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PRE 2010 DOCSCity of Fridley SUBJECT o17851 AT THE TOP OF THE TWINS BUILDING PERMIT r REC O. ....... COMMUNITY DEVELOPMENT DIV. 1 r PROTECTIVE INSPECTION SEC. / d'15-� D CITY HALL FRIDLEY 55432 v NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 2/5/85 JOB ADDR SS 7590 Lakeside Road N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ] 6 ] Blomberg Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Braddon Construction Inc. 311 Sunrise Lane, Champlin, MN 55316 867-1845 3 CONTR CTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Sam 4 ARCHIT CT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 1 5 ENGINEER MAIL ADDRESS SEPARATE 0, 5P TS ROM) &Rp�p�gLI NO. S"" IV9 9 ^ , h� EE�a � 9 99 C IIJJ r e. 6 USE OF BUILDING u � `, o'@ :ftT �ti '1, '� b d C = GG Nit Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK I Construct a 24' x 318' + 10' x 20' Dwelling and a 22' x 221 Garage 9 CHANGE OF USE FROM TO STIPULATIONS provide a hard surface driveway. Provide sod in the front and side yards Provide City with a copy of the verifying survey. SEWER LOCATION: (Approx. 10' Deep In Street) 25' N. of N.H. (Inv. 892.74) WYE ELEVATION: 892.86 TOP OF FOOTING: 895.86 WATER LOCATION: 10' N. of Sewer Service DRIVEWAY DEPRESSION COST: 16' + 6' = 22' x $13.50 = $297.00 THE CI l OF FRIDLEY DOES NOT GUARANTEE THE F.CCUI<;,!;Y O (.ITJ_1T'( L0C",T;!0N AND ELL ; ATd{jP•I`_% 2101fe digging CaH lof .)f�a I. � , :� CJi�Ii.,,,.i Iv �; E�EGiRI�� C°'� {; AND PERS&-,iS U •ICBG T I --IIS INFORMATION SH'GU"�1? _d VERIFY IT ON THE SITE. TYPE OF CONST, OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 1160 +484 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 ISTALLS 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 $ 26.15 WITH WH THER SP HEREI OT. THE GRANTING OF A PERMIT $52,300 DO NOT P ME TO GIVE AUTHORI TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE OVISION O ANY OTHER STATE OR L CAL LAW REGULATING CON- $425.00 T OR HE PERFORMANCE OFC STRUCTION. $292.00 LAN CHECK FEE TOTAL FEE 73.00 $816.15 + Driveway URE OFC NTR AUTHORIZED AGENT IDATEI WHr5N PROPERLY � IDATED THIS IS YOUR PERMIT r BLDG INSP r) TE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI 1 NEW [ City of Fridley Fffec a 4/1/84 ADDN. I R-1 AND R-2 ALTER. I ] Building Permit Application Construction Addn Legal Description Owner Name & Address: ' �°'' Tel. # 917-l�P Contractor: -L-911 Tel• # s Address. Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. ®/ GARAGE AREA: Length Z Z_ Width 2 Height 9 Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ ] Inside Lot -[1 Ft. Yd. Setback 37 Side Yard Setback Type of Construction: /-��-'� Estimated Cost: $ Approx. Completion Date: > - & Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: a �a �() $ See Back Page for Explanation DATE: /Lf �� APPLICA 4Tel. 0-,7IJ-°� CITY USE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee $ ` q2. ou $ 7`S, 00 $ a(0arJ $ LAX *�'0U a Sewer Main Charge $ TOTAL STIPULATIONS: W -CU4 Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $425 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] i J 9 EX 7ER1 OR ENVELOPE AVEEAGE 'U" C OM:P'U TA TI ON t OWW. } o coil TUG = eHA, ON Gens 1. VX11111 DATE it Lolaf PHONE Determine working square footage of each. j 14 lb t44 exposed wall area. • • .. •„x/13 U •.`Z -7 .. sq* f t. x� .<;L0 r � / Total roof/Ceiling axis&...... 1ma _sq. f t• X--Xe—mm To te,l exposed wall area above floor /3 40. Z � I 69,9 as Total wall window area....• ............. •.........•...�....•.�.n...i .. be To tal door area .................................. • . • . • ........ 1 c, Total sliding; door area....... ........................,...... 3 d. Total fireplace gall area ..................................... — - e, Total wall framing area (average 1psd).......................•.� f, To . I � Total matwallarea above bov.e To %I Lim Joist GX0a.*• .. s afl. aoo.r. •. 60000 0,100. •. .Y moose 0 &f.