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PRE 2010 DOCSt. �(o City of Fridley, Minn. 1151 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: - -Timp 15e 1972 Oma: Vern Donnan Realty, Inc. guilder Same Address —7300 - 36 h A - venue N_XX Address - Same LOCATION OF BUILDING No 1362 Street Meadowmoor Drive N.E. part of Lot Dot 11 Block 3 Addition or Sub -Division Meadowmoor Terrace Corner Lot Inside Lot X Setback 35.5' Sideyard - 10.5' $111V6¢r IIevation - 8891-89 >�'bi d'ahib / bal dl>! Min- of 3 ftmp+- ahoVp J at ar table Nze Top of Footing (Water. TamQ�,pp=o ...) DESCRIPTION OF BUILDING To be Used as: nwel l ing Front —321 Depth 24-41 Height _ 20 t Sq. Ft. 7 7. 1 Cu. Ft. 5-.x.52 caragp Front 14' Depth —221 Height - 101 Sq. Ft. _._308 Cu. Ft. 30$0 'Type of Construction Wood Fr m . Est Cost $ 19-5880 To be Completed Sept.. 1972 WATER LOCATION: 9' E. of Sewer Service SEWER SERVICE: 47' W. of E. property line STIPULATION: This permit issued subject to stipulations in "Mutual Agreement" signed by Vern Donnay Realty, Inc. and dated June 14, 1972. In consideration of the issuance to me of a permit to construct the building described above, I agree to do tue proposed work in accordance with the description above set forth and in compliance with all provisions of w�.�l' S....r...... .dT In consideration of the payment of a fee of $ gA.Q® , permit is hereby granted to Vern Donnan Rp_alty, Inc. to construct the building or addition as described above. This permit is the express condition that the person to whom it is granted and his agents, employees and workmen�n�i all work done in, around and upon said building, or any part thereof, shall conform in all respects -to the ordinances of Fi ddley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings Within nthhee city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordihInspector CARER(' BELISLE NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to no the Building Inspector for separate permits for these items. r I ' _ r Land Pl°m��n� r X873 He, hYA �S Nf Lad Survey r1y Mrrmao� s32, Sods ks6q ENGINEERING, INC. Civil 6- M,, Kip7/ Stfrwl If 4066 to jiaeeriny' E n ineers Sur veyors cestifzcate of ssv �o: E_ -1 i Pj-ktJNA'y'P�t MEADOWM002 DOVE NOR TH 75 N M NuY� `IiouSQ M 1362 N � ►4 a s� Lor 11 75 ODIN07,'CS IRON 7— – oCNOrZ-S Urairy e ORAIAIAGC .44SLAZENr ll ,Lor 8� ock 3 ACA DOWWOR - 7Z-RqAC&C- CO&NrY Or AAVKA /h&vhy cwtr`y *d /his is a true and wrrtd representation 0 sirvey #'hx AwnddAw q'& Jew AwvW Gwd;,a d op#r► /ate, qro# duddurys , Marin , aid d/ rrstbte ff"v rhmenfs , ipaay, * Or' assaid /aid. As,swveged �fim tIAi,= . dy A.Q 19-0. SUBURBAN CeNCi1 UMN5, INC. SCALE : 40 .--- m _ , � • s ��/�� ��'��//ate __- ,�.�!. J � 7 �!� � � � � 7 y �_� J T� � ���� � A // Ee. �� � �� ApplaM6n for Power Phuft and Heating. Cooling. fion. Refrigeration cmd Air Condhfoning System and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ........................... $10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ............. 6.00 $ — Repairs & Alterations each add. $500.00 ............... 3.00 $ NEC* . WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............$10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines --to 400 sq. ft. EDR Steam .. . $10.00 $ Furnace Shell & Line—to 640 sq. ft. IDR Hot Water .. 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00'$ Each add. 320 sq. ft. IDR Hot Water . . . 3.00 $ OIL BURNER—to 3 gal. per hour ..... ' ... ..... 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ..... .:..............' .. &00 $ . over 199,000 BTU See. Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures .... ................. x$ 200 $/ Additional Fixtures ................ x .75 $ Gas Range to 199AW .......... is 8:00 $ AIR CONDITiONIIlG $ FAN HEATING SYSTEM See Fee Se6ed�a VENTILATING SYSTEM ALTERATIONS & REPAIRS TOTAL FEE 9111 FINAlc //— Z J�7 '? -z— Dept. of Bldga. Phone 880-3480 City of Fridley: The undersigned hereby makes application for a permit for the work hereit specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. ft. ° f' 'idley, Mtnn. '/lg ,. 1& I& Owner Kind of Building Used as To be completed about Estimated Cost, $ Old New. wilding Permit No. Permit No. DESCRIPTION OF WORK HEATING orPO) team, Hot Water'`Wa;m No� 7 Trade Names - el ° �l0 Size NO Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load sJh2v Kind of Fue BURNER — Trade Name Size No- Capaci Sq. Ft. EMR BTU H.P: (eMuaKs—OVER) signed 4—At" J— - BusinessLFo5E-0GUgC UTZ a' AIRrnNn- W, 1001 Xenla Av. S. - 545-1611 N0110apolis, Minn. 55416 Base 1st 2nd 3rd City of Fridley ApplIccOhm for ftnibbis and Gnu r Dept. of Bldoe. Phone SOD -3t30 DESCRIPTION OF WORE Number. Rind and Location of Iixtutm L3 6 Z fY/F n o /ter o o c� 0"1 e wArni «te. � a , 1 Do 'It 11-11! gl 13 � I to � �I 1� 5 D p GAS [ltC. MMMMIMM y At Sawar 11 Cesspool 171 PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES- NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ........... x $1.50 t New Fixture Olaf Opening .......... x $1.50 = Catch Basin ..... x $3.25 Water Heater 'Up to 99.000 BTU) .... x $3.00 $ New Ground Run Old Bldg......... x $3.85 S Electric Water Heater .............. a $100 S GAS FITTING FEES. NO. RATE TOTAL lot 3 Fixtures z$100 $ Additional F latt................—z$.76 i Gas Range to 199.000 BTU ............ z $5.00 1 - State Surcharge $ .50 REPAIRS k ALTERATIONS.—Rater to Co& _ Description ........................................... ; TOTAL FEE S . City of Fridley: The undersigned hereby mattes application for a permit for then work here!:. specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings. and hereby declares that all the fact and representations stated to this application are true and correct Fridley. Minn 7— Z2 0-A7 2.a IS _ Owner V Kind of Building F Used as � To be completed about A® 1i�%�+ Estimated Cost. $ Old ew ullding Permit No. Permit No. Signed By Business Phone No 9� '2 il017 1 ►'j Cify of Fridl®y 53-84-s-915.51 Applies for Phmbing and Gmn Fbtbg hmb Dept. of Bldgs. Phone 960-3480 DESCRIPTION OF WORK lee 1362 N. E. Meadow Moore Drive Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLVMSING FIBTVRE RATES: NO. RATE TOTAL Number Fixtures ................ x $200 $ Future Fixture Opening ........... x $1.50 $-- New _New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater ;Up to 99,000 BTU).... x $3.00 $ New Ground Run Old Bldg. ........ x $3.25 $ Electric Water heater .............. : $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .................. x $2.00 $ Additional Fixtures .................. x $ .75 $ Gas Range to 199,000 BTU .............. 1 x $S.00 $ 5.00 REPAIRS A ALTERATIONS—Refer to Code Description ......................... ................................$ TOTAL FEE $ 5.00 (SURCHARGE City of Fridley: The .undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City ordinance and ruling of the Department of Buildings, and hereby declares that alit the fact and representations stated in this application are true and correct Fridley, Minn 11-3-72 , 19, Owner Vern Donnay Homes Inc. Kind of Building Frame Used as Res. To be completed about 11-10-72 Estimated Cost, $ 10.00 Xgkb@FNew. Building Permit No. Pe No. .j c9yj Signed By MINNEGASCC ---• - Business Phune No ROUGH FINAL pzass o -%i 11--.511 N WATEA MTR. ELEC. Base 1st 1 2nd 3rd 4th ' Future CoauecAm Openings * New Fixture, Old Openings Coaaectsd with Sewer 1 Q PARTIAL RATE SCHEDULE PLVMSING FIBTVRE RATES: NO. RATE TOTAL Number Fixtures ................ x $200 $ Future Fixture Opening ........... x $1.50 $-- New _New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater ;Up to 99,000 BTU).... x $3.00 $ New Ground Run Old Bldg. ........ x $3.25 $ Electric Water heater .............. : $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .................. x $2.00 $ Additional Fixtures .................. x $ .75 $ Gas Range to 199,000 BTU .............. 1 x $S.00 $ 5.00 REPAIRS A ALTERATIONS—Refer to Code Description ......................... ................................$ TOTAL FEE $ 5.00 (SURCHARGE City of Fridley: The .undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City ordinance and ruling of the Department of Buildings, and hereby declares that alit the fact and representations stated in this application are true and correct Fridley, Minn 11-3-72 , 19, Owner Vern Donnay Homes Inc. Kind of Building Frame Used as Res. To be completed about 11-10-72 Estimated Cost, $ 10.00 Xgkb@FNew. Building Permit No. Pe No. .j c9yj Signed By MINNEGASCC ---• - Business Phune No ROUGH FINAL pzass o -%i 11--.511 r 17 s ATTENTION OF: To Darrel Clark, Community Development Administrator SUBJECT Claim for mowed down trees, Mrs. Castro CITY OF FRIDLEY 6431 University N. E. Minneapolis Minn. 55421 612-560-3450 DATE October 1, 1973 SUSPEND: October 5,-1973- - - Please review the attached letter and formulate a recommendation so we can get this matter settled. NASIM M. QURESHI, ACTING CITY MANAGER SIGNATURE I REPLY: I CQ �.�... REFLIER°S COPY ® RETMe [FOR YOUR FELES NEW [ ] Effective 1/1/94 ADDN [ J. CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R -I AND R-2 Building Permit Application' ConstructionAddress: 1 �� tkk&0 U-) rAaQC 1"� 1z.1 Ui_ Legal Description: Owner Name & Address: M 0-4 V. N 6A�l rZ 0 Tel. # J S41 - o)(o4 a Contractor: VJQ,VC.I/aG �v�S i�t MN LICENSE # Q'y 73 Address: lQ 12AyJ AAV �l� . Tel. # ''4 c5 L `9 S P Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to. scale. LIVING AREA: Length DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length��-- Width Hgt/Ground " � Sq., Ft. OTHER: K,1� C�U��,tJ C* 3 5 2e-h'1nd Cil.. Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Rem o a& Estimated Cost: $ 4 JAI j '9 •00 Approx. Completion Date: 3(Ilqq if (Cost on Back) Driveway PA Cut Width Needed: Ftp+�6�yF.t, =, q Ft x $ = $ DATE: c) ` N joiq APPLICANT: c k C:,Ty- �o1CW Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation Tel. # AQ—&S 1'7 $800 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] sueJEcr PE RM City of Fridley f �2 2329 AT THE TOP OF THE TWINS BUILDING PERMIT i V V ------COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 3 ?63 B r i `plea�, V� CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 3/16/94 108 ADDRESS 1362 Meadowmoor Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 3 SHEET Meadommoor Terrmep 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Marilyn Castro 1362 Meadommoor Drive NE 784-2662 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Enerjac Construction 1688 Strawberry Hill Rd Afton 55001 436-8517 2473 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION C� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Remodel kitchen and two baths 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 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 80 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $14,800 PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIO OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- RUCT N R THE PERFO ANCE OF CONSTRUCTION. $162.00 114-1111 C PLAN CHECK FEE T M E FEE S License SC $5.00 $189.20 SIGNATURE OF CONTRAnT16A OR AUTHORIZED AGENT (DATEI WHEN PROPERLY VLI T D THIS IS YOUR PERMIT a. �-1�-9y Bu DATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1993 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures 1 $ 7.00 , Old Opening, New Fixture b $ 4.00 q, G'C' Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater —Electric $ 7.00 Water Heater — Gas $10.00 Gas Range $10.00 Gas Dryer $10.00 Back Flow Preventer Required ( )Yes () No Type -$5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance State Surcharge $ .50 JOBADDRESS V ('0, ;®ty MM' -&- 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 Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. .3 "02) , 199.q Owner COs (Va Building Used As Jn 1 v.a Lr- ta1M { Cy Estimated Cost 3 0 00E.0 ° PERMIT NO. 11L PLUMBING COMPANY H i LC C I/c'S% nk SIGNED BY al ✓` Approved By Rough—In Date R TEL N0. q9 9-.38-3 Final Date p MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 TOTAL FEE $ PLUS THE $.50 STATE SURCHARGE CITY OF FRIDLEY INSPECTION DIV. r 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On January 1, 1999 PLUMBING FIXTURE RATES: New Fixtures Old OpSning, New Fixture Beer Dispenser Blow Off Basin -- -' Catch Basin Rain Water Leader NO. RATE TOTAL JOB ADDRESS /,3� <- 1#MXA1�t� X NE Sump/Receiving Tank Water Treating Appliance Water Heater —Electric Water Heater — Gas** Gas Range" Gas Dryer** Back Flow Preventer Required ( )Yes () No $ 7.00 The undersigned hereby makes application for a permit for the work herein $ 4.00 specified agreeing to do all work in strict accordance with the city codes $ 5.00 and rulings of the Building Division, and hereby declares that all the fads $ 7.00 and representations stated in this application are true and correct. $ 7.00 $ 7.00 -3 _,1999 $ 7.00 $10.00 Oyner z;'1A 1t yj11 049 06 $ 7.00 $10.00 Building Used As $10.00 $10.00 Estimated Cost PERMIT NO. Type . $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance A ®e State Surcharge .50 PLUMBING COMPANY MRROOTER OFANOKAOW X50 INDUSTRY AVE N. 4114 SIGNED BY ROM, MN 5W TEL N0. Approved By Rough—In Date Final Date /10 1016V TOTAL FEE . $D PLUS THE $.50 STATE SURCHARGE "COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES. CIIYOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287 October 2, 2000 Marilyn Castro 1362 Meadowmoor Drive NE Fridley, MN 55432 Re: Final Inspection at 1362 Meadowmoor Drive NE Contractor: Mr. Rooter of Anoka Co. Dear Ms. Castro: A plumbing permit was issued on April 8, 1999, for the above noted address, to install a gas water heater. According to section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the plumbing authorized by this permit. 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. DAVE Xt4SEN Build i nspector CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 YAX: (763) 571-1287 ADDRESS : 1362 MEADOWMOOR DR NE PIN : 123024120091 LEGAL DESC : MEADOWMOOR TERRACE : LOT 11 BLOCK 3 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PE N0.:2004-01836 DATE ISSUED: 10/07/2004 VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL A FURNACE (WARM AIR, CARRIER, 70,000 BTUS) AND AN AIR CONDITIONER. # A/C UNITS 1 # FURNACES 1 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) APPLICANT CENTERPOINT ENERGY/MINNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304- C01 WIa1:7 DUANE VOGEL 1362 MEADOWMOOR DR NE FRIDLEY, MN 55432 5700 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 work 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 state or local law regulating construction or the performance of construction. HEATING PERMIT MINIMUM FEE 0.00 FURNACE SHELL/DUCT WORK 35.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 25.