PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT
Date: _ l ��
Address
N® '7406
LOCATION OF BUIL ING
lvo.�� street `�L f Ilot
Lot__ Block (addition or S-Divisi
Corner Lot Inside Lot Setback Sideyaard,� Q
Sewer Elevation - G - 57- .5- S ---Mma&0en Elevation S -�
to r 0 t- PC" -r//1/ 0
A DESCRIPTION OF BUILDING
T0, Used -�/��-�=�
Front Depth Height Sq. F't. Cu. nol
Front DepthHeight �� Sq. Ft. Cu. Ft.
Type of coon - Est.. .s 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 pUlm with a'll provisions of
ordinances of the city of Fridley.
e�
In consideration of the payment of a fee of s/ ,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 anypart 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. _ /i /-�7
Building Inspector
0
NOTICE:
" permit does not cover the conMrudion, hotallMloe for wiring, plumbing, on heattmg, sewer or water. Be son to ass
the Building hupeetor for separate permits for these fteum
APPLICATION FOR BUILDING. PERMIT
CITY OF FRIDLEY, MINNESOTA,,
OWNER'S NAME BUILDER
ADD. ADDRESS.��
411 �j r C ,
LOCATION OF BUILDING
No. Street _PC a, k- Part of Lots
Lot_, °f Block Addition or Subdivision;JK-Ze rr� � -��r� o.y �.� 2-
Corner Lot Inside Lot X 1 Setback ,:f;Cf Side Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these. Certificates.
To be used as;
DESCRIPTION OF BUILDING
_ Front ,3 Depth} Height %S
Sq. Ft. •i3 Cu. Ft. /.� STO
• i'
Front Depth Z z Height,/ 3
Sq.. Ft. ! Cu. Ft. 3-6-"
Type of Construction Estimated Cost
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 true and correct.
DATE J= L &J S
(Schedule of Fee Costs can be found on the Reverse Side).
GNOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55433 • (612) 571-3450 • FAX (612) 571-1287
October 31, 1990
owner/Occupant
7838 Pearson Way N.E.
Fridley, MN 55432
RE: Monument Sign at East River Road/Pearson Way N.E.
Dear Owner/Occupant:
The monument sign located at the above referenced intersection has
experienced substantial deterioration and is in poor condition.
I have been unable to locate anyone who could be held responsible
for the maintenance of this sign. This monument sign, which is
located within the City right-of-way, has become an eyesore and it
also constitutes a health and safety hazard.
The City is currently considering removing the monument sign from
this location for the reasons cited previously. Please contact me
at 572-3595 on or before November 20, 1990, if you have concerns
regarding this possible action, so that these may be taken into
consideration.
Sincerely,
Steven Barg
Planning Assistant
SB:ls
C-90-946
suejEci
PERMIT NO.
City of Fridley
e2TF81 �9
AT THE
BUILDING
PERMIT
2.T3gd4
NO.
• COMMUNITY DEVELOPMENT DIV.
j PROTECTIVE INSPECTION SEC.
F
1 �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
= CITY HALL FRIDLEY 55432
612-571-3450
910-F15
2110/7/981
1013 ADDRESS
7838 Pearson Wav BE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DescR.
4
6
Pearson's Craigway Estates 2nd Addn. SHEET
2 PROPERTY OWNER MAIL ADORES$
ZIP PHONE
Curt Obermoller
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
L J Roofing 10151 Foley Blvd Coon Ra ds -M 55448 767-1587
9036
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
O NEW O ADDITION 0 ALTERATION J& REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and garage 26 S 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 OWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT THE GRANTING OF A PERMIT
2225
$1.11
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION O TH ERFORMANCE ONSTRUCTION
.$74.75
Fir 8C 2.23
>'/-/"�
PLAN CHECK FEE
LFEE
.---00/
Y3.09
SIGNATu F CONTRACTOR OR AUTHORIZED AGENT IOATE,
EN ROP
Bl INSP ZlAiE
ALIOTHIS IS Y UR PERMIT
S-GNATURE OF OWNER ,-F OWNER BUILDER, IDATEI
NEW [ ] Effective 1/1/98
ADDN [) CITY OF FRIDLEY
ALTER [ ] SINGLEBUILDINGPERMITDUPLEXES
�D R-2
BUG APPLICATION
ConstructionAddress:
Legal Description:
Owner Name & Address: �( vr7 (9 �ja��,.e lac �' Tel. #
Contractor: l7- 40'(125 MN LICENSE # �o i
Address: E"), 41, Ct Tel. # 7j ? 7
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
GARAGE AREA: Length Width _
DECK AREA: Length Width _
OTHER: -f— "-c ,, v
Height Sq. Ft.
