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AF - 41728l. .� LOT AND RARM 8{�AY�� CdN8T1�ttCT10li sURYEYB _ R�B�RT A. BUSCM �...�.�.�___r �'a�d su�� , � v� i N RE�B(BTBR$D WNDBR LAWS OP BTAT6 OF NfINNESOTA :,� � PltCNE PARICWAY 4�B��B �' -�6�,•' a4, . !�821 9QTtt AdE. 80. MtNNEAF�l.t9 6. M1NN. � � �, �,�--�'"` SURdEYQR'S tERTIFICATE ► ....�'- , . . ,�° ,� , , � , � .....�-�;� �R,� � � . . ; ,� . — � 5 , " _ . icon� l�N ' " ' �—� �� n �.�... :;;� TOP�RArH/CAL PLATTINti � �� • ` ��5 I�� ',`r` - - ,f 1 r' - � � � 'y , ' � .--�--+r�: 1D , � her,e�y eerti�'y ihat thia is s� Lrtae e.r�8 ,', ,• . aorres�t repreaentatior� of a-eurQey erf Lhe r ' • ( ��LIIlC1�PS,lRL1 � O'� j � �i't �'e� �' �1�0� �1 � �8�'21S � • } � a i�'� � Fir�t Additlor�, �Anoka Coun�t�►, M�nn. 'i � attd �! the i��at4on ot all buiidiing8. � �t an1, �hereon and all vi�ible emcraac- �, � j raente, �.2' �r��, f�� r or� asid 10�. I � - , As aura�eyed by me t�i� �th �ay cf I ° F°ei��ru�,ry � 96�4. I - , �l � ' A' ` ' ' r . • ' + , , , � , . '� ' ' � � � � a:\, . . ' i � _ � . .. , P , r . � i . . . ; �-, , y �'°� - ,' ` . .. . . . —� . . �� o,j r_ �� j � ' �� . ,, ;� � • ; . � � � � � � . �� y �.. � tl G, � � � � �t � °°--�,,� - • ; ' � _- °� __.. ___._ .� _ _ � __ .- a . , • ' • � -� F �� i � , } r: _! �; � '' a�.��iY �'i �l ��, ` � -'':� �1y� 4� �.`` + � �� `� 4 �'�' �: ��i�"�� . � �' s � � rp ��' , � • ' ; , . , � � r . �c�e� � 1�� 3� - a ��GN � � �, � I�i1�1E80TA REj�'RATWN Wa: OSQ = Ir � "�'i_�- �.�� -_ ` ' _ �... �� y of F�a�ey, n�. n BUILDING PERMIT NA _ s s 17 �� Date: "� `� � � � OWner: e Builder �� Adaresa _ Address � /"1 a ��' L�CATIO O U�.LDING No. .�� S�eet �'� .�e�r , ��i Part oY t Lot �_ Block -� Addition or Sub-Divieio� � Corner Lot � Inside Lot l� Setback _�yL�__._ Sideyard �� Sewer IIevation .�Z�' `��' _ n IIevation �� l �"� o� ��s= �� r�� , DESCRIPTION OF BUILDING To U Front � Depth �� Height �� Sq. F't �� Cu. Ft�� Frant _.�,,�� Depth s fTeight _a�l� Sq. Ft � Gti1. Ft �Z.�:�...�� Type of ctioa __ Fast _ T be Completed Ea consideratton oP the issuancre to me of a permft to constru building �lescrih�d above, I ag�e to do th� proposed work in accc�rdance with the description above set �ppliance wi all proviafona of orrlinances of the dty oP Frldley. � �/L _ _ �� In consfderation of the �yment oP a fee of $.�� , permBt fs hereby granted to to construct the buflding or addition as described above. Thispe rmit is granted upon the expreas c�ndition that thepe�o n to whom it ia graated and h3a agent$, employees and worl�en, fn all work done in, around and upon said build3ng, or anypart thereo$ shall conform fn all respecta to the ordinauces of FridleY� Minnesota regar�g lacation, construction, alteration, maintensnce, repair and moving of bufldings ordin �e�. dty ]imits and thia P�t anay be revoked at any� upon viola�fCn of a�► of the Proviaiona of said � 1 Buqlaing' Inapector NOTICEs ilds petmtt doa aet eavsr ths eoestrudiee, Ie�alWion �er nrf►1n9. P��B. 6as headee, �r�r er vrater. B� airo to � f6� Boildieg lesp�eter far apuab p�rmhs hr tk�a h�ms. � . . _� � � � a � N 0t IfI :s � N � � � � � p �o O c�i x t�' M � � y x x � � r � o � xxx� � � � O � � � x � � � � � � � �n � o � �E 0 � � � � � O �, � r � � o0 ►� H �' �y � � � ! ~ � `1 �� " y�j 9d � '��0 o � I � m k !' � W o `.,. � � t�A c � w 0 N iC � rP '� W o � : o ,� :-- 0 0 �� O A O � • � y�„ 'y 0 H : ' � '�' � �1 , . � N . . . � . . . . . m . . : : : � : : : : : � : : : : : � � I I I � � � � � � x : oa �e oa o : N � � °o 0 0 � °o rn �» fn � cn _ o G,� �" 0 � � p' �' � � o °o � � �� x� � � � � M ' ao � � � � �� ' �� ,w �� ,w V, O � � � W � G � � � � �' � � � � P� � � p�„ F' � � � � � � � Q � � � � � � o � ,a,, �' : p0 a' $ a � � o � p. � : � .. en ,°o : • -� ,'� $ � : : o � � : : ' � � : : : : : � : : : : : w iv N ao 00 °o 0 0 °o o° f» t�s rn t� cn v� N o0 o °o °o °o °o en sn en rn tn � � O A�i ►�1 � � O vC"i � � ��' m a. � � a� a. p, � �' � � � � O �4 �, 7y fD a7 O y ~' y x � � � � �, ro � I � y' O � � � � � � � � � �' � � � � � g � � � � � � \. n, '�] �l � ° � � 0 b O � � � � �m o � 0 y 1 1 1� ; M � pq � m � 0 � �9 0 � � � � �� 'R°m �Ay � 9 � ►��- 3 � � � � M � � � � � � � � � � b � o a' a � � a d' . . � . . � ° : : O 0 . . c . . $ : : : t.� rn en o� � cn o 0 0 0 0 0 0 �n O � �� n aa��r. � � � t�.,� 0 M �p�� (A OQ � � �o�� a �*'� m � c�C�' �4 y d�� , �b � ��°� � pp�� ► a �o��p�� A yrotiP"'i '�'C 0� �Ii'�'�' � � ��m �� yb Oyanr�¢1 p�mat a� � �� ,y � ��b � � �. � �� r► ��y � �� ,� �Q 8 M y �i ~+ � � iP � � �g � si��' � 1 �� D '� r � � m � 2 m C m d b M � � a � b A � V O c-, � J� �, � � � � �' O � �� 0 O � D 0 �L � o, o. �_ �� 0 � 0.� v< A• �� • � �s � � � � � 0. i , _ �� HEAT LOSS CALCULATIONS DEPARTMENT 0�' BUILDIN � _ Weatherstrips A.S.H.V.E. Construction No. 1 sulation Guide � �' dows I oors Reference Out. W 1 Int. Wall Ceili ,, Roof Floor Kind o� No 1`° No 19_ F'1•� '' Width �� Height F7.� s�/� ;' Room i,cngth ! Width Wmdows and �oors—Crac ge and Area Windows and Doors--Crackage and Area \Vldth Helght No. ot Llneal It. Area Wldth HaiBht No. ot Llneal ft. Area Na. ot vane o[ vane Ilghta ot crack eq. It. � ho. o[ Dg*+e ot Dane Ilghte ot crack eQ. [t. � � � �� .�n � � �� e.� � � E" � _ , Bcu � �. Oill Infiltration �� e � `� � jnkltration Glass �, Glasa G �� Exp. walD Eap. wall � Net exp. wall .�" 1`�et eap. wap )nt, wsll Int. wall Ceiling � ; � � � Ceiling � "� Floor � � Floor 7'ocal Btu. ` Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. E.D.R. or sa. ins. WA. Leader area Fl.� F�oom � Length Width Height �ry,� " Room � Leagth Width /d �` eight Windows and Daors—Crackage and Area ' Windaws an oors---Ctackage and Area Wldth Helght No. o( Lineal [t. Area Wldth Hefg�t 1Vo. ot Llneal [t. Area No. ot pane ot Fane 118hte ot crack eq. tt. No. of Da e of Dane Itghte o[ crack eq. tt. � � � 1 � �' � t� d�, Coef. Btu ef. Btu ln6ltration � Infileration Giass , � Glass ' � Exp. wall Eap. wall Net c:p. wall Net eap. wal! /� Int. wall Iac. wall Ceilin8 � � Ceiling e ' ' Floor � ,� Total Btu. Total Btua � Required sq. ft. E.6�.R. or sq. ins: W.A. Leader area Required aq. k. ED.R. or aq. uis. W.A. L.eader area F7. oom � Length Width ,� ' Height �,� Etoom I C.ength Widtlk/� Windows and Doors—Crackage and Area Wiqdows and Doora—Crackage and Area Wldth Helght No. ot Llneal [t. Area Width Helght No. of Llneal [t. Area No. ot pane o[ pana Ilghte ot crack ep. ft. No. of pane ot Dape Ughte ot craak ep. [t. � � � Coef. Btu ! (',lass Exp. wall Net exp. wall Int. wafl Ceiling Floor Total Btu. Reqaired sq. ft. E.D.R. or sq. ins. W.A. L.eader area � � . ;6.