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AF - 41579City of Fridley, Mirm.. � �� BUILDING PERIVYIT NO 7099 aa�: t� �..�- �' � �� o�: suua� ��..-� A Ad�iress Address LO F BUILDING No � Street ° _.._... Part o t� -��-� � Lot ��Block �.. Addition or Sub-Div9sian . ° � � � e Coraer Lot ,� Inaide Lot S.etback _,��,�..r�.._ Side3►ard Sewer IIevaa�on — ._._ Foundal3on IIevation DESCRIPTION OF BUILDING To Used : 4� Front '� Depth Height _� Sq. Ft Cu. Ft � t Depth I%ight —�_ Sq. Ft Cu. Ft Type of Coristruction �.,� F�t.�C� `' To be Completed � � In consideration of the isauance to me of a permit to construct the building descrilxd above I agree to do th� proposed work ffi accordance with the d�scription above set fo�h aad in � plian �w7,� a�l provlsions of ordinances of the city of FrYdley. /�' /%/ � In conafderatfon of the payment oP a fee of $ �, pernzit fs hereby granted to construct the buflding or addition as descxibed above. Thia permit ia granted u�n �he expr�s condition that the person to whom ft is granted and his agent�, employees and worl�en, in all work done fn, around and upon said building, or any part thereof, st�all conforra in all respects to the orrlinances of Fridley, A�innesota g locai3on, construction, alteration, maintenaace� repair and moving of buflafnge within the dty ]iamtts��a d�this permit may be revoked at any time upon violation of any of the provisiona oP said ordin$no�. ��, � A .�, Builaiag Inapector NOTIC� 'IMs per�t doa not aavu t6s eoedrudi�, testalla�ton ter wWeo, plmnbiee, en hsaMng, wwu er wdse. B� arro !o aes flro Bnildiep lesp�tor #or ppnab p�rm6s for fh�ss hxnt. , .d - �- .. E - r --- ' ..._. .�. , � 6: __ e 9• _g. APFLICA7�'ION FOR . BUILDING PE.RI!�IiT :.�� ,: iz v;,,;r , . � . ; _ . . . � _ _ .,.y. �. � ^ � . K`. . . 'jie . . ... ., < ., .. �r. ;. . - � . :: , . �, ,: : . , CITY OF FRID�EY, . MINN�$OT� : °� •3 �. : ". � .;� +' � ' , .. ` , ' . : . � . , . � .. . . . . . o `r ' _ __ . � r � o .,. `� . ,::. ' .�,; i � • _ . . g , t`�: _ ._ _. � . T�+ ♦� � � .. , �_IF'�`7i,� . ` y ; �waW+R's NCULi WIIaDG1i .. .. . , _ � p � �ADDRES3, _ � . , ._ ADDRBSS � . , . . ,, _ _ _ �r , , . -.. ,., � ,'.� . LOCAZ'IOAi OF B�JILDING - •� W . _ � �� , ; , . : , � �To. -�_,, / , . .... : . Stre�t, . , ' .. .�.. , u .gart. of �I,ot� . ' , ;, : . . . _ _ Lot Block Add•ftion or Sub ision , . ; . _,_,_ �. � - , . . . _ a , ,:. . : : �, . ,.; Corner Lot`Inside Lo�t Setback : , Side-Ysrd ; ,�� SEWER ELEVATION FOUNDATION ELE9ATION ,�r Applieant attach ,to1 �his. #orm Two ;Certif�cates of Survey, of Lot; and..�roposed bu�ld- 3ng locat,�.trr� � drawn ,�n these' ,Cer�tificates . , . . , , .. . ..� , .. . . . . . . . ,_ " „ _i . .. . _. . . . .. . .. . , f 4:.. .. . 1 . . . . . � . .. � . � � . _ .. _ . • �.•' . . i 5 " . , , . . . .._ ,. DESCRTi�1ZON OF BUILDING � � , :� To be used as: �' � " . , ` k;ro�t , . , : � Uepth Height ° -- - � e,• F�Q.., Ft.. � Cu. F�,.�. �� .; � � � . . .. - � . . :; _� � . . -• .: ��Fzont Depth Height _; , , • ' �` ,� Sq. Ft . � �,. ,� �Cu . �z , . _ �a • ' ,� � � . S t 9 � � ry Ty�e v�.Coast�ct�;ad � - Es�ima,ted �Gomt - �� ^� r•, ..•�• � � � ' . � . , � .. � �,� To, •be � Comple��tl � • ' , : . . . � 1 � • . . �f-. . . "'... . �_, • ' .... 9� .. . � . � _''. � . <...._. The'sut�ders�g�a�,c�;'hL�'�by makea application �for�� .permit for Cha �ork;�he�ei� s.gecified, agreei8g to do all work in strict accorda.nce with the City of �Fridley Ordinances and rulin�s of the Department of Buildi,ag�, , and� hereby �dealares : that aIl :the „faots aad repreaentatious"stated in-Chis applicativa are true,�aad:correc.t. � .,.�,," _ i �-' �T.-�-. F / G � I�" �� °' �Schadule of Fee Costs caa be fouad on the Reverse S3de). a a • 'r / \ � r �! � 1 �` ��` � � \ .