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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N° (:5:4:2: 8 j, Date: Owner: Builder Address Address No. ,�.. Street Lot __ Block Corner Lot -- Inside Lot '*-0I Setback c X37 r. Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING Twu Used Front 441 Depth Height v Sq. Ft. Cu. Ft. Fro t Depth Height Sq. Ft. Cu. Ft. ' Type of nstructioa Est----.ro be coinpleted 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 pon violatio any of the provisions of said ordinances. , ''- A ,r I Building Inspector NOTICE: This pemit does not cover the construction, installedon for wiring, plumbing, gas hooting, sewer or water. Be sure to sae the Building Inspector for separate pennhs for these items. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY.. MINNESOTA Owner's Name Builder L o A IJ A, A&e-� e� Address Address 2/1-7— L4--,4At sA vi -r- LOCATION OF BUILDING No. r Street �'^ t`1 h 1.A-N4C, Part of Lot Lot L Block 3 . Addition or Subdivision lle1odo r � Corner Lot Inside Lot _Setback Side -Yard _ ��o %- 7 SEWER. ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: DESCRIPTION OF BUILDING 713/ Sq. Ft. ��! d Cu. Ft. Front 2-7—,Depth__2=7-_- Height Sq. Ft. 9-0 Cu. Ft. Type of Construction Estimated Cost To be Completed The undersigned hereby makes application for a permit for the work herein specifiedt agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that a1n J* facts and repre,�tions stated in this application arF true and correct. 0 DATE / SIGNATURE (A Schedule of Fee Costs can be found on the Reverse S . City of Fridley Application for Plum ing and Gas Fitting Permit D Lo f Bldome Ph SII 4 7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE _ Number Fixtures ......................— x } Z F Z Future Fixture Opening ....... Z s� Z O W ,<�i J $ Z �O • F • N WATER HTR. GAS ELEC. New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: 1st 3 Fixtures ..........................� NO. RATE TOTAL, x $1.50 $--/,Additional Fixtures .................... x .50 < Una 63 �°d $ m Bas 1st 2nd 3rd 4th Future Connection Openings Connected With Sewer E]I Now Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ......................— x $1.50 �f Future Fixture Opening ....... LA—x 1.20 $ � New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Beater (Up to 200,000 BTU) ......� x 2.00 d $ New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: 1st 3 Fixtures ..........................� NO. RATE TOTAL, x $1.50 $--/,Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE iLs-=�`T� ep gs. L Location—7 ! /� City of Fridley: i The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, AgAn Owner Kind of Building Used as v� To be completed about `5 Estimated Cost, $ 014�Building Permit No ge, Permit No. Signe By Business Phone ROUGH - x 3 - 4o / FINAL I� Application for Power Plants and Heating. Cooling. VentRation..Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SU. 4-7470 -f �b GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 It 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 $ 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 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 & REPAIRS TOTAL FEE $ d� z 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 Kind of I Used as To be completed about (�`�C 6 / �� Estimated Cost, $ 4 / Ol New. wilding Permit No.� Permit No. (O DESCRIPTION OF WORK HEATING or P R PLANTS—Steam, Hot Wa CWarmAir�---2 Trade Name ,� Size Noy Capacity Sq. Ft. E D.R. BTU H.P. Total Connected Load ��® Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H P. Signed.•+ .. , N. WEo -TER u e A T l N r. f'' r By 4637 CHICAGO AVE. MINNEAPOLIS 7, MINNESOTA az 2M 7-59 Business Phone No- (REMARKS—OVER) i SUBJECT ERI City of Fridley 2 AT THE TOP OF THE TWINS BUILDING PERMIT r � T NO. 1 `V __�___ COMMUNITY DEVELOPMENT DIV. SEC. r PROTECTIVE INSPECTION � ��JJv 1 � = CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/21/99 JOB ADDRESS 7411 Ly ric Lane 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 26 3 I Melody SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Andy Jank 7R3 -7R-1;6 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Amek Const. Inc. 1SRR-1200 2nl644n? 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 O ADDITION ❑ ALTERATION REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage 25 S Tar -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 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 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 $2185 $1.09 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- 83.25 Flr SC $2.19 XRTIO�OR &ERFO�R"NCE�OFCQN�STRUCTION PLAN CHECK E TOrl EE —� Li e C 9 3 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE- WH PMV LIDA D I$ IS R B OG IN I ITMATE S-GNATURE OF OWNER OF OWNER BUILOERI IDATEI i r NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY 1D ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION \� Construction Address: 7y(( Lyji c L;,. ��1j (-C , Legal Description: Owner Name & Address: Tel. #-7'33- 719 -5( ­ Contractor: 111yorA MN LICENSE # 2c16,kgc3. Address: /z/p cam. Sleym, ��►. S5'.1120 Tel. # Zoo 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 EMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Driveway Curb Cut Width Needed: Ft. + 6 Ft = Estimated Cost: $ Ft x $ DATE: 7 - Z (-Q APPLICANT: Tel. # SWR -120 t) TOTAL STIPULATIONS: J CITY USE ONLY Permit Fee $ _ Fee Schedule on Reverse Side Fire Surcharge $ % .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1050 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: J Building c b— BUILDING Permit Fee Permit No.: OP Inspections Plan Review RESIDENTIAL APPLICATION Received By: 763 -572 - $ CITY OF FRIDLEY Surcharge tg X.�'� 2 3 2010 763-502-49774977 FAX License Surcharge $ = $5.00 (State Licensed Residential Contractors) SAC Charge $ EFFECTIVE 1-1-2010 Curb Cut Escrow $ DATE 7 f ® YOUR E-MAIL ADDRESS dA�AQ AJA a 41--0 SbQW e Y 1,r a C' o M SITE ADDRESS Park Fee $ THIS APPLICANT IS: ❑ OWNER WONTRACTOR $ PROPERTY OWNER/ NAME: $ TENANT ADDRESS: CITY STATE"ZIP - - PHONE: 10t2--73C—P- -Z--Z!2 S7- CONTRACTOR CONTRACTOR NAME: The Window More Home Improvements: _ STATE LICENSE #� �% �% EXP DATE 2� IS 0 12 SUBMIT A COPY OF YOUR STATE LICENSE 4-I L CITY O STATE /, IP AND CERTIFICATE OF ADDRESS: d l INSURANCE PHONE FAX PROPERTY TYPESINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION I&MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: f e f In A , %y1,d zJ 1134e:--�4In Q2g4 i ®r.4 A'qq SIZE OF IMPROVEMENT i LENGTH WIDTH SIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS. & PORCHES SUBMIT: ❑ Vinyl ❑Soffit 1. Site Plan/Survey showing the existing structures 13 Aluminum ❑Trim t. and proposed project ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS AYes ❑No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF V -0 -on 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: 4 USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ c b— 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 $ $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 Dae $ Make checks pa able to: Citv 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 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. y SIGNATURE OF APPLICANT IMI ,BI _PRINT NA,� ndq ,a e UCn I c� DATE (Mi n� , Cr / C)