=�� ` � � � 1 Inhltration � �d3S i _ �' Eap. wall Nec eAp. wall Int. waU Ceiling �, ' i � Floor ,� �' Total Btu. ' Required sq. ft. E.D.R. or sq. ins. W.A. Leader area G7�� Btu City of Fridley, Minn.. 6431 University Ave. N. E., Minneapolis, Minn. 55432 �UILDING PERMIT yafs: ALg , a 9 h s�.271 p��; Bernard Scholzen $�� Same � 480 Fairmont Street N.E. Ad�s Same LOCATION OF BUILDING �,°`�� ' �{ 11156 , � � No. 480 Street Fairmont Street N.E. Part of Lot Lot 2 Block 1 Addition or Sub-Division - 4J.2�tn.e � R lst Addi ti on Corner Loi Inside Lot Setback Sideyard �3ewe� IIe�a't4an Foundal3on IIevation DESCRIPTION OF BUILDING To be vsed as: Basement Remodel�ont Depth Height ..._.. Sq. Ft, Ca, Ft, Front Depth Heipht Sq. Ft Cu. Ft. 'ryFe of Construction F�t, Cost -. �300.OQ To be Completed �yea.r . In consideraiion of the 3seuance to me of a permit to construei �the building described above, I agree to dp the Propesed work in accordance with the description above set forth and ia compliance with ali provisions oE Ordi'naaces oY the dty of Fridley. � .50 State Surcharge In consideral3on of the payment of a fee oi $ 5� QO_ , pelmit 4s hereby graated, to Mr�a _ Cn7�n1 �ar, to consixuct the building or addition as desc�ibed above. This permit is granted �on, 9he enpress conclition that ihe person to whom it 3s granied and his agents, employees and worlflnen, in all work done in, around and upon said building, or any part thereof, shall coffiorm 3n a]1 respects •to the ordinances oi I�'13dley, Minnesota regarding location, construction, altera.tion, maintenance, repair and moving of buildirig� �� dty ]imits and this germit ma.y be revoked at any time upon violation of any of the provisions oi s�tld � ��x' �� '� -� �� -��8 �� GLARENCE BELISLE NOTICE: ihis permit doas dot eover the eonstruetion, insfallafion fo� wirine, plumbing, gas heatia8, eswa� or water. �e mrs to sas !6e Buildfng laspe�fae fo� aeparafe permits fo� theae hems. � � � «_.. ` AP.pLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITiON BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: �61eNARd cSCii%7.0 �2.t,°it� BUILDER: AADR�$S S��U � i,�/�Q o)) T�. ADDRESS : � NO : . l�� %� I �/v6o��TREET : � : � BLOCK � / ADDITION •� � � /.�. ` CORNER LOTs INSIDE LOT: SETBACR: SIDEYARD; aA,ppliceut a�tach to this form T�io Certificatea of Surv@Y of �ot and pxopoaed buildin� loeat�.on d�awn oa these Certificatas. H�SCRIPTION OF BUILDING To Be Used As: ,[� � ° (�i� y��, 6�,y , Fxant: Depth • Height • -��'�� Square Feet : Cubic Feet : Fxonts Depth: Height: Squa�e Feet; Cubic Feet: 1�►pe of Coastruct�.on: � Estimated Coet: $�� v�-a �� To Be Completedg The uade�signed hereby malces applicatisa for s�pesmi.t for the work hereia epec�iied, agreeing to do all ao�k in stlict accordance witt� C�a C�,ty ot F�ridley O�cdiaaaces and ruliqge of the Department of Buildinga, and heraby dacl�ree that all the facta and representatione stated i,n tLis app2icatioa are true aad correct. DATE: �/�%� . SIGNATORE: ��O (Sea Sevaree Side For Additianal Information.� � S � �� -�, ��, ,� ��9 .Y � ' � .�` _ .�//✓ ` J � U ._�� . �� , � BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing per.mita for the erection of any building or etructure, or for any addition to any exiating buildiag or structure, or for any alteration or repairs to any exieting buildiag or structure, upon application therefore, require the payment by tlae appli.caat for such pennit of feea to the amount herein below set forth and in the tuanner herein pravided to-wit: UNIFORM BUILDING CODE: 1�ype 1, 2� 4-$2.15 for each one thousaad cubic feet, or fraction thereof, in such cubical conteats. Type 3� 5-$1.85 for each one thousand cubic feet. ADDITIONAL INFORMATION Fo7c the pu�pose of compu�ing fee� for building permits, the cubical contents of any building or addition, is detenained by multiplying the ground area covsr�d �rom a point six (6) inches below the floor line of the basement or �he cellar to the average heights of �he upp�r surface or to the average�• hei�llt af Che roof surface of the main gable of a pitched roof. For xepair� or alterations to an exiating structure, the fee shall be at the rate of $3.OQ per each five hundred dollars ($500.00) or fraction thereof in the coat of all propoaed work. Ia no case sha11 the fee chasged for any► pe�it as set forth in Sectioa 2 be 1.888 ti1�II $.S.ODe V�RIFICATION OF FOUNDATION NOTE: $erm�.ts for c�oastruction wi11 be ieaued a minismun of 24 hou�a Eram the ti�e of application, to allow.for propeg review of the proposed structure at►d of the conatsuction �ite. A Cexti�iad Survey of the lot, shawiug �he location.of tha foundation, once it hss besu coastructe�d, will be required before proceediatt with the framing. CERTIFICATE 0]F OCCUPANCY Application for a Certificat� of Occupancy ehall be made teu (1Q) days prior to the use ar occupancy of e�r etructure for which a building geYmit has been isaued; and said etructure shall aot be used or occupied uatil a Certiticate of Occup�cy has b�en issuedo � sue�ecr PERMFF hf0:"- c�ty of Fr�a�ey 29575 AT TME TOP OF TNE TWINS g � I L D I N G P E R M i T' � � � RECEIPT NO. � �v __�� COMMUNITY OEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. �� ' � ' i ' � �"'1 � CITY MALL FRIOLE� 55�32 NUMBEN pEV OATE o�GE O� �vvaOVED Br �----� • •'� 612-571-3460 9�0-F15 5/27/99 � � JOB ADDRESS 480 �'�i Fairmont Street NE t LEGAL LOT NO. BLOCK TRACT Oii AODITION SEE ATTACNED DESCR. 