ith the City of I'ridley► Ordinances �azd rulu�gs of the Departm�t of IIuildings, and hereby declares that all the facts and reprQSCntations stated in this applicat�oae are true and correct. Dl! � I � SIGAiATUItE: Stipulation : � � ► . �% p�C' $,� 3 I ,�� ! � o .�� . BiJILDING PERMT,T FEE SCHEDULE The Inspector of buildinqs shall, before issuing permits for the erection of any building or structure, or for any addition to any bxisting building ar structure, or for any alteration or repairs to any existinq building or structure, upon application therefore, require the payment by the applicant f or such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUATION 51.00 t� $500.00 5501 to $2,000 $2, 001 t� $25, 000 $25,001 to $50,000 550,001 to $100,000 $100,001 and up FEES $10. 00 Minimum Fee $15..00 plus surcharge $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,-000 $32.50 for the first S2.000 plus $6.00 for each additional $1.000 or fraction thereof, to and including $25,000 $170.50 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including 550,000 $283. 00 for the first $50, 000 plus $3. 00 for each additional $1,000 or fraction thereof, to and including $100,000 $443. 00 for the first $100, 000 plus $2. 50 for each additional $1,000 or fraction thereof PLAN CHECK: 25 perce�t of building pezmit fee DRIVE�IAY DEPRESSION ESQtOW: Concrete Curb Streets Only Alternate "A": Removeal and replac�nent of curb and gutter only Driveway width plus 6 feet x$13.50 Alternate "B": Renoval and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth Driveway width plus 6 feet x S15.75 VERIFICATION OF FOUNDATION Permits for construction will be issued a minimlm► of 24 hours from the time of application to allow foz proper review of the proposed structure and of the constru ction site. A Cert3ficate of Sunrey of the lot, shawing the location of the foundation once it has been constsuctt� ur�ll be required before �roceedin� with the framinq. e � * � D � 1 � n 0 �� 0 � m o' v, � A O � � � a o o m � � c'n c�i a Q � � �p N � N o m � � m �' , Q � s 0 � � � --� � n C �� co � m �r n m � D n � m �I � D � � Z O Z m � rn � z �� n m m � � o �' � m z o o m m � Z p m D n � N � � 'AL' $ �n0-< _ � Z 2 C� � � D O Z � v 0 N Q m �o 0 c cn � � � � m fD � �" m 0 , (D � , 1�V J r �� N � � 3 0 3 O A •� w = m � o � � C a =� � � O � 0 0 � �IQ O (�D r � Z � r � � -�.� � G� m � � m � Z � � � � � o � °o z � � � o � � cn � m � � - -� Z L� � � Az e � O o � � � w �' o � D � �� m � � 0 0 � o � �. r -�-t 0 Z � n 3 D � 0 � ❑. 0 � � tfl I n � m � � A1 � 0 N 1 � N � A� � � � � � � ,cNi� o 0 g o° °o � � � � � O O � � - � � Q z � o c� - � o Z n��i sn m Q 3 p; � � � z � 3 c m �' � �, � ° �. � ��``. 2 -i � C) o .� �� 1� �, A � � � � � 0 �,�� n � � � �7 � 0- in A�1 � � �;�; o Q°, m `° 3 Q Z �� 0 7° � o e� � � r. �� D �6 � --C - r�i S o c c� N o m � -� � � � m � � � Z O � ¢�j 4D-1 C N `� ° � a � ��o� m �- fl. � m •�i� cn �D � �� a? � � Z j 3 <° w Q I � � °' ?� c �p � � m � 7 n m p� �° � � � c � o0 c � �. v I � � 0 0 � °o $ a«' m � � 0 n � r g� � _ � s Z � � cci �D � � � � � � o � � � o`m`QCfl � N � � m � � � � � a �-' . -�, c�o Q� o � • o o °_ �a-', s"3 �+ o m ? o m� '� � � AN] ()� Q. .� 'U m � �'v O � � A �7 (D .n► � � � n � �' O O � � c c�Di � -� m � � n� , � � N � � � � � � � �: � � � � o e'A�' '"" N 3' � � � � n � � � � l / � � O � Q � ca Q u�Di m CO � �• V � � � � C� 2 v C rn O � D � v � m � � •. � i � �e, � V � �� , N Q W � � o � C O� �� T� Z � ?v J �� oG -- wD� �e. N � � � � m v�i �\ n ; � -=-i � -� Z � < T � � � L� � my � oz Z � D O Z 37 v. � a �� z� v� � � O .� Z � Z � � v� v � � � -� �z �� m � S � c� Z � � < � '�'� � � Z m m � <' m O � L 9u � C � � cp c0 v ,�_ ��o � � � NOTE: 4�1 through ��•� required when using a side vent furnace. 