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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N® 3389 Date: . L .-.......... ..... Owner... . Address . . Builder..?�........................................ Address ............................................. LOCATION OF BUILDING No. !.[Q.l.�... Street. .. .... ................... Part o Lot . _ ............................ Lot ....� ...... Block ............... .. Addition or Sub -Division Q .. . Corner Lot ............ Inside Lot ............ Setback ............ Sideyard ........................... DESCRIPTION OF BUILDING To be UsSgr. .. ... ...Front y : <. Depth ! Height ./. % :. P "Sq. Ft. ✓. ?� Cu. Ft. .................... Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ........ Type of Construction ................... Net. Cost..................... To be Completed ................... -1&101114 1~40-A ' f00-1 In In consideration of the issuance o me of a permit o construct th ��gdesrlbed above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. _ In consideration of the payment of a fee of " . ! . 0-0 ... , permit is hereby granted to ................... ......................... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it Is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Building Inspector NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. 4Ir /Ai0 V //1/6�- City of Fridley, Minn. PERMIT Date: . C. ... J.. 7 r -J' .................. Owner .46 ... ®may .............. Address .16 It .. CJ,Aa c�: •..... . N° 3533 %i16TIl��4P � . Address....................................... �j LOCATION OF BUILDING No. .�(O /. Street . ��..................... Part of Lot.....�J A0. /� �y Lot ... �...... Block .................. Addition or Sub -Division G:�i�r°1.�9.�a..! K.0 .............. Corner Lot ............ Inside Lot ............ Setback ............ Sideyard ........................... DESCRIPTION OF BUILDING To be Used as: .................... Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ........ .................... Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ........ Type of Construction ................... lift. Cost..................... To be Completed ................... In consideration of the issuance to me of a permit to construct the building desribed above, I agree_ to do the proposed work in accordance with the description above set f and in com li with all provisions of ordinances of the city of Fridley. )0401 4 r� ©a In consideration of the payment of a fee $. (.........., permit is hereby granted to ................... ......................... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ... . !.. . ... ..... Building Inspector e NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Item& APPLICATION FOR MOVING PERMIT No Fridley, Minn., /d Inspector of Buildings, 6431 Univ. Ave. N.E. The undersigned hereby makes application for permit to move building as herein specified, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Department of Buildings, and hereby de- clares that all the facts and representations stated in this application are true and correct. Lot Block Addition Present Location: To be moved to: ys� Routing: _W_1/0�46M i. i Distance moved -2 a/0C r ft.To be completed about // - /® 195 Taxes paid? Estimated cost $ 00'00 Foundation and alteration permit numbers Certification as to cost: I hereby certify that the above designated building is worth at least sixty (60) per cent of the cost of a simi- lar new building. Signe Owner or Agent Approved by: Utilities Notified: Water & Sewer Department (Title) Minneapolis Gas Co. (date (Title) Northern States Power Co. (date) (Title) orthwestern Bell Telephone Co. (date) _ ;ce � (See reverse side for 'ws, lions) City Engineer In the event that the moving permit is to be applied for by the owner or by any other person than theta licensed Mover, the following letter must be completed and signed by said mover: Inspector of Buildings, 6431 University Ave. N.E. Fridley, Minnesota Please issue the bearer of this application, Mr. a permit to move building from: k Date , 19._ to: to which I hereby authorize him to sign my name. Signed Licensed Mover GENERAL INSTRUCTIONS The following must be secured before moving permit will be issued: 1. A building permit for new location of building to be moved. To obtain this building permit, the following is required: (a) The building to be moved must be inspected for structural soundness by the building inspector. Phone this office for inspection. SUnset 4-7470. (b) A survey of lot to which building is to be moved. This survey must be made by a licensed surveyor. (c) The building and moving permit must be obtained at the same time. 2. Tax receipt showing that all real estate taxes due have been paid. Duplicate receipts may be obtained at Anoka County Auditor. 