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AF - 47411, � . �, - City of Fridiey � • App�icatian for P'fumbing and Gas Fitting Pernrit r y�`� � - Depi. of Bldgs. Phone SU 4- 4� 7� � f} C l�s O �'1% J/� DESCRIPTION OF WORK � �/ � / � y �t� �' . Number, Kind and Lxation of FixYures Location W��Q � x� i � x} Zz '� p� z �z p= � i� z 3c7 � o� � � 3� o� v=, O� c�� <3 �<° �� o Base �st 2nd 3rd 4th L_ I I I I I • Future Coanection OpeninBs * New Fixture, Old Openiags PARTIAL RATE SCHfDULE WATER HTR. • • F N GAS � ELEC. PLUMSING FIXTURE RAT£S: NO. RA7 Number Fixtures .. ..... . .... ... ....... b x $1.50 Future Fixture Opening ................ New Fixture Old Opening .............. X 1.20 x 1.00 Catch Basin ............................ x 3.25 Water Heater (Up to 200,000 BTiT) ......�L x 2.00 New Ground Run Old Bldg . . . . . . . . . . . . . x 3.25 3ewer � Cesspool � TOTAi. � f-�.' a-e! � $ $ � ? , o't/ $ City of Fridley: i 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 oP the Department of Buildings, and hereby declares that ail the facts and representations stated in this application are true and correct. �? �' � 6 1962 Fridley, 1Vtinn. , 19— Owner /.� U.S�,$' E� �/1 / c i� s d.�/ � G�At S Kind of Building �2 Used as 'D � ' To be completed about ( � � ^ �O �" Estimated Cost, $ Old ew. Building Permit No. �� Permit No. °Z � si�nea �-QNDON PLU�IQiN� �r. � � �,/ By � °+�s:..��a f` � �.. Business Phone No. ROUC3H FINAL GAS FITTING FEES: NO. RATE TOTAL lst 3 Fixtures .......................... x $1.50 $� � /� Additional Fixtures . . . . . . ... . .. .. ... . .. x .50 � � Gas Range to 200,000 BTLT . .. ..... ... ... x 2.00 $ �-, / / REPAIRS & ALTERATIONS—Refer io Code Description ................................................$ s`f d'Y/ TOTAL FEE $�'� 4a sM �-s4 City of Fridley, Minn. BUILDING PERMIT N° 5 8 3 7� �w.. ,w..f +�,}� Date: _.._.. �_....�...�...� -__3�C_.,IE!•• .____ • Owner: _.:....._.�"�"iK�--�L�;,.e!_'�. ... � tulder .._ .---- . ......... - ---�---....-----........._..__.._.__..__.-- Address Address L ATION L NG � _.._: � ...t .,t.. P f �'�.'� .. No. � ��. Street ._. .. . _ ..._ . Lot ._..--�.�'�.�...»..-_._ Blo ....... .' ____� Addition or Sub-Didisio r � ----_ �'l��rt�!_ __ •- Corner Lot ....._......__...._......_ Inside Lot •---._....:---•-•-----._....._------ Setback ..-�.+ �--...... .- -- Sideyard ••��---._ _._±r.�..�..._._._._..:.._. +f"` ". _" _ Sewer Elevation .....__.._._..__._._._...._.....-----_...._------__..__...._----_....--.•---_ Foundation E'levation .....---...__..-----------__._.._..__.__..._._._..--•--____..�.. �, DESCRlPTION OF BUILDING v�a , , . � , , _ F . . .. �. Front -•• -•_�_ _pepth ..� _:_. Height .�.. Sq. F � Ft�-� R /I''� �� _ _ ._r Fro t,�.�.� Depth .Lr! eigh � Sq. Ft. _..� Cu. F� ..�� Type of nstruction ....._.. ` _-• Est. CosC�'..� .:---.'"�".:.'i�o be Completed ..._�._........._.......___.._.._...__ In consideration of the isauance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. �.—_._..__...._.._ In consideration of the payment of a fee of $� ___......._.., permit fs hereby�granted to_.._.�. ......_....__.�.._._...___..__..__.._..r..__..__ to construct the buflding or addition as described above. This permit is granted upoqs 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 location, construction, alteration, maintenance, repair and moving of buildings ��e city ]imits and this permit may be revoked at any tix�,e �vio �ic�qof any of the provisions of said fl / 1 Buildin8 Inspector NOTICE: This permh doss no1 eover ths eon:fruetion, fnstaliafion fo� wiring, pWmbipg, �as heafing, s�w�r or wat��. B� wn to sN the BuiWins Mspeeto� ior separoM parmits for thsss itsms. .a _ , r . `�'4 • ...._t APPLICATION FOR BUiLDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Nan�e _ Huilder - ...._ _.,...._..._ Address Addx'ese LOCATION OF BUILDING �o. Street Part of Lat . . . ��r�l�� Lot . Block Addition or 3ubdivision -.