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PRE 2010 DOCSCity of Fridley SUBJECT PERMIT NO. 146 AT THE TOP OF THE TWINS PERMIT ' BUILDING RECEIPT NO. COMMUNITY DEVELOPMENT DIV. s r PROTECTIVE INSPECTION SEC. 1 � � ' o "n CITY HALL FRIDLEY 55432 '.J NUMBER I REV. I DATE PAGE OF APPROVED B 612-560-3450 910-F15 5/12/78 JOB ADDRESS 300 Liberty Street N.E. 1 LEGAL LOT NO, BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1, 2 , 3, 4 5 6 1 Spring Brook Park SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Al Forsland 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. DalbeKg Builders Inc. 1121 -80th Avenue N.E. 784-2720 -7-ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR pOrPat11g 611 fbWNfIitie 8 DESCRIBE WORK TELEPHONE Construct a 5V x 28' Dwelling and a 24f x 24' Garage Kc%0LOIRED BY 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface. driveway. Provide sod in the front and side! yards. Provide a verifying survey by June 15, 1978. Provide combustion tti P; air to furnace. Check U.L. & State Seal. G (f';I ,; y SEWER LOCATION: CApprox. 9' Deep In Street) 52.5 W. of Manhole &!2 �'►` (W. Inv. 844.64) 60.8' S.W. of Manhole %y,�4�i WYE ELEV: 844.90 Top of Footing: 847.90 Minimum `�4 WATER LOCATION: 11.4' E.of Sewer Service, 50.4' S.W. of Manhole4C�'�'g-�0'+ DRIVEWAY DEPRESSION COST: 20' + 6' x $14.50 $377.00 AEP.. TE PERMITS REQUIRED FOR WIRD � ? � ok°� �Q� 1 ING-0 PLUMBING ASID SIGN& % �C9 SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCU O k 0 OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood Frame �'r THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING bult�p t CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 1386+864 36,360 Total OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 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. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �5!'-S&F08.5-' Q*jmU $28.04 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- $400.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. AkifiKii $159.26 PAN CHECK FEE TOTAL FEE -AIM $39.62 MMM $627.12 GNATUREOFCONTRACTOR ORAUTHORIZED AGENT7 (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT ate, �L (a, -j- C /a --2cy BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) i CITY 01 FRIDLEY APPLICATION FOR I;E:5I}:k(:.isa Il1f_ IaIJ(L()I(aG PERI. 1TS �i i�I1d ��f_(I_E�IOTI�iid; c �'DDITImi' , QE? RE PAIR ;1 tdY:f_•sS. No. Zoo TIUILMIR: 4,6,C4 a- Address: ��/�/ 9'ZIo ";7 0_.. Tel. No. :_i ��".� , d Street: BLOCK: � ADDITION: CORN R Lr -)T- l/ INSIDE LOT: SETBACK: .3.5^ SIDEYARDS: Applicai.t attach to this form 'I\.,o Certificates of Survey of Lot and p -O. osed building location drawn on these Certificates. , DESCRIPTION OF BUILDINIG To Be Used As: Fxont:_ ?depth: Height: Square: Feet: Cubic Feet: Front: — Depth: Height: Square Feet: Cubic Feet: Type of Construction.: �/- T-- Estimated Cost: $ _ lb Bc, Coz;i lcted: �' /�� /%�� -�--�.— Jilt. A �'�lt s k'rzJposed Driveway I•:idth If New Opening Is Desired $ $ (SLE REVERSE SIDE OF SKEET) The unders:inned hereby makes ak?plication for a permit for the work: herein specified, agroeing to do all work in strict accordance with the City of Trrid tee%, Ordinances and rulir_us of the Dcpa.rtment of ) uildings, and horeby declares that all the facts and representations stated in this application are true and correct. See reverse side for additional information. MTI: SIGNATURIE: stipulations: � `'� �7� 77 GOG, �w (16.064/y So - BUIL)INu PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building or structure, or for any.addition to any existing building or struc:xrc, or for any alteration or repairs to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: NEW CONSTRUCTION: Single Family Hames and Garages: $4.00%1,000 cubic feet. PLAN CHECK: 25 percent of building permit fee. DRIVEWAY DEPRESSION: (Concrete Curb Streets Only) Alternate A: Removal and replacement of concrete curb and gutter only; Driveway width plus 6 feet x $14.50 Alternate B: Removal and replacement of concrete curb and gutter and install a 3 foot, wide approach with 6 inch depth; Driveway width plus 6 feet x $17.20 ADDITIONAL INFORMATION For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3,00 Zjer each five hundred dollars ($500.00) or fraction thereof in the cost of all. proposed work. In -no case shall the fee charged for any permit as set forth in Section 2 be less than $7.50 plus $.50 state surcharge. 