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PRE 2010 DOCSCity of Fridley, Minn. WELDING PELT N® 3603 Date: ./l.......-. <............ Owner ...... Builder Z .. Address...................................... Address ............................................ LOCATION OF BUILDING No. .� ! . !. �! ... Street.. (/...... .. ....... ........ ..... Part Doff Lot ................ ...... ... . Lot .19 ...... Block .. Y ............. Addition or Sub -Division )4.. . �. .. .. . Corner Lot Inside Lot A ......... Setback ��... ... Sideyard y DESCRIPTION OF BUILDING Two /be Used as: 00- .. ... From 1/11:.�ry Depth �j .: Height .. f7K SQ. Ft./017. c . Ft.�4!q, :A� .l t� f..f- ,e ii p Height /� fO" Sq. Ft.. /.. m Ft.3Z'Fi From / !'.. De th Hei ht Type of Construction ................... Bet. Cost../. �6 Y. .: ---.. To be Completed .................... �1- In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description above set forth and in mpliance with all provisions of ordinances of the city of Fridley. ?/_ An <A In consideration of the payment of a fee of $.. ....... permit is hereby granted to ................... ......................... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location; construction, alteration, maintenance, repair and moving of buildings with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ../,1....... Building Inspector NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items.. Application Oar Power imp cjndf ® I:n ® Venng CN®n, Rang °®n ®ad Air C®ndieloning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL . Furnace Shell & Duct Work .......................... M $ $14,00 Replacement of Furnace $ 6,0Q Repairs & Alterations—up to $500.00 .................. kjbc $ 6000 Repairs & Alterations each add. $500.00 ............. $ 3.00 MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ each add. 60,000 BTU ....................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 ................. Repairs & Alterations each add. $500.00 .............. STEAM or HOT WATER SYSTEM $. $10.00 3 $ 3.00 c $ 6.00 H4 $ 6.00 ba $ 3.00 Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... ift $ $10.00 Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... $ 10.00 Each add. 200 sq. ft. EDR Steam ...................... I,& $ 3.00 Each add. 320 sq. ft. EDR Hot Water .................. YU& $ 3.00 OIL BURNER—to 3 gal. per hour ........................ $ over 3 gal. per Hour—fee Fee Schedule 199 000 GAS BURNER hip to BTU) ..... ................. 5.00 $ GAS FITTING TM: 1999000 BTU NO RATE TOTAL 1st 3 Fixtures ...................... x $ Additional Fixtures ((� Gas Range to 4 �TI�T ........... x $ x 2.00 $ AIR CONDITIONING F 0.A/TSee FAN HEATING SYSTEM Fee Schedule VENTILATING SYSTEM ALTERATIONS & REPAIRS $ TOTAL FEE $ ROUGH FINAL M- $2.00 �f $2.00 •75 $5000 Dept. of Bldgs. Phone 560-34M .coa4ioa y, City of Fridley: AO � in 'Y"' - 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. d Fridley, Owner �r-/&Z�=-r a Kind of Building Used as To be completed about Estimated Cost, O1d--�New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No 19 ';�-e Trade Name Size No. Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fuel BURNER — Trade Name- Size No Capacity Sq. Ft. E.D.R. BTU H.P. (REMARKS—OVER) Signed t Af�b AM CQi-J0iTI0NIhJG INC .<z Business Phone N City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING PERMIT P O. 2 7143) r ` _ COMMUNITY DEVELOPMENT DIV. L PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 612-571-3450 RECEIPT NO. (� NUMBER 910-F15 REV DATE 8/12/98 PAGE OF APPROVED BY JOB ADDRESS 6771 Plaza Curve 1 LEGAL DESCR. LOT NO. 12 BLOCK 4 TRACT OR ADDITION 1 Rice Creek Plaza South SEE ATTACHED SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Dee Kristians 571-1119 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Progressive Building Systems 23120 Garrison Rd Corcoran5 340 498-7241 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20104340 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION XX REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Rernof house and garage (26 Sq.) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SO. FT. CU. FT. 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION 2168 SURTAX $1.08 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- STRUC ION OR THE PERFORMANCE OF CONSTRUCTION. $74.75 Fire SC $2.16 PLAN CHECK FEE TOTA FEE Lice S 5 0 2.99 GNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI EN OPE YMATIS IS YOUR PERMIT e &-147 '1-5 SIGNATURE OF OWNEROF OWNER BUILDERi IDATEI BLD INSP BATE I / 11'ro ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: (/.-, Legal Description: Effective 1/1/98 Owner Name & Address: ,D.� S�-.y,.� . Tel. # Contractor: �iz�� a �. Q ;� —� -- MN LICENSE # Address : ,)-?/OG �r 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 Width Hgt/Ground Sq. Ft. r OTHER: lei% '_� - � S� �-� ��, Construction Type: Driveway Curb Cut Width Needed: Ft. + 6 Ft = Estimated Cost: $ yy (Fee Schedule on Back) Ft x $ _ $ DATE: 9-;r"PLICANT:1�--,' r-=-- Tel. # 3 e e -S 35 - STIPULATIONS: CITY USE ONLY Permit Fee $ �� �%� 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 .C,C $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 $ G 9 STIPULATIONS: Building BUILDING Permit riot: C Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 65% of Building Permit Fee Fire Surcharge CITY OF FRIDLEY n _I 763-502-4977FAXEFFECTIVE 502, .001 times the total job valuation 8-19-09 $ DATE_T. 3��{ 20©7 YOUR E-MAIL ADDRESS 5 CQ� Q i.� �TC°7 1\0(—• C�+C-4 SITE ADDRESS Com 7 ( °?�_ta3_ct SAC Charge THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR Curb Cut Escrow PROPERTY OWNER/ NAME: ' (_i. i C @M t h Erosion Control TENANT ADDRESS: C�7'T iy L_a�,a �,y� V 2 �@ CITY_ -'c � STATE is n(ZIP�j?��-�J T �^ lrZ $ PHONE: L I �® Sewer Main Charge CONTRACTOR NAME: Total Due SUBMIT A COPY OF 1' I Make checks payable to: Citv of Fridlev Attach Stipulations YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE I!( SINGLE FAMILYMEW CONSTRUCTION SIZE S i 0\ q £ E1Ot Lp ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH W ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCUJREPAIR 0 REMODELING DESCRIBE WORK BEING DONE: 6 V a2 W ryD SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES Z3 ❑ 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: 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 FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. 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 $ OCCUPANCY TYPE Permit Fee $ h:See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 502, .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ 1 $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $Agreement necessary ( ) Non Necessary ( ) Total Due $ 1' I Make checks payable to: Citv of Fridlev 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 on site; that the work will be in accordance with the approved plan in the case of all work which requ'res re ' w and approval of plans. SIGNATURE OF APPLICANT 0 ^ .acs PRINT NAME ATE