3. Approval from, the Fridley Water and Sewer Department showing that bills chargeable against the property to be moved have been paid and water connections have been discontinued at the curb line or at the main. (See reverse side of form.) 4. Approval from Fridley Director of Public Works office approving routing. 5, Notification to, and signature of; utilitycompamiies. (See reverse side of form.) (a) Minneapolis Gas Co., 739 Marquette Ave., Engineering Department, Fourth Floor. (b) Northern States Power Co., 15 South 5th Street, Application and Extension Department. (c) Northwestern Bell Telephone Co., 224 South 5t1i Sheet, Business Office, First Floor. iioglso. 250-8-58 i City of Fridley, NUmm. BUILDING PERMIT Date: Nov. 8, 1967 Owner: _ Dean Harmon Builder Address 1618 Onondaga Address No. 1618 Lot 4 Corner Lot Sewer Elevation Same Same LOCATION OF BUILDING Street _ Onondaga — part of Lot Block _ __ Addition or Sub -Division . Aud . Sub 108 Inside Lot _ Setback -- Sideyard —.— Foundation Elevation DESCRIPTION OF BUILDING VU /® / X9 9,548 To be Used as: Garage Front 20 t Depth 22 c Height _ _ 10 Sq. Ft, 440 CtL Ft, 4440 Front Depth _ _ Height _ _ Sq. Ft. Cu. Ft. Type of Construction _ Frame Fst. Cost T $1-0_00.00 _ To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with alb provisions of ordinances of the city of Fridley. A , In consideration of the payment of a fee of $ 7.00 permit is hereby granted to_._. Dean Harmon to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time up o � of the provisions of said ordinances. A ii Offical Building Gasterland NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, on heating, sewer or water. Be sure to see the Building Inspector for separate permits for these hems. APPLICATION FOR BUILDING PERMIT CITY OF M --LEY, MINNESOTA OWNER'S NAME r Sti%LDER ADDMS9 ADDRESC; LtTIOA� OF Bi�1LD1NG 110. l 971tEE ® ; .1RT OF LOT LOT BLGCK. ADDITIO* 01" 9UBDIVISI.ON CObER LbT INSIDE LO'f' ti SETBACK BIDE=YARD II SEWER ELEVATION FOUNDATION ELEVATION Applicant, attach ,,to •ahis� #off Two: Certjfio at ssp.. S�rvey a�f Lat i ►d psogosed building; _ : ocatl,on-awa' os==these Veitificste . ' e r i ne 3 ; I?ESCRIMON�F" BU=D1MG d ` "To Be .Used Aei� s • , . � � ...� , ..• :.de . s 4fteight Sq. Ft. VY F~� Type of Construction „ �1 � Estimated Cost! 00 O �g To Be Completed �- The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with th& City of Fxidlsy Ordinances, and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. (Schedule of Fee Cots can be found an the Reverse Side). r �C a 4 Fe SUBJECT City of Fridley 161.0.5 AT THE TOP OF THE TWINS BUILDING PERMIT _ rp R ' ' • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. ep t � _ CITY HALL FRIDLEY 55432N UMBER REV. DATE PAGE OF APPROVED BY L J \ 612-571-3450 910-F15 14/6/81 JOB ADDRESS 1618 Onondaga Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 Auditor's Sub. #108 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Guy Halvorsen 1618 Onondaga Street N.E. 786-8239 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Robert Starr Roofing 10416 Partridge Street N.W. 757-4281 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 C ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof structure 9 CHANGE QF USE FROM TO STIPULATIONS Roof can be second but not third roof. install ridged galvanized valleys. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $2,500 $1.25 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $15.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. -12 1 PLAN CHECK FEE TOTAL FEE $16.25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR P RMIT L/ BLDG INSP I DAT SIGNATURE OF OWNER OF OWNER BUILDER$ (DATE) CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PEW41TS (New, Alterations, Additions, or Repairs) OWNER: _ � ��-S�;�J BUILDER•;.