•....*fees*::: 1D a r f Total exposed foundation area I h. Total fou nda. tion door area... ................................. _,,' 4 Total foundation window area (includes sliding doors).........„ % Total. net foundation area above grade ......................... Z - k. Total wall framing area. (average...........................�►-- �. • To tel net wall fraodng area .............. •.. • ................. • a Determine '4J" value of each wall augment I a. C) q y X" U" . 3,s L = a4.6 3 ! b.., X"Un..._. - p d; +---- – X "U„ f..� XIOU 0' �04:3 To �� •S4 141, X f'U of c h. X'0 to IOU n 3 0 '�.•...•......................................TotalINS 37.�Z If iteM ie the same as or less than item #l, you have met the intent of BBC 006 (c)2. Total exposed roof ceiling area a 1IS4 `Total skyliCbt area ................ ................... n. Total roof ceiling fraxing are (average 79b)........... ?30•� 8 . 'lb tal net insulated roo f/o ei ling area** . . 10'23 10 - Determine z - Determine "Q" value for each roof/oeiling segment. Xnun ■ 10 - 400600 &gee* 000,0400 00000 6*6049*0 *on 0*09.b ta.l ' If 'dotal of. #4 is the same, or, less than #2r you have met the intent of SEC 6006(o)l. Alternate Wilding Eavelupe Design To tabilize the total envelope ^ystem method, the values established by the arm ofai terve #3 and #4 shall not be g Tea ter thnn the eam of items #1 and #2. Plao 2. Plus -- 4. &-Interior Air Film 2+1 Mieetrook 3-3 11 soft Wood & 8a" jawl.. 4->bcterior Air Film Total R Total U :bl .45 31.30 .sa 32.97 .03 i 12" Insul2,tion 1 -Interior; Air IYim 2-4t�" She©tlrock 3`•1211 Insa,lation 4->erio Air Film Tota R Totn. U 1 -Interior Air n1m 2" Sheetrock 3- "'Soft Wood 4- 32" rliberbd. Sheathing i 5-7 16" Med. Dense Hdbd. 6+Exterior Air Film Total R 1 Total U Insulated Wall Interior .Air Film 2.41 It, ftl©etrook 3-%11 Insulation 4-253211 biberbd. Sher,.thLit,: 5A711611 Med. Dense Hdbd. 66cterior Air Film Totmi k Total U ,I. R Mi 451 6.881 2.061 .671 iqr� .09! . LA,3; .4.5 19.00 2.061 . 67 .1 ?3.03 .UQ, +45 38.00 61 .025 Rim Joist 1liate- rior Air Mm R �-•� 2-6" Insulation 19.00 3-11 " Soft Wood � 1. 4-771611 Med. Dense Rdbd. -67 5-&terior Air Mm! -•..17 � Total R j 22", Total U ! •04 , 1-A Conc, Block Uninsulatod! Total R 2.12 Total U • 47 1-13 Coast;. Block Strippine, & 3%411 loam Znoalation Total R, 7.91 & " Sheetx�c t. Total U .13 PIP�RCRAIT MOOD CnSEL�IITS U. R. _ LOUgLE *I1�NSULA'i'F� . 35 2 2.84 TRIPLE INSULATED -3Z7 3.o6 UNIT S{J. ITO OF LIGHT AREA UITIT SR W. OF LIGHT AREA 12828 5.o6 12036 4.62 -12836 6.56 12042 5.41 12842 .7.69 12048 6.2o 12848 8.81 12o 6o 7.78 11628' 2181. 12072 9.37 11636 3.65 12428 4.31 111642 4.27 12436 5.59 11648 4.90 12442 5.55 7.1660 6.15 12448 7.51 12028 3.56 12460 9.42 DOUBLEHUNG MIMOVIS U R Single-glazed .85 1.18 ` Double-glazed .47 2.12 UNIT SQ. FT. OF LIGHT AREA UNIT SO.AFT. OF LIGHT AREA 16x16 3.55 32x16 7.11 16x20 4.44 3200 8.88 16x24 5.33 32x24 10.66 16x24/36 6.66 32x24/36 13.33 20xl6 4.44 36x16 8.00 .x20 5.55 36x20 10.00 _2Dx24 6.66 36x24 12.00 20x24/36 8.33 36x24/36 15.00 24.16 5.33 4oxl6 8.88 24x20 6.66 40x20 11.11 24x24 8.00 4Ox24 13.33 24x24/36 10.00 40x2436 16.66 28x16 6.22 48x16 10.66 28x20 7.77 48x20 13.33 28x24 9.33 48x24 16. oo 28x24/36 11.66 48x24/36 20.00 Warranty Deed. Individual to corporation. Form No. 3-M. Miller -Davis Co., Minneapolis Minnesota Uniform Conveyancing Blanks (Revised 1976) 2s-vo (-9 eisoE ,e0 I TbfigNbeuture Made this ....................15th..................... day of ....................... June............................. 19.81...., between ..Thom .... as E. B.lomberg,.,and„Karla A. Blomberg,,., husband gnd„wi.fe,,Qadry..A.I.4Q,i.gj,.P............. i ....... .. single and Anthony Stulc, single of the County of ......................... Anoka Minnesota ... ...................................................... and State o f............................................................................................., part....... Pe§f