2 1 Wa e's, lst Addition SFIEET 2 PROPERTY OWNER MAIL ADDRES$ 21P PMONE Dan Nosko 786-7845 3 CONTRACTOfi MAIL AODRESS ZIP PMONE LICENSE NO Owner 1 ARCHITECT OR DESIGNER MAIL ADCRESS ZIP PMONE LICENSE NO. 5 ENGINEER MAII ADORESS 21P PMONE LICENSE NO 8 USE OF BUILDINO Residential 7 CLASS OF WORK O NEW ❑ ADDITION O ALTERATION L�4x REPAIR O MOVE ❑ REMOVE 8 OESCRIBE WORK Reroof house and ara e(20 S) Tear-off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS AqE REOUIfiEO FOR EIECTFICAL. PLUMBING. HEATING, TYPE OF CONST OCCUPANCY GflOUP OCCUPANCV LOAO VENTILATING OR AIR CONDITIONING. � THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENOED OR ABANDONEO fOR A PERIOD OF /2p DAYS AT ANY TIME AFTER WORK IS COMMENCED NO DWLG. UNITS OFFSTREET PARKING � HEf1EBY CEFTIFV 7NAT I MAVE READ AND EXAMINEO THIS APPLICATION S7A�LS GARAGES ANO KNOW TME SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS yp�UATION SUR7AX AND ORDINANCES GOVERNING TNIS TYPE OF WORK WILL BE COMPLIED WITH WHETMER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �1714' �.86 DOES NOT PRESUME TO GIVE AUTHOii1TY TO VIOLATE OR CANCEL TME pEqMIT f EE SAC CMARGE PROVISIONS OF ANY OTNER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR TME PERFORMANCE OF CONSTRUCTION �(3.15 Fire SC�I.JI P�AN CNECK fEE TOTAL FEE $65.72 $�GNGTUpEOFLON'AACTOpOp4UTMOA�2E0AGENT �o�rE� WMEN PROPERI ALIOATEO TNIS IS VpUR PERMIT - �� S�GNaTUAE O� OWNEA�� OWNEpBU4DEA� �DA1E� BL WSP ryaTE �[ ] ADDN ALTER Effective 5/10/99 [ ] CITY OF FRIDLEY � l SINGLE FAMII,Y AND DUPLEXES R 1 AND R-2 BUII,DING PERNIIT APPLICATION Construction Address: �i V �� "��f � � Legal Description: n� �� Owner Name & Address: �� S ��-o Tel. � � � � —'? � �-? �-c/� Contractor: a�- MN LICENSE # Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length Length DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. C.�a�s�� construction T 2Q � � l� ,�' YPe��= � �:i��—� . Estimated Cost: $ % � � �% �-e�v�� Driveway Curb C�t Width Needed: Ft. + 6 Ft = Ft x$ _$ . DATE: � � 7 APPLICANT: ��- Tel. #� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: � �3 /�s $ /. �%/ $ 0 �� $ $ $ $ $ $ �v �. %� $ CITY USE ONLY Fee Schedule on Reverse Side .001 of Per�mit 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 [ ] ,. , � �. BUII.DING PERMIT FEE SCHEDULE The Cluef Building Official shall, before issuing permits 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 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 $5(� $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,(�0 $500,001 to $1,000,000 $1,000,001 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 $14.00 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 $50,000 $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 $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,0� or fraction thereof, to and including $1,000,000 $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) Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. 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 $23.25. VERIFICATION OF FOUNDATION Permits for consiruction will be issued a minunum 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 co�tru�tt�d will be required before proceeding with the framing. � �,r sue�ecr c�ty of Fr�a�ey 3 0 9 61 AT THE TOP OF THE TWINS g U I L D I N G P E R M i T r � � RECEIPT NO. � ; v _ COMMUNITY DEVELOPMENT DIV. �j ! � � PROTECTIVE INSPECTION SEC �"C/�('�n � _ ; V �l L_--. ` �r��,'� CITY HALL FRIDLEv ��3Z NUMBER NEV OATE PAGE Of APPRpVEO BY i J` 612-571-3450 910-F/5 5/22/00 / / JOB ADDRESS 480 Fairmont Street NE t LEGAL �OT NO. 9LOCK TiiACT OR ADDITION SEE ATTACNED oesca. 2 1 Wayne's lst Addition SNEET 2 PROPERTY OWNER MAIL ADDRESS 21P PNONE 3 CONTRACTOR MAIL ADORESS ZIP PMONE LICENSE NO Eagle Builders & Remodelers 12390 W 162 St, Lakeville, MN 55044 435-9591 1426 � ARCMITECT OR DESIGNER MAIL ADDRE33 ZIP PMONE LICENSE NO S ENGINEER MAII ADDiiES3 21P PMONE LICENSE NO 8 USE OF BUILDIN(i Residential 7 CLASS OF WORK O NEW C� ADDITION O ALTERATION p REPAIR O MOVE O HEMOVE 9 DESCRIBE WORK Construct a 16' x 14' Addition 9 CHANQEOFUSEfROM TO STIPULATIONS See notations on plan. SEPARATE PERMIT� V�% ' � � REQUIRED F�R: �efore digging call for WIRING HEATING �II utility Iocations PLUM�ING� AN� SIG�Y� 4540002 REQUIRED �Y LAVI/ SEPARATE PERMITS ARE REOUIRED FOR ELECTIiICAL, PLUMBIN(i, MEATIN(3, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SC. fT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OF IF CONSTRUCTION OR WORK IS SUSPENDED OF ABANOONEO FOR A PERI00 OF 120 OAYS AT ANV TIME AFTER WORK IS COMMENCED. NO OWLG. UNITS OFfSTREET PARKING I MERE9V CERTIFV TNAT I MAVE READ ANO EXAMINEO THIS APPLICATION 1 STA�LS GAiiAGES AND KNOW TME SAME Tp BE TRUE ANO CORRECT. ALl PROVISIONS Oi LAW$ yp�UATION SURTAX AND ORDINANCES GOVERNING 7HIS TYPE OF WORK WILL BE COMPLIED WITM WME7NER SPECIFIED MEREIN Op NOT. TNE GRANTING OF A PERMIT �1'4,235 �%.12 DOES NOT PqESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL TME pEqMIT FEE SAC CMARGE PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- TRU T�ON OR ERfO NSTRUCTION $251.Z.rJ Fire �.' �I�F.Z�F PLAN CFIECK FEE TOTAL F E Licen $5.00 $2 .61 S�GNATUAE O� CON•AACTOA Op AUTMOp� EN� IDATE� EN ROPER V LIOATE IS IS VOUR PERMIT - �O� �G/f/ SGN4TUAE O� OWNEAi�F OWNEpBU4DEAi iDATE� BLO �NS qpTt NEW [ ], ADDN � ALTER [ ] Construction Address: Legal Description: _ Effective 1/1/2000 CITY OF FRIDLEY (763) 572-3604 Bldg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMITAPPLICATION ,�,� O�� ( �� 1 r� I'►'1 � �2 � _ �'7�' �� ,��o�/t'/, �a��1 �-�' �'i�e�7� /-��`fo�,o ��s�a �"� Owner Name 8� Address: �� Tel. # Contractor. .��q /� ,�u.a `�hq �I /�� MN UCENSE # �� Address:l��9� u1. ��('I�,,, �.�o,��/7�%. �'"`�� Tel. # G'f.�Z -��£°-��`1/ !/�. - b�o�' 8q�%� � Attach to this application, a Certificate of Survey of the ��. `� ��! '�� "� lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT � LMNG AREA: Length � Width � Height i� Sq. Fti o� GARAGE AREA: Length ,�, Width �_ Height Sq. Ft DECK AREA: Length � Width � Hgt/Ground Sq. Ft OTHER: �5�� .� / �au� �- �`�-�7 �"� Construction Type: ,� �d i �cs„ �,z��,ye Estimated Cost: $ � '� -- t�d`J cP .�.�� rrt ,�,�'_ Driveway Curb Cut Width Needed: ��Ft + 6 Ft = Ft x$ _$i DATE: � 03-/� - 6D APPLICANT: Tel. #�n �b?- �( �f ' 1 y/�. CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ . Fee Schedule on Reverse Side Fire Surcharge $ � .001 of Permit Valuation (1/10th%) State Surcharge $_ , /y $.50/$1,000 Valuation SAC Charge $�$1100 per SAC Unit License Surcharge $ .� $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [] Not Necessary [) TOTAL STIPULATIONS: $ • �� BUII,DING PERMIT FEE SCAEDULE 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,Q00 $2,001 to $25,0� $25,001 to $50,000 $50,001 to $100,000 $100,001to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $23.50 $23.50 for first $5� plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 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 $50,000 $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 $500,0� $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,OQ0,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION E��ROW (Concrete Cbrb Streets Onlyj Alternate "A": Removal and replacement of curb and gutter only - Drivevvay v�idth plus 6 feet times $15.50. 