0 �� .�� FR � � L t�- y CHLMi_�?Y �Ni� STACK VEItiFICAT�UN The undersigned hereby verifies that the exisdng chiIImey or stack: 1. 2. 3. 4. 5. Has be� carefully examined Ls free from rust or detexioration Has no foreign objectS lodg� within Is securely supported iVie� all carrent �ode requirements for size and total BTU's connected 6 Has total heating BTtJ's of �C��O� � All other BTU's (' TOTAL BTU's ��% 0 � C) 7. Has a liner be�n provided for water heater - — - --- - -- 8. Has combustion air been provided for water heater Remarks: Yes ( ) No � Yes ( ) No (!f Yes ( ) No � Y�()No� Yes ( ) No „(� � e "_ �, ` � � Yes ( ) No ;(� �l � �I-�,��r Yes ( ) No .(� --- 1 � �Ci ,� �CG�..� � � � � � • �� , i � cr _ t� �- HEATING CO: Signed By: Date: �'��i�fi��f"� �-1��a�.4'� �:: r�i� 5�,��1�104�I�G C�. :�� 1� Wd a�iP,MB&l! 211 Pti�:�'p�� F�Mb1tl i� - -�— � �° i - {��[3GWICK HEATING & AIR CONDITIONING CO. HEATING JOB NO. �� 891�0 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(612) 881-9000 TEST RECORD � _. r � ADDRESS ��/!p;T� f/oW� �`id QCCUPANT SOLD BY �S�_��( O MAKE .CJ ��,�L � � SERIAL NO. � .��// 7��-� THERMOSTAT /f��! G� VALVE �� LIMIT �� . e,�`,,,� i LIMIT SETTING �A,�'c d FAN SETTING �iiiLr� � PILOT TYPE ��.�I��lCrt. IGNITION MODEL y�� PILOT TIMING �� a PRESSURE��J�e' PERCENT COZ �� INPUT CFH �[�i�l^� PERCENT OZ �� ../ STACK TEMP.� � � �� PERCENT CO ��,� FORM 235 (REV. 11/&9) cirr ��-�.��e c% OWNER .67!'r�,,�E. INSTALLED BY �e�E,�� : • � rr �� I , �� VENT SIZE /' TYPE OF LINER ��G.,.... LINER SIZE : ��. t FILTERS: SIZE �� lwy NUMBER WIRING � O�i �/ � TEST TAG LIGHTING INST. DATE TESTED Y O COMPANY TESTING � NAME OF TESTER FORM DI U'fION: WHITE CAPY • JOB FILE YELLOW COPV - CITY S �. _ CI7YOF FR[DLE.Y a � FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 March 12, 2001 LeSean Bruneau 6664 East River Rd NE Fridley, MN 55432 Re: Final Inspection at 6664 East River Rd NE Contractor: Sedgwick Heating & Air Conditioning Dear Mr. Bruneau: A mechanical permit was issued on December 30, 1998 for the installation of a furnace and gas dryer at your address. According to Section 305(a) of the 1991 Uniform Mechanical Code, a final inspection shall be performed on the work. As of this date no inspection has been called for. The permit fee that was paid covers the inspector's time to check to make sure the appliances were installed correctly. We also check to make sure combustion air was installed and that the vent and vent connectors are sized properly. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, your permit will expire and any inspections on this installation will require a new permit. Any questions can be addressed to myself at (763) 572-3603. Sincerely, DJ/mh � SuB�ECT City of Fridley 29039 AT THE TOP OF TME TWINS g U I L D I N G P E R M I T i � , � R O. � `v __�� COMMUNITY DEVELOPMENT OIV. /� / j � � PiiOTECTIVE INSPECTION SEC. � . , �•--- A;�'��;,, CITY NALL FfiIOLE� SSIJ$ NUYBEF pBV DATE PAGE OF AVPROVED BY �� 612-571-3a5o slaFts 3/22/99 / / JOB ADDRESS 6664 East River Rd NE t LEGAL �07 NO. BLOCK TRACT OR ADDITION SEE ATTACNED DESCR. P'C 8 Revised Auditor's Sub. ��23 SNEET 2 PROPERTY OWNER MAIL ADDRESS IIP PMONE Lesean Bruneau 6664 East River Rd NE 572-0798 � CONTRACTOR MAIL ADORESS 21P PHONE IICENSE NO S3IIle d ARCNITECT OR OESIGNE1i MAIL ADOAESS ZIP PNONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PNONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WOF;K O NEW O ADDITION O ALTERATION �I REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof House & Garage (35 Sq) Tear-off 9 CHANOE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. CONSTRUCTION WORK I30URS: 7:00 am to 9:00 pm, Monday thru Friday; '9:00 am to 9:00 pm on Saturday; No work on Sunday. TYPE OF CONST OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, NEATING. VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NUIL ANO VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU fT, AUTMOqIZED IS NOT COMMENCED WITMIN 80 DAYS, OR IF CONSTRUCTION OF WORK IS SUSPENOEO OR ABANDONEO fOR A PERIOD OF 120 DAYS AT ANY TIME AFTEF WORK IS COMMENCED NO DWLG. UNITS OFFSTpEET PARKING I MEfiEBV CERTIFV TMAT I MAVE REAO AND EXAMINED TMIS APP�ICATION STA�LS GARAGES AND KNOW TNE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAW$ yq�UATION SURTAX AND ORDINANCES GOVERNING TMIS TYPE OF WOFK WI�� BE COMPLIED WITH WMETMER SPECIFIED MEqEIN Op NOT. TME GRANTING OF A PERMIT $2,999 �I.SO DOES NOT PRESUME TO GiVE AUTMORITY TO VIOLATE OR CANCEL TM� pEpMl7 fEE SAC CM GE PROVISIONS OF ANY OTHER STA7E OFi LOCAI LAW REGULATING CON- STRUCTION OR THE PERFOFMANCE Of CONSTRUCTION �]/{. ]S Fi e C�3.00 PLAN CMECK FEE Tp AL P $7 .25 S�GNATUpEO�CON'AACTOpOAAUTMOp12E0oGENT IO�TE� MEN R ALI E T IS OUF P MIT �ti�. � ��,� 22 m�� g�i ' ,�-�� $�GNSiUAE O� OWNEA �� OWNEA BWIDEp� �DATE� ' '- BLO �hSv ppt( �w [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 r� BUII.DING PERNIIT APPLICATION �� . �d� � ConstructionAddress: hd6 4 El� ��v E� �.D. � `� Legal Description: Owner Name & Address: LE SEA1N B�U�vE��i 666i ENst �IVEf� Rr�ryO Tel. ��12� S'�2�-D�� Contractor: MN LICENSE # Address: Tel. # ' 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 HgtlGround Sq. Ft. OTHER: ��F ��IG�nsE � G�RAGE 35 S'Qu�92E5 �E�R oF{' Construction Type: Estimated Cost: $ �� % (Fee Schedule on Back) Driveway G�rb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �� M!� 1� �1�1 APPLICANT: ,c �..�� I�'1�,� Tel. #� I a- s�a- 0"�9� Permit Fee Fire Surcharge State Surcharge SAC Charge License 5urcharge Driveway Escrow Erosion Control Pazk Fee Sewer Main Charge TOTAL STIPULATIONS: $ .i $ .� � C� $ �, S?� $ $ $ $ $ $ $ ,o�� — CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1050 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 [ ] �. . _ . 0 BUII..DING PERNIIT FEE SCHEDULE The Chief Building Official shall, before issuing pernaits 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 $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction 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 $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or 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 5treets 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 isSUe�; 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 be required before proceeding with the framing. -_ .._a � D � � � '� '� � m Q- � � �' � N � N. � O N � n � j 0 � � 0 �, � ,a�� 0 �•'a � �' Oq � � � O � � �' �- VJ �G Q- o fD � � � � � r+ � O c � -a a 0 < N a � � 0 c a� S � � n� N =n � ' � � � m V � m z � '0 m n � O z '�'I m m � -P V 0 0 � _ � e p �' o `cNon � p� � � o �, d � m Q C Q � "� _ -a °—' N � � m 0 O � o � � D fD r � rn � rn � � � OC N Ey9 tfl O� � D y�` `�o _ �• - O n "'h (fl � <� � d � _: m m � O �' � -+. � . � . . � � . a Ro ?' m' a � � � cu fD �. o °:.' �o �� N � r � -� 0 Z W D � v 69 N t�1 0 0 L� � Gi a "�'I �D N N N N � � � � � � � � � �i j -p. � N � .��r c�u � � � � S m' �z��cu � � � � � 'Dy, � .� �- O. � Q - � � � � � � � � �h� 3�W.�° f � � � - � �� v � W � C N � A � -� C�D � O i-o 0 E� tfl {� � � �, a �? = cu 2. -a � � . °° °° �' oo ,� z �c °� m -a .�.� . . �-1� �,��, o, �. � �_. �� C� _c� o N y � -w Q � z = L! ,.�.r .-�w �'. (p � fl1 �p n a� .� a� . y � � a� - � o m°�oa� �- m = � ,, � � �D � � � �' c��'o- nZi c ��'' : aa � �e�a �, a � 3 � ro�O� `� `� c�� a �- � C. � � �y �v� � _ '_--• u, o' `z �r. � �` i n� ?� y � � C� [^' '7 � � � fl1 d A i'� , c�,' �- � � c7 � a��rtn• � O r -y � � � 'n'� =' fD � �' � � � 0 rt ^ C1 � � � � (n _� m (�D �. C�') � N� �- Cn C�D =._ ,..,. m o.