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AF - 46332SUBJEC7 c�ty of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M i T i � � � � ' y ______ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. , � , � �'-'1 � CITV HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF �----� • •�' 612-571-3450 910-F15 8/30/79 / / 108 ADDRESS 5260 Horizon Drive N. E. 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION oesca. 10 1 Carlson' s S�mit Manor North 2 PROPERTYOWNER MAILADDRESS Thoma.s Haskins 5260 Horizon Drive N.E. • 3 CONTRACTOR MAILADDRESS Stuart Construction C,o., 4611 Lyndale Avenue North 4 ARCHITECT OR DESIGNER MAIL ADDRESS 5 ENGINEER MAIL ADORESS _ 15425 RECE . � �� APPROVED BY SEE ATTACHED SHEET ZIP PHONE Z�P PHONE LICENSE NO. 529-9661 ZIP PHONE IICENSE NO. ZIP PHONE LICENSE NO. 8 USEOFBUIIDING Residential 7 CLASS OF WORK ❑ NEW �l ADDITION ❑ ALTERATION ❑ REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Construct an 18' x 12' Addition to Dwelling 9 CHANGE OF USE FROM STIPULATIONS TO SEPERA�'E PERMITS R�Qt1tR�p FOR 1iYlRi�fG, H'EATING, PLtIMgtNG A�iD S1G�t�. �e �il��HiN�: : eto�, dig8iny ca� ro� �+�r�ias tElf�NpnE • EIFCr�'C • r�� Et�; REQU�,�`� �Y ��,,�,y SEPARATE PERMITS ARE REQUIREO FOR ELECTHICAL, PLUMBING, HEATING, TMPE OP CONST. OCCUPI VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IP WORK OR CONSTRUCTION ZONING SO. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION 1 STALLS AND KNOW THE SAME TO BE TR AND CORRECT. ALL PROVISIONS OP LAWS yALUATION AND ORDINANCES GOVERNIN THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED H REIN OR NOT. THE GRANTING OF A PERMIT $G� GOO DOES NOT P ME TO GIV AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE PROVI S ANY THER STATE OR LOCAL LAW REGU TING CON- STRUCT N O HE F R NCE OF CONSTRUCTION. $42.00 � �o PLAN CHECK FEE $ 10.50 CONiRACTORO UTHORI AGENT (DATE _�•�i � _ _ .e WHEN PROPER VA _ � SiGNATURE OF OWNER �IF OWNER BUI DERI IDATEI ai nr. iuco GROUP �OCCUPANCYLOAD CU. FT. 216 4320 OFFSTREET PARKING IGARAGES $3.30 AC CHARGE �� OTAL FEE $55.80 THIS IS YOUR PERMIT ,� �� CITY OF FRIDL�Y - APPLICATION FOR RE5IDENTIAL BUILDIPJG PERMITS (P�ew, Alterations, Additions, or Repairs) . .�.- 4 ' OWNER: ! y�s ��u�l�► �sw�S ADDRESS : �Z(ep ��2i2�� ,�� Al� TEL N0: 0 - STRE'ET NO: � STREET: / " �� I � . ' � BUILOER: �� Cs�-�� C� AUDRESS: �(� I( c....��jg� �� TEL N0: �� 9�� / Constr�action Location LOT: �� BLOQC: �_ ADDITION: �� S�t9�l,'�'ii, i� � r Corner Lot: � Insicle Lot: � Setback: �� Sideyards: � Applicant attach to this form two Certificates of Survey of lot and proposed buildi.ng location drawn on certificates to scale. � � DESCRIPTIOtd OF CONSTRUCTION • � Front: •1� Depth: ��- Hea.ght: �� Squa�e. Feeta � � Glibic Feet: � Front: Depth: Height: Square• Feet: Cubic Feet: • . ��'�^� Type of Construction �w� �''� i c 1�,'�9 Estimated Cost: $ 1 J-�. ".[b Be Cbmplei:ed: ��J. �� . Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $' $ . , SEE REVERSE SIDE OF SHEET _ 7`he undersigned hereby makes application for a permit for� h agreeing to do all work in strict accordance with the City ruli.ngs of the Department of Buildings, and hereby declare representati s s ed in this applicati e tr DATE: � Z� 7 ! SIGNATURE:. � �e work herein specified, f Fridley Ordinances and that arl the facts and �ect. ^ 5tipulations: p � � � � � � ��.