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 60.50 PAID WITH CHECK # 6092 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. I O_V_� t4 aI;,- -ITY OF FRIDLEY BUILDING INSPECTION v. 9 3431 University Ave NE 9 2ridley, MN 55432 L 763-5723604 FAX 763-571-1287 9 D n RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS ?) Meodc)-� 22000 �R Fee Total` 1 Owner V)U a -n +e V on e - $35.00 $ ✓�'� -00 Building Used As $10.00 $ ESTIMATED COST S -1©O - PERMIT NO $10.00 $ DESCRIPTION OF FURNACE AND BURNER $10.00 *Air Conditioning -All Sizes $25.00 Cir- f, -e_ -r z)c L(� a Ids All Other Repairs or Alterations (List on Back) r 1% of Value of Appliance or Work a Minimum Fee $15.00 for Residential or 5% of cost of Y Improvement whichever is greater on work less than $300.00 L � Commercial/Industriallinstitutional } 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/industrial/institutional YState Surcharge TOTAL FEE v v $ # of Heating Units Circle One (Steam) (Hot Water)(:Warm Air Trade Name 0--c- c r e 5S(1%5 P"6 10-1- I ;t, Size No. $A!a.� BTU 0 00 0 HP EDR Fuel N '� o -S Total Connected Load REINSPECTION FEE $50.00/HOUR m *Air Conditioners can not be placed in side yard without written approval 1 + from adjoining property owner - copy to City o - .50 FILL OUT BACKSIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Burner Trade Name Size No. BTU HP EDR 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 Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. CENTERPOINT ENERGY MINNEGASCO HEATING Cr0 13562 CENTRAL AVE NE BLAINE, MN 55304 Signed Tel S 763-757-6202 FAX #1i�-757-6701 Date /v -®Y Approved by V :L Rough -in Date Final Date Zo ' d 14101 FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verges that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes No( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes (i1 No( ) When required to install a new combustion air, will be sized and installed to meet the current codes and manufacturer's specifications. Yes No( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes No ( ) Appliance Type and Size/Common Vent and Vent Connector Information i Appliance #1 Type l'��"" ' BTU Input 76, t ev Fan Assisted or Nat r-4 Appliance #2 Type _ BTU Input 35—yay Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input /G D &ru Common Vent Type C I -13 Vent Height a-4' / Diameter Y inches Appliance #1 Vent Connector Height _=5_i?ft Length "7 ' ft Diameter J/ ""in Type 0/ Appliance #2 Vent Connector Height _eft Length ift Diameter in Type -C - L Appliance 93 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) CENTERPOINT ENERGY MINNEGASCO HEATING CO: 13562 CENTRAL AVE NE BLAINE, MN 55304 Signed By: -men V\ - Date: l L) FMIFR * A t lgi..SL Ol A31G I dd AO A110 WON -1 qZ : Z t b00Z-LZ-8848 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 FAX: (763) 571-1287 ADDRESS : 1362 MEADOWMOOR DR NE PIN : 123024120091 LEGAL DESC : MEADOWMOOR TERRACE : LOT 11 BLOCK 3 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 004-00693 DATE ISSUED: 05/12/2004 VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL A DRYER WITH 1-1/2" COPPER. # A/C UNITS # FURNACES # GAS RANGES APPLICANT CENTERPOINT ENERGY/MINNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304- CASTRO MARILYN J 1362 MEADOWMOOR DR NE FRIDLEY, MN 55432 0 VALUE OF APPL OR WORK 273 0 # GAS DRYERS 0 0 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 state or local law regulating construc,)ion or the performance of construction. Bldg HEATING PERMIT MINIMUM FEE 15.00 FURNACE SHELL/DUCT WORK 0.00 GAS PIPING FEE 0.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 AIR CONDITIONING FEE 0.00 HEATING REPAIRS/ALTERATIONS 0.00 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 15.50 PAID WITH CHECK # 1008098 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning -All Sizes All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater goo -167r Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB Al Fee Total Owner $35.00 $ Buildir $10.00 $ ESTIMATED COST -PERMIT NO $10.00 $ DESCRIPTION OF FURNACE AND BURNER $10.00 $25.00 Commercial/Industrial/Institutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/Industrial/Institutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR $ # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. $ BTU HP EDR Fuel Total Connected Load $ r ' Burner Trade Name Size No. BTU HP EDR 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 Building Division, and hereby declares that all the facts $ 50 $ /,567 *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE and representations stated in this application are true and correct. HEATING CO Signed Tel #-A3" a /> J FAX # �c3,-%/' �V Date Approved by Rough -in Date Final Date �� !: FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type / BTU Input 3G Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed B 9 Y: Date : �� CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 571-36U4 YAX: (763) 571-1287 ADDRESS : 1362 MEADOWMOOR DR NE PIN : 123024120091 LEGAL DESC : MEADOWMOOR TERRACE : LOT 11 BLOCK 3 PERMIT TYPE : ELECTRICAL PROPERTY -TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-01837 630 DATE ISSUED: 10/07/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. WIRE FURNACE AND AIR CONDITIONER. # INSPECTIONS 1 APPLICANT CENTERPOINT ENERGY/1VIINNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304- 111:•/►1 DUANE VOGEL 1362 MEADOWMOOR DR 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 work 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 state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp. ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 6092 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Building $ BUILDING Plan Review Permit - Inspections Fire Surcharge RESIDENTIAL APPLICATION .001 times the total job valuation Received By: 763-572-3604 �— .0005 x Permit Valuation Minimum $.50 CITY OF FRIDLEY $ Date - 2 DATE YOUR E-MAIL ADDRESS $1550 per SAC Unit (Pians to MWCC for determination) SITE ADDRESS 1362 Meadowmoor Drive ne $ ft+ 6 ft = R x $21= $ Erosion Control $ THIS APPLICANT IS: O OWNER E)CONTRACTOR $ PROPERTY OWNER/ NAME: Marilyn Vogel $ ADDRESS: CITY STATE_ZIP TENANT q fi LF Make checks payable to: City of Fridley Attach Stipulations PHONE: CONTRACTOR NAME: Cedar Valley Exteriors STATE LICENSE # 20177295 EXP DATE 3/31/2008 SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 1700 93rd Lane ne CITY ataine STATE mn;MI55449 WITH APPLICATION PHONE 7637552221 FAX 7637555390 PROPERTY TYPE 13 SINGLE FAMILYINEW CONSTRUCTION SIZE ❑ TWO FAMILY/KEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH GOOF ❑ DRAIN TILE ❑ DECK QSIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: re -roof SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES _ 20 ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2. Existing Floor Plan 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 Al2DITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim L Site Plan/Survey showing the existing smwtun s ❑ Other ❑ Fascia and proposed project. 2. Two sets ofconstruction plans WINDOWS IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINOS-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) Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ �— .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Pians to MWCC for determination) Curb Cut Escrow $ ft+ 6 ft = R x $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ q fi LF 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 d codes of th ity of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application a permit rk is not to start without a permit; that the work will be in accordance with thea oved plan in the case of all wor ich e ' $ra`taLgf plans. SIGNATURE OF APPLIC pTNAME Emily Bernard PATE — ��_ 07 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 1"AX: (763) 571-IZ57 ADDRESS : 1362 MEADOWMOOR DR NE PIN : 123024120091 LEGAL DESC : MEADOWMOOR TERRACE : LOT 11 BLOCK 3 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.