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AF - 47482Ci.ty of Fridley, Minn.. BUILDING PERMIT �. , N° 5818 Date• �' '�" i#' '� • ,�,s,. � r �"'� �� ,�1� OWnPS: . � '�i'G. Addreas .._ Address ,�, `��CATION O P G No. " y' ' 1 Streei ��.�C'i9� Part of � ,� , Lot _ Block Addition or Sub-Division � Corner Lot — �7nside Lot Setback "'' � Si yard r.�' �� Sewer IIevation Foundation IIevation � ' DESCRIPTION OF BUILDING To v�a ,� �,, �� Front "�� DePth ,�� Height ,l�� Scl. F� �� Cu. F�,�� Depth i" H' ht Sq. F't. Cu. Ft � ,w a � Tyn2 Oi �'.OIlBtTliC130 �*' F.aS� COSt ,�: �.� `��w To be Completed '' ` In consideration oY the issuance to me of a permit to construct the bwtldin� described above, I agree to do the proposed work in ac�ordance with the descripi3on above set forth aad 3n compliance with all provisions of ordinances of the dty of Fridley. � �o In consideration of the payment of.a fee oE permit is hereby granted to to construct` the building or addition as desc�ibed above. This permit fs granted upon the express cwndiiaton that the person to whom it is gra.nted and his agents, employeea and worl�en, in all work done in, around and upon said building, or any part thereof, shall conform in all respecta to the ordina.ncea of Fridley, Minnesota regardiug locai3on, construction, altera.tion, maintenance, repair and mov3ng of buildings �►ithin the city ]3mits and this permit may be revoked at any time upon viol�ta�. of any oP the provisions of said oTdiII&uC� .�°'+� s�°r �3 �+°r $il��IiB � NOTICE: TWs permif does aot eover ihs eonstrucHon, insTallation foe vririeg, plum6inp. ees, heaMag, sewe� or watee. B� ww to sM the Buildhrg Inspeetor fo� ssparate pamika Por th�a ira�m. . _ � -- _ _ _--�— �:{-,�-"'—. � 4 �� , - ,,,,,- �. � �� 1 � Land Plannin9 Lar�Surveyirr9 � Sails 7estin9 C�vil b Mudicipnl E�ineerin9 5 g e-� � 6875-Hir�h�voy *�G'S NE. . MinnreaPo/s 2/, ENGINEERING, IN:C. ��'° SUnset4-6066 En ineers � Sur vecJo�s — 9 ce:ti�icate o� s�s�eT �o: � � � a��'� ��%c��-�- ��: � e x� t� � 1 � —11q,�'�° � �} � � s � � ' � ( � t% � �,,. ea I � I � ( .s �� ' r � � I � 0 � — �3�.9�'° �� TM A V � i� �.J � � .9 2 -� IV. E. I� —�. � � �. � �,e � i� � � � � � 4� P ,�s W L►� � � � L 0 T 9, �,� Q c�l� /, ,CY/VDA,C� �3Ul�pE��i i �'ADI�/%1�� //r�'e5y cerfi�y � fhis is o frue ond mrrecf re�esenfoficn o�'a sarrey �'fht b�,mda��es ��e abore de�cr'�Ged l�, ond o�� /or,o�ian o�'o// bur/din9s ,1luieon, md o1/ risrb/e arrrovrfimenfs ,��'a�y. � or ansoid /and. As w�veyed by ��5 _�y � Fe b r ua w c�, A.� �95�l-. SUB URBAN ENGIlVEE2/NG , INC. SC,�� „' �O � ' En ineers� Fr Surretfor f�, �, �' x � � � � � � a � � � _ --- � APPLICd�iTIO�T FOt3 BUI3�DING PERMIT Ci3`�t OF �'RID�,EY, NLZ11iNESOTA Owne�r' e Name Builder� �" 4 Address Rdalress `��vf �w'�-�'" \, r�`� • LOCATION OF BUI�DING No e �� ° � Street �..��'�� _ Part oi Lot — � t5�*J�. L,o� � / Block l Addit3.on or Subdiviaion ��_a-� Co�ner Lot r/ �nside Lot Setback 3,� Side-Yard �� `� �' °� SEVdEIt ELEVATION FOUIiTDRTI0IV ELEVATION Applicant at�ach to �this �orm Certi�icate of Survey of Zot and proposec� building location.- To �e used aso DE�CRIPTION O�' BUILDING S�.--� o-�- � ,�'? � y % � � �ront � � � Dep ! � � �eight--�� %.1� Sq. Ft._ 1.�.,� �� Cu. �'t. � - F'ront �,_ Dep�h Height . Ft. Cu. Ft, . �� Type o�' Constructio Es��.mated Cost �'� f' lo be Completed The undersignecl hereby makes application for a permit �or �the work here�.� spec3f�.ed, agreeing to do all work in Stric� accordance with ti�e City of Fridley Ordinances and ruling o� the Deparic�me�t of Build- ings � and hereby declares that all the facts and represenicatcions stcated in this application are true and correct. -(y-G�/ (Schedule o£ Fee Costs ca� be �ound on the Reverse Side). �� a • � � ,� . � BUILD�NG PE�tIT � SQ�DULE Sec�ion 2. The �nspector of Suildings sha11, before issuing ariy per3niti �or the e�ec�ion oi any louilding or s�ruc�ure, or for any addi�cion to any oxis�ing building or sttuc:ure, or for any alt0rations or repairs �o any �xis��.ng build�.ng or structcu�e, upon application th�re�or, require �he pay�aent by the applicaat Lor such pe�mit o� fees to the amount herein belawr set �orth and in the marina� here3.n provided to-�raito ?.1. �or any such pe�ait fos the erection of any fire-prooi build3ng, o�:her than a garaqe, wa;eehouee, factorcy or gra�.n eZevatorc, or �or �he erec�ion OY c7,I1jj l��'O-p�oo� addition, for similar occupancy, to any exis�jng bu3.].ding� sha11 be at t1�ie rate o� $1.960 for each ono thousand cu3�i.c �eet, or �rac��ton �chereoiE, in such cubical contents. 