�� a�1� � � � . � �� . � �� d � �'�� _i'� � � � � � � %� �� , ✓ P _�'. _'-_'' I� i �fI B 0 .. _ _. .. . _ . "-:�.,�'y� " BUILDI(JG PERf�IIT FEE SCHEDULE� . � 5�CTION 2. The Insl�ector of•13uildings sha7.1, bePozc i�suing pe�ni�s for the erection oi any bui�.ding or �L-ructure, or �or any addition tn any exisL•ing building or structure, ax for any alteration or repairs to•any exi�ting buildir�g or structure, upan app�.ication LhereL•ore, require the payment by ttie applicant for. such permiL- of L•ees� to, the amount herein below set Eorth and in the manner herein provided L-o-wiL-: • N}3W CONSTRUCTION: Single rami].y IIomes and Garages: $�.00/1,000 cubic iect. . PLAN CHECY.: 25 percent of bu�.lding permit fee. � DRIV�WAY D�PRI:SSIOtJ: (Concrete, Curb Streets Only) �" ' Alternai�e�A: Removal and replacement o£ concrete curb and gutter only; Driveway width plus 6£eet x Y1a.75 -. Alterna�e B: Removal and replacement of cancrete curb and •� gutter and install a 3 foot wide approach with " " ,� 6�.nch depth; Driveway width �plus 6 feet x$17.85 � ; 1 1 � ► � ' ,: � 1 For the purpose oi computing fees for building perm.its, thE cubical contents of any building or addition, is determined by muli:iplying the ground area covered from a poa.nt six (6) inches below t`�e floor line of the basement. or the cellar to the average heights of the upper surface or to the average height of the roof suri'ace of the raain gable of a pitched roof. � For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars-($500.00) or fraction tYiereof in the cost of all proposed work. . , ' In •no r.ase shal.l t.he fee charqed for any permit as set forth in Section 2 be less � •tha.n $7.50 plus $.50 state surcharge. . • � .. _. V�RIFICATIOV OF FOUNDATIOtV NOTE: Permits for construction will be issued a minim�n of 24 hours £rom the time oi application to allow for proper review nf the proposed structure and of the consL-ruction site. ° A Certificate of Survey of the lot, showing the location of the foundation once i� has been constructed will be required before proceeding with the framing. -► : -- � ' E1 ' Applicatian for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for h*hich a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been i.ssued. :� . 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N N xro I�O � ��y � � � xaN a � N "J rS !rt'� � Ai N (I .'3 �mao n a n � F'' w m w ro � � � � � �P N `G N W � m a E � � ��x� � a w � m a�M� �n�x � n 1~-��M I : � � y�j �. H O � � r 0 tr a IL n N N N v 'D 'D r c� y �--I G z "rl O � v 0 � m � � "� � � z c-� --i o � 7 C7 3� •• z -i C7 O 2 z my H (Z �-�+ -G � � � -i c"� �n o � o v z z � t� � lJ < m m < � n m � � � 0 z � m 'T1 � � m � a � 0 Z a Z b �, � � � � iR � SuBJECT • , City of Fridley 2 2 2 01 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � O. � `� _ COMMUNITY DEVELOPMENT DIV. �� ` , r � � PROTECTIVE INSPECTION SEC. � F�� ii = � .--• A��" ;,J CITY HALI FRIDLEV 55432 NUMBER REV. OATE pAGE OF APPROVED BV t �� 612-571-3450 910-F15 1Q/22/93 / / J08 ADDRESS 526Q Horizon Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,0 ]. C3Y1SOri � S SUICtI0.7.'t N.