Height Sq. Ft.
Hgt/Ground Sq. Ft.
e
Construction Type: Estimated Cost: $ p '�1C,
T
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: A($` f APPLICANT: yam` ;7 Tel. # 7—%J��
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee $
Sewer Main Charge
TOTAL
STIPULATIONS:
$ u13. C
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1000 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 [ ]
CITY OF FRIDLEY BUILDING INSPECTION
6431 University Ave NE
Fridley. MN 55432
763-572-3604 FAX 7636711287
RATE SCHEDULE
Residential
Furnaoe Shell and Duct WorK Burner &
also Replacement Furnace
Gas Piping (New Furnace, Flreplace, Insert)
Fireplace insert
Gas Range
COO 751-,
Effective 4/1,/2004
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
EN ill
$35.00
$10.00 $
$15.00 $
$10.00 $
Gas Dryer $10.00 $
*AlrConditioning- AllSizes $25.00
Ail Other Repairs or Alterations (List on Sade)
196 of Value of Appilanoe or Work $
Minimum Fee $15.00 for Residential or 5% of cost of
Improvement whichever is greater on work less than $500.00
Commercial/Industriauko tutlonal
1.25% of Value of Appliance or Work (List on Back)
Minimum Fee $35.00 forCommerciel/IndustriaVinstitutlonal
Rate Surcharge
if permit fee is over $1,000 multiply by .0005)
JOB ADDRESS 7r3$ Pea✓5W cr, � N C'4le r„�
Building used As Res; J,.,A"4
ESTIMATED COST .O D PERMIT NO
# of Heating Units Clyde One (Steam) (Hot Water {Warm Air}
Trade NameY�,� Size No.
BTU A T .(.7 HP EDR
Fuel ftp . --0- Total Connected Load 4PO.i of
Burner Trade Name Size No.
BTU HP EDR
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work to 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 owect.
$ 0.5
_..__._ TOTAL_F_EE $ bo• -0
rAir Conditioners can not be placed In side yard without written approval
rom ad j of ping property owner - copy to City
'ILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
FAX #1 Date J 7 ` U
4 p/fC,5, rjj /rt. 4r, CU/ C✓c-e],•f '6-1 ✓I U. -•,tom
FL,- &t;"/-yJ9.5 7-7o - `rf-te% JtX cA, rL-e-
Approved by Rough-ln Date Final Data
n
0
m
m
M
0
m
C
170
MAY -09-2005 1300 CITY OF FR I DLEY
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING
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.
The venting system is plasticfPVC and meets all current codes and manufacturer
specifications Including sizing, length, number of elbows and termination.
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 -LAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances.
The existing combustion, n air is sized and installed to meet the current codes
and manufacturer's specifications.
When required to Install a new combustign air, it will be sized and installed
to meet the current codes and manufacturer's specifications.
When installiag g 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.
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.
Appliance #1 Type w.-,J,J'5 ETU Input 110 Wl Fan Assisted o(
Appliance #2 Type BTU Input Fan Assisted or
Appliance #3 Type BTU Input Fan Assisted or
Total Appliances _�_ Tctal Btu Input +0 01
P.03/03
IJI=KM11
(v�
No( )
( t� No ( )
G�1
No( )
() No (v)�
Ye No( )
I
Yes (t� No ( )
Common Vent Type Vent Height I Diameter_,_
Appliance #1 Vent Connector Height
ft
Length
ft
Diameter
in T
Appliance #2 Vent Connector Height
ft
Length
ft
Diameter
in T
Appliance #3 Vent Connector Height
ft
Length
ft
Diameter
in T
&s I - y3F -'S-
Date:
sDate: .S'— 9 —D
W111" No( )
TOTAL P. 03
zoo 18 %V3 ZT906CVT99 YVA L9:60 SOOZ/TT/50
rAir Conditioners can not be placed In side yard without written approval
rom adjoining property owner - copy to City
ILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
n"'. -F, cu'- rC4L'4/ ✓iv,m1�W
Fc, Pvev>>4 {et &TI-YJ`1-5774 - 12�tek—ICS let,lcw
Approved by Rough4n Date Final Date
10
N
m
W
- G 0 & �` -,-�
CITY OF FRIDLEY BUILDING INSPECTION
�� Effective 4/1,2004 t
6431 University Ave NE
Fridley, MN 55432
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION
763-572-3604 FAX76"711287
REFRIGERATION
j
AND AIR CONDITIONING SYSTEMS AND DEVICES
CD
J09ADDRESS 7ir3k Pea✓se,., W" N.&.
