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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N® .7404 Address Address O IOG No. rfF ly INstreet Part of Lo Block _ Addition or Sub-Division Corner Lot Inside Lot '�� Setback c 2 _ _ _ Sideyard Sewer Elevation W, 3 Elevation -` t 3 DESCRIPTION OF BUILDING Front Depth 51 ..n r.l..<' r '9��o�e Completed 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 above set fo and in pliance with ail provisions of ordinances oP the city of Fridley. P In consideration of the payment of a fee of $ permit is hereby granted to 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 Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings theme dty limits and this permit may be revoked at any �%TI/0 vioJ�ion of any of the provisions of said NOTICE: Ude permit does not corer the censhnctlon, hutallaHon for whine, Plumbing, gas heafiae, sewer or wafer. Be son to no the Building inspector for separate permits for thea hems. APPLICATION FOR BUILDING PERMIT CITY -OF FRIDLEY, MINNESOTA of Lot Corner Lot Inside L4 SEWER ELEVATION FOUNDATION ELEVATION �,_, Applicant attach to this.form Two Certificates of Survey of Lot -and proposed•bv id- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: �y- 2 R/ Front. ..-Dep Height c Sq. ;Fi. x Cu. Ft.. yk4t 01 e� Front Depth`_Height Sq. Ft..� Cu. Ft. Type of Construction Estimated*Cost.�, To be Completed / The undersigned hereby makes application fora 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 represen;71,lb stat d in this application are true and correct; DATE SIGNATURE44�_'e !�� V (Schedule of Fee Costs can be found on the,RevFse Side). w I M CITY OF FRIDLEY 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 Dolphin Pool & Patio 8832 - 7th Avenue North Golden Valley, PIN 55427 TELEPHONE ( 612)571-3450 Re: Swimming Pool Construction at 7490 Melody Drive N.E. Dear Sirs: This letter is to make clear this department's requirements for the swimming pool construction at the above address. 1. As indicated, two (2) skimmers approved by the National Sanitation Foundation will be provided. 2. As indicated, three (3) inlets of approved design for fresh and/or repurified water will be provided. 3. As indicated, a main drain of approved construction will be provided. 4. The filter and pump shall be approved by the N.S.F. and be of sufficient capacity to provide a minimum turnover of at least two (2) times in 24 hours. This department recommends a turnover rate of 6 - 8 hours. 5. A deck of at least three (3) feet wide, measured from the pool waters edge, shall be provided which extends completely around all private residential pools. Above ground private residential pools may be provided with decking of a minimum size of 4 feet by 4 feet at pool entry points and provided that such decking has the approval of the City. 6. The diving area will be acceptable provided there is. no overhead obstruction. 7. Fencing or other effective means including but not limited to walls or buildings, acceptable to the City, shall be provided to positively control all access to public and private residential swimming pools. Fencing shall meet the following criteria: (a) The fencing shall prevent the entrance of children and be without hand or foot holds that would enable a person to climb over it. (,b) The fencing shall be at least 6 feet high and entrances shall be equipped with self-closing and self -latching gates capable of being locked. (c) Self-closing and self -latching devices shall be placed at the top of the gate or otherwise inaccessible to small children. (d) The opening between the bottom of the fence and the ground or other surface shall be not more than four inches. 