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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: — April 5, 1968 Owner: Homedale Blders . Builder Address 5217 Wayzata Blvd. Address Same Same LOCATION OF BUILDING N® No. 7573 Street Lyric R Lane _ __ - Part of Lot Lot _- Block 3_ — Addition or Sub -Division Melody, Manor 4th Corner Lot ---- Inside Lot — X Setback 35' Sideyard 10' Sewer Elevation ___ 881.59 883.59 Top of Footing DESCRIPTION OF BUILDING 9654 (106 f�/ To be Used as: Dwelling Front 37 Depth 24' Height 20' Sq. Ft. 888 Cu. FL1_ _ 7 , ..760 Garage Front Z0' Depth 24' Height 10' Sq. Ft, 480 CU, Ft, _ _ 8 0 Type of Construction _ _ _Frame Est, Cost - $20,,QQQ.__.._.. To be Completed SEWER LOCATION - 35' East of Manhole WATER LOCATION 45' East of Manhole 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 fo and in compliance with all provisions of ordinances of the city of Fridley. $100.00 S er Connection Charge gid, In consideration of the payment of a fee of $--34 -�0Q, permit is hereby granted t, Homedale Blders . 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 of any of the provisions of sadd ordinances. bispectorG CLARENCE B SLE NOTICE: Ibis penult does not cover the construction, humllallon for whing, plumbing, gas heating, aver or water. Be ane to as the Building inspector for separate permits for thea items. 01 j APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA ADDRESS ADDRESS/ t0CATXON OF BUILDING N0. STREET �„ PART OF LOT LOT Z9_BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT___Z�SETBACR 157", SIDE YARD SEWER ELEVATION g a�� FOUNDATION ELEVATION 8F 4-6-1 Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. �-o-� - "4 • :�, 27L. y/ To be used as; DESCRIPTION OF BUILDING Front DepthHeight Sq. Ft. Cu. Ft. 1 -% 7 � 0 ' Front Depth,L�Height Sq. Ft. Cu. Ft. g Type of Construction To be completed. Estimated Cost tp"ep 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 SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). , C I. City of Fridley Application for Plumbing and Cas Fitting Pernut Dept. of Bldgs. Phone 560-3450 DESCRIPTION .OF WORK jF'�.� Number, Kind and Location of Fixtures Location / a 1 z y I Number Fixtures ...................... Is 12 � $ 12 Z 3 c� u3 oi�� U < U�' •d C�9d UN' (�y0 R N WATER HTR. GAS ELEG Base a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ 1st Ir r 2nd 3rd 4th • Future Connection Openings e New Fixture, Old OpeningsSewer I Connected with El Cesspool F] PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $2.00 $ Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ............................ x $3.25 $ Water Heater (Up to 99,000 BTI) ...... x $3.00 $30.0 New Ground Run Old Bldg. ............ x $3.25 $ Electric Water Heater a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE City of Fridley: The undersigned hereby makes application for a permit for the work herei 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 nd rrect. Fridley, Minn 19� Owner A4a z Kind of Building --V- Used as To be completed about Estimated Cost, Old—New. Build ROUGH FINAL 52-84-s915. 51 City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone 860-3450 DESCRIPTION OF WORK 7573 Lyrick Lane Number, Kind and Location of Fixtures Location q �G WATER HTR. Base 1st ns G s e 2nd 3rd 4th • Future Connection Openings * New Fixture, Old Openings I Connected with Sewer El Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... Future Fixture Opening ............... New Fixture Old Opening ............. Catch Basin ...... .................... Water Heater (Up to 99,000 BTU) ..... New Ground Run Old Bldg. ........... Electric Water Heater GAS FITTING FEES: x $2.00 $ X $1.50 $ X $1.50 $ x $3.25 $ x $3.00 $ x $3.25 $ a $2.00 $ NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. 