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PRE 2010 DOCSa\� City of Fridley, Minn. BUILDING PERMIT N° 4101 Date: ....._...._..-......._-........__..._......._.._................................. Owner: ...... .......................................................... .... ..... .... ... .................................... Builder.................. _.... ........._........ ..._....... ---------- .._._ ___...._..._.... Address........_..........................._......._...._................_..__...__...._._._ L CATION OF BUILDING No......�.....®_®..... Street.....�--------------_..----._...._.. ---. .......... ._./.zL—ce-'{.--.......... Part of Lot ........................... Lot...............I.................. Block ...... ........ ....... ....................... Addition or Sub -Division - ................ .. .. .',�9�1 .. Corner Lot ......X.+ .................... Inside Lot ....._ ................................ Setback...........�...p......... Sideyard... -........................... _............. Sewer Elevation -•---- ............. .............. .............. -....... .............................................. Foundation Elevation DESCRIPTION OF BUILDING To j2e Used as: e P >9 t/ q p •i / / ..................... ........._....... ............ Front7......: Depth �C'..`:.� Height 1....'. Sq. Ft f .. Cu. Ft. .................... _...................... _.............. Front ........................ Depth .......... Height Sq. Ft Cu. Ft. Type of Construction .... _ y�2 �..... Est. Cost..... .$... .. ......:. -7107.7b 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 all provisions of ordinances of the city of Fridley. A , „ _ In consideration of the payment of a fee of (� P $ ............ .......•-------., 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 within 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 for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. ' 4 Application for Power Plants and Heating, Cooling, Ventilation, ReMgen*ion and .� Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ........................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ NECK. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. IDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal, per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x $1.50 S. Z�D Additional Fixtures . ............... x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $2, ROUGH FINAL G Dept. of Bldgs. Phone City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn `.2 �® 19`�� Owner Kind of Building iLop -i�.a Used as 150�zle 4y-k±� To be completed about Estimated Cost, $ 10 ® . o 0 (aNew. Building Permit No. �� Permit No. -Zg`1 6 DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No Trade Name�C_/lSize No/O.3g Capacity �-e la -BO eFI?7 gw 7 Total Connected Load Rind of Fuel BURNER — Trade Name_ Size No Capacity. (REMARKS -OVER) t<1 42 Sq. Ft. E.D.R BTU H.P. Arm G7YOF FRIDLEY CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450 June 1, 1989 Frank and Clara Karpowicz 900 Pandora Drive N.E. Fridley, MN 55432 RE: First Notice of Noncompliance at 900 Pandora Drive N.E. Dear Mr. and Mrs. Karpowicz: The City of Fridley has established a City Code for the purpose of promoting a pleasant and attractive suburban environment. A recent inspection of the property north at 900 Pandora Drive N.E. has revealed that not all Code requirements are presently being met. Listed below are the items which do not comply with the City Code: 1. Observed several bags of garbage along west side of property. Fridley City Code 113 requires that all solid waste be kept in secured receptacles in rear yard or garage except for placement by curbside on pickup date. Your prompt attention in correcting this situation would greatly assist us in helping make Fridley a better place to live. An inspection will be conducted on or about June 12, 1989 to determine compliance. If you have questions or would like to discuss this, please contact me at 572-3595. Thank you for your cooperations Sincerely, Steven Barg Code Enforcement Officer SB/dn C-89-344 1� C17YOF FRIDLEY CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450 March 5, 1990 Frank and Clara Karpowicz 900 Pandora Drive N.E. Fridley, MN 55432 RE: First Notice of Noncompliance at 900 Pandora Drive N.E. Dear Mr. and Mrs. Karpowicz: The City of Fridley has established a City Code for the purpose of promoting a pleasant and attractive suburban environment. A recent inspection of the property at 900 Pandora Drive N.E. revealed