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PRE 2010 DOCSSUBJECT PERM I City of Fridley I V. r1l12170 AT THE TOP OF THE TWINS 13011-DING PERMIT 16EIPT • COMMUNITY DEVELOPMENT DIV. �L ------� INSPECTION ` r/ r � � PROTECTIVE SEC. CITY HALL FRIDLEY 55432 ,•� NUMBER REV. DATE PAGE OF APPROVED BY L"-' 612-560-3450 910-F15 6/7/73 JOB ADDRESS 5861 Main Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 30 24 Hyde Park Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mr. Clyde DeBolt 5861 Main Street N.E. 7-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 X ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct 20' x 20' Addition to Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Side yard variance approved by Council. PERMITS REQUIRED POR WIRING, SEPERATE HEATING, PLUM13ING AND �+,GNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood 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 R-3 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 ISTALLS 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 $5,712 2.86 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- $15.00 STRUCTION OR THE PERFO MANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE T S ATUREOFCONTRACTOR O AUTHORIZED AGENT (DA' HEN OPERLY VALIDAT THI§ XYOUQ PERMIT A BLDG. INSP DATE SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) m APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME:J�Z/&404* BITILDER: ADDRESS: ADDRESS: NO:. 5 All STREET:_ //IAW1///' LOT • 30 BLOCK • ADDITION: CORNER LOT:_ INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As; 17-/0111 7-( Front• �® Depth: Height: Square Feet: Cubic Feet: Front: —Depth: Height: Square Feet; Cubic Feet: Type of Construction: )n "k'9 ��/��� Estimated Cost:_$ To Be Completed:-�- The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stfict 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. s DATE: ZZ75 SIGNATURE: (Seeeverse Side For Additional Informat n.) . 1'7 t City of Fridley r 4T THE TOP OP TME TWINE ------- COMMUNITY pEVi6.OPMENT OIV, PROTECTIVE MItMECTN)N KK i �.. CITY HALL. sIUMgV 0002 EIst�EGT PLUMBING PERMIT APPLICATION JOo Aaaress (/ L n e­'� � Address Phone �� '� Con,pfactor Address Phone Kind of Building Use Completion Date Estimated Cost u Ii Plumbing Fixture Rates: NO. RATE TOTAL I I i I �I � { — � II ~ J Number Fixtures x $2.00 $ y D v Future Fixtures ' x $1.50 aosvo� New Fixture -Old Open. x $1.50 ,aarl I ; I O ! Catch Basin x $3.25 aro ! Water Heater -99,000 BTU x $3.00 •aslw i Ground Run Old Bldg. x $3.25 •MNlval I I } I i, m gNlere I — j Elec. Water Heater x $2.00 Gas Fitting Fees: QNIVOC �� C eloo�� • 3 o I I I I ` ra I 1st 3 Fixtures x $2.00 Q u I eaaMOMSI ` I I I W � �0 I Additional Fixtures x $ .75 •.Lwnod V HNING I I I I Gas Range -199,000 BTU x $5.00 q "IMMI I I I Repairs & Alterations See Ii BUN- I I I Description: Code a� sNlsrsl I I I State Surcharge .50 sum + I I I I I TOTAL FEE 141"I $ �0 8'rNRI°!The undersigned hereby makes application for a permit I I I for the work herein specified$ agreeing to do all work in strict accordance with the City Ordinances and Tulin u uovlM I I { of the Department of Buildings, and hereby declare that all'the facts and representations stated in this application are true and correct. Si iture Date P Land Planning PIPfuCy�i%i�in 687S Highway No. 65 N.E. Land Surveying• • �JM/+ Minneapolis, Soils Testing nyvnee�Gin�, V,�6L• Minn. 55432 Civil Engineering Telephone 784-6066 Municipal Engineering Engineers & Surveyors Area Code 612 Mortgage Loan Survey for (LYV7L IJL ©Li 12.l cV l m N ."591 1 P ' - 128,99 - n, 30' N � � N O N M Q0 CT 0 I ?5` -- ( 123 old wire YI Q. N I LOT 30 � 16 --OCK ' 4� �4 yr) c= 14, R � Aiioj�A Cowily This is a true and correct representation of a survey of the boundaries of the land above described and of the location of all buildings, if any, thereon, and all visible encroachments, if any, from or on said land. This survey is made only in connection with a mortgage loan now being placed on the property and no liability is assumed except to the holder of such