PRE 2010 DOCSCify of Fridley
App icafion for Plug mid Sm Fh1bq P ndt
Dept. of Ridge. Phone NO -3450
DESCRIPTION OF WORE
J 2 ������ / -5 7412- �
Number. Kind and Location of Fixfures Y
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
ov
Number Fixtures ................
x $2.00
$
Future Fixture Opening ...........
x $1.50
New Fixture Old Opening ..........
•
e
WATER WM.
Catch Basin ....................
ELEC.
Base
Water Heater :Up to 89,000 BTU) ....
x $3.00
$
«�
New Ground Run Old Bldg.........
x $3.25
$
2—
Electric Water Beater ..............
x $2.00
$
1
NO. RATE
TOTAL
I
� x $2.00
1st
Additional Fixtures .................
x $ .75
$
2nd
3rd
4th
• Future coaneetism Ope:liags
+ New Fixture. Old Openings
Connected with
sewer
°I Cesspool ❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
Number Fixtures ................
x $2.00
$
Future Fixture Opening ...........
x $1.50
New Fixture Old Opening ..........
x $1.50
$
Catch Basin ....................
x $3.26
$
Water Heater :Up to 89,000 BTU) ....
x $3.00
$
«�
New Ground Run Old Bldg.........
x $3.25
$
Electric Water Beater ..............
x $2.00
$
:;AS FITTING FEES:
NO. RATE
TOTAL
1st 3 Fixtures .............. • .
� x $2.00
Additional Fixtures .................
x $ .75
$
City of Fridley:
The .undersigned hereby makes application for a permit for the- work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that aA the fact
and representations stated in this application are true and correct �
Fridley, Wnnn Alb � / �+ 1 182/4/
Owner
Kind of Building
Used as - -� / �h /4c-
To
4c
To be completed about -�y o
C -
Estimated Cost, $ ,�C1® >
AId—New. Building Permit No. Permit No.�
Signed.
By �- t
Business Phune No
ROUGH
Gas Range to 199,000 BTU... ,.......... x $5.00 $
REPAIRS & ALTERATIONS—Refer to Code �Z► �2='- �C��«
Description ............-................................ $
TOTAL. FEE $ 14
+moi".
Thomas T* 0asney
!)Opt. Gf Housing & 'rban Do,
1821 University Ave.,
4t. pau1, rdlinnesota 55104
TRI -CO. BUILDERS, INC.
7555 VAN BUREN N.E.
FRIDLEY, MINNESOTA 55432
)ser dire L-heney s
-4ubjean,
FHA Case .No. 271
:mel Irwin
236 Liberty St. it
i'ridley, Ainnesota
PHONE (612) 427-6250
Fay 251 1976
55432
In reply to the letter you received from Mrs Sam Irwin, I believe
the natter has been resolved. I met with -Are Irwin, along with
Darryl C1akk, City of gridley Building Inspector, and Nre Charles
Wallace, the cement contractor. It was decided that the chipping
of the gave4p floor and apron waa caused from shale in the adgre-
gate wroth caused scaling. This, according to the Redi-Ax compWWq
is a non -warranter item and so states on the delivery slip. 4lb•.
Wallace armed to clean out the scaling and patch the damaged areas
with a special hkona patching cement at no cost. It was explained
that it would be a different color. Are Irwin agreed to this.
`She basement floor was. also Inspected. There was normal shrinkage
cracks. There was me hole approximately 2" in 64 ter which was
caused by some foreign material which couldn't be identified. 49
Wallace also patched -this holes
As for the grievance about the dock, I told. airs Irwin that we
usually build a deck large or just a platform and stairway and the
owner can have a concrete patio, which in my estimation is much
better and far less expensive than a redwood aleck. The aleck has
1"x6" redwood decking, 211x6" redwood top rail and hand rails and
211s4" radwood railing and 4"x4" redwood support paste. The stair
jackal, stair treads and dock joists are all fir. gee have never
constructed a total redwood stair and deck, noir do I know any
other contractor who builds them totally from redwood.
