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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N® 3971 Date: ..... ?uae..? s..195.9 ................. Owner ....................................... Builder .... BYT118.Be8On ......................... Address ...................................... Address ............................................. LOCATION OF BUILDING No. 11 ........ Street ..... ftft: Q, XXi1M . Rs . Z* ........ Part of Lot .... .. ............ ...... . 1? ......!4 . Esookviev �Torreae 3rd Adds, Lot ............ Block ......... Addition or Sub -Division .......................... �. ........... Corner Lot ............ Inside Lot ............ Setback 35V! ..... Sideyard ... 1001 ................. DESCRIPTION OF BUILDING To be Used as: t . Womme ...... I Front .41 F4.1 Depth Vs. .. Height .1964" sq. FL .1.0541 . Cu. Ft. 4045. .................... Front ........ Depth ........ Height ........ Sq. Ft. ........ Cm Ft. ........ Type of Construction ................... Est. Cost... 0120.9646%.... 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 descrl a o set forth compliance with all provisions of ordinances of the city of Fridley. /�). In consideration of the payment of a fee of 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. 139 sure to see the Building Inspector for separate permits for these Items. City of Fridley, Minn. l BUILDING PERMIT N® .7226 tBuilder Address Address 7%� LO TION O I/UIL`DING No. �� -�-- Street � - _ P Lot _ Lot - Qom__ Block Addition or Sub- on . i Corner Lot Inside Lot �� Setback Sideyard _ Sewer Elevation ___ F021 Elevation DESCRIPTION OF BUILDING TTIV Front Depth Height 112 Sq. Ft. Cu. Fro Depth Height Sq. FtAa Cu. n/,f Type of Construction Fast. be Completed In consideration of the issuance to me of a permit to construct the building described a , I agree to do the proposed work in accordance with the description above orth and in compliance wi all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $�'� , 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 FdY� leB�innesota regarding location, construction, alteration, maintenance, repair and moving of buildings hin he dty ]units and this permit may be revoked at any time upon violan of any of the provisions of said inances. NOTICE: This portt does not cower the construction, fnttaMon for wiring, plumbing, gat heating, wwor or water. Be suru to see the Building Inspector for separate permits for theta hom APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME�`ev,/ a/ el];�od /.g,4LG BUILDER ADDRESS �%�f ;tt�L�l� a � � ��� .ADDRESS i g - d C'e� LOCATION OF BUILDING No. ,� �l Street �� �/®,;2. Part of Lot Loti Z. Biock.. Addition ,or Subdivision , Corner Lot Inside Lot Z-- Setback Side : Yard, •3 SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to•this -form Two Certificates of Survey of Lot and proposed build- ing location-draww on these Certificates. DESCRIPTION OF BUILDING To be used as: „., Front Depths Height r Sq. Ft. .Cu. Ft. 2'a Front Depth Height /d Sq. Ft. Cu. Ft.. 4 Type of Construction. ;X. Estimated Cost To be Completed C,� �� / S7 . 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 Ordinanc'ea and rulings ©f.the.Department of,Buildings, and hereby declares that all,the facts and representations stated in this application are true and correct. DATE_- 0 Schedule of Fee Costs can be found on the Reverse Side). City of Fridley, Minn. BUILDING PERMIT Date: JUNE 18, 1965 RONALD DE BROBANDER Builder JAMES W. WALTHOUR ,:)-k- l(c/ N° '7942 Address 711 Pandora Drive N. E. Adder 3507 Woodbine Lane North Brooklyn Center, Minnesota LOCATION OF BUILDING No. 711 Street PANDORA DRIVE N.E. Part of Lot Lot 17 _ Block 4 Addition or Sub -Division Brookview Terrace, 3rd Addition. Corner Lot _ Inside Lot Setback Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Fast. Cost $1,550.00 To be Completed REBUILD GARAGE ON ORIGINAL FOUNDATION 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 aplorth and in compliance with 21 ons of ca dinances of the city of Fridley. / In consideration of the payment of a fee of $_5 - 00 v , permit is hereby granted to James W. Walthour 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, Minnesotating location, construction, alteration, maintenance, repair and moving of buildings wiorthinn�. city limits � this permit may be revoked at any time upon violation of any of the provisions of said NOTICE: Ibb permit doss not cover the coestrocHm, ftwhWtlen for wkhm plumbln& gss hedhm sewer or water. Be sore to see the Beiidiae kapseter for sopmft permits for thm hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME 91 ��.