PRE 2010 DOCSibing gas heating,
�s.
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Effective On January 1, 1991
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
11
JOB ADDR
RATE SCHEDULE
"Air Conditioning - All Sizes $ 10.00 $
All Others/Repairs & Alterations (LIST ON BACK)v 0 I;
1 % of Value of Appliance or Work d_�-, $ /S0
► _A_ , /a It,
Commercial/Industrial
1 % of Value of Appliance or Work $
State Surcharge $ .50
TOTAL FEE $ A CIO
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (Hot Water)arm?AkTrade Nameri L� SizeNo. 6�aao
BTU _ HP_ EDR
Fuel `7' Gov Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
HEATIN
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 Signed
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
"Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Tel No.
Approved By ( Rough -In Date Final Date l6)' ZZ --I (
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
The undersigned hereby makes application for a permit for the work
Residential
Rate
TOTAL
herein specified agreeing to do all work in strict accordance with the
Furnace Shell and Duct Work, Burner -
city codes and ruling of the Building Division, and hereby declares
Also Replacement Furnace
$ 20.00
$ 2�2�0 Q
that all the facts and representations stated in this application are
true and correct. 9- .9- 91991
Gas Piping (Needed with neW furnace)
$ 10.00
$
OWNER
Gas Range
$ 10.00
$
BUILDING USED AS
Gas Dryer
$ 10.00
$
ESTIMATED COST PERMIT NO.� _
"Air Conditioning - All Sizes $ 10.00 $
All Others/Repairs & Alterations (LIST ON BACK)v 0 I;
1 % of Value of Appliance or Work d_�-, $ /S0
► _A_ , /a It,
Commercial/Industrial
1 % of Value of Appliance or Work $
State Surcharge $ .50
TOTAL FEE $ A CIO
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (Hot Water)arm?AkTrade Nameri L� SizeNo. 6�aao
BTU _ HP_ EDR
Fuel `7' Gov Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
HEATIN
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 Signed
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
"Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Tel No.
Approved By ( Rough -In Date Final Date l6)' ZZ --I (
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
ft
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes 00 No ( )
2. Is free from rust or deterioration Yes (- No ( )
3. Has no foreign objects lodged within Yes (K) No ( )
4. Is securely supported Yes ('J) No ( )
5. Meets all current Code requirements for
size and total BTU's connected Yes No ( )
6. Has total heating BTU's of Q) /ir O �l
All other BTU's
TOTAL BTU's
Remarks 1%
W -,o-
List Alterations Being Done:
HEATING COMPANY G
Signed By
Date
HEAT --LOSS CALCULATIONS DEPARTMENT OF BUILDINGS
Weatherstrips A.S.HN.. Construction No.
Guide
Windows Doors Reference 1,1 Out. Wall TInt. Wall Ceiling Roof Floor
y'es-FoI e� s— o 19.__
FII7,—
I-- Rneirrt L.enath If Width/0 Height p' 11
Windows and Doors—Crackage and Area
3 ( lie
lCoef.1
w 1.11h Height I No. of Lineal ft. Area
NO, or Dane of pane lights of crick 11q ft.
2 3r 2�zl
3
/ 362
/
Glass
aw
S
d &/
Coef.
Btu
Infiltration
31(-
Net exp. wall
Glass
/
l
am
Glass
Exp. wall
S",)[
Ceding (/
M
900,49
wall
i
/ n I . o___ It ---.L 017
ar:J.L
r%
LJ_:_L. -A-
_Exp.
Net exp. wall
Floor
3
/
2y' -
Int. wall
%%
Ceiling
lix
Floor
_Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
FI.14ZO Room I Length,ff Width
Windows and Doors—Crackage and Area
width Height No. of Lineal rt.F2.0
Ara&
N.r. or pane of pane Il.hta of crackw. ft.
� 2-0z �/
Windows
Windows and Doors—Crackage and Area
3 ( lie
lCoef.1
Btu
Infiltration
3
3f
/
Glass
aw
S
d &/
Exp. wall Cy
Exp. wall
31(-
Net exp. wall
Glass
/
l
Int. wall
3
Exp. wall
S",)[
Ceding (/
M
900,49
Floor 1,91-1
Total Btu.