- ADDRESS:�,v 6 © d �+ ADDRESS: TEL NO: X�3 TEL NO: Construction Location ` STRICT NO: STREET: LOT: BLOCK: ADDITION: /wR Corner Lot: Inside Lot-: Setback.: Sideyards: Applicant attach to this form tcao Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTIOtN OF CONSTRUCTION - Front: Depth: Height: Square.Feet: Cubic Feet: Front: Depth: Height: Square -Feet: Cubic Feet: Type of Construction: _ 1 Estimated Cost: $"5-00 To Be ODrnpleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ ' $ SEE REVERSE SIDE OF SHEET Mie undersigned hereby makes application for a permit for the work herein specified, agreeing to do•all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: SIGNATURE:: Stipulations: 7 SUBJECT PERM City of Fridley 45561 AT THE TOP OF THE TWINS BUILDING PERMIT r ______ COMMUNITY DEVELOPMENT DIV. v PROTECTIVE INSPECTION SEC. r i NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 ' 612-571-3450 910-F15 10/2/97 / / JOB ADDRESS 1618 Onondaga Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 4 Auditor's Subdivision #108 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jan Armentrout 1618 Onondaga Street NE 786-8238 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Coty Construction 1001 6 St S, Hopkins, MN 55343 933-3536 9356 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 & Garage (20 Sq) Tear-Off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 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 $1,668 $.83 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $54.00 Fire SC $1.67 STRUCTION OR TH PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE LIpaij4SC 00 TO AL FEE $61.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI E P O VALI T THIS IS YOUR PERMIT SIGNATURE OF OWNER i IF OWNER BUILDERI iDATEi BIAG INSP BATE 7 j ] Effective 1/ 1/95 NEW NEW(] CITY OF FRIDLEY ADDN ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: l 6 Legal Description: Owner Name /& Address: a Tel. Contractor: (, 0Cf �sG 5 f&k MN LICENSE # Cl 3 Address: 10 � Tel. # 3 3 3536 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 Lenges Wim Height Sq. Ft. Length Width Height Sq. Ft. Cn Ft Length Corner Lot (] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ Approx. Completion Date: "� IQ `L ' 'V-7 (cost on Back) DrivewayCurbCut Width Needed: Ft. + 6 Ft Tel. # o = Ft x $ _ $ DATE: G ' l %- q 7 APPLICANT:rc�. CITY USE ONLY Permit Fee A $ �- Fee Schedule on Reverse Side Fire Surcharge -- .001 of Permit Valuation (1/10th%) State Surcharge's $.50/$1,000 Valuation SAC Charge $ $850 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 [ l TOTAL $ r' STIPULATIONS: r Building Permit Fee BUILDING 6 See Back Page for Fee Schedule Permit NO.: Inspections 65% of Building Permit Fee .RESIDENTIAL APPLICATION $ Receiv 2 � 763-572-3604 $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge CITY OF FRIDLEY $2000 per SAC Unit (Plans to MWCC for determination) Date Rec'd: 763-502-4977 FAX ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee EFFECTIVE 8-19-09 Fee Determined by Engineering Sewer Main Charge DATE OUR E-MAIL APPRESS Total Due SITE ADDRESSJul Make checks payable to: City of Fridlev Attach StiDU12tions THIS APPLICANT IS: ER ❑ ONTRACTOR PROPERTY OWNER/ NAME: �� TENANT ADDRESS: CITY S ATE hIP� PHONE:.Z'2 a2„7 3 D IX J CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTEN E/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 13o` <' SIZE OF IMPROVEMENT Ql LENGTH ILI WIDTH HEIGHT SO FT 0 ROOFING 13 HOUSE ONLY NUMBER OF SQUARES 13 HOUSE &GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl nY ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum 13 Trim I. Site Plan/Survey showing the existin Y g g structures ❑ Other ❑ Feria and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING TIE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 2 3 5 © OCCUPANCY TYPE Permit Fee $ 6 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .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 $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks payable to: City of Fridlev Attach StiDU12tions 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 Ci n y and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit - Vrev' t to start without a permit o site; that the work will be in accordance with the approved plan in the case of all is equiand approval of pl n1. SIGNATURE OF APPLICANT PRINT NAME \ i TE ®�',Z 74 Surveyors Certificate COMSTOCK & DAVIS, INC. Consulting Engineers and Land Surveyors 1446 County Road J, Mpls., Minn. 55432, 784-9346 LOT SURVEY FOR: DEAN HARMON PART OF LOT 4, 1618 ONONDAGA ST., N.E. AUDITORS SUBDIVISION NO. 108 PRIDLEY, MINNESOTA ANOKA COUNTY, MINN. - _Nor/ii /ine fuW Sul. No. WO -Soal. /i4e of ZoI4, ^/W Sob. Als. /oB LEGAL DESCRIPTION: The East 93 feet of the North 1/3 of Lot 4, Auditor's Subdivision No. 108, Anoka County, Minnesota. Subject to an easement to the City of Fridley over the North 30 feet and subject to other easements of record, if any. SCALE: /"3 so' 4 denotes iron monumenf /vnod O demes iron monurnen1 seil I hereby certify that this -survey., plan or rPrort was prepared by me or under my direct supervision and that I am a duly Registerea Land Surveyor under the laws of the State of Minnesota. .0,:::�'.