�._.�...._ Corner Lat Tnside Lot_,,,,,�"�^Setback„_,,,r�g�ae_y�d SEVJER ELEVATION FOUNDATION EI,LVATION ` Applicant attach to th�ls form Certificate of Survey of Lot and proposed building location. . DE�CRIPTION OF BUILDING To be used as; t �� (/ 3q . Ft . Cu . Ft .-._...._...,.._...,, Frorit_�_Depth eight : Sq. Ft. �� Type of Construction�� Eatimated To be Comp]. Ft. Cost ' The uridersighed here]by makes $ppllcation for a herein �pecified, agree�.ng to do all work in strictiaccordan e�with � the City of Fridl,ey Ordinances and ruling of the Department of 8uild- ings, and hereby declares that al], the fac�s and representati,ons stated in is application are true and correct. DATE � � %� ` SICRTATURE1'� ....�. (Schedule of Fee Costs c�n be found on the Reverae Sidej�✓. �•.- � � ` �� ..„ -� � �� ►Pi�ication for Pawer Pfants ar� Heating, Cooliny, Ventilation. Refrigercrtion ca�d Air Canditianing Syste�ns a�d Devices PARTIAL RATE SCHEDULE G�tAVITY 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 ta 1?A,000 BTIT . . . . . . . . . . . . each add. 6Q,000 BTU ....................... Replacement of 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.OQ $� _� 5.00 $ 5.00 $ 2.50 $ 3TEAM or HOT WATER SYSTEM Furnace Shell & Lanes—to 400 sq. ft. EDft Steam ...... 8.00 $ Furnace S�hell & Linc�to 640 sq. ft. EBR Hot Water ... 8.00 $ Each add. 2Q0 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . . 2.50 $ Each add. 320 sq. ft. E�R 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 $ Additional Fixtures ................. x .5b $ Gas Range to 200,000 BTU . . . . : . . . . . . x 2.00 $ AIR CONDITIONIMG FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS REMARK3: �� / d�,`�� V � See Fee Schedule � TOTAL FEE ��°�' 1 (/l�� L / Ill��i��i/� � �,V ' ` \ Depl. of Bldgs. Phoae, SU 4-7470 � � , le � U' 7 � G� � � 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 ail the facts and representations stated in this application are true and correct. Fridley, 1Vlinn. G v'9 l�lit�a CCa , 19�Z Owner + ��-c�12Z- ! �2c,e'�-2N-- � ��d"� � 195— Kind of Used as To be completed about ��'N`� �`�?�6 � Estimated Cost, $ � l 3 �--'� / Permit No. .� g 3 � DESCRIPTION OF WORK HFATING or POWER PI.ANTS--Steam, Hot Water, a�'�-No. � Trade Name `�/ �1G2-f�-�c,-+-•� Size No. 4? S C'% -1 � a r � Capacity �� ' Sq. Ft. E.D.R. � g,p, Total Connected Load j G� ��7 L- Kind of Fue �� BUR.NER — Trade Name Size No. Capacity. Sq. Ft. E.D.R. BTLT H.P. si� �/ ' 1�:,.. C:�-� sy " � 11 pOST i M- t 2-58 Business Phone No- �`'� � S- 3 7$? r , �i�l�lafl � �a'1' � �. H�:�. Cooting. Ventilc�ion, .Refriger�el�ion end Air Conditian�ng Systems a�d Device�s PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOT1�iI.. l Furnace Shell & Duct Work . . . . . . . . . . . . . . : . . . . . . . . . . . 8.OQ � Replacemeni of Furnace ............................. 5.00 # R.epairs & Alterations—up io $500.(}0 . . . . . . . . . . . . . . . . . . 5.00 $ Repairs & .Alterations each add. �500.00 . . . . . . . . . . . . . . . 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 1�O,OOQ BT[T . . . . . . . . . . . . ,� each add. 60,000 BTU .....e .................. Repiacexnent oP Furnace ............................. Repairs & Alterations—up to $5QO.Q0 . . . ` . . . . . . . . . . . . Repairs & Alterations each add. �500.00 . . . . . . . : . . . . . . 8.00 $ 2.00 � ___.�__ �.00 $ 5.00 $ 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—ta 400 sq. ft. EDR. Steam. ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . : : . 2.50 $ Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 $ OIL BURIVER—to 3 gal, per hour . . . . . . . . . . . . . . . . . . . . . . . . 5.00 $ over 3 gal, per hour--See Fee Schedule . . . . . . . . . . 