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)