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AF - 45196�� n Date: • _ City of Fridley, Minn. BUILDING PERMIT � ��-�� N° .'7441. � �- �. � � � � f C..� ��—� — Builder -�.��° � Addreas - Address � - --- -- - --------- Na r��?,�� Sts�eet � art f Lot . Lot �_ Slock � Addition or Sub-Div3eian A��'�� ---� Coraer Lot _ Inaide Lot � S.etback _�� Sideyard —� �.�� c Sewer IIevation — "� >�' . �'" �-� ��'�da� �Elevation � � �° � r" �-� �j►pe of DESCRIPTION OP BUILDING Front � Depth �,� Hei�ht �&1. �'t.�� Cu. F'��s�=-� t�.q�, Depth I�eight �-�_ �9. Ft ��d,�'� Cu. F'k y�V �� — � � �, FF�t. .,� �To be Completed `� C'l.t A9'- r�� r�C'"/��"�l� �!� C�,i ,�,('Al�"; ��, �.-C� 9 In cansfderat[on of the issuance to me of a permft to construct b g des a�ve I agisee to do the proposed work in accordance with the d�scription above set fo com with afl provis4ons af ordinaaces oP the dty oE FricIIey. � In canafderation oP the payment of a Pee of $� f� , Permft is hereby graated to to construct the building or addition as descrYbed above. This permit ia granted upon the express cwnditlon that the person to whom it ia granted and hfe agenta, employees and worl�nen, in all work done in, around and upon eaid bufldiug, or any part thereof. ahall oonform in all reapects to the or�inancee of Fridley, Minn�ota regardiag lacatqon, conatruction, alteration, maintenance, repafr aad movin� of bufldings or�� dty ]imfts and ti�is permit may be revoked at any time upon� tion of aqy of the provisions of said ��S � aonc� 7� pe� dees nef eora His co�ru�, fashll�loe ior �riaa. P��9. 6a h�adng, a�ru er wahr. 8� ara to a� dn BolWie� lesp�etee fer ap�rd� pamNs Po� fhea Rsms. owt�R' s � � �. � APPLICATION FOR BUILDI1vC F'�:P,MIT CITY OF F;ttIDLEY, Mi�1i�'ESG�A ��_ l c�; p C. e �n/ ��. � ADDRESS + ADI3RE5S ��S � �A��7ld�j- /�'l� LOGATION OF BiJ7CLD�NG � No. � � � � Street� Part of �ot Lot � Block �Additioa or S�bdiwisioa� ��t�-�-�� Corner Lot Inside Lot �" Setback �� Side-Yaxd �� SEWER ELEVATIO�i FOUNDATION EI.EVATION Applicant attach to thia form Two.Certi�icates of Survey of Lot aad proposed build- ing location dxawn�on..these Certificates.: . D�SCRZFTIOIV OF BUILDIi�'� To be used as: ��--5 fcQ�� Froat i�?�Lh Height Sq. Ft. � Cu. Ft. ' . FronC Depth �Iieight Sq. Ft . Type of ConsCructioa To be CompYeted Cu. Ft. Ced Cost ��s�-� The undersigned hereby makes application for a permit for tlne work herein sp�cified, agreeing to do all work in strict accordance with the Citq of Fridley Ord3na.nces �nd rulirags of the Department of Buildings, and hereby declares that a11 the fac�a �nd represeatatioas stated in this applicetion are true,and correct. � �- � DATE � � SIGNATUI2E . �Schedule of Fee Casts can be found on the Raverae Side). � � _ ^ _ n „ , s ' � . > " � z SUII�DING PE�T FEE SC9EDtTLE Section 2. The Inspector of 8uildings shall, before issui�g any pex�mit £or the erectioa of aay building or st;�cture, or for any addition to any �:�et- ing buildin� or atrucCure, or for auy aiteratians or iepairo to any esistl.ng buflding or atructure, upon application therefor, require the pay�ent bq the applicaat for such permit of fees to the amount hereia below seC �orth anad in the maaner hereia provided to-witt 2.1. �'ot any.auch permit for th2 e�ection o� any fire-proof buildi��, rCher thaa a garage� �rarehouae, fgctory► or grain elevator, or for t�e erect�.on of any fire-psoo� addition, for aimilar occupancy, to any zxisting builci3r� ahall be at the rate of $L.40 for each.one thousand cubic feet, or frac�jon thereof, in auch cubical cantents. 