AF - 42566.� _ —
City of Fridley, Minn.
BUILDING PERIVIIT
-1` � ,
__�
N° 5i�
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Date: "'" �"" � �
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Owner: f " I � �Y Builder �.L —
Address � Address
L4CATI0 O ILDiNG
No. ,-,-=...,.2- �� Street � �'' .� . , --- Part Lot
_'�,�":.:�G`.f a
Lot —_,�...�_ Block �._.___� Addition or S -Division ��� ^' � -s"'
�� ✓ fe r
Corner Lot �t Instde Lot —� Setback �.,!— � Sideyard .,,��
Sewer IIevation � R Foundatlon IIevation
DESCRIPTION OF BUILDING
To �
�' ��� ��±,� ����� �� —c�" � � �` � � � �
Front �.�,�_ Depth Height 5q. Ft. �'' Cu. F
1� Depth He�ght �� Sq. Ft. Cu. Ft �
Type of Construction „ �i -s*�-'� Est, Cost �t''�H��+r a�__. To be Completed �,...
��.___.__
In consideration of the issuance to me of a permit to construct fhe building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinanves of the dty of Fridley. �
� �' . `. ,,_-.,,
In consideration of the payment of a fee of $�. �____.._.., permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and worlunen, in all work
done in, around and upon said building, or any part thereof, shall conforin in a]1 respects to the ordinances of
Fridley, Nlinnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
wlthin the city limits and thie permit may be revoked at any time up violatiou'aof any of the provisions of said
ordinancea
,,� �. (� 4� +%
. ,S .f .��,r� -s� �•,,.T Building Inspector
NOTICE:
Thh pernilt does not aove� ths eonatrudlon, ie�allallon for wirtng, plumbing, gas heatieg, sewer or water. Be �un to ses
ths Butldin8 Inspeeior for eeparete perm(ts for thess items.
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MINDER ENGINEERING CO.,INC.
a . ENGI NEERS AND SUR�/EYORS
lANO �uRVeY�rvo 901L3 TESTINO
GIVIL 8t, MUNICIOAL ENOINEEIiINO LANO DLANNINO
6418-5�'oT" AVENUE N.
' Ml�t�IEAPOLIS 2'i. MINN.
KE 'i- 3637
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WE HEFtEBY CERTIFY TFIqT TH►5 IS A TRUE AND CORRECT REPRESENTATIOAt OF A Sl7RVEY OF TNE BOUNDARIES OF TNE
LAND ABOYE DESCRIBED AN� OFTHE LOCATION OF ALL CiUIL�INGS, IF ANY, 1NEREON, A1�1� AI.L VISlBLE ENCROACHMENTS,
IF ANY� FROM OR OIV SAiLy LAIVD.
i MINDER ENGINEERING CO., INC.
OATED TN�S "r or�Y oF .S� ��etY1 �7�iP r�.o.�e5q
I ENG1N 5 AND SURVEY RS
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APPLICATION FOR HIIILDIIVG P�MIT
CITY OF FRIDLEY, N�TNESOTA
-�.,- �
O�mer's l�fiaame Bu3lder � Z��"� G s�'` �c��-�.�T �
�ddress �ddress ��� e� �,�����,,,�„�l��.si ��.�� �.
No. ���
Lot � Block
Corner Lot � Insid
LQCATIQN OF BIIILDIlVG
��� �`�� �� Cc/� � Part of Lot .
� Addition or Subdivision �.��e��� ��s< �
� � ��,e�
�rs�7'�� �
e Lot Setback �� Side-Yard � � °
S�rJER ELEVATION FQUNDATION ELEVATION ��C �
�/ � e� e�i�.5'✓_ .
�pplicant attach to this form Certificats of Survey oi I�ot and prcposed building
location. ��,�.��� � � 7��c� ���,��r�� Gti/Ali
DESCRTPTTON OF BIIILDING
To be used as:
���'G � �.t�� , Fa`ont °�`� Depth � / � �rHe3ght
Sq. Ft. /--'�`� Cu. Ft.
Front Depth Hei�ht
Sq • k''t. Cu. Ft.
�
T�pe of Construct3on �� ���. Estimated Cpst ��`� o�� ��
To be Comple'ted _ / ��� �� r� �' � � �
ai ^
The undersigned hereby makes application for a perm3t for the work here3n specif3ed,
agreeing to do all �rork in strict accordar�ce with the City Ordinancea and rul�i.ng of
the Departrment of Bui].dings, and hereby declares tha.t all the fact d representat3ons
stated i.n this application are true and correct.
�
DATE f°—'��� � ,� �� � SIG1VgTiTl� - � �`'�^��. �
(A Schedule of Fee Costs can be fo�nd on the Reverse Side.)