5.00 $ '� ` 0 � GAS BURNER (up to 400,000 BTU) . . . . . . . . . . . . . GAS FITTING FEES: 11�0 RATE TOTAL lst 3 Fixtures . . . . . . . . . . . . . . . . . . . . . . x $1,50 $ 'S� Additional Fixtures ........... .... x .50 $ � Gas Range to 200,000 BTiT . . . . . . . . . . , x 2.aa $ AIR CONDITIONINC+ � FAN' HEATING SYSTEM 3es Fee Schadulo VENTILATING SYSTEM � ALTERATIONS 8e REPAIRS TOTAL FEE '� a � ROUGH FINAL � Depi. cf Bldgs. r_,,..a�:.... � , ��. �_ � . �" �1� � `� t :�, `� Y, � 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. Owner � ' Kind of Building �--1P� Used as D�-p-�-��'`� To be completed about /�� r�� U Estimated Cost, $ ��` ✓ Old—New. Building Permit No. Permit No. � � / � DESCRIPTION�F WORK HEATING or POWER PI,ANTS—Steam,'Hot Water, Warm Air—No. Trade Name Size No. Capacity Sq. Ft. E.D.R. BTLT H.P. i Total Connected Load Kind oi Fuel BURNER� ��ade Name ''w�'t'� Size No �� ~� Capacity ��d m"-' Sq. Ft. E.D.R BT[T H.P. (REMARKS—OVER) ��:'r`�. a z 4M 7.59 �GY-¢1 Sign sy . Business Phone No. �/� — � 6 � Base 2nd 8rd 4th t �ity of Fridley _ APP�ica�ion for Plwnbieg a�d Gat Fitii�q hn�ir D�pt. of Bldys. Pkoru 5�0-3450 DESCRIPTION OF WORIC Aiumb�r, Kind �ad Loeatioa oi Fixtuns FuRur� Conn�elba Op�ninqs N�w Fixtur�, Old Op�ai�s PARTIAL RAT� SCHEDULE S��IK � FLUMBING FIXTURE RATE3: NO. RATE TOTAL Number Fixtures . . . . . . . . . . . . . . . . _.,,� x 5200 a �• � � Pt�ture Fixture Opening . . . . . . . . . . . x a1.50 S - New Fixture Old Opening . . . . . . . . . . . x a1.50 ;__ Catch Basin . . . . . . . . . . . . . . . . . . . . x a3.25 E Water Heater :Up to 99,000 BTU) .•.. x 33.00 s New Ground Run Old Bldg. . . . . . . . . x :3.25 $ El�ctric Watu ii�at�r . . . . . . . . . . . . . . : =2.00 i GAS FITTIIYG FEES: � NO. RATE TOTAL lst 3 Fixtures . . . . . . . . . . . . . . . x �2.00 i Additional lristures . ... . . . ..... . . . . . x = .7b ; Gas Ran�e to 199,000 BTU .. . .... . , . . ... x 56.00 � REPAIRS � ALTERATIOI�b—R�i�r to Cod� Descriptlon . .. . . .. . .. .... . ........... . ...... ....... ..... i Tarwi, � � � � o v �/ City of PYidley: �- `` ; J� � The undersigned hereby makes appllcation tor a permit tor the soak herei specified. agreeing to do 8ll work in strict accordance with the Ci4,� Q�+dinance and ruling of the Department oi Buiiding�, a� hereby declares that alI the facl and representatlons stated ia this appHcation,�re true and correct r�;a�er. Owner Kind of Building /�_i�2l�vr� 4 t � /� f Used as _ _��i%'�%'�%�'�l' To be completed about is �� Estimated Cost, a Old ew. Bui2ding Permit No. P�rmit No. O f Signed. By �� Business Phune No. �/�y 5 � � � ROUGH FINAL �o ^ � ^ % l \� � Permit for UMBING AND GAS F ING N.B. When work covered by thia permit is ready, the Plumbing Ordinance requirea that request for inapection ahall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit., C St0liee W i 3 Basement / lst 2nd 3rd 4th ur.��.niraa�rn vt vvvtta Number, Sind and Location of Fixtures � J Z S tll Z � _� Y Z �m 'm Z sQ z' � m F m 'm 3� o°a � Connected �vith � K I Q 6 I Q O I i 4 I(7 U � N° 5i91 s3 �� Permit Fee $ � . O C� I W WATER HTR. Clty Of FTLdJ.C� /� , 19?� a z V � gAS ELEC, Owner — Location IKind of Building ��N �L./ Gas Piping for Ope�g$ Permission is hereby granted to do the plumbing and gas fitting in the building described in the s ment hereto attacJr.ed, upo the express condition that the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and this permit may be revoked at any time upon the violation of any of the provisions of said ordinances. By Order Of Tlze Inspector Of Buildings Rougking in Inspection Date lnspector. Finallnspection Date •a 1M-6•69-V flSPCCtOl. r , Used as To be Completed , l9_ Estirnated Cost $ Old- ew. Building Permit 0 0 ITI3PQCtOT Of CITY OF FRIDLEY APPLICATiON FOR PWMBiNG AND GAS FITTING PEtiMIT qb, � w � � � o Water � m a � � [+ '� u� w .o � ro e�i ,� w 'w� M Neater � � � ro m � n� � �30, g b� a°' 3 � � i� o s lec m v 5 w a�i m � o w rn w u lst 2nd 3rd 4 th (R) • Future Connection Opening Connecte� with g�r (") � New Fizture, Old Openinq 1later RATE SCNEDULE PLUMBING FIXTURE RATES: N0. t/eM lixtureQ luture l�ixtures Old Opening, NeM li:ture Beer Diepenaer Blow Of! eaein Calch Sasin Rain Nater Laader Nydraulic Val�e Sua►p or Rsceivieg Tank Nater Treating 1lppliance Not Mater 8eatar Gas Renge Gas Dryet RATE S 5.00 S 3.50 S l. 50 S 4.00 S 5. 