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AF - 46430aue�etr P . City of Fridley 3 0641 � AT TNE TOP OF TNE 7WINS g � f L D I N G P E R M I T � � COMMUN�TY DEVELOPMENT DIV. a �, ! . i � V � � �� r � � PROTEC7IVE INSPECTION SEC. r . � i--_- A ��"' �'� CITY HALL PRIDLE� SS132 NUM6EP REV D�TE v�GE O� �PVqOVED Br l �� 612-571-3450 9t0-F15 1/25/00 / / 10B ADORESS 5180 Hughes Avenue NE t LEGAL �OT NO. BIOCK TRACT OR ADDITION SEE ATTACMEO DESCR. 1() 7 Carlson's Summit Manor South SNEET 2 PROPERTYOWNER MAILADDRQS$ 2�P PNONE Jerold Moses 5180 Hughes Ave NE 572-9161 3 CONTRACTOR MAIL ADORESS ZIP PNONE LICENSE NO Master Remodeling Inc 32 10 Ave S, Hopkins, MN 55343 932-9311 20012916 a ARCMITECT OR DESIGNER MAIL AODRESS ZIP PMONE LICENSE NO. 5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION O ALTERATION � FiEPAIR O MOVE O REMOVE 8 DESCRIBE WOfiK Reroof House & Garage (30 Sq) Tear-off; Soffit/Fascia/Gutters 9 CHANOE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Install soffit ventilation to meet the State Building Code. �� `:, a ��'t�r� �i��lr�� bl �� r��t Inspe�t�on ��r�s ��r ��ss� ��a�� NSml1 �� Mailed a��ooa� To Mom�o�ner To �ost �� , �� TYPE Of CONST. OCCUPANCY GFOUP OCCUPANCV LOAD SEPARATE PERMITS ARE REOUIpED FOR ELECTRICAL, PLUMBING, MEATINCa, VENTI�ATING Op AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING S�. FT CU FT AUTHORIZED IS N07 COMMENCED Y�1ITHIN 80 OAYS. OR IF CONSTRUCTION OF WORK IS SUSPENDED OR ABANOONED fOR A PERIOC OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCEO. NO. DWLG. UNITS OfFSTREET PARKING I HEAEBY CEfiTIFY THAT I NAVE READ AND EXAMINEO TMIS APPLICATION 1 STALLS GAiiAGES AND KNOW TME SAME TO BE TRUE ANO CORREC7. ALL PfiOVISIONS OF �AW$ ypLUAT10N SURTAX AND OROINANCES GOVERNING THIS TVPE Of WpRK WIIL dE COMP4�E0 @ WITH WHE7HER SPECIfIED HEREIN OR NOT. TME GRANTING OF A PERMIT 4'4s622 �2.31 DOES N07 PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL TNE pEWM1T FEE SAC CMARGE PROVISIONS OF ANV OTMER STATE OR LOCAI LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION � 111 .25 ire SC �4. 62 PLAN CMECK FEE TAL FEE Licen SC $ .00 $123.18 S�GNATUpE OF LON •AACTOA OA AUTNOp�2E0 AGENT IDAT�� W EN P RLY V UD ED TMIS IS UR PERMIT � ' ��1 G �o-� S�GNATUAE O� OWNEp��i pWNEA BU�IDERt IDAfB� LOG iNSo � ��1F �u(+-10-1770 11�37 rKUI'1 �11r UF fklLLtr IU y��y�lb N,bl�b� N� � � Effective I / 1 /98 ADDN [ ) CITY 4F FRIDLEY �-T� ( l SINGLE FAMILY AND DUPLEXES R-l. A1�D R-2 �� / �� ILDING PERMIT APPLICATION (� /� , / `� i� constructionAadress: J`�J�f—�%'•� /�7v�'jLl '� /�v� �l/� � � Legal Description: Owner Name & Address: J`�,[ o lf l/J%4 ��--� � Tel. #�S'�7 'z "' �/�o/ Contractor: ��,t� h� �",�;:` �; _,_, MN LICENSE f� 2� l Z9'f !o �� c��n� e�F��.;,� �i!'s-. Address: . ' Tel. � 9�2 — 93 / / � �,. _. , �_ , �. ��'��, 'ta tius application, a Cercificate of Survey of the � ' �'�-� _ . lot, with the proposed construction drawn on it to scale. LIVING AREA: GAR.AGE AitEA: DECK AREA: DESCRIPTION OF IMPROVEMENT Length W idth Height Sq. Ft. Length Width Height Sq. Ft. Ixngth Width Hgt/Ground Sq. Fc. OTI�R: f� !