11 14N11. WL NOTE: Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. G Its 11M."I I WO 9W110091.11 Application for a Certificate of Occupancy shall be made teri (10).days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has :been issued. i. C t , EXTERIORENVELOPEAVERAGE "U" COMPUTATION 0WNER � A,C n' 2.%l–Arjn_ SITE ADDRESS CONTRACTOR DATE PHONE Determine working square footage of each. 1. Total exposed wall - area ..... % Z/, (o sq. ft. x!_ 2.' Total roof/cei.ling area ..... sq. ft. x 3001' 00 Total exposed wall area above floor = 15 81,Lc a. Total wall window area ........................... .® b. Total door area................................. _ Zo.0 c; Total -sliding glass doorarea......... , d. Total fireplace wall area....... ..... — e. "Total wall framing area (average.l0q)...:........ , g f. Total net wall area above floor ................. g. Total rim joist area :.......... Total exposed foundation area = h. Total foundation wy'aarea.. ....... / Q i. Toal net foundat o� n area above grade ............ Determine 'U value of each wall segment. Am a. 1 god O X 11U11 . 3-i = Q ,9O s b. �io , O X ..U.. . 13 = 7.28 C. 44 , X 11U.11 , 5 = 23. 32 i d. X Hull _ e. I S8.2 X "U" X 11U11 0 - g•- 14-2.0 X "U" 0- 033 = q -•(o9 h. X 11U11 r fG =®� i . X loull _ Z,7�,�4G 3 ................................... .Total = If item #3 is the same as, or less than item #1, you have met the intent of SBC 6006(c)2. F i 1 Total exposed roof/ceiling area = X 04 Sq ,A j. Total skylight area .............................. k. Total roof/ceiling framing area (average 10%)... 167. .1. Total net insulated roof/ceiling area........... logo ip, Determine "U" value for each roof/ceiling segment. j. k. 6tog. 4 X 11U11 O. 1-_ 15 O(P. U X 11U11 0.042 = 1cS. '2 8 4 ................... ..............Total - ,3 If total of #4 is the same as, or less than 74T2, you have met the intent of SBC 6006(c)l. Alternate Building Envelope Design To utilize the total envelope'lystem method, the values established by the sum of items #3 and #4 shall not'be greater than the sum of items #1 -and #2. 1. + 2. C), 4-41 i 4 - Uw2 1/Rw2 _ 1�I�rJ`l - 0'0.§ "R" and "G" Value: Analysis of the 1•lall Sections *.F.Insulated area between studs R -Value, - .68 Interior air film 1 I' { ` 0 T. S U t. C, ION t ` -,u _ - 5,41 t—L-�.17 Exterior air film Total "Rwl" Value UW _ 1/Rwl - U . - - 0.055 �. C.Studs/Framing Area* R=Value .68 Interior air film o,45 i 4,38 3')z goad. S-ro to iy � - l ' 541._.... _I" ;. - • 1 t. 1' U .17 Exterior air film Total "RW2 Value Uw2 1/Rw2 _ 1�I�rJ`l - 0'0.§ 5 _ AP.y, Rim Joist Area R -Value — r .68 Interior air film Imo- • �> > x_88 Zoc �.--�.Qod . f3ox So�sr 17 Exterior air film 30'LA;k Total "Rw3" Value UW = 1/RW 3 3 Foundation Wall Area (above grade) R -Value .68 Interior air film .17 Exterior air film . Total "RW " Value U4� = 1/Rw = 1/, _ 4 0.1f' Door Area The door units have been tested and found to have an R -Value of 7.81 including air films. Ud1 = 1/Rdl = f--7 1�. "R" and "U" Value Analysis of the Roof/Ceiling Sections. 40.,k,Insulated Area between the Joists R-Value .61 Interior air f ilm to v I 0.4.5 'I z" cu 06 (;map .61 Interior air film r o�3�iO1 Total "Rw 1 Value Uwl = 1/Rwl = 1/. =E64 2 (.,..,Joist/Framing Area R -Value .61 Interior air film .61 'Interior air film Total "Rw 2 " Value Uwe f GEOTECHNICAL 1925 Oakcrest Avenue 26 - 7th Avrue North j7l a v PROJECT: ENGINEERING CORPORATION Roseville, Minnesota 55113 (612) 636-7744 St. Cloud, Minnesota 56301 (612) 253-3451 (Direct written correspondence to the Roseville office.) REPORT OF DENSITY TESTS PROPOSED RESIDENCE 300 LIBERTY STREET FRIDLEY, MINNESOTA GEC JOB NO. 1753 INTRODUCTION REPORTED TO: DALBERG BUILDERS, INC. 1121 80TH AVENUE, NORTH EAST MINNEAPOLIS, MINNESOTA CC: FRIDLEY BUILDING INSPECTOR C/O DARRELL CLARK DATE: JUNE 6, 1978 Three field density tests were conducted at the referenced site on June 5, 1978. The tests were done uaing the Density of Soil in Place by the Sand Cone Method (ASTM D 1556). One Standard Proctor Density Test (Moisture -Density Relation of Soils using a 5.5 lb Rammer and 12 inch Drop ASTM D 698-70) was also conducted. Relative density was then computed by dividing the field density by the Proctor density, expressed as a percentage. The results of