Required s% ft. E.D.R. or sq. ins. W.A. Leader area
i
/ n I . o___ It ---.L 017
ar:J.L
Ceiling
LJ_:_L. -A-
Windows
Windows and Doors—Crackage and Area
3 ( lie
Windows and Doors—Cra kage and Area
Width HeightNo. of Lineal ft. Area
No of pane of pans liffhte of crack sq. ft.
Z
s /04'
Exp. wall 'ef—
/
Net exp, wall 1i
Coef.
Btu
Infiltration
Exp. wall
31(-
Net exp. wall
Glass
Floor
L09 117
-710 3
3
Exp. wall
S",)[
Required sq. ft. E.D.R. or sq. iris. W.A. Leader area
1 ew I rs 1 r I_ _ .r
Net exp. wall
Int. wall
133
/
/
Ceiling
Floor
3
Z
Total Btu.
sq. ft. E.D.R. or sq. ins. W.A. Leader area
Insulation
How
R... m Ilii,pmoth // Width /a Height
Windows and Doors, --C, aekage and Area
3 ( lie
Windows and Doors—Cra kage and Area
Width Height N� , M Lineal ft. Area
No. of pane of pane 11 :4111 or crack sq. ft.
16 ill- 04
s /04'
Exp. wall 'ef—
/
Net exp, wall 1i
Coef.
Btu
Infiltration�t
Exp. wall
Ceiling
Net exp. wall
Glass
Floor
L09 117
-710 3
�
Exp, wall
7 1
Required sq. ft. E.D.R. or sq. iris. W.A. Leader area
1 ew I rs 1 r I_ _ .r
Net exp. wall
133
/
/
Int. wall
Ceiling
Floor
%%
Total Btu. 1 I. —
Required sq. ft. E.D.R. ora . ins. W.A. Leader area
Fl.l Room I ngth /ZWidt
Windows and Doors --Cr ckage and Area
Width Height No or Lineal tt. Area
No. or pans of pane Ili to or crack aq tt.
Infiltration
3 ( lie
Windows and Doors—Cra kage and Area
Glass
-w
Exp. wall 'ef—
/
Net exp, wall 1i
Infiltration
/%
Int. wall
Exp. wall
Ceiling
Net exp. wall
Floor
L09 117
-710 3
Total Btu.
Floor
7 1
Required sq. ft. E.D.R. or sq. iris. W.A. Leader area
1 ew I rs 1 r I_ _ .r
VVPJ.L /
rt.l ewvm 1 Wean �. •....
....e... v
Windows and Doors—Cra kage and Area
Width Hot It No. Lineal It. Area
No. of pane of pea* Ilih of crack w. ft.
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
7 1
Total Btu. 11
Required sq. ft. E.D.R. or sa. 16s. WA. Leader area W1 3
SUBJECT
P
City of Fridley
2 69 9
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
4/9eo
r
NUMBER
REV
DATE
PAGE OF
APPROVED BY
i I CITY HALL FRIDLEY 55432
----�
612-571-3450
910-F15
8/5/98
JOB ADDRESS 1428 Mississippi St
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
7
1
1 Spring Valley Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Marguerite E Pratt 1428 Mississippi St
571-8136
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Owner
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 REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house 10 S Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building
Code.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED 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 80 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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
834
.50
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$32.00
.84
PLAN CHECK FEE
TOT L FEE
33.3
SI NATURE OF CONT RACTOROORRjA'UTHORIZEgD.�AyG��EGyNTT.- IDATEI
N P DP
ALIDA TNI$ I
UR PERMI
BL NSP
PATE
SG ATUR F OWNERUF OWNER B ERi IDATEI s
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FANIILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION (Q�
0
ConstructionAddress:
Legal Description:
Owner Name & Address. Tel. #��� �`/ 3 4
Contractor:. 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 EMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: 11-3 f o Ai,., , ,,moi
Construction Type:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Estimated Cost: $ 8�3
(Fee Schedule on Back)
Ft x $ = $ -
DATE: APPLICANT: 6 Tel. # 7 /--,ql 3
CITY USE ONLY
Permit Fee $ 2c� OCC Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge
$ ,S3
$.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
$ =33 3
STIPULATIONS:
SUBJECT
P .
