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PRE 2010 DOCSCity, of Fridley, Minn.. BUILDING PERMIT Date: ; Owner: der _ Address _ Address OCAT,ON F BUILDING No. ✓ r3treet — +� Part of t Lot —.__ Block ddition or Sub -Division I Q;;�491 Corner Lot —,Inside Lot — A Setback ,, Wr Sideyard 9/22 Sewer Elevation ____ _ Foundation Elevation DESCRIPTION OF BUILDING To Used y ' � ,py Front — Depth =+ Height Sq. FL Cu. Ft. Front Depth H t Sq. Ft. _ _ = Cu. Ft. _ Type of ConstructionIE.CZ - Est. Cost1'o be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $,_, permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation oany of the provisions of said ordinances. .00�, ---L^ Building Inspector NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for these hems. d APPLICATION FOR BUILDING PERNQT CITY OF FRIDLEY, MINNESOTA Owners Name Builder a Address Address LOCATION OF BUILDING No. StreetL Part of Lot Lot % `V Bloom . / Addition or Sub.Div. Corner Lot Inside Lot Set Back S Side -Yard /J SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: " S- 3 Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Eastimated Cost To be completed 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 ruling of the Department of Buildings, and hereby declares that all the facts and representa- tions stated in this application are true and correct. (A DATE 3 .l SIGNATURE (A Schedule of Fee costs can be found on the Reverse Side.) SPI Application for Power Plants and; Heating. Cooltoing, Ventilation, Re%igeration d Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU, 4-7470 GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... 8.00 $ A= Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ... ................... 2.00 $ _ Replacement of Furnace ............................. .§.00 $ Repairs & Alterations—up to $500.00 ... ............ 5.00 $ Repairs & Alterations each add. $500.00 ....... :....... 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam....... 8.00 $ k Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ ' Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ t Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTL) ....................... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS 8c REPAIRS TOTAL ROUGH FINAL 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 Ordinances 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, 1V!!nn "-/" _F , 14/ Owner Kind of Building / Used as CS To be completed about _ Estimated Cost, $ Old—New. Building Permit No. '"� Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water Warm o 0 NE - Trade Namef I�A rjy Al R L Size No 00 C Capacity Sq. Ft. EM.R /00 002 BTU H.P. Total Connected Load Kind of Fuel �/TS BURNER — Trade Name . Size No Capacity. (REMARKS -OVER) Sq. Ft. E.D.R BTU H.P. Sign ® 44 ^S 4fb G By / y�'��?: "4Z 2M 7-59 Business Phone No. C✓ ��© HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS, MINN. Weatherstrips* S.H.V.E. Construction No. Insulation Guide aintNo wsrs Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How. Applied I . Ye No 19—, /Fl. /I vl� J Room I Length.7/'. Width /L,l� Height Fl.� Room Length�t/ —Width / HeightePI Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. G So Btu Exp. wall &.1- e7o `- s &0 Oi�% -:?7 0 �u oC z /5— /0. Required !&$t. E.D.R. or sq. ins. W.A. Leader area Fl. 1 4 ni IJ o oom I Length %% Width % -' Height lle7 Windows and Doors—Crackage and Area Coef. Btu Infiltration _,-5V- _-719 Glass G So Btu Exp. wall &.1- � `- s Net exp. wall 6, 71- ® I Afe Int. wall Exp. wall ,V — Int. wall Ceiling /® /0 &O Floor Oe Floor Total Btu. -:570 1 A.6 l Required !&$t. E.D.R. or sq. ins. W.A. Leader area Fl. 1 4 ni IJ o oom I Length %% Width % -' Height lle7 Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. , / _,-5V- Coef.1 Coef. Btu Infiltration — `- s ,/ Glass �Q -e,17 29 Exp. wall ,V — Int. wall ,6 /® /0 Net exp. wall (j7ya Floor Int. wall -:570 Floor 67 Ceiling Q ,� ®� f® �® Floor p Total Btu. Require ft. E.D.R. or sq. ins. W.A. Leader area FI.ID F a tV'Vr Room I Length % "f Width /, / Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack sq. ft. , / Coef.1 Btu Infiltration Infiltration `- Glass ,/ Glass �Q Exp. wall Net exp. wall Exp. wall Int. wall /® /0 Ceiling (j7ya Floor Int. wall -:570 Total Btu. 447/' Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Width Height No.of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Coef. Btu