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AF - 47358r� � �J r� LJ �. . .N City of Fridley, Minn.. BUILDING PERMIT �y y�� .� N° 645'7 nate: _..._..�.�_..;.' _.�.Q.....�..��.._._.��__._..._ Owner: �s�� .�C.�l�._.1�s�.�~�'��! _._.�� Builder _.. .._ . _.. .._..:._..._._._......_...._...__.._._._._........ Address._._.___m._._..___._...._..__�_._..._.__..___..._.._.._...._..._..______ Address �._____�_.____._ �O � d LO TION UI DING No. ._ __. �._. Street ...__.. _. .:.. _ _.. . .. 4��. P o# Lot ...__.._._..._..._ .__.__._.– Lot ...._.._f".,�..__...._.__ Block _._._____,� .._._,.....___ Addition or Sub-Division . .. . _ _. __..._.�..... ____,_`. ✓ � Q � Corner Lot ..___.__.._._._ Inside Lot ....._..._...._...__.._.... Setback .._�..s�...^_._._.._ Sideyard ._..._.._._..�._. _.___...._._.�. Sewer Elevatian ____...____._...__..___._.�..._._..._...._._......_.._.._._ Founda.tlon IIevation DESCRIPTION OF BUILDING To Used : / � _ Front _... �� /Deptl�'�_..._.. iieight .._�. Sq. Ft. � . . Cu. FtOS�.�GG.`?�.� _ ._ .._. ...._. Front _1 �..� Depth _. . .. H ight y�. � Sci. F� .� ..� Cu. F� tt��'�–� Type of truction �. _._.._. .... ...__. _.._.__._ Es� G�►st ..-_. ... J•u�.-�..__...'TO be Coanpleted _.._...__.._.._:_ f /T — In consideration of the issuance to me of a permit,�% construct the b ding described above, I th� proposed work in accordance with the descriptior� above set forth compliance with all ; ordinances of the city of FridleY• , i''�� In co�sfderation of fhe payment of a fee of �a�?! �_..—., pexmit is hereby granted to._.._ ...... to c�nstruct the buiIding or addition as described abave. This permit is granted upa� the �express condition that the person to whom it is granted and his agents, employees and workmen, in all wark done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair aad moving of buildinga within the dty ]imits and this permit may be revoked a t any time upon violation of any of the provisians of said ordinances. � ,. _ � Builc]in8 Inspecto� NOTICE: '�6is p�emh doa nM wwr tM eonstruelioe, inshllatton fer wteinry. P�+�Y� 9+= h�afin�, s�w�r er wahr. B� wn fo a» fh� duiWieg In�p�etor fer s�p�rat� p�nnits for fha� iNms. . ,�.,. APPT.ICATION FOR BUILDING PERMIT CITY OF FRIDL�t', �SINNESOTA �wr�� s� � G--�—� BvitnBx �„�� t 1�. Pfo AI Q T�i ktTl elf / l� C annR�ss � - At�n�ss � s y o (��..c��c� rV � LOCATION OI�' BU7LDING � No. t�<) �� Street I��,� S�0 � $`�-- Paxt of Lot Lot ` '�-� B1ock �_Addition or Subdivision�� Corn.er Lot Inside Lot� � _$et�$ck �� Side Yard ,�'�— � O SEWER BLEVATION FOUNDATION ELBVATION o�l��' �@�. Applicant attach to this form,Two Certificates of Survey of Lot and proposed build- ing Location drawn on these Certificatee. DESCRIPTI�N OF BUILDING To be used as: � d ` _Front;�� :�"�„Hepth�/Z,�,__Seight` �� O o ,� cu . Ft . �t' � o sq. Ft. �� j� ' Froat ��_Depth � 3 Aeight Sq. Ft. Cu. Ft. ` Type oi Construction �,�l.vt�� Bstimsted Cost /�, �� , -.�— To be Completed i S � 3 The undersigned hereby makes applicatioa for a`permit.for the work herein specified, agreeing to do all work in strict accordaace with the Citq of Pridley Ordinances and rulings of the Department of Buildings, and hereby:declar�s that all the facts and representations atated in this application are aad correct: DATE � �9 (9 � S IGNA (Schedule of Fee Coata can be found on the Reverse Side). � , `- � "' � ,. . E • 4 F _ . � Application for Power Plants and Heating. Cooling, Ventilat�on. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: Furnace Shell & Duct Work . . . . . . . . . . . . . . ... . . . . . . . . . . Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . . Repairs & Alterations each add. �500.00 . . . . . . . . . . . . . . . MECH. WARM AIR Furnace Shell & Duct Work to 120,OOQ BT[J . . . . . . . . . . . . each add. 60,000 BTIT . . ........ . .. .. ... . . .. . Replacement oP Furnace ............................. Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . . RATE TOTAL 8.00 � 5.00 � 5.00 $ 2.50 $ 8.00 $ 2.00 ; 5.00 $ 5.00 $ 2.50 $ BTEAM o: HOT WATER $YSTEM F�.�rnace Shell & Lines--to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Linc�-to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDft Steam . . . . . . . . . . . . . . . . . . . . . . 