� m r- N• a� �� c`—' a a� z o m� � m � o .. m v �> > >y�� o a�a,-. � g rt � �. . 2.. � � � � �. O' �` � y �' O ' � -s ... � �'=S� _ :� �m nfD ` � c �c o s � n � � � � o- � � Q y � D � �� v � �6�9 {� �bi9 N i-+ (�J O O O o °o °o � m if1 fA b9 --I O A r m ., . cn � v --t m � � � � � v � -� � � � Z ' +7 ,� e � Z � 7 � � � m 7 � v � � � � :. � n �.: _: � � �.� W � o 'rn z � � c � m v .zi �"� m. N t� 2 m v C rn r,-�a,n a�iQW� � � F.+ � � c7� =� C � � � N�� c,,,i Z c� � Q,j� o � � � � .t� � � m �: W � � � ^' � z � z� m� m c� � O z � C N a � -o z �v r- �� r� O �t% Z R1 .n a� -{ � O� Z� Z� � .� a� � Z Q N za v� _ _ - .� v ` o� ...� Z � a �Z v° ..�'c � A � N mo � N Z Z� v< � vZ _�� c� f/! O • - Z �� . '. �� m n fD � � � � � c d � � N O O N THE BELOW MUST BE FILLED IN !lVHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE, RETURNED CC)MM(�N VFNT, VENT G(�NNFCTOR r4ND GOMBl1STlC)f� AIR V RIFI .ATinl� ... When � la -ing an pxictmQ-f�rance, the undersign�d her�by verifies that the - � :- venting has °been ex�rriined _�nd is free from rust, deterioratior�; obstructions, � - : and is securely supported and firestopped where required. - �'Yes (} No (�� The venting system is plasticJPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No () The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fwmace Venting Tables for fan assisted and natural draft appliances. The px�g �eme��en air is sized and installed to meet the current codes and manufacturers specifications. . Whe� �equl�ed t0 inc±all a new r_om6�ctien air�,it will be sized and installed to meet the current codes and manufacturers specifications. Whe� inctallinQ a new ventin��,y�m, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Isthe common vent and vent conneetors sized and installed correctty after an appliance has been removed from the common vent and vented separately as per current codes. � Yes ( ) No ( ) Yes( ) No( ) Yes( ) No( ) Yes ( ) No ( ) Yes( )No( ) �.. ,. - .- ... - .��.� -�� .�. -�, ...-«. � ..��. .. Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total AppFiances Total Btu input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type � T RNTInNS• (Deyribp,l HEATING CO: Signed By: Date : n � � O z < m z � z � 0 O Z W D c� � � v m ♦ � � m � c � A � � � r � T rn m � � � 0 (� � � r N r � �O � �, = c�i w � � c � T o Z � ,�v rfl �O V � o m = � D ' D— v � v � °1 D N 0 1'D" � m � 0 z � pWj � � G G G C 01, G) � N �(D '� � u) m.01+, �.�-► 3 7 �� Q' � � � � � m m m � � � o v -o �! ° m � m m � m °: � � � � � �� c� j, � _ � N � � � <; r . m � � � c� � � � rn Z m � m D� a m � N � � � � � � m * A c�i � c � � m m Q. .-. .� � N ... Z 0 I (( I I�I I( I I I I � ��a�� cs� o 0 0 � o y � v � cn � � o c o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 � 3 v -� �n � C? � � Z � -� 3 n � � � C � � � mm � o �„ m � °� a � � � , ��. � --� m r Z 0 m � � N a n O .�y. � � � m � � � �)�.1 � W c a 3 m C y Q � � � � °- m � '� N � \� ^ � O � � o � N i .y�► 01 � a ' � � � �. -o v � � � o' � n� . m � 2 c� d � � A I o ; � m ' � rt i f i _ i N � � r C � W Z � � � C � m � m � z 0 � � m -� O D r � O W 1 �� wQ-�� m cn � C p iv�� -n �,,, z m � �p�� N � � m m c�n � = �< 'z� �G o � � � �- � �. \� � m m � '< m O � L N � N O O N : a�ea :�(g pau6ig �O� JNIl`v'�H _ . . _�� , � � ; - ad�(1 w aa�aweia }� y�6ua� }} ;y6iaH �o}�auuo� }uan £# a�uei�ddy adl�l ui �a�aweia � t�}6ua� � �y6iaH ao�auuo� }uan Z# a�uegddy adAl w �a}aweia � y�6ua� }� ;y6iaH �o�auuo� �uan �# a�uei�ddy say�ui �a}aweia �y6iaH }uan adi(1 �uan uowwo� �ndu� n}g �e}ol sa�uei�ddy �e�ol �eN �o pa}sissy ue� }ndul f118 ad�l E# �uei�ddy ;eN �o pa�sissy ue,� �ndul f119 ad�l Z# �uei�ddy �eN �o pa�sissy ue� �ndul f118 ad�tl �# a�uei�ddy � � M • nr � n • �a _ � � • �1�t=1.��PI�l�r1.t�I�l�.