In aW estimation, I believe that these problems have been resolved
between ice Irwin and .-too buildere, Inc**
Sinoerely,
q." z-,
James &. Ceorge, asuurer
as Ar. d Irwin
Fridley Building Ins for
dr* Charles viallace
11
City of Fridley
r ?I AT THE TOP Of TME MHO
r'L------- COMwVNITY DEVELOPMENT 01V,
I i PROTECTIVt NMfECTION 09PT.
CITY MAIL F1IOL9V #Mt
W.
53 -M -S-915.51
iI��EGT
236 N. E. Liberty Street
PLUMBING PERMIT APPLICATION
,aaaress Phone
Samuel M. Irwin 784-376
Contractor
Kind of Building
MINNEGASCO
Frame
Address
713 MAROUErrl!
Use Reps'!" MINN.
-Phone
Completion
Datestimate
ost
12 -37--7L
10.00
Plumbing Fixture Rates: NO.
RATE TOTAL
I
ii i
Number Fixtures
x
$2.00 $
t nI I
Future Fixtures
x
$1.50
BDNYtl I I
SYDI I (
&
!
New Fixture -Old Open.
x
$1.50
•1ddY ;
I
I O
Catch Bastn
x$3.25
BYDI
!
�
I
Water Heater -99,000 BTU
x
$3.00
0SIN
i
Ground Run Old Bldg.
x
$3.25
gaa�
it
MNIVUI I
i f
w �
8N18V8I I I I
II
Elec. Water Heater
x
$2.00
Gas Fitting Fees:
lst 3 Fixtures x $2.00
Additional Fixtures x $ .75
Gas Range -199,000 BTU x $5.00
Repairs & Alterations
Description: Install Dryer See
Code 5.00
State Surcharge Class 'Awl Surcharge .50¢ .50
TOTAL FEE $ 5.50
The undersigned hereby makes application for a permit
for the work herein specified, agreeing to do all work
in strict accordance with the City Ordinances and Tulin
of the Department of Buildings, and hereby declare that
all'the facts and representations stated in this
ap 1 true orrect.
.
'Signature Date
r
for Power Pkmft and Heating. Cooling, Vemliapion. Refdgera and
Air CORMoning Syde ns and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell &Duct Work ... ............ .. $10.00 =
Replacement of Furnace ..... 6.00 $
Repairs & Alterations—up to $500.00 6.00
Repairs & Alterations each add. $500.00 3.00
MECiL WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ... .. .
.. $10.00 $
each add. 60,000 BTU .................... 3.00 i
Replacement of Furnace 6.00 $
Repairs & Alterations—up to $500.00 6.00 $
Repairs & Alterations each add. $500.00 .... .. 3,00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam
$10.00 $. _
Furnace Shell & Line —to 640 sq. ft. EDR Hot Water
10.00 $_
Each add. 200 sq. ft. EDR Steam
3,00
Each add. 320 sq. ft. EDR Hot Water
3,00 $—
OIL BURNER—to 3 gal, per hour 6,00 $ _
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 199,000 BTU) 6.00 $_&e —,,
over 199,000 BTU See Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures .. .... _L__ x$ 2.00 $e
Additional Fixtures a .75 $
Gas Range to 199,000 s$ 5.00 $
AIR CONDITIONING $
FAN HEATING SYSTEM See Fee Schedde
YENYILATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE $ ('
ROUGH (SURCHARGE $_a53)
FINAL Z, �- e - 7�
Dept. of Bldgs. Phone 960-3=
Lam,, 236 Liberty
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinance;
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
Fridley, Minn 1875Z_
Owner Tr io o B ldr s .
Kind of Building .__ Frame
Used as -- __—_ ._ _... _ Dwg .
To be completed about
Estimated Cost,
Old—New. Building Permit No. Permit No. A
DESC tXMON OF WORK
HEATING or POWER team, Not Water, Warm No-- 1
a-4P.4��0
Trade Name Y' �ss� S� Ne- Q$sa+llj
Capac3tY— Sq. Ft. E.D.R s 000 _BTU
_Hp
Total Connected Load 44,669 Rind of FueL Nat. gas
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R B=
(REMARKS -OYER)
Signed_ Mill City Heating & A/C Co.