t�
BATE SCHEDULE
fr&
i✓;dleN�
T4tlll J
Residential
owner __ 4„_ a.Tj S k Iy e c V, W
FumaoeShell and Duct Work. Burner &
m
also Replacement Furnace
$35.00
$�_ Building Used
Gas Piping(New Furnace, Fireplace, Insert)
$10.00
$ ESTIMATED COST_ kSD .off PERMIT NO
Fireplace insert
$15.00
$
Cas Range
$10.00
$ DESC?IP77ON OF FURNACE AND BURNER
Gas Dryer
$10.00
$ Ilt of Heating units Circle One (Steam) (Hot Wa (Warm Air) o
Trade Name_��� Size No.
*AlrConditioning-ADSizes
$25.00
$ j5- BTU HP EOR
0
Fuel zV -m- —Total Connected Load - � O, n 0 () fn
All Other Repairs or Alterations (List on Back)
196 of Value of Appllance or Work
$ Burner Trade Name Size No.
Minimum Fee $15.00 for Residential or 5% of cost of
BTU HP EDR
Improvement whichever Is greater on work less than $500.00
The undersigned hereby makes application for a permit for the work herein
Commercial/Industria)jin5ti uVonal
specified agreeing to do aA work In strict accordance with the City Codes
1.25% of Value of Appliance or Work (Ust on Bach
$ and rulings of the Building Division, and hereby declares that all the facts
Minimum Fee $35.00 for Commercial/IndustrieVinstitutionel
and representations stated in this application are true and correct.
N
3tate Surcharge
$ 0.50 HEATING COGo
If permit fee is over $1,000 multiply by .0006)
M
TOTAL FEE
$ 60.5 Signed Tel # 6S/--L1.T%-Y77p
to
FAX
rAir Conditioners can not be placed In side yard without written approval
rom adjoining property owner - copy to City
ILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
n"'. -F, cu'- rC4L'4/ ✓iv,m1�W
Fc, Pvev>>4 {et &TI-YJ`1-5774 - 12�tek—ICS let,lcw
Approved by Rough4n Date Final Date
10
N
m
W
Y {.r+ , Ai7"2Kl66 PLdi! ®ER. „� � t , II 5�'�, l� �� q�'. : �v .j-.. ) ,"p��3 mak.., gAi�'9 `•
jpaj]�'j�'�ypy�/�+
�Y1,'L19, 1.19�YB
'JIM,
Jlji'k�i .'Vend ,r'e a•�;plG,C"!�}'� , �i��t4►� � d a�b Vk.G �� � �
Z�q ,
�.�•- � )� .Ayy j i3 ,t' T •8 Q".�.� �ia 4 d i i3 .'�'i •I '
d, ,�R t�alt'��:'��": 6yty.%7:iaR4.E?'%9'`Y3F?�h�`�d9'#j �Y •` *a iii. i fid'
4i
Yi�
12'e'idj,-rM7 y�t� t � n"lP t $
+id`eaen rpglt-d to i s 3 a OR
to meet the currer ;codes and anufacturees specifications. Yes Q N® (
iNh8f1 iris I' a
Maiweinfi stern the undersigned hereby verifies that
it is ai Ilsted assernbly and mere the current codes and r6anufacturer's
spwAcations. 7*
does indtide AGA-0AMA Category I .Central Furnace
Venting Tables for assisted! and natural draft appliances.. Yes
1w' No(
)
„
Is the mammon ve
an appliance has I;
sepejrakely as per c
II As
Appl106ce #f TYPO
Apptiarice #f2 TYpg
Appliance #3 Type
Total Appliana
Common Vent Tyl
Appliance #1 Vent
Appliance #2 Vent
Applla m #3 Veen
A and vent', nnectors sized and installed correctly after
Ban remove' from the common vent and vented
Yes
BTU! Input 40 Wl Fan Assisted o ;Nat
BTU' Input Fon Assisted or a
BTU Input Fan Assisted or Nat
Trial Btu Input
Vent
mnector� eight
mnecto I• eight ft
Dnnector 1 eight
ielght Diameter
.ength ft Diameter_.____ in Tyf
.ength ft Diameter �n Ty;
.ength l Diameter,:_ _ Tyl
Date .S- V
No( )
TOTAL P.m3
918069VT99. XVA W ST 900Z/60/90
DESCRIBEIVVORCBN DONE: 0
.:....,,,� T V*,Tt-.q= WMT14 HEIGHT So. Ft
b.LL Ur uVJ rXt.0 v r'1V1r 1N
ROOFING j
11
❑ HOUSE 014LY
NUMBER OF SQUARES
Building,
g
-7
I!
