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AF - 47744/�' • �z s�.�rr►.�I %� ��', � �_ BUII.DING PERMIT Village of Fridley, Minn. No Date Owner Addre � � �o :p S �.. � f ' .,. ti � . � � � i�� 2�33 Builder....... . . ............................... Address.. . .................................. LO�ATION OF BUILDWG A � �....... Street . ... ...�........... No. . � .7 . . Part of Lot . . . . . . . . . . . . . . . . . . . . . . . Loic . . . . � . . . . . . . . . Block . . . . � . . . . . . . . . . Addition o r Sub-Division .��.1?. . . ��I,S�L . ��. . �. . . . . . . . Corner Lot ............ Inside Lot ....�. Setback ............ Sideyard .......................... DES�RIPTION OF BUlLDING To be Used as: • • • • ��9 � ��-. .. . Front . . �.�, Depth . ��. . Eiei ht �: � � g ..�..� Sq. Ft. ,/.� . Cu. Ft. ........ . . . . .� � :�:-��.. . . . Front . . � v.i. . Depth . :� � . . Height �� Sq. Ft. .��. .�Q. . Cu. F't. , . . . . . . F 2.� ;� e �� . . . . . Type of Construction . . . . . . Est. Cost ,1�, ,o�, ,�; `f, , , , , , , , , , , To be Completed . � �'� o , In eonsideratic�n of the i�ssuance to me of a pernut to construct the building deseribed above, I agree to do the proposed work in accordance with the description above set fo an in comppp liance with all p ovisions of ot�dittances of the village nf �ridley. ., � � .,..::`-:!. .. ....... ...............a . �Iti consideratiori cif the pgyment of a fee of $. . � ?� o�permit is hereby granted to . .� . . . . . . . .. . . . °•"�• �. . .. to Cunsttvct the building or ad dition as described above. This permit is gran • upon the express condition tl�.t the pe.rson to whom it is granted and lus agents, employees and worlmien, in all work done in, around a.nd upon said building, or any part thereof, shall eonform in all respects to the ordinances ot Fridley, D2intiesot�, regarding local3on, construction, alteration, maintenance, repair and moving of buildings with- in the village limiRs �nd this permit may be revoked at any time upon viola of y of the provisions of said ordinances. ....:. ...••.. .. .. . .. . Building Inspector NOTICE: Thls permit does nbt cover !he construC4lon, ins4allation or alieration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permtts for these items. I� -' y� _ � : �*"� �°i► p. l � ��w �"1 r''1 `,�'�,`,�. � � � � � � �. �. 07� � �� I ��,� �� ` � � P � ♦ A � � .wr ��,�� '��1 /'� City of Fridley, Minn. BUILDING PERMIT nate: 1��„e z�bi � y� / � N° '7635 owner: 673? J�ft'ex�son st. N. E. �� QnaLity Homes, Snc. Adare�a 6?37 deff rson N. E. A� 3701 Fr�mont 1�v�. l�o. LOCATION OF BUILDING N� 673? S�t Jeffers�on Street At. E. P� ��t Lot _ 3 Bl�k 1 Addition or Sub-Divislon R• CTeek TerPaCe 5th. Add. Coraer Lot Ine3de Lot Setback Sideyard Sewer E1e�►etlan Foundation IIevation DESCRIPTION OF BUILDING To � v�a as: Front Depth Height Sq. Fi. C,u. F't Front Depth I�eight Sq. Ft. Cu. F'L Zj►pe of Construct[on E�t. Cost —�,�:'j�s� To be Completed Storla damag�e repa3.r tha p�ro� work in�ac�rdance w�ilth the d� criptio�n abo�vec�s�e�o�rth�a d�i �c�rom�p a�n�ce wi h a'11I a� to do azdinaaces of the dty of Frldley. � ^`-, /i � Pr°visions oP In camaideration oP the paqment of a fee oP �-� �•� � permit fs herebY granted to �2�7.3.'�y Home9 � 311C• to conatruct the building or additfon as described abave. Thiap�� t is granted u�n the. exPress conditiam that thepe�o to whom it is grented and his agents, employees anc� worl�nen, in all work. done fn, araund end upon ssid huilndin� or any part thereoP, shall contorm in all respecte tfl the orrlinsaceg oP FricIIeY� Minaesota regardia�g location, conatruction, alteration, anaintenance, repair and moving of bufidings w1�� dty limits a�i this permft may be revoked at any tiiae upan violat[on of aay of the provfsiona of seid A11@II deIISe11 $�S �r NOTI�& 'llds p�md! do�s eet eera t6s eomfroeNoe, IeafaOalim Ior �ete�► P�me. ob �s, �nr ar �rater. B� sara to � � �9 �� pP�*+� � Ior �h�a h�ms. � , � �.,..�r - , b737��erson -L.?E. Droasel �5,735.00 gLc1r.-Quality Homes� Inc. 3701 Fremont Avenue North Replace all roofing� honse �c ga.rage- repair and replace siding v�here necessar� repair �ater damaged sheetrvok inaide-repaint inside & outside �rhere nec�ssar� �.�.� � � � APPLICATION F08 ING PERM�T . CITY OF F�2I.EY y a�1dId�90TA OWN�R'S NAME A�DRESS � � LOG�Z"lON OF S�II� No._ (�' � .� � _ Str"�et � � �att of Lot�_ Lot_ �' B1ock / _ Addit.ioa' S �wiB�ion _�� _ Coraer Lot Inside i,ot __,��e��k Side-Yard,. SFWE$ E�.E�ATIQN FOt1ND�iTTON EI.�I�TOi� .. , , , q . , �.r.:.r��i rM�r r.....r.�� :.p . '. Applieaat attach to thi� form, Two Certificates ot, Suxvey of i�o� aad pra�sed 1�,d�-- ing loca ioa d��,wa ot� these GA�°tificates . � � � G��,,�� j��G�� '� � , DESCRIP�ZON bF BiTILDING Zb be used �s: ' �ronC� Dep�h '�ight , ��.. 