Infiltration `- Glass ,/ Glass �Q Exp. wall Exp. wall Net exp. wall /® /0 Net exp. wall Ceiling Int. wall -:570 Floor 67 Ceiling Q ,� f® �® Floor Total Btu. I I %O y� Required !y. f .D.R. or sq. ins. W.A. Leader area FI.I f n�0 i1! m 1 Length /,/"Width A,/ - Height / Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration `- Glass A �® �Q Exp. wall Net exp. wall /® /0 Int. wall Ceiling -:570 Floor 67 Q ,� Total Btu. 1S Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 ce_4 el Room I Length vr's Width ,P Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef.1 Btu Infiltration `- Glass S -V Exp. wall Net exp. wall /® �® Int. wall Ceiling -:570 Floor 67 Total Btu. �C Required sq. ft. E.D.R. or sq. ins. W.A. Leader area City of Fridley, Minn. BUILDING PERMIT N°s 117 Date:o Builder Address Address ,/ CATI N B LING N Street t Block Addition or Sub- Corner L� _ Inside Lot hackideyard Sewer Elevation Fo dation Elevation DESCRIPTION OF BUILDING T e ed as: .� Front Depth y Height Sq. Ft. Cu. Ft. ._.— Front Depth HeightSq. Ft. cu.Ft. F't. ,�`_.rmW of Construction Est. � To be Completed Type.. , p In consideration of the issuance to me of a permit to construct the building described above I agree to do the proposed work in accordance with the description above set forth and in compliance with aft provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of ,permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express crondition that the peon to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform ffi aII respects to the ordinances oP Fridley, Minnesota regarding location, construct[on, alteration, maintenance, repair and moving of buildings within the city liaoits and this permit may be revoked at any time upon violaof any of the provisions of said ordinances. Building Inspector NOTICE: 'fhb permit dos not cover the conttructiay hwteWen for whim plimbine, en hedk& ower or waMr. Be sure to m the Bulmhm Wpcctar for "perste permits for thea home. owner's Address APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOC ION OF -tANRING Part of Lot % Lot Block Ad ion or Subdivision 4 Corner Lot Inside Lot Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To used as: Front ® Depth--Z�2- Height / Sq. Ft. Cu. Ft.�� Front Zo Depth — Height Sq. Ft. /1y0 Cu. Ft. Type of Construction Estimated Cost�O To be Completed The undersigned hereby makes application fora permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Departm nt of Build ngs, and hereby declares that all the facts and represe stated Aff this app l ions are true and correct. c DATE�SIGMA 17 (Schedule of Fee Costs can be found on the Re errs Side). . r SUBJECT PER City of Fridley_ 16073 AT THE TOP OF THE TWINS BUILDING PERMIT r � R COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 � � CITY HALL FRIDLEY 55432 �s NUMBER REV. DATE PAGE OF APPROVED BY S J` 612-571-3450 910-F15 6/14/82 JOB ADDRESS 1051 Lynde Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 1 Lyndale Builders 6th SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ted McCaxty 1051 Lynde Drive N.E. 574-1490 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Norsk cement Company 7401 Central Avenue N.E. 786-1910 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW X7 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 20' x 10' Garage Addition 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR YIRM. HEATING. PLUMBING AND SIGNS. lwl­ via call awin. idwe di�Bl�� I(LE WE 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 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 $2'060 $1.03 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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- $38.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $39.53 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DAT(E)S WHEN PROPERLY VALIDATED THIS IS YOUR ERMI 4' 1 7 ^r2o r` j BLDG INSP SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDENTIAL BUILDING PER14ITS (Um. Alterations, Additions, or Repairs) OWNER: cWa,, (he C,.,ek BUILDER: &21s/C C_rhe:Z�e ADDRESS: 16 ADDRESS: 2Y01 �, ,,� A,,,, AO TEL NO: S kAa TEL NO: 2 L,6— % / o Construction Location • STREET NO: �® �`% STREET: LOT: BLOIX: L ADDITION: Corner Lot: Inside Lot:� Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION A �c Front: CP 0 — Depth: zd Height: Square Feet: o�,)QQ Cubic Feet: QX�00 Front: Depth: Height: Square. Feet: Cubic Feet: Type of Construction: (A)0&j 6:e3� Estimated Cost: $a�Q` To Be Ooripleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET . Tile undersigned hereby makes application for a permit for the %:,ork' herein specified, agreeing to co,all work in strict accordance with the City of Fridley Ordinances and rulings of the Department. of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: / �- ?12 SIGNATURE: !0 (1 Stipulations: FrOPOSUI Page No. of Pages NORSK CONCRETE CONSTRUCTION INC. 7401 Central Ave. N.E. FRIDLEY. MN 55432 Phone 786-1910 ------------- TO Al 5`9 lit•,/= , 8 _u JOB We hereby hereby submit specifications and estimates, subject to all terms a'� %.7% r and conditions as set forth on both sides• as follows; .�wsTi4t.L L/1i9xi46f SG9�s /d J aa' LuSi H GxGx/131��d L,,.iK�n.,Es-� _ f3S xr£SSn,ec� '0P P1�}1iiSP e y to f ish aterial and l=- --mP1"t- sumfnce with at�v�esppc�Qinbb,�7yytions,dollars . ms proposal may be withdrawn by ug if not accepted within days. Sign r� *'4rtPr?t: The above primo s conditions are satisfacto ��cations and / are authorized to dote an es rrebyaccepted •You eta/rof will be made as outlined above Pacified. Payment Sign 10 Date R r SUBJECT PERMIT NO. City of Fridley 28199 I 519-E��ME TWINS BUILDING PERMIT RECEIPT NO. � • _ COMMUNITY DEVELOPMENT DIV.®� r PROTECTIVE INSPECTION SEC. F NUMBER REv DATE PAGE of APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 10/13/98 JOB ADDRESS 1051 Ly nde Drive NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 12 1 L ndale Builders 6th Addition SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Ted McCarthy574-1490 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO D L Builders 1166 14th Ave SE M is MN 5541378-0950 20096711 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 � REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage (28 Sq) Tear -off 9 CHANGE OF USE FROM 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 ISE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT 2399 $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- TRUCTIO THE PERFORMANCE OF CONSTRUCTION 74.75 Fire SC 2.40 ��13 -�V PLAN CHECK FEE TOTAL FEE c $83.35 S AAT RE OF CON TRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERL ALIDATED THIS IS YOUR PERMIT BLD -NSP FIATE SIGNATURE OF OWNEA0F OWNER BUROERI IOATEi r NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: TEi� (V\c- (' u Tel. # S 7 L -t — I `f g !D Contractor: � - L - -�-y" , aez-'. MN LICENSE # zov %to -71( Address: 11(1(a j L4 -1 " se (1\r" SCu ju Tel. # 37 - oq cz 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: Length Length DESCRIPTION OF IMPROVEMENT Width Width Length Width r Height Height Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. cep Construction Type IE#Q 2 Estimated Cost: $ zfab' 60 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: lb - / 3 S APPLICANT: Tel. # 3 7 ?-699 TOTAL STIPULATIONS: $ CITY USE ONLY Permit Fee $ d 7f Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ Z, 20 $.50/$1,000 Valuation SAC Charge $ $1000 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 STIPULATIONS: $ 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: Construction Type: IY�SCzt�� LUy if l4yj Estimated Cost: $ I -In OC Driveway Curb Cut Width Needed: Ft + 6 Ft = t x = DATE: Zb� b APPLICANT: Tel. # -7%3- Z7 Call (763) 572-3604 for Permit Fees if m ' ing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ r� $ , av $ Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ TOTAL $ l 09•.Op'r STIPULATIONS: NEIN [ ] CITY OF FRIDLEY Effective 4/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: t! wnd >° Or IV Legal Description: Owner Name & Address: 1 e -A -t- DOI ori 1Vt cCG1 r Tel. # 7(03 , 5'7�/ Contractor. J C C)asiwc-h0V) NLICENSE#33970 Address:�30-7 ) Canchers ed 1 e� AtJ 55Y32- Tel.