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BUILDING PERMIT FEE SCiIEDIII�
Section 2. The Tnspector of Buildings shall, before isauing any permit for the
erection oi e�n,y buildin� or atructure, or for any addition to e.ny existin� bu3.ld-
ing or atructure, or for an�r altarations or repairs to any existing bu3lding or
structure� upon s.pplics.tion therefor, require the payment bg the applica.nt for
such perm3t of feea to the amaurit herein bel.ow set forl�,h and ia the moasner herein
provided to-ar3.t:
2.1. For e,n�r such permi.t for the erection of an�r fire-proof building, other thaa
a garage, warehouse� factory or grain eleeator, or for the eraction of aay fire-
proof addition, for aim3lar occupancg, to any exist3ng bui].ding shall be st the
rate of �1.40 for each one thousand cubic f�et, or f°raction thereof, in such
cubical contenta.
2.2. For any such permit ior the erection of any fireproof garage, warehouse,
factory or grain elevator, or for the erection of any fireproof addition, for
sim3lar occupa,ncy, to any existin� building shall be at the rat8 of �7..25 for
each one thoueand cubic feet, classified as "fireproof" by Section 502 of the
Minneapol3s Building Code.
AO�.�''.�$
2.3. For any such permit for the
then a garage, warehouae, factory
addition, for s3m31ar occupancy,
each one thousand cubic feet.
GARAGES
erection of a� non-fireproof building other
or grain elevator, or aay nor�firsprooP
to any exist3ng building. Permit $�..00 for
2.y.. For any such perm3t for the erection of any non-fireproof gara�e, waxehouse,
factory or grain elevator, or for the erection of any nor�fireproof addition, for
simi].ar occupancy, to an� exiat3ng build3ng or for each such building or addition.
Ninety Cents f'or ea.ch one thousand cubic feet or fract3on thereof, in the cubical
con�euts thereof with a minimum of �1�.00.
For the purpose of computing fees for build3ng permits the cubical contents of ang
build3ng or add3tion to a uniform height throughout b,y multiplying the ground area
covered from a point a3x (6) inchea below the floor line of the basement or cellar
to the average height of the upper surface or to the average height of the roof
�uurface of the main gable of a pitched roof.
2.5. For repaira or alterationa to an existing atructure, the fee sha].1 be at the
rate of $3.OD for each Five Hundred Dollars (�500.00), or fi�action thereof in the
cost of a,11 proposed work.
2.6. In no ca.se ahell the fee charged for any permit as set forth in Sectioa 2 be
less than �4..00.
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CRONSTROMS HTG. & AIR COND.� INC. Job Name
D-S6 ��0 Bzeelsior �ule�ard, MDnneapofla 16, M9en.
ZB N6A'� LO�S CA�CIILATIONB Job Addrees
Weatherstrips A.S.H.V.E. � Construction No. I Insulation
Guide
Windows Doors Reference Out. WaU Int. Wall Cxiling Roof F1oor I Kind How Applied
Yes—No ;�= Yes—No 19_
1 Fl.� ,, 4-r: r _� _.. ` _ y Room ( Length � ;�>: Width � � Height �� ep� Fl � ,�.,3'� . . � Room Leagth - Width �^� :�' Height `�;`
Windows a,r�y Doors—Crackage and Area '' Windows and Doora—Crackage and Area
Wldth ' Height No. ot Lineal t. Area � Wldth Halght No. ot Lineal fL Aeea
No. ot pane o[ Dane llghts_ ot crack eq. ft. `�� �� No. o[ Dane o[ Dane IfBhte ot crack ea. f4
� � �'�,r" �. : �' �-�if0, �� ,� '!��� ,� e�a�' �.f �F �`
�: � � ��� � � �
� ��
Coef. Btu
Ia6ltration °;� �, �'�� �
Calass ,�� �
Exp. wall :;f � � > ,:�,, ��,
Net exp. waU �"# ��' � �r�� ;,�?
�
Int. wall
Ceiling ,°� �-.;�, '-� °s,�`c
Floor
Total Btu. ,�' �
Required sq. ft. E.D.R. or aq. ins. W.A. L.eader area �
)FI.� ,�. L`.,, ,; '. , � Room � Length ,� �: Width �" Height
Windows anel''Doora--Crackage and Area
Wldth Hetght No. o[ Llneal ft. Ares
No. of pane o[ pane llghte ol Ceaak eQ. ft. ,
y �_•y.
l � �° i�' 1�_y +�?� � � �
Coef. Btu
In6ltration �^ �'.° �:_ t ��i R��}
Glaaa ,ii � �' �„ �'��; �a
Fap. wall � ,�' �� � ad� ��^ �
Net eap. wall �' , °�+t' ,r�' �; ,� '_� - ,�
r4t. Wau
Ceilin8 �;��'; ,�:_�� � r�"' i �J
Floor
Total Btu. -� �, �";-0
Required sq. ft. E.D.R. or aq. ins. W.A. L.eader area
Fl. A° . : :�,_�Room �Length �' Width �'� .� Height ��'
th
Windows and Doors—�rackage and Area
Wldth Helght No. ot Ltaeal ft. Area
No. o[ pane of paae Ilg6te ot creck eq. tt.