8. An automatic chlorinator should be provided with a suitable test kit. Dolphin Pool & Patio July 20, 1981 Re: 7490 Melody Drive N.E. Page 2 9. All electrical and plumbing installations shall be inspected and approved by the City Inspection Department. 10. All overhead electrical lines must be a minimum of 10 feet horizontally from the pool surface, and 18 feet straight line distance from the waters edge. An alternative is to bury said lines. 11. The pool fill spout must be protected by a vacuum breaker or air -gapped. 12. Suitable safety equipment to include but not limited to a ring buoy and rope that is 122 times the pool diameter, and shepherds crook pole must be provided and maintained with the pool at all times. Furthermore, these and any other requirements must meet the provisions of the Fridley City Code, Section 115, Swimming Pools. The building permit is approved contingent on final inspections and approval by the City. If any questions or problems arise from this letter, please feel free to contact me at 571-3450. Sincerely, STEVN J. OISON, R.S. Environmental Officer SJO/mh CC: Joe Shrake 7490 Melody Drive N.E. Lid f�lannauf &M -,qor4xj 00 AT 1m9 Suu A1rrns )Z, 9 L �.oMDs:;?ow 60D MOM EDALEBUILDERS c��� T o F � i MEUDY ®IR1vE O'DEN07CS IRON_ __ ®Ei�®i�S 6RA►�G� !® IJYI�IY� �ASEMENT 1 ANOKA COUNTY M. nm� ar$ Aaeq r_,V lir) 13 a ha Ord ccrmd 'ropt'sn'7¢4t6a of a $Lrt,-,y eib t=e*vvs of 6 6=2 &- d 1--4, *y C� i 1. , f'� araF ,X71;/ �l iV>9G`43' arvvc4hr,7adj , ff c�J, fm cr c9P.� & 15d. A5 .mrw �� v Ick-.- �-ey D � •d ' j e f t L" r/ 6632 Seventh Avenue north, Golden Valley, MN 55427 • (612) 542-9000 EQUIPMENT -SPECIFICATIONS Customer .-mpv�k NAT CNAL DATE J4/0`0// Address D F City /2®� State_ Phone Home % Ste?. Office Submitted By:, �^ POOL DATA: Pool Size & Shape .0A 34 Turnover Rate 9 Hours Surface Area- Sq. Ft. Rate of FlowGPM Capacity .r 2.00 0 Gallons Perimeter 4�— Lin.Ft. PIPING DATA: Suction ��� oo* Returns Manifold LINER STYLE COPING STYLE BOTTOM MATERIAL FILTER PUMP & MOTOR SKIMMERS DIR.FLOW INLETS CHLORINATOR POOL HEATER POOL STEPS LADDER ANCHOR CUPS DIVING BOARD SLIDE POOL LIGHT MAINTENANCE KIT VACUUM KIT AUTO POOL CLEANE WINTER COVER SOLAR COVER CHEMICAL KIT DECK WORK DECK BRACES CONCRETE FOOTING FENCING ELECTRICAL OTHERS ER.' DECK BOX ,- j TEST KIT !=� WALL BRUSHzs' WALL FITTING _— r�� SOLAR REEL--_- EEy o ��-))____A--_may'f� 0-17 WALL WORK J GAS LINE O:'� NATIONAL SWIMMING POOL INSTITUTE Doe�'..1-L�L11�1 DATE Tc DECK WORK SPECIFICATIONS CUSTOMER _ JOZ- 5���,r �� ADDRESS %i -AO '00t'ewk ,Q_f_/_11 C I TY & ZIP TELEPHONE' DIRECTIONS TOTAL SQUARE FT. PRICE PER SQ. FT. FINISH OF DECK .8.�`� C�✓�S� REDWOOD DIVIDERS DECK EQUIPMENTi DIVIITG BOARD LADDERS IiANDRAILS SLIDE OTHERS 0/'./--- z1,01"-er si b DRAWING: �L fArL 001o"D J0OoC g 1ct ,gam///P,0 ,60440 8832 Seventh Avenue North, Golden Valley, MN 55427 • (612) 542-9000 7 7-i '�-AUYZ '�P'7dP VAI a,.