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AF - 46055SUBJECT P O. City of Fridley 19 4 S 9 ' ` AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ECEIPT NO � � �,v � COMMUNITY DEVELOPMENT DIV. � �� r i � PROTECTIVE INSPECTION SEC. 1 = � � �'��1 � CITY HALL FRIDLE� 55432 NUMBER REV. OATE PAGE OF APPROVED BY �'"""� � ,�� 612-571-3450 910-F15 5/24/88 � � JOB ADDRESS 1322 Hillcrest Drive N. E, 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 28 3 Moore L31C@ F�]..1�.3 SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE Robert/Ma.rgaret Knudson 1322.Hillcrest Drive N.E. 571-3030 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO Durabilt Associates Inc. 7343 Ann Oourt, Eden Prairie, l�T 55344 938-9350 4 AflCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDHESS ZIP PHONE LICENSENO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW f� ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WOFiK Construct a 14� x 24' Porch Additian and a 14'� x 14' Deck Addition 9 CHANOE OF USE FROM TO STIPULATIONS 5ee notations on plan. Raom can not be hea.ted unless proof of Energy Code compliance is submitted to City Halle I� well exists and is not to be usc�, it must be a,Yiandoned by a licensed well driller. ��, � � �. �* -"� �� B�fore di�??ing r,uit fa�::i utiii;;�� S�� F��`�t`�I�� ; �'�. �6�0� �4.E�Cj S6C�'�S. ��CLF��J'i�,► _ r �. .. „_ � �, t�, ` �� .T�� L `�` ' '�� ' LLtCiRf� �aLLf S.E!�. �. ��: � r � �: � � �'�' �.�.`i�� TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED 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 ANV TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �' STALLS GAFAGES 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 $17 7OO S8•85 WITH WHETHER SPECIFIEO HEREIN OR NOT. THE GRANTING OF A PERMIT / DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER ST TE OR LOCAL LAW REGULATING CON- S RUCTION OR THE PERFORMA CE OF CONSTRUCTION. 5�-89.00 PLAN CHECK FEE TOTAL FE �9► / I �"� ` $197�.85 SIGNATUREOFCO �R TORORAUTHOR12EDAGENT IDATEi WHEN PROPERLY V ATED THIS IS YOUR PEFMIT ! �� S�GNATURE OF OWNEA IIF OWNEA BUILDEF:1 �DATEI LDG �NSP tiTE 1�7+�1 [ ] ADDN [ ] ALTER [ l Construction Address Legal Descriptian: I Owr�er Naane ,& Address Co�ractor : Address: City of Fridley R-1 Ai�ID R-2 �,;�ding Penait Application � � � 1��,r�t EEfec�ive 5/L88 l-�k� I�-i ll� �e � 1Lr��3c1� r� T�. � � - b� . ��C cI.��1C�ft . Tp1. �"��b� t#. R3� �� Attach to this application, a Certificate aF S�uv�y of the lat, with the proposoed vonstruction draa�m on it to scale. �ESatIFrION OF II�'ROVII�JP < LIVIING AREA: Length � Width � Height � 9q. Ft. �� C�RAGE ARFA: Length Width Heic�t SLZ. Ft. DEC�c 1�RFA: Length � Width v Hgt/Groimd � Sq. Ft. .�:. a �� . � e �� a s�.