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PRE 2010 DOCS11T° 4984 Original Permit f®r IrLUMBING AND GAS FITTING '-I d-1- A`7 N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for Permit inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit., Fee $ � � O DESCRIPTION OF WORK Number, Kind and Location of Fixtures City o f Fridley ,19 K pj a .ayi W m Y F m E W = G W WATER HTR. Stories F O Z F m m Y N} Z� O O Q F 0 D Permission is hereby granted to do the plumbing and gas fitting in the building described in the stat4nent hereto attached, upon the express condition that the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and this permit may be revoked at any time upon the violation of any of the provisions of said ordinances. By Order Of The Inspector Of Buildings Roughing in Inspection Date Inspector. Final Inspection Date + Inspector. 42 IM -6-68-V Me'. D 9 V Location 6 Vn Kind of Building A Used as To be Completed—, 19— Estimated Cost Old -New. Building Permit No. Date Inspector of Buildings. Q J U X O Q O m F Q M Z N Q 0: 3 F a0 O W I N J K LL O W Q Q U m Z� Q O a J _m x 0 y Q IL 2 Q a GAS ELEC. Basement Ist 2nd 3rd 4th Connected with Sewer -Cesspool Gas Piping for Openings D Permission is hereby granted to do the plumbing and gas fitting in the building described in the stat4nent hereto attached, upon the express condition that the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and this permit may be revoked at any time upon the violation of any of the provisions of said ordinances. By Order Of The Inspector Of Buildings Roughing in Inspection Date Inspector. Final Inspection Date + Inspector. 42 IM -6-68-V Me'. D 9 V Location 6 Vn Kind of Building A Used as To be Completed—, 19— Estimated Cost Old -New. Building Permit No. Date Inspector of Buildings. City ®f Fridley ApplicMian Dept. of Bldgs. Phone 360.3450 DESCRIPTION OF WORK Number, Kind and Location of Fixtures WATER IITR. 01 31f`9 N GAS ELEC. Base lit -- — — 2nd 3rd _ ¢ 4tla _ - -- ruture Connection Openings Connected with e Now Fixture, Old OpeningsSewn I Cesspool O PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...... .. .. ....... x $2.00 $ Future Fixture Opening .... .... ...... x $1.50 $ New Fixture Old Opening ......... .. x $1.50 $ Catch Basin ... ....... ....... x $3.25 $ Water Heater (Up to 98,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg. .... .... x $3.25 $ Electric Water Heater z $2.00 $ GAS FITTING FEES: NO. RATE TOTAL let 3 Fixtures .......................... x $2.00 $ Additional Fixtures . .......... , ....... —x$.75 S Gas Range to 198,000 BTU .............. x $5.00 $ REPAIRS B ALTERATIONS—Refer to Code Description ................................................$ .� TOTAL FEE $ ' 0-0 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 all the fact and representations stated in this application are true and correct Fridley, Mnn °" 19 Owner Kind of Building Used as To be completed about Estimated Cost, $ J/ Old—New. Building Permit No. Permit No. 7 �� 1 Signed- By./ igneBy ll Business Phone No ROUGH FINAL --k– 2 � - � U SUBJECT PERMIT_N.. City of Fridley 2 0 6 AT THE TOP OF THE TWINS BUILDING PERMIT Ir � RECEIPT NO. t � • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 0 Zv( r NUMBER REV. DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 ,'j 612-571-3450 910415 10/2/90 JOB ADDRESS 840 Mississippi Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1-5 4 1 Florence Park Addition to Fridlev SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James Kelley 840 Mississippi Street N.E. 571-7786 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑X REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling (30 Squares) 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can he 2nd layer but not 3rd. Install ridged galvanized valleys. On all new roofs or tear-offs and replacement roofs, State Code requires that 2 layers of 15 Ib, felt, mopped to6ether, be installed to a point 24 inches up from exterior wall line, or the use of other approved underlayment membrane. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING S0. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN BO 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 $1,500 $.75 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- $35,00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE 'lore SC $1.50 $37.25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT ]DATE] `- WHEN PROPERLY V fIDATED THIS IS YOUR PERMIT O� A SIGNATURE OF OWNER OF OWNER BUILDER] (DATE) l ]NSP JOATLF NEW [ ] ADS [ ] ALTER [ ] Construction Address: R-1 AND R-2 Building Permit Application '0"' �� 257" Effective 8/16/90 �^ Legal Description: Owner Name & Address: �/ Tel. # contractor: (/� �C S 4OIA" W UX y Tel . # 4 /` Address:. l/ Ye, ";" ? l r`s� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. L'IV3= AREA: Length Width Height Sq. Ft. GAME AREA: Length Width Height Sq. Ft. DECK AREA: Lexxfth Width Hgt/Gr and Sq. Ft. Corner lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ it I _4z;0®.06 Approx. Caopletion Date: Proposed Driveway Width If New Opening Is Desired: Ft. $ $ J 'dth + 6' See Back Page DATE: 1� " APPT TC M: Tel. # CITY USE MZ Permit Fee Fire Surcharge State Surcharge SAC Charge Driveway Escrow Park Fee Sewer Main Marg TIPULATIMS : $ e 00 Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th �) $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 1 Dov S"0 ri� Ps. ®V )ate 3's4u CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 - r APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Effective On May 10, 1999 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR :::�`��' Urinal ��-: ::$, . Shower ��'�.:::.. %�'�t'�' Wash : �: t1 � :: bf'1:..�=�:.. lrQ�tCllr�........ Floor Drain :.:�.;:::.::>:.:<: Auto. :��i�'�.. �...... eft:':': Washer ��: ��:�:i::.::::. Gas : Water Heater ::;ryY:{�iy:?: Ran a i�::�r:::::::� Gas Elec S tones .... Basement t Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS(6 / CJ /,// / ss/S'51"'1 New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $ 7.00 The undersigned hereby makes application for a prn for the work herein $ 4.00 specified agreeing to do all work in strict accorda ce wi the city codes $ 5.00 and rulings of the Building Division, and herebyAdeciar that all th fa $ 7.00 and representations stated in this application are true d co t $ 7.00 $ 7.00 ,1999 $ 7.00 $10.00 Owner (, IIV $ 7.00 x- $10.00 Building Used $10.00 $10.00 Estimated ost PERMIT NO. $15.00 PLUMBING CO P NY Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance 13 . S SIGNED BY NO. ��'�-�- lIzI- Approved By Rough -In Date Final Date 'v2 State Surcharge S .50 TOTAL FEE PLUS THE TATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED A/PER SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ I S/�J/'— . "r//4- w f� 1f111w� '�/ �v SUBJECT City of Fridley 733078 AT THE TOP OF THE TWINS BUILDING PERMIT r ` RECEIPT NO. `L -------COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. ��-36®t�E� F� CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BV l J` 763-571-3450 910-F15 9/12/02 JOB ADDRESS 840 Mississippi Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,2,3 4 Florence Park Addition to Fridley SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ted & Kari Ciardelli 118 Craig Way NE, Fridley, MN 55432 763-572-2370 J CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Beaudette Construction Inc 1913 120 Lane, Blaine, MN 55449 612-867-7818 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 Gk NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct 24' x 20' Slab for future garage 9 CHANGE OF USE FROM TO STIPULATIONS See stipulations on LS #02-02 for lot split. Garage must be removed from Parcel B by December 1, 2002. Existing bituminous drive from Van Buren must be removed, curb restored, and turf restored prior to December 1, 2002. Grading/drainage plan to be approved by City Engineering Dept. Hard surface driveway exists except for apron which must drain toward driveway. M 15 WARNIM Before digging call folf all utility locations 4540002 REQUIRED BY LAVA SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 1 HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAM BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES OVE NTNG THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER THE GRANTING $1 900 $.80 PECIFIE HEREIN OR NOT, OF A PERMIT DOES NOT PR LIME TO IVE AUTHORITY TO IOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS F ANY HER TE OR LOC LAW REGULATING CON- $66.20 Fire $1.90 STRUCTI N R THE FOR A CE OF CO RUCTION .SC el PLAN CHECK FEE TOTALFEE City License $68.90 5� NATURE OF CON"RACTOR OR AUTHORIZED AGENT IOATE, MEN PROPERLY VALIDATED THIS IS Y UR PERMIT iNSo riAYE $,GNATURE OF OwNER,'F OWNER BUILDERS iDATEI NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN (] 6431 University Ave NE, Fridley, MN 55432 (763) 5723604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION L� Construction Address: < (91� ( SS Legal Description: - 2- 3 o �� .p ��- lL DAO" Owner Nam Address: �� Co i Tel. #� 3 �� Contractor. t4-10�C MN LICENSE# 1 l (7 � - Tel. # 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 Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft Construction Type: Estimated Cost: $ 1 tti4 /t'a Driveway Curb Cut Width Needed: + 6 Ft = Ft x $ _ $ DATE: - l 'L APPLICANT-.L,4'(V1L'4't QC-(` Tel. #�� ?�'` -C-)` Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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 $ &8. go------------ ` STIPULATIONS: G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 CITY COUNCIL ACTION TAKEN NOTICE August 28, 2002 Ted & Kari Ciardelli 118 Craig Way NE Fridley, MN 55432 Dear Mr. & Mrs. Ciardelli: On August 26, 2002, the Fridley City Council officially approved your request for a Lot Split LS #02-02, to have two separate lots, legally described as Lots 1, 2, 3, 4, 5, Block 4, Florence Park, Lots 1-5 together with %2 vacated alley adjacent there to, generally located at 840 Mississippi Street NE. Approval of this Lot Split, LS #02-02, is contingent upon the following stipulations: 1. Property owner of record shall obtain all necessary permits prior to construction. 2. Grading and drainage plan to be approved by City's engineering staff prior to the issuance of any building permits, in order to minimize impacts to the surrounding properties. 3. Provide proof that any existing wells or individual sewage treatment systems located on the site are properly capped or removed. 4. Property owner of record at time of building permit application, to pay required park fees prior to issuance of building permits. 5. Property owner of record at time of building permit application, to pay all water and sewer connection fees prior to issuance of a building permit. 6. Garage must be removed from Lot "B" by December 1, 2002. 7. Existing bituminous drive from -Van Buren must be removed, curb restored, and turf restored prior to December 1, 2002. Action Taken Letter — Ciardelli Page 2 August 28, 2002 If you have any questions regarding the above action, please call me at 763-572-3590. Sincer ly, s I Sc Yi kYi k Community Development Director SH/jt cc: Address File Assessing Dept. GIS Dept. a a�T Please review the above, sign the statement below and return one copy to the City of Fridley Planning Department by September 9, 2002. Concur with action taken. C-02-108 09/11/2002 12:14 6' Y0 � I o -F /NEk✓ s /oL,b 5116/818,6306 HOLIDAY INN EXPRESS PAGE 01/01 f OR YGD G\ I�-ct..oCl.l-..� CM 788-9769• W MW ,au -re I 'HERESY CERTIFY THAT THa5 SURVEY, PLAN OR REPORT 0 3 0 DATE Se- 1% —O'1 --- VAS PREPARED VY NE OR tMMLW DIRECT stPERV I S I ON o = IRON MONWENT �'-C AND THAT 1 AM A DULY LIC S LpN URv�OR UNDER • , TSTA E OF uIMI ROTA. SCALE IN FEET Randy L. b h. .U. S. No. D770 Qeo,?O&jCC10 'KMOV� Sv��ly1S10N Russell J. Kurd I.L.S. No. 16113 _YRS?Ait�C �ut_�1 b Z00L MASS - 3� 1 m N p 9 a --- _-._-_ > ON o >r Q 0 m�o xa� 0.t1 ado `— 7I'lLS.ST � 28 tx' ; ' 13.6' Slate _ - 40 r.01 WL ' IL E w t— •• �- t �. c70 q2! To- p 1�, 'G �✓ a9 �cWa�.rt�isv. FQ.+aF hq 2 )14 A*?- tr to EXISMG LE L DESCRIPTION Lata 1 thru S, Blod, 4, Florence Park, Anoka Courcy, Minnsso>'s. together with 1/2 vacated alley adjarest thereto. 