[ailOY.' NOY''�1 SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS Z�P PNONE LICENSE NO. Citywide Home Itttproveznent 1Q05 Ti�T Broadkra - 4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PMONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CIASS OF WORK ❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK RerQO� Eiouse (Tear-o��) 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Huilding Code, Provide adequate attic ventilation. �rovide smoke detectors as per UB.0 1210 adjacent to all sleeping areas and in basement. SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONINO SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCEO. NO. DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PqOVISIONS OF LAWS yALUATIOPI SURTAX AND OHDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2 f 28Q $�-. 14 DOES NOT PHESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW HEGULATING CON- STRUCTION OR THE PERFOfiMANCE OF CONSTRUCTION. $5.4. OO Fire SC $Z , Z S PLAN CHECK FEE TOTAI. FEE License SC $5.00 $62.42 SIGNATUREOFCONTFACTORORAUTMORIZEDAGENT IOATEI yy PER VALIDATED TNIS IS OUR PERMIT . %a-�� SiGNATUREOFOWNEFiIFOWNERBUILDER� �DATE� �? BLOG �aTE �, a . �� . � �� .. � .... � .�v � � . �� N�.v� ._. � ' ��.#ve ��l �1�� ADDN [ J C1TY OF FRlAL�Y ��-� �� ALTER [] Sll�t�1.E AAMII,Y AND �UPI.EXNS R-I AND R-� ° Building Pertuit AppliCatiQn _� � �. � '- �:�� .� ��actructian Addtes,c: � _ _ �, Leg�►t Desc:rilition: . �. Owner N�une 8t Addres.c: ,.,,� Te1. ��, '' '� Cuntrdctor: _ . _ _ MN LIC�NSE # � � t�c�ctress:^, _, „��,� ... '�`el. � .� ` AUacri ta this a�►iicatian, � C �cale cff Survey of the lot, with the p�opased conslruction drawn �n il to sc�ai�. LL'VING AR�A: (�ARAC�i ARLA: DL�K AAF.A: �THER: D1?SCRIFTION OF IMPRUVT1V1�tN'T L�m�,th � Width „, Height LengtlY Width ,� Height L.ength .� . ____`_ Width _, HgtlGrotsntl Sq. Ft. Sq. Ft. _��.___,__� Sq. Ft. Corn�r I�ot [] Insid t[ j Ft. Xd S�tb$��C _ _ Side Xau'd Setbacks Type af Const�,�ctian: ,. Lstimate.ci Ccas�#: � �� Approx. Completion l�te: .,��.. � (Cv�� on a�ck) Driveway Curb Cut Widlh N�ecfed: Nt. + b Ft = Ft x$, ___� _ bATE: 1�' `� � APPLiCANT: �,. . . . _ � T�1. ,� ��' y � Pern�it Nee S�� Fir� Surcharge $__ �� 5t�tte Surcharge $�..,.. �� SA�: Chdrgc $ ...� Lic�nse Surcharge $.. .,_ S Driveway F.sGrow $ _ Paek I�ee $ Sewer Main Cht�r�e $_ . _ 1� 't'pTAL $ � . S'fIPU1.AT14NS: ,�I'�'Y _ US� ONLY Nee Schedute o� Revcrse Sicie .(}01 of Permit Valuatiott (1/lOth9'o) $.SO/$1,0� Valu�dun $700 per SAC Unit $S.QU {S`t�te 1..icen5ecl ltesidentital Contr�.ct�rs) A1t. "A" ur Alt. "B" Abt�ve Fee Delerminid by Fngiiteering Agrt�ment Necessary �] Alc�t Neces,�aly [ j . sue�ecr r City of Fridley L_ �� 9 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � �• COMMUNITY DEVELOPMENT DIV I /T NO. ' j L �"" � / � / / r � � PROTECTIVE INSPECTION SEC � � i � � /"'1 � CITY HAL� FRIDLE� 55432 NUMBER REV DA�E VAGE Of APPROVED Bv �----�; ,.' 612-571-3450 9�0-F15 4/29/97 � � JOB ADDRESS t LEGAL LOT NO. 9LOCK TRACT OR ADOITION SEE ATTACHED DESCR. lO 1 Carlson's Summit Manor North Addition SHEET 2 PROPERTY OWNER MAIL ADDHESS 21P PHONE Tom/Sandy Haskin 5260 Horizon Drive NE 572-8270 3 CONTRACTOR MAIIADDRESS Z�P PHONE UCENSENO Panelcraft of MN 3118 Snelling Ave S, Mpls., MN 55406 721-6628 2179 4 ARCHITECTORDESIGNER MAILADORESS ZIP PHONE LICENSENO. 