�Z� � � � �� mrner Lot [] Inside Lat [] Fte Yd Setback Side Yard Setbacks Type of Construction: �c� ��(�-(`rl� Estimated Cost: S� __ �' Approx. Comgletion Date: - o� l') iOtJ 1 Al� A Alt. B Proposed Driveway Width If New Opening Is Desired: S � W'clth + 6' See Back Page nATE :�' Z�� APPL IC�11JP : � � Tp>.. � P�e�it FF1ee State Surcharge SAC CY�arge Driveway Escraw Park F�ee Sewer Main Cl�arge TO�Ai, Sl'IP'ULA�IONS: � .. �� ; �� i .!. �.:rr_ � � . . QTY OSE 0l�Y F�ee Schedule on Reverse Side 5.50/51,000 Valuation 5550 per SAC Unit � Alt. °A" OL Alt. "B" AbOV2 F�e Determirnd by Ehgir�eering Agreenerit Neoessary [ I Nat Neoessary I] , ��.�'� ��?/� .�°a`� c.�— �f �� . (�%i�a ` „ C� �F" t.ut��c '�.1tis� - A�+ � I c z r.��- �-IJ,oCI � ; ?8 �f� C�S �.p �T �i�S� �. � � �S 1 �l ��(�0--_ ��Il'N Q(�N JL�1 � Q.11,�.�1 �:► �,� �- C�s�. w , .� �a�� 1�5.�a �': 1 �. �. ' �i�v 4 yl�l ``M:1��. 1 �e 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 rep�ir to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein belaw set forth anc] in the manner herein pravided to-wit: �'I'AL VALUE EFES $1 to 5500 $15 (Minim�a Fee i.s S15 plus surcharge) � 5501 to $2,000 $15 for first 5500 plus $2 for each additional 5100 or fraction thereof, to and including 52,000 S2, 001 to $25, p00 S45 for f irst $2, 000 plus $9 for each additional S1, 000 or fraction thereof, to arad including 525,000 525,001 to �50,000 $252 for first $25,000 plus 56.50 for each additiona]. 51,000 or fraction thereof, to and including 550,000 550,001 to 5100,000 5414.50 for first 550,000 plus $4.50 for each additional 51,000 or fraction thereof, to and including 5100,000 5100,001 to 5500,000 5639.50 for first $100,000 plus 53.50 for each additional. $1,000 or fraction thereof, to and including 5500,000 5500,001 to 51,000,000 $2039.50 for the first 5500,000 plus $3 for each additional $1,000 or fraction thereof, to and including 51,000,000 51,000,001 and up $3539.50 for the first 51,000,000 plus S2 for each additional $1, 000 or f raction thereof �)��il�, : � �+' � ,� • ti ��;,�., • - . -- • Alternate "A": Remwal and replaaement o� curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Renaval anc] replaoement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times 515.75. /�+: • � � ' y� 1�� • � Permits for construction will be issued a minimum of 24 hours f rom the time of ap�l icatian to allaw for proper review of the propos�ed structure and of the �nstruction site. A Certif icate of Slirvey of the lat, shawing the location of the foundation once it has been oonstructed will be required before prooeeding with the fr�aing. . �: � . . � �: Brown Land Su�v 7701 Harriet Ave. So. Richfield, Minnesota 55423 (612) 866-4580 � �-•.. � , . .��-=�-=-=.=d°.--=- _ Inc. WOOOROW Il BiiO�WN, l�L8. Pr�id�nt � SURVEY FOR: ROBERT KNUDSON r M � SCALE: 1��= 40� PROPERTY DESCRIPTION Lot 28,.Block 3, MOORE LAKE HILLS, Anaka County, Minnesota. I hereby certify that this survey, plan or report was prepared by me or under my direct supervision,and that I am a duly registered Land Surveyor under the laws of the State of Minnesota. � W. BROWN LAND SURVEYING, INC, Woodrow•A. Brown- R.L.S. MN REG N0. 15230 Date:�0/�i �/9� � 88 i� /ts 1�1 f�1 � —, p=3O7sa�4's,� ' i . � L= SO.00 20 6 � 25:0'_ � ____- - ;, 13, .40 ' �4.4 , EXISTING �' , �_ ST•ORY '. - N DW El11NG�`� FRAME • N ,. 