PRE 2010 DOCSCITY OF FR IDLEY
APPLICATION FOR
POWER PLANTS AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
AIR
CONDITIONING SYSTEMS AND DEVICES
Furnace Shell & Duct Work to 100,000 BTL'
each add. 50,000 BTU
4.00
$
Replacement of Furnace
7.00
$
PARTIAL RATE SCHEDULE
7.00
$
Re_airs & alterations each add. $500.00
4.00
GRAI'ITY WARM AIR:
8:1'1'1.
TOTAL
Jos Address
rb ® 7
Furnace Shell & Duct Work
$12.00
$
4.00
$
R eplacer..en t of 1 mace
7.00
7.00
$
$
Department of Buildings
6.00
Repairs & alterations -up to $500.00
4.00
$
City of Fridley
each add. 3 gal. per hour
Repairs & Alterations each add. $500.00
$
GAS BURNER- from 1CO,000 BTL' to 199,999 BTU
-el. '571-3450
$ 1,4=
MECHANICAL WARM AIR:
$12.00
$'
Furnace Shell & Duct Work to 100,000 BTL'
each add. 50,000 BTU
4.00
$
Replacement of Furnace
7.00
$
Repairs & Alterations -up to $50J.00
7.00
$
Re_airs & alterations each add. $500.00
4.00
$
SMAM OR 40T WATER SY STLM :
Boiler & Lines up to 100,000 BTU
$12.CO
$
each addn. 50,000 BTU
4.00
$
Boiler only up to 100,000 BTU
7.00
$
. each addn. 50,000 BTU
6.00
$
OIL BUR\ER- to 3 gal. per hour
$10.00
$
each add. 3 gal. per hour
10.00
$
GAS BURNER- from 1CO,000 BTL' to 199,999 BTU
510.00
$ 1,4=
(over 199,999 B.0 see Fee Schedule)
$
GAS FITTING FEES:
1st 3' Fixtures x $ 3.00
Additional Fixtures x $ 1.00
Gas Range to 199,000 BTU x $10.00
AIR CONDITIONING �I
FAX HEATING SYSTEMS See Fee Schedule
VENTILATING SYSTEMS
ALTERATIONS & REPAIRS_ J
State Surcharge
TOTAL FEE
I ROUGH INSP.
FINAL INS?.
REINSPECTION FEE
Date (.$10.00)
i,ate
APPROVAL FOR PERMIT /44y
X1NT-XUA1 FEE FOR ANY HEATING PERKIT IS $7.50
The undersigned hereby makes spnlication for a permit for•the wort: herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the D:partment of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
n Fridley,,4inn.
OWNER
KIND OF BUILDING
e
USED AS
TO BE COMPLETED ABOUT
ESTIVATED COST
OLDNEW BUILDING PEP -MIT NO. PERI -11T NO. 00
$ •s•.... DESCRIPTION OF FURNACE/BURNER
$ HEATING or PO PLANTS, Steam, of Water, Warm Air NO.'.
$ Trade Name �' ��L�/ ie Size No.Ir�
$ sf
$ Capacity Sq. Fr.. EDP HP
$ — L
$ .50 Total Connected Load Kind of Fuel
$ BURNER - Trade Name ' Size No.��
Capacity Sq. Ft. EDR BTU IM011 HP
Company RAY N. WELTER HEATING CO.
4637 Chicago Ave.
Signed By r�
minneopulra,
Tel. NO.
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMITe�����-�
PARTIAL RATE SCHEDULE
PLU%iBING FIXTURE RATES: NO. RATE
F irt.,.: es x $3.00
cBlut..re .-.....re Cpening x $2.00
.:e» Fixture, Old Opening r. $2.00
Catch Basin x $5.00
Water neater - to 99,COO 571 $5.00
1CO3 30 BTU to 199,000 BTU x $10.00
i:ater Softener x $7.00
Nc--a Ground ?.•r. Old Building x $5.00
Electric %:a=er Heater x $5.00
GAS FITTING FEES:
1st 3 firt..res x $3.00
A--ditio nal Fixtures r. $1.00
Gas %L-nge to 199,000 BTU x $10.00
REPAIRS F ALTERATIONS
First S1C0.00 $5.00
each add. $100.00 or fraction $2.00
State Surcharge
TOTAL FEE
REI..SP£C.IO:, F E
TOTAL
S X24 0 D
Job Address 7,�- �
Departmont of Buildings
City of Fridlcy
Tcl.