�,� ��` � ,V r, ,O V,OAC BUILDER J9iV ADDRESSZZ( �� A.JQ4/4 A V9, DDnSs 35-d 7 W.6 el adr'V e LOCATION OF BUILDING Street part of Lot LOT aLOCIC ADDITION OR SUBDIVISION Corner Lot Inside LOT Setback Side -Yard SEWER ELEVATION _TFOUNDATION ELEVATIOk Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To be used as: DESCRIPTION OF BUILDING Front Depth` Height Sq. Ft. Cu. Ft. Front Depth _Height Sq. Ft. Cu. Ft. Type of Construction , .V)c .7. � ""'Y" '* "' , NZ�I�fff Estimated Cast To be completed_ -�J—VL / t b 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 true and correct. (Schedule of Fee Costs can be found on �e Reverse Side). 11 SuBjECT PERMIT City of Fridley "10 9 2 5 AT THE TOP OF THE TWINS BUILDING PERMIT REC . ` COMMUNITY DEVELOPMENT DIV. - ______ SEC. r PROTECTIVE INSPECTION 1 � � � CITY HALL FRIDLEY 55432 NUMBER AEv GATE PAGE OF APPROVED BY L 612-571-3450 9�0-Ft5 5/9/00 10B ADDRESS 711 Pandora Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17 4 1 Brookview Terrace 3rd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ron Debrobander 711 Pandora Drive NE 571-1967 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO North Central Builders Inc 7401 42 Ave N, New Hope, MN 55427 533-6168 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 O NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Soffit & Fascia 9 CHANGE OF USE FROM TO STIPULATIONS Install soffit ventilation to meet the State Building Code. Permit inspection Cards Will Be Mailed ib Homeowner To Post 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 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 $.76 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,532 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTA FEE Licen $5. 0 $ 4.34 SIGNATURE OFCON 'RACTORORAUTHORIZED AGENT IDATEI PR PE Y ALIDAT HIS IS JPUR PERMIT _ 0601FHEN A, nit'Nip OA TE SIGNATURE OF OWNE A, IF OWNER BUILDER, IDATEI 11 NEW [ ] Effective 1/1/2000 ADDN [ ] CITY OF FRIDLEY 612-572-3604 Bldg)nsp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 6 Construction Address: ll EdA)'Ooke / E� U E Legal Description: Owner Name & Address: Contractor: -/L/O Address: /Ve EL °L L U f � S C'.MN LICENSE # rain 14�uc-U)UE ua4 Tei.# `7&3-533- 61�8 4oPc- / /" /L) sf5ga7 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$ DATE: APPLICANT: Tei. # CITY USS ONLY - Call (612) 572-3604 for Permit Fees if mailing in application Permit Fee Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ ° %b $.50/$1,000 Valuation SAC Charge - - $ • ` . $1100 per SAC Unit License Surcharge $5.00 (State Licensed Residential Contractors) Driveway Escrow $ r 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 [ j TOTAL $ L .N STIPULATIONS: Su6jEGT City of Fridley 7,32107 AT THE TOP OF THE TWINS BUILDING PERMIT t• �' >r __�___ COMMUNITY DEVELOPMENT DIV. ���-�® 4 RE f : � PROTECTIVE INSPECTION SEC. 509 1 NUMBER REV DATE 8/28/01 PAGE 0; APPROVED BY = CITY HALL FRIDLEY 55432 612-571-3450 910-F15 10B ADDRESS 711 Pandora Drive I LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17 4 Brookview Terrace 3rd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ron Debrobauder, 711 Pandora Dr, Fridley MN 55432 763-571-1967 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Renewal by Andersen, 350 73rd Ave NE, FRidley, MN 55432 763-502-4777 20130983 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 J NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ MOVE - ❑ REMOVE 8 DESCRIBE WORK New window 9 CHANGEOFUSEFROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulking & flashing for all exterior openings. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. " NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2,105.00 $1.05 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- W STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE se $5.00 1$91.41 SIGN A TUAE OF CON TRAC TOR OR AUTHORIZED AGENT IDATEI WHE PROPERLY VALIDATED THIS IS V UR YERMIT / )<a0AtX1_1 eql&a"& ,NSP BATE S,GNATURE OF OWNER,IF OWNER BUILDER, IDATEI NEW [ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: �-`� �gt�hCCk_ ;u4 Legal Description: Owner Name & Address: 1 vv lorolr,guc -2r( Tel. #7[ta -S-fl •Ig(p - Contractor:; Renewal By Andersen MN LICENSE #. Address: 350 -73rd Ave. NE Fridley, MN 55432 Tel. # 763-502-4777 #MN20130983 of Survey of the Aaron it to scale. DESCRH!n- ON OF VvI[PROVENIENT .. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Driveway Curb Cut Width Needed: r Estimated Cost: $ 014 <0t-- Ft. + 6 Ft = Ft x $ =S DATE: Q . tz q . p APPLICANT: .ic,. so,N Tel. # %134S -Wq0 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Chargef CITY USE ONLY $ Fee Schedule on Reverse Side $ J- .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1050 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: a su9jEcr P N6,._® City of Fridley 3 3 2 3 8 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. f PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 763-571-3450 910-F15 12/2/02 JOB ADDRESS 711 Pandora Drive NE 1 LEGAL LOT NO, BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17 4 1 Brookview Terrace 3rd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ron De Brobander 711 Pandora Drive NE 763-571-1961 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Wellington Windows 3938 Meadowbrook Rd, St Louis Park MN 55426 952-933-6300 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 B DESCRIBE WORK Replace windows within existing openings 9 CHANGEOFUSEFROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. Permit lnS rtion Cards illBe elle TO Homeowner To Post 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 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 $ 11,457 $5.73 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FE City L Sinse $.00yl, $22 .44 SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT IDATE, N P OPER V (DATED TZIS YOUR PERMIT S.GNATURE OF OWNER,,F OWNER BUILDER. IDATEI BLDG NSR GATE a NEW (] CITY OF FRIDLEY ADDN (] 6431 University Ave NE, Fridley, MN 55432 ALTER (r' SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Effective 1/1/2002 (763) 572-3604 Bldg Insp Owner Name & Address: ISLOWZ19LL Tel. # 1-1(01 Contractor. W R dl �� MN LICENSE # A19 Address: kl !�1` el. # C15, I`z s 116 Attach to this application, a Certificate of Survey o the lot, with the proposed construction drawn on it to scale. LMNG AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF OMPROVEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft Length Width Hgt/Ground Sq. Ft Construction Type: Gc Estimated Cost:-$ ,YS7, Vi vaJ5 Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ —=$ DATE: C .Z6 APPLICANT: Tel. #,__ Call (763) 572.3604 for Permit Fees If ma*1nication ax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee $ O . 05 Fee Schedule on Reverse Side Fire Surcharge $ 6 .001 of Permit Valuation (1/10th%) State Surcharge $ Ste, $.50/$1,000 Valuation SAC Charge $ $1200 per SAC Unit License Surcharge $° 6 $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 $ Of STIPULATIONS: (JAW CIIYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 June 4, 2004 Mr. Dennis Brobander 711 Pandora Drive NE Fridley, MN 55432 Re: Contractor's License Dear Mr. Brobander: We were asked to check our records to see if you were a licensed blacktopping contractor with the City as you are installing driveways for people in the City. Our records indicate you are not licensed to do blacktopping work within the City of Fridley. Please be advised that per the City of Fridley Zoning Code, you must be licensed and show proper insurance before performing any further blacktopping work within