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PRE 2010 DOCSo. y; City of Fridley SUBJECT - `® 14529 AT THE TOP OF THE TWINS BUILDING PERMIT t � N0.�.COMMUNITY DEVELOPMENT DIV." INSPECTION SEC. r,ECEIP*,l - 'nPROTECTIVE '7 i1 � i L A" �"--,CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ---- 612-560-3450 910-F15 12/22/77 JOB ADDRESS 5511 Matterhorn Drive N. E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 10 7 Innsbruck North SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Harstad-Todd Construction 2200 Silver Lake Road 636-371 3 CONTRACTOR MAILADDRESS 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 WORKJJ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOfirAjjLjM&E 8 DESCRIBE WORK Construct a 41' x 2716" Dwelling and a 22' x 22' Garage BOWS dl ' ng call local. (!till TELEPHONE ;ELECTRIC -GAS SE°�ERA?`E PERMIT 9 CHANGEOFUSEFROM HEATING, PLUMBING AND SIGNS. STIPULATIONS Provide a hard surface driveway. Provide sod in the front and side yards. Provide a verifying survey before capping. Install saddle at chimney. Install exhaust fan in laundry. Provide combustion air to the furnace. area. Provide additional column footing as shown on plan. Provide truss design. Vent attic at 1:150 ratio. Verify sewer depth before setting footing elevations. SEWER LOCATION: (Approx. 9' Deep In Street) 65' N. of Manhole (Inv. 984.14) WYE ELEV: 982.81 TOP OF FOOTING: 985.81 WATER LOCATION: Approx. 10' South of Sewer Service DRIVEWAY DEPRESSION COST: N/A THE OTY OF FRIDLEY DOES NOT WA.RANTEL- THE ACCURACY OF UY(Lf1Y LOCATIONS AND ELEVATIONS. THIS DATA IS FOR INFORMATION PURPOSES ONLY AND POWNS USING It SH6UW VEMY THE MRMATIO14 nN 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 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 R-1 1066+484 35,180 Total ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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. $64,415 3X�NX$B $32.21 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVI O ANY OTHER STATE OR LOCAL LAW REGULATING CON.- $140.72 $375.00 STRUCTION OR H ERFORMANCE F CON ION. PLAN CHECK FEE TOTAL FEE $3-5. t$ $583.11 SIGNATUR OF CONTRACTOR ORAUTHORIZED AGENT ATE) WH NRLY LIDATED THIS IS YOUR PERMIT BLDG I SP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) @s tc: D CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS V1 (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER: /�� ►rS f �% BUILDER: �� ►' S 7 ? �1 i� C' r � Address: ;2-,:)- v c, S, /y im' X 1< (2c� Address: 9L -(-j y S; No. LOT: le CORNER LOT: Tel. No. Street: �%`r 7I�E°�oehJ Pe - BLOCK: �_ ADDITION: Y C)� /4 i / s / INSIDE IAT: %<- SETBACK: SIDEYARDS: 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: / r Front: Depth: /D Height: Square Feet: 2 /Cubac Feet: 3yj ✓q'o Front: Depth: A 2-* Height: lay & U. 3 3 Square Feet: Cubic Feet: y8 `Y � Z -4, ) T Type of Construction: (/OO jr' >vv%e_ _ Estimated Cost: To Be Completed:�.` lelAlt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) 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. See reverse side for additional'informatio DATE:,2fc 711' SIGNATURE•s� Stipulations- ations : of r �, t : / 5d • p �D. _ J L &4 7 064 OWNER EXTERIOR ENVELOP AVERAGE "U" COMPUTATION r -r A f � SITE ADDRESS /-& f- 0 (3 1,k I CONTRACTOR I i ft W. DATE %�" �"' 77 PHONE Determine working square footage of each. 1. Total exposed wall area .....s sq. ft. x 17_ _ 2. Total roof/ceiling area .00, seesQ. ft. x Total exposed wall area above floor _ a. Total wall window area...... .... •..••••• b. Total door area ........................... ..._ c. Total sliding glass door area ........... 00..00.0 d d. Total fireplace wall area ......................... r� ?•7 e. Total wall framing area (average 10%) .......... •• f. Total net wall area above floor ...•.••••••••••••• g. Total rim joist area ... ........ ...?. 0. Total exposed foundation area = �� Total foundation window area..............•.•.•••• h. Tot i. Toal net foundation area above grade ...........•• Determine "U" value of each wall segment. llull a. be 'Yo Xllulv flull X 'lull ies) e. X aufi Q _ 4 o f. i ---- tiA �®6 _ g • �.� x 1.._ (a X u qX. 