Buses Phone No 544-1501
a
a .� �.�! � ate. -_.i... - 7 � .1*" r e •
►x�.AT'l�S� CALCULATIONS——
Mr�afilli14 04 BUILD F71ID1F'f,
- —l --
Weatherstrips IIA-S.H.V.E.1"
Guide —
rdGwsl� rs I'�eference !I Qvt, iIVa!I Int. Wall _<°eil:[ag_Roof ( Floor-�---Ilo•v �.ppli�3
_ ---� i
FI �/r',t°-4 Doral Length idtli /;'�eil:E eT`''` !Len t:ia?ti,•
a Y r
Windows and D ors—Crackagt and Area
G y
Coe Ecu — —
j�
_--\
__ \h'tJ h Height
yo. of of Da W
1C o. of Lineal ft.
lights of rr ck
Area
ft.
_
Y.'`
Infiltration ty-
Class
Exp. wall
Vet eap. wall
Sat. wall
C /
Cciling:-
}=1oor
f
W_ irJ `,�:ird Dec s-- Cracl 'p and Area
s t nca! PC. Aaea
II No. 1.° e 1 D� 1 at cf. rark eq. ft. tt,-1 •
�—
C;lasl
F,' - wall
Nt.t :xo_. wal! _
Pnt. •e•,
Nw.
1'e?ui ed •�. fi. F,a .b. f c[ s ins. W.A. Lead,
7—
!'1 1 r � f ) S, r::5•`.Cr^ !Mp t'r•.9�-1 A� .: -
a e
`_�• `, ,i t^,. ;;,r---�Crac'a r - a,<d :,Tea
W -A. Loatier area.
�meatEt�Y!t:la9 i _ :s a� 1134i�*i
OQJ' ows� ors Reference i -Out. ��Yail 1 Irt. gall (ez?.r� i $iaofl lo
-- —___.—
!! w A l
. ied
es7- o Yes o I. 19�
FII -_
s Room (Length T Width 7 - Hsi h@ r °'1 t . '- - �•- -=-=
--- B g t�/ Fl.'�T; :' -'ram i< 1t1 v lYi9th f '� 1IP� ht
Windows and Doors—Crackage an Area
9
N of ane of Ga a
t an f pa a
No. of L1nea1 ft. Area
Itghtq nt t sq. ft.
Y'Total
exp. wall
Int. wallPoor
Ceilintg
Btu.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiiing
Floor
,
squire t . W.A. Jeader area
Fl•� m I Length aVidth H, ht
1 o nd rackage and Area
kith Height Ydo. of Lineal ft. Area "�/
No. l ane otpone lights of4r&
�•' _ °tip
OIL
111111OF11 i+ /"IMAI l
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
in
quire E.D.R. or aq. ins. W.A. ader area
'�• oom Length Wideh
Windows andboors—Crackage and Area
Width Height .No. of Llncal ft. Area
o4pane of ne light• of crock sq. ft.
I
Infiltration
_Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
Tbtal Btu.
ft.
Windows and Elo-:°s--rrrackage and AreAxt
j� V:Vd'n Lineal Yt.
f — Nr•._ 1 .,P
)a,e e «;,. j ryuhin rt at L
- -- �–_ -� — C2el: BtIs
Ea
P. wall
Net cep. wall -
Int. wall
Ictal'Stu. ._
arV` q, ft EPAR sq. ins. �Lmader rrers
Length/_:'Width I -Leigh _
Windows and Doors—Crrckage and Area f
'W'tdch $I61ght 1Jo. ot�LUte:.! ft. arra �/ '
pane I of I:ane lights ct crack sq. ft.
Inrilts•ation
_Glass
Exp wall
t��
Nct exp. wall
Irt. wr % -
Port -
r.
Tot: ; qtr.