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 $23.25. VERIFICATION OF FOUNDATION . Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation° once it has it has been constructed will be required before proceeding with the framing. New Houses Onlv � V � V \ �` � 1.! Q H f Z zaaaE o - �� aW ffi W � ��rc � ;� , ,� ,� ;�}/ , �� \�'. � � � �� s� �� N$ � OLL' N•.fAi� � ai ^�� 'c�� a�� r�5 �� y `1� �' � � � � °� � �D � � w t� � a ,�� w � �� ' n � � ; � � \ �h �Q`� ��w'`///�� ' � y ,\ m � yv � a:, �, . 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D _ ��fv �m'� -t Z y f'1 � � f't � t1 �.� � d � C ""� 3 C� C..� Dpy by 0� �� 7��=-f -Ni '� � "� .'� � � � O "'1 O r' �7 f'�"1 � � � X � �0 �D N 3�• �D 0� y�' r Ll r N � � � � p TI W � .� -C � rn �� r*i ay a r y ---1 -�i 3 Li r W � � D �C p D t� y f') D � N �� d � �` C dZ � � � Z .. � D r ZG 3 D p 2 � EU '"� 'D*'1 C r Z f`l ---1 X 0� � a N n D � .Z7 D � N � � � 3 �? C r= Z y D � -+�j n O � r d � a -�, < � ay v � � � � r � cZi �� y D � 0 � A n O Z � Z C ❑ � C H � � � f'7 z Ll Z I'1 � � f'1 C --i � C N H f'7 H \ (7 N f'1 O � '� E ed a � I*1 70 G D 3 W <,� �` Fridley Rambler Remodeling Specifications 480 Fairmont St Family Room Addition Foundation • Provide and install 18" diameter tubed pier footings 48" deep at 4'-0" O.C. for side walls and 3'-6" O.C. for end wall. Install 12" anchor bolt with 6"x 6" galvanized base plate for each footing. • Remove and haul away sod underneathe family room addition and cover straw. Resod areas around both family room and garage additions as necessary. • Install black 6 mil poly vapor barrier, placed over leveled soil at interior crawl space. 2" of 3/4"gravel to be placed evenly on top of poly. Framin� • 6" x 6" treated posts set on pier footings • Engineered floor joists or floor trusses. Floor joists to run parallel to house joists for mechanical runs. Provide proper bearing for outside walls.(Cantilever opening for future fireplace, see plan). � Sill sealer at sill plate/block junction foam type • Exterior wall construction: 2x6 per plan 16-in O.C. • Sub-floor adhesive • Wall sheathing 7/16 osb • Subfloor 3/4" OSB T. & G. • 3/8" treated 4'x 8'plywood nailed under floor joists. • House wrap taped at all seams and azound all openings. • Provide and install 15-ft microlam beam to provide structural support for existing bearing, and family room addition bearing. (Verify load capacity and requirements for beam size). Install triple trimmers at each end of beam. NOTE: Include framing in, "dog house" for future fireplace unit at exterior, see plan). Roof • Manufactured trusses 2 ft. O.C., vaulted 6/12 pitch inside and outside (see plan). • Roof sheathing'/2" OSB with clips. • So�t overhang to meet existing overhang of house. Match e}cisting shingle brand and color. (See C.M.) Provide flashing and ice and water dam per building code. Remove existing step flashing at garage/house roof transition. Install new step flashing at this location and wrap fascia. • Provide and install continuous rigid shingle over type ridgevent on family room addition. a. �. , Windows • New windows for family room are to be Low - E High performance Marvin wood windows per attached window schedule with screens and exterior cladding. • Relocate existing sliding patio door at location specified per plan. Install new interior wood trim (see millwork). • All main floor windows, except existing kitchen window above sink, to be replaced with new Marvin low-E high performance windows with screens and e�cterior cladding. Lazge bank of windows in living room location to become a large picture window with double hung side flankers sized as 25-50-25 window proportions. See CM for color selections. Insulation • Family room walls to be R-19 fiberglass batts unfaced. Ceiling to have fiberglass batts unfaced, R-38. Provide minimum of 1'h in air space for attic ventilation and install wind wash barrier and air schutes between rafters. At floor joists and cantilever for future gas fireplace, insulate joist space with fiberglass batts to R-38. Attach 3/8" treated plywood underneath floor joists. Sidms • Remove existing masonite siding at house and garage. Provide and install new high- grade vinyl dutchlap siding, .044 thickness. Meta1 wrap exterior trim of new windows and existing house windows and doors. See C.M. for selections and colors. Soffits and Fascia • Replace existing fascia on house if necessary. Fascia on new additions and existing house to be metal-wrapped. Provide continuos metal soffit venting throughout existing house and new additions. Cut in additional soffit venting as necessary. (See construction manager for all color selections). Electrical • Relocate mast at house roof to above garage and replace service and update . Bring gazage wiring up to code and insta114 incandescent ceramic base fixture at stalls per plan. • Airtight (Lessco) boxes at exterior wall outlets and ceiling outlets at addition per new energy code. Seal all exterior penetrations. • Air tight recessed lights only, (if called out on plan, these have no perforations and utilize a foil gasket to seal between housing and ceiling. Provide and insta115-blade 52" ceiling fan with 2'down rod. Fan to include center light globe, and to be Hunter or equivalent brand. At bottom of kitchen bearri provide and install white 4light track light fixture. Install exterior wall light at east side of patio door. a 0 , • Per plan. Install wall switches for ceiling fan, and one switched outlet. Install additional receptacles in family room addition. Install GFI's in kitchen per electrical code at snack counter transition. • Relocate phone jack to family room between furnihue locations. • Install new smoke detectors at each level and each bedroom per code. • Insta1150-70 cfin e�chaust fan at main floor bath ceiling. Vent fan out roof with insulated flex duct and terminate at roof with dampered outlet. • Install GFI at main floor bath. Plumbing • Relocate plumbing stack and exterior spigot. Replace spigot with frostproof anti- siphon type. • Plumb and install existing dishwasher into base unit. • Provide and