2.2. For any such permit for.the erection o£ atiy fire-proof garage, wareh�uea,_ faceory or gra3n elevator, or foY the erection of any fire-proof �dclit3.o�, for similar occupancy, to any exiatiag buildimmg shail be at the rate of $1:25 ior each on� thousand cubic feet, cla�s�.fied as "fireproof" by Section SC2 of the Minneapolis Buildiag Gode. � -. HOUSES 2.3. For any auch perm�tt for the e�ection of aay aon-fireproof buildir..; oE:r�s thau a garage, warehouse, factory or grein �levator, or anq noa-firep.rr4r>� addition, for aimilar occupaacy, to any existing building - permit $�..�� s each one thousand cubic feet. GARAGES 2`4,�� For aay such permit for the ere�s:i^r of a.;::, r�on-�{�,Apscc�o� gara�e, warehouse, factory or grain elevaeor, r�• 'c,��: z.�1� �-��E�-�iou o:� any non-s1.=.�r�of additi,ou, �or -s3milar occupancy, to �.-, y;��:i� _..:rb L-:�::1 �;.ng or for each s�ch _ . . -- � .buildiag or additfon � - aiaety ce�a� � �;;�,; >�� b�� 'EF{o�;Y one Chousand cubi� feet or fraction thereof, ia the cu��c4� r�� n;:. ,t��erc�o�: with a minimum of $4.00.- For the purpoee of comgut3.ug fees fcr �auf �.�ing perm3�_s, the cubical conteats of any building or �ddi�ion to a uaifca�.a iaei;izt throLghout by multiplying the ground area covered from a point aix (6) iaehes be��w the flaor line o€..i.he basement or cellar to the average height of -Chs �g:�er su�face or to tha average height of tha roo� surface of the main gable of a pitched roof. 2.5. For repairs or alteratioas to an exiatiag stnuture, the fee shall be at the rate of $3.00 per each Five 8uadred Dollare ($500.00) or fraction thereof in the eoat of all proposed work. 2_6 _ In no case sha11 tbe fee. .charged. fnr _ any pesm,{t a�s set forth in .Section 2 be lesa. than $4.00. � "`� ° ^ ., ,.o � ,, a � HARVEY A. CAR7WRIGHT wpouw couirrY euRVSrs MENNEPIN GOUNTY StJRVEYB MINNEAPOLIB SURVETB 84f0 PALM 9TREET N.W. BUNeET 4•7688 owaea INDUBTRIAL — JUpIC1AL 9USINE88 — TOPOGRAPMICAL CITY LOTS — PLATTING Sam Templin � ` �� ' �� '� 0 �� 0�� LA1VD SURVEYORS R6fiisT6RLD UNDBR LAWS OF BTATH OP MINN680TA LiC6Ni80 9Y ORDINANCt OF GlTY OF MfNNBAPOLIB S26 PLYMOUTH BUILDING FEDEfiAL 8-8721 HENNEPIlV AT SfXTH • MINIVEAPOLIS 3. MINNESOTA �9burbtpor'� �ertiiKatc � CpMBINING TNE RECORDS OP J. E. HILL. CIYIL ENOtNSEW ceraeueHto �sye C. F: BANDHOFF GIVt�. ENGINE6R fiSTA8L18XED 1YGH JAMES'NELSON SURVEYOR EBTABLBNQC tYa1 METROPOLITAN LAND $URVHYORB, EBTABLIBNED �pe� T�rrTOiCO 22582 � �� I hereb�► CCP'�1.�'Ji 'i,Y12,'t 'tiYi.�.9 is -� tru� and correct represeMi,�tion ai � survey of; Lot 2, Blocl� 1Fp G�rd�na.I��1.ol�sr�1 Garc�ens � , !3.s svrvey�d by me this 9th c36.y af 1Voaember� 1962. � � � � SIGWEO �i �rI'6""n�� :'� d��a�g�'"z.9��i''�:'�. �, y � ClqTW GHT w�cr' �s30N , d. � ; � 4 sua�ecr MIT NO. � City of Fridley � � �? � � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � RECEIPT NO. � • COMMUNITY OEVELOPMENT DIV. f � �.------ � �� PROTECTIVE INSPECTION SEC. � � � �'�'1 � CITY HALL FRIDLE� 55432 NUMBER REV OATE vpGE OF AvPaOVED Br �'"""� � ,�� 612-571-3450 910-F15 5/2/97 � � JOB ADDRESS 6035 Gardena Lane NE 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 1 Gardena Meloland Gardens SHEET 2 PROPERTY OWNER MAIL ADORESS ZIP PHONE Gunner Wikstrom 6035 Gardena Lane NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Midwest Siding & Roofing 3533 Perry Ave N, Cr stal, MN 55422 521-3652 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20010277 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION Q ALTERATION � REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof House & Garage (21 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING, HEATING. VENTILATING Oi; AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 OAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED � 1� 732 �• 8] WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING coN- $56.75 Fire SC �1.73 STRUCTION OR THE PERFORMANCE OF CO STRUCTION. PLAN CHECK FEE T L FEE ��-�� License $5 0 $64.35 SIGNATUAEOFCON'RACTOAORAUTHOAIZEDAGENT IDATEI N jjQ Y VALI ED THIS IS YOUR PER .� � / G ' vr�S-� S�GNnTUF7E0%OWNEAnfOWNERBU��DER� �DATEi B G�NS� p47E NEW ADDN ALTER [] �� ConstructionAddress: Legal Description: Owner Name & Address: Contractor: i,i(1 �r�1 e , � Address: CITY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUILDING PERIVIIT APPLICATION � i n �- �r �. � Tel. # Effective 1/1/97 -L " . �� il � .� �f�,, � i . . , - � � � i. _ . _ �': � , � � � . Attach to �s application, a Certificat� of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IlVIPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: LeII Width Hgt/Ground Sq. Ft. OTHER � ' ' ?� � � �° �l S - � � Consiruction Type: I�.�L" � Fstimated Cost: $ �%� - - - �r � (Fee Schedule on Back) Driveway Curb C�t Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: 5 ��l � l APPLICANT: i Tel. # � � �� °� � � �] �- Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ � iP. �� Fee Schedule on Reverse Side $ � . � .�1 of Permit Valua.tion (1/lOth%) $ � c�� $.50/$1,000 Valuation $ $950 per SAC Unit $ � D L� $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 [ ] $ • �� s (�U(i,U1NG 1'EitM[1' FEE SCHED('l..E; "I'he Chief I3uilding Of�cial shall, before issuing permits for tiie er�tion of any building or structure, or f��r any addition to any existing building or structure, or for any alteration or repair to any existing buildinv or stiucture, 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 pr.ovided to-wit: TOTAL VALUE $1 to $S00 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $S00 plus $2.75 for each additional $100 or fraction thereof, to and including $2,(� $62.25 for first $2,000 plus $12.50 for each additional $1,0� or fraction thereof, to and including $25,�0 $349.75 for first $25,�0 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,�0 �50,001 to $100,OQ0 $574.75 for first $50,000 pius $625 for each additional $1, 000 or fraction thereof, to and including $1 Qp, ppp � 100, 001 to $500, 000 �500,001 to $1,000,000 $ I , 000,001 and up $887.25 for first $1(�,000 plus $5.00 for each additional $1,OQO�or fraction thereof, _to and including $S�,OOtI $2887.25 for the first $500,000 pius $4,25 for each additional $1,000 or fraction thereof, to and including $1,�;000 $5012.25 for the first $1,000,000 plus $2.�5 fot each additional $1,000 or fraction thereof DRI'VEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) �Iternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.>0. �Iternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION °crnlits for construction will be issued a minimum of 24 hours from the time of application to allow for pm�+:;r .:view of the proposed structure and of the construction site. �i Ceriificate of Survey �f tlie lot, showing the location of the foundation rmce it has it has been c��nstruc�� ' '.�? h;: rcquirai hcft►rc ��rcx:cccling ��ith ti�c framin«. _ _ �� sue�eer PER -� City of Fridley 30299 , AT THE TOP OF THE TWINS g � I L D i I� G P E R M I T r � � RECEIPT NO. � • COMMUNITV DEVELOPM�NT DIV. � � �� j V �'�� r � � PROTECTIVE INSPECTION SEC. 1 = i � �'�� CITV NALL FfiIDLE� '��3Z NUMBER REV DATE PAGE OF AVPIiOVED BY �'""'� � �'' 612-571-3450 910-Ft5 9{27/99 / / JOB ADDRESS 6035 Gardena Lane NE 1 LEGAL ��T NO. BLOCK TRACT OR AODITION SEE ATTACMEO DESCR. 2 1 Gardena Meloland Gardens SNEET � PROPERTY OWNER MAIL ADORES$ 21P PNONE Gimnar Wikstrom 571-9632 3 CONTFACTOH MAIL ADDRESS 21P PNONE LICENSE NO Advance Home Products Inc. 3770 W. Broad.wa Robbinsdale 55422 521-9211 2332 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO. 5 ENGINEER MAII ADDFiESS 21P PHONE IICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WOFK O NEW O ADDITION O ALTERATION 7�. REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Alumi.num Trim 9 CHANOE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV LOAD SEPARATE PEiiMITS AqE REOUIRED FOR ELECTfiICAL, PLUMBING. MEATING, VENTILATING OR AIR CONDITIONING TMIS PERMIT BECOMES NULL AND VOIO If WOFK OR CONSTRUCTION ZpNING SG. FT CU FT AUTHORI2ED IS NOT COMMENCED VjIITMIN 80 DAYS. OR If CONSTRUCTION OA WORK IS SUSPENDED OR A9ANDONED POR A PERIOD OF 120 OAYS A7 ANY TIME AFTER WORK IS COMMENCED NO. DWLG. UNITS OifSTpEET PARKING I MEFiEBY CERTIFV THAT I HAVE pEAD AND EXAMINED THIS APPLICATION STA�LS GARAGES AND KNOW TME SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS Of LAWS yALUATION SURTAX ANO ORDINANCES GOVERNING THIS TVPE OF WORK WILL QE COMPUED WITM WMETMEii SPECIFIED MEREIN OR NOT. TME GRANTING OF A PERMIT �2rJOO .��..ZS DOES NOT PRESUME TO GIVE AUTMOfiITY TO VIOLATE OR CANCEL TME pEqMIT fEE SAC CMARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON- STRU TH �IYfORMANCE OF CONSTRUCTION �H3. ZS Fire SC .�Z . SO PIAN CNECKFEE TOTA EE c� - License $5.00 $ .00 S�GNATUAE OF C TAACTOp OA AUTMOAIZED OGENT IOAT�� N OP AUDAT MIS IS R P L � � i SGNOTUAE O� OWNEA�� OWNENBWIDEp� iOATE� � 9� iNS� ' � �� L 2 r�w � �` ADDN [ ] ALTER � Effective 5/10/99 CITY OF FRIDLEY SINGLE FAIVIILY AND DUPLEXES R-1 AND R-2 BUII.,DING PERMIT APPLICATION Construction Address: � f� ��S — Legal Description: Owner Name & Address: �s �, Contractor: U� q„ Address: �7 7� — Lr�e� Tel. # �'7l- l( 3� MN LICENSE # �3,3 � Tel. # ��'�/- �� /� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground OTI�R: Sq. Ft. Sq. Ft. Sq. Ft. �--� � Construction Type: �' ��; ►.v,,,,,, I,o'Jw. Estimated Cost: $ oZ, 5� �, �c7 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: -�. — APPLICANT: i"`' a�- � J�� l�c�-s7�.'� Tel. # V�� '� 6� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $��5 $ �t - `; ?� $ .� $ $ �j'_ l9 D $ $ $ $ $ �'�_� 0 CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuadon (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 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,OQ0 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $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 ea�h 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 $1,000,000 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 5%et 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 applica.tion 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 b�en �o�truct� ovill be required before proceeding with the framing. * � D � O � a � o � � � � � A o � 3 � Q o o m� � -o c� c�'i v a c�c � � N � m � � � � � 0 � �� c m � � � � n --� 7� �� v m n � n � m � � � � � D � O z 0 Z � m z � m � O Z rn � � � � � < n. � � 0 c cfl .? 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Has been carefully examined Yes () No () 2. Is free from rust or deterioration 3. Has no foreign objects lodged within 4. Is securely supported 5. Meets all current Code requirements for size and total BTU's connected 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: List ALTERATIONS Being Done • HEATING CO: Signed By: Date: Yes ( ) No ( ) Yes()No() Yes ( ) No ( ) Yes ( ) No ( ) Yes()No() Yes ( ) No ( ) Building BUILDI�G Permit No:• --c�c�l Inspections RESIDENTIAL "APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY D�'�°� E� �00� 763-502-4977 FAX EFFECTIVE 1-1-08 DATE `� � YOUR E-MAIL ADDRESS �it7�,P_�_2_�L� �°ccr7 ��'C�J/!�( SITE ADDRESS �J ' C� �� -C ,'.7,'. � 3 �. THIS APPLICANT IS: �OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: �.l� -�' !.� Q� ` TENANT qpDRESS: �� A7�.� CrIX�v�f�P�C�i C.1?, CITY ��K� STATE�ZIP S��i �— PHONE: (�lc�- �S�— �d� � NAME: CONTRACTOR ADDRESS: CTfY STATE ZIP SUBMIT A COPY OF pHONE FAX YOUR STATE LICENSE STATE LICENSE # EXP DATE PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SiZE ❑ TWO FAMILYMEW CONSTRUCTION STOR[ES PERMIT TYPE 0�DITION 0 GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF , ❑ DRAIN TILE ❑ DECK ❑ SIDING � OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION O ADDITION ❑ MAINTENANCE/REPAIR REMODELING DESCRIBE WORK BEING DONE: i�°lL- �/� U(�Fa7UY! t�� /�/ �1.r�G'1 LU�I SIZE OF II�IPROVEMENT �LENGTH WIDTH HEIGHT S FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: ANMBER OF SQUARES ❑ HOUSE & GARAGE I. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DE'CACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: � SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soff►t ADDITIONS. & PQRCHES SUBMIT: 0 Aluminum ❑ Trim 1• Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project 2. Two sets of conswction plans WINDOWS 3. Energy Calculations M EXISTING OPENINGS �Yes �No LOCATION OF WINDOWS OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL P15L�'J AKN: SAJL+'li U1V VALUA"1'lU1V,1NC:LUDllVG "1'HE (;UST ON' LABUR AIVD MATERIALS: (USING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ ,/,5�, �'� OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Pazk Fee Sewer Main Charge Total Due $ �s �� $ � '� $ $ $ $ $ $ .-� . . � 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) $1825 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21 =$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridlev Attac6 THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building perrt►it 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 Construc 'on Codes; that I understand this is not a permit but only an application for a permit and work is not ta start without a pertnit on site; that the ill be in accordanc�tvi a ved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPL ANT..- � � PRINT NAME ��--�a� DATE Z v� APPROVED BY /J D., B� /�J �s ,(/�� /1 DATE � e Page 2- Building Residential Application BUILDING 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 pernut 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. New Houses Onlv City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 � 763-572-3604 Faz: 763-502-4977 yt�r i„� y. s � Address Purchaser(s): Ed�n� Realiy Ti�le vvww.edinarealty.com Closing Documents: 6035 Gardena Lane fVE Fridley, Minnesota 55432 Roger Lamhert Howard Teresa Ho ward Seller(s): Gunnar Wikstro►n Jr. ``' Closing Date: 2/74/2008 ERT File #: 8433 78 Closer Name: Doris Pyle I;�loser Address: 6800 France Avenue Soufh #160 Edina, A9N 55435 Closer Phone: 952-928-5765 Closer Fax: 952-928-5160 '' ;Closer e-mail: dorispyle�edinarealty.com i;�,;are the 8uyer(s) in this transaction, you will be receiving your original �rded deed when the policy is issued. � f , t -- `� � � ,�_ � __ �� w . , , zo ° _ . � � � M--_� ,_ _ , � i. � �� /�V V � �wa r� wiwwor � �w�rw, �.�e � � .. � � � �'a ►`�:, r�:, � � '� � � �� V'1 � � P�,1 :� � � � Q% � � � . 1� � ,f � � �� ' . � �� v . -- �U � °� � � �`�. � : �/'� �„�� j � � � � ��n VJ � � , � �� f � ��? � �• � .:: � .,,,r� � �� V � � , 11 V � � � V V 4, ..,,y', �: i;' � {I C � � , � � � , .' �� ' ti � � ._ :; , � _ - � �� R ' . r `� �• � �' ? � � - -- � � � � � 1 � , � � � , �` , , , . , _ � � � 4 �-- �-� --- _ .:,� �� i� �!�1�1��€1�`-��I�� I� Building Inspections 763-572-3604 763-502�4977 FAX DATE cT/ cX./ /71 � ��_� SITE ADDRESS _ THIS APPLICANT 1S: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND CERTIFICATE OF INSURANCE PERMIT TYPE TYPE OF WORK: � OWNER PLUMBING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR ❑CONTRACTOR PHONE: Ct7l,� — ,�� ' . � � � STATE LICENSE # STATE BOND # _ ADDRESS: PHONE �l SINGLE FAMILY ❑ NEW OF WORK ❑ TWO FAMILY � REPLACEMENT Permit Received By: i ,►��- �,� CITY�/2 G/ (��STA EXP DATE EXP DATE FAX ❑ TOWNHOUSE �� ATE ZIP, PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, instatlation 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 = plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOV�. MINIMUM FEL $15.50. BATH SINK/LAV _FLOOR DRAINS SHOWER _ WATER PIPING BATHTUB GAS PIPING (NEED CITY LIC) SWIMMMG POOL _ WATER SOFTNER ($35) CLOTHES WASHER � KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($IS) � DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER _ OTHER Permit Fee TOTAL DUE $1 _ . _.,. $ Number of fixtures @ $10.00 x $10.00 = $ .50 Number of f xtures @$15.00 x$15.00 =$ $ OR Number of fixtures @$35.00 x$35.00 =$ Sta.te Suxcharge = $ ` o .50 (MINIMUM $15.50) Tota1= $ Z TH1S 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 will be in confotmance 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 case of a�o�� requires review and approval of plans. SIGNATURE OF APPLICANT APPROVED BY NAME DATE 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 763-502-4977 FAX DATE °� � � O SITE ADDRESS _ TFIIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR NOTE: SEPARATE CITY LICENSES ARE REQUIRED FOR GAS AND HVAC. SUBMIT COPY OF BOND AND MSURANCE PERMIT TYPE TYPE OF WORK: DETAILED MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 1-1-08 YOUR E-MAIL ADDRESS 'd�OWNER OCONTRACTOR NAME:_��5� G�.� a,no�ss: [�3 � PHONE: �%�,�' �i-'rj ' �I COMPANY NAME: _ CONTACT PERSON: STATE LICENSE #_ EXP DATE ADDRESS: CITY PHONE F� � SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE ❑ NEW ❑ REPLACEMENT �.ALTERATION/REMODEL ON OF W ORK �? <F L i^ /'% l;Ll �� f°�-o�CiL ,�I �'_ • - . 6��C!_ �i� , � �-- -�: - / r '` � � ' 1I � ��= I'�: � � ;ATE M�ZIP SS �� ATE ZIP PER M3 16�.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installarion or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) OR Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUIVIBER OF EACH BELOV►� Equipment Installed MFG: MODEL: S��T� MFG: MODEL: SIZEBTU MFG: MODEL: SIZEBTU _A/C $25.00 _FIREPLACE (GAS) $15.00 �,GAS RANGE/OVEN $10.00 AIIt TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOILER $35.00 FURNACE $35.00 GAS UNIT HTR $10.00 _CHIMNEY LIWER $10.00 �GAS DRYER $1.0.00 _POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 _VENTILATOR $15.00 �...� ,_ .<,.� m,.�.�. _ ....... ..........._..,.__.,__., __._. _. Permit Fee $ Number of fixtures @$10.00 x$10.00 =$ Surcharge $ .50 Number of fixtures @$ I 5.00 x$ I 5.00 =$ TOTAL DUE $ OR Number of fixtures @$25.00 x$25.00 =$ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $' .50 MINIMUM 515.50 MINIMUM $15.50 Total = $;� THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED 1 hereby apply for a mechanical permit and I acknowledge that the information•above is complete and accurate; that the work will be in confortnance with the ordinances and codes of the City of Fridley and with the Minnesota Conswction Codes; that I understand this is not a permit but only an application for a permit and work is not to start witt►out a permit; th e work will be in accordance°wi appr d plan in the cas f-a�l work which requires review and approval of plans. SIGNATURE OF APPL ANT �A PRINT NAME DATE APPROVED BY � DA � City of Fridley 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 PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-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 Chapter 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 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations. Buildi�.g � - Inspections 763-572-3604 763-502-4977 FAX srrE nnnxESS �vJ THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONT1tACTOR SLJBNIIT A COPY OF YOUR STATE LICENSE PROPERTY TYPE ■ � � ;�� PHONB STATE: BUILDING RESIDENTIAL A,PPLICATION CITY OF FRIDLEY � YOUR % O TWO FAMII.Y/NEW �NSTRUCITON PERNIIT TYPE ❑ ADDTITON ❑ �pgpG � SASE�VT 1�ATISH O ROOF 0 DF,CIC O SIDINQ � O SWIl�IM TYPE OF �VORK: I DESCli�E WORK BEII�T(i ROOFING � NUMBER OF SQUARi;S � GARAGES PROPOSffi SIZE: PROPOSED HEIQTiT: SIDING O V'myl o a,�;p�, o au� O NEW HOME CONSTRUCTION wnvnows 1N EXI$TIIJ(i OPENIN(�S OYea ONo OR FOR NEW OPENIl�TC9S-DESCRIDE SI�E OF OPFd�i]NO CH�W(3ES bt TYPE OF. WIIV�W TO BE INSTALLED ALL FEE3 ARE B�iSED ON TOTAL JOB VALUATION S ln ."L o Permit Fee Plan Review Fire Surcharge Surcharge License S�ucharge SAC Charge Gi�rb Art �Escrow Erosion Control Park Fee Sewe� Main Charge FAX 0 DRAIAT TII,$ ❑ OTFIER O ADDTITON � REMODELII�Ta �,� � HOUSE ONLY O HOUSE 8c (�ARAaE ❑ ATTACi�D (3ARAC�E � DETACFffiD (iARACiE �SOffn ' o � I _ 5 SL. ,�� l - 3.Q�� 5L .G-^",' h"`�� IACA� OF Wl'(�1DOVy5 � � ��U � l�.eitA iucv, uvw..UDING T� COST O� THE 1997 UBC FEE 3CHEDULE) � � �a Permit No.:'L�� Received By: � Da� �� MAR ;2, BASEIVffi�P�' �EMOD i►VQ SI7BNAT• T. Exiadag FI'oor Plan 2. Proposed floor plan 3. List of struadaal a�nbers w 6a used FORNEW CONSTRUCITON INCLUDINC� DECKS, ,ADDITIONS 8t PORCHBS MIT 1. Site PledSiuva}r ahowmg the existmg etrucpaes andpropoaedproject, 2. Two seta of oonshu�l3on plaas 3. ��aT�-ons — - - 5ee Back Page for F�e Schedule 65% of Bwlding Permit Fee .001 time� the total job valuation .0005 x Permit Valuatioa � $SO . �$5.00 (5'tate Licensed Residential Conlractore) $1825 per SAC Umt (Plans to MWCC for determination) ft+6ft= �ftx$21=$ $450 Conservation Plan Review Fee Deter�ned by Engin�ing � Agreement nece,ssary ( ) Non Ne�ry ( ) � �iake cLecks psqable to: City of I�ldley • Attach THIS LS AN APPLI�ATION FOR A PERNII�' NOT VALID UNTII, PROCBSSED I herebY BPPiY for a bw'ld'mg pamit ead I aclmopvledge that the on above ie complebe aad aca�uat� that the work wID be ia coaformance with tha ordfria� and codes of the City of Fridiey and with the m Conshucdon Codes that I imdeiamad thia i� aot a peimit but oniy an lu�tion for a P m t BPP � P�t and work is not to stazt wid�out a perarit on srte; that d�e work be m wi9� � plan in tha case ofaD work which � ew aad `��' P� SIGNA P PRIIVT NAIVIE ��J I�'ti. DATFG�' !' �' 1 O � � n . 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