9 _
i1Ct7Yi1"t:d vT. ft. E-D.R2 r:°' vn_ nntt_ VV A. t r„Lr ares
_ F•.,
- Windows and "Doors—C
—r*;a'Idch fieiaht
No. of pane of !,ano I!
Width
e and Area
.'noel tt.
ck aa. tt Area
of cra
Required sq_ it. E.®.R-or so. ins. WA, ["der even
Glass
Exp. wall -
�Net
.1
--
Y'Total
exp. wall
Int. wallPoor
Ceilintg
Btu.
Width
e and Area
.'noel tt.
ck aa. tt Area
of cra
Required sq_ it. E.®.R-or so. ins. WA, ["der even
SUBJECT
PERMIT
City of Fridley
124'76
AT THE TOP OF THE TWINS
BUILDING PERMIT
i
`
RT NO
L'__"_ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION
SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
812-580-3450
910-F15
4/3/74
JOB ADDRESS 236 Liberty Street N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
37,38
6
1 Spring Brook Park SHEET
2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE
Tri -Co Builders Inc. 7555 Van Buren Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
-7-ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USEOFBUILDING Residential
7 CLASS OF WORK
}Cl NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK Construct a 24' x 40' Dwelling and a 20' x 211811 garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide a hard surface driveway. Provide a verifying survey before
capping. Set house lines parallel to side lot lines.
SEWER LOCATION: 140' East of Manhole (Inv. 847.43)
Wye Elev: 848.13
Top of Footing: 851.13 Minimum
WATER LOCATION: 10.8' East of Sewer Location
HOUSE PLAN SAME AS 280 ELY STREET AND FILED UNDER PERMIT #11,386
SEPERATE PERMITS REQUIRED
FOR. WIRING
HEATING, PLUMBING '
AND
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING. OR AIR CONDITIONING.
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
OR WORK IS SUSPENDED OR ABANDONED FOR A. PERIOD OF 120 DAYS AT
1
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
I
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.
10.38
WITH WHETHER SPECIFIED EIN OR NOT. THE GRANTING OF A PERMIT
$20,756
DOES NOTESUM O IV E UTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISI O A� Y T T E 0 C L LA REGULATING CON-
TRU Tr ION.
$44.00
300.00
PLAN CHECK FEE
TOTAL FEE
!/
$354.38
SIG RE OFCONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPERLY VALID5TED THIS -IS YOUR PERMIT -
BLDG INSP DA E
SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE)
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR DDITION BUILDING PERMIT
CITY OF I-I21DLLY, MINNESOTA
�2
OWNER ' S NAME: _�� � • BUILDER:
ADDRESS: 515 �I�lY�L �G��� /42� ADDRESS:
NO:. '? 3 (0 T STREET;
LOT: 370 3 s' 13LOCK:
v
P
CORNER LOT INSIDE LOT:�_SETBACK: :J'SSIDEYARD 16104
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
Front: o'�`% -Depth:
�� Height:
Square Feet: Fe/0 Cubic Feet c F
Front • -Height: / Ale-
Square"
Feet; Cubic Feet: a"
Type of Construction: Estimated Cost: 6pew° �-C,
To Be Completed :67
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that .ill the facts and represents ions stated in this application
are true and -_.)rr,_-c t .
DATE: —�`�/ S IGNAI
See Reverse Side For Additional Informs on.)
IA
��, t
Land Planning d"Ida"V6-875 Highway No.65 N.E.
Land Surveyjng &Y
• /h� /• /+ Minneapolis,
Soils Testing "leel 'G J _ 11'1r• Minn. 55432
Civil Engineering Telephone 784-6066
Municipal Engineering Engineers & Surveyors Area Code 612
Certificate of Survey for 7PKIIJIV, �.
B&IO j, X,
UPKQTV '�TPUT
59.94 Mens.
r9 I
I `n
.� Q(-irc fe ° it or % ; rrnr�uli7En�
LOT J O Pto c
' k'*'WNG N01� MV
� F t
rr ,�,.j � J 60.0PIat
i9,96Adeus,
12,
�rnrt�o
a a
.� Q(-irc fe ° it or % ; rrnr�uli7En�
LOT J O Pto c
' k'*'WNG N01� MV
� F t
rr ,�,.j � J 60.0PIat
i9,96Adeus,
12,
I hereby certify that this is a true and correct representation of a survey of the boundaries of the above
described land, and of the location of III buildin s, th reon, and all visible encroachments, if any, from or on
said land. As surveyed by me this /1 T day of A. D. 19] .
