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PRE 2010 DOCSCity of Fridley, Minn". BUILDING PERMIT Date: FEBRUARY 15, 1966 Owner: WILLIAM ZAIER Address 6212 Carol Drive N. E. Fridley, Minnesota 55421 Builder Address 3231 Central Avenue No E. Minneapolis, Minnesota g°Yz- N° 8678 ERCO, INCORPORATED LOCATION OF BUILDING No. 6723 Street Overton Drive N. E. pmt of Lot Lot 8 _ Block 1 Addition or Sub -Division MSADOWGANDS, 2nd Addition Corner Lot _ Inside Lot % Setback 35 Sideyard 5 and 10 Sewer Elevation ____ 862.5 Foundation Elevation 872 DESCRIPTION OF BUILDING To be Used as: DWELLING Frcnt 41 Depth 25 Height 20 , Ft. 1, 025 Cu. Ft. 20,500 GARAGE Front 19 Depth 25 Height 10 Sq. Ft. 475 Cu. Ft. 4, 75 0 - Type of Construction Frame Est Cost_ $16,500 To be Completed In consideration of the issuance to me of a permit to ding described above I agree do the proposed work in accordance with the description abov t f as once with ail ns of ordinances of the city of Fridley. n In consideration of the payment of a fee of S 26.00 . permit is hereby granted to ERCO, INC. 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, construct%n, alteration, maintenance, repair and moving of build within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ALLEN G. JENSEN Building inspector NOTICE: ffib pormh don not cow Ao aondmcd n, W tsllsNon for wlrh o, pWmbina, Ya henna osonr or webr. Be am to so the BuNhro hopator for apmft pormhs hr than halm .q APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA II OWNER" S NAME /f� Z,4, es -e-- BUILDER 52-3 i i LOCATION OF BUILDING (� 7-3Street Part of Lot LOT KADDITION OR SUBDIVISION:�%�Zs✓�c �rl� Corner Lot Inside LOT f/ Setback Side -Yard � l .-SEWER . ELEVAT'LON i® 2-- r FOUNDATION ELEVATTON._ �Z.•� Applicant attach to this form Two Cer ificates of Survey of Lot and proposed building location dtawd on these Certificates. DESCRIPTION 6F BUILDING To be used as; Sq. Ft._—rZ1 J Cu. Ft.!!roe) Front ( Depth7- S�geight Sq. Ft. ✓ Cu. Ft.�Z 7 Type of Construction Estimated cost,116,�`� 0 To be completed_ The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are trAV and correct. (Schedule of Fee Costs can be found on the Reverse Side). SUBJECT City of Fridley 26 J7, AT THE TOP OF THE TWINS BUILDING PERMIT r REC � COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r � � PROTECTIVE 1 i � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/31/89 JOB ADDRESS 6723. Overton Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 1 Meadowlands Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Swanson 6723 Overton Drive N.E. 571-5175 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Amre 2804 Vicksburg Lane, Plymouth, MN 553-9274 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 8 DESCRIBE WORK Construct a 161 x 1V Deck Addition 9 CHANGE OF USE FROM TO STIPULATIONS See plans for notations. Provide flashing where new deck meets existing house. 