the forst part, and ..... CitY...of Fridley.................................................. ............................................................................. ...............................................................................................................................................................................................................................................I a corporation under the laws of the State of...................Minnesota party of the second part, ..................., . t5itneggettj, That the said part ..... ies of therst part, in consideration of the sum of ONE DOLLAR AND OTHER VALUABLE CONSIDERATIONS********************************�},g, ............................................................................................................................................................................................................................... ,...,,.,t................................................. In hand paid by the said party of the second part, the receipt whereof is hereby acknowledged, do .......... hereby Grant, Bargain, Sell, and Convey unto the said party of the second part, its successors and assigns, Forever, all the tract..... or parcel...... of land lying and being in the Countp Anoka ..............................................and State of Minnesota, described as follows, to -wit: Lot 16, Block 1, Blomberg Estates Subject to restrictions, reservations and easements of record, if any. — �/1'��9 TO 3babe anb to 3001b tbt Oame, Together with all the hereditaments and appurtenances thereunto belonging, or in anywise appertaining, to the said party of the second part, its successors and assigns, Forever..Rnd the said..... Thomas ... B ...... Bl.Qmbe.rg... and ... Karla ...A,.....B.l.ombe.xg., ..husband... and ... wi£e.. Gary .... A.'.,A,igl.e... .... s.ing.le... and ... Anthany....StuIr....... sing.le................................................................................................................... part .... iejof the first part, for ..... themselves ...... their...................heirs, executors and administrators, do............ covenant with the said party of the second part, its successors and assigns, that ....... they ... axe..................well seized in fee of the lands and premises aforesaid, and ha ... ve.... good right to sell and convey the, same in manner and form aforesaid, and that the same are free from all Incumbrances, .lnd the above bargained and granted lands and preinises, in the quiet and peaceable possession of the said party of the second part, its successors and assigns, against all persons lawfully claiming or to claim the whole or any part thereof, subject to incumbrances, if any, hereinbefore inentioned, the, said part........... of the first part will Warrant and Defend. In Tatimonp Mbertd, The said part.1e5. of the first part ha..ve.... hereunto set..... tb.CIT........... hand ...... sthe day and year first above written. �i iptate of , inneota, y9 County of /L jThe foreboin.o i))struinent iras aekn.o)cdedded before me r this...... ....... day of........—'V!q............................................... 19.. . �4......... Thomas E. Blomberg and Karla A. Blomberg, husband and wife, Gary D'Aigle, ^^ .^----------� by....s.ing.l.e... and -Anthony ... S.tulc,....s.i.ng.1e................... .*�• p �p E_. •`-' f� 1'"t fy"IC /7 + E OF F SON ACKNlQWLEDGED) ANCKA � � '• •" r 1iOTARY f�PUC — /•aN"�E'Mp f ',W,', ............................. .. ........... My Com—lesion exgires fur. 2, 1:-7 (SIGNATURE OF P . TAKING A(KNOWLEDGMENT) !............................................................................................................................. THIS INSTRUMENT WAS DRAFTED BY (TITLE OR RANK) Ewing's Closing Service 13084 Goodhue St. N.E. (Name) Blaine. Mn. 55434 (Address) L fe cFa �At .