the field density tests are as follows: TEST TEST MOISTURE PROCTOR RELATIVE NO. DATE LOCATION DEPTH* CONTENT (%) NUMBER DENSITY (Jo) 1 6-5 Rear footing line and 3' 7.2 1 97 33' west of SE corner 2 6-5 12' east and 22' north 6Z' 5.5 1 101 of SW corner 3 6-5 6' South and 4'West of NE corner 3/4' 6.6 1 100 * Below basement slab The results of the Proctor test are as follows: HYDROLOGY • SOIL AND FOUNDATION ENGINEERING • TEST BORINGS MATERIALS TESTING a PERCOLATION TESTING 9 ENGINEERING GEOLOGY a CONSTRUCTION INSPECTION GEC #1753 Page 2 PROCTOR OPTIMUM MOISTURE MAXIMUM DRY NUMBER SOIL DESCRIPTION CONTENT (%) DENSITY, (pcf) 1 SILTY SAND, fine grained, 11.4 112.0 brown, (SP -SM) qWAVA.Mito Based on the results of the field density tests, it appears adequate compaction of the backfill material has been achieved. CLOSURE Report Prepared By: Charles W. Bisek Under the Supervision of: Obert E. Pendergast Minn. Reg. No. 8450 ' Geotechnical Enqineerinq Coraoration I CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $3.00 $� Future Fixture Opening � x $2.00 u New Fixture, Old Opening x 0 $ Water Catch Basin x $5.00 $ Water Heater - to 99,000 BTU x $5.00 $ m x $10.00 $ Water Softener Heater $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater ! x $5.00 $ GAS FITTING FEES: lst 3 fixtures x •$3.00 $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ a w 8 ai V First $100.00 $5.00 $ O $2.00 FA, w u ai c S H ob0 aro c5 c� as lec ,02 1st 2nd 3rd 4 th (R) - Future Connection Opening Connected with Sewer M . New Fixture, old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $3.00 $� Future Fixture Opening � x $2.00 $ New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water Heater - to 99,000 BTU x $5.00 $ 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater ! x $5.00 $ GAS FITTING FEES: lst 3 fixtures x •$3.00 $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS & ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ REINSPECTION FEE (510.00) Job Address Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. , 19 OWNER~ KIND OF BUILDING r USED AS TO BE COMPLETED ABOUT 7 ESTIMATED COST �✓1��e / OLD - NEW BUILDINGP— ERMIT NO. t� PERMIT NO. Compan Signed Tel. N ROUGH INSP. Date FINAL INSP. .0 Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SMCMU GE CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work $12.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Repairs & Alterations each add. $500.00 4.00 $ MECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTU $12.00 $ m G each add. 50,000 BTU 4.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Repairs & Alterations each add. $500.00 4.00 $ STEAM OR HOT IiATER SYSTEM: Boiler & Lines up to 100,000 BTU $12.00 $ each addn. 50,000 BTU 4.00 $ Boiler only up to 100,000 BTU 7.00 $ each addn. 50,000 BTU 6.00 $ OIL BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ /6. (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: 0 1st 3 Fixtures x $ 3.00 $ © 3. Additional Fixtures x $ 1.00 $ Gas Rahge to 199,000 BTU x $10.00• $ AIR CONDITIONING $ FAN HEATING SYSTEMSSee Fee Schedule $ VENTILATING SYSTEMS $ _ALTERATIONS f, REPAIRS $ State Surcharge $_ 50 TOTAL FEE $ '�U 3 v ROUGH INSP. REINSPECTION FEE Date ($10.00) FINAL INSP. Date � V a APPROVAL FOR PERMIT MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHAM Job Address JO o Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. ZI I 'd Fridley"Minn. C�Jg!✓r F . 19?10 OWNER KIND OF USED AS Cf__ TO BE COMPLETED ABOUT ESTIMATED"COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. • DESCRIPTION OF FURNACE/BURNER C HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No._':5"<x/ Trade Name I Size No. Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU d AHP Company 77 �= Signed B Tel. No. ! Lw ���/� i 8431 UNIVERSITY s� t November 28,=-`1978 Mr. Sam Dalberg Dalberg Builders Inc. 1121 - 80th Avenue N.E. Minneapolis, MN 55432 AVENUE N.E., FRIDLEY, MINNESOTA 66432 TELEPHONE ( 812)571-3460 Re: Final Inspection at 300 Liberty Street N.E. Dear Mr. Dalberg: A final inspection was made on November 27, 1978 of the above address and the following items were noted which must be completed before the structure can be finaled out; 1. Post house number on structure by December 15, 1978. 