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City of Fridley, Minn. BUILDING PERNYIT lv? s 0:il) Date: .,`t.,,,,,. - Owner:�'Jluilftr Address Address ,. L40CAT10 F UILDING No. Street_- Part t Lot _Blockddition or Sub -Division . Corner Lot _ Inside Lot Setback _ __ Side yard ——r Sewer Elevation _ ___ Foundation Elevation DESCRIPTION OF BUILDING To ERU,sed,p Front Depth I1eight Sq. Ft., ' Cu. Ft, ._..� _ Front Depth. ei�14 ghi, 0�► Sq. Ft. �'Cu. Ft.' Type of Construction ,d_. Est.t "'""!""Ta 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 a'll provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ —07 =2 7 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 pert thereof, shall conform in all respects to the ordinances of Fridley, Minnesota location, conatruct%n, alteration, niaintenance, .repair and moving of buildings within the dty ]imus and permit may be revoked at 8ny , ' upon violati�by of the provisions of said ordinances. None Ibb permit don not cover the conatrection, hwallatbn for whbq, pli mblae, Bn headng, sewer or water. Be sure to me 69 BOA* Inspector for separate permHs for thea hams. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Name ,� �ilder AddressAddress LOC ION OF BUILDING No. Street Part of Lot /� Loth Block�_Addition or Subdivision ^ 3,�,PX Corner Lot Inside Lot Q/ Setback 3 6 Side -Yard SEWER ELEVATION FOUNDATION ELEVATION 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 2 S� Height_2:Ld Sq. Ft. Cu. Ft. Z/ Front ` Depth Height Sq. Ft. Cu. Ft. .A 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. 1111 (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley Application for Plumbing and Gas Fitting Perndt DepL of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL f 6 Number Fixtures...................... x $1.50 $ Future Fixture Opening ................ 0 0 z F • N WATER HTR. GAS ELEC. Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg. ............ x 3.25 $ 90 NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 s---/. .5 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ Base 1 1st 2nd 3rd 4th • Future Connection Openings Connected with I Sewer � New Fixture, Old Openings Cesspool E] PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL f 6 Number Fixtures...................... x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 s---/. .5 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ .fes City of Fridley: The undersigned hereby .makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this applicatio are true and correct. ,r 1 DFridley, Minn �✓ 1952•i Owner r " Kind of Building Used as To be completed Estimated Cost, $ Old ew ding Permit No 6 drZ Permit o. Signe r By Business Phone No 7.2 ROUGH - 07 7' 6 y FINAL c' 42 2ND Application for Power Plants and Heating. Cooling, Ventilation. Refrigeration 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 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ each add. 60,000 BTU ....................... Replacement of Furnace .............................. ;RRepairs & Alterations—up to $500.00 ................. ,Repairs & Alterations each add. $500.00 .............. ST,VAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. IDR Steam ..... Furnace Shell & Line—to 640 sq. ft. EDR Hot Water . . Each add. 200 sq. ft. EDR Steam ...................... Each add. 320 sq. ft. EDR Hot Water .................. 8.00 $ 2.00 $ 5.00 $ 5.00 $ 2.50 $ 8.00 $ 8.00 $ 2.50 $ 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 $ 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 $ ROUGH FINAL Dept. of Bldgs. Phone SII 4.7470 i 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 aret e/aand correct. Fridl Minn � �' Owner ( L LTJ ' ( u<< C e - Kind of Building C C� Used as To be completed about Permit No. G / Permit No. --- DESCRIPTION OF WORK HEATING or rZNTS-Steam, Hot Water, Warm Air—No Trade Nam Size No Capacity -2 d G G (S�q. Ft. E.D.R D BTU H.P. Total Connected Load / 6 ny Kind of Fuel BURNER — Trade Name Size No Capacity Sq. It. E.D.R. BTU H.P. (REMARKS -OVER) .kjG.2-42 'jM D•36 7 9 HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E. Construction No. Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor es Noa No 1 19- -1 R.I , _,�Room I Length S Width 9 Height R II Fl.l Windows and Doors—Crackage and Area . Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Coef. Btu Infiltration / 3 _3S_ Net exp. wall Glass 7 Glass o Exp. wall �e o _±.2L Exp. wall Net exp. wall 33 1 / f 3 G 3 Int. wall Int. wall Ceiling Z/v / z 41 f d Floor Ceiling Floor Total Btu. I / 7.;1- 7 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ,9_Fl.1 V %_�.. r-., Room I Lenath -7 Width <5--' Height /-'? Windows andboors—Crackage and Area Din 4 Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Infiltration Coef. Btu Infiltration Coef. Btu Net exp. wall 3 r ! 2 Z Glass Ceiling 9 a 1) ®e d Exp. wall 6 Ceilings ^ , Net exp. wall Net exp. wall Int. wall 3 Int. wall Ceiling Ceiling Floor /S- 4 Floor Total Btu. I �e/ / Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1 6 ' F1.1 Room I Lenath Width Height Windows and Doors—Crackage and Area Din 4 Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. No. of Lineal ft. Area lights of crack sq. ft. Coef. Btu Infiltration Infiltration Glass Exp. wall ' Coef. Btu Net exp. wall Exp. wall Int. wall Ceiling Floor Int. wall - Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area MINNEAPOLIS, MINN. Insulation Kind How. Applied Rnem I Lenath Width Heistht Windows and Doors—Crackage and Area Din 4 Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. No. of Lineal ft. Area lights of crack sq. ft. Coef. Btu Infiltration Infiltration Glass Exp. wall Coef. Btu Net exp. wall Exp. wall Int. wall Ceiling Floor Int. wall - Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l Room I Lenstth Width Height Windows and Doors—Crackage and Area Din 4 Width Height No. of I Lineal ft. Area No. of pane of pane lights of crack sq. ft. No. of Lineal ft. Area lights of crack sq. ft. Coef. Btu Infiltration Glass 70gt,eJ Coef. Btu � q -L Exp. wall Net exp. wall/ Int. wall - t h. r 6 Ceilings ^ , Net exp. wall Floor Total Btu. U I Required sq. ft. E.D.R. or sq. iris. W.A. Leader area F1.1 Room I Length Width Height Windows and Doors—Crackage and Area Din 4 Width Height No. of pane of pane No. of Lineal ft. Area lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area IY56 79 W . HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS. MINN. Weatherstrips A.S.H.V.E, Construction No. Insulation Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied es No Yes No 19— Fl.l , " ' _ Room Length' /G Width e e j Height II Fl.l .r /'�� Room I Length 7 Width ,// Height Windows a� Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane llghts of crack sq. ft. Width Height No. of Lineal f . Area No. of pane of pane lights of crack sq. ft. o z Y, z Coef.1 Btu Coef. Btu Infiltration 7 1-7— 7Glass Glass 30 /"r Z- Glass Glass 79 Exp. wall 4' 0 2.Zo 7 l Int. wall Net exp. wall Net exp. wall -33 Int. wall /1573 Floor if 3 Int. wall Ceiling Floor Total Btu. ,Z 70 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ,/ Z. 9 F1.1.. .� -A," _ Room I Length iry Width //- Height ? Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane llghts of crack sq. ft. / 2c% / 49 Z' /3 ✓ .�Z 70 w % /2 Coef.1 Btu Coef. Btu Infiltration 7 1-7— 7Glass Glass 30 3'? d/ Glass 79 4 e) 4' 0 Exp. wall 7 l Int. wall /% Z Net exp. wall -33 /1573 Floor if 3 Int. wall Ceiling Floor Total Btu. 1 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I' F1.1 A _ 7' Room 1 LenathZ 6 Width �5- Height / V Windows andBoors—Crackage and Area Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack sq. ft. 36 G �� Coef.1 Btu Infiltration 3.e 7 1-7— 7Glass Glass / a Exp. wall 79 Net exp. wall 60 �P 7 l Int. wall Ceiling -33 S Floor Total Btu. 1 .19- If Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ° Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 36 G �� Coef.1 Btu Infiltration j 6 Lig Glass / a Exp. wall 7 Net exp. wall 61.11 7 l Int. wall Ceiling /d S Floor Total Btu. 1 -31* / Requiredsq..ft. E.D.R. or sq. ins. W.A. Leader area O * s''y�e I 7 .1J _ 0 P-- I I P..t'h S 7 W Wit/,6 'nP1Oht 6A Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration j �,•} Glass Exp. wall /� o Net exp. wall A J / Int. wall Ceiling Floor Total Btu. IS -4671 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I f ' -9 F1.1 R,.1 z Room I Length 9-d Width / ? Height ? Windows and Doors—Crackage and Area Width Height NO. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Coef. Btu Infiltration j �,•} Glass Exp. wall /� o Net exp. wall A 1177,1 Int. wall Ceiling Floor Total Btu. S'G 6 S Required sq. ft. E.D.R. or sq. ins. W.A. Leader area e D•96 , s HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS NIINNEAPOLIS, MINN. Weatherstrips A.S.H.V.E, Construction No. Insulation Guide Windows Doors Reference Out. Wall J1nt.Wall Ceiling I Roof Floor Kind How. Applied e No I No 19— e Fl.l Room I Length /-C-c Width i / Height 7=6 II FI_I Room I Length 17 Width /U Height Windows andboors—Crackage and Area Width Height No. of Lineal f . Area No. of pane of pane lights of crack sq. ft. -2 ;a,© /,-, 1- IP 5- 13 z 6 Z 2- /5- Coef.1 Coef. Btu Infiltration 31 -3,r- 39 5/ �.. Glass / a Z 2 C. 1,64 Exp. wallNet Net exp. wall �,� car exp. wall Int. wall S- Ia4.-Waf,8 6 ,° 3 Floor Ceiling 4- 4 Floor o Total Btu. I Required sq. ft. E.D.R. or sq. ins. W.A. Leader area If3 ' / F1.I . /F' 1 - Room I Length 9 c Width // Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. z 6 Z 2- /5- Coef.1 Btu Infiltration 31 -3,r- y2 Glass / / a Z Exp. wall y Net exp. wall �,� car 3 5- 2-,- Int. wall 5 3 Ceiling Floor /2,6 4- 4 Total Btu. e3 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area /a / Fl.1 /61 )�- Room I Length 9 Width /e Height 7_ G Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane Iights of crack sq. ft. 7 /s, / Coef. Btu Infiltration 31 -3,r- y2 Glass / / o Exp. wall °7 Net exp. wall 3 ; - car �e Int. wall S- / y' Ceiling Floor /2,6 4- �p a Total Btu. I Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 2 z _-7 3 /17 Coef. Btu Infiltration 31 3 rr // 7 S" Glass / / o Exp. wall °7 Net exp. wall tt �e `' �e Int. wall - .3 3; 0 Ceiling Floor /2,6 4- �p a Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / R.Wa .f _ /o Room I Length cP Width/ z -�o HeightP � Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of Dane lights of crack sq. ft. /9 Coef. Btu Infiltration ,/ 3k 117 ff Glass Exp. wall 7 Net exp. wall 7,V 7 34 9 Z Int. wall 37-3- Ceiling Floor //3 %S Z. Total Btu. 1 6 7-- / Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / s Fl.l ,0q - ;,41 Room I Length S- Width 7 Height 7--c Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of.pane lights of crack sgft. Coef. Btu Infiltration 3 F Glass Exp. wall ;? 2 Net exp. wall / Jr 1 =:7 7 Int. wall Ceiling Floor a Total 13tu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area City of Fridley, Minn. BUILDING PERMIT No 6691 010-f77 Date: Owner• a Builder -� � F .. C"•'L� Address LOCA►TION0,�,UNG No. Street-,�=��yt Part t Lot Block Addition or Sub - Corner Lot. Inside Lot aback Sideyard w Sewer Elevation _ F94ation Elevation DESCRIPTION OF BUILDING T U ?%-4 Front Depth Height Sq. Fte.4d Cu. Ft __. — Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Fast. ;^ 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 and in plias with all pro 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 within the city limits and this permit may be revoked at any time upon violati ordinances. "' 'n , f any of the provisions of said � 1 NOTICE: iib permit don not cover the construction, Installation for wbk& plumbing, gas beating, sewer or water. Be sure to see the Building Inspector for separate permits for than Rana. 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 Mr. Jerry Wraneschetz 6355 Pierce Street NE Fridley, MN 55432 March 10th, 1977 TELEPHONE ( 612)571-3450 Proposed Construction of Storm Sewer Line Along Your South Property Line (Lot 1, Block 1, Don's 3rd Addition) Dear Jerry: This letter is to confirm the telephone conversation on March 9th, 1977 regarding the proposed storm sewer line to be constructed along the South line of your property. We informed you of the need to remove three Cottonwood trees in order to accommodate the proposed storm sewer utility. One of these trees is lo- cated on your property. As discussed, the City will replace the tree with a 11j" to 2" Ash or Maple of your choice and will place it at a location as determined by you. The City also suggested that perhaps the cyclone fence could be replaced on your property line as it is presently, approximately 3' TJorth of your South line. We ask that you contact myself or Clyde Moravetz of this