'1571-3450
The undersigned hereby maces application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Cedes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
/p �7 Fridley, :'1.C/(� 8 . ,g-zz
OWNER
KIND OF BUILDING /4 6ti�
USED AS I/
TO BE COMPLETED ABOUT
ESTIMATED COST /
OLD- NEW L'ILDING PERMIT NO. PER�:IT NO. 4U( �
Company
Signed By(/
[p . /
Tel. No. Z/,P L -
ROUGH INSP.
Date
FINAL INSP.
Date
9 �1
APPROVAL FOR PEf'SIT % (J
MINIMUM FEE FOR ANY PLL':.P.ING PERMIT IS $7.50
x
c
11ater
r,
T C
$4
a
4Jn
.-4
.i
u.
C
Hca ter
.T
.4
M
r-
U
_U
0
.=
ti
ri�io
I
I
I
�thl
(F) = rut:ure Connection Gpening
Connected with Sewer
(*) = ..cur _ irt..re, Old C. _ning
Watcr
PARTIAL RATE SCHEDULE
PLU%iBING FIXTURE RATES: NO. RATE
F irt.,.: es x $3.00
cBlut..re .-.....re Cpening x $2.00
.:e» Fixture, Old Opening r. $2.00
Catch Basin x $5.00
Water neater - to 99,COO 571 $5.00
1CO3 30 BTU to 199,000 BTU x $10.00
i:ater Softener x $7.00
Nc--a Ground ?.•r. Old Building x $5.00
Electric %:a=er Heater x $5.00
GAS FITTING FEES:
1st 3 firt..res x $3.00
A--ditio nal Fixtures r. $1.00
Gas %L-nge to 199,000 BTU x $10.00
REPAIRS F ALTERATIONS
First S1C0.00 $5.00
each add. $100.00 or fraction $2.00
State Surcharge
TOTAL FEE
REI..SP£C.IO:, F E
TOTAL
S X24 0 D
Job Address 7,�- �
Departmont of Buildings
City of Fridlcy
Tcl.
'1571-3450
The undersigned hereby maces application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Cedes
and rulings of the Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
/p �7 Fridley, :'1.C/(� 8 . ,g-zz
OWNER
KIND OF BUILDING /4 6ti�
USED AS I/
TO BE COMPLETED ABOUT
ESTIMATED COST /
OLD- NEW L'ILDING PERMIT NO. PER�:IT NO. 4U( �
Company
Signed By(/
[p . /
Tel. No. Z/,P L -
ROUGH INSP.
Date
FINAL INSP.
Date
9 �1
APPROVAL FOR PEf'SIT % (J
MINIMUM FEE FOR ANY PLL':.P.ING PERMIT IS $7.50
of Fridley
SUBJECT
jPrER'O.City
391AT
THE TOP OF THE TWINS
BUILDING PERMIT
RE-CETP
COMMUNITY DEVELOPMENT DIV.���
r PROTECTIVE INSPECTION SEC.
1 ` �
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
' ----I CITY HALL FRIDLEY 55432
IL
---- A / I.J 612-560-3450
910-F15
1 /31/77
JOB ADDRESS 7555 McKinley
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
5
1
Bayers Lakeside 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Cedar Bay Builders 1700-3rd Avenue NW 633-8800
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 IM NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
New home 55' X38' "
THE - --
ACCURACY OF UTILITY LOCATIONS AND ELEVATIONS.
!'A NOTIFY THE FRIDLEY IrNr.R
9 PERSONS USING R SHOULD VEIIIFY , THE IWORMATION TODIVISION REGARDING CURB
STWILMORP AT DRIVEWAY OPENINGS.
1. Provide fan in utility room and bath if basement bath is installed.
2. Increase rafter dimensions to 2" x 81.' - 16" on center.
3. Provide a verification survey before capping. ���NG
4. Provide a hard surface driveway. n
Before ftft call local ufilitiea
T€ OWOr* - ELECTRIC - OAS Etc.
REQUIRED BY LAS/
SEPERATE PERMITS REQUIRED FOR WIRING,
HEATING, PLUMBING AND SIGNS.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Frame
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
1,034
26,500
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. AfLL 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
$33,685.00
$16.84
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-
$375.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$106.00
PLAN CHECK FEE
TOTAL FEE
26.50
$524.34
SI ATUREOFCO 0 AUT ORI GENT (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
BLDG INSP DATE
A URE OF O NE IIF OWNER BUILDERI (DATE)
z
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
ADDRESS: 21111,11!