40 Ad�. ._�16.9 _ � � s � 14' 33 np :`,.1 • is . < � �y� CEINENT 3�BOARD FENCE Porro e �� .o � FOUNTAIN 5.1 �-- LOT 2 8 j_ ��, ; ? �� F � M . � , N � � J�t � � � swAMP �C xc � � 80.�� — — � ;� � � r g 145 ` 9•� � _ STORY m �AME N �103 �29 i_ �✓ i L i � t0 N I i 0 / . , .._.. _ .,_ , i:� �__1`ER WELL ABANDOIa+�NTS FOR ANOKA CODNTY LISTED BY CITY NUM�RICALLY BY ADDRESS FOR THE CIT� OF *** FRIDLEY *** ��F. 6431 UNIVERSITY AVE. NE. B.I. 1rIIL. DARREL CLARK S� 1rIlL. DON �ARRIGAN 574-3450 NO PERMIT FEE OR INSPECTION DRILLER SIZE OWNER-CONTRACTOR SITE ADDRESS J�/ �/,� �, DATE SEALID TORGERSON E.H. RENNER MORR KORR A-WELL E.H. BENNER E. H. RENrTER roRCExsox E. H. BErIliER B. H. BE2IlIER L. H. RErIlJER B.H. RENNER E. H. RE1�IliER �. H. BErIl�iER E. H. RENI�IER B. H. $II�iIdER �. H. RENI�IER E.H. RE1�IldER DON STODOLA KORR GUDWIG E " . RIIIIdER l� 2 3 3 4 2 1� i� 1� 2 2 3 3 1� 3 4 2 2 1� BORDEN SHARON ANDERSON ANORA CO. COMM. ACTION ANOBA CO. COMM. ACTION ELLEN BARI FRIDLEY SCH. DIST #14 HARLIN S� MA%INE SIIND Robert Bnudson LOIS HLAVINKA LOIS ffi�AVINKA ONAN CORP ONAN CORP JERRY McBNIGHT s�viA r��cui� SYLVIA McGIIIRE BINCRNER BOILDERS TIM FAflS � TIM FAHS ENEBECK COIiST1tUCTION CLARENCE GRAVES CARL CHRISTENSEN 260 Longfellow�St. 380 Longfellow St. 400 OsborrrERd . 401-76th Ave. NE. 511 Ironton St. NE. 611 Miss3ssippi St. 776-63rd Ave. NE. -�1322 Hiilcrest Dr. 1500 Osborne Rd . 1500 Osborne Rd . 1600-71st Ave. NE. 1600-71s�t Ave. NE. 4607-2nd St. NE. 5928 Oakwood Ave. - 5928 OSkwood Ave. 5980 Stineon Blvd. 6I05 Woody Lane �"�o 6105 �ioody Lane ��,,,�� 6222 Old C� Rd. 6229 Sunrise Drive 6509 East River Rd. ANORA COUNTY PARBS DEPT. 66f�6 East River Rd. 1 Jan. May. Sep. Sep. Mar. Sep. Sep. Jul. Apr. Apr. Jul. Jul. Nov. Sep. Sep. Apr. Feb. Feb. Aug. Oct. Jun. Jul. 88 86 87 87 88 87 87 88 88 88 88 88 87 87 87 88 88 88 88 87 88 88 � /A 6 E RENNER 1� RICR MALACflER E._. RENNER 1'� BOISE CASCADE CORP/BARR E.S. RE1�Il�iER 1� BOISE CASCADE CORP/BARR E.H. RE1�Il�TER 1� BOISE CASCADE CORP/BARR E.H. RENNER 1� BOISE CASCADE CORP/BARR E.H. RENNER 1� BOISE CASCADE CORP/BARR E.H. RENNER 1� BOISE CASCADE CORP/BARR E.H. RENNER 1� BOISE CASCADE CORP/BARR E.H. REN1�iER 1'r BOISE CASCADE CORP/BARR E.H. RENNER 1?}� BOISE CASCADE CORP/BARR E.H. RII�INER 1� BOISE CASCADE CORP/BARR (10 WELLS..F'P7, FP10, FP18. FP11, FP13, FP9, [ALL OF 1'SE ABOVE 10 WELLS FOR NATIONAL POLE E. H. REIIl�iER 1� JAMES L. SCHLEY A-WELL 2 JIM HAM ANOKA/O18 L�ND NOVE[�ER 16th, 1988 NOi�ER OF WELLS SEALID IN THIS CITY TO DATE: t,.--- 2 7136 East River Rd. Aug. 87 7300 Block � Old Central Aug. 84 7300 Block � Old Central Aug. 84 7300 Block S� Old Central Aug. 84 7300 Block � Old Central Aug. 84 7300 Block & Old Central Aug. 84 7300 Block � Old Central Aug. 84 7300 Block � Old Central Aug. 84 7300 Block & Old Central Aug: 84 7300 Block � Old Central Aug. 84 7300 Block � Old Central Aug. 84 FP1, FP8, FMB, FP3 Less Than 30') bc TREATING SITE/MEDTRONICS SITE] 7512 East River Road Sep. 87 7551 Alden Way NE. Jun. 88 35 ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 FAX: : 1322 HII.,LCREST DR NE : 243024120049 : MOORE LAKE HII.,LS : LOT 28 BLOCK 3 : ELECTRICAL : RESIDENTIAL : ADDITION/ALTERATION 571-1287 PEItMIT NO.: 2004-01791 / �, I ` � DATE I5SiTED: 10/OS/2004 VALUATION . NOTE: ELECTRICAL PERNIIT BECOMES VOID 12 MONTHS AFTER PERNIIT ISSUE DATE. INSTALL A SAVERS SWITCH. # INSPECTIONS 1 APPLICANT HUNT ELECTRIC CORPORATION 2300 TERRITORIAL RD ST PAiJL, MN 55114- OWNER CHRISTINE BELLAND 1322 HII.,LCREST DR 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 know the same to be true and correct. All provisions of laws and ordinances governing this type of work 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 construcrion or the performance of construction. Applicant Date Bldg Insp ELEC PERMIT FEE - MIN (RESn STATE SURCHARGE, ELEC FLAT TOTAL PAID WITH CHECK # 118132 SEPARATE PERNIITS REQUIRED FOR WORK OTHER "1'HAN ll�;5C;K1�3�ll At3UV�. 20.00 0.50 20.50 Building Inspections 763-572-3604 BUIlLDING RESIDENTIAL A.PPLICATION CITY OF FRIDLEY DATE I C) -�� - c9�i YOUR E-MAIL ADDRESS �ec, cz�f� l L\� SITE ADDRESS THIS APPLICANT IS: ❑ OWNER '�CONTRACTOR Perm.it No.: Received By: Date Rec'd: PROPERTY OWNER/ NAME: � 1 o a ci �' Crn �� e^ c �� 2^• S�- TENANT �DRESS:,J � 2 2.. j�� 1.1 � w e j�} J� r CITY F A� � STATE�'! �� 7. PHONE: � � 2, ' z o q-��(� G. CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE �vlT \ayJ�n�,t��r STATE LICENSE # Z c Z'� I�, � EXP DATE ADDRESS: � � �"l �a °'— �- fJ . CITY � � STATE �L -�S^Y'�/�% PHONE C� t L- a.. o� '�'�G, G FAX FAMII.Y/NEW CONSTRUCTIt MII.Y/NEW CONSTRUCTION ❑ BASEMENT FINISH �.RQOF ❑ DRAIN TILE ❑ D� ❑ SIDING ❑ OTf�R ❑ SWA�vIII�1G P(�L �rE oF woRx: I o ❑ DESCRIBE 9JORK BEING SIZE OF IIvIPROVEMENT NUMBER OF SQUARES ��_�v L� GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other VF'INDOR'S IN EXISTWG OPENINGS OYes ONo OR FOR NEW OPENINGS-DESCRIBE S1ZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED ❑ HOUSE & GAR.AGE ❑ AITACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia LOCATION OF WINDOWS NUMBER OF HEIGHT Ft. BASEMENT REMODELING SUBMIT: 1. Existing Fl�r Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUC'ITON INCLUDING DECKS, ,ADDITIONS. & PORCHES SUBMIT: 1. Site Plan/Sncvey showing the e�cisting structures aad proposed project 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING TIiE COST OF LABOR AND MATERIALS: (USING 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ � a 33�1 OCCiJPANCY TYPE Permit Fee Plan Review Surcharge Fire Surcharge License Surcharge SAC Charge Cwb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ � S.�S $ $ � 4 l—i $ a33 $ �,� v $ $ $ $ See Back Page for Fee Schedule 65% of Building Pemut Fee (.0005) times the total job valuation — Minunum $.50 .001 x Permit Valuation (1/10%) $5.00 (State Licensed Residential Contractors) $1450 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclmowledge that the information above is complete and accurate; that the work will be in conformance with the ordinanc codes � ity of Fridley and with the Minnesota Construcrion Codes; that I understand this is not a permit but only an applic 'on for a p i and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of a11 ork which r uires evie "approval of plans. SIGNATURE OF APP ICANT PRINT ATAME �J �c� � J S�^ca-.. s�-- DATE (�7 "- a S^ "aJ � Page 2- Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structvre, 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 an.d in the manner herei.n provided to-wit: 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 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 Oniv City of Fridley Building Inspections Depariment 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 Building � MECHANICAL Permit No.� � � Inspections RESIDENTIAL APPLICATION Received B � 763-572-3604 CITY OF FRIDLEY Date xec'd: 3- c5�'-O DATE � I�- � YOUR E-MAIL ADDRESS SITE ADDRESS 1,3�0'1 C� 1 11C f'�5 � ,v�=- THIS APPLICANT IS: ❑ OWNER �7CONTRACTOR PROPERTY NpME: ° � k„Q„ � '` C9 C� �F- OWNER/ pDDRESS: � . f 5 �� STATE �i�1ZIP� TENANT pHONE:`7( � 3-�K 3- `�Q'i CONTRACTOR co�A�v�r Na�: CENTERPOINT ENERGY SUBMIT A COPY OF CONTACT PERSON: '7OANN 'Ic INREN YOUR STATE STATE LICENSE # EXP DATE LIC�NSE WITH �Dx�ss: 9320 EVERGREEN BLVD STE �rry "C0011i'°R1�P.IDS sra�MN ziP55433 APPLICATION PHO� 763 — 757 — 6202 F,� 763--757�6701 PERMIT TYPE �,SINGLE FAMILY ❑ TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: � �W ��'LACIIvIENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK S � v '�- PER MS 16B.663 the permit fee is a minimum of $15.00 or 5% of the tot$I cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fi�cture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOVi� Fquipment Instelled MFG: �o� � MODEL: � R L_ �� SIZF/BTU �60 MFG: MODEL: SIZEBN • MFG: MODEL: , SIZFJBTU A/C $25.00 FIREPLACE (GAS) $15.00 _GAS RANGElOVEN $10.00 _AIR TO AIR EXCHANGEER $15 FII2EPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOII.ER $35.00 ✓FURNACE $35.00 _GAS iTNIT HTR $10.00 CHIlVTNEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 _DUCT WORK $10.00 GAS PIPING $10 00 VENTILATOR $15.00 "��1�*.�j'1 JI�+�X:�, .",�,�"�'��-y_�I`J�.�SIU�'� t;d.1(j�n �.�4°c'k�,��.i>�p�,"�,ex_�'`?' }�ks�,��t�kysi'�,i3�a zY,lr��f}�`�,-��,R�� ..�,h �.�T�r�.�� .`�!'�.�. �i. �� Permit Fee $ � Number of fixtures @$10.00 x$10.00 =$ Surcharge $ � .5U I Number of fixtures @ $15.00 x $15.00 = $ TOTAL BiJE $_ Number of fixtures @$25.00 x$25.00 =$ Number of fixtures @ $35.00 � x $35.00 = $ �� State Surchazge = $ .50 Tota1= $ _°'<", � THIS IS AN APPLICATION FOR A PIItMIT-NOT VALID UNTII. PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota. Constcuction 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 a11 work which requires review and approval of plans. SIGNATURE OF APPLICANT �• �° � �vTN� ROGER HOFFHSIN DATE �/ z O� ��'k?L�A r �,t�S��r�� '��[T�.�� ' .��,�7��1�'�i��,.T.��+��.