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AF - 46725City of Fridley, Minn. B� �= 5 ING PERMIT No 611 fi Date: —�,f *.a�"' �� '`"'. � � f Owaer: Buflder � Address Addre�s � � � " � LOCATIO �ING No. �� treet _��! �� .,� � P I.�t � Lo Block �� Addition or Sub-Divisian '� Corner Lot —_ Ins3de Lot —� Setback ti*�._� Sideyard �� Sewer IIevatian Foundatlon IIevatiaa DESCRIPTION OF BUILDING To vsed f F'ront .��I� Depth ti�_"'__ Height � Sq. Ft. � C�1. Ft�#��I� t Depth _..._� %Teight � F� � Cu. F� Type oP Constructio Fs� Cost �.�(��_-_ To be Completed r.. In consideratlon oP the �tssuance to me of a permft to construct the building described above, I agree to do the proposed work in accordance with the desc�iption above set forth and in compliance with all proviaions of ordinances oP the dty oP Fridley. � In cansfderation oP the payment of a fee of $.� , permit is hereby granted to to construct the buiiding or addition as described above. This permit is granted u�n the express condition that the person to whom it is granted and. his agents, employees and worlunen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding lacation, conatruction, alteratfon, maintenance, repair and moving of buildinga within the dty lian�tts and this permit may be revoked at any time upon violati�-�aay oE the provisions of said ordinancea � .� , .�° Buflding Inapector NOTICE: T6ts psrmit dea em eovsr ths eoeshueHoe, testallafiee fee wie1�9, �lumbin�, �a haNeo, �nr er rr�r. B� suro to ss� 16� Baildieg lesp�ete� fo� aparal� premib fet t6a� thea. ..► .-. .. -��,y, � � � 1 r � -w'�� PPLICATION FOR BUILDAdG PERMIT CITY OF FRIDLEY, �OTt owner s Name � C�v,�sT� � !�i � �d'/t'� �/ •�'uitaer S �a- �i != lddress ��3.5 D (��i ��Y 5T �ll>�° Address S��T •— � LOCATION OF BOILDTNG No. St�ree�_ l� l� r�- C� Part of Lot I�ot _ �� . Block � Azld3tion or S�.b.Div � �/ l�� '/� !� /�% �/i T� Corner Lot Insicle Lot � Set �.ck � s� ( 3ide-Yard L��, „/`/ � S�'41ER. ELEVATION FOtiNDATION ELEIlATION Applicant attach to th3s form Certificate of Survey of I�t and proposed buildin� location. DESCRIPTION OF BUILDING To be used asa Front .. 2. `� , ,____DePth � � Height � � Sq. Ft. �l Sr � Cu. Ft.. /��°I 7�v � , Front Depth He�.ght Sq. Ft. G'�t. Ft. Type of Construction ,�= �r¢��. Estimated Cost � � To be completed �.�._,,,�//`f �� The undersigned hereby n►akes applicat3on for a pex°mit for the work herein specif'3.ed, agreeing to do al1 work in strict aecordance with the City Ordinances and ru].ing of the Department of Bu37.dings, and hereby declares that a17. the facts and representa- t3ons sta.ted 3n this application are true and corre t. DATE z,�� / �l � � , SIGNATURE � , D� (A Schedule of Fee costa can be Found on the Reverse 5ide.) � �m � f�' �/�'" - - .� ;� �, o- --., � � �_<' .� BIIILDING PERMIT FEE SCHIDULE Section 2. The Inspector of Buildings she11, before issuing any permit for the erection of any bui.lding or structure, or for any add3tion to any existing building or structure, or for any alterations or repairs to any existing builclin� or structure, upon application therefor� require the payment by ihe applicant for such permit of fees to the amount here3n below set forth and in the manner herei.n provided to-wit: 2.1. For a.n9 such permit for the erection of any fise--proof buildi.�� other tha.n a gaxage, warehouse, factory or grain elevator, or for the erection of an�r fireproof addition, for similas occugancy, to any exist3ng buil.din� shall be at the rate of �1.40 for each one thousand cubic feet� or fraction thereof� in such cubical contents. 2.2. For ang such permit for the erect3on of any f3xeproof �arage, ware- house, factory�"or grain elevator,� or for the erection of e.ny fireproof addition, fbr similar occupancy, to any exi�ting building �ha1l be at the rate of �1.25 for each one thousand cubic feet, classified as "f3xeprooP" . by Section 502 of the Minneapolis Build3ng Code. HOIISES 2.3. For an�r such permit for the erection of an other than a garage, warehouse, factory or grain fireproof addition, for s3mil,ax oocupancy� to an Permit $]..� for each one thousand cubic feet. G1�AGES y non fireproof buil.ding elevator, or any non- g exist3.ng bu3lding. 2.l�. For any such permit for the erection of any non-fireproof garage, warehouse, factory or grain elenator, or for the erection of any non- fireproof addition, for similar occupancy� to ar�r existing building for each such bu3.lding or addition. N3nety Gents for each one tho�d cubic feet or fraction thereof, in the cubical contents thereof with a �initm�m oF �1i.�00. For the purpose of computing fees for building permits the cubical contents of an� building or addition to a uniform height throughout by multiply3ng the ground area covered from a point six.