City of Fridley
2 7 0 7 0
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
______ COMMUNITY DEVELOPMENT DIV.
1 L PROTECTIVE INSPECTION SEC.
�� 9
r
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910415
8/10/98
JOB ADDRESS
1428 Mississippi St
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
7
1
1 Spring Valley Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Mar uerite Pratt
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Best Siding Co 1310 154 Ave Ham Lake 55304
413-0500 2846
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 $X REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside house and soffit & fascia
9 CHANGE OF USE FROM TO
STIPULATIONS
Call for building wrap inspection before
covering.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
4702
$2.35
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OgfvANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTI HE PERF09MANCg OF CONSTRUCTION.
$99.75
Fire SC $4.70
Q/
0
PLAN CHECK FEE
TO L FEE
®
7;p!*
ice S$5-W/111.80
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (FATE,
N R P
M
LID T THIR-71-Te-
j1r
11
OF OWNER I$F OWNER BUILDER$ IDATEI
SIGNATURE
BLPG INSP
BATE
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION � 70 74
ConstructionAddress:
Legal Description:
Owner Name & Address: '4 e f e Qr4 Tel. #_
Contractor: MN LICENSE #
Address: A",- 4-4 to 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 Hgt/Ground Sq. Ft.
OTHER: r@ S; A e AA D S So -)q;4 cL-1+-&,-i x
Construction Type:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
DATE: J ��
Estimated Cost: $ V 76,;2
i
(Fee Schedule, on Back)
Ft x $ _ $ -
APPLICANT: � /.,— & 4 's Tel. #
CITY USE ONLY
Permit Fee
$ Ct r? - 71/
Fee Schedule on Reverse Side
Fire Surcharge
$ y. 7 0
.001 of Permit Valuation (1/10th%) .
State Surcharge
$ 2
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ <. o o
$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:
�//:� v54b
/41
SUBJECTRMIT
NO. -
City of Fridley
2 9451
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
� `v _�____ COMMUNITY DEVELOPMENT DIV.
SEC.
7d_//
r PROTECTIVE INSPECTION
""'1'j CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
L 612-571-3450
910415
5/12/99
JOB ADDRESS 1428 Mississippi Street NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
7
1
1 Spring Valley Addition
SHEET
2 PROPERTY OWNER MAIL ADORES$ ZIP
PHONE
Marquerite Pratt 1428 Mississippi St NE
571-8136
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Sussel Corp 1852 Como Ave, St Paul, MN 55108
651 645-0331 1934
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
X] NEW O ADDITION ❑ ALTERATION ❑ REPAIR
O MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 22' x 22' Detached Garage
9 CHANGEOFUSEFROM TO
STIPULATIONS
See notations on plan. Provide a hard surface driveway.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
SEPARATE PERMITS ARE REQUIRED 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 80 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 PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$9,196
$4.60
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$174.75
FirA SC $9.20
-r'l2n
PLAN CHECK FEE
Lice S $5 0
OT
TL FEE
$193.55
SIGNATURE OF C00RACTOR OR ACTHOR12EO AGENT iDATEo
EN ROPjiqLZVALIDAT D/'_HIS IS OUR PERMIT
S-GNATURE OF OWNER, -F OWNER BUILDERS IDATE,
BL �hS�
T/ATt
/41
NEW Effective 5/ 10/99 L�
ADDN [ ] CITY OF FRIDLEY
ALTER [ J SINGLE FA I LY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION 1
Construction Address: AfLUtil'jJ q it i4e 4e
' o \,
Legal Description:
Owner Name &Address: !�� cT U_y10 _ �f �''' Tel. #
Contractor: S uU S �� C_ m J ® MN LICENSE # i t(
Address: � L a i4 V S'rf �� �a l Tel. # 4P9
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EMPROVEMENT
LIVING AREA:
Length
Width Height
Sq. Ft.
GARAGE AREA:
Length - Width4.0
1 Height
Sq. Ft. - 6�
DECK AREA:
Length
Width Hgt/Ground
Sq. Ft.rj%`
OTHER:
Construction Type:t �n Estimated Cost: $ i 1.
