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AF - 45587Caty of Fridley, Mi�nn.. BUILDING PERMIT � ��:1�. �-��___ �: 8,�� x Adaress Ad�ese — ^ � �� N° '7271 LOCATION O BUILDING No. Street �.�. Part o t.—. � Lot __ Block Addition or Sub-Divisfon .!5�� s�L �r Corner Lot ._ Inaide Lot °/ S.etback ��;x-.a�-.—� Sideyard � Sewer Elevati� �.s�� etion IIevation •� % � • l � �oCs 6 oTc� i�.s rs i G � S �ilo T c DESCRIPTION OF BUILDING ��R,�-,�� ,�- ia/6/b ��: �,�J. ZT . 7A-/�,��tJ oF � �P` f ��3l�S. Front ��' Depth _�� Height .�..� Sq• Ft Cu. F't a�i�r��° Fro ..�� Depth � eight .,�� Sq. FL Cu. Ft Type of ctfon � F�� Cost � ` To be Completed In cons4deration of the fssuance to me of a permit to construct the buildiug described above, I agree to do the proposed work in accordance with the diescription above set forYh and in compliauce with all proviaiona of or8lnaaces oP the dty of Ft3dley. � �� a �.�_ In conafderal3on of the payment of a fee of �`$,��°� , Permit is hereby granted to to conatruct the building or addition as described above. This �ermit fs granted upon the egpress condition that the peison to whom ft is granted and his agents, employees and worl�en, fn all work doae iq around and upon said building, or anypart thereof, shall conform fn all respecta to the orclinances of Frldley, Minnesota regerding lacation, conatruct�on, alteration, ma3ntenaace, repair and moving of buildiuge within the dty limits and this permit may be revoked at any� �n� olatio�of a�► oP the P�vistons of said or�dinancxa /N � 1 Busldin8 Inspecta� NOTIC� TWs psneh doa ao� eerer �hs comtrncH�, teafalldtee tsr vrieleg, plombte9, 6a haNeg, sswer er wafer. B� suro to sas �6a Boildiee le�ter tor a�rw p�r+n6s for th�a Itf�. L �� _ , _ �'�''I : �` , i,�1 0 � 'J' � � � � L OWNER'S NAME . . - ".;4« .. . . - _ � e APPLICATION FOR BUILDING F�P.�IIT CI7.`Y OF FRIDLEY, MINNESOTA �.r..��: LOCATIOPi OF BUILDING No. �� Street � ' �are of Lot Lot �a Block Addition or Subdivision �� Corner Lot Inside Lot Setback Side Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant atCach to Chia £orm Two Certificates of .Survey of Lot and,proposed hu�ld- ing Zocation drawa on these Ceatificates. To be used as: DESCRIPTIOIV OF BUILDING Front �: �<�h Height Sq. Ft. Cu. Ft. Front �Grth Height Sq. Ft. Cu. Ft. Type of ConsCructian Esti�ated.Cost. � To be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and ruliags of the Department of Buildings, and.hereby declares that all the facts.and representations stated in this application are true and correct. DATE �G / � � SIGNATUR� . „ �(Schedule of Fee Costs can be found on the Reverse Side). r . T—' � r ` �. . - � � , r � _ � � R' _ � � a BUILDING PE3tl�T FEE SC;iEDULE Section 2. The Insp�ctor of Buildinge shall, before is�ui�g ataq pera�it for the erectioa of any,building or structure, or for any addition to any ��ist- iag building or structure, or for any alterations or repa3rs to any esiatcZng building or seructure, upon application therefor, requ3re the payaent by the applicant for auch permit of fees to the amount hereia below aet forth aud ia the manner herein provided to-wit: � 2.1. For any such permie for �he erection o,i any fire-proof building, other than a garages warehouse, factorq or grain elevator, or for the-erection of aay fire-proof addition, for similar occupancy, to any exieting buildi�g ehall be at the rate of $1.40 for eac�i one thousand cubic feet, os fracCis�a thereof� in.such cubical contents. ,,:� -.-- 2.2. l�or`any auch permit for the erect3on of an� fire-proof garage, warehouse.,� factory or grain elevator, or for tha e*ection of aay ffre-proof edditio�, for s3mi2ar occupancq, to any eaiat�.ng�bu�ildiffig shall be at the'raCe of $1.25 for each one thousand cubic feet, claasified as 11fireproc�f" by 3ection SC2 of the Minneapolis Buildiag Code. flOUSES 2.3. For any auch permiC for� the erection of any noa-fireproof bu3.ldir. ; o4:Y!e� than a�arage, warehouse, factorq or graia elevator, or any noa-fireg,c«� additi.on, for similar occupancy, to eay euistiag 'huilding - pernmit $�..