GARAGES
B�I, �G
T I � ..
Permit No.: e "
Inspections,
�
;ISIDE
13 DETACHED GARAGE, 3. List of structural members to be used
TT �L PPLICATION
Received By:
�Z-X:
763-572-30041
SIDING
1CITY IOF F tIDLEY
Date Rec'd:�/Z'
DATE � ' �' .�
❑Soffit ADDITIONS & PORCHES SUBMIT:
I ' e existing structures
❑Trim 1. Site Plan/Survey showing th g
YOUR E-MAIL ADDRESS
—
❑ Fascia and proposed project
2. Two sets of construction plans
SITE ADDRESS'
❑No
OR FOR NEW OPENINGS -D
OPENING CHANCES &
SIZE 0
(LABOR
TYPE OF WINDOW TO BE INALLED
E OF WS
THIS APPLICANTjISc
❑OWNS ONTRACTOR
ALUATION, INCLUD TH9 COST OF AND MATERIALS:
PROPERTY�O1 WNER/
TENA1rT
E;
a
W0 CITY 2
STATFIP
VALUATIT
DRESS:Y
A J 1
$
See Back Page for Fee Schedule
ONE
1
1
1 65% of:)3uilding Permit Fee
CONTRACTOR
I
AME
, h
Surcharg e
TATE LICEN # EXP DATE
` �
SUBMIT A C�ISY OF
YOUR STATE INCENSE
WITH APPL,I(�AnON
DRESS:
HONE
7
ASC
SAC Charge
PROPERT� TYPE
SINGLE F
ILY/NEW CONSTRUCTION SIZE
$
; ft + 6 # = ft x $20 = $
TWO FAM
/NEW CONSTRUCTION STORM
1 $450 Conservation Plan Review
Engineering
PERMITME
Q ADDITION',
❑IGARAGEjSHED ❑ WINDOWS
Sewer Main Charge
$
BAS
tJROOF ❑ DRAIN TILE
$
® Make checks payable to: City of Fridley Attach Stipulations
DECK
164ISH
-fj SIDING ❑OTHER
I hereby apply for a b
ding permit'and I acknowledie that the information above is complete and accurate; that the work will be in
conformance with the ori
❑ ISWIMMIN6 POOL
'odes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
TYPE OF ORK:
I NEW
MAINTENY
AADDITIOO�N
❑IREMODELING
i
whic e'
DESCRIBEIVVORCBN DONE: 0
.:....,,,� T V*,Tt-.q= WMT14 HEIGHT So. Ft
b.LL Ur uVJ rXt.0 v r'1V1r 1N
ROOFING j
11
❑ HOUSE 014LY
NUMBER OF SQUARES
RHOUSE &IGARAGE BASEMENT REMODELING SUBMIT:
GARAGES
!
1. Existing Floor Plan
❑ ATTACHED GARAGE' 2. Proposed floor plan
PROPOSED SIZE:
13 DETACHED GARAGE, 3. List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
y
❑Soffit ADDITIONS & PORCHES SUBMIT:
I ' e existing structures
❑Trim 1. Site Plan/Survey showing th g
❑ Aluminum
❑ Other
❑ Fascia and proposed project
2. Two sets of construction plans
WINDOWS r
IN EXISTING OPENINGS ❑YtRIBE
❑No
3. Energy Calculations
LOCATION OF WS
OR FOR NEW OPENINGS -D
OPENING CHANCES &
SIZE 0
(LABOR
TYPE OF WINDOW TO BE INALLED
E OF WS
ALI ES ARE
ASED O
ALUATION, INCLUD TH9 COST OF AND MATERIALS:
SING THE 1991 U.B.0 FEE SCHEDULE).