2, 2. For any such porm�ic �or the erection o�E any gire-proof garage, wareY�ouse, facfio� or gra�,n elevato�c, or �or the erection or ar�y �ire- pr�o� addi�tion, �o� 'sim�.lar occupamcy, �o any ex3sting buildingr shall �e at the rafia oi $�..25 ror each one thousand cubic fe�t, classi�ied as "�iseproo�" by �ee�ion 502 of tha M�.rineapolis Building Code. fI0_ E S 2� For any such permit for�the erec�ion of any non-fi�eproo� build- ing other �han a gara�e, warehouse, �'ac�ory or grain eleva�or, or any non-�ixe�roo� adciit�on, �or similar occupancy, to any exis�ting building Pe�m�.t $1.00 �or each one thousancl cubic feet. � GARAGES 2; �or any such �ermi� for tha erec�ion or any non�fireproog g�arage, tn�arehouse, �actory or gsa�..n elevator, or for the erection of a.ny non-�irep�oor add�.t�.on, ios simi�ar occupancy, to. ariy ex3.sting. building or ior each such building or adcl3tione NinOty Cen�s �or each one thousand cubic feet or fraction �chereo�, 3n the cubical conten�s �there�a� wifi�i a min�nuro o� $9;.00 0 Fo�c i:.he pulcpose o c compu�ting fees for bu3lding pexm�ttss the cubical con- ten�s os any building o� addition �o a uniforcm he3.ght throughou� by multiplying �he ground area covered �rora a poin� six (6) inches �elovv �he rloor line o� �the basem�nt or cellar to the average height of the up�er surfa�e or i:o �che average heigh� of the roof surface of the main ga'�le o£ a pitche� rooa�. 2,�,.5. For repairs.o� alterations to an exis�t3ng structur�, the �ee �ha,1], be at �the ra�e of $3.00 pe�c each Five Hundred Dollars ($500.00j or �raction thereo� �.n �he cos� o� ali proposed work. 2.6. �n no case stiall the fee charged��or any permit as set �orth in ��ction 2 be less tY�� $4.00. � « _ �_. .___� � � p N � m � 0 � x F� N � � � � � � �p � r� � � C� L•J � ~ � � O �xx�^ �, �n r � a `• �'q �i r. � � �d �-'�i H e��- O � R'9• c�i. y � M Z� c.' � � c pd x x �n��o �a �h� � I Fp � y o"�'y U4 �, k L*1 '�d � o � � "1� ,�.,. � L*1 �.. � w � m� o�� m o � oa � N� o � 0 0 o � � o�: m �� O y GI ' ' � y O � : : � � . . . . � . . . . . � . � � � . . � � � � : : : : � : � . . . : � : - � : � : � ' � • n ' y � p4 6E �C O : � N � � � p o p � o {� {� {� � {fl � � y G, . . �H � `d `� '� 1 � Gd H f] �� m � � I � � � a �+ � z °' � � � � b N � � � � � � � z � � o c� , � ro � �. � 1 �! � 0 � � b Cn O O � � z � ro � ��] �D 'O � o x x ° o � � � � 0 � � F� : a � �`. w m � � � � � � � !x � � � � b � � m N O a w � @ � � �c�o a a. m m p R° R° '� '� '� � p o °o .�"'-. � � � � � � G � � � R° R' '� � � � � � �� o o � � � � o� � � ��o �.� �,� � o� �' . �' o fD ° o � � �' � '� o �� o' : � ~ . C� � 4 � . : O . . e�: `i 0 . . . � : : ° � � � : � � : : � � :. ' : : : : : � : : : : : : N l� OD 00 N pt :ST� N 00 O C O O O O C O O �" � � I �� .. M � � � � � a �'4 m�. �� f rb ��,5 � v � � � � � w � � R° R° y � � � G � � � o R� 0 0 � �� .��o � ; � m � � : : w . . e�n � ' : O 0 . . Op . . P ' ' ' � � � � � F7i O O O O O O p � O t' R. R. � �" � A y � � � M A�� "'�� °� �o�n � �.� � �. ��° � � � a � �� °►,, ►°� �, c � �� o�� pp��€i ��'�p `��,o F •�.� H � � � � �.��.� �~�� [�� r7 H ��iYi � � �� > � 1'A" � ""' m y _ m C r m y � � L •'� � M � ��`r � ^_\ � �N � ob � � � V O - � � ��p '1: �i � � � �� w� � = � � .0. � � `�N . � N a ' 0.� v< e� � � � • 3 �o � 3 � 0. ., .� � �� TG�s as6 � s __ HEAT LOSS CALCULA'fIONS DEPARTMENT OF BUILDINCS� ,��z�.-r+� NIINNEAPOLIS� MINN. Weatherstrips A.S.H.V.E, Construction No. Insulation _ Guide ;Wind�ws Doot�s Reference Out. Wall Int. Wall Ceiling Roof F1oor Kind How Applied Ye�No I f Yes� 0 19_ °'�' ry .., Fl.� .�. �� Room � Lengt /� Width f' Height �' / FI.� Room Length /- Width�� ' Height�° Windows and Doors—Crackage and Area Windows and Doors—Crackage nd Area �Vidth Helght No. of Llneal f. Area Wldth Helg6t No. of Ltneal It. Area No. of pane of pane lighte ot crack eq. ft. No. o[ pane of pane Iighte of crack eq, tt. / i� -� �/� �- o�� G .� � � a?G i , /d'. � /G /�/ o Coef. Btu Coef. Btu Infiltration � ,�2, Infiltration �/ � / Glass ,� '�'% Glass r 'j77 �j� Exp. wall 'a�- Esp. wall ,/�-.� ,� ,� Net egp. wall /� /� 1�' Net egp. wall ,� /� lj+ Int. wall Int. wall Ceiling � /�� Q �� Ceiling � fo / �d Floor �Q Floor � � Total Btu. / Total $tu. ,� Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required s ..D.R. or sq. ias. W.A. Leader area / F7. �j/G► Room � Length O- Width /� Height ° �.� , Room ( Length , Width ' Height Win ows and Doors—Crackage and Area Windows and Doora—Crackage and Area Width Helght No. of Liaeal ft. Area Wldth Helght No. o! Lineal tt. Aree No. ot pa e ot pa e lighte ot crack eq. ft. No. ot pane ot pane Iighta ot crack eq. [t. , � / rd' � � �� L� �� / �� .� �a �i �� . _ In6ltration fp� • Glass � o Exp. wall �/ - Net esp. wall ��' �'� u Int. wall Ceiling �� / � Floor /, Total Btu. � Required sq f. E.D.R. or sq. ins. W.A. Leader area Fl. '" rj �,- Room � Length `- Width o?