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 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 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 $l, 350 $.68 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- $33.00 STRUCTION OR TH5 JERFORMANCE OF CONSTFLUCTION. PLAN CHECK FEE TOTAL FEE in _ $33.68 SIGNATURECONTRACTO ORAUTHORIZEDAGENT IDATEI WHEN PROPERLY ALIDATE THIS IS YOUR PERMIT • �, BLDG INzw f DAT SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE) NEW [ ] ADDN [ ] R-1 AND R-2 ALTER [ ] 2 �/ 7 -7 Building Permit Application Construction Address: 6j � 6 u cWVA �p, Legal Description: /_ -3 A /6 Effective 5/1/88 Q�M M Owner Name & Address: 9tj_QJ) 1- ��J�¢�1J d E �arn� Contractor: ASA e. Tel. Address: 2 ob Z_( U l% Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. OF LIVIM AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length - 1 Width / Hqt/Ground' Sq. Ft. % Z GUM Corner Lot [ ] Inside Lot Ft. Yd Setback Side Yard Setbacks Type of Construction: 46-6 L.n Estimated Cost: $ 0 Approx. Completion Date: Proposed Driveway Width If New Opening Is ired: Ft. $ $ Wi + See Back Page DATE: 2 APPLSCANT: r Tel. CITY USE OMY Permit Fee $ , Fee Schedule on Reverse Side State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $575 per SAC Unit Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL � �oJ � 00 06 , ®d ;ITY.dF FRIDLEY INSPECTION DIVISION Effective On January 1, 1999 A31 University Ave NE 'ddley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, ;72-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS C; __72- 2D Gye'-+. ✓1 IZ RATE SCHEDULE tesidential Fumace Shell and Duct Work, Bumer — Also Replacement Fumace (Side Vent — FII Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer Rate TOTAL $ 30.00 $ $10.00 $ $10.00 $ $10.00 $ "Air Conditioning — All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work :ommercial/I ndustrial 1.25% of Value of Appliance or Work The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Building Division, and,hereby declares that all the facts and representations stated in this application are true and correct. OWNER BUILDING USED AS ESTIMATED COST S 5 PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Total Connected Load State Surcharge $ .50 Bumer Trade Name Size No. BTU HP EDR TOTAL FEE $ A'S_ HOME ENERGY C zNTER 15200 25TH AVE. N. #128 PLYMOUTH, MN 55447 HEATING COMPANY MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION 1EFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 FLUS THE $.50 STATE SURCHARGE 3EINSPECTION FEE $42.00/Hr Signed By Tel No. Approved By Rough—In Date (4 _?Cn- l q 9 Final Date 'Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Witten permission from adjoining property owner. RIGHT -J LOAD AND EQUIPMENT SUMMARY File name: Loadl . bld For: Wilka 6723 Overton Drive Fridley MN 55432 By: Home Energy Center 15200 25th Avenue North Plymouth MN 55447 612.476.1990 WINTER DESIGN CONDITIONS Outside db: —12 Deg F Inside db: 70 Deg F Design TD: 82 Deg F HEATING SUMMARY Bldg. Heat Loss 0 Btuh Ventilation Air 0 CFM Vent Air Loss 0 Btuh Design Heat Load 0 Btuh INFILTRATION Deg F Method S impl i f ied Construction Quality Design TD: Average Fireplaces Daily Range 0 0.00 HEATING COOLING Area (sq.ft.) 0 912 Volume (cu.ft.) 0 7296 Air Changes/Hour 1.2 0.5 Equivalent CFM 0 61 HEATING EQUIPMENT SUMMARY Job # Wthr Minneapolis /St._Paul_AP MN Zone Entire House SUMMER DESIGN