'l��l 3 .............0...............000. .. .Total If item #3 is the same as,'or less than item #1, you have met the intent of SBC 6006(c)2. Ental exposed roof/ceiling area = tA Total gross roof/ceiling area = C-, 4�' j. Total skylight area ..............••••.••••.•. k. Total roof/ceiling framing area ............ 1. Total net insulated roof/ceiling area....... Determine "U" value for each roof/ceiling` segment. X fluff k. ® X X fluff d .....Total ...... .. .......::: R, . If total of #4 is the same as, or ,less than #2,you have met the intent of SBC 6006(c)l. To utilized the total envelope system method, thevaluesestaof blished by t tand h#2.. sum of items #3 and #4 shall not be greater 3. + 4. U s .A . _ ..max_ -.w.._,.,•,.___ 11 o.e., -26 o.C7-1� 411 r Z, 7 //07 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTA4G PERMIT PARTIAL RATE SCHEDULE x '$3.00 PLUIMffiING FIXTURE RATES: NO. RATE TOTAL R=ber Fixtures Gas Range to 199,000 BTU x $3.00 S 33,1 o Future Fixture Opening_ x $2.00 a New Fixture, Old Opening Water N �+ $ m each add. $100.00 or fraction x $5.00 $ Water Heater - to 99,000 BTU [a m a 100,000 ETU to 199,000 BTU i .+ w w g :seater w e°s -+ h x $5.00 m °x� N -+ ro a 3 y a ro ++ o e ti r .ci H c o�u .Ki epi of + U m IA 3 o ° w ni fr4 U O as lec 1 I 1st 2nd 3rd 4 L•'1 (R) m Future Connection Opening Connected with Sewer (*) a New Fixture, Old Opening Water PARTIAL RATE SCHEDULE x '$3.00 PLUIMffiING FIXTURE RATES: NO. RATE TOTAL R=ber Fixtures Gas Range to 199,000 BTU x $3.00 S 33,1 o Future Fixture Opening_ x $2.00 $ New Fixture, Old Opening First $100.00 x $2.00 $ Catch Basin each add. $100.00 or fraction x $5.00 $ Water Heater - to 99,000 BTU % x $5.00 $ S,D. 100,000 ETU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Pun Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x '$3.00 $ 3,L)o Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS & ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $`/ .SO TOTAL FEE $ 7�.5p REI"VECTION FEE Job Address }'1sJ l47? C 1-14b (°2/�I! Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. L-1 , 1979 OWNER KIND C USED AS TO BE COMPLETED ABOUT ESTIMATED COST OW - NEW BU LDING PERMIT NO. PERMIT NO. Company 'y-e'L-1 LA4.1-, Signed By 10 A / Tel. No. oL [• J ROUGH INSP. Date FINAL INSP. k r a Date APPROVAL FOR PERMIT F� MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATS SUFM ARGE 41 w F August 28, 1978 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE ( 812)571-3450 Mr. Bob Todd Harstad-Todd Construction 2200 Silver Lake Road New Brighton, MN 55112 Re: Final Inspection at 5511 Matterhorn Drive N.E. Dear Mr. Todd: A final inspection was made on August 28, 1978 of the above address and the following items were noted which must be completed before the structure cart be finaled out; 1. Provide anchor bolt nuts by September 7, 1978. 2. Provide sod in the front and side yards by October 15, 1978. 3. Provide a hard surface driveway by October 15, 1978. We will expect the above items to be completed by the scheduled dates when reinspections will be made to detennine compliance. If you have any questions on these items, please contact me at 571-3450. Sincer RON HOLDEN Building Inspector RH/mh P IT NO. 15797 SUBJECT City of Fridley AT THE TOP OF THE TWINS BUILDING PE IT r rry_______ COMMUNITY DEVELOPMENT DIV. / ) r PROTECTIVE INSPECTION SEC. � l�1Cry 1 � / G i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 6/25/80 JOB ADDRESS 5511 Matterhorn Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 7 Innsbruck North SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE David Liddell 5511 Matt horn Drive N.E. 571-0298 3 CONTRACTOR MAILADDRESS 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 ❑ ADDITIO� ❑; ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Finish basement - Add ste' s down from exist' deck.- Add walkwayfrom existing deck to front of house. 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR 1MRING. WARNMCv HEATING, PLUMBING AND SI Setae 4k&s Coil local utilities MENW - EUC TRIC &g �, REQUIRED 8y !AW 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 SQ. 