�T1��Y� �T�N��;��U`0��`� r,=�F�n C;ity of l+'ridley 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 REOUIRED 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 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. Duct Design Per IMC 1346.0603.2 - --- - - - - -- �.. ACCA Nfanual �7— — -- NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations. Building Inspections 763-572-3604 763-502-497Z: FAX DATE O � SITE,4DDRESS r 3.� 1'HIS APPLICANT IS: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 1-1-09 ❑ OWNER YOUR E-MA1L ADDRESS ��. PROPERTY OWNER/ N�: '%p d �e (/q� d TENANT ,r�DRESS: /�� l`�I �CL�.CPS�' �� lU€ CITY, PHONE:�i� �— 70 3' 7�'7 7 CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF INSURANCE PROPERTY TYPE STATE LICENSE PHONE � / �0 3 � `� S `/ � V v.�7 ❑ SINGLE FAMILYMEW CONSTRUCTION ❑ TWO FAMILYMEW CONSTRUCTION PERMIT TYPE � �DITION ❑ G�U ❑ BASEMENT FINISH ❑ RQOF ❑ DECK ❑ SIDING ❑ SWIMM TYPE OF WORK: I DESCRIBE WORK BEING SIZE OF IMPROVEMENT_ ROOFING NUMBER OF SQUARES _ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING— — - " ❑ Vinyl ❑ Aluminum O Other Pemut No.: ��,�'�� Received By: � � �f�� - ol(�� STA' EXP DATE 3� � a F,ax 7[0 3 — `7K3 — � SIZE ❑ NEW HOME CONSTRUCTION � ADDITION s�ivtAt�rrFNAN�FIRRPAIR ❑ REMODELING 0 HOUSE ONLY ❑ HOUSE & GARAGE � ATTACHED GARAGE ❑ DETACHED GARAGE ❑ DRAIN TILE ❑ OTHER � �f3�- �l � iTATE�ZIP 'J�3� 5� FT BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used _ FOR NEW CONSTRU_CTION INCLUDING DECKS, ---- - p nDiTI�NS_ & PORCHES SUBNIIT: ❑Soffit 1. Site Plan/Survey showing the existing sdvctures � Trim and proposed project ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS �Yes DA10 LOCA110N OF WIN }�'S_B, OR FOR NEW OPENINGS-DESCRIBE SIZE OF � U�1(�QO ��a�C�. OPENING CHANGES 8c TYPE OF. WINDOW TO BE INSTALLED 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 $� I'�l - QC OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surchazge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ �I�(, a� See Back Page for Fee Schedule $ 65% of Building Permit Fee $ '��q .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $ �'�� — $5.00 (State Licensed Residential Contractors) $ $2000 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$22=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ '% �. Make checks payable to: City of Fridley Attach THIS IS AN APPLtCAT10N FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building 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 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 al ork hic requires review and approval of pl s. SIGNATURE OF APPLICANT l��-" 4 PRINT NAMFII ��(� �. �OE�Gi iM DATE � d D 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 a.lteration or repair to any existing building, or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: VERIFICATION OF FOUNDATION Pemuts for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of proposed siructure 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 Fax: 763-502-4977 � q' 1. 5� ��.