(6) inches below the floar line of the ba.sement or cellar to the average height of the upper surface or to the aeerage height of the roof suriace of the main gable of a pitched roof. 2.5. For repa.irs or alterations to an existing structure� the fee shail be at the rate of �3.00 for each Five Hundred Do].].a�,s (�500.00), or fraction thereof in the cost of all proposed work. 2.6. In no ca.se shall the fee charged for any permit as set forth in Section 2 be less than ��..00. � , � � �, = - , 335� �� y` �� : �— �� e. .s�� 9, is�a �. C�aerster L. l�ci�ze� 63�3� C�uiaa�� tre�� . E. 4��13� 2i, �� e s �a�i�.��aa� ��ra�� o. 6416 L�s 47 � 4�, �i�k S, ��.ve�de�r Hsi��s 8��a�es! �/3S?/62 �� Sir; ��a �aa�� }��a��c� i� �r�� it� ��► w�ls� �i�d3.y e�� ,�z� �� .�� fa ��;�� c�� `�� ,b�� . �e �� :��n;� :�.`��.�:o ::�� a � : c�Cs , . � � .,�� ,d�� ,, _ , .:, 1_ y,�, .,,a��_� �;�y �� i ��`� ;, � G. 5��9 �saild�.� I��ectos � V �+� c� �VvL � ��.U�t f�.N.� �SSOC�a��S, �U�C. LAND SURVEYORS Anoka, Minnesofia ' I CEttTIPICATE OP SURi/�V: Cheater Meciae2ek g-�r 1�� 6,�p �/� /-� �� L � �� J � . 1�r � �S-t • �VGa . 5�•, M 5 � . 2. . d 25 � p. � � � 1 0 0 0/ , �y, b � �a � ,a� � , , a — , � � — ► :� �, � � 4�� '� \ U� � ' �► 3- �, -� �'�' ' � r 1 � . 'j� ��. �Os� � P�4� `�o Lots 47 nnd l�8, Bloc�c S RIV�RVIEW AElt�iiTS Anoka Co�t�, Minneeota Telephon� �421-6340 �I 764-117-�6 � �, — - - - - ,_5-F G� , --� QEnroT�s 1 Ra►r►�a _�> — �F� .� 1 HEREBY CERTIRY THAT THIS IS A TRUE AND CORRECT &EPRE59JTATION OP A SURVEY OP THB BCUPlDq1�E5 OF THE ABOVE , DESLRIBED LAND, AIdD THE lOCAflOP1 OP ALt BUq.DWGS, THfRfON, AND ALL VIStB1E BYCROACHMEt�iTS, IP APIY, F&OM OR ON �91i1 L.AND. , �, .f AS SURVEYED BY ME TFRS ....��C� DAY OP ...............AT3g,i18t.... .............».o... A.D. 19.6Z.. Id. C, HOIUM AND ASSOCIAT , INC � LAND SURYEYORS _ �� :�� . ,� ,,•� ............................_.................._...... ........ ...........................................�................... d, � 3 _ ..., � � � � � 1 ;�1 ; � � d � n � 'd N o '� p � . M . 7i . � . m • M : o • O • a . m �7 . � . � • v, �, V - � � N � � � ►� H � � W � � O � � �j t+l o � � � N � . O • o � : o . to : : � : : � � >d iE �a N � � o O G � ai ris �a � "� . O � � � � � z � � � � � m m � Z x 8 � � � � n � � � � � � � � y � � � � � � ;d : O � � � � a � � � � a ; � �_ : � N • 6 � V°oo : �' °° : � � . . . . O W : : : : : � : : : : � O i! k DC i4 k �E W n� w r� ►� � '�I eNii °p ca o 0 0 „�,� e�3 tn tn t�n tn t» tn � � H H � � � � 0 � x 4d tl � � � � � D � i D � m �^ lI 2 m C r m o � I �z y a � � � � � � dQ � � 0 �`3 `4 � m � � 0 cr � 0 b t�-h a � � � � � � a. � ~ � a � � � � � � �M � � � � � � � � � � � � 8 8 M � � a � � � °w � b�i � c o�xi y WATER ca.osers URINALS enT►+ � BASIRS SINKS �WA4H ra�rs DRINK. FOUNT. sHwas. �FLOOR DRAINS CATCH &\.INS wuTo 11/ASFIER �� APPL GAS RANGE GAS OPENINGS a • z . r � s � A m � m � ��b �aa�" � � � °�, �tiaR'� � �o�� y � oc�o 5' ". `' y CU � � '� �a � �� '��a er � � �"�� b � �ro � b �N�m w �o � � o p �' �, o ��w � ¢�� o��. ��y �w W� �. � � m �oo pr a oa' �+ � � � i M, � 11 3 `� � r C m M � � A �ro aQ A � &� p � M � �n w � � � �� i � � � � � � � O � "�7 � � r o 0. �- � � � � � M � M � � � � �. Q o � � A �� + � o � � � � a r r+ � � U O� m �� A � T �� P p oOb .�. p Z iY � 2 p _� � T �>z �o r�� •� s T 3 O � :< � Z A �� " �o � o M � � � �� O � `� � � � � � Q � �� M � H � �h ° � � � � ��- � M � M x 4� � � b � � �' �Wo �, � o o � � � � �: � � � 0 0 . ;� �' o � � o � � w � � � � � w � � �►. � B� � � � 1 � � � �' °� oy� o � G b O r � � � � � cq � �. �, � � � � � � � . � � �� ' m w � � � �. o M ,�a. a � `° � w w � p�' y 0 o a � � � a �° �° � �� s. � � � � � �.� o0 � � � F! ' � y„ : : '`b � . . � : : � �. : : � : � � N � � � o o c °o � � z � � �' � ro � v � � � � o ' p� x ct� � � � M � � � � � o � � o � � �° � �° � � ��'� � � �' R� R� � � � � ��° &�� g1 o � Q � fp O � � � � � � a. � ' � � c�n ; . " 0 . O $ Q° � � °o � � � : � � � � N � � a o 0 0 0 0 0 0 0 � � � a � ° � z � � � �, � � � �' � � g � ' � I� y� O � � � �� Q i � `0 '� � � o �° � � � m m m � � � � � � �� '�� o � a o ?? �� 8 � o : �, a � ; � C�7� p � . 0 0 : . °o • : : � N��,�� o 0 0 0 0 0 0 � � O e y � aa� � � �� o � �� - � � d�� o�. �� O y � � �� p. �E �,°.� o � m �� y m • `� �-�+ o�� pp�� p'op ��,o �� M �� ¢ �' � �� ~ �� o _ ��-' � �. � � 5' D --�-I r�- � m N _ m C m 9 � � L � �. i �' � � � o � � b p � A {'�N ,� a\ o � � � - � \ � � � `3 � i � 'O t o � .�' � (i� 0.� j�' 0. Qe Z ,• �� ; �y� y �� 0.� �A e� �,. � � � �. � �. � :�. � `��''I�:i�'� Cf v �'�' + � I /�' 6 li j�S6 � � 9 � % � '!� , tz�° ., r HEAT LOSS CALCULATIO ARTMEIVT OF BUILDINGS �� y�� NIINNEAPOLIS, MIIYN. li Weatherstrips A.S.H.V.E, Construction No. Insulation Guide Windows Doors Reference Out. Wall Iat. Wall C,eiling Roof F1oor Kind How Applied Yes—No I Yes—No 19— Fl.