�„� � �� ��: ��� � �
c V�,� .� � ' ja G� —'
e p:;�
Coef. Btu
lnhltration �' � �e� A, �:;,.
Glaea ��1 `'� �? r� �,
Exp. wall ! °� '�P ;�: °° � � �
Net esp. wall �� �='' �?� : � �A ":�`'�` ��
Int, wall
Ceiling ���'; �, - � :� '.,�, �:_�
Floo�
Tbte� BtU. � ° ;
�°�;��:
Required aq. ft. E.D.R. or sq. ins. W.A. Leader ana
Coef. Btu
In6ltration }� : �g;r �°� �r��
Glaaa �_� ' h�; '`�.�:�`r�.�
�. W� �# � �';. '" „�.3 .
&
Net eap. wall ��� {,r;�" ,f �� �"� '? d
InG wall
��'
Ceiling ¢��...v, �' ,� �r �.
Floor
Total Btu. ,�, ° �; �,�
Required sq. ft. E.D.R. or aq. ins. W.A. Leader area
FI.I ,;+�:;.:� Room ( Length ;� _ Width / / Height ,�'
Windows and Doora—Crackage and Area
Wldth Helght No. o! Llneal It. Area
No. ot nane of pane Ifahte ot crack ea. tt
In6ltration
Glasa
Eap. wal�
Net eap. wall
��. Wau
Ceiling
/ �"' �
�� r: �' ,,� r;
Total Btu. ` j �� �� �'y
Required aq. ft. E.D.R. or aq. ins. WA. Leader area
Fl.� �- ��:� �"�toom I l.eegth � �Width ;/;/ Height �'
Windowa and Doora—Crackage and Area
Wlflt6 HelBbt Na of Lineal [t. Area
No. ot pane o[.pane Ilghts o[ crack sQ. t�
S �
'� � �, t.. �' ,�'';° / ��:.
Coef. Btu
Infiltration ,.�- � �r�, �
Gless
Eap. wall
Net eap. wall
InG wall
Ceiling
F7oor
Total Btu.
—==
����
—��—
�������
_ Required aq. k. E.D.R or sq. ins. WA. Leader area
I
CRONSTROMS HTG. & AIR COND.� INC. Job Name
D�Sb ��0 Bxeelsio� Bonlo�ard, Mieneapolis 16, Mtnn.
ze II�AT LOff C/i�LC11LAT10Nf Job Address
A.S.H.V.E.
Weatherstrips Guide `� �nstruction No. I Insnlation
Windows Doors Reference Out. Wall Int. Wall C,eiling Roof F1oor Kind How Applied
Yes—No I.-. Yes—No 19— I
F7.� ' - Room � Length �/�� Width �"�i Height � Fl.� Room Lengch Width Height
Windows and Doors—Crackage and Area Windows and Doora—Crackage and Area
�Yidth Helght No. ot Llneal t. Area Wldth Halght No. of Llneal tL Ares
No. ot pane o[ pane lighte oL crack, eq. ft. No. ot nane ot vane lfahte ot crack eQ. it. I
Infiltratioa �
Glass
Eap. wall �� �
Net exp. wall �
Int. wall
Ceiling �� �
Floor
Total Btu.
Required sq. ft. E.D.R. or aq. ina. W.A. Leader area
Fl.� Room � Length Width
Windows and Doora--Crackage and Area
1 Width Height No. o[ Liaeal tG Area
No. oi yane ot psne llshte ot craok w. it
In6ltration
Glaaa
Eup. wall
Nec eap. wall
Int. wall
Ceiliag
Floor
Total Btu.
Required sq. k. E.D.R. or aq. ina. W.A. Leader area
�. R�m � �� w�a�,
Windows and Doora--Crackage and Area
Wldth Helg6t No. ot Llneal it. Area
No. ot nane ot naae tfahts of crack m. tt
�
Infiltratioa
Glasa
Esp. wall
rv�� �:p. w8u
Iac. wall
Ceiling
Floor
Tbtal Btu.
ft. E.D.R. or aq. ias. W.A. L.eader ana
BcU �
,,�°�
Infiitratioa
�� Glese
Eap. wall
� Net eap. wall
In� wall
`� Ceiling
Floor
� � �''� Total Btu.
Height
B�{1
Btll
uired aq. ft, E.D.R. or aq. ina. W.A. Leader area '
F7.1 Room I Length Width
Wiadows and Doors—Crackage and Area
Wldth Helght No. o! Llaeal It. prea
i. ot nane of oane Ilahb ot creck `ea. tt
In5ltratioa
Glaaa
Eap. walD
Net eap. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. f� ED.R. or aq. ins. W.A. [.eader area
�.� �� � �� w�a�
Windowa and Doord—Crackage and Area
No. ops e of vins Ilghts of c a k ap� t�
In6ltration
Glassa
Fap. wall
rr�t �. Wau
In� wall
Ceiling
Floor
Total Btu.