� iv83,z i 29/73 3474 - Reg. No. Date Job No. , ' -- 93.00- - - '--- O/ 0A1DRGR o ,J - -- 93.00-- 1 { { I {^ nl 48.4 Q r r ry 24 24.6 e N s•zs v r � k N 3 /99.08 v - _Nor/ii /ine fuW Sul. No. WO -Soal. /i4e of ZoI4, ^/W Sob. Als. /oB LEGAL DESCRIPTION: The East 93 feet of the North 1/3 of Lot 4, Auditor's Subdivision No. 108, Anoka County, Minnesota. Subject to an easement to the City of Fridley over the North 30 feet and subject to other easements of record, if any. SCALE: /"3 so' 4 denotes iron monumenf /vnod O demes iron monurnen1 seil I hereby certify that this -survey., plan or rPrort was prepared by me or under my direct supervision and that I am a duly Registerea Land Surveyor under the laws of the State of Minnesota. .0,:::�'.� iv83,z i 29/73 3474 - Reg. No. Date Job No. Building BUILDING Permit No.90 CW1 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY ftiaeAN 763-502-4977 FAX EFFECTIVE 1-1-2010 DATE�s�l I l 1t' O YOUR E-MAIL ADDRESS SITE ADDRESS ��44 C; 7u-% �, (,:.A C'. SC� OZE THIS APPLICANT IS: ❑ OWNER @iCONTRACTOR PROPERTY OWNER/ NAME: - LLeljto TENANT ADDRESS: i 1®\j C, sm is �a e,.T_5 # E CITYf e: � STATE M� ZIP PHONE: CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE #_ _ (AQ i l`I Ia EXP DATE AND CERTIFICATE OF ADDRESS:_ 1315 to*, 0.rd, &I CITY Gy,;'tP�STATEift4ZIP 5.54,77 INSURANCE PHONE - - 00 FAX ,. 546 " 0 k,21 PROPERTY TYPE PCSINGLE FAMILY'" RW ^^' TeTD"^'^^''' SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING KOTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR P11 REMODELING DESCRIBE WORK BEING DONE: � Lrp, '4 AAwo-A SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT 7v'@ ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2.. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1, Site Plan/Survey showing the existing structures ❑ Other ❑Fascia and proposed project 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ W I S Ll . C0 OCCUPANCY TYPE Permit Fee $ `o See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $iO .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ 1-1 th $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks savable to: Citv of Fridlev Attach Stimulations 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 work whit requires review and approval of plans. SIGNATURE OF APPLICANT - PRINT �i' PRINT NAME �t ; L� Kts�w�lhec,n n DATE �p r 11 / 1 0 Ll nafiR'~_FW American Family Insurance Group AM KM ALdlfE581 Ai4L fB Lff . Attn: scanning center 6000 American Parkway Madison, WI 53783 mhermal@aamfam.com 763-205-5545 Fax 1-866-587-4590 Insured: GODINEZ, LEONSO A & MEZA, MARIA D Property: 1618 ONONDAGA ST NE FRIDLEY, MN 55432-3654 Home: 1618 ONONDAGA ST NE FRIDLEY, MN 55432-3654 Claim Rep.: Mike Herman Business: Attn: scanning center 6000 American Parkway Madison, WI Estimator: Mike Herman Business: Attn: scanning center 6000 American Parkway Madison, WI Claim Number: 00841073558 Date Contacted: 6/1/2010 2:00 PM Date of Loss: 5/30/2010 5:00 PM Date Inspected: Policy Number: 22BG824501 Price List: MNMN5B_MAY10 Restoration/Service/Remodel Estimate: GODINEZ LEONSO A & Home: (000) 000-0000 Business: (763) 495-6150 MvV,N Cell: (612) 998-2541 Type of Loss: Fire Date Received: 5/29/2010 Date Entered: 6/1/2010 7:23 AM AMERI' CAS N~ F� American Family Insurance Group Aura xamAac�ass�xcrrr® Attn: scanning center 6000 American Parkway Madison, WI 53783 mhermal@amfam.com 763-205-5545 Fax 1-866-587-4590 GODINEZ LEONSO_A_&_ Main Level 1 ]Kitchen Ceiling Height: 8' 466.78 SF Walls 273.85 SF Ceiling 740.63 SF Walls & Ceiling 273.85 SF Floor , _'Rd 30.43 SY Flooring 56.75 LF Floor Perimeter - !� 66.33 LF Ceil. Perimeter Missing Wall: 1- 414" X 810" Opens into Entry hall Goes to Floor/Ceiling Missing Wall: 1- 997" X 618" Opens into Living Goes to Floor DESCRIPTION CALC QNTY 1. Remove 1/2" drywall - hung, taped, floated, ready for paint WC/2 370.31 SF 1/2 area 2. Remove I" x 6" lumber (.5 BF per LF) APPROX 1/2 AREA C/2 136.92 LF ceiling 3. Remove Tile floor covering F 273.85 SF 4. Remove Underlayment - 1/2" particle board F 273.85 SF 5. Apply anti -microbial agent F/2 136.92 SF 6. Clean stud wall W 466.78 SF 7. Clean floor F 273.85 SF 8. Seal stud wall for odor control W/2 233.39 SF 9. Seal underlayment for odor control F/2 136.92 SF 10. Remove Dishwasher - Standard grade 1 1.00 EA 11. Remove Refrigerator - top freezer - 14 to 18 cf 1 1.00 EA 12. Remove Range - freestanding - gas 1 1.00 EA 13. Landfill fees - (per ton) APP 4 4.00 EA 14. R&R Batt insulation - 10" - R30 C/2 136.92 SF 15. 