the City. A license application is enclosed and should be filled in and returned to the City with the application fee and a certificate of insurance listing the City of Fridley as a certificate holder. Please contact us at 763-572-3604 if you any questions concerning this matter. Sincerely, DAVE JENSEN Building Inspector DJ/mh ENC: 2 :ITY OF FRIDLEY INSPECTION DIV. Effective April 1, 2004 431 University Ave NE 7ridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT �� 0 — 763) 572-3604, FAX (763) 571-1287 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR OoYaa �Wffl ILUMBING FIXTURE RATES: lew Fixtures )Id Opening, New Fixture leer Dispenser Ilow Off Basin ;atch Basin lain Water Leader ;ump/Receiving Tank Yater Treating Appliance Vater Heater -Electric Vater Heater - Gas** Sas Range" NO. RATE TOTAL JOB ADDRESS_ 6aAAAR. ' a.S O -W AAA _ $10.00 The undersigned hereby makes application for a permit for the work herein $10.00 specified agreeing to do all work in strict accordance with the city codes $10.00 and rulings of the Building Division, and hereby declares that all the fads $10.00 and representations stated in this annliratinn — f-te and correct. $10.00 DERBROBANDER, ELAINE `� , �j v/ $10.00 711 PANDORA DRIVE NORTHEAST v' 2005 $10.00 FRIDLEY, MN 55432 $35.00 OWNER (763) 571-1967 $35.00 $35.00.0° 11 BUILDING USED AS VAST dey1C-e- ILUMBING FIXTURE RATES: lew Fixtures )Id Opening, New Fixture leer Dispenser Ilow Off Basin ;atch Basin lain Water Leader ;ump/Receiving Tank Yater Treating Appliance Vater Heater -Electric Vater Heater - Gas** Sas Range" NO. RATE TOTAL JOB ADDRESS_ 6aAAAR. ' a.S O -W AAA _ $10.00 The undersigned hereby makes application for a permit for the work herein $10.00 specified agreeing to do all work in strict accordance with the city codes $10.00 and rulings of the Building Division, and hereby declares that all the fads $10.00 and representations stated in this annliratinn — f-te and correct. $10.00 DERBROBANDER, ELAINE `� , �j v/ $10.00 711 PANDORA DRIVE NORTHEAST v' 2005 $10.00 FRIDLEY, MN 55432 $35.00 OWNER (763) 571-1967 $35.00 $35.00.0° 11 BUILDING USED AS VAST dey1C-e- gas Dryer" lack Flow Preventer Required ( )Yes () No $10.00 $10.00 Type $15.00 W a4ur �,S*+cn&r c n'c'° leinspection Fee $50.00/Hr +LL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge $ .0 ESTIMATED COST q60 --co PERMIT NO. PLUMBING COMPANY NO (_\0 oVIA SIGNED BY - TEL N0. ('lolZ) $2%-Sl033 Approved B Rough -In Date Final Date .on.uuvm 9 �� ■ v.% Allo. rrL.MVINa Km �v1i7.VV VI O7e %jr VVi TOTAL FEE OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. -6-7(01.5y .OMBUSTION AIR SHALL BE PROVIDED PER Ll1q SECTI 504(A) AND TABLE 6-A. prce, �/ l rrS�eCfi�s cttpar4-Me4)-�- "PROVIDE COMMON VENT INFO ON BACK SIDE FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verges that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications 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-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When Installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) 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 Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat 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 ALTERATIONS: (Describe) HEATING CO: Signed By: Date: :ITY OF FRIDLEY INSPECTION DIV. Effective April 1, 2004 431 University Ave NE 7ridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 763) 572-3604, FAX (763) 571-1287 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR ZZon c�- r ��Y`7 'LUMBING FIXTURE RATES: Jew Fixtures )Id Opening, New Fixture leer Dispenser Ilow Off Basin :atch Basin Iain Water Leader ;ump/Receiving Tank Yater Treating Appliance Vater Heater -Electric Vater Heater - Gas** 3,as Range** NO. RATE TOTAL Sas Dryer** lack Flow Preventer Required ( )Yes () No Type teinspection Fee $50.00/Hr kLL OTHERS AND/OR REPAIRS AND ALTERA $10.00 $10.01 $10.00 $10.00 $10.00 JOB ADDRESS "nnnr2. - 0-S aw IiU�ni 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 fads and representations stated in this application are true and correct. DERBROBANDER, ELAINE / d nC, 711 PANDORA DRIVE NORTHEAST ! 