1 x Am s--3.0D--- REPAIRS ?.00 REPAIRS & ALTERATIONS—Refer to Code City of Fridley: The undersigned hereby makes application for a permit for the work herei 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. Owner Fridley, Minn 8-15-68 19_ Hcmedale Bldrs Kind of Building frame Used as rem To be completed about 8-20-68 Estimated Cost, $ 1- Old—New. Building Permit N Pe it No. By Business Phone No ROUGH Description ................................................$ TOTAL FEE $ 3.00 dz Application for Power Plants and Healing. Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE $ TOTAL Furnace Shell & Duct Work .......................... $10.00 $ 5.00 Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ x$ 2.00 Repairs & Alterations each add. $500.00 ............... 3.00 $ $ NECK. WARM AIR x$ 5.00 $ Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ FAN HEATING SYSTEM See Fee Schedule each add. 60,000 BTU ....................... 3.00 ; $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. IDR Steam ...... $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water . ................ 3.00 $ OIL BURNER—to 3 gal. per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ....................... 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL. 1st 3 Fixtures ...................... x$ 2.00 $ Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $--�� ROUGH FINAL e4 (REMARKS- Dept. of Bldgs. Phone SM -3450 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 trueandcorrect. Fridley, Minn_ & Owner Kind of Building�� Used as To be co Estimated Cost, $ :��29 �e'_*p Old- N�►�. Building Permit No. 06 1 Permit No. '/'/,p ;z - DESCRIPTION . DESCRIPTION OF WORK HEATING or PO TS—Steam, Hot Water, �No Trade Name ��®�� i �� Size No Capacity Sq. Ft.ft;? BTU H.P. Total Connected Load 4cb�-�� Kind of Fuel-- BURNER ue BURNER — Trade Name &--y' 4;aer'5-Size No Capacity. Sq. Ft. E.D.R BTU H.P. Y ill. WELTER HEATING C®. 4637 CHICAGO AVE. • Mj <a Business Phone No-%�� STATE OF MINNESOTA DEPARTMENT OF HEALTH ABANDONED WELL RECORD 1. LOCATION OF WELL MINNESOTA UNIQUE MLLI N0. f (leave blank if not known) County Name ANOKA Township Name Township Number Range Number Section No. Fraction 4. WELL DEPTH (completed) Date sealed FRIDLEY 30 23 E 11 SENENW Is 4 of k 20 ft. MARCH 6, 1990 S W Numerical Street Address and City of Well Location or Distance from Road Intersection 7573 LYRIC LANE M Show exact location of well (in section grid with 'X•) Sketch map of w N b 2. PROPERTY OWNER'S NAME EMILY JORDEN 3. FORMATION LOG If not known, indicate E T RILLING METHOD (if known) l[] Cable' tool 40 Reverse %Driven IC Dug 20 Hollow Rod 50 Air so Bored 110 3E] Rotary 60 Jetted 90 Power Auger ion 6. OBSTRUCTIONS Well obstructed I] Yes If No Obstructions removed [] Yes 0 No If obstructions cannot be xy removed. contact NDN O before sealing. _ 7. USE �• a Domestic 40 Monitoring So Heat Loop V• 20 Irrigation SD Public g0 Industry 30 Test Well 60 municipal 100 Commercial 7[3 Air Conditioning IC] Hing Address if different than CASINGS) 125 property address indicated above 10 Black AXThreaded 70 7573 LYRIC LANE 4WGaly. S[3 Welded FRIDLEY , MN . 55432 30 Plastic 1 q 6[] Stainless Steel in. to 1 7 ft. NEE COLOR FORMATION FRON TO b 2. PROPERTY OWNER'S NAME EMILY JORDEN 3. FORMATION LOG If not known, indicate E T RILLING METHOD (if known) l[] Cable' tool 40 Reverse %Driven IC Dug 20 Hollow Rod 50 Air so Bored 110 3E] Rotary 60 Jetted 90 Power Auger ion 6. OBSTRUCTIONS Well obstructed I] Yes If No Obstructions removed [] Yes 0 No If obstructions cannot be xy removed. contact NDN O before sealing. _ 7. USE �• a Domestic 40 Monitoring So Heat Loop V• 20 Irrigation SD Public g0 Industry 30 Test Well 60 municipal 100 Commercial 7[3 Air Conditioning IC] Hing Address if different than CASINGS) 125 property address indicated above 10 Black AXThreaded 70 7573 LYRIC LANE 4WGaly. S[3 Welded FRIDLEY , MN . 