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0 City of Fridley SUBJECT AT AT THE TOP OF THE TWINS BUILDING P E R M r i I `L -------- COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 L���_� ,•� 612-580-3450 R T NUMBER 910-F15 REV. DATE 6/22/78 PAGE OF APPROVED BY JOB ADDRESS 1455 N. Innsbruck Dr. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 2 Innsbruck SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Anil K. andfRabha Bhatna ar 3755 Trenton Plmmth, En. 55441 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Jo -112-4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING house with garacre 7 CLASS OF WORK [� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK New house and crarage 9 CHANGE OF USE FROM TO STIPULATIONS 1. Provide Combustion air to Furnace 2. Provide copies of truss design and verifying survey by July 30, 1978 3. Provide exhaust fan in lower laundry area. 4. rear wa c o tells :.ice ��4 �" �n mor SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Residental/ ingle D. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ZONING SO. FT. DNX 2544 CU. FT. 46,656 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 pit ��i/ �� D 7J // $42.43 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PRO ONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- SMY22 $207.06 $400.00 STFUCTION OR TH ERFOR NCE OF CONSTRUCTION. PLAN CHECK FEE $51.76 TOTAL FEE $ 701.25 SIGNATURE Off CONTRACTOR OR AUTHORIZED AGENT (DATE(V01t N PROP(cEID�RL V (DATED THIS IS Y04R PERMIT BLDG. INSP DATE SIGNATURE OF OWNER (IF OWNER BUILDER( (DATE( • CITY OF FRIDLEY APPLICATION FOR RESI1 ENTIAL BUILDING PEIMITS (NEW, ALTERATI0n, ADDITIONS, OR REPAIRS) O1%?WBR: AM1L k, AM QRA�H4 affTMAc P]1UILDEj1* : Address: 3�S S' TREt4TM CAMC-7 u-, No.: 0113�� Street: Address:-, rG LOT: 10 BLOCK: 2. ADDITION: P` 14S f aggjK CORNER LOT: INSIDE MOT: _��_ SETBACK.: 3 S'I SIDEYARDS: 1 O' Applicant attach 'Lo this form 'loo Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING s To Be Used As: 0ctc, Front: o Depth: L12 Height: -20 _ Square Feet: Cubic Feet: (s A AACf Front: 2 L1 I Depth: 2-1- Height: ' Square Feet:•8 Cubic Feet: Tyle of Construction: . !I To Be Completed: 9EP 19 -1 I Pr6posed 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 cork in strict accordance with the City of Fridley Ordinances and rulings of the.Dcpartment of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. See reverse side f dditional information. 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J F y'ypp�, F ti K'F'Cy# Et;` t r{1#r �Jy }' ,p;' ,r l�" '.'� ,F"ky F: t...' .y•` , !a �` r y# e`• r t '! * .. �a� 1•. 3. ,: + fx td} } •7 n• �� i'1''{� ~ � s i-, f; .�{ , ;If a r s a y � s� . i4 �C,t:�r`Y�'� r..; 6 1 'elg- i- f -1,-,u oiz- jpIki *QwMandol /I- �o LAW 7-ey 4,&Fs1.v CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: N0. RATE Number Fixtures a. to Future Fixture Opening —3 x $2.00 v x $2.00 b+ Water Catch Basin x $5.00 Water Heater - to 99,000 BTO x $5.00 b Cg $10.00 Water Softener x $7.00 �0, w 1 Electric Water Heater Heater L Lpp�� J N b 1st 3 fixtures yn '$3.00 .14C � t w �' •,qa, 8 .�c 12 ag u ani First $100.00 $5.00 each add. $100.00 or fraction $2.00 41 o vsi u Z) m vi 3 w° . u oo 4 4 i3 c� as lec Ragrpj / f 1st 3 Y 3 2nd 3rd 4th (P.) a Future Connection Opening Connected with Sewer M s New Fixture, old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: N0. RATE Number Fixtures =�_ x $3.00 Future Fixture Opening —3 x $2.00 new Fixture. Old Opening x $2.00 Catch Basin x $5.00 Water Heater - to 99,000 BTO x $5.00 100,000 BTU to 199,000 BTU x $10.00 Water Softener x $7.00 New Ground Run Old Building x $5.00 Electric Water Heater x $5.00 GAS FITTING FEES: 1st 3 fixtures x '$3.00 Additional Fixtures x $1.00 Gas Range to 199,000 BTO x $10.00 REPAIRS $ ALTERATIONS First $100.00 $5.00 each add. $100.00 or fraction $2.00 State Surcharge TOTAL FEE REINSPECTION FEE (510.00) TOTAL $ �n , UZ $ $CSCi S _ $ Job Address / 1( Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the cork 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 application are true and correct j�� Fridley, Mn. �� , 19 q 0 1 �Ii OWNER ) L 8A P I/ X\I � /'1 G R. KIND OF BUILDING � A M 6 USED AS TO BE COMPLETED ABOUT /C3 ESTIMATED COS� 2 CJ S% V OLDNEW BUILDING PERMIT NO. PERMIT NO. 1263 Company a Signed Tel. No. ROUGH IMP. Date FINAL INSP. Date APPROVAL FOR PERMIT / AOX MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 pLUS $.50 STATE SURCBARGE CI'T'Y OF FRI®LEY 8431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 66432 December 28, 1978 Mr. Jon Nelson Jon Nelson Construction 3755 Trenton Lane North Plymouth, MN 55441 TELEPHONE ( 812)571-3450 Re: Final Inspection at 1455 North Innsbruck Drive N.E. Dear Mr. Nelson: A final inspection was made on December 27, 1978 of the above address and the following items were noted which must be completed before the structure can be finaled out; 1. Provide sod in the front and side yards by June 15, 1979. J/ 2. Provide combustion air for both furnaces by January 19, 1979. dK 3. Post address on house by January 19, 1979. ae 4. Patch holes in garage ceiling by January 19, 1979. ,at S. Provide handrail on lower stairway by January 19, 1979. d 6. Fill block under steel beam in workshop by January 19, 1979. - de 7. Provide door closer on door between house and garage by January 19, 1979. #14 B. Provide a verifying survey of lot by January 19, 1979. We will expect the above items to be completed by the scheduled dates when reinspections will be made to determine compliance. In checking our files we noted that you are not licensed for the current licensing period so we are enclosing a license application that should be filled in and returned with the license fee and insurance applications. If you have any questions on the above items, please contact me at 571-3450. Sincerely, DARREL G. CLARK Community Development Adm. DGC/mh ENC: 1 CC: Mr. Anil Bhatnagar 1455 North Innsbruck Drive N.E. 91 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE ( 612)571-3450 January 3, 1979 Mr. Jon Nelson Jon Nelson Construction 3755 Trenton Lane North Plymouth, MN 55441 Re: Final Inspection at 1455 North Innsbruck Drive N.E. Dear Mr. Nelson: A reinspection was made on the above address to determine compliance with our letter of December 28, 1978. It was noted during the reinspection that all items noted on this letter had been completed with the exception of installing the sod in the front and side yards which.is to be done on or before June 15, 1979. A reinspection will again be made on June 15, 1979 to note compliance on installing the sod. If you have any questions on this matter, please feel free to contact me at 571-3450. Sincerely, DARREL G. CLARK Community Development Adm. DGC/mh CC: Mr. Anil Bhatnagar 1455 North Innsbruck Drive N.E. CITY dF FRID0 APPLICATION POR PUIMBING AND GAS FITTING PEF"IT dob Address �`� S` / V bepartmaht of Buildings city of Fridley 'tel. #511-3450 The undersigned hereby fnakes dpplicdtioh for a permit for the work hereih specified agreeing to do all work ih strict accordance with the City Codes and rUlings of the bepartment of Buildings, and hereby declares that all the facts and represehtatibns stated in this application are true and correct Fridiey; Mh. a, li- - , ig-z? X-� n __ - - b i&P kf9b big tditbiko USBb AS Tb bt toilipiETEb Abodt PARTIAL RAIL SCHMLL o a m tSttMATEb COST o PLUMBING FIXTURE RATES: NO: N o' tOtAL Water Heater PERMIT NO. / /a� Number Fixtures X $3.00 S E ro m a q(d$4 company w w x $2,00 $ 4)m A Signed By aat 3 N cci0.0 $ `� U� Water Heater - to 99,000 BTU N $5.00 $ Tel. No. $4 100,000 100,000 