Required aq. k. E.D.R or sq, ins. W.A. L.eader area
Bcu I
Height
Btu I
�
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City of Fridley, Minn.
BUILDING PERMIT
���� �
N° 7312
;
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f//,�� , , � �
� ' ..G��le�, : d� �� ..�> 1 �� . �%.��l�.:Y�
�.00AT F BUILDING
No. Str�et �� ���..e. P of Lot
Lot �_ Block - �_. Addition r Sub-Di
b �
Corner Lot _� Inaide Lot Setback Sideyard -��
Sewer IIevation Fo tion IIevation
DESCRIPTION OF BUILDING
a8: � �� '
._.. �ont .�= I ne� .�� x��t .�'� sq. r-t.�� �� cu. ��;����7
t Depth fTeight ��____ Sq. F� Cu. F't.
Zj►pe oP Construc°ti ��$��� Fst,_C'a���_�� �� To be Completed
In consideration of the fssuance to me of a�rmit to conatruct the b s� above, I to do
the proposed work in accor+dance with the drescrip�ton above set Porth with all ona of
ortiinances of the dtq of Fridley.
���
In camafderation of the paqmeat of a fee of $�`� , pernlit fs hereby granted to
to cronatruct the building or addil3on as deacribed above. Thi� �ermit is granted upon
the eupress condition that the persfln to whom ft is granted and h3s agents, employees and worl�en, ffi all work
done fn, around and upon said building, or anypa� thereof, st�all conform in all reapects to the ordinance� of
w�ilth n then d��limits�and�tbis �t co � ct��al8eration, maintenance, repair and moving of buildings
ordivan�. � Y �Y �ne upon violal3on of aay of the P�vis�lone of safd
Building Inspector
NOTICEs
ihb permtt dess ao� eewr ths coasteueH�, IestaQnlee �o� vrhd�, plumbteg, �n 6aNng, awa� or wNer. B� sura �o ae
f6a Boildies lesp�ar to� ppvah p�em6s hr th�ss h�ns.
.a. _ � �
b . .
,_ .
APBLICATION FOR BUILDING FLI'1�i�T
CITX OF FRIDLEY, MIId�I'ES�TA
� i i � �
�,.�� �, � � y , ■ ► � . ss-� � ��, .
►/ /
�►�� ii �i��- r�v' ���• : /
� ,�` /
LOGATION OF BUILDING
No. %��G Street , P
,._ �art of •Lot
� —
Lot / B1c�ck Add3tion or Subdivisio /.� �
Corner Lot In�ide Lot Setback . Side Yard, �� °
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach.to thi� €orm T�io C�rti�icaCes of Survey of Lot ai�d proposed buiZd-
ing loc�tion draw� ori these Certifiaates,
DESC�tIPTION OF BUILDING
To be used as: �
v�-� �
���i��� Froat o�'c ��ai�Lh p� Height �� �
�
Sq. Ft . �%� Cu . Ft . � �'7 G� �
,
� Tront Depeh Ae3ght
Sq. Ft. Cu. Ft.
Type of Construceion �Z����,� Estimated Cost ��O � }
To be Completed ��"'`�/�, �
�---�
The uadersigned hereby �akes appTication_for a permit for Ehe work herein spec�fied,
agreeing to do all work in strict accordance with the City of Fridley Ordinaaces and
ruliags of the Department of Buildings, and hereby declares that all/ �acts and
repreaeatationa atated in this application are true an�correc�: � f _
DATE�� �p� � �� SIGNATURE, �����
4
�(Schedule of Fee Costs can be found on the Reverse Side).
�
� ,
� , ._ �.
�
�' : n'
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C
BUILDING PERt;�T FEL S�IEDULE
5ectioa 2. The Inspector�of Buildings sh�ll, before issuisg any pes�i.t for
the erection of any 6uilding or structure, or for any addiCion to any eeiiet-
iag building or strucCur'e, or for any alterations or repairo to any esis�:tx�g
building or s�ructure, upon applicatioa therefor, require the pay�eat by the
applicaat for such permit of fees to the amouat herein below set forth ar�d
ia the manner herein provided to-wit:
2.1. For any such permit for the erection o.i any fire-proof buildin�, c+ther
thaa a garage� warehouse, factory or grain elevaCor, Qr for the erect�on of
aay fire-proog additioa, for similar occupaacy, to any �xiating 6uild3�g
shall ba at the rate of $1.k0 for each om� thousaud cubic feet. or fraction
thereof, in such cubical contents.
