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PRE 2010 DOCSCity of Fridley, Minn. 1254 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUH DING PERMIT Date: November 10, 1971 �� John Hanson Builder Donco Builders, Inc. OwnAddress 1052 Osborne Rd. N.E. Address Fridley, Minnesota 55432 Ne 6705 Street LOCATION OF BUILDING Main Street N.E. part of Lot Lot 10 Block 2 Addition or Sub -Division Rice Creek Plaza South Addn. Corner Lot Inside Lot x Setback 35 Sideyard 15' Sewer Elevation Foundation IIevation DESCRIPTION OF BUILDING To be Used as: House Front 321 Depth 40' Height 20' Sq, Ft. 12126 Cu. Ft. 223520 Att. Garage Front 26' Dept 22 Height 10' Sq, Ft. 488 Cu. Ft. 4,880 Type of Construction Frame Est;. Cost 23, 000.00 To be .Completed March 1972 202640.23) i u . Verifying Survey Hard Surface Drive �o ' S . `_6 In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description aboveVol)nd in compliance with all provisions of Ordinances of the city of Fridley. V/ // / t In eonolderation of the payment of a fee of $_5l _-00 , permit is hereby granted to Donco Builders to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects .to the ordinances of li`ridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings city limits and this permit may be revoked at any time upon violation of %any of the provisions of said u c Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building inspector for separate permits for these items. APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAM: (V U k -ii La n 5e2j BUILDER: Donc o Builders, Inc. ADDRESS: 10,52 Osborne Rd. N.E. ADDRESS: Fridley, Minnesota 55&32 STREET • Main St. LOT: 10 BLOCK: 2 ADDITION: Rice Creek Plaza South Addition 0, CORNER LOT: INSIDE LOT: X SETBACK: 3 5' SIDwARD: 151 Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As: Home DESCRIPTION OF BUILDING Front: _ Depth: 40 Height: -1-2— Square Feet: — Cubic Feet: ° ._ # Front: Depth: Height: Square Feet; Ada' Cubic Feet: ` Type of Construction: Frain Estimated Cost: $23,000.00 To Be Completed: March 1972 �j �� e10 ° 2 3 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict accordance with the City of Fridley Ordinances and ruliggs of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: 11— 1 SIGNATURE : �/ (See Reverse Side For Additional Information.). er% 2� -J P '5 , ®oe 2;) MY -7 f Y 3 (YI-3 06 �oi� iv:�)07 �� V City of Fridley Application for Pluobing and Gas Fhtkg FWmIlt Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Ids J ®Si Number. Kind and Location of Fixture PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ........... x $1.50 $—&4 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 $0 .44"onal Fixtures .................. x $ .75 $ Gas Range to 199,000 BTU ............... x $5.00 $ REPAIRS It ALTERATIONS—Refer to Code Description ............... TOTAL FSE 3 (SURCHARGE $ _.5a) 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 Cit' Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct Fridley, Minn a` , 19ZL Owner Kind of Building,, /��✓� Used as To be completed about /y 7 �2- Estimated Cost, $ / }� Old ew. uilding Permit No. Perr�mitN,�o. n�`7 9 Signed By �..2s-C�.n - • - Business Phune No ROUGH FINAL O Q e e WATER MTR. GAS EIEC. Base 1st y`, ✓" f 2nd 3rd 4th • Future Connection Openings + New Fixture, Old Openings Connected With Sewer Cesspool ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ........... x $1.50 $—&4 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 $0 .44"onal Fixtures .................. x $ .75 $ Gas Range to 199,000 BTU ............... x $5.00 $ REPAIRS It ALTERATIONS—Refer to Code Description ............... TOTAL FSE 3 (SURCHARGE $ _.5a) 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 Cit' Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct Fridley, Minn a` , 19ZL Owner Kind of Building,, /��✓� Used as To be completed about /y 7 �2- Estimated Cost, $ / }� Old ew. uilding Permit No. Perr�mitN,�o. n�`7 9 Signed By �..2s-C�.n - • - Business Phune No ROUGH FINAL O PARTIAL RATE SCHEDULE GRAVITY WARM ASR: RATE TOTAL. PNnzace Shell & Duct Worts . $10.00 $ Replacement of Furnace 6.00 $ Repairs & Alterations—up to $500.00 600 $ Repairs & Alterations each add. 5500.00 300 $ DWAML WARM Aid Furnace Shell & Duct Work to 120,000 BTU "eh add. 60,000 BTU . ......... Replacement of Furnace Repairs & Alterations --up to $500.00 Repairs & Alterations each add. $500.00 STEAM of HOT WATER SY91TEN ..