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AF - 47376� � City of Fridley, Minn. BUII,DING PERMIT N° 3 3 5 0 nate: .. �� ..//.... `..��.... Owner ....................................... Builder .�i��........................... • Address...................................... Address ............................................. LCaC�4T(O�( OF BUILD[NG No. �j. � AZ � Street .1�.1 . . . . . . . . . . � . . � ! . �Part o t . . . . . . . . . . Lot ....5�...... B2ock .....,Q........... Addition or Sub-Dfvision .��lfe�4/... . . � ......... c�r r.�t . . . . . . . . . . . . Inside Lot . . � . . . . . . . Setback . . . � �3"i . �:'�Sideyard . . . .� tJ .-�t5 . : .'. . . . . . . . . . DESCRIPTION OF BU[LDING To t�e usea as: f.1,%+�J�l��'�et^.'�. . . FSront . ��. . . Depth � P�. . Height .1. Z . . . Sq. Ft. . 9�/ Q Cu. Fk �J�.L � . . . . . . . . . . . . . . �� . . . Front . . . . . . . . Depth . . Height . . Sq. Ft. . . . . . . . . G�. Ft. �. . . . . '1`ype of Construction � . . . . . . �et �� , 7. � . .� . To be Completed . . . . . . . . . . . . . . . . . . . In consideration of �he issuance to me oi a permit to rnnstruct the buil ' g desribed above, I agree to �o tk:e prop�ed work fn accordance with the description above set forth an compliance with aIl rovisio�s of ordinances of the city of Fridley. /�' '� �. . ..... ..........°..� .. ... ............ In consideration of the payment of a fee of .! !. �. permit is hereby grazrted to ... .. .. .. .. .. ...... ......................... to construct the building or addition as described above. This pe�nit is granted upon the express condition that the person to who:n it is gi�anted and his agents, employees and worl�nen, in all work J done in, around and upon said building, or az►y part thereof, shall conform in all respects to the ordinanoes of F�idley, Minnesota regaxding location, construction, alteration, maintenance, repair and moving of bufldings with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances: 1 NOTICE: This permit does not cover the construation, installation or alteration for wiriny, plumbinp, sewer or water. Be sure to see the Buildin� Inspeator for separate permits for these (tema � � � • • Date: Owner: Address .3 ��a City of Fridley, Minn. N� � 2 2 Z BUILDING PERMIT May 5, 1967 LuVerne H. Skare ....___ ....._...._.. —� Builder _..,._.._.�Q�.��---._._......_...._..___.._......_...._._____._ 6320 Jackson St. R..^E._.^N.T..� Ad� �_��____�_._.._._._...._.___ LOCATION OF BUILDING 6320 Jackson St. ft. E. p� of Lot ...__._._.__ No. -----.........._..._.__. Street .__..__._..--_-•••-.__.._.._._._.._..__.�_.___._._........_........._. _. ( g , Christie Addn. Lot ._-•--•---..__._.._.........__ Block _._.�.._.._._..__.___.._....__._. Addition or Sub-Division -.-----_..__...._..____.__�_ Corner Lot ...__._...__.._....__ Inside Lot ---_..---X-----__.._.-----._ Setback _.._..__35 .4-.---._ Sideyard _..._ 31.9 Sewer Elevatian ._._...._�._--------.__----------_...�___..._..______ Founda.tion IIevation ....._______.__._ To be Used as: Double Garage _._.._.___.._. _...._...... Front _.___..____..._.�.._.._.._..__ Front 7�pe of Construction Frame DESCRIPTION OF BUILDING � � � 2 7 Depth _ 26 Height .� 1�..._ Sq. F't. _�. 7 02 Cu. Ft �..— .._.. Depth .____�.__ Height _.._...._._.__ Sq. E't. ._.._ Cu. F'� __._.__.. Est. Cost __.� $ 2, 000.._....----- - Aug . 