._ 2.2. For any such permit�far the er�ctioa of any fire-proo� garage, wareYrouse,..
factory or graia elevator, or �or the erectioin of any fire-proof edditioc,
for s3mil�r occupancy, to anq existing bu3.ldiaag s�all-be at the rate of $1.25
for each one thousaad cubic feet, cla�sified as °1fireproof" bp SectiQn-5C2 of
the Minneagolia Buiidiag Code.
HOUSES . _
2.3. For aay such permit for the erection of any.non-fireproof bui�.d�r.� o�:Hes
than a garage, warehouse, factorq or grain elevator,��or aay aon-firegrcc>¢
addition, for similar occupancy, to any exietiag building - per�.t $�.oQ4 �or
each one thousaad cubic feet.
GARAGES
2.4. For any such permit for the erecti�r �: a�:�,� r���s-iE{;,P:��;�o� gara�e, -
warehous�e, factory ar grain elevator, n.� rr,�,� �..��;. "�.•E:::�icra e� any non_i�ra.,mro�.f
additiou, for--�3milar oacupancy, to �=n�r .��r.:t;;:��.r_�, b:<::�4:�.ng or for each e�:ch
_, � bui],diug .or addiCion - niaety cP�at^ <,,R;:;�+�°; �^� er.�::i one tho�aaaad cubi� feet
or fract3.on thereof, in the cu�ic� 1 s;�r � �z� �= ttjer�o� with a minimum of $4.00.-
For the purpose of ce�puting fees fcr ���.:� �.c�.ing perm� `.:s, the cubical coatenCs
of aay buildiag or addition Co a u�ifcs�.� I�e�'uiit thro�ghout by multiply�ng the -
ground area covered from a pqint six (6) iaches be1,�� the floor line of.i:�e
basement or cellar to the average heig�it of t�a� Ug��er surface or to the
average height of the roof surface of the maia �able of a p3tched roof.
2.5. •For repaiza or alteratione to an existing structure, the fee ahall be
at the rate of $3.00 per each Five flundred Doll,axs ($500..00) or fraction
thereof'ia`the cost of all proposed work.
2.6. In�no case ahall the tee._charged.for-aay permix a� set�forCh in
.Sectioa 2 be lesa: than $4.00.
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SUBJECT I� NO�.'�O�
City of Fridley 3355 ��
AT THE TOP OF TME TWINS g U I L D I N G P E R M I T
r
; � RECEIPT NO..
� • COMMUNITY OEVELOPMENT DIV. `�
� j �i - +� �
r � � PROTECTIVE INSPECTION SEC. /� �
1 . � /i`�� @i
� � /"'1 � CITY NALL FRIDLE� SSIJZ NUMBEN REV DATE V�GE Oi APPROVEO BY
�"""�� ��' 763-571-3450 910-F15 5/23/03 / /
JOB ADDRESS 7886 FiYWOOd WSj� NE
1 LEGAL �OT NO. BLOCK TpACT Oii ADDITION SEE ATTACFIEO
DESCR. j, 2 Pearson's Crai a 2nd Addn SHEET
2 PROPERTY OWNER MAIL AOORESS 21P PMONE
Liz Galliant 7886 Firwood Way NE 763-572-8657
3 CONTRACTOR MAII ADDRESS 21P PHONE LICENSE NO
Cedar Valley Exteriors Inc 1700 93 �tt NE Blaine MN 55449 763-755-2221
< ARCNITECT OR OESIGNEfi MAIL ADDRESS 21P PMONE LICENSE NO.
5 ENGINEER MAII ADDRESS ZIP PNONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION � REPAIR O MOVE O REMOVE
8 DESCRIBE WOFK
Reside House
9 CHANCiE OF USE FROM TO
STIPULATIONS
Per Section 1402, 1997 Un�form Building Code, requires that a weather resistive
barrier be placed over exterior sheathing to protect the interior wall covering.
Exceptions fo� this provision would be if sheathing 3s an approved weatherproof
panel or when the siding is a� approved weather barrier. Vinyl siding is not
a weatherproof covering unless the manufacturer states th3.s in their application
guidelines. Call for inspection of wrap before covering or take pictures. Caulk
and flash a�l exterior openings.
�e�mit onspection Card� °
ill �� ailed
To Homeo�n�r �� P�st
SEPARATE PERMITS ARE REQUIREO FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST OCCUPANCV GROUP OCCUPANCV LOAD
VENTILATING Oii AIR CONDITIONING
THIS PERMIT BECOMES NUIL AND VOIO IF WORK OR CONSTRUCTION 20NING SO. FT CU fT
AUTMORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO DWIG. UNITS OffSTREET PARKING
I HEREBV CERTIFV 7HAT I HAVE READ AND El(AMINED TMIS APPLICA710N 1 STALIS GARAGES
AND KNOW TNE SAME TO BE TFiUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION SURTAX
AND ORDINANCES GOVERNING TMIS TYPE OF WORK WI�L BE COMPLIED @
WITM WHE7MER SPECIFIEO MEREIN OF NOT. THE GRANTING OF A PERMIT `P7,764 �3.HH
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLA7E OR CANCEL TME pEFMIT FEE SAC CMARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- @ iS3 . LS Fire SC �% . 7E)
STRUCTION OR THE PERfQRMANCE OF CONSTRUCTION W
PLAN CMECK FEE TOTA� FEE
License SC $5.00 $169.89
S�GNATUAEOFCON'FACTOpOpAUTHOpIZEOAGENT IDATEi HEN PflOPEiiLY VALIDATED TH�S IS VO ii PERMiT
S�GN4TUqE O� OWNEp i�i OWNEp BWLOEAi iO�TE� �
BL �NS� 6ft
� � .