� p'� �� Room � Length � Width /�/ Height F1. Room Length %/ Width 9 H Windows and oors—Crackage and Area Windows and Doors—�rackage and Area Nldth iielght No. ot Llneal ft. Area WIdt6 Height Na. ot Lineal ft Ares No. of pane of pane lighta oP crack eq. ft. No. of Bgne of pane Ilghte of crack eq. ft. �; . � / / }� '� � � � 2 2 � � � �. � 2 gl Z � o / �' ° Cv °� Coef. Btu Infiltration � !1'0 � �, o � Glass S gT A � e� -� Eap. wall � �j Net exp. wall p O � o 0 Int. wall Ceiling Floor (o� /,�' p Total Btu. � o � Required sq. ft. E.D.R. or sq. ins. W.A. Leader area � Fl e� Room � Length /� Width Height �'' Windows and Doors--Crackage and Area Width Helght No. oY L1nea1 tt. Area No. of pane ot pane lighta ot crack eq. tt. l !� �'/ / (0 2 � / '7 In6ltration / � ycy Glass / � '.l'c Eap. wall �� Net esp. wall � / / � Int. wall Ceiling Floor (e(1r !,� Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area �% F7. � Room � Length Z Width / 5 Windows and Doors—Crackage and Area Wldth Helght No. 01 Lineal ft. Area No. ot pane of Dane IlBhta ot crack eq. ft. � 2d ��O � �-� %% � In6ltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. � °�. Btu �� .�`� 0 Coef. Btu ?� Co �O O D ! �o �B � oBo ft. E.D.R. or sq. ins. W.A, l.eader area o � � Infiltration Glass Egp. wall Net esp. wall Int. wall Ceiling Floor Total Btu. Coef. Btu �, �L � G // 2G I ��. 9 �poe� 2 -z o / 'z�c� /4� i� �.o r o 0 5' e Required sq. ft. E.D.R. or sq. inp. W.A. Leader area Fl.l Room ( Length j� Width Windows and Doors—�rackage and Area Wldth Hefght No. o! L1nea1 Pt. Area No. o[ pane ot pane llghte ot crack s9: ft. / � C�r / �0 2_ / % / f? Infiltration / 6 4'e % 'y G Glass r B �v S e c3 ' Eap. wall `� I Net esp. wall � P r o �� ' Int. wall Ceiling , Floor - /' Q /-�' � Total Btu. 6°d' a Required sq. k. E.D.R. or sq. ins. W.A. L.eader area I,�//�1.� Room I Length �►/ Width Height �' Windows and Doors—Crackage and Area Wldth Helght No. ot Lineal ft Aree No. ot pane ot pane Ilghte of creck sQ. tt / �� Y� 'L �% /C1 �%-aJ / 2 % �/` � / d�0 Coef. Btu Infiltration � 4�� / 9 ! o Glass 3 � �'ti / 9 w-o Eap. wall �� Net ezp. wall �'?J �C, ,y—�o Int. wall Ceiling Floor ♦ � �c,��- $ Z'otal Btu. �' -� y�s- Required sq. k. E.D.R. or sq. ins. WA. Leader area �, � � City of Fridley, Minn. BUILDING PERMIT Da�: May 6, 1968 �o pwaer; Gunt�� Zickerman Builder Same �� a� 640 H� Hugo St . N. E. �,g�.� Same � �� 9'715 LOCATION OF BUILDING No. 640 Street ._._.. H� Hug�o St . ._..�__._ Part of Lot � 47 & 48 gl� S- Addition or Sub-Divlsion _��verview Heights Corner Lot ._ Inaide Lot Setback —� Sideyard Sewer IIevation ___.__ , Foundation IIevation �� DESCRIPTION OF BUILDING To be vsed ss: Garage �nt 20 � Depth ...r 22 � Height ._.��__ Sq. Ft ___�0_ Cu. Ft �UD. Front Depth fTeight Sq. F't. C;u. FL Type of Construction Frame Fas� Cost �. $1, 000 _ _ To be Completed In cans�ideratfon of the i�uance to me of a�rmit to constrruuct the building descrlbed above I agree to do th� proposed work in acc�rdance with the description above set forth and ffi compliance with a'll proviafona of orrlinancea oP the dty of FrYdley. , , In cam�deration of the payment of a fee of $ 7. 00 � pe�t is hereby granted to Gtmter Zickerma.n. to conatruct the building or addition as described above. Thispe rmit is granted upon the express condition that the pereon to whom it fs granted aad his agents, employees and workmen, in all work done in, around and u�n said building, or anypart thereoP, sl�all conEorm in all reapecta to the ordinances oE Fridley, B?fnnesota regarding lacation, constructton, alteration, maintenance, repair and moving of builaings within the dty limits and this permit may be revoked at any time u�n violation of the provie�tona of eaid ordinances. % , � _ ' �� CLARENCE BELISZE NOTICE: Tlds permN does aof eover Ihs eonafweHon, IeslaUalloe ier wUtee, plumbina, en 6stline, ssw�� or wdsr. B� wn to u� tin Bntldiu� Im�etor for aparats poemib for thas i1�s. �- a . . Y • � . . . '�).• . . � � . . � .. . .�r�.� . • . . �� .......... �PPLIGATIOIY FOR BUZLDTNG �ERMIT , ' . .. .. -- ' C�TY OF � P"RIDLEif; ��50'1'A . ,. ' � - . . . . �I l , R. � s �" ` i 1 ' ' � •.3 ' . . ' ' � /� ,t. •, . ., ,"a :.l� � #. , 06�NE�'S NAME�� . , _ : � � ��'-°s.�, , ��:::�..... .: HTfiL'I��t �_ _ . �1DDRESS� � � �e ��.._�..`�,�,�� .. �JDId��.�� ` _ _ ..�.._ __.� _ � LOCATION 4F flllILDING � ._ .�i�;.�:. , .� .. . , , �;� NO.�_„_ S1REE1'" . w..:� ��_..._. � . _ . . LOT G� �� °� BLOCR � oS_____�,_____.ADDITION OR SDBD'IVISTON ,�'ff;':�"°;�� CORNEB LOT "C/L/ 'IIVSIUE ,LBT � SETBACK • SIDEYARD ,. . �y.'i��5�� .�� .i:q.�r.. _ - �..r..�r ��...-...i.r.�. SEWER ELE�IATION TOP OF FOaTING� � e •� � .r , Ag�licaiit attacl�' `Eo ttii�s �foim Twc Cert3ficat�s of .Surve� ,o£ �ot aIId �proposed •building locatioa drawn an theae Gert3fieates . "' ''` �'�''' '!: ' � ., e .;. :.,¢ , • ,.i , . , ' .:,f., ,' " �. DES�CRIPTION OF BiIILDING . � To Be Used As= '� !�� -�' � �_: s� FropC � � Depeh `�- �- Height _� <f . . Squaze feet � �� Cubic Feet � ' � 4 � —.�.�— FxoaC Depth HeighC Sqaare feet Cubic Faet Type of Caastruction T��EetimaCed CosC ,_��'1 � O /- To Be Campleted�_ ` The undersigned hereby makes application for a permit for tbe wbrk herein specified, agreeing to do s11 work in atrict accordance with the City o€ Fridley Ordinances and rulinga of the Degartmant of Buildings, and hereby declares thaC a11 the facts and represeatationa stated in this application are true and correct. � DATE _ _ .� _ _ � _ _SIC,NATU�1�'�� = � �—'�� (Schedule of Fee Costs can be found on the Reverse Side). h�U�� °�� o� i--'� .� 2. � � P��/ _� � l2 �/ �� /� S� x I �� l� . �- n � - e lti '�- ~ 0 z :��:� . . � BUILDIAiG PERMIT FEE SCHEDULE : . �.�� SECTION 2. The Inepector bf HuiYdirigs shall, before iseuing permf�ts for the erection af;�ny b�i�.di�g•o; atructure, or for any addition to any existing struc�ture �ot buildinffi, ar f,�r s.ny alteration or repairs- to anq exiatiag building os structure, upon..application th�refere, require the �� the payment by th� applica�it for��suah �pera�it of f�� to the araout�t herein :`'��],�a set , foxth.:an6i,r�n the manner h�rid , provided to•t,tit t� _ ,. .. i ';.;i� - � . �tTniform &uildi�r�e:'"�' Tgpe 1, 2, � 4- �$1.75 for �ach one thoueand cubic feet, es fr�cti,c�. thereof, in such cubical ccnteat�s .� Type 3, � 5- $1.50 for • each.oce theusaa� cubi�.£�et. � . � � � . .. . . ,:. � . " ° Fsr the pus�oae ef cn}mputigg fee��,�or build3ng permite, the cubicai contents ef anq'buildiag oi add3�tion t• a u�iform height throughout �y multiplyi�g the ground area covered fr�, a po�.n�t sirt� (6) inches belora the floc•. line af the basement or the aellar ts the'average hei�ht of the upger eurfece or t• the av,exage heighC of the,roof surface of the,main gable of a - ��pitched roaf':' . � . • . . . � ' ,,,� ,.� •_ •, _ ' ... • �,•l�i�r.� rep�ii�s ar a7.teratioits� to aa exiatiag st=�cture, the fee. shall. be at the rate of $3.00, per each five h.undr,ed dollars ($500.00) .or..�raction thereof . � � � •ia� tha cost•• ef a11 � �pro��c��ed '�fiork. . . . . ,: : .. Ia no c�s�, ai�all thes �E��.�eharged� for anq perm�t as set forth _ia Section 2 be leas than $S.OD. , , , � . � NSSSD C�naeEtion Charges based on Iocatien- A�ea:l.�oir� �: . • , . _ . . .. . ' .. . - . ' ��. • j.• . . . ' . • ' . • . . • . . .. , � • • :i , . . . . ' . . . � � _. � � . � r.� _ . . � � ,�� _ . . • • � . . • .; -. .. . _ �c�Ce � r a »e � .. , . � � :A . ! \ y. t � �� '�� , ,� � _ , �� A NSl� N O R T H E R N STAT E S P O W E R C O M P A N Y May 6, 1g68 Mr. Gunter Zickermann 6�-0 Hugo Street N.E. ' Fridley, Minnesota 55�-32 Dear Mr. Zickerm.ann: , . , This is to confirm our conversation of this date regarding the proposed 3 foot garage encroachment on the existing 5 foot utility easement on your property, which property is described as follows: I,ots �=7 and 48 Block S °" Riverview Heights Please be advised that we have no objection to said encroachment as long as it does not interfere with our existing facilities Qccupying easement. EPR GCL/pr /`�� Yours truly, E.P. Robertson Distribution 5uperintendent Minneapolis Division By � �..u-�� .� Geor C. Lewis Senior Right of Way Agent � .. � ;- � : �. _ @_,�^ � �� c� P � � I � � � � � � �,° :� -� � r� -:f� � �� a � v � � w 3 > s � M ' � S w � � i r � � � � � � � m��o°o R � � � � � � p � � � � � � n � � �� 0 �o = N � � � M ,� � o � 8�0�, M M I � � � o � � n � � � � � C a � � � " n � � � � � A :•' � � ra 'O � � � �� . . • I I I • � � w � �~ r� w n O . � s � A � �e O r ee � < � ti � w � �w �� M C � ^ A � � E � � ��'1 � � � � 8 �i El � 0 � s � I � � � � � w� x � a � N $ � � x x �� o � � � � � � � � � � x � a C R� y r �d s� o� � M � �o � � 4� _�t O O ssss � � � �� I � t I 0 Z � R � � z 0 s � x 0 � � Ci W � m � S d, 0 � � fD O� m S I � � � � � � � �� aa.»�� p�d, R� � 0 0 � � � � � g � �� °� �, s � s � � . OQ � � : v � � � � W Of O� 4: O sss�s M � � �, � 4 1.�� , � � I � I � � M � � � w '�x� � � � � � � �� m � m � n � � � a � ' � � � C � ��~�� ; ��.. ��a� 6f O � d M � �G . O o . . S : w a Q+ o � �sgg� r� � ,� �� 1 I ao.� � n �! ��'� � b r. � � � � � � a ~ M� � � O A �' �. � d°° $ .. =�o 0 w .�j CL '� ��o� m �� o 0 y M�� b c _. � ��m ra�b b o�� Op 7 � �A r� �pm �� a�� i �� A a� w �� o► �1a O � � . � r� • D � D r � � ri: H _ T C r T � M t �� x � � �� e w � � a � � � �. �� sus�ecr pE City' of Fridley � 14592 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T • r �� RECEIPT NO � `L _ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. � �t� 1 ; � _7 � i--_- ��,,� CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY L J \ 8� 2-58aaaso 910-F15 3/9/78 � � JOB ADDRESS 640 Hugo $'tY�2't N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oesca. 47, 48 S Riverview Heights SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Gunter Zickermann 640 Hugo Street N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE UCENSENO. Chet Maciaszek 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUIIDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install fireplace 9 CHANGE OF USE FROM TO STIPULATIONS ��.�� lg�� from opening to nea.rest combustible vaalls. SE�ERATE PERN1iTS ��QUI�E[� FpR IiVIRiiVG, HEA�TIt�G, P�.�J�1�IN� A�p StGf1�, SEPARATE PERMITS ARE REQUIRED 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 ZONING SO. FT. CU. FT. AUTHOFIZED 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 AIVD ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIEO HEHEIN OR NOT. THE GRANTING OF A PERMIT S%�JO yS`. r'JO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHAFGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � y5`%.SO PLAN CHECK FEE TOTAL FEE $8.�� GNArUREOFCON7RA TORO tnuTHQBiz� IOA - 1 WHEN PRO ERLY VALIDATED THIS IS YOUR PERMIT � ` ° �'� , f ��J �' -�I� '�SIGJATURE FOWNERII � WNER DERI DA BLDG INSP DATE CITY 01= f=1ZIllLCY . ' APPLIC�TIOt� FO�t RI�SII)[:NTI/1L BUILDIPJG PE(t��1ITS , ' ` ��L"W, �1LTER/1T10(JS, �DllIT10t�S, OR RCPAIRS) Qh'ti�R: l� , 1� •� ��j/� � P-�� 13UILll�R: ' C� S� •, �--� 1 I �'� � 1 � �1�- . Address : _ � �d l� U 6 n � , �, �, Address : � � Tel . l�o . : � No.: 5treet: � LoT: �� sr�ocr.: � nnni�zor� :�-i V E�V r� �UJ 1�7 � i�!� i� CORNER LOT: INSIDE LOT: � SLTBACK: SID�YARDS: ApplicarL- attach 'to L-his form T•�o Certii'icates of Survey of Lot and proposed bui.lding loca.tian dra�m on these Certificates. . To 13e Used As: 0 DESCRI PTI-0Pd OF BUI LDI (�G Front: � Depth: � Height: Square Feet: Cubic Feet: Front: � Depth: � Height: � Square F'eet: G�ibic Feet: � /' • Type ot Construction: � n � �� Estimated Cost: $��Q; C� O To Be Completed: _��L�(�" Alt. A Alt. B Proposed Driveway ��Tidth If 11ew Opening Is Desired $ $ • (S�� R�VERSE SIDE OF SHEET) The undersigned hereby makes application for a permit for the work herein specifS.ed, agreeing to do all work in strict- accordance wa.th the City of Fridle�� Ordinances aud rulings of the Dcpartment oL• Euildings, and hereby declare� that all the facts and re��resentations stated i�i L-his application are true and correct. See reverse si �ar aclditiona ini'o ion. � � c DAT�: ,.� c ` SIGNATUP.E• � 5tipulations: • � - � ,. ��Z. �� z,� -,� ��' �.��2 .�-'j�-�.�.� � � , -�--/ ��;�� ./�'Z�"-E�,✓?��.✓� �</CG'1�L're_.�%U�'-�' �c:-��e�e..� — � � . � G�� " �-o �,'�-"'K �� _ G� i � ��-u BUILDII�G PERt�IIT FEt SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing pennits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repairs to any existing building or structure, upon application therefore, require the payment by th e applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet. PLAN CHECK: 25 percent of building permit fee. DRIVEWAY DEPRESSION: (Concrete Curb Streets Only) Alternate A: Removal and replacement of concrete curb and gutter only; Driveway width plus 6 feet x$14.50 Alternate B: Removal and replacement of concrete curb and gutter and install a 3 foot wide approach with 6 inch depth; Driveway width plus 6 feet x$17.20 � 11 � : 1 �' : �l For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average height of the roof surface of the main 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 thereof in the cost of all proposed work. In no case shall the fee charged for any permit as set forth in Section 2 be less than $7.50 plus $.50 state surcharge. ' � _� � 1 �1� �j NOTE: Permits �or construction will be issued a minimiun 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, sho ing the location of the founda.tion once it has been constructed will be required b�fore proceeding with the framing. Application for a Certificate of Occup ncy shall be made ten (10) da.ys prior to the use or occupancy of any structure for hich a building permit has been issued; and said structure shall not be used or oc pied until a Certificate of Occupancy has been issued. � � ? �. � : d'� �� pa�� Building �[1S��Ct�i•il15 ris _ c 7��s7�-�bo� DA7`8.. . . _., � 3iY� AliufitliSZ�� 'I'HIS API'LICAN!'!S; �► �J 1.�1�11�1 ii RESII�►El'�T'�'�:�!►L APFLI�ATI(JN �� Y it 14 ADDRE�S __ . � s . � ��_ y, � s �3�z- .— 0 OVYP�iER ,r�{�C)f�TliACTOR p�nit Itc�ived Hy: ��te tt8c'd• .1�� , Gas: i v�vnd�� NAMG:_ ._�A-1"ti ^I' �` ` c.,6C?�L.w7"' iLN.alfilT ....:.. _.. ,aac�x�s:� ?- A3 S � -�e. CIT�! •-• • . . 5'TA7'G__ LIN �wc��b3- �-�� -z�a 3 ��ii'�"mK sTnn,�. sl �IL�- � �F.P�2 /d, '. �aJ� �i— �t ". r.hA Pe� SU13Mee A G`UNY t>F Yc)[11i �['ATI: I.(Cl+Ni�E WI1�] Al�}LIt`.Ai'tt)Ai �a�►�li'1'� �tP� PERiNiT TY�E �� 'J�.'r��Z''�"i STA'PE L1CIiNSE fl....l�Tv �2'L "G �' a�c�tii.S.B: � �b �0 '�+�� • PtiCildC Q.S Z�� 1- 3� FAX �iT.� AMIl.Y/NEW CQNSTRUGTlO�N � fiR►O FAMELYA�EW �NSTtttl�'tiUN C1 DTTIBN � G CiH/SiiB EMi�.N'i' NINISH � ROt3F I�SCK 0 SiDINC I ❑ MAiN7 b�SCItIHE WURK $13iNG Dt7�lE: SIZE t!F M1MBF�t OF SQUARES A �� RROPOS�D StZE: r�ea��ur�,�t��: � ❑ Vffiyl B Al�simpn �� 'WINDQ�+fi w �ns�r� ar��s t�� rnv�► C�R F13i�t idC�V OFEt3�dtiS-DTSGRl�k' StY.,L UF IJPi.�ttt�3ti GHANG'�5 dc G�' 1'emilC Fee Pl�n Review Fire SurGh�rge Surc�arge Lic:ense �urcher� �AC Charg,e (�rb Gut �scruw Er�si� Cantral Park Fee Se�rer Main Ch�tr: s ❑ uous� � c�ac�r,� O ATTAG7�iEi] fiAR�Gi � QBTACHED GARAGE GlSoffit � Tr'tm la F�ia Lo�a�ea� c�F �+r�rx�ws EXP DA7�! � � �rr�r � �e� Gi,e�r��n��z� � 2 � Q�l r - e/2,�-�,� 015�lt,�iN -ru.� O o7'HEit '"`.''.�... ��`s'ti � ^�► � �/� y�°^ �..� WiDTii ---- H�tGHT Sca. Fx ��EME�VT.RF.�vIODGC1Nti SULiA9i'�': 1, 6'xiscmg Ftoor Ptas 2. Pra�ed tlutv plan 3. L.i� af strn�tural mrrnbera tv ba �cd EOR NEW GONSTRUCTit?N IAICi.t�fWG [�L;I{�. �i�rru�►Nti. � rr�e�,HPS SL1HMf1'� 1. Site FL�a/9vrveq showing q�c oxisaii� sguctu�us � �� Z. Twu sa�a; �P �slrucBi�n pl� 3. �+C.�tiICUl�tim�s � Bfi @TSTALLEI7 �v� or• wnvaows_ __ _ � � ARE BAS�B O!Y VALU�I,TIUN, INCLUDIl+�iC TI� CU�T QF l.A�AR AND (UbyN� HL �7 U.B.0 FEE SCAEDUL�) L JOB VAI.UATION � � UCCUPANCY T'YP � $ �''� See Back l�age for F� Schesduld �1 �� r $ �Sp/o of Build'Llg Fc�iii Fee ,��~ ,c �'l S .�1 tim� � tcyt�tl job �aluation �,+-j �$ -.�;,�, .UOOS x Permit Vatuatiau Minie�vm S.SU j.�c� � --...`�. 0� $S.Ot1(Stets Lioeased Resi�.�tti�1 Conb�actors) $ S1550 p�rt SAG Unit (Plans tio MWCc; fnr det�rmin�tioa) $ _ Pt+6ft= 8x�21 °$ $ $45A Canservatioa Pl� Review $ Fee Determined by En�ineering � ' $ A�ment neces�' t ) Noa AJecess�ry ( ) � "'' °�� I7�1� 15 A�At RI'PLICATt FDR A PERMITfi10T VALf!'] t1t�'1�4 �'tii[)C:ESSBD r h�aby �.tply '��ermit aa eka t€�t the itrfrnm�##iacm atu�ve is complete and acewate; that th� worQc wilt be in ca�fo� vei� �ite ordia�ne�s � co�s �f the City of Fridley and with the Mianes�nta �onstivction Codes; tf�t 1 und�`st�rtd this is not a �i�i butt o�tly an applic�tion f �rmit rk is nc�t � start without a p�extnit; th�t the work will � in aacordance �vith the appr�ved pl�u in Ct� � of 3p worlc ' h ' s revi�w �val af plans. ��►� � A� __ �� N� �� ^._ �•�� 6 6 Fd t•ldOT;� � 9� 'int LEf��LS�9L: 'ON }Cti� �atAi�� .��' ��a: W�I� � �/. �1 > 3 z z z � 3 n� �� 2- 3u�l.ding :n.spectioixs 163-572-�604 �ATE — �� Z- i1TE ADDiiF.SS C� �D$ APPLICAIVT 15: �RO�a�.z�r ar� TENAN�' CONTRACTOR � �A CI7Y OF FRIDLEY : 11�1�1►�� Per�mit No.: �o �� ESYD]ENTYAL ,A►�.'PI.ICA�TI�1�' R�"°a sy:-�-�,.� �'�. C�'X O� FR��Y n��a: �° �� . _- .. _._ YOUR E N�AI4 AAD1�S ■ • . �,. w� b�.vti �nxESS: Grrgr srArE z� pxorrE: SUBMTT A COPY OF �A� Yp[Jlt STATE L�t�NSE �D� WITH APT'LICA'Y'ION pHONF PROPERTY �£�: � � PEXtMiT ��.. 'i'YPE UF' DESGRtBE VIQRK BEING SIZE � ■: � i� � tiy _'•'� ■�_� ■ wrc ■ i,/�tirltr' ��.� GA�tA�ES PiLOPaSED 5�� PROP4S,ED f�tGHT: cIDIIVG p vmy� ❑ Altnninum � OEher „^� wnvnows W E7CIS"�1G OP£NINGS �Yes DNo OR FRR AIEW OPfiN�QS-DESCRI�B ST� OF OPENnVG CI��ES & /`"i4��-3�:�� V Plan Reviow Surcharge F"ue Swrcharge License Swrcharge SAG G'1�arge Gbrb Cut Escrc>w Erosivu Cvntrol Parti Fee Sewer Main Ci�arge Totat Dne 1�AiR O REMOD8L1 o-t� � TT '�" LENGTH 0 HOUSS QTB.Y O HOUSE � GAitAG� ❑ ATTACf�D Cr.ARAGE O DEiAGHED GARAGE vs� II Tcim ❑ Fastia LOCATlON OF WII�TDOWS (TJSII�TG '�'� � pA�� Ctnt �iPlLt k1d?T�� Sb5 S'TORIES o wn�no s Q DRAA1 Z'II.E ❑ O'I�]�'R �� V+�ID'�'fi H�GHT _ �� MIT� 1 _ &xist6�g F�oor PIam 2 Prapo�d 800r pl�o 3. List of s�nasaal m�nbers to bc vseci FORNEW CONS"�RUCPION INQ.UDIl�G LfE�I{S, AbD1';IONS. & PS2Rc�S SUSMR: !. Sioc Plad�vey showiuS the ansd� struct�es and praposed proj�d. 2. Two sas �f a0n�euctian P1ar�s 3. Energ�+ Caicuiation4 � +COS"� bF LABO�t ,ANb SC�b�JLE) $ . °,1 See Back Page �or �ee S+chedule $ 65% of Bn�lding Penm�t �'e�e $ /.(� i.0005� i�ae�s the total job vsluation — Min�iuu�um $.50 $ C� � A01 x Permit Valua�ton (1/10%) $��`.f�a $5.00 (State Lfcensed Residential Co�asractors) $ $1450 pe� SAC Unit (Plans ta M"�NCC for detena�ina2ion) $ �ft+68= f�x$20=$ $ $450 Gv�servatian Pla�a Review $ �'e� l7ete�ined by Enguneering $ Ageement �aecessary' ( ) �1'o�n N�assa�7+ ( ) $ �. a Make cbecks payable to: City of �'�id1eY Attac THLS YS AN APPLICAI'I9N FOR A PERMYi NOT YAI.ID UNTII. PROC&55� 1 hereby appiy �or a buildiong perm�t aad I acknowledge tt�at the iaformation above is complete aad acc�uate; that the woric avill be m conformertce with the ardiwences and codes of the City of Fridley and with the Mioainesot� Cons�uction Codes; tbat I uu�de�rs�nd this is not a permit but only an applioadon for a permit aad work is not to st�t witl�out a perinit; that tl�e wark will be in accordance with ti�e gpproved plan in t�e cas� of a]1 work w�a qu�res review and pprovai of p�ans. SIGIdATURS OF APPLICANT NAM�� "' � �ATE - — � � Building M�+ CHANICAL Permit No.: �-� �. c, Inspections RESIDENTIAL APJPLICATION Received By: 7. 63-572-3604 CITY OF FR�LEY Date Rec'd: ° DATE �D ��% YOUR E-MAIL ADDRESS STCE ADDRESS lo S� �G THIS APPLICANT IS: � OWNER �bNTRACTOR � PROPERTY NpME; /1U,G � dJ �,! OWNER/ ADDRFSS: StL�L CiTY !'/2/ �.� STA IPs, 7.3L TENANT PHONE: CONTRACTOR COIvlPANYNAME: �6@9�f° �E � �: �� , ��. CONTACT PERSON: ��o �161 �. . ., �I � /S SUBMIT A COPY OF �•� ��' YOUR STATE STATE LICENSE � LICENSE WTTH ,a,DDt�ss: �763) 7�4-�199 F�X (7�3) 7� � STATE ZIP APPLICATION PH�� p,,� , PERNIIT TYPE �c'�.��,°'�'�.Y ❑ TVi'O FAMILY _ D TOWNHOUSE_ _ - - - — - - -- TYPE OF WORK: � �w �P�'CEMENT ❑'4I'TERATION/REMODEL DETAILED DESCRIPTTON OF WORK � �- 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 fnctures. (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 Wi�RE TABOR EXCEEDS $500, FEES ARE BASED ON 510.00 PER FIXTURE> EXCEPT WHERE NOTED. FDCTURES: (INDICATE TOTAL NUNBER OF EACH BII.OV� ��.�,� Equipment Installed MFG: �d�= MODEL: a� a� SIZFJBTU MFG: MODA.: SIZFJBTU � MFG: MODEL: SIZFJBTU ✓A/C 525.00 _FIREPLACE (GAS) 515.00 . _GAS RANGFJOVEN $10.00 AIR TO AIIt EXCHANGEER $IS FIREPLACE (WOOD) S35.Q0 NEW GAS GRILL $10.00 BOILER $35.00 _FURNACE $35.00 _GAS IJNIT H1R $10.� CHIMNEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 _DUC'f WORK $10 00 _GAS PIP]NG $10 00 VENT'ILATOR $I5.00 �"�_ �'.. � a��_ _ i�a�� : �� .:;" .�� ` .��.�'.-.�� T ; , �%�.. . .�_ .,�� `..��`�bi��. Permit Fee � $ Number of fixtures @$10.00 x$10.00 $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DLTE $ Number of fixtures @$25.00 � x$25.00 =$ DO Number of fixttu'es @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ �SS� THIS IS AN APPLICATION FOR A PERM�T-NOT VALID UNTIL PROCESSID T 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 work which requires review and approval of plans. SIGNATURE OF APPLICANT � A/- ' PRiNT NAME � IS�„/,l DATE Q D I^V �o q�a �{�.'.+.��.,* �]� ��+ � y;¢� ��7y� *� �y 4;"" �c ��.�i�a7%e.�%1�I� 1;tu.��'�� . � �n�r-'�I,�ti',J�:V,l:l.i��.11�l�!! �� ' ,��Z.vJ.4'y � �� yYy� ,: t,,�t;E� ">= iC3�C�' : '�.. C�`.. � . zs':;.�-: City of l+'ridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 �. REQUIRED INFORMATION NEEDED TO PROCESS PERMIT REStDENTlAL PERMIT APPLICATION HVAC NEW HOMES/ADDtTIONS ❑ EXISTlNG HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) . � Oil or solid fuel IMC Cha�ter 7 with MN Amendments b. Natural Gas or Propanei�'GC Chapter 3 with MN Amendments � 2, Make_up Air (See note below) a. IMC Chapter 5 with MN Am endments � 3. Venting a. Gas appliances ]FGC Cha.pter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & coo]i.ng load. per room a. Required on new conslruction TMC 1346.0312 5. Ventilation a, per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346:0603.2 a. ACCA Manual D NOTE: Cenierpoint Energ3� Mechanical Code Guidelines sofiware may be used for comb.ushon and make up air calculations From: Gitypf Fridley To: 9.52-�.91-�4250 Page: �15 Date: 8l�/2� 3:26:55 PM �uilding �l�Z° � BUII.DIloT�G P�'t N°.:`� �' `�A . Inspection j�+ S`,jDENTIAL APPLIC�TIQN R�eiY�a B�: 763-572-36U4 CIT� OF FRIDLEY Date Rec'd: �� .� DATE � YOURE- ADDRFQC STPEADDRESS � ' �� THIS APPLICANT IS: ❑ OWNER ONTRACfOIt PROPERTY OWNER/ H,�: ia� ' C, /hq �J TENANT ABDRESS: �.4 M4— A5 S%�2 CITY STATE ZIF CONTRACTOR SUBMIT A COFY OF YOUR STATE LICERISE WPfH APPLTCATTQN PROPERTY TYPE PERMIT TYPE TYPE OF WORK: PHONE: NAME: r [ 1 y STATE LICENSE ❑ ADDITI(}N 0 GARAG ❑ BASEMIIdT FINLSH 0 ROOF ❑ DECK 0 SIDING 0 SLVIlbIlE� ERP DA'FE D �� 'tS 2- 49! -c� 2�- SIZE STORIES QWS ❑ DRAIN TII.E O OTFIER P Ni �, .S-S! 2 �J I ❑ MAA�I7'EI�tANC,'FlREPAIR �REMODELIIoTG DESCRIBE WORK BEING DONE: �� ( 4-�t (,� L N r%�.�• S S 4-�- � ti r� 2.� IP�� "� .S SIZE OF NIIMBER �F SQUARES _ GARAGES PROFOSFA SIZE: PROgOSF.D HEIGHT: ❑ HOUSE ONLY ❑ HOiTSE � GARAGE 0 ATTACAII� GARAGE � DETACFIED GARAGE HEIGHT BASER�II�iT RERAQDII.ING SUBMPP: 1. E�sting FFa� Fian 2. Yresposedfloor�}an 3. List of structurai ucembe►s to be used Ft SIDING FOR NEW CONSTRUCTI�N INCLUDINC� DECKS, ❑ Virryl OSoffit ADDITIQNS � PORCI3ES Si1BMiT` ❑ Alumim►m 0 Trim i. Site Ptan/Survey ��aing the e�sting structnr� 0 Ottxx ❑ Fascia and Proposed pro.�. ��Otiyg 2. 1�eo sets of construction plans IN EX[STING OPENIrTGS es QNo LOCATION OF WII�TDQWS 3. Energy' CatCUlatiaffi OR FOR NE9V OPENINGS- 3CRIBE SIZE OF OPENING CHANGFS & TXPE OF WINDQW TO BE INSTALLID Ni7MBER QF �1RrIDQWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AP1TD MA7'FRi,��.S: ([TSING��} 997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION S h,`7 � y OCCUPANCY TYPE Permit Fee $ r �,'Z SEe Back Fage for Fee Schedule Plan Review $ b5°fo of Buiidiag Permit Fee Fire Surcharge $ �.