SUBURBAN ENGINEERING, INC. '
Engineers Surve orf -
by
/ J9
1'/-z Tore
+- a
GIcmletlrrc(
fl. o
c c�
c �*
I hereby certify that this is a true and correct representation of a survey of the boundaries of the above
described land, and of the location of III buildin s, th reon, and all visible encroachments, if any, from or on
said land. As surveyed by me this /1 T day of A. D. 19] .
SUBURBAN ENGINEERING, INC. '
Engineers Surve orf -
by
/ J9
01
SUBJECT
City of Fridley
30280
AT THE TOP OF THE TWINS
?
B
I I L D I N %�
PERM
A I T
Ir
`
v
v
"'v,
_RMUIOT NO.
• COMMUNITY DEVELOPMENT DIV.
� INSPECTION SEC.
r � PROTECTIVE
) L
1 � �
NUMBERREV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIOLEY 33432
612-571-3450
910-F15
9/23/99
JOB ADDRESS
236 Liberty Street E
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
37,38
6
ISPring Brook
Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Phyllis Irwin
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Tabor & Sons 10547 Terrace
-
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION a REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage 19 Sg1 Tear -off
9 CHANGEOFUSEFROM
TO
STIPULATIONS
Underlayment must comply with the State Building Code.
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
AUTHORIZED IS NOT COMMENCED WITHIN 60 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
STALLS
GARAGES
ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1661
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
.$.83
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$60.10
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
Fire SC $1.66
/
PLAN CHECK FEE
FT7AL FEE
Licen C $5.
7.59
SIGNATURE OF CON'RACTOR OR AUTMORIZED AGENT IDATE,
M PRWADTHIS
IS WPRMl?�
S,GNATUAE OF OWNEA,1F OWNER SUROERi MATE.
OG iNSP
01
NEW[ ] w Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �� `
BUILDING PERMIT APPLICATION b2.,�/`\
Construction Address: "D ° h e -
Legal Description: - 5:
Bt�ldin'g
MECHANICAL
Permit No.�bfl
Inspections
RESIDENTIAL APPLICATION
Received By: ,
763-572-3604
CITY OF FRIDLEY
DatREM AUG
763-502-4977FAXEFFECTIVE
1-1-05
DATE U YOUR E-MAIL ADDRESS
SITE ADDRESS
THIS APPLICANT IS: ❑ OWNER tC@RACTOR
PROPERTY
NAME; -E.. N,.con
OWNER/
ADDRESS: S6um_4 QA GjbOy -- CITY STATE ZIP
TENANT
PHONE:
CONTRACTOR
COMPANY NAME: i
NOTE:
SEPARATE CITY
CONTACT PERSON: �OL4 t
STATE LICENSE # EXP DATE
LICENSES ARE
REQUIRED FOR GAS
AND
�9 /y�
CITY a STATE M VZIP 57J
ADDRESS:- a
d
SUBMIT COPY OF BOND
�y / 2
PHONE a FAX Ito v� a S 4 J7
ANDINSURANCE
TYPE
FAMILY ❑ TWO FAMILY 13TOWNHOUSE
XSINGLEPERMIT
TYPE OF WORK'
❑ NEW PLACEMENT ❑ ALTERATION/REMODEL
DETAILED DES RIPTION OV WORK 4 ii dYki
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 )
OR
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) Q
Equipment Installed MFG: MODEL: (H ' SIZE/BTU
MFG: MODEL: 2�� SIZE/BTU
MFG: MODEL: SIZEIBTU
A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00
AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
_1BOILER $35.00 FURNACE $35.00 _GAS UNIT HTR $10.00
_ CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00
DUCT WORK $10.00 =J= GAS PIPING $10.00 _VENTILATOR $15.00
PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500
Permit Fee $ Number of fixtures @ $10.00-:;t, x $10.00 = $76co
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ OR Number of fixtures @ $25.001_ x $25.00 = $ ol5. W
Number of fixtures @ $35.00 - (— x $35.00 = $ 3.00
State Surcharge = $ .50
MINIMUM $15.50 MINIMUM $1550 Total = $ 70-5
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a mechanical 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 ota Construction Co es; that erstand this is not a permit but only an application for a permit and work is not to
start without a permit; that the work wi a th the latt th case of all work which requires review and approval of plans.
