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PRE 2010 DOCSSUBJECTr?i4,.7 NO. City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. L.0• COMMUNITY DEVELOPMENT DIV. f PROTECTIVE INSPECTION SEC. 1 . � CITY HALL FRIDLEY 55432 NUMBER REV, DATE ' PAGE OF " APPROVED BY 612-560-3450 910-F15 10 27 77 / JOB ADDRESS 1345 Meadowmoor Driv a N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 22 2 Meadowmoor Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lambert -Peterson 1435 Osborne Road N.E., Fridley 786-2840 3 CONTRACTOR MAIL ADDRESS ZIP PHONE' LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK Ek NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Im Am 1111111% 8 DESCRIBE WORK Construct a 24' x 39' Dwelling and a 22' x 241 Garage Before'diaginglocal r^ �aji C_¢�+ t p p� -'GAS TELEPHONE - ELECT RIC - GAS Ek. 9 CHANGE OF USE FROM TO REOVIR BY LAW STIPULATIONS Provide City with copy of truss design. Provide sod in the front and side yards. Provide a verifying$ survey before .capping. Provide a hard surface driveway. SEWER LOCATION: (Approx. 11' Deep) 105' E. of Manhole (E. Inn. 888.37) WYE ELEV: 888.79 TOP OF FOOTING: 891.79 Minimum WATER LOCATION 10' E. of Sewer Service DRIVEWAY DEPRESSION COST: 16' + 6' x $11.75 = $258.50 PERMITS REQUIRED FOR WIRINGS TE gEPERA THE CITY OF FRIDLEY DOES NOT GUARANTEE THE PLUIU�Rl�IG AND SIGNS. HEATING, ACCURACY OF UTILITY LOCATIONS AND ELEVATIcras. THIS DATA IS FOR INFORMATION PUPPOSES Oi dY ANa PERSONS USING IT SHOULD VERIFY THE INr0&j,1,ATION ON THE SITE. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Wood Frame VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS'COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $34.545" $17.27 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- $99.84 $375.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $ 2_,4.96 $517.07 SIGNATUR FCON AcroRORAurHORQEDAGENT (DATE) WHEN PROPRLY VALIDATED THIS IS YOUR PERMIT LJ CJL.Qn2 J -oZ LDG OAfE�� SIG T EO WNER IIF OWNER BUILDER) (DATE) j1IF�1111RIMP�1111 110110,11111111111 111, '�'Ijj' 71 W�4 -.5 wn -A, k4k Ai CI 41, A z v M3 I CITY OF FRIDLEY Ok' APPLICATION FOR RESIDENTIAL BUILDING PERMITS i (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER: J0,BUILDER: Address: y`'J5 6O �� -P Address: / Tel. No. Y C� No.: ( � Street: 3 p Y LOT: BLOCK: 2�— ADDITION: 7 - CORNER LOT: INSIDE LOT: 1/ SLTBACK: 7 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: �� _e 5 Front: Z Depth: 3 Height: Square Feet: ® /0 Cubic Feet: D 9- C) Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: L et v^ -e Estimated Cost: To Be Completed: /2-- � r 77 =-\ Alt. A Alt. B Proposed Driveway Width If New Opening Is Des'red �` $ $ ax \ (SEE REVERSE SIDE OF SHEET) The undersigned hereby makes application fo a permit for the work herein specified, agreeing to do all work in strict accordance with the City of at declares Ordinances and rulings of the Departm of Buildings, and hereb declares that all the facts and representations sta 'cation E4are true and correct. See reverse side or additional 7,ormation. DATE: AQ— ) 2-- — SIGNATURE: Stipulations: — -- _�---- -- -- - l 02 - COX, A9 w. Sid 0 � CER70FRICAT'E OF SURVEY JAMES L. mMm7m ILAPID nMnvrilvon 4002 JEFFERSON ST. N.E. COLUMBIA HEIGHTS 55421 788-9769 B ==0V G 'TCPV rMAT VI110 CUMISV. PLAEI. On RaPORT WAG IPMErPARMID OV MIZ On UNDER MV ®1RtZCT CUFaTRVICIION AND QGyA7 1 AC7 OULV C=0107tI 0 LMD CUMV=Cn UNDER TMM 6ACJ0 077MIZ OTATC OP MIMMMOOTA. 'Aa DAVE ✓ Q7 +� /T SCALEV'= a G190. 5332 0=6RON MONUMEN7 m() suvkvalt me cps I �►®' Dt�AI It�t C u-T1uT— Ln �t t vrc- r t ?