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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERM13 N° q�6 Date: Owner: Address +' 5 Builder .t..�' Address LOCATI BUILDING No. Street —� Paikrof Lot 04 V Lot _ �_ _ Block Addition or Sub -Division �`� . ` � Corner Lot Inside Lot otf, Setback Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING Toyt User*: i a Front d epth . 16� Height �_ Sq. Ft — J: "" Lai ]'Pg t Depth ;Height , '.c�' "' Ft CU. Ft. of Construction �' Est. Cost ,�'�-' '' _ To 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 is compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ iZ , permit is hereby granted to to construct the building or addition as descrlbed 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 clone 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 We city limits and this permit may 1e revoked at any time upon violation of any of the provisions of said •= '� _ Building Inspector NOTICE: This permit does cwt cover the construction, Installation for wiring, plumbing, gas hosting, sewer or water. Be sure to tee the Building Inspector for separate permits for these Items. APPLICATION FOR BUILDING PER11IT CITY OF FRIDLEY, A+11rTNESOTA Owner's Name Builder sVI�XX . Address LOCATION OF BUILDING No. �® Street .Part of Lot Lot Block Addition or Subdivision hQjaga -YA��jr Corner Lot Inside Lot ✓ Setback Side -Yard SEM ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: v Sq. Ft. ®10 Cu. Ft. FrontI 1'-!�_Depth 2��Seight Sq. Ft. Cu. Ft. Cost i -�s 00 0 T-� 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 representations stated in this applicatjon are true and correct. A A A ��— (A Schedule of Fee Costs can be found on the Reverse Side.) City of Fridley Appiicatian for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures I'RO� I<_}� Z 1- �� pK O� ~Z 0 �a �G ? �a • R • N WATER HTR. GAS ELEC. o� t�'c t9 t70 Base 1st I I 2nd _ 3rd _ 4th • Fuiure Connection Openings I Connected with Sewer � New .Fixture, Old Openings Cesspool 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, NCnn DEC, 4 1961 , 19— Owner 141 11, L e/ T /3 L D 4 S Kind of Building Used as D W To be completed about PARTIAL RATE SCHEDULE Estimated Cost, $ Old—New. Building Permit No 0s �' Permit No. PLUMBING FIXTURE RATES: NO. RATE TT�OT��AL LONDON ONDON P L � jj D I N Number Fixtures ................ x $1.50 $ Signed Future Fixture Opening ................ x 1.20 $ By� New Fixture Old Opening .............. x 1.00 $ Business Phone No Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ ROUGH New Ground Run Old Bldg . ............ x 3.25 $ FINAL GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ �'•SO Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 REPAIRS & ALTERATIONS—Refer to Code Description............................................... $ TOTAL FEE $ •-SO ° 2 2M 7-59 Application for Power Plants and. Heating, Cooling, Ventilation, .Rel %cork n and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL. Furnace Shell & Duct Work .......................... 8.00 $ 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 ............................. 5.00 $ 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. IDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ 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 BTU) ....................... 5.00 $� GAS FITTING FEES: NO RATE TO L 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 Fes Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE ROUGH NAI' hb� �Ix Dept. of Bldgs. Phone SU 4-7470 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. Owner zap`. ;� e Kind of Building Used as — 7�� To be completed about Fridley, Minn_ DEC 2 11961 , 19 EB 2 11962 o� Estimated Cost, $ d7 2 NEw. wilding Permit No. Permit No. /,f G DESCRIPTION OF WORN HEATING , Warm Air—No- Trade Name Size No S� 7 - o Capacity Sq. Ft. E.D.R �� a-,"-� —BTU—H.P. Total Connected Loa Kind of Fuel BURNER — Trade Nam /�Size No sod Capacity Sq. Ft. EM -R.;;y d BTU P. K EO. SEDGW HTG. IIS- U 1001 Xenia AV. S. Minneap06 16, Min. Signed If By 1101, ^,F •4Z 2M 7.59 Business Pho a No (REMARKS -OVER) HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS. MINK. Weatherstrips