00 $ 5. 00 S 5. 00 S 5.00 S 5.00 $ 7.00 $ 5.00 g 10.00 S 10.00 TOTAL S S S S S S S S S S S S S�— Heck Flar prevsnter peq�iied. .. Yes () po I) �e S 5. oo � S ALL OTHERS AND/OR REPAIRS AND ALTEttATIONS lt of Value of Fixture or Appliance S R�eins State Snrcharqe S .50 pection Fee $ (S15.00) TOTAL F88 $�—�-V Effective Oate May 1, 1988 Job Address ---__L�_-f —�� %1 � ,�/ SO�> S7`� �- � Department of Buildings City of Fridley Tel. 11571-3450 The underaiqned herEby makes application for a peneit for the work hezein specified agreeing to do all work in strict accordance with the City Codes end rulings of the Depart�nent of Buildinqs, and hereby declares that all Che facts end representationa stated in thie app ation ere ttue and correct Fridley, Ptr�, � 19 X 1/ �Q,� � -G11J qfNER �r� I'a d.�i c KIND OF BUILDING IISED AS � v �� TO HE C�OM�+LETED ABOUT ESTIMIITED COST � . �Q OL� - NEM BUILD21� PERMIT NO. �i�_ P�rpM2T li0. (�' ��y �/�i% i i� Si9ned By �� .�C�C„�� /' � . Tel. No. __ �% t ��- �� ROUQI INSP. Dnte FINAL INSP. nate APPRWAL FOR PEf�IIT �'�,�5.� -_ MINIHUM FEE FOR ANY PLUMBING PERMIT IS 515.00 PLtJS THE S.50 STATE SURCHARGE CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1991 APPLICATION FOR PLUMBING AND GAS FITTINGPERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOUR PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures � Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin � Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas Gas Range Gas Dryer Back Flow Preventer Required ()Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $ � 0.00 $10.00 $10.00 $5.00 JOB ADDR 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 oi the Building Division, and hereby declares thai all the facts and representations stated in this application are true and correct. Owner L �C�� /Cf� Building Used As----�� i Estimated Cost PLUMBING CO C Reinspection Fee $30.00 SIGNED ALL OTHERS"AND/OR REPAIRS AND ALTERATIONS � 1% of Value of Fixture or Appiiance �,L� State Surcharge S .50 App�oved By O �jT ,1991 PERMIT NO. l � �� Rough-in Date � No. ��/- �.�5 Final Date � � �� / MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT 1S $15.00 TOTAL FEE $� PLUS THE �.50 STATE SURCHARGE sue.,ec. F�RMIT N . City of Fridley 2 9 5 96 AT THE TOP OF TNE TWINS g � I L D I N G P E R M i T r � . , � O. � `L _��_ COMMUNf7Y DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. 3�� i . , i---.�� "' �'� CITY MALL FRIOIE� SS132 NUMBEN nEV O�TE v�GE OF •PVqOvEO Br i 612-571-3450 910-Ft5 6/2/99 � � J09 AODRESS 6435 Jackson Street NE t LEGAL �OT NO. ,�. 5 BLOCK TRACT OR AODITION SEE ATTACMEO DESCR. � 4 SHEET 2 PNOPERTY OWNER MAiI ADORESS ZIP PHONE Frank & Pat Rmman 571-5333 3 CONTRACTOR MAIL AODRESS ZIP PHONE LICENSE NO Northern Sun Builders 772 Mississi i St Fridl 5543 � ARCHITECT OR DESIGNER MAIL AOORESS ZIP PMONE IICENSE NO. 5 ENGINEER MAIL ADOFESS Z�F PMONE LICENSE NO 8 USE OF BUIl01NG Residential 7 CIASS OF WORK O NEW O ADDITION O ALTERATION X(�9 REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house and ara e 22 S Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comp1y with the State BuildingCode. TYPE OF CONST. OCCUPANCV GROUP OCCUPANCY LOAp SEPARATE PEFMITS ARE REOUIREO FOR EIECTRICAL, PIUMB�NG, MEATING, VENTILATING OR AIR CONOITIONING TMIS PERMIT 9ECOMES NULL AND.VOIO IF WORK OR CONSTRUCTION 20NING SO. f7 CU FT. AUTMORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OA WORK IS SUSPENOED OR ABANDONEO fOFi A PER100 OF 120 OAYS AT ANV TIME AFTER WORK IS COMMENCED. NO DWIG. UNITS OFFSTREET PARKING 1 MEFiEBY CERTIFV THAT 1 MAVE READ ANO E%AMINEO TMIS APPLICA710N STAILS GAFAGES ANO KNOW THE SAME TO BE TRUE ANO CORRECT. ALl PROVISIONS Of LAWS VA�UATION SUfiTAX AND OROINANCES GOVERNING TMIS TVPE OF WORK WILL 8E COMPLIED A WiTM WHE7MER SPECtfiED HEREIN OR NQT. THE GRANTING OF A PERMIT ].923 . 