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AF - 47821__ : City of Fridley, Mi.nn. BIJILDING PERMIT No s o 5� Date: """ t�' ` ""� � ,, '� � .•�� Owner: Builder --�� Address Address — �+ � O TI B ILDING No. .s�� st�� _��.�! _.�:.. � o t Lot ,�.�� Block ' Addition or Sub-Divi�ian . 6�' u '-� a .� ,/r Corner Lot — Inside Lot _. +�"'' �tback '` ' Si yard __ _ Sewer IIevation _ Fo tion IIevatian DESCRIPTION OF BUILDING T U as: , �Yont ��.�.. Depth _.p�� Height �,� Scl• F'w ��Cu. Ft ��!,�� • Front DeAth �eight � Sq. F't. Cu. Ft Type of Conatrvction��'_�.�� ' Est_�.�..,�E�;--''"'_'�To be Completed In consideratlon of the issuance to me oP a permit to construct the buflding described above, I agree to do th� proposed work fn accordance with the deacription abwe aet forth and in crnnpliance with all proviaions of ordinancea oY the dty of Fridley. _� In considerat3on of the payment of a fee of ��_�`� , permft fs hereby granted to to coastruct the building or additlon as described above. This permit is gra.nted upon the express condition that �he person to whom it is granted and his agents, employees and worl�en, in all work daae in, around and upon said building, or any part thereof, shall conform in all reapects to the ordinances of FridleY, Minnesoffi regarding location, construcl3on, alteration, maintenance repair and moving oP bufldinga �� dty ]imits and this permit may be revoked at any, ti pan vi�o of any of the provisions of said Buildiag Inapector NOTICE: T6b psnaM dop eo1 core� �6s eonshueHoe, Inatall�tlon fo� �rietoy, 'Ivmbte�, �a� 6aHey, s�w�r or �raMr. 8� sun to � fbs Bu(Idiee Iesp�eMe fer apual� p�em(h fer t6� �. _� �-�i� ,� "'� _ ►.-�.-.n. �.. ,,i. uZ OWt�er' Addres APPLICATI01� FOR BUII�ING PERMIT CITY OF FRIDLE'Y, MIAiNESOTA LOCATION OF BUII�DING � No. �� / � � �l Street_ �� , ^ part of T,ot�� Lot BZock Additioa or Subdivision ` Corner I,ot Tneide Lot��Setback Side-Yard SEWER ELEVATION FOUNDATION ELEVATTON Applicant attach to thia form Two Certificatea of'Surveq of Lot and propo�ed building location drawu on these Certificatea. DESCRIPTION OF BUILDIIJG To be us d as; ' Z �y. ��` Front� Depth � � �fleight ` Sq. Ft. %��L� Cu. Ft. � �$C� � F'ronC Depth ` Height Sq. Ft. ' Cu. Ft. � � Type of Construct�.on_��2��,� ^ Eatimated Cost %�� To be Completed-�'-=—�� / � � '�he undersigned hereby makea appiic8tion for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of F'ridley Ordinances aad rulings o€ the Department oi Buildings, and hereby declarea that all the facts and representations seaCed in this application are true and correct. DEiTE �- i � oZ- SZGNATURE . (Schedule of Fee Coets can be found oa the Reverse 3ide). ' _ . _ - ^ �� . . - .. u BUII.DTIUG PERMIT FEE SCHEDULE � .Section 2. The Inspector o£ Buildin�s shall, before iaeuing any permit for tihe� erectfon of-any building or structure, or for any addi�ion to �ny exist- ing building oi'structure, or for any alterations or repaira to any exis�ing building or atcructure, upon application tl�erefor, require the paya►eat by the applicant for such perm3t of fees to the amount herein below set forth aad in the manner herein provided to-wit: " ,� 2.1. For aay such permit for �he erection of aay fire-proof building, other t�an a garages warehouse, factory or �rain elevator, or for the erectioa of axay fire-proof addition, for'similar occupaacy, to any existiag builciiag shall be at the rate of $�.:40' for each ot�e thausand cubic feet, or fractioa thereof, in such cubical contents. 2.2. For any such permie for �he erec�ion of any fise-proof garage, warehouse, 'factory or grain elevator, or for the erection of an.y fire-proof addition, for simflar occupancy, to any exiating bu�lding sha11 be at the r�Ce of $1.25 for each one thousand cub�.c feet, classified as °`fireproofBt by Section 502 of the Minneapolis Building Code, � HOUSES 2.3. For aay such permit for the erection of any aon-fireproof building other than a garage, warehouse, factory or grain elevator, or any noa-fireproof addition, fo� similar occupancy, to any existing building - permit $1.00 for each one tthousand cubic feet. GARAGES 2.4. For any such permit for the erection o£ any non-fireproof garage, wareliouse, f�ctory or grain elevaicor, or for the erec�ion of any non-firepsaof additioa, for similar occupancy, Co any existing building or for each such building or addition - nine�y cents ($0.90) for each one �housand cubic feet or f�acCioa thereof, ia the cubical contents thereof with a minime�u of $4.00. For the purpose of computing fees for building permita, the cubical contents of �.y building or additioa to a uniform height throughout by multiplying the ground area covered fram a point aix (6) inches below the floor line of the basement or cellar to the average heigh� o� the upper surtace or to the average height of the roof surface of the mai.a gable of a p3tched roof. 2.5. For repairs or alterations to an exis�iag structure, the fee aha11 be at i�he rate of $3.00 per each Fiv� Hundred Dollars ($SOO.QO) or fraction thereof in the cost of a11 groposed work. 2.6. In no case ahall the fee charged for any permit as set forth in Section 2 be 1eas,th�n $4.00. � r.