196 7 ...... To be Completed ...._ In consideration of the issuance to me of a permit to construct the building described above, I agree to do thP proposed work in accordance with the description above set forth and in compliance with pravisiona of ordinanoes of the city of Fridley. � �n ca�sideration of the payment of a fee of �._.._10. 00 ��t is hereby granted to—LuVerne Skare ._._._,.......___.___.._..�..._......__._.._ to construct the l�uilding or addition as described above. This permit is granted upat the express condition that the person to whom it is granted and his agents, employees and workmen, in all work. done in, around and upon safd building, Qr any part thereof, shall conform in all respects to the ordinances o� Fridley, Minnesota regarding lceation, construction, alteration, maintenance, repair and moving of buildings within the city littuts and this permit may be revoked a t any time upoz� violation of any of the provisions of said ordinances. CLARENCE BELISLE B�� NOTICE: Thb p�emit doa not cewr fh� construeHoe, inqall�Nen ier wir�q, plumbtn�, qu hNHa�, anwK oe wabr. !� wn M sM t6� Butidfag Insp�eb� for s�p�nt� pKmits for tha� IfNns. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER' S NAME � I,t ��a J� �� /� e BUILDER �W /� e F ADDRESS ,��3.�� CL C�SO I7 S% .,LC ADDRESS � LOCATION OF BUILDING NO. C3�0 STREET �ac /��cDh .� PART OF LOT � LOT � BLOCK � ADD� I` T�� OR SUBDIVISION C'%jY��j,��'i� � CORNER LOT INSIDE LOT � SETBACK 3,� � SIDE-YARD � I. �' SEWER ELEVATION TOP OF FOOTING Applicant attach to this form two c.ertificates of survey of lot and proposed building location drawn on these two certificates. DESCIPTION OF BUILDING To be Used as: ,� c, ,AL � CT0.fet q� - Front � � �'%/ Depth ,�C /�T_ Height � O T Sq. Ft . ��O � Cu. Ft . Front Depth Height Sq. Ft. Cu. Ft. � Type of Construction GU� a p� t= fG, h� e Estimated Cosl�,� D l� C,? '�O _ —� To Be Completed,�U� % �j' G ? The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley 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. DATE�� — � G % SIGNATURE �.l.ee.,�.�-•�._+��y.rCZi�� (Schedule of Fee Costs can be found on the Reverse Side). s.�''�' .� �� ;,�, . _�... �____--r��. r.,, / J • � . , .. � l , . � .Y( �:%. / �.__ _� �.f ' .� �-� 1 � �� f=,�- � � � . -=t f`-�� r �=�-� �1!' ------� �—�=_ - __.._. .'-`-i_"- ' TFIE E. 6. McDOtiOUGi-1 CO. tFE. 5-6611 7�: 1953 I�NIV�RSiTY AV£.. SnINT P>!IL 4� TELEPHONES�� MI. 6-6958 SCALE: F INGH_.v� FEET 814 NATIONAL SUILDING. MIivNEAF`OLIS 2 � lMl. 9-5072 �� ..'�� a �� 17 � �� . � �/�',✓;,'�� /.T;� r�,. ___l"��,�'<�° - = :-I �T � �,- � � ,,/, , . OF PROPERTY OF� -- �/ ., �}" .: - � .• �.� _� -,?�'7 . �1 >�� f/� � � ° f� "l/ •, f�:r.�?/''��' G� � _ �� OESCRI6ED AS FOLLOWS��-� c.- ;.-.t�.c._'.�--�' =�_..�✓��11 i," /• �f•�T..L1�i .lr f I C{�. —_- � � i � . � cNC .;r� � -- � ___�- 4� 3 %3 . , h Q`j � /39.,�/ �__ � _ — --�-r----._._. _.._.... • � 2 r � ,� � I i� {�J. � , F, r% , � �. s � r ; �.� L ni � ri : � . � � �i i �� ' � w� � ! t ( �+ :A � �� :: .i (� ,� � � , . - .�� i •i ,-� " T ' �---- ___ __. _ --- -- --- ___ _f . • _5�_�•_�_ .__i ;; :� E :y . ; -�� 1 � ` ( �+ -� �, _ " � __ __�_______ � �. � � � .._ _ _ ,—� � � . ' . �. � � _ ' N :r ... . _�-.1 . � ; 1 4 � ---�---- ---- • � �- % . � . �� ' S'': � � �-- �= � � �1/'�.