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P - 48457�'� Building BUILDING Permit No.: D U' Inspections RESIDENTIAL APPLICATION Received By: �..� 763-572-3604 CITY OF FRIDLEY Da��c1NdU 0 LO 763-502-4977 FAX EFFECTIVE7-1-2010 DATE ►V�iV1CW1 {�' �(�j�Q��'% YOURE-MAILADDRESS /J�'Y1t�11rr�?a'`c��l/��''Ccv��rve��G��'(,CCf� SITE ADDRESS ��, jM -f' Gi C G l�/N-(y' 4 THIS APPLICANT IS: ❑ OWNER �ONTRACTOR PROPERTY OWNER/ NaME: I� �� f ��- SC y1 (/ J'f� TENANT ADD�SS: 51n� � W�P o /�,- � V��i �a t� 1'c►SS ciTY �ri d k v sTATE r''' /I/ziP h h l/32 PHONE: (p�7 I^ ZG�'o- � 7 3 CONTRACTOR NAME: L� , ii� i J-C � l � SUBMIT A COPY OF STATE LICENSE # �3 �"1 EXP DATE �/ %jI/ �� %Z YOUR STATE LICENSE t ,t AND CERTIFICATE OF ADDRESS: %,�p %! ('t°�'t {✓'r.� I�'i ✓P_ CITY �✓' �cI It STATEM �/`LIP 5� INSURANCE PHONE �, - 3-1 I FAX 7ro 3°- �SU " % PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: � NEW HOME CONSTRUCTION ❑ ADDITION �$('MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: R[f�-i�_r _�_y_�� {1 Su Ia� �� o(�I �i- 1 Ut� S� S�it-P �%t'iC If SP� S�a� � SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ONo LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U-VALUE AND OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ Z.�C��. �� 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 �'►.�• i� _�� 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) $2100 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$24=$ $ $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 LTNTIL 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 on site; that the work will be in accordance with the approved plan in the case of all wo.t� whic uires review and approval of pla / �,/ SIGNATUREOFAPPLICANT s�''�'� ��L� PRINTNAME---�Y��i11'� M,I�Py DATE I/,��O��IV APPROVAL INSPECTOR SIGNATURE 5�7�� `� R. Miller Construction, Inc 7671 Central Ave Suite 101 -- Fridley, MN 55432 763-571-3514 Lic. #6354 11/30/201012:48 PM Insured: Property: Home: Business: Type of Loss: Deductible: Date of Loss: SCHULTZ, KATIE 5651 W BAVARIAN PASS FRIDLEY, MN 55432-6006 (651)895-3293 (651) 266-3673 Water Damage ] 1 /21 /2010 Line Item Total Matl Sales Tax Reimb Subtotal General Contracror Overhead General Contractor Profit Cleaning Sales Tax Estimate: SCHULTZ_KATIE Claim Number: 23L347799 Policy Number: 23BPA6708 Price List: MNMN9F_NOV 10 Restoration/S ervice/Remodel F= Factored In, D= Do Not Apply Summary for Dwelling @ 7.125% x 22 ] .31 @ 10.0% x 2,366.74 @ 10.0% x 2,366.74 @ 7.125% x 399.77 Replacement Cost Value (Including General Contractor Overhead and Profit) Less Deductible Net Payment -- -�� ii t '� �s �a r� � �.. � �. � �. � f;�d �;-i� a�ri:3 �.. 's t ,;,_ . ... rp J�� Y ' . � .. . 1 ��lC� � t��,� }4..-. � •. � a � .' � . �....'1 F F . 1 � . . 'I�. i � 4a t Ron Miller ----____.__u...... ALL AMOUNTS PAYABLE ARE SUBJECT TO THE TERMS, CONDITION LIMITS OF YOUR PpLICY. 2,350.97 15.77 2,366.74 236.67 236.67 28.48 2,868.56 (0.00) $2,868.56 -- � � ��u � � : � I �.� � �� , , ca� , � �� . � � �� c. � �� S�nn �N � c9rJ � 2L 1 �, ��.� � � V��. - r � �-- �, ��c `� , F I 5� � ��c�S � �`�� — �(Vl. � �,�t N � �' � s�t� �i Q� �,`� � w�-�v � W 1�-�,� S 2� c6 �� S� C�+.,7 5��-t �.- ��- r ,� � — �g�. � ��< <ti--�-ff ��o� s _ _ � 0 SCHt �TZ, KATIE General 0.00 SF Walls 0.00 SF Floor 0.00 SF Long Wall R. Miller Construction, Inc DESCRIPTION 1. Taxes, insurance, permits & fiees (Bid item) 2. Content Manipulation charge - pei• hour 3. Haul debris - per pickup truck load - including dump fees Totals: General Family Room Subroom 1: Hallway � 0.00 SF Ceiling 0.00 SF Short Wall QUANTITY 1.00 EA 1.00 HR 0.50 EA M�ssing Wall: 1- 6 10" X 8' Opens into Family Room Subroom 2: Stairs Missing WaIL• 1- 3' X 8' Opens into Hallway Missing Wall: 1- 3' X 8' Opens into Exterior 712.00 SF Walls 336.57 SF Ceiling 351.74 SF Floor 126.00 SF Short Wall 240.67 SF Long Wall DESCRIPTION 4. General Demolition - per hour Recut sheetrock so that it is strait and staple sagging wires back up. 5. 