The URL can be used to link to this page

AF - 47875SUBJECT City of Fridley . 1321 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � ; � R��O� � � • COMMUiJITY DEVELOPMENT DIV. i Vy �� r � � PROTECTIVE INSPECTION SEC. 1 � �� ' �'�'1 � CITY HAIL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY ----�•' '�� 6�2-56o-3a5o 910-F15 9/22/75 / / JOB ADDRESS 1430 Kerry Ci rcl e N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. $ � Heather Hi 11 s 2nd Addi ti on SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bruce Anderson 3 CONTRACTOR MAIL ADDRESS Z�P PNONE LICENSE NO. Commercial Erectors 5298 Fillmor Stree N.E. 4 ARCHITECT OR DESIGNER MAIL AODRESS ZIP PHONE LICENSE NO. AM 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING re ' ' a 7 CLASSOF WORK CK NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 82�E x R�� "�iouse 22 x 28 garage 9 CHANGE QF USE FROM TO -c�,,s� K STIPULATIONS Before digg►ng ca�� ocal utilities 1. Provide a verification survey T�LEPHONE-ELECTRIC-GASEtc. 2. Pr vid a ar s f ri REClU�RED �Y �-p`� o e h d ur ace D ve 3_ S�" Fa,w�r d 5.,�,� p'�- paid $400 storm sewer escrow 9/22/75 SEPERATE PERMITS REQUIREQ Fp� �yJ}�«J�� HEATING, PLUMBING AND SIGN.S.. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING Of? AIR CONDITIONING. WQQ() f �"ame THIS PERMIT BECOMES NU�L AND VOID If WORK OR CONSTRUCTION ZONING SQ. FT. C FT AUTHORIZED IS NOT COMMENCED WITHIN 60 �AYS, OR IF CONSTRUCTION ��2,q. OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TtME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PA KING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE Of WORK WILC BE COMPLIED $3(�,350 �9.GH 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 PRO NS F ANY OTHER STATE OR LOCAL LAW REGULATING CON- $47. CJ7 $325. OO ST ION R THE PERFORMAN E CONSTRUCTION. � � PLAN CHECK FEE TOTAL FEE �. � $392.25 SGNATUREOFCONiRACTOR AUTHOR12EDAGENT IDATEI HEN PROP LY VA D THIS S YOUR PER �fIT �C.%��'� r/ y 7s.}- ' SIGNATUREOFO ERIIFOWNERBUILDERI IDATEI BLDG INSP DATE •' t. �1'I'LICl1TION FOR RI:SIllLNTInL, r1L'1'I:1:AT?�1�, OR I�llllITION 13UILDING PEIZI�IIT CITY OF FP.i.DLEY, MINN�SOTI� ,/ � � ' �/�.� � : � / i��. r..� � , �, • _ . � � _F � � � • °� � � �..ri��..� � �/ � NU : •. S TR�ET • LOT : � BL4CK: • ADDITION : %��, ��'`�C � �` CORN�R LOT: INSIDE LOT: � SETBACK: SIDL'YARD: Applicant attach to this forcn Two Certificates of �urvey of Lot and proposed building locatioLz drawn on these Certificates, DESCRIPTION OF BUILDING To Be Used Ass � _ Front : 2�Depth : 2 G Height • 2� Square Feet : Cubic �Feat :�(�21�� y � -� Front: Z�-! 'Depth: �Z � Height: � S� Square Feet; D Gubic Feet; ��d Type of Construction: ��2i1'/V%� Fstimated Cost: $ �� "�� To Be Completed: The undersigned hereby makes applicativn fox a permit for the work herein speci�ied, agreeing to cio all woxk in stxic� accordance with the City of Fxidl�y Urdinances and rulings of the Department of Buildings, and hexeby declares that all the facts and iepresentati�ns stated in this appli.cation are true and correct. . � DATE : � ...