2. Submit verifying survey to City by December 15, 1978. We will expect the above items to he completed by the scheduled date when a reinspection will be made to determine compliance. If you have any questions on these items, please contact me at 571-3450. Sincerely, ay"- DARREL G. CLARK Community Development Adm. DGC/mh suaJEcr PER City of Fridley ' AT THE TOP OF THE TWINS BUILDING PERMIT _ _19276 r RPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 L NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 11/18/87 JOB ADDRESS 300 Liberty Street N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1-5 6 Spring Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Richard Fitch. 300 Liberty Street N.E. 786-8436 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Patio Enclosures 6219 Cambridge Street, St. Louis Park, MN 55416 920-1575 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 XCJ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct an 8' x 16' Porch. 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan WARNING SEPA �i 1NG AND S�GG��� Before digging call local utilities WiW`I' a � TELEPHONE a ELECTRIC - GAS EM REQUIRED BY LAW SEPARATE PERMITS ARE REQUIRED 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 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 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 $1.33 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,650 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $38. 50 LAN CHECK FEE TOTAL FEE "64 Ir-- 9.63 $49.46 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY I ED TH IS YOURPE IT / �% U� SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) --BLDG iNSP GATE NEW [ ] City of Fridley Effective 4/1/86 ADDN. R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: 300 - Legal 00Legal Description: - - - -- t G��,� 3D . /✓�. Tel. 76 Owner Name & Address: �+ Tel. # 'PAD-ISMContractor • ®��/� - Address: 6d,12 Gd✓"dn�s1 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 Width Height Sq. Ft. DECK AREA: Length Width _ Hgt/Ground Sq. Ft. OTHER: d,Ic1� /6 /O�t 410®�l 14 caas b7 416qd L/G back Corner Lot [ ] Inside Lot fa] Ft. Yd. Set � Side Yard Setback �a 6 �6D'' Type of Construction: 1-4-kam Estimated Cost: $ Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation �✓�-Tel. DATE: Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ Fee Schedule on Reverse Side $ 25% of Building Permit Fee $p ,` $.50/$1,000 Valuation $ $ 525 per SAC Unit $ Fee Determined by Engineering $ Agreement Necessary ( ] Not Necessary [ ] SUBJECT PE City of Fridley 2 9 7 AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. i LV RECEIPT NO.� r PROTECTIVE INSPECTION SEC. 3 � I NUMBER REV DATE PAGE Of APPROVED BY CITY HALL FRIDLEY 55432 A-0"'' 612-571-3450 910415 9/25/98 JOB ADDRESS 300 Libe ty Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1-5 6 ISPring Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Steve Daugherty - 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Stock Roofing INC. 289 Liberty - 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 O ALTERATION REPAIR ❑ MOVE : ❑ REMOVE B DESCRIBE WORK Reroof house and garage (28 S Tear-off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2400 $1.20 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- TION OR THE P RFORMANCE OF CONSTRUCTION $74.75 Fire SC 2.40 PLAN CHECK FEE TOTALFEE �A.' ^� License 5.00 83 SIGNATURE OFC N7RACTOR OR AUTHORIZED AGENT IDATEr N ROPE ALIDAT T IS R PERMIT ,eqE g INSP rIAiE S,GNATURE OF OWNER,6 OWNER BUILDER, (DATE I (-j q�u NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 3CY,-) �--\ he r A,u -SA Legal Description: Owner Name & Address: ��e v �O.v� �n e Y Tel. # `1"iG - U A(o(p Contractor: CUe.1L G 7--v\ c MN LICENSE #_� i\ a Address: �Rc} Tel. # ��(.i - ?)-S(R Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. 