that not all Code requirements are presently being met. Listed below is an item which does not comply with the City Code: 1. Observed approximately 20 bags of yard waste in side yard. Fridley City Code prohibits storage of these materials such that they are visible from the public right-of-way. Please move to an appropriate location. Your prompt attention in correcting this situation would greatly assist us in helping make Fridley a better place to live. An inspection will be conducted on or about March 19, 1990, to determine compliance. If you have questions or would like to discuss this, please contact me at 572-3595. Thank you for your cooperation! Sincerely, Steven Barg Code Enforcement Officer SB:ls C-90-85 11 SUBJECTR pit2 City of Fridley ji: 2 9 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 4/11/90 JOB ADDRESS 900 Pandora Drive N.E@ 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 4 Brookview Terrace 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Clara Karpowicz 900 Pandora Drive N.E. 574-1377 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Rick Bailey for Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroaf Dwelling (13 Square.al 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd layer but not 3rd. 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 $650 $ .50 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- $19.00 CTION OR THE PERFORMANCE OF CONSTRUCTION. x PLAN CHECK FEE TOTAL FEE r�� —//— (� $19.50 SIGNATURE OF CONTRACTOR OR AUTHOR12ED AGENT (DATE) HEN PRO E VALI TED THIS IS YOUR PERMIT ulf" BLDG WSP qA E SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI 11 NEW [ ] CITY OF FRIDLEY Effective 1/1/90 ADCN [ ] R--1 AND R-2 ALM [ ] Building Permit Application a Oanstnxtion Address: < � �f4-El c� s° er 4:)` iy legal Description: tee® ` Owner Name & Address: �' Ice r !� « `r , r . n w ; �. - , c/csrc-, Tel. Tel. #�o� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn an it to scale. LIVIIWx ARM: length Width Height Sq. Ft. GRRAGE AREA: Length Width Height Sq. Ft. DECK ARM: length Width Hgt/Gzwnd Sq. Ft. 07MM: 6eq, ? ( ®u S '�/ s C<vcc. Jic--� - Corner lot [ ] Inside Lot ] .r't. Yd Setback Side Yard Setbacks Type of Construction: e4 Estimated Cost: $ �o ,--S7 6 Approx. Cmpletion Date: Proposed Driveway Width If New Opening Is Desired: Ft. $ $ G lc� r T$idth + 6' See Back Page DATE: V I' - /90 APPLICANT: Tel. # I Permit Fee $ 9 0e) State Surcharge $ �� SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ $ �9/-�z &IT ULATIONS : CITY USE ONLY Fee Schedule on Reverse Side $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Detemined by Engineering Agreement Necessary [ ] Not Necessary [ ] FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 April 3, 1991 Frank and Clara Karpowicz 900 Pandora Drive N.E. Fridley, MN 55432 RE: First Notice of Noncompliance at 900 Pandora Drive N.E. Dear Mr. and Mrs. Karpowicz: The City of Fridley has established a City Code for the purpose of promoting a pleasant and attractive suburban environment. A recent inspection of the property at 900 Pandora Drive N.E. revealed that not all Code requirements are presently being met. Listed below is an item which does not comply with the City Code: 1. Remove, repair, or replace fence located along north side of driveway. Your prompt attention in correcting this situation would greatly assist us in helping make Fridley a better place to live. An inspection will be conducted on or about May 1, 1991, to determine compliance. If you have questions or would like to discuss this, please contact me at 572-3595. Thank you for your cooperation! Sincerely, Steven Barg Code Enforcement Officer SB:ls CE -91-73 0, CIlYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY. MN 55432 • (612) 571-3450 • FAX (612( 571-1287 April 23, 1991 Frank and Clara Karpowicz 900 Pandora Drive N.E. Fridley, MN 55432 RE: Property at 900 Pandora Drive N.E. Dear Mr. and Mrs. Karpowicz: Recently I sent you a letter concerning a fence in disrepair along your driveway. Yesterday I happened to drive past your residence and noticed that the fence had been removed. Thanks for your prompt attention! While making this observation, I also noticed several bags along the west side of the property. Please take action to remove these materials or place them in a location screened from the public view. Feel free to call me at 572-3595 if you have questions or wish to discuss this further. Thanks for your cooperation! Sincerely, Steven Barg Code Enforcement Officer SB:ls CE -91-111 SUBJECT PER City