BTU to 199,000 BTU x ,�c $ � x C' x g $ New Ground Run Old Building x o WU ROUGg tNSP. _ D rd M M $5.00 3 Q N a'ni 04 u aroa 3 as lec FINAL INSP. 1st 3 fixtures x $3,00 $ Date Additional Fixtures x $1.00 $ APPROVAL FOR PERMITy - Gas Range to 199,000 BTU x $10.00 1st 2ndJ III 3rd 4CI jA 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water dob Address �`� S` / V bepartmaht of Buildings city of Fridley 'tel. #511-3450 The undersigned hereby fnakes dpplicdtioh for a permit for the work hereih specified agreeing to do all work ih strict accordance with the City Codes and rUlings of the bepartment of Buildings, and hereby declares that all the facts and represehtatibns stated in this application are true and correct Fridiey; Mh. a, li- - , ig-z? X-� n __ - - b i&P kf9b big tditbiko USBb AS Tb bt toilipiETEb Abodt PARTIAL RAIL SCHMLL tSttMATEb COST PLUMBING FIXTURE RATES: NO: kATI tOtAL <2 !{jltDtkd BBRRiT ATO. ______ PERMIT NO. / /a� Number Fixtures X $3.00 S f Future Fixture Opening x $2,00 $ company New Fixture, Old Opening x $2,00 $ Signed By Catch Basin x $5.00 $ Water Heater - to 99,000 BTU x $5.00 $ Tel. No. 2:- 100,000 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ ROUGg tNSP. _ Electric Water Heater x $5.00 $ bate GAS FITTING FEES: FINAL INSP. 1st 3 fixtures x $3,00 $ Date Additional Fixtures x $1.00 $ APPROVAL FOR PERMITy - Gas Range to 199,000 BTU x $10.00 $ REPAIRS & ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ MINIMUM FEE FOR ANY PLUMBING PERMIT S $7..5�PLUS�$TATE SURCHARGE State Surcharge $ .50 TOTAL FEE $ IF, OP REINSPECTION FEE ($10.00) SUBJECT .PE -MI O. City of Fridley 142 18484 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. ? 7y r PROTECTIVE Q 1 � ` CITY HALL FRIDLEY 55432 '•j NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 6/9/86 I JOB ADDRESS 1455 North Innsbruck Drive N.E. 1 LEGAL LOT NO. TRACT OR ADDITION SEE ATTACHED DESCR. TBLOCK 10 Z Innsbruck North. SHEET 27 PROPERTY OWNER MAILADDRESS ZIP PHONE Rasheed Khan same 571-4065 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D & D Home Improvement Inc 784-7543 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION C% ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling 9 CHANGEOFUSEFROM TO STIPULATIONS 1. Shingles can be second layer but not third, 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 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 1500 °75 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- $ZS.00 STRUCTION THE PERFORMANCE OF CONSTRUCTION. eyj-n� PLAN CHECK FEE TOTAL FEE $25,75 IGNATURE OF CONTRACTOR OR AUTHORIZED AGENT f (DATE) WHEN PR ER V LIDATED T IS . n BLDG INSP UL`1*6 gaTE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW [ ] City of Fridley ADDN. [ ] L R-1 AND R-2 I ALTER. Building Permit Application Construction Addre Legal Description: Effective 4/1/84 Owner Name & Address :._/'IAMend ISAOAV Tel . #- Contractor:coD 54:-L) ; Tel. 78y 7�Y3 Address: / /L�/ 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: Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: !�,eAti�� ®4SE Estimated Cost: $ e Approx. Completion Date: ��� a Proposed Driveway Width If New Opening Is Desired: Alt. A Alt B See Back Page for Explanation DATE: APPLICANT: C _ L� Tel. #��4'7J7V-7? Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge R-470 M USE ONLY Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $425 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 00O-L166v 60()- la,vv SUBJECT PE ID. City of Fridley4 AT THE TOP OF THE TWINS BUILDING PERMIT Ir? COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. � , NUMBER REV GATE POF AGE APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 7/6/95 JOB ADDRESS 1455 North Innsbruck Drive NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 2 1 Innsbruck North SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Rasheed Khan 1455 North Innsbruck Drive NE 574-1065 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Fred Quinzon Construction 2605 Stark, Little Canada MN 55117 486-9836 8226 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 6 DESCRIBE WORK Interior alterations 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 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 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 $3,200 $1.60 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OT ER ST TE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PE OR E OF CONSTRUCTION $63.00 Fire SC $3.20 PLAN CHECK FEE TOTALFEE L SC $5.00 72.80 GNATU FCONTRACTORO AUTHORiZEDAGENT �DATE� Y.VAALIDATED THIS IS YOUR PERMIT pgWHENPFIOPE BLQrU iNSP qAT[ SIGNATURE OF OWNER OF OWNER BU(LDER1 (DATEi NEW [) Effective 1/1/95 ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application > Construction Address: .S . Legal Description: Owner Name & Address: %S`S�i�6i Tel. # Contractor: ,✓� �I �' MN LICENSE # Address: Rei ,O .5�7� r �r rrz �� A SS�t7 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: Corner Lot [ ) Inside Lot [ j Type of Construction: Approx. Completion Date: _ Ft. Yd Setback Side Yard Setbacks Estimated Cost: $ �� (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 F = t x $ _ $ DATE: %S S APPLICANT: Tel. # f �4�� _ CITY USE ONLY elo Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ 20 .001 of Permit Valuation (1 / 10th %) State Surcharge $ , GO $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit License Surcharge $ J, $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 Nw sary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: D, SUBJECT City of Fridley =59�5 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. ------ PROTECTIVE I L PROTECTIVE INSPECTION SEC r I CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By 612-571-3450 910-F15 9/24/96 JOB ADDRESS 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 2 Innsbruck North SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 'R.q--hp-pd Khan 1499 North Tnnsbruck Drive NR 571-1165 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20060494 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 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 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $2,227 $1.12 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- STRUCTIO THE PERFORMANCE O CONSTRUCTION. $74.75 Fire SC $2.23 PLAN CHECK FEE TOTAL FEE i License SC $5.00 1 $83.10 9IGNATURE0 GyiJNT A OR OM U MORIZEDAGENT IDATEI N PROPERLY -4&z BL INSP ALIDATED THIS IS YOUR PERMIT �TE DA SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI D, NEW [ ] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application G� 59- ConstructionAddress: ��� o �%, ,4 Legal Description: Owner Name & Address: A -h # i5/ Tel. # Contractor: S MN LICENSE #-2 GYi Address: 0-a, Tel. # - 2 -?l LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of` &VXy ofJtlie 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. Corner Lot [ ] Inside Lot [ J Type of Construction: Approx. Completion Date: Ft. Yd Setback Side Yard ketbacks Estimated Cost: $ �" J STIPULATIONS: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + Xtx = $ DATE: a , APPLICANT: Tel. # CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $.3 .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $900 per SAC Unit License Surcharge $ D 4) $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 $ O STIPULATIONS: CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 1998 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES 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. HEATING COMPANY.9 -44 Signed By Tel No. Approved By Rough -In Date Final Date 4� FILL OUT BACKSIDE FOR STA K VERIFICATION ON REPLACEMENT FURNACE JOB ADDRESS RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner - rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ . 0 representations stated in this application are true and correct. (Side Vent - Fill Out Back) 01-0 11998 Gas Piping (Needed with new furnace) $10.00 $ %�Cl�i�f� �'Cobel OWNER_ Gas Range $10.00 $ BUILDING USED AS � rI Gas Dryer $10.00 $ ESTIMATED COST %/�Q w _ PERMIT N0. J *Air Conditioning - All Sizes $ 25.00 $ A5 • D O DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs 8 Alterations (LIST ON BACK) $ No, of Heating Units Circle One (Steam) (Hot Wate (Warm Air 1 % of Value of Appliance or Work Trade Name Ruud, Size No Commercial/Industrial BTU HP EDR 1.25% of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge $ .50 Burner Trade Name Size No, BTU HP EDR TOTAL FEE 169,50 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. HEATING COMPANY.9 -44 Signed By Tel No. Approved By Rough -In Date Final Date 4� FILL OUT BACKSIDE FOR STA K VERIFICATION ON REPLACEMENT FURNACE Idem---k- AT TAM Q Ppingy Done: REATIN s Sined: Bv: Date: fA CHMIN.EY AND STACK YERMCATION The undersigned hereby vermes that the existing chimney or stack: I . Has been carefully examined Yes (,,'f -No ( ) 2. Is free from rust or deterioration Yes ( /f No ( ) 3. Has no foreign objects lodged within Yes (-f 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 BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes (,�- No ( ) Q. use rnrnh1iR inn air been provided for water heater Yes No ( ) Idem---k- AT TAM Q Ppingy Done: REATIN s Sined: Bv: Date: fA b g9 \ ve ly VVIVI Stv��J�C Y� �. ' � ���5 ori •� m - .. � ,� r1'L •��� Ta .w•y N � y d a � •: (, / ' , 9. 4 ,iii+ ls r`µy�, 5.. , �.d - / ^� i• 1 b .Y t lr „ar-�� T' �,.•,�fAf' fi �!� 4' t•c�I��d f.+ll^^[^i^� ., " „'Ybi f •, , t b. 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X , � 7 n d J•! � ?� Y � a J' k �.ua4, y � ,'S:f ;'� tr4,r,.. r ; q�' �, � 9 J.: Ag4 •t '^`� '� b tia'' 4 �r .! 4.�� , {f'� � a. � � k x .e g7'"u'! 91yf�''., Y w: �y V,' y e>a �#,y+M err 'R iP » ° r f jJZ• ,y�`� i"g�g. �^'fi �7l yC, f� , tj �L A':.A,ra 1"r`•x� pa -�• .�q eft ri.. ..d ..r�., r,Sr.. .....a .4 1.. :. "F! .�tG✓k _�,.... i�.. ,. • 4. • �`,L��c'L�T.4%Z �iyS Mi01►wap Ne.O6 KR to fRJ , �' .• J Eagino*", � surv, yore coa. e» � t�a,gs Loan ..Survey !orb 601 IL e - , ?} •� b g9 \ ve ly VVIVI Stv��J�C Y� �. ' � ���5 ori •� m - .. � ,� r1'L •��� Ta .w•y N � y d a � •: (, / ' , 9. 4 ,iii+ ls r`µy�, 5.. , �.d - / ^� i• 1 b .Y t lr „ar-�� T' �,.•,�fAf' fi �!� 4' t•c�I��d f.+ll^^[^i^� ., " „'Ybi f •, , t b. La,� . 4 ny d J y. / G . � l Y _ �, 9. r i 9 : � f P. w , i . r � Y + t(6+•, •.{�e. r bV+ y;a t yr+S+ J'f _Z .� '<rQ P� n- ,� Cary q"_ 4+•+Tp 15��Ki ,S�J 't � - w r - r-. ,�� F t' �{. �5fr'e [�.- ,F. �.. 1 � ,1`i �'o &•�QT�'�r i',��pb�• .a4r� +:, . dL ...5 p ..A �- J ?� K r - rr i 1 't G ,a,•, 4 � r: .¢'"f... �'C••i av fs kr_ I. - 1• F "r. f • f k • 'f 1• '�b •Vk ` fy. ¢ 41,J't► J� P },,9 } i�P� y �' b'' t a - r . r� n d 1 b •wl. 1 r C - s �.' .. , r , +, Yir yr � � . L �1�a �. �} � �:� �1 I i! � t b t d'fr '+F y S a+ � r s I. y f',n•{ : Y [y.� ' o�`aie as d 4 t rA g•^l �ysa '.. C• 3 - rr A r: s .ras. + d' afb d 1 p r i� t ,• q f'1i2� '�7F- � t•1`Sa' r � •� p v •a , !; . a''pt �,R F � •1 � ..,,. atN. 2t .! .f - ,, t t� �'� s {' Fit ia` In �.rR' ��) p r by�tirr�4. a• T : * .A K 4�r Y f2ye�, ki.�. Gp, ,� .". X , � 7 n d J•! � ?� Y � a J' k �.ua4, y � ,'S:f ;'� tr4,r,.. r ; q�' �, � 9 J.: Ag4 •t '^`� '� b tia'' 4 �r .! 4.�� , {f'� � a. � � k x .e g7'"u'! 91yf�''., Y w: �y V,' y e>a �#,y+M err 'R iP » ° r f jJZ• ,y�`� i"g�g. �^'fi �7l yC, f� , tj �L A':.A,ra 1"r`•x� pa -�• .�q eft ri.. ..d ..r�., r,Sr.. .....a .4 1.. :. "F! .