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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N? C1O9 Date: ea -jjt Owner: Builder ' Address Address �4� �.� � TI OFMING No. / Street P o! Lot Lot _ Block er Addition or Sub -Division Corner Lot _ Inside Lot Setback� Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To U , Front Depth Height Sq. Ft. Cu. Ft a/ ion Depth eight Sq. Ft. ____,_____ Cu. Ft. Type of Construction dope, ._ Fit. ++. "" .. To be Completed 4- "5 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 $ , permit is hereby granted to to construct the building or addition as described above. This permit is granted upon ress condition that the person to whom it is graated and his agents, employees and workmen, in all work ound and upon said building, or any part thereof shall conform in all respects to the ordinances of FldlY4sor inneta gcity limits NOTICE: Ob permit doss not carer the conslroctboe, hub f dan for whinB, phnobine, pe hyo, awra or wafer. Be ams to ale the Befldh* hopeder for a►para» pwndit for thea hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name Builder Address Address LOqATION OF BUILDING No. Stree a Part of Lot Lot Block Addition or Subdivision � � 4 Corner Lot Inside Lot i� Setback Side-Yard- SEWER ide-Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING Tobe used as: Front Depth._y Height r Sq. Ft. Cu. Ft. Ar Front Depth Height Sq. Ft. Cu. Ft. Ili 7 Type of Construction Estimated Cost To be Completed The.undersigned hereby makes application for e 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 IGNATURE `- (Schedule of Fee Costs can be found on the Reverse Side). SUBJECT of Fridley nPERMITNCity 229 AT THE TOP OF THE TWINS BUILDING PERMIT r _ COMMUNITY DEVELOPMENT DIV. L % PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER DATE PAGE OF APPROVED BY 612-571-3450 910-F15—T-7 3/10/92 JOB ADDRESS 125 Pilot Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 31 2 Carlson ' s Summit Manor South Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Duane Tyo 125 Pilot Avenue NE 572^8772 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Twin City. Storm Sash. 10825 Greenbrier Rd, Mtka 55343. 546^8160 3090 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Soffit/Fascia and window trim 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2r200 $1,10 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $54� QQ Fire SC $2.20 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License ,SC $5.00 $62,30 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WH PROPE ATE THIS IS YOUR PERMIT G SIGNATURE OF OWNER OF OWNER BUILDER) MATE) ,..� INSP GATE NEW [ j Effective 3/1/92 ADDN [ ] CITY OF FRIDLEY 7 ALTER[ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: �� I° o -f- /4 cue Legal Description: Owner Name & Address: __,D c r, e ` i V © - �c M e Tel. # 5 -7a - R 7 7 -� Contractor: w, o C i AA 4 MN LICENSE # 3 o 9 a Address: /yy�2pA 1,,fl r CA lit _v sS �yTel. # :5V& - 81/Co 0 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: , �-�-tu � w d a� _, - I" Corner Lot [ ] Inside Lot [ ] Type of Construction: Approx. Completion Date: Ft. Yd Setback Side Yard Setbacks Estimated cost: $ a a 00 > 0 0 Driveway Curb Cut Width Needed: Ft. + 6 Ft = (Cost on Back) Ft x $ = $ DATE: 3 - - APPLICANT: ,`kc--- Tel. # .5'q & -,Z' & d Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Park Fee Sewer Main Charge $ TOTAL STIPULATIONS: $ Looe 30 CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $700 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Aee ent Necessary [ ] Not Necessary [ ga ©o / a 5� Building PLUMBING Permit No.Ao Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: l 6''� DATE /O .. N - O (p YOUR E-MAIL ADDRESS SITE ADDRESS _ /� �� U i (J /V C THIS APPLICANT IS: ,OWNER OCONTRACTOR PROPERTY NAME: ADDRESS:/aZ �� C /J % /7 U CITYSTATE t Lill' S S <l OWNER/ TENANT PHONE: -7 S 7 -7 2- CONTRACTOR NAME STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS: CITY STATE ZIP LICENSE WITH PHONE FAX APPLICATION PERMIT TYPE 0 SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: 0 NEW 0 REPLACEMENT DETAILED DESCRIPTION OF WORK ej AAA ,S 1 UU 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 ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 =cost of labor x.05 = FORfPROJECTS WHERE LABOR EXCEEDS-$500; FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT .WHERE NGTED, FLXT-URES ,=(INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV DRAINS SHOWER WATER PIPING _ _FLOOR _ _ —BATHTUB _ GAS PIPING (vEw clrrucEmse) _ SWIMMING POOL —WATER SOFTNER ($35) _ CLOTHES WASHER _ KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREV. ($15) DISHWASHER LAUNDRY TRAY HEATER ($35) FOR IRRIGATION _ _ _WATER _ WATER METER _LGbTHER q x �) 5 Permit Fee $&V Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $_ State Surcharge = $ .50 Total = $ 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 work which approved plan in the case of all wnc�ich requires review and approval of plans. 7� SIGNATURE OF APPLICANT n " ' i/ �- 0 �` PRINT NAME , V /4 (+2-V L Et u-- -Tye DATE to City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL Permit No. s - Inspections RESIDENTIAL APPLICATION Received By:--'��T 763-572-3604 CITY OF FRIDLEY Date Rec'd: 763-502(-4977 FAX EFFECTIVE 7-1-2010 / YOUR E-MAIL ADDRESS DATE -14'-' /d SITE ADDRESS %+ZS 7 t �pLy� /+vt Al ('t THIS APPLICANT IS: ❑ OWNER *r TRACTOR PROPERTY NAME: Lw a ADDRESS: %� P/ Lo F A-2 Ale CITY 7;67y— STATE ZIP 5 TENANT PHONE: 7 7.L CONTRACTOR COMPANY NAME: /� F�� F S CONTACT PERSON: DAj r2 2 i C A i l, SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE �+ LICENSE WITH ADDRESS: �a `t 1 _1 'Zd La CITY Ny S t . JOAL STATE ZIP APPLICATION PHONE CaS%P 7�- 3�3 FAX — °O's OGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE PERMIT TYPE CerALTERATION/REMODEL TYPE OF WORK: ❑ NEW ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK W 3A) SIZFJBTU Equipment Installed MFG: SOTv L MODEL: ga&-.�A MFG: MODEL: SIZEIBTU MFG: MODEL: SIZEIBTU A/C(GAS) $15.00 _GAS RANGEIOVEN $10.00 A/C $25.00 _FIREPLACE — TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00 $35.00 $35.00 _GAS UNIT HTR $10.00 _BOILER _FURNACE LINER $10.00 DRYER $10.00 _POOL HEATER $35.00 _CHIMNEY _GAS DUCT WORK $!10.00 I GAS PIPING $10.00 VENTILATOR $15.00 Z x �t _.f R i`a wogg�s A v�,g„5`� £ \.� 3 r � X� 1 3 S A{ WI ��, Zi't S ) vs •-� � rtF k � ff. } .fi� -� a � � ',� 1A �`� " �� k� � R.R .a+$ £ �' �� f � �� � �*i � � f °SRF'. ���. � "� "�•\ '. Cw � � `�. f' � e.'i ".. a,aPit _ A evG 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 appli ion for a permit d work is not to start without a permit; that the work will be in accordance with the approved plan in the case o I w rk which re i es v' approval of plans. % q )$J L �� 1 DATE / �® SIGNATURE OF APPLICANT PRINT NAME1 APPROVAL INSPECTORS SIGNATURE DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 3