3�. �'C . Cu . Ft . Front Depth Aeigh� 3t�. Ft . Cu . Ft . Type of Constructian Eatimated CosC 5�3 7�� ,� :omp�.eted . The undersigned hereby makes application for a permit for the work herein specified, agreeittg �d �o �]�1 tvork ii� atr3c� accos�daace with the City of Fridley Ord�i�eances and �tulings i� el�e Depart�ex�t• �of Buildiags, and hereby declares tisat aIl the f�cts and rePresea�atioas stated in this application are true and correct.� 7�� _ ,, : � e1; ,�S�4esi�il�s .of Fee Coats can be fouad on the Reverse Side) . .� �� i � � — � I 1 .�,:.�.'.4� ��t: .. . � � °�t" 'i.',,..s';' .., �'�.i �p±;.. ��..z��R � ..�s:,;�: : �-ri�° ' ...�• , Bua,D� r�� Sc�� +�. ^e. Section 2. The Inspector of Buildiu�s �s�al�., be�ora ise,u�,�g �►y permit fox th+� erection of any building or struFt,,urra, �r for aay add,�t3� ts aoy euist- ing bu3ldiag or atructure, or for, aun� a�terat�;�s�,or'.:re.pattb t�+ any e.�l.stiag build:i,mg or structure, upon applicet�Co�. #�}er,e#or, ��re the paqlp��tt by �he applicant for auch permit of feae ��a xlie amouat •�er�in�•below set 'forth._atrd in the mann�= her�in provided to-W�.t; �� k� � �. 'K�----'- �.1. �P'�r any �uch permit �or the t��:��.on-e�� any fire�gi�j@# �bu�l,d�pg� a�t►er �. .,,::,�-��a a�ar�ge�, war•ehouse, factory or:�g��a� �ev�f�ycy f�r. the e�e�t�t�ra �� s"' •' Auy'fii,e-�r�f �aSdi�ton.. °fQ� s �;a�+•a�. Q - - �� . _ . �s�alY �e at t.he rate # � .°�P� �, '�� $�Y �cis��,i�tg bt�l-d� ' ?•::' - �:��.• b •$1.4Q for �cb:.,a� tl�sand �e�i,e fe�t, or' fr�t� - ,�r� .. :thereof, in such cubtcal coat�n�s.• . ,•. ��: ' . , ' ' . ' -.� ,.. .,. - . . - '�.2.2. �'or any euch permit f�o;:.:��e erection o� any fi,serpraoi g�r�..•��-�-��,' �.c�ory �r grain elevator, or ��•.�h� �t�ctioa �,f aayn�� fl ..m • Fos' similau oacu�ancy, to �ny eiciat�tng �tld�[�pg shaLl• •be �t `e . �'� . ••.:r:-fof��e�h one .thOus�d .cubic-.ieet• '..c�a.aseifie� �e, nfirep.rcia�" by� 3� � p�ie��8ut ' th�.-Minaea. �� L.�� , . i'.fiSaatin` . . ., `.' HQU3LS � . , � �_ rs��^� 2_ rti Fcir aay such permi� foz the er.�ction af aay non-tirep�f �uildiag ,�tt�an a gargge,�warehonse, factory or, grain elevator; or any noa-fi�4�b��: addixi�a,. Eor ai�i�d� �Cupa�y; to au�+ el�i�ti.�g tiu3E each �oae thou� .�:d� - pe�it $I.�00 fo�r .- , ^ . � �c�bi�, fe��.. .. GABAGES � . � ' ' .. . . . - �o �•4. For any such peraui,t f�or the eiection of aaq non-firepr4of garage� warehous�, factory or graia elevator, o� for th� erecCion of any non-fi��, lar�occupancy, ea any exi.sting build3ag $r for eec� such � a�a+ng ox addition - niaet cents � or f� 3' ($0•90j for each one thousaed Cvbic feet > � ae►-t�on thereaf. in the cubica�� coatents thereof witb a miai�um :of �4.QQ,..•�• � Fo'r tbe purpoae of cem�ut3ag fees for building permits, tb��cubical c�te.�`� of an buf,ldi =m � Y ng or ad+ditioa to a uni�orm height throug'ho�tt •�9' ��P23'in8 t�- � gro�tnd atea �oyered .fsom a point six. (6) iachsr� bel�m the �loor line �f�he-,,.�f,.. baaement or �cellar to the average i�eight of t�e upper sut`face or eo the avera�e height of the r�of seirface of the maia gable of a.�fitthed roa€. _ • � � 5_.�. For repaira or aleeratioas to �a �cist�g s�ruc � ,; at the rate of 3. :: �t� gee st�11 , b��:� ;: : $ 00 per each Five �tuadred DoU,ar,s ,($50�'z„ );, oic, �recxiastt" . N, therebF in �he cos� 'of, ��11_ proposed work. . ... • ' • � . . . . . . �,i' . . 2=„_ In no case shali � Ehe . .. . � .: set "fi�i�'th �Lu ' . .; . •F`'" � ,Sectiaa..2 �be Iea 0: , . ,. ' . . , . . . . , . . . ' � �� ' � .V. ... . . i �' . . �� • . -�.. _ .. • . ' d ��A ✓ �. ,• �� . .4 • . r ,,y,,r r � � G � � 'd -�i Ex y ° � : � : °x : � . � . m : M : o . � �J : � : �� W . 0 0 N � � Fi � � � � � p czo � w m � �" z � W x � 8 " � � � � ."� � � ~ � w � � � � � � � � � � � o �° �' � °' ►�, . `° � � � ,..�, . �; �d � : O `�8 � � � b ¢ o � � � . : " a ° � � � � � �y : : t� „cmc : �' � : "' . . 07 � . . . . ' ' : : � : : : : � � �a �a �a " x�e x x�e k ,�ii � ,[�� r�+ .r�+ ,[�.� '�1 S�c�, o�y' c� � g� g g�� t t�ss fn � t n t� n tsr t�n ts� tn a y H H � � � O �: x � � r D � m � � a m C r m O � I� �' 8 a Gl p p � � � � 0 m � � W � .�{. • �P w p w aJ � p, p, � y � � A 8 � @ �� p O �a '$ � I �� 8 8M �❑ o m �� n � � y P � ',d.., � � p a. aa g � � � o � �� m � Z � � I m I WATER aosErs URiNALS sarH � �� SINKS wws►+ TRAYS DRINK. FOUNT. s►+was. FLOOR DRAINS UTCH BASINS �uro WASHER GAS APPL GAS RANGE �� OPENINGS a • z s � � A n � ��b � CL � � Cs' ►�w � �a� M�.j Vl OQ � W p ,o� � p�, � m � p �o�a� � ��a��o � �p G� � $ � ��o m �. bd b �� vy � y � � p y� � m p c�o a ° p �' �, o '! � � � � �� . �� y � � �� o �aa' � � � � co 3�� c �' d � A � � aM �rx & �°n p � M � M �i OD � � • N � � � -� _. �i a � � • � � � -r' 3 '� � d O v b rt � � �, � �� ro �p 0 w m A � � � � � � � m � m � � � � i 1 V � ' �.n .