-ntm vv VY.'A �.Gy, dv., X -X IVOI1.719 7MOMONOI Ogg Y- IV Ivoli ONY eZWlvf A)N. YON I i �vs 111 V?IS 735 S�Vlll-.)V? �Wt,y.o V. a oztlrs Tw—a - FRU 2 �7," 700d JO Nfl7d aVnhryar Tr 735 S�Vlll-.)V? �Wt,y.o V. a oztlrs Tw—a - FRU 2 �7," 700d JO Nfl7d sueJEcr PER NO. City of Fridley 16 2 9- AT THE TOP OF THE TWINS BUILDING PERMIT t RECEIPT NO. • _____ COMMUNITY DEVELOPMENT DIV. •7 q �/ r 1 PROTECTIVE INSPECTION SEC. 1 � NUMBER REV. DATE PAGE OF APPROVED BY = 1 I CITY HALL FRIDLEY 55432 ��j 612-571-3450 910-F15 7/23/81 JOB ADDRESS 7490 Melody Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 34 4 Melody Mamr 4th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Joe Shrake 7490 Melody Drive N.E. 784-5253 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Dolphin Pool & Patio 8832 - 7th Avenue North 542-9000 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 ❑ REPAIR ❑ MOVE ❑ REMOVE x 8 DESCRIBE WORK Construct an 18' x 36' Swimminci Pool 9 CHANGE QF USE FROM TO STIPULATIONS Stipulations as per letter dated July 20, 1981 by Environmental Officer. 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 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 STALLS I 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 $6,000 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE O CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LPCAL LAW REGULATING COW $36.00 STRUCTION OR'T P FORM�NC O RUCT N. PLAN CHECK FEE TOTAL FEE �. $9.00 $48.00 '�+ SIG ATURE OF CONTRACT OR AUTHORIZED AGENT IDATEI WHEN PROPERLY VALIDATED/THIS IS YOUR PERMIT • 01 BLDG iNSP SATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PEIV41TS (Now, Alterations, Additions, or Repairs) OWNER: JOE S/yRAa ADDRESS: 7f-90 Nr_ GOD) 40W A/.6 TEL h0: 78V_" S112S3 BUI LDER :.,00iy j.#j 000e.7A ADDRESS: 7� A*e, No. TEL NO: Sia" QOoO Construction Location ` STREET NO: 7"0 STREET: /7iE�GOL�,k CAR • Al- LOT: r•LOT.: �T BLOCK: ADDITION: �I,EGOD/�1�OiE' /own 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 1g %4 x 34`14#8 3 " ` 9'.DJ00N Squame. Feet: Depth: Height: Cubic Feet: Front: Depth: Height: Square - Feet: Cubic Feet: Type of Construction: 1/I�'Lt G/PrX 5U- MJ41000( Estimated Cost: $ 4�10 0 %b Be Oorupleted: A110,?r Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET Mie 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 Delhirtment. of Buildings, and hereby declares that all the facts and representations stated in this application ar /true and correct. DATF: 40�v� /!p4r/ SICNATUF.E : Stipulations: 00 Land Ramwif 6875 -A *CS AIE. Lard sw'T"y MomrhS iP. eisksfy ENGINEERING, INC. "m°'° C,r,l b A�r►aapv! S"1111"6 -- En yinee rs Sur vec .5 --- certificate of sasoei► for NOMEDALE BUILDERS lg vA. p00c 3•-,°- 56.24 � ?0 y--zr--- °'',_, _ _,..IQs,._ ► a'- r 7#L740 MELODY DRIVE o DENOT E S IRON ----DENOTES DRAINAGE AND UTILITY EASEMENT LOT 34. BLOcIc 4• MELODY MANOR 4" ADDITION ANOKA COUNTY i hvvby curi y rwi Firs is a Irw and a me/ rrprsw/stia7 i f # swwy eAk A*vm ww grAr shah aEs v&d lad, and arlir largll w 4r4v beridr , ihfeaq , and d/ mAir swv* ha mis , if ay. fm or an said led As swwyed �( AK thi �- ab► Septarab r A.O *I&. SUBUR&W ENGINEERING , INC. A.�s fr Sums 46 2I CITY OF FRIDLEY 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 Dolphin Pool & Patio 8832 - 7th Avenue North Golden Valley, MN 55427 TELEPHONE ( 612)571-3450 Re: Swimming Pool Construction at 7490 Melody Drive N.E. Dear Sirs: This letter is to make clear this department's requirements for the swimming pool construction at the above address. 1. As indicated, two (2) skimmers approved by the National Sanitation Foundation will be provided. 2. As indicated, three (3) inlets of approved design for fresh and/or repurified water will be provided. 3. As indicated, a main drain of approved construction will be provided. 