�._._ SIGNATURE : ^ (See Reverse Side �'or Additional Informatio�.i.) . � � � � ��-R = y �. � 7�1' = / g, 68 S!1c ! 3z ��,�" o� �q 2 Z.s .- . � � .,�, � �__ -�,,,. �.�7 �S '��.�,rL 2. �/ � � s[Q, 3� Z�: ?�C 2�� 9�{ �'x A a 5��-�.-�,.�Q¢. !�' Z�� X z� = G9►N �� x S�- S'SSz ��',. , 2� z�.3X �� _�7io x iz � 8�'ZV - GgaAr.Q,,. Z� � X Z. 2= �� °�r iu = � v�d �^ .I�` � -- ` -_ .�. ''�� 1 ( M _. . _ _ _ I �9�X �� z 3� z3 ,o� ____ _ _ (�1 �l � 2?. 60 � I�; bgy yd _ rj� � i�x Z?. �c� ~ 1 �� 0�16, o0 G o 1 � �! �la -� � 6�1 � (�O.o o d1.. 3�. 3S� �' , s' �► � 1�.G� �� 3 — - , �ssZ- SS'� Z iY �'"L O �g G �� °�° � Z.� 7 � ��'�C /. � s = y� S� � ��n y� �� ' /9. � � S,D�' � t�': o0 ,� Z 2� 3� . ,. � . � . . . Ci�i a� �cic�iey • . �'�a��i��sz�a� �c� i'Ic��sg ��a�a �� Ft�a�� Pe�� ---------�--�---- Dept. of Btdqa. Phoa• SE0.34S0 . DESCRIPTI02d GF VlOI::L �� • f�l��j1` �J o� ' Num�sz. Kiad ased l..oerifca ot Flsiure� � c° �-. � ��' tj WATEt MTII. �+►7 va s+auac�. a � .N N S W = � � ' c �� z� � �.� Z 5�j 7 7� 7` r w c�s ncc. The uadersigned hereby tnskes applicatian for a prrmit tor thr wozk heni _N .; �, i� � N�; . o� � g o S�< 3 u� u. o$ Specified, agreeing to do all wo: k fA s:rict accordance with the CitJ OrCinana �a:t 1 �1 • and ruliag of the Department of BuiIdings, ared hereby deciares that alt the facl •. and represe�ntations siaced in this applicatiaa are true arxi correct l st � .... 2r,d ' % Fridley. Mian �� 19 ��^� 3: d Owner . �th Kind oi Building '. "Futurs Ccnaact:ca Gp:.nin;�Y Cos�re::>d wiYn Sesaer ❑ Used as • Nsrr i'is:f�rv. �2d O;�n.ir:�s Cc:rpcol � . � � , - � - To be completed about PARTIAL RATE SCH�DULE ,. est;m3,�a cos�, s OS --- ew tiuiiding Perrnit No.�� P.rmit No. �-S /� PLtTMBING F`IX'I'URE RJITES: N�. RJ1T$ TO?AL � �� U11i�fi '�XtUiCS • • � � �.•. • � � • . • • • / / X y��.� .�_�, a � .�'1l$i1Cd il�ture Flxture O��cning . . . . . . . . . . . x 51.50 S__. ' . gy � � � . _.. �Tew Fixture Old Opening.....:.... x S1.5Q f--.:__. , Businrss Ph�ne No . Catch Basfn . . . . . : . . . . . . . . . . . . . . x 53.25 ; Water i{eater '.Up to '59.000 BTU�• •, • � � x S3.C� S ' � Q �• ' ROUGH :.'ew Ground Run Old 8:dg. . . . .•. . •. . x �.3.25 S FJsccrle Pl.!•s Haat�r . . . . . : . . . . . . . . s $2.Gt� s�� FINAL �R.3 FITTING FEE$: 2�I0. RAT'E TOTAL • � i�Si �.3'�'1X:11ICS • • • i � � � � � � � � � � � • • • X S.Z.� ��-..QL�.��. .. . . . . � . Addltioaal Flztures . . . . . . . ,.. . . . . . x ; .75 S • Gaa; RanYe to I94.00d HTU . . ... . . . . .. , x S5.t30 6 • ^�T':.�RS ir 11LTER1ITIONS--A�fss !o Cod� .50 Stdte Sttz'Ch3rgB • De«criycion . . . . . . . . . . . . . . . . . ."... . . . ... . . . . .... �. . . . .� • ; T`CYrAL l� EE S�1�a1.�.�.�.� � � 'CY � , • � � • ' � . sue�ecT PERMI . City of Fridley 19619 ' AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � R � � • � 1 y_ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. a 9�jr �/ � � � i.--- A;��'�,'j CITY HALL FRIDLEY � 55432 NUMBER REV. DATE - PAGE OF APPROVEO BV � l J` 612-571-3450 9t0-F15 8/4/88 /� / . JOB ADDRESS 1430 Kerry Circle N. E. i LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. $ 1 xeather Hills 2nd Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE Bruce/Joan Anderson 1430 Kerry Circle N.E, 574-1006 3 CONTRACTOR MAILADDRESS Z�P PHONE UCENSENO. Same 4 ARCHITECT OR DESIGNER MAII ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAII ADDRESS Z�P PHONE LICENSE NO. 6 USE OF BUI�DING Re sidential 7 CLASS Of WORK O NEW C� ADDITION ❑ ALTERATION ❑ REPAIR � MOVE O REMOVE 8 DESCRIBE WORK Construct an 18' x 13` Three Seasan Porch Addition; 7' x 8' IIitry Into Garage 9 CHANGEOfUSEFROM TO STIPULATIONS See notations on plan SEPARATE PERMITS REQUIRED FOR �� A��G INIRfNG, HEATING, PLUMBWG AND SIGNS. ore diggipg cali �ocal utilities TEtEPHONE - EIECTRIC - R�QUIRED gY GA,s Eta. � LA1�V SEPARATE PERMITS ARE FEQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV �OAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTpUCT10N ZONING SQ. FT. CU. FT. AU7HORIZED IS NOT COMMEMCED WITHIN 60 DAYS, OA IF CONSTRUC7lON 'OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING I HEFEBY CEFTIFY THAT I HAVE REAO ANO EXAMINED THIS APP�ICATION 1 STALLS 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 �`j_].,750 S5•88 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqMITFEE SACCHAqGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. S13S.00 ,. PLAN CHECK FEE TOTAL FEE . ��, �` � - :� � � $140. 88 . SIGNATUREOfCONTRACTORORAUTMOAIZEOAGENT IDATEI WHEN PROPER VALIDATED THIS IS YOUR PERMIT � • � �� -- SiGNATUFiE OF OWNEA IIF OWNER BU�LDERI �DATEi BLOG �NSP � E 2�7�T [ ] • ! �1� AL�R [ ] City of EYidley R-1 ADID R-2 �,;�ding Permit Application EEfe�ctive 5/L88 Construction Address: � y3d K�2rc� L c 2�� 2�nLE� M�� y3� Legal Description: �o � gS� at.Gt �I t��-Thr�e tirti'�S F� �� -_ " - - -- Owr�er Nanae & Address :� Qu c, �. r- '� a+ n.c � ni A e res o�v Tel. # S ��( -! b o c� Q�ritractor : � -�cr ` - - } Tel. # Adc3ress: Attach to this a�ppl ication, a Certif icate o� Stixvey of the lat, with the proposoed oonstructio� da�a�m on it to scale. 354�,� �to��'. L1ESQt7.�TI01�1 OF II�RW�� • Lenc�tl�► t 8 F � , GAR�� AR�,: I,ength wiatn t a FT. Height st�. Ft. a3� Width Heic�t �. Ft. D�QC ARFA: Length V Width �� Hc,�k/Grot�d �. Pt. �0 • : 1� �5.. a3 �a '8� �48�� 3 x�t,9�4�33�3z t a �x �. 2n��, + �4 . ��x . a� z II �v�� °� (brner Lot [� Inside Lat [�Sl Ft. Yd Setback Side Yard Setbacks 11,� SO•o d Type of �nstructionl Q�S�af�t"TiA�. � woba �ir.�-.�.� Estimated Cost: S-+�-re+b I I,'�`v Approx. Comple�tion Uatet SEP`t, a8 At� A Alt. B Proposed Drivavay Width If New Opening Is Desired: S S_ Width + 6' See Back Page n�: Au� a - gg �t.ic�rrr: �n�.�. � . ��.t � State Surcharge SAC Chsrge Driveway Escrow Park F�ee Sewer Main Q'i8rge � srr.�cn.��: .� ,�F� a^`� �,., ,�, : :��:.. �� : ��"� �f'' s 3s,c� S � g� � S S S � I.�a � i CLTY DS� �LY Tel. # S�y�loo�o l�ee Scheciu].e on Reverse Side 5.50/51,000 Valuati� 5550 per SA�C Unit Al� �• or Al� �• Akaove Ftee Determ3ned by Fhgineering 1�gr� Neoessary [ l Nat Neaessary I] i I, �� u e t,--- I o Y°i wS,O� 90 �3�° sue�ecT PERM ___ City of Fridley �%f�� 6 � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T " f ; � RE IPT NO. � COMMUNITY DEVELOPMENT DIV. , �,,------ . � / � � r � � PROTECTIVE INSPECTION SEC. i � � ' /'��\ � CITV HALL FRIDLE� 55432 NUMBER REV DATE PAGE Uf APPROVEO 8� �"'""�"� ��' 612-571-3450 910-F15 8/16/95 / / JOB AODRESS 1430 Kerr Circle NE t LEGAL LO7 NO. BLOCK TRACT OR ADDITION SEE ATTACHED oESCa. g 1 Heather Hills 2nd Addition SHEET 2 PROPERTY OWNEF MAII ADDRESS ZIP PHONE Joan Anderson 1430 Kerr Circle NE 574-1006 3 CONTRACTOR MAIL ADDRESS Z�P PHONE �ICENSE NO All S stems Roofin Inc 2340 Charles Dr St Paul MDT 55114 646-3533 8963 a AqCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO. 5 ENGINEER MAII ADDRESS Z�P PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION � REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House 19 S 2nd La er 9 CHANGE OF USE FiiOM TO STIPULATIONS Roofing can be the 2nd layer but not 3rd. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REOU�RED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PEFiM1T BECOMES NULI AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. fT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEFiEBY CERTIFV THAT I HAVE REAO ANO EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND OROINANCES GOVERNING THIS TYPE OF WORK WI�� BE COMPLIED WITH WHETHEf: SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 1],/{O .S% DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS Of ANY TE CAL LAW REGULATING CON- STRUC T MAN E OF STRUCTION ({Q 2 Fire SCi 1. I�F "'.- -.. ,_ \ LAN CHECK FEE TOTAL FEE _ .._--- ._._ � -1l� �`� S 46.96 ATU�7EOFC � ACTOFlORAUTM0�71ZEDAGENT i0nrei . WHEN PfiOPERL VALIDATED THIS IS VO R PERMIT F 4 SiGNATURE Of pWNEAUF OWNER BU�LDERi IDATEi BlD �NSP D6TE .....�x.,......,h^ch^.�c:.....,,........ . . ...... .......... ...............,..... .....,,.. _ ... ...... ._......... NEW � l ADDN [] ALTER [] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: l �J? 0 Legal Description: Owner Name & Address: Contractor: � � Address: � � � U r r �. � Cffective 8/ 1 /95 � /a,�,� ,�I i., � ,-� �,�.t�--�r��, Tel. # �� - ! 0 O � S�yy�,s �m ' h � . _ MN LICENSE # � � � � �ta�-P� _ �� 11. A� �t� Tel. # �U �U " �� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT I;IVING AREA: . Length , GARAGE AREA: Length DECK AREA: Length OTHER: 1 ��5� - _ �rv Widtli � . . H�igtit Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. Corner Lot [] Inside Lot Ft. Yd Setback Side Yard Setbacks Type of Construction: 8 Estimated Cost: $ '� _ . Approx. Completion Date: � ` Z- ��l3 (Cost ack) Drivewa Curb Cut Wi Needed: F �— t x =$ DATE: � � � b '�� APPLIC T: Tel. # '" �� . �ITY USE ONLY Permit Fee Fire Surcharge Sta.te Surcharge SAC Charge License Swcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ -� S Fee Schedule on Reverse Side $ /, / � .001 of Permit Valuation (1/lOth%) $ . S'i $.50/$1,000 Valuation � $ $850 per SAC Unit $ S, ��O $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engine�ring $ Agreement Necessaiy [ ] Not Necessary [ ] $ "7 • � STIPULATIONS: . CITY OF FRIDLEY INSPECTION OIV � 6431 University Ave NE Fridley, MN 55432 572 — 3604 Stories Basement Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES; Urinal � �� APPLICATION FOR PLUMBING AND GAS FITTING PERMIT � MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR t(�<:;;: Was h ;4r"`.;.:<;:>:>::i:`' Flo ;;;;;:;:>:::>;:<.>: (n. or .:;:>:::>::<:<: :> :::;:: >:.;::>:::>:>:>:::< .k.:::;::,:. G'�tG�i::<::>: Auto. �as::`:<:::: ki; :` Shower Sink Tray �outlt .. Drain BasEn. '"` Washer Appl. ': 0 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 $ � 0.00 $ 7A0 $10.00 $10.00 $10.00 $15.00 Reinspeciiori I-ee $42.00/I-ir ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5�� of Value of Fixture or Appliance State Surcharge TOTAL FEE .50 $1:.�.L'..7LJ Effective On January t, 1997 Gas >fttl;is�;�:�}<: Water H eater ; Range �i�it>»:;:;�`:: Gas Elec , ' - t � � �. . . i:vL:: .. . . � - . .. ' ��` ' . �' � JOB ADDRESS �� C��_�L'� The undersigned hereby makes application for a perm it f,�r the work herein specified agreeing to do all work in strict accordance with the city �codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. I 7/3� , 198b � ANDERSON,JOAN 1430 KERRY CIRCLE NORTHEAST Owner FRIDLEY, MN 5�432 (612)574-1006 Building Used As_�g�b�� PERMIT NO,_ l��l� Estimated Cost PLUMBI� SIGNED � Approved By �� Rough—In Date Final Date C� Z� MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20 00� ��v( PLUS THE $.50 STATE SURCHARGE **COMBUS110N AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SG1 INCHES. U CITY OF FRIDLEY INSPECTION DIVSION Effective On January t, 1998 c�P 6431 University Ave NE � / Fridiey, MN 55432 , APPLICATION FOR POWER PLANTS AND HEAT{NG, COOUNG� VENTILATION� 'y' 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES _ JOB ADDRESS l� 3 a �� r�' � ct+� �� RATE SCHEDULE • Residertiai - Fumace Shell and Duct Wbr{c, Bumer – Also Replacement Fumace (Side Ve� – Fili Out:Back) Gas Piping (Needezf wiw new fumace) Gas Range � : Gas Dryer �.: .. *Air Conditioning = AI! SiZes . All Othe�s/Repai�s $ Alterations (UST ON BACIq 196 ot Value oi AppGance or Work Commercial/Industrial 1.2596 of Value of Appiiance or Work Rate $ 30.00 $10.00 � 10.00 -� S 10.00 ;.. � 25.00 r State Surcharge TOTAL FEE TOTAL $30� � $ $ (. $ `a,S � $ $ $ .50 . 5$ S, SO ; k�NIMUM FEE FOR ANY F�ATING/COOUNCaNENi1LAT10N � REFRIGERATIONIAIR CONDITIONING PERMIT tS �25.00 PLUS THE 5.50 STATE SURCHARGE � REINSPECTION FEE $4200/Hr The unde�signed hereby makes application br a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and ndings of the Building Division, and hereby cfeclares tt�at all the tacts and representations stated in th+s application are tn�e ar� c� 5 ,is�'f .�. QWNER �G'� Il�e!'SO✓► BULDINGUSEDAS �4►�e q �+ Esn�r�� cos� � � ��ur rvo. � DESCRtPT10N OF FURNACE AND OR BURNER No. oi Heating UnRs l Cirde One (Stc�am) (Fbt Water� � Alrj �� Trade Name A,� Size No. � �W B� HP EDR Fuel Total Cornected Load BumerTrade Name �''�ti�� SizeNo, � �1_ � ��1° � HP EDR �� t�nrv� co�avY «ts�ON1�E Signed By— - - ' •.• • :• :� 'Air Conditioners can not be placed in a side yard witho� FILL OUT BACK SIDE FOR written permission from adjoiMng property mNner. REPLACEN�IT FURNACE ��. �{�' 7�y - 6�ao � Rough–{n Date Fnal Date 1'�'"�9 VERIRCATION ON Building BUILDING Pe�it No.: � � '�`� -� ': ' � �c? Inspections RESIDENTIAL APPLICATION Received By- - �63-s�2-3bo4 CITY OF FRIDLEY D �c 763-502-4977 FAX ��-U �� EFFECTIVE i-1-08 DATE � I S d 0 YOUR E-MAIL ADDRESS ��✓1 � rI I 11c� �('�e.�1 a hS • CO^1 SITE ADDRESS � —f 3 {% �--r� � THIS APPLICANT IS: Q OWNER CONTRACTOR PROPERTY OWNER/ NAME: �Oa/1 n�('� n TEN ANT qpDR6SS: ( 3� K�� ^ CITY �r ��(�� STATE M ZIP PHONE: 1ib3 57—I— ��O �i . NAME: a� r► x e.r � o,r nC CONTRACTOR ADDRESS: 3� I �� o. I V�= CITY F i �� STATEM� JZIP S5 Z SUBMIT A COPY OF pHONE ��a� 7� '� q 3Cv FAX 7� 3�l7 ' 3 OC�� YOUR STATE LICENSE STATE LICENSE # � ��`2� �Z OC� EXP DATE PROPERT'Y TYPE SINGLE FAM(LY/NEW CONSTRUCTION • S1ZE ❑ WO FAMILY/NEW CONSTRUCTION STOR[ES PERMIT TYPE ❑ �DITION p�GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINiSH (,�ROOF O DRAIN TILE ❑ DECK �S, SIDING ❑ OTHER ❑ SWIMi�tING POOL TYPE OF WORK: � NEW HOME CONSTRUCTION �ADDITION � MAMTENANCE/REPAIR REMODELING DESCRIBE WORK BEMG DONE: I'�" Y"� O , 'r 2.— S1 C. SIZE OF IMPROVEMENT LENGTH WfDTH HEIGHT S fT ROOFING ❑ HOUSE OM.Y NUMBER OF SQUARES 2'-� ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT• 1. Existing Floor Plan GARAGES CJ ATTACHED GARAGE 2. Proposed floor plan PROPOSED 5IZE: ❑ DETACHED GARAGE 3. List of structural members to be used, PROPOSED HEIGHT: SmING FOR t�7EW CONSTRUC7'ION INCLUDMG DECKS, ❑ Vinyl OSoffit ADDITIONS & PORCHES SUBMIT• ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures �Other et— ❑ Fascia and proposed project 2. Two sets of construction plans WINDOWS 3. Energy Caiculations IN EXISTING OPENINGS ❑Yes ONo LOCATION OF WINDOWS OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUIvBER OF WINDOWS ALL FEES ARE BA�$ED ON VALUATTON, INCLUDIlYG THE COST OF LABUIZ A1Vll MA"1'L�'K1ALJ: tiV S � 1997 UBC FEE SCHEDULE) AL JOB VALUATIUN $� , OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Gut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ ��.�o� S $ $ $ . b $ �. UC�— $ S $ $ $ ,. _ � i See Back Page for Fee Schedule 65% of Building Permit Fee .001 rimes the total job valuation .0005 x Permit Valuation Minimum $.50 55.00 (State Licensed Residentia! Contractors) $1825 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ �450 Conservarion Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach THIS IS AN APPLICA'CION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a b� ing permit and I acknowledge that the infortnation above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley an ith the Minnesota Construction Codes; that I understand this is not a permit but oniy an application for a permit and work is not to start without a permit on site; that the work ill be in accordance with the approved plan in the case of all work which re review d ap roval of plans. SIGNATURE OF A A r,-�� PRINT NAME �=�� d �'� � h� DATE 17 �$ � � APPROVED BY I� ��% J�� I DA