- �9 � �� a fr7 V1 � � � . � � �e � r 0 � � � m r �� a�� °�� w� o�Qa �� g � � � �� ° �� '�� . � � f� I -� - - I �6 � K O . � � �i �i d �� M M i '� , � Q � �` _ � �I� —; �: r � �e �: �` � � � � � � � � �. � <� M I va � p � m� � �� g� �� fii �� o � � � � � � � � � a � p � � � � � �j o � � � ' � � � �� a � � � . � �� a�� . �� O � � '�r° � � ,�° �° �° � �� s� s �� . � � x �o � � � � � -- -� t� �o 0 0 ��g� M N H� H i I1 I I ! i � � � � � � � � � � I � I i � 0 � � 0 �i �� 0 � � � m � r� . {�� . � � �� o � �� m � : � � � � � � � � � � � � �g�� 0 � � � � �=� � �� A� � � �'�� b � m � � � �� f�, � � �� , � � � � � : : �� a sa o � �� I � i � � �� ~�� q � 0��• .. � �� e'� � �� ' �� b� � a! o e Vi '� `9 � � d �� p�� e �� w �� 67 �� R �• �� F � � �' �� . �� c� � � � �. a � �� ;t�,�° Q � °� � �;� �:;>, �a� e �� ,:� `� � 3 � � � �� 8 � �� :. � � � � �� ^z �N r ro o py o y O �..� ..z � � b m� �'ro� �' a u�, °' � m w a� m u� � C � m H N�'' �n ��r E m iu �£� 6� w K � ��`.' y �t n � o� � r m n z W r� � o rn ,.� �• o cn o x df k � a r y,,, w � r• �„y � a o m a n��+f ��+i O � Y R z $ w rt O� W I��i iC % '77 r o a o ��+] n " °+ � ° � � •" G rr '-i °o ° t��ry1 � G% N lTl n � � �''�-, � � � � C�y 0 9 � M c�l� (�D ° rr o p' K7 tr1 N o ro .. a a o �� " o ° N K � ��° � � � a n � °d � :° o � `� r��, -�-�t � � �' °o ° w � A o`� oo c� r � G � y � -�--I m � � � � 2 m � � I I( I! ( I I I Iw I IN � m � m a x x x x x�; x x� x x � � v, Z, +a t„ tn tr, �v, �n r tn v, v, �v, v, N l!I O I-' W U1 lT� J O ll� lT� N N W a . . . . . . . . . . . . . . 0 0 0 0 0 0 0 0 0 0 0 0 0 o H O D O O O O O O O O O O O p [rJ � � �� N � o � � � � �i O x � r � z � � � H H N iM V � O tn tn in tn m +n tn tn tn tn tn in H a, o � 9 r 0 � � � 0 z ro t� d H m � M zy L� � ro �' � O a x H � ro � � 0 � W N �' Stories �. � � w a fi o �� n a er � � Closets m � E G Urinals ny r� x � DC Bath Tubs � � �° � � Basins o rt a � 1» sinks � � � � Wash Trays � N. N Drinking `Q � Fountains n� Showers n 0 �., Floor Drai O � �"' �' Catch �D � Basins � � Automatic a � Washer � � Gas Appl. Misc. Fixt £ y Gas Range rt� �y n Other m m w � (�D K � t� G H o C��! Z H W C7 Ci � � � N � c � �i � H y G � � o ro r� d � � r� H O L�' ''�J z •° rr-i � °o c�i [ro+7 � H 0 H r r � N � m w c�u y r rt ro tr' � ro�wt�o �� n rwC v�ii�-n W �i � wa �� m � `�w m �ao `� W o n w cnrrn fi � (�p p � `�C trJ C � � `° �' a p�t � � f�D W v � N K 0 "< � W rt � t�i r� �� w n � t-n E H �+Mxro � ft a �r m ro � � a�� w a w a � p ry N V] � � N O � � m � rt M • lb � Q M Z ro� a as � � ��- � � � w� � o � � ��wM U�i K i�-+ x M � �°�� art�x IV � � F~+ W {Mp N � .7 O ff r a v v r c� D --1 O Z �I 0 � "O E " 3 —� W -< � o -n D Z C � G7 �--� a m � r rn -n -� --I --1 . Z � -v m � � r u P, . S sue�ecr PERMIT N - City of Fridley o 8580 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � Z RECEIP O. COMMUNITY DEVELOPMENT DIV. � � � �� r� � L � PROTECTIVE INSPECTION SEC. � -- �� _ , -__.� �"'1,J CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY � , 612-571-3450 910-F15 8/7/86 / / JOB ADDRESS 6737 Jefferson Street N. E. t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 ], Rj,C@ Creek Terr. Plat 5 SHEET 2 PROPERTYOWNER MAILADDRES$ 21P PHONE Leland D�ossel 6737 Jefferson Street N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO. Victor Fridlund & Son 5700 Grove Street, I�ls. 55436 926-5364 4 ARCHITECTORDESIGNER MAILADDRESS ZtP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING ,�esidential 7 CLASS OF WORK ❑ NEW CI ADDITION � ALTERATION � REPAIR ❑ MOVE ❑ REMOVE X 8 OESCRIBE WORK Construct an 18' x 16' Dwellirn� Addition and a 15' x 12' Garage Addition 8 CHANGE OF USE FROM TO STIPULATIONS Provide a� hard sur�ace driveway. � jFjef°l� r/igg�� SEPI�RATE p � ��DNF, F�£ a�� ' , . WI�iIVG ERMITS REQ11l#��D �� FQ(Jj� �rRiC, Cqs �it,�s , HEATIN�, pLU�B�iV� ,��D fid B r FtE, sl�NS. �q t�, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOIO 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 CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION ], STALLS GARAGES AND KNOW THE SAME TO BE TRUE ANU CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND OFDINANCES OOVERNING THIS TYPE Of WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT ].�j OOO $%.SO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF AN OTHER STATE OR LOCAL LAW REGULATING CON- TRUCTION OR T PERFORM CONSTRUCTION. ],].O. SO ,� PLAN CHECK FEE TOTAI. FEE ��i�,L �t.F' , _ .�d,��' L�2�G � � s�,�" 3 145. 63 SIGNATUREO CONiRACTOROR UTHORIZEDAGENT IDAT WHEN PROPERLY ✓dCpIDATED THIS IS YOUR PERMIT �l ' � � l� G��cs�,i�� ' c`�/ SIGNATUREOFOWNER�IFOWNERBUILDER� �DATEi BLOG �NSP rl TE N�r I ] ADDN. [ ] pLTER. I � Construction Address: Legal Description: City of Fridley �R-1 AI�iD R-2 Building Permit wpplication 3 7 _�/� �. c..�� 3 �3�oc`c �� Effective 4/1/86 � �� c��.��. T.�. �lat �' Owner Name & Address : �P �� aSS� / Tel . � Contractor: ��C �� l Q`U�v c `S��L Tel .� Z� � 53i� Address : c7 ��O ��/ Is`P ��'�"-E' '� !