�r- Conscrucaon Type: D � 2� s��unaced Cosc: $ `7`� � Z. (Fee Schedule on 9ack1 Driveway Curb C�t Width Needed: Ft. + 6 F�t = t x$ _$ ,/ G�� DATE: �'� Z 7—�APPiiCANT: Tel. � l 3 2-9�/ / CTTY U E ONLY Permit Fee $ ) � �� 2 5� Fee Schedule on Reverse Side Fire S�rcharge $ .( 2 .001 of Petmit Valuation (1llOth%) State Surcharge $ � 3 $.50/$1,000 Valuation SAC Charge Liccnse Surctiarge Driveway Fscrow Erosion Concrol $ 51000 per SAC Unit $ $ : � $5.00 (State Licensed Residential Concractors) $ Alt. °A" or Alt. "B" Abvve $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agzeemen[ Necessary [ J Not Necessary [] TOTAL STIPULATIONS: $ /�3./� /� � � ��`5�a�_� 3 ��/ r,��N 2 4 2000 C!R:�1�L$ j�%� �A�by�� `.� � 1��9 Y9n P City of Fridley AT TME TOP Of TFIE TW�NS � � I�. D i N G P E R M I T r � • � �� `y __�� COMMUNITY DEVELOPMENT DIV. r � � PAOTECTIVE INSPECTION SEC. � � �'�'1 � CITY HAIL FRIOLE� SSIJ2 NUM9Ep REV OATE �� '� 612-571-3450 s�aF�s 4/19/00 JOB AODRESS 5180 HUGHES AVENUE NE 1 LEGAI LOT NO. BLOCK TiiACT OR AODITION oescR. 16 7 Carlson's Summit Manor South 2 PROPERTY OWNER MAIL ADDRES$ Z�� Jerold Moses 5180 Hughes Avenue NE 3 CONTRACTOR MAIL ADORESS Z�� Master Remodeling Inc 32 10 Ave S, Hopkins, MN 55343 4 ARCHITECT OR DESIGNER MAI ADDRESS ZII 5 ENGINEER MAIL AODRESS 8 USE Of BUILOING Residential 7 CLASS OF WORK p NEW ❑ ADDITION O ALTERATION �7 REPAIR 8 DESCRIBE WORK Reside House & Garage; replace windows in existing openings 9 CHANOE OP USE FROM TO / / 30847 �3� � vROvEO Br SEE ATTACNED SNEET PMONE 572-9161 PHONE LICENSE NO 932-9311 PMONE LICENSE NO. PMONE LICENSE NO O MOVE O REMOVE STIPU�ATIONS Provide s�oke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Perr�lt In�� rds f�'lll ��:� ��d To H00118a�� POSt TYPE OF CONS SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING. HEATING, VENTILATING OR AIF CONDITIONING. TMIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION 20NIN(i AUTHORIZED IS N07 COMMENCED V�1ITNIN 80 DAVS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANV TIME AFTEq WORK IS COMMENCED. NO. DWLG. U I MEREBY CERTIFY TMAT I HAVE REAO ANO EXAMINED TMIS APPLICATION 1 ANO KNOW TNE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAIUATION AND ORDINANCES GOVEiiNING TMIS TYPE OF WORK WILI BE COMP�IED 11 � 9OO WITH WHETHER SPECIFIED MEREIN OF NOT. TME GRANTING OF A PERMIT � DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEL THE pEqMIT FEE PROVISIONS Of ANY OTNER STATE OR LOCAL LAW REGUTATING CON- �ZO9.ZS STRUCTION OF TME PERFORMANCE OF CONSTRUCTION PLAN CMECKI Licens S�GN4TUpE OF CON'AACTOA Op AUTMOp�2E0 OGENT ID�TE� � Er No � S o � �y' OCCUPANCV SO. fT STA�LS $5,,,Qp� LOAD CU FT OFfSTREET PARKING IGARAGES SURTAX $5.95 SAC CHARGE Fire SC $11.90 TOTALFEE $232.10 . TMIS IS VO PERMIT �) � ' �� %i%' i p6fE JU�'�-10-177C1 11•.)