� v t11 ' QQ O v •ei i� i► p i v Oa C' J y� F0 O~ arc U o ° ti Z 4Q a ; 32 I CIIYOF FMDLEY CIVIC CENTER • 6431 UNIVERSITY AVE. N.E.. FRIDLEY. MINNESOTA 55432 • PHONE (612) 571-3450 May 10, 1985 Mr. Gary D'Aigle Garjac Construction Co. 481 - 206th Avenue N.E. Cedar, MN 55011 Re: Final Inspections at 7590. & 7600 Lakeside Road N.E. Dear Mr. D'Aigle: Final inspections were made on May 7 & May 3, 1985 of the above addresses and the following items were noted which must be completed before the structures can be finaled out: 7590 Lakeside Road N.E. 1. Provide sod in the front and side yards by June 15, 1985. 2. Provide a hard surface driveway by June 15, 1985. 3. Provide City with a copy of the verifying survey by June 15, 1985, 4. Post house number on structure by May 20, 1985. 7600 Lakeside Road N.E. 1. Provide a hard surface driveway by June 15, 1985. 2. Provide sod in the front and side yards by June 15, 1985. 3. Provide City with a copy of the verifying survey by June 15, 1985. We will expect the above items to be completed by the scheduled dates when reinspections will be made to determine compliance. If you have any questions on these items, please feel free to contact me at 571-3450. Sincerely, DARREL G. CLARK Chief Building Official DGC/mh CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Rate TOTAL Furnace Shell and Duct Work, Burner — Also Replacement Furnace $ 30.00 $ (Side Vent — Fill Out Back) Gas Piping (Needed with new fumace) $10.00 $ 0,00 F64- eA,,4_ -� Gas Range $10.00 $ Gas Dryer $10.00 $ *Air Conditioning — All Sizes $ 25.00 $ All Others/Repairs & Alterations (LIST ON BACK 1 % of Value of Appliance or Work $ Commercial/Industrial 1.25% of Value of Appliance or Work Effective On January 1, 1997 JOBADDRESS0� i The undersigned hereby makes application for a permit for 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 t e and//q� rrect. �� A�,� ,1998 BUILDING USED ASS�� 4 I _ ESTIMATEDCOST PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU $ Fuel State Surcharge $ .50 Burner Trade Name TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. HP EDR Total Connected Load Size No. BTU HP EDR - � 112�S1Q�- HEATING COMPANY Signed By Tel No._6 33 — �6 Approved By Rough—In Date FILL OUT BACKSIDE F R STACK VERIFICATION ON REPLACEMENT FU CE Final Date C'Z� TOTAL BTU's 7. Has a liner been provided for water heater Yes ( ) No ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: . List ALTERATIONS Beina Done: HEATING CO: Signed By: Date: CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely supported . Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes ( ) No ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: . List ALTERATIONS Beina Done: HEATING CO: Signed By: Date: a CIZYOF FRIDLEY CIVIC CENTER • 6431 UNIVERSITY AVE N E., FRIDLEY. MINNESOTA 55432 • PHONE 1612) 571-3450 June 18, 1985 Brandon Construction Inc. 311 Sunrise Lane Champlin, MN 55316 Re: Final Inspection at 7590 Lakeside Road N.E. Dear Sirs: A final inspection on June 17, 1985 of the above address noted the following items which must be completed before the structure can be.finaled out; 1. Provide house numbers on the structure. 2. Provide the City with a copy of the verifying survey. We will expect these items to be completed by July 15, 1985 when a reinspection will be conducted to determine compliance. If you have any questions on these items, please feel free to contact me at 571-3450. Sincerely, DARREL Chief Building Official DGC/mh FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 • FAX (612) 571-1287 May 14, 1997 Susan Sweet 7590 Lakeside Road Fridley, MN 55432 RE: First Notice of Noncompliance of the Fridley City Code at 7590 Lakeside Road Dear Ms. Sweet: The City of Fridley has established a City Code for the purpose of promoting a pleasant and attractive suburban environment. A recent systematic code enforcement inspection of your neighborhood and property revealed that not all Code requirements are presently being met. The following item does not comply with the City Code: • Fridley