55432 30 Plastic 1 q 6[] Stainless Steel in. to 1 7 ft. HARDNESS OF COLOR FORMATION FRON TO f nearby well. in. to ft. BROW 0 125 9• SCREEN Screened well from 17 ft. to 20 ft. (If known) ❑ open Role from _ ft, to _ ft. GRAY 25 50 GRAY 50 85 10. STY! WATER LEVEL 11 ft.below ❑ above 3-6-90 land surface Date Measured BROW]85 90 WATER SAND ' GRAY 90 100 11. WELLHEAD COMPLETION 10 Pitless Adapter 40 Found Buried 20 Basement offset 1' ABOVE GRADE 313 Weii Pit i. REMARKS, ELEVATION, SOURCE OF DATA - CASINGS REMOVED, CASINGS PERFORATED, ETC. 12. GROUTING INFORMATION 1 BAGS THE GEOLOGY WAS TAKEN FROM THE WELL AT: 9 Rest Cement 20 Bentonite 30 UNIVERSITY & OSBORNE ROAD Grout material PORTLANProm 2 Ot, SU1RFA•CT&_ FRIDLEY, MN. NEAT 13.J (1 EST SOURCES OF CONTAMINATION feet nW direction CITY SEWS& WATER LEVEL IN THE WELL ABOVE: 40' Well disinfected before sealing? J9 Yes MAIN DATE WATER LEVEL WAS TAKEN: 6-24-69 �.-.gym.. MAR According to ('Ad Sa•'e Regulations FFICIAL ABANDONED WELL RECORD (May be used for Property Transfer) ZMMrAIVV's FILE' WIPE DMW 14. PUMP W Removed 0 Not Present Type: 1[) Submersible 30 L.S. Turbine 50 Reciprocating 20 Jet 59Centrifugal 60 15. EXISTING WELLS (Please sketch locations of abandoned and active wells in remarks section or on back.) Other unused well(s) on property? 0 YesNo Abandoned: 0 Permanent 0 Temporary 0 Not sealed 17. WATER WELL CONTRACTORS CERTIFICATION This well was sealed under my jurisdiction and this report is true to the best of my knowledge and belief. E.H. RENNER & SONS. INC.7101 Address 5 1-612-427-6100 Signedl. Data 3-8— Name of Driller JON WAGNER SUBJECT City of Fridley 0 951 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT COMMUNITY DEVELOPMENT DIV. v PROTECTIVE INSPECTION SEC. e / / NUMBER REV DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 612-571-3450 910-F15 7/19/91 JOB ADDRESS 7573 Lyric Lane NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 3 Melody Manor 4th. Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bruce Vranish 7573 Lyric Lane NE 783-0769 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. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW Q. ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 20' x 14' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on ,plan Before digging call for all utility locations 454.0002 REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2,100 $1'05 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 8 $54.00. Fire SC $2.10 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PL EE TOTALFEE 7. SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI WHEN PROPERLY V ID H I OUR PERMIT SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)G )NSP SATE MW I I Effective 2/2/91 ADM R-1 AND R-2 ALM Building Permit Application Construction Address: 7573 kyetc lALUL Legal Description: Owner Name & Address: 75*7-3 L YA'?l C- ' L+VV,-7 &e Tel. Z?3-0 Contractor: 73 p- A kaodr (66UVFP-> _'rel. Address: Attach to this application, a Certificate of Survey of the lot, with the prioposed cmns xuatim cbmm an it to scale. CROMMIM CW Tin VENM LTVM AM: Ierqth Width Height Sq. Ft. GRIUM AM: lerxfth Width Height Sq. Ft. 7) IS= AIM: length Width Hgt/Omund Sq. Ft. Corner Lot Inside Lot rt. Yd Setback Side Yard pptbacks Type of Construction: 7 - �5100 /64DO P-4�-A� Estimated Cost: Approx. Coupletion Date: Proposed Driveway Width If New Opening Is Desired: Ft. $ y widw+ 61 See Back Page DAM 7MAAPPLICANT: cp 'Del Zal 9 C= Un ONLY Permit Fee Flee Schedule an Reverse Side Fire Surcharge .001 x