$10.00 $ 3.W a 6.00 ! &00 $ 3.00 $ Furnace Shell & Lines—to 400 sq. ft. F.DR Steam $10.00 $ Furnace Shell & Line --to 640 sq. ft. EDR Hot Water 10.00 $. Each add 200 sq. ft. EDR Steam 3,00 $ Each add. 320 sq. ft. EDR Hot Water 3.00 $ OIL RUPKER—to 3 gal. per hour 6,00 over 3 gal, per hour—See Fee Schedule GAS BURNER (up to 189,000 BTU) 6.00 $ over 199,000 B7U Sem Fee Schedule GAS FITTING FEES: NO RATE TOTAL Ist 3 Fixtures %S y00 Additional Fixtures x ,76 $_ Gas Range to M.000 x$ 6,W $ '•+` ?%`.': .f' G, ._ `fps <. ;1,1'fit� State Surcharge .50 Is" Foe TOTAL nz $� 9N, Dept. of Blag a. Phone 1O -34M 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 Ordinanci and ruling of the Department of Buildings, and hereby declares that all the fad and representatiuns stated in this application are true and correct. Kind of Used as C To lv completed about,�,L_� ' q? L q e� Estimated Cost; $ C91,04New. Building Permit No. _—_ Permit No.oj,9,) Total Connected Load bind of 1 13URNM — Tnde 23e Stae Ngo Capgacity Sq. Ft. ED R- BTtT I I AMM -OMI �r.�sm•an�•.. :� n • � • SUBJECT PE City of Fridley 2 2 3 7 AT THE TOP OF THE TWINS BUILDING PERMIT (� i RECEI_� Nfl: COMMUNITY DEVELOPMENT DIV. _ v PROTECTIVE INSPECTION SEC. D CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY �•"' �'' 612-571-3450 910-F15 3/30/94 JOB ADDRESS 6705 Main Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 1 2 SHEET Rice Creek 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Barb/Kevin Pohaw 6705 Main Street NF 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Suburban Exteriors 6000 Hwy 12 Maplp Plain MN 55159 4 7 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PH NE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑K REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (Tear -off) 24 Squares 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. 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 1 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 $1,800 $.90 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- $41.00 $1.80 Fire SC. TRUCTION OR THE PERFORMANCE 0 CONSTRUCTION. PLAN CHECK FEE TOTAL FEE f�/t{/ J(, �? L cense SC $5.00 $48.70 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI HE RLY VALIDATED THIS IS YOUR PERMIT '1( BLDG INSP GATE SiGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/94 ADDN (] CITY OF F. ][XY ALTER [ ]. -SINGLE FAMILY •AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: [ 7 0 S 5 � . 11U - 1�_ - Legal Description: Owner Name & Address: 6fl r b J- ke v; vv Tel. # 5-21-5-03y Contractor: S c_�u f - b A� MN LICENSE # Address: 6�0� /�c�-� 12- 3 5 �/ Tel. # Z/7l 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 HlIgt/Ground Sq. Ft. OTHER: J e -Ar- o (� ,^oma ftrvei KJ'J10( 1)1,1 0_00T 2 LI G f® V c Corner Lot [ ] Inside Lot (] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6Ft = Ft x $ _ $ DATE: 3—?09e( APPLICANT: 1%'� Tel. # e-/77-/9/0 CITY USE ONLY Permit Fee $ b Fee Schedule on Reverse Side Fire Surcharge $ / &- .001 of Permit Valuation (1 / 10th %) State Surcharge $ 5�0 $.50/$1,000 Valuation SAC Charge $ $800 per SAC Unit License Surcharge $ 00 $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: CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1996 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR CITY OF FRIDLEY INSPECTION OIV. 6431 University Ave NE Fridley, MN 55432 572-3604 ' Effective On August 1, 19% 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 $ 7.00 Old Opening, New Fixture $ 4.00 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** ". S=W 0 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes O No Type $15.00 JOB ADDRESS l,a '74 _-�- 1111a.l—,1, \J '?I/E 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 t e and correct. Owner _ ,;=�� . ll >�_.