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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N 61 o 5 Date: Owner:.„ ��t'�' `��.+'.T�t Builder Address Address Lot _ _ Block C ddition or Sub-Divisio s Corner Lot — Inside Lot , Setback . Sideyard Sewer Elevation _ Foundation Elevation DESCRIPTION OF BUILDING Front Depth s Nelgbt Sq. Ft Cu. li`t Fron ., `Depth TTeight Sq. Ft. _jW Cu. Ft. — &V Type of ction . Est Cost To be Completed T In consideration of the issuance to me of a permit td `construct the building described above I agree to do the proposed work in accordance with the description above set forth Ind onanpliance with afl 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 pelt is grantedupon 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, Bffinnesota location, construction, alteration, maintenance, repair and moving of buildings within the city limits and permit may be revoked 'a t. any time upon violation of any of the provisions of said ordinances. w. ,�,. Building Inspector NOTICE: %b permit dos not eswr the eommeden, Inds len for wkk& pNosbing, ga hating, aver er gates. Bo sm to sm the Bulidhng Inventor for aparaM penolfs for thea hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name Builder Address ress F BUIL I o. Street Part of Lot Lot BlockAddition or Subdivision /J Corner Lot I Inside Lot Setback 5J / Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To be used as: DESCRIPTION OF BUILDING Front Depth Height, Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City 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. /�� �; /1 r, (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley Application for Plumbing and Gas Fitting Penna Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK �� Number, Kind and Location of Fixtures Location 07 C 3 • TOTAL ?� Number Fixtures ....... .............. ti o� u'S C Z �� `fin �ai 5 u�i <3 (�7°d w (�'10� Z �O • F • N WATER HTR. GAS ELEC. Base New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: RATE TOTAL 0 1st 3 Fixtures .......................... x $1.50 $T Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ 1st 2nd 3rd 4th • Future Connection Openings e New .Fixture, Old Openings I Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE • TOTAL Number Fixtures ....... .............. x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ C G New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: RATE TOTAL 0 1st 3 Fixtures .......................... x $1.50 $T Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ _ TOTAL FEE $ �� P 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 feel and representations stated in this application are true and correct. e—,FridlM Minn�'Z" fn 19 Owner OL/ Kind of Building Used as To be completed about Estimated Cost, $ Olduilding Permit No — By L---= t' i Business Phone ROUGH V— -1 is o ( i— FINAL .QW42 21A Application for Power Plants and Hearing. Cooling, Ventilation. Refrigeration 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 $ PTEAM 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 VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL See Fee Schedule TOTAL FEE -4 ° d Dept. of Bldgs. Phone SU 4.7470 el 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 tfue and correct. _� Owner Z Kind of Building Used as To be completed about Estimated Cost, $ 016". Iding Permit No. �� Permit No. v `L DESCRIPTION OF WORK 19 �Z HEATING or R`te Hot Water, Warm Air—No Trade Nam 1-�`f�- Size No °? Capacity12 ®- Sq. Ft. E.D.R q ' r BTU ®® H.P. Total Connected Load �� �. b Kind of Fue 7j BURNER —Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. v 42 2M (REMARKS—OVER) City of Fridley Application for Plumbing and Gas F'itti'ng Permit Dept. of Bldgs. Phone 560-3480 DESCRIPTION OF WORK Number, Kind and Location of Fixtures p� G7 x $2.00 $ Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 �in U °C <3 d �U' Sa 6 z �p • F • N WATER HTR. GAS ELEC. Base x $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ...... ................... x $2.00 $ 2.00 Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. 2 x $5.00 $ 6.ot 1st Ingtallt 2nd 3rd 4th • Future Coanectioa Openings New Fixture, Old Openings I Connected with Sewer ❑ Cesspool ❑ 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 BTU) ...... x $3.00 $ New Ground Run Old Bldg. ............ x $3.25 $ Electric Water Heater x $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ...... ................... x $2.00 $ 2.00 Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. 2 x $5.00 $ 6.ot REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ 8.00 Location 6561 NE. monni ey 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. Fridley, Minn. MAY 19 1969 19— Owner Vernon B. Nyberg Kind of Building Used as Residenoe To be completed about MAY 2 4 1969 Estimated Cost, $ 10,00 OldX' New. Building Permit No Permit No. signe MINNEAPOLIS GA CO. Business Phone N 90, ROUGH FINAL—L-7- l SUBJECT - City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT(""'RECEIPT r I , COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 71-1 r I �5 I NUMBER REV DATE PAGE OF APPROVED BY i CITY HALL FRIDLEY 55432 L 612-571-3450 910-F15 9/3/98 JOB ADDRESS 6561 McKinlev Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3 1 Clark's Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Vernon B. Nyberg 571-8096 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Owner 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 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 27 S ear -off 9 CHANGE OF USE FROM TO STIPULATIONS "Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, 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 2313 $1.16 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $74.75 Fire SC $2.31 PLAN CHECK FEE TOTAL FEE 1$78.22 TU OFCON�RACT, AUTHORI2EDAGENT �DATEi HEN PROPERLY DATED HIS IS YOUR PERMIT YNA 1!kz-� SLOG NSP A!�­11 - - BATE S,GNATUR O U OWN UILDERi iDATE� l NEW [ ] $ S� Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY .001 of Permit Valuation (1/10th%) ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ ConstructionAddress: Driveway Escrow $ Legal Description: Erosion Control $ X Owner Name & Address: PZ WAJOA) Tel. # 76_ Fee Determined by Engineering Sewer Main Charge $ X Contractor: oGUNIx 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 BiPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: LenA Width Hgt/Ground Sq. Ft. x OTHER: _ Construction Type: Estimated Cost: $-� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ ATE: - -! APPLICANT: _ Tel. # CITY USE ONLY Permit Fee $ S� Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ /, / $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ ! �� STIPULATIONS: - 1. Building BUILDING Permit Fee Permit No. o , 11 ?,q Inspections P Plan Review RESIDENTIAL APPLICATION Received By: 763-572-3604 $ CITY OF FRIDLEY n��°� � '�� P 763-502-4977 FAX 0005 x Permit Valuation Minimum $.50 License Surcharge $ $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 9 12_� 110 YOUR E-MAIL ADDRESS` �t i nas m k c I U o �-e Q mss n, C n w SITE ADDRESS m C fc ( e � e Park Fee THIS APPLICANT IS: ❑ OWNER CTOR Sewer Main Charge PROPERTY OWNER/ NAME: Total Due TENANT � ADDRESS: C r7r CITY �-,,A ( e C.1 STATE V�vgIP3�— PHONE: CONTRACTOR NAME: C t I r= Sr O► r V G SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # 02 0 7oZ Co FS'—/ EXP DATE 3 I3/ rZU l I AND CERTIFICATE OF ADDRESS: (0 3 C/ / /YJO "ROE S NE CITY 1-12 STATEMIUZIP573-L:j— INSURANCE PHONE 76 2 —3?(o7 FAX PROPERTY TYPE I—N FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGFJSHED ❑ WINDOWS ❑ BASEMENT FINISH S IZOOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: C O e 1 GLC e e— eL{ a ca e! 96t ra SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING OHOUSE ONLY NUMBER OF SQUARES_ ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: d q 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 I. Site Plan/Survey showing the existing structures 13 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) 1U1ALJUIS VALUA11UN 1i uuuuYANUY "1YYLe Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ ,4-1 .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 Due $ l L 7 < !T Make checks savable to: Citv of Fridlev Attach Stiaulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby appl r a buil ' etmtt owledge that the information above is complete and accurate; that the work will be in conforman with th rdinances and codes th City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only application for a permit d rk is not to start without a permit on site; that the work will be in accordance with the approved pl in th ase of all work which s review and approval of plans. n SIGNATURE OF AP PRINT NAME lSf N A:+ r LGo CL DATE