� � '— �` _ er 4 BUII,DING PERMIT FEE SCHEDULE Section 2. The Inspector of Bu3ldin�s sh�.11, before isauing any permit for the ere�tioa of any building or structure, or for any addiCion to any exist- iag building or structure, or for any alterations or repairs Co aaay existing buiiding or sCructyre, upon application Cherefor, require the paymeat by the applicant for such permiC of fees to the amount herein below �eC forth and in the manner herein provided to-wit: � 2.1. For any such permit for �he erection o.f any fire-proof building, other than a garage� warehouse, factory or grain elevator, or for the erecCioa of any fire-proof addition, for s3miLar occupancy, to any �xiaeing building ahall be at the rate of $1.40 for each.one thousand cubic feet. or fraction thereof, in sucb cubical contents. _.. 2.�. For any_such permit for the erection of any fire-proof garage, warehouse,� factory or grain elevator, or for the erection of any fire-groat add3tion, _ for similar accupaacy,'to any existing building �hall be at the rate of $1.25 for each one thousand cubic feet, clas�ified as t1fireproof" by Section 502 of ,_tha Minneapolis Building Code. _ HOUSES . 2.3. �'or auy such perm3t for the erection of a.ny non-fiteproof building othe= than a garage, warehouae, factorp or grain elevator, or any non-firegroaf addition, far similar occupaacy, to eay existing building - permit $1.00 for each ane thousend cubic feet. GARAGES 2.4. For any such per,mit for the er�ctiva of any non-firepraof garage, warehcu"se, iactory ar..grain elevator, or for the erectioa of $ny non-fireproaf addition, �or-�sim3lar occupancy, ta any existing building or for esch auch ,,__ build3ng or addition - Ainety �ents ($0.90) for each one thouaand cubfc feet or fra�tion thereof, in the cubical coatents thereo£ with a minimum of $4.04.- For the purpoae of camputiag fees for building permits, the cubical co�rteats _of auy building or additian to a uaiform height throughout by multiplqing the ground area covered from a poia� six (6) inchee below the floor line of r.he bas�ment or cellar to the average heig�t af tha ugper surface or to the average height of the r�pof surface of the mai� gable ot a pitched roof. 2.5. For repairs or a�.terations to an existiag structwre, the fee ahall be at the rate of $3.00 per each Five Hundred Do�.lars (�SOQ,00) or fraction thereof i� t�i�-cast of all progosed work. � Z.6. In-no case, s1�a�1 Che fee.__charged,for.aay-permiz.-as �et forth ia Section 2 be less. than $4,D0. � � _ . i'� �`, �.,, - .�. s.. .- - � . - _ �-�. ._ 0 . "� f�j t ,� CE�TIF��AT� �� SU�l�EY v RAILNER VN. CARLEY 8 ASSOCI�LiES ' CONSULTING Cl�/ti EPIGIPlEERS—LAND SURVEYORS 500 W. HWY. 96 \ 1$ FOURTH AVE. S.E. ST. PAUL 12, MINN. , Si, CLOrUD, MINNESOTA 484-3301 B� �'�51 ( hereby certify thot this sur.vey, plan, or report was prepared by me or under my direct supervision and that't am a duly Register d Land Surveyor under tfie laws of the State of Minnesota. � � � /� � ��sf''. ".-�' �� s /�� °� • Reg. No.352? Date April 22, 1984 , �� . , y �. . � FL Y .S 7-�c'�~ a .� " � . 0 • � - I - .._ I it i5� � � ; .. � � I . C� R a ; U ; , , ; , � ' ` • ' ��.4<<. �.,_ 3v. � , • :�. _ ' � - -- _._ ,iJ ' .�' --.-•. . _ . � _ 'T...�.�' � f�j � / Lots 40, 4,1, . :- �.�� the �desterly 10 ��t o�" :�� : �3, BI:GC�1C "K" ��tI�%_��;,rrIL•'F'T I1�IGlfit'S� AuOka, Coutl�r b�.riesotF�.� e:coQ��t tiae ��ester�ly 15 feet o�� said Lot �C� , �, �, . .. � . - � ''-.� �-1 � y -�ai �y_ y,��=- �� -� y W � a ,'; � M �� ro' r o `� p ,,�,, : y : ''1'. : � . m • M : o � a . � 0 ' � : � • t!3 4A .� N � � � r � � � W � � o '� co �' �y M � � � � � � . o • o • o . o . o . . ta : : � . . I I I � 94 iG 6! N N � o O O � �9 � H H � z � � � � �1 m � � z z � � � � � n � � � � � � � � y�� ;�� d ' O � � � ro °' � � � a p ' � �' ' � N . � . R o : � � : Oti � . . . . O ' Gd : : : : . � . . . . � � p: >C DE i! �E W t� w r� r ►�+ � e�» p e�i� o 0 0 � &3 <fi {f! �A ifl iA � � � � � � � � 0 A x � � � � �. � � y N � m 1 D � i � � m � _ m C r m ¢ � o � � � � O ��! A � � � e�-h a � � � fD � � ? z � ° � L � rt � � .