1/2" drywall - hung, taped, floated, ready for paint WC/2 370.31 SF 16. Acoustic ceiling (popcorn) texture C 273.85 SF 17. R&R Cabinetry - lower (base) units 6 6.00 LF 18. R&R Cabinetry - upper (wall) units 9+11 20.00 LF GODINEZ LEONSO_A_&_ 6/10/2010 Page:3 1W AM6RICAM FAMILY American Family Insurance Group wm+r ausmfasr�evxLa Attn: scanning center 6000 American Parkway Madison, WI 53783 mhermal@amfam.com 763-205-5545 Fax 1-866-587-4590 CONTINUED - Kitchen DESCRIPTION CALC QNTY 19. R&R Countertop - post formed plastic laminate 9 9.00 LF 20. R&R Baseboard - 2 1/4" hardwood PF/2 28.38 LF 21. R&R Base shoe 16 16.00 LF 22. R&R Countertop - Tile BACKSPLASH 8+9+2+6 25.00 SF 23. Ceramic tile F 273.85 SF 24. 1/2" Cement board F 273.85 SF 25. Clean part of the walls and ceiling REMAINING WC/2 370.31 SF 26. Clean window unit (per side) 10 - 20 SF l 1.00 EA 27. Clean door (per side) 2 2.00 EA 28. Seal then paint the walls (2 coats) W 466.78 SF 29. Finish door slab only - 1 coat urethane (per side) 2 2.00 EA 30. Finish door/win trim & jamb - 1 coat urethane (per side) 1 1.00 EA 31. Stain & finish door/window trim & jamb (per side) 1 1.00 EA 32. Chandelier 1 1.00 EA 33. R&R Light fixture 2 2.00 EA 34. Remove 110 volt copper wiring run and box - rough in only 2 2.00 EA 35. 110 volt copper wiring run and box - rough in only 2 2.00 EA 36. Remove 110 volt copper wiring run, box and switch 3 3.00 EA 37. 110 volt copper wiring run, box and switch 3 3.00 EA 38. Remove 110 volt copper wiring run, box and outlet 8 8.00 EA 39. 110 volt copper wiring run, box and outlet 8 8.00 EA 40. Remove Outlet 6+7 13.00 EA 41. Outlet 6+7 13.00 EA 42. Remove Ground fault interrupter (GFI) outlet 2 2.00 EA 43. Ground fault interrupter (GFI) outlet 2 2.00 EA 44. Dishwasher connection 1 1.00 EA 45. Remove Sink - double 1 1.00 EA 46. Sink faucet - Kitchen 1 1.00 EA 47. Garbage disposer 1 1.00 EA 48. R&R Smoke detector 1 1.00 EA 49. R&R Thermostat 1 1.00 EA 50. R&R Microwave oven - over range w/built-in hood 1 1.00 EA GODINEZ_LEONSO_A_&_ 6/10/2010 Page:4 A"0"'"' _ American Family Insurance Group wmno�armaass�xeuf' Attn: scanning center 6000 American Parkway Madison, WI 53783 mhennal@amfam.com 763-205-5545 Fax 1-866-587-4590 :KOUY M I —t"J IM f DESCRIPTION CALC QNTY 51. R&R Dishwasher 1 1.00 EA 52. (Install) Range - freestanding - gas 1 1.00 EA 53. Rough in plumbing - per fixture 3 3.00 EA 54. Sink -double 1 1.00 EA NOTES: +T Living Missing Wall: 1- 917" X 618" Missing Wall: 1- 314" X 810" 364.11 SF Walls 548.02 SF Walls & Ceiling 20.43 SY Flooring 53.50 LF Ceil. Perimeter Opens into Kitchen Opens into Entry hall Ceiling height: 8' 183.91 SF Ceiling 183.91 SF Floor 43.92 LF Floor Perimeter Goes to Floor Goes to Floor/Ceiling DESCRIPTION CALC QNTY 55. Clean the walls and ceiling WC 548.02 SF 56. Clean window unit (per side) 10 - 20 SF 5 5.00 EA 57. Clean baseboard PF 43.92 LF 58. Seal/prime the walls and ceiling - one coat (white pigmented WC 548.02 SF shellac) 59. Paint the walls and ceiling - one coat WC 548.02 SF GODINEZ LEONSO_A_&_ 6/10/2010 Page:5 ZZE CANS AMILY American Famfly Insurance Group earn ro� eus+e®saeum me w Attn: scanning center 6000 American Parkway Madison, WI 53783 mhermal@amfam.com 763-205-5545 Fax 1-866-587-4590 CONTINUED - Living DESCRIPTION CALC QNTY 60. Clean floor F 183.91 SF 61. R&R Outlet 6 6.00 EA 62. R&R Light fixture 1 1.00 EA NOTES: Entry hall I � Fra�I�+ —fib e 1 ..i 244.00 SF Walls 304.81 SF Walls & Ceiling 6.76 SY Flooring 30.50 LF Ceil. Perimeter Ceiling Height: 8+ 60.81 SF Ceiling 60.81 SF Floor 30.50 LF Floor Perimeter Missing Wall: 1- 3+4++ X 8+0++ Opens into Living Goes to Floor/Ceiling Missing Wall: 1- 4+4" X 810" Opens into Kitchen Goes to Floor/Ceiling DESCRIPTION CALC QNTY 63. Acoustic ceiling tile C 60.81 SF 64. Seal floor or ceiling joist system F 60.81 SF 65. R&R 1/2" drywall - hung, taped, floated, ready for paint C 60.81 SF 66. R&R Acoustic ceiling (popcorn) texture C 60.81 SF 67. Clean the walls W 244.00 SF 68. Clean door (per side) 2 2.00 EA 69. Finish door slab only - 1 coat urethane (per side) 2 2.00 EA GODINEZ_LEONSO_A_&_ 6/10/2010 Page:6 American Family Insurance Group Attn: scanning center 6000 American Parkway Madison, WI 53783 mhermal@amfam.com 763-205-5545 Fax 1-866-587-4590 CONTINUED - Entry hall DESCRIPTION CALC QNTY 70. Seal/prime the walls and ceiling - one coat (white pigmented WC 304.81 SF shellac) 71. Paint the walls and ceiling - one coat WC 304.81 SF 72. Remove Tile floor covering F 60.81 SF 73. Remove Underlayment - 1/2" particle board F 60.81 SF 74. Apply anti -microbial agent F/2 30.40 SF 75. Seal underlayment for odor control F/2 30.40 SF 76. Ceramic tile F 60.81 SF 77. 1/2" Cement board F 60.81 SF 78. R&R Baseboard - 2 1/4" hardwood PF 30.50 LF 79. Stain & finish baseboard PF 30.50 LF 80. R&R Light fixture 2 2.00 EA 81. R&R Outlet 3 3.00 EA NOTES: I- all. - i Bath 214.67 SF Walls 264.82 SF Walls & Ceiling 5.57 SY Flooring 26.83 LF Ceil. Perimeter Missing Wall: 1- 510" X 810" Opens into Tub GODINEZ_LEONSO_A &_ Ceiling Height: 8' 50.15 SF Ceiling 50.15 SF Floor 26.83 LF Floor Perimeter Goes to Floor/Ceiling 6/10/2010 Page:7 AMERICAN FAMILY American Family Insurance Group auaxa�tN fAR rW. Attn: scanning center 6000 American Parkway Madison, WI 53783 mhermal@amfam.com 763-205-5545 Fax 1-866-587-4590 DESCRIPTION CALC QNTY 82. Clean the walls and ceiling WC 264.82 SF 83. Clean door (per side) 2 2.00 EA 84. Clean window unit (per side) 10 - 20 SF 1 1.00 EA 85. Clean bathroom fixtures 1 1.00 EA 86. R&R Interior door - oak veneer - pre -hung unit 1 1.00 EA 87. Stain & finish door slab only (per side) 2 2.00 EA 88. Stain & finish door/window trim & jamb (per side) 1 1.00 EA 89. Seat/prime the walls and ceiling - one coat (white pigmented WC 264.82 SF shellac) 90. Paint the walls and ceiling - one coat WC 264.82 SF 91. Remove Tear out vinyl & underlayment F 50.15 SF 92. R&R Underlayment - 1/2" BC plywood F 50.15 SF 93. Apply anti -microbial agent F/2 25.08 SF 94. Seal underlayment for odor control F/2 25.08 SF 95. R&R Baseboard - 2 1/4" hardwood PF 26.83 LF 96. Stain & finish baseboard PF 26.83 LF 97. Remove Vinyl floor covering (sheet goods) F 50.15 SF 98. Vinyl floor covering (sheet goods) F 94.00 SF 99. R&R Underlayment - 1/4" 5 ply F 50.15 SF 100. Toilet - Detach & reset 1 1.00 EA 101. Detach & Reset Vanity 4 4.00 LF 102. Detach & Reset Sink - single 1 1.00 EA 103. R&R Light fixture 1 1.00 EA 104. R&R Ground fault interrupter (GFI) outlet 2 2.00 EA NOTES: GODINEZ_LEONSO_A_&_ 6/10/2010 Page:8 AMHRI� p Fy American Famfly Insurance Group auraun�e Attn: scanning center 6000 American Parkway Madison, WI 53783 mhermal@amfam.com 763-205-5545 Fax 1-866-587-4590 bed 1 X6'6° x Ir 31. (r F--13' -I 320.00 SF Walls 413.75 SF Walls & Ceiling 10.42 SY Flooring 40.00 LF Ceil. Perimeter Ceiling Height: 8' 93.75 SF Ceiling 93.75 SF Floor 40.00 LF Floor Perimeter DESCRIPTION CALC QNTY 105. Clean the walls and ceiling WC 413.75 SF 106. Clean patio door (sliding glass) (per side) 1 1.00 EA 107. Clean door (per side) 2 2.00 EA 108. Clean window unit (per side) 10 - 20 SF 1 1.00 EA 109. Clean baseboard PF 40.00 LF 110. Seal/prime the walls and ceiling - one coat (white WC 413.75 SF pigmented shellac) 111. Paint the walls and ceiling - one coat WC 413.75 SF 112. Finish door/win trim & jamb - 1 coat urethane (per side) 1 1.00 EA 113. Finish door slab only - 1 coat urethane (per side) 1 1.00 EA 114. Clean floor F 93.75 SF 115. R&R Window screen, 17 - 25 SF 1 1.00 EA 116. R&R Smoke detector 1 1.00 EA NOTES: bed 1 closet id. Tt, b N IV 152.00 SF Walls 167.00 SF Walls & Ceiling 1.67 SY Flooring 19.00 LF Ceil. Perimeter Ceiling Height: 8' 15.00 SF Ceiling 15.00 SF Floor 19.00 LF Floor Perimeter GODINEZ_LEONSO_A_&_ 6/10/2010 Page:9 aMeeicaw FMnv American Family Insurance Group Attn: scanning center 6000 American Parkway Madison, WI 53783 mhermal@amfam.com 763-205-5545 Fax 1-866-587-4590 DESCRIPTION CALC QNTY 117. Clean the walls and ceiling WC 167.00 SF 118. Clean door (per side) 2 2.00 EA 119. Clean baseboard PF 19.00 LF 120. Seal/prime the walls and ceiling - one coat (white WC 167.00 SF pigmented shellac) 1 1.00 EA 121. Paint the walls and ceiling - one coat WC 167.00 SF 122. Clean floor F 15.00 SF NOTES: irfri Stairl Ceiling Height: 17' R I I 302.08 SF Walls 30.21 SF Ceiling F. ED 332.29 SF Walls & Ceiling 55.40 SF Floor 1 V &MUM 6.16 SY Flooring 30.13 LF Floor Perimeter 24.17 LF Ceil. Perimeter Missing Wall: 1- 2'6" X 1710" Opens into Exterior Goes to Floor/Ceiling DESCRIPTION CALC QNTY 123. Clean the walls and ceiling WC 332.29 SF 124. Clean patio door (sliding glass) (per side) 1 1.00 EA 125. Clean door (per side) 1 1.00 EA 126. Seal/prime the walls and ceiling - one coat (white WC 332.29 SF pigmented shellac) 127. Paint the walls and ceiling - one coat WC 332.29 SF 128. Finish door slab only - 1 coat urethane (per side) 1 1.00 EA 129. Clean stair tread - per side - per LF 12*3 36.00 LF 130. Detach & Reset Handrail - round / oval - softwood - wall 16 16.00 LF mounted GODINEZ_LEONSO_A_&_ 6/10/2010 Page: 10 Rim- American Family Insurance Group A=0 Attn: scanning center 6000 American Parkway Madison, WI 53783 mhermal@amfam.com 763-205-5545 Fax 1-866-587-4590 DESCRIPTION NOTES: -- Bed room �a �r reg. CONTINUED - Stairl second floor 452.00 SF Walls 643.44 SF Walls & Ceiling 21.27 SY Flooring 56.50 LF Ceil. Perimeter :0 in 01 QNTY Ceiling Height: 8' 191.44 SF Ceiling 191.44 SF Floor 56.50 LF Floor Perimeter Missing Wall: 1- 3'0" X 810" Opens into Stairl Goes to Floor/Ceffing DESCRIPTION CALC QNTY 131. Clean the walls and ceiling WC 643.44 SF 132. Clean door (per side) 1 1.00 EA 133. Clean window unit (per side) 10 - 20 SF 1 1.00 EA 134. Clean baseboard PF 56.50 LF 135. Seal/prime the walls and ceiling - one coat (white WC 643.44 SF pigmented shellac) 136. Paint the walls and ceiling - one coat WC 643.44 SF 137. Stain & finish trim 20* 10+PF*2 313.00 LF 138. Clean floor F 191.44 SF 139. R&R Smoke detector 1 1.00 EA GODINEZ_LEONSO A &_ 6/10/2010 Page: 11 A oER W American Family Insurance Group aura rra� euavessrrptmtveW Attn: scanning center 6000 American Parkway Madison, WI 53783 mhermal@amfain.com 763-205-5545 Fax 1-866-587-4590 CONTINUED - Bed room DESCRIPTION NOTES: CALC QNTY T T Stairl Ceiling Height: 17' N 303.13 SF Walls 36.38 SF Ceiling 339.50 SF Walls & Ceiling 66.85 SF Floor 7.43 SY Flooring 30.20 LF Floor Perimeter 24.25 LF Ceil. Perimeter Missing Wall: 1- 310" X 1710" Opens into Exterior Goes to Floor/Ceiling Missing Wall: 1- 3'0" X 1710" Opens into Bed room Goes to Floor/Ceiling DESCRIPTION CALC QNTY 140. Clean the walls and ceiling WC 339.50 SF 141. Clean door (per side) 2 2.00 EA 142. Clean stair stringer - per side 32 32.00 LF 143. Clean stair tread - per side - per LF 12*3 36.00 LF 144. Clean baseboard PF 30.20 LF 145. Seal/prime the walls and ceiling - one coat (white WC 339.50 SF pigmented shellac) 146. Paint the walls and ceiling - one coat WC 339.50 SF 147. Finish door slab only - 1 coat urethane (per side) 1 1.00 EA 148. Clean floor F 66.85 SF 149. Detach & Reset Handrail - round / oval - softwood - wall 18 18.00 LF mounted GODINEZ_LEONSO A_&_ 6/10/2010 Page: 12 AMERICAN m,Ly American Family Insurance Group Attn: scanning center 6000 American Parkway Madison, WI 53783 mhennal@amfam.com 763-205-5545 Fax 1-866-587-4590 DESCRIPTION NOTES: Closet CONTINUED - Staid 260.00 SF Walls 314.63 SF Walls & Ceiling 6.07 SY Flooring 32.50 LF Ceil. Perimeter CALC QNTY Ceiling Height: 8' 54.63 SF Ceiling 54.63 SF Floor 32.50 LF Floor Perimeter DESCRIPTION CALC QNTY 150. Clean the walls and ceiling WC 314.63 SF 151. Clean door (per side) 1 1.00 EA 152. Clean window unit (per side) 10 - 20 SF 1 1.00 EA 153. Clean baseboard PF 32.50 LF 154. Sea]/prime the walls and ceiling - one coat (white WC 314.63 SF pigmented shellac) 155. Paint the walls and ceiling - one coat WC 314.63 SF 156. Clean floor F 54.63 SF NOTES: basement GODINEZ_LEONSO_A &_ 6/10/2010 Page: 13 AaEORcnn F"American Family Insurance Group Attn: scanning center 6000 American Parkway Madison, WI 53783 mhermal@amfam.com 763-205-5545 Fax 1-866-587-4590 Utility y 4 b 6 11 °� 625.33 SF Walls 899.97 SF Walls & Ceiling 30.51 SY Flooring 78.17 LF Ceil. Perimeter Ceiling Height: 8' 274.63 SF Ceiling 274.63 SF Floor 78.17 LF Floor Perimeter Missing Wall: 1- 3110" X 810" Opens into Hall Goes to Floor/Ceiling DESCRIPTION CALC QNTY 157. Clean floor or roof joist system C 274.63 SF 158. Clean the walls W 625.33 SF 159. Clean ductwork - Exterior (per LF) 16 16.00 LF 160. Clean water heater - Heavy 1 1.00 EA 161. Clean furnace - forced air 1 1.00 EA 162. Cleaning Technician - per hour - MISC WATEP GAS,& 4 4.00 HR DRAIN LINES 163. Clean floor F 274.63 SF 164. Seal floor or ceiling joist system F 274.63 SF 165. Remove 110 volt copper wiring run and box - rough in only 1 1.00 EA 166. 110 volt copper wiring run and box - rough in only 1 1.00 EA 167. Remove Light fixture 1 1.00 EA 168. Light fixture 1 1.00 EA 169. R&R Ground fault interrupter (GFI) outlet 2 2.00 EA 170. Breaker panel - 70 amp w/arc fault breakers 1 1.00 EA 171. R&R Smoke detector 1 1.00 EA NOTES: GODINEZ LEONSO_A_&_ 6/10/2010 Page: 14 AMERICA_R� American Family Insurance Group sura eros sine rtsa i�erax urt � Attn: scanning center 6000 American Parkway Madison, WI 53783 mhermal@amfam.com 763-205-5545 Fax 1-866-5874590 Bathroom Ceiling Height: 8' 236.00 SF Walls 49.88 SF Ceiling 285.88 SF Walls & Ceiling 49.88 SF Floor 5.54 SY Flooring 29.50 LF Floor Perimeter l 29.50 LF Ceil. Perimeter sr—a' II DESCRIPTION CALC QNTY 172. Clean the walls and ceiling WC 285.88 SF 173. Clean door (per side) 2 2.00 EA 174. Clean window unit (per side) 10 - 20 SF 1 1.00 EA 175. Clean bathroom fixtures l 1.00 EA 176. Seal/prime the walls and ceiling - one coat (white WC 285.88 SF pigmented shellac) 177. Paint the walls and ceiling - one coat WC 285.88 SF NOTES: i r a 1 Hall T - T Missing Wall: 1- 3110" X 810" DESCRIPTION 178. Clean the walls and ceiling GODINEZ_LEONSO_A &_ Ceiling Height: 8' 266.67 SF Walls 53.47 SF Ceiling 320.14 SF Walls & Ceiling 53.47 SF Floor 5.94 SY Flooring 33.33 LF Floor Perimeter 33.33 LF Ceil. Perimeter Opens into Utility Goes to Floor/Ceiling CALC QNTY WC 320.14 SF 6/10/2010 Page: 15 AMIR1 American Family Insurance Group aumacc�e�s�vxtnr� Attn: scanning center 6000 American Parkway Madison, WI 53783 mhermal@amfam.com 763-205-5545 Fax 1-866-587-4590 CONTINUED - Hall DESCRIPTION CALC QNTY 179. Clean door (per side) 1 1.00 EA 180. Clean window unit (per side) 10 - 20 SF 1 1.00 EA 181. Clean floor F 53.47 SF 182. R&R Smoke detector 1 1.00 EA NOTES: bed 3 540.00 SF Walls 786.19 SF Walls & Ceiling 27.35 SY Flooring 67.50 LF Ceil. Perimeter Ceiling Height: 8' 246.19 SF Ceiling 246.19 SF Floor 67.50 LF Floor Perimeter Subroom 1: Closet Ceiling Height: 8' 6 9• • 148.00 SF Walls 16.88 SF Ceiling N .4°F— ?9'N 164.88 SF Walls & Ceiling 16.88 SF Floor 1 1'6° 1'9° 1.88 SY Flooring 18.50 LF Floor Perimeter 18.50 LF Ceil. Perimeter DESCRIPTION CALC QNTY 183. Clean the walls and ceiling WC 951.07 SF 184. Clean door (per side) 1 1.00 EA 185. Clean window unit (per side) 10 - 20 SF 1 1.00 EA GODINEZ_LEONSO_A_&_ 6/10/2010 Page: 16 AMHRi�CAp` FAAmerican Family Insurance Group AMfi &fffi=X%MLtt Attn: scanning center 6000 American Parkway Madison, WI 53783 mhennal@amfam.com 763-205-5545 Fax 1-866-587-4590 CONTINUED - bed 3 DESCRIPTION CALC QNTY 186. Clean floor F 263.07 SF 187. R&R Smoke detector 1 1.00 EA NOTES: Garage LxWxH 20' x 24' x 8' 704.00 SF Walls 480.00 SF Ceiling 1184.00 SF Walls & Ceiling 480.00 SF Floor ®� 53.33 SY Flooring 88.00 LF Floor Perimeter 160.00 SF Long Wall 192.00 SF Short Wall 88.00 LF Ceil. Perimeter DESCRIPTION CALC QNTY 188. Clean part of the walls W/2 352.00 SF 189. Seal & paint stucco W/2 352.00 SF NOTES: Miscellaneous GODINEZ_LEONSO_A_&_ 6/10/2010 Page: 17 AM6RI' �p�p �pjy�o�y American Family Insurance Group aurd�a Attn: scanning center 6000 American Parkway Madison, WI 53783 mhermal@amfam.com 763-205-5545 Fax 1-866-5874590 DESCRIPTION CALC QNTY ADDITIONAL REPAIRS IF REQUIRED BY CITY OF FRIDLEY WILL BE AT EXTRA CHARGE. 190. Furnace - check, clean, replace filters and service 1 1.00 EA 191. Clean ductwork - Interior (PER REGISTER) 12 12.00 EA 192. Dumpster load - Approx. 30 yards, 5-7 tons of debris 1 1.00 EA 193. General clean -up 8 8.00 HR 194. Taxes, insurance, permits & fees (Bid item) 1 1.00 EA NOTES: Grand Total Areas: 5,681.43 SF Walls 2,180.16 SF Floor 160.00 SF Long Wall 1,700.16 Floor Area 2,688.00 Exterior Wall Area 0.00 Surface Area 0.00 Total Ridge Length 2,124.50 SF Ceiling 242.24 SY Flooring 192.00 SF Short Wall 1,771.18 Total Area 336.00 Exterior Perimeter of Walls 0.00 Number of Squares 0.00 Total Hip Length 7,805.93 SF Walls and Ceiling 691.67 LF Floor Perimeter 698.92 LF Ceil. Perimeter 4,278.89 Interior Wall Area 0.00 Total Perimeter Length GODINEZ_LEONSO A_&_ 6/10/2010 Page: 18 Building BUILDING Permit No0 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 763-502-4977 FAX EFFECTIVE 1-1-2010 DATE 2— P7 - A® YOUR E-MAIL ADDRESS SITE ADDRESS 16 /J! ®12QV7 Z04- '_ 5 f /V d % l".'J't Y 12 - ZTHIS THIS APPLICANT IS: (LOWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: ADDRESS:J�./g 04 0,1? Sf NF CITY �r STATE ziP SS`/)Z TENANT PHONE:6 j fi'S CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: I CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED 12 WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING 0 HOUSE ONLY BASEMENT REMODELING SUBMIT NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ❑ Vinyl ❑Soffit ADDITIONS_ & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGSYes ❑No LOCATION OF WINDQWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF SeP" e014 7 MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: TOTAL JOB VALUATION $ '(V670ING THE 1997 U.B.0 FEE SCHEDULE) OCCUPANCY TYPE Permit Fee $ ��, y7C=> See Back Page for Fee Schedule Plan Review $ I�'. , 12 2! 65% of Building Permit Fee Fire Surcharge $ I -qo .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ l Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks savable to: Citv of Fridlev 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 ork which requires review and approval of plans. SIGNATURE OF APPLICi� ~ _ NAME 4w 5a DATE 9-1 '7