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City of Fridley, Affim. BUILDING PERMIT N°5 9 0 7')' Date: Owner: .� A Builder Address Address LOCATION =art G No..j�� Street o t Lot —..___ Block ddition or Sub-Divisiop + Corner Lot _ Imide Lot Setback. �104F ideyard _. Sewer Elevation ____ Foundation Elevation DESCRIPTION OF BUILDING To Used f Front _ Depth Height - Sq. Ft. CIL F art— it � Depth eight Sq. Ft. � .. Cu. Ft. Type.of ction Est. Cost _; o be 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 forth and m compliance with all provisions of ordinances of the city of Fridley. A 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 within theme city limits and this permit may be revoked at any time upon violeJon of any of the provisions of said Inspector NOTICE: This permit does not cover the construction, Installation for whdng, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. 4 APPLICATION FOR BUILDING PERMIT` CITY OF FRIDLEY, MINNESOTA /Fe X _ �1 Owner's-/ Address Address �i LOCATION OF BUILDING No. 9 6 (0 Street 29-9le art of Lot Lot ` Block Addition or Subdivision Corner Lot Inside Lot Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION 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: Front Depth _reDeight Sq, Ft. I, -Cu, Ft. EtyCr. Front Depth ,,'l Height Sq. Ft. y30 Cu. Ft. / Type of Constructions ��`�� Estimated Cost;04. To be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE r -�-�--`-1 - SIGNATURE . 44-� (Schedule of Fee Costs can be found on the Rev re Side). - City of Fridley Application for Plumbing and Gas F•rtting Pernut Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures N NO. RATE TOTAL & x $1.50 12 Number Fixtures ...................... toz Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ t t N WATER HTR. Water Heater (Up to 200,000 BTC) ...... ELEC $ New Ground Run Old Bldg . ............ /7 m V1 3 F C LL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ �O F $ GAS Base r Ist r 2nd _ 3rd 4th • Future Connect9on Openings I Connected with Sewer (� e New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL & x $1.50 $ Number Fixtures ...................... Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTC) ...... x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ 1116"0 City of Fridley: The undersigned hereby .makes application for a permit for the work herein 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. Fridley, Minn. CI , 19". n Owner Kind of Building Used as � /," ` To be completed about o Estimated Cost, $-lazt2j)� Oldew uilding Permit No Permit No. -� Signe 7—A-4 By Business Phone No�� ROUGH 4 ' .2 7 - ( Z FINAL - -08042 2M 7-$9 Application for Power PMnts and Heating, Cooling, Ventilation, ,Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII. 4-7470 GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 each add. 60,000 BTU ... _. .................. 2.00 Replacement of Furnace ............................. 5.00 Repairs & Alterations—up to $500.00 ................. 5.00 Repairs & Alterations each add. $500.00 .............. 2.50 STEAM or HOT WATER SYSTEM City of Fridley: The undersigned hereby makes application for a permit for the work herein 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. Fridley, Minn_ 19 L- $ _ Owner $ Kind of Building Ai!'~ J—:! $-g- �✓✓� $ Used as To be completed about®P Furnace Shell & Lines—to 400 sq. ft. IDR Steam....... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ GAS FITTING FEES: NO RATE ��TOJAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE ROUGH FINAL Estimated Cost, $ ere®" �\ / �d1 U Permit No. 7Z C' '%6 Olduilding Permit No. , DESCRIPTION OF WORK HEATING or POWER PLANTS/—Steam, Hot Water, Warm Air—No Trade Name �L e_S t, Size No ps� Capacity ®� Sq. Ft. E.D.R BTU H.P. r^ Total Connected Load �`"S Kind of Fue>/ x 2 BURNER — irrade Name / y e? 5 Size No. t- / 16 0 Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signe . je�� W 22"� 6 442-1w By / ..