20 l!V FRIDLEY, MN 55432 OWNER (763) 571-1967 BUILDING USED AS K4,Si 0)p.V►C-C_ ESTIMATED COST q6 o 00 PERMIT NO. PLUMBING COMPANY NO (_ Pk OVA Wvv1 i SIGNED TEL N0. A&12) $2%-5/033 1.25% of Value of Fixture or Appliance d State Surcharge $ - Approved By Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5°/. OF COST TOTAL FEE OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. 'POMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE " WE, 'LUMBING FIXTURE RATES: Jew Fixtures )Id Opening, New Fixture leer Dispenser Ilow Off Basin :atch Basin Iain Water Leader ;ump/Receiving Tank Yater Treating Appliance Vater Heater -Electric Vater Heater - Gas** 3,as Range** NO. RATE TOTAL Sas Dryer** lack Flow Preventer Required ( )Yes () No Type teinspection Fee $50.00/Hr kLL OTHERS AND/OR REPAIRS AND ALTERA $10.00 $10.01 $10.00 $10.00 $10.00 JOB ADDRESS "nnnr2. - 0-S aw IiU�ni 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 fads and representations stated in this application are true and correct. DERBROBANDER, ELAINE / d nC, 711 PANDORA DRIVE NORTHEAST ! 20 l!V FRIDLEY, MN 55432 OWNER (763) 571-1967 BUILDING USED AS K4,Si 0)p.V►C-C_ ESTIMATED COST q6 o 00 PERMIT NO. PLUMBING COMPANY NO (_ Pk OVA Wvv1 i SIGNED TEL N0. A&12) $2%-5/033 1.25% of Value of Fixture or Appliance d State Surcharge $ - Approved By Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5°/. OF COST TOTAL FEE OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. 'POMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, 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 () No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications 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-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No( ) The existing combustion air is sized and installedto meet l"he Curren codes s and manufacturer's specifications. Yes ( ) No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When Installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () 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 Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat 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 ALTERATIONS: (Describe) HEATING CO: Signed By: Date 3uilding $ BUILDING $ Permit No.: -'01 � j inspections Surcharge RESIDENTIAL APPLICATION License Surcharge Received By: 763-572-3604 $ CITY OF FRIDLEY $ Date Rec'd: '14) a DATE —3 ^ ®� YOUR E-MAIL ADDRESS Park Fee ;ITE ADDRESS J I 0 ✓h $ Total Due $ 900 -WI HIS APPLICANT IS: ❑ OWNER ONTRACTOR PROPERTY OWNER/ NAME: Wo r,/ ADDRESS: %� i �< h �o fe. hJ r CITY rYt i STATIi��ZIP TENANT PHONE: 7 571— /16 7 CONTRACTOR NAME: e rJ-� a d° me r"�✓ STATE LICENSE # 12 4/6 _L17 0 EXP DATE 14 'y5d e W SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 6,s I - — 62 3 CITY /�✓t5 t'° STA ZIP WITH APPLICATION PHONE36S SW JS I S ? FAX 6 5 i- �✓ — � 7®U PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE TWO FAMILYCONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS Cl BASEMENT FINISHROOF E3 DRAIN TILE ❑ DECK SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING lee11P&/' DESCRIBE WORK BEING DONE: D Qf P SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE I. 2. Existing Floor Plan 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 OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) AL JOB VALUATION Permit Fee $ Plan Review $ Fire Surcharge $ _K Surcharge $ L� .n License Surcharge ^�S $ 71'0 SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ 900 -WI I hereby apply for a conformance with the permit but only an ap; plan in the case of all SIGNATURE OF APPLIC, 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 oavable to: City of Fridley Attach IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED and tow ge that the information above is complete and accurate; that the work will be in of Fridley and with the Minnesota Construction Codes; that I understand this is not a rk is not to start without a permit; that the work will be in accordance with the approved and approval of plans. /� �� � � / PRINT NAME D / DATE