� He � Wiadows and Doors—Crackage and Area Wldth Height No. o[ Llneal Pt. Area No. of pane _o[ pane llghte ot crack eq, ft. s� ' ��— Infiltration � Glass Exp. wall °�� Net eap. wall Int. wall �Q Ceiling �`�— Floor �(� Total Btu. Btu / � In6ltration � �,� Glass Exp. wall Net exp. wall � Int. wall Ceiling / ja jj � Floor ! ,�� Total Btu. / Required sq. ft. E.D.R. or sq, ias. W.A. l.eader area � �� , Required sq. k. E.D.R. or sq. ins. W.A. L.eader area Fl.� Room I Length _. Width � Windows and Doors—Crackage and Area Wldth Helght No. of Ltneal ft. Aree No. of pane ot pane Ilghte of cracB eQ. fA r' �l - � 6� ��i� �� Infiltration Glass Eap. wall Net ezp. w Int. wall Ceiling Floor 7ota1 Btu. Q G � ired sq. ft. E.D.R. or sq. ias. W.A. Leader area �f� Btu ��. 6 ��. . , �. Sa�1 Ad� ��t 3+��f��n S�. �t. �, Bysi�isy Z�, MiAn�tat� Dt� t�i�: �� I y �.$� �6� �at�� +�+om� a�� e�t � ��.�� '�'� �a��$e. I� �C �.� t� 'be ��t��het1 �� owr 1su3.1e��ag, qt�s a�t h�a ��ea fe�� ra�a � �� .o� �i� �� t�r� � �c��e►e� ir�� .i� �a�� b� ��cas� �� ia €r� �� fre�n� �►� t'� bc�ii��t�. � �'�� t ��rti�t�it ru� a�� s� afits�'h�i ��;s�c� +�re�u��t 1� �i�� e�� i�r �ae� ��h , �i� €acor� �� g�� i�� Sl�`�d . �'� - rtec�,� fl�tv� t� e� ��g�'0+� c�ost ��`oi� tt�e ��t� e��e�m it �ua� �e �,7'8�' ot� gn�^ �#3t�� ot 3��ct�. �f' !� � d�E�is�� i� n�� b�r �n �!� �� y�d on�y �� a�J d�� y�$� '�`.+�+��"�'�� B�C�%! cE� A i��n�: C��." �C �ie�a �h� e��p��;� �'�►� c� an iu�id� �� in�, �h�ee €�ee ��,d � �'�e ��i�. . . � g�� t b� c�tr��t� �+� �� t� �,�ud. �han��d th�za� � ax� ��e�t e�i�� '��se ec�e�ea� a� a� mp oi�f.�a. � . �� 9�.'qe��Y�► AI�� @. J�SSN 8��1H�� u��c�o� ..--, � � City of Fridley, inn BUILDING PERMIT �.�`� i �� N° '72'75 .: _ � � _ �� :� _ .�l:�' '� � � , � . � .�, �I I .�r% r' �� M��:, , ....,- � � � � CATION OF ILDING No.�.� Stceet art Lot Lot �.__ Bl Addition or Sub-Di on ' Corner Lot._ � Inside Lot S.etback Sideyard � l�� Sewe1.' IIevation ---.- ._._ Foundation IIevation DESCRIPTION OF BUILDING T as: ' Front ��.. Depth .�_ Height ��_ Sq. Fw�� Cu. Ft DePth eight �� Sq. Ft Cu. Fk 1'ype of Conatructi ��-� Est_�J��,7_.�� To be Completed In considerat[on oP the issuance to me of a permit to co ct the building described above I agree to do tha proposed work in accordance with the d�scrlplion above set orth and in�n w �. '1provi� m�inances of the dty of FrYdley. A? °�l �/ pliance ! 9 l � l� � � In conaideration of the payment of a fee oP $a "� • , permit 9s hereby granted to to construct the building or addition a� descrlbed above. Thisp�� t fe granted upon the express condition that theperson to whom it ia grented and his agettta, employees an� workmen, fn all work done fn, around end upon said building, or anypar� thereof, shall conform in all respecta to the ordinaac� of ��eY, �ota g laation� conatruction, alteration, maiatenance, repair and moving of bufldings o�� dLY limits��an�this permit may be revoked at any t�une upo� violation of at�y► of the provisions of said '�`7 ,�...1 BUild9ng IaepeCtOr n Nonc� Tld� permk doa eo1 eevsr ths eoesfeneHee, mshllafim ier rr6�es, pdimbine, ea 6�Miea, a�ru or w�Mr. B� sun to s» f6s Bnilding I�efer h� qp�rdr pumtts for �6�» �.e .� � . t. . . . ...,. •� . ♦ � APPLTCATInN FaR BUILDING FL�,h�T CITY OF �'RIDLEY, MIi'd�ESOTA n / � . OWNER' S NAM��! '��.��,�_� BUILDER � � � Al}DR�SS 'S .� <� � Q DRESS / ,��'f.� /�, � � LO�TIOI� OF BUILDING �10• :� �' �� C� Street �� a�t of Lot � �" � Lot Block�� Additiorl or Subdivisio ��. Corner Lot �Inside Lot ,Setb�ck Side-Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant atCaeh to this form Two Certificates af Surv�y of i,ot and proposed bLi?d- ing location drawn on these Certificates, DESCI�IPTI0�1 OF $U�.LDIAIG To be used a��— � Front � (�' ��,.�.h � � Height � � Sq. Ft. �� Cu. Ft. �!��'`il� Front Depth Height Sq. Ft. Cu. Ft. Type of Construction ��,� /�!C" Estimated Cost f_� ��r �`° � To be Compl.eted _ � . � � ��, _ �� The undersigned hereby makes applicatioa for a permit for the work herein s.pecified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and ruliags of the Department of Buildings, and hereby declares that all the facts and , representations stated 3n this applicati �ar�e�t� e� nd �co,rrect. �� DATE_�� , �! SIGNATURE. �� . �(Schedule of Fee Gosta can be found on the Reverse Side). .� � , > `s"� i � i�1 � � .. r e BUILDING PLRI'�T ffEE S��iEDULE Section 2. The Iaspector of Building� sh�ll, before issuisg any pez�ait for the erection of anq buildirig or structure, or for aay addition to any ��:iEt- iag buildinffi or structura, or for"any alteratioas or repEir3 to aay esis�3.xsg bu3lding or seructure, upon applicaeion therefor, require the pay�aent by the applicant £or such permit of feee to the amount herein below aet forth ar.d in the manaer hereirt prov�tded to-wit: 2.1. For aay such permit for t�ie erection o.� anq �3re-proof buildin�, other thaa a garage� wareh�use, factory o� graii� elevator, or�£ar Ctie erection of aay fire-proof addition� for similar occupaacy, to any exieting building shall be at the rate of $1.40 far each oAe tho`usand cubic feet, or fractic�n thereof, in euch cubical contenta. 2.2. For any such-parm�C'-for the ereet3on of �nq fire-proof-garage; warehouse,_ factory or graia elevator, or for the erection of aay fire-proaf edd�tion, for sim3lar...oacupancy, to any ex3sting builclimg shall b� at the rate of $1.25 for each one thousand cubic feet, clasaified as "fireproof" by Section S.C2 of the Miaaeapolia Building Ccde. HOUSES 2.3. For aay such permi.t for the �rection of'any non-fireproo� buildir� oE:t�e� than a garage, warehouse�, factorq or grain elevator, or atty non-fireg�ec�� additioa, for s�tmilar occupancq, to any exiatiag build3ng - pernmit $�.00 �or each one thousand cubic feet. GARAGES 2� For any such permit for the ererr.�� r ?�r� rs�c��ft�?�tiaos gara�e, warehouas, factory or gra3n elevator, �*_� r��- �.�3�, �.E:s:�ie� c�f z�xy noa-r�r. groof additioa, �£or -s3milar occupancy, to r=,�: ,�-<�t� :�:,r_�, �:�:. ��: ao or for each eLCh � �_ � building or addition - ninety cP*��:-� f,�;;,"��?; �:^s e�>�: a one Chctasand cub�� feet or fraceioa thereof, in the cu��cE� �,?*�� s.;;. tz�er�ci• with a minianum of $4.Q�.- For the purpoae of comput�Lag fees fvr '�L:;.�.ing �ern�i�s, the cubical crnxtents of any buildiag or additioa to a uaifc�.a He�'�tit tliroL�hout by multiply{n� the ground area covered from a point s3x (6) inch�s be?:,w the floor line of.i:Iie basemeat or cellar to `the average hei�ht o€ t'►.z� e.��er eurfcace or to the average height of the roof surface of the main �;able of a pitched raof. 2.5. For repaira or aleerationa to an existing strucCure, the fee shall be at the rate of $3.00 per eath Five Euadred Dollare ($500.00) or fraction thereof in the cost of all proposed work. 2:6. .Ia no case shall the fee._charged.for.eay permit a� set forth in .Sectioa 2 be 1eas. than $4.00. � b o e � �"1 �� . . - � � d � �. � o� p � : � : 7i . � ' M . N . O . � °� : � : � � tn tn AJ \ �� y � � F+ !'� � �•, � `� cxi �� N • o • o • o : o . o . . bd : : � . x 0 �E a! p4 � � � °o q o � � � H . y I � Q � � � � z � � z � z � 8 � � 8 �" � � �y �� '� y � � �� d ' O � • �. � � b a' � � � �. � � : M R+ N ; co �' ; e/1 � ei � o : � : a o . . . 0'0 � : . . : � . . . . : � : : : : �O p4 Pv k k D4 pC w n� w� t- � pd c�i, °p � o 0 0 'b � r�a tfl tsa � tsa � 'i H � � � � 0 � x a � r � � m �^%: " 2 m C r m � � O � �' zr � a o M C'� �O w � � � m � � � � N ro � �. � � � ...�1 � : ...■' g s. ..��' * � ��■�, ;• ,= ��, � : �� + N �� a. � b � � 0 Lm • V YYATER � uaiwus earH rues swgi� SINKS WASH � rnAYs DRINK. FOUNT. SFIV✓RS. FLOOR � DRAINS CATCH BASINS AUTO WASNER GAS APPL GAS RANGE GAS OPENINGS � .� • z e � \ � � m A � � "d aR.� ��rp y � ��q P F�fi H � m k�7. p`�' �• �'. y � 0 � � `� �� °�° � m � b � �� a��w 0 ��'�� ,o M ��w �fD m �. a��. ��" r.�� w � � y ii ID .y. hbn ��y f.: �1 Lr� � °� F ,C e � d a A ; �� R. A x � �" p � M � �� i � � � � � � � � � � . r t7 p. �- � m m � � � M � � _ ; w e� � � �, City of Fridley, Minn.. BUILDING PERMIT nat�: J�ane l, 1965 owaer: �rl Adams B„��, Sussel �o. �� 58(� Jeffersoa St. �'. E. A� 1850 Cc�mo St. Paul N° '7627 � �� No. s�t Lot _ Sl�k Coraer Lot _ Inside Lot Sewer IIevatiaa LOCATION OF BUILDING Part of Lot Addition or Sub-Divfaion 3etback Sideyard � Fo�mdatlon IIevation DESCRIPTION OF BUILDING To be vsed as: Front Depth Height — Sq. Ft Cu. Ft Front Depth �Teight Sq. F't, Cu, F't, 1'ype oP Constructton F�t. Cost �.1�200•Cf0 To be Completed StOrm Dama�e rep�3.r In consideratton oP the iesuance to me of a perinft to construct the building d�crit�d above I agrce to do the propo�d work 'in accordanoe with the description above aet fo� ,' and in compl�tance with a'll prwlsYons of m�linaaoes of the c4ty of Frldley. !/ i a��, � � _, In c�mffideration oP the payment oP a fee oP $ l 0,�, �t is hereby granted to SL'1898�]. �Q to construct the buflding or addit%n as d�crlbed above. Thispermi t fa granted upon the esPr�s �ondition that the person to whom ft fs granted aad his agents, employees an� workmen� ia all work done fn, around ead upon said building, or aay�ar� thereo� shall conform in all respects to the ordinance� of FridleY� Minnesota regarding lxation, cronatruction, alteral3on, aaintenance, repair and mov3ng of bufl�inge wlo�� dty limfts and thfa permit may be revoked at aqy time upon violal3on of any of the Proviaiona of eaid Al 1 �mil d@I18�II 8�� p NOTIC� 1'I� pumb dea �1 eemr t6s comlracdo�, �StaOHioe /er rvGte9. P��+�9. 6� �*�8� +�r�r or �rNer. 8� son to � Na BaiWioB I�to� te� aW►tl� Wrm6s for tMw t�m. � , " . . . � ` , � � . • . � _ . � APPLICATIAN F4R : ING PERMIT` ' � . . : � . � � CITY OF FRIDL�Yy ��S4TA f . . , , � „ � t ., 06�R' � NAME `��/S� ��?� BUT�DER � + ��'��'�� . � , �ADDRESS �sb'��'�i��e)�a/ ��AUDI�SS /��% _ �`� � ' � �`- ��L= I " . Q . . . . __ .. r _ ' .. _ .. � ��-� �, y; LOG�Z'iOPT OP' ��iNC No� Str"�et Patt of Lot . a '��- � .. ,�" i .� ;� � ��.....%'" �.'�_:� Lot_ �� Block Addit.ior% or Subd��isien ��'`' �; �,�i-+ � �' _`i �, �a f r-�-� Coruer Lot Inside %at __,.:$e��k S�id �'Yard S�1n1ER -�EVATIQN FOUNDiATION EL�V'V�fiION Applicant atCa�h to thi� form,Two Certiiicates of Survey of Lot'and proposed buS1d-� ing location d��wn o�t the9e (;�Y'tifi�cates . � _ ��.�� -� ��`�-�` ��r,�o�� ,�-�� . �� . ,.� • DESCRII�J.ZOA1 OF BiJII.DING To be us ed �s : �,��i�L'��,� �� f,� � � '��c � �62f.� �i2 �:.9ai��-�'� /��l��P � ' d � � ,��.��ta� � . ^ � �� i �ronC �� D�Pth kie,ight� � �,_�.�,-�.: . �" Y�/ . , � 9q. Ft. _ Cu. Ft: . � „ _,_,i, Ftont Depth Height ,, . . ` �q. Ft. Cu. 'Ft. ° � Type of Construction _�/�,��',� Estimated Eost �� -� �/%��_ , , .-. ,. , . , - - - - The underaigned hereby makes applieation for a pe�rmit for�tne work herein-apecified, agreeirtg �r� do a]�1 work ii� str�ct accordance with the City of Fridley Ordinances and . rulin�s �� tbe Department' of Buildiags, and hereby declares Cfiat all the f�cts and represent�tioas statsd in this appl3cation are true and correct. /� � DA� � � l�9� �fra�u�m� � .. � �� +��.e of Fee Costs cea be found on the Reverse Side). �� + ,--� � - _ _ .�� d� � � ��s��j� ;� '. .+3�i,�� .. . . 'i.'``i:'°.' �e�! �`" . � y��..a, y+,. .r4'`;�.�„�� • . :a � a'. .!,�. Hi�DII� �ERMI�T F�E SCH�UL� Seetion 2. The Inspec�or:•�of,-8uildi:ngs �°sh�I3�, b��or� issuit�g any permit for , th� erection of any buildi,ng or �tru�ture, ar for agy add�.ti� Ce any euist- . iag building or atructure, or_ior �ny a�`Cerat�4.�s�'tar�:repatr� to an�r existiag . buildi�g oY atructu�re� �upon applicat�:o� ��}��eior, ��qt�ire th� paym�rtt by �he applicant for such petmit of fees •�i3 xhe amoUn� ��ier�ia�� 6elow set �forth end : �in the manne= hereia prdvided to-w�.C: t.� ... 2.�1.,� F�Y� aiiy guch permit� �or the Qte�.tibri -o�� anq �i�e�:g�f butldipg� ather ��. ,�han a�,ar�ge� warehnuse, f�c�o�► ox g��tt��ev��C'� _�fmr tha e�tioa of � .' ,any f3r�-pr,�of `ad�ii��.oii, fax s3n��11ar`�cic�i�p�acy� �d, e�y��xie��i�ig bu�1d�.�ag - . wh�ll �e �e the ra�e �f $1.4Q for aa�b ona� tt�o�rs9ad �t�bie feet � or � frac��f,nn . J.�� .. thereof � im such cubical cont�n�s '.<�.. '. �._ ' ' ' ' � , . . .,. . . Z.2. For �ny such permit fa7c..,_��e erection o�,�tay firerpraaf g�raee__ wA:oa�.---,�. f— r _.. �'y sr graia elevator, .or fqi��the ��r,e�tion af aay� �r�P�� ;•,� f�r afmal.lar occupancy, to aa exist#n b��ldi '" y g . 'r�- stie�.1� �be at .t�ie .a•�for e�teh one .thbussnd cu�ic .feet;�.,c�lassi�ied asi"firep.rov#" b�► S� the M�i..aueap�9;ie sui�.ciinS <G�tle.. :m�S.:..: � � ' . . . � . �� HOUSES . . . . . • . . . � 2��:. Fcir as�y such permi� for �he . er:.�ction . o� �uy aon-f�rep�oirf liuildiag cath r. 'tha 8 gargge, waiehouse, factory or, grain elevat0r, br a�y`non-firegr�f ��;•:., add3tivn, For �im�,�,�� ocOUp�Yuys to aa�r eicis�ti�dtg "Tiui�din,� - pe�mi.� 4�.�00 fos each �one thou�e¢e� ct�bi�. fe��.� GARAGES � � , . ... �.__4_ For any such per�aLt ftfr the erestion of any noa-firep�raag ga�a e warehouse, iactorq.or �raia elevator, or for the erec�iaa vE v�y non-firepraaf additi�a,• €or-s3miiar•'occupeacq; to aay exfsting building dr for ��c� such ` 1�i.lding or addition - nia�aty cents ($0.90j for each one thousand cubia �eet or fract�ion •thersof; ia the cubic�i� contents thereof c�fth a minimum of $4.OA.• A �� For Che -purpoae oi compuei,ng fees for building permies, th� cubical cat�ter�CS� �� of anq building or additioa to a uniform height throug'hou[t •'by multipiqi,ng gf� � grouad a�ea tovered i-zom a poi�t siK (6} incta�� b�l�e� the �loor lia� mf the baeement aY ce11�r tu the average height of the upper su�face or ta Cbe � average height of the rcaaf surface of the m�3m gable of a.�eitched reo€. •� � 2, 5. •. For repaira or aXteraCions to aci existi�ig, s�suct�r.�y �1't� gee si�al�l. be -�'� . ,. at the rate of $3,00 per each F�Lve F�undred Dollax:a .($30b':�) qr �ractfoa X'therebf i� �he ,cos-t �� 11 progo�sed work. . ' � � • • . , . 2� In ao cg� :s$„ �.' �-w .• '. � � '� . , ' _ . .�5. . . � Lve fee� charged � fQZ anp �.. �._..�t.: �;;� se£ f'oi�th 3rt' . . � � Sectiaa 2 be les� �:faan $4.pp;:. � : . . . . . . . _ . , .,„ �� . � . . ;, �. . . � � . \ . , . •�a� �� .� , . ., :. , b . �y � 9 � � � �` , � � � � i� � � �� i6� ��i «� � q� �9 Q:� a �� .�, n � ,• •.� '.J � � � � a � ro . � x�� ,��W ti t� �� N � �' � � � y �o � � a� ,., ti a ea '-�� g � ; �� x.�� :� � � �� . . �m � � � � �� '�* E � � I � �� ( � � I � � . � � � �� 04 E� 6a � � $�� u � � � � . � I � � O � � t' \ , � ,\ � � �� ?�' �� ` s �• � Y , � ��\ ti a ; � x'' �,� �� = ►. � � �� V ; 1 � � � V �J � � � � I � r� � � n F � W w � I I 1 � �� V ?�9 � � � a � � 0 a r trr C � �0 � I �1 L+ W � w W �. oa �� S ~ a �. C p � � A ry R � S�° � a. � , � � � � � � � O � � � � � � � � k3 � � � 0 � � � � � � a � � :� � � � � W d a� � N � � � N o N p'� 4� A � O - p �.. "r � � A s� � .�, � � � r � d M � �' l�e ..,,. �9 � o s w e9 � �» � .�. � � � � A �a � ~ i� � e b � � o N '. f; � � � <Po w :a o 0 � � � � m+ go ve .n � `W y � °' T %p � O. :!� p E' St 7 � � � 0 � � � O i v � � .� 0 O � 'V� A � ff � �. � '� ti '� Y'`� � � . � R� R^ � � � � a .. � � � O �� Qa � � ° � �� 2 A �C�� ti � � a � S � � � � �O . �Q A � v � : � . � w � � w � � � � �v � sm �o C � Qr CL m � O � � ( � � �p+ � 0 I , ' � � � I .� 'f ti V � RG w d � n � � �►�� .a�� n p "� W " ;� � � � � � °o � � ��6� '� x� � � � a � � � � pQ Up " . O . • � � w c� � cr �n � � � � � � � � Cr w u Q�r�p a � ^1 n �! -�i A C �• � �v � .:. � T R'7' � :n �C � M� �y � 9a p~ Po � ��.pyp ' S � W � � yd � � �o �b �; �� R,�O.' a. � � �' � �� .. 1 � N p � � �5" � � � 't: C, "' � � b '�' �' a � ��Nb C.sin n' n O - .+ N s� „�,u 0 ��o� ro r _�� .o ,1 �y M �� a �.� �� N '� � r� � � � O � � .. ea y � p l� � � �; G c � � � � � �1 6rf`� (.� � �� t.� �:1 � �� 17 n ( �) � r� f� �� .� `: �a n,� e , e� % � �... � ;3 � � � f'i �J' r �r•.� t:�-r �:;i �, .., c;� �a cw f � +-'?7s �_ � r;;.g c,o �;: .j "� � f� � -. �-o �� .:) a�- E;� F� � c.� ,� C� .,� �� [t � �.� � b�t � (�D'� � �J 3 �i � a�? � •1 6:�8 c '0 �� e:e r- ry� � �i � �e {w� � �� r :'9 C.-� r» E � G.4 � � �� 0 sua.,ecT � PE N0. - City of Fridley 19 30 8 , ` AT THE TOP OF THE TWINS g U I L D i N G P E R M I T R EIPT NO. � � ; L � COMMUtJITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. � 7�� 1 i � � /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. OATE PAGE OF APPROVED BV �'""'� � ,�� 612-571-3450 910-F15 12/31/87 � � JOB ADDRESS 5800 Jefferson Stxeet N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCH. 9 1 Lyndale Huilders 7th. Addition SHEET 2 PqOPERTY OWNER MAIL ADDRESS ZIP PHONE Keith Mallow 5800 Jefferson Street N.E. 571-0115 3 CONTRACTOR MAIL ADDRESS Z:P PHONE LICENSE NO. Panel Craft of Minnesota Inc. 3118 Snelling Ave. So., Mpls. 55406 721-6628 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE UCENSE NO. 8 USE OF BUILDIN(i Residential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK • Install soffit & Fascia 8 CHANGEOFUSEFROM TO STIPULATIONS SEPARATE PEFiMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING, HEATIN(i, TYPE OF CONST. OCCUPANCY (iROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. � NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �' STAILS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2�],OO $I..OS WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 538. SO PLAN CHECKfEE TOTALFEE - _ $39. 55 SIGNATUREOFCONTRACTORORAUTMOH12EDAGENT IDATEI i WNEN PROPERL T D THIS IS VOUR PERMIT �,. „� «.r _ � , `I SiGNATUREOFOWNER11fOWNERBUILDERI IDATEI � - I .t ��s { INSP �ATE NEW [ ] ADDN. [ ] pLTER. � Construction Address: Legal Description:_. Owner Name & Address: Contraetor: p Address: City of Fridley �R-1 AHD R-2 j Building Permit Application Q�IC: 0 Effeetive u/1/86 Te� . � —D ..�" .# Attaeh to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to seale. DESCRIPTION OF IMPR09EMENT LIVIPG AREA: Length Width 1rIeight Sq. Ft. GARAGE AREA: Length Width Hei�ht Sq. Ft. DECR AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [] Inside t[] Ft. Yd. Setbaek Side Yard Setback Type of Construction: • Estimated Cost: $ r��L�� Approx. Completion Date: ___i�� Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: Permit Fee Plan Check State Surchar�e SAC Charge Park Fee Sewer Main Charge TOTAI. STIPULATIONS: APPLICANT: Tel. �_,e'_21!_=�I��61 CITY IISE ONLY $ .�,5 �Q Fee Schedule on keverse Side $ �— 25� of Building Permit Fee $ ��_ $•50/$1,000 Valuation $ P" -- $ 525 per SAC Unit $ �— Fee Determined by Engineerin� $ _'�-- � �S. Agreement Neeessary [ ] Not Neeessary [ ] $ �� ' .. � �. BOILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or strueture, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon applicatio n therefore, require the payment by the ap�licant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: Total 9aluation $1.00 to $500.00 Feea ,,, � �� . , ::.,� :� �,`�°' � �+�"� -�'r � � �. , $10.00 (Minimum Fee is $15.00) �'�` $501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and ineluding $2,000. $2,001.00 to $25,000.00 $25,001.00 to $50,000.00 �$32•50 for the first $2,000 plus $6.00 for eaeh additional $1,000 or fraetion thereof, to and iiie3.udir� $c^� � 00{�. __. -- -- — ----- $170.50 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to and ineluding $50,000. $50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for eaeh additional $1,000 or fraetion thereof, to and ineluding $100,000. $100,001.00 and up $433.00 for the first $100,000 plus $2.50 for each additional $1�000 or fraetion thereof. DRIVEi�TAY DEPRESSION ESCROii (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50 Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approaeh with 6 inch depth - Driveway width plus 6 feet times $15.75 ___ _ VERIFICA�ION 6F F'�}HHI�DAi-IGi� - - = -- Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construetion site. A Certificate of Survey of the lot, showing the location of the foundation once it has been eonstructed will be required before proceeding with the framing. . , SuBJECT 1 City of Fridley � BU ILDING PERMIT 2 6� 5� AT THE TOP OF THE TWINS r ; � NO. � • COMMUNITY DEVELOPMENT DIV. �/� � i ty ��'� r � � PROTECTIVE INSPECTION SEC. 1 . � � � �"'1 � CITY NALL FRIDLE� SS43Z NUMBER REV DATE PAGE OF APPROVEO BY �----� � �'� 612-571-3460 910-F15 / / 7 13 98 JOB ADDRESS 5800 Jefferson St. NE 1 LEGAL �OT NO. BLOCK TRACT OFi ADDITION SEE ATTACFIED DESCR. 9 1 dale Builders 7th Addition SHEET 2 PROPERTY OWNER MAIL ADDFiES$ ZIP PFIONE Keith Ma.11ow 571-0115 3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO. American Roofin and Const. Inc 1 a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO. 2 1 395 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING - Residential 7 CLASS OF WORK O NEW O ADDITION ❑ ALTERATION �] REPAIR O MOVE O REMOVE 8 DESCRIBE WOF1K Reroof house 27 S Tear-off• Fasc a 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCV aROUP OCCUPANCV LOAD VENTILATING OFi AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTFiUCTION OR WOHK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTEH WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLICATION 1 STALLS GAfiAGES AND KNOW THE SAME TO BE TRUE AND CT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING TYP F WOFiK COMPLIED WITH WHETHER SPECIFIED EIN OR T. TNE G OF A PERMIT $3301 �I..C)S DOES NOT PRESUME T IVE AUTH ITY 10 E OR CANCEL TNE pERM1T FEE SAC GHARGE PROVISIONS OF ANY THER STA CA AW REGULATING CON- STRUCTI OR TH ERFORM E F TFUCT . �S%.ZS ir SC �$3.30 PIAN CHECK FEE T AL FEE Licens $5. 97.20 IGNATUHEOF iRACTOAOAAUTH0�7�ZEDAGENT 1DATEI HEN OP .V D D THIS IS YOUR PERMI - _- - 6- SiGNATURE OF OWNER�IF OWNER BUILDERI IDATEI BL • INSP f1ATE NEW [ ] Effective 1/1/98 ADDN [ ] �, CITY. OF FRIDLEY . --; . / ALTER [] SINGLE FAMILY-AND DUPLEXES R-1 AND R-2 0�� - . BUILDING PERMIT APPLICATION , �") � . � a�� co��onaaa�ss: ��CC� � � w� g � �v � _ . Legal Description: Owner Name & Address: �C.e�� --�'�i l�''�-a �� v� Tel. # ,�^ � f^ 6 l(,� Contractor: c.=. �- rb U�; c� � C o�-.-� 1'�i� MN LICENSE # 2� � C� �-t .3 �S Address• % 3 � 2 �'1 S i�a-�-.� � �J �( �2 Tel. ��.3- ? �J�% ' Attach to this application, a Certificate of Survey of the • lot, with the proposed construction drawn on it to scale. _ DESCRIPTION OF IlVIPROVEMENT LIVING AREA: Length GARAGE AREA: Length DECB AREA: Len�th `� . � . Width Height Width Height �� Sq. Ft. Sq. Ft. Sq. Ft. _�i�- �� /, t�� o`� �.�/ Construction Type: Q-�G c� � Estimated Cost: $� � r %O�� -� ee Schedul e, on Back) � 3 D� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft�� _$ DATE: �� APPLICANT: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ c�/•�S $ �_�o � �. �� $ � � d c� $ $ $ $ $ °�.�� Tel. # � � — 7 �J � CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.so/$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 [ ] , BiJILDING PERMIT FEE SCHEDULE The C1uef Building Official shall, l�fore issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: - - TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,�0 $25,001 to $50,0� $50,001 to $1Q0,000 $100,001 to $SOO,OQO $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $SQO plus $2.75 for each additional $100 or fraction thereof, to and including $2,0� $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each addidonal $1,000 or fraction thereof, to and including $50,000 $574.75 for `first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012:25 for the fust $1,000,4� plus $2.75 for each additional $1, 000 or fraction thereof DRNEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. _ .. d Building . Inspections 763-572-3604 763-502-4977 FAX oA� � �9 � Je SITE ADDRESS � ��i.� J �'- 1 THIS APPLICANT 1S: �OVVT;ER PROPERTY OWNER/ TEI�i ANT CONTRACT'OR SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND CERTIFICATE OF INSURANCE PERMIT TYPE TYPE OF WORK: PLUMBING RESIDENTIAL APPLICATI�N CITY OF FRIDLEY YOUR E-MAIL .0.I)DR[$S �'� � � — OCOh'TRACTOR � L C"ITY Permit lVo. Received By: Da�'� E PHONiE � � .7�y' ,- �J7 l -(,�t�'� _ __ AME: I � ✓✓✓1 C� v`f'f�G�C L�0'1 _f �_�0 �� __.-. -- STATE LiCENSE ++ �� 1 '� 7 � �_.` �_ � i -. -_--. ---- EXP DATE 554 3G- STATE BOND �t _ , EXP DA'TE ADQRESS ��% L��1 i I'� �'� CI"T'Y_ G f`�i � STATE i��ZIP� PHONE `��- -��a�- S��O __` �AX__��'_� iD�- �r��- - - �SiNGi.E FAMILY O AiEw C3 TWU FA!vS{�y p TOWA1HOlJSE �REPLAC'EMENT � DETAILED DESCRIP'T10N OF WORK �i �� l I ��0' �'LLL±�i �_ _...W�� `° �"�f �� °`' � �f �'°'�`� _ (� �� r�c� C�o ---- --� ---- - PER MS 16$.665 the permit fee is a minimum of SI5.00 or 59�0 of the totai cost up to $SOO.UO; whichever is greater, forthe improvement, iastallation or reptacement of a residentia) fixture, exclud+ng the fixtures. (This shouid retlect onfy the cost of labor ) Labor cost under $300 =$15.Q0. Labor cost between $300 to $500 = cost of tabor _ x.OS = plus .50 surcharge FOR PROJECTS WHERE LABOR EXCEEDS 3500, FEES ARE BASED ON S 10 QDRPER F(XTL;RE, EXCEPT wHERE NOTED FSXTURES: (INDiCATE TOTAL NUMBER OF EACH BELOV�. MINIMUM FEE $15.50 BATIi SINK/LAV FLOOR DRAR�iS SHOWER �WATERPiPiNG BATHTUB GAS P1PfNG (NEED C1TY I..IC) � Sw1MMlNG PdOt �wATER SOFTNER ($35) CLOTHES WASIiER KITCHEN SINK WATER CLOSET BACKFLOW PREV. (SIS) _ DISEiWASHER _ LAUNDRY TRAY �! WATER FiEATER ($35? FOR fRRtGATfON WATER METER _ OTHER Fee AL DUE INIMUM $15 � i:1 � i �t ' l ' • ' ' : ' :!i ili.Y''l��C..1'i�: ' 1�1�' -•. �t .,�.� � ' . $ Number of fixtures �$ l 0.00 x$14.00 =$ s� — .50 i Number of fixtures @$ I 5.00 x$15.00 =$ $ OR Number of fixtures @$35.OQ 2 x$33.00 =$ 7� _� State Surcharge = $�� (MINiML'M$I550) Total=$ (�1d�� THIS !S AN APPLI�ATt04 fiQR A PERMI� -NOT Vql_1D U�T1L �'RCitESSEU 1 hereby apply for a piumbina permit and i acknowledge chac the ,nfor,nation ai�ove is complete and accurate; that Lhe work wil{ be in confomtance with the ordinances and codes of the City of Fridtey and with the Minnesota Construction Codes; that i understand ihis is aot a petmit but only an application for a permit and work is not to stan without a permit on sitc: that the work witl be in accordance with the approved plan in t case of al{ r which requires review and approval of pJans. SIGNATURE OF APPUCANT PR(AiT `�)AME ___� ��_��aTE Z�� APPROVED BY ______ ___ DATE City of Fridley Suilding Inspections Department b431 University Avcnue i�iF.. I�ridley, M!�I 55432 763-572-3604 FAX: 763-SQ2-4977 m From: unknown Page: 1/1 Date: 2/4/2011 9:08:33 AM • ---- —_ __. . .._.._ �__..__._. . ��1� — O� Building MECHANICAL Permit No.: Inspections RESIDENT�AL APPLICATION Received By: � 763-572-3604 CITY OF F12IDLEY �at� �tec�a: 763-542-4977 FAX �� i•�-xo� � UAT'E y�i � YOUR &MAIL ADPRE.i3 dave(�devesheat)ngendelr.�m SiTB ADn�tESS 58� JefPerson St TFiIS APPLICANT IS� 0 OWN�R L7CQNTRAGTOR PROAERTY �,��; Ke�th Mal�ow OWNER/ ADDRESS: �00 Jefferaon St Ne CITy FRlDLEY STATB �N �p b6A32 TENANT PHONE: CONTRACTOR COMPANY NAME: DAVE'S HEATING AND A1R SUBMIT A COPY OF ��AC7' PBRSON: AMY MADVIG � W YOUR STATE STATE I.ICENSB N EXP DA'I'� LTCENSE WITH pDDRESS: �� 37TH AVE NE ��. COI.UMeIA H�IGHT3 g��Tg MN Z�p 55421 APPLICATION pHONB 783-78i-6901 h� 783-789-88Qb p��.r �� ,✓ INGLB FAMILY �'WO FAMILY �'OWNHOUSB u �._i TYPE OF WORK: ��W �P�CEN(ENT O ALTERATION/REMODEL DETAILED DESCRl:PT10N OF WORK Replace Fumece wl iist�i equipmarit below I'EES ARE BASEA OiV 510.06 PER RIXTURE, EXCEPT Wt1�RE NOTED. FIXTURF.9: (INDiGTE TOTAL NUMBER OF EACN BGI.Q1� PROVIqF HEAT LOSS CALC'8 P�R MANUAL J Z006 A6HRAE NANDB�OK. �quipment lnstalled MFG: �� MOp8L: ��z� 51ZFJSTU �% 80,000 B7U MFG: MODEL: SIZUBTU Mf�: MODBL: SiZE/BTU C $2S.Q0 F1RE!'LACE (GAS) $I 5.00 _OAS RANG$/OYF'N ${0.00 �CR TO AIR fiXCHANG&ER $ IS FiRBPLACB (WQ4D) $33.00 ,�NE14 QAS CiRILL Sl0_00 BOTt.ER $35.00 �J RURNACB 535.00 f3A3 UAIIT FITR � 10.00 CHIMIVEY LINCft $10,00 laAS ARYER S1Q.00 �P004 NP.ATER $34.00 DUCT WORK $IO.UO GAS PIPfN4 $10.00 V�NTILATOR $I 5.00 Number of fixtures �$ lO:Op � x$10.00 �$___,_____ �lumber oPfixUsres � $15.00 � x $15.00 = $ Numbor of. Fxtu�es �$25,00 � x 525.00 =$ Number of fuctures Q$35,q0 Z x$35,00 =$ 70.00 Stata Surchacge = � Nv�� y $_.. S.OQ IMUM FFE $4b.00 Total = $ 7$•� THIS IS AN APPUCA'1'ION POR A PBRMTf•NOT VALiD llNffL PRQCESSED I hereby apply for a building permit and 1 aclrnowledge that the information above. is complete and accurate; that the work will be in conformance with tho 'nances end codas of the City of Fridley and with the Mianesota Construction Codes; thst i understand this is not a permit buc only a lication for a permit and work is not to start without permi� that the work wil be ln accordance witit tha approved plan in the e work which requir d approval of plans. SiGNATUR80PAPPI.ICA T PRINTNAME y APPROVAL fN5PEC1'q 6(GNATURft DATE PI.EASE NOTE: SEPr�RATE PB S ARE RE UIRED FOR UII.DING BLBCTRICAL, AND M�CHANICAI, WO Gity of Fridley Building Inspectians Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977