� iJ�S � �s�, e �� /3 (o Attach to this application� a Certificate of Survey of the lot, With the proposed construction draWn on it to scale. DESCRIPTIOA OF IMPROVEMENT _ � � � � LIVING AREA: Length � Width l� Height � Sq. Ft. � CARAGE AREA: Length � Width � Height �_ Sq. Ft. � DECS AREA: Length _ Width Hgt/Ground Sq. Ft. � OTHER: �� P �`�� 1 ��. � l��c I�. � � ,ZO�. � �y,��.�� .orner Lot [] Inside Lot Ft. Yd. Setback _ Side Yard Setback � `� a.0 Type of Construction: I/j/4�/c� -tvC�� Estimated Cost: $ Approx. Completion Date: (/� � • ��`� � � ��6 r`� � o� � Alt. A Alt B � Proposed Drivexay Width If NeW Opening Is Desired: � $ See Back Page for Explanation , r � DATE: u • r � � Permit Fee Plan Check State Surcharge SAC Charge Park Fee SeWer Main Charge TOTAL STIPULATIONS• �� . APPLICANT : ' Tel . �� CITY IISE ONLY �%��•� Fee Schedule on Reverse Side $ ��•�� 25� of Building Permit Fee � �.� E.50/$1,000 Valuation � �475 per SAC Unit $ Fee Determined by Engineering $ � pgre�a��s� �lecessary [ ] Not Necessary [ ] � ��.�� Yc�� - �, �� G � �� _� ` � � i� �� y �� s , C / �� BIIII.DING PERMIT FEE SCHEDIILE The Chief Building Official shall� before 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 applicatio n therefore� require the payment by the applicant for such permit of fees to the amount herein belo� set forth and in the manner herein provided to-xit: Total Valuation �1.00 to �500.00 �501.00 to �2,000.00 �2,001.00 to $25,000.00 $25,001.00 to �50,000.00 �50,001.00 to $100,000.00 �100,001.00 and up Fees �10.00 (Minimum Fee is �15.00) $10.00 for the first �500 plus $1.50 for each additional �100 or fraction thereof� to and including �2,000. $32•50 for the first �2,000 plus $6.00 for each additional �1,000 or fraction thereof, to and including �25,000. $170.50 for the first �25,000 plus �4.50 for each additional �1�000 or fraction thereof, to and including �50,000. �283.00 for the first �50�000 plus $3.00 for each additional �1,000 or fraction thereof, to and including �100,000. �433.00 for the first �100,000 plus $2.50 for each additional �1�000 or fraction thereof. DRIVEHAY DEPRESSION ESCRO�W (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - DriveWay width plus 6 feet times ��3.5�D Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach With 6 inch de�t�i - Drive�aay Width plus 6 feet times $15.75 VERIFY��iION OF FOUNDATION Permits for construction xill be issued a minimum of �u hours from the time of application to allow for proper revieW of the proposed strueture and of the construction site. A Certificate of Survey of the lot, shoWing the location of the foundation onee it has been constructed Kill be required before groceeding With the framing. s v � �� "' �i - _,�A � � �_ � �� /�' �,�f �s � I �'•� .��, � �. 8 3 IY y,�pa �.�"� 4° i � � � -� �� o S�d � �� o `� �� , �p, . � � . ; � � , � ; , . , (�� 3� ' ;� , .� 7 � s i �� _ �. 07' � ��. � I � ��' !� � � � � c � � � K ir��-. � � � ; . fj �• 5� }S r� FRa�vl /i1E T�� sz�ld'7� �� J OC� j ?� 'J� 9�/7` — �7 �o'. �'�/Q . .> G!' 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' � ii , , hecess�; y; %eQC%v� _ � �-- �"- - � I_ . _ ' ; � � i ' � -� �.� - i �N � ._ _ F �� s► � � _ _ �� _ --, � . � a �'�� o �� - ! ; ' � � • � J� � � t � Y �1 � � � �� .' �� _` �,. ��' �` , ' �� ' � � i ` i .... IL:? � I ;� r� . t �J � ��' ; ;:; � ; '� I � f�r.•� i /y roos� � �� ; �� r.r,� . � clrct � � � � ' � add,'f�'or� ; .� i r �, I �� x .h s��.a2. � p' , � . � ; ,a,�, �� }, ' - , �� . - � � , ; �_, -�� - �,�, i , ,;, � ��f , �_ r; � i � �;� ' � , • ; i' i _. i , ,� , � , � . �_ t _ _ __ _ i , 4 � SUBJECT City of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � � `L _�� COMMUNITY DEVELOPMENT DIV. f � � PROTECTIVE INSPECTION SEC. 1 . , i_.--� �"' `,� CITY HALL FRIDLEV SSA32 NUMBEF REV OATE t 612-571-3460 910-F15 6/22/98 J08 ADDRESS 6737 Jefferson Street NE t LEGAL LOT NO. BLOCK TRACT OR ADDITION DESCR. 3 1 Rice Creek Plat 5 2 PFOPERTY OWNER MAIL ADORESS ZIP Lee Drossel 6737 Jefferson Street NE 3 CONTRACTOR MAII ADDRESS 21P B& B Roofing 6760 Madison Street NE, Fridley, MN 55432 4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP 5 ENGINEER MAIL ADDfiESS ZIP 8 USE OF BUILDING Residenital 7 CLASS OF WORK O NEW 8 DESCRIBE WORK Reroof House & Garage 9 CHAN(3E pF USE FROM STI PULATION S PAGE Of � � �RMIT NO. 2b�97 R� �.N /� APPROVED BV SEE ATTACHED SNEET PFIONE 571-5626 PMONE LICENSE NO 571-0248 9042 PMONE LICENSE NO. PHONE LICENSE NO. ❑ ADDITION ❑ ALTERATION �.7 REPAIR ,❑ MOVE ❑ REMOVE 7 Sq) Tear-off TO Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED FOH ELECTRICAL, PLUMBING, HEATING, � Trc vr a.vna�. v�,t,urP VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTtON IONING SO. FT. AUTMORI2ED IS NOT COMMENCED WITHIN 80 DAVS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONE� FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWIG. UNITS I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION 1 STALLS AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITM THER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �2 � 2S 1 DOE'S NO PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEL THE pERMIT FEE PF,,�OVISI S OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- S`TRUC ON OR THE PERF MANCE F C NSTRUCTION �74.75 � PLAN CHECK FEE License SC $5.00 SIGNATU OF N'RACTOAORAUTHOA�ZEDAGENT IDATEI WHEN PROPEFI VAI _ t}. a- �DAT6 �' � �r��.e� � �v OCCUPANCVLOAD CU. FT. OFFSTREET PAqKING IGARAGES SURTAX $1.12 SAC CHARGE Fire SC $2.25 TOTAI.FEE $83.12 D THIS IS YQUR PERMIT .� T NEW [ ] Effective 1 / 1 /98 ADDN [ ] CITY OF FRIDLEY `` � ALTER [] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION _` „�' ��'� �� ConstructionAddress: : °`� �f�/`"��–�� Legal Description: �L�c� %� G�-Jl � Owner Name & Address: � �� %�/�O � � � � Tel. # � �/— �la� Contractor: �� i�'l�r �L � MN LICENSE # 5D Gl � Address: . �p ��P� i�s'i�/–�71J l S / �� /�% Tel. # .,��` Dc� �� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length GARAGE AREA: DECK AREA: DESCRIPTION OF IlVIPROVEMENT Width Height Length Width Height Length Width � Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. OTI�R: � ^ �� Construction Type/�� Estunated Cost: $ o�� .5 (� /�%17�- —D�i� (Fee Schedule on Back) Driveway Curb C�t Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: lv � . % APPLICANT: Tel. # ,�7��D" Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL . STIPULATIONS: $ �� %�� $ ��2�`� $ �- /.� $ $ � , C�� $ $ $ $ $ � j . /� CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1 / l Oth %) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] BUII.DING PERMIT FEE SCHEDULE The Chief Building O�cial shall, before 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 $25,000 $25,Q01 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $5(}0 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,0� 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 additional $1,000 or fraction thereof, to and including $50,000 $574.75 for''first $50,000 p�us $6.25 for each additional $1,000 oL fraction thereof, io and including $100,000 $887.25 for first $100,000 nlus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.2� for the first $500,000 plus $4.25 for each additional $1,000 ur fraction thereof, to and including $1,000,000 $5012:25 for the first $1,C�00,000 plus $2.75 for each additional $1, OOQ� or fraction thereof DRIVEVi'AY DEPRESSIOI� ESCROW (Cancrete Curb Street� Only) Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B" : Removal and replacement �f curb and gutter a�nd install a 3 foot wide approach with 6 inch depth - Driveway width �plus 6 feet times $15.75. VERII��ICATION OF FOiJ�1DATION Permits for construction will be issued a minimum of 24 hours f'rom 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. �= _ � ,, � 0 � � m m m � � c 0 � m � m � � � � O � � � m � � O �-� �'m� m � 7 m a m o, Z co T O � � � N c � 7D o o � ? v � -� m v � z � v � -� m � Q Z � D Cn � � -° z `m v a m -°Dt 0 c cQ S � � v �' m I � m r 'n Z � o � � v ,� � � � � � �� C�'� �:-� � ao L� �� i� v� � c� o0 0o O z �� N N m m� � 3� � i c� °' g -o .n v �p -. � -, � � � o � � � � � � � � � � � � � ' � "O 4 � N � � z. r� y y(Q f�A < i i � � � � m Z � �.m v � � i � N � �. j T .fDn o' � � � c � m a � m � I � I I � I I I I I ( I I I � �tit� ��t�►tfltnt�t�tfl�n �JI O O O V p V�I V V(J1 A V 0 0 0 0 0 0 0 o c o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 V � 'v r c � m z � c� O � � > z � � � � � 3 m m a ci 0 � O � � � m � � . � z O � �' � m c a � � c N m a y � � � � � �5 � O � � m � � � J 0 0 > > v � a a m m 1 "'� �. � C �� C a � Q� a m y � y � °. m m' � 3 m o m � a (� y W O � m a Q �- o, c° °' 3 � � o � � o � �, Q1 ? 7 'p � � � �. � °- � p1. � � � a, o o � o � � � o 0 m a m w c c�i o �m � � m m f � o- ;� s o � � r. -, o � � � � m � m ��o __m.o_;� � � o � , � � v c � 00 Z �ii � x � m � m � z O b� --1 m � � � � O m � v � m � � •� V � A� r� a w �_, � � 7 0 s ,°A � < -� Z m � � �'• v �� N � � Z Z m -�o . � � O z v_ < ,-�_ � m a m O � � � _ � � 0 �o � , `ti � � � -r r� ';�.. �,; :!�� / � FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 Mazch 16, 2001 Lee Drossel 6737 Jefferson Street NE Fridley, MN 55432 Re: Final Inspection at 6737 Jefferson Street NE Contractor: Tim's Quality Plumbing Dear Mr. Drossel: i A plumbing permit was issued on June 3, 1999 to install a water heater at your address. According to section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the plumbing authorized by this permit. As of this date, no inspection has been called for. The permit fee paid covers the inspector's time to make sure the appliance was installed correctly. We also check to make sure combustion air has been installed and that the vent and vent connectors have been sized properly. If you would like the installation inspected, please contact us within 30 days to arrange the inspection. If we do not hear from you, we will expire the pernut and note that no inspections were called for. Any questions can be addressed to me at (763) 572-3603. Sincerely, D NSEN Buil Inspector / CITY OF FRIDLEY PERMIT NO.: 200�02223 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE IS5UED: 12/02/2004 (763 572-3604 FAX: (763) 571-1287 ADDRESS : 6737 JEFFERSON ST NE � 0 0 PIN : 143024130059 LEGAL DESC : RICE CREEK TERRACE PLAT 5 : LOT 3 BLOCK 1 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION . NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOII�TING PROPERTY OWNER COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. VALUE OF APPL OR WORK 0 # FURNACES 1 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR NIINIMUM CALC) 3000 APPLICANT HEATING PERNIIT MINIMUM FEE 0.00 SHARP HEATING & AC INC FURNACE SHELL/DUCT WORK 35.00 7221 UNNERSITY AVE GAS RANGE FEE 0.00 FRIDLEY, MN 55432- GAS DRYER FEE 0.00 (763) 572-0459 HEATING REPAIltS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 35.50 OWNER PAID WITH CHECK # 15048 DROSSEL LELAND E 6737 JEFFERSON ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or constniction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this applicarion and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or th erfo ce of construction. Applicant Date Bldg Insp Da� � SEPARATE PERNIITS REQUIRED FOR WORK OTI�R THAN DESCRIBED ABOVE. Y � v < a � � 0 c � � v °� N 31 � � � m � 0 � 0 O�a � 0 � 0 � � � �� o' n c �� , '� � rn O y , .� Q /'r\ a � � � �� ' , s m •m � � � '� � • O \ 'Q .' 2 A C � .� � � v rn w i � � N � 0 �� 3 N � � C o � � -On . � m � C w o (37 '"' �� b O ? O � � O �� O v Q tC r�'- � � � N ��i m � °' � � � � � rt r�-r, O � � � � � , O m � � rn w � � J N I O � 11� l� _ � � O x N a rt N- � A a� � c� H � � 1 'NQ L � � � � c . � ' � W � � � F � o�a' � � �. ;�� :o� ;o� � °_' 3 m � o � �'�d r � -�7 i � �. � � ��. r � p 7 � � o a� ` » � � � � m � � � � � � ' � -� � ,� ° � �� m � � n m = � o n � " a � y � � 3 � � � � � o � C �� fD 71 � t�D r�-r � p '�7 ��"a�; F� � v <8m� 3 /r. � O �p � N � C Ly � N g � 4 � � O `��.�� o = tn � o �. �, V � � �, � � � � fl. L'F 7 v�a � N L� N � � o�i v � c � N N y � O � � �� m �° � 3 c�D 0�R d � �+ Z � � � c�p °' . � .�* 4 �� o ('� � r-4 cD � � � � n �D . � � � � � �° � C1t O O O Ul g o g � � � � � � � 0 - - -- (c� r � � C � � � � � � � o � _ m � � � °- c� aa �� I � � �' � n o � 17 ni = O � � � m 7 m � � � a � r 0 m °' o vo v�'� � . � fD m z� 0 m a � � 0 � � $ a � a � `� v � O °' � �' �� h � m � � �. o , � � w a: �' � � � N � � Z � O A c,�ii � � � �' � � � � v z �V m � � � C '' v � � Z � m � � Z .�% � � r m � � �z � o � n � vo a� � m O � � v z � m � —{ � � � on z �.zv ��s c� _ � �� --1 � m � � � � 3s O � Z � � � a � � � n m V1 � � � � � � � Z � co c�. m � N O � City of Fridley MN �. FILL Ild CO�tfPLETELY FOR REPLACEMENT FUEL BURPt�NG APPLIANCE PERMITS COMNtON VENT. VENT CONNEGTQR AND COMBtJSTIQN AIR YERIFICATION Wher� realacina an existina fuenace, the undersigned I�eceby veri�es that the ve�ting has been examined and is free from rust, det�rie>rafiion, obs�ructions, and is securely supported and f�restopped where required. Yes� No () The venting system is plastic/PVC and meets all current codes and manufacturer specfications including s'izing, fength, number of elbows and termination. Yes O N� The undersigned also verifies tl�at ths replacement unit is a listed assembly and meets the cuRent codes and manufac�urer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliar�ces. The existina cc�mbustion air is sized and installed to meet the current codes and maraufacturer's specifications. When �}uired t4 install a�ew�cot�bustion air, it will be sized and installed to m�t the current codes and manufacturer's spec�cations. Ye� No ( ) Yes�%) No ( ) d" Ye� No ( ) When installin� a new ventin�t svstem, the undersigned hereby verifies that it is a Gs#ed assernbly and meets the cuRent codes and manufacturer's spec'�'tcations. This does include AGA-GAN�4 Category I Central Fumace Ver�ting Tables for fan assisted and natural draft appliances. Ye�� Is the common vent and vent connectors sized and installed correetly after an ap�aliance has been remaved from the common vent and vented separately as per cuRent code�s. No ( ) Yes �� No ( ) Aaaliance T,yt� and SizelGommon 1/ent artd Vent Cc�nnec�or lnformation Appliance #1 Type �►% � _ BTIJ Input �� Fan Assisted o Nat Appli�rice #2 Type ' ts f w«�� TtJ Fnput �� ssi . r t Appliance #3 Type BTU Input sisted or Nat Total Appliances Tc#al Btu Input �� Comman Vent Type - Verrt Height � Diameter � inches ApRlia�ce #1 Vent Connector Heigh# ,�ft Length ��ft Diameter �� in Type�,. Apptiar� #2 Vent Connec#or Height ��ft Length �ft Diameter �'�r in Type � Appliarrce #3 Vent Connector. Height ft L+ength ft Diame#er in Type HEATING CO: a Heatin & AC Inc %�ate : r�- ` �' � � Signed By: % BU1��Ii1�;- Inspections 7Er3-572-3604 763-502-4977 FAX BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY � Pertnit No. ��°' 01 �Q Received By:� Date Rec' d: So DATE / i�q. �oo U YOUR E-MAIL ADDRESS �� I�n� �J ��1 �j� O(� . C G�t. SITE ADDRESS �O% s�7 ��F�F-C/.SLY�J S� .R.d� �✓� THIS APPLICAATT IS: ❑ OWNER �CONTRACTOR PROPERTY OWNER/ NAME: L�' � !��'`�°'r''r�yk� �/'ot1°'c. � TENANT p�DRFC�:�•?3.� _'�.G��or� /l� CITY �� l� PHONE: �(0 3. S% I. SG�Ce ..��,§�Z - ZZ� ��1 SU A�y�Zrp s�_�� CONTRACTOR ADDRESS: ��oS� P��/@/C �S7L CITY /��'dl STATE�_i�IP �Sy�l2 SUBMIT A COPY OF pHONE �S� �.'�� _��5� FAX 7�7 Ss7 �/ � 1.3 � YOUR STATE LICENSE STATE LICENSE #�O�aZ.,�F/oZ � EXP DATE �, 3/. '�� / PROPERTY TYPE I,B'SINGLE FAMILYMEW CONSTRUCTION SIZE ' ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE 0�DITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN T1LE ❑ DECK ❑ SIDING � OTHER n ecimueen�n nrvv TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR �REMODELI DESCRIBE WORFC BEING ROOFAYG NUMBER OF SQUARES _ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum � Other WINDOWS IN EXISTING OPENINGS ❑Yes ONo OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE MSTALLED f� ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE HEIGHT `l�� SO Ff BASEMENT REMODELING SUBMIT: l. Existing Floor Plan 2. Proposed floor plan 3. List of slr�ctural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, OSoffit ADDITIONS. & PORCHES SUBMTf: ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Fascia and proposed project 2. Two sets of construction plans 3. Energy Calculations LOCATTON OF WINII�WS NUNBER OF ALL FEES ARE BASED ON VALUATION, INCLUDING TIiE COST OF LABOR AND MATERIALS: (U ING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ r�� OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ 7�� .�5 See Back Page for Fee Schedule $ ,�� 65% of Building Permit Fee $ �.�('� .001 times the total job valuation $ f�� .0005 x Permit Valuation Minimum $.50 $ j�D $5.00 (State Licensed Residential Contractors) $ $1825 per SAC Unit (Plans to MWCC for determination) $ ft+dft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $.�' o Make checks payable to: City of Fridlev 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 codrs 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 wo 'll be in accord ce with the approve lan in the ca%se �all work which requires review and approval of plans. SIGNATURE OF APPL ANT .�--- �.G � PRINT NAME �P/'�/ %��o.�.• dp�i r� DATE 2eO APPROVED BY C DATE �� Page 2- Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before 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: VERIFICATION OF FOUNDATION Pennits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. 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PAtaE 03 �18Q / 3103 • ��'i"f �7 t�' �7 � Building MECHANICAL Permit No.:�i�'OI �� Inspections RESIDENTIAL APPLICATION Received By:,� 763-572-3604 CITY OF FRIDLEY D�� 763-502-4977 FAX EFFECTIVE 1-1-08 Dp'�'� ^ O YOUR E-MAIL ADDRESS srrE Annt�ss �o °73y J 2 s aN cS�• ' THIS APPLICANT [S: O OWNER L9CrONTRACTOR PROPERTY NAME: OWNER/ pDDRESS: CITY STATE ZIP TENANT PHONE: CONTRACTOR COMPANY NAME: �I� NOTE: SEPARATECITY CONTACTPERSON� nn°4� �1,cc, e;c_�st� LICENSES ARE STATE LICENSE # EXP DATE REQUIl2ED FOR GAS AND HVAC. A�DRESS: I L�S� Z� N" eS� /V 1�. CITY S�- /+ti /�-F1/i�L STATE ��LIP�7(� SUBMIT COPY OF BOND pHONE �ZiQ.3° �'I4 �%^ %t�.�, FAX AND INSURANCE PERMTT TYPE 's „"'GLE FAMILY ❑ TWO FAMILY O TOWNHOUSE TYPE OF WORK: ��EW � REPLACEMENT [�'ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK (�:.2,�„��,..1� Gu,.�e�.�.� �-(o�� s�.-�v� /Za.�.�n /E�ir PER MS 16�.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (T'his should reflect only the cost of labor ) OR L�.bor cost under $300 =$15.00. La.bor cost between $300 to $500 = cost of la� �.%D, m a x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELAt� Equipment Installed MFG: MODEL: S1ZE/BTU MFG: � MODEL: SIZE/BTU IvIFG: MODEL: SIZEBTU _A/C $25.00 _FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 _AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $]0.00 BOILER $35.00 FLFitNACE $35.00 GAS UNIT HTR $10.00 CHIMNEY LMER $10.00 GAS DRYER $10.00 PQOL HEATER $35.00 DUCT WORK $]0.00 GAS PIPING $10.00 VEAITILATOR $15.00 — ��`�� , . � �a �" F. � �� ". ¢,_ ;_.. ��F � �� 3�.,�. �� - _ _ _ . . .-- .� ,... � A._.. _.. , >: �...�M... � �� ,��. _� � � �� . � t �. Permit Fee $ Number of fixtures @� $10.00 x$] 0.00 =$ Surcharge .50 Number of fixtures @$15.00 x$15.00 =$ TOTAL DUE $� OR Number of fixtures @$25.00 x$25.00 =$ Number of fixtures @ $35.00 x $35:00 = $ State Swcharge = $ .50 MINIMUM $15.50 MINIMUM $15.50 Total = $ THIS IS AN APPLTCATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a mechanical permit and I acknowledge that the information above is complete and accurate; that the work will be in confom►ance with the ordinances and codes of the City of Fridley and with the Minnesota Conslruction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT (.�--.. PRINT NAME i� �'�.vi�/� DATE /O— ?-o� APPROVED BY DATE �� `S>'�,�. �� a�,��,��.. M°�� %�, a ,�: City of Fridley � �� Building Inspections Department i 6431 University Avenue NE, Fridley, MN 55432 � a`� 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES` 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations. Buildi.ng � PI,UIVI$II�TG Permit No.:��`��` Inspections �i �j��+ ��`jAT Ap�LICAT'IOl\T Received By: 763-572-3604 CITY OF FR�DL]EY Date��'�i:�CT � 7 20 � 763-502-4977 FAX E�cr,v�l-,..os DATE /�°� 7—�� YOUR E-MAIL ADDRESS srre �nxsss �3? �e �s�a/ cS N F � THIS APPLICANT 13: ❑ OWNER �2dNTRACTOR � PROPERTY NqME: OWNER/ ADDRESS: CtfY 3TA'I"E ZIP TENANT ' PHONE: corrr�,c�roR N,�: n..�- o� b� �� SUBA�IIT A COPY OF STATE LICENSE #� �� ^ l� � EXP DATE YOUR STATE LICENSE. BOND AND STATE BOND # 9.3 O 7�/ 9.� I EXP DATE . CER'I'IFICATE OF ,qDDRESS: 1 l�S� 2. �� A%�. CITY tS'sL •%h i �-�/� STATE /y►N ZIP?�� 7 6 INSURANCE . PHONE �I 3 ° ei � % � � � .� I FAX PERMIT TYPE �GLE FAMILY ❑ TWO FAMiLY ❑ TOWNHOUSE TYPE OF WORK: ❑ t�w �ri.ACE�nrr DETAII.ED DESCRIPTION OF WORK /+�l o �a-� 1��,� P,�. �� 1 � 1�+5,�,.!/ k.��`• 5��;l.0 , a c,..� a. ; ce.� lc.v� PER MS 16B.665 the permit fee is a minimum of $15.U0 or 5% of the total cost up to 5500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This shauld reflect oniy the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = c6st of labor x.OS = plus .SO surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500. FEES ARE $ASED ON $]0.00 PER FIXTURE, EXCEPT WH£RE NOTED. FIXTURES: (INDiCATE TOTAL TNMBER OF EACH BELOV�. MINIMUM FE� $15.50. BATH SIIIIULAV _FLflOR DRAMS SHOWER _ WATER PIPING BATHTUB GAS PIPING (NEED C1TY L!C) SW1MMiNG PO�L _ WATER SOFI'NER ($35) CLOTHES WASHER I KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15) � DISHWASHER _ LAUNDRY TRAY _WA7'ER HEATER ($35) FOR IRRIGATION WATER METER OTHER . � � �.,`.^ � -� ,�,� Y'K �o _' •''�3 S " Permit Fee $ Aiumber of fixtures @$10.00 x$10.00 =$. Surchar e .50 Number offixtures @$15.00 x$I5.00 =$ TOTAL DUE $ OR Number of fixtures @$35.00 x$35.00 =$ � State Surcharge = $ .50 $I5.50 (MIMMUM $15.50 Total = $ THIS LS AN APPLICATION POR A PERMIT-NOT VALID UNTIL 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 appGcation 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 all work which requires review and approval of plans. SIGNATURE OF APPUCANT �—�-��- ��^-9 PRINT NAME °/ i� ��y�'� � DATE �� °%' �� APPROVED BY DATE ��w�� ; �x. - �-��"��.. `a City of Fridley �uilding Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL P�t No.: `? Inspections RESIDENTIAL APPLICATION R�"'� B R; 763-572-3604 C�y OF FRIDLEY �� p � 763-502-4977 FAX ��,� 2_,�,, DATE //� g�� YOUR E-MAII. ADDRFSS SITEADDRESS �Q�I.�-! ��.TF�P�On S�'. N.c. THIS APPLICANT IS: ❑ OWNIIt �ONTRACTOR PROPERTY x,,,,�: L c r 1 ow�vE� Annx�ss: (o'� 37 3'e�i'Fu'So� .�1�. crr5r �t �•1/�,/ sTn�/nz� � RE 7 TENANT PHONE: ��D � •� �% I � �(� °�Z � J CONTRACTOR co1�� N.�: .��eChrmloQ�� Inc. SLJBMIT A COPY OF �NTA� P�ot�B Fir�Hearth & Home YOUR STATE STATE LICENSE #�_�� oya. E3� DATE LICENSE WITH ADDRESS: 96VH19� NIN 55113 �� STATE ZIP APPLICATION � PHONE 851I FAX PERMIT TYPE �CSINGLE FAMII.Y ❑ TWO FAMII..Y ❑ TOWNHOUSE TYPE OF WORK: �� E�T o n�-'rmn'r►ox�onE[. DETAILED DESCRIFI'ION OF WORK �/� �w I � �jc� ; t�p � 6 � �.� �,v sS f� t FEES ARE BASID ON $10.� PER FIXTURE, CEp'� WHERE NOTED. FBCTIJRES: 1CATE TOTAL NUMBER OF EACH BELO� Fa��r �uea �G: Ca 4., � 1 o tr[onn.: a I'sr► � x� s�✓s� —ti�,�t� MFG: MODEL: SIZFJBTU MFG: MODEL: SIZFJBTU A/C $25.W —�LACE (GAS) $I5.00 GAS RANGFJOVEN $]0.00 AIIL TO AIR EXCHANGEEIt $15 FIREPLACE (WOOD) $35.00 NEW GAS GRII.L 510.00 BOII..ER $35.0� FURNACE $35.� GAS UNTP H7'R $10.00 CIiIIvINEY LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.1K1 DUC1' WORK $10.00 GAS PIPING $10.00 VIIVTILATOR $15.00 Number of fixhues @ $10.00 x $10.00 = $ Number of fat�ues @ $15.� x $15.00 = $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixhves @ $35.00 x $35.00 = $ St�te Surcharge = $ .50 /j�� V FEE $35.50 Total = $ THIS IS AN APPLICATiON FOR A PIIiMIT-NOT VALID UNTIL PROCESSID I hereby apply for a building pern�it and I acl�owle�ge that the informatian above is complete and accurabe; that the work will be in conformance with the ordinances and c�odes of the City of Fridley and with the Mim►esota Construc6on Codes; that I�mderstand this is not a permit but only an application for a pennit and work is nat to start without a pennit; that the work will be in accardance with the approved plan in �►e case of all w which req�rires neview and approval of pla�ss. SIGNATURE OF APPLICANT PRINT NAME /�Cd I`<! r/'I� S 6 f e DATE /� �% PLEASE NOTE: SEPARATE PERMITS ARE RE tJIRED FOR BilILDING, II,ECTRIGAL AND MECHANICAL WORK c:ity of i+'ridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977