�tG✓k _�,.... i�.. ,. SuBJECT City of Fridley 5=06 AT THE TOP OF THE TWINS BUILDING` PERMIT R NO. `� ------COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r � � PROTECTIVE Qf/ a � = CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/20/99 JOB ADDRESS 1455 N Innsbruck Drive 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 2 1 Innsbruck North SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mr & Mrs Khan 3 -;CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Five Pillars Contracting 4319 3rd St NE Columbia Hts 55421 759-1554 20098641 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 M( REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 24' x 12' Deck 9 CHANGE OF USE FROM TO STIPULATIONS 'See notations on plan WAIM Before digging call for all utility locations 454-0002 REQUIRED BY LAW. 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 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL 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 $2618.48 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- $8rj TR CTION OR THE PERFORMANCE OF CONSTRUCTION kimmi ax2h iXH O rPLAN ®`1 CHECK FE Li cen $5.00 TOTA EE SIGNAT ON TRACTOR OR AUTHORIZED AGENT IOATE, E PROP ALIDATE THIS IS YOUWPRT S-GNATURE OF OWNEROF OWNER BUILDERS tDATEiELCOG NSD pAtE NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 6 BUILDING PERMIT APPLICATION '0 4 �" Construction Address: //-/ J %U i --,n n - 6 (�� �/\ � r (� Legal Description: Owner 1� Contract Address: MN LICENSE #7 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 /�P Hgt/Ground Sq. Ft. 7 0-Y OTHER: Construction Type: oe-c- \ kPim,11" Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: `7 APPLICANT: y Tel. # > )- CITY USE ONLY Permit Fee $ � �� Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ /, 5() $.50/$1,000 Valuation SAC Charge $ $1050 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 $ < STIPULATIONS: Z. ITY OF FRIDLEY INSPECTION DIVISION V3-33)- Efiective On January 1, 2002 (,j 431 University Ave NE ridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 763) 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES n_ JOB ADDRESS 1g.55 &Lt� ►sbrvck ®rive - ©RATE SCHEDULE OWNER �� 5�►e�n r .esiden'tial Rate TOTAL Furnace Shell and Duct Work, Burner • BUILDING USED AS_Ne5i cQ/iCe, Also Replacement Furnace $ 30.00 $ 30. ' c 141(Side Vent • Fill Out Back) ESTIMATED COST /569 PERMIT NO. Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCR PTI N OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of Heating Units_ Circle One (Steam) (Hot Water) ( arm Air Gas Dryer $ 10.00 $ Trade Name --& lZo6cW Size No. � �r BTU a2 4W HP EDR 'Air Conditioning • All Sizes $ 25.00 $ Fuel ,) alyral G-&5 Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR W A-ommercial/Industrial 1.25% of Value of Appliance or Work $ The undersigned hereby makes application for a permit for the work herein LL U , specified agreeing to do all work in strict accordance with the City Codes an 0 State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. u TOTAL FEE $ ° �v BLAINE CENTRAL ELECT, VE �IfEC- DATE��- ANOKA, MN 65304 UNIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEXI"ING CO Ao ,► LUS THE $T Q STATE SURCHARGE CONDITIONING PERMIT IS $25.00 Signed eX. 3-75% Fan 10 --?57-6-7ol. m ;EINSPECTION FEE $47.00/Hr m Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final Dat iritten permission from adjoining property owner. 