CONDITIONS Outside db: 89 Deg F Inside db: 75 Deg F Design TD: 14 Deg F Daily Range M 0.00 Rel. Hum.: 50 % Grains Water 33 gr SENSIBLE COOLING EQUIP LOAD SIZING Structure 13901 Btuh Ventilation 0 Btuh Design Temp. Swing 3.0 Deg F Use Mfg. Data n Btuh Rate/Swing Mult. 0.95 CFM Total Sens Equip Load 13206 Btuh LATENT COOLING EQUIP LOAD SIZING Internal Gains 1380 Btuh Ventilation 0 Btuh Infiltration 1367 Btuh Tot Latent Equip Load 2747 Btuh Total Equip Load 15953 Btuh COOLING EQUIPMENT SUMMARY Make Make Model Model Type Type Efficiency / HSPF 0.00 COP/EER/SEER 0.00 Heating Input 0 Btuh Sensible Cooling 0 Btuh Heating Output 0 Btuh Latent Cooling 0 Btuh Heating Temp Rise 0 Deg F Total Cooling 0 Btuh Actual Heating Fan 665 CFM Actual Cooling Fan 665 CFM Htg Air Flow Factor 0.000 CFM/Btuh Clg Air Flow Factor 0.048 CFM/Btuh Space Thermostat Load Sens Heat Ratio 83 MANUAL J: 7th Ed. RIGHT -J: V I 3.0.0 5 S/N 11089 Printout certified by ACCA to meet all requirements of Manual Form J Loadl Job# Zone: Entire House Printout certified by ACCA to meet all requirements of Manual J Form MANUALJ: imna. a.U.U� 0iiN -- 1 NameofRoom Entire House Wilka 2 Running Ft. Exposed Wall 124.0 Ft. 124.0 Ft. Ft. Ft. 3 Room Dimensions, Ft. 0.0 t. 24.0 x 38.0 Ft. x Ft. x Ft. 4 Ceiings, Ft Condit. Option 8.0 d 8.0 cool_only TYPE OF CST HTM Area Btuh Area Btuh Area Btuh Area Btuh EXPOSURE NO. Htg Clg Length Htg Clg Length Htg Clg Length Htg Clg Length Htg Clg 5 Gross a 12C 7.4 1.6 992 twr♦ +tss 992 ssss rrss trrr ♦sss ♦sss ssss Exposed b 0.0 0.0 0 ss«+ ssss p rerr +srr sss♦ ♦sss •sss rwss Walls and c 0.0 0.0 0 +rs. wtr p ss«« sss« ssss rwrs ss«s sss« Partitions d 0.0 0.0 0 •"' '•'• 0 *'•' '**• ««+« ssss sss• ssss e 0.0 0.0 0 +rss tssr p ssss ssss «sss rrrw ssr♦ +«+« f 0 0.0 p ttss tits p ♦wtr t♦t♦ stss +t:♦ e♦ts +sss 6 Windows and a 2A 39.0 *• 138 0 *'** 138 0 *'** '•'* "`" Glass Doors b 0.0 •• 0 0 •"• 0 0 «*** '°'• `"`" Heating c 0.0 •' 0 0 •+•' 0 0 "'* '+'• s«+« d 0.0 ** 0 0 ssss p p an ssss sss+ e 0.0 •° 0 0 rrrr p p •sss ««w ♦sss f 0.0 •' 0 0 •••' p p sss« ass was 7 Windows and North 27.0 60 *"• 1620 60 •*'• 1620 "" •"" Glass Doors NE/NW 0.0 0 *'*' 0 0 •'•• 0 "'• •"" Cooling E/W 85.0 18 °'•• 1530 18 *'•• 1530 ""• '""" SE/SW 0.0 0 ssss p p sit♦ p rtss ssss South 44.0 60 •**° 2640 60 •'•' 2640 Horz 0.0 0 i°" 0 0 •*•• 0 *"' •"•" 8 Other doors a 1OF 26.2 5.6 42 0 237 42 0 237 b 0.0 0.0 0 0 0 0 0 0 9 Net a 12C 7.4 1.6 812 0 1286 812 0 1286 Exposed b 0.0 0.0 0 0 0 0 0 0 Walls and c 0.0 0.0 0 0 0 0 0 0 Partitions d 0.0 0.0 0 0 0 0 0 0 e 0.0 0.0 0 0 0 0 0 0 f 0.0 0.0 0 0 0 0 0 0 10 Ceilings a 16D 4.3 1.6 912 0 1450 912 0 1450 b 0.0 0.0 0 0 0 0 0 0 C 0.0 0.0 0 0 0 0 0 0 11 Floors a 19F 8.9 0.0 912 0 0 912 0 0 b 0.0 0.0 0 0 0 0 0 0 C 0.0 0.0 0 0 0 0 0 0 12 Infiltration a 0.0 5.2 180 0 938 180 0 938 13 Subtot Btuh Losses+8. +11+12 +sss p ssss ss«r p ssss ssss •+++ s«ss •**« 14 Duct Btuh Loss 0% 0 '•'• 00� p ss«+ o� srs+ off* sts« 15 Total Btuh Loss = 13+14 ••*r p ss*+ rsss p stst +«sr ♦+s+ srss s«s« 16 Int. Gains: People@ 300 6 ••'• 1800 6 '•'• 1800 ***` `"°• Appl. @ 1200 2 ssss 2400 2 **'• 2400 °'•' rns 17 SubtotRSH Gain=7+8..