�0 £or each one thousend cubic feet. i 2�4,_, For aay such permult for the �erers:�n� ^t �.;:�� n�n-�i:.?��c�+¢ gara�e, warehouse, factory or grain elevator, �a� r�,;� �,�3�; �-.E:::�,o,c�, �� 2�y �on�=�?regre�' addit3,on, �€or -s�.milar occupancy, to r-;�; ,�z�•�.�: _::r_�, ��;�:.3.��0 or for each acch �. � bulldiag or additioa - niaety a��a �^ �,� ;; , rl;� � b�c ec.n: :� c�ne thousand eu��? � feeC or fraction thereof, in the cu� �c��:� �:;3 sc r.r. �. ti;e� no:� with a minimum of $4.OU. � Fos the purpose of comput3�ng fees f�;r ��:' ::xi�+g per�;,:� N8, the cubical coutents of any buildiag or addition Co a uu�fes.a c�e��i:t tiirau�hout by multiplying the ground area covered from a point s3g (6) 3nches be?.:�w the floor liae of:ihe basement or cellar to the average height of �� ,��rer su�iace or to the average haight of th2 roof surface of the maia �;able of a p3tched roof. 2.5. l�or repairs or alteratioas to au existing atructure, the fee ahall be at the rate of $3.00 per each Five Hundr•ed Dollass ($SOO.QO) or fract�.oa thereof in the coat of ail proposed work. 2= In no caee shall the fee._charged._fer.any permit ag set forth 3n .Sectioa 2 be lesa. than $4.00. � s t. � � ., �1 -,-.� • - .� >, _� . .. . . - . . a,� et . � . . 1:.��. .-'� 4 'g�, �: i :y . . . . . 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City of Fridley ��16 3 3 5 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � � ; � REC . � ; y _ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. � 9 71 � i � � �"'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV �'"'"'� � `�� 612-571-3450 910-F15 � � 8/10/81 JOB ADDRESS '7481 Hayes Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 1 Gunderson Terrace SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Paul Schmi.dt 7481 Ha.yes Street N.E. 3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO. Pearson Masonry 741 Kennaston Drive N.E. 571-7224 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING ReBlCl@1Tt].BL�. 7 CLASS OF WORK ❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install a ma.snnry fireplace 8 CHANGEOFUSEFROM TO STI PU LATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR 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 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2/ 54O $�'• 25 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISION ANY OTHER ATE OR LOCAL LAW REGULATING CON- STRUCTION�THE PERFO M CE OF CONSTRUCTION. $3S. SO � � PLAN CHECK FEE TOTAL FEE �,' G�� ^ , _.�'''��'��- � � /C� � $39. 75 SIGNATUREOFCONTRACTORORAUTHORI2EDAGENT �DA7Ei � WHEN PROPERL�VALIDATED THIS IS YOUR PERMIT d ��'�� ev� ' SIGNATUREOFOWNERUFOWNERBUILDER� IDATEI - � s' BLDG WSP ATE CITY OF FRIDLCY Effective Aug. 1, 19s1 APPLIC/I7I�"� FOft RCSIDEi�TIIIL QUILDIt1G PEIL'�iT7S (tJe►•r, Alter.�tions, AddiLions, or Repairs) OtJIJER: �/� �1 L� C!°��//J i ADDP.ESS : � � � / � �� TEL n10: [3UILDER: ��i9-� J v �� Yl fti`; c�1P�� AUDRCSS: � �� — � � ^ - . S 1 �`� �/�' TEL f�d0: �7 I — 7.2 � "( Consi:ruction Location STItI�T NO: �� I STI2EET: 0�� li� �� ---�-- -- . LOT: � BLOQC: � ADAITION :� k N i� L yt Sc!-'� 1�� c 1'� C� Corner Lot: Insiiie Lot: � SetbacY.: Sideyards: Ap�licant attach to tl�.is foxm two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTIOfd OF COFlSTRUCTIOPJ � � lr�� / � � s��i�d� (_ �- Front: Depth: Height: Squane. �'eets (xibic Fcet: Front: Depth: Height: Square- FePt: Cubic Feet: r�..p'�L (_ ,'L-� d • eJ �_i Type of Construction : �`� � �� - Estimated Cost: $ � � UJ -- Rb Be Oor.�pleted: �S'� �� Alt. A Alt. B Proposed Drivet�ay Width If New Opening Is Desired: $� $ SE� R�VERSE SIDE OF SHEET 75ie undexsigned hereby ma}:e� application for a permit for the tvrk� hexein specified, agreeing to do ,all work in strict accordance F�ith the City of I'ridley Ordinances �azd ruling� of tlle De�zri�nent of Buildings, and hereby declares that all the facts and rapresentations stated 3n this application ,�e tru�d correet. D.7TE: �' _� C� _ �-+0 SIGNATUI'�: �,�� G'�1. �.�i,.n�_ Stipulations: � ��: . `_ <� � p L � 9✓ >: _-,--�i �,,`_'. � 4.,� ' ��" �� .� s - ` � SUBJECT City of Fridley � 17113 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T i � ' � ECEIPT N � d�: ------� COMMUNITY DEVELOPMENT DIV. � � r j � PROTECTIVE INSPECTION SEC. � ; i (-__- A ��,,� CITY HALL FRIDLEV SS432 NUMBER REV. DATE PAGE OF APPROVED BY z � � 612-571-3450 910-F15 $ � � JOBADDRESS Paul & Janice Schmidt 7481 Hayes Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. .L rL � SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Paul & Janice Schmidt 7481 Hayes 5treet N.E. 786-3192 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO. 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING residential 7 CLASS OF WORK � � NEW ❑ ADDITION � ALTERATION �] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK re- roof 9 CHANGE QF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. aS ha�.t THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S�. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WII.L BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 5rJO.00 .�jO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �'rJ.00 PLAN CHECKFEE TOTALFEE 15.50 SIGNAT RE OF CONTR CTOR OR AUTHO IZED AGENT �DnTE� EN PROP LY A ATED THIS IS YOUR P RMf�T� F'�'L� O � ! �NATUREOFOWNERtlFOWNERBUILDER� DATEI BLDG I•� �TE� 0 CITY Of FRIDLCY Eiiective �►ug. 1, 1ge1 APP1IC11Tl�1 FOt� RESIDCNTI/IL BUILOli1G PLRi�fITS (NN,r. A1 terations. Addi tions. or Repa irs � Owr�FR: l �.�, / °� �� G�� ` �� ADDP.ESS: , 7 ��/ {�,Y�' �a� �� . TEL M0: ' 7�'� � � � i � ' BUI LDER: �a � '� . ADDRLSS: TEL t�0: < . Construction Location • 6TRIST NO s % �f � / 6TItEET: _ ��'�f' �� IATt � BLODCt �� IDAITIONt �'d'°!��'�''SOc� ��-va�� Cornez Lot: Insiile Lot: 6etback: Sid�yazds: � J1p�licant attach to t)�is ioz� tvo Certificates of Stirvey of lat ar�d pzoposed builcling locatim arawn on certificates to scale. �ESCRIPTIOtt OF COt•iSTP.UCT10ri �i_�o�-� Frcnt: Deptha Heiqht: Square Fcset: Qibic Fcet: . Front: Depth: Height: Square Fe�t: Qsbic Feets 7ype oi Gbrstzuction: �!n �- � 7° Estfa�ated Cost: 5 S-SO ' Rb 8e O�r.�plcted: �C� �aLy�� ; 711t. A 7►1 t. 8 Pzop�sed Drivc�+ay kidth Ii Ne� Opening Is Desfred: t' S,__ � , . 6EL RiVER;E SIDE OF SHF�T � si�e undessigned hereby a�a1;e� applic�tion for a per�nit icr tbe ��Ark hezein specified, agreeing to do ,all vezk ft, 6trict accozd�ce NiLh the City of Fridley Ozdinances e»d rulin9s of the Dcl�►�:tment of Duildings, and hereby declares that all t]�e fect� and sepres�t�tiens stated f,r� this application are true and corzect. D�1TEs �l 'f /�`l � 6IGNATOAE: �� 6tiiwlations: � �� . �� I � . �°� _l� � BUILDZNG pERMIT FEE SCHEDULE The Inspectoz o! buildinqc shall, befote issuing permits fos the •r�ction oi any building oz structure, os ior any addition to any •xistiAg buildinq or stzueture, os tor any alteration os sepairs to any •:istinq �uilainq oz strucluze. npon application thezefoze, r�quize the pay�ent �y the applieant f oz such permit ot ises to the aaour�t b�zein belov set iozth •nd in the sanner hezein psovided to-vit: '1'0�!'112. V71LL1A?IQ�1 :i. oo e� tsoo. o0 :SO1 m =2,000 52�001 m �25,000 :25,OC1 to 550,000 li�5 i30.00 �linim� Fee 515.00 plus surcharqe =10.00 ioz the first 5500 plus S1.50 foz each additional 5100 oz fracticn thezeof, to and ir�cludirg S2,OOC �32.S0 tor the fiz�t 52•000 plus 56.0� for each additional S1�000 or tzaction thrseof, to and including 525.000 5170.50 foz the first 525,000 plus 54.50 foz each additional 51,000 oz fz�ction thezeof, to ana �n�ivainQ sso,000 550, 0�1 tc 5100,000 �283.00 tor t?�e f3zst 550, 000 plus S3. DO for each additicnal 51,000 or fzacticn thezeof, to and includir�g 5100, 000 s100,001 ard up 6043.00 foz the fizst 5100, 000 plus S2. S� foz each additional 51,000 oz iraction thezeof pI.�W C7�OC: 25 percent of building permit fce DRIVii�tAY DEPRESSION ESatOW; Gonczete Q�rb 5treets �ly 111teznate `1►": Re�ov�al and replace�oent of cvzb and gutter only Drive�+ay vidth plus 6 feet s 513.50 111terr�ate '8's Reooval ar�d zepleeelo�t of a.vtb ar,d guttez and install a 3 foot wide appzosch with 6 fnch depth Driveway vidth plus 6 t eet � 515. �S VERIFICATION OF FOUNDATION Pe�its for construction vill De issuee a mfni�n�n of 24 houzs fzoro the time of application to allow for proper zeview of the propose8 structuze and of the constn�ction site. 71 Cert3ficate of �n►ey of the lot, �howing the location of the foundation once it has been oonstsucted vill be required before proceeaing with the fza�ni.r�g. �a�r 0 � � � � �.� � � � � m cn � � � �' � �� 4 " o n�'� � � � � � �. 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W � 1 �+� 'c C � O =. � � m � W b a � � � m �,,� � : � � � � � m O � � � � c� SUBJECT P � , City of Fridley 2 7�7 9 0 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � i � NO. � `y __�___ COMMUNITY DEVELOPMENT DIV. �� r � � PROTECTIVE INSPECTION SEC. 1 i � � /"��1 � CITY HALL FRIDLE� SS43Y NUMBER NEV OATE / PAGE OF AVPqOVED BY �----� � �'� 612-571-3460 9t0-F15 9 15/98 � � JOB ADDRESS 7481 Hayes St NE 1 LEGAL LOT NO. BLOCK TRACT gR AODITION SEE ATTACNED DESCFi. 2 2 Gunderson Terrace SNEET 2 PROPERTYOWNER MAILADDRESS ZIP PFIONE Paul Schmidt 786-3192 3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO. Maverick Construction 11227 River Rd NE Hanover 498-7401 5572 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS 21P PHONE LICENSE NO. 8 USE OF BUILDING sidential 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION � REPAIR O MOVE O REMOVE 8 DESCRIBE WOFK Reroof house & garage (25SQ) Tear-off 9 CHANOE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PIUMBING, NEATING, TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV IOAD VENTILATING OR AIF CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF /20 OAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES ANO KNOW THE SAME TO BE TqUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �Z�I�FL.00 �1.OJ WITH WHETHER SPECIFIED HEFEIN OF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEHM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- ][F.7S Fire SC �Z.I.�F STRUCTION OR THE PEFiFORMANCE OF CONSTRUCTION. � PLAN CHECKFEE TOTA EE ��'�J��/� �� Licens C $5. $82.96 Si ATUR OF CON'RACTOa OR AUTMOaiZED nGENT I TE1 EN ROP V IOA THIS IS UR P R IT � � � � S�GNATUREOFOWNEFl�IFOWNERBUIl0ER1 IDA7E1 B iNSP f�qTE NEw ADDN ALTER [] [] [l ConstructionAddress : Legal Description: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION l Effective 1/1/98 �� 1 � Owner Name & Address: �� '�`J7/ � � Tel. # %�� —�� 9a2. Contractor: �� MN LICENSE # ��702 Address:_ f,1��`7 �—�- ��1� ,�� /�l� ��t,��Tel. # ��— 2�� 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. Length Length Length DESCRIPTION OF IlVIPROVEMENT Width Width Width Height Height Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. � ��'�' �-ic/� �� 1 � �` � Construction Type: �2��' Fstimated Cost: $ � � , ��' (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: .� APPLICANT: Tel. # ��'�—��D% Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ � ` $ $ �� $ $ �� $ $ $ $ $ ,�C CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1�0 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 [ ] p BUII.DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing germits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $5�,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $1Q0,000 plus $5.00 for each additional $1, OQO or fraction thereof, to and including $500, 000 $2887.25 for the first $500,000 plus $4.25 for each additional $1, 000 or fraction thereof, to and including $1, (�0, 000 � $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be 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. � , . .� * � D �: � 7 p a � m a- �s :_r �' 7 N � N. 's O N � � � � o � � � � O N ''~ a� `o_ � � _' fl/ 00 (np � .Q � O � N � � N �- `� m � � � � � o � Q � . o � �� ;�1 � � rt � ,� ?� � �� Sc,�� Cl � �.dJ\�� (e � 1� � r r O D C -� � � 0 � �- � � � O c Ov � 7 0 m m � � � v � � �. �1 � m z � � m n � O Z �'I m m � -P v O 0 � _ � Cn 2 c�o -Di a Z � n A O v -i m � � � � \ � � 11 .,� � r p �� e� -. °, e''. N \ m n. C o � -o ci "� — 01� � m 0 O � � ''~ � D m r -n c rn � rn � � � m � � � � o � -i y � � = m ? n � m� cp�� ,.