•.
LOT: ,°� BLOCK: % ADDITION:,.
CORNER LOT: INSIDE LOT: /j SETBACK: t-5— SIDEYARD:_,�—/O
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
'Front: -6-5- Depth • 1? Is- Height • /
Square Feet: 103 Cubic Feet:
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost:_ $
• To Be Completed:
PROPOSED DRIVEWAY WIDTH IF NEW OPENING IS DESIRED
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stxict 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. F
DATE: SIGNATURE :
(See Reve se Side For Additional Information.) jT1,9�rt'? 0 _
/Ufa. 00
/�• (')
c r�tiet
-2. mitt"' elF'FE �
GERALD T. COYNE
300 BRUNSWICK AVE. S.
GOLDEN VALLEY, MINN.
MINN. REG. NO. 4741
INDUSTRIAL — JUDICIAL
COMMERCIAL — TOPOGRAPHICAL
CITY LOTS — PLATTING
I _F,'DA . PAY LU1 J. L11_, 3
t r "
LOT SURVEYS COMPANY
LAND SURVEYORS
REGISTERED UNDER LAWS OF STATE OF MINNESOTA
LICENSED BY ORDINANCE OF CITY OF MINNEAPOLIS
5747 W. Broadway Minneapolis, Minnesota 55428 533-9922
#mn. irs (grrtif rate
0.7'Cn +i liver
. SwI'�t
-
(-5- spi r
- 1 1-ar!r' ,tevr_'.
RAYMOND A. PRASCH
6917 IDAHO AVE. N. it
_BROOKLYN PARK, MINN.
MINN. REG. NO. 6743
INVOICE NO.
F. B. NO.i
SCALE I"
�•� O — DENOTES IRON
I
WARNING
1 _
-13%Z4 -
.
` ' j)
TE MORE - ELECTRIC - CAS Etc.
CA W
6 REQUIRED BY LAW
- -x.45"-
--'I
8 Jul
FYIo
I
!�✓��
Al
3rd C)
(-5- spi r
- 1 1-ar!r' ,tevr_'.
RAYMOND A. PRASCH
6917 IDAHO AVE. N. it
_BROOKLYN PARK, MINN.
MINN. REG. NO. 6743
INVOICE NO.
F. B. NO.i
SCALE I"
�•� O — DENOTES IRON
I
TIS 6TY I OF ,FRIDLEY DOES NOT GUARAMM.
ACCURACY' OF UTILITY LOCATIONS AND ELEVAT
THS DAT IS FOR INFORMATION PURPOSES ONLY
F`EILSONS G R SHOULD VERIFY THE MFORMA
ON THE
V e •b;Cert,,',-i"a' this ', a True and ccrrect representation of a survey of the boundaries of the above l 07 F,
r, r-a'i i8r7 and r^e 1r c _f o!' Lui.'�dings and v;sibla encrcachmec's, ;f any, from or on said 'ard. Signed ;-j &
L.y Is th,; day ofy - 4 � ' 1 A " '' 19 LOQ' SURVEYS COMPANY
WARNING
Be#ote digging call local utilities
` ' j)
TE MORE - ELECTRIC - CAS Etc.
CA W
6 REQUIRED BY LAW
4-
8 Jul
FYIo
0
!�✓��
TIS 6TY I OF ,FRIDLEY DOES NOT GUARAMM.
ACCURACY' OF UTILITY LOCATIONS AND ELEVAT
THS DAT IS FOR INFORMATION PURPOSES ONLY
F`EILSONS G R SHOULD VERIFY THE MFORMA
ON THE
V e •b;Cert,,',-i"a' this ', a True and ccrrect representation of a survey of the boundaries of the above l 07 F,
r, r-a'i i8r7 and r^e 1r c _f o!' Lui.'�dings and v;sibla encrcachmec's, ;f any, from or on said 'ard. Signed ;-j &
L.y Is th,; day ofy - 4 � ' 1 A " '' 19 LOQ' SURVEYS COMPANY
A , 9 " Of
Xlf 121,
155- 7 -F Cl'�u V- -7
3 I
F��. 3 y
It-
1;4alIJIU,C�
11029) z-
fA
coli co 2-
6
-/
awl,
dF
50 egg 3, �
SVLl
�
'
1
� t
L
f
May 11, 1978
1,44
�= �=
0431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
r. Don Wehlast
edar Bay Builders
/o D. W. Construction
8804 Lexington Avenue
New Brighton, MN 55112
Re: Final Inspection at 7555 McKinley Street N.E.