of Fridley 27147 AT THE TOP OF THE TWINS BUILDING PERMIT r COMMUNITY DEVELOPMENT DIV. 1>r __��__ PROTECTIVE INSPECTION SEC. r � NUMBER REV DATE PAGE OF APPROVED BY `1 ` CITY HALL FRIDLEY 55432 � .J L 612-571-3450 910-F15 18/12/98 JOB ADDRESS 900 Pandora Dr 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 4 1 Brookview Terrace 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Clara Kar owitz 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO ua it 7053 Contracting - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING RARjdPntfal 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Kk REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 15 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING. VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 1251 $.62 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS ANY OTHER STAT OR LOCAL LAW REGULATING CON- STR TIO R T FORMAN OF CONSTRUCTION.43.00 Fire SC $1.25 PLAN CHECK FEE TOT FEE ? / / g/ icens 5.0 49.87 SIGNATURE 9 CONTRACTOR OR AUTHORIZ D AGENT IDATEI EN ROP B G INSP r VALI T THIS VU RP I r GATE SIGNATURE OF OWNERJF OWNER BUILDERI IDATEI NEW [ ] ADDN [ ] ALTER [ ] ConstructionAddress Legal Description: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION /00 pazt�6c-4a- je'^ Owner Name & Address: k,� (OR -M Contractor: Quality Contracting Address: 11380 West River Road Effective 1/1/98 l �1 aw Tel. # MN LICENSE # 7035 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # 427-7733 LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: say S' Construction Type: Tear off and reroof Estimated Cost: $ 0S�/ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE:2 X APPLICANT: Tel. # 4427"--%%,33 CITY USE ONLY Permit Fee $ �� 0 O Fee Schedule on Reverse Side Fire Surcharge $ �� .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ S-,06 $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 ')—IOL $ Ll co Building BUILDING Permit NO Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY D a 763-502-4977 FAX d EFFECTIVE 1-1-08 r DATE YOUR E-MAIL ADDRESS SITE ADDRESS C7 PANDOLL ( f THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME. TENANT ADDRESS: CITY CoL ; �I s , STATELILQ - PHONE: % C73 - Y!�a-06c of 763 - -291 - 4 -?3 8'0 NAME: 1&MZbkA 15U10)*-aV-1 ADDRESS: AZ -Nue- S11, CITYeQLa STATA IJ ZIP CONTRACTOR SUBMIT A COPY OF PHONE %3 •- y,5 8- %1 % y "k YOUR STATE LICENSE STATE LICENSE # 2-001 9 '9 3'3 EXP DATE 3— O PROPERTY TYPE WSINGLE FAMILY/NEW CONSTRUCTION SIZE 21 ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED jFj-WINDOWS I -- 4abczsS 'BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR EMOr D, ELING DESCRIBE WORK BEING DONET14%,j 'Z- U4A,,, A e u - V -'%T SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE I. 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 ADDITIONS. & PORCHES SUBMIT: ❑ Vinyl ❑Soffit 1. Site Plan/Survey showing the existing structures ❑ Aluminum ❑ Trim and proposed project. ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WIN DO S OR FOR NEW OPENINGS -DESCRIBE SIZE OF P -r (l , 3O 1< 4 OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED ! S Ul NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $__ 44 S-00 .o`' OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1825 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED lations 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 Constru tion 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 acrA7 i a approved plan in the case of all work which requires review and proval of plans. SIGNATURE OF APPLICANT PRINT NAME�211. A, irJ2,C s DATES -22-0t APPROVED BY DATE Building MECHANICAL Permit NoV-.515 Inspections RESIDENTIAL APPLICATION Received 763-572-3604 CITY OF FRIDLEY 763-502-497�7/ FAX EFFECTIVE 1-1-08 DATE D YOUR E-MAIL ADDRESS SITE ADDRESS fk- THIS APPLICANT IS: ❑ OWNER ,CONTRACTOR PROPERTY NAME: ADDRESS: CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR COMPANY NAME: P A Au CONTACT PERSON: NOTE: SEPARATE CITY LICENSES ARE REQUIRED FOR GAS STATE LICENSE # EXP DATE 6q/3 CITY IP�33 AND HVAC. SUBMIT COPY OF BOND ADDRESS:/ PHONE JL - 9 FAX ANDINSURANCE PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE ❑ NEW ❑ REPLACEMENT ALTERATION/REMODEL TYPE OF WORK: DETAILED DESCRIPTION OF WORK PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) OR Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZEIBTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU $25.00 FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 _A/C TO AIR EXCHANGEER $15 (WOOD) $35.00 NEW GAS GRILL $10.00 _AIR _FIREPLACE _BOILER $35.00 _FURNACE $35.00 _GAS UNIT HTR $10.00 HEATER $35.00 CHIMNEY LINER $10.00_ S DRYER $10.00 _POOL P1p� VENTILATOR 5 DUCT WORK $10 00 GAS G $ I 0 00 $1 Permit Fee _ $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ OR Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ 50 MINIMUM $15.50 MINIMUM $15.50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a mechanical 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 o 'dley and with the Minnes Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that work will be 'n accor with th approved plan in the case of all work which requires revi wand approval of plans. Ie,, OF APPL AN Garth PRINT NAl �L$- GAS: DATE SIGNATURE 6MOM BY DAT APPROVED N City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, NIN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations. Building PLUMBING Permit No —' Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'dA(4� 763-502-4977 FAX EFFECTIVE 1-1-08 DATE a� YOUR E-MAIL ADDRESS v LA L O''Ltv`J - G0 SITE ADDRESS 9 an do ^, c�-- THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: ADDRESS: CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR NAME• c rr. STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS:5 , Yl W . CITY�vm�i STATE ZIP INSURANCE (`-' 3 S�PHONE PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: 0 NEW ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK &, ti ' L- L�L'r t I GL. PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = plus .50 surcharge .0 FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10000 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $15.50. L BATH SINK/LAV DRAINS SHOWER _ WATER PIPING _FLOOR BATHTUB GAS PIPING (NEED CITY LIC) _ SWIMMING POOL _ WATER SOFTNER ($35) _ CLOTHES WASHER 7 KITCHEN SINK WATER CLOSET _ BACKFLOW PREY. ($15) DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER —OTHER Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ OR Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ State Surcharge = $ (MINIMUM $15.50) (MINIMUM $15.50) Total = $ THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 approV'ell Ian in the case of a 1 work which requires review and approval of pi s. SIGNATURE OF APP IC CAA C� PRINT NAME CAL- CL' DATE APPROVED BY �� DAT City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL Permit No. �. Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604CITY OF FRIDLEY n , p p �n 763-502-4977 FAX EFFECTIVE 1-1-08 DATE YOUR E-MAIL ADDRESS ✓I Q, e D Pi (� 1 U6- SITE ADDRESS A 00 PPL V ! (1 Of &A d C "6- THIS APPLICANT IS: ❑ OWNER CONTRACTOR THIS PROPERTY NAME: ( in' S OWNER/ ADDRESS. ' �ft LQ_ on 61107 JC r CITY STATE ZIP TENANT PHONE: CONTRACTOR Q� COMPANY NAME: J, me,_Pm C NOTE: ® SEPARATE CITY CONTACT PERSON: FAU I f 1. STATE LICENSE'tQ # EXP DATE LICENSES ARE SUIRED FOR G� ADDRESS: P 0. /4CITY C'' STATE fVnkIP�,V 'K AND HVAC. 'Box SUBMIT COPY OF BOND PHONE flI n al - )0,9 _ 501!4(FAX � &3- 79 5�g13 AND INSURANCE �� PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW ❑ REPLACEMENT )6L.TERATION/REMODEL DETAILED DESCRIPTION OF WORK Lct th fag � PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or re lacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) OR Labor cost un er �$15.abor cost between $300 to $500 =cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZEIBTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOILER $35.00 $35.00 UNIT HTR $10.00 _FURNACE _GAS )i(il CHIMNEY LINER $10.00 iGAS DRYER $10.00 _POOL HEATER $35.00 DUCT WORK $10.00 _GAS PIPING $10.00 _VENTILATOR $15.00 PERNUT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ (S .00 Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ 15 .Se) OR Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 MINIMUM $15.50 MINIMUM $1550 Total = $ THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a meeha Li I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances =and and codes of the City of Fridl and with the Minnesota Construction Codes; t I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the w rk will be ' rdan oved pI in the case of all work which requires review and approval of plans. 'KIl�Sfi +L0.1�(I�,/1 s SIGNATURE OF API PRINT NAME DAAWORK APPROVED BY DA PLEASE NOTE: P TE PERMITS ARE REQUIRED FOR BUILDING, ELECTRICAL AND MECHANICA V City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building BUILDING Permit No."(�� Inspections RESIDENTIAL APPLICATION Received y7z�x 763-572-3604 CITY OF FRIDLEY Date Rec'd: --7— -g —y 763-502-4977 FAX EFFECTIVE I-1-08 DATE r/ l 3 L} d � YOUR E-MAIL ADDRESS SITE ADDRESSqL7D A -A THIS APPLICANT IS: OWNER %CONTRACTOR PROPERTY OWNER/ NAME; `1�t/I,'/-. �:rJ/a�/�iv,� a� f �!