install new 20 gauge 4 hole stainless steel2 bowl kitchen sink and new Moen or equivalent high grade faucet with sprayer. Duct Sealin� • Wrap 6 in. round ducts to addition with R-19 fiberglass insulation and tape a11 seams. At a11 duct work transitions wrap with foil tape. • Run additional supplies and return for new addition as necessary. Interior Air/Vapor Barrier • Provide and install 6 mil poly at ceiling, wa11s, and above floor rafters. At vapor barrier for all perimeter seams, areas around windows ext. doors and outlets at exterior walls and ceiling, seal with acoustical sealant (Tremco brand or equivalent, see C.M.for questions). • All adjoining seams sealed with acrylic sheathing tape (red 3M tape or equivalent). • Foam window and door openings with low or minimum expanding foam. (Have shims installed and be careful not to over fill.) Cabinets and Counter tops • Remove existing upper cabinet to the right of sink location, and salvage. All remaining cabinets to remain in place. Existing counter tops to remain in place. Build wall for snack bar and install '/a"oak plywood and oak corner cap over %2" sheetrock to backside from floor to bottom of snack baz counter. Stain to match existing cabinets. Install new 20"snack bar counter top to match existing style and length. Millwork . • At new addition and replacement windows, provide and install ranch casing and base to match existing as possible. • At new addition, provide and install t/a"oak plywood and oak corner trim for back of snack bar, provide and install miscellaneous cabinet cove, base, and shoe. Finishin� • Stain and varnish 3 coats, new millwork to match existing kitchen cabinets. Color samples must be approved by C.M. prior to finishing. • Insta113/a" knotty pine car siding at family room ceiling and 1/Z" sheetrock at walls. • Tape, sand, prime and paint remodeled areas, ceiling to have "three coats of satin polyurethane. See C.M. for paint selections for walls. Miscellaneous • Scrape, retexture with knock-down, and paint living room, hallway, and kitchen ceilings. • Trim tree branches overhanging new family room addition. • Contractor is responsible for obtaining permit from the city of Fridley. • Lock-box for access to property will be supplied by contractor. • All debris from renovation to be hauled away. Floorin • Existing vinyl flooring in kitchen to remain. Cover floor to protect it during renovation. Floor at new addition to be low pile carpet $20/ sq. yd. installed. New carpet to be separated with carpet transition trim and be flush with existing kitchen flooring. See plan for new carpet location. Garage Addition • , 12-ft by 24-ft addition to gazage per plan. Ins ft wide by 7-ft high white steel ins ed overhead garage door to match exi g. Install2 ranch windows at backside (see ), of gazage and wrap with inum coil stock. Wrap brickmold of new garage door, ' ting garage door, an ervice door with metalwrap. See CM for color selection. • Provide 8-in block and frost 4-in top course block to match existing garage elevation. (NOTE: There are e' ting courses of block buried in vicinity of new gazage foundation. It is no own how own block courses go). • Install new 2x4 walls match existing garage height, and remove e�cisting outside non-bearin all and gable-end truss. Provide install roof trusses to continue existin oofline and to match existing garage roof s . Verify existing slope and m' tain existing sofFit overhangs. Sheet new roof with p to match existing. eet new addition walls with build-rite. to match existing. Remove old course block at old gable-end wall to allow for new garage slab at addition. Existing gazage floor to remain. Install concrete floor at new garage stall floor. Haul away all debris from remodeling projects. ��(�� d C Stairs off of Family Room Addition • Build to code 3' wide treated stairs leading from sliding door from family room addition. Provide and install concrete pad at stair landing 2-ft out from end of steps. . v_ . W a � A � U � � 0 � 3 y Q O ...� .w+ .., "O "O d� a� o�o e� � � � b �� 0 a � � w � �z �� , w� ob �. �w 03/27/2000 09:53 7887602 KURTH SURUEYING INC PAGE 01 ■ "!�' t►�KTI�IC�TE OF' S �1�c�r, � (° •i ' , tt�Ei1 Sl�PE71lElVTS SMD6hV /N fEET U R � � � �((,RTH ;. c0p c�N��CZ �,oQ GN�Q�Y ' TNIS /S M�T �4 �i�RY��-�1 FQOT� �002 ��Si�►�� S�/� ;��; I �� GN V t¢o N M t= tvT �a�� KF'�I-ITS.� �� li� ( t�ERE9Y CERT I Fl� THAT TH I S pLOT P�AN YAS PIt�P/1Rfn .. I' ��E'R Ii1Y DIR�CT SUPERVISIaId . iHAT THIS D^TE _3-23-00 ; I;,� PIJdV CdtRECTLY SHOyg 1F� p�,/�CEfABdT pF A pappps�p I RON MONUMENT FOJI �� D fER�ON DESCRIBEb MID 1}�AT � BEI1R I NGS ARE PER PL/1T �°; Ml A DULY LICENSED W�D �y�yp� �R UVS •= SP I KE SET t� ;' 0� STATE oF itr,E �. <_ -� = EX I ST 1 NC3 ELEV1IT I O t ) = PROPOSED �LEV. �� Rondy L. Kurth, L.L„S: No. �0270 F— ° ORAINAGE ARR04l � ,Russell J. Kurth. L.L,S. No. 16113 � . � ��oN� . � � �— ✓ � � m o � � r f w . 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D �_ � O °, � < fD � N � c�u c�p °a , o� D 's� � � (lo � .=r �� o �»; �o � O N 1 r� �r N � � Z D n v D 0 0 7 � � D � N c� � � N � O O � � � cW � fD � � � d a m Z d m 2 � � N�' �D .z m � :O G� G� G� D -n � c� c� c� �, c �n v� �n �n o� a � �' �� m � � � � � y ot � � � < � c� ''� � ,.�� Q . � � �Q-��o — C � r+ � � .n�r �s�� W � o � � � � v � v � C � � �� ' —e n � tfl �a � � � � � w O O O O O O O O � m ba � � � o �' 0 O � Too�z ��,o — C Q ' �p o � � � �' fD ? � C � N 2 � � n a� � c� � o p > > 7 �p � � � Q- cn m .� O N � fl1 j7'� z v � � O � • 2 O � � 3 � 01 � D v m � D -�1 rn � C� � � � � � m � � Z O \ 1 � -D�I r� N n 2 rn v C r rn � � `o r z � Cn-nrnn Nfl.W� �� rn� co o � ��•-n Z c� � �� m w � -< N m Z Z � m� m c� � O z � C � a � .9 z � r 'mn � �O L) Z rn� � � � � O� Z� Z � v .� a� �Z oN za vz .� v o= Zm z -a+ �ii z -C � -N,1 C� m� O N Z Z -� v< v "' �Z � n � y0 z �1 ) � fD � <' m O � (__. iu � t oci � r N O O O COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacina an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No () The venting system is plastiGPVC and meets all cuRent 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 Fumace Venting Tables for fan assisted and natural draft appliances. The existing combustion air is sized and installed to meet the current codes and manufacturers specifications. When required to install a new combustion air, it will be sized and installed To meet the cuRent codes and manufacturers specifications. Yes ( ) No ( ) Yes()No() Yes ( ) No ( ) When installina a new venting svstem, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's spec�cations. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes () No () Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No () Appliance Tvae and Size/Common Vent and Vent Connector Infonr�ation 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 Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 V�nt Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type n 0 W c -�-I O Z D � � _ � r � m -o � 0 v m v � m z c n � m c� � O z cn °� D Z v D W r m rn D n O � � O z m z -� z � O O z W D n � � v m � � co � c -� �. D � r � � m m D � -a �fD � o � 'Np T-� � i � � �o �� C � m °�v`D � �� o m = � a, � -o � � Z �v D � m � z � � � � �Q or � D 'O � < a � � 0 c � � s m � T 0�t v m m � � � a°�G��2�tn�na000pZ `C � N N .�-r .��► •�i� � �' n O � a � -� �,vz� m m-� ��ov� ?� � ° m � m c=u � rn °: o�i � �' � � 1� � :� � �• � � � � � ' � � � -, � � �' r v�, �, � v, � � � �C � � 7 (�p Z � o�i � v � m g �'�' A � (�p � g �• � � c � � m a .-. c�D H � z 0 � r C � � Z � � � m � � I I I I I I I I I I I( I � � �� cn 000�o�v�vc�,A.i m co 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 � O . C � � � � r z � m � v °D W z _.� c� � � N m �. � 0 � � m z � _� I� W � � c � a ► � � m � � N N �O � ) L � W . N � � -; c. ca awi � -' � �� O Z m '*� �.11 f�/1 � �� m z� m� m c) � O Z v < � N � � 0 � � m � � N 0 0 0 COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacina an existina furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No () The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbow� and termination. Yes () No () The undersigned also verifies that the replacement unit is a listed assembly and meets the cuRent codes and manufacturers specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The existina combustion air is sized and installed to meet the cuRent codes and manufacturer's specifications. When required to install a new combustion air. it will be sized and installed To meet the current codes and manufacturer's specfications. Yes ( ) No ( ) Yes( ) No( ) Yes()No() When installina a new venting system, the undersigned hereby verifies that . it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes () No () Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No () Appliance Tvae and Size/Common Vent and Vent Connector Information 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 Appliances 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 ALTERATIONS: (Describe) HEATING CO: Signed By: Date : T!II �� '�R 1�:R1 FR rFnRr1A-PA�1Fir .tiA� ?Rh R9�� T� 91F1?4474Ad� P,A��q7 GEORGIA-PACIFtC CORPOFtAYiON P, Wshner, P.fi �e �u� �pp0 �:� p�, 43Q0 VlfildWpAd P�t3c��l maii s4�on 43-1-4, Afl�t�, OA. 30339-8401 (i70)221 2381 FA$Tgeam� En�;n�enn�Analysls t� lS96-20D0 Geer�i�Pec�1a Camcraflan Versi�: 3.1f93/NT1 ��,i�d� 3 7.n 5 Ma�x �t-: - ,l�is! - Root De�sc : Usage� : Joist(Roatj Repetiiive : No Max befl : LL =(.,t360 T! � U2�40 Composiie Action : No –1 3.5", 335 ps� U �- �, �� r � 7' 3" . <�, , : �: -fi ..--�t, . : - - sPop�e'•s (m') ' �a 3,5", 33� p.si �,^� , �_- � z Max R'n a92 �sz Min R'� iZ2 t� a°�� as�etin.) � s i.�rs . v� s�, � 1 a�z o 0 04 t x . ,. � , � 8' il$Ei C'.sP14� 9r$Gp " C!.c• %�1c pa-s.s"PR1�4 ��_ � .� — � � �� t,s�� t �s�c Grede. oep�lt se1e�lear dy vsar �� MOTES : �. ��d i�r aiCeDl08Ir� wi�li Nauorrd! DeSYg�t �pP�iNcat/ars fCr Waa� GansguB�iOA �rtot �pp�lf?t�f� MproY�9 � 14� R@poRS. 2, Prov�rde I�t� suFport �t flta bt�t�ing /oc�fo�t 1+�est ea� �aad ot tJre �ase�ib�•. Ce»dAwYS lat�lr�l8�port Ie+qttlredlor apnp►e��y► 3. � r�id for �dry � �oNly. s. r►�r r�r�ian �s � on otre wmbinatio�r oltosds � dur,�orr faetars that pro�dra.�es fho hlghast str�ess ratlo �d may b� le�ss �r� �im� r�tror►. Therelaere when rsac!!an valrre�s are neqtiired. usa Nmr R'a}� ' vDOats'a�oe above. 5. Ba�r7ig lengLfr hss�d a� �te�rbl: svpport materJaJ +e�p�elty � be re►fl�l �b oU�►sJ• s. Fa�im�aRaor�li c�et,s vs W� thedc W;th G-F' �igin�eredtu�ar Tetbru'oa� Se��es. 7_ rA+s on�lnoora� l�nroe�r proditet t+a� besen sixed � resldantfaJ t�s� A c�sntr�t�d IQad NBU�. per !he batil�� l�ft�5t 6@ A�mte�d fOl C+b/Ml�fl !� $. ��x/�Iin r�c6or�S �re ��sed o� tne appliCabte loa� canbrnations oirl�d i� the natGS S� of �indn �Qfo�+a far' a�ria� DDL nr.a�► not n�a+a toW �w�a1n ro�o�v� 9, COA7f�y, �/pf�11C�Orb�91Pd �Sl2�l�t1lC8d 91@ �6JI1811fS QIIC�I$(6'M!d diid�(�B O�tAd'I 9wAp:R. �0. &ra�sr�v� err� vsrrNl�ed �rrly Ff �tl the lolle�ringr c�df�iOrrs are met: aut►s atlow end ot root , o�+mfiar+g does rrot exeeed 2 fq �tl peRrin9 sWitenfrs aro �rsrd -A- -__.— - , ___ � _-- _._ ♦I C � �.�w�/.�w�W� �I/LQlNIB I%IA�NAM 61M9/MIO/IJ\/►fFf/f%71 y _ - -_ . -' _ _`�_ � �,rin�ereeroen� er±e�Ge�ur� f"er .teteherd ieist_ Ca7 a�etnch 2 layers 112' x 6.z5' da�ep � 2�' long pty ood fillers to wef� o¢ t�� 6�� u�c.rb Of �i5t with carpentQr's wood gluef oround perine�0er ar�d �n nn 'X', �tart filter ot Joist end. [8� Attwch 23/32' x� 1/Z' x 2a• APA 48/24 pan-r4ted plyweod �uur��t r to the footh faces of jCi�t with 8dy� e 6' �� sta�g�fed to �op &� bot fl�.n�+�5. A'ltaeh te fiii�r xit1�' one roas 8d +naits 6' a�c. Stogger na�s on ea �nce 3f..-s-� that net spncin8 on �a�t �s 3' e�c. U�e carpenter's woOd �l�ue`� to att Coritoct surface�. Plywootl nust s!t �lus�s on toearing pt.att� \�<� � � = -- _ _ __---- �-�r_,,�.•.- - Page 1 011 ** TOTAL PAGE.02 � s�e��eT City of Fridley 3113 4 AT TNE TOP OF TME TWINS � � I L D I N G P E R M I T r RECEIPT NO. � � � � COMMUNITY DEVEIOPMENT OIV. �� / i t y � �(r f � � � PROTECTIVE INSPECTION SEC. � j , � ��1 � CITV NALL FRIOLE� SS�3Z NUMBER pEV OATE PAGE OF ACVROVEO BY �""'�' �'� 612-571-34b0 9t0-F15 7/6/00 / / JOB AOpRESS 480 Fairmont St. NE t LEGAL LOT NO. BIOCK TRACT OF ADOITION SEE ATTACFIEO oesca. 