Dear Mr. Wehlast:
TELEPHONE ( 812)571-3450
On May 10, 1978 our office received a phone call from a resident
complaining about construction boxes and the general overall
appearance of the yard at 7555 McKinley.Street N.E.
Upon checking our file, we discovered that we had never made a
final on the house. Therefore, the afternoon of May 10, 1978
we visited the home and found that the front and side yards of
the property had not been sodded and that the rear yard was not
being maintained. Upon trying to speak to the occupant, it was
discovered that they do not speak the English language. Therefore
will you please arrange a time when we can gain entrance to the
home so that a final inspection can be made.
We do require that you sod the front and side yards of the property
by June 15, 1978 and please cleanup the rear yard of the property.
If you have any questions on these matters, please contact me at
571-3450.
S' ely,
X1
DARREL G.
Community Development Adm.
DGC/mh
CC: Mr. Chi -Shing Chang
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 56432
TELEPHONE ( 612)571.3450
January 27, 1983
Mr. Paul C. S. Chang
4314 Manorwood Drive N.W.
Rochester, MN 55901
Residential Rental Property Located at 7555 McKinley Street N.E.,
Fridley, MN
Dear Mr. Chang:
Enclosed you will find the City's application form for a license to
operate residential rental property for the time period from
September 1, 1982 to August 31, 1983.
Section 220.11, of the Fridley Housing Maintenance Code, states that,
"To allow for a systematic enforcement of this ordinance upon rental
dwellings, no person on or following the sixtieth day after the
enactment of this ordinance shall operate a rental dwelling without
first having obtained a license to do so from the City of Fridley...
No operating license shall be issued or renewed unless the rental
dwelling and its premises conform to the ordinances of Fridley and
the laws of the State of Minnesota."
Therefore, you are required to complete the enclosed application,
sign it and return it with the appropriate fee to the City offices no
later than February 14, 1983.
If there are any questions or problems, please feel free to call on
me at 571-3450.
Sincerely,
STEVEN J. OLSON, R.S.
Environmental Officer
STO/mh
ENC: 1
,b-&, s&,l
y
Ai x• -A7A- a -4
v
-4c� 14' re" -4� �b'e7 ---' -
0,
K,roz) adea - ����
J. 'U
CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 1999 0
6431 University Ave NE Z�
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, '
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE JOB ADDRESS
All Others/Repairs & Alterations (UST ON BACK)
1 % of Value of Appliance or Work $
Commercial/Industrial
1.25% of Value of Appliance or Work $
State Surcharge $ .50
so -
TOTAL FEE $ J�J•
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $4200/Hr
No. of Heating Units I Circle -One (Steam) (Hot Water (Warm Air)
Trade Name Size No.
BTU HP EDR
Fuel Total Connected Load
Burner Trade Name_11 Size No.
BTUYd /Zp HP EDR
HEATING COMPANY
Signed By
Approved By Rough—In Date Final Date
*Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
written permission from adjoining property owner.
The undersigned hereby makes application for a permit for the work herein
Residential
Rate
TOTAL
specified agreeing to do all work in strict accordance with the City Codes and
Furnace Shell and Duct Work, Burner —
rulings of the Building Division, and hereby declares that all the facts and
Also Replacement Furnace
$ 30.00
$
representations stated in this application are true and correct.
(Side Vent — Fill Out Back)
,1998
Gas Piping (Needed with new furnace,
$10.00
$
but not replacement)
OWNER
Gas Range
$10.00
$
a
BUILDING USED AS
Gas Dryer
$10.00
$
_
ESTIMATED COST � � �(��� � -PERMIT N0.
��
*Air Conditioning — All Sizes
$ 25.00
$_
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (UST ON BACK)
1 % of Value of Appliance or Work $
Commercial/Industrial
1.25% of Value of Appliance or Work $
State Surcharge $ .50
so -
TOTAL FEE $ J�J•
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $4200/Hr
No. of Heating Units I Circle -One (Steam) (Hot Water (Warm Air)
Trade Name Size No.
BTU HP EDR
Fuel Total Connected Load
Burner Trade Name_11 Size No.
BTUYd /Zp HP EDR
HEATING COMPANY
Signed By
Approved By Rough—In Date Final Date
*Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
written permission from adjoining property owner.
CHIlVINEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes No ( )
2. Is free from rust or deterioration Yes (� No ( )
3. Has no foreign objects lodged within Yes (� No ( )
4. Is securely supported Yes (� No ( )
5. Meets all current Code requirements for size
and total BTU's connected Yes No
6 Has total heating BTU's of LOQ
All other BTU's 16" jU"b
TOTAL BTU's l �2- C7 f cam)
7. Has a liner been provided for water heater Yes No ( )
8. Has combustion air been provided for water heater Yes No ( )
Remarks: °
CLO � b0 S, ti �a� et -�v � FL,,"J.Ic if °
d- �-d1-4 �,C (?, 14 22, Le -i ;VS 41/,e J
List_ ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
f�t& 14 -on -.0
755.5 mi'ffl4we�-X"
P1b �
HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTION MINNEAPOLIS. MM.
Q4atherstwes-0
A Guide Construction No. Insulation
Windows Reference I Out. Q'all Int. Wall Cuing Roof Floor Kind How Applied
u—No '1 1921- ( 1- T— b
R4 Roomi Length Width Height
Windows and Door*-taekage and Arca
too
%tYeth Ilelghl Nc N
or pan of pane Ila me
Lineal IL. Ana
of crack go ft.
p
pt
ogt
Infiltration
Glass /
L
"
Erp. wrll 20
Eitp. wall
Btu
Ia5!tratioa
Inbltratioa
lot. wall
Exp. w•aH
Ceiling
Fila is
Glaze
Int. wall
Ceiling
Lip. wall
Exp. wal!
NCI C. -.P. wall
Net exp. wall
Int. wall
Int. wall
Ceiling
Ceiling
Floor
Floor
kequired sq. ft. E.D.R. or sq. int. WA. Leader area
Fl.I Room I Length width Height
Vin&ws and Dootr- Crackage and Area
wleth N.Irht Die of Lraeal ft.
NO or pane of pane Its "to of crock
Ana
as rt
p
S
ogt
Infiltration
Glass /
L
"
Erp. wrll 20
Eitp. wall
Infill -'tion
Coef. Btu
Inbltratioa
lot. wall
Exp. w•aH
Ceiling
'
Glaze
Int. wall
Ceiling
Exp. wal!
Net exp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. U.R. or sq. 'ins. WA. leadet area
Fl. � (-,Room ILength ? Q,'idt} %' yHcight
Windows and Doom--Crackage and Area
Width heightNo •t Llaeal ft. Arca
No of pane of panne it to of track
A ✓ ' V-
Ceef. &u
Infiltration
Glass /
L
"
Erp. wrll 20
Net clip. wall A41
Int. wall
Ceiling l
Floor
Total Btu.
Required sq. ft. ED.R. or sq. its. a'A. LeAdcr arta
I'Ll Room I Length Width Height
Windows and Doo»&--Craekage and Arca
Nlath Ha/ritt alo of Lloul R Area
NO of Mee of Mne rights of crack Kill,
RIEth Might plc. of Ltaaal t4 Ana
of µre of Mea itrhta of crack M K
Coef. Btu
Infiltration
I
Glass
Eitp. wall
Infill -'tion
Net tip. wall
Gaff
lot. wall
Exp. w•aH
Ceiling
'
Floor
Int. wall
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Leader area
Fl.I Room I length 'Width Height
Win&ws and Dogro—Zraekage aad Arse
North xetrht iio. of Lroeal It. Area
we of pane of gone Ilrhta of crack aq h
RIEth Might plc. of Ltaaal t4 Ana
of µre of Mea itrhta of crack M K
Iceef. Btu
lnfiltratioa
I
Chir
Eap. wall
Infill -'tion
Net tip. wall
Gaff
kat. will
Exp. w•aH
Ceiling
'
Floor
Int. wall
Total Btu.
Required sq. ft. ED.R. or sq. Isis. WA. leder area '
F1.1 Room I Length Width Height
Windows and Doors- Craekage and Area
rte
RIEth Might plc. of Ltaaal t4 Ana
of µre of Mea itrhta of crack M K
I
COW &u
Infill -'tion
Gaff
Exp. w•aH
Net esp. wall
Int. wall
Ceiling
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. WA. Lader area
CIIYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287
August 9, 2000
Rich Haws
7555 McKinley St NE
Fridley, MN 55432
Re: Final Inspection at 7555 McKinley St NE
Contractor: Ray N. Welter Heating Co.