� � .QOl times the total job valuation Surch�ge $�,, l� �_ o:+�� .�5 x Permit Vatuation Minimum �.50 License Surcharge $ �'> D�$5.(� (State Licensed Residential Cont�actars) SAC Charge $ $1550 per SAC Unit (Plans to M�VGC for determination} Curb Cut Escrow $ ' Q + � � = ft x $21 = $ Erosion Control Park Fee Sewer Main Charg Total Dae e ` $ $450 Conservation P� Revie� $ Fee Deteimined b}� Engineering $ Agreement necessaTY i) Non Neces�rY f �� Make eheeks �ra�abl� to: Cit� of Fri�lev THIS IS AN APPLICATIQN FOR A PERMIT-1V4T VALID UNTIL PROCESSED Attaet� I hereby apply for a building permit and I aclmowledge t�t the mformatian above is complete and accurate; that the wark will � in conformance with the ordinan s and the City of Fridley and vrvith the Mumesota Construction Codes; that I understand this is not a permit but only an applicati a it and w k is ot ta start without a permit; that the work wi71 be in accordance with the approved plan in the case of all work Iv ' es review d va1 of plans. SIGNATURE OF APFLICAIVT 4 1 / a� JV /�/ � gRIN'P NAME DATE -Trr�-T.�-- Building MECHANICAL Pe�t No.�—t— o � , Inspections RESIDENTIAL APPLICATIC�II�TT Received By: 7. 63-572-3604 CITY OF FRIDLEY nate xec'd: ia �% DATE, � • � • � � YOUR E-MAIL ADDRESS srrE a.nDxFSS v. &, p s T' N� TMS APPLICAM IS: ❑ OWNER PROPERTY N,�: C Q�i—� � 1�t u �` r� OWNER/ � 5 j `/3 ADDRESS: �.e ulP �-F � G o ST l�-� °L__—CIT�' � � 1 STATE IP TENANT PHONE: �L G2 3.'? 8�o . Z 4� 3 CONTRACTOR co��N,�v�: Home Ene � SUBMIT A COPY OF YOUR STATE LICENSE WI1'H APPLICATION PERNIIT TYPE TYPE (�F WORK: CONTACTPERSON: STATE LICENSE # EXP DATE ,a,DDx�ss: 15200 25th Ave N#� �8 cj�nr Plymouth sTA� MN ztP 5r 4Z Pxor� 763-476-1990 F�c 763-476-11 3 � SINGLE FAMILY ❑ TWO FAMILY ❑ �yy �] REPLACENih'NT DETAILED DESCRIPTION OF WORK ❑ TOWNHOUSE ❑ /�I,T'ERATION/REMODEL PER MS 16B.665 the pemnit fee is a minimum of $15.00 or 5% of the total cost up to 5500.00, 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 WI-IERfi 1-ABOR EXCEEDS 5500, FEES ARE B.°.SED ON $10.00 PER FIXTURE, EXCfiPT WHERE NOTID. FATURES: i1NDICATE TOTAL NUMBER OF EACH BELOV� MODEL:�M it °t S SIZEBTU ��. O �� EquipmentInstalled , M�G: �ogO� �'^O1 `� ""'— SIZFIBTU �G: MODEL: �_ �G. MODEL: SIZFJBTU FIREPLACE (GAS) S15.U0 _GAS RANGE/OYEN $10.00 A/C $25.00 — ppD $35.00 NEW GAS GRILL $10.00 AIR TO AIR EXCHANGEER $15 F�ACE $35.00 � _GA3 UNIT HTR $10.� _BOILER $35.00 � POOL HEATER $35.00 CHIMIdEY LINER $10.00 _GAS DRYER $10.00 —y�,qTOR $15.OU DUCT WORK $10.� GAS PIPING $]000 — ,y _ � ,.... .b.,�:,,.:.�w:.,.e�:au��neez:�:aah:r..�'sYi'YSaaa".:�:4.�i"�a�Yd.i'i�te�"a"'�a,f'F�'l1��''f��tTi�%�'%'_.�`��.�Y(.�'�. ',�': us',�`�'�i�wY,'�'��t�%.rvTi1�,R b:7A"Il✓�ilt,'�p.cvaiv.C�a, v;i,r,.: s.:;. . �:,-., �-....,...: ti..-::•�,. :..,,r-..W.«-- _...._. . . _ .. . Permit Fee $ Number of fixtures @$10.00 x$10.00 = Surcharge $ .50 Number offixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 � x $25.00 = $ �i� Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Tota1=$aS.s� TH15 IS AN APPLICATION FOR A PERMII-NOT VALID UNTH. P�OGF.�S�A 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 c des of the City of Fridley and with the Minnesota �Construction Codes; that I understand this is not a permit but only an applicatio fo 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 f all w k wh' h requires review and approval of plans. SIGNATUREDFAPPL PRINTNAME �� l�rl� MQY�fz DATE dZ•S.� % r '! °� , . �� ' � E�'a�.� <'� - _, � : ; 4 `( ..��( �y ,�7� •, % ,. � ' -'.T.' 40 . � ..� . �y '��(� � � ��. . . '.. . �... .. . Lr+-T�^++�"+.L.. .' ,� '� V �.7�� ' �� .. . .... .,, . :. ., , . .. . . . City of Fridley Building Inspections Department . 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FA:t: 763-50?-4977 � REQUIRED iNFORMATION NEEDED TO PROCESS PERMIT RE�IDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMESIADDITIONS� ❑ EXIST!!�G HOME ❑ MAKE-UP AIR I�EQUIRED FOR NEW/EXlS�'�1�IG Ha OMES 1. Combustio�. Air (See no' � t� elow) . a, Oi1 or solid fue111��I� Chapter 7 with MN Amendments b. Natvral Gas or Pi apane/IFGC Chapter 3 with MN Amendments � 2. Make-up Air (See note below) a. IMC Chapter 5 vr�th MN Amendments 3. Venti.ng a. Gas appliances IF rC Chapter S with AgN A.mendmen.ts b. Fuel other than g�.s IIVlC Chapter 8 with MN Amendments REQUIRED FOR NEW HOM�� 4. Heat loss & cooling loa.d. per room a Required on new construction IMC 1346.0312. 5. Ventilati�n . a Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 13 �-6.06Q3.2 a.. AccA �,� D N�'�'�: Cente�point E�.A�� 1l�echanical �ode Guid�lines sOff.ware may be used for coml�usfion and make up ai.� calculations