2.50 $ Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 $ OIL BURNER—to 3 gal. per hour . . . . . . . . . . . . . . . . . . . . . . . . 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) . . . . . . . . . . . . . . . . . . . . . . . 5.00 $� GAS FITTING FEES: NO RATE TOTAL lst 3 Fixtures ...................... x$1.50 $ �• 3 C Additional Fixtures ......... ... x .50 $ Gas Range to 200,000 BTU . . . . . . . . . . . x 2.00 $ AIR CONDITIONING � FAN HEATING SY3TEM See Fee Schedule VENTILATING SY3TEM a ALTERATIONS & REPAIRS TOTAL FEE $ � • �n ROUGH FINAL Dep2. of Bldgs. Phoae SU � � �7 - �� City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Kind of Building Used as To be completed about � � 7 , is � 3 � ,f '/ Estimated Cost, $_ 7 % �� ' Old"� ew. uilding Permit No. ,�T 'S� � Permit No. �� 5_� DESCRIPTION OF WORg HEATING or POWER i'Z.ANTS—Steam, Hot Water, arm —No. � Trade Name �� `�-K-�'L�� -Q--•�-a-� Size Non��l° � � � Capacity � � �' � Sq. Ft. E.D.R. BTiJ H.P. Total Connected Load '��;�' /� Kind of F�e �-+2-� BURNER — Trade Name Size No. Capacity Sq. Ft. E.D.R. BTU H.P. (REMARKS-OVER) ��.z zN► Signec3 � / ;� Gc.� �'�� -�- ( 7 By Business Phone No �- Z- �_� �/ (p � � App�icai�ian far Pawer Pfcrnts and He�ating� Coaling. Ventilatian. Re�frigeration c�d Air �Canditior�ing Syste�n�s and Devic,e�s PARTIAL RATE SCHEDULE nep:. of Bidgs. Phone So�-�s�o -� GRAVITY WARM AIR: RATE TOTAL Furnace Shell 8c Duct Work .......................... 8.00 $ Replacement of �rnace ............................. 5.00 � Repairs & Alterations—up to $500.OU . . . . . . . . . . . . . . . . . . 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 1?A,000 BTU . . . . . . . . . . . . each add. 60,000 BTU . ... ........... .. . ..... Replacement oP Furnace ............................. Repairs & Alterations--up to $500.00 ................. � � Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . . STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... Furnace Shell & Line—to 640 sq. ft. EDii Hot Water ... Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . . Each add. 320 sq. ft. EDR. Hot Water . . . . . . . . . . . . . . . . . . 8.00 � ��-'�' 2,00 $ 5.00 $ 5.00 � 2,50 $ 8.OU $ s.ao � 2.50 �, 2.50 $ OIL BURNER to S Bal. Per hour . . . . . . . . . . . . . . . . . . . . . . . . 5.00 � over 3 gal. per hour--See Fee Schedule GAS SURNER (up to 400,000 B1'[T) . . . . . . . . . . . . . . . . . . . . . . . 5.00 � GAS PIPING (Up to 3 Fixtures) . . . . . . . . . . . . . . . . . . . . . . . . . . 1.50 $ (Add 50c each over 3) AIR CONDITIODTING f FAN HEA1'1NG SYSTEir[ Ses Fee Schodule VENTILATING SYSTE� � � AI.TERATION$ 8c AEPAIRS TOTAI. FEE $_� • d"� aEMAASBt i c i �� v..�l k i� ,l City of Fridley: � The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correc� 18� Kind of Building � Used as � To be completed about Estimated Cast, $ DESCRIPTION OF W4RS HEATING or POWER PLANTS—Steam, Hot Water, Warm Air No Trade Name��p-r-y �� -'�'�t'�'"�'`�'`'`' Size No 7L.� �/�' � L-- Capacity �� Sq. Ft. E.D.R BT[J H.P. Total Connecteci Load y� •�� Kind of Fue BURNER — Trade Name Size No Capacity. 11 POST iM-8-58 Sq. Ft. E.D.R BTU H.P. Sign �-� '/�ERFFtttOt�! i�tEATING OM . gy 2�aa.�G4J�a�lE� cn . t� �3q 'MWNE�� i �b Business Phone No � ��Ck' �/-��.��r �� •7 � �`�t./ D-56 � � s (G' s� � � � /�-4.��s �� . H�AT LOSS CALC IONS DEPARTMENT OF BUILDINCS MIIVNEAP0I.IS. MINN• Weatl�erstrips A.S.H.V.E, Construction No. Insulation Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Roof F7oor Kind How Applied Yes—No Yes—No 19____ f Fl. ,L�� Room � Length Z, Width � Height l.) ' Room Length /� Width Height � Windows an oors—Crackage and Area Windows an oors—Crackage and Area �Yidth eight No. o[ Ltneal fi. A�ea Width eight No. oi Llneat tt. Atea No. oP pane f pane ligh[a of crack aq. ft. No. o[ pane of pane lighte of Crack aq. ft. 3 �° 7 � � :� 2- �� l � -�.- � � 2-e� Coef. Btu Infiltration yp � � 8 � Glass S 3-z, � Exp. wall Net exp. wall o � Int. wall Ceiling Floor �� / o-,� Total Btu. / � ,�'{� o Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ��Fl.� �•�-:�.