•-MAY=23-2003 W�26 FROM C1'Y OF FR�DLEY TO
-�••• �•• . �•�+o �+e�,m I L 1 I Y
'7a�53'30 P. �?
OF ��D�EY TO 69s5'S6z a.0v0a
,�� 'd!�� �.IA.W\�.V •I ���y
4 DDN ( j Cl"1�"Y bF FRIDI,�X
q LrER I] SnvGz.� �auvr�.�t arrn DuPt.�xzs �t- �u �t �RY �F �R 1 D LEY
���:m.DiNG P�vsrr pPPL�car[oN 643i UNIVERSI7Y AVE. N.E.
FA10LE1�', MN 55432-4384
��,�u�cxio�A,ddc�ss: ��CY_ i 21i'�tiC� ( D V� �� _
(.e gal Deseription:
�
J�+ner Namc & Aadress:
�,
Tel. �
rc ntcacto�: Ced�tr Valw�r �+�w��•••••� ••�-. �t I.ICEIVSE �� 1 �
�' �-
Ac dr�ss: �� � Tel. ���j-��SS-
._—�_..�
�►cr�cn w cht, ap�tic�ac3on. a C�ctificate oE 5unrey oE �he
ioc, Wit� th! prOpOSed coa�cruC[ipA drayvn oe it t0 Scale.
�r �n�rG aREa:
�A R.�G� AiLEA:
DE :K A�iE,r�:
oT�x:
ABA�CRxPT'�ON OF II4lPRp`VElyg,�VT
��tth __i Width _ �Icight ,� Scl, F�.
�� _..,. � Width __,_�.� Height __,..� Sq. Fi , _.__.�
LengtA _,,.T_ �'4f�idth �' �gVC�rowad �, Sq. Ft. _
� —. ,
.-
.,-
:on:auction 1�ype: o' - Eswna4ted Cost: $� U� •
lFee Sahedu2e on BackJ
Jriv:way Clitb G�c Width Necded: Pt. 6 Fc a F� x� =$
-- � ..��. � _..`��
�aT �: � � � -{�3 a,Pp�.�c�v�r, �r�. rJ1�3 -7 - �?�1
'e.�t� it Feo
�ice , �urcharge
�cate Surcharge
�AC ^,harge
acen �c S�rcharge
)rive way Escrow
'sxosi+►a Coattol
�ar�c =ee
�ewe� Mai� Charge
TC TAL
�TlPL LA7IONS:
$
g,_,�, "l . 'I
$
$
� 5`�
$� .
S
$'
$ '
� ��
y Y.� � ,+.� ..w
Fa 9chedule oa Revctx Side
.001 of Parmic Valuation (�1/10th�)
�.SO/$i.000 Valuatioa
�81000 per SAC Unit
,65.d0 (State Llctnsed ResideAtial Contractors�
,vt. "A° or Alt. `B" Above
:S4S0.00 Conservatioa Pl�u Review
1;ce Determined by Engi�s�eerin8
��8rcemeat NecessarY f l Not Necessary t]
�
TOTAL P.02
Building
Inspections
763-572-3604
DATE
SITE ADDRESS _
THIS APPLICANT IS
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT TYPE
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAII. ADDRESS
❑ OWNER ❑CONTR.ACTOR
's: �–. � �— S � � � � �
:ESS: �fr �6 -- �'•A�`*>e�z-1�
�. '-7 �-- �72�fsf�i
STATE LICENSE # J `7�'(
.e.DDx�cs: �.3iS -5��7kc��-,--
PHO� -�rl-g��-Z�--z
❑ SINGLE FAMILY/NEW CONSTRUCTION
❑ TWO FAMILY/NEW CONSTRUCTION
❑ ADDTTION ❑ GARAG
❑ BASEMENT FINISH ❑ ROOF
❑ DECK ❑ SIDING
❑ SWIMM
EXPDATE
�/ �
�� � -
Permit No.:
Received By:
Date Rec'd:
A�'tr'z� �f-3 �—
�r- a� �
CITY � S� STATE ZIP `�
❑ DRAIN TILE
� OTHER
TYPE OF WORK: I���' V�ll111VN
❑ IvIAINTENANCFJREPAIR 0 REMODELING
r-�'' iA '+� A'l(a� So�.�j^'I,`T'
DESCRIBEWORKBEINGDONE: l�`�--�a�°°rF �v�=��� 6� ��!�r� e�.� �
cr7R [1F TMPR(�VEMENT LENGTH WIDTH HEIGHT Sq. Ft.