Dear Mr. Haws:
A mechanical permit was issued on May 19,1999 for the property located at
7555 McKinley St NE for a furnace and an air conditioning unit. According to
Section 305(a) of the 1991 Uniform Mechanical Code a final inspection shall be
performed on the mechanical system. As of this date no inspection has been
called for.
You will be given thirty (30) days from receipt of this notice to respond. If we do
not hear from you, we will expire the permit and any inspections on this
installation will require a new permit.
Any questions can be addressed to myself at (763) 572-3603.
Sincerely,
DAVE J�tISEN
Buildip( nspector
SUBJECT
PE2
City of Fridley
3.1 U G
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT Nq
, _ COMMUNITY DEVELOPMENT DIV.
v
PROTECTIVE INSPECTION SEC.
f 97 ��
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
11/17/94
JOB ADDRESS 7555 McKinley Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
I 5
1 Bayer's Lakeside 2nd Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Kathy/Rick Haws 7555 McKinley Street NE
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Netko Bros Roofing 7118 Riverdale Rd, M ls., MN 55430
566-3731 6700
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
8 DESCRIBE WORK
Reroof House (23 Sq) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
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
SO. 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 I
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
$1,725
• 86
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
P��
Fire SC $1.72
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
'M �
SI ATURE01CON'RACTORORAUTHORIZEDAGENT (DATE,
WHENN� PROP Y VALIDATED THIS IS YOUR PERMIT
P
BL G ,NSP
;
DATE
SIGNATURE OF OWNERUF OWNER BUILDER, IDATEI
NEW (] Effective 1/1/94
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 log
Building Permit Application
Construction Address: i PA
i C,g �4 L ✓�
Legal Description
Owner Name & Address: Oda �c-`r2i, /� V��.� ( �� Tel. #
Contractor: N U (Cb MN LICENSE # iQ O
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
LS 5<
Tel. # . 5 & (,-37;
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale. 6E)
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width HgdGround Sq. Ft.
Corner Lot [ ] Inside Lot (] Ft. Yd Setback Side Yard Setbacks
Type of Construction: ^o W t Estimated Cost: $ 3 5 —
Approx. Completion Date: Il ( '� X
(Cost` on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ – $
DATE: ) ( APPLICANT: A Tel. #
/� G G}cm , E ONLY
Permit Fee $ ,i ,ice Schedule on Reverse Side
Fire Surcharge $ j_, %2..001 of Permit Valuation (1/10th%)
State Surcharge $ .5041,000 Valuation
SAC Charge $ $800 per SAC Lint
License Surcharge $ 5, ® C$5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Alcove
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary ( ]
TOTAL
STIPULATIONS:
-
-
SUBJECT
,
City of Fridley
T3
3 7114 47
AT THE TOP OF THE TWINS
BUILDING PERMIT
t
16
RECEIPT NO.
v ______ COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r PROTECTIVE
CITY HALL FRIDLEY 55432
Nu"EA
REV
DATE
PAGE OF
APPROVED 8Y
612-571-3450
910-F15
10/5/00
JOB ADDRESS 7555 McKinley Street NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DEscR.
5
1
Bayer's Lakeside 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Kathy/Rick Haus 7555 McKinley Street NE 784-1301
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Franzen Construction 4250 5 Street NE, Columbia Heights, MN 55421 788-4071
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
2744
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION 0 ALTERATION C:k REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace subfloor and sheetrock in first floor bathroom
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS
REQUIRED FOR:
WIRING HEATING
Pu JMBINd AND SIGIMS
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 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
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
200
$3.60
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
�7,
DOES NOT PRESUME TO GIVE A RITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC C ARGE
PROVISIONS OF ANY 0TH T OR LOCAL LAW REGULATING CON.
153.25
Fi SC 7.20
STRUC ION R THE PER E OF CONSTRUCTION
PLAN CHECK FEE
T A FEE
/'nZe
Lice a SC
169.05
iGN4TURE OF CO TaACTOF+OA AUTM TIED AGENT DATEiM
_
PR VAL AT HIS IS�YOUR PER 17
j
6l G INSP gAtE
$,GN4TURE OF OW NEA OF OWNER KURD- TDATE-
NEW [ l Effective 1/1/2000
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: SSS , ell`
Legal Description:
Owner Name 8Address: Tel.
Contractor: MN LICENSE #.