Permit Valuation (2/10th State Surcharge $.50/$1,000 Valuation SAC Charge $650 per MC Unit Driveway Escrow Alt. "A" or Alt. "B" Above Park Fee Fee Determined by Sewer Main Ouuge it Necessary Not Necessary UIAnCNS: t. SUBJECT City of Fridley 3 2 TRECEIPT AT THE TOP OF THE TWINS BUILDING PERMIT i O. rr COMMUNITY DEVELOPMENT DIV. �3 �-- r � PROTECTIVE INSPECTION SEC. `� J � NUMBER REV DATE PAGE OF APPROVED BY i A "',•; CITY HALL FRIDLEY 55432 ---- L J� 612-571-3450 910-F15 9/24193 JOB ADDRESS 7573 Lyric Lane NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 3 Melody Manor 4th. Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bruce/Colleen Vranish. 7573 Lyric Lane NE 783-0769 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 CR REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Fascia Board on House 9 CHANGE OF USE FROM TO STIPULATIONS Provide adequate attic ventilation. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 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 VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $300 $.50. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $15100 Fire SC $,30 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $15.80 /-,GIG NATURE OF CONTRACTOR OR AGE (DATEI WH OPE VALIDATED THIS IS YOURRM�T9- I �1.JVTHORIZED �I a QQ{{ ��TE� z _ //iiJJ�� . , 3 BLDG I&U& DATE SIGNATURE OF OWN pF OWNER BU DERi NEW [] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPIMM R-1 AND R-2 Building Permit Application Construction Address: Legal Description: �) u Effective 5/26/93 a_ -4k-3 (0 5-- Owner Name & Address: kcn VQ&o 1S41 SIL( . otlld�4 ea --)Tel. # 9 f Contractor: ti e 1 { MN LICENSE # Address: LIVING AREA: Length GARAGE AREA: Length DECK AREA: Length OTHER: .� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF 11"ROVEMENT Width Height Width Height Width Hgt/Ground Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Type of Construction: Approx. Completion Date: Tel. # Sq. Ft. Sq. Ft. Sq. Ft. Side Yard Setbacks Estimated Cost: $ J�po (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 'ail`Q3 APPLICANT: ,h . � `�C'� & Tel. # 3 �%&e Permit Fee $ CITY USE ONLY ��L�� Fee Schedule on Reverse Side Fire Surcharge $ C) .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $750 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ Conservation Plan Review $450.00 Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: SUBJECT City of Fridley 235 4 8 AT THE TOP OF THE TWINS BUILDING PERMIT f RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 7/14/95 JOB ADDRESS 7573 Lyric Lane NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 3 Melody Manor 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bruce/Colleen Vranish 7573 Lyric Lane NE 783-0769 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. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION fel REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling (20 Sq) 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, 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 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 $1,100 .55 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $27.00 Fire SC $1.10 PLAN CHECK FEE TOTALFEE $28.65 �GNATURE OF CONT RACTOR OR AU HORIZED AGENT DATE i WHEN PROPE VALIDATED THIS IS YOUR PERMIT WH �i� l 8 G INSP p SIGNATURE OF OWNER OF OWNER BUILDER) iDATEi NEW [ ] ADDN (] ALTER ( ] Construction Address: `7 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application l Effective 1/1/95 Legal Description: Owner Name & Address: y�LS }h_Tel. # Contractor: Address: lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground OTHER: Corner Lot [ ] Inside Lot [ ] Type of Construction: Approx. Completion Date: _ Sq. Ft. Sq. Ft. Sq. Ft. Ft. Yd Setback Side Yard Setbacks Estimated Cost: STIPULATIONS: (Cost on Back) Driveway Curb Cut Width Needed: Ft + 6 Ft = F x $ _ $ DATE: i I Lj APPLICANT: Tel. #Y 3 CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $-S $.50/$1,000 Valuation SAC Charge $ $850 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 [ ] � c TOTAL $ ' STIPULATIONS: CITY OF FRIDLEY INSPECTION DIVISION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLIN (763) 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. TOTAL $ 3o.00 $ .50 $ sf- .. 