7G OOES NOT PRESUME TO GIVE AUTMORI7Y TO VIOIATE OR CANCEL 7ME pEqMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAI LAW REGULATING CON- STRUCTION OF TME PERFORMANCE OF CONSTRUCTION 69. Z�J Fi r SC 1 92 P�AN CMECK fEE TOi EE -- 1 , S�Ga�ru EO�C A,iOQOAAUTMOAIZEO�GENT iD�iE� E ROP VA�IO TNIS IS OUp PEp I I S�GNSivaEO�OwtiEQ��O�NNEpBU�IDEAi �O�TEi DG �ti5� �i�TE y .. NEW � l ADDN ALTER Effective 5/10/99 [ ] CITY OF FRIDLEY [] SINGLE FAMII�Y AND DUPLEXES R-1 AND R-2 BUII.DING PERNIIT .APPLICATION Construction Address: � -�-�� Legal Description: Owner Name & Address: Contract� Address: N C I 71 d`'v v �� ', ��D � Tel. # .��-�,.�Zf' Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. 'ENSE �# Tel. # �.�C�� —�� DESCRIPTION OF Il�ZPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: �-`'��,` r` d " s 0 Construction Type: ��—' �� Estimated Cost: $ �,�C� a 3- `�' Driveway Curb Cirt Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: --L — l' APPLICANT: Tel. # �� i�� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ .Z� $ % Z $ _ �l � $ $ �� $ $ $ $ � ��, l3 CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A° or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] � Building Inspections 763-572-3604 DATE �/ SITE ADDRESS �� THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE TYPE OF WORK: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY ❑ OWNER STATE �SINGLE FAMILY/NE ❑ TWO FAMILY/NEW ❑ ADDITION �BASEMENT FINISH ❑ DECK NEW DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other WINDOWS IN EXISTING OPENINGS ❑Yes �No OR FOR NEW OPENINGS-DESCIEIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED_� ALL FEES ARE BASED O � YOUR E-MAIL ADDRESS EXP DATE _ CTI'Y� ��',r� _�9� SIZE ❑ ROOF ❑ SIDING ❑ SWIMMIN( II ADDITION ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑So�t ❑ Trim ❑ Fascia LOCA ON OF WIND W$ �s inP. n l '- � / � I�I' �-- -,: �� '� 1 � ► = � �.-�- � �,,,,� /'= ./__1� �iu__ r • � � l ❑ DRAIN TILE ❑ OTHER � �j IA � . �TH HEIGHT S . Ft. BASEMENT REMODELING SUBM17': 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations ',� `��S NUMBER OF WINDOWS � I ALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: JSING_T�I� 1,99,�,]J.B.0 FEE SCHEDULE) TOTAL JOB VALUATI N$ �-�-= OCCUYANCY '1'YY� Permit Fee $ , See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ ;�`'j,'7(.� .001 times the total job valuation Surcharge $ ? ��.(, .0005 x Peimit Valuation Minimum $.50 License Surcharge $ �, �j _$5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft+ 6 ft = ft x$21 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary () Non Necessary () Total Due $ 1 R', Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT-NOT VALID LJNTIL PROCESSED I hereby apply for a building permit and I aclmowledge 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 applicatio for a ' and ' not to start without a permit; th t th work will be in accordance with the approved plan in the case of all work � i'ch r i• revi a proval of plans. SIGNATURE OF APPLICA ( PRINT NAM /D' DATE ` !/ �� l� �� 7 �07� 0 Superior Construction Services Inc. sua�rainu �°NS7R�c-ri°" 9702 85th Ave North s�awces ,�_,�,„_,�.z��fi_�,.�, Maple Grove, MN 55369 Phone (763)424-9434 Fax (763)424-5428 Federal ID# 41-1766131 MN ID# 7231 Insured: AMMANN, PATRICIA Property: 6435 JACKSON ST NE FRiDLEY, MN 55432-5061 Home: 6435 JACKSON ST NE FRIDLEY, MN 55432-5061 Estimator: Keith Strombeck Company: Superior Construction Services Claim Number 0 Dates: Date of Loss: Date Inspected: Date Est. Completed: Policy Number 0 09/23/2007 10/08/2007 10/16/2007 Price List: MNMN4B7D Restoration/Service/Remodel Estimate: AMMANN-PERMIT Type of Loss Other Date Received: 09/24/2007 Date Entered: 10/09/2007 Home: (763) 571-5513 Cellular: (763) 670-0956 Business: (763) 424-9434 Deductible S0.00 0 5,��,�� Superior Construction Services Inc. � �"'�'�"4°'�"�� 9702 85th Ave North S�avtc�s ,�,��__,,,�� _� Maple Grove, MN 55369 Phone (763)424-9434 Fax (763)424-5428 Federal ID# 41-1766131 MN ID# 7231 t--10'4� � � r,m � r � � i �� . . , . 1 .� ir y�.-r r -{ � ' 2, �, � � 1 9 r � � �l - � 'd") DESCRIPTION AMMANN-PERMIT Lower Level Room: BEDROOM 337.85 SF Walls 455.52 SF Walls & Ceiling 13.07 SY Flooring 48.26 LF Ceil. Peruneter Subroom 1: CLOSET 68.83 SF Walis 74.58 SF Walls & Ceiling 0.64 SY Flooring 9.83 LF Ceil. Perimeter QNTY REMOVE Ceiling Height: 7' 117.67 SF Ceiling 117.67 SF Floor 48.26 LF Floor Perimeter Ceiiing Height: 7' 5.75 SF Ceiling 5.75 SF Floor 9.83 LF Floor Perimeter REPLACE TOTAL Carpenter - General Framer - per hour - 1.50 HR 0.00 59.89 89.84 Remove basement windows. MASONRY - Bid to dig out window well 1.00 EA 0.00 1,750.OQ 1,750.00 and cut open block wal] for egress window. MASONRY - Bid to fill in other window. 1.00 EA 0.00 200.00 200.00 Window well - Metal - up to 36" wide 1.00 EA 0.00 103.41 103.41 Carpenter - General Framer - per hour - 8.00 HR 0.00 59.89 479.12 Additional window well work. Contractor's Note: Framing labor includes detaching and resetting the landscape timbers and cutting to new window well, back filling some dirt to window will, and filling the bottom of window well with rock. Re-routing of sprinkler system water line, removing of extra dirt or additional landscaping work by others. Remove Furring strip - 2" x 2" 154.00 SF 0.40 0.00 61.60 Remove Batt insulation - 2" - R6 (split 154.00 SF 0.20 0.00 30.80 R11 batt) Stud wall - 2" x 4" x 8' - 16" oc 22.00 LF 0.00 14.11 310.42 Batt insulation - 4" - R13 154.00 SF 0.00 0.63 97.02 Visqueen vapor barrier 154.00 SF 0.00 0.29 44.66 2" x 10" lumber - treated (1.67 BF per LF) - 16.00 LF 0.00 2.96 47.36 Egress window frame. Wood window - casement, 12 - 23 sf, High 1.00 EA 0.00 61730 61730 grade AMMANN-PERMIT I1/l9/2007 Page: 2 5�,��w Superior Construction Services Inc. ��'�'�'�'�'�"`� 9702 85th Ave North '�'`Eav�r E „�,�,�� Maple Grove, MN 55369 Phone (763)424-9434 Fax (763)424-5428 Federal ID# 41-1766131 MN ID# 7231 DESCRIPTION CONTINUED-BEDROOM QNTY REMOVE REPLACE TOTAL Contractor's Note: Actual selection and pricing of egress window will need to be verified. Insulation Installer - per hour - Insulate 0.25 HR 0.00 74.16 18.54 around window 1/2" drywall - hung, taped, floated, ready 337.85 SF 0.00 1.61 543.94 for paint Trim board - 1" x 2" - installed (cedar) - 16.00 LF 0.00 2.15 34.40 Exterior trim Trim board - 1" x 6" - installed (hardwood - 16.00 LF 0.00 5.17 82.72 oak or =) - Window extention jamb. Casing - 2 1/4" hardwood 16.00 LF 0.00 3.17 50.72 Baseboard - 3 1/4" hardwood 48.26 LF 0.00 3.41 164.57 Room Totals: BEDROOM 4,726.42 � �--ra°.-.---� Room: HALL Ceiling Height: 7' 208.83 SF Walls 264.44 SF Walls & Ceiling 6.18 SY Flooring 29.83 LF Ceil. Perimeter 55.61 SF Ceiling 55.61 SF Floor 29.83 LF Floor Perimeter DESCRIPTION QNTY REMOVE REPLACE TOTAL 1/2" drywall - hung, taped, floated, ready 208.83 SF 0.00 1.61 336.22 for paint Baseboard - 3 1/4" hardwood 29.83 LF 0.00 3.41 101.72 Room Totals: HALL 437.94 AMMANN-PERMIT 11/19/2007 Page: 3 0 s�� Superior Construction Services Inc. �°N��"�"°�'�"` 9702 85th Ave North SFHl�1T"� �.