mortgage or any other interest acquired by the reason of such mortgage. It is understood and agreed ntmonumenss have been j loced for the purpose of establishing lot lines or boundary corners. Dated this : S day of AA P c A. D. 192J SUBURBAN ENGINEERING, INC. Enginee s ; Su ve�.a Q it 71 1867 City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING PERMIT P 23022 r � • _COMMUNITY DEVELOPMENT DIV. I 1 v ______ PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 �""� ,•J 612-571-3450 R I NO. `H®� {'/(//p,•(7 NUMBER 910-F15 REV DATE 10/21/94 PAGE OF APPROVED BY JOB ADDRESS 5861 Main Street NE 1 LEGAL DESCR. LOT NO. 30 BLOCK 24 TRACT OR ADDITION Hyde Park Addition SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Patricia Donnay 5980 2nd St NE, Apt #1, Fridley 572-8011 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 ❑ ALTERATION jl REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK Reroof House (12 Sq) Tear-off; Replace living room window 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SO. FT. CU. FT. 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 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 $1,100 $.55 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL 7HE PERMIT FEE SAC CHARGE 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 SIG OR AUTHORIZED AGENT IDATEI HEN PROPERLY LIDATED THIS IS YOUR PERMIT TOFON'FACTOR Amh v461' SIGNATUR OF OWNER OF MNER BUILDERI IOA EI BLDG 14S P DATE NEW ( ) ADDN () CITY OF FRIDLEY ALTER { ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: Effective 1/1/94 Legal Description: Owner Name & Address: Dog t% _;FJP&P ;2'-',Jj Contractor: --.5e / MN LICENSE # Address: S e e a Tei. # 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: l �z .ems 11PA4-.,.,1j 1196V-00 Corner Lot [ ] Inside Lot (] Ft. Yd Setback Side Yazd Setbacks Type of Construction: Estimated Cost: $ Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: Q a 41 APPLICANT: Tel. # STIPULATIONS: '7,06 ICY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ /-/0 ..001 of Permit Valuation (1110th%) State Surcharge $ , �S� $.501$1,000 Valuation SAC Charge $ $800 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: Building $ BUILDING Plan Review Permit No.: OO Inspections Surcharge RESIDENTIAL APPLICATION (.0005) times the total job valuation — Minimum $.50 Received By: 763-572-3604 .001 x Permit Valuation (1/10%) CITY OF FRIDLEY $ Date Rec'd: _a'9 – 0 S $ DATE d YOUR E-MAIL�ADDRESS $ SITE ADDRESS — LP � �/� S T' .N if cSd M Erosion Control THIS APPLICANT IS: OWNER ❑CONTRACTOR Park Fee PROPERTY OWNER/ Fee Determined by Engineering Sewer Main Charge ADDRESS: S Ala -(,I sr N6 CITY PCI I STATS 3 Q� TENANT Total Due PHONE: Z— Make checks payable to: City of Fridley Attach Stipulations CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION FAX PROPERTY TYPEINGLE F W CONSTRUCTION SIZE d 4C Zi ❑ Y/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ BLOOF ❑ DRAIN TILE ❑ DECK gSIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: VNEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: /ZF — S'>D % ^J &-- 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 PROPOSED SIZE: ❑ DETACHED GARAGE 2. 3. Proposed floor plan List of structural members to be used PROPOSED HEIGHT: SS ID.ING 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 $ S00 . Q O OCCUPANCY TYPE Permit Fee $ . �"Zj 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 $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Z— 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 w w ich r q fres ,vier and approval of plans. , \ SIGNATURE OF APPLIC I PRINT NAME�AtV, \ DATE ��� Building $ BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: Y� 763-572-3604 $ CITY OF FRIDLEY Date Rec'd: DATE v v YOUR E-MAIL ADDRESS SITE ADDRES _�CJZ I IAS 1 `� S�(L T- Nk- $ THIS APPLICANT IS: OWNER ❑CONTRACTOR P SAC Charge PROPERTY OWNER/ NAME: � -- cl'e- j Nj Curb Cut Escrow ADDRESS: MAN V' 1 tib CITY L -1 -- -PHONE: ft + 6 ft = ft x $20 = $ TENANT $ PHONE: $450 Conservation Plan Review Park Fee CONTRACTOR NAME: Fee