&�4e ZM 7-59 Business Phone No- U 6 City of Fridley, Mm. 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: Auzst. 12' 1971 Owner: Steve Hawrysh Builder Same Address _? 6 61Kercry Lane N . E . Address Same LOCATION OF BUILDING No. 266______ Street _Mercury Drive N.E . Part of Lot Lot .^_ 3_ _ Block _ _2_ _..___..__ Addition or Sub -Division Sylvan Hills Plat 4 Corner Lot _.__.._._... __ Inside Lot —__.X Setback Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Shed __ Front 12Depth _ 1 Height 10' Sq. Ft. 288 Cu. Ft. Front . _ Depth Height Sq. Ft. Cu. Ft Type of Construction Frame Est. Cost $1, 261 00 To be Completed 3 weeks 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 forth and in compliance with aril provisions of ordinances of the city of Fridley. .63State SxxrchsrSa In consideration of the payment of a fee of $ 6.00 , permit is hereby granted to Steve Hawrysh 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 ordin4nees of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of builditlga I the city limits and this permit may be revoked at any time upon violation of any of the provisions of Said ordinances. t CIARENCE BELISLE g NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to soe the Building Inspector for separate permits for these items. 4 APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: Z/6y 441�BUILDER: ADDRESS : .2(!ct e , ADDRESS: ly/ NO • C�_ & % STREET • 1'1'16 eC' u.e L LOT: 3 BLOCK: /ADDITION: SV'L. r/AAI 9 LLs At9T CORNER LOT: INSIDE LOT:_SETBACK: SIDEYARD: 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: SI- 61 Front: Al, Depth: .2 Height: /Q Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: Estimated Cost: $ -�%/ 5 ) To Be Completed: CA1 (f 6 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stiict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE:' / i SIGNATURE : Ix� ✓/%y (See Reverse S de For Additional Information.) C,d-e i61 s -- a s Land Planning (4a&"6w7L 6875-9i hnvy aGs uE. Lard Surveying MinnwPo/s ?l, SowsTe5my ENGINEERING, INC. mnlw-w/° Civil & m Uicipiol SOnsef 46066 Enlineeriny Engineers Surveyors -- Mortgage Loan Survey for I. t P 1 ViA-1, � F I { qr a This is o fret md Correct representation afa survey erfhe barmdories o�"fhe lid oboe aFseribed a�4'1/ie /oration o`o//div ln-9s, i('ony, fbrrrm . ari4 0/1 risible enuviothme�s , i`'any, {'rain or on said l�rC. This su^ray rs made ady n tarr�ect�n wiN� v morfy� /an max► dray pbud m lfu p�fy � ao /robi/ify n atwmed crept !d fiieh� a�wr�i mar%o9e or alht�' i�esf or�►i �/ �1r ism srah ma�fyaye. Ha unda�figd wrd a�!cad nn ma�►cvnenfs fare &r�, � the Prirpnse 4�'�ob/�shv� /oiliites arbawdrsry arners. . Md this / ff daj ����e��,x - AP d ? SUBURBAN ENGINEERIAIG, INC. & yinetr wd Surreyors 3e, ' by C(AO .� SUBJECT I City of Fridley ® 442 AT THE TOP OF THE TWINS BUILDING PERM 1 i ` RECEIPT N COMMUNITY DEVELOPMENT DIV. INSPECTION r PROTECTIVE SEC. 1 . � CITY HALL FRIDLEY 55432 IL ,'J NUMBER REV. DATE PAGE OF APPROVED BY ""'A"f 612-560-3450 910-F15 10/17/77 JOB ADDRESS 266 Mercury Drive N. E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3 2 Sylvan Hills Plat 4 SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Tom Clark 266 Mercury Drive N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Milton L. Johnson 2513 Central Avenue 781-9548 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 [j ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Aluminum trim and gutters 9 CHANGE OF USE FROM TO STIPULATIONS 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 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,700 $.85 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- $12.00 STRUCTION OR THE PE RMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE D—�� �� _ $12.85 SIGNATURE OF CONTRA O R AUTHORIZED AGENT (DATE) WH€N PROP 2 r BLDG. INSP RLY VALIDATED THIS IS YOUR PERMIT vy DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEw, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER: 0 "31 ` (/A (L 1C BUILDER: i a 0 1-Y d J Address: 4' 1 �lL C�.L 2 2 /�% Address: S 1 3 e: Aj 7" g B Tel. No. 7 �1 - I s �/ No.: Street: \ A LL LOT: BLOCK: T ADDITION: �y L dA 0 t4i 119 Pe -,q 7 - CORNER CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING Front: Depth: Height: Square Feet: Cubic Feet: Front: Square Feet: Depth: Height: Cubic Feet: Tr 6. Type of Construction: �w ,:, ;,y, ( � u ; „, Estimated Cost: $ l7 o o To Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. See reverse side for additional information. DATE: SIGNATURE: C, Aq, Stipulations: r BUILDING INSPECTION DMSION BUILDING PERMIT REVIEW CHECKLIST AND ROUTE SHEET FILE DATE DUE DATE &"1 0) .114 V& COMPANY NAME C { }PLANNING Barbara Dacy F. l Pe ormance Bond { } ENGINEE John Flora Req'mnts . I Mich le Mc herson iS 1�ti ✓t 04 • ev- pi )n t)14-1 ance with City Council stipulations Fee Required Fees n/Dra Scott Erickson Clyde Moravetz.1W inage Plan Conservation/Erosion Control Plan Fees Stormwater Calculations (Hydrology/Hydraulic) Land Alteration Permit Issued Pond Maintenance Agreement Rice Creek WSD Permit Re wired Easements Required ] Obtained Inspections Sewer Laterals Required Fees Water Laterals Required Fees LEON MADSEN l/- 2 BILL CHAMPA ;, Igo TOM BLAZINA DICK LARSON Return to Mary Hintz Any comments made directly on the routing plan set need to be transferred to the other set located in Tom's office or the plan check room. STIPULATIONS lease PRINT or TYPE clearly): 11 P i . t ' 1 • City of Fridley 6431 University Avenue NE Fridley, MN 55432 Properly owners at 266 Mercury Drive NE, Fridley MN and the property owners at 256 Mercury Drive NE, Fridley MN 55432 agree to have both driveways closer that three feet to the property line between the to properties. Kim and Janet Herrmann 266 Mercury Drive NE Fridley, MN 55432 Clinton and Karen Coppicus 256 Mercury Drive NE Fridley, MN 55432 J SUBJECT P City of Fridley 2 6 5 3 5 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. v COMMUNITY DEVELOPMENT DIV.®� ` � r PROTECTIVE INSPECTION SEC. -T C/� i NUMBER REV DATE PAGE OF APPROVED BY �,� CITY HALL FRIDLEY 55432 L 612-571-3450 910415 7/10/98 JOB ADDRESS 266 Mercury Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 2 Sylvan Hills Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kim/Janet Herrmann 266 Mercury Drive NE 571-5139 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION J7 REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof House & Garage (33 Sq) Tear -off 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. 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 1 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $2,752 $1.37 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- $74.75 Fire SC $2.75 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $78.87 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI EN RO Y VALI A D THIS IS UR PERMIT k -- SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI SL IN SP DATE J NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Z to la M traLry Dr - Legal r -Legal Description: 1 I Owner Name & Address: Kon `I- j �1 t f�C�' ICY WYl ,l� {�l Tel. # 571 — 0 J Contract Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height Length Width Hgt/Ground ENSE # Tel. # Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: Estimated Cost: $ (Fee Schedule. on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: -1 U APPLICANT: Tel. # STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ �� .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $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 $0 d C -1I STIPULATIONS: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 763) 572-3604 FAX: (763) 571-1287 ADDRESS : 266 MERCURY DR NE PIN : 143024320029 LEGAL DESC : SYLVAN HILLS PLAT 4 : LOT 3 BLOCK 2 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : GARAGE, DETACHED PERMIT O.: 2004-00617 DATE ISSUED: 04/30/2004 VALUATION : $ 16,980.00 NOTE: CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. PROVIDE HARD SURFACE DRIVEWAY. SEE NOTATIONS ON PLAN. CONSTRUCT A 24 X 34 2ND GARAGE. APPLICANT HERRMANN KIM M & JANET C 266 MERCURY DR NE FRIDLEY, MN 55432 OWNER HERRMANN KIM M & JANET C 266 MERCURY 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 convect. 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. ADol Ri A Date e A Bldg BUILDING PERMIT FEE 279.25 FIRE SURCHARGE 16.98 STATE SURCHARGE, VALUE 8.49 TOTAL 304.72 PAID WITH CHECK # 2034 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW ADDN ALTER ID LA [ ] CITY OF FRIDLEY [ ] 6431 University Ave NE, Fridley, MN 55432 [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Ai 112 Effective 1/1/2004 (763) 572-3604 Bldg Insp (763) 571-1287 Fax ) q , ��6) �_' I � Tel. # 963-,5'71-6-39 Contractor. b -e MN LICENSE # Address: Tel. # 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 o21 Width Height /0 Sq. Ft. v DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: Lk) ® o 8 Estimated Cost: $ /&, q �/� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 16Y APPLICANT • Tel. #412-261-9,222— / f Call 4/moi-a2%/-c/,22a— Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 [ ] TOTAL $ ®q %a STIPULATIONS: Land Planning a7s-,gOmy Ks A/"E. Lard suwey;7Y mlmwr/s 2/, SodsTestin9 EN G I NEE R I N GI INC. ""q Civil & Mulaipal I SUnsef 4 606b E�inee>ti� Engineers Surveyors — Mortgage Loan Survey for , N Ibis a o b w ax/ carred up,rsmia/ion #Pa sL rmj oflhe bmdaries g the lard abooe described and 4W /oc Av o`oll bwldlhys, iPaq, ldrrran, and od( risible owwchimab, /fany, Al" ar on sold fid. & sorry n MO& Wq n eoWctiar A4 v mA lem new dray pbud m Ae Crawly and w IWWiy >s oJsuncd sxcePt fa I/re /aWer of 'ua w4sye 7X474 nhresf ar �rird by ia+7sm q(' such nnar�O9e. #ri w*s1wd and ayneid an mancontnts fare &gym � �r floe Purpose /o1 /vacs Or" bamdary amens. Paw/If 9(' fl�r:�s.��'?'. AD./9_'. SUBURBAN ENGINEERING, INC. r &Yweer mrd Surretyors ,+ A � •1 r �•, �h h � � L 1 , N Ibis a o b w ax/ carred up,rsmia/ion #Pa sL rmj oflhe bmdaries g the lard abooe described and 4W /oc Av o`oll bwldlhys, iPaq, ldrrran, and od( risible owwchimab, /fany, Al" ar on sold fid. & sorry n MO& Wq n eoWctiar A4 v mA lem new dray pbud m Ae Crawly and w IWWiy >s oJsuncd sxcePt fa I/re /aWer of 'ua w4sye 7X474 nhresf ar �rird by ia+7sm q(' such nnar�O9e. #ri w*s1wd and ayneid an mancontnts fare &gym � �r floe Purpose /o1 /vacs Or" bamdary amens. Paw/If 9(' fl�r:�s.��'?'. AD./9_'. SUBURBAN ENGINEERING, INC. r &Yweer mrd Surretyors ,+ A Building PLUMBING Permit No.: &2 � Inspections RESIDENTIAL APPLICATION Received By - 763 -572-3604 CITY OF FRIDLEYc' 763-502-4977 FAX EFFECTIVE 1-1-08 DATE r°- - -1+ 4 - ©� YOUR E-MAIL ADDRESS h ed• e m aA �nkC. <Li o 1-R .11`e . PLO)S SITE ADDRESS : (Q A THIS APPLICANT IS: KOWNER OCONTRACTOR PROPERTY NAME: i t s moo. ADDRESS: b 1Q IAe rL CITY STATE -RA) ZIP SS `f 2-- OWNER/ TENANT PHONE: Cv 13 - at$ ' SIS07 O. CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDS: CITY STATE ZIP INSURANCE . PHONE FAX PERMIT TYPE ` d SINGLE FAMILY O TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: ❑ NEW II(REPLACEMENT DETAILED DESCRIPTION OF WORK PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x .05 = plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $15.50. BATH SINIUL.AV DRAINS —SHOWER _ WATER PIPING _FLOOR —_BATHTUB GAS PIPING (NEED CITY LIC) _ SWIMMING POOL WATER SOFTNER ($35) _ —CLOTHES WASHER _ KITCHEN SINK_ WATER CLOSET _ BACKFLOW PREV. ($15) DISHWASHER LAUNDRY TRAY NATER HEATER ($35) FOR IRRIGATION WATER METER —OTHER .. Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ OR Number of fixtures @ $35.00 x $35.00 = $� TOTAL DUE $ State Surcharge = $ .50 MINIMUM $15.50 (MINIMUM $15.50) Total = 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 sof Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and wrk is not to start without a permit on site; that the work will be in accordance with the approved plan in the casp of all work which requires review and approval of plans. SIGNATURE OF APPLICAN PRIAIT NAME eft inn M • P%°'yy?40 4 DATE !� Ir. APPROVED BY 'City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 DATE Building MECHANICAL Permit No.. Inspections RESIDENTIAL APPLICATION Received By:, 763-572-3604 CITY OF FRIDLEY n 'd J 763-502-4977 FAX EFFECTIVE 1-1-08 / /� DATE dB /A 0 YOUR E-MAIL ADDRESS �1? ! �!f/° Or7d di e t > Af5lZ/+ Cr SITE ADDRESS 'A �f✓C THIS APPLICANT IS: ❑ OWNER `CONTRA TOR PROPERTY NAME:� �� OWNER/ .j? ADDRESS:�d CITY STAT IP TENANT PHONE: L CONTRACTOR COMPANY NAME: 7i -4 �'� � �% �✓� ' CONTACT PERSON: NOTE: SEPARATE CITY LICENSES ARE REQUIRED FOR GAS STATE LICENSE # EXV DATE STATEN ZIP $ /� AND HVAC. DRESS: CITY SUBMIT COPY OF BOND PHONE �°' FAX l AND INSURANCE PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DES RIP ION OF WO /Z �j,A ` PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) OR Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) �� Equipment Installed MFG: �� MODEL: 649'14TIC, e, SIZE/BTU ^/ MFG: '0I MODEL: �e� ' SIZE/BTU y MFG: 6` /SIZE/BTU MODEL: SIZEBTU tl--A/C $25.00 (GAS) $15.00 _GAS RANGE/OVEN $10.00 _FIREPLACE TO AIR EXCHANGEER $15 IREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _AIR $35.00 �URNACE $35.00 _GAS UNIT HTR $10.00 _BOILER LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.00 _CHIMNEY � DUCT WORK $10.00 V_GAS PIPING $10.00 _VENTILATOR $15.00 77 Qvp Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge 0 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ OR Number of fixtures @ $25.00 x $25.00 = $ _ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 MINIMUM $15.50 MINIMUM $15.50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a mechanical 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 accordm& wi Vapo:ved� in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICA ��° PRINT NAME � t' `�Di �'� G 0 _DATE APPROVED BY DATE MARIsz s �... _bum �, - �.... _....„ City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-5024977 f '4 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations. Building MECHANICAL Permit Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY D°IU 0 763-502-4977 FAX EFFECTIVE 1-1-08 DATE f �-M - YOUR E-MAIL ADDRESS SITE ADDRESS oc i6 i e M ellCt t (ZLI 1 ,Oe_ THIS APPLICANT IS: OOWNER ❑CONTRACTOR PROPERTY NAME: V rvn0.Y'%' ADDRESS:a(*Le 14eyQ-%,krf'-1 bk, -CITY. � STATEMO-)ZIP SSt( OWNER/ TENANT PHONE:(,.q2- CONTRACTOR COMPANY NAME: NOTE: SEPARATE CITY CONTACT PERSON: LICENSES ARE STATE LICENSE # EXP DATE REQUIRED FOR GAS AND HVAC. ADDRESS: CITY STATE ZIP SUBMIT COPY OF BOND PHONE FAX ANDINSURANCE PERMIT TYPE • XSINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW ❑ REPLACEMENT b<ALTERATION/REMODEL DESCRIPTION OF WORK Ck- cI � 5 At 'f 5-44- '40 5k DETAILED T PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) OR Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) U Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU MFG: MODEL: SIZEBTU A/C $25.00 (GAS) $15.00 _GAS RANGE/OVEN $10.00 _FIREPLACE _AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 W/ S UNIT HTR $10.00 BOILER $35.00 _FURNACE $35.00 CHIMNEY LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.00 WORK $10.00 GAS PIPING $10.00 _VENTILATOR $15.00 _DUCT r09 a ft xaM- Permit Fee $ 1:20. dhn Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ '�ZD • _5D OR Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 MINIMUM $15.50 MINIMUM $15.50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a mechanical 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 quires review and approval of plans. start without a permit; that the work will be in a rdance wi the approved plan in the case of all work which r/(,n4 �J�1V M Q VK DATE I � `6 Aq SIGNATURE OF APPLICANT, PRINT NAME • APPROVED BY DATE ."*121001 111-22 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building BUILDING Permit No.:200q--0,4113 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd 763-502--4977 FAX EFFECTIVE 1-1-09 17 DATE — q — oq YOUR E-MAIL ADDRESS k i w n tr-a .+i n a L Corn ois -, net I _ ermu Drble, 4_0 SITE ADDRESS 2-WeM THIS APPLICANT IS: W6;kNER ❑CONTRACTOR PROPERTY OWNER/ NAME: Vim Herr mann TENANT r ADDRESS: 1p d�PX(,U1'�l Drive_ CITY Fri STATE—kg-zip 55432 PHONE: 142-201.!9Z42. CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED 5MINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING l%rOTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR Gni ODELING DESCRIBE WORK BEING DONE: W s) SIZE OF IMPROVEMENT LENGTH WI TH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES 11 HOUSE & GARAGE 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 ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS O(Yes ON, LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF ihrpu&hnL t OPENING CHANGES & A pwnlrl 13 TYPE OF, WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALLTATION, INCLUDING THE COST OF LABOR AND MATERIALS: SING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ q Al � OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge 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) $2000 per SAC Unit (Plans to MWCC for determination) -ft +6 ft= ftx$22=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) I l650�;— Make checks payable 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 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 al work which requires review and approval of plans. c SIGNATURE OF APPLIC PRINT NAMErt%)%k M . �6r*_IC AVI DATE g " d Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604CITY OF FRIDLEY DateWM: � fi 20 763-502-4977 FAX EFFECTIVE 2-19-09 DATE 8'4'OQ YOUR E-MAIL ADDRESS ki wntraL+; SITE ADDRESS 266Pr('. aUJ� r 1111✓ THIS APPLICANT IS: ER ❑CONTRACTOR PROPERTY NAME: Yj m Ner rma nn OWNER/ ADDRESS: 2" Mei utg 'DrLVl° CITY r f i� d [eel STATEWZIP2 TENANT PHONE:_ LIZ.2OI.4ZA2 CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX N/ PERMIT TYPE JINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW VkEPLACEMENT DETAILED DESCRIPTION OF WORK nfxzW fur- re-mcdtf FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. 2, BATH SINK/LAV _FLOOR DRAINS SHOWER WATER PIPING _ _ 1 BATHTUB _ GAS PIPING (NEED CITY LIC) _ SWIMMING POOL _ WATER SOFTNER ($ _ CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREY. $1 _ DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION _ WATER METER —OTHER F ry _, `i � „�'''�� I°.. T g�7E � hm" �i t .$ S =� y., ✓?. Y- N�j.�, S5. �" 3L } �?,�i� �l"�'' Y-�e'a�S��y �^ � az tis 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 c e of all wok which requires review and approval of plans.. _ 1�`� SIGNATURE OF APPLIC A. AC `NL 9-T'0? - PRINT NAMRI C k M DATE 0 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977