SIGNATURE OF APPLICA PRINT NAME V f-lkj k" DATE
APPROVED BY DATE
PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-5024977
Building
PLUMBING
-11
Permit No - �0 ' r
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRMLEY
Dat
763-502-4977 FAX
EFFECTIVE 1-1-08
J – z JJ'C1C `�'2SG
DATE ,9 YOUR E-MAII DRESS z �vI
SITE ADDRESS .3/7
THIS APPLICANT IS: ❑ OWNER CONTRACTOR
PROPERTY
NAME: Eel y/ V C, V—),A
ADDRESS: CITY STATE ZIP
OWNER/
TENANT
PHONE:
CONTRACTOIt.
NAME: R GL V) O h
It/ STATE LICENSE # fEXP DATE
SUBMIT A COPY OF
YOUR STATE
LICENSE, BOND AND
STATE BOND# EXP DATE
CERTIFICATE OF
p�
ADDRESS: ! l %4 �lo/� 1. J� Q STATEZIP
INSURANCE
2! 19 -CITY
�y
PHONE 74 :5'—✓]S t%7 FAX %6.3-78° /Qf 3'�
PERMIT TYPE
�4INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW PLACEMENT
DETAILED DESCRIPTION OF WORK
�44T4 tr /_' ".-e6 twi ,SLs�
PER MS 1613.665 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 = plus .50 surcharge
OR
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW). MINIMUM FEE $15.50.
BATH SINK/LAV DRAINSSHOWER WATER PIPING
_FLOOR
_ GAS PIPING (NEED CITY LIC) _ SWIMMING POOL _ ATER SOFTNER ($35)
—BATHTUB
CLOTHES WASHER KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREY. ($15)
_ _
DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION
_
WATER METER OTHER
PERMIT FEE PROJECTS FOR. UNDER $500
PERMIT FEE FOR PROJECTS OVER $500
Permit Fee $Y5Number
of fixtures @ $10.00 x $10.00 = $
Surcharge .50
Number of fixtures @ $15.00 x $15.00 = $
OR Number of fixtures @ $35.00 x $35.00 = $
TOTAL DUE $
State Surcharge = $ .50
MINIMUM $15.50
MUM $15.50 Total = $
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing 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 applica 'on for a p t and work is not to start without a permit on site; that the work will be in accordance
with the approved plan in caas of al r ich requires review and approval of Tans. c �f a ep
SIGNATURE OF APPLICANT v� PRINT NAME �� ���✓� DATE / �v �^
APPROVED BY DATE
PLEASE NOTE: SEPARATE PERMITS ARE RE UIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
�;
I
3uilding
BUILDING
Permit No.: 2V --a. csl
[nspections
65% of Building Permit Fee
RESIDENTIAL APPLICATION
Received By: Q>
763-572-3604
$
CITY OF FRIDLEY
Date Rec'd:
763-502-4977 FAX
$5.00 (State Licensed Residential Contractors)
$
EFFECTIVE I-1-08
$
)ATE ' 15 105
YOUR E-MAIL ADDRESS
$
,ITE ADDREss
$450 Conservation Plan Review
$
Fee Determined by Engineering
PHIS APPLICANT IS: OWNER ❑CONTRAZTOR
PROPERTY OWNER/
NAME:
ADDRESS: ';g 3 F 1-113eRrl =- CITY '��-�Fy
STATE&&LZIP Sy3vZ
TENANT
PHONE: bldg-
NAME:
ADDRESS: CITY
STATE ZIP
CONTRACTOR
SUBMIT A COPY OF
PHONE FAX
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
PROPERTY TYPE
P SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS
ABASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
[❑ DECK ❑ SIDING
IROTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
MAINTENANCE/REPAIR ,$REMODELING
PJ14A%5 8fPTH !�u/W Z€✓CL
A/O") T`1 -1i1111 ETA"
DESCRIBE WORK BEING DONE:
6 -AJ fe�?/tfe-
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT 600
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 MATERIALS:
SING THE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION $ 141,6-60 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
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
lations
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 accord a with the app oved plan in the case of all work which requires review and approval of plans.