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE: �- 7 �' APPLICANT:
cr �(/ tf o ,��
Tel. # V11
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$ 0/,- 2D
.001 of Permit Valuation (1/10th%)
State Surcharge
$ �/ d ��
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$ ;S.
$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
$� �S
STIPULATIONS:
suejECT
PERMIT
City of Fridley
i 6 � 1
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT N
` __���_ COMMUNITY DEVELOPMENT DIV.
Tr
r PROTECTIVE INSPECTION SEC.
E _ ,
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
L •� 612-571-3450
910-F15
3/15/01
JOB ADDRESS 1428 Mississippi Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
1 7
1
Spring Valley Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Marguerite Pratt 1428 Mississippi St NE
763-571-8136
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Advance Aluminum Supply Inc 7701 Main St NE, Fridley, MN
55432 571-3440
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
7983
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O ADDITION ❑ ALTERATION IR REPAIR
O MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace window sashes
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk
and flash all exterior openings
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 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO OWLG. UNITS
OFFSTREET PARKING
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$3,800
$1.90
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW
Fire S $3.80
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$97.25
PLAN CHECK F
TOTAL F
Lice e SC $5.0
$10 .95
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
EN P OP IDATEDPH16 IS YOUR P
OG So IoaTE
//MIT
/V
S-GNATURE OF OWNER,IF OWNER BUILOERI IDATEI
g03/11�4/2001 [ 1]4:13
ADDN C ]
ALTER [ ]
ConstructionAddress:
Legal Description:
7635712260
ADVANCE ALUMINUM SUP
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
e
PAGE 01
Effective 1/1/98
Owner Name & Address: f l��L]�Ytke_ i�(/�- - �` ( •`M""`rr` "` Tel. # 7/A �9/—
Contractor:_ b'�i�t sr. �9 c•� ,�-� �. s o� �'•�°� 5 : i -�L MN LICENSE # 2P 8
Address: 770/ -7— 'q -0c- Tel. # S7/'- 3 Y518
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 Estimated Cost: $ • L� OMAJO
(Fee Schedule on Bach)
Driveway Curb Crit Width Needed: Ft. + 6 Ft = Ft x $ = $_
DATE: , APPLICANT: Tel. #
CI"i'Y 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/),! S
.
STIPULATIONS:
�q rca,I'-�D -cat .GnG
Q�
Building
Inspections
763-572-3604
DATE / 67 —,0&
SITE ADDRESS l `-P DES
THIS APPLICANT IS:
PROPERTY OWNER/ I NAME:
TENANT .-I
I
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR /E-MAIL ADDRESS
ST
❑CONTRACTOR
PHONE:
Permit No.;
Received By: _
Date Rec'd: /i
TEk*Tp.'-� ;:L -
STATE LICENSE # EXP DATE
ADDRESS:CITY STATE—ZIP
nurnrF FAX
❑ SINGLE FAMILY/NE
❑ TWO FAMILY/NEW
❑ ADDITION
❑ BASEMENT FINISH
❑ DECK
Is]
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
NUMBER OF SQUARES
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
❑ Aluminum
❑ Other
WINDOWS
IN EXISTING OPENINGS ❑Yes ONo
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
W ROOF
❑ SIDING
❑ SWIMMING POOL
❑ ADDITION
PAIR ❑ REMODELING
LENGTH
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
❑Soffit
❑ Trim
❑ Fascia
LOCATION OF WINDOWS
OF WINDOWS
❑ WINDOWS
❑ DRAIN TILE
❑ OTHER
HEIGHT
Ft.
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS. & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing structures
and proposed project.
2. Two sets of construction plans
3. Energy Calculations
Permit Fee
111,2,6$ A7
Plan Review
Fire Surcharge
$
$
Surcharge
$
License Surcharge
$ Ga'. 00
SAC Charge
$
Curb Cut Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge
$
Total Due
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach Sti
THIS IS AN APPLION 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. �1
SIGNATURE OF APPLICANT yr/ W7� vz y Eiae1 PRINT NAME, � � Y �C f 7 ' t Pfd DATE a y- / - 7 b