�1�c) ®F-�`8 cJ.5D 1w J — 4� 0 l ; 2-2- -2 MENDO! th�S /1 -OC -V, � r E ARS()Kk C-00"TY, 0 d CERTQ RV TE OF SURWEY JAI ES L. KURTH .IAB\JD SURVEYOR ' 73b -40TH AVENUE N.E. COLUMBIA HEIGHTS 55421 788.8769 I &"'ZnZ0Y C."-ATIFY THAT THIS BURvEy. PLAN. OR REPORT WAS PR--PAR=D DY 0.1E OR UNDER MY DI ECT SUpSnV131ON A047 THAT I AM A DULY R3O13TL°R3O LAND oURVZVO:! UNO=R THC LAY/3 OF THE STATE OF MINNESOTA DATE _ j 21 - SCALE MINNESOTA REGISTRATION NO. 5332 o= IRON MONUMENT BOARD OF (APPEALS EXHIBIT Ml:FftNG-pig 2C %.;, /�- ��Ts `s 2 :�� 17L s a N . F 41 X. ki—� r, 1 i.�.10 Ias 1 Ib. I d'1. trJ I . 23 BOARD OF (APPEALS EXHIBIT Ml:FftNG-pig 2C %.;, /�- ��Ts `s 2 :�� 17L s � X. r, �n m 0 BOARD OF (APPEALS EXHIBIT Ml:FftNG-pig 2C %.;, /�- ��Ts `s 2 :�� 17L c;2 477 - (� ` .�' �� • `� �� 3q �OIW Z &7-S 67- W C - .a CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTI.LATION, REFRIGERATION AND .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE ;ZN A _73- . GRAVITY WARM AIR: RATE Furnace Shell & Duct Work $12.00 Replacement of Furnace 7.00 Repairs & Alterations -up to $500.00 7.00 Repairs & Alterations each add. $500.00 4.00 MECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTU $12.00 each add. 50,000 BTU 4.00 Replacement of Furnace 7.00 Repairs & Alterations -up to $500.00 7.00 Repairs & Alterations each add. $500.00 4.00 STFAM OR HOT WATER SYSM.1: Boiler & Lines up to 100,000 BTU each addn. 50,000 BTU Boiler only up to 100,000 BTU each addn. 50,000 BTU OIL BURNER- to 3 gal. per hour each add. 3 gal. per hour GAS BURNER- from 100,000 BTU to 199,999 BTU (over 199,999 BTU see Fee Schedule) GAS FITTING FEES: 1st 3 Fixtures Additional Fixtures Gas Range to 199,000 BTU AIR CONDITIONING FAN HEATING SYSTEMS See Fee .Schedule VENTILATING SYSTEMS ALTERATIONS $ REPAIRS ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT TOTAL S $12.00 $ 4.00 $ 7.00 $ 6.00 $ $10.00 $ 10.00 $ $10.00 $ x $ 3.00 $ x $ 1.00 $ x $10.00 • $ State Surcharge TOTAL FEE REINSPECTION FEE ($10.00) MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE Job Address /. *3 il_!� 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, Minn. �d , 19 '27 `-sem OWNER SL KIND OF BUILDING USED AS TO BE CC ESTIMATED COST O NEW -B ILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER F HEATING or POWER PLANTS, Steam, Hot Water, rmAir- o. Trade NameSize No. Capacity Sq. Ft. EDR Total Connected Load BTU lee, CIO 0 HP Kind of Fuel BURNER - Trade Name size No. Capacity Sq. Ft. EDR BTU HP 7 / � Company y� f ' 1' 6i oe Signed By Tel. No. °T-/ ` l CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $3.00 $ Future Fixture Opening_ x $2.00 $,r New Fixture, Old Opening Water $2.00 S Catch Basin x $5.00 $ Water Heater - to 99,000 BTU_ royd,1 9 Q m 4, u 2 $ Water Softener x Heater $ New Ground Run Old Building x $5.00 $ Electric Water Heater x k $ GAS FITTING FEES: r g C3 u x GNl Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x m $ REPAIRS & ALTERATIONS .N o $4 m .4) ro $5.00 e a •� .oi w e $ .50 ro S a w x to w u as a 3 O as lec m u D m H 1st 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $3.00 $ Future Fixture Opening_ x $2.00 $,r New Fixture, Old Opening x $2.00 S Catch Basin x $5.00 $ Water Heater - to 99,000 BTU_ x $5.00 $ 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x '$3.00 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 $ .50 TOTAL FEE $ REINSPECTION FEE ($10.00) Job Address foL Department of Buildings I 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 C /� Fridley, 0� , 19 USED AS TO BE COMPLETED ABOUT //— =:0-s— 22 ESTIMATED COST d OLD - NEW BUILDING PERMIT NO. Comp" Signed Tel. N ROUGH INSP. Date FINAL INSP. 1-,9,1 - ?5- Date APPROVAL FOR PERMIT _9" MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 pLus $,S0 sTM gp APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE , GRAVITY WARM AIR: RATE TOTAL Job Address 1,2 A/� Furnace Shell & Duct Work $12.00 $ , Replacement of Furnace $ USED AS Repairs & Alterations -up to $500.00 7.00 $ Department of Buildings Repairs & Alterations each add. $500.00 4.00 $ City of Fridley $10.00 $ Tel. #571-3450 MCHANICAL WAPUM AIR: $ ESTIMATED COST $10.00 $ /0' 4 OLDNEW UILDING PER14IT The undersigned hereby makes application for a permit for the work heleZ•s Furnace Shell & Duct Work to 100,000 BTU $12.00 $ specified agreeing to do all work in strict accordance with the City Codes •. each add. 50,000 BTU 4.00 $ and rulings of the Department of Buildings, and hereby declares that all the Replacer.ent of Furnace 7.00 $ facts and representations stated in this application are true and correct. Repairs & Alterations -up to $500.00 7.00 4.00 $ $ ZC Fridley, Minn. / 19 Repairs & Alterations each add. $500.00 . STEAM OR HOT WATER SYSTEM: Boiler & Lines up to 100,000 BTU each addn. 50,000 BTU Boiler only up to 100,000 BTU each addn. 50,000 BTU OIL BURNER- to 3 gal. per hour each add. 3 gal. per hour GAS BURNER- from 100,000 BTU to 199,999 BTU (over 199,999 BTU see Fee Schedule) GAS FITTING FEES: 1st 3 Fixtures Additional Fixtures Gas Range to 199,000 BTU AIR CONDITIONING FAN HEATING SYSTEMS Sea Fee Schedule VENTILATING SYSTEMS • ALTERATIONS I, REPAIRS S MUCH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT, &Ile • moi' /✓il '�=moi � � $12.00 $ KIND OF BUILDING 4.00 $ 7.00 $ USED AS 6.00 $ TO BE COMPLETED ABOUT $10.00 $ 10.00 $ ESTIMATED COST $10.00 $ /0' 4 OLDNEW UILDING PER14IT NO. ! `T PEX41T NO. �O— S x $ 3.00 $ X $ 1.00 $ X $10.00 • $ State Surcharge TOTAL FEE REINSPECTION FEE CS10.00) MINIMUS! FEE FOR ANY HEATING PERMIT IS $7:50 PLUS $.50 STATE SURCHARGE DESCRIPTION OF FURNACE/BURWER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. 0 Trade Name , f3 O_ 4,-{°� Size No. Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP r Company Signed By • Tel. No. Building $ BUILDING $ Permit No.:, Inspections Surcharge RESIDENTIAL APPLICATION Recei 763-572--37604 SAC Charge CITY OF FRIDLEY Curb Cut Escrow 0 DATE / 0 Q YOUR E-MAIL ADDRESS /Da SITE ADDRESS A&: - Sewer Main Charge THIS APPLICANT IS: ❑ OWNER CONTRACTOR $ _ PROPERTY OWNER/ NAME: ADDRESS: CITY STATE ZIP TENANT PHONE: 76 — % 3 9 76Ir CONTRACTOR NAME: AA&I STATE LICENSE #�s�%,3%� EXP DATE -316 S SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: /O%/ �3i�i� A.J �SJ�. E- CffV-1 .106 STATeP21P `53 6,9 WITH APPLICATION PHO %�� ' /S- tOrOC% FAX 3 ' �/� ® 8 PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE ❑TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SW NEVIING POOL TYPE OF WORK:❑ ❑ ADDITION CE/REPAIR J ❑ REMODELING / // gg�� DESCRIBE WORK BEING DONE: .S / w, / A4 dJ ' 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. WINDOWS0'0 2. Two sets of construction plans IN EXISTING OPENINGS es ❑No LOC ON OF WS / 3. Energy Calculations OR FOR NEW OPENING ESCRIBE SIZE OF %f�..>>rcrrl�d'�z OPENING CHANGES & J�c TYPE OF WINDOW TO BE INSTALLED Z _1. f5 ER 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 $ 4� 4/eU OCCUPANCY TYPE Permit Fee $ Plan Review $ Fire Surcharge $ 1�p _ C�() Surcharge $ ::?,;, License Surcharge $ 145, 00 SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ _ 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) $1675 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks savable to: Citv of Fridlev Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this 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 NAMEDATE 7