office when your determinations have been made. We would like to work with you on this project. Councilman Dennis Schneider apparently has discussed with you some concerns that you have relating to this improvement project. A copy of this letter will be sent to him for his information. If you should have any further questions or comments please don't hesitate to call us at 571-3450. Sincerely, CITY OF FRIDLEY Thomas A. Colbert, P.E. Assistant City Engineer TAC/grs c�yo4�T o-G6C : Dennis Schneider, Councilman 2nd Ward U m /7�6 _ t996 CITY OF FRIDLEY APPLICATION FOR PUiMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE m PLUMBING FIXTURE RATES: NO. RATE >, 0 x $3.00 ro Future Fixture Opening 0 $ K 0 $ Water ' m m A x $5.00 $ 100,000 BTU to 199,000 BTU a •C m Water Softener x $7.00 41 0 .i •. u+ 01 Electric Water Heater Heater $ 0Ee M H�� $ Additional Fixtures x $1.00 Ctdea Gas Range to 199,000 BTU x $10.00 $ H s INvy a .e L N C N c •.1 S U 17 N. $ N N REINSPECTION FEE p �U p +i ro � O W o tll n ' u D i i o r2W u M 3 0 o as lec 2nd 3rd 4t i 1 (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water Heater - to 99,000 BTU x $5.00 $ 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ 7� New Ground Run Old Building x $5.00 $ Electric Water Heater x $5.00 $ G=AS FITTING FEES: 1st 3 fixtures x $3.00 $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS $ ALTERATIONS First $100.00 $5,00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ REINSPECTION FEE ($10.00) Job Address "� V �[ Jt/1 'J ✓ - Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facL-s and representations stated in this application are true and correct Fridley, Mn.6 � 191 OWNER KIND OF BUILDING C USED AS TO BE COLLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. t Company Signed By Tel. No. ROUGH INSP. Date FINAL INSP. '94-V -O Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SUROMRGE 01) su9JEcr RMIT NO. 71 City of Fridley ��3 AT THE TOP OF THE TWINS BUILDING PERMIT �65 r ` RECEIPT NO. 1 114.L COMMUNITY DEVELOPMENT DIV. ______ r PROTECTIVE INSPECTION SEC. E NUMBER REV DATE PAGE Of APPROVED BY _ CITY HALL FRIOLEY 55132 763-571-3450 910-F15 8/6/02 10B ADDRESS 6355 Pierce Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 1 1 Don's 3rd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jon Williams 6355 Pierce Street NE 763-573-1572 J CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 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 O ADDITION O ALTERATION X REPAIR X ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof House (16 Sq) Tear-off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlaymeut must comply with the 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 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,715 $.86 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- $63.15 Fir SC $1.72 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK E TO^L FEE M5.73 SIG U OF CON CTOR OR AUTMORQ D A 4DATE� -n - WH PR LY VA OA D THIS I$ YOUR PERMIT o �Q S-GNATURE OF OWNEROF OWNER BUILDER) iDATEi B DG INS rjATE 01) NEW [ ] CITY OF FRIDLEY ADDN (] 6431 University Ave NE, Fridley, MN 55432 ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/2002 (763) 572-3604 Bldg Insp ?, Peer .IT 3A9�5 Construction Address: Legal Description: Owner Name ddress: Tei. #2 � Contractor. MN LICENSE # Address: Tel. # 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 ru_uc dth / Hgt/Ground Sq. Ft OTHER: AV- RAF I l Elf�e -6 r�r Construction Type: Estimated Cost: Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ Cc// DATE: z5Z� APPLICANT: LZ Tel. #a.Z-oZ3 Call (763) 572-3604 for Permit Fees if ailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by'Engineedng Agreement Necessary [ ] Not Necessary [ ] &du STIPULATIONS: Building Permit Fee BUILDING See Back Page for Fee Schedule Permit No.; Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION $ Q0 Received By: 2�j 763-572-3604 $ :5-00 CITY OF FRIDLEY License Surcharge Date Rec'd: l b DATE YOUR E-MAIL ADDRESS $ SITE ADDRESS Curb Cut Escrow $ THIS APPLICANT IS: // kOWNER ❑CONTRACTOR $ PROPERTY OWNER/ NAME: $ TENANT ADDRESS: /Iii CITY %i -f /Cs.