� �V� Maple Grove, MN 55369 Phone (763)424-9434 Fax (763)424-5428 Federal ID# 41-1766131 MN ID# 7231 Room: Miscellaneous � FmnXeiyM � � Fmn AoomY/JM1 �� DESCRIPTION QNTY REMOVE REPLACE TOTAL City of Fridley building permit 1.00 EA Open Room Totals: Miscellaneous 0.00 Area Items Total: Lower Level 5,16436 Line Item Totals: AMMANN-PERMIT 5,164.36 Grand Total Areas: 1,274.54 SF Walls 476.55 SF Floor 0.00 SF Long Wall 476.55 Floor Area 744.19 Exterior Wall Area 0.00 Surface Area 0.00 Total Ridge Length 476.55 SF Ceiling 52.95 SY Flooring 0.00 SF Short Wall 525.90 Total Area 108.69 Exterior Perimeter of Walls 0.00 Number of Squares 0.00 Total Hip Length 1,751.09 SF Walls and Ceiling 181.96 LF Floor Perimeter 184.46 LF Ceil. Perimeter 1,274.54 Interior Wall Area 0.00 Total Perimeter Length AMMANN-PERMIT 11/19/2007 Page: 4 � Superior Construction Services Inc. � SL7Y^ERION ��NS rr��c inh� 9702 85th Ave North 5�.�+vir� ,��.,�„��,r��, Maple Grove, MN 55369 Phone (763)424-9434 Fax (763)424-5428 Federal ID# 41-1766131 MN ID# 7231 Line Item Total Matl Sales Tax Reimb Subtotal Overhead Profit Replacement Cost Value Net Claim AMMANN-PERMIT Summary for Other @ 6.650% x 2,069.42 @ 10.0% x 5,301.98 @ 10.0% x 5,301.98 Keith Strombeck 5,16436 137.62 5,301.98 530.20 530.20 6,36238 6,36238 11/19/2007 Page: 5 y � r Superior ConstrucNon Services Inc. Sw�er�i �W C`�s�-�`"`'71°� 9702 85th Ave North S�avir Fs ,.,.,„ „,�,�� ,,,,, Maple Grove, MN 55369 Phone (763)424-9434 Fax (763)424-5428 Federal ID# 41-1766131 MN ID# 7231 O&P Items GENERAL DEMOLITION DRYWALL FINISH CARPENTRY / TRIMWORK FRAMING & ROUGH CARPENTRY INSULATION MASONRY SPECIALTY ITEMS WINDOWS - WOOD Subtotal Matl Sales Tax Reimb Overhead Profit O&P Items Subtotal Grand Total Recap by Category @ 6.650% @ 10.00% @ 10.00% Total Dollars 92.40 880.16 434.13 926.74 160.22 1,950.00 103.41 617.30 5,164.36 137.62 530.20 530.20 6,362.38 6,362.38 % 1.45% 13.83% 6.82% 14.57% 2.52°/a 30.65% 1.63% 9.70% 81.17°/a 2.16% 833% 833% 100.00% AMMANN-PERMIT 11/19/2007 Page: 6 5�,��o� Superior Construction Services Inc. C°"'�"'r'�� 9702 85th Ave North S'EK7V�,.ES ,��, x,,,� Maple Grove, MN 55369 Phone (763) 424-9434 Fax (763)424-5428 Federal ID# 41-1766131 MN ID# 7231 Lower Level e" G� 1!YLC'I � t�..��.,�� \ ��, �.�� , ��„w.h , �� L��u,�� 7�� c� � �`� _ �v�. �� . � � k� � �-�a, s � ��, �� rv� �G� � � �a�� , ��Q� I� � ' ^ � l �u�. 11/19/2007 Page: 7 c� LowerLevei � � � , From: unknown Page: 2/7 Date: 7/6/2010 10:03:09 AM �U11C�lYl� �i��i��i Permit No_: � Inspectxa�as �+ �IDENTIAL APPLICATIUN Received B�: �' � 7�3-�72-3�oa� CYT'Y� UF �'�tIDLE`Y� 763�502-4977 FAX ate 'd: EFFECTIVE 7-1-2010 bATE � 'YOY1Ct U1vIA]T. AnDlt&SS m� c]n e 1 I e o� e, l�j g�d �1�. l' I�A � �� 1�-� S1T$ADDR.E$S l��i �J ��CI�.�C�1\i. LJi" �C THIS AFPLICANT IS: ❑ OWN�R �ONTRACi'OC� �it01'�Yt7'Y' O'W1�T�Yi/ Wal�: ��_,� (].tJAj - TENANT ADDRE3S: Lo.�I�� IOSK-`3C� pJ�' CITY �2JPt�/�.y STATEIV�,ZIP�,�� PHONE: � �G. u"�rI l�.SS I.3 CONTRACTOR ��: Z SUBMTT A COPY OF gTA'IE LICEN3E �1 �Q,?� I P, �iln.1 F.3{P DATE I Y'OT�L STAT� Y.YCENSB AN'Y7 C�li17FTCA1'� O� AUD�ei'sSS:��p,�(,1 1(i� i.J��t!!\�,�,Q.".� /4V C. CI'f'Y (Yii Nn'7CD�lL)h11g STA'C�,�,ZiP�r- ,�1 ,`�p nvsu�vc� PHONE -1 � a Fnx c�ra-a� � a PROP�RTY TYPE Q S1Ni0LE FAMII Y/NEW CON3TRUC'IION STLE O 1W0 FAMILYiNEW CONSTxtUCCCON ST'ORIES p�t�j�X'X"X"y'p� ❑ ADDlTION � QARAO�JSiiEA O V�TNnOW'S � BAS�' FII�T�STi 0 i200T> 0 D1i.AYN TIY.� 0 ri�CyC i7 StbMG �JTF3�R � SWIl�Il4IINCiP00L TYPE OF R►ORK: � NEW HoME CoNSTRUCitoN ADDIIION � MAIhI"iENANCFlR�PAYR �vtOri�'L.iN'Q n�scRr�ae woR� e�rrro not�: 1Li�n �e t`l -`�c-#'- ,�1(�.1 � SI280171Iu1PROVBMENT L�i4TH WIDTH ilEfAIiT F7' �OF SQUARES O HOUSE b� (3ARAQE �--�T ��[NQ SC]B11a7': GA�A.Gr�S Cl ATTAC�iEb GAitAG$ 2. PCOj10SCd �009( p�911 p�OpOSBb 5�: ❑ D�TACF�D DARAGE 3. List of struct�nel mdmbeta to be used PROPOS&D HElGHT: ��.0 FO� I�TBW' CObTS'Y'�T7C7T�T 11JCx.YJDINti DEG7CS. o�'�ny► osoffn AnorrYOtas_ � roxc�s svaiarr� I. Sine PIen/S�uwey sfmwing d�e mcisting atrucauea O Aluminum ❑ Trim �� O(kher O Fescia 2. 