NUMBER OF SQUARES
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
❑ Aluminum
❑ Other
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
�Soffit
❑ Trim
0 Fascia
, WINDOWS
' IN EXISTING OPENINGS �Yes ONo LQCATION OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBE STZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WIND
ALL FEES ARE BASED ON VALUATION, INCLUDING
TOTAL JOB VALUATION $
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb G�t Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
Total Due
$ 0�-3o a �
$ —�"
$ �� �l�
$ � ��
$ � oc�
$
$
$
$
$
$ � �
BASEMENT REMODELING SUBMTT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be us�
FOR NEW CONSTRUCTION INCLUDING DECKS,
p`nDTfIONS & PORCHES SUBMTf:
1. Site P1an/Survey showing the existing structures
and proposed project
2. Two sets of constcucbon plans
3. Energy Calculations
OF LABOR AND MATERIALS:
OCCUPANCY TYPE
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Muumum $.50
$5.00 (Sta.te Licensed Residential Contractors)
$1550 per SAC Unit (Plans to MWCC for determina.tion)
ft+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an applica.tion for a p rnut and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work w� re ' es review ap oval of plans. �
SIGNATURE OF APPLICANT PRINTNAME IL.vI�'T M'�1G, DATE � ^� v
Building c�� 1��
Inspections
763-572-3604
DATE �I " o� � -��'
SITE ADDRESS � �
THIS APPLICANT IS;
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE V✓ITH
APPLICATION
PERNIIT TYPE
MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
-� r �:�oc� V�:►c�
❑ OWNER �CANTRA(;TOR
�.� i'�o�� �'l -�
a,DDRFSS: 1�S`6(� I—i ✓�.:-oo�+
PHONE: �l lo �j ° '� � � � �� � �
COMPANY NAME: ••••.. `.""` .. _-- - ----- -
CONTACT PERSON: �Q� Z�
STATE LICENSE #
EXP DATE
Permit No..
Received By:�
Date Rec'd: ���� ���
ATE�NZIF��
,�nDRESS: 13562 CENTRAL AVE NE crrY ANOKA STATE ffi�TZtP 55304
PHONE 763-737-6202 p,� 763°757-fi701
TYPE OF WORK: � O�W
FAMILY ❑ TWO FAMILY
�REEPLACEMENT
DETAILED DESCRIPTION OF WORK
❑ TOWNHOUSE
❑ ALTERATION/REMODEL
� � � er �n G � � �$ v
PER MS 16B.665 the permit fee is a minfmum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, instaliation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (Il�IDICATE TOTAL
NUMBER OF EACH BELOV� ��� MODEL: F` C7� SIZFJBTU _���
Equipment Installed . 1vffG:
�G; a� MODEL: ' � S��T� �LJ 3 5��
SIZFJBTU
� A/C $25.00 MFG: _FIREPLACE (GAS) $15.00 ODEL: GAS RANGF/OVEN $10.00
_AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.Q0 NEW GAS GRILL $10.00
BOII.ER $35.00 TFURNACE $35.00 GAS UMT HTR $10.00
CHIMNEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00
DUCT WORK $10.00 _GAS PIPING $10.00 VEIVTILATOR $15 00
_ _ .�,�,.�� � �� � -�
� _ .., � r- . _ N-�--,-�.. .-.: �. . _ ... .�,. .__ .__. .. _. _ _
Permit Fee $ Number of fixtures @$10.00 x$10.00 =
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
1"OTAL DUE $ Number of fixtures @$25.00 1 x$25.00 =$ �!5 •�
Number of fixtures @ $35.00 � x $35.00 = $�5• �
State Surcharge = $ 50
Tota1= $ � ° �U
'fMS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclrnowledge that the infarmation 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 requires review and approval of plans.