# 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: Construction Type: IY�SCzt�� LUy if l4yj Estimated Cost: $ I -In OC Driveway Curb Cut Width Needed: Ft + 6 Ft = t x = DATE: Zb� b APPLICANT: Tel. # -7%3- Z7 Call (763) 572-3604 for Permit Fees if m ' ing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ r� $ , av $ Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ TOTAL $ l 09•.Op'r STIPULATIONS: Building Inspections 763-572-3604 96 SITE ADDRESS THIS APPLICANT IS: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS 0 E - ❑ OWNER CONTRACTOR Permit No.: -2 f )P I/'' Received By: Date Rec'd: Mon'0� IC 0r05 -f C ova PROPERTY OWNER/ NAME: 00/0V -61S MCCar4u See Back Page for Fee Schedule TENANT ADDRESS: /® {,'le Y 117E ITY eL,, PL,, STATELY IP � ,SSy32 Fire Surcharge PHONE: % 3- S% 4- 65 f e127V .001 times the total job valuation CONTRACTOR NAME: D ✓7S C .0005 x Permit Valuation Minimum $.50 STATE LICENSE # Q 0 c? 70 EXP DATE 3L3 1 7 8D7/ $ S_C,C7 SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: C! en`s7EW CITY P STATE:ZIPy WITH APPLICATION PHONE (4 - S- S / FAX -7(D3 - 7i - 9 % C/9 ft + 6 ft = ft x $21 = $ PROPERTY TYPE K&SINGLE FAMILY/NEW CONSTRUCTION SIZE $450 Conservation Plan Review Park Fee ❑ TWO FAMILY/NEW CONSTRUCTION STORIES Fee Determined by Engineering PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED nWINDOWS Agreement necessary ( ) Non Necessary ( ) Total Due ❑ BASEMENT FINISH ❑ ROOF ❑ DRAM TILE Make checks payable to: City of Fridley Attach Stipulations ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: Inafri 113 redacemPnf to Indoors i n ex i s+) nq o peni rA_i SIZE OF IMPROVEMENT NUMBER OF SQUARES _ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other LENGTH WIDTH HEIGHT ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia WINDOWS IN EXISTING OPENINGS MYes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF i iz l72l1 bPC( rD��' OPENING CHANGES & 3 TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used Ft. FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS & PORCHES SUBMIT: I . Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ D 0 OCCUPANCY TYPE Permit Fee $ j _a� See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ a�i (� .001 times the total job valuation Surcharge $ (. 'j .0005 x Permit Valuation Minimum $.50 License Surcharge $ S_C,C7 $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Ci(_Ll 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 applicatio for a permit and work is not to tart without a permit; that the work will be in accordance with the approved plan in the case of all work h requi e r ie and appro al f plans. ��y /n SIGNATURE OF APPLICANT PRINT NAME Vag' l & �� d DATE Building AND MATERIALS: BUILDING (USING THE 1997 UBC FEE SCHEDULE) Permit 90, 60 OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Inspections $ RESIDENTIAL APPLICATION Fire Surcharge e 763-572-3604 Surcharge CITY OF FRIDLEY .0005 x Permit Valuation Minimum $.50 RT�ecd: 763-502-4977 FAX $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow EFFECTIVE 1-1-08 ft + 6 ft = ft x $21 =$ Erosion Control $ J_ 1 /� ADDRESS C 00ki C f U so 6i1 I `c G ns -f 'UC f -Loo mm, cc, r" DATE YOUR E-MAIL Sewer Main Charge SITE ADDRESS 1051 Dr I` E L u i1 dP n Total Due THIS APPLICANT IS: ❑ OWNER AONTRACTOR Make checks payable to: City of Fridley Attach PROPERTY OWNER/ NAME: Tec', O res Al C 6 TENANT ADDRESS: IO J I Lc, o D >r ✓ I L CITY �._STATEIIrLZIPSS �e PHONE: _N 3- 5 7 4- I L I0 NAME: i a qsliuclip -m. ADDRESS:pr7i 4a v1 C e r s Wd CITY fridICLI STATE14NZIP S51Lf3z CONTRACTOR SUBMIT A COPY OF PHONE? VJ �jS ' FAX (p' - -79S` S? 7GI9 YOUR STATE LICENSE STATE LICENSE Cl _�70 EXP DATE .?/O -r PROPERTY TYPE N -SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ffWlNDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR REMODELING DESCRIBE WORK BEING DONE:_ I pl 5-1—uI/% 1 1 N! y 1 r o ,f2 k (& .-n er) W j PiO l+o % q e K! Sv1 � t; j4 e"-7 t, 7 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: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia 2. and proposed project. Two sets of construction plans WINDOWS IN EXISTING OPENINGS 6Yes []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: (USING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ 90, 60 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 $ , .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 =$ 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: 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 Constructio Codes;t I unde and this is not a permit but only an application for a permit and work is not to start without a permit on site; that th w 11 be in acVoe;.ijfi�'�tho%41_ in th of all work which regIsreview andSapproval of plans.///SIGNATURE OF APPLI ANT..L- " PRINT NAME t n eT C C �� i'© �` Q DATE -5 / Ui APPROVED BY DA' 11 PLEASE NOTE: SEPAItkWSERMITS ARE REQUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK 11