TOTAL JOBI
VALUATIT
$ " 3 1 OCCUPANCY TYPE
Permit Fee
$
See Back Page for Fee Schedule
Plan Review
1 65% of:)3uilding Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharg e
$
I � � .0005 x Permit Valuation Minimum $.50
(v
License Surcharge
i $ I
co $5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1550 per SAC Unit (Plans to MWCC for determination)
Curb Cut 18sarow
$
; ft + 6 # = ft x $20 = $
Erosion Control
$
1 $450 Conservation Plan Review
Engineering
Park Fee
$
Fee Determined by
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
® Make checks payable to: City of Fridley Attach Stipulations
IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a b
ding permit'and I acknowledie that the information above is complete and accurate; that the work will be in
conformance with the ori
ances and
'odes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit buto,�y an appli
on for a
d k is not to start without a permit; that the work will be in accordance with the approved
plan in the cc a of all wql
whic e'
d approval of plans. )
SIGNATURE OF APPLICAN
to PRINT NAME_JhAJ
f
iI
i
Building
j'I
$IjjIj,j0
Permit NO.: P
Inspections
p
�
SIDENT�AL APPLICATION
Received B :
Y
763-572=3604
�'I
CITY�� OF'RIDLEY'
Date. - �0
DATE �-
YOUR E- ADDRESS /Zi Gi S i • moi
SITE ADDRESS
OWN
❑C CTOR
THIS APPLICANT IS:
PROPERTY OWNER/
'AME;
101
TENANT
—CA
DRESS:
d, CITY STAT>a
�
NONE•
CONTRACTOR
AME:
SUBMIT A COPY OF
;TATE
LICEN
# EXP DATE
YOUR STATE LICENSE
DRESS:
CITY STATE ZIP
WITH APPLICATIONH
F
PROPERTY TYPE
SINGLE F
YMEW CONSTRUCTION SIZE
TWO F
/NEW CONSTRUCTION STORIES
PERrvM TYPE
ADDITION
❑;1GARAGE/SHED 01WINDOWS
IJ
BASE
FINISH ❑ROOF ❑ 1IN TILE
IP
DECK
❑!SIDING OTHER
E3 SWIMMING POOL
TYPE OF WORK:
ADDITION
CEZEP ❑ REMODELING
DESCRIBE WORK BEINGI
DONE:
! �� 9 / G Iq -�
LE40TH 0TH WIDTH HEIGHT Sq. Ft.
SIZE OF IMPROVEMENI
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
❑ GARAGE
1. Existing Floor Plan
2. Proposed floor plan
PROPOSED SIZE:
PROPOSED HEIGHT:
DETACHED
3. List of structural members to be used
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
WINDOWS
2. Two sets of construction plans
IN EXISTING OPENINGS DYt s
❑No
LOCATION OF WINDOWS
3. Energy Calculations
OR FOR NEW OPENINGS-DES
E SIZE 0
OPENING CHANGES &
TYPE OF WINDOW TO BE INS
NUMBER OF'WINOOWS
ALS.FEES ARE
ED ON
LUATION, IN LUDINTHE COST OF LABOR AND MATERIALS:
SING THE 199 U.B.0 FEE SCiR EDULE)
TOTAL JOS
UATI :
$ 3D® J OCCUPANCY TYPE
Permit Fee ;
$,
-0 j See Back Pagefor Fee Schedule
Plan Review
$
II'
65% of8u Permit Fee
Fire Surcharge
$
e �� 001 times Zhe total job valuation
Surcharge
$
JZ? .0005 x Permit'Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1675 per $AC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $21 =$
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Maui Charge
( )
Agreement necessary( ry ( )Non Necessary(
Total Due
$
Z' Make checks payable to: City of Fridley Attach Stipulations
TH;
IS AN APPLICATION FOR',A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a buil i Ing',
permitd
I acknowledge, that the information above is complete and accurate; that the work will be in
conformance with the or
ces and c des of the City of ridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only! an applia on for a pei`
it and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all worl TW,ch
SIGNATURE OF APPLICANT
requ'
lWan approvakof plans; f1l�/ I
PRINT N:10* 4 `�5. I /tel N�- %ADATE
Buildin&
BUILDINGPermit No.:� 2007A
Insoection,'SIDENTIAL
APPLICATION Received By
763572360
- -yve
cd:
CITY OF FWLEY
DATE
14
YOUR E-MAIL ADDRESS ' C.0%4
SITE ADDRESS
THIS APPLIC�NT IS-
i . WN R ❑C apit