�ll�[�L1rr�L • � ' -'• - � ' � • 7 () oN () sa� �sapo� �ua�un� �ad se �(�a;e�edas pa�uan pue 3uan uowwo� at,� wo� panowa� uaaq sey a�uei�dde ue �a}�e ��a�uo� pa��e;sui pue paz�s s�o�auuo� �uan pue �uan uowwo� ay� s� () oN () sa� �sa�uei�dde }�e�p �em�eu pue pa�sisse ue� �o� sa�qel 6u�uan a�ewn� �eAua� � No6a�e� yWy�-y�y apn�ui saop siyl �suoge��ads s,�am}�e�nuew pue sapo� �ua�n� ay� s�aaw pue �(�qwasse pa�si� e si �i �ey� sa�}uan �qa�ay pau6is�apun ay� ` , , , uay/N ( ) oN ( ) SaJI ( ) oN ( ) SaJI �suoqe��ads s�a�n}�e�nuew pue sapo� �ua.un� ay� �aaw o� Palle}sui pue paz�s aq ��u�n �, , , o� pa�mba� uay/N •suo�e��ads s,�a�n}�e�nuew pue sapo� �ua�n� ay� �aaw o} pa��e}sw pue paz�s si , , ,, ayl () oN () sa� �sa�uei�dde ue�p �em�eu pue pa�sisse ue� �o� sa�qel 6uquan a�ewn� �e.�ua� � tio6a}e� ywy�-y�y apn�w saop siyl �suo�e��ads s�am�e�nuew pue sapo� �ua�rr� ay� s�aaw pue �(�qwasse pa�si� e si }�un �uawa�e�da� ay� �ey� sa�uan os�e pau6is�apun ayl () oN () sa� �uoqeun,wa� pue snr+oq�a �o �aqwnu `t�6ua� `6ums 6uipn�w suoq��r�ads aa�n}�e�nuew pue sapo� �ua.�n� ��e s}aaw pue �n�gse�d si wa�s�(s 6uguan ayl () oN () sa� �pa�inba� aaaynn paddo�sa�y pue pa�oddns �(�a�n�as si pue `suop�ru;sqo `uoge�oua;ap `�sru wo� aa�} si pue pauiwexa uaaq sey 6uRuan ay� }ey� sa�uan �(qa�ay pau6is�apun ay� ' ,, , uay/� a3Nt1f113t138 TIIM N011t��l�dd�d 3Hl 210 S3�Mdlldc�d JNIIVaf19'13f1� JNI��dld3�l N3HM NI a3Tll� 391Sf1W MO'138 3Hl Building PLUMBING Permit No.: - Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY �� DATE '% YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: 0 OWNER OCONTRACTOR PROPERTY NAME: L �SF�N B�GC /�Al.� OWIYER/ ppDRESS: (o� Li 4� }�'L��, TENANT � ��°-t STATE!'Y1�ZIP �S�{3-� PHONE: °— • CONTRACTOR NAME: SUBMIT A COPY OF STATE L[CENSE # �{(�� P DATE YOUR STATE ADDRESS: �oZSRb /�Le�vm //.�oi� �CITY ��,�STATE�%i{CZIP 5b%T> LICENSE WITH pHONE �(p3-%�� 3 %� FAX '%(o� �338 - /3'�'t!S APPLICATION PERMIT TYPE �SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: � NEW �REPLACEMENT DETAILE DESCRIPTION O WORK PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 =$15.00. 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 BELOW) BATH SINKILAV FLOOR DRAINS SHOWER WATER PIPING _BATHTUB GASPIPINGrxrra�rin•�.ic•�:NV:) SWIMMINGPOOL WATERSOFI'NER($35) _CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15) _ DISHWASHER �LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGAT[ON _ WATER METER �C OTHER �1a��a��._ �� +� ,is��.*„�� ;�` � �-�.� �� k l �.�/ m� 3�i . � ��'&� c.�� '�:.. - .La, .� r,�, _ � ,,.,._ . ,,,., ..., . , .^�c, r ..., � .n., m,. �' A . ..,. , - Permit Fee $ Number of fixtures @$10.00�� x$10.00 =$ D- (,"� Surchar e .50 Number of fixtures @$15.00 x$15.00 =$ TOTAL DUE $ Number of fixtures @$35.00 x$35.00 =$ State Surcharge = $ 50 To�� _ $ ac�. s THIS lS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building perm.it and I acknowledge that the information above is complete and accarate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of a ork which re uires ev' and approval of plans. SIGNATURE OF APPLICANT PRMT NAME �/GU�/tI ��d2�'I'E� .� ..� , �ah ,�.` � � - �: � � �� ..�� F ��,' ? � � � � - , �< ,A , H . _ , , ::::,. . �. , _ . ��... .. _ . .�._ . _ ,. ° * � City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 � � • _ _ � : 0 SAP 02-601-29 (CSAH No. 1) PARCEL 9 - PAUL DAHLBBRG A permanent street easement over and across the following described tract of land: Lot 8, Revised Auditor's Subdivision No. 23, County of Anoka, State of Minnesota. Said easement being all that part of the abo�e-described tract l�ing Easterl3 of a line described as beginning at a '� Point on the Southerly line of the above-described tract a distance 37 feet West of the Southeast corner of said Lot 8; thence in a Northerly direction to a point on a line parallel to and 13.21 feet Southerl3 of the North line of said Lot 8 said point being 15 feet West of the East line of said Lot E thence terminating. c�ntainin� 1482.00 square feet, more or less less FreL�iously acquired right-of-way Revised 11-17-86 n�fo.ro . � � i o . 