Determined by Engineering Sewer Main Charge STATE LICENSE # EXP DATE Agreement necessary ( ) Non Necessary ( ) SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS CITY STATE—ZIP— TATEZIPWITH WITHAPPLICATION PHONE FAX SINGLE FAMILY/NEW CONSTRUCTION SIZE PROPERTY TYPE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION 13 GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH )N ROOF ❑ DRAIN TILE ❑ DECK ba SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAIN77ENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: � t Q; QAA0 'TIAE- CAa.aae SIZE OF IMPROVEMENT LENGTH 3 WIDTH )09-, HEIGHT a— S . 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: 13 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 E 9�7 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ 3 S, 7 S' See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $ 0 50 (.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 $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ L40 , j 1, Make checks payable to: City of Fridley Attach Sti nlations 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 FROM :City of Fridley FAX NO. :7635711287 May. 09 2006 10:3BM P3 Permit No.: " Building WCH,NICAL IF= ved By: Inspections RESIDENTIAL APPLICATION n �,d. 5-I � 763-572-3604 CITY OF FRIDLEY q BATE ` YOUR E-MAIL ADDRESS SITE ADDRESS , 1 TFi15 AppLiCANT 1S. O OWNER r CTOR w OWNBItt/ TENANT CONTRACMR COMPANY NAME: w • " CDMACTPERS01q: tD bel SUBMIT A COPY OF U STATE • 1 EDW DATE YOUR STATE G L1CF,)dSE Vw=rm ADDRtsss: APPLICATION PHONE G FAX j PTRM;T TYPE SWGLE FAMILY O TWO FAMILY D TOWNHOUSEi! TYPE OF WORK: 1]NEW xim"CEMENT OALTIMAT10*7LO+IODSL -VVV. n rr+ nT:QrRrPT10N OF WORK fee is a minimum ot515.00 or S°10 of the total cold up to 5509.00, whitbever is �, for the PER MS 16B.665 the permit exchtdntg the fes. (This sLoutd reQat only do cost of tabor ) improvement, irosta Winn or repltt =cnt of a residentia) fixture, Labor cost under S300= Sl S.00. Labor cost betwom 5300 to $500 -cog of labor � x . FOR PROJECTS WHME LABOR WWOM SM. FEES ARE BASED ON SIO OD PER F7XrUltEt7tCEi=T vrl�ae>: NOTED FpeJtJRFs: �ICATS TOTAL. NUkUM OF BACK jp t L�statted sEBELOW)MFG. �.—� MODEL. P OC . C) S MFG. _ MODEL SIZF►BTt7 MFG- MODELGAS RANGMV04 S10.00 _FIREPIACE(GAS) SIS.00 NOW GAS GRIM SIOAD A/C US -00 (WOOD) 535.00 AIR -roam EJccJiANGmt sts �FIJitNACB s3s.o� cAs tJN1T FTI7i S10.OD BOILER $35.00(1A5 DRYER at0.00 POOL HEATER $35.00 C"%61EY Iz4M SIO.00 "VFSiTO,ATOa SIS DUCT WORK $10.00 OAS PIPING SIQ00 �es_�� � wu Number 0f miures (t� E10.0t1 x 510.00 = S Permit Fee S o Number of fumn+es @ S1S.00 x SIS.00 = S 5iur3tarSe . of fncntres @ 525.00 x US -00 = S TOTAL. DUE S TOTALNumber of fixniros @ $35.00 x $35.00 = S State S0 Sar bwp — S___A0_ Tow = 5 TIM 15 AN APPLICATION FOR A PEItM[T-RIOT VALID URM PROCESSM t and I ackrrowledge that the information above is copra** and aaairate; that the work w01 be in ) hereby apply for a building permi ,Con�vedon that t uodustand this is conformance wilt the ordinances and modes of the City of Fridley and with the Minnesota not a permit but o* an application for a permit and work is trot to start without a permi>y do the work will he in mcordante with the approved plan in the case of an work review and approval of p (1A A fl 1 A M t�n6�-tin/) — _ �. L1 W r 1 Y✓1 1 1 1/ I L DA -111 ✓ I SIONAn= OF APPtJCANr City of Fridley Building luspeetitons Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX- 763-502-4977 Building $ BUILDING Permit No.: A067 q, inspections $ RESIDENTIAL APPLICATION Received By: 763-572-3604 $ CITY OF FRIDLEY D 'S 7 FATE 01 YODUR,�E-MAIIL ADDRESS CI f Q /d, r �y . i10M ,iTE ADDRESS 6541 M-ot/) �TI '� L /"' NV V r I HIS APPLICANT IS: ❑ OWNER EteONTRACTOR V u PROPERTY OWNER/ NAME: a`ot. M -or -len to 4 z om t f\ V TENANT ADDRESS: .5w � � r9611) /1! S l . /gyp CITY �j' I Cl I t v STATE_"ZIP—JSA3' $ PHONE: -76 61 -q-)1 - ft + 6 ft = ft x $20 = $ CONTRACTOR NAME:_ The Home Depot A.H.S. Inc. SUBMIT A COPY OF STATE LIC 3200 Cobb Galleria Pkwy. $ YOUR STATE LICENSE ADDRESS: Atlanta, GA 30339 CITY STATE ZIP WITH