Address: f- ! - Z71 -S Tel. #
2
Attach to this application, a Certificate of Survey of the
Y
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 W Hgt/Ground Sq. Ft. "
OTHER: Lit f
Construction Type: Estimated Cost: $_ % 24D
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE. 6C—Z�'d APPLICANT:W1J Tel. # %��� �/�-71
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee
$ ��.o�Z�� Fee Schedule on Reverse Side
Fire Surcharge
$
'%, �b .001 of Permit Valuation (1/10th%)
State Surcharge
$.50/$1,000 Valuation
SAC Charge
$
$1100 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
$
< Pi OS�'
STIPULATIONS:
Building
$
BUILDING
See Back Page for Fee Schedule
Permit No.:0�
Inspections
$
RESIDENTIAL APPLICATION
65% of Building Permit Fee
Received By:
763-572-3604CITY
$
OF FRIDLEY
(.0005) times the total job valuation —Minimum $.50
Date Rec'd:
DATE
YOUR E-MAIL ADDRESS
SITE ADDRESS
S
License Surcharge
THIS APPLICANT IS:
O OWNER XONTIVACTOR
$5.00 (State Licensed Residential Contractors)
PROPERTY OWNER/
NAME;
$
ADDRESS: CITY
STATE ZIP
TENANT
Curb Cut Escrow
PHONE. -_14 3— —Z 3 d
CONTRACTOR
NAME; i G IC S v
STATE LICENSE N 3 5-� EXP DATE 3D
$
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: �S�o e S dL! CITY
0 / ATE ZIP
WITH APPLICATION
PHONE 63175- FAX 6<1 &33 —
Q%
PROPERTY TYPE
SINGLE FAMILYINEW CONSTRUCTION SIZE
$
O TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ WINDOWS
Make checks payable to: City of Fridley Attach Stipulations
A0A7GE1SHED
O BASEMENT FINISH O ❑ DRAM TILE
❑ DECK O SIDING O OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
RVAMINANgMEPAIR MODELING
DESCRIBE WORK BEING DONE: - r— °� C ®�
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT S . Ft.
ROOFING -
❑ HOUSE ONLY
NUMBER OF SQUARES'
❑ HOUSE & GARAGE
BASEMENT
REMODELING SUBMIT:
GARAGES��
e ❑ ATTACHED GARAGE
1.
2.
Existing Floor Plan
Proposed floor plan
PROPOSED SIZE:
2� ❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
O Vinyl
❑Soffit
ADDITIONS.
& PORCHES SUBMIT:
O Aluminum
❑ Trim
I.
Site PIwAurvey showing the existing structures
O Other
O Fascia
and proposed project.
2.
Two sets of construction plans
\1� ND W
IN EXISTING OPENINGS OYes
❑No LOCATION OF WINDOWS
3.
Epergy Calculations
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL PEES ARE BASED ON VALUATION, INCLUDING THF COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION S OCCUPANCY TYPE
Permit Fee
$
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
3.
Surcharge
$
(.0005) times the total job valuation —Minimum $.50
,15,
Fire Surcharge
$
.001 x Permit Valuation (1/10%)
License Surcharge
$
t
$5.00 (State Licensed Residential Contractors)
'
SAC Charge
$
$1450 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $20 = $
(p
Erosion Control
$
$450 Conservation Plan Review
�a
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due •
$
Make checks payable to: City of Fridley Attach Stipulations
TION FOR A PERMIT -NOT VALID UNTIL PROCESSED
' I hereby apply for a building permit and 1 acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes o.f a City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a pe it d 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 re uir r w and appy al of plans.