1 � � � ��, •� � v - fe � �� a �� 2 ;,, � �� • � , �::�, r ;;LOCKE LAKE sRO. g �'j4 � J�i�,,: . � ; lt� ,,-�f � , , ;' .�� pyi �et �o .� ` y � � � � CtSTMA � S� NQ ~ D � � e�x'��ri°' x �` f $ . � �• rv.a nriei� ' � ,�W � � � nt ' �0' ., i � �c . : A�16�A• : ; r' � ii 1 'l/ ,- ' ` � /9 �h� �' C� � • - .1 �� r 9 v 7 to . i � � ��r a : � Ct3� I y. _ � � , '•, w ' �7 � C� " '--•.. t /l . � 1� �� , � �'• ..- � �? e +i;' N @ '� ,ti � :`'>� � j �� ar s B� -- ' � y .�.� s '� ��i,y,°:s. 0 � _ ; �g � : - Ip�I � , (�i � t � � �. . � �! i 27� � / 'a°N` i' 6 .W 114� �� -+ . ,;: -�,;y '• ` ,y t•. � 1:`1�A '6' e W 1�� s .� .'�� `�� .,�� °. 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' ��t (�7 ?��. s t , '�� l9 � � �� '', �,,,,,�.- — ��' . ` ` N�, .r� � �,. ,� � 3, , ,� ,�� . �, ,e �5� ` �'' i �` �S. 3�a.,! �j 1�� 8 t� V � � R• �� ,, R �,�,�'�°� ;�a � �� , . � � _ �I/,,p �• t ,�./�,� � \ � �� ° N' pb �� V � I,`� �� Ib C�1, \ �3 P�� ; s. •�� '� `. 1 � T R � ., ?R�' ,,� �,A. � . � �� f c� �.. ` ,�i ��• s• .. 6�' �' �ct y I j 4�° � A ��o a s.� ��ORT � �, � I p oo � �A�t �s.� .��6 , .: � ' � � � lo \\ e �o � y 'p 'r Qa � al E ., .'�. Q•� v�. _' i � I I ti �� , �y! j� � �� - � � � I ` `V N 7 �� q ,,,�.. �' � � .. \`�,` i � 5 ; �jz.�� f. a w� 511 !: �.aaam ' 8 t _.,�p � � R -- � ` -• �.�••- \ ; ,! �•`�. _ _�'r � Z � � , '\ . I . . .ce•� L � FROM :City of Fridley Bui�ding lr�,spections 763-572-3604 763-502-4977 F flATC — .�.� � srn� Ann►�rss.._.__. '1'F1IS APPLIC:ANT IS: D OWNL�R/ TENANT FAX N0. :7635711287 Feb. 15 2008 12:55PM P2 PLUM�ING � p��.;t N�.: �. _� RESIDENTI�4L APP.LICATION Recxi�ea K D.� $� CITY OF �RIALEY n�� _..�. _ �c� , tve i•i-os . . . ..�..---- YOUK E-MA1L AUDR}:sS � � � . —. �. ��—�—� -�=V--1��`+ , ' — � JER \ NTRACfOR „- - - --y „— —,— _"_—.— —. .— �— t — _— — — S1'A1F , 'LIi' . CONTRACTOR ,�: ..��.�C�p�n�{j'p�g'i� SURMIT A COPY OF TA.�, WL�SF.. d — - nA� ----- YouR s�rn,� '��31'3 'D�'ti�'1'�r _ exv aA�_. _. --. --- �— �..,��s�. �o,� � ��: go�« _ ..— ---�'i"a cl—o�..ee.�M��.. ,�r�Tp—, Z�N.—. — CERTIF`]CATEOF i�AESS• _ . • .—'— INSUItANCL� p►iON�: _ .. _. �i�rJ��•�— — _ — -- — —..-- PE�M1T TYPE �r�t�E �F w��c: DksTA1L'ED D�SCRI D' NGLE FAMiI.Y O'fW0 FAMiLY � O TI�WNHOUSC _ .. - ' , � NF.W RE CEMENT �ON 4F WOR.K _ . . _ . —• —� --- PFR MS 16U.665 the p rmit Fee is a miniMUm of �15.(IQ or 5% ot the Wtal co.t up tn �.SI10.00, whichcver is greater, for the improvement, installati n or replacc.�ment of o �eaidential fixture, excluclin� the fixturea. ('�.his sb<�ul�i r�:fleet only the cost of lab�r ) Lahor cost under S3U0 S1g.�0. LAl�or cc�ct betwec:n S30U tc� SSW ° cust �f labor __, ,_ x.AS -, ,_ plus .Sfl surehar�e FOR YR076L IS WMF:ItL L FiOR EXG'[�AS SS00, FEES� ARF DASED ON St O00 YE'R FIX`iUR)-.:� CRCFPT W HCIt� NOTEf). FURURF.S': (MAICA'rE �POTAL NUW�P.R OF EAGH PF1A , MMlM1.IM I�CP? � 13.50. WATER PIPINC'i 13ATH SINK/LAV h'IDOR I)kAiNS _ SHAWER "— WATGR SOI�TNEIt (�.i5) BA:i'HTUB 6AS P�PING (NE��) C1TY LICj _ SWIMMMG f'00I. _. � CLOTH�,.S WASHER KITCHF,NSINK _ WATCRG�ASrf __RACKi'L,pW PRL•V. (S15) DISNW/45HER � I,AI.INDRY'('RAY _wATER FIEAi'ER ($33) rOR IRRiGAT1UN ... _ WATGR METEIt . _ UTf IfiR F�: AL I h�.�leby apply for � p conform�nce wid�the not a permit but �mly with the approvcd pla� SIGNATIJRE OF MYItOV['.� BY � _p_,_^ Number nf fixtutes (� �10.�U _ _ x E10.00 � $ � _. .SO Nu�nbcr offixturec (d T I5.00 � x$15,Q0 ° S_, __ _ . � • _ pR Number uP fixtur�s u� �35.b0 x �35.