City Code requires that all solid waste must be kept in secured 32 -gallon containers with tight -fitting lids stored in the side yard (screened from view), rear yard, or garage, except on the day of collection when the containers may be placed up to 3 feet from the front of the garage. A recent inspection revealed one visible refuse container. We understand that you may have been unaware of these requirements. Your prompt attention in correcting this situation will greatly assist us in helping make Fridley a better place to live. An inspection will be conducted on or shortly after May 28, 1997. Please have your property in compliance at that time. If you have questions about the systematic code enforcement process or would like to discuss your particular situation, please call me at 572-3595. Thank you for your cooperation! Sincerely, CITY QF FRIDLEY of Kurt J sen -Schneider Code Enforcement Officer KJS:ls CE -97-190 SUBJECT IT NO. City of Fridley 33189 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. �• COMMUNITY DEVELOPMENT DIV. j PROTECTIVE INSPECTION SEC. 1 NUMBER REV DATE PAGE OF APPROVED BY CITY MALL FRIDLEY 55432 �'"'"�" �•' 763-571-3450 910-F15 10/18/02 JOB ADDRESS 7590 Lakeside Road NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 1 1 1 Blomber Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Sue Sweet 7590 Lakeside Rd NE 763-786-2822 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Advance Aluminum Supply Inc 7701 Main St Fridley, 55432 763-427-38 a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 7983 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR O MOVE O REMOVE R 8 DESCRIBE WORK Reroof House & Garage (24 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code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ire SC $2.78 PLAN CHECK FEE TOTAL FEE Licen SC $5. y $92.42 SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT (DATE, N PR LY VALID ED THIS IS YOUR P IT S-GNATURE OF OWNER OF OWNER BUILOERi (DATE, LOG 'NSP FIAT Cot 16 02 02:44p NEW [ ] ADDN [ ] ALTER [ ] Ansi 7634273857 Effective 590/99 CITY OF FRIDLEY SINGLR FANDLY AND DUPLEXES R-1 AND R-2 FUII DTNG PERMIT APPLICATION p.3 Construction Address: 0 ES-�2lde Legal Description: Owner Name & Address: C3 o Tel. # z Contractor: ' i ~' MN LICENSE # n-4g"�A)� Address • i no l _-br4.i '-'�'� i Ci� til ,, ► h . Tel. Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. D.E+ S+CP,..=ON OF AVD",ilt)'`JY,.►`V + i�I ]LIVING AREA: Length Width � Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground __. Sq. Ft. OT HER: YP �ZC�C� f Construction Type: �� Estimated Cost: $ �'Zi�� � Qfl 'Z,.l Driveway Curb Cut Width Needed: __ -..-Ft. + 6 Ft = Ft x $ _ $ DATE: ! U I CMZ. APPLICANT: C.. n.n .%�2.� Tel. #_-- (� C( '% Pen -nit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee CI'T'Y USE ONLY $ �'S ` �-�D Fee Schedule on Reverse Side $ .001 of Permit Valuation (1/10th%) $ $.50/$1,000 'Valuation $ $1050 per SAC Unit $ �J C 0 $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary ( ] AK TOTAL $ -w' ` -'O'O VeJ C"' ,, STIPULATIONS: Building Permit Fee BUILDING S See Back Page for Fee Schedule Permit Ivo.:, Olt Plan Review $ 65% of Building Permit Fee Fire Surcharge Inspections n .001 times the total job valuation RESIDENTIAL APPLICATION Received By: 763-572-3604 D .0005 x Permit Valuation Minimum $.50 CITY OF FRIDLEY License Surcharge Date Rec'd: -0 06 763-502-4977 EFFECTIVE 1-1-08 SAC Charge $ /FAX, DATE t I( 1 Zdp0yaYOUR E-MAIL ADDRESS —�-1, I c, /-706SITE ADDRESS /U Laealc@,� l $ THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: NkSu (Stud— $450 Conservation Plan Review ADDRESS: -I S �LE J�UX,RLJe CITY STATE �h z>P S5 -13 Z TENANT Fee Determined by Engineering PHONE: Sewer Main Charge $ NAME: l ADDRESS: 2 Q O s- L00_0k+r U O 0 CITY STATE ZIP S S CONTRACTOR SUBMIT A COPY OF PHONE (4 S l - -1-4 - R�10 (P FAX (0Q - _( 1b - O'4 S YOUR STATE LICENSE STATE LICENSE # ba - ZO 3 Z (k K -I EXP DATE ��y PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE of the City of Fridley and with the Minnesota o tion Codes I understand this is not a permit but only an application for a permit and work is not to start without a ❑ TWO FAMILY/NEW CONSTRUCTION STORIES accord ce PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE APPROVED BY ❑ DECK XSIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCEIREPAIR REMODELING DESCRIBE WORK BEING DONE: S SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ 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: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS. & PORCHES SUBMIT: ❑ Vinyl ❑Soffit 1. Site Plan/Survey showing the existing structures ❑ Aluminum ❑ Trim and proposed project. ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes []No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATE LS: (USING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ 10,000 — OCCUPANCY PE Permit Fee $ S See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ n .001 times the total job valuation Surcharge $ D .0005 x Permit Valuation Minimum $.50 License Surcharge $ J $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 R = ft x $21 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ , Make checks payable to: Ci of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I ackn dge that the info n above is complete and accurate; that the work will be in c nformance with the ordinances and codes of the City of Fridley and with the Minnesota o tion Codes 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 SIGNATURE OF PL accord ce . the approvIan i' a case of all work which requires review and approval of plans. PRINT NAME Q•iW k/ QJLN DATE _T/1 0 DATE 'i� 6 � �� 6 APPROVED BY Building MECHANICAL P unit No. iQ y Inspections RESIDENTIAL APPLICATION Received ByJA 7.63-572-3604 CITY OF FRIDLEYa' DATE d YOUR E-MAIL ADDRESS 4;74, SITE ADDRE S THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: 1Y 26 CITY -T,4o,t STATES,9tiLIPxi��3vZ OWNER/S?ADDRESS:?., TENANT CONTRACTOR COMPANY NAME: SUBMIT A COPY OF CONTACT PERSON: 18550 County Rd 81 YOUR STATE STATE LICENSE # LICENSE WITH ADDRESS: (761) 42R-3677 CITY STATE ZIP APPLICATION PHONE FAX 6 `✓� PERMIT TYPE k5INGLE FAMILY O TWO FAMILY O TOWNHOUSE TYPE OF WORK: ❑ NEW PLACEMENT [3 ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK] l !6 Com, PER MS 16B.665 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, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x .05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: BRP 'A✓�/`� MODEL:_�5.SC1/V0SIZE/BTU l01 � MFG: MODEL: SIZEIBTU MFG: MODEL: SIZE/BTU $25.00 (GAS) $15.00 GAS GE/OVEN $10.00 _A/C _FIREPLACE TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _AIR BOILER $35.00 >4FURNACE $35.00 —GAS UNIT HTR $10.00 LINER $10.00 DRYER $10.00 POOL HEATER $35.00 _CHIMNEY —GAS DUCT WORK $10.00 GAS PIPING $10.00 ATOR $15.00 -. .. _- is h+'Lr N Permit Fee $ Number of fixtures @ $10.0 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.0 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.0 x $25.00 = $ Number of fixtures @ $35. 0 x $35.00 = $ .3 '40 State Surcharge = $ 50 Total = $ 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 Constructio 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 wok will be in accordance with the approved plan in the case of all work which requires review and approval of plans. /� SIGNATURE OF APPLICANT ®r �– PRINT NAME %�°�✓�is'yl� DATE /d % BS ` ..,-W�tm :...' �.. + .. j OUT' :. ..YI;1_] ,vL.!!..�VjA C �'Y _ City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 r. A v. tee,) enn en'1'7 Building BUILDING Permit No.: 1,;5 Inspections RESIDENTIAL APPLICATION. 