�✓✓ ADDRESS: o ol.�c7 ! ?/� ✓g , r% NF. �J CITY Cl�lli,,,y6iSTATEe AJZIP •i��/ TENANT F PHONE: 77F- z -173F NAME: v i z' ADDRESS: S %i ' �C'% /7 �'1L ii Nom` CITY -6,- 4r, S' STATW�N ZIP CONTRACTOR SUBMIT A COPY OF PHONE 7e(3 - 7 P/ z-1 71 S- FAX YOUR STATE LICENSE STATE LICENSE #f G�Z�? Fj J _EXP DATE PROPERTY TYPE RSINGLE FAMILY/NEW CONSTRUCTION SIZE 5U -3C> ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH PROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWE%4MING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION INTENANCE/REPAII�R,, ❑ REMODELING DESCRIBE WORK BEING DONE: %E Q G+FF- fyg f Cor -7' SIZE OF IMPROVEMENT LENGTH J D WIDTH 3o HEIGHT SQ FT ZrG ROOFING JR HOUSE ONLY NUMBER OF SQUARES '7' ❑ 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: FOR NEW CONSTRUCTION INCLUDING DECKS, ING SID ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures ❑ Aluminum ❑Trim and proposed project. El Other ❑ Fascia 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 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ Plan Review $ Fire Surcharge $ '7 Surcharge $ License Surcharge $ SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1825 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 savable to: Citv of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the 9formation above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and 'th the Mirmesota ;etion odes; that 1 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 w, be an the ro pl ,n the case ofAl work which requires review and approval of plans. SIGNATURE OF APP \-WNT NAME ATE7-31 Building 0'UV BUILDING $ Permit Ivo.: Inspections $ RESIDENTIAL APPLICATION 65% of Building Permit Fee Receive ftu 08-2 763-572-3604 .001 times the total job valuation CITY OF FRIDLEY j.Q jp Date Re 763-5024977 FAX $5.00 (State Licensed Residential Contractors) $ $2000 per SAC Unit (Plans to MWCC for determination) EFFECTIVE 1-1-09 -ft +6 ft= ftx$21=$ DATE —71Ioll YOUR E-MAIL. ADDRESS $450 Conservation Plan Review SITE ADDRESS P AA N ® Z L L G Ala UN q32— 2THIS THIS APPLICANT IS: *OWNER ❑CONTRACTOR Agreement necessary ( ) Non Necessary ( ) PROPERTY OWNER/ NAME: RUN'�Q„ tL & j Q Make checks payable to: City of Fridley Attac TENANTADDRESS: ® N r1'Y D L STATE N zIP 55,132 PHONE:-7lg23 -Zoe- 9,5a-5 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 XSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE XDECK ❑ SIDING ❑ OTHER ❑ SWIMMING ML TYPE OF WORK: ❑ NEW HOME CONSTRUCTION U4DDMON 14 L ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ 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 1. Site Plan/Survey showing the existing structures 13 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: SING THF 1907 IT u C F SCHEDULE) 'OTAL JOB VALUATION Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due 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 pP4 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 al),v��PRINTNAME approval of plans. p / SIGNATURE OF APPLICANT ` V" t t f C 1 e 4 M9'� DATE - 1 SASE NOTE: SEPARATE PERMITS ARE REOUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK I1' 0'UV 7_a OCCUPANCY TYPE $ 2y See Back Page for Fee Schedule $ 65% of Building Permit Fee $ .001 times the total job valuation $ j.Q jp .0005 x Permit Valuation Minimum $.50 $ $5.00 (State Licensed Residential Contractors) $ $2000 per SAC Unit (Plans to MWCC for determination) $ -ft +6 ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ 1(p (p ,0 Make checks payable to: City of Fridley Attac 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 pP4 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 al),v��PRINTNAME approval of plans. p / SIGNATURE OF APPLICANT ` V" t t f C 1 e 4 M9'� DATE - 1 SASE NOTE: SEPARATE PERMITS ARE REOUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK I1' Building MECHANICAL Inspections RESIDENTIAL APPLICATION 763-572-3604 CITY OF FRIDLEY 763-502c-4\977 FAX EFFECTIVE I-1-2010 DATE �1 1l� YOUR E-MAIL ADDRESS ZgTZ]M SITE ADDRESS THIS APPLICANT IS: O OWNER XCONTRACTOR PROPERTY NAME: ADDRESS: C Ti OWNER/ TENANT Permit No.: CONTRACTOR COMPANY NAME: ® " % lk-- SUBMIT A COPY OF CONTACT PERSON-.-VY-AC) � YOUR STATE STATE LI # E ATE LICENSE WITH ADDRES CITY TA�IP APPLICATION PHONE r AX PERMIT TYPE It SINGLE FAMILY 0 TWO FAMILY [3TOWNHOUSE TYPE OF WORK: I [3 NEW PLACEMENT ❑ ALTERATION/REMODEL City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977