4. The filter and pump shall be approved by the N.S.F. and be of sufficient capacity to provide a minimum turnover of at least two (_2) times in 24 hours. This department recommends a turnover rate of 6 - 8 hours. 5. A deck of at least three (3) feet wide, measured from the pool waters edge, shall be provided which extends completely around all private residential pools. Above ground private residential pools may be provided with decking of a minimum size of 4 feet by 4 feet at pool entry points and provided that such decking has the approval of the City. 6. The diving area will be acceptable provided there is no overhead obstruction. 7. Fencing or other effective means including but not limited to walls or buildings, acceptable to the City, shall be provided to positively control all access to public and private residential swimming pools. Fencing shall meet the following criteria: (a) The fencing shall prevent the entrance of children and be without hand or foot holds that would enable a person to climb over it. (b) The fencing shall be at least 6 feet high and entrances shall be equipped with self-closing and self -latching gates capable of being locked. (c) Self-closing and self -latching devices shall be placed at the top of the gate or otherwise inaccessible to small children. (d) The opening between the bottom of the fence and the ground or other surface shall be not more than four inches. 8. An automatic chlorinator should be provided with a suitable test kit. Dolphin Pool & Patio July 20, 1981 Re: 7490 Melody Drive N.E. Page 2 9. All electrical and plumbing installations shall be inspected and approved by the City Inspection Department. 10. All overhead electrical lines must be a minimum of 10 feet horizontally from the pool surface, and 18 feet straight line distance from the waters edge. An alternative is to bury said lines. 11. The pool fill spout must be protected by a vacuum breaker or air -gapped. 12. Suitable safety equipment to include but not limited to a ring buoy and rope that is lis times the pool diameter, and shepherds crook pole must be provided and maintained with the pool at all times. Furthermore, these and any other requirements must meet the provisions of the Fridley City Code, Section 115, Swimming Pools. The building permit is approved contingent on final inspections and approval by the City. If any questions or problems arise from this letter, please feel free to contact me at 571-3450. Sincerely, EST EN J. SON, R. S. Environmental Officer SJO/mh CC: Joe Shrake 7490 Melody Drive N.E. CITY OF FRIDLEY APPI ICATIAN FnR P111MATNP, ANn GAR FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $ Future Fixtures $ 3.50 $ Old Opening, New Fixture $ 1.50 $ Beer Dispenser $ 4.00 $ Blow Off Basin $ 5.00 m Catch Basin Water 0a� Rain Water Leader $ 5.00 $ Hydraulic Valve $ 5.00 $ .ci m $ m w $ w $ 5.00 $-n o Heater $ 10.00 $ Gas Dryer $ 10.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance 8 6C� 0 $ .50 Reinspection Fee $ TOTAL agpoi $ Ab sem ii :+ ro 3 w w rd u 3 o lec m v 5 m m 1st 2nd 3rd 4th (R) - Future Connection Opening Connected with Sewer (*) - New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $ Future Fixtures $ 3.50 $ Old Opening, New Fixture $ 1.50 $ Beer Dispenser $ 4.00 $ Blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Water Leader $ 5.00 $ Hydraulic Valve $ 5.00 $ Sump or Receiving Tank $ 5.00 $ Water Treating Appliance $ 7.00 $ Hot water Heater $ 5.00 $-n o Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance 6C� State Surcharge $ .50 Reinspection Fee $ TOTAL FEE $ Ab sem Job Address 7 4r�v , c �OA , 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 app ica on are true and correct Fridl , Mn. , 19-�j OWNER BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. ROUGH INSP. Company Signed E Tel. No. Date FINAL INSP. Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT$10.00 PLUS THE $.50 STATE SURCHARGE CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Rate TOTAL Furnace Shell and Duct Work, Burner - Also Replacement Furnace $30.00 $ 3d • 00 (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace) $10.00 $ Gas Range $10.00 $ Gas Dryer .$10.00 $ . *Air Conditioning - All Sizes $ 25.00 All Others/Repairs & Alterations (LIST ON BACK) I% of Value of Appliance or Work $ Commercial/Industrial 1.25% of Value of Appliance or Work $ State Surcharge $ .50 TOTALFEE$ 5.5D MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. .:J'VaNtz: Effective On January 1, 1997 JOB ADDRESS JLf 9 0_ _ _rAf,J u GL L� 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 an correct. I (e ,1997 BUILDING USED AS h ESTIMATED COST 3 O©D• 00 PERMIT NO _ '' Z! DESCRIPTION OF FURNACE AND OR BURNER, i No. of Heating Units Circle One (Steam) (Hot Water) arm Trade Name 2>Na�A, SizeNo.,395_eA-Vd3(o0?d BTU (pi-0-0HP EDR Fuel W� .Total Connected Load Burner Trade Name Size No. BTU HP EDR BLAINE WO. A/C ELECT., INC. 13562 CENT W_ AVE. N.E. HEATING CO P Y Signed By o. % -62,00 Approved By Rough -In Date FILL OUT BACK SIDE * R STACK VERIFICATION ON REPLACEMENT FURNACE Final Date CH C,gEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. . Has been carefully examined Yes No'( ) 2. Is free from ruse or deterioration Yes No ( ) 3. Has no foreign objects lodged within Yes No ( ) 4. Is securely supported Yes No (. ) 5. Meets all current Code requirements for size and total BTU's connected Yes { No ( ) 6 Has total heating HIVS- of �0 0 , DO 0 All other BTU's H U , y 0 TOTAL BTU's (out ®00 7. Has a liner been provided for water heater Yes No O. 8. Has combustion air been provided for water heater Yes .0 No ( ) Remarks:oz- -� List ALTERATIONS Being Done: F I" R� • i i BLAINE HTG. AIC ELECT., INC. ' HEATING CO: Signed By: Date: Ili -1�0 -6-7 � From: 6127883111 Page: 111 Date: 9/5/2007 2:40:15 PM FROM :City o4 Fridley FR?: 1 U. : 70S71 tar? Sep. 05 21007 01:4" P2 Building . BUILDING Inspections RESIDENTIAL APPLICATION Received By 763-572-3604 CiTY OF FRTMEY DiJttl�'3 1 SrrR ADIAM45 It �- --�- THM APPLICAW 19: 11 iaUNUR VLDMY'R CTraR 1�ddS I/� PROPERT OWNERS NAM1i: , 97AT % ,t�r ` ANT ADURR5,; - ' ^�t,iTY Tit�AT�, I PH<aNR: • " . COIti"FRACTipli TVATE LIC IS R 11 ` ` • 4� Exp r1A m . SUMMIT A COPY OF I ► • �� �_ TA . �Ytlult S'rfa.'ri;1.1f'ii,�iSE ADDRESS _ //�� . � �,r f WITHAPPLICA't1(9N �I't•1VNE T` I '- - — -- I p{>:t;IPERTY 7'M1:'"+ ❑ 3�Cri F. ItAiYi1LY.NE"oV CUNSTRiIGTICTN +iT.F. a _ G1 [ U FAI�TILY%NEw C�J]dS'rRU411�N PURI PERMI'i- inTE O A ITIRIbN G �ARAU' S1dLrD w1NnOW ` iJ DAst rNT PiNIWl U ROOF C7 MAIN TTi.r• I p 1)1•.�.t� 0 SIVING O �i'l'IIL�It 13 SWiMMINSJ P001- 1--�.