PROPER O NER/
AME:0i
DRESS:
ITY sTAT LIP�2,
TENANT
CONTRACTOR
AME:
SUBMTr A COPY OF
TATE LICEN
E # EXP DATE
YOUR STAVE LICENSE
S: •'
^ CITY STATE ZIP
WITH APkICATION
;H,1:rPROPERTY
TYPE
GLE F
Y/NEW CONSTRUCTION SIZE
TWO F
Y/NEW CONSTRUCTI STORIES
PERMIT TYPE
ADDiTIONj
BASE
GARAGE/SH D WINDOWS
FINISH ❑ ROOF C] DRAIN TILE
DECK
❑ SIDING 0 OTHER
❑ S G POOL
TYPE Off' WORK:
W
DrrloN
MAINTEN
CE/REPAIR [3 REM DELiN G
DESCRIBE' WORK BEIM
` DONE:
E'
SIZE OF IMPROVEMEN
�S LENGTH WIDTH ✓� HEIGHT S . Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF!�QUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
ATTACHED GARAGE
C HED GARAGE
1. Existing Floor Plan
2. Pro floor plan
Posed
S
PROPOSED IZE
DETA
3. List of structural members to be used
PROPOSED HEIGHT:
SEDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
I
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
Trim
Site Plan/Survey showing the existing structures
❑Other❑
Fascia
/and proposed project
WINDOWS I'
IN EXISTING OPENINGS 13Y
ONo
LOCATION OF WINDOWS I
Two sets al construction plans/
3. Energy Calculations
OR FOR NEW OPENINGS -130
E SIZE O
— —
OPENING CHANGES &
TYPE OF WINDOW TO BEM
ALLED
NUMBER OFWINDOWS
AL FEES ARE
ASED ON 111
kALUATION, INCLUDMING TI]11E'I COST OF LABOR AND MATERIALS:
SIN E FEE SGiEDULE)
TOTAL JOB
ALUATIO
$ �• OCCUPANCY TYPE
Permit Fee$
See Back Page for Fee Schedule
Plan Reviej
_
$ ! �'%. �/ 65°�b of $tiildi# g Permit Fee
Fire SurchargO
$
A5, 0z) .001 timesthe total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$1675 per,SAt Unit (Plans to MWCC for detennination)
Curb Cut Escrow
$
ft + 6 ft = ft x $21 = $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$ — Fee, Determined by Engineering
Sewer Main Charge
$
— — _ Agreement necessary ( ) Non Necessary ( )
Total Due
$
g permit
'73� & Make checks payable to: Ci of Fridlpy Attach Stipulations
$ IS AN APPLICATION FOR A PER �vII f -NOT VALID UNTIL PROCESSED
Ind I acknowledge that 'the: }nf.ormation above is complete and accurate; that the work will be in
I hereby apply' for a bui
conformance with the ord inances
and c ides of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an appli
'on i fo pe
it and work is notwilhout a permit; that the work will be in accordance with the approved
plan in the Ease; of all wor
SIGNATURE OF APPLICANT
a u
roval of plans. �— �'
RINT 14AME �J 19� e S 1— DATE
i
Building;
`
MECHANICAL Permit No. 7'
Ins eCflcnS
Re Y� �
I RE IDENTIAL APPLICATION ceived B
763-572:-3604
CITY OF FR.IDLEY Date Recd:,
9 a
DATE h0 —
YOUR E-MAIL ADDWS
V, '
SITE ADDRES$
, ��� y� �✓r/
TICS APPLICANC IS:
R DCO CTOR
,
PROPl7RTYr
:'' G
STAT��
E;�
OW"R1, RFSB. CITY v
TENANT'' P
I'
CONTRACTOR
ANY
SUBMIT A'COPY OF
YOUR 5TA TATE
ACT PERS IN:
LICENSE F-0 DATE
LICENSE WTIH
ITE
�RESS: CITY STATE ZIP
APPLICATION P FAX
PERMIT TYPE
ING Li F Y O TWO FAMILY 0 TOWNHOUSE
�I I
, 0 REPLACEMENT ALTERATIONMEMODEL
TYP` E OF WORK:
�
I
DETAILED D�SCRIPTI N OF W0og
PERMS 116B.665 the
e is a nimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
of labor
r'eplacem t of a residential fixture, excluding the fixtures: (This should reflect only the cost )
improvement, ipstal.W0
or
Labor cost, under $300 =
II =
115.00. Lab cost between $300 to $500 = rost of labor X.05
1A
rX(=XM CTU1tE, 500, FEES ARE BASED ON 510.00 PER FDEXCEPT WHERE NOTED. FIXTURES: ONDICATE TOTAL
FOR PROJECTS WHERE
NUMBER OF EACH SELOV
MODEL' SIZE/BTUEg
wpmeni h }ad
MF SIZFlBTU
MODEL:
ii SLMMTU
FIREPLACE (GAS) SIS -0 GAS RANGFJOVEN $10.00
$10.00
A/C 5200IT0MAS
AIR TO AIR EXCHANG
GRILL
515 _FIREPLACE (WOOD) $35.00,GAS UNIT HTR $10.00
FURNACE $35.00
BOILER $35,011
Ci R"Y LINER $10.