�r p, � ~ G1 � GL �' � $torfes � � WATER � �� $�'$ �@ � �% URINALS � eAr►+ � � � p � � B/lSil� i � � ,... siNKs � � WASH " rRAYS DRINK. FOUNT. sHwRS. FLOOR � DRAINS GTGFI A &lSINS � AUTO �/ASHER � GAS APPL GAS RANGE GAS i . OPENINGS e • Z • W (A � N D � m m 8 A � ti � � ]j$( � i � p a w � � � a.a� `�° � �; � h9 y •a� � � °� � � � o m �' �. N � � ^ ':y � ��.o � �. � � �� °'° � � a� � �� w p � m o Q, a p tD � � � O ��w . i►�� `��y �� • A �' �� m �y�M o �' � p'' � � � � �� 3� �. � w 0 � � � � M d � A � � w0 4 � & h°n p � M � � � � � � �i � � � � 0' � � � � gr d 0. �- �, �i b � � � � � b�� `ro � � � � � a�A �A a r �« e� ,--� � C�..ty of Friclley, Minn.. BUILDING PERMIT Dsts: AUGIIST 17, 1965 �: LEONARD MATIiISEN 8��, SAME ,p,d� 514 Elv St. N'. E. A� Fridley 32, Min.nesota LOCATION OF BUILDING No. 514 Stceet ELY STREET N.E. Part of Lot Lot _ Block Addition or Sub-Division Coraer Lot � Inaide Lot Setback Sideyard Sewer IIevation Foundal3on IIevai3on , N'� 8369 ��/C� LOT 40 (E$. Westerly 15 D�SCRI�TIO�V�OPtBU�.DIN�1y 10 ft. of Lot 43, Block R, Rive7cview Heights To be Used as: D. Garage �t 24 �p� 22 H��t 10 �, � 528 � r•t, 5, 280 Front Depth �Teight Sq. Ft Cu. FL Type of Construction F�t, Cost 1 5�{..�0_Qy__ To be Completed In cons3deration of the iasuance to me of a permit to construct the building described above I agree to do 'th� proposed work in accordance with the d�scrlption above set forth and in compliance with a�ll provis�tons of ordinanc�s oP the dty oE Fridley. (��.�.�.� In consideration oP the payment oE a fee of $, �• 00 , permit fs hereby granted to LEONARD M'ATHS,SEN to conslruct the buflc�tng or addition as descrYi�d above. Thispermi t is granted upon the express condition that theperson to whom ft is granted aad his agent�, employees anc� worlmzen, ffi all work. done in, around and upon said building, or any part thereof, shall conform 9n all reapects to the ordinanc� of Fridley, Minnesota la�tion, construCt�on, attere..tion, maintenaace� repafr ana moving of builain�s wittiin the dty limits and permit may be revoked at any tirae upon violation of aay of the provfsiona oF seid ordinaa�. LXLJI.IL'llV \ie aJ••.�Va7�lV �r++a�+++8 +�°Y'�� n NOTIC� '161s perm� dea not eo+rsr t6s coesteudfoe, 6�alWton hr wieleg, pinmbieg, ea 6�aNne, sevw� er walse. B� sun to n� tln &riWinB Im�or toe �Parat� � for tha�s it�n. OWNER'S APPLiCATION EOR BUILDING PERM:[T Cx3�t OF �'RIDLEY, MIHNESOTA •��• � �i..��1��%�j ,��. �/�v ' .' -- / - � � � : � � � , N0. STREET PART OF LOT I,OT BLOCR AbDI1�ON OR StJBDiVISION CORNER LOT INSiDE LOT SETBACK SIDE YARD SEWER ELEVATION FODNDATION ELEVATIQN Applicant attach to this form Two Certificates of Survey of Lot and proposed building locat�toa drawa on these Certificates. To be used as; DESCRIPTIOR OF BUYLDING . / . � Front � � Depth 7�iieigh� / . � Sq. Ft. �� Cu. Ft. � �� Front Depth Height � Sq. Ft. Cu. Ft. �� a T a� !� Tqpe of Construction Estimated Cost To be completed The undersigned hereby�makes application for a permit far the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and ruliaga of the Department of Buildinga, and hereby declares that��all the facts and representations stated in this application are true and correct� DATE_ � - � % - lv S (Schedule of Fee Costs can be found on the Reverse Side). � : .� � :..� �i .. , � _ � __�._ HIIILDIftG PERMLT FEE ..SGgiEpU�B SEGTIOR 2. The Inspector of Buildin$s shall, before is$uing any permit for , the erection-of anq buildiag or strucCuret or for any acYdition to any esiatiug building or structure, or for any alterationa or repairs to any existing building or etructure, upon appl�.cation therefore, require the payment by the applicant-�or such permit of fees'to the amount he�ein below set forth and in the manner herein provided to-wit; - � .2.].