�� 5 7®sl® 3 Building Used As Estimated Cost (00 00 PERMIT NO. / U PLUMBING COMPANY c Reinspection Fee $42.00/Hr: SIGNED BYTEL N0. %�� ALL OTHERS AND/OR REPAIRS AND ALTERATIONS o� 1.5% of Valua of Fixture er-Annllhnm Rough -In Date Final Date STATE; SURCHARGE J' BLE 64A. MINIMUM SIZE 9 SQ INCHES. } k f SUBJECT City of Fraley 25 97 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV.®l v PROTECTIVE INSPECTION SEC. / r , I NUMBER REV DATE 4/27/98 PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 j 612-571-3450 910-F15 JOB ADDRESS 6705 Main Street 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 2 Rice Creek Plaza South Addn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kevin Rohan, 6705 Main St., Fridley 55432 571-5034 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Minnesota Rusco, Inc., 9901 Smetara Dr., Minnetonka 55343 935-9669 2173 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 A❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace siding and garage door 9 CHANGE OF USE FROM TO STIPULATIONS Building wrap 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 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL OF LAWSAND ORDINANCES GOVERNING THIS TYPE OF WORK WILL EN COMPLIED VA �pTLON0.00 // IIJJUU S<$3. k WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT F124.75 SAC CHABG PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- re SIC 7 .00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN icense CHECK FEE 00 TTp �EE_5 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY ALIDATED THIS IS YOUR PERMIT DG INSP MATE SIGNATURE OF OWNER I IF OWNER BUILDERI IDATEI tEP-19-1995 14:23 ribw 11 ADDN fl . RJ ConstmetionAddress: Legal Description. Owner Name & Address: Contractor: n'Aus Address: OAA LIVING AREA: GARAGE AREA: DECD AREA: OTHER: CITY OF FR I DLEY CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R -l. AND R-2 Building Permit Application lig __ �_► 612 571 1287 P.01:02 Effective 3/1196 Tel. #1�5 MN LICENSE Tel. # Qj –I Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRII[MON OF UAPROVEMENT Length Width Height_ Sq. Ft.1 Length Width Height Sq. Ft. Length Width Hgt/Grround Sq. Ft. -� bze- � r�"q ali-d Aara cm ,wr 'r1LATIONS: 0- v Conner Lot [) Inside Lot [) Ft.d Setback Side Yard Setbacks type of Construction• S1 M7 Estimated Cost: $©� kpprox. Completion Date:�— (Cost on back) Driveway Curb Cut Width Needed: + F – t $ $ GATE: – APPLICANT Tel. # el ®� qC s''A'psc�"" CITY USE ONLY r 'ermiit Fee $ o� �. ,� Fee Schedule on Reverse Side A ,ire Surcharge $ ? ' b e .001 of Permit 'Valuation (1/10th%) tate Surcharge $ $.50/$1,000 Valuation AC Charge $ $900 per SAC Unit Icense Surcharge $ $5.00 (State Licensed Residential Contractors) t )riveway Escrow $_ Alt. "A" or AIt. "B" Above . ,rosion Control $ $450.00 Conservation flan Review ark lee $ Fee Determined by Engineering ewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ a s 'r1LATIONS: 0- CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Fee Total Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace $35.00 $ 3S� 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 Commercial/Industrial/Institutional $10.00 $ JOB ADDRESS Owner Pkv l V-\ Building Used As & s I ESTIMATED COSTS i UV PERMIT NO $10.00 $ DESCRIPTION OF FURNACE AND BURNER $10.00 $ # of Heating Units _ Circle One (Steam) (Hot Water) (W::a:rm;A* Trade Name ju-e l Size No. $25.00 $ BTU UAW HP EDR