APPLICATION PHONE 763-542-8826 1:1 SINGLE License #20268257 Agreement necessary ( ) Non Necessary ( ) PROPERTY TYPE $ ❑ Two A .ORIES PERMIT TYPE QADDITION ❑ GARAGE/SHED GLWR,1DOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEWre� 1r, ❑ ADDITION IN, ELMAII�PTENANC ❑ REMODELING )ESCRIBE WORK BEING DONE: t tifndow ry o ! l Y1 ,IZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. tOOFING ❑ HOUSE ONLY DUMBER OF SQUARES 0 HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 'ARAGES ❑ATTACHED GARAGE 1. Existing Floor Plan 'ROPOSED SIZE: 13DETACHED GARAGE 2. Proposed floor plan ROPOSED HEIGHT: 3. List of structural members to be used TDING FOR NEW CONSTRUCTION INCLUDING DECKS, I Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: I Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures I Other ❑ Fascia and proposed project WINDOWS 2. Two sets of construction plans '4 EXISTING OPENINGS &Wes ❑No LOCATION OF WINDOWS 66.51 p1jA It+ 3. Energy Calculations )R FOR NEW OPENINGS -DESCRIBE SIZE OF >PENING CHANGES & YPE OF WINDOW TO BE INSTALLED �C, I 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 S 6,5 6' OCCUPANCY TYPE ermit Fee $ Ss --Io See Back Page for Fee Schedule Ian Review $ 65% of Building Permit Fee urcharge $ • To (.0005) times the total job valuation — Minimum $.50 ire Surcharge $ , $ 4 .001 x Permit Valuation (1/10%) icense Surcharge $ V u $5.00 (State Licensed Residential Contractors) AC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) 'urb Cut Escrow $ ft + 6 ft = ft x $20 = $ .rosion Control $ $450 Conservation Plan Review ark Fee $ Fee Determined by Engineering ewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Iotal Due $ Af ;I - OG Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in Dnformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a -rmit 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 an in the case of all work which requirArw and. approval of plans. GNATURE OF APPLICANT�,r� PRINT NAME -rJM fC14W I- DATE -)L d October 3, 2007 Fridley, City of 6431 University Ave. N.E. Fridley, MN 55432 To: Building Department Elder -Jones Building Permit Service, Inc. I am requesting a refund for cancelled building permit #2007-01734, issued 09/19/07. (Homeowner Canceled Job) The permit was for replacing windows at the residence of: Jose Romero Lo ez 5861 Main Street NE ` -P.O. 1=„-7 6711 Fridley, MN 55432 Enclosed is a copy of the original permit. Please make the check payable to Elder -Jones Building Permit Service, Inc. If you have any questions or need more information, please call me at 952-345-6047. Thank You, 6'W e Jodi letten Elder Jones Permit Service Elder -Jones Building Permit Service, Inc. 1120 East 80th Street • Bloomington, Minnesota 55420-1498 952-854-2854 • FAX: 952-854-4909 CITY OF FRIDLEY PERMIT NO.: 2007-01734 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 09/19/2007 (763) 572-3604 FAX: (763) 502-4977 ADDRESS 5861 MAIN ST NE PIN 233024230103 LEGAL DESC HYDE PARK : LOT 30 BLOCK 24 PERMIT TYPE BUILDING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE WINDOWS/DOORS VALUATION : $ 855.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R-313.2.1 OF THE 2006 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS. CONSTRUCTION IN THE CITY IS UNLAWFUL EXCEPT BETWEEN THE HOURS OF 7:00 AM AND 9:00 PM, MONDAY THROUGH FRIDAY AND BETWEEN THE HOURS OF 9:00 AM AND 9:00 PM ON SATURDAYS. NO WORK IS ALLOWED ON SUNDAYS OR ANY LEGAL HOLIDAY UNLESS AN ALTERNATE WORK HOUR PERMIT HAS FIRST BEEN ISSUED. ONE WINDDOW REPLACEMENT INTO EXISTING OPENING STATE LICENSED CONTRACTOR? 1 THE HOME DEPOT AT-HOME 3200 COBB GALLERIA PKWY STE 200 ATLANTA, GA 30339- (770)779-1423 OWNER LOPEZ-ROMERO, JOSE M & JIMENEZ CANA 5861 MAIN ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other st to or local law regulating construction or the perfo nce o construction. Applicant Date Bldg Insp Date N B ILDING RMIT F 35.70 FIRE S CHARG 0.86 ST SURC RGE, BLDG VALUE 0.50 ZDWI'TtH NSRCHARGE 5.00 TOTAL 42.06 P CHECK # 49845 SEPARATE PERMITS REdUIRE% FOR WORK OTHER THAN DESCRIBED ABOVE.