-� Room � Length > �+ Width � Height � Windows a oors—Crackage and Area Width elght No. o[ Lineal ft. Area No. o[ pane ot Dane llahta of crack ea, ft. Coef.l Btu Infiltration � '� Glaas Exp. wall Net exp. wall i Int. wall Ceiling Floor ��? Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1. %..e�,,Q,�,,,, Room � Length r Width i Windows and Doors—Crackage and Area Wtdth Height No. of Lineal ft. Area No. of yane ot pane IlShts ot crack nq. ft. S l� � / � �' �6 �- i y �'' Coef. Inhltration d Glass ��o .S'�o ' Exp. wall � �' 2 Net exp. wall � c 1nt. wall Ceiling Floor /'S Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. l.eader area � c*--e� � G� Height / !I ! r5 Infiltration Glass Exp. wall 1Vet exp, wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. I.eader area diFl. Room ( Length � Width Windows and Doors—Crackage and Area Wldth Hefght No. o! Lineal ft. Area No. of pane of Dane itghta OL crack aq. [t. % � '�-- / �n ''3 / 5 � Q I In6ltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Btu 0 �� f �'1� / � - .a p' o-,d / d �`o �"� d�-,o � � � io Sl6 � /S'�� f0 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area (/F1,� Room I Length y. Width r z-- Windows and Doora—Crackage and Area Width Height No. of Lfneal ft. Area �� . No. o[ pane ot.pane lighte ot crack eQ. tt.� � *1►D / t�.3' i 3 �- � � � i -z� d,' Bcu � � y.� In6ltration . a„9 C,lass Exp. wall Z(o O Net exp. wall Int. wall Ceiling 3� �� Floor Total Btu. �ef. Btu 4�d / 2 � sq. ft. E.D.R. or sq. ins. W.A. I.eader area / �eL� -s�i �,�..�c.-Q;l--c.c � -�.c.,o--�� [.. Z..— n��6 � 9 .��' � 7 / — �-�-e�-�-� � ' 6�, HEAT LOSS CALCULA�`� S DEPARTMENT OF BUILDINGS 1VIIIVNEAP�I.IS. MINN• Weae�erstrips A.S.H.V.E, Construction No. Insulation Guide Windows I Doors Reference Out. Wall Int. Wall C,eiling Roof Floor Kind How Applicd Yes—No Yes—No 19_ .� Room Length -- Width � Height Fl.� Room Length Width Height Win ows and Doors—Crackage and Area Windows and Doors—Crackage and Area tiVidth Height No. of Lineal ft. Area Wldth Height No. ot Llneal ft. Area No. o[ pane of pane lights of crack aq. ft. No. ot pane ot pane Ilghta ot crack eq. tt. / yi_� �.-� �- � 9 i� Coef. Btu Infiltration ¢rp / �, y � Glass � S�, J Exp. wall Z Net exp. wall e+ i0 / 7�^ e Int. wall Ceiling Floor / �,/�/ /g / (� O Total Btu. �. �� Required sq. ft. E.D.R. or sq. ins. W.A. Leader area '.I Room ( Length /-yWidth i a Height � Windo oors--Crackage and Area Width Helght No. o[ Lineal ft. Area No. of pane of pane lighta of crack eq. tt. ! �/� � �- i g iy Coef. Btu In6ltration / �,lp Calass L, d Exp. wall j� O Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. Room � Length Width Windows and Doors—Crackage and Area Width Height No. ot Lineal tt. Area No. ot pane of pane 1lghta o[ crack eq. ft. Infiltration Glaas Exp. wall Net exp. wall Int. wall Cei�ing �loor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. L.eader area �a c� s Btu � Infiltration Glass Exp, wa�l Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l R�� I Windows and Doors—C Wldth Height N No. ot pane ot pane 11 Btu Width Height : and Area ,ineai tt. Area of crack eq. ft. Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling I Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.� Room I Length Width Height Windows and Doors--Crackage and Area Width Height No. ot Llneal [t. Area No. of pane ot.pane IiBhta ot crack ea. tt. Inhltration Glass Exp, wall Net exp. wall Int. wall Ceiling Floor Z'otal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Btu 53-84-591�.�� ity of Fridley � AP�ication �or Plwnbing and Gas Fifii�q h� Dept. of Bldgp. Phon� 590-3430 - DESCBtPTiON OF WORIC �� 6281 N E Jackson St Numb�r, Kiad aad Loealion oi Fixturss 1i1 3� � 3� � � (�� o�. � g�bi3� �� $ Base lrt 2nd 8rd 4th _ j � � � � � � • F,iaur. coan.ction Op�nia�s * I�f�w iixtur�, Old Op�aia�s WA7EN MI1. • • I N GAS ELEC. s....: p �� n PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Flxtures . . . . . . . . . . . . . . . . x �2.00 a P�ture btixture Opening . . . . . . . . . . . x 31.50 : _ New Fixture Old Opening . . . . . . . . . . . x a1.50 i,_ Catch Basin . . . . . . . . . . . . . . . . . . . . x �3.25 ; Water Heater :Up to 99,000 BTU> ••.. x�3.00 ; New Ground Run Old Bidg. . . . . . . . . x E3.25 $ Et�ctric Wahr ii�at�r . . . . . . . . . . . . . . : :2.00 i GAS FITTING FEE$: NO. RATE TOTAL 1sL 3 Fixtures . . . . . . . • • . . . . . . : �2.00 ; Additional l9stures . ... . . . ..... . . . . . x = .76 i Gas Ran�e to 198,000 BTU .. .... .... .... x a6.0� i Gas Dryer 1 5.00 REPAIRS A� ALTERATIOI�b—R�t�: !o Cod� Description ....... . ...... ........... ....................� 1'O�P/�1L �'EL ��. 5' �� Clty Oi �'1�Cj�: y The undersigned hereby makes application for a permit tor the asork herei speciiied, agreeing to do all work in sttict accordance with the Ci4� Qrdinance and ruling oi the Department oi Buildin�s. and hereby declares that alI the tacl and representaUons stated in this application are true and rnrreM 11-30-70 FridleY. Minn 19, Owner P Weglinski xina or suilaing frame res Used as 12-5-70 To be completed about Estimated Cost, a �-�� Old—New. Building Permit N P it No. �� °�"� �t--','�t,� �- qa?:�;�� ` t �+� ��"� �F�` �...? ��?� _ Bj� 5 C - Business Phune 1�To. ROUGH £INlIL � ' � 2 ^ � � _.y.__._ . .� . ' . . . �� ' �rif'y/ O'� �i'If,��t3� . �' , ; ; -.�x _ � . . �"�� 9 ��.�;��9 �i' �� '� �i�'`:.��' _ Dept. of Bldys, Phon� S&0-3490 --- - D£SCRIPTIOlY OF WaRR � /' � �� ""�.Q G �S� +� S � /— c= 1Vumbar. Kind �d Lxaliea oi Fi:tiures �s�""�— �� "' N WATEA NTII. � .. � Cl� Oi �7�By; �. . � � . � � . � � . � �N '� � 3r Z� 7 �_,�= o� � � � . . ' o �; �� S� � z 1� �� g� 3�� 7� 7� 7� r N c�s c�cc. The undersigned hereby makes applieation for a permit for ihe asork herei cn '" ;`' °` `° 3" "°` " specified, agrecing to do all work 3n strict accordance with the City Oz�dinance Be� • and ruliag of tl►e Department oi Buildings, and hereby declares that a3I the fact — • and representatfons stated in this applicatiosi are true and correct � lst — Frid ey� M3nn JJ — � � � � � . 19�.. 2nd � � . � 3rd . Owner 'v� '� S' � . dth Kind o! Building �d°' � • Fuxur� Conaxlioa OpeniaQs Cona�ctod wi3i� . L � , * N�w Fixtur�. Old O�aiags Soa�s � Used as v 1� � L� 6�e '� .,' I Gesspool � . � To be completed about ., I�� l�'" 7 C,( '� SQ °',.'`—_ PARTIAL RAT� SCHEDULE � �St'm3t,�d c°St, � ' Old--New. Building Petmit No. P.:mit No. �� PLUMSING FIXTURE RAT£S: NO. RATE TOTAL L( J/� �6� _% . Signed �°1� ' �/(/ Number F�xtures . . . . . . . . . . . . • x 32.00 S l . / ` F�ture Ftixture Opening . . . . . . . . . x 31.5U s . gy Q � • �° �4[� �. ��+• -J~+t New Fixture Old Opening . . . . . : . . . . ' x 31.50 ;.f-- Business Phu�e No J`� `'1� s� � ° � 6 Catch Basin . . . . . . . . . . . , x 33.25 3 � Water Heater :Up•to• 99.000 B'T'U�... . ( x 33.00 ; � New Ground Run Old Bldg. `. ...•. .•. . x a3.25 g ROUGH , E1�c� wsc.: H.ac�, . : . . . . . . - = s2.00 s Firtu, f. - / L - � . � : � � ` �AS FI?TING FEEB: NO. RJ1TE TOTAL . Isi 3 Fixtures . . . . . . . . . . . . .' � � x 52.00 = . . . . , • . Addtt3onal Flxtures . ... . ... ..... . . . x s .?6 ; . Gaa Ran�e to 199.000 BTU .. .,.. .:.. .... . x a5.00 i . _ . II • • ` REPAiAS 3c 11LTEAJlTI02i8—R•i•s to Cod• • :. .50 State 5urcharge • • . Deuription . . . . . . . . . . .. . . .. . ... . •.... . . . .... . . .: . :... . ... . .� . . FLE � • • , � TCYrAL � . . , . N� � � City of Fridley ADDN. [ ] �R-1 AND R-2 � �T�. [ ] ' Building Permit Application I�e c . �� '� �� Effeetive 4/1/86 Constructioa Addresa: �� 8 � 5s 3 a Legal Demcriptio�: _ Cvs-v� 3 l�- 3 9/L Owner t�am�e & Address: �:r`-� % �-l/ � a�"-'-� - -- Tel. # ��-S/a�. Contraotor: r�l• � Addr�ss: Attaeh to Lhia applioation, a Certifieate oP Survey of the lot, �►itH the propoaed eonstruction drawn on it to scale. LITIIlG d1tEA: GA�AGE ABEA: DEG'� IRBA : r V i Aisri i DE3CRIPTIOx OF IMPaOYEMEN? Length WidtB Height Length iiidth ,___._� Height Length _________ Width Hgt/Ground Sq. Ft. Sq. Ft. SQ. Ft. Corz�er Lot [] InaiQe Lot j] Ft. ?d. 3�tbaok Side 7ard 3etback Type of Conatruction: Estimated Coat: � ♦pprox. Co�pletion Date: Alt. � Alt B � Proposed Drive�ray Yidth It New Opening Ia Deaired: l�,'�- � ; a�• �S = 3 e e B a ck Pa ge for Ex planation DAi'L: S- //- 8% APPLICANT: � � Tel .! S�'/-,S/aa CITY 038 ONL7 Permit Fee Plan Cbeck State Surcharg� �c cn�r6. Psrk !'ee 3e`rer !lain Charge ?OT�I. STIPtTLATI0�t3: a � � i � � � Fee Schedule on Reverse 5ide 25� of Building Permit Fee �•50/�1,000 Yaluation � 525 Per SAC Unit Fes Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] d CITY OF FRIDLEY INSPECTION D{V. 6431 University Ave NE Fridley, MN 55432 �4PPLICATION FOFt PaWER PLANTS AND HEATING, COOLIh1G, VEN7ILATI�N, 572-3604 . REFRIGERATION ANQ AIR CONDITIONING SYSTE6VI5 AND DEVICES RATE SCHEnULE R�:sidential Furnace Shell and Duct Work, Burner — Also Replacement Furnace (Side Vent — Fill Out Back) Gas Piping (Needed with newfurnace) Gas Range Gas Dryer *Air Canditioning — All Sizes All Others/Repairs & Alteratians (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $10.00 $ 25.00 State Surcharge: TOTAL FEE j9y� Effective On March 1, � . ' •:•�� _ i � ,� . The undersigned hereby makes application for a permit for the work herein TOTAL specified agreeing to do all work in strict accordance with the City Codes and rulings �f the �uilding Division, and hereby cleclares that ail the facts and $�� (� representations stat�d in this application are true and correct. $ $ $ $ $ $ .50 �.�a,.5 n MINIMUM FEE FOR ANY HE14TIN�COOLIWGNENTILATION REFRIGERATIONlAIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SUACHARGE REINSPECTION FEE $42.00/Hr "Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. � / ••- OWNEFI �,�-�4. �1%c, ,G ��/ cv; S' 7/ -- S�� Z Z BUILDING USED AS E g t~nEn�Gl' ESTIMATED COS�/,LfD,2,,•(%D PERMIT N0. /� �� SCRIPTION OF FURNACE AND OR BURNER No, of Heating UnitsT Circle One (Steam) (Hot Water) arm Air Trade Name ,t� Size Na BTU 7G o0o EDR Fuel �,4 c Total Connected Load Burner irade Name Size Nn. BTU FiP EDR HEA7ING COMP. Approved Sy Rough—In Date Final Date �ILL OUT BACK SID� F STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes (y�No () 2. Is free from rust or deterioration Yes (� No O 3. Has no foreign objects lodged within Yes () No (.� 4. Is securely supported Yes (�- No O 5. Meets all current Code requirements for size and total BTU's connected Yes ( r.y No O 6 Has total heating BTU's of ` ::� All other BTU's '�0 d�a - � � TOTAL BTU's � `�D, OGO� tq/ ,J`� • 7. Has a liner been provided for water heater Yes (1/j No () 8. Has combustion air been provided for water heater Yes (�j No () Remarks: List ALTERATIONS Bein Done: HEATING CO: Signed By: Date: ��, SUBJECT P N City of Fridtey 267 25 AT THE TOP OF THE TWINS g � I L D I N G P E R M f T � ` RE O. � • COMMUNITY DEVELOPMENT OIV. � r � ~ � PROTECTIVE INSPECTION SEC. ��`% �� _ � ' �'��1 � CITV HALI FRIDLE� SS:.3� NUMBER REV DA�E PAGE Of APPqOVEO BY �._..�' �•� 612-571-3450 9t0-F15 7/20/98 � � JOB ADDRESS 6281 Jackson St. NE t IEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACNED oesca. 5 1 Irene Henr sHEer 2 PFOPEfiTV OWNEF MAIL ADDAESS 21P PMONE Rita Weglinski 571-9522 3 CONTRACTOR MAI� ADDRESS Z�P PHONE LICENSE NO. Homes "R" Us 7398 Concerto Curve NE Fridle MN 55432 786-6 3 4 ARCHITECT OR DESfGNEF MAI� ADORESS ZIP PMONE UCENSE NO. 5 ENGINEER MAIL ADORESS ZIP PMONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION (� REPAIR ❑ MOVE O'REMOVE 8 DESCRIBE WORK Reroof house and ara e 21 S Tear--off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply withState Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR EIECTqICAL, PLUM8ING, HEATING, VENTI�ATING OR Alq CONOITIONING. THIS PERMIT 6ECOMES NULI AND VOIO IF WORK OR CONSTRUCTION ZONING SO. fT. CU. RT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOFi A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DW�G. UNITS OFFSTREET PARKING I HEREBY CERTIFV TNAT I HAVE READ AND EXAMINED TMIS APPLICATION ], STA��S GAFAGES AND KNOW THE SAME TO BE TRUE ANO CORREC7. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO. WI7H WHETHER SPECIFIEO MEREIN OR NOT. THE GRANTING OF A PERMIT �1%SL .$% DOES NOT PRESUME TO GIVE AUTHOR�TY TO VIOLATE OF CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. S6. JS Fire SC 1. 7S C � Q PLAN CHECKFEE TOTALFEE !"�"( l License SC 5.00 64.37 �GNA7URfOFCON�RA OROAAUTMOA�ZEDAGENT IDATEI WHEN PROPERLY VA ATED 7HIS IS Y�R �� IT _ /A�^ G 7T !/(/ O SiGNnTU:iE OF OWNER iiF OWNER BUILDEA� ID/1TE� BLD ��NS� �1FTE NEW ADDN ALTER [] [] �l CITY OF FRIDLEY SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/98 � ��%�� c��' c � ��,,, �i� ConstructionAddress: _ � � 8� �� ,�so� �.�, Legal Description: �� o �� ,� � / ,, ��i��.('PwG� __ _ Owner Name & Address: (� , �-� l�e a /, �s ?� , r Tel. # �7/ - 9�22 Contractor: _�/� �iPS "d2 �' G� S . MN LICENSE #�� 3n�37 7 Address: 7�3g8 G�-a� �� u_ �� Tel. �# 7g'G- G 8��3 � Attach to this applicadon, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. �� ' ` LNING AREA: : GARAGE �AREA:. DECB AREA: 01"HER: DESCRIPTION OF IlVIPROVEMENT Length Width � Height �ngcn wia�n Height Len Width HgtlGround • �/2U�� r �/ S� - / Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: � e_ �o o �- Estimated Cost: $ �j� % �.,5�� (Fee Schedu2e on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ � DATE: 7- z o- 5f� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPUL.ATIONS: t $ �. $ , .� $ . � $ � $ . �� $ $ $ $ $ `.� � Tel. # 7�G-G13C CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above � $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] y� . r f ' 0 sue�¢tt P . City of Fridley 30082 AT TNE TOP Of TH£ TWINS g � I L D I N G Pf R M I T r � . � � • � • COMMUNITY OEVELOPMENT DIV. �� VL _'�'� r � � PROTECTIVE INSPECTION 5EC. 1 ; � � � �"'1 � CITY NA�L f RIOIE� 55�32 NuMBER pEV D�TE v�GE Of �PVROVED Br �.__.Jl; '•� 612-571-3450 910-F15 8/19/99 / / �oe nooaess 6281 Jackson Street NE t LEGAL �07 NO. BLOCK TRACT OR AODITION SEE ATTACMED DESCR. CJ 1 Irene Hen SMEET Y PROPERTY OWNEF MAIL ADORESS ZIP PHONE Rita We linski 3 CON7qACTOR MAIL ADDRESS 21P PHONE UCENSE NO North Central Bldrs Inc - 4 ARCNITECT OR OESIGNER MAIL ADORESS ZIP PMONE LICENSE NO. 5 ENGINEER MAII AOORESS ZIP PHONE IICENSE NO 8 USE OF BUIIDING Residential 7 CLASS Of WOFK � NEW � ADD4TION O ALTERA710N � REPAIR O MOVE O REMOVE 8 OESCRIBE WORK Reside house and garage; Re lace fascia Hail dama e 9 CHANGEOFUSEFROM TO STIPULATIONS Cali for building wrap inspection before covering. Permit inspection Cards T Wiii Be Malled o Homeowner To Post SEPARA7E PEFiMITS ARE REOUIRED FOR EIECTRICAI. PLUMBING, HEATING, TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV LOAO VENTILAT�NG OA AIR CONOITIONING TMIS PERMIT BECOMES NULI ANO VOIO IF WORK Oi; CONSTRUCTION ZpNING SO. FT CU fT. AUTHORIZED i5 NOT COMMENCEO WITMIN 60 OAYS. Oa IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOp �► PERIOD OF 120 DAYS AT ANY 71ME Af7ER WORK IS COMMENCED. NO. DWLG. UNITS OfFSTREE? PARKING 1 MERE6Y CERTIFY THAT V HAVE READ ANO EXAMINED THIS APP�ICATION STAIIS GARAGES ANO KNOW THE SAME TO BE 7RUE AND CORRECT. ALl PROVISIONS OF �AWS VALUATION SURTA% ANO ORDINANCES GOVERNING 7HIS TVPE OF WORK WI�L 8E COMP�IEO WITM WME7MER SPECIFIED MEfiEIN OR NOT. TNE GRAN7ING OF A PERMIT �SOOO Z.SO DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEI TME pEqMIT FEE SI1C CNAfiGE PROVISIONS OF ANY OTHEF SfATE Oi7 IOCAI LAW REGULATING CON- STRUCTION OR THE PERfORMANCE OF CONSTRUCTION 111. 25 Fir SC S. OO PLAN CMECK fEE TOT EE Lic C 5. 23.75 S�GN�TU�7EO�CON"NACTQAON�UTMOpi2E0�GENT �O�iE� EN P ALIO �HIS i R P MIT / S�GNO�UFE OF OWNEQ�� OWNEABU4DEA� iO�TE� B�D �NSP �i�TE NE�iI � C] Effective 111/99 ' ADDN [ ] CTTY OF FRIDLEY ALTER [] SINGLE FAMILY AND Dt)PLEXES R-1 AND It 2 �, �_/ $UILDING PERNIIT APPLICATION � � ��j� tM S LI�° � _ � ��-% � �' - -�— � . �.,►��,,, ConstructionAcldress: � � �__ i �-��p�---,� � , . , :-- _ ._ . .._. ._; . ^,:,_ .._. ' Legal Description: . _ . _ .. � . . . Owner �1ame & Address: R ; �- � �,�,��,�Ki .. ',�'e1.� ��,� • .S� LL Contractor: �o�-�h Cc NTQR � B td�s •_.�1'1 �. MN LICENSE #.�% i 3; Address: r%:�O / - �if a /'1 � ��E /�/� . /�/ElL �, fl S�'ya'J�'I'el. # 533 —b /i• '' Attach to this application, a Certificate of Survey of tl�e `�2�9 `, lot, i�+ith the proposed ct�nstructiali drawn oi� it to scale. �.IVING A1tEA: GA1tA�� AYtEA: �ECK AR�A: U'TI�ER: DESCRIPTION OF Il1�IPROV�MENT Length iNidth Heigl�t Sq. �t. Le�gth � Widt� Height . � Sy. �E. I.�ngtfi Width �Igt/Ground Sq. �t. Yp � Estimated Cost: $ ��D� � � � Cnnstruction T e: ' � ` • , .. r ,. : ,, ,..,; ; A� (, dp,w►�c (Fee schedul e on Ba�ck/ briveway Curb Cut Width Nee�ed: Ft. + b Ft = Ft x$ _$ bA1'E: $'1'g - q 9 Al'PLICANT: Tel. �.533 -% /L�i CITY US� UNLY 'f „ � { F'ermit Fee $ Fee Schedule on Reverse Si�e �ire 5urchazge $ ,� .001 bf Permit �aluation (lilOthR�) St�te Surcl�t�ge $ � , �r-'� �.50/$�,C�U �Valttation � f �;-�``�`� , 5AC Charge $ $1050 per SAC Utut License 5urcharge $ c $S:dO (State LiCens�d Residential Coi�tr�ctbrs) �riveway Escrow . $ � Alt. "A" or A1t. "�" Above � �rosiot� Control $ $450.QO Conservatioa Pl�a Review 1'ark �ee i$ �ee Determined by Engineering Se�ver 1Giairi Charge � ( �, . ' . . , Agreement Ne�essaty [ ) �Tot,�iecessary' [ �, ' . moT�. 5'I'IP�TLATIONS: � $._. a3_: � � . :�. � . . _ ._. . _ ... r . ;. ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 57"L-36U4 r��: : 6281 JACKSON ST NE : 143024440005 : IRENE HENRY ADD : LOT 5 BLOCK 1 : PLUMBING : RESIDENTIAL : ADDITION/ALTERATION 571-11iS"/ PERMIT 1�0.: 2004-00464 ``�; DATE ISSUED: 04/08/2004 VALUATION : $ 400.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A INSTALL GAS WATER HEATER # ELEC WATER HEATERS # GAS WATER HEATERS # GAS RANGES # WATER TRMT APPLIANCES APPLICANT NORBLOM PLUMBING CO 2905 GARFIELD AVE S MINNEAPOLIS, MN 55408-2173 (612) 827-4033 OWNER WEGLINSKI RITA T 6281 JACKSON ST NE FRIDLEY, MN 55432 0 # NEW FIXTURES (EXIST OPENINGS) 1 # GAS DRYERS 0 # OF NEW FIXTURES 0 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 construction or the performance of construction. Bldg Insp PLBG PERMIT MINIMUM FEE PLBG FIXTURES (NEW OPENINGS) PLBG FIXTURES (EXIST OPENII�IGS) WATER TREATMENT APPLIANCE WATER HEATER - ELEC WATER HEATER - GAS GAS RANGE FEE GAS DRYER FEE STATE SURCHARGE, PLBG FLAT TOTAL PAID WITH CHECK # 28069 !TT[1 TTl1TTTTTT T/lT t[1l1TTJ /1TTTTT TTiALT TTC�l�DT�L'T ADl1�7L Jlil Al\A 1 li 1 li1�1Y111 V iW� V ii�aJ✓ a Va� ♦� viv� v i ii�.wa� a a u aa � aiuvvavu...... .�... v..J. 0 0 0 0.00 0.00 0.00 0.00 0.00 35.00 0.00 0.00 0.50 35.50 :ITY OF FRIDLEY INSPECTION DIV. ' Effective Apri11, 2004 431 University Ave NE �`� ridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FI ING PERMIT ��, 763) 572-3604, FAX (763) 571-1287 � MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR �• ---- - . _..., , ..... :.:.: .... ...... .:::. ::.. :::: ::: ... .. ... � . �-8 I � �c�o� �LUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS �ann�.2 � a.S �� IlU�n� Jew Fixtures $10.00 The undersigned hereby makes application for a permit for the work herein )fd Opening, New Fixture $10.00 specified agreeing to do all work in strict accordance with the city codes 3eer Dispenser ' $10.00 and rulings of the Building Division, and hereby declares that all the facts 31ow Off Basin $10.00 and representations stated in this application are true and correct. ;BtCh �2SI11 $10.00 WEGLINDSKI, RITA t� zaln Water Leade� $�0.00 6281 JACKSON STREET NORTHEAST �/�� 20 � 1 iUt71P/ReC21Vt�9 Tatlk ' $10.00 FRIDLEY, MN 55432 Nater Treating Appliance $35.00 O� (763) 5��-5�22 Nater Heater -Electric $35.00 Nater Heater - Gas*" � $35.00 �• � BUILDfNG USED AS �Si � e�v1��. 3as Range"* $10.00 /' O° � o�Ob�. C�,,`�%�- / �as Dryer*'` $10.QU ESTIMATED COST �7 ��' PERMIT NO. 3ack Flow Preventer Required OYes (} No TYPe $15,00 PLUMBING COMPANY O � � ` (�✓W�, �jZ �einspection Fee $50.00/Hr SIGNED BY TEL N0. ��t�8�`yd33 4LL OTHERS ANDlOR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance � Approved By Rouqh-1 Final Date � State Surcharge $` . Sd , MlNIMUM FEE FOR ANY PLU PERMIT IS 15.00 or 5% OF COST TOTAL FEE $�S � OF THE 1MPROVEMENT WHICH G EATER PLUS THE SURCHARGE. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PR ON VENT INFO ON BACK SIDE \\ _ � - �a, � Building MECHANICAL Permit No.: !�' � Inspections RESIDENTIAL APPLICATION Received By: 7. 63-572-3604 CITY OF FRIDLEY Date R��d4� J — 7 07 DATE %�S � O% YOUR E-MAIL ADDRESS SITE ADDRESS b 2 8/ �%fL� Or�1 S /�F TFI[S APPLICANT IS: O OWNER jdCONTR.ACTOR � PROPERTY NAME: !c �� A G�I P Q L�:JSK i OWNER/ ADDRESS: f0 Z S � T/�'�l�O�J S f�i CiTY /�i.� STATE�ZIP SLY3 L ' TENANT PHONE: %b� - 57/ - Si Z 2 CONTRACTOR CotvtP,4NY NAME: I��+� �%; ',�n�%'�"� �•�� A'M G.