I� DAS DRYER $10.00 POOL HEATER 535.00
VENTILATOR 515.00
DUCT WORK 510.007GAS
PIPING $10.00
Permit Fee
'� i . i ^ $• ! Number of fixtures @ $10.00 x $10.00 = $
Number of furfures @ $15.Q0 x $15.00 = $
Surcharge
T6`TA1'< DUE
$ .50 �
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ 50
Total= $
ANJJ_ to
'r
IS
Tj IS AN APPLICATION FOR A PES -NOT VALID UNTIL PROCESSED
I hereby) apply for a b ding p enni Land I acknowledge that the in ormation above is complete and accurate; that the work will be in
Mumesota Construction Codes; that I understand this is
conformance with the di>Yances an codes of the City of Fridley and with the
a but only application or a permit and work is not to start without a permit; that the work will be in accordance with the
not pe#mitj
approved plan in the
a of o w ' es d ap �rovil of plans.
U
SIGNATURE OF APPLI
.� PRINT NAMETq V<� �
i
City of ridle
Building Inspections Department .
6431 University Avenue;NE, Fridley, MN 55432
L
763-572-3604
FAX: 763-502-4977
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMESIADDITIONS ❑ 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 propanDUGC 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 copstnxtion 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
1
I* Q
Buil in PLUMBING Permit No. tM�"' b
Ins ctions�
P� SIDENTIAL 1� PLICATION Received By:
763-512-1604
i
CITY OF POLEY Date Rec'd: 1144vaj
763-5!04-4977 F j EFFECTtvE'i�1L' 0101
DATE YOUR E-MAIL Able S .' �?<'• �C -
sITE ADDRESS 'f_t �8.. '
THIS APLI� IS: R ❑CONTRACTOR
PR PARTY A1.2A+
Rll'S° CITY i STATEIP
AD SS`.zz
T1 T PHONE: � ���
SUB O bR T ASTAPT E OF
STATE LIC
E #
EXP DATE
LICEN E, BOND AND
STATE $ON
EXP DATE
CEndAT EOF
ADi)RLSS.
CITY
STATE ZIP
SU►NC
PHONE
FAX
PE TYPE
AvGLE F
LY ❑TWO FAMILY
❑; TOWNHOUSE
TYP OF WORK:
❑
I�MPLAC
I
I
DETA E DESCRIP
O , OF W
RK _e
-
I
II
FE BASED
ES HAS
ON 1 0,
P R XTti
FE
EXCEPT WHERE NOTED. FIX "' INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM E
0 TU
$
$]LAV
SHOWER _WATER
PIPING7SB0A
BAAS
PIPING (NEED CITY LIC)
SWIMMING POOL _
WATER SOFTNER ($35)
_ CLWASHER
CHEN SINK
WATER CLOSET _
"'
BACKFLOW PREY. ($15)
_ DISI ASHER
_
pUNDRY TRAY
WATER HEATER ($35)
FOR IRRIGATION
tl b I,
WATER METER _
OTHER
U j l 1 S IS AN APPLICATION FOR A PE T -NOT VALID UNTIL PROCESSED
I hereby �p�ply for a p bing perm) and I acknowledge that the'inf rmation above is complete and accurate; that the work will be in
conformance with the �, dittanlces ati codes of the City of Fridley an with the Minnesota Construction Codes; that I understand this is
not aetn t but only a plic or a pernlian�d work is noU to tart without a permit on site; that the work will be in accordance
with tltiep roved pl Case which regaires rcvtw d approval of plans.
SIGNATIJRE'OF APPLIC P1 NAME l ��(°�°GT DATE
City of F idley
If
I
Building Inspedetans Department
6431 University Avenue! Fridley, MN 55432
I: ty Y
763-T2 3604
I; FAX: 76'x- 02-4977
i
i
I
I
Building din�,.
gI
BUILDING Permit vo.. L f
Inspections
IR
ESIDENTIAL APPLICATION Received By:
763-5t-3604 �
'��
CITY OF FRIDLEY Date AM 1 S 2
763-502-4977 F
EFFECTIVE 1-1-2010
DATE
YOUR E-MAIL ADDRESS
SITE ADDR ISS
i
c-� �/'�C�
666 1
-R ❑CONTRACTOR
THIS APPLICA IS:
PROPERTY OWNER/
7 ro
TENANT
ADDRESS:
'a/�'t �. �����
CITY STA�ZIP
PHONE
>
CONTRACTOR
NAME:
SUBMIT, A COPY OF
YOUR STATE LICENSE
TA
ADDi
IE # EXP DATE
AND CERTIFICATE OF
CITY STATE ZIP
INSURANCE
PHONE
FAX
PROPERTY TYPESINGLE
F
LY/NEW CONSTRUCTION SIZE
TWO FAMI Y/NEW CONSTRUCTION i STORIES
PERMIT TYPE
ADDITION',
❑ BASEMENI
❑ QARACEISHED ErWINDOWS
FINISHF
❑ DRAIN TILE
Q DECK
IDING ❑OTHER
❑ SWIM [ING POOL
TYPE OF WORK:
HO
CONSTRUCTION 13 ADDITION
AINTEN
CEIREPAIR ❑ REMODELING
DESCRIBE WORK BEING DO
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT SQ FT
ROOFING
NUMBER OF SQUARES
�
❑ HOUSE ONLY
� ❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:1.
GARAGES
❑ ATTACHED GARAGE
Existing Floor Plan
2., Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
ID G
j
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS_ & PORCHES SUBMIT:
1. Site Plan/Survey
13 Aluminum!
00(-'
❑ T mt
showing the existing structures
[3 Other
13 Fascia
and proposed project.
WIlVAOWS
2. Two sets of construction plans
3. Energy Calculations
IN EXISTING OPENINGS t
OR FOR NEVI( OP9NINGS-DES
❑No
E SIZE OF
LOCATION OF WINDOWS
FOR WINDOWS — PROVIDE U -VALUE AND
OPENING CHANGES &
MANUFACTURE STICKER ON WINDOW.
TYPE OF WINDOW TO BE INS
LED
NUMBER OF WINDOWS
ALL FEES ARE B$
D ON V
UATION, INCLUDING THE COST OF LABOR AND MATERIALS:
�I�
{
SING THE 1997 U.B.0 FEE,,, S HEDULE)
TOTAL JOi VALUATIO
OCCUPANCY TYPE
Permit Fee
$'�
See Back'PP' a for Fee Schedule
Plan Review
$
' 65% of Build ng Permit Fee
Fire Surcha'ge i'I
$'
6 .001 timeslth total job valuation
Surcharge +,
q $
.0005 x Perrrtt Valuation Minimum $.50
License Surcharge
g
$ i
$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 Cotltroll
$'
$450 Conserviation Plan Review
Park Fee
$
! Fee DeterminFd by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
Make checks' payable to: City of Fridle Attach Stipulations
I hereby apply for a build)
THIE
l'g permit
S AN APPLICATION FOR A PERMITINOT VALID UNTIL PROCESSED
I the information is
acknowledge that above complete and accurate; that the work will be in
conformance with the ordiilknces
and codes
of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an applica
approved plant in the case o
in for a e
l k w
it and work is not to start without a permit on site; that the work will be in accordance with the
d approval
of plans.
SIGNATURE OF APPLICANT
_
OMANU ' , IA01'i'I'NU
10