'fwo xb of oomtru�tim plans WnVbOV1rS 3. Ena�gy C`alculadons IN�ISTINa QP�IJNQ3 4Yes ONo LOCATfON OF WINDOW3 EOR WIlVDOWS � PRO'VIDE C1-VALC� A� OR FOR Nb'W OPENIN05-DESCRIDE SIZE OF MANCIFACfYIRfi S'1'TC�! OI�T'QVIN'ri0'OV. OP�MNQ CTiAN(iES & �riB O�'l�l�DO'W"TO �� T1�TSTAiLBD NUIvIBER OF wfNDOWS Ai,�. �'��S ARE BASED ON VALUATION, INCLUDING TSE COST OF LABUR AND MATERIAIS: 'Q'X'A,X� J'Og'V',AC.CI`A"X`XON Permit Fee �lan T�eview Fire Surcbarge Swrcbarge C.ic.�nse Surch$rge SAC Gharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge 'rotAl �ue 7cH� 199ti �.B,C �lE SCHIEpUX,,IE} $ v11 1� S See Back Page for Fee Schedule S r"—' 65% of �uilding Permit Fee S '3 .001 times the total job vatuation S � .0405 x perm'rt'V'aluation Minimum $5.00 � �b $5.00 (State iicensed Resid�tial Contractors) � SZI00 per SAC C7nit (pIans to MR�'CC far de,texmina�on) S ft�68=�„ftxSZ4=S � 5450 Conservation plan Review � �ec Determined by Engincering $ Agreement necessary () Non Necessa�y t) $ l!'�'� .� �.P Make checka naW$b�e to: Citv of �'ridlev Attac THTS [S AN APPLICATION FOR A P��IT-NC�T VALIp UNTlI, pliqCE$36D [ hereby apply for s building permit and I acknowledge that fhe information above is complete and accura#e; that the work will be iu� conforn�ance with the ardinances and codes of the City of �'ridley and with the Minnesota Construction Codes; fhat I uncierst�nd tlus is not s permit but only an applicatian r a permit and v r's not to start withotn a permit on site; that the work wiil be i�cccordance with the approved plan in the ease of r�r ' re s rc 'e(w a approval of plan�s./ �_(�n l SI�NAT[IIiE OF APPLICANT � PItTNT NAME M � U Jc �� nATE �� I O APPR4'VAL 1N'SPEC'C'OR STQNA � PLEASE NOTE: SEP T�.ATL P�ItIvXITS AR� �QUTRBT? PO�L PT,L1M$1N4. �T,�Cf�tTCAi, AND h�CHANICAI. WORK � w � � L� � . .. , � � , .... From: unknown Page: 4/7 Date: 7/6/2010 10�03:10 AM . � �,�...- `�-t� �� S- � . ; _ za�o � ��-. 1 � _ 23fi" 101a' nr �'. �' �f 9• " +n`� ' y A � 1Z.cmc��..��xi�i-i Cc�bi►�,�� 1�1 . , ,,� p�,�,�, , �� ,�,�,,�,� . �� . a �. �� e�:� � �» �, s� a s�� o��°� o � � a y 3.b � � ��o� �� . �� "�� niya 4. N .7 � � y , . J ove e.xt� �� t 7�." 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Ug :a6ed unnou�un :wa� - �' IN � � �� j� � u� � 00 �o � b� �� a � � � �' � ��b � �$ �, � � �� Im o� � �� ,~��i3 �� : ' ��N � � � � �I� � 0 0 � � .� � � c q o� ��w .�w � ti�� ,��,� N�� '� � �W�, .. � '� � , „ ,. ,,.� ,... - — ....,,.�._�.�, .� .,�. Wd l l�£O�O l 0 �OZl9/L �a3�p L/L �a6�d unnou�un :wa� � M B� � � � a Building Inspections 763-572-3604 763-502-4977 F.AX _� SITE ADDRESS � THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND CERTIFICATE OF INSURANCE PERMIT TYPE TYPE OF WORK: PLUMBING Permit No. RESIDENTIAL APPLICATION Re�ei�ecl By: I`� CITY OF FRIDLEY r��'�ec�i�� '��Q EFFECTIVE 7-1-20t0 YOUR E-MAIL ADDRESS a l�ex� � so � bo��,D1 � rn 1� %tq, G a M ❑ OWNER C�'iONTRACTOR a�nDRESS:��Q as 410a v� CITY, �a� z� Na,�: � o wc�c� � L'Scz�n q Y(.� v�k "�. STATE LICENSE # 5�,3,�" 3 EXP DATE /� �`3/-/ 0 STATE BOND # a.e ��%P EXP DATE �� '�l-,ca ADDRESS: Q. �.� o x l�� CITY ��/Y�7✓�' STATEj'�% C�ZIP Ssa 1` PHONE 76 3- ll%l -�� 702- FAX ��3 -�L�/� r^�� cJ`� � � �SINGLE FAMILY ❑ NEW ❑ TWO FAMILY ❑ TOWNHOUSE �tEPLACEMENT � DETAILED DESCRIPTION OF WOR� � owQ.r' K��tn- etir4�� .c T'�-e. � �� vt� c,� Si� k��i�C+e�'- p ispZ�S'�L, E-�, t� FEES ARE BASED ON $10.00 PER PIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELAW). MMIMUM FEE $35.50. BATH SINK/LAV _FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING (NEED CITY LIC) SWIMMING POOL WATER SOFTNER (S35) CLOTf�S WASHER � KITCHEN SINK WATER CLOSET BACKFLOW PREV. (S15} = DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATTON WATER METER OTHER THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTTL PROCESSED I hereby apply for a plumbing 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 c f work which requires review and approv� 19f plans. c-� SIGNATURE OF APPLICANT �� ,y _�-- PRINT NAME,y�i(�lC�/T.�'�r � DATE /��-�la APPROVAL INSPECTORS SIGN T City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977