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 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 $5,000 $2.50 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. $30.00 NONE' PLAN CHECK FEE TOTALFEE NONE EN PRO IDA III $32.50 D THIS IS YOUR°(PPER(]MIIT,,��AAA- DATE SIGNATURE OF CONTRACTOR OR AUTHOR D,�IGENT "ID SIGNATU EOF OWNER OF ER BUILDERI G INSP P IT NO. 15797 CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (flew, Alterations, Additions, or Repairs) OV114ER: ADDRESS: A.4-r76F,, TEL NO: S7 I - b Z. cl_z BUILDER: �� r ADDRESS: TEL NO: Construction Location STREET NO: �J STREET: .rhe ' jeJJ .JR LOT: BLOCK: 7 ADDITION: //y T �3°aJ C' Aj- ---- - - Corner Lot: Inside, Lot: Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION ,,,ox.4 eAss ej Front: Depth: Height: S .Fas jp'0'4 v F'2asv% Squane.Feet: Cubic Feet: jrx)Sa' ,..e6 '01C-6ky -t tj a r,,LA- Ay r4I, , Front: Depth: _ H eight: Square - Feet: Cubic Feet: Type of Construction: Estimated Cost: $ 7b Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET. .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: � Z � A D SIGNATUIE Stipulations: 01, SUBJECT City of Fridley 0 5 5 4 AT THE TOP OF THE TWINS BUILDING PERMIT i RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 7 / % Y(® r NUMBER REV DATE PAGE Of APPROVED By -'"11 I CITY HALL FRIDLEY 55432 "IL "'j 612-571-3450 910-F15 96%90 JOB ADDRESS 5511 Matterhorn Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 7 Innsbruck North. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mike Kitlinski 5511 Matterhorn Drive N.E. 571-9707 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 ClX ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 294 s£ Deck Addition 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. WARNING Before digging call for all utility locations 454-0002 REQUIRED BY LAIN 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 I 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 $2f.150 $1.08 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- $54.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE F' C $2.15 0,, $57.23. 51 NATURFICO 'R OR R 1(1TH0 fDAGE DATE WHE PRO�LY�AT THIS IS YOUR PERMIT SiGNATURE OF 0 ER IIF OWNER BUILDERI I AT I L G INSP GATE 01, NEW [ ] Effective 8/16/90 ADEN [ ] R-1 AND R-2 ALTER [ ] Building Permit Application Construction Address: 55721 H/FT712"40— ,% 2&::� Legal Description: Owner Name & Address: I �E Ll T-LIk�SKf w� 3Z-71-33� 32397 Contractor: -�-�� Tel. # Address: S/q0j6 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF STP LIVIM AREA: length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. .*DEM AREA: length X 7 Width Hgt/Gra0.u�d g -(� Sq. Ft. 238 t Flo =2�[4- OTHER: �X qL0 Corner lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: -1'P-,-AT-j5_o Estimated Cost: $ Approx. Cmpletion Date: Proposed Driveway Width If New Opening Is Desired: Ft. $ Width + 6' See Back Page HATE: �1 �D APPLICANT: Iiil g1 rLL ),AJs t Tei. # S7l 707 Permit Fee $ Ll 06 Fire Surcharge $ w State Surcharge $ SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL $ 1 CITY USE CMLY Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th �) $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary.[ ] ,tom n aw ,.� ," � �, ; Y� li ��' �• Y. r Ny �`� a� '' id, For: HARSTAD-TODD CCNSTURCTION CO. s �e /?X 1 �k IV.1-oino9e C Uri/irr CaXd1MN41 LtA 10, Block 7, INNSBRUCK NORTH, Anoka County, Minnesota OlR We hereby certify that this is a true and correct representation of a survey of the E. G. RUD 81 SONS, INC. boundaries of the above described land and of the location of all buildings, if any, LAND SURVEYORS thereon, and all visible encroachments, if any, from or on said land. E.G. RUD 8i SONS, INC. 3847 155th Avenue N. E. Dated this _Lday of ✓, IsZ. Anoka, Minnesota 55303 by x' �Tel: 434-6505 Minn. Rea. No. 9 04 SuBjECT PE City of Fridley 3 44 9 5 AT THE TOP OF THE TWINS BUILDING PERMIT r • _____ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. 71/6 r PROTECTIVE 1 L /"' �•� CITY HALL FRIDLEY 5532 NUMBER REV DATE OF APPROVED BY _.