(10 � $ — -• Stete Su�charge ° ��50 (MIlJiM11M fil S.SU? TOtel ° � ,_,,,,, 'I'HIS � AN MPI.ICATif)N �OR A RERMIT-NU'f V�I.IU UNTIL FROGGSSF.0 ,mbing permit nnd T aeknowledge lhat �,e infnrmati�n above is cc�rnpictc nnd r�ccurate; that thc work will be in �rdhuu»ces oad codes of thc City of rridicy and with �he Minnesota C.on,�tniction Cc�des; that 1 under:�tand this ig n application or a permit and wc►rk is �ot to stnrt without n perntft o� site; lhat tho work will be in accc�r�:+nc;e in th.e c.�se n I work whi� u' es revi and approval pl s. � I `� �� . NT _ T NAME DA'1'C c �� — — --r UATE _ _, -- — � � City o� �r�a��y ` . , ,� Suilding In��ect�ons 'Dep'artwent 6431 Uni.vcrsity Avenue N�:, Fridley, MN 55432 763-572-:�604 � F/U�: 763-502-4977 � � �3uilding _Tnspections 763-572-3604 �4� � �(�q S r�E-14H �r i HIS APPLICANT IS: PR�t ERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROFERTY TYPE PERMIT TYPE TYPE OF WORK: �ESCRIBE WORK BEING �IZE OF IlvIPROVEMENT :OOFING dUMBER OF SQUARES rARAGES 'ROPOSED SIZE: 'ROPOSID HEIGHT: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-M_AIL ABDRESS a o d+ S 1A �. ( d� r ❑ OWNER °QCONTRACTOR aDDxESS: � L l� K` � l� rvt r R Pxoi•rE: `71. 3 I S� 1�� r c. y N,a,ME: i'HD At- Home Services, Inc. sTa.� r�c 2690 Curnberland Pkwy, Ste 300 ,�nD�ss Cumberland Office Park PHONE Atlanta, GA 30339-3913 ❑ sINGr� Lic# 20268257 Ph. 763/542-8826 ❑ TWO FA • ❑ BASEMENT FINISH ❑ DECK 1,� r ❑ ROOF ❑ SIDING ❑ SWA�IIv�JG POOL ❑ ADDITION ❑ REMODELING � O HOUSE & GARAGE O ATTACHED GARAGE ❑ DEfACHED GARAGE Permit No. Received By: Dat��:�d; � 5' S �/ 3� qsa ( aYS- c, o�t 7 CT1i' STATE ZIP ❑ DRAW TII.E ❑ OTi�R /'�7�/ HEIGHT BASEMENT REMODELING SUBMTf• 1. Existing Floor Plan 2. Proposed floor plan 3. List of strucwral members to be used F� '�G FOR NEW CONSIRUCTION 1NCLUDING DECKS, 7 Vinyl OSoffit ADDTI'IONS. & PORCHES SUBMIT• �� T� 1. Site Plan/Survey showing the existing structures 7 Other ❑ Fascia and proposed projecL �'INDQWS 2. Two sets of construction plans 1 EXISTII�IG OPENINGS �.Y.Yes ONo LOC TI N OF WINDOWS 3. Energy Calculations �R FOR NEW OP£MNGS-DESCRIBE SIZE OF ��- � h,� n >PENWG CHANGES & � YPE OF WWDUW TO BE INSTALLED � k' NUMBER OF WII�IDOWS 3 ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDiJLE) TOTAL JOB VALUATION $ r l• OCCUpANCy ' TypE emut Fee lan Review urcharge ire Surcharge icense Surcharge AC Charge 'urb Cut Escrow rosion Control ark Fee ewer Main Charge otal Due � 3. ?� See Back Page for Fee Schedule $ 65% of Building Permit Fee $ /. 0 (.0005) times the total job valuation - Minimum $.50 � �- � .001 x Permit Valuaxion (1/10%) $ �S , bv $5.00 (State Licensed Residential Contractors) $ $1450 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$20=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ I Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED ulations hereby apply for a building permit and I aclaiowledge that the information above is complete and accurate; that the work will be in �nformance with the ordinances and codes of the City of Fridley and with the Minnesota. Construction Codes; that I understand this is not a �rmit but onIy an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved a.n in the case of all work whic� ires r'ew and approval of plans. GNATURE OF APPLICANT PRINT NAME T IYi S� �!