�n/b CONTACT PERSON: K�-� � SUBMIT A COPY OF p� DA.I,E YOUR STATE STATE LICENSE # �ib2t� STA ZIP SJy28 LICENSE WITH ,n,�DRESS: � LyS LA�clA+fD A►K M CITS' IS2�°K�� TF�J� APPLICATION pHONE �63-536-obto7 FAX 76 3- s36' 02 rb , PERNIIT TYPE I� SINGLE FA1vIILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: � �W ��p�CE�T �'v-'TERATION/REMODEL V,�1, ftit 9 2 .i�`' DETAILED DESCRIPTION OF WORK %�� L�rt3TA^�a �/h`2 ��Cu��,+.+,s°'� kh+i► �"`'�"� �M"�� (i, ; •�c PER MS 16B.665 the permit fee is a minimum of $15.00 or 5°/. of the total cost up to S500.00, whichever is greaier, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (lfiis should reflect only the cost of labor ) Labor cost under $300 �$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECTS WI�RE I.ABOR EXCEEDS 5500, FEES ARE BASED ON S 10.00 PER FIXTURE> EXCEPT WFiERE NOTED. FDtTt.)RES: (DdDICATB TOTAI- NUNBER OF EACH BELOV� MODEL: X CkI ' �� S�, u Zy, q�° Equipment Installed . MFG: ��X J�, ffG; MODEL: MFG: MODA.: SIZFJBTU �,A/C 525.00 _FIREPLACE (GAS) 515.00 . GAS RANGFJOVEN 510.00 AIR TO AIR EXCHANGEER S 15 FIREPLACE (WOOD) 535.00 NEW GAS GRILL SI0.00 BOILER 535.00 _FURNACE S35.00 _GAS UMT H1R 510.00 CHIMNEY LINER 510.00 _GAS DRYER 510.00 POOL HEATER 535.00 DUCT WORK S10.00 _GAS PIPING SI0.00 VENTILATOR S15.00 , ... _ '�j , �� . g . . . . . �N�� . .. , .... . .... > ' �.... . _ �� .: . .. . .. . . .. . . .. . . . . . ' . . '� :.. . Permit Fee �$ �_. Number of fixtures @$10.00 x$10.00 $ Swcharge $ .50 Number of fixtures Q$15.00 x$15.00 =$ 'TOTAL DUE $ �_.� Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures Q$35.00 x$35.00 � S State Surcharge = $ .50 Total � S Tf�IIS IS AN APPLICATION FOR A PERM�T-NOT VALID UNTtL PROCESSED I hereby apply for a building permit and I aclaiowledge that the information above is complete and accwate; 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 appro��al of plans. SIGI3A'NRE OF APPLICANT �� PRINT I3AME 1`� ( IN �'I R2SN( DATE� O% �'r�� . ��,. � a , �� .. t��ty oi r r�aiey Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building Inspections 763-572-3604 763-502-4977 FAX DATE I I � I 1 1 U SITE ADDRESS � THIS APPLICANT IS PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICA'I'E OF INSURANCE BUILDING RESIDENTIAL APPLICATION ❑ OWNER rrAME: r ADDRESS: PTiONE: - NAME: �t,b2r STATE LICENSE # Permit No.:�U�'�n `�� Received By: CITY OF FRIDLEY Date ��11,; h tl �; �' �(� � EFFECTIVE 1-I-09 _ YOUR E-MAIL ADDRESS ��e S� :� (� /� a U U S" Ca $�07 flL� e, �1'e-"r" r-» c r.r A l f— �ONTRACTOR ��z�� PROPERTY TYPE I t�-SINGLE FAMILY/NEW CONSTRUCTION ❑ TWO FAMILY/NEW CONSTRUCTION PERNIIT TYPE TYPE OF WORK: DESCRIBE WORK BEING ROOFING NUMBER OF SQUARES _ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl 0 Aluminum ❑ Other ❑ BASEMENT FIAIISH ❑ ROOF ❑ DECK ❑ SIDING ❑ NEW HOME CONSTRUCTION ❑ ADDTI'ION �MAINTENANCE/REPAIR ❑ REMODELING �P[Act �f (�J�NOou�s [�v �u.iSrrti LENGTH WIDTH ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE EXP DATE � CITY� FAX �[� � � � ❑ DRAIN TII.E ❑ OTEIER FT BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ❑Sofiit ADDITIONS_ & PORCHES SUBMIT: � T� 1. Site Plan/Survey showing the existing structures ❑ Fascia �d ProP� P%lect. 2. Two sets of construction plans WINDOWS 3. Energy Cakculattons IN EXISTING OPENINGS �Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED 1�-► �u05AY ViuV4QtJ�Ex oF wtrtnows � ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (IIS G THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION S c� �I ��`-� OCCUPANCY TYPE . Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Pazk Fee Sewer Main Charge Total Due $ f� �, 'p( �j See Back Page for Fee Schedule $ 65% of Building Permit Fee $ .001 times the total job valuation $ , .0005 x Permit Valuation Minimum $.50 $ .��. U� $5.00 (State Licensed Residential Contractors) $ $2000 per SAC Unit (Plans to MWCC for determination) $ ft+6fi= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ /. . Make checks pavable 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 acknowledge that the information above is complete and accurate; that the work will be in conformance with the orclinances 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 f ork whic re s re �and approval of plans. SIGNATURE OF APPLICANT ��GQ-G��-/1 PRINT NAME �� Y -�_�-. , �a ��DATE � / � � PLEASE NOTE: SEPARAI�,�ERMITS AR�.R�QUIItED FOR