22 " V�P Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: CA a.5 9q APPLICANT: Tel. #! Y& - '35(o CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ /,70 $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ -5L' $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: SUBJECT P City of Fridley 32638 AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. cQ S6 6& 1 � � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 9t 0415 5/24/02 JOB ADDRESS 300 Liberty Street NE I LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1-5 6 Spring Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Stephen/Kim Daugherty 300 Liberty Street NE 763-780-0266 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE : ❑ REMOVE 8 DESCRIBE WORK Remodel kitchen and demo two walls 9 CHANGEOFUSEFROM TO STIPULATIONS See stipulations on plan. S BERATE PERNiIT� QUIRED FOR: ?LUNIRid ANgi ®SIGNS SEPARATE PERMITS ARE REQUIRED 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 BO 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 1 STALLS 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 $1,500 $.75 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT W 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- $ STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE $5y.25 IGNATURE OF RACTOR OR AUTHORIZED AGENT IDATEI EN OPE AT D IS IS YOUR PERMIT FrNsp - OATE Si NATURE OF WNER qF OWN RBWLDER (DATE, NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 5723604 Bldg Insp ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 300 L , b -e H-6. n/,E . Legal Description: �( Owner Name & Address: f Tel. 42 Contractor. _O w 1A eR MN LICENSE # Address: Tel. # LMNG AREA: GARAGE AREA: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft DECK AREA: Length Width Hgt/Ground Sq. Ft ,4 OTHER: Re IMed4 1,aL.. a Kdl bey -.o IN,e1l rmsi `� Lae &0%01 �J Construction Type: Wo -64 Frg w%e` Estimated Cost: $I 11, -5-60 Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ —=$ DATE: APPLICANT: -Tel-#7A; -20o-6.2,C4' Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 63-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fee Schedule on Reverse Side Fire Surcharge $ % ' S 0 .001 of Permit Valuation (1/10th%) State Surcharge $ , 77 $.50/$1,000 Valuation SAC Charge $ $1200 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ . Fee Determined by'Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ +c-:;) S� STIPULATIONS: 3333' -- 154Pq �— 30 66 8V6 201 801 501 ---- 6 11512 — 3 6 - 6 4e 15 30 2-4 --Z+ 18 1131 24 10614 24 ---/ 12 24 - 3,6 15 18 30 30 —th- - - 36 W3636 i! ;:�Wl 5 W3,'624 W18 !CW2436 MW 1 241 1 1371 tci Z- -- - ==---- -_-. kZ4 SB36 B15 DBl 8 BE312 DISH. 24. Qr-- - L B24-1 B24-1 B24-1 B-SS2 B S -S2 B SS2 R-GB30/05 BS 6R 3 N W 18 161 18 loll 3624 -- -- -65 z� 36 -3 1137 :-UT 18 .7 5 581i .13 ;291! V/ • 8 3 2 4 6015 97 413 42 7 a 14 oar s� a, 140VP�;� D 4J PAN APPROVE ('�/ ���� ECT TO FIELD .� ��=� /don A00% All dimensions & size designations THE given are subject to verification on job site and adjustment to fit job HOME D conditions. This is an original design and must not be released or copied unless OT applicable fee has been paid or job order placed. 82101135 Scale: ma)drr Am Wood Newport Steve & lQm Daugherty 300 Liberty St. NE Designer Fridley, MN I Darcy �_, i a ted- t-RIULtY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR t11c-t:u,ic uii .;air i, 2002 PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range** NO. RATE TOTAL Gas Dryer** . Back Flow Preventer Required ( )Yes () No N $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 Type $15.00 JOB ADDRESS 300 �'&rkA 17f , N. FY M (e y; 1'4v,- 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 true and correct. Owner Building Used As i' me_ Estimated Cost PLUMBING COMPANY 0 PERMIT NO. L 7 3 Reinspection Fee $47.00/Hr SIGNED BY TEL N0. 76 3 H6 - Z t6 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS FAX # 1.5% of Value of Fixture or Appliance . Approved By Rough -In Date Final Da State Surcharge .50 j MINIMUM FEE F R ANY PLUMBING/GAS PERMIT IS 20.00 TOTAL FEE $ PLUS THE $.50 STATE SURCHARGE F ST) COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED GnMMQN VFNT, VFNT _QNNF _TQR AND OMB ISTION AIR VFRIFI _ATIml When re la ring an PAsting fur2neta, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes( ) No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes( ) No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing cnmh ,_atien air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to install a new cnmhustien air. it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When installing a new venting Ustam,, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( ) No ( ) Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: Signed By: Date : MGI THE MCSHERRY GROUP, INC. STRUCTURAL ENGINEERIN© SEIMCES -: Mr. Steve Daugherty 300 Liberty Street h _ Fridley, Minnesota 55432 Home Phone: (763) 780-0266 ` RE: Daugherty Residence Limited Structural Evaluation