�.. �' CLF:TIFICATE OF LOC �TIO� OF BUILDI\G CPRTIFICATE OF SURVEI ' I i�ere� y ce:•tif� thnt on �-'`" 13 �'� I hereby certify that on � 19____ ' I n a�;e i,�u�v��,� of titc (u�•atiun uf t c��uiirlir>f sl ±�n_ the I;urreyed the pcoperty de: cribed al�u�•e �in:l that tl;e abvve � �hocy r�_ccci�x i l�rot�ert, zinrl Liiat t�.c Iocation o2 �aid . �, buildin;;(s) is correctl5� shc�«�n an the above piat. pl�,t is a correct representafion of sail survel-. I' - . --- ' ' — -- ---- 1 � � — � • l� E. B. McDONOUGH. REGISTERED SURVEYOR No. 1990 - =, PAUL J. CRANE. " " No. 4449 . � � � InH'N �t avni�. . ^ . . • � Nn ddA9 � . � � � � . . SUBJECT City of Fridley AT THE TOP OF TME TWINS g U I L D! N G P E R M i T r � . � � � • COMMUNITV OEVELOPMENT OIV. r� � y � PROTECTIVE INSPECTION SEC. , , � � �"'ti � CITY HAIL FRIDLEv 55432 NUMBER �'""'�" �'' 612-571-3450 9�0-F�5 JOB ADDRESS 6320 Jackson Street NE 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION DESCR. fj g Christie 2 PqOPERTY OWNER MAIL ADDRESS 3 CONTRACTOR MAIL ADDRESS Steven Woods Construction 68�0 xParA A 4 ARCHITECT OR DESIGNER MAIL ADDHESS 5 ENGINEER MAIL ADORESS REV IDATE 5/6/97 ZIP PAGE UF � / PERMIT NO. ` � �a��:��4 t., RECEIPT� ..�I-63 APPROVED BY SEE ATTACNED SHEET PHONE LICENSE NO. 537-2664 PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITtON ❑ ALTERATION X REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (22 Sq) 2nd Layer 9 CHANGE OF USE FROM STIPULA710NS TO Roofing can be the 2nd layer but not the 3rd. SEPARATE PERMI7S ARE AEQUTAED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONOITIONING. THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTHUCTION OA WORK IS SUSPENDED OA ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UN I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 AND KNOW THE SAME 70 8E TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAlUA710M AND ORDINANCES GOVERNING THIS TYPE Of WORK WILL BE COMPLIED 364 WITH WHETHER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT $1� DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- �45. %S STRUCTION OR THE PERFOfiMANCE OF CONSTRUCTION. PLAN CHECK FE License ' OCCUPANCYGROUP IOCCUPANCVLOAD SO. FT. CU. FT. STAILS $5. OFFSTREET PARKING IGARAGES SURTAX $.68 SAC CHARGE Fire SC $1.36 TOTALFEE r �52. �9 S�GN TUR CON' CTOAORA MOAIIEDAGENT IDATEI FlOP VAL ED THIS �S Y U�ERI V � � Y + ' � S�f,NATIIRF nF nWNEF i1F CIWNER BUILDER� IOA EI Ri n iraCP r�a7E NEW ADDN ALTER [l [] �� ConstructionAddress Legal Description: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION � � \1n Effective 1/1/97 �a�� Owner Name & Address: �1 h C� y� —� 5 o`�'�� Tel. # Contractor: S�,�I't°�/1 �� ,Q,� j� C'�l� MN LICENSE #� g�C7 Address: (0�3� � ` ;�(�� N, � �� Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. I.ength Length Length DESCRIPTION OF IlVII'ROVEMENT Width Height Width Height Width Gi �� Sq. Ft. Sq. Ft. Sq. Ft. , -- �- c Construction Type: I`e- Fstunated Cost: $ (Fee Schedule on Back) � .��r-�. , Driveway C�rb C�t Width Needed: Ft. + 6 Ft = Ft x$ _$�� . DATE: � APPLICANT: �� \ �/�/�4�� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STiPULATIONS: $ �. � $ �, $ .�2 $ � _�,OD $ $ $ $ $ ��- ? CITY USE ONLY T��. #�37� �� Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.SO/$1,000 Valuation $950 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 [ j Not Necessary [) ;,,e, . ,- ,- � GiG �l �� CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPl.ICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATfON, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES. FAX (763) 571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% ot Value of Appliance or Work Rate TOTAL $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25 00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $� � $ $ $ $ �5,� $ $ $ .50 $ 5 � 50. Effective January 1, 2003 e %�' `�-�, �'',� ` % ' C�� JOB ADDRESS lo �� d �� kso►-� s-�- I�i� OWNER ��a..