+12+16 •'•• *"' 13901 ••*• •'•• 13901 **°• "" •'•' "°• 18 Duct Btuh Gain po/ ♦stt p poi sws♦ p o� ssss % tsrs 19 Total RSH Gain=(17+18)*PLF 1.00 °"` 13901 1.00 •'•' 13901 "°* •'•• 20 CFM Air Required *"* 0 665 *'•• 0 665 •'** "" Printout certified by ACCA to meet all requirements of Manual J Form CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 YAX: (763) 571-12137 ADDRESS : 6723 OVERTON DR NE PIN : 143024140087 LEGAL DESC : MEADOWLANDS 2ND ADD : LOT 8 BLOCK 1 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMI'I�O.: 20040035 13�� DATE ISSUED: 03/18/2004 VALUATION : $ 700.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A INSTALL GAS WATER HEATER # ELEC WATER HEATERS # NEW FIXTURES (EXIST OPENINGS) # GAS DRYERS # OF NEW FIXTURES 0 VALUE OF FIXTURE/APPLIANCE 0 0 # GAS WATER HEATERS 1 0 # GAS RANGES 0 0 # WATER TRMT APPLIANCES 0 APPLICANT PLBG PERMIT MINIMUM FEE 20.00 RIVER CITY SHEET METAL INC PLBG FIXTURES (NEW OPENINGS) 0.00 9928 BLUEBIRD ST NW PLBG FIXTURES (EXIST OPENINGS) 0.00 COON RAPIDS, MN 55433 WATER TREATMENT APPLIANCE 0.00 (763) 754-2199 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 0.00 GAS RANGE FEE 0.00 OWNER GAS DRYER FEE 0.00 WILKA JAMES P & LEE M PLBG REPAIR/ALTERATIONS 0.00 6723 OVERTON DR NE STATE SURCHARGE, PLBG FLAT 0.50 FRIDLEY, MN 55432 TOTAL 20.50 PAID WITH CHECK # 12611 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating conspction or the performance of construction. ADnI cE aftt-- II Date 1 Bldg SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Y OF FRIDLEY INSPECTION DIV, 31 University Ave NE dley, MN 55432 a •3) 572-3604, FAX (763) 571-1287 9 L Effective On Jan 1, 2003 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RAADW TVI IRADCD nG C1YT1 IDFC Tn RK INCTAI I r -n nN FAn" FI r1nR .UMBING FIXTURE RATES: - aw Fixtures id Opening, New Fixture :er Dispenser ow Off Basin atch Basin ain Water Leader errtplReceiving Tank later Treating Appliance later Heater -Electric Dater Heater - Gas" NO. RATE TOTAL I ias Range" Sas Dryer— ' .ack Flow Preventer Required ( )Yes No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.G0 $10.00 $15.00 Wnspection Fee $47.00lHr ►LL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .5a TOTAL FEE $ ao - SO JOB ADDRESS_ LrI a3 ©ui9i( +O n3 .1f�, w, F_ . The undersigned hereby makes application for a permit'for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. 311x. ,2004 Owner Building Used As � . 3e LLS h - Ca -Estimated Cost 7 0 0. 0 0 PERMIT NO, 00,V m! U� S aee4v rneT AI , ire PLUMBING COMPANY X010 SStF33 SIGNED BY TEL N0. 6 103— —C1 Ci Approved By Rough -in Date Final Dale l) MINIMUM FEE FOR ANY PLUMBINGIGAS PERMIT 1S $20.00 PLUS THE 8.60 STATE SURCHARGE 30MBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE FI Wash Floor ?,,h Auto.s Gas .. , - Water Neater Stories 33. Urinal px �.� �_ = Shower xf . 1 is � i - z % Tra �,�.. ��w Drain _1t1 ;_Washer , ': ._ .. Range »? :.- Gas Elec ;ai•!?i 'mis ��: _ 3%ifieFx ..�x.mci�"'.•'7:for. II°.°-io•••'�,oai?xs ;a Si^i a+5. - t%`` �; Basement ..,>��_�:_ :.. :.: ,�,>� :�,>�::_ x� . n}:�.�.R �. • I K:F�-,''• y�s�� :..,. f�" �.'