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Z O H U w a � Z W � v a� > 0 a Q Q � 0 t { � � �p C � 3 � O '� � N �' m a C � :o a a� m U C Q .0 � '� ., io c � c ° U C N 0 � �N a� ,� � �E C a o c U � a 3 Z Z F- � Z OO Z a _ U � � J � J W > � � LJJ Q m _ � � � m O U 0 z w, -• NEIyV ADDN ALTER Il fl [l Construction Address: Legai Description: Owner Name & Address: Contractor: � Address: .l �,� LIVING AREA: GARAGE AREA: DECK AREA: OTHER: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Tel. # Effective 1/1/2001 (763) 572-3604 Bldg Insp � c �f `�� 1a� � � MN LICENSE # Attach to this application, a Certificate of Survey of the lot, wiih the proposed construction drawn on it to scale. Length Length Length DESCRIPTION OF IMPROVEMENT Width Width Width Height Sq. Ft. Height Sq. Ft. HgUGround Sq. Ft. Construction Type: Estimated Cost: $ Driveway Curb Cut Wdth Needed: Ft. + 6 Ft = Ft x$ �! _$ "7' ��� DATE: � �� D/ APPLICANT: � Tel. # t0�� ' �� �C�'Y�� CITY USE ONLY - Call (763) 572-3604 for Permit Fees if maiting in application Permit Fee -- $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1l10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1150 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [] Not Necessary [] TOTAL STIPULATIONS: $ Mark Conrath •' Edina, MN 55435 ' Phone: (�52) 831-4300 Faz: (952) 820-2340 :Y iAA ��:` �Y_...---.T.�tN,�� —.._�_.___`.._....._....._..........._...�_....._.�........... ---�`��-- :_ � _ ._..�. ..__..._ ___...._�.__...__. - ...._._._.. '�' Ts __...__�6...�� ......................_..._t,�' �-_ _ �.._..�_�__�_ __..�_.�.__._._...._ .................._....._..._..,._.._....--- - -- -- ..�..._.._Q ._...__�� '------- ��� �_ ....................C4.� . � . _......._._....._.._..__�_.._.._.__�..........._...._....-�-------._.._ ......................... .. _ ..._... ....._. 6 20�______�� _�........_...._t ___l�-�. ............._...._..__....__.. ..._._....---�---- _......._.__c-F�1�_�P G4i�._._.._.� rb�Q �^' i'{� —..--- - �-------..._......_.....� .._._.. _.._ � ... . .. . __. _. _� .. V� i........_�1 �1J 5_ iiis �u T�_.._.... ___-�`�.__._._.........a.........�..... � ._ � _....--- __...._...._ ......................._.__..... __.� _..._... ._ ��_---�..__�.��.�( ........................... __._� - :� f2-3b3-oa4� *� - INSURANCE � OWATONNA • ATIANTA • PHOENIX sus�etr PE c�ty of Fr�aley 3 � 6 a 6� AT TME TOP QF THE TWINS BU I L D I N� P E R M I T r � ` R . • COMMUNITY OEVELOPMENT DIV. � j V �".� . . . J � � PROTECTIVE INSPECTiON SEC. /� / � i----�; �"' �•� CITY MALL FRIDLE� 551�2 NUM�ER pEV O�TE ��GE Oc AVVROVED 9r t 612-57�-3450 9�aF�5 3/19/O1 � � lOB ADpRE55 � Heather Place NE t IEGAI �07 NO. BLOCK TRACt OR A001TION SEE ATTACNE� oesca. 2A, 2B 1 Heather Hills North SHEET 2 PROPERTY OWNEii MAIL ADDRESS 21P PMONE Kootenia Homes 7975 Afton Rd, Woodbury MN 55125 651-731-2345 3 CONTRACTOii MAIL AODRESS ZIP PHONE LICENSE NO Same 20060346 t ARCMITECT OA DESIGNER MAtL A��RESS ZIP PMONE LICENSE NO 5 ENGINEER MAIL ADDRESS tIP PMONE IICENSE NO 6 USE OF BUIlO1NG Residential 7 CIASS OF WORK C� NEW O ADDITION O ALTERATION D REPAIR O MOVE O REMOVE 8 OESCRIBE WORK Construct a 41'8" x 43' Dwelling; a 20' x 22' Garage; a 14' x 12' Porch; and a 1 x Dec c 9 CHANGEOfUSEFROM TO STIPUlAT10NS See notations on plan. Provide City with copy of verifying survey before capping. Provide a hard surface driveway. Provide sod in the front and side yards. Paid park fee of $1,500.00. Sewer & Water Locations: See City Engineering Dept. V1/ARNING SEPARATE �'�RN���`� Before digging cali fof REQUlRED FOR: aii utility Iocadons ' PLUMB� NGG� ANDnSf GN� 454-0002 REQUIRED BY LAW TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE RE�UIREO FOfi ELECTRICAL, PLUMBING. MEATING. VENTILATING OR AIR CONOITIONING THIS PERMIT BECOMES NULL ANO VOIO IF WORK Op CONSTRUCTION ZONING 50. fT CU fT AUTHORIZED IS NOT COMMENCEO vyITMIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDEO OR ABANDONEQ fOR A PERI00 OF /20 OAYS A? ANY 7iME AFTER WOiiK IS COMMENCED NO OWLG. UNITS OffSTpEET PARKING I MEREBV CERTIFV THAT 1 MAVE REA� ANO EXAMINEO TMIS APPLICA710N 1 STA�LS GAHAGES AND KNOW ?ME SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS Of LAWS VA�UATION SURTAX Fire SC AND OpDINANCES GOVERNING TMIS TVPE Of WOpK WI�� BE COMP�IED WIT►i WMETMER SPECIFIE� MEREIN Oii NOT. TME GRAN7ING OF A PERMIT $259,669 �129.$O 259.70 DOES NOT PiiESUME TO GIVE AU7MORITV TO VIOlA7E OR CANCEL 7HE pERMIT fEE SAC CHARGE PROVISIONS OF ANY OTMER STA7E OR IOCAI LAW REGULATING CON- STRUCTION OFi TME PERFORMANCE Of CONSTRUC710N � 1 � HH9 . 7S � I,150.00 P�AN CMECK FEE TpTA� FEE $5.00 '_,icense SC $3,434.25 + PF SiGN�TUAEOf�QN'AACTOpOp�UTMOQ�2ED�GEN1 iD�iE� ME PpOpERIY VALIOATED TMIS IS YO PER iT � ��� � TUpEO�OWNE U�� EA� iD�TE� �pgD - r��TE { � NEW ..:;,,� I I A�I�`� [ ] ALTER ( j Effective 1/1/2001 CITY OF FRIDLEY (763) 572-3604 Bldg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: ��� J? ��.-�z�cZ p�« Legal Description: �-oTS �A � 2�3 ��f�C � �4�z�.cz, ,���s 'tJc,a.-�ct Owner Name & Address: 1����A ��G� Tel. # 6S\- "1'3t -Z'34S Contractor. ��zt.��A ��.� MN LICENSE # z�6�0� Address: Za"15 A�o�_ CZ� V��,�.� ME�I � 55 � ZS Tel. # 6 s� - � 3� -Z-3�S Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. ���, LNING AREA: Length GARAGE AREA: Length � -BEE�lE�kRE�t: �o1LCN� Length � �: � � r� DESCRIPTION OF 1MPROVEMENT Width .� � Width °?°'� Width ��' � Height �� Sq. Ft. Height Sq. Ft. HgUGround Sq. Ft. a 5 9 l�(o Y• 7d Construction Type: 'I�\Ew ���7�T1 � Estimated Cost: $ 313 � �� � � Driveway Curb Cut Width Needed: �Ft + 6 Ft = Ft x$ �$ DATE: 3- �\' � APPUCANT: --,cs� � ��r�..A Tel. #�S\-'1'3�-'L3�S CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application $� g g�'� %s Fee Schedule on Reverse Side $ � � 7� .001 of Permit Valuation (1/10th%) $ l a , g0 $.50/$1,000 Valuation $ l I S0, DO $1150 per SAC Unit $ S� OO $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ �O Q Fee Determined by Engineering $ Agreement Necessary [] Not Necessary [ j $ �-�9 � � � M1�2-12-2001 10�25 E.G.RUD & SOhtS INC 612 766 6007 P.02i02 ����'� ( ���� � ����� o���� � FOR: KOQTENIA HOMES �0�"�'4 ��', ---0� � , OVERNEAD WIRES �---: �Q O~ 1~ a�'� � � � � � °s �w _.—�—_—� �----- • N �,� ,r--- i �. r I I i q +s. � I Q � f �6 ��s � NB9'$8 �43t"!� � � . s >�d.01 _ _ t h 4.ty 4 Oroinagc�i� Utilit0/ Eo�rnent ��� N' ��_�_��_�_ ��� f� ;� �- CFWN�LINKED FENC � �r�- $MALL WO�� j � BUIL.D�IG ; �-- Wi000 PRNACY FENCE� x 9a� s 2A�: x ptas � � ,� \�,�� \ j ,a I 4 � � _"�"_..�_--------� I 33 � � 41.67 xlt1.0 ( ! -�(Lookwt �+do+rs) � I PH°o,s�e d `" �`� I __� � a.�� I— ��.o � 18.33 � - - Geraqe _��� � � 20.0 N / ^ 125.00 , � I � � � �� ���� _.,�_ �� 4 � � � _l� N-�_y �I,6Q '�� I N ��� �Z.O � --- -�---�_�_��� 89'�S'42'E � � I ��, ,� �� ..._—�__�—�..Is �,o A� � —�� NORtI-! � � ~ �w w� �a � o'� �� P� PG � t�' " ��'� �0�"� q1g� 1—!�A 7"l�-1� PLAC� (9 � POUR£D CONC FOUNDATION) DIAG: 54.0 X 8?.0=106.88 LOOKOUT WINpOWS G� Denotes Proposed Erevatlon. PROPOSED ELF�/�roN�,s- x�o��.2' Denotes Extsting Elevo{;on, G,4RAGE FLOQR = 916.1 � D�notes Dfrection of pralnvge. TOP OF 6LpCK = 916.5 Der�otes Nbor! Hub at 1t' foot olfset. �g��r FLbOR = 9p7_8 OF FOO7)NG sY 907.5 L.OTS 2A dc 2B. BLOCK i. HEATHER HIU.S NORTH. AIVOKA CUUN7Y, MINNESOiA, •— - Scole 1"s�,,' e pMOtes Iron Mvnument 8eorin Ootum: As=umed ,1 I hereby certify thot this plan. �urvey or report wos prepored by me or under my direct aupervision cr+d that I om o duly Licensed Land Surveyor under the lowa of the State of Minneaota. �I�t�d/: �SV�d�C �,/O�C CueA�iON E, R�N� N�i� 8��. Dated this,� day o� L''��� 2001 Minn�rsoto License No. PioB t. c�. �ur� � �s, �� {.�4NIC Fdrll!'vEYORB til� I.�KINCiTON �►vE. NO. criRCL! PIN�S, MIIWl��TA �14-3�+T8 'f�L.l'ib:lJ 'tdb•99�6i� Tar� P. e2 � �' - 4 MNCheck COMPLIANCE REPORT Minnesota Energy Code MNcheck Software Version 2.0 Minnesota Department of Public Service 1-612-296-5175 1-800-657-3710 COUNTY: Anoka STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: DATE: 3-12-2001 Single Family DATE OF PLANS: 3-12-01 TITLE: Fridley Parade PROJECT INFORMATION: xxxx Heather Place COMPANY INFORMATION: Kootenia Homes COMPLIANCE: PASSES Required UA = 718 Your Home = 670 Permit # Checked by/Date Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS: Raised Truss 1983 44.0 0.0 44 WALLS: Wood Frame, 16" O.C. 3114 19.0 2.0 161 GLAZING: Windows or poors 565 0.350 198 DOORS 63 0.340 21 FLOORS: Over Unconditioned Space 13 38.0 0 BSMT: 9.0' htj6.0' bg/9.0' insul. 1603 11.0 102 SLAB FLOORS: Unheated, 42.0" insul. 210 10.0 144 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Minnesota Energy Code. Builder/Designer ���C�S`t� �� / � ,�,,,� \ ��_ Date 3 � �2-�.j � 4� . `• NEW HOME FIELD INSPECTION ENERGY CHECKLIST MINIMUM REQUIREMENTS (CATEGORY 2) FOUNDATION: [ ] Exterior foundation wall insulation installed: R- [ ] Slab-on-grade insulation installed: R- [] Ducts in slabs have R-5 insulation bottom and sides PENETRATIONS: [] Window and door frames sealed [] Framed wall openings into attic sealed [] Other joints in wall sealed [ ] Dropped ceiling air-blocked [ ] Plumbing penetrations sealed [ ] Exterior walls behind tub and shower sealed [ ] Plumbing vent stack sealed [] Chimney flues sealed at ceiling [] Perimeters of all grills and registers sealed to vapor barrier [ ] Electrical service sealed [ ] Recessed light fixtures sealed [ ] Wire penetrations into attic sealed [ ] Telephone, cable TV penetrations sealed [] Fans sealed where vapor barrier penetrated � OPTIONAL (CATEGORY 1) [ ] Foundation rim joist sealed airtight [ ] Upper story band joists sealed airtight 0 [ ] Ceiling poly sealed to top of interior partition walls ] Electrical boxes sealed to vapor barrier [ ] Fan housings air sealed � � '•� NEW HOME FIELD INSPECTION ENERGY CHECKLIST PAGE 2 MINIMUM REQUIREMENTS (CATEGORY 2) INSULATION: [ ] Vapor barrier installed [ ] Interior foundation wall: ( ) Vapor barrier installed ( ) Insulation installed: R- ( ) Moisture barrier installed [ ] Attic insulation installed: R- [] Attic card posted with proof of bags installed [ ] Floor insulation installed: R- [ ] Wall insulation installed: ( ) R-19 ( ) R-21 ( ) R- WIND WASH BARRIERS: [] Wind wash barrier installed at attic edge [ ] Overhangs (cantilevered floors and bay windows)have wind wash barriers MECHANICAL: [ ] Ducts running outside conditioned space sealed and insulated with minimum of R-8 [] Returns in same space as furnace sealed [ } Ducts in unheated spaces [] Water heater has pipe insulation or heat traps installed [ ] Furnace AFUE: [ ] Central Air SEER: OPTIONAL (CATEGORY 1) [ ] All exterior joints in building envelope sealed [ ) Residential mechanical ventilation slrstem installed (Mandatory if one or more item in this column is checked) ----NOTES TO FIELD (Building Department Use Only)------------------------- . . MAR-15-01 THU 16�23 KOOTENIA HOMES �OO�lC�11. M � " � �Q�i�S FAX N0, 16517312314 P, O1 �-_�..�� ._ „�- .. ��S1GN�R5 ANp I3UlLARRS' 7975 ARon Road 'I�VoadburvLMN 5512_ S (651 ?31-23�a F�x Mexno TU: ��+Nlb ��, FROM: ��� lrl'ti'�I�{.�.�� ��'�'�Y� ORFfCE !�: FAX#: FAX#; DA'1'E: 3"[ S r �� ._:. 651-731-2345 651-731-2314 # PACES (inclpding a►ver lclter) � M F.SSAGE: �'�2''� � '-�r�- _ t�.l � S - ���'�- �4� S _C� �� �. �w �� ..��...r� MAR-15-01 THU 16�23 .� . � � . ___.� ----. . ... . KOOTENIA HOMES FAX N0, 16517312314 � �N �- �133�2�-3001 a ��� � jZ ( 3 3 a 2�-30o g� �'�i �' ��3�o2�3a�S�v �K� c�v�-r� , 0 P, 02 • . s L++s..�•. _ �____' _. MAR-13-01 TUE 16�19 KOOTENIA HOM�S FAX N0, 1651�312314 P,O1 �� • �(���5 ---.,.._.� -- -� ..-... _ �. _�, n�S1GNF,RS AND Rir.CLDERS _ 7975 Atton Road, wnodbur� MN 5�125^ (65t1731 23�5 Fax Memo TO: _�l� �,�SS��. FltOM: �'� CUMPANY: OFFICF, #: 65]-73l-Z345 _ . „� F - FAX#: 651-731-2314 ^�yF•7r�°'T� � f: ^��:Fr-++� DATE: � ' � 1 � l�"'�,....,�.......-- � PA(;LS (includin� covcr leaer) � � MESSAGE: �� . ''C � :T � . �AR-13-01 TUE 16�19 --• --. _� _ �.,. �� Oate TO: KOOTENIA HOMES FAX N0, 16517312314 P.02 o��tai�4 JL 4�1I1'E CO PAGE 01 � C�t'�T� N IA �Q��� ��i�nera & Bu�tdi JL Whlte F�diey Parede ,� xx�c�c Heaiher P�ce �: 01 di � p�o►� ^ Fax 6$1-731 �346 65�-7'31-2314 ^ �a yome$ has just completed workir�9 dr�;ngs fiae, a new home �o be bupR a� the ab address, You �re (nviter! to subm� a� hId for this 8ids aA tre �urned to us within one (9) week of the date of thi��req�e�. �°sed plans. Bidde shall p�mppy �#y ��la Homes o� any ambiguity� inoon�t �Y Y discover �r� there eocamination of the p�ans, specit�bons, and t�he��emor which �on�' ns. S�oof Ca/1 0 Jarnie refer #o th� p���� Rumber in y�our bid and any othe� oorr������,� M,�� �s, Is fo be perfcxmed �s foqa�ws: � /—�/aX�b X�6�'Q � `� �,a^ � r � x � G � � � J `�� � "'� � b+ V j�' .3 � ' �ii � r ,,,, i,s w � � -Z 1t' ! �-- �O �' � � � � � �� .� � � � �.-., � �� �� / a f y � � _ _ Ct1Y0E FRtDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 September 28, 2001 Kootenia Homes 7975 Afton Rd Woodbury, MN 55125 Re: Final Inspection at 6203 Heather Place NE, Fridley, MN Dear Sirs: A final inspection was conducted on September 28, 2001 for the construction at the above noted address. We found that the construction complies, to the best of our knowledge and belief, with all the requirements of the building codes of the City and the State of Minnesota relating thereto, and permission is hereby given for the occupancy of said dwelling. If you have any questions on this matter, please feel free to contact me at 572-3602. Sincerely, RON JULK W, Building cial RJ/mh � 7 7 � � � :a � � v :J � � ) � U • � � + `� u� � >Zc' �C � ti � � � _ � a� -� . M 'a CMO � ' CO LL � . \ � � � � Ll1 � � � Q m Q � � � r W F- Q � � a 0 N U � \ `o v U � C ^ � ��V � � w N . � c 0 .� U .Q �. m � � L C �1 � •+ N N � c 0 .� c N i � N a � m c m O m N � rn c 'v .� m 0 U � a� m � .y W U � Z m � � J a O O O O O O O O p O O O O O O O O O O O O p O O O O � � �j ^ �.: � �.: o � o o c �ri � tfl tr� � v� t� � � t� � � � � Z ( I I I I � � I � I I I 0 Z � N N } r. � � W � Q 3 `� V N W ?� Y (0 . V s � 2' LL C•— � a � � U � � � 'D p� Q W � N X Z N C y.0 �' ' � ( r� N C � N C a.. N N Iy0 N � ` 0. pp x� N� 00 �� F- 2 2 C�� fl. �, � � � � � � O� O L� �- � N N�� Y T J N � N 0 (0 /9 � IC f0 f9 � � �� a Z O m m U� cn ��� C� C9 m } m 0 w � z � C9 � LL � Z O Q � w }- J Q Z U Q C N � Q � Q Q ¢ 2 W � O � � o �. y ti � X EA � ��.- � Z � � a � C � fp O � � � = O � o N O�C � Q � v > 0 n G Q 0 � N � (0 L � 7 � N � � f� w w � J Q H � � w � � Y U Q m Z O O � z H Z w > Z � � � U ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSIT'S� AVENUE NE FRIDLEY, MN 55432 s�i-36u4 r��: : 6203 HEATHER PL NE : T000065 : HEATHER HILLS NORTH PLAT 2 : LOT 2A BLOCK 1 : ELECTRICAL : RESIDENTIAL : ADDITION/ALTERATION s�i-li��i PERMIT NO.: 2004-01754 � �� DATE ISSUED: 10/OS/2004 VALUATION . NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL A SAVERS SWITCH. # INSPECTIONS 1 APPLICANT HUNT ELECTRIC CORPORATION 2300 TERRITORIAL RD ST PAiJL, MN 55114- OWNER REBECCA KLANDERUD 6203 HEATHER PL NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and lrnow the same to be true and correct. All provisions of laws and ordinances governing this type of wor� will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date ELEC PERNIIT FEE - MIN (RESI) STATE SURCHARGE, ELEC FLAT TOTAL PAID WIT'H CHECK # 118132 Sr;YAKA"1'� Y�KMi"1'S Kr,QU1R�D FOR WORK �THER THAN DESCRIBED ABOVE. 20.00 0.50 20.50 City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 Mechan�cal Permit # Zcx'�-��I Residential Application City of Fridley %�Z� o� See Back Side For Required Information �i �Z�fS -v� Date Site Address: The a licant is: (cirlce one) Owner Contracio Properry Owner. �cc k/ �le� Address: �1 � i-1r�t/" �<< C�y: State: Mrv • Zip: "� S � Phone: - - IL� Cell: Fax: Corrtractor Informat'�Q n Company Name:,��'C.SdG NPo.�f�, � � Contact Person: C' Inr;s R�d�r Address: Z�vv Fi.r�.�v�• p..t . Ciry: �e�,!