A.S.H.V.E. Construction No. Insulation Guide W'frdows Doors Reference .'Out. Wall Int. Wall Ceiling Roof Floor Kind How. Applied esNo INo 19_ FI.I ; ,�� Reem Length �� Width I� p�.. Height II Fl.l [` Room I Length Width Height indows and Doors—Crackage and Area ' Width Height No. of Lineal f . Area No. bt pane of pane of crack sq.. ft. �liipghts ,s1'� w__' F $" i Coef. Coef, Btu Infiltrationl Infiltration -77 777 .6, I )(rGlassExp. / Glass t.) j - Exp. wall It, v' I9 c4j wall t I Net exp. wall ED Exp. wall o 'Ve Net exp. wall Int. wall �., ( to 9Int. wall Int. wall Floor Ceiling' �" c� 731— (� Floor Floor Ceiling � ' , ',. T Required sq. ft. E.D.R. or sq. ins. W.A. Leader area �` \ 1 F1.1 ' d �e�e� Room I Length a ✓'' Width f Height Windows and Doors--Crackage and Area ' � a Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. w__' F $" i Coef. Btu Infiltration Infiltration -77 777 .6, Glass / Glass t.) j - Exp. wall It, v' I9 c4j C Q 0 Exp. wall Net exp. wall ILL Exp. wall o 'Ve Net exp. wall Int. wall �., ( to I er Ceiling 04 k, Int. wall Floor Ceiling `` e' Ceiling 731— Total Btu. I410:/ O.V Required sq. ft. E.D.R. or sq. ins. W.A. Leader area IFI.I P , :.,:,./6" Room I Lenath Width V Height Windows and Doors—Crackage and Area ' Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No.p of pane of pa a lights of crack sq. ft. b' er7 ��tCp x t Coef. Coef. Btu Infiltration -77 777 .6, IL (� Glass t.) j - �,q' I9 c4j C Q 0 Exp. wall I °� ILL Exp. wall o 'Ve Net exp. wall Net exp. wall �., ( to I er , Int. wall Floor Ceiling `` e' Ceiling 731— Floor Floor Floor Ceiling � ' , ',. a Total Btu. 1 5.7 A 4 Required so. ft. E.D.R. or so. 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. WidthHeight No. of Lineal ft. Area No. of pane of pane_ lights of crack sq. ft. b' er7 ��tCp x t Coef. Btu Infiltration 7 -77 777 .6, Glass s ys t.) j - Exp. wall I9 c4j Exp. wall Net exp. wall ILL Exp. wall o 'Ve Net exp. wall Int. wall �., Q, `' �✓ Ceiling'r Floor Ceiling `` e' Int. wall 731— Total Btu. 94 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l .%:' Room I Length /4) Width R I Height �4e. Windows and Doors—Crackage and Area ' Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No.. of pane f.pane lights of crack sq. ft. b' er7 ��tCp x t Coef. Btu Infiltration 7 Infiltration, " el Glass J Y ! I9 c4j Exp. wall Exp. wall o 'Ve Net exp. wall �., Q, `' �✓ Int. wall Ceiling `` e' Int. wall 731— Floor Floor Ceiling � ' , ',. Total Btu. Loy Ld Required sq. ft. E.D.R. or sq. itis. W.A. Leader area e F1.1 A :a_ 1,4Room I Length " � Width Height Windows and Doors--Crackage and Area 1�7- _ Width Height No. of Lineal ft. Area No.. of pane f.pane lights of crack sq. ft. Coef. Btu Infiltration, �0 6 Glass Exp. wall o 'Ve rs t Net exp. wall Int. wall Ceiling � ' , ',. a J Floor " Total 13tu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area " D•56 9 HEAT LOSS CALCULATIONS '' DEPARTMENT OF BUILDINGS MINNEAPOLIS. MINN. Weatherstrips A.S.H.V.E. Construction No. Insulation Guide 'a Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes—No I Yes—No 19____ - 7' Room I Length Width/;:.s Height '` F1.1 Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq.. �frt. / Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. r Room ( Length /�! Width f 3 Height Windows qM Coef, Btu Infiltration Height No. of Lineal ft. Area �'19,4 No. of pane of pane lights of crack sq. ft. Glass Net exp. wall v 3 i Exp. `wall t� ti V iy Net exp. wall y Int. wall Ceiling " e L "', 0 Floor.1 Total Btu., Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. r Room ( Length /�! Width f 3 Height Windows qM Doors—Crackage and Area Coef.Btu width Height No. of Lineal ft. Area Glass No. of pane of pane lights of crack sq. ft. Net exp. wall v 3 i Infiltration Glass Exp. wall+.€ Sr Net exp. wall d` Int. wall Ceiling Floor Total Btu. 3!,o4.- Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l Room I Lenath . Width 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 Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. 