5 ENGINEER MAIL AODRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW � ADDITION ❑ ALTERATION O REPAIR O MOVE � REMOVE 8 DESCRIBE WORK Construct a 15� x 20� Deck 9 CHANGE OF USE FROM STIPULATIONS See notations on plan. TO �� efore dig�ing caN for. all utility iocatinns 459•0002 REQI�fRED 8Y LJ41�d` TYPE OF CONST. SEPARATE PERMITS ARE RE�UIRED FOR ELECTiiICAL, PLUMBING, HEATING, VENTILATING OR AIF CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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 I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILI BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2�660 DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR T E PEfiFORMANCE OF CONSTRUCTION. �74'.7S � � PLAN CNECK FEE �, / � License C S AT E O� CON7FACTOA OF AUTNORIZED AGENT �DATEi P .. s` SiGNATUFlEOFOWNEAi�FOWNEABUILDEAI iDATE� nr. ir o SQ.FT STALLS � �, 0 OCCUPANCYLOAD CU. FT ' PARKING GARAGES $1.33 iAC CHARGE Fire SC $2.66 '07AL FEE $83.74 I THIS IS V01dR PERMi 0 H�w Cl ADDN (] A[,Tl:lt ( ] Cl'L'Y OF TRII)I,EY SINGL.� I�AMlLY ANU DUPI.�X�S R-1 ANU �-2 Buitding [�crmit Application Corut�vction Address: � . � �`� � �'� � � ��_ �(� � �p � Cffc;c�vc 8/1/)S -�"/9 �/ Legal Description: Owner Namc �t Addrras: I� y`,�'"� _ ��, ... ---,—� , — �el. � .� � �.�:'��`. �.�'�. c�- Contracior: ��,,;�_��.' _� . . �� '� ... . .__ MN I,ICI:NSL �_- � �� Address: �.� � � ��.j t�� '�� ✓/ Ir.'�`� �� C�- -- Tcl. 1i , ��'��-"�`c ' - Alta�eh to thi.s apnlic:ation, a Certificate of Su�cvey of d�e lot, wiU� the pro��osed conslructiun dr.�wn ola it to scale. DESCR1PTtON Ol� YMPROY�MEI�I�' LIV1NGr ARI?A: Length . ._ WidUi _. Height , GA�t.F�.GIC 1�A: Leng�l� _ Width �jeight _. _ ��CfC Al[t��: Y.engih �� _ Width �� Hgt�Caround � OTl � I :R: Sq. Fl, � Sq. �t. $q. Ft. �.�!8�% Corner Lot (� Inside p ol [) Ft. Yd Setback ._ Side Yard Setback-s T j+pe of Consh-uclion: ��r'� � . Estimatccl Cosl: $ . .. .. .�,D?S Ap�rox, Completion Uate: � r�_. __ . (Cos� on Back) D�rivcway Curh C1rE �4fidtts �T�ected: � �t = Ft x $ . _ $ �AT�: �� APPLICANT: �� , �__ , Tcl, /�_��,� r ,�X US� O1�IL�C Pernuit Fec Fire Surcharge Statc Surcharge sAc cn�s� License Surcharge Driveway Escz�ow Erosioa Control Pack Fee Sewer Main Charge TO"I'A[. $ � . �.�_ $ �?. G � $ 1.33 _.._ $ .. . _. , $_ .OD _ $ .. $ S` ._ $ . . .._ S 83• �� Fce Schedule on Reverse Side .001 of Pcrmit Valuation (1/xOth�) $.SO/$1,000 Valuatinn $85Q per SAC Unil $5.00 (State X.icensed Residential Contractors) Al�. "A" or Alt. "B" Above $450.00 C�nserva[ion Plan Review Fec Determincti by Engineeriu�g A�•cement Necessary [ ] Not Necessary [ ) STIPULATIONS: - ' 0 � ' � z . � � n � m � � � �2�� Ofi�IZON Dfi�IV� � - - - - - - - - - m r Cl ��o�-�� cu� 3 �z i i N� J ' O I A I � � � , � z � � n � � ti 3 . � � I \�. `�6� . i ,9,, . \ �� N N �� X �a� � `� ° � �E° i ��v mbZ�A N��-t � o N� � �rn��N�7o�0 00�� 70��D�AO N�� b�`�ov � ��' �`��'`o ��`��m�� '°1 � rn � Z �r° �n° .� � � � -n -o -o -+ � « �, a �N— °�� o � � —�� z�o �zg �� ^ � rn N � 6 ,A � � .. C� D � r � ii1 ..