`>' rKUI'� l,l � i U� 1=k1LLtr ��J �j,S�yjlb I�,�]�'�j� N� � � Effective 1/1/98 ADDN L l CITY 4F FRIDLEY ^ �-T� I) SINGLE FAMiLY AND DUPLEXES R-� A1�D R-2 Q�' ` BUILDTNG PERMIT APPLICATION i) � � �� ConstructionAddress: _ ,Sr� �d� � � �'t/� %1%�— � Legal Description: Owner Name & Address: ; �n a/�' /��.� � < Te�. � � � 2 r� Z 9i�/ Conuactor: ��,�. /��p� �, ��1�� MN L,TCENSE ft_ 207�/ Z 4�� Address: �2 �D �' /�/� S' f� �'+� Tel. !� �< Z 9 2- J�// . , LIVING AYtF.A: GARAGE AREA: DECK AREA: OTI�R: Attach to this applicarion, a Certificate of Survey of the lot. with the proposed conswction drawn on it to scale. DESCRIPTION OF IMPROYEMENT Length W idth Height Sq. Ft. Length Width Height Sq. Ft. Leugth Width Hgt/Ground Sq. Ft. r � � � Construction Type:` � fr�•y^-�o•�5 Estimated Cvsr. $ �� (Fee Sched�Ie on Back) Driveway Curb C�t Width Needed: Ft. + 6 F�t = Fi x$ _$ DA'TE: APPLYCANr: Tel. �t Permit Fee Fire S�ucharge State Surcharge SAC Charge Liccnse Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Chazge TOTAL CTTY U E ONLY $� D�, 2 S� Fee Schedule on Reverse Side $ � I, 90 .00� of P��c v��on ci�iocn�� $ �', � S- $.50/$1,000 Valuation $ $1000 per SAC Unit $ ,� �� $5.00 (5tate Licensed Residential Contractors) $ Alt. "A" �r Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreemen[ Necessary [ ] Not Necessary [ ] $ � STTPULATIONS- �� -�� p.� �G� ,��U�"1�� iz'��-f-✓� ;�.��- S�"�� l°. � /�'�� G��G . . ._ � � i�� G�� `�� Building Inspections 763-572-3604 SITE ADDRESS THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRA.CTOR SUBMIT A COPY OF YOUR STATE LICENSE WTTH APPLICATION PERMIT TYPE TYPE OF WORK: PLUMBING RESIDEN�I�L APPLICATION CITY OF FRIDLEY O OWNER STATE LIC 5E #_ ADDRESS: PHONE °L� �� GLE FANID.Y ❑ NEw - � DETAILED DESCRIPTION OF WORK YOUR E-MAIL ADDRESS ❑ TWO FAMIl.Y CITY �� Permit No.:, Received By: °7 �� - �'L�i� .�� i � !1r , �%� 0 TOWNHOUSE PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cQSt up to $500.00, whichever is greater, for the improvement, installaxion or replacement of a residential fixture, excluding the fDCtures. (This should reflect only the cost of labor ) Labor cost under $300 =$15.U0. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $i00. FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FlXTURES: (INDICATE TOTAL NUMBER OF EACH BELOVI� BATH SINK/LAV FLQOR DRAINS SHOWER _ WATER PIPWG BATHTUB GAS PIPING (n�m cmuc�r✓s� SWININIING PCCmL WATER SOFi'NER ($35) CLOTHES WASHER KTTCF�T SINK WATER CLOSET _BACKFLOW PREV. ($IS) DISHWASHER _ LAUNDRY TRAY �WATER HEATER ($3� FOR IItRIGATTON — _ WATER METER _ OTf�R Fee 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 = $ 35 State Surcharge = $ 50 Tota1= $ � THIS IS AN APPLICATION FOR A PERNIIT-NOT VALID UNTIL 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 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 worl�vl�ch requi�es�re� iew�nd approval of pl�s^ �_ �, ��.� P �� SIGNATURE OF APPLICANT City of Fridley lBuilding Inspections Department 6431 University Avenue NE Fridley, MN 55432 � 763-572-3604 FAX: 763-502-4977 � � � �