� �+ ��n k o BUILDING USED AS ��5�� c�--�rin ESTIMATED COST ��vGY� � 00 PERMIT N0._ �� DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units � Circle One (Steam) (Hot Water�rm Air Trade Name �rr� er Size No._S �S �LP� fl�n-ia BTU ��lo o� HP EDR Fuel_ N Total Connected Load Burner Trade Name Size No. BTU HP � EDR �a�.r � �. � � 3� �'2-C� L�a�--{ �� The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes ar rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE 1 � - 1�- �3 CenterPoint Energy Minnegasco HEATING C013562 Central Ave NE, Anoka, MN 55304 Signed 202 FAX # 763-757-6701 Approved By,�..L Rough•In Date Final Date �� y FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE � THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNiNG APPLIANCES OR THE APPLICATION WILL BE RETURNED �e� , the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, Yes (X► No () and is securely supported and firestopped where required. The venting system is plastic/PVC and meets all current codes and manufacturer Yes (XI No () specifications inciuding sizing, length, number of eibows anci termination. The undersigned also verifies that the replacement unit is a listed assembly , and meets the current codes ande t al F inace Vent ngCTabl s for' f noes i n c l u d e A G A- G A M A C a t e g o ry I C Y e s (� ) N o () assisted and naturai draft appliances. The is sized and installed to meet the current codes Yes �) No () and manufacturers specifications. Wher1 nequired to �;,� "" "��" ^^""e�`b°^ air_ itwill be sized and installed eq Yes � ) No ( ) to meet the current codes and manufacturer's specifications. �� the undersigned hereby verifies that it is a I'�sted assembly and meets the current codes and manufacturer's specifications. This d�ss s ed and na ural�draftaa pli nces.ntral Fumace Yes �) No () Venting Tables for fan a Is the common vent�n removed from the commonv nt alnd entedt'y after an appliance has be Yes (X) No O separately as per current codes. - -� • /[`��+r+men � n nd V _nt C qpp�jance #1 Type ��r ^� BTU Input �vL� � F ssiste or Nat �� Fan Assisted or�T Ap�� T�e �� BTU Input � Fan Assisted or Nat App�� Ty� Total Btu Input Total Appliances _._,_ Vent Hei ht Z� Diameter �� inches Common Vent Type � / � 9 � ft Diameter m Type e(� qpp�iance #1 Vent Connector Height �ft Length _� Diameter �� in Type �� t-�- Appliance #2 Vent Conne�tor Height �_ft Length f� �-- __ Appliance #3 Vent Connector Height ft Length ft Diameter in Type � I�:��i�:�rr...�:,�,.,.,:�:,c. HEATING CO: CenterPoint F.nerQ� ra;..� Ee 13562 Central Ave NE, Anoka, MN 55304 Signed By: _ Date : � � � Z- � � . j W/I�l1 O//I i n �� Minnegasco ADDRESS tJ.��C} J ►�(..�-sa1 �fi /��- OCCUPANT �N� HEAT LOSS Yes DATE HTG. INST. SOLD BY Electrical Work Bv � �''ti e. TYPE OF HEAT FA X SPACE HTR. � n� D GAS DESIGN MAKE U Model ��`� Serial � NPUT Pressure �.S- � L� C Percent CO2 0 nput CFH �2 .�� Percent 02 l� StackTemp. 37�{� PercentCO sn°�'1 11 HOIJS� �a�Ai1NG TE�T RECORD APT. FLOQ R CITY �' �'� OWNER �/JAId1 [�� INSTALLED BY r' n r Gas line By �'�'►e UNIT HTR. ____ OTHER CONVERSION �/ "' . Vent Size KIND OF LINER � S S SIZE NONE J Draft Hood _�N% �ce'^ Regulator L� W Filters Size eC a n� � C- Number Chimney Location Inside � Outside Chimney Construction C'� 5s I�-- Wiring � Test Tag Lighting Inst. Date Tested _ I __- � -D Company Testing 'nt i Name of Tester � �� "� C�/'. 