��; Bu�l�.nir�G Ir�sp�ctio,us �5��TIAI. AP�'LICATI�D�T 7�✓��L�3604 I �ITY OF F1tID�•EY Up,'(T+, �+�"i� ,_ YC)URE•MAILADDRh»ti5 . , , srn�AUUrc�s� 13�.2_..1� �llcre�,s± _.._ Jr..... NE, _. THiS ApPLI(:ANT I5� ❑ OWNHR ��,'C.JNTRAC'I'()R P'YtOPEIt'�Y �WNER/ NAME: C�S}"I.ne �B-Q.r a�� TEAIAlv�' nnDK�ss: l3aa � llcres�- Dr AlE ci�rv. .�rPdl� PIiON�. �� ! g 3 � q q% . C:ONTRAY�'CUR u nnnE:.• W� r. d d W C o n c e p i' S St1f�MCI' A 4�PY Ul�. YpUR STAT� LICFNSB W I'1H APPUICA'f'Tc�N �RO�'ER1'� TYPE I►�IiMIT'T'YPE TYPE �FIWiBRK: STp�'P� LICEIJSki N_ ,�c o I lo.� auURESS: `��D Lo.,n e � PIIONR � Q 5 0 ❑ SINCiI:f: CAMILY/N W GUN;1 O '!'WO fAMU.YMCW Gc)�CSTi R d AUfIlT10PI ^ O FiASEMENT FlIViSH p UC�CK A New "�° C] MAR�1'CGI�ANI:`�'AIk 13�S�RIB� WUKK S�iN(i SI7E Ul� iMPIt(7V�MLNT S(2UA21i3 T, f,gARrLGF�`` ARO!'�)SED SiZ}�:_. YROPUS.�t ) [ IEIC3H'1': „ .�� . ❑ Yinyl ❑ Al�sneuwn p Otlx+e �VINL�W1 iN Fi3�ISTING: (')PLIVINIi.S�1'cs c)K POR Nl� (�1'BNINGS-17riC'. �P}31�R�FG �'IiANGFhti & ALL '�67TAL.] Per�it Fee P`lan Itevie�v Fira Surcharge Surrmaa'�e License Surc;hargg SE1� Charge; Curb Cut �crow �ro�i� Cvntrrt - Par� ree Seuer Ma3n;Ghar,�� e �qK, Kpe �� d ftUCTIc)N . C:1'lON D c;a.R.aC► ; 0 ROO� ❑ SID1Nti C1 WJIMMlfV CI Allt�mot iJ ItGMC1UH� W i 1^�, C� NI{ltlS� & QAR.4CiF�. ❑ A'I'fACI-IE171:�ARACiE G LD�i'ACHF u CiA.I1ACiE; OSomt ❑ Ta�n1 I� Na�cfa �x,yr nA�r�' 3 - � �. ' ST� • II LI CiTY ONu LUGa170N Ur' W1Npc:lWS :IBk; SIZC c7F �__.� _�! v� _ r O D y�R P�rtnit . o.r�_�� Recx�iv d �By: �� ' Da _ '�: ��G � �� S ATE ZIP SJ�y,3� C.c� sT �N :�� 550a1 N�S - — INDUWfi � DRAM TiLE ❑ U9'H�K �iCi 5�'i o n i n. ,_ TH IiEIGHT ,o,�CS' _ F1s5G . RE (317G 1 tilfB i: e:x�do� r�,m 2, PropoNed Boo plan 3. Li�t at rul �ncmber:� tu;ba uacd FUR NLW l nnd prn�n 2. 'liw se1� 3. �.n�gy C 1ASED U1VT VALl1ATl!UL�I, IIVCLUDIPTG� THE COS'I' OF I�ASOR AniD ►V1ATi (i19[N�� Ti-e� 1997 U.B.0 FL�E SCHEDULE) Vt�L1lAfION $ oi o'tlI • 00 OCGUP'ANCY TYYL� $ '� r , Ses 8ack Page for Fee Schedule $ 6S% of Build'u�g Pennit Fea $ �.001 times tha tatal job valuutian � � �,,.d�� . 0405 x Permlt V�tuation Miniuium fi.50 �'� !��.� $S.UO (St�te Lic�.^nsed Residential Cc�ntraatars) y; �DG75 per SAC �.Jnit (Plans ta MWCC for dc.tenY _,� — - �� + G n rz ft x $21 = $_— � $�k5��v�ervutfoit P�� eview- -- — $ F'ee Aetermined by�nginedring � A�reamettt nece�ArY ( ) Nan Nec�saty { ) 7Ti15 ffi Ahl APPi,�Gr1T�t)N F[)R A PRkMI'f-NCi'f VAl.i13 UN'f'{L P[ti�CCSSED 1 h�reby ap�ly fior a building penuit and I acknowled�;� th�t tho ittforntation above is oom�lete and accun cotrform&nou with 8�e ordinancc�e aud eode.� of the City o1' l�ridley and w�ith the Minresot� C�onscruciien �ode�; perniC b�t c#nly nn �pplictttivn tor a permic And work is not tc� start witl�out � p�rrnit; that thc� woric. will be in � p]a.-t in fihe c��e af afi! work which requires rovi w o appravs�l csF plans. �� r� • ' .,N�L.��,c.�. — _ _ su��rn��'i.rRE3 OP APPLICANI� . —..-- i70A WCt.IJDIIV(3 LiEd�1tS, IE5 5il s ; �ey showint; lNe czttsUng e�mcxuras projec4 rngltltciion pl�n�s that the vwork at�iH be in 1 undorst�cl f�ti3 �s fltlf a rda�ce with the spprq�ved � g - �_l�. Ld bJd90:b0 L00z �z '��0 ZB�LTLS£9L: '�N SCti� helP�� do: fi�t�' W02i-I