- � �� -- 0 �' _ � A n � 1� a '� E cn o z m n � N --F �,C' '--� � � � � r C� � 3 �Z m N O � A z n w �+ :. �, �. �� Xt�t �c�y r tp ��Z 0 ��t�A 8 � ��$ �g 0 � � D � � z� � � � � � Q� �� O v� � w � �P � br O ,c,�n � gV W � � � � � � �I► U o � 3 Cl � � Z m � � � �y�� m � �� A � l7�Am n -� ��n0� � ��r�� m� a ,�•�� i �� —��" c �� o � �� 3�m � �� r rn � O`�� - r O n � � � � �� W � 8 � .U�' � � � 0 � � � p � E� �� s � �, N �� E � � � S `� � � � � � � � � �� O O � �� n� � � t�i ca n z � -� � n --� m � � � -U z m r C1 � � � 3 z m � O � b� z n � N � �. u �. � � � � e � -� u n b r rn � �� - e � � � � � N �' �rn �rn �� ,�_ � ,_ ep � � �rn rnr .. t--�-�r �� „_ � ' O 0� o� n O z N --t � n rn U tA -( � D Z rn r C1 � � � 3 Z z m N O � � z n � � � � � n � � C� � � a � � a � —n � � r � 0 0 � � z� o� �rn o —+ � �' D� � � m r � � �r � x €�O mr � � )C � � �� ' � n g � = r zm �u�=�� o m � � � �� o -+ C7 $ � � o N � �rn� �� N� �� d r D� r o r=� � rn fi � 0 m � � � � A � � O N � � � � � � � � �� y � � O N � � O � � -D � r n � � 3 � CP � -�f � z n � � � a � � � � � u � � 0 � � 1""' O � --� � O� -+ � � 0 � � 0 R � m W L A �g "' .: w -• .� �. � � N - m X � � �i � ��S X X ,p' � �� - � � � � � y�f�� d �� o �� $ �� r � �� g ; �-� g� �g � �� _ � -� � p, n m � �m e / � �� i ! A \r= r �� a � X X X �� ' � n . Q x�, x� ?S � ° � � �s rn rn v = i7 v n A 70 v v��' � A �0 �� m�� o �, � � �� rn O -Ni 0 � � � I I I �� a � �� -( �, ,XA, X �� O � � S� \ E� � II — II S CP � _ < 4, � EO P sue�EtT pE c�ty of Fridley 2 95 06 ' ` AT TNE TOP OF THE TWINS g � I L D I N G P E R M I T IPT NO. � � `L _�� COMMUNITY DEVELOPMENT pIV. � ^�� r � � PiiOTECTIVE INSPECTION SEC. �� _ � ' �'�'1 � CITY HALI FRIOLEr SS�32 NUMBEii pEV DATE PAGE Oi APVRpVED BY �'""'�� '' 612-571-3460 910-F15 5/20/99 � � JOB ADDRESS 5260 Hori zon Dri ve NE t IEGAL LOT NO. BIOCK TRACT Oii ADDITION SEE ATTACMED oescR. 10 1 Carl son ° s Summi t Manor North SNEET 2 PROPERTY OWNER MAIL AOORES$ 21P PMONE Tom Haskin 572-8270 3 CONTRACTOF MAIL ADDRESS ZIP PMONE LICENSE NO Panelcraft of MN 3118 Snellin Ave S M ls MN 55406 7 1-66 8 4 ARCHITECT OR DESIGNER MAIL ADDFiESS 21P PNONE LICENSE NO S ENGINEER MAIL ADDqESS iIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WOFiK O NEW O ADDITION O ALTERATION �( REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Fascia, Trim, Patio door Storm door 9 CHAN(iE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING. HEATING, TYPE OF CONST OCCUPANCY GROUP OCCUPANCv �OAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SQ. FT CU FT. AUTHORIZED IS NOT COMMENCEO WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDEO OR ABANDONE� FOR A PERIOO OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ ANO EXAMINEO THIS APPLICATION STA�LS GARAGES AND KNOW TME SAME TO BE TiiUE ANO COFRECT. ALl PROVISIONS OF LAWS VALUATION SUpTAX ANO ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED W17H WHETMER SPECIFIEO HEREIN Oii NOT. TNE GRANTING OF A PERMIT $5255 �Z.63 DOES NOT PRESUME TO GIVE AUTMOfiITY TO VIOLATE OR CANCEL THE pEpMIT FEE SAC CNAqGE PROVISIONS OF ANY OTHEF S7ATE OR LOCAL LAW REGUTATING CON- TR C710N OF TNE PERFOflMANCE OF CONSTRUCTION $125.2rJ Fire S �'rJ.2'�J . pLAN CNECK FEE TOTAI F Licens 5.00 $1 .13 S�GN TUAE FCON'AACTOAOpAUTMOA�ZEDAGENT �OATEi EN OP �IDATE IS IS VO R ER IT � � � S�GNOTUAE O� OWNEp�� OWNEp BIiRDEp� �DAiEi B�0 �NS� r��tE . w NEW � l ADDN [ ] ai..�z [ l CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUII,DING PERMIT APPLICATION ConstructionAddress: J�� l�f"! ��r� �I�' Effective 1 / 1 /99 �� f1Q'-�n�l� Legal Description: Owner Name & Address: ��'/ /7 � si<i�, -�a (o' � �f�v� � z � �" � `' Tel. # �s �a � � � � � Contractor: � v?