SIGNATURE OF APPLICANT PRINT NAM Q f l 015 e —lc�./ ATT 4-7-0
Building
PLUMBING
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd: /� Z
DATE q I 1211) to YOUR E-MAIL. ADDRESS
SITE ADDRESS SS' lne. IC ,JG F y 17- AJ,6
THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR
PROPERTY
NAME: R ,CIC NAW S
OWNER/
ADDRESS: %SSS CITY `lei ;> t e y STAT&�_ZIP S113 Z
TENANT
PHONE: -763 7 y q /30/
Terry Overacker Plbg Inc
CONTRACTORNAME:
STATE LICENSE # 51 y 4 i n'1 EA 1628 County Hwy 10
SUBMIT A COPY OF
Spring Lake Park, MN 55432
STATE
ADDRESS: up
LICENSE WITHYOUR
(763) 572-8880
PHONE FAX—
AX_APPLICATION
APPLICATION
PERMIT TYPE
SINGLE FAMILY 0 TWO FAMILY 13 TOWNHOUSE
TYPE OF WORK:
[3 NEW REPLACEMENT
DETAILED DESCRIPTION OF WORK
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 ARE�AS�3tf V-&—IIIOOYER FIXTURE, EXCEPT WHERIr NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
_ BATH SINK/LAV _FLOOR DRAINS _ SHOWER _ WATER PIPING
—BATHTUB _ GAS PIPING (vEw curucEw) _ SWIMMING POOL _ WATER SOFTNER ($35)
_ CLOTHES WASHER _ KITCHEN SINKWATER CLOSET _ BACKFLOW PREY. ($15)
_
_ DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION
WATER METER? OTHER
�y ¢
Permit Fee $ S .0 U
Number of fixtures @ $10.00 x $10.00 = $
Surcharge .50
Number of fixtures @ $15.00 x $15.00 = $
Number of fixtures @ $35.00 x $35.00 = $
TOTAL DUE $ .50
State Surcharge = $ .50
Total = $
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 APPLICANTPRINT NAME JrAC � � IL� /Z,1 ^� DATE 9 f �
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
Building
BUILDING
Permit No.
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604Da
CITY OF FRIDLEY
'EV�1
DATEIZ a-!� YOUR E-MAIL ADDRESS
SITE ADDRESS
Iz S %�
THIS APPLICANT IS:
❑ OWNER CTOR
PROPERTY OWNER/
NAME: <
ADDRESS:�rr�
CITY �� STAv rn�y3Z
TENANT
PHONE:
CONTRACTOR
NAME:
STATE LICENSE # EXP DATE 3
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: 019G JS%�Yif 2 �� �7'L
CITY �l STAPL9%3
WITH APPLICATION
PHONE 2-010 FAX
PROPERTY TYPE
GLE FAMILY/NEW CONSTRUCTION
SIZE
❑ TWO FAMILY/NEW CONSTRUCTION
STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED
ErWINDOWS
❑ BASEMENT FINISH ❑ ROOF
❑ DRAM TILE
❑ DECK ❑ SIDING
❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MANTENANCEJREPAIR 81tMODEUNG
DESCRIBE WORK BEING DONE: re z
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
WINDOWS
2. Two sets of construction plans
EXISTING STING 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:
ANCY
Permit Fee $ See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Surcharge $ pLe .0005 x Permit Valuation Minimum $:50
License Surcharge $ , 00 $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1675 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft + 6 ft = ft x $21 = $
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( )
Total Due_ $ cj 1.uS 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* erni and work is not to start without a ermit; that the work will be in accordance with the approved
plan in the case of all wo w r s review'and approval of plans.
SIGNATURE OF APPLIC PRINT N /�'G' DATE
Building
BUILDING
Permit No.: bdi
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd:
763-502-4977 FAX
JUL 01:mol�
EFFECTIVE 1-1-08
DATE E- ADDRESS
GYOUR
SITE ADD SS 7Ts'� 1�i.7 Coe
THIS APPLICANT IS: ❑ OWNER eCUNTRACTOR
PROPERTY OWNER/
NAME: / Gt
ADDRESS: `TS S /J% / • CITY)
C STATIyAJ/J ZIP.SSy32
TENANT
PHONE:/.rig/
NAME: it
L �- /
ADDRESS: .�`7 D n'J/ �� S ir-c� CITYr5 ; STAT ZIP, 'S $Z
CONTRACTOR
SUBMIT A COPY OF
PHONE %� 3 %� '' �!� FAX
YOUR STATE LICENSE
STATE LICENSE # Z75� EXP DATE
PROPERTY TYPE
INGLE FAMILYINEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAM TILE
K ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:❑�OME
CONSTRUCTION ❑ ADDITION
TENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
Z LENGTH 8 WIDTH 6 HEIGHT 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
❑ 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:
(US G THE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION $ B� °'R a�( OCCUPANCY TYPE
.Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ GO •qI'S See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ .001 times the total job valuation
$ .0005 x Permit Valuation Minimum $.50
$ $5.00 (State Licensed Residential Contractors)
$ $1825 per SAC Unit (Plans to MWCC for determination)
$ -ft +6 ft= ftx$21=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ % . Make checks payable to: City of Fridley 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 is not a permit but only an application for a permit and work is not to start ithout a
permit on site; that the work will be in a vith oved plan in the case of all work which m r view an appro of plans.
SIGNATURE OF APPLICA PRINT NAME / I��Y%�j/! DATE /_'77=4
APPROVED BY DATE