2 1 Wayne's 1st Addition SFIEET 2 PROPERTY OWNER MAIL ADORES$ 21P PMONE Nosko 480 Fairmont St. NE 3 CONTRACTOR MAIL ADDRESS 21P PNONE IICENSE NO Ea le Builders/Remodelers 12390 W. 162nd St., Lakeville, NIN 55044 619-3325 1426 4 AFCHITECT OR DESIGNER MAIL AOORESS IIP PMONE LICENSE NO. 5 ENGINEER MAIL AODFiESS ZIP PNONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW � ADDITION O ALTERATION � REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Remove and replace siding 9 CHAN(iE Of USE FROM TO STIPULATIONS Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions for this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof couering imless the manufacturer states this in their application guidelines. Call for inspection of wrap before covering. TYPE OFCONST. OCCUPANCY GROUP OCCUPANCVLOAD SEPAfiATE PERMITS ARE REOUIRED FOR ELECTFICAL. PLUMBING, HEATING, VENTI�ATING OR AIR CONOITIONING THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION 20NING SG. FT CU FT. AUTMORI2ED IS NOT COMMENCED VIIITMIN 80 DAYS, OR IF CONSTRUCTION OA WOiiK IS SUSPENOEO OR ABANDONED FOR A PERIOO OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWL�G. UNITS OfFSTREET PARKING I HEfiEBY CERTIfY TMAT I MAVE READ ANO �XAMINEO TMIS APPLICATION 1 STALLS GARAGES AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAIUATION SUR7AX AND OROINANCES GOVERNING THIS TYPE OF WORK WILI BE COMP�IEO ,�2 OOO.00 .�I.00 WITH WHE7HEii SPECIFIED HEpEIN Ofi NOT. TME GRANTING OF A PERMIT � DOES NOT PRESUME TO GIVE AUTMORI7Y TO VIOIATE OR CANCEL TME pEqMIT FEE SAC CHARGE PROVISIONS OF ANV OTHER STATE Oii LOCAL LAW REGUTATING coN• �69. ZS F re SC �2 . OO S\, Tijl1CTION OR T PER�A E OF CONSTRUCTION j\ PLAN CMEC E T 7A1. FEE P� �� 4� Lice e C 5 00 $77.25 S�GNATUpE OF CON'AACTOp Op oUTMOA�ZEO AGENT IDATE� M N PR Y VA A ED TMIS IS�JR P MIT � / �/ S�GNnfUAEO�OWNEp��FOWNEpBUiLDEp� iO�fEi B OG �hSD n�tE n , N� I l Effective 1/1/2000 ADDN [) CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 � BUILDING PERMITAPPLICATION `� �1,� U( Construction Address: �0 � �� i /C'' �/yi � � / �� l Legal Description: Owner Name 8� Address: �� iw Tel. # Contractor. � d�� S MN UCENSE # j �`a� Address: %�3y'D � l �an� -f- � �°�� Tel. # �i �� 3�-1— LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate 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. Fi Length Width Hgt/Ground Sq. Ft Construction Type: ,e e�•o �e /�'� It�— s� A''�`i Estimated Cost: $��' '— Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _� DATE: � Y� � � APPLICANT: 0��` "`" `ev' �'� Tel. # �0��3�-� CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application � Permit Fee $ r� Fee Schedule on Reverse Side Fire Surcharge $ -.(�D .001 of Permit Valuation (1/10th%) State Surcharge $ /, D O $.50/$1,000 Valuation SAC Charge License Surcharge Driveway Escrow Erosion Control $ $1100 per SAC Unit $ � � C� � $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Consenration Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ 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 hereia 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,Q01 to $50,�0 $50,(�1 to $100,000 $100,001 to $500,000 $500,001 to $1,Ot�,000 $1,000,001 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 $14.00 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 $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,0� or fraction ttiereof, 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 $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Gbrb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 faot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of S�rvey of the lot, showing the location of the foundation once it has it has been cons4�cted will be required before proceeding with the framing. 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OG � � ; '- � N a � � _ �i n u, n � N� � �, � O rt �o � O y � r � � � Z W D n � v � N (Tt O O G) 01 N v `� � G� G) D � � N N O 7 Q. � ��, � � �,v_?� � � °� ��d � �Z� ; � "~ � .�+ � d � Q . � � o Q-�� v—c � O � c�i � S � � G � � W � o � � � � � ""�' v .-r = � v � � � � � � _CAD � � � � � � t-� �--� W O O O O O O O O � cD � � t� � � � � � o ' D � r cW � � -� � � a co z � � '�, �_ � � N� (D Z 0 m 0 � W � o a� � O -., ��Z 2 C� � � lJ �`° � „f �. c ti ? o- I cn m r' N � a�'z� � �o = �o � �'t fD v a� 1 v m � -_I A m 0 n O N --I � C� "0 rn � � � z O � 1 �J � C r � Z � C Cn m 0 � � i � � rn N :�i s m v C r m � O W D � cn -� c�t n V �.-� — N Q. W :� w � ~ � �1 � C � °�34•„ z� � �� v . W � � . N m Z z � rn � ... m . ._ —�i O z � C � a � � z � r �� N Q CIi Z �� 0 � � � ZO L � Z � � -� v .� D D � Z ON Z vz .� v o= Zm Z � L� Z -N-1 n O O N Z z � �� vm �vZ � .� rc� �a � N O ( Z � � � c�o � �- <' c� O � � r O 1-�+ � � � �� :.a � 7. �' CHIlVINEY AND STACB VERIFICATION The undersigned hereby verifies that�:the existing chimney or stack: � 1. Has been carefully exanuned Yes () No () 2. Is free from rust or deterioration :- .:. Yes O No O 3. Has no foreign objects lodged within Yes () No () 4. Is securely supported ._ Yes O No O 5. Meets all� current Code requireme�ts for size � and total BTU's connected Yzs () No () 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No () 8. Has combustion air been provided for water heater Yes O No O Remarks: List ALT�RA�'I�3ATS�$eing Done: HEATING CO: Signed By: Date: �" .;- �r � �° 1082 Payne Ave. St. Paul, MN 55101 651 /772-2449 GAS WORK ORDER . STAN DARD 410 W. Lake St. b HEATING � Minn 612/824 2656��$ & AIR CONDITIONING A Blue Do�: Service Co. E�UIPMENT INF�RMATI�N L/'�51�'�Cr1^F,;�� O' �/.�i��e�� d1�IRST �"d ADDRESS �� e�� 6n � � f ° �• � CITY �� R r� � ZIP � HM PH WK PH TECH��/� DATE �- � �-� � , C�Z�� • � ��i!��,iiJ NET STaCK TEMP � ,— ., v � � % % % o �� MAKE �`� ��"' '— MODEL��.3��d�'1�LaQ �� . �� = SERIAL ��/rQ� %��-� f . P... i'..�.a. INPUT �,,� �� ORSAT TEST RECORD METERED INPUT �� Cfh CHIMNEY TYPE ��'B� � LIMIT SETTING ��G ° FLUE SIZE „� in. PILOT OUTAGE � sec CONNECTOR SIZE � in. ° TOTAL CHIMNEY INPUT gJi�' �'� btuh � _ CIIYOF FRIDLE.Y FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 March 29, 2002 Mr. Russell Amsler 480 Fairnaont Street NE Fridley, MN 55432 Re: Final Inspection at 480 Fairnaont Street NE Cont�actor: Standard Heating & Air Conditioning Dear Mr. Amsler: A mechanical permit was issued on March 15, 2001 to install a fiunace at your address. According to the 1991 Uniform Mechazrical Code a final inspection shall be conducted on the work authorized by this permit. As of this date the inspection has not been requested. The permit fee that was paid covers the inspection to mal�e sure the work was completed according to the C�es. We will ke�p your pernut open for another 30 days and if we do not hear from you witliin this time to set up the inspection, we will mark the permit "no inspection called for by homeowner after notification" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. Sincerely, JENSEN � g Inspector DJ/mh �,iuilding �nspections 763-572=3604 DATE �7��`7I D'� SITE ADDRESS 7 �'•ti THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMTT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAII. ADDRESS �OWNER ❑CONTRACTOR ADDRESS: `9 Y'�� s�!'1i+.v+� -�1-- ✓l PHONE: �� —% �5°-7o v � STATE LICENSE # EXP DATE ADDRESS: PHONE FAX �,SINGLE FAMILYMEW CONSTRUCTION SI� ❑ TWO FAMILYJNEW CONSTRUCTION STi �LBASEMENT FINISH ❑ ROOF ❑ DECK ❑ SIDIIVG TYPE OF WORK: I ❑ � � DESCRIBE WORK BEING SIZE OF IlVIPROVEMENT NUMBER OF SQUARES _ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Alumin�un � ❑ Ofher WINDOWS IN EXISTING OPENINGS ❑Yes �IJo OR FOR NEW OPENINGS-DESCRIBE S1ZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED __ _ ADDITION I - ' - � � .