�+ ° �- m d '"f' 6/ N O fD � � N �D �. cD y � a '-�. ' oa s m � � � a � n. 6 � p o � � � � � N� � � � � o N �� ' Q. � '� °: � � eAi. � � �, =� � � � � � � � � ��ad � � d �� y (�p � a3� � � � � o •+30 `1 � p} � ,� � f�D ? N i7 � N �G O � w o � � Q � cD � � 1 � � � _ _. D 1-+ � � Q °, s < fD N y \ m � � -�i. � �� a v_ �� 7 � c� ° o� g� N � r � � 0 Z W D C7 � � � N � v 0 a � � .ti: � � 0 � j rt � � � D � �' cn �� v v�i �� m � S � rn v � � \ � � D � N N .� ��N � v�� d r.��S � m,��.�°' � T � Q —�v c � � � rt C p� A �; � � o �� = v � �i � �� _cnD� I � � �/ t� � c�'n o 0 0 0 � °o °o °o °o °o � fD � � � � � � -� 0 � C � � m � --� a� Q m Z � � � . . N m z 0 m' v � �W—IZ �—�do — C a ' � o z= � � � °� fD j � N 2 � _° c) a� � i� � o p � � � � m � � fl- fn N .� r N � mz� a �o,� 2 0 � � rh tD v � d 3 D v � � m N � 2 m v C r m � W O � C � � � Z D D z � � p � � m � m F N I� � � � � \ �' V 5 � � � � 6 � '0 m � � z O V'-=1J e� � �l � �� Cn �l 01 C7 V "'. .p — ivaw� F-+ � � � O � z `m � �� m w < � N cu Z z� m� m � O z � � � � z � r �� O L� Z m� a° �� Z o Z� v Da �z ON vz .� v O= Z � Z -Di � Z �n � m O N Z Z� vm vZ < � n � yO z � m .n+ m O � � � r O f-+ � � � CHIlVINEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. 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 ( ) sue�etr PE OO-°"-�. City of Fridley 31 15 0 AT THE TOP OF TME TWINS � � I L D I N G P E R M I T � � � COMMUNITY DEVELOPMENT DIV. F1ECE� N� f � L � PROTEC7IVE INSPECTION SEC. � '�/ � � � _ � � /'�"1 � CITY MALL FRIOLE� SS1$$ NUM¢EN NEV OATE PAGE .OF APPROVED BY �"'"�" ,'' 612-571-3460 gt0-Ft5 7/10/00 / / lOB ADORESS �481 Ha es St. NE t LEGAI �OT NO. BLOCK TRACT OR AODITION SEE ATTACHED DESCii. 2 2 Gunderson Terrace SFIEET 2 PROPEiiTY OWNER MAIL ADORES$ ZIP PHONE Paul Schmidt 7481 Ha es St. NE 3 CONTRACTOR MAIL ADDRESS ZIP PNONE LICENSE NO Lambert Construction 12741 Jefferson St. NE Blaine MN 55434 754-5648 2006196 a ARCHITECT OR OESIGNER MAIL ADORESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PNONE LICENSE NO 8 USE OF BUILOING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION $1 ALTERATION ❑ REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Add basement bath, alter 1st floor bathrooms 9 CHANCiE OF USE FROM TO STIPULATIONS ' For stipulations, see attached plans. � �? �r��. p�RMIY� ��Q�1�� FO�: ��a'1�6r3�, @��p►TING ��.��e�G ��9� SAGw '' -" • SEPARATE PERMI7S AqE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATINa, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAO VENTILA7ING OR AIR CONDITIONING. THIS PERMIT BECOMES NUIL ANO VOID IF WORK OR CONSTRUCTION 20NING SO. FT CU fT. AUTHORI2E� IS N07 COMMENCED V�IITMIN 80 OAVS, OR IF CONSTIiUCTION OR WORK IS SUSPENOED OR ABANDONEO FOii A PER100 OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OffSTREET PARKING I HEfiEBY CERTIFV 7MAT I HAVE READ AND �XAMINEO THIS APPLICATION 1 • S7ALLS GAFiAGES ANO KNOW THE SAME TO 8E TRUE ANO CORRECT. ALL PROVISIONS Of LAWS yALUATION SURTAX AND OROINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED � WITM WHETMER SPECIFIEO MEREIN Oti NOT. THE GRANTING OF A PERMIT �9�000.00 �4.SO DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL TME pERMIT FEE SAC CNARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGU�ATING CON- TRU TION OR TNE PERFORMANCE OF CONSTRUCTION .�].()%.ZS Fire SC ��I.00 PLAN CMECK F TOTA EE ?� �° '�° Lice e 5. 0 185 . 75 S�GNATUpE 0� CON • ACTOA OA AUTMOp�2ED OCENT IOAfEi HEN PROP V ALIDAT D MIS IS VO R PE T� _ ,� r S�GN4TUAE 0� OWNEA ��F OWNEA BU40EN� �DAI�i _ — - , s BL �NSP ' q6}E NEW ADDN ALTER Il Il Il Construction Address: : y �!! CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMITAPPLICATION � Effective 1 (763) 572-36 dg Insp � (�,� � \ ,��- � Legal Description: � �� ,� �j ��c ►� � G uao p e a So.V %�r�¢ C� Owner Name � Address: ��Iv C .Sc � �°h, �� Tel. # Contractor: �d✓�'l�P� 7 Cd�v 5'� MN LICENSE # 2 d��v �� d� Address: /2 % �// `��C �� Su n� ,P'� ��°. ��y�� Tel. # 7 S�/ � S6 �l � ,_ =�„�—a— Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length � Width � Height '� Sq. Ft �- �� GARAGE AREA: Length Width Height Sq. Ft � DECK AREA: OTHER: Width HgUGround Sq. Ft /� � �-?