/i � DA� 7� L� U g Page 2- Building Residential Application BUII,DING PERMIT FEE SCHEDULE The Chief Buildin.g Official shall, before issuing permits for the erection of any building or �s ,rT�ucture, or-�or any on o a.ny ex�.s g g or s c e,—or or �-�ra on or repair to any existing build.ing or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: VERIFICATION OF FOUNDATION Permits for construction will be issued a m;n;mum of 24 hours from the ti.me 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 ihe existing foundation will be required before proceeding with the fram.ing. New Houses Onlv City of Fridley Buildi.ng Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 �3uilding Tnspections 763-572-3604 4� � q o� 5i�--�BBR£SS-� ! i HIS APPLICANT IS: �R�UPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROFERTY TYPE PERMIT TYPE BUILDING RESIDENTIAL APPLICATION CITY OF FRII�LEY Permit No. R� J Date Rec'd: YOUR E-M�� ADDRESS ,l o d � s m � l d.r r,��n Q s � o r�'� � �� r !� n e� /�L— — ❑ OWNER I�ONTRACTOR PHONE:�� 5Z i' ji 1 �. �f N,�: fHD At- Home Services, Inc. sTa,� Li< 2690 Cumberland Pkwy, Ste 300 ,e,DDx�ss Cumberland Office Park PHONE Atlanta, GA 30339-3913 o s�tGr� Lic# 20268257 Ph. 763/542-8826 ❑ TWO FA • ❑ BASEIvIENT FINISH ❑ ROOF � DECK ❑ SIDING ❑ SWIMA�II�iG TYPE OF WORK: � �' ❑ ADDITION 3ESCRIBE WORK BEING >IZE OF IMPROVEMENT �ER OF SQUARES _ �ARAGES 'ROPOSED SIZE: 'ROPOSID HEIGHT: :IDING 7 V'myl 7 Aluminum ] Other n LENGTH ❑ HOUSE ONLY O HOUSE & GAR.AGE ❑ ATTACHED GAR.AGE ❑ DETACHED GARAGE OSoffit ❑ Trim ❑ Fascia 4�INDOWS J EXISTII�IG OPENINGS �Yes pI�To LC?CATI�t OF WIIQDOWS >R FOR NEW OPENINGS-DESCRIBE SIZE OF rS t c�%r onin g �PENRJG CHANGES & � �3� 3Y5- (.Oy7 CTT'1' STATE ZIP ■ �� • i � ■ � i�,i _. QVIDTH HEIGHT �ASENNIENNT REMODELING SUBNIIT• 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used F� FOR NEBJ CONSTRUCfION INCLUDING DECKS, ADDITTONS. & PORCHES SUBMIT• 1. Site Plan/Survey showing the ezisting strucwres and proposed project 2. Two sets of construction plans 3. Energy Calculations YPE OF WII•iDOW TO BE INSTALLED NUMBER OF 9JIl�]DOWS � ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING'�'�' �� U.B.0 FEE SCAEDULE) TOTAL JOB VALUATION $ � d b v OCCUPANCY � TYPE ermit Fee lan Review urcharge ire Surcharge icense Surcharge AC Charge urb Cut Escrow rosion Conlrol ark Fee ewer Main Charge otal Due .� $ $ /. ou $ ,-; v o $ S.ao $ $ $ $ $ See Back Page for Fee Schedule 65% of Building Permit Fee (.0005) times the total job valuation — Minimum $.50 .001 x Permit Valuation (1/10%) $5.00 (State Licensed Residential Contractors) $1450 per SAC Unit (Plans to M'WCC for determination) ft+6ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: Citv of Fridlev Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED hereby apply for a building permit and I aclaiowledge that the information above is complete and accurate; that the work will be in �nformance with the ordinances and codes of the City of Fridley and with the Minnesota. Construction Codes; that I understand this is not a :mut but only an application for a permit d work is not to start without a permit; that the work will be in accordance with the approved an itt the case of all work which require re andapproval o€plans. �, GNATURE OF APPLICANT}�. PRINT NAME ! ��_ S�� DATE � 1 l 1 � Page 2- Building Residential Application BiJILDING PERMIT FEE SCHEDULE The Chief Building Offi.cial shall, before issui.ng permits for the erection of any building or - s�racture, oi �r any a�dition�a.ny existing b g or stru.c e, or or �m�y a��ra�on or repair — to any existing building or structure, upon application iherefore, require the paym.ent by the applicant for such perm.it of fees to the amount herein. below set forth and in the manner herein provided to-wit: VERIFICATYON OF FOUNDATION Perm.its for construction will be issued. a m;n;mum of 24 hours from the time of application to allow for proper review of proposed structure and of the construction site. A Certifica.te of Survey of the loi, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Onlv City of Fridley Buildi.ng Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977