McSherry Group Commission Number 02202 Via: Mailed July 08, 2002 (Draft) Dear Mr. Daugherty: Thig-mpodrxiatains the written findings of our Limited Structural Engineering Evaluation for the residence located at 300 Liberty Street indle-y Minnesota 55432. This evaluation was performed according to our consulting agreemen e e 12, 2002. The primary concerns of this evaluation were the current holes in the main floor wood joists and poss oles in the roof joists at the residence. The evaluation was limited to those items. The following are the results of our evaluation. Information Available for Review: The only items used to arrive at our findings were discussions between you and myself and the site observations made on June 15, 2002. No building drawings were available for our review. General Information and Observations & Recommendations: 1. The results of our evaluation are based solely on the site visit conducted on June 15, 2002 performed by Doug Fell of MGI and verbal information that you have given us. Present at the site were Mr. Doug Fell of MGI and you. 2. Field notes, sketches and digital photos that were created as part of this evaluation are on file in our office. 3. Only materials listed above were available for us to review. 4. Weather records were not available nor were they obtained by MGI for this report. The homeowner may choose to obtain these records if they desire from the National Weather Service or other sources readily available from the Internet. 5. For the ourposes of this retort, the front of the house faces north, which is Liberty Street. 6. There were 2 1/8" inch diameter holes drilled by the homeowner into many of the floor joists at approximately mid depth, at approximately 4'-4" from the center support beam end of the joists. These joists are right at their structural capacity limit and we are at this time suggesting that the holes be reinforced to reduce the potential for crack propagation radiating from the holes (stress concentration points). The reinforcement should be in the form of 6" square by %" thick plywood material on each side of the floor joist attached to the joist with full contact structural adhesive and four temporary screws on each of the plates Into each side of the joists. The plywood cover plate should be centered over the opening. No additional holes should be drilled within 2'-0" of any existing hole. 7. The roof joists could have very small (say %" diameter holes) drilled at approximately mid -depth of the member for minor penetrations of electrical materials. These should be single penetrations without grouping the penetrations together. These openings would not appreciably affect the load capacity of the members. 0Any variations of these penetrations should be brought to the attention of the engineer, In writing, prior to Installing the penetrations. Continued on next page... 1523 Selby Avenue St. Paul, Minnesota 551048304, USA Phone (651) 731-0308 ■ Fax (651) 73143421 ■ Toll Free: (800) 321-6719 ■ Website: www.mcsherrygroupine.com ■ E-mail: mgi@mcsherrygroupinc.com July 08, 2002 Page 2 Daugherty Residence Limited Structural Evaluation. MGI Commission # 02202 for Steve Daugherty General Information and Observations & Recommendations, continued: DRAFT On the end of the back side of the house, there is a floor joist that had been reinforced by the home owner due to cracking from the hole within the joist. This hole should also be reinforced with a similar reinforcement as was outlined earlier within this report Some floor bridging should be added to each side of the repaired floor joist to share the loads to adjacent joists. This bridging could be solid bridging or could be metal cross bridging. Some of the floor framing under the kitchen area was at 12° on center. The framing adjacent to that area was at 16° on center. I suggested that some additional bridging be added to the area where the framing is at 16° on center (near where the washer and dryer will be) to reduce the amount of differential deflection of the floor joists by having the joists share the loads together. This bridging could either be full height solid bridging or metal or wood cross bridging. Summary The items listed above should be easily repaired/monitored and does not appear that they will be a significant source of concern for the homeowner. Fire ratings, means of egress, ADA