-�`� �-L i�.2 %'e` _ �-�ao2 �7��2�ryiS Construction Type: � tL ,�v� .�i �tr' � A tL Estimated Cost: $ 9, � ° � • , Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: 7- 6' do APPLICANT: �� `�� Tel. #�S y-S� y 8 d� — CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Call (763) 572-3604 for Permit Fees if mailing in application $ lG?..?✓r Fee Schedule on Reverse Side $ '�7_'dG .001 of Permit Valuation (1/10th%) $ .�d $.50/$1,000 Valuation $ �� $1100 per SAC Unit $�..GU $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [] Not Necessary [] TOTAL STIPULATIONS: � . � 0 BUII.DING PERNII1j 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 $2,000 $2,001 to $25,000 $25,001 to $50,� $50,001 to $100,0{� $1�,�1 to $5�,00() $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 $1Q0 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,IX}0 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fracrion 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 $S�,Q00 plus $4.75 for each additional $1,000 or &action thereof, to and including $1,000, 000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1, Ot� or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) . Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15 .50. Alterna.te "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 $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of S�rvey of the lot, showing the location of the foundation once it has it has been cons�°�acted vvill be required. before proceeding with the framing. New Houses Onlv �.e�w� ��,� ��g�. � ��'1�•! i a .-�}, .�{�. q,� � ' 1 �� - • a Yy i'., f a r � M?.�,:,�- r� �,1a.��,�� [� � � 1 a\ `a�: a 6.� dj y ;.,�. �rrS�'vrr�*-jt�"". � . - , "'��..�`a Y`t.r,��'� ��.:� 9'.�.,;r��r`� �,yti�j.y,y�`�?�..` �.., 'a;y",a 'i3,.i�i� , 'a�; 6t„? 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' �:.jr � '�Jl ' , 4 � '° . _ !Y:,: �. �F� �. . ... .s.,. sue�eCr PERMIT NO. City of Fridley 312 4 4 � AT THE TOP OF THE TWINS � � I L D I N G P E R M I T � � RECEIPT NO. � `L __�� COMMUNITY DEVELOPMENT DIY. ��/� A r � � PROTECTIVE INSPECTION SEC. �/ �=j�, � � , ' � r"'1 � CITY HALL FRIOLEr SS:�i NUA198p REV DATE PAGE Of AOPROVEO BY ti.__.Jl.� '•� 612-571-3460 s�aF�s ��25�0 / / 10B ADDRESS 7481 Hayes ST NE t LEGAL �OT NO. BLOCK TiiACT OR ADDITION SEE ATTACMED DESCR. 2 2 Gunderson Terrace SNEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PNONE Paul Schmidt 7481 Hayes St NE 784-3192 3 CONTRACTOq MAII ADORESS ZIP PMONE LICENSE NO La.mbert Const. 12741 Jefferson St. NE Blaine, NIl�I 55434 754-5648 2006I962 a AqCF11TECT OR DESIGNE1i MAII ADORESS ZIP PMONE LICENSE NO. 5 ENGINEER MAIL ADOFiESS ZIP PHONE LICENSE NO 8 USE Of BUILOING � Residential 7 CLASS OF WORK O NEW O ADDITION �1 ALTERATION ❑ FIEPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Construct 12' x 16' Deck 9 CHAN(iE Of USE FROM TO STIPULATIONS For stipulations, see attached plan ' SEPARATE PERiN�S �efore digging call fo� REQUIRED FOR: �� tY location� w�Rir�c ��►nN� 4540002 �LUM�9N� AND SI6�� Q�$IR�� Y LI�vV SEPAqATE PERMITS ARE RE�UIREO fOR EIECTRICAL. PLUMBING. HEATING, TYPE OF CONST_ OCCUPANCY GROUP OCCUPANCV LOAD VENTILA7ING OR AIR CONOITIONING. THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION 20NING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED V�1tTHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENOED OR ABANDONEO fOR A PERIOD Of 120 DAVS AT ANY TIME AFTER WORK IS COMMENCEO. NO. DWLG. UNI7S OFFSTREET PARKtNG I HEREBY CERTIFV TMAT I HAVE READ AND E7fAMINED THIS APPLICA710N ], STA��S GARAGES AND KNOW THE SAME TO BE TiiUE AND CORRECT. ALL PROVISIONS Of LAWS yqLUATION SURTAX AND OFOINANCES GOVERNING THIS TYPE OF WORK WILL BE COMP�IED WITH WHETNER SPECIFIED HEREIN OR NOT. TME GRANTING OP A PERMIT �1�HU4.00 � .�.90 DOES NOT PRESUME TO GIVE AUTHORI7Y TO VIOLATE Ofi CANCEL TM& pEFMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER S7ATE OR LOCAI LAW REGUTATING CON- R TION OR THE PERFOfiMANCE OF CONSTRUCTION .