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 Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I FM Room I Lenuth Width 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 Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. his. W.A. Leader area Fl.l Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane f,pane llghts of crack sq. ft. Coef.1 Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area II Required sq. ft. E.D.R. or sq. ins. W.A. Leader area City of Fridley AT THE TOP OF THE TWINS SUBJECT P O. 15.3.3 6 g U I L D I N G P E R M I T r • COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. f iCITY HALL FRIDLEY 55432 612-571-3450 RECEIPT NO 116 3dp� NUMBER 910-F15 REV. DATE 7/13/79 PAGE OF APPROVED BY JOB ADDRESS 7350 Lyric Lane N. E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 6 4 Melody Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John E. Miller 7350 Lyric Lane N.E. 784-8459 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Larkin Construction 2100 Stillwater St., White Bear Lake, 55110 426-3410 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 x 8 DESCRIBE WORK Construct a 20' x 8' Addition to rear of dwelling 9 CHANGE OF USE FROM TO STfPULATIONS FOR �V�R TE PEMAITS R,�QUIRGi�S• 1NARNING S� S�p�RpG� 'P1-�M$1NG ANB . NEpTIN Before digging Cel! IMI utilities TELEPHONE - ELECTRtC • CAS Etc. 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 AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SQ. FT. CU. FT. 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $4,050 SURTAX $2.03 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHE STATE OR LOCAL LAW REGULATING CON- STRUCT N OR THE ERFO ANCE OF CONSTRUCTION. PERMIT FEE $27.00 SAC CHARGE NONE < PLAN CHECK FEE TOTAL FEE $6.75 $35.78 SIGNATURE 9 CONTRACTOR OR AUTHORIZED AGENT (DATE) PROPERLY VALIDATED THIS IS YOUR PERMIT =WHEN BLDG INSP OAT SIGNATURE OF OWNER OF OWNER BUILDER) iDATE) CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) I OWNER: ri6 k K � \� BUILDER: � L�(�. �� . ADDRESS: Lc:zy%a ADDRESS: 2100 it (C �V k -f TEL NO: :Zfs4— `_ `f5 TEL N0: 0-a- to - X41® Construction Location STREET NO: 1 3 ® STREET: L)y- % L. LOT: BLOCK: 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 Front: Depth: Height: Squane Feet:�( d Cubic Feet: 1q;1-0 Front: Depth: Height: Square - Feet: Cubic Feet: � 6 Type of Construction :`v�j o v►,N.A'C Estimated Cost: $ ��w/� �A s J L�.1(3M(J � oQ '!b Be Completed: 11t; U � ..3 �' `�'�+� Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET The undersigned hereby makes application for a permit for the work herein specified, agreeing to do 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: -I ` l t - i i SIGNATURE : Stipulations: Pv v 4:S-)( G = .00 G). e (0.1h CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Number Fixtures Future Fixture Opening New Fixture, Old Opening Catch Basin Water Heater - to 99,000 BTU 100,000 BTU to 199,000 BTU Water Softener New Ground Run Old Building Electric Water Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS & ALTERATIONS First $100.00 each add. $100.00 or fraction NO. RATE TOTAL x $3.00 $ M $2.00 $ x $2.00 u x k v x Water 01 x 4 $ x $7.00 $ IIcf.(' � q Qp m ro $+ pa, w $3.00 $ Heater .e+ ai x $10.00 e mm goal p W O '4 L N C N •.1 y O O 49 N N W N M .0 y a wb c ai o w° v°i w v ci°a a 3 0 as lec .1st 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Number Fixtures Future Fixture Opening New Fixture, Old Opening Catch Basin Water Heater - to 99,000 BTU 100,000 BTU to 199,000 BTU Water Softener New Ground Run Old Building Electric Water Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS & ALTERATIONS First $100.00 each add. $100.00 or fraction NO. RATE TOTAL x $3.00 $ x $2.00 $ x $2.00 $ x $5.00 $ x $5.00 $ x $10.00 $ x $7.00 $ x $5.00 $ x $5.00 $ x $3.00 $ x $1.00 $ x $10.00 $ $5.00 $ $2.00 $ State Surcharge $ �y.50 TOTAL FEE REINSPECTION FEE ($10.00) Job Address / 1 AA -e _ '" 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. �.' Z 19 7�? OWNER f KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST C9 C., d� /OLD -JNEW BUILDING PEM T NO. PERMIT NO. Company ' Signed By -7 Tel. No. 3 4 � ROUGH INSP. Date FINAL INSP. J-" 74-0 Date /�,,( APPROVAL FOR PERMIT *4Z - MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE 01 SUBJECT IT NO. City of Fridley 2 6 7 8 6 26786 AT THE TOP OF THE TWINS BUILDING PERMIT r ` NO. COMMUNITY DEVELOPMENT DIV.