5-01 JOB Al 191TA►1� Effective On January 1, 20 G, VENTILATION, AND DEVICES AS 12gz" " icYep/G <!�_ BUILDING USED ESTIMATED COST Ste/.�� PERMIT N0. / DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Un';s Ci cle One (Steam) (Hot Water) arm . Trade Name C4 Size No. BTU HP EDR Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR 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 an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE cy ,lp -b HEATING CO' Glm4f S(74C Signed L # e_- Approved By Rough -In Date Final Date 0� COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, 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 (PfNo ( ) 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 manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes (4 No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes (V/ No When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes (WNo When installing a new ventina system, 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 (v) No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Appliance #2 Type BTU Input Appliance #3 Type BTU Input Total Appliances Total Btu Input Common Vent Type Vent Height Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat 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 ALTERATIONS: (Describe) HEATING CO: Signed By: Date : NEW [] ADEN [j ALTER [ ] Address: Legal Description: 3 ' CITY OF FRIDLEY Effective 4/1/2004 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp SINGLE FAMILY`AND DUPLEXES R-1 AND R-2 (763) 571-1287�/O'S� BUILDING PER APPLICATION ,/13 7 11 IZI r 5-113 a L 4,vE / JC- FR ) L. / I R A-) 15" Owner Name & Address: 11 -mm 4' Co Lk,V944j j5g QDAfte ovs rrwvvvi ei. # 7LQ3-7 03 - bZ61 Contractor. �� `� MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length o2 p ! y GARAGE AREA: Length Length OTHER: DESCRIPTION OF IMPROVEMENT Width � Y � Height Sq. Ft -710 5Q Width Jt� Height Sq. Ft lay a Width Lf I to Hgt/Ground Sq. Ft 108 D 33 Construction Type: ` jN A ag 4 Luwe 5 -AOEstimated Cost: 40 Driveway Curb Cut Width Needed: Ft + 6 Ft= Ft x $ _ $ 7 DATE: b5 APPLICANT: - Tel. # 7f; 3 r c- g J��/ 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. 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 TOTAL 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 [ ] STIPULATIONS: NEW (J CITY OF FRIDLEY Effective 4/1/2004 ADDN [ ] 6431 Uniuersity Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: Tel. # Contractor. MN LICENSE # Address: 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: Estimated Cost: $ Driveway Curb Cut Wdth Needed: Ft + 6 Ft = Ft x $ _ $ DATE: APPLICANT: 0 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. CITY USE ONLY - Permit Fee $ 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 $ $5.00 (State Licensed Residential Contractors) Curb Cut 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: MNcheck COMPLIANCE REPORT Minnesota Energy Code MNcheck Software Version 3.0 COUNTY: Hennepin STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: Single Family DATE: 7-6-2005 DATE OF PLANS: 7-6-05 TITLE: 05119 PROJECT INFORMATION: VRANISH COMPLIANCE: PASSES I I I I I Permit # I I I I I I Checked by/Date I I I Required UA a 147 Your Home = 118 19.5% Better Than Code Area or Cavity Cont. Glazing/Door Perimeter R -Value R -Value U -Value UA ------------------------------------------------------------------------------- CEILINGS 632 8.0 0.0 19 WALLS: Wood Frame, 16^ O.C. 922 19.0 2.0 52 GLAZING: Windows or Doors, Above Grade 75 0.350 26 FLOORS: Over Unconditioned Space 580 30.0 0.0 19 FLOORS: Over Outside Air 52 30.0 0.0 2 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirenjpnts of the Minnesota Energy Code. Builder/Designer Date J� Certificate of Survey Lot 6, Block 3, Melody Manor 4th Addition, Anoka County, MN for Colleen and Bruce Vranish, 7573 Lyric Lane, Fridley, Minnesota O Denotes found Iron as shown on the Suburban Engineering's Certificate of Survey for Homedals Builders dated September 1984. ....... Denotes drainage and utiUty easernent - - - - Denotes fence. 1 hereby certliy that this is a true representation of a survey of the boundaries of the above described land, and of the house and garage thereon, and all visible encroachments. As surveyed by me this 10th day of Manch, 2005. Corwyn Arlt, PLS # 25360 20' cc' -0J 3cZ NEW [ ] CITY OF FRIDLEY ��rEffective 4/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: 26'7.3 Lyre Ln N E _ Legal Description: Owner Name & A Contractor: Address: r -SOA MW Q. Tel. # 763- 7Y3-67Cq MN LICENSE # 92 ,Z? 7 7 Tel.# 1,j�3-YY3 3,,'W 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: ` Estimated Cost: $ /'� O �'7 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: ' s3 APPLICANT: - Tel.# 7G3-4Y3-.j3d0 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. CITY USE ONLY - Permit Fee � 7 $ Fee Schedule on Reverse Side Plan Review $ 65%'of Permit Fee Fire Surcharge i. -CY $ .001 of Permit Valuation (1/10th%) State Surcharge° V)$ $.50/$1,000 Valuation SAC Charge $ $1350 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Curb Cut 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: 62268-"�� Building $ BUILDING Permit NO.: Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION Received By: 763-572-3604 Fire Surcharge CITY OF FRIDLEY Date DATE l afe 10 S YOUR E-MAIL ADDRESS :R'Va&)1 rS `SIJ (Rev'd: 1t\` . C& / y SITE ADDRESS i $ THIS APPLICANT IS: a&NER ❑CONTRACTOR $ t-4 0. PROPERTY OWNER/ NAME: $ ADDRESS:�� CITY STA�i a. TENANT Fee Determined by Engineering PHONE- `2=7 3-16'7(a c] CP CONTRACTOR NAME: $ V1 VD "r;'s "r;' STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE INGLE 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 ❑ ADDITION ❑ MAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. 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: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 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 $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ t-4 0. _ft + 6 ft = 0 L( ft x $20 = $—qk Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ V1 VD "r;'s "r;' 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 DATE CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning - All Sizes Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND.AIR CONDITIONING ° SYSTEMS AND DEVICES JOB ADDRESS 75TS S `ane- Ir. n P r, dl , F Fee, Total Owner -C O I l .nyrn n t, k $35.00 $ $10.00 $ /( Clo T $10.00 $ $10.00 $25.00 All Other Repairs or Alterations (Liston Back) 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater. on work less than $500.00 Commercial Industrial Institutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/Industrial/Institutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR Building Used As 1'i' Oi'�'1 ESTIMATED COST - PERMIT NO DESCRIPTION OF FURNACE AND BURNER $ # of Heating Units Circle One (Steam) (Hot Water) ED Trade Name Size No. $ BTU HP EDR Fuel Total Connected Load $v Burner Trade Name Size No. BTU HP EDR 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. $ .50 HEATING CO��-�(—(p/�(�r�1G/1 $ 36S®//®0 Signed Tel # 7(0 715y_fO06 *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FAX ��" _�� Date /0��`C35 FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved by n Rough -in Date Final Date FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, 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 combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes (} No( ) When installing a new venting system, 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 Type and Size/Common Vent and Vent Connector Information 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 H EAT I N G CO: bu r, b on A, Cbli c1f h on Signed Yy: Date /0 Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: (� 763-572-3604 CITY OF FRIDLEY Date Rec'd: DATE l I / Z` /07 YOUR E-MAIL ADDRESS o�. S � S � � 4 • GwI SITE ADDRESS'75 (n Cr N► �r ' THIS APPLICANT IS: ❑ WNER CONTRACTOR PROPERTY OWNER/ NAME: I;U (A,,LE,, LAS ty� TENANT ADDRESSIS 7 3 �y L1lG. L.•k NtDY STATWIP SSy32,. PHONE: CONTRACTOR NAME:[•^ L�Q'yg SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE rr ! ADDRESS: 1506 St' CITY t STATI ZIP J �J WITH APPLICATION PHONE -241 11t Q &U a FAX PROPERTY TYPE ❑ SINGLEFAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAW TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: Tia Fk Re, hr— SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING� HOUSE ONLY NUMBER OF SQUARES HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE I. 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 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: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION Permit Fee Plan Review Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due TYPE See Back Page for Fee Schedule 65% of Building Permit Fee $ �] 4 .0005 x Permit Valuation Minimum $.50 $ $5.00 (State Licensed Residential Contractors) $ $1675 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 Fridlev 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 isnot 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 requirS�4eview 'and approval of plans. _ SIGNATURE OF Building PLUMbING Permit No.: Inspections RESIDENTIAL APPLICATION Received B=-9 763-572-3604 CITY OF FRIDLEY Dz�i EMM DATE '5– t (0_69 Y,OUR E-MAIL ADDRESS SITE ADDRESS �� LVYl CS LYl f�1C-_ K) THIS APPLICANT IS: D OWNER MCONTRACTOR PROPERTY NAME:B Y U e—y y GU6�S� ADDRESS: CnY d STATE�ZIP� ® OWNER/ TENANT PHONE: 7(03 - ??-O� l CONTRACTOR NAME; SUBMIT A COPY OF STATE LICENSE # (pl Vb?M 3870 Dodd Rd TE YOUR STATE ADDRESS: $rry STATE ZIPS LICENSE WTIH PHONE FAX APPLICATION PERMIT TYPE SINGLE FAMILY O TWO FAMILY 0 TOWNHOUSE yi TYPE OF WORK: O NEW IS -REPLACEMENT � DETAILED DESCRIPTION of WORK W c C1r beu,,�u Y�'.�`T Com"ewPiVI-A" PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES AREBASED ON $10.00 PER Fo=RE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV DRAINS _ SHOWER —WATER PIPING _ _FLOOR _ GAS PIPING (Amw c rrrL ) _ SWIMMING POOL _ WATER SOFTNER ($35) —BATHTUB _ CLOTHES WASHER _ KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($15) _ LAUNDRY TRAY TWATER HEATER ($35) FOR IRRIGATION —DISHWASHER WATER METER OTHER �, f y g F V, � I�S•j ;,'� `., :�;# idJ >31s. ��1 ,%t.��Ma:. >:F J �*Y�'$S�.ti Number of fixtures @ $10.00 x $10.00 = $ Permit Fee $ .00 Surcharge .56 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE s. M State Surcharge = $ .50 Total = $ ,6-0 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 w ch re i es i ew and approval of plans, SIGNATURE OF APPLICANT ^"'"i'RINTNAMEAaNreS ," `'lv, DATE +1� j h ",'y ..oi�i�_'Y E.,.ON - City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 ,3 cj V A v. P741 cnn AnP-r