�. For aay such permit for the erection of any fire-proof building, other than a gara�e, warehouse, factorq or grain elevator, or for the erection of any fire-proof addition, for�similar occupancy, .to any e.xis.ting building, shall be.at the rate of $I.40 for each one thouaand cubic feet, or-fraction thereof, in auch cubical contenta. 2.2 Fox any Buch permit for the erection of any fire-proof garage, warehouse, factorq or grain elevator, or for the erection of any fire•proof addition, for similar occupancq,,to any asisting building aha11 be at the raee of $L.25 for each one thousand cubic feet, classified as "fireproof°t by Section 502 of the Minneapol�s.Buiiding Code. flOIISES 2.3. For any such pezmit for the erection of any non-fireproof building, other than a garage, wa.rehouse, factory or grain elevator, or any non-fireproof add�.tion, for similar occupancy, to aay existing building - peranit $1.00 for each one thousand cubic feet. GARAGES - 2,4. For any such permit for the erection of any non-ffreproof garage, warehouae, factory or gra�Ln elevatar, or £or the erec�tion of any noa-iire-proof addition, for aintilar'accupancy,.to any egisting buildi'ag or for each such building or addition - ninety ce�ta ($Q.90) for eaCh one thbus.anr��cub3:c feet or fraction thereof, in the cubical coatents thereof with tiie �mini'mwn of $4,00. For the purpose of computing fees for building permita, the cubical contents of any building or addition to a uniform height throughout by mulCiplying the ground area covered from a point sf$ (6) inches beiow the floor.line of the basement or cellar Co the average�h��tghC of�the upper surface or to the average height of the roof surface of�,the�u�ia gable of a pitched-roof. ' � 2_ 5. For repairs or alterations to an existing atruAture, the fee aha11 be at the rate of ,�3.00 per each Five F�an�rced Dollare ($Sua.GJ) or fraction thereof in the cost of aZ1 proposed wo•r�c. 2.6. In no case shr�11 the fee charged for any permit as set forth in Section 2 be less fihan $4.G0. STORM REPAIR DAMAGE ??rES: Residential; Commercial; � . �� Estixnated Cost of work up to $50�.00 •$5.40 Estima�ed Coat of work over �`�r.i�7AC�a -$�.U,aO -e _ _. � Estim.ated�st of wor.k up to $��?��.00 -$10� Esti.mated st of work over $500.00 -$i0; , �_.., ,-..-� �'-h:1r2:;,`i`��iK.ti!iJ.:.•ti.. uui5J2i.... 'hiC;v�., . ..i...2},�, . .�...,.i1.�h1�:,.i>..:w�. �iti:w . .. .. . .. ..... . . . . .. .. .. .. .`..:, u. . .......�...:h' :.... . .,. .� ...v .... . .. ... . . . ... . . .. ,.,. ,. . .. . � A � n 3 � �n. � O tA � W 3 � O � 3 3 a o `o m � �a cQ c�i '� n. � a � � � � 3 � � c� � . a � � 0 � �� 0 n� rn z� � � co Z� D � C1 � rn� � � n � � -n A O z Z 7D m z � � m � Q Z iTt � � 'a -a °< m r�. � �u c �a s 1 3 v � � � s m .r � cn a m � C3. W � n 0 � D Z � 1.�', � o.► O �3 0 °. 3 � � c A � � � � � G 'a M, a—, �. � 0 0 � O � � � � c rn � � tQ w ...► � o � �. � < � � � � -��. fb 1 ' .+�' t�! m' D � � o � �' � o ? �� -a O Z m n 3 tfl ts � � C � � � � � a� Q m Z � � S "D � 0 m v � . � � i� � � � c -�-� � p � � `�� o � � A �3 � � � � C � � _ � � � n O A �' m 'n � o � � � � A � �-. [n m � � 3 a � a = � � c"u � m � D � n Q. � � (� 1 D � � m � � v m -t �i � � � � ai � � � � � Q � Q. � � � � h W � � � o � � � � � ��: A ? �. � � � m .�-« �. -n v c � � � � � m c � m � �s tfl tts t� r� 0 0 0 0 0 � o° °a o° � °o � m � cn m � � rrl v n O � -� � � -D � � 0 � � � � C v Z � c � m v � r. � z � � `' • �� -• -, v, -� m� °.c � N � 7 �'iQ�`� � W � � ay -- 3 Q. Q, Q- � � Q� o Q 3 v o ,� �a_,'p' � � � ? o m � � X- � A Q. � 'a � � N� � ��w� °' '� a � ��o�' � � � � �' � � � � N � a ,,. m A S o � � �' o � �? r. -. � '« � � s � n o �� a �, C� z � � a u, � 3 � j a � w 1.+ � � w li �� i � O W D � v � � � � , � .