5.S _ _ C� l I OF FRtDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 May 4, 2004 Mr. Donald Danko 6320 Jackson Street NE Fridley, MN 55432 Re: Final Inspection at 6320 Jackson Street NE Contractor: CenterPoint Energy/Minnegasco Dear Mr. Danko: A mechanical permit was issued on November 14, 2003 to install a fumace and air conditioner at your address. According to the 1991 Uniform Mechanical Code a final inspection shall be conducted on the work authorized by this permit. As of this date the inspection has not been requested. The permit fee that was paid covers�the inspection to make sure the work was completed according to the Codes. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for by homeowner after notification" and the permit will be expired. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DJ/mh CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning - All Sizes All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater �oos -�� ii8 Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Fee Total $35.00 $ $10.00 $ $10.00 $ JOB ADDRESS U��V , /�"/ �`�-' I�� " v Build'mg Used As ��%� �� /iG� ESTIMATED COST PERMIT NO DESCRIPTION OF FURNACE AND BURNER $10.00 $ # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. $25.00 $ BTU HP EDR Fuel Total Connected Load Commercial/Industrial/Institutional 1.25°� of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/Industrial/Institutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR $ Burner Trade Name Size No. BTU HP EDR $ $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. H EATI NG $ S, 5v s; *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE FF �v� ��5�� f,,� Q�G��`�� "��'� ✓1� �S�'�'�`'� �t� C�i'�, Approved by Rough-in Date Final Date '�; Building PLUMBING Permitrto.: � '}I � ' , Inspections RESIDENT_IAL APPLICATION Received By: 763-572-3604 CITY OF FR�DLEY nate xec'd: (�� ' � � ti'� DATE I YOUR E-MAIL ADDRESS ' SITE ADDRESS ��(� � ��p.�_d,I F_ ' THIS APPLICAI�TT IS: ❑ OWNER P�NTR.ACTOR PROPERTY NAME: O WNER/ p,DDRESS: S CITY�j (,�,[ (J STATB'u��IP�s�3 TENANT pHONE: lL73' %`{ - v l�� CONTRACTOR N,a�vtE: ' SUBMIT A COPY OF STATE LIC S# � EXP DATE la.Jo � YUUR STATE ADDRESS:� 1 �1f' r' �1�'9i' CITY STATE ZIP LICEI�TSE WITH pHONE APPLICATION PERMIT TYPE LE Fa�rtLY ❑ TWO FAMILY ❑'rowNHOUSE TYPE OF WORK: � NEW �CEMENT DETAILED DESCRIPTION OF WORK I PER MS 16B.66� 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 fixtures. (This should reflect only the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (►NDICATE TOTAL NUMBER OF EACH BELOV� BATH SINK/LAV _FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING �e�C�rruCerr.s�j SWIMNffNG POOL Z WATER SOFTNER ($35) CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15) DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION — WATER METER OTF�R PE3tMIT.FE£.`PAfl��'� ,1�flR� . �` � � �.., � �. , a, _ fi. .. . .. _ . ... , e .7�.. . ., _ . . � . �.� � . .., .. .» . „i.., _ Permit Fee $ . Op Number of fixtures @$10.00 x$10.00 =$ Surchar e .50 Number of fixtures @$15.00 x$15.00 =$ TOTAL DUE $ Number of fixtures (a3 $35.00 x$35.00 =$ State Surcharge = $ .50 Tota1= $ 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 ordinances and codes of the City of Fridley and with the Minnesota Conshvction Codes; that I understand this is not a permit but only an application for it 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 w r ich requires review and approval of plans. SIGNATURE OF APPLICANT RINT NAME .�% o� C�� DATE��I O� ,�.. �"r ��,. u..��'�� ... � ' ' �� ' �APL�.A�SE%Nf.�"I'� � � �-� �' City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 �3� f�0 Building BUILDING Perrr►it Ivo:: ZC1 �G I'7I vv Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY vat�e d� ��►' 763-502-4977 FAX EFFECTIVE 8-19-09 DATE I2�! �D9 YOUR E-MAIL ADDRESS SITEADDRESS_j2��D , �Qekso=, ��. THIS APPLICANT IS: ❑ OWNER }�EONTRACTOR PROPERTY OWNER/ NpMg:�� 'F►-e v W tve K TENANT ADDRESS: CITY STATE ZIP PHONE:}� � $ � j� O/Y�o CONTRACTOR NAME: /"t'IIS�'eY Cowsi+-vc�Fib►� SUBMIT A COPY OF STATE LICENSE #�C9(o �1 S 1�'�'l EXP DATE 3 a YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS:�f S/S SriidS��'�l s�� CITY ic r <1 STATE�I) ZIP ss3s� INSURANCE pHONE S�'OO FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT F[NISH �ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER � SW[MMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUC7'ION ❑ ADDITTON ❑ MAINTENANCEJREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: v SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELIIVG SUBMI?: NUMBER OF SQUARES � �HOUSE & GARAGE I. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: O DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS_ & PORCHFS SUBMIT: ❑ Aluminum ❑ Trim 1. Site Ptan/Survey showing the existing swctures ❑ Other ❑ F�1e and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS OYes ONo LOCA7'ION OF WINDOWS FOR WINDOWS — PROVIDE U-VALUE AND OR FOR NEW OPEMNGS-DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS E+i.i. rr,r,� �►icr. u�►��L v1r vA1.UA11Vtv, i1vl:LUli1NG "I�HL C;V�"1' VN' LABUH ANll MA"CERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ y, gvo —_ _ OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Chazge Total Due � �f' ,� dJ See Back Page for Fee Schedule $ 65% of Building Permit Fee $ .001 times the total job valuation $ .0005 x Permit Valuation Minimum $.50 $ S $5.00 (State Licensed Residential Contractors) $ $2000 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$22=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ ___ • Cj j Make checks payable to: Cit.y 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 ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of a work which requires review and approval of plans. SIGNATURE OF APPLICANT � ��2��( PRINT NAME ��r�C � L. /�/Re� DATE Building Inspections 763-572-3604 763-502-4977 FAX DATE �] V �� SITE ADDRESS THIS APPLICANT IS: PROPERTY OWNER/ TENANT SUBMTT A COPY OF YOURSTATE LICENSE, BOND AND CERTIFICATE OF INSURANCE PERNIIT TYPE PLUMBING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 7-1-20 ] 0 ❑ OWNER STATE LICENSE # STATE BOND # YOUR E-MAIL ADDRESS �f CITY PHONE � ?)"�� - ��G :'� FAX _� J�I SINGLE FAMILY ❑ TWO FAMII.Y ❑ TOWNHOUSE �., �rE oF wo�: I ❑ NEW DETAILED DESCRIPTION OF WORK `�.REPLACEMENT . Permit No.: Received By: EXP DATE EXP DATE 7 STATE M ZIP 2 �- . FEES ARE BASED ON $10.00 PER FIXTCTRE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOVI�. MIIVIMUM FEE $35.50. BATH SINK/LAV FLOORDRAINS SHOWER WATERPIPING BATHTUB GAS PIPING (NEED CITY LIC) SWIMIbIING POOL WATER SOFfNER ($35� CLOTI�ES WASHER KTfCHEN SINK WATERCLOSET BACKFLOW PREV. ($15) _ DISHWASHER _ LAUNDRY TRAY �WATER HEATER ($35) FOR IRRIGATION _ WATER METER _ OTHER THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a ptumbing 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 pertnit on site; that the work will be in accordance with the approved plan in the cas S��f�I�I�'�'ork ich requires review and approv }qf plans; SIGNATURE OF APPLICANT ��(�iui� C� PRINT NAME� (! LIL C6Gr�fi'� DATE � b �V APPROVAL INSPECTORS SIGNATURE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977