SIGNATURE OF APPLI�C��..� �° :``�'�'� PRINT NAME ROGLrR HOFI�HEIi�i DATE �'�(.� -A�°
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
��z_���_��na
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REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below) .
a. �il or solid fuel lMC Chapter 7 with MN Atnendments
b. I�Iatural�.s_Qr Pro�ane/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 Chapter 5 wifih MN Amendmen.ts
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooli.ng load pei- room �
a. Required on new construction IMC 1346.0312
5. Ventilation
a. Per MN Ener�y Code 767Q or 7h72
6. Duct Design Per IMC 1346.0603.2
.a. ACCA Manual D
NQTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
. ,
combustion and make up air calculations
Building pl,�g�G Permit No.:
Inspections j��j]�]EN'�j.�.i, Appj.,jCA7Cjo� Received By:
763-572-3604 CIT,Y OF FR�DI.E'�" Date Rec'd: �' ",� 1`���
DA� August 18, 2406 Yocm �-�n�z, a�DxESS wnelsontc�la��a.. nplumbina.com
srrE,anDx�ss 7886 Firwood Way NE
THIS APPL1C,41��''C IS: � ORTiER QDCONCRACTOR
,
PROPERTY N� Elizabeth Galliart
���� ann�ss; 7886 Firwood WaV NE ctrv__ FridleY STATEMNZIP JJ�2
1TLNANT PHONE: 76�I'rJ7�-HSS7
CorrrRr�►►G°�roR �: Larson Plumbinq, Inc.
SUBMIT A COPY OF STATE LdCENSE q 3341 PM �xr na� 12/31 /2Q06
YOUR STAT'E Anp�ss: 3095 -162nd Lane NW c�rv Andover STATEMN ZIP �J�J3O4
LICENSE WITH Pxorr� 763/427-7680 Fnx 763/427-9448
APPLICATION _
pERNIIT .1.YPE I� SII�FGLE FAMILY O TWO FAM[LY ❑ TOWNiFOUSE
TYPE OF WORK: � ��' � 1�P1.f►CEMENT
DETAILED DESCRTPTION OF WORK 1Nater Heater Replacement
PER MS 16B.665 the permit fee is a minimum of $15.Q0 or 5% of tha total cost np to SSODAO, w�hichever is greater, for the
improvement, installation or replacement of a residentia.l fixwre, excluding the �ixtures. (This should reflect onty the cost of labor )
La.bor cost under $340 °�15.00. Labor cost batween $300 to �500 � cost of labor x.OS =
FOR PROJECTS Wf3ERE LABOR EXCEEDS $500, FEE$ ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTL)RES: ([NDICATE TOTAL
NUNBER OF EACH BELOW}
BATfI STNK/LAV `FLAOR DRAINS SHOWER WATER PTPING
BATkITUB GAS PIPINQ �x�'ED Cmt�cExs�j SWIMMIN(� POOL � WATHIt SOF'iNER ($35)
CLOT1�5 WASHElt � KITCHEN SiNK WATER CLOSET � BACKFLOW PREV, ($IS}
DISHWASHER _ LAUNDRX TRkY WA'TER HEATER {$35) � FOR IRRIGATION .
_ WAT£R METER _ OTHER
_ ��_. ..i. `e'�+?;•4 �`,"?�3:?�,>,,;••.:�:'„y'H�>. a• •< - - •
YG>'� ^X"/,�
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� i.: �'. � �G::.,...4,�..s,n.,o;..-Y e_.�?. :� . ..=L .:�' � t.�1,^s � .. i .. q _ -•�t..
:'I�E��`.�' X;:�,�£T,�•��QI2.; � :�:`$'$Ob .s�:. :�',;�: y�.�.<...�r...,:.,......::��,:,.< ;,,,,a:.��,.:�t. r.c,"�„` . ,.3?�''R�`Ta� E��`it:���7���;O�IZ;�'�00 `
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Permrt Fee . $ 35 .,,�Q, Number of fixtures @$10.00 x$10.00 ffi$
Surchar �e .54 Number oFfixtures @ $15.00 x $15.OQ = $
TOTAL DUE ��.,� Numbar of fixtures @$35.00 x$35.00 =$
State Surcharge � $ .50
Tota1= $
THIS lS AN APPLICATION FOR A PEFMTT-NOT VAL1D UNTIL PROCESSED
[ hereby apply for a building permit and I acknowledge tiaat the information above is complete and accurate; that the work wiil be in
canformance with the ordinances and codes of the City of Fridley and with the Minnesota Consiruction Codes; that I understand this is
not a permit but only an applica6on for a permit and work is not to start witbovt a permit; that the work will be in accordance with the
approved plan in the ca; all wor w ici equires review and approval of plans.
SIGT�iA1URE0FAPPLICAr��� , Rn,rrr�,a� Michael Malonsk't nars $/18/�6
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✓.F. ���°� .. . . .+. _ �•• iiir' �. f ;...,'�,',.__ .. ,.,,. :k'57.,. i.. .� ,: .,... ..,.$5• �: .: L;7Yfi7>11V�17�'=�'r�r�`.1'i14i'iJa� tJ�'i - - `ifa., . . ;s^5:�i"',,.
:�<..�;��..�'�°t�.'"��� �'.�.�_....s.�?��:. _. .... .. _ . _ .;� ... . . '.�:�p.���. _ ::�EC��Yi.`A�.:CVO�ti�. ,.:�s.
City of Fridiey
Building Inspections Department
6431 University Avenue NE, Fzidley, MN 55432
'163-572-3604
FA�: 763-502-4977
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