requirements or any other factor not specifically addressed within this report is excluded from this report. Due to the nature of the structure, additional movement, deflection, etc. may occur, however, based upon our review, there were no signs of significant structural distress. Report notes, photographs, sketches, etc. that were used in the preparation of this report will be kept on record in our files. This concludes our limited structural engineering evaluation for this residence. I hope this evaluation has met your needs. Please let us know if there is anything that you would require regarding this evaluation or any addition future projects. It has been our pleasure to serve you. Respectfully; The McSherry Group, Inc. Douglas L. Fell, P.E. Director, Structural Engineering Services CEO cc: Project File Evaluation Report File I hereby certify that this plan, specification, or report was prepared by me or under my direct supervision and that I am a duly Licensed Professional Engineer under the laws of the state of Minnesota. Signature Typed or Printed Name: Douglas L. Fell Date: Reg. No. Certification is only for page 1-2 of this letter dated July 08, 2002. CONCLUSION OF REPORT Building $ BUILDING Plan Review Permit No.: Inspections Surcharge RESIDENTIAL APPLICATION Received By: 763-572-3604 $ .001 x Permit Valuation (1/10%) Date Rec'd $ _ 40 $5.00 (State Licensed Residential Contractors) CITY OF FRIDLEY $ $1450 per SAC Unit (Plans to MWCC for determination) DATE 57/a4 ° 6 YOUR E-MAIL ADDRESS ft + 6 ft = ft x $20 = $ SITE ADDRESS 3 do ig ally $450 Conservation Plan Review THIS APPLICANT IS: ❑ OWNER ®CONTRACTOR Fee Determined by Engineering PROPERTY OWNER/ NAME: PA4y ---47y Agreement necessary ( ) Non Necessary ( ) TENANT ADDRESS: 3,9 O 1: 9*R7 y s t CITY IA, nkl STAT&-hw ZIPAg3,& PHONE: 743- a¢s- `3-7` CONTRACTOR NAME: Lx/61 r,,,L 1i STATE LICENSE # Oc AC11s3 G EXP DATE o SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 120-0- 13TH I vt N CITY �o „z_ „z M STATP IeZIP-Y$441 WITH APPLICATION PHONE 74 3. 3 f/ ^ D 30 t FAX 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 ❑ SWARMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE:--47zpoi��Aod 95A097 SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES _ MOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan 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 WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations 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: 7T' I�. (USING TH_EJS7 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $'S d OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $ _ (.0005) times the total job valuation — Minimum $.50 Fire Surcharge $ .001 x Permit Valuation (1/10%) License Surcharge $ _ 40 $5.00 (State Licensed Residential Contractors) SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ / ®l7_ 14 Make checks payable to: City of Fridley Attach Stipulations 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. SIGNATURE OF APPLICANT PRINT NAME�'f� Jf' DATE Sia s��6 3uilding BUILDING Permit No.: inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY nate Recd: )ATE YOUR E-MAIL ADDRESS ;ITE ADDRESS oci e i HIS APPLICANT IS: ❑ OWNER PCONTRACTOR PROPERTY OWNER/ NAME: , ADDRESS:^� a CITY i L (` 'y//( STATF�ZIP T 1T_ /.O� TENANT / PHONE: CONTRACTOR NAME: ,,,NQ , 1-, STATE LICENSE # G ` EXP DATE SUBMIT A COPY OF `I L;2 �' CITY L b E-, � STATiLdl!`„_C C0 YOUR STATE LICENSE ADDRESS: WITH APPLICATION PHONE — ��I FAX 11 PROPERTY TYPE O'SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE P -DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: NEW ❑ ADDITION RMAWTENANCEIREP ❑ REMODELING DESCRIBE WORK BEING DONE:—b—" i I CV Rl - 01 SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Fte ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 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 ❑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: �p cT1SIN THE 199- U.B.0 FEE SCHEDULE) TO AL JOB UATION $ . 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 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) $1550 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 savable 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 anif 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 w ch r e w and approval of plans. r( SIGNATURE OF APPLICANT PRINT' NAME r k 1 S' DATE