- STAT) ✓/YLIP S.S � Agreement necessary ( ) Non Necessary ( ) PHONE Cp/o�-a39-6/�9i $ ! lo. CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE ❑ SINGLE FAMILYMEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED DOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ,SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE:�n/S 7`�Of✓ iv��,� !�.✓.r 7— SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 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) TOTAL JOB VALUATION $ l ex—g/0 OCCUPANCY TYPE Permit Fee $ , o� S' See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ Q0 .001 times the total job valuation Surcharge $ :5-00 .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC 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 Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ ! lo. Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work wh' quires nwiew and approval of plans. SIGNATURE OF APPLICANT PRINT NAMEOUZ~ s- DATE rAKW G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 BUILDING PERMIT APPLICANT: PROPERTY OWNER understand that the State of Minnesota requires that all residential building contractors, remodelers and roofers obtain a state license unless they qualify for a specific exemption from the licensing requirements. As the owner of the property at ass j-1, , , Fridley, I am exempt from the state licensing requirement only if I am not building or improving this property for purposes of resale. By signing this document, I attest to the fact that I am improving this house for my own use and do not intend to sell it. I hereby claim to be exempt from the state licensing requirements because 1 am not in the business of building or remodeling on speculation or for resale and that the house for which I am applying for this permit, isl the first residential structure I have built or improved in the past 24 months. I also acknowledge that because I do not have a state license, I forfeit any mechanic's lien rights to which I may otherwise have been entitled under Minn. Stat. 514.01. Furthermore, I acknowledge that I may be hiring independent contractors to perform certain aspects of the construction or improvement of this house and I understand that some of these contractors may be required to be licensed by the State of Minnesota. I understand that unlicensed residential contracting, remodeling, and/or roofing activity is a misdemeanor under Minnesota law, and that I would forfeit my rights to reimbursement from the Contractor's Recovery Fund in the event that any contractors I hire are unlicensed. I have also been informed and acknowledge that by listing myself as the contractor for this project, I alone will be responsible to the City of Fridley for compliance with all applicable building codes and city ordinances in connection with the work being performed on this property. r Name Date_ S7--/ j ate" RECD JUL 2 7 2007 "2-47 0,? Building BUILDING Permit •No.;V4927 -614 PO Enspections RESIDENTIAL APPLICATION Received By -.- y:763-572-3604 763-572-3604 CITY OF FRIDLEY Date Rec'd: (o DATE 91— (=G% YOUR E-MAIL ADDRESS 3ITE ADDRESS THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: �/ 41 s TENANT ADDRESS: /� CITY STAT54,ZIP .3 PHONE: CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE OGLE FAMILY/NEW CONSTRUCTION SIZE O FAMMyft4EW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH�❑ R�J F ❑ DRAIN TILE [3 DECK `,®SIDING ❑ OTHER ❑ SWINNONG POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: c Si ;n25 / SIZE OF IMPROVEMENT LENGTH Ig WIDTH -S HEIGHT S . Ft ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures XrOfher .4q4 ❑ Fascia and proposed project WINDOWS Z. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations 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) x TOTAL JOB VALUATION $ spry_ ooa OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ . '6 .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 per SAC 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 Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ p . Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowl6dge 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 pennit but only an application for a permit 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 work whic4-Muires review approval of plans. * SIGNATURE OF APPLICANT NAME ; %��//y/yis ilC DATE /—�D a%