�� PROTECTIVE INSPECTION SEC. r 1 I NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 17/23/98 JOB ADDRESS 7350 L ric Lane 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 4 1 Melodv Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Miller 784-8459 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Eagle View Const 2937 174th Lane NW Andover 55304 75_3_9469 20076043 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 0 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof (24 SO Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 80 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2001 $1.00 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. $74.75 Fire SC $2.00 CHECK FEE TOTAL FEE JPLAN tt- & — License Sc $5.00 1 $82.75 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATEI WHEN PROPERLY LIDATED THIS IS YOUR PERMIT `� 4BLEY,INSP 7-�y-& MATE -A/ SIGNATURE OF OWNER OF OWNER BUILDERI IDATE I 01 NEW [ ] Effective 1/1/98 ADDN [ J CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: -735 d Ly%i, !-ihe, Legal Description: Owner Name & Address: 50� � fit° 7 352 —Tel. #21t Contractor: V" cc.- MN LICENSE# X007 609 3 Address: a 4 37 j 7ff* !A n e &t,., ✓ r4o✓cr 55301 Tei. # 753 - S y61 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: �e,-fvo -o F v Estimated Cost: $ `�CZ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: -ci APPLICANT: Permit Fee Fire Surcharge $ Ub State Surcharge $ /, 0c) SAC Charge $ License Surcharge $ 's-06 Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ 8,;2. 2S STIPULATIONS: I CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.501$1,000 Valuation $1000 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 [ ] • NEW L ] CITY OF FRIDLEY ADb-M [ ] 6431 University Ave NE, Fridley, MN 55432 ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 71515 Legal Description: Owner N Contract Address: Effective 4/1/2004 (763) 572-3604 Bldg Insp (7,q 571-1287 Fax Tel. # -74- .3 - 7qL( - p MN LICENSE # _ 17 �f g Tel. # %5(— -7G1 4 —" Lf to 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:T�� 1 Estimated Cost: $ 3r V Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ =$ Lf DATE: " 57T b APPLICANT: Tel. # Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. 0 CITY USE ONLY - Permit Fee $ 60-(0 Fee Schedule on Reverse Side Plan Review $ — 65% of Permit Fee Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge' $ $1350 per SAC Unit License Surcharge $ ��T- $5.00 (State Licensed Residential Contractors) Curb Cut Escrow $ Alt. "A" or Alt. T" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: h Building $ BUILDING Plan Review Permit No.: Inspections Fire Surcharge RESIDENTIAL APPLICATION -3 6 0 .001 times the total job valuation Received By 763-572-3604 763-5002-4977 FAX CITY OF FRIDLEY License Surcharge n tiN 50d $5.00 (State Licensed Residential Contractors) SAC Charge EFFECTIVE 1-1-2010 $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow DATE—:2 F' ;ZO(O YOUR E-MAIL ADDRESS j Erosion Control $ SITE ADDRESS 2 3.5-0LMll -c $ THIS APPLICANT IS: ❑ OWNER CONTRACTOR $ PROPERTY OWNER/ NAME: Q IL $ TENANT ADDRESS: %�56 I ` K'i C L-acr ,P CITY STATE MZIP PHONE: CONTRACTOR p� NAME: OM(v Cc9v+ S �- K `oaf SUBMIT A COPY YOUR STATE LICENSE N STATE LICENSE O6 Sp'Z0EXP DATE CERTIFICATE OF 1 le ADDRESS: yc� ell,,, /t j, CITY Ovh STATEMNZIPS INSURANCE PHONE (®j ^ J C) 6 `/ FAX - 45,62 - -69'q'5- .PROPERTY PROPERTY TYPE 14 SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH TO ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: a V bip SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: _2, 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ 21, Z57 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ -3 6 0 .001 times the total job valuation Surcharge $ I SU .0005 x Permit Valuation Minimum $.50 License Surcharge $ 50d $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 013 , q Make checks uavable to: Citv of Fridlev Attach Stinulations 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 on site; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. A SIGNATURE OF APPLICANT _/fit lellhr�'' PRINT NAME / l� v ()d — Z DATE" G i 6