�. �..��. � _ _ .�.. � r� n Caty of Fridley, Mi�rm.. ,,� BUILDING PERMIT �� s�lo Date: �' .� � � i�� Oerner: Builder Address Address ....r � � r L CA N 1 ING No. �� Sfreet � ...� Part Lo� Lo�b�� Block /� Addil3on or Sub-Divisian -� � �� Corner Lot _ Inside Lot � Setback �.. ' _._.._ Sideyard _... � � � Sewer IIevatlon — Fo�mdatton IIevation DESCRIPTION OF BUILDING T Used as: �� ont �.�.. nepw .�� x��t / � sq. Ft. �� c:�. �� Depth FTeight �� Sq. F� Gw. F'k Type of Constructi _ ��°!-� Fs� G�st .��0°.��To be Completed � � In conaideration of the isausnce to me oP a�rn�it to const� ct the bwilding described,�ov e, I agree to do the prnposed work fn accordance with the d+escript3on above setU$orth and in complian\c� �virth all prwIafons of mdinana� oP the dty oP Fr1d1eY• _ �9 a JI n �� .� In conaideration oP the payment of a fee of $�—_p�rmit is hereby granted to to canstruct the buflding or addition as d�cribed above. This pernnft ia granted up� the express condition that theperaon to whom it is graated and hia agenta, employees and worl�en, in all work done in, around and upon said building, or anypa� thereoE, shall conform in all respects to the orainaaces of FridleY� Minnesota regarding location, construction, alteration, mainten$nce, repair and moving of bufldinga ordinano�es. dty limits and this permit may be revoked at � upon viola�f any of the provis�lana of said Building Inspector n Nonc� � '11� penah doa no� eorer ths eeestrueHee, InshQ�oe M� vrWne, P��9. 6a 6�9, air�� or waM�. 8� �un to ss� 1ba Boitd6�g lesp�efsr tor apartlr p�rmhs fer t6as items. � L,_a�+ APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, Mt1dNESOTA LOCATIOAT OF BUiLDING No. Stre�t Part of Lot Lot_��/� �� Block �� Addition or Subd3vision / ' '� Comer Lot Inside Lot Setback Side Yard SEWER ELEVATION FOUIQDATION ELEVATION ApplicanC attach to this form Two Certificatee of Survey of Lot and proposed build- ing location drawn on theae Cer.tificates. DESCRIPTION OF BUILDING To ed as: y�;:"; T Front Depth � Height ,� � Sq. Ft.�� Cu. Ft. ��,C'�� F'ront Depth Aeight Sq. Ft. Cu. Ft, Type of Construction $stimated Coat To be Completed The undersigned hereby makes applicatiaa for a permit for the work herein specified, agrePing to do all work ia atrict accordance url.th the Citq of Fridley Ordinances an3 rulings of the Department of Buildings, and hereby declares that all the facts aad xepresentations atated ia this appl3cation are true and correct. DATE SIGAIATITRE (Schedule of Fee CosCS can be found o�, the Reversa Side). �-�.., � . � _.. � i�l . . _ .� e BUILDZNG PEIiMIT FEE S(�iEDULE Sp�tion 2. �he Inspeceor of Bu3.ldinge sh�.11, before issuing anq permit fAr tche erection of any buildiug or structure, or for any addition to anq exiee- in� building or strticCure, or for any alterations or repa3rs eo any e�ia�ing building or seructure, upon application therefor, require the paymen� bq the applicant for auch permit of feea te the amrnmt herein below set forth and in the manuer here3n provided to-wit; 2.1. For any such permit for �he erection o.f aaq fi,re-proof building, othes than a garage� warehouse, factory or gra�.n elevato�, or for the erection of aay fire-proof addition, for similar occupancy, to any exietiag building shall be at t�ie rate of $1.40 for each one theusand cubic feet, or fraction thereof, in such cubical coutenta. 2.2. For aay such permit for the erection of any fire-proof garage, warehouse, factory or grafn elevator, cir for the erection of any fire-proof edditian, f�r aimil�r�occupaacy, to any existing bu3.lding shall be at the rate of $i.25 for e�ch oae thousand cubic f�et, alasaifiefl as °1fireproof" bq Section 502 of the P"3nneapolis Building Cofle. . � �OUSES 2.3. Eor anq such permit for the erection of any non-fireproof buildiag other than a garage, warehouse, factory or grain elevator, or aay non-fireproaf additioa, for similar occupancy, to any euistiag buildiag - permit $1.00 for each oae thouaand cubic feet. GA_�tA�GES 2.�>. For any such permie for the erectioa of anq non-f�reproaf garage, warehouae, f�ctory or gra3n elevator, or for Che erection of any non-firepraaf a.ddition' �or similar occupancy, Co any es3.atin� building or for each such � ��.iding or addition - ninety cents ($0.90) fos each one thousaad cubic feet ot fraction thereof, ia the cubical cvatents thereof with a minimum of $4.04, For the purpose of comgu�ing fees for building permita, the c�ab�ical conteata of any building or �ddition to a uniform height throughout by mult3plying the ground area covered fr�n a point six (6) 3nches below the flaor liae of the basement or cellar to the average heighe of the upper surface or to the averege heighti of the roof eurface of the main gable of a p�.tched roof. 2.5. For repairs or alterations to an exis�ing structure, the fee sball be at the rate of $3.00 per each Five Hundred Dollars ($500.00) or fraction thereof in the cost of a11 propuaed work. 2.6: In no ca�a shall the fep chac�ad for anp per�,tt ae �et forth in Sectioa 2 be less than $4.00. � �� .