• • •-+•�-� U NF'w • r'IAh)1N'iI N�.. .._��.. TYpE Olr WORtC: d MAI FNANt:1:+R ATR OTY o DFRCR1BE WORD SE�0 DONE: , % . ---fy U9 OFF IMPROVEMI•:�T LENGTH YvTDTII Hal 4T �I 13 ra(a118>+ i v 6A4 Pore t�41T iRly]I t: MIT . VP .9911ARGS � ❑ WOUAE Jr C3A1tAarll 1, Fxi4hnk Doer Plen CA ACF I ❑ArrAC:i•!E'D*-ARAflR 2. P�,rw f=lae PRQ :SLrD Jit' G VWrA6TTRn CaAjaAUL• 3 Li3t Oratruan�l mgtpbrds t0 i>e ascii PRraT'f3SEta til l4iH P. rOR NUW CON-MIUC"rION 1NCLl:DT4f4 DP,M SID1M10 AAMW!L& itter9PO IR ' �► i3 Vlnpl I GSeiIi1 I, RiEo Putvey s 6watg the mlistinfl slatlrrlAnww� ❑ �i�xuimm� Q flim Pea }m powd pra lfti, G 17titer _ 13 Fascm z, -1-Wo Pete of 400wdlon 014M �y� 3. Fiialttt_,ry Cakuladmta RM,w, ti -PENIN ' END r f CA'1'R)N OF vANn()w6 on FOR NEN, OPfiNNCi - ' , CRISE SIZE OP ni+I;-W. W 3 C ANDES A I �.e n*rt rhnwC sI e-REDUE) Permit Pee -- — � San Back Page for Fee Schedule plan Reviow 6s%a of Building Permit Fee Fire Surcharge.001 times the total job valuatinn 0005 x hermit V81uatIM Minimum S-50 Surchergu $5.00 (Steele 1 .1consed Residential Contr l;M) License .SUM1111r><e I _ _ SAC Caar� I $1615 )ler SAC Unit (Plana to M Wt:(: 11br daturmintltioTT} Curb Cut Eacmw $ �� , A 1,6 ft- ft x $21 Erosion COMM I $ � $450 Cs11acm�atinn PiM Rtroicw Park Fee j fi �� Fee I)MMined by ETT13isMing Sear Main Charge $ Agrcamelat necessary ( )Non NeceBrrary ( ) 'Cotal Da m„ a �� - { IMttke cite c a aisle to. Cit- pri Aetach Btlpulatlans rL -Ms [SAN ArpUtATION FAR A rVjtt irl'-N0T VALID TINTil (IMOCL'S511ll I hereby apply for a buil !ng t+amit and i acknowltldgc that the information above Is complete and pooutxete; that that work will 11e in ved conformanr c .Miti► the ofd an ed • es the a::icy 'rr'41 y and with to Mitmmwia Con11truetilnn C,odeg that 1 understand this is not a permit but only an alppl! to dwork s t4 !dart W' bout i ,th a wor w 1 be in aecordaRce")with trio 1>Im1� plan in tha caao ot°e11 wu*k io itl1Y a SiGNNrURB OP APPIACANT NA Building $ / 9,7 as- BUILDING Plan Review Permit No.: Inspections Fire Surcharge RESIDENTIAL APPLICATION Received By: 763-572=3604 $ • . d' CITY OF FRIDLEY Date D A 2 200 DATE O YOUR E-MAIL ADDRESS $5.00 (State Licensed Residential Contractors) 4ti 4,4 e- ,1 e. C 0/1.7 SITE ADDRESS ® (� $1675 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow THIS APPLICANT IS: ❑ OWNER CONTRACTOR Erosion Control $ PROPERTY OWNER/ NAME: $ Fee Determined by Engineering TENANT ADDRESS: % y Q © 2- IP 0 r" CITY STATE ZIP $ 1-9 10 . CJO PHONE: CONTRACTOR NAME• Af 5 o4aS 2 i STATE LICENSE # a O EXP DATE ADDRESS: _r' 2 °!U Ke �s ey r. CITY S X o f-' VJOo STAT§&Z& S-S33 SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PHONE A 3 —2 12 -& ©t FAX 263-2/2-0/10 PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISHROOF 13 DRAIN TILE E3 DECK SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAIIJTENANCE/REPAIR REMODELING DESCRIBE WORK BEING DONE: i - ' SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT, Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ATTACHED GARAGE I . Existing Floor Plan PROPOSED SIZE: 11 DETACHED GARAGE 2 3. proposed floor plan List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl flit ADDITIONS. & PORCHES SUBMIT: ❑ uminum Other rim fFascia 1. Site Plan/Survey showing the existing structures 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 $1(1 -5-0 C) OCCUPANCY TYPE Permit Fee $ / 9,7 as- See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ /0.6D .001 times the total job valuation Surcharge $ • . d' .0005 x Permit Valuation Minimum $.50 License Surcharge $ 6-1 Ull $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 $ 1-9 10 . CJO 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 w 'ch a it review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME / ! Gt �T E Ur� 4 k A,, I) DATE— 0