/� State: M N' 7rp: ��/� � Phone: /2-3 63 - 6"�/ 6 Cell: Fax: Email: MN Bond# & Ex Date �S ! Zc�(o� T pe of Work (circle one : Re lacement AtteratioNRemodel Detailed Description of work: �,�('h�p/.rc� � Equipment Installed: MFG: Model: �s�x •�61�u Size/BTU: :� y, o� MFG: Model: Size/BTU: MFG: Model: Size/BTU: P4ease check afl that apply: _Fireplace (g $15 _New Gas Grill $10.00 _A/C $25.00 _Fireplace (wood) $35.00 Gas Unit HTR $10.00 Air to Air exchanger $15.00 Fumace $35.00 Pool Heater $35.00 Boiler $35.00 _Gas Dryer $10.00 _Ventilator $15.00 Chimney Liner $10.00 _Gas Piping $10.00 Duct Work $10.00 Gas Range/Oven $10.00 Permit Fee $ �S �`� (Total from above-Minimum fee $35.00) Surcharge �. ^ 0.50 Total Due $ �' S� Make check ayable to C' of Fridle This is an application for a permit- not valid until processed I hereby apply for a mechanical permk 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 ConsVuction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permi� that fhe work will be in accordance with the approved plan in casa of afl work which requires review and approval of plans. Signature of Approval Ins Date: Date: � Please Note: Separate permits are required for Building, Plumbing, and Electrical work Building Inspections 763-572-3604 DATE � " d'c SITE ADDRESS � THIS APPLICANT IS: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS � OWNER �ONTRACTOR PROPERTY OWNER/ NAME�e. �eCL� iC��j��/'tk]� TENANT ,�DRESS: �o�-O 3 /�ect �,al /�/4 c� C�7'Y PHONE: l�'1D.3�s7� a,� a/ CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION Permit No.: o, Received By: Date Rec'd: �� ����`�' 'nTe�/LtP ss y3o? STATE LICENSE #�s y6a e 9 E3� DATE 3^3/-0 ? ADDRESS: � �f� CiTY �ICI✓�1 �t%%�STATFl�i'�P��3 PHONE '7� �^5��� "'�/.3�0 FAX `%�03'� ��%.3%I PROPERTY TYPE � SINGLE FAMILY/Nl ❑ TWO FAMILYINEW PERMIT TYPE TYPE OF WORK: ❑ ADDITION ❑ GARAGF/SHED ❑ WINDOWS ❑ BASEMENT FINISH �OOF ❑ DRAIN TILE ❑ DECK SIDING D OTHER O SWA�Il�IING POOL DESCRIBE WORK BEING DONE: �e %'Q�j � SIZE OF IMPROVEMENT_ ROOFIIVG TfUMBER OF SQUARES �L GARAGES PROPOSED SIZE: PROPOSED I-IEIGHT: SIDIlVG O Vinyl ❑ Aluminum ❑ Other LENGTH WIDTH HEIGHT [�'HOUSE & GARAGE � ATTACHED GARAGE 0 DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia WINDOWS IN EXISTING OPENINGS DYes �No LOCATION OF WINDOWS OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENMG CHANGES 8c BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used Ft. FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project 2. Two seu of construction plans 3. Energy Calculations TYPE OF WWDOW TO BE INSTALI,ED NUMBER OF WINDOWS � ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $.�`'r� i�e �o�( ,^ OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow I Erosion Control , Pazk Fee � Sewer Main Charge Total Due $ � Cn . ale s 3• )3 � S-� $ S $ $ $ See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuarion .0005 x Permit Valuation Minimum 5.50 55.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftxS2l=$ �450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks oavable to: Citv of Fridlev Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I herehy apply for a building permit and I aclrnowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work whic ires review and approval of plans. i, SIGNATURE OF APPLICAN��Ces� i'�" r PRINT NAME /�� %!'� DATE ��� '� �/