�. <; a1.yb`,.S .x". - .P�, f�. .. . �� n. i$ee,'� '°X 3ioF• •<o zxa�3�` .. ,z^:`. •' ivy',... .EYAI`h;Q' .00r I Floor �•£�Fi:. ;F '•i.nnr �-�(����i•Rt ync1F.;�r:- �1??ei2:..: .::nom c ..per •ii! .. . _?M•:..F f.,.. r.- pd?.:•:. ea?�_-: ;1cx:pxE!3x Floor 2 �': xY.:nc?!'•'��.: xz:•:.-.. sii-r<.:, -3�-7�y:•A='o^ -»� •3E3?. `'�yiGiT[� 4i� :o�"s..c p''eCe=�I�e3i''a`: .:. '7R:'$.=.•.... s:R-3�'lFY°�oe'_.IF a..•x�::..4r..... •y,;irF:. .. .. xaat.. J�LIR `?xypx �'?�O;/�0�^X _:'• .. FI 3 ??C-saY':': z.......M,.�tiE_ .y. _""• �'u.. J�x �ac� ,;i..._p: -.:: Y Floor 4 = x�- ��10Kx:- -ix,t<�= •�::,y'1:, ->t�t;rf :ilt�'��T.ia��1p,ic x,-; .•:,g._d�a� z=-:. lrrs.:>••.>; -'T°-_�siuts-` =x<i'.,� -z��es: .UMBING FIXTURE RATES: - aw Fixtures id Opening, New Fixture :er Dispenser ow Off Basin atch Basin ain Water Leader errtplReceiving Tank later Treating Appliance later Heater -Electric Dater Heater - Gas" NO. RATE TOTAL I ias Range" Sas Dryer— ' .ack Flow Preventer Required ( )Yes No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.G0 $10.00 $15.00 Wnspection Fee $47.00lHr ►LL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .5a TOTAL FEE $ ao - SO JOB ADDRESS_ LrI a3 ©ui9i( +O n3 .1f�, w, F_ . The undersigned hereby makes application for a permit'for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. 311x. ,2004 Owner Building Used As � . 3e LLS h - Ca -Estimated Cost 7 0 0. 0 0 PERMIT NO, 00,V m! U� S aee4v rneT AI , ire PLUMBING COMPANY X010 SStF33 SIGNED BY TEL N0. 6 103— —C1 Ci Approved By Rough -in Date Final Dale l) MINIMUM FEE FOR ANY PLUMBINGIGAS PERMIT 1S $20.00 PLUS THE 8.60 STATE SURCHARGE 30MBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE wilding BUILDING Permit No.' Inspections RESIDENTIAL APPLICATION Received By. 763-572-3604 CITY OF FRIDLEY Da'd: 763-50//2��-4977 FAX EFFECTIVE 1-1-2010 THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: S 1 nn Is 1 ► I K&, ADDRESS: (e -ja 3 ®ver-FDN CITY P ICA ( U4 STATE MW ZIPe�- TENANT PHONE: CONTRACTOR NAME: STATE LICENSE # EXP DATE 3 -Z3 1-- ao, SUBMIT A COPY OF YOUR STATE LICENSE ��} P " ZILPIL HWZIP $IOJ AND CERTIFICATE OF ADDRESS: a-`� p�=-tydr CITY rk; STATE INSURANCE PHONE % c7--7 f6 '7-7, FAX -76,3 _ $— 6, r1 PROPERTY TYPE ,}'SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH PROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: NEW HOME CONSTRUCTION 11ADDITION F�SMAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: —7249-e--7249-e-OLFf iK l6 00or SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES NHOUSE & 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 Pian/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 $ /010- 00 OCCUPANCY TYPE Permit Fee $ ,y _qO:1.15 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ j. .r .001 times the total job valuation Surcharge $ rL& 10 .0005 x Permit Valuation Minimum $.50 License Surcharge $ 7 - ry $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 la, $ Agreement necessary ( ) Non Necessary ( ) Total Dae u$ 1. Make checks parable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all >Nyork wh'ch regUes review and approval of Plans. e SIGNATURE OF APPLICANT _PRINT NAME �`^�y �"� S DATE PLEASE NOTE: SEPARATE PERNM ARE REQUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK