B - 41400Building
Inspections
763-572-3604
763-502-4977 FAX
', DATE -�T-fj I /
SITE ADDRESS �
THIS APPLICANT IS:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTIVE I-1-2011
YOUR E-MA1L ADDRESS
❑ OWNER .,�'CONTRACTOR
PROPERTY OWNER/ NqME:
' TENANT �
ADDRESS:
PHONE:
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
INSURANCE
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
'.� t.a �
CITY
STATE LICENSE #� Z��j3 %,� Z� LEAD CERT NUMBER
ADDRESS: Z�I��CC.Sj.Lt¢JY�1J✓ G�J' lfF � �'3 � crTV/�'�
PHONE ^] / J.SU !�/ / y
�'SINGLE FAMILY/NEW CONSTRUCTION
O TWO FAMILY/NEW CONSTRUCTION
❑ ADDITION ❑ GARAGE/SHED
❑ BASEMENT FINISH ❑ ROOF
❑ DECK ❑ STDING
❑ SWIMMING POOL
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR �REMODEL
DESCRIBE WORK BEING DONE:�
SIZE OF IMPROVEMENT '
ROOFING
NUMBER OF SQUARES _
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
❑ Aluminum
❑ Other
WINDOWS
IN EXISTING OPENINGS ❑Yes (�No
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED
FAX (� � / / `l
SIZE
STORIES
❑ WINDOWS
❑ DRAIN TILE
�OTHER� �,
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED �w
❑ DETACHED �������CJiE� ��'4 �
/1
❑Soffit
❑ Trim
❑ Fascia
LOCATION OF WINDOWS
NUMBER OF
HEIGHT
Permit No.: i::�^��
Rece
� ��
Date Rec'd:
/�
,�:
STAT� ' '�ZIP�_
A
FT
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS. & PORCHES SUBMIT:
I. Site Plan/Survey showing the existing structures
and proposed project.
2. Two seYS of construction plans
3. Energy Calculations
FOR WINDOWS — PROVIDE U-VALUE AND
MANUFACTURE STICKER ON WINDOW.
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ �,/�"�d "— 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
$ ��1�d�
$
$
$
$
$
$
$
$
$ _
$ � �
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $5.00
$5.00 (State Licensed Residential Contractors)
$2230 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$25=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks navable to: Citv of Fridlev Attach
lations
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and 1 acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the�i�y of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a permit a ork 's not start without a permit on site; that the work will be in accordance with the
approved plan in the case of all w e ires revi w d approval of plan '/�J � ��
SIGNATURE OF APrLICANT R�jJT�A}AME � �Y�T (a`� DATE I�� �
TURE
_ �►
�
Project: Bathroom Remodel
Location: 1488 Onondaga St NE, Fridley, MN 55432
Property Owner(s): Dan and Lori Kraska
Contractor: Luxury Remodeling & Bath, MN License # 20632528
Project description:
Strip bathroom to stud and or drywall. Remove current tile floor. Reinsulate and vapor barrier
as needed. Add dedicated CGFI protect outlet. Relocate light to accommodate changes. Upgrade�
existing exhaust fan. Install new acrylic tub and thermostatic tub/shower valve. Install new moisture
resistant drywa I ass needed. Mud/Tape/finish coat as needed. Prime and paint. Install solid surface
tub surround. Install tile floor. Install new vanity and sofid surface vanity top. Install new vanity
faucets. Reset existing toilet. Install finish trim. Install lights. Install curtain rod, towel bars, towel ring,
and tp holder.
Materials List:
6mil poly sheeting moisture barrier, as needed ``
Fiberglass insulation, as needed
%: inch moisture resistant drywall, as needed
Bathtec Acrylic Soaking Tub with tile flange (www.bathtec.net)
Moen Positemp Tub/Shower valve
Moen Tub/Shower Trim
Onyx� solid surface tub surround (www.onyxcollection.com)
Moen Curved shower curtain rod
'/: inch cement board tile underlayment —
Ceramic tile
48 inch vanity
Onyx� solid surface vanity top (www.onyxtop.com)
Moen vanity faucet
Fante �brand in-line exhaust fan (wv�r�^J fa.__._ �_!��+._��, model PB110
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245 Roselawn Ave E• Suite 35 ■ Maplewood, MN 55117
651-330-6414 main 651-797-3416 fax
www.luxurybath.biz
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