17 �f FILLOUT BAC SIDE'F STACK VERIFICATION ON REPLACEMENT FU NA JAN -16-2002 00:32 FROM CITY OF FRIDLEY TO 7575701 P.02/02 THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED rQMMCIN VENTVFNT (CnNNFCTnR AND CQMRI ISTION AIR VFRIFICATInN When impta ring an ex`s, tingf� ran _P, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes VSNo ( ) ie venting system is plastic/PVC and meets all current codes and manufacturer .:cifications including sizing, length, number of elbows and termination. Yes No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAIMA Category I Geritral Furnace Venting Tables for fan.. assisted and natural draft appliances: Yes No( The existing cnmhiLstinn air is 5z and installed to meet the current codes and manufacturer's specifications. -I Yes ( No( ) When required to installn new cemh iggtinn air, it will be sized and installed to meet the current codes and manufacturees specifications. Yes - No ( ) When iastallinCI a new v nting.syrdern, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GANIA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes �y No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes No( ) Appliance #1 Type I L Ud r-vi(Mff- BTU Input tW Fan Assisted or Nat ,0a f" Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: Signed By; TOTAL P.02. .If HEATING MIC AIR CONDITIONING ME • AND ELECTRIC, INC. ADDRESS —/L%S% /U®r' LIn��Sbi�✓C✓� �v OCCUPANT HEAT LOSS DATE HTG. INST. SOLD BY iVC1 �w Electrical Work TYPE OF HEAT GA FA�— HW STEAM SPACE HTR. GAS DESIGN MAKE 7- VV °°' P1 t Model IAf9 ?L -a7 M Serial 65 D ©2-f3#®-/31 $ INPUT '7 2 DO o THERMOSTANT Oil a[. l Value wk dy levi-e-6 CONTROLS Heat Plug L.imi C U CITY SUBURB Limit Settino L4, Lighting Inst. yC Fan Settin w' j / tk C� E/,-2 Pilot Type D2le 5wwv — � G � f%eG PilotMake PLIJ r Pilot Model _ L 114 Pllot Timing Ir0 , a L.W. Cut CM Pressure Peroent CO2 Input CFH Percent % Stack Temp. �%�� Percent CO 6 HOUSE HEATING TEST RECORD CONVERSION d. Vent Size 13 KIND OF LINER SIZE NONE Draft Hood 'Cl^ 4['A Regulator 3� 7-5 Filters Size �!¢L Number / Chimney Location Inside _ Outside Chimney Construction —CIA t-'!5 a Smoke Bomb Wiring >e - APT. FLOOR CITY SUBURB OWNER Lighting Inst. yC 7) INSTALLED BY _ r5 j&lflf f� / tk C� E/,-2 Gas Line By L$Y& � � G � f%eG UNIT HTR. OTHER r CONVERSION d. Vent Size 13 KIND OF LINER SIZE NONE Draft Hood 'Cl^ 4['A Regulator 3� 7-5 Filters Size �!¢L Number / Chimney Location Inside _ Outside Chimney Construction —CIA t-'!5 a Smoke Bomb Wiring >e - Draft Draft Test Tag Door Pressure Lighting Inst. yC Date Tested— CompanyTesting r5l 6q? Name of Tester r Pressure Percent CO2 Input CFH Percent 02 Stack Temp. Percent CO From: City of Fridley To: 7173949 Page: 213 Date: 8/22/2006 4:33:29 PM Building MECHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Recd: - DATE ®I ZZ I YOUR E-MAIL ADDRESS�CDMCA.l COM SrrE ADDRESS I y iy • mnsny )rr' um l n P_ THIS APPLICANT IS: ❑ OWNER kONTRACTOR PROPERTY NAME: �(+�r>�� ed K' Cb n OWNER/ ADDRESS: t L-iS'S N- • T�UV\ 3C4� LC\.CITY Pi- \6 t V STAT S TENANT PHONE(3(o�) S- LA- ILA D5 � CONTRACTOR COMPANYNAME_:F[f'_\ SMQLn \kCO3-41nG dC ZC\C_ . SUBMIT A COPY OF CONTACT PERSON: YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS:Z0- -dRV£. t4r. CrrY F±[7jn0 LAKe_ STATFNjt � APPLICATION PHO Z ' UD(, FAkM0) I -I - 3q y `l PERMIT TYPE ''SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW VYLEPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK FaLYXVLC�e ?f 2. C 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: Q SIZE/BTU � Ci(� MFG: v u MODEL: IL SIZE/BTU MFG: MODEL: SIZEIBTU XA/C $25.00 FIREPLACE (GAS) $15.00 GAS RANG&OVEN $10.00 DEER $15 (WOOD) $35.00 NEW GAS GRILL $10.00 _FIREPLACE _BOILER $35.00 AFURNACE $35.00 _GAs UNrr HTR $10.00 _CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 .............................................................................................................................................................................................................. Permit Fee $—.— Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures n, $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures (a, $25.00 x $25.00 = $ e - Number of fixtures (a, $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ , AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a build' permit d I acknowledge that the information above is complete and accurate; that the work will be in conformance with the o finances an codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only applicat* 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 a of all rk 'ch requires revi val of plans. SIGNATURE OF APPLICA PRINT NAME�TC�1 L DATE 22 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55,432 763-572-3604 FAX: 763-502-4977 Building BUILDING Permit No.: tg -019Y67-7 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Recd: "'p-016 DATE YOUR E-MAIL ADDRESS SITE ADDRESS �s I�Y T�(11f�S�.j� V b THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: &,t c TENANT ADDRESS: CITY STATE ZIP PHONE: R03 -- 5_J1 G467 NAME: Renewal By Andersen CONTRACTOR SUBMIT A COPY OF STATE LICENSE #_ 1920 County Road "C" West YOUR STATE LICENSE WITH APPLICATION ADDRESS: Roseville, MN 55113 t STATE ZIP PHONE ❑ SINGLE FAMILY/NE` License #20130983 PROPERTY TYPE ❑ TWO FAMILY/NEW G 651-264-4_777 _ ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS PERMIT TYPE ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: N n SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT t ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REmoDELiNG c IRMIT• GARAGES PROPOSED SIZE: ❑ ATTACHED GARAGE I. ❑ DETACHED GARAGE 2. Existing Floor Plan Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING• INY ❑ ❑Soffit FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Aluminum ❑ Other ❑ Trym ADiN QNC 1. ❑ Fascia &anRruFc et ta�err. Site Plan/S—ey showing the existing structure WINDOWS 2. and proposed project. 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 MATFRIAT.c- Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge (USING TJIE1/997 U.B.0 FEE SCHEDULE) ATION N S, -7/ ) — A!Y 1 ro A IUn 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$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: Citv of Fridlev Attan 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 ben conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not. 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 plan in the case of all work whic equires rev' and approval of plans. J� approves SIGNATURE OF APPLICANT moi► N , NAME/1 1 O��[•� • v�Gn �� DATE L) Building Inspections 763-572-3604 DATE SITE ADDRESS THIS APPLICANT IS: PROPERTY NAME: OWNER/ ADDRI. TENANT PHONE CONTRACTOR ,..AIM. SUBMT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: PLUNGING Permit No.:V62 RESIDENTIAL APPLICATION Received By:CITY OF F+ RIDLEY Date U: JU L 9 YOUR E-MAIL ADDRESS ❑ OWNER IXONTRACTOR STATE LICENSE # (0 I T`M II I nr, q _,aasi_42 A n EXP DATE ADDRESS: 3670 Dodd Rd. #100 CITY STATE ZIP PHONE r_,igan, MN 55t1W-133a SINGLE FAMILY ❑ NEW DETAILED DESCRIPTION OF WORK ❑ TWO FAMILY WEPLACEMENT ❑ TOWNHOUSE PER MS 16B.665 the permit fee is a minimum of $1&00 or 5% of the total cost up to $500.00, whichever is greater, for the improveme�, 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: (INDIC TE TOTAL NUMBER OF EACH BELOW) _ BATH SINK/LAV _FLOOR DRAINS SHOWER WATER PIPING _ —BATHTUB GAS PIPING Mw CSL ) SWIMMING POOL _ WATER SO ($35) _ _ _ CLOTHES WASHER _ KITCHEN SINK WATER CLOSET _ BACKFLOW PRE 1. ($15) DISHWASHER _ LAUNDRY TRAY T ($35)OO _ TATER TER WATER ME RRIGATIO PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ p) Number of fixtures @ $10.00 x $10.00 = Surcharge .50 Number of fixtures @ $15.00 x $15.00 = TOTAL DUE $ 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 wo 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 ice with the approved plan in the case of all work which regmrees review and'approval of plan's`. - ' • - , �f �j SIGNATURE OF APPLICANT /./m ... -PRINT NAME 1LU/ 11 PC l ii _ A&w- I � / DATE 1 / NOTE: SEP. City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 1; A V. '7412 CA'2 AnPYP7 A