� .. ^ � -� _ - . M � � a � � 0 � � � N O c�i x �' e ^h : �� A Y y 'j � x � � o � � � Z � M � � M A ^ � � � � � � o � � � . � 0 Y � � c�ay y ypR'., `� ''y'' � w � a � � � �; �"' A L�i � k � y N y O `* O ' O � • H : : � . . � � � � M � � 0 O O O 0 0 � � =��. �� ' Q. Ow. C � � � wN y p O O w w W � �,�n ;r Q° H, � i.m.. ;'� N M � � " � � y � o � � . � � � . � . � � „ � � : . : � : : : � : : : � : : � � . . . � �� N N x �' y -{�+ � � � � � � � � 0 0 � ',� � � � � � � x . . . . . . x �e �a o : : : : n� � vi e�, N n� ao w c o o� °o °o 0 0°o °o ffl t!! {fl � d! {fl ifl {fl fA i!i W 0 or o w m `Q m� � � e�% � Q � � o w �� w O �! i � � � � w � �' z � � ;� W � � �� °. ybd o �, G B � `� ro m A �� m � o � . � � � a x O M � � � �� O C m � z 0 � � �� '�'� � • � � � � � � � ��&�� y � °�, � R� � o � Q � Q �'r � � � a"� � � � � o �, � : � � o . � $ Q° . ; o° � ' � ' � n� w vi t� go o °o °o °o °o {!! iH Cl� iA p� � � N � � � � � a � � O � � F! a � � o � € y �/jp � vl"r W � w °° � � � 1�' , S � 0 i� �b,� S mm.�� ' � � � R° R° � � � a � � � � � � � ro �' Re '� � f+ � � � I � �, �a � o a � � � a �„ . . � . . � O : : 0 0 . . c . . $ : : : n� v� o� ao y ir o 0 0 O O O p i�� ip :il � � A aa� � ��„� O Y'b y � �'� � p�� ! O � p � � �d�� b o �� °� � a&�� ► O ��{t- � ��y Ti � ��'� w�y�� p �' `�� m �p'op ��,o � ., �� a � �� jyf�DM �� o x � ►� fD � Cr m � � �� e D � r � � m � 2 m C m d � M � � a � b r A O �b '0 � �' O � �� 0 � ' � � ' O� � ;. � � �' A � � 0 � 0.� v� `• �. � � � 70 � � � ', 9 d � � �� .��-,r9 , � ;�. ' .. �'r � 7 9 _S� ) �' 1/ / �Tn �.a e �' ,;� r�A V � � ! ass � � �� o HEAT LOSS CALCULATIONS DEPARTNff.NT OF BUILDINGS NIINNEAPOLIS. MIMV. Weatherstrips � .•H.V.E, Coastruction No. Insulation uide Windows Doors - Reference Out. Wall Int. Wall Ceiling Roof F1oor Kind How Applied Yes—No I Yes—No 19_ Fl.� ,;, Room � Length � Width Height � Fl.� Room Length /� Width Height � Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area Width Helght No. o[ Llneal f. Area Wldth Helght No. of Lineal tt. Ares No. ot pane ot pane lighte ot crack aq. ft. No. 01 pane of psne Ilghte ot crack eq. Lt. � � °A �' �►+ , =�. ; � ' � � I �. . .�-s�C. F t7 I �� I �s e�% / f ''' , . � CR ""° � � 7 •.J �e�' Coef. Btu Coef. Btu Infiltration ,,� /� (o � Infiltration Glass * � �-�} � � , d � � � @% � �ass , Eap. wall ��? G� �'= � Esp. wall /� Net eap. wall � ,� / � � . � '� Net egp. wall �l Int. wall Int. wall Ceilin8 J ;/ " �' �� l t.� �� Ci Ceiling �,� ,� / . �' � � Floor J �,� Floor Total Btu. � Tocal Btu. ' ,� / Required sq. ft. E.D.R. or sq. ins. W.A. L.eader area Required sq. k. E.D.R. or aq. ins. WA. I.eader area % F7•� � J� Room � Length I�' Width � Height � �,� Room � Leagtl�yj Width Height �*' Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area Width HefghL No. oL L1nea1 it. Area Wldth Hetght No. o! Lfneal tt. Area No. ot pane o[ pane lighte ot crack eq: it. No. of pane ot pane llghte ot crack sq. ft. .� �' � ' J3'i .� �e � /�� .2 � ;I ,�) �t J'.� � / .� . � /'.'� In6ltration � Glaaa f .�"' : Exp. wall � �'�, ° �j' � Net esp. wall � Iat. wall Ceiling � �' ' .. �� ,,,� Floor Total Btu. Required sy. ft. E.D.R. or sq. ins. W.A. Leader area Fl. Room � Length ,A °J Width Windows and Doors—Crackage and Area W1dth Height No. o! Llneal ft. Area No. ot pene ot pane llghta ot crack aq. tt. � �r, .�� . � . � �±r. Infiltration � / f � �855 � Exp. wall - �j( Net exp. wall j p Int. wall Ceiling f e. �' `�► � �loor t Total Btu. Required sq. ft. E.D.R. or sq, ins. W.A. Leader area Btu Coef. , � Infiltration � ,� ��_ Glass '" °'�y Esp. wall .�. A�--- � J � � Net egp. wall � Int. wall � � , j Ceiling .:�'° d h �" � Floor - - - �� 'I'otal Btu. Required sq. k. E.D.R. or sq. ins. WA. Leader area '�� Fl•� Room I Length Width I� Windowa and Doors—Crackage and Area Wldth Helght No. of Llneal ft. Ares No. of pane ot psne llghte ot crack ap. it. / / � � � ..� I J...� �r 3 Btu F� Infiltration ��j_ Cslass Eap. wall r � � Net eap. wall Int. wall /� � Ceiling �,� � Floor td 7otal Btu. Coef. Btu .� r .�J J � Required sq. ft. E.D.R. or sq, ins. WA. l.eade� area �:.. �� i�l City of Fridley, Minn. BUILDING PERMIT .: . ..- •.: p��; Gerald R. Lambrecht B�� Same : Address ---��_K��? ��t N E. Address _ Same Rec # 44.619 N� 9981 LOCATION OF BUILDING No. ��.� Street Ki�ba l l �-�r��t N T: ^ _ Part of Lot Lot 1�,.1¢.,.L}.,� �Block - P Addii3on or Sub-Divlsion . R i v rv; tr A.; g�y-��_ Coraer Lot _ Inside Lot Sewer IIevat3an Setback _.._�_ Sideyard �— Fo�mdation IIevation DESCRIPTION OF BUILDING To be Uaed as: �?.�-R�gf F'ront __�Q_.._ Depth - �, �._ Height ._.._ Sq. Ft. (;u, Ft, Front Depth I�eight Sq. Ft Cu. Ft. Type of Conatruction F�� Cost �� -0� __ To be Campleted _.'�. �,�_ �;,..� In consideratfon of the iasuance to me of a permit to construct the building descri�d above I a�r�e to do the proposed work in accordance with the description above set forth and in cbmplian th all' ,�rovisfons of ordinances oP the dty oP Fridley. �� In c�sfderation of the payment of a fee of $._.�2Q.._._.._, permit 3s hereby granted to Gerald R. I,ambrecht to construct the buflding or addition as d�cribed above. This �rmit ia granted upoa the express crondition that thepereon to whom it fs granted and his agents, employees an�� worl�en, 3n all work done in, around aad u�n said building, or anypa� thereof, alxall cronform 9n all reapecta to th� ordinaa � FridleY. Minnesota reg lacation, conatructCon, alterat3on, maintenance, repeir and movin of buil �� d�'Y �� permit may be revoked at any time upon violation of ar�y of the proviaions of seid ordinances, i CLAR�NCE BELISLE ° Nonc�: 'Ihts pene� dosi no� eowr ths eenstrnsHoe, IeshllaNun /er �ririee, P�+14B, 6+� 6��9, s�w�� ee wafsr. B� an to ru t6o Bnildie8 lespata� Po� aparat� par�tts ter f6�a k�. ��, 4 �PPLI�ATION FOR BUII,DINC PERMIT CITY OT F`RIDI,EY9 MINNESOT� OW1VEfi Q� 1VAl� �e r� �r l � ,� ��'ss-r/ U!o' �G �jBiY1�uEft �� _ ADDRESS ,� �� r�h�I b� �/ s/. I V. rADDRESS LCCATION OF BUILDIPTC I�10a �STR�°I' �/ .�r�� ./� c� �� . LOT / � BLOCK D �DITIOIV OR S�BDIVISIO?V �/ � � �� 7 �� COR��ER I,OT ITT�IDE y0T S�I'BA�K SIDE`_�ARD SEGTER ELE�ATIOTa TOP OF rOCTII�G Applicart a-ctach to this �°o�u. T�7o !:e�tificate� c�` S�vey oi Lot a:n.3 propo�ed. buildi:c�g lo�atio:rz c7x°a�x o�� thes�v Ce�tiiicat�s o i�ES�'RI�'I' +_ON 0� BL�II,DZNG To Be ��p� A�: � o Fzo�t � ��pth `� cr Height �qua�e �°eet Cubic �'E�t F�°oi�t Depth Height Squ�,re � eet Type of Construction To Be Completed Cubic Feet Estimated Cost � �'� °?� The undersi�ed hereby makes application for a permit for the wotk he�°eixa. speciii�d, agreeir�g to do all work i�, strict accordance vaith the �ity of Fx°idley Ordinance� and rulicig� oi thc� Departne�a.t o:f Build�ng�, and hez°eby decla�es that alI the �°act� at�d rep��3er�tations stated in this appZicaicion are true �.nd� correct o DATE ��.?�g�E (Sehedule o� F'ee Co�ts ca� be f°ourid on the ReverSe Sideo ) S "� � � � 3 �/ � � <1G1�� _; � �_, �, ��_ - � � , � � - .� BUILDING PE�MIT �'EE SCHEDTJLE SECTION 2 o The In�pecto�° of Buildinge shall, before issulra.g pe�it� ior the e:�ection of aza.y building or stzucture, o?� f°or any add.ition to any exi�ti.ng st�°ucture ox buildi:�zg, or for any alte�ation o� �epairs to any exist�ng buildix�g ot stru�tu?�e, upo� �.ppli�at:�or� therefo�F 9 �ec�uire the payment by the appli�axa.t io�^ �uch perm.i� o� fees to the anount herei�. belota �et iox°th anc� in the ma:�er here�n provided toawit: Unifoz°m Buildin Code o Type � 9 2 9& 4-$1 0 75 �'or each o:ae thou��.nd cubie feet, or fraction thereof, in su�h cubical c:o:rate�t�o Ty,pe 3& 5- $1 0 50 for ea�h one thousar�ci cubic �e�t o For the purpose of com�uting fees for building per.°mits, the cubical contenta of a.ny buildin.g or addition to a ut�iform height throughout hy multiplying the groun� area covered from a point six (6� inches below the floor line of the basement or the cellar to the aver°age height of the upper �u.riace or to the avera.ge height o� the roof surface of the ma.in gable of a pitehed roofa For repairs o�° alterations to an existing stru.eture, the fee shall be at the �ate oi $3a00 per each five hundred dollars ($500000) or �raction ther�of in the co�t cf all p�opo��d worko In no case shall the ��e uha�ged ior �.x�.y permit as set ?orth i:� Sectio:ri 2 bE less than $5a00o NSSSD Connection Cha:c�ges ba�ed oxs location - Area 1 or 2 � ° � _.r�,y -! °i �\ . ' 3 ` Vz � ^ � sus�ecT PER City of Fridley T. 1219'7 � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � � CEIPT NO � ; L _.__ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. � i' i ' .--_� �r��;', CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-560-3450 910-F15 6/25/73 � � JOB ADDRESS 531 Rimball Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oescR. 13,16 D Riverview Heights Addition SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Gerald Lambrecht 531 Rimball Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADORESS ZIP PHONE LICENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION C�( ALTERATION ❑ REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Re-roof Structure and Alterations 9 CHANGE OF USE FROM TO STIPULATIONS SCPERATE PER�IITS REQUIF�ED FOR tNiRING, HEATING, PLUMBII�G AIVD SIGNS. SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. WOOC�. FraIIlfl THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R��. ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARK�NG I MEREBY 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 WILL BE COMPLIED �s WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT y7�.�ZOO.00 .()O DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PFiOVISIONS OF ANY OTHER ST E OR LOCAL LAW REGULATING CON- $9 , OO STR C ON OR THE PE ORMA OF CONSTRUCTION. � PLAN CHECK FEE TOTAL FEE .60 SIGNATUREOFCONTRACTORORAUTHORI2EDAGENT IOATEI � EN ROPERLY VALIDATE THIS S YOU PERMI ` / SIGNATUREOFOWNERIIFOWNERBUILDERI IDATEI BLDG INSP f'lATE. �PLICATION FOR RESIDENTIAL, ALTERATION, OR AllDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME BUILDER: ADDRESS :_S 3 � � �.� f,��1� . ADDRESS : .. � :,:r... �,z �,: NO :�/ S TREET : _ _ �ivvc_,Qi7 � D -��" �T� B�K� ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: r Applicant attach to this form T�„io Certificates of Survey of Lot a,nd propoaed building location drawn on these Certificates. �ESCRIPTION OF BUILDING To Be Used As: � ��.�� '''�'� ' �;�'Fr�nt�__�� ; � `- Depth; �/ , � � Height; Square Feet• Cubic Feet• Froat• Depth• Height: Square Feet; Cubic Feet: Type of Conatxuction; �) Estimated Cost, $�/o�� To Be Crnaplated; Tha undersigned hereby Tnakes application for a permit for the work herein apecified,� agreeing to do all work in sttict accordance with the City of Fridley Ordinances and zulings of the Depax�ment of Buildings, and hereby declares tkiat all the facts and representat�.ons stated in this a.pplication are true aad correct. . DATE :/� o� J"� 7� S IGNATITRE • � Ge2r��'�'� (See Reve�rse Side �px Additional Information.) . � _ �� a _� �; ,. , _� _� _�,, �� • r � �`� a ..—� V �'o ' / F� � �,: e ` � ��`�° �,�"°� ��.... ' . /,++"•Y , , . l �� k'_.f 6 ,. BUILUTNG PERMI� FEE SCHEDULE SECTION 2. The Iaspector of Buildings 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 repairs to any existing building or structure, upon application therefore, require the payment by the applicant fox such permit o� fees to the amount herein below set fozth and in the �anaer herei.n prwided to-wit : ' UNIFOZiM BUILDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic feet, or fsaction theseof, in such cubical contents. 7�rpe 3� 5-$1.85 for each one thousaxid cubie feet. . � ADDITIONAL INFORMATION �"or t�e puzpoee of computing fees for building peamits, the cubical contente of an� building or addition, ia determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or tt�e cellar to the average heights of the upper surface ox to the average heigh,t of the roof surface of the main gable of a pitched roof. For r�paira or alterations to an existing structure, the fee shall be at the rate of $3.00 pex each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. In ao case shall the fee charged fox any pexmit as set forth in Section 2 be leas than $5.00, VBRIFICATION OF FOUNDATION NO'I'�: Permits fox eonatruction will be issued a minimu�a of 24 houra from the tims of applic��ion� �o a2low for proper xevie�a ai the proposed structu�e an,d of tY�e construction mi�e. A Certified Suxvey of the lot, showing the loeation af tiie foundatioa, once it has b�eea construc�ed, will be required before,proceeding with the fr�ing. CERTIFICATE OF OCCijPANCY Appli,eation for a Certificate of Occupancy shall be �pade ten (10) days prior t4 the uae or occupancy of any stxucture for �hich a building permit has been iasued; aad said et�ructure shall aot be used or occupied un�il a Cextificate of Occupancy ha� beext i.esae�d. � ` �'-' -- �7� -- � ---- - - Q � � � N � A d � � � � � � r � 0 � 1 1 1 ° . ,� � /� � __ 4 � b 1 � �. i ��:.:__ /. ,1�. y� . i � � � ' • � �� _-------------------------_ —f ---�-- � -- ��- �NSt�� . -�------ -- w � i� � � - � --- ----�- -- _ � � - ------- � - -,�----_--� '�' _ ---- - --�-- - _ � � � � i � s � n --�-�-:-.�` _ --.� _ _ � / �-- �, / �,�� `'� �� -- 1 ---- V" -� _ ` -- �� , / /�\ � - � -- � � � Vl! � � � P i /�l� � ��' � � c , / � • I � . ' . � �.i ii'�, _. � I... � ' _.. __._. -- �--._._.__._ ..,._ ,_ ..._ ... . .' ...........__...--_..__..r__._..__.._.. __._._ . . _--- .. I � � � � � + /�� 1 I � � I : ' . ___ ,-� . � �. � . , � � I _ �r�-'— - :s � �iG' � ,. . V� � � . � ?� � � _ . � � ♦ a � �. . T- � � . � � , �+j � ( �;. � 7' �3 : . � � �� ,� � —: —� �, :� � ' 7'. � • ' .,i sue�ecr pE City of Fridley 16 3 41 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � r � � � � REC T NO. � • COMMUNITY DEVELOPMENT DIV. � ; ,: ------� �%o � r � � PROTECTIVE INSPECTION SEC. � . � � ' � ��ti � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY �'""�� ,�� 612-571-3450 9t0-F15 8/17/81 / / JOB ADDRESS 531 K�.mba,ll Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ],3-16 D Ri.verview Heights SHEET 2 PAOPERTYOWNER MAILADDRESS ZIP PHONE Mr. G. Iambrecht 531 Kimball Street N.E. 784-5151 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO. Aaone Concrete & Underpi:nning 3612 - lOtii Avenue South 825-1881 4 ARCHITECTORDESIGNER MAILADDRESS 21P PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW X ADDITION ❑ ALTERATION ❑ REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Install a 28' x 30° Basement under Dtiaellin 9 CHANGE QF USE FROM TO STIPULATIONS SFPEFi�'fi� P£RiNITS ft�QLiiREfl F�� ii'� W��VG HEA?�NG, NLt1M�1NG AND SiGN�. Befare �iQging ca� bcal utiM'des TEI.EPNONE - �LECTRIC - GitS Et�. ' REQtJlRED BY LAW SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMB�NG, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 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 PAqKING I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROYISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $�-2�GOO �S`(.3O DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRU I OR THE PERFO CE OF CONSTRUCTION. yS`9H. SO PLAN CHECKFEE TOTALFEE ,� �� $104 . 80 �� SiGNn uREO C NTRACTOR HORI2EDA ENT IDATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERtJIIT � (�'�J�� .�,� _ SIGNATUREOFOWNERUFOWNEFBU�LDERI �DA7E� - BLDG WSP pp E CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICl1?Ia'J FO�; RCSIDL"f�TIItL QUILQIt1G PEF��fT7S (��e►•r, Alterations, Additions, or Repairs) UlltdER: /t�� . G� �s�c � ��. �./� � I3UILDER: � c� e l<��G��e �/�' ��f��e��•�'rs � �— . ADDRESS: :j�/ �/( ,�,c�i. ��- ADDRESS: � � � �. — %� �� i • � �r TEL R0: % �� °S � TEL IJQ: � �-,.� — % � �1 ______� Consi:ruction Location STRITsT NO : � � STREET: �'/�f! /��$, � t,oT: /� , / � BLOCx : rd �,nniTiorr : �i �l �tJ��) � �,�s� Corner Lot: Insiiie Lot: SetbacY.: Sideyards: Ap�licant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. �� DESCRIPTIOit OF COFJSTRUCTIOPd � - �� Front: 2�' Depth: �``'9 Height: 7 Square. Fcet_ � 1�-,� (ubic Feet: � �O _ Front: D�Pth: Height: Square� Feet: Cubic Feet: GG Type of Construction: �� !� �oi1�,�,�' y' Estimated Cost: $�� Q —� �` Zb Be O�r,�pleted: �% — �� '— �� Alt. A Alt. 8 Proposed Drive��ay Width If New Opening Is Desired: $� $ . . SE� REVERSE SIDE OF SHEET 75ze undersigned hereby ma};e� application for a pez�ait for the ��ork� herein specified, agreeing to �o ,all work in strict accordance a�ith the City of I'ridley Ordinances zazd' rulings of �tl1e Department of IIuilc3ings, and hereby declares that all the facts and representations stated in this applicatio�a, are true and correct. D.'�TE: _ Sf — ��—�` SIGDiATUF� : Stipulations: � f �� -��. -� ��.� �� , �� BUILDI•NG PERMIT FE�E SCHEDULE The Inspector of buildings shall, before issuing permits for the erection of any building or structure, or for any addition to any �xisting buildinq or structure, or for any alteration or repairs to any esisting building or structure, upon application therefore, require the payment by the applicant f or such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUATION $1.00 to $500.00 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 FEES $10.00 Minimum Fee $15.00 plus surcharge $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 fixst $2,000 plus $6.00 for each additional $�,000 or fraction th.ereof, to and including $25,000 $170.50 for the first $25,000 plus $4.50 for each additional $1,00� 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 $100, 001 arnd up $443.00 for the first $100, 000 plus $2. 50 for each. additional $1,000 or fraction th,ereof PLAN CHEQC: 25 percent of building penait fee DRIVEWAY DEPRESSION ESCROW: Concrete Qirb Streets Only Alternate "A°: Remoneal and replacement of curb and gutter only Driveway width plus 6 feet x$13.50 Alternate "B°: R�oval and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth Driveway width plus 6 f eet x$15.75 VERIFICATION OF FOUNIIATI.ON 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 t�f the c�nstruction site. A Certificate of S�rvey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with_th.e framing. l� � i d �' � �. � �- � � �.� � �� ; L� .� �� sue�ecr PER c�ty of Fridley �� o � 6 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � RE EIPT NO. � `� __��_ COMMUNITY DEVELOPMENT DIV. � �� r j � PROTECTIVE INSPECTION SEC. � I i , l.-__� � ��,,; CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BV i 612-571-3450 910-F15 8/2/83 / / JOB ADDRESS 531 Kimball Street N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oesca. 13-16 D Riverview i#eights SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Gerald Lambrecht 531 Kimball Street N.E. 3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO. Milton L. Johnson Co. 2513 Central Avenue N.E. 781-9548 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USEOFBUILDING Residential 7 CLASS OF WORK � NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WOHK Build staa.rwa �:o basement to Code, Hath floor and tile 9 CHANGE OF USE FROM TO STI PU LATION S SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 80 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 1 STA�LS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTqX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $S� OOO �XX y5`2. rjO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANV OTHER STA E OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERF AN OF CONSTRUCTION. �`SO. SO � � PLAN CHECK FEE TOTAL FEE g 7J � � $53.00 SIGNATUREOFCONiRAC OR RAUTHORIZEDAGENT iDnrE� � WHEN PROPERLY VALIDATED THIS IS VOUR PERMIT SIGNATURE OF OWNER iIF OWNER BUILDERI IDATEI BLDG INSP � 7� �l CITY Of FttIDLCY APPLIGIITIO:d FOf�, RCSID[:i�TIl1� (3UILQ1itG PCRiiITS (��e►•r, Alter.ifiions, AddiLions, or Repairs) Ol•lNER: `��°�C�� '1 ��. C hi ADJRES S:� 3 B �� n-� /i /a LL •S %` � C TEL nSO: . Effective Aug. 1, 1981 �[3UILDER: �; �ro ,� �i . .l o ��,usa N � , 11DORCSS: � �`e 3('_ e�, >�r .� � rl � TEL t10: 7�/--,�5�% � Construction Location STItITT NO: g�l STItEF.T: �� n-� /f �q LL V�', � C , LOT: BLOQC: ADAITION: Corner Lat: Insicie Lot: SetbacY.: Sideyards: Ap�licant attach to tliis form two Certificates of S1�rvey of lot and proposed building location drawn on certiiicates to scale. DESCRIPTIO�� OF COi•lSTRUCTIO�� Front: Depth: Height: Square Feet: (�bic Fcet: Pront : Depth : Height: Squar.e Fe�t: GUbic Peet: � a�.;� s7A,�w,� �d a�S��N� �c�E- .� Rype of Con,truction :�,��. . Ff e o,�, s]: 6 E Estimated Cost: $� a e o. � Zb Be Oor.�pleted: � 0 7�..�, s �— Alt. A Alt. B Proposed Drive��ay �r'idth If New Opening Is Desired: $� $ . . . S�� PEVF:R;ii SIDz OF SHEET 1S�e undersigned hereby ma};e� applicaticn for a permit fcr the �:ork herein specified, ac�reeing to c� ,all work ir� strict accordance with the Ci�y of I'ridle}� Ordiiiances aiid ruling� of the Departme��t of Duilc3ings, and hereby declares that all tle facts and represer►�-►tiens stated in this appl,ication are true and correct. D.�TE: t L �.3 SIGNIITUI�: Stipulations: �� 5(�- �� .5� �3.c�b � �._�� ,� S �:iR . � • _ ,��_ _ - . : . _ The ChieP Buildiag OPPicial shall, before issuiag permits Por the ereetion of any building or structure, or for any addition to any egisting building or structure or for any alteration or repairs to any existing building or L�truc�iure,�upon application therePore, require the payment by tbe applicant for sueh permit oP fees to the amount herein beloW set forth aad in the,manner herein provided to-Wit: �� e Total 9aluation �1.00 to �500.00 $501 to $2,000.00 $2,001 to �25,000 Fees �10.00 (Minimum �15.00) �10.00 for the Pirst �500 plus $1.50 Por each additional $100 or Praction thereof� to and ineluding $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 $25,001 to �50,000 �170.50 Por the first �25,000 plus ��•50 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $283.00 for the first $50, 000 plus $3.00 for eaeh additional $1,000 or fraction thereof, to and including $100,000 $100,001 and up $�433.00 for the first $100,000 plus $2.50 for each additional $1,000 or fractioa��hereof . . , Plan Cheok: 25 percent of building germit fee. � DriveWay Depression EscroW: Concrete ourb streets only. Alternate "A": Removal and replaaement of eurb and gutter only - DriveWay width plus 6 Peet times $13.50 Alternate °B": Removal and replaeement oP curb and gutter and install a 3 foot wide approach With 6 inch depth - Driveway width plus 6 feet iimes �15.75 - .� �� -. ..: .� Permits for eonstruetion t�ill be issued a minimum of 24 hours from the time of application to alloW for proper review oP the proposed structure and oP the constr�,ction site. , A Certificate of Survey of the lot, shoWing the location oP the foundation oace it has been constructed Will be required before oroeeedi na taith the framing. _,-� � I: Building pI,�B�G Pemut No.: + ; Inspections RESIDENTIAL APPLICATION Received By: � � � 763-572-3604 CITY OF FRIDLEY Date xec'd:1 �' �� i DATE I�� 1 U�o YOUR E-MAIL ADDRESS SITE ADDRESS �'�� ) iYlrJ�.1/1 .� • � r _ __ __- __ � THIS APPLIC.4T�'T IS: ❑ OWNER �ONTRACTOR PROPERTY NAME: 'L � �WNERI ADDRESS:�L.� CITY � STATE�ZIP�) �� TENANT � PHONE: CONTRACTOR Np,�: ° SUBMIT A COPY OF STATb LICENSE # - EXP DATE �+ O 90 I'OUR STATE ADDRESS: CTTY STATE ZIP ; �tc€�.s€ u�rTx �� - (�1-31�-�� APPLICATION -- - PERMIT TYPE ��GLE FAMtLY ❑ TWO FAMILY 0 TOWNHOUSE . ' TYPE OF WORK: ❑ �w �PLACEMENT � DETAILED DESCRIPTION OF WORK ��A[4��f1nlL�'1 � GIIG�C� E:�JI-P•(' � PER MS 16B.66� the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installaxion or replacement of a residential fixture, excluding the fixtures. ("Ihis should reflect only the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FTJCTURE, EXCEPT WI�RE NOTED. b�XTURES: (INDICATE TOTAL NUMBER OF EACH BELOV� BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING BATHTLJB GAS PIPING (x� cm�rcervs� SWIMivIlNG POOL WATER SOFTNER ($35) CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15) DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION WATER METER OTI�R , . ... � � . > >' t ur,.µ � r$,i°j � x:, Fv r� w �, `�" urt s�' ,3�#f`.��✓ rc r4' > :3 '�'"ir ..� . , ` 4�t�?,L'i'��"�'n , ,.µ ��::: PEi2NII'i'.:FEEPRC3�C';��'��T��"��I�;x��l �i��.�:�:�.��>��s,. ,;� �,q3,,��;��.�'��,..� ±� Permit Fee $ �'a .6� Number of fixtures @ $10.00 ' x $10.0U = $ Surchar e .50 Number of fixtures @$15.00 x$15.00 =$ TOTAL DUE $ .� Number of fixtures @$35.00 x$35.00 =$ � State Surchazge = $ .50 Tota1= $ THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTII, PROCESSED I hereby apply for a building permit and I aclrnowledge 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 applicarion 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 w r which requires review and approval of plans. SIGNATURE OF APPLICANT ��4�� PRINT NAME 1� 4 S O i� DA1'E `a �O''"(�� , . . ,,: :-� .�'LEASE NOTE,;`��,r�� , � ��a . �'H � ,� . � �:; F ' �� ; �`�� . �� , t ��r � � - — — - - --�i�, oi�`ricfiley -- - -- - - --- - - - Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 � fl � . � �� Buildis�g In,spectians 763-57Z�36U4 '�His N�.tCi4.N7' Is: OWNERJ 7'�NANT s�BMr�' A copv oF YOUtt 57'A'fE [.ICENSE wlTtl APPLICA'iION �� TYFE OF WORxi: From: 9528814491 Page: 2/3 Date: 6121/20071:58:16 PM 1V�CI�ANICAL PErmit No� RESTDENTLA.L A�"FLIC�i�`ION ��'v� �y: �ITY t]F FRIDLE� �8t��° Y� e-Mnu nfynxa�9S O Owr�R '�GOnrrnncrOR. AD17RE99: S"'�- ��--' I.tYY1 �Yl i C"� � �totve: ��3� 3co- 2'�S a �55�� CoMPANY NAME: �oivrac�r rE�soH: �91��r.�'•^/� � STAi'E LiCENSE � �� - . ADDRES.4: i�5�_BiS'.��TT�' STATE Z!P �. _.�: ° • • ' FAx . . . . � PHOrIe � snv�.eFnMU.v O'fWUFAMILY L7 NE1�i �RBI'LAC:E1tA&N7' DE'PAILED DESCRIPTION OF WORK �L� 1� C.�¢. � rowrrFtovsr O ALTERATIONlttEMO�EL � PER MS 1 bB.665 the jtemtit fee is a mNnimum o: $15.00 or S% oi ti�e ta�l cost np to �50A.60, whtchaver is gt�rt�r, for the 9mprovem�a� insta]lation or replecement of a reaider►tial flxhac, exeludtng the fixtur�s. ("rh�s should ret]eat oniy tha cost of tal�r ) L�WC C�� i �DJ� a�7j 5.��. Ls�+�+i �gt �C811 ��0 t0 �5� ° cost of labor �� 7C .0� ° FOR PROJ�ECI''3 VVii�RE LAS�R 1s,KCEED5 S3DO� I�ES ARE BASED O1V S 10.00 PER F1XTl1R� EXCEPT V�liERE NOTED� FtXT't7RES: ([NAICATE TO'fAL MJR/1�ER OF FACH BELO� �t MO�E1�Q4�1�.��+ 7� Sf7,FJ87U �% b0� �� Equipmc4t io5telled ►�� ,Rda.� hIFG: i n.r. r� 01G MOI7RT« �( C.t vi OZ �'�' S�Tu � �� _FiR'EPLA<.Ty (GA5} �+l 5.� ODEL: 9il•F.IBTU .!�_ NC $25.Od GAS RANGF10dSNT 510.� AIR TO ADi EXCE1ANCiEER �1S FIltEPLAGE (WdOD} Q3S.Q0 _NEW GA3 QrRILL 510,00 Bo¢,ER$3s.� ,�FIJRNE►tx $35.oD GA5 UNn' H7R StO.00 CFQM1�iBY LINER 910�00 !3A3 DRYER 3t0,U0 POoL FiEATER �35,00 DUG7 WORIC S10,A0 (iAS PII'QiG 910.00 VF.iVT1LATOR $15.00 • ��° � . ' . .:': • . . � .: �! : :. �� • : � • • • t Paxmit Fee $ �� . Number�of fixhues � $10A0 ,� x �10.00 = R Sutcharge $ — .50 Number of fixturas (a7 $15.00 x �13.00 ° $ TO'�AL DIT� $�� Number of fixtures (a� �ZS.QO I x$�S.dO =$?� Number vf fixturos @$35.Oa � R$35,OQ °$ 5• o0 Sta�e Surshargc ^ $ .50 Toml=� bb.Sa �r[�ns �5 AN nra�.[Cn�nON FOa a PE�rr-NO'r vat-m unrttL �oCES9�v I hereby �pply for a build�ng petmit 81td T aakuowie+9ae that fhe inform�toi► ebov� ie complete a�►d �our�t� �� he w�tk will � in conformsnco with t�'►e ordinances and � of the Ciry of Ftidley end wltlt the M'im�esoc�. Consirucdon Codes; that 1 underster►8 this is tmt a pe�mit but orfly an applir.a�on for a ' and wrnk is not t� st�rt withbut a permifi that the work wt11 be in aecoidettoe witt►'t�e em approved plan in the case� work w' r.e�� and approval afplans. 1 `~�F:r�l�n(1_ . �n i� -------._ �'i7��,�ne 1�.`�.,�ct1�1,� �_1�71�Oi src�vA'rt� aF ArrucA►t�rr � `� �ity of Ftti�dley Buiiding Ins�c.�ti�ns �epa�rttmeat 6437 University Avemie NE, Fridley, MN 55432 763�572-3604 �.AX: 7b3-502-4977 .�� From: 9528814491 Page: 3/3 Date: 6/21/20071:58:16 PM �iry oiFridley ResidenLial Mecbaniasl APPU��on Page 2 �EQi�.tED TNFOIiMA�dN NEED�b TO PRUCESS P�RML'� R�SIDENTIAL PERNAT A�'PL�CA�TION RVA,C _ f� NEW H�MESIA,DI7�ZTI4NS EX.ISTTNG HOME r� N�AKE-UP AIR � A �.�rrot�t� Ti AD I�TT.W/F'.7��(t �QMii � �'' L,71.�Jy ,a vt� ...,.. . ] . Combustion Air (See note below) a. Oil or solid fuel [MC C�apt�r '7 with N�N Amendmen.ts b. Naturat Gas or Fropana/IFGC Chapter 3 with, MN Ame�dmen�.s 2. Make-u� Air. {See nate below) a. �1VtC Chapter 5 with �►lN Amendm�nis 3. Ve�nting a, Gas �ppliauces Ik'GC Ch�pter 5 v�'�t� M�1 Amon�dmemts b. Fuel other than gas IMC Ch�pter 8 with MN Amendnae�nts REU_UII�D F NEW HO � S 4. Hcat lass & coalting laad per room a, Reyuired on new c4nstruction IMC 1346.0312 5. Vent3.11ation a Per MN Energy Code 7670 ur 7672 �. Zyuct Dasign Per Il1�IC 13�6.4643.2 a. ACCA Maaual D �iOTE: Centerpoirtt Energy Mechanicsl Code Guidelin� software m�ty be am�l far combnstian and wnalce-up �i�r ca�calati4ns.