� � N � � w `c C O �zm � �• o � < � N � Z m� m � � v < � � � � mn � �O O � Z z1 z� � -D D �� n � Z '0 O � _� Z O .� Z� � Z v� v u�i = m �� Z z� v c� < � mZ �� < m Z � D � Z � m O � � � � c m � � W CHIMNEY AND STACK YERIFICATION The undersigned hereby verifies that the existing chimney or stack: l. Has been carefully examined Yes O No O 2. Is free from rust or deterioration � Yes () No () 3. Has no for�ign objects lodged within Yes O No O 4. Is securely supported Yes {.) No ( j 5. Meets all current Code requirements for size and total BTU's connected Yes () No () 6. Has total heating BTU's of All other BTII's � � TOTAL BTII's Remarks List Alterations Beinq Done: a HEATING COMPANY Signed By Date i; Inspections 763-572-3604 DATE--- �_ 3 J0 6 SIT'E ADDFESS THIS APPLICANT IS l� 5-1- , BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY Pernut No.: Received By: Date Rec'd: YOUR E-MA II, ADDRESS S� � ii c� r 7�� a� y a�G d,� i%/�'l ` OWNER ❑CONTRACTOR PROPERTY OWNER/ N�: TENANT ADDRESS: CONTRACTOR S S �a-- � �' CITY M� CL I�' _STATF/?�LII' � 3� 8 � �- SUBMIT A COPY OF STATE LICENSE # ,�� EXP DA'I'E YOUR STATE LICEN5E ADDRESS: �"�� CITY, WITH APPLICATION pHONE FAX PROPERTY TYPE PERMIT TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION ❑ TWO FAMILY/NEW CONSTRUCTION � ADDITION � GARAGF/SHED �ASEMENT FINLSH ❑ ROOF ❑ DECK ❑ SIDING ❑ SWIMMING PO( TYPE OF WORK: I ❑ �W ❑ MAIT ❑ ADDITION DESCRIBE WORK BEING DONE��,s� rheo�-�- F��^� S� SIZE OF INlPROVEMENT �� ROOFING NUMBER OF SQUARES _ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other LENGTH ❑ HOUSE ONLY 0 HOUSE & GAR.AGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit � Trim ❑ Fascia WINDOWS 1N EXISTING OPENINGS �Yes �No IACATION OF WINDOWS OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF � TE ZIP, SIZE STORIES �WINDOWS (�E�PeSs ❑ DRAIN TILE ❑ QTHER HEIGHT BASEMENT REMODELING SUBMTf: 1. Existing F7oor Plan 2. Proposed floor plan 3. List of structura] members to be used Ft. FOR NEW CONSTRUCTION INCLUDING DECKS, ADDTfIONS. & PORCHES SUBMIT: ]. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING TAE 1997 U.B.0 FEE SCAEDULE) TOTAL JOB VALUATION $ %, �� " OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb G�t Escrow Erosion Control Park Fee Sewer Main Cha�g�`�� Total Due i'�� `�� .�,�� % . �I �j. ,_ +-'1i -.� -� y � See Back Page for Fee Schedule 65% of Building Pernrit Fee .001 times the total job valuation .0005 x Permit Valuarion Minunum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$20=$ $450 Conservation Plan Review Fee Deternuned by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of FridIey Attach THLS IS AN APPLICATION FOR A PERMTf-NOT VALID tJNTIL PROCESSED I hereby apply for a building permit and I aclmowledge that the infom�ation above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a pernut but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work whi equires revie and a proval of plans. , SIGNATURE OF APPLICANT �' G�9!�/O��Z''��{/� PRINTNAME �� L' �(if � � � � ls � DATE �I.�/d � d r /� ' I � � � �� ,'� �� i' 1 �� .._,- � � � � � � . � ,� � 0 v V a 0 � � 3 � . � � ...__ � _ � . � � 2 i 3 � � � -� �� . _ M � 'i 1 ��• V� ✓ V v � _ ,_ = a c`� , �6 �� 9 �� J "1 � � . ., � W r �J � �, � � .. Q� 0 � � �„� . � � �v � � �, � - � �t _ --�v� �-� : � �� . .S7'�1 «S `�1 ,� � � � � � � � b � � � � � 0 : 3 !�- � � � � � 1� � r � ; Building PLUMBING Permit No.: ��-c�� Inspections �.+ SI�EN�IAL �.PPLICATI011T Received By:� 763-572-3604 �DateRec'd: �" ��° CITY OF FRIDLEX DATE �� I d 6 YOUR E-MAIL ADDRESS SITE ADDR£SS �� v .S�_ T�IIS APPLICANT IS: j�OWNER OCONTRACTOR PROPERTY Nq�: n n�,� /Ii� ; S�, I S�C� ow1vER/ an�xESS: s�� / Sf crrx �-�, �� STATE ��ZIP .S�S�.3 TENANT PHONE: !o_S��- ��'D , �� -� CONTRACTOR Nq�: SUBMIT A COPY OF STATE LICENSE # EXP DATE YOUR STATE ADDRESS: CITY STATE ZIP LICENSE VJITH PHONE FAX • APPLICATION PERNIIT TYPE n SINGLE FAMILY O TWO FAMII.Y ❑ TOWNHOUSE TYPE OF �VORK: �NEw ❑ REPLp.CEMENr DETAILED DESCRIPTION OF WO� F•, � S�/� ��. e rt � � �- '�• I� '�-tl � S+�, �. U o � ; �. v v�- PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cQSt up to $500.00, whichever is greater, for the improvement, installation or replacement of a residentia.l fixture, excluding the fixtures. (This should reflect only the cost of labor ) La 9T� cost un�e* � D�5-on �.�hor cost between $340 to $500 = cost of labor x.OS = FOit PROJEGTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIX'TCTRE, EXCEPT WHERE NOTED. FlXTURES: (R�IDICATE TOTAL NUMBER OF EACH BELOV� BATH SINK/LAV FLAOR DRAINS SHOWER WATER PIPING BATHTVB GAS PIPAIG (n�m crrruc�.� SWINIIvIING POOL WATER SOFTNER ($35) CLOTf�S WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15) DISHWASHER _ LAUNDRY TRAY WATER HEATER (S35) FOR IRRIGATIOAi WATER MECER OTT�R - 5,,�. '3d-.. . y �` 6 ,y g l� �� P a s . s.'C„ ,.'�.., • � � Permit Fee . $ Number�of fixtures @$10A0 x$10.00 =s$ Surchar e .50 Number of fixtures @$15.00 x$15.00 =$ TOTAL DCTE $ Number of fixtures @$35.00 x$35.00 =$ State Surchazge = $ .50 Tota.1= $ THIS IS AN APPLICATION FOR A PERMIT NOT VALID LJNI'IL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all ��vork which requires review and approval of plans. SIGNANRE OF APPLIC �'' PR1NT NAME �.i� ��G'� � STC/� /� e DATE 'T � 7� _ . , , � ,. a ,. , < ; . ,# _ , ,. , , . : . . . �: ; £ ,;�. �h � City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building Inspections 763-572-3604 S1TE ADDRESS � TFiiS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WTTH APPLICATION PERNIIT TYPE TYPE OF WORK: �' .... lYIECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS �OWNER OCONTRACTOR Pemut No.. �o �' Received By: Date Rec'd: �'� � ADDRESS: ��f � � °f� -� CITY F�� o� � ao __STATF�I�ZIPS �'{3 PHONE:�� S / ,�- r1. � (�'�� COMPANY NAME:_ CONTACT PERSON: STATE LICENSE �_ EXP DATE ADDRESS: � C�y STATE ZIP PHONE SINGLE FAMII,Y FAX ❑ TWO FAMILY O TOWNHOUSE O REPLACEMENT ❑ ALTERA770N/REMODEL DETAILED DESCRIPTION OF WORK F,. �.`s� �� '� j �,�i, n rn n�.. f�i Rrn �.l�e..� PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.40, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtui'es. (This should reflect only the cost of labor ) I;alLorcost der $300 =$15 Oi� Labor cost between $300 to $500 = cost of labor x.OS = i FOR PROJEGTS WI�RE U+,BOR IXCEEDS $500, FEES ARE BASED ON $] 0.00 PER FIXTURE, EXCEPT WI�RE NOTED. FIICfURES: (II�iDICATE TOTAL NUIVIBER OF EACH BELOV� SIZFIBTU Equipment Installed . MFG: MODEL: MFG: MODEL: STZEBTU MFG: MODA.: SIZEBTU A/C $25.00 FIitEPLACE (GAS) $15.00 . GAS RANGFIOVEN $10.00 AIR TO AIIt EXCHANGEER $15 FIREPLACE (WOOD) $35.00 = � �r � $�10�.� _BOILER $35.00 _FURN�`CE $35.00 CHIMNEY LINER $10.� _GAS DRYER $10.00 POOL HFATER $35.00 �DUCT WORK $10.� GAS PIPING $]0.00 VENfILATOR $15.00 — �--� ,�,� , �" ;�. -. .. .,.�,� ., ..:. .. . _....... . _ . Permit Fee $ Numher of fixtures @$10.00 x$10.00 = Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DiJE $ Number of fixtures @$25.00 x$25.00 =$ Nu�ber of fixtures @ $35.00 x $35.00 = $ State Surchazge = $ .50 Tota1= $ THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSID I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in confoimance with the ordinances and codes of the City of Fridley and with the Minnesota �Construction Codes; that p 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 ork which requires r,eview and approval of plans. SIGNATURE OF APrLICATIT � r ��''�- PRINT NAME - �P v1Ge/ IS t�(Sl� DATE tl ��-? �d 6 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 r� REQUtRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC � ❑ NEW HOMES/ADDI�IONS ❑ EXISTIMG HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Cambustion Air (See note below) . a. Oi.l or solid fuel ]MC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments � 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Ven.ti.n.g a. Gas appliances IFGC Cha.pter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation . � a, per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 134b:0603.2 a. ACCA Manual D NOTE: Centerpoint Energ� Mechanical Code Guidelines software may be u�ed for comb.ustion and make up airr calculations 3uildi.ng nspections �63-572-3604 o� BUILDING RESIDENTIAL APPLICATION ITE ADDRESS S I� � 1 y S-}Ye e� 'MS APPLICANT IS: CITY OF FRIDLEY YOUR E-MAIL ADDRESS OCONTRACTOR Pemut No. Received By: Date Rec'd: � � � ' �� PROPERTY OWNER! N,yME: �'�� „� �- /Ul� s}e. l 5 K� �N� ADDRESS: Sl4 E' 1 u S� CITY �<'d i STATEn''�IP �3 °� PHONE: !o �t . 'L3� , �"��d-- CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERNIIT TYPE , .�.� 3TATE LICENSE EXP DATE ADDRESS: CiTY STATE ZIP, O SINGLE FAMILY/hIEW CONSTRUCI'iON ❑ TWO FAMILY/NEW CONSTRUCTION 0 ADDITION ❑ GARAG ❑ BASEMENT FINISH �ROOF ❑ DECK ❑ SID1NG ❑ SWARVI TYPE OF WORK: I � ❑ O DRAIN TiLE O OTHER DESCRIBE WORK BEING DONE: T'ea �- o%-� a F , I� ��r� n e� S�, �9 i�-S �� S�, l��'i� �ort , SIZE OF IMPROVEMENT LENGTH HEIGHT F� ROOFIIVG � ❑ HOUSE ONLY NUMBER pF SQUARES �iOUSE & GARAGE �ASEMENT REMODELING SUB1vIIT: GARAGES ❑ ATfACI�D GARAGE 1. Existing Fl�r Plan PROPOSID SIZE: �ETACHED GARAGE 2• ProPosed floor plan PROPOSED HEIGHT: 3. List of struc4ual members to be ased SIDING FORNEW CONSTRUCTION INCLUDIIdG DECKS, ❑ Vinyl OSoffrt ADDI770ATS. &. PORCHES SUBMIT: ❑ Aiumin� ❑ Trim 1. Site Plan/Survey showing the existing strucwres 0 Other ❑ Fascia and propc�sed projeet WIIVDOWS 2. Two sets of construc�ion plans IN EXISTING OPENMGS �Yes �A10 LCKATION OF WINDOWS 3. Energy Calcutations OR FOR NEW OPEMNGS-DESCRIBE SIZE OF OPENING CHANGES 8c TYPE OF WII�iDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCI�DULE) TOTAL JOB VALUATION $ �`1 L�� OCCUPANCY TYPE _ Pennit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Chazge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Dne $ $ .C�°1 $ 1. '� $ $ $ $ $ � �: See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residenrial Contractors) $1550 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 aavable to: Citv of Fridley Attac THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclmowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work w' h requires view and approval of plans. , Li6i�e'�L�� SIGNATURE OF APPLIC �,�P'>e___ PRIN'f NAME �+C'��C'-//6` /�i��S/`�--DATE r Z i�� Page 2- Building Residential Applica.tion BUII..DING PERNIIT FEE SCHEDULE �°�., The Chief Buildang Official sha11, before issuing pemuts for the erection of any building or sttv.eture, or for any addition to an.y existing building or structure, or for any altera.tion or repair to any existing building or structure, upon application therefore, require the paym.ent 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 min;mum of 24 hours from the time of applica.tion to allow for proper review of proposed stru.cture and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Onlv City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 FR�M : RT565 FAX N0. : 65134C18212 Dec. 07 2006 04:25PM F1 w ,. �` `�� . 5-? ( . I �- �� " �� = ��. n � �e � ��f �� ..g � / S� -. � � � �� . � �r _ � � � �� .�� GQ��- � �"t` � . r �� - SJ n t� t`� � �� 1 �� t�� ..