Fuel - Q4 6c' -E Total Connected Load �--� $ Burner Trade Name 1.25% of Value of Appliance or Work (List on Back) $ Minimum Fee $35.00 for Commercial/Industrial/Institutional d State Surcharge $ TOTAL FEE $ mbv REINSPECTION FEE $50.00/HOUR 35 X55 *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City BTU 7M 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. FAX # A8 -7 - ola-53 Date Tel # &Q _'EeP �+ FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE 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 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 : Building Permit Fee BUILDING See Back Page for Fee Schedule Permit No.:L Z)C,- '�5 Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION Received Byh 763-572-3604 Surcharge CITY OF FRIDLEY _ .0005 x Permit Valuation Minimum $.50 Dates : •J��iV 763-502-4977 FAX $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow EFFECTIVE 1-1-2010 ft + 6 ft = ft x $24 = $ Erosion Control �j $450 Conservation Plan Review Park Fee —/ DATE �� YOUR E-MAIL ADDRESS Sewer Main Charge SITEADDRESS Agreement necessary ( ) Non Necessary ( ) Total Due THIS APPLICANT IS: ❑ OWNER [CONTRACTOR PROPERTY OWNER/ NAME: uM TENANT ADDRESS: `1'1 CITY STATE (4/1ZIP5!;'-/3a PHONE:_ / ' 5 O-& CONTRACTOR NAME: e,&,44-0 SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: !S::79 / a4.A_C4 e Aj.'� CITY STATE% ZIP ( INSURANCE PHONE — FAX PROPERTY TYPE 6�SINGLE FAMILY/NEW CONSTRUCTION SIZE �j TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED DOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: — A 8 P d SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT f/ SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures 13 Other ❑Fascia and proposed project. 2. Two sets of construction plans WINDOWS IN EXISTING OPENINGS Yes ❑No LO�ATIQN OF WIN�DO�j�S--136 3. Energy Calculations FOR WINDOWS - PROVIDE U -VALUE AND A �i � 3 OR FOR NEW OPENINGS- ESCRIBE SIZE OF / r NG15 *V&5'�'�' y MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: TOTAL JOB VALUATION $ (USS THE 1997 U.B.0 FEE SCHEDULE) 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 $ _ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ I '� 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 on site; that the work will be in accordance with the approved plan in the case of all ork which requires review and approval of plans. / SIGNATURE OF APPLICANT � Fes' PRINT NAME 914144A (PhN DATE�dLI ld Building PLUMBING Inspections RESIDENTIAL APPLICATION 763-572-3604 CITY OF FRIDLEY 763-502-4977 FAX EFFECTIVE 2-19-09 DATE 7/3 e f, a YOUR E-MAIL ADDRESS SITE ADDRESS ®S 1h4 . a/ s r- Al .0 THIS APPLICANT IS: ❑ OWNER CONTRACTOR Permit N Received B, DaF 'J ROPERTY NAME: /DA 0-,6 A A 2 0 "o+ ^1 OWNER/ ADDRESS: (. '10 5 M A ..J f 7 A-) a: CITY%! --ST TENANT PHONE: %L -4 – S7I - � ® 3 f°__ CU1V 1 KAC:1 Vic NAME: Terry Overacker Plumbing, Inc. SUBMIT A COPY OF STATE LICENSE a 502 E Main Street YOUR STATE — Anoka, MN 55303 LICENSE, BOND AND STATE BOND # License# 061945PM CERTIFICATE OF ADDRESS. 763-572-8880 INSURANCE — FOR IRRIGATION _ — DISHWASHER —LAUNDRY TRAY PHONE — OTHER PERMIT TYPE ❑ SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: 0 NEW "REPLACEMENT DETAILED DESCRIPTION OF WORK X5-1- j Z STATE ZIP FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE FEES ARE BASED ON $10.00 PER FIXTURE. EXCEPT WHERE NOTED. $35.50.SHOWER BATH SINK/LAV FLOOR DRAINS — _ WATER PIPING WATER SOFTNER ($35) —BATHTUB — GAS PIPING (NEED CITY LIC) _ SWIMMING POOL CLOSET — BACKFLOW PREV. ($I S) CLOTHES WASHER — KITCHEN SINK _,WATER HEATER ($35) — FOR IRRIGATION _ — DISHWASHER —LAUNDRY TRAY —WATER WATER METER — OTHER THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 on site; 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 >rP e ®- 1 _PRINT NAME J/ /1 L /C--�= ® �� DATE 3 1 �y City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977