�'-'' /�s. � - - - , : i�� . - � - , �� AT��IP.-.S�.�Y � 2f CITY STATE ZIP ❑ DRAIN TILE ❑ OTFIER AnrA ly P�k1''+ 1CR-�'ho LENGTH WIDTH HEIGHT ❑ HOUSE & GARAGE ❑ ATTACI�D GARAGE ❑ DETACHED GARAGE ❑Soffit � Trim ❑ Fascia LOCATION OF WINDOWS Ft. BASEMENT REMODELING SIJBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of strucwral members to be used FOR NEW CONSTRUCTION INCLUDMG DECKS, ADDITIONS & PORCHES SUBIVIlT: l. Site Plan/Survey showing the existing strucwres 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 THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ %—% � s Ov OCCUPANCY TYPE Permit Fee Plan Review Fire Surchazge Surcharge License Surcharge SAC Chazge Curb Cut Escrow Erosion Control Park Fee 8ewer Main Charge Total Due $ �j .!S" $ �fl , O -.�`.�' $ / . 7r� $ . � $ $ $ $ $ $ $ .�' o . � � See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1675 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 payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMTf-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclrnowledge 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'ch requires review approval of plans. SIGNATURE OF APPLICANT i C�7��'�� P1tINT NAME �Ctl�G�.tJ�i�c�l� �VhS��ATE �_" �� T— . Page 2- Building Residential Application 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 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 minimum of 24 hours from the time of application to a11ow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. 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(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: (WDICATE TOTAL �ER OF EACH BELOV� � SHOWER WATER PIPING BATH SINK/LAV F�PIP��,U��,� SWIMMING POOL _ WATER SOFI'NER ($35) BATHTUB — � WATER CLOSET BACKFLOW RREV. ($15) CLOTHES WASHER _ KITCHEN SINK �yp�R HEATER ($35) FOR IRRIGATION _ DISHWASHER _, LAUNDRY TRAY — WA�R METER _ OTI�R Permit Fee $ �.._,.�.o,..,o .50 TOTAL DUE Number of fixtures @ $10.00 � x $10.00 = � .�C� Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $is� Tota1= $ 3� .S`� 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. 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 which� es review and approval of plans. SIGNATURE OF APPLICANT ��^�'�"' PRINT NAME �� YtWuo\ �� lRl�"DATE �— 1�� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 I ' , � ��q , a � �� ; � �L � , �� '�; p �a/] _ / 1 � /1 � �� L� ; ! ! / `u`..,,v_ S !I ; � �, � � � � �� ,. � �ti � r�� l _ I ��N�__--� �^`� �tiie. �1 a►�.__'� _ �,,,,� '��% t�`tio �i'n _�_�.� � j i , If,�'�� t �, h o� , , �;r��o��, a i� a,�__�S� i' / �'O!�.�� 1 �/1h�I�i-� �— � .. 71 ..�e � _ _i_ � � _ _� P , i �� , � 1 �� e .r�J , ;� � � I ��.g E� /^ 1�.� � � o�G�� I f� •Q�__,�� ` o �.., ,�_—�� .., I' J_ /, ' � I `7� ! Qil�' %� � � ��4 /" �� l,.,.�.��. 0 ��,► �- � 200-,_ oa�71 ----- � _' Z 2. - D�o__ �� ---- — - I� ,j r 1 ►�-�°!�� _'�___s%�-_�!Lo�!� __ b�,d,�i1►�,..� � � -�Y--- ___ � S�� _ '� - i�-_ w��__. �ir ---_--___-�___. ° � __�� __�.�,.�� _---�-__��.�.a.�_a--��-�1 � � �� - �� Lg s � �,-`�_ ��__ ��,�� ; / . , �I -`��_- C°%�� p�i. -----a��---�t, �� n �ha � ti-- ----� � � � � � � ��e��► �- �-�,,c�� -�--- -�_-.- r Zoo� _ 7 $�_ _ � , %`•�.- '�"�___ `'�—�' -�_��'_,. �-!�� . .�_� ��'' � --- I __ � � %��- __-_- �iylw-.�i-.�--'dL�--� (/W �'C� � ___ 1..!�R.T_,��-,��N° �!Y�--_--_. --- � --- I 'w��.e w�z.�__w� �a� __��.�y�_.___�-_ �---, _�._ /v,��_ .^.?� ��l�i�?-_�� L�� .t��c�,� _ .��_- ____�__ '�- ____f�,�� - ,f- ,��.�-�_��-�,,�`�l� _�- p� _k_,. ; �- ___. � � �1�� __ a� � _��_ � e !� �y�, � � r► � !� �S.r #' �b �%� C C . �� - ��'q�"� T� -- —� � n �/C�Ow � �ln— Tb �r O� ZOJZ____� i.✓lts17 � st� ^pz�� w, i'� �.��¢r� � � �S_ G %a �-.�. a.� - � �,s n.,,s7�r�,s i�, � �� , � s �•�r-c� �% �,...� ,_,-� s S � h, o.,�. c. �� [l I . � ; a�, � �- G �. �; � , �: � t'� �f`►��!,'1`��,� �'^—?k�_-��-r - ��-'�---�-- ��si- ! �.,,- � � �' �' �_ a� � � _ �s� ______ �(�( �i" --�_wD�IL �o��i'acie!__�; � _ " °��. l�"�� __ �`�;___�� r�.. _��,.,_ _�- _ _��: � �,_�-��1---�.�ek�-�__� w � �l�_�_�� _ /%� - LS Gc.n �C—,� .S/ �� rv��1_ �,�l�'► ."'� o �� - �s- � T�__ e_ ^ Z�m� . i ��.�L= o-� `�(__s_ � _�_� __ _g Y �/�.C°.PiweilL vS�C�. l � �' ��'k�� Building Inspections 763-572-3604 763-502-4977 FAX DATE___ �� SITE ADD S THIS APPLICANT IS: PROPERTY OWNER/ TENANT � i /� CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND CERTIFICATE OF INSURANCE PERNIIT TYPE PLUMBING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR � _�"��J�I �� ■ • �- • • � ADDRESS r�v � ��+. �i f/ii%� ".r � �`i/iL%� . � STATE LICENSE Permit No `.� �U� �,l � �' Received By: t Dat � � 7'E STATE BOND # EXP DATE ADDRESS: CITY PHONE %�_�'-� �`{% 3.�11e�, FAX TYPE OF WORK: I � �'' FAMILY 0 TWO FAMILY ❑ TOWNHOUSE DETAILED DESCRIPTION OF WORK �REPLACEMENT A1'E�IP FEES ARE BASED ON $]0.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MIMMUM FEE $35.50. BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING BATHNB GAS PIPING (NEED CITY LIC) SWIMMING POOL WATER SOFINER ($35) CLOTf�S WASHER KITCHEN SINK WATER CLOSEf BACKFLOW PREV. ($15) _ DISHWASHER _ LAUNDRY TRAY =WATER HEATER ($35) FOR IRRIGATION _ WATER MbTER _ OTHER THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work wip 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 on site; that the work will be in accordance with the approved plan in the c of all work wh' h re juires review and approval of plans. SIGNATURE OF APPLICAS�F �9�"/� _ /l PRINT NAME ��j � � ��b � DATE � �� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 ` FAX: 763-502-4977