� � -�-�. �� V � r _ � �� ✓ � , VJ \ � ��''� U � 0 CITY OF FRIDLEY .,. � � 6431 iTNIVERSITY AVENUE NE FRIDLEY, MN 55432 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 514 ELY ST NE PIN : 033024320029 LEGAL DESC : UNAVAILABLE : LOT 40 BLOCK K PERMTT TYPE : HEATING - LABOR BASED PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DUCTWORK VALUATION : $ 300.00 NOTE: FIMSH BASEMENT, RUN HEAT DUCTS, FUTURE FIREPLACE GAS LINE. SPENCER MISTELSKE 651-230-4852 APPLICANT MISTELSKE,SPENCER 514 ELY ST NE FRIDLEY, MN 55432 (651)230-4852 OWNER MISTELSKE,SPENCER 514 ELY ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and exa,mined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wor� will be complied with whether specified herein or not. T'he granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp _ Date PERMIT NO.: 2006-00694 DATE ISSUED: 04/27/2006 HEATING PERMIT FEE, LABOR-BASED STATE SURCHARGE, MECH VALUE TOTAL PAID WIT'H CHECK # 7148 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 15.00 0.50 15.50 �� ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE IN5PECTION TYPE GAS PIPING/AIR TEST HEATING ROUGH-IN HEATING FINAL INSPECTION COMMENTS: CITY OF FRIDLEY PERMIT NO.: 200�-00694 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 0�2��2006 (763) 572-3604 FAX: (763) 571-1287 514 ELY ST NE PERMIT APPLICANT: : 033024320029 : UNAVAILABLE : LOT 40 BLOCK K : HEATING - LABOR BASED : RESIDENTIAL : DUCTWORK MISTELSKE, SPENCER 514 ELY ST NE FRIDLEY, MN 55432 BUILDING INSPECTION RECORD 24 HOUR NOTICE REQUIltED FOR ALL INSPECTIONS. CALL FOR INSPECTIONS WEEI�AYS: 8 AM TO 5 PM DATE INSPECTOR INSPECTION TYPE DATE INSPECTOR IN ACCORDANCE WITH CITY ORDINANCE, NEW OR SUBSTANTIALLY REMODELED BUILDINGS SHALL NOT BE OCCUPIED UNTIL ALL WORK HAS BEEN APPROVED, AND A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED BY THE BUILDING DEPARTMENT. THIS CARD MUST BE POSTED AND VISIBLE AT ALL TIMES UNTIL WORK IS COMPLETE. Permit No. • , � � �� MECHANICAL �`� � Building � Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: i��°�� DATE I Z I? I�� YOUR E-MAIL ADDRESS SITEADDRESS .�I E � ,�' ee+' THIS APPLICANT IS: �-OWNER OCONTRACTOR PROPERTY NpME; � c2� /11 � '� l S�'e— oWNER/ ,anD�ss: � �� i�i-, d I e y STATE�/� ZII' Sr�` TENANT PHONE: � S t . Z3° � `� � � �-- CONTRACTOR CoMPANY NAME: SUBMIT A COPY OF CONTACT PERSON: YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH p,DDg�g; CITY STATE ZIP APPLICATION PH�� FAX PERMIT TYPE �INGLE FAMILY ❑ TWO FAMII.Y ❑ TOWNHOUSE TYPE OF WORK: � ��'�' � �PI''�CE� /�'�-TERATIONtREMODEL DETAILED DESCRIl'TION OF WORK �� S� `�, � a� 9�S 7)�P�� `e ��` ��t C°�'�e`� � PER MS 16B.i565 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. (T'his 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 WHIItE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WI�RE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOV� Equipment lastalled MFG: � MODEL: SIZE/BTU MFG: MODEL: SIZFJBTU �r,; MODEL: STZEBTU A/C $25.00 ,�FIltEPLACE (GAS) $15.00 GAS RANGF�OVEN $10.00 —AIR TO AIR EXCHANGEER $15 FIl2EPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00 BOILER $35.00 _FURNACE $35.00 _GAS UNTf HTR $10.00 CI�vIIQEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 . _ � x,� ',: � � . _ � � ° �,; , , , ` , � N> - . , , � � � _� �,�., w:� � �, �,,, 2 ux $10 00 $ ~ �a . �1�;: Permit Fee $ Number of fixtures @$10 00 Surcharge $ .50 Number of fixtures @$15.00 � x$15.00 =$ 1'� • 6 b TOTAL DUE $ Number of fixtures @$25.00 x$25.00 =$ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ 50 Tota1= $ �i � •°� THIS IS AN APPLICATION FOR A PERMTf NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclaiowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all rk which rec ires review d approval of pl s. SIGNATURE OF APPLICANT � T1pivlE ��G � � I S'�-��'�� f Z% 7 �rf =� _ , � �, " t;ity ot 1+�riuiey Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT , RESIDENTIAL PERNIIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAI{E-Up AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Cha.pter 5 with MN Am.endments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new constntction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manua1 D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations.