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AF - 47994City of Fridley, Minn. BUILDING PERMIT Date: --�� f"" Owaer: '��'�''� '--'� Builder ...._� Address Address N° 6040 �, �, � OC ON BUILDINC No. '�� Street !'��.�ry�.!!�� Part t Lot�_�� Block — ._.._._ Additian or Sub-Dfviei � � �' Corner Lot �� 7nside Lot �� 8etback �� Sideyard Sewer IIevatian —_. _ Fo�mdation IIevatiaa ; DESCRIPTION OP BUILDING T Used '� �f � Front � Depth �� Height .1�_1ke! . Sq. F'L ' Ft�� t.� Depth 1�� FT gY�t �.G:.__� Sq. F't. Cu. F`k -.�/��r�c � Type o nstruction Es� Cost �.��L�� """_"'i�o be Completed In consideration of the issuance to me of a permYt to construct the building described above, I agree to do the proposed work in accordance with the description above aet forth and in compliance with all provlsions of ordiaaaces oP the dty oP Fr3dley. � ... ` In co�afderation oP the payment of a fee of $��_ , peraiit is hereby granted to to construct the building or addition as described above. This permit is granted upon We express condition tt►at theperson to whom ft fs granted aad his agents, employees and workmen, in all work doae in, aroun� end upon safd building, or any gart thereof, shall conform in all respects to the ordfnances o4 Fridley, Minnesota regarding location, conatruction, elteration, ma3atenance, repair and moving oE buildiugs within the dty limits and thia permit may be revoked at any time upon violatton of any of the proviaiona of seid ordinaacea a Bulldi�►g Inspector NOTICE: 'Ibb p�rmit dws aot eowr th� eon�rueHoe, Rahllatloa foe vrhL�o, plum6tne, �a h�fle�, sar�� or wabr. B� mrr to sN th� Bulldia8 lesp�eiee ior ap�nb p�emN� foe l6a� (t�na. r � .s � �...; ,+� ,� .r' - -. - �" �1 OWl'!eY' � S APPLICCI�„TIOitT �'Ol@. BUIi,DING PERMIT Ci'I'Y OF I+RID�,EXr MIT�ESO'I'A . �,. , � Address � � �~ � � � �s-�--C . _.,`. % �_.. Address �� , LocA o a�nzNG No, �^ Street � Part oi Lot ��"° • � �..K �`�'�s"— Lot� � 1-� '�� lock � Addition or Subdivision _�� Corner Lot �nside Lot X Setback�Side-Yard 0� sEfr7E�? ELEVATTON FOUNDATSOLV ELEVATiOL�T Applicant a��ach to this �orm Certi�icate of Survey o� Lot and proposea huildit�g locat3on. To �e used aso DE�CRIPTYON OF BUTL�ZIITG �' G_______ I�eight � { � � Sq. Et. �D � � Cu. Ft. � Front _ Depch �,Height Sg. Ft. Cuo Ft, lype of Construcicion �ot��. Est�nated Cos•�� o�� ro be Completed The undersigned! hereby makes application �or a permit �or �the work here�.n specified, agree�.ng �to do all work in strict accordance �vith the C��ty of F=idley O�dinances and rul3.ng o� the Depar�nent of Build- ings, and hereby declares that all the facts and represenfia�cions s�ateci �Ln this apg�licat3.on are true and corcrect. D1'�,TE � �'� SIGNI�TURE � ` (Schedule � Fee Costs �cas� be �ouncl on the Revers �icle) . � < K �1 ?A ti", ` J.S ^ -�- r M�`+ ,� � f"? 9L '� BUILD�NG PERMIT I'EE SCHEDULL sec�:ion 2. The Tns�ector o� Buildings shall, before issuing ariy pegmi� �o� the erec•��.on of any build�.ng or structure, or for any addition to any ox�s�ing Iouilding or st�uc�cure, or for any alterations or repa3.rs to any �xis��.ng buildingt or . structure � upon appl3cation �h�re�or, require the payaaent by the applicant �or such permit of rees to the amount here3.n belaw set �o�cth and in the manner here9.n provided to-wits 2.1. �'or any such �ern►it for �he erection o�E any fire-proo� bu3ldir�g, o�?ner than a garago, wa�cehouse, factoscy or grain elevator, or gor the erec�t�.on of any ��.ie-p�oo� addition, for similar occupancy� to any exis�ing buildiny shall be at the rate og $1.960 for each ono thousand cubic �eet, or £raction thereo�E, in such cubicab contenta. 2�,.2_. �or any such perm�t Zor the erec�t3on o� any tire-proo� garage, wagehouse, factory or c�rain elevator, or �o�c the erection oi ar,y �ire- proo� addi�t�.on, ior similax occupancy, �o any existing bu�ilding shall �e at the ra�a oi $1.25 �or each one thousand cub ic feet, classif3eci as "�3reprooi" by �eetion 502 oi the M�.nneapolis Building Code.. HO� 2.3. For ariy such ,perm3.� for the e�cec�ion o� any non-f3reproo� build- 3.ng o�her �than a garac�e, warehouse, iac�ory or grain elevator, or ariy aon-�irep�coo� addi�:� oa, for s3.mi.lar occupancy, to any exis�ing building = Perm3.t $1000 �or each on� thousa�d cubic feet. Gt�iGES 2.Q. For any such �e�►3t for �he erec�3on oi any non-fireproo� garage, warehouse, �actory or g�a3n eleva�or, or for the erection of ar�y non-firepsoo� addi�3,on, �or aimilar occuparicy, to any existing builo�ing o�c �or �ach sueh building or addition, Ninoty Cen�s �or each oae �housancl cubic �eet or fraction �thereoi, in the cubical contents thereof wi�h a min�num of $4.00. For the purpose or co�q,outi.rig fees for building permit� the cubical con- ten�s o� any build�.ng or additiori to a un�.form height throughout by multiplying the g�ound axea covered yrom a po3.nt six (6) inches be].ow the floor line o� the basement or cellar to the average height of th� upper sur�ace or �co che average heigh� of the roof aurface ofc the ntaiu gable o� a pitched roof. 2.5. �`or repairs or alte�ations to an existing structure, the �ee �hall be at the rate of $3.00 pe�c eaeh Five Hundlr�dl Doliars ($500.00) or �ractior� �hereor �.n �the cos� o� all propased work. 2� in no case sha11 the fee charged �or any perm�,t as set forth 3n soctio�2 be less tl�^� $4.00. � � - ' ? �. �,. ��OEU.I/�t �U�� c,.�SSOCi�.{.QS9 �tC. T��ep��,e �:��-6s�.a � IAN� SURYE1fORS � Ar�oka, Minnesota CER�'I�iC�1TE AP SUitVEY: Rn1�h N . Lund ��{�..I�7-23 +,.,-.--r-�i ��c . . �� F�' �� 1 � , 1 - _ _ � � �o t �. _ 0 `-1 � �� -�� - �� , � • � i. , �. j � ,�� t �� O � � �.�-� O �'� � PR��as� �� REs51�►ENCE — � �/t k�; � �� . '. Si �/�,� �'� �o f� � . —� �E�Q�� o�� {�oNS GaR�a� 1� �� _ - - _ t�� mta I�9,5b and 51, ��.�ek D �- RIV�3FTIE� HE".LGHTS �t��k8 Count�, Minne�ota� 1�Y CERTIfY THAT THIS tS A TRUE AND CORRECT HfPRES�ITATlON OP a SURVEY OP THf Bpt11�1DARtEB OF THE ABOYE DFSC�BED LAND, AND THE LOCATION OP ALl BULLDINGS, TNEREON, AND ALL VtS1BL� H�iCROACH�1lEt!ftS. IP ANY, P&OM O& ON SAFD LJe►ND AS SUBVEYED BY ME TFUS ....2Q�I1 DAY OP .............. J;L1�;�........��.....ww,.. .._.�......... AA. i9, �'� T.. N. C HOIUM AND ASSOC.f1A�'�S, !NG 1.AND SURVE1fORS � �F � � � ,k!F_. �' � rt f� Yr '1f .» .......................«.. �� ... ,; � - �� . � - � ! ..... .u.«... .......��.........e...«........��.�.�....... I . 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V \ ¢ � E � O "1 �s � � ( a �� - � r � m �� b � b � S m m �' � � � � m � � � � � � � � � � � � o � � �, � � � � � � I � � � � � ° � a � � � a, rn . . cn . . a � ' : 0 0 : . o . . $ : : : a a� en en oo � C7t C O G O O O p {!i 0 � �� o.a� �� ° � �a� � WOQ� p �� R�. � � � ��.�, � � d�� R � ��; � ��° � � dp�-�'`� �� O r.p �C'! � m a� � c b�� .� °a�"'i m �°'ots a�o �y H �� ro a�y o ��R � y � ►O! �n� ��cD ��o � �. � � � � Sk 5' D � � � T H n _ m C m d » M � � a C a � � O D � 7 O � �1 � 7 � 0 ^ ' � � � ' � � � �y. •F � � � a � 0.� v< �� i � �. � 7v � � � .i O. �� Building Inspections 763-572=3604 BUILD]�TG RESIDENTIA►L APPLICATIOl�T CITY OF FRIDLEY DATE ��S ��.8 D % YOUR E-MA; SI� ,aDDxESS SS�B L � �',QY � l� '�e�/ � THIS APPLICANT IS: ❑ OWNER �CONfRACTOR PROPERTY OWNER/ TENANT CONTRACTOR sus�r .� coPY oF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERNIIT TYPE I:��:i�$} PHONE: �%� � 7 �d .6 ^ v� � v�� STATE UCENSE # $(SiNGLE FM�III.YMEW CONSTRUCTII ❑ TWO FAMII.Y/NEW CONSTRUC110N O BASENNIENNT FWISH ❑ DECK TYPE OF WORK: I � ❑ DESCRIBE WORK BEING SIZE OF IMPROVEMENT NUNBER OF GARAGES � PROP05£D SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ' ❑ Other . wwnows IN EXLSITNG OPEI�IINGS OYes DATo OR FORNEW OPENINGS-DESCRIBE SIZE OF OPENWG CHANGES & TYPE OF WIIQDOW TO BE INSTALLED �ROOF SIDIIJG ❑ SWD�] ❑ ADDITION ❑ REMODE f�HOUSE & GAR.AGE ❑ ATfACI�D GARACrE 0 DEfACHED GARAGE �Soff t ❑ Trim ❑ Fascia L�ATION OF F✓IND09JS Pemut No.: Received By: � Da�' � 7 _ E}� DATE L cmr � �iDlr� AX SIZE STORIES I�D ❑ WIIJDOWS 0 DRAIN TILE ❑ OTI�R G POOL LING WIDTH HEIGHT a��,3 z �� z �ASEMENT REMOAELING SUBMIT: 1. Fxisting Fl�r Plan 2. Proposed flaor plan 3. List of stru�hual members to be used F� FOR NEW CONSTRUCTION IAICLUDING DECKS, ADDTI'IOAIS. & PORCF�S SUBMIT: 1. Site PIm�iSurvey showing the existing structures and proposed project 2. Two sets of wnshvetion plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING 173E 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALiJATION S ,�i I D� OCCUPANCY TYPE_ Permit Fee Plan Review Fire Surcharge Surchazge License Surcharge SAC Charge Gtirb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due � 3. >3 � $ $ a-�a $ l . ,3.5 $ 5�w $ $ $ $ � $ See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1675 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley 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 codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. P � SIGNATURE OF APPLICANT J��iC�.t�� PRINT NAME DATE d Page 2 - Buildi.ng �.Zesidential Application BUTLDING PERNIIT FEE SCAEDULE The Chief Building Official shall, before issuing permits for the erection of any buildi.ng or strucivre, or for any ad.dition to any existing bwilding or struciure, or for any alteration or repair to any existing building or structure, upon applica.tion therefore, require the payment by the applican.t for such permit of fees to the amount herein below set forth and in the manner herein provided io-wit: TOTAL VALUE FEES $1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for 1�` $500 plus $3.05 for each additional $100 or fraction, to and InCilldlIIg $2,��0 $2,001 to $25,000 $69.25 for 1� $2,000 plus $14 for each additional $1,000 or fi-action, to and �ncluding $$25,400 ' $25,001 to $50,000 $391.25 for 1� $25,000 plus $10.10 for each additional $1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for 1�` $50,000 plus $7 for each additional $1,000 or fraction to and including $100,000 $100,001 to $SQ0,000 $993.75 for 1�` $100,000 plus $5.60 for each additional $1,000 or fi-action to and including $500,000 $500,001 to $1,OQ0,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each addirional $1,000 or fi-action to and including $1,000,000 $1,000,001 and up $5,608.75 for the 1�` $1,OOQ,000 plus $3.15 for each additional $1,000 or fraction VERIFICATION OF FOUNDATION Permits for construction will be issued a m.inimum of 24 hours from the time of application to allow for proper review of proposed structure and of the construciion site. A Certificate of Survey of tlie lot, showing the loca.tion of the existing founda.tion will be required before proceeding with the framing. New Houses Onlv City of Fridley Building Inspections Deparlment 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 " Building 1�',+ C�N][CAI, Permit No.. Inspections �S�ENTI�I., �PLICt�TION Rer,eivea. By: 763-572-3604 �I� p�' ��y � ��9'd: DATE � ` `� ` � � YOUR E-MAIL ADDRESS ST!'E ADDRESS �� 4I � �� '� Ce� �, � �-� s aE ��"° ,�G�° a d'� A � � TfiIS APPLICAM IS; ❑ OWNER OCONTRACTOR � PROPERTY N,e,ME: � efl�. 9 � � �.� a r' ,� ,� � a `'�' . oWNER/ .aDDxESS: •� °� � � � � � ��-E �� crrY �� o �i E � STATE �d�ZIP J� �� - TENANT PHONE• "A � � � �S� '� �' � �� ,'I � CONTRACTOR Co1v1P,�.NY N,�Iv�: �� ° � � � � � � � �-� RT�f a.. � g� S SUBMIT A COPY OF �NTACT PERSON: �. � � � � � �--� � YOUR STATE STATE LICENSE il Q� DATE LICENSE WITH ADDRESS: �:�-� � � 4�. t °'9 �� °� CITY � � d +� I �� AT� �-� ZIp,�� V � � APPLICATION PHONE `°°� 6� `�� l Cj �� FAX , PERNIIT TYPE SINGLE FAMII.Y ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: � �' ��cENm•rr ❑ nr.�xn�owx�nRODn. _ � - ETAII.ED DESCRIPTION OF DJORK �►;�� ^a 6 a � �� : � � u �.� � � �'��. � � �-�- `� � g �`� � �'"• �� ° � � �°� `'� PER MS 16B.665 the permit fee is a minimnm of $15.Q0 or.5%;of fhe total �st up ta,S5Q0.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding tlie fixtau�es. (Tl�is should reilecC.o�l�the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECiS �E LABOR IXCEIDS $500, FEES ARE BASID ON $10.00 PER FIXTLJRE, EXCFPT Wf�RENOTED ; FD�TURES: (@1DICATE TOTAL r�v�� oF �cx s�va� � � ;� ;� MODEL: � i � fJ A � c� ^�{ � � � E� su.�Ttr � � � �• EquiPment Installed , MFG: `� NffG: �m— e�°—�' MODEL: R�" �:¢ ►,,. �'.+-°i , A z SIZE/BTU ,`°�- �� s • MODEL: SIZF.IBTU MFG: � A/C 525.00. _F[REPLACE (GAS) $15.00 . GAS ItANGFJ0�1$10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (W�Dj 533:00 NEW GAS GRII.L 510.00 FLJRNACE $35.00 _GAS UNTf HTR SIO.� BOILER $35.00 � pppL �,p'�pt $35.00 C�IDyWEy UNER $10.00 GAS DRYER $10.00 �,p,TOR 515.00. DUGT WORK $10.00 GAS PIPING $10.00 — — .�. — , ,, .,. ... _. .. _ - �. . , � ��,�, .r , ' _ _ . . .. , , r � ;, ...� ._ _ . . .. . . . . ,. . ._� _ _� ...�.. . ... * . _ Permit Fee $ � � . �• "= Number of fioctures @ $10 00 x $10.00 $ Surcharge $ .50 . Number of fixtures @ $15.00 x $15.00 = $ TOTAL DLJE $ ��.� o Number of fixtures @ $Z5.00 � x $25.00 = $ ..�� e� Number of fixtures @ $35.00 �,_ x $35.00 = $ �� State Surcharge = $ .50 Total = $ � � � �0 'fHIS I5 AN APPLICATION FOR A PERM�T NOT VALID UNTIL PROCESSID I hereby apply for a building permit and I aclmowledge thaz the information above i� complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota -Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all wark which requires review and approval of plans. ��ti �'s ,� � PRINT NAME �'a � tv � C' (J'� DATE �•' ^� ` Q C� SIGNATURE OF APPLICANT � �' � �� ' .. �� :� �s"�`('�r_._ _.. ... ��R1!'�?S'�'$�� .�� a . D#�t?7� ' _ . p _ . I� T.I��;� ; ,.�� : ... : _ .... _ � . 'S?+,� ,. l;gt�' �I r rluicy �uilding �nspections Departmen� 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 �.- REQUIRED INFORMATION NEEDED TO PROCESS PERMIT ' RESIDENTIAL PERMIT APPUCATION HVAC � [] NEW HOMES/ADDt�IONS ❑ EXISTIMG HOME ❑ MAKE-UP AlR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) . a. Oil or solid fuel IMC Chapter 7 with MN Amendments — - -- --- -$: �Ta%ar�-or�� g� 3 v�t� �-?�endm.ents - ' - 2. Make-up Air (See note below) . a. ZMC. Cl�agter 5 with MN Amendm.ents � . � 3. Venting � a, Gas appliances IFGC Chapter S with MN Amendments - � b. Fuel other thaa gas ]MC Chap�r 8 with NIN Amendments REQUIRED FOR NEW HOMES o� 4. Heat loss & cboling load per roorn. a. �equired on new consiruction 1MC 1346.0312 5. Ventilation . � a, Per N1N En.ergy Code 7670 or 7672 _- ----_ -- - - 6. Duct Design Per IMC 1346:0603.2 a. ACCA Manual D N�'1'E: Cenierpoint Energ3� Mechanica.l Code Guidelines software may be used for comb.ustion and �o.ake up air calculations