4 - PROPOSED TR C r A Lacs 1 tlhtu 3. Bl 4. Flotence Pant Anoka County, kimneaotR, toadlua with V2 vacated alloy edjaeanttIterwo. dL &OW -S 4VI PROPOSED TR CT 13 Lots 4 and S, Block 4, Florence Park. Anoka County, Minnesota, together with 1/2 vacated alley adjacwt thereto. �� e17 S d�1 �# `--(' l 0 NEW (J CITY OF FRIDLEY Effective 1/1/2002 ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 5723604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: ii /(,"Ss i .S5 1 mv, Legal Description: 1-.5- Owner -.5Owner Name & Address: /r Tel. # -703-5-7-2-D-3-70 Contractor. a* 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 Width Height Sq. Ft DECK AREA: Length Width Hg Ground Sq. Ft OTHER: Construction Type: stimated Co : $ Driveway Curb Cut Width Needed: �� Ft + 6 Ft = �f Ft x $ �-7- _ $ , �tu DATE: 9-0 -o;,-' APPLICANT, Tel. # 14-3-9-/�-2370 Call (763) 572.3604 for Permit Fees if mailing In application or 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 Driveway 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 $1200 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 $ STIPULATIONS: CoNcRL j'V- 30`-1 I I 1 s N p C -NMA -1- K. �,33.50 � •J J . N ILit j �,S �� r P AClbA1' , _ _ Litt_l Oott_Y3— 1 ' F -I uj 1 _ o v S • 133 ,15 4- ct-� rn. N L�Nt� � a rt c. C .• ' 1 > l GSC-._ %C) . 3 co — 4'L—' 0 7 WOOD 2� 133 ,15 4- ct-� rn. N L�Nt� � a rt c. C .• ' 1 > l GSC-._ %C) . 3 co — 4'L—' 0 00 ;?C-9 NEW [ ] CITY OF FRIDLEY ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: �)-- L/ () /'h � N SS/ Legal Description: Owner Name & Address: � Tel. # 42 SI . ?4;10 Contractor. L//-/ / 7 /.,� 70 r'� jVA MN LICENSE # Address: Tel. # z/,2 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 Hgt/Ground Sq. Ft. OTHER: Construction Type:Wh/ Estimated Cost: $ Ll 00— Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 3 - 0G/—O�;- APPLICANTTel. 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. CITY USE ONLY - Permit Fee Plan Review $ 12 Fire Surcharge $ State Surcharge $ SAC Charge $ License Surcharge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ - ('08 Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1450 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 [ ] STIPULATIONS: Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY V 2 7007 DATE ®C • - YOUR E-MAIL ADDRESS 4 LAA SITE ADDRESS THIS APPLICANT IS: ❑ OWNER (CONTRACTOR PROPERTY NAME: OWNER/ _ ADDRESS: Ll Z.1 / kV V �h CITY C� STATF ZIPSSS�.�� TENANT PHONE: CONTRACTOR NAME: SUBMIT A COPY OF STATE LICENSE # lr=40f 1514'%ATE YOUR STATE ADDRESS: CITY STAyy0ZIP LICENSE WITH PHONE 'Z r/ &—WF7 FAX G – CJ APPLICATION INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE PERMIT TYPE TYPE OF WORK: tgoEw ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK ADIP r✓► 7 t� �r rt:A44 , 5'A& . 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 ) 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) I BATH SINKILAV _FLOOR DRAINS SHOWER _ WATER PIPING _ GAS PIPING ovmo urrucmm) _ SWIMMING POOL _ WATER SOFTNER ($35) —BATHTUB _ CLOTHES WASHER _ KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($15) DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION _ WATER METER OTHER yam[ ,.: �.yl. �. .:NO; Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ SCS. 0-0 Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ State Surcharge = $ .50 Total = $ JD Z7 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 e 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 d 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 requ es review and approval of plans. '�gg / SIGNATURE OF APPLICANT PRINT NAME _Z6 DATE/ e City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL Permit No.: - W Inspections RESIDENTIAL APPLICATION Received By: 7N�� 763-572-3604 CITY OF FRIDLEY Date Rec' / 763-50�27-4977 F(AXy EFFECTIVE 1-1-09 DATE L' �J " V"I YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: XOWNER ❑CONTRACTOR PROPERTY NAME: K_n RE ID M A N t1j OWNER/ ADDRESS: �� YY7�$_. CITY STATE ZIP TENANT PHONE: CONTRACTOR COMPANY NAME: CONTACT PERSON: SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: CITY STATE ZIP APPLICATION PHONE FAX PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK' ANEW ❑ REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK p>O\SQ A 0 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 ) 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: SIZE/BTU MFG: MODEL: SIZEBTU MFG: MODEL: SIZE/BTU _AIC $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 _AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _BOILER $35.00 _FURNACE $35.00 HTR $10.00 =UNIT CHIMNEY LINER $10.00 _GAS DRYER $10.00 L HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 r• VENTILATOR $15.00 10 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 _ Total = , � THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. ) } SIGNATURE OF APPLICANT f/t �✓ PRTNT NAME�b-r 6 �� / n .TE - / J " City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC 0 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 PLUMBING Permit Note -W Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: Wit,— t 3-0 763-502-3604 FAX EFFECTIVE 1-1-09 DATE 2- - I _ V YOUR E-MAIL ADDRESS SITE ADDRESS r..: ' pi THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY NAME: - - 0 (Yl TENANT ADDRESS: 3 T O Y� Iv,�� 1 �S i'o,� / 5r ✓`V'CCITY / r?� e STA P N z 2 PHONE: " � �� " `71P 0 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 PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ANEW ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK $Q 1'YLG eafil F0C) M 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 ) 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 SINK/LAV _FLOOR DRAINS X SHOWER X WATER PIPING —BATHTUB _ GAS PIPING (NEED CITY LIC) _ SWIMMING POOL _ WATER SOFTNER ($35) —CLOTHES WASHER _ KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15) _ DISHWASHER _ LAUNDRY TRAY HEATER ($35) FOR IRRIGATION _ _WATER WATER METER OTHER sot, .. #� ��sp.. ^�✓, �./��il, .<_ �'�':, rs' �� Q - Yi e�, �, • �� ,„,°�F �� .._ .W„ ,,, � Permit Fee $ .�. , . Y k- ., _ .... , Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ State Surcharge = $ :�O .50 INIMUM $15.50) (MINIMUM $15.50) Total = $ 'G 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 of alll wo(rkh ich requires review and approval of plans. �casee Q SIGNATURE OF APPLICANT ' J�^ lel eCZ617_ �� PRINT NAME ��/ l C ! J 1��PE / City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building $ �38'75^ BMIjBING ' Permit No. "00 Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION Received By: 763-572-3604 Surcharge CITY OF FRIDLEY Date Rec'd: ,;)—(-3 763-502-4977 FAX $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) EFFECTIVE I-1-09 $ DATE Z ` G.7) " Q� YOUR E-MAIL ADDRESS SITE ADDRESS V4 0 n )'s s! Park Fee _ THIS APPLICANT IS: gOWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: W 7 ADDRESS: 0 J n 1 S S' S S yQ CITY L STAT ZIP C - TENANT' Make checks payable to: City of Fridley Attach Stipulations PHONE: 6 I Z- Z51- 7 6 0 2 CONTRACTOR NAME: S 'rC L STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE 3,SINGLE FAMIL SIZE ❑ TWO FAMILYINEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILEEC{ ,d- Q ry-),� ❑ DECK ❑ SIDING4 OTHER ((�� _ r*� � K.OG (n N z� 0 ❑ SWIMMING POOL I — TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR J4 REMODELING DESCRIBE WORK BEING DONE: vE6RrQ-®lam SIZE OF IMPROVEMENT LENGTH WIDTH I HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE I. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS. & PORCHES SUBMIT: ❑ Vinyl ❑Soffit I. Site Plan/Survey showing the existing structures ❑ Aluminum ❑ Trim and proposed project. ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 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: SING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 100o, o G OCCUPANCY TYPE Permit Fee $ �38'75^ See Back Page for Fee Schedule Plan Review $ 2.51 ( 65% of Building Permit Fee Fire Surcharge $ 114CX3 .001 times the total job valuation Surcharge $ ��? .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 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 $ (nS', 44 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 w rk which requires review and approval of plans. �� ,% (� SIGNATURE OF APPLICAN . Ll ek-? G PRINT NAME �j Aid! /1 m TE - 1