�6C) • ZO Fire SC ��. • HO PLAN CFIECK E TOTAL F � � �'��1``�� Lice C $5.00 $7 90 - S�GN4TUAEO�CONCRACTOpOAAUTMOA�2ED4GENT �D�iE� �pqOP V ALIpAT � I$ 1$ V��R�� S�GNATUAE O� OWNEp��f pWNEA BU40@R� IOI�TEi _ � INSP ' ryp�t NEVV [ ] ADDN Il ��R Il CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/2000 (763) 572-3604 Bldg Insp �� ` ,� ��. �/y Construction Address: _ 7 ��i �f4r�s �if Legal Description: Lof � J3CX 2 ��v�bc�s0� Ttl�2�`� Owner Name � Address: /°9 �z Sc �m�e ¢ Tel. # 7� y- 3 i�' Z Contractor. L�r�i3e.� 7 �v�.S� MN LICENSE # Z�n �i �d 2 Address: / z � y� ?��.es�,� � �y� ,8�,�„r�� Tel. # 7s S�- S�y� LMNG 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. Ft Length Width Hgt/Ground Sq. Ft %�� L %�� Construction Type: Estimated Cost: $ �U � �� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _� DATE: 7� Z y-u� APPLICANT: s��I �� 4�,,�.a�— Tel. # 7sy-s�y� CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ >�.o�(J Fee Schedule on Reverse Side Fire Surcharge $ /-° O .001 of Permit Valuation (1/10th%) State Surcharge $ �(� $.50/$1,000 Valuation SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ $1100 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 [ ] $_�� . BUIIrDING 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 tawit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $1�,000 $100,001 to $SQ0,0(}0 $500,001 to $1,000,000 $1,000,001 and up FEF..S $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,(m0 $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,Q00 or fraction thereof, to and including $1,(}00,000 $5,608.75 for the first $1,0(}0,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb 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 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of applica.tion to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. New Houses Onlv Lond Plannin9 Lcv,d Swweyii� Soils Testin9 C7►nl b Municip�v! En9irreerin9 / / �7'S-N�hn�y �S NE. Minnieu�o/s32, EN G I NEE R I N G, I N C. Mmraesofa � SUnsef4•60i� En�ineers � � Sur vecJo�s � certi�s-cate o� su,tve ��: � , �. � U��I�C� �ol�.) � t-! 1_ . � •. ��,,� : .'t �y�., � �� V, V' � / � � /,o,, ._ � 1 =t• � 3; , �1. ar' �� J - ,u-1 � _ ' �.95 ` �� .� � . ` ::: ,� � � i; , ` . , ' , ' . �D : `', � . � �.� �ti _�p�,5_ � � ;,�� {�� 1�' ( �' � .�y _ I -� � �� .�, . T � � ' t� ' 1 ,�o�' 1 � —�, i �� • , �oi 2,13�-0 �K �., �, u�aC.C� Sa� 'TCI�C� �,�E //,�eby certi�y lhoi fhis �s o Irue av�d cor�cf �epr�senfofian o�'a survet1 qi'llnt f�,rndories �i'�e aba►r �esuy6�d /an�,m�d �1i�r %' gl'a// br�ildar9s, �ream , andd/ risib/e ara»v�fimtnfs ,��'o,x�, �vii or ar�soid /ond. As wrreyed by me lhis _ cby �` � A.� �� SUBURBAN ENG/NEE2ING , /NC. 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Owner Name 8� Address:�O�U `�CmtC� �' � Tel. #`�-l0 3• �$(o - 3 4 a- Contractor. _MN IJCENS�#�OI�JOq$3 Address: RENEWAL BY ANDERSEN Tel. #�pS �' o�{0't �� 1920 COUNTY ROAD C WEST ROSEVILLE, MN 55113 icate of Survey of the � drawn on it to scale. , DESCRIPTION OF IMPROV�MEN7 LMN� AFiEA: GARAGE AREA: DECK AREA: O71iER: Length � Wid� � Height_ Sq. Ft Leng� __ W;� __ Height__ Sq. Ft Length Width Hgt/Ground Sq. Ft 1�et1 f�ro 12r.x...�.,.. _� ..n. _ .-- f� Construction Type: Estimated Cost $ privewa Curb Cut �dth Need�d: �/ Y Ft + 6 Ft = Ft x$ _$__� 3 leR I /tc+p DATE: - I APPlICAN7': C� Tel. # `� �d • �J�'(,� • �p O�'I � Call (763) 672-3604 fer Permit Fe� if ma�Ting in application. Fax to 763-577-128T i# u�ing credit card and we w"itl call you for card number. Permit Fee Plan Review F"ire Surcharge - State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer �Main Charge TOTAL CIT1( USE ONLY - � a 3�' •�a 5 Fee Schedule on i2everse Side � 65°/a of Permit Fee $ � �• � .001 of Permit Vafuation (1/10�h%) �_ �o . Fs5' � $,50/$1,000 Valuation � � $ $1350 per SAC Unit $—�d � $5.00 (Staie Licensed Residential Confiractors) $ AI�. "A" or AI�. "B" Abov� $ $450.00 Conservation Plan Review $ Fee Determined by Engineering � Agreement Necessary [ ] Not Necessary [ ] $ �� J STIPULATIpN : Buildin MECHANICAL Permit No.: a� j��' IT1S ections C��b� Received B:. P RESIDENTIAL APPLICATION y 763-572-3604 CITY OF FRIDLE�' �� G 1 200 DATE �� 4 � 3 F o� o�$ YOUR E-MAIL ADDRESS srrE anDxESS 'ly 81 �aw�e s S� N�. � - THIS APPLICANT IS: ❑ OWNER �JCONTRACTOR PROPERTY x�: ��_� ��m �� .� oWNER/ a,DnxESS: °l�Fg l ��.�s s� N� crrY �r �� l sTa,�rnNz�� TENANT PHONE: � �o �j' "1� (e • 3 lal � CONTRACTOR co�A� NAME: CENTERPOINT ENERGY SUBMIT A COPY OF CONTACT PERSON: '7OANN 7 INREN YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH �Dx�ss: 9320 EVERGREEN BLVD STE �rrY "COON ""RAP.IDS sTA�MN zrn55433 APPLICATION PxoNE �63 — 757 -- 6202 F,� 763--757--6701 PERMIT TYPE �SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: � �W "��PLACEMENT ❑ ALTERATION/REMODEL DETAIF,ED DESC TION OF WORK �, v� 5� c�.� l � �.. ��r c1 � � tar��er PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECTS Wf�RE LABOR EXCEEDS $500, FEES ARE BASED ON $] 0.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOV� Equipment Installed MFG: C4r r��e� MODII.: �S� �1.,I� O�Q S� � Lp �p �C,�p MFG: � i� 1r MODII.: �SL10�4 SIZE/BN v� MFG: MODEL: STZF/BTU A/C $25.00 FIItEPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 _AIlt TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _BOII.ER $35.00 _FURNACE $35.00 _GAS UNTT HTR $10.00 CH�IVINEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 DUCT WORK $]0.00 GAS PIPING $10.00 VENTII,ATOR $I5.00 PERMIT FEE FROJECTS FOR UNDER $500 �` °_ - ' -: PERNIIT FEE FOR PROJECTS OVER $500 ' Permit Fee $ Number of fixtures @$10.00 x$10.00 =$ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 _� x $25.00 = $ �5.� Number of fixtures @$35.00 �_ x$35.00 =$ �3�� State Surchazge = $ .50 Tota1= $ o. SD THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acl�owledge 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 requires review and approval of plans. SIGNATURE OF APPLICANT �� ° �� N� ROGER HOFFHEIN DATE $ I 3 D� ' PLEASE NOTE: SEPARAT� PERMITS ARE RE UIRED EOR BUII,DING, ELECTRICAL AND MECHATTICAL WORK ` 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 NE�DED TO PROCESS PERMIT RESIDENTIAL PERNIIT APPLICATION HVAC 0 NEW HOMES/ADDITIONS �EXISTING HOME 0 MAKE-UP AIR REQUIItED FOR NEW/EXISTING HOME5 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 (5ee 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 REQUIItED 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. H�s� De�gn-��r � 1346:�bA�.2 - - -- - -- a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations. Building Inspections 763-572-3604 763-502-4977 FAX ° �� SITE ADDRESS [ THIS APPLICANT IS: PROPERTY OWNERJ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND CER'I'IFICATE OF INSURANCE PERMIT TYPE TYPE OF WORK: PLUMBING RESIDENTIAL APPLICATION CITY OF FRIDLEY . EF�cTtvE �-i-ZOio YOUR E-MAII. ADDRESS �� ❑ OWNER Permit Received By: Date �1�_ NAME:_ ��1�� a�. �1 �e � � ADDRESS: CITY STATE ZIP PHONE:_ �� % ^�, STATE LICENSE #_ STATE BO # ADDRES • a PHONE V � C,'�SINGLE FAMII,Y � ❑ NEW DETAILED DESCRIPTION OF WORK ❑ TWO FAMILY �REPLACEMENT FAX ❑ TOWNHOUSE EXP DATE EXP DATE �►. FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FDCTURES: (II•TDICATE TOTAL NUMBER OF EACH BELOV�. MIl�TIMUM FEE $35.50. _ BATH SINK/LAV _FLOOR DRAINS SHOWER WATER PIPING _ BATHT[7B _ GAS PIPING (NEED CTfY L1C) SWIMMING POOL WATER SOFPNER ($35) _ CLOTf�S WASHER _ KTfCHEN SIAiK WATER CLOSET BACKFLOW PREV. ($15} _ DISHWASHER _ LAUNDRY TRAY �TER HEATER ($35) FOR IRRIGATTON _ WATER METER OT'HER THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I aclmowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only a lication fo a 't an work is not to start without a ernut on site; that the work will be in accordance with the approved pl ��S I hic equires review and app o plans. � SIGNATURE OF APPLIC T Y�a.� PRINT NAME ATE APPROVAL INSPFI'_T(�RC CTC:NATf iRF City of Fridley Building Inspections Department 6431 Uruversity Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 