2" x 4" lumber (.667 BF per LF) Sheetrock backer. 6. 1/2" drywall - hung, taped, ready for textw•e 7. Remove Tear off painted acoustic ceiling (popcorn) texture 8. Seal/prime the surface area - one coat 9. Acoustic ceiling (popcorn) texture 10. Mask per square foot for drywall oi- plaster work SCHULTZ KATIE QUANTITY 1.00 HR 32.00 LF 17.12 SF 319.45 SF 284.75 SF 284.75 SF 506.67 SF 11/30/2010 (2:48 PM 0.00 SF Walls & Ceiling 0.00 LF Floor Perimeter 0.00 LF Ceil. Perime[er UNIT COST RCV OPEN OPEN 129.35 D 64.68 64.68 LxWxH 22' 4" x 12' 9" x 8' LxWxH 'I' 9" x 3' x 8' Goes to Floor/Ceiling Formula Stairway 7' x 3' x 8' Goes to Floor/Ceiling Goes to Floor/Ceiling 1,048.57 SF Walls & Ceiling 94.05 LF Floor Perimeter 94.05 LF Ceil. Perimeter UNIT COST RCV 42.85 D 42.85 1.77 D 56.64 1.25 21.40 0.78 D 249.17 0.32 91.12 0.74 210J2 0.15 76.00 Page: 2 SCHiJLTZ, KATIE R. Miller Constraction, Inc CONTINUED - Family Room DESCRIPTION 1 1. Mask or cover per square foot I 2. (Install) Trim board - I" x 4" - installed (cedar) Reattach false beam. 13. (Install) Ceiling hook 14. Batt insulation - 6" - R 19 15. Batt insulation - 2" - R6 (split R 1 1 batt) 16. Visqueen vapor barrier 17. (/2" drywall - hung, taped, floated, ready for paint 18. Seal/prime the surface area - one coat 19. Paint the walls - one coat 20. (Install) Baseboard - 2 1/4" 21. Clean and deodorize carpet 22. Clean carpet - cleaning charge per step 23. Final cleaning - construction - Residential Totals: Family Room Sitting Room 352.00 SF Walls 120.00 SF Floor 96.00 SF Long Wall DESCRIPTION 24. Clean and deodorize carpet Totals: Sitting Room SCHULTZ_KATiE QUANTITY 284.75 SF 12.75 LF 1.00 EA 8.00 SF 24.00 SF 32.00 SF 84.67 SF 54.67 SF 712.00 SF 20.00 LF 351.74 SF 10.00 EA 351.74 SF 120.00 SF Ceiling 80.00 SF Short Wall QUANTITY 120.00 SF UNIT COST 0.36 D 1.35 7.IOD 0.71 0.58 025 1.40 0.32 0.35 1.30 0.32 3.20 0.22 D I 1 /30/2010 12:48 PM RCV 102.51 17.21 7.10 5.68 13.92 8.00 1 18.54 27.09 249.20 26.00 112.56 32.00 77.38 1,545.09 LxWxH12'x10'x8' 472.00 SF Walls & Ceiling 44.00 LF Floor Perimeter 44.00 LF Ceil. Perimeter UNIT COST RCV 0.32 38.40 38.40 Page: 3 . SCHI LTZ, KATIE Exterior 0.00 SF Walls 0.00 SF Floor 0.00 SF Long Wall DF.SCRIPTION 25. 2" x 4" lumber (.667 BF per LF) Backer 26. Urethane foam sealant 27. R&R Batt insulation - 6" - R19 28. Soffit - wood 29. (Install) Soffit - metal R. Miller Construction, Inc 0.00 SF Ceiling 0.00 SF Short Wall QUANTITY 4.00 LF 4.00 LF 4.00 SF 4.00 SF 4.00 SF I 1/30/2010 12:48 PM 0.00 SF Walls & Ceiling 0.00 LF Floor Perimeter 0.00 LF Ceil. Perimeter UNIT COST RCV 1.77 D 7.08 0.89 1.02 D 3.72 D 1.87D 3.56 4.08 14.88 7.48 Totals: Exterior 37.08 Line Item Subtotals: SCHULTZ_KATIE 1,685.25 Adjustments for Base Service Charges . Adjustment Carpenter - Finish, Trim/Cabinet 126.5 S Floor Cleaning Technician ,72 80 Drywall Installer/Finisher 259.96 Insulation Installer Painter 114.40 91.98 Total Adjustments for Base Service Charges: 665.72 LINE ITEM TOTALS: SCHLJLTZ_KATIE 2,350.97 Grand Total Areas: 1,064.00 SF Walls 471.74 SF Floor 336.67 SF Long Wall SCHULTZ KATIE 456.57 SF Ceiling 206.00 SF Short Wall l,520.57 SF Walls and Ceiling 138.05 LF Floor Perimeter 138.05 LF Ceil. Perimeter Page: 4