- 2004 -00694 - DATE ISSUED: 05/12/2004 VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A # A/C UNITS 0 VALUE OF APPL OR WORK # FURNACES # GAS RANGES APPLICANT CENTERPOINT ENERGYMIINNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304- 5CIr%�I�� _9 CASTRO MARILYN J 1362 MEADOWMOOR DR NE FRIDLEY, MN 55432 0 # GAS DRYERS 0 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 state or local law regulating construction or the performance of construction. Avvlica�ff'�, n Date I Bldg HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS PIPING FEE GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 1008098 SEPARATE PERMITS REQURkED FOR WORK OTHER THAN DESCRIBED ABOVE. 75 0 15.00 0.00 0.00 0.00 0.00 0.00 0.00 0.50 15.50 CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer i .. *Air Conditioning - All Sizes All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS Fee Total Owner $35.00 $ Building Used As ,�i%�-i�/o � % ' ` o'" $10.00 $ ESTIMATED COST '75 O PERMIT NO " r' $10.00 $ DESCRIPTION OF FURNACE AND BURNER $10.00 $ $25.00 $ Commercial/Industrial/Institutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/IndustriaVInstitutional State Surcharge TOTAL FEE REINSPECTION FEE $50.00/HOUR # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Total Connected Load Burner Trade Name BTU HP Size No. EDR 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 Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. $ l� HEATING CO �5- $ Signed Tel # FAX #�1/ -�o�i`"J� Date_ "V v)� *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved by Rough -in Date Final Date 5 g5 &L( FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No( ) The venting system is plastic/PVC and meets all current codes and manufacturer BTU Input Fan Assisted or Nat specifications including sizing, length, number of elbows and termination. Yes ( ) No( ) The undersigned also verifies that the replacement unit is a listed assembly BTU Input Fan Assisted or Nat and meets the current codes and manufacturer's specifications. This does Total Btu Input include AGA-GANIA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date : ing $ BUILDING Plan Review Permit No. " , coons Fire Surcharge RESIDENTIAL APPLICATION (p .515 Received By: 763-572-5604 3•ZB CITY OF FRIDLEY $ hw Date DATE LZ • I(P ' O-1 YOUR E-MAIL ADDRESS ; Mn n es�+�.-- ru, C SITE ADDRESS IS(OZ i O -e Ne- N 550a THIS APPLICANT IS: ❑ OWNER CONTRACTOR 00 V $ PROPERTY OWNER/ NAME: r09 VAW $ TENANT ADDRESS: `� 11A, I rrY STATE ZIP PHONE: , LG3' 71 8I-{ - aio�a $ CONTRACTOR NAME. A SUBMIT A COPY OF STATE LICENSE # A /73 EXP DATE '3191' 47W � '-71 -fice- YOUR STATE LICENSE ADDRESS: 515-153ZDV CITY STATE ZIP WITH APPLICATION PHONE 9S2 • 935 • '74109 FAX 62' 9 `' 95`iq PROPERTY TYPE Cl SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE Q ADDITION ❑ GARAGE/SHED WS [3BASEMENT FINISH E3ROOF DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMl!vIING POOL TYPE OF WORK: ❑ NEWITION MODELING MAINTENANCE/REPAIR C3D DESCRIBE WORK BEING DONE: Q -ns L{V Co w1 tidow aAq( Cr l bay- inh alir e 1 n J SIZE OF IMPROVEMENT P Jam. aRZIIK�J WIDTH v— HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I . Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes o L 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF S 11 110) �-1 TCf►P�11 OPENING CHANGES & gp, (1 i t y1 r 0 0 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 $ (055`6 - " OCCUPANCY TYPE Permit Fee $ /3q • Zs Plan Review $ Fire Surcharge $ (p .515 Surcharge $ 3•ZB License Surcharge $ g --- 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) $1550 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: 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 pe it 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 r es revie an tip r of plans. (� ( r /n SIGNATURE OF APPLICANT T NAME �� V Or `-' DATE r Z �`