SIGNATURE O L NT &GI� PRINT NAME ��L(L A &0VJ k) --DATE-f- /57 -198'
APPROVED BY _ DATR (� '
See Back Page for Fee Schedule
$
65% of Building Permit Fee
$
.001 times the total job valuation
$
7, ,��
.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
lations
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 accord a with the app oved plan in the case of all work which requires review and approval of plans.
SIGNATURE O L NT &GI� PRINT NAME ��L(L A &0VJ k) --DATE-f- /57 -198'
APPROVED BY _ DATR (� '
Building
See Back Page for Fee Schedule
BUILDING
Permit NO,'
$ ,p 3
.001 times the total job valuation
$
.0005 x Permit Valuation Minimum $.50
[nspectibns
$5.00 (State Licensed Residential Contractors)
RESIDENTIAL APPLICATION
Received By:
7637572-3604
ft+6ft= ftx$21 =$
CITY OF FRIDLEY
Date Rec'd:
763-502-4977 FAX
EFFECTIVE 1-1-08
$
DATE /n YOU E-MAIL ADDRESS
$
SITE ADDRESS 936
THIS APPLICANTS-
OWNER CONTRACTOR
PROPERTY OWNER/
NAME:w/— '- dul-v
ADDRESS: CITY ���ilDLE y
STATEA'-0—ZlP
TENANT
PHONE:
NAME:
ADDRESS: CITY
STATE ZIP
CONTRACTOR
SUBMIT A COPY OF
PHONE FAX
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
PROPERTY TYPE
PfSINGLE FAMILY/NEW CONSTRUCTION SIZE
13 TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
T FINISH ❑ ROOF [3 DRAIN TILE
I� DECK ' �� X ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: �E��i
SIZE OF IMPROVEMENT
/ LENGTH WIDTH HEIGHT SQ FT j yG%
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 MATERIALS:
S G THE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION $ �20 4 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
$ ,p 3
.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 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 C nstruction Codes; that 1 understand this is not a permit but only an application for a permit and work is not to start without a
permit on site; work will be in accord c with the ap ved plan in the case of all work which requires review and approval of plans.
SIGNATURE OF A LICAT % �✓ PRINT NAME � U L t; R% DATE
APPROVED BY [,Q -n DATE
.r
L nci Planning su� a � 6$75 Highway No. 65 N. E.
and'9urveyjng Minneapolis,
Sails Testing Minn. ssass
Civil Engineering Telephone 784-6066
Municipal Engineering Engineers & Surveyors Arva Code 612
Certificate of Survey for IOU Roku Q�Oi� N,
I hereby certify that this is a true and correct representation of a survey of the boundaries of the above
described land, and of the Location of qll buildings, thrreon, and call visible encroachments, if any, from or an;
said land. As surveyed by me this � day of A,2P•;, A. D. 19]?Z.
�Cu�e'. �inc.�� `3C �EE� �
•'
�
�
�
� r
i
p
eau
4' 6
{,
Awcfes It of?
.�t'N
i
AHO� 11Y
c�.4%1+/12u3.
12,
A Ile-
I hereby certify that this is a true and correct representation of a survey of the boundaries of the above
described land, and of the Location of qll buildings, thrreon, and call visible encroachments, if any, from or an;
said land. As surveyed by me this � day of A,2P•;, A. D. 19]?Z.