� �'�' �t o � ��'J MN LICENSE # .� / � Address: �3f� � .Ss� e �� v� . .�, f�''/��' � �� SS �D fa Tel. # -7 � � - Co �a �- �' Attach to tlus application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. IDESCRII°'rI01o1 OF IlVIFItO�NNYENT LIVING AREA: I.ength Width Height GARAGE AREA: Length Width Height DECK AREA: L,ength Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. OTHER: �Ct SG' /%� �/ s�`/j ��F / ! d �G� F�" /' e c:, Construction Type: ,S i �� r� �1.� 6 � _ Estimated Cost: $ �vZ �� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x o =$ • .�" l C/ '� � APPLICANT: C-C��2�� Tel. # 7� � � � � a � DATE. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ ,�� Fee Schedule on Reverse Side $ ,5 �,� .001 of Permit Valuation (1/lOfih%) $ ,�.(�.3 $.50/$1,000 Valuation $ $1050 per SAC Unit $ ,� � � � $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservarion Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] � l � 8`, /3 .�,-W BUII,,DING PERMIT FEE SCHEDULE The Chief Building O�cial 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 e�sting 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 $S00 $501 to $2,000 $2,001 t� $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 $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 iust $2,000 plus �12.5C1 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 additiona.l $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1, 000 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, 000, 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 tunes $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. 3R�, Building Inspections 763-572-3604 �� PLUMBING RESIDENTIAL APPLICATION CITY OF FRIDLEY DATE 4 � (� YOU,/R� -MAIL ADDRESS SITE ADDRESS /�se THIS APPLICANT IS: ❑ OWNER I�ONTRACTOR PROPERTY NAME: h'1 D � OWNERI qDDRESS: ��'�fo� �%pv` Z� �1 /, TENANT PHONE: ��a�° �� CONTRACTOR wie�n�•Ti_ o .s ,,,_ �i. �r� �... oG SUBMIT A COPY OF YOURSTATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: STATE L[CEN � #_ ADDRESS:�� I PHONE � �INGLE FAMILY O NEW DETAILED DESCRIPTION OF WORK 1��J EXP DATE / �/ (/ L � � CITY � �19 -ty�eZZ�— FAX � s ��Z �� 0 TWO FAMILY ❑ TOWNHOUSE L�ZEPLACEMEN'I' � �� ` � i1 !� �Gr �L' � � , Pemut No.: Received By:_ ��T 'A' 'A�� IP, c c� �� PER MS 16B.665 the permit fee is a minimum of 515.00 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 $300 =$ I5.00. Labor cost between $300 to $500 = cost of labor e.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BEI.OW) BATH SMK/LAV FLQOR DRAINS SHOWER WATER PIPING _ BATHTUB GAS PIPING rxH:i:n r��rurr:n:eF:) SWIMM[NG POOL ,� WATER SOF7'NER ($35) CLOTHES WASHER KITGHEN SINK WATER CLOSET BACKFLOW PREV. ($15) _ DISHWASHER _ LAUNDRY TRAY �WATER HEATER ($35} FOR IRRIGATION _ WATER METER _OTHER Permit Fee $ Surcharge TOTAL DUE $ Number of fixtures @ $10.00 x $10.00 = $ .50 Number of fixtures @ $15.00 x $15.00 = $ _ Number of fixtures @ $35.00 � x $35.00 = $� State Surcharge = $ 50 Tota1= $ `7D..'� THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and 1 acknowledge that the information above is complete and accwrate; 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 or a per ' and wor ' ot to start without a permit; that the work will be in accordance with the approved plan in the case o wo whic ires r ie and approval of p � SIGNATURE OF APPLICANT PRINT NAME i/�� L. ¢� ATE d/ �� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 F,4X: 763-502-4977 ; Building Inspections 763-572-3604 763-502-4977 FAX DATE � � .S � U SITE ADDRESS � � j THIS APPLICANT IS: PROPERTY NAME: OWNER/ aDDRE: TENANT PHONE: MEC�IANICAL 1ZESIDENTIAL APPLICATION CI`TY (��' F�tIDIJEY EEFECTIVE Z-19-09 YOiTR E-M.4II. ADDRESS ❑ OWNER �CONTR.�.CTOR CON'�RACTOR I COMPANY �� CIl'Y Permit No.: Received By:!`� Da�'�+U G STA E SUBMIT A COPY OF �UNTACT PERSqN: FI.OyCl JOSW1Ck YUUR STATE STATE LICENSE # EXP DATE LICENSE WITH �Dt�s�221 University Ave N E cirYFridley srarEMN z�55432 APPLICATION pHONE 763-572-0459 Fax763-572-0164 P�IZli'IgT �I'YPE I�SINGLE FA:vIIL�' ❑ TWO FAA4ILY TYPE OF WORK• � NEVd '�REPLACE�IEN7 DETAILED DESCRIPTION OF WORK C�D M'r ❑ TOWNHOLTSE O .aL TERP,TIUN/REMODEL FEES ARE BASED ON $10.00 PER FIXTi?RE, E''EP ' NHERE NOTED. FIXTI?RES: (�ypY 'r1 T TAL NLI?1IBER OF EACH BELO�i� Equipment Installed N1FG: MODEL: �//i {� SIZE.�BiU---yy� MFG: MODEL: SIZE:BTU MFG: MODEL: SIZE�BTU �A�C 525.00 FIREPLACE (GAS) SI5.00 _GAS RANGEJOVEN 510.00 _AIR TO AIR EXCHANGEER S15 FIREPLACE (WOOD) S35.00 NEW GAS GRILL S10.00 _BQILER S35.00 FLIRNACE 535.00 GAS UNIT HTR 510.00 _CHIIVINEi�' LINER S10.00 GAS DRY'ER S 10.00 POOL HEATER S35.00 _DLtCT «�ORK S 10.00 ' _GAS PIPING S 10.00 _�'ENTII,ATOR S 15.00 Niunber of fixtures �) $10.00 x� 10.00 =� Number of fixh�res (a� $15.00 x� 15.v0 =$ ftl Number of fixtures (n� �25.00 � x �25.00 = $• S• ^ Nuinber of fixtures (a� �35.00 State Surcliarge = $ .50 x $35.00 = � (1v1.t1viMUM FEE �3S,S0) Tota1= $ �j.� � (J ' 7HIS IS AN APPLICATION FOR A PERMIT-NOT VAL,ID UNTII. PROCESSED I hereby apply for a building pernut and I ackuowledge that the information above is complete and accurate; that the work will be in conforuiance widi tue ord'uiauces a�id codes of the City of Fridley and with tlie Muvnesota Construction Codes; tliat I understand this is �iot a peniut but only an app cation for a permit and work is nor to start without a pennit; that the work will be in accordaiue with the approved plau in d�e case of �11 work wl��req�j�s review aud approval of plan�. AA SIGNANRE OF-APPLICANT NAME TE PERMITS ARE UIRED FOR BiJII.,DING, ELECTRICAL AND �ity of F�°idley �uiiding Inspections Department b431 University Avenue NE, Frldley, MN 55432 763-572-3604 FAX: 763-502-4977 G City of Fridley Residential Mechanical Application Page 2 REQiIIRED INFORMATION NEEDED TO PROCESS PERMiT RESIDENTIAL PERMIT APPLICATION HVAC � NEW HOMES/ADDITIONS �' �XISTING HOME _' MAKE-UP AIR REQUIRED FOR leTEW/EXISTING HOMES ___ __ _ 1�_ C�m�ustion Air�See note below) __ __ a. Oil or solid fuel IMC Cliapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MIN 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 witli MN Amendments REUUIRED FOR NEW HOMES . 4. Heat loss & cooling load per room a. Required oi1 new constniction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 -- - - —��uctIIesigri er . .� — ___ _ - - - - - a. ACCA Manlial D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air cAlculrations.