--� L 612-571-3450 910415 11/9/99 F;GE / JOB ADDRESS 5511 Matterhorn Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 7 1 Innsbruck North SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Barb Kitlinski 571-9707 3 CONTRACTOR MAIL ADDRESS 55 311 ZIP PHONE LICENSE NO Midwest Roofing & Siding 18979 Gladstone Blvd Maple Grove 416-4804 20010277 d 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 O ALTERATION XX REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof house 23 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Permit inspection Cards Will Be wiled To i'omeoviner To Post 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 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 $3850 $1.01 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON. $83.25 Fire$2.01 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION ',SC PLAN CHECK FE TOTAL E Licen S $5.,p 0 $ 9,Y112 7 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE. EN OPPOR ALIDAT S IS IPU j�IT l/�.�F SIGNATURE OF OWNER OF OWNER BUILDERi iDATE, BLO iNSP MATE 04 Building Inspections 763-572-3604 DATE "' I SITE ADDRESS — THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY 0c- _ , YOUR E-MAJL ADDRESS 0 OWNER ADDRESS: COMPANY NAME: , I ANDAE CONTACT PERSO 1E tyrn 1k 41 Permit No.: Received By: % Date Rec'd: STATE LICENSE #, MN 55408 ADDRESS: N 24- STATE ZIP PHONE FAMILY ❑ TWO FAMILY ❑ NEW REPLACEMENT DETAILED DESCRIPTION OF WORK FAX ❑ TOWNHOUSE ❑ ALTERATION/REMODEL 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 BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)MEG – MODEL: SIZEIBTU _ Equipment Installed MFG: MODEL: SIZEIBTU MODEL: FIREPLACE (GAS) $15.00 SIZE/BTUMEC,. GAS RANGE/OVEN $10.00 A1C $25.00 —AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 GAS UNIT HTR $10.00 _BOILER $35.00 FURNACE $35.00 CHIMNEY LINER $10.00 AS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15 00 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00= $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ '15'.1=1 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 Ei of Fridley and with the Minnesota -Construction Codes; that i understand this is not a permit but only an on for a it drk is not to start without a permit; that the work will be in accordance with the approved plan in the of all hich r es�eww and approval of ans. SIGNATURE OF APPL IC / /L "' ` lTN ��s �/YICt ATE © City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley,MN 55432 763-572-3604 FAX: 763-5024977 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEWIEXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or PropanellFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas 1MC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACOA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations Building $ BUILDING Permit No.: Inspections $ RESIDENTIAL APPLICATION Received By: 2 763-572=3604CITY $ OF FRIDLEY2007 .001 times the total job valuation S' 7 $ 7'74t DATE % - '� YOUR E-MAIL ADDRESS $ SITE ADDRESS _J`�,S" M 4.-N�2 hm'-J IA - $5.00 (State Licensed Residential Contractors) THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME; LAIEIV 14t -'Mn F $ TENANT ADDRESs;S-S-1/ MA4Fa2- CITY sTATFMNziP S'Sy3 2 - $ PHONE: 71, 3 S 72 — 79 57 2 - PHONE: $450 Conservation Plan Review CONTRACTOR NAME:_ d/1w.,;J+',IANcC F"t Mir/Noss g Tr+c— STATE LICENSE #2OL 12698% EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: !17y ( W d c AVE All! Cn`Y M fl I S STAT$V�rJZIP_4UE!J 2-1 WITH APPLICATION PHONE . S1 � / qz X M 4. A( - PROPERTY TYPE RSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH %ROOF ❑ DRAIN TILE ❑ DECK ASIDING ❑ OTHER ❑ SWARMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ANCE/REPAIR IN REMODELING DESCRIBE WORK BEING DONE: -70 %lu]' } S►' di,�� SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES 11 ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: I ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDINGFOR �1 NEW CONSTRUCTION INCLUDING DECKS. tPLVinyl 2, D O ❑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 $ %,`j , g �®, f�G OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ 7'74t .0005 x Permit Valuation Minimum $.50 License Surcharge $ 0-1) $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 $ M 4. A( - 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 APPLIC PRINT NAME �i4-Sum /Z1'-' �` `01 �) DATE 6-1-0-7