'Received By: 763-572-3604 CITY OF FRIDLEY 763-502-4977FAX EFFECTIVII 11-08 �' DATE o+ YO Pt &MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑ OWNER �GONTRACTOR PROPERTY OWNER/ Nom. TENANT ADDRESS:75�d sTATF�I�ziP 554�3a PHO 7 � _a FA a NAME: CONTRACTOR ADDRESS:STATTa zrnS SUBMTf A COPY OF STATE LICENSE PHONE l 'J q— y FAXYOUR STATE LICENSE # EXP DATE -51311A,011) PROPERTY TYPE )§siNGLEFAm1LymMKMMnWMW SIZE 17 TWO FAMILYMW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHEDWS E3BASEMENT FINISH C3 ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWB4M[NG POOL TYPE OF WORK: ❑NEW HOME CONSTRUCTION ❑ ADDITION M,4IIVTIIVANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH IGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES O HOUSE & GARAGE BASEMMqT REMODEL G SUBMIT• GARAGES ❑ ATTACHED GARAGE1. . 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE PROPOSED HEIGHT: 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS & PORCHES �n3MIT ❑ Aluminum C3 Win I. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. WINDOWS �`wA�YtJ 2. Two sets ofconshuctionplans IN EX1Sf1NG OPENINGS )IYes 17No LOCATIO1�j�OF�WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF �(,L �lJ �f o� �G�•rc� 3. Energy CalmUtions OPENING CHANGES & TYPE OF. WINDOW TO BE INSTALLED NUMBER OF WINDOWS ATT _ VWWQ AD1W DA aW" f%W vAT TTART^T&T V VTrW TT11�Tl1 mr. �n _� _ _ _ _ �W�.�..+. �.. +..-.v.+..-1 Taaata�e�aava��il�t.LVL11\V MOIL' I.U.01 Ula LA2fUKAND ty MMM11 — (USIN�C THE 1997 UBC FEE SCBEDULL) 'OTAL JOB VALUATIONS �. /'/D '5 > nrrrrn A Nry 1rXMW Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due 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) $1825 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 pemit 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 Conshuction 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 accpIaInce wit the plan in the case of all work which requires ew d al o plans. /4 ��jj SIGNATURE OF APPLICANT PRINT NAME DATE /4 9 m/16 APPROVED BY DATE Building - Inspections 763-572-3604 763-502-4977 FAX DATE_ `D SITE ADDRESS %n D THIS APPLICANT IS: ❑ OWNER PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE PROPERTY TYPE PERAM TYPE TYPE OF WORK: DESCRIBE WORK BEING Dc SIZB OF IMPROVENCENT BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEV O&NTRACTOR STATE LICENSE TWO FAMMY/NEW CONSTRUCTION Cl BASEMENT FINISH Cl ROOF ❑ DECK ❑ SIDING ❑ SWR" ❑ NEW HOME CONSTRUCTION Cl ADDITION ❑ REMODELING FAX DATE ❑ DRAIN TILE ❑ OTHER 5SZf3 A — ROOFING 13 HOUSE ONLY ncrvar S FT NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMOD •ING SUBMIT• GARAGES PROPOSED SIZE: ❑ ATTACHED GARAGE ❑ DETACHED GARAGE I • E ds&g Floor Plan • 2. Proposed floor plan PROPOSED HEIGHT: 3. List of struotual members to be used $MING ❑ Vinyl FOR NEW CONS MUCl•ION INCLUDING DECKS, ADDITIONS ❑ Aluminum ❑ Other ❑Som ❑ Trim 4ynurRrvc MM rt,. 1. Site PlaWSurvey showing the existing structures WINDOWS ❑ Fascia `, 1Q� .. LL4A, jL,-%, and proposed project. 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yee ❑No OR FOR NEW OPENINGS -DESCRIBE SIZE OF LOCATION OF WIN OWS — 3. Energy Caleamens OPENING CHANGES & TYPE OF. WINDOW TO BE INSTALLED a."% I NUMBER OF WMDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING TEE COST OF LABOR AND MATERIAff. SING 1997 UBC FEE SCHEDULE) COTAL JOB VALUATION $ d • OCCUPANCY TYPE Permit Fee $ See Back Page for. Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $.001 times the total job valuation Surcharge $ 140 ,.A'D .0005 x Permit Valuation Minimum $.50 License Surcharge $ SL aG 15.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = .ft x $21 a $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks Payablato• City of FridleyAttach St3unlations THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclmowledga that the informadu above is complete and acetate; that the work will be in Confomrance with the ordinances and codes of the City of Fridley and 'th the Hlmnesota Construction Codes; tmderstand this is not a permit but only an application f a Permit and work is not to start without a permit on site; that the work be in with the in tha case of all work which requires 'ew of p SIGNA=BYL)� PRINT NAME DA Tom► '��" /G APPROVDATE 7,( rt