The URL can be used to link to this page

PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT N? 3179 Date: % ' 7 5�.: °`:. ............... 2� Owner 27- �,.......... ............. 4 1 Builder ............................................ Address...................................... Address ............................................. 9 LOCATION OF BUILDING Ai N .P StreetF�.O' ......... Part Lot .............. /� Lot ...... �.�.. Block ........ Addition or Sub -Division .. Z. w ";/ ...lam .... Setback . .. D ... Side and ® �, tc dd Corner Lot . ..... Inside Lot ........ � y � ... DESCRIPTION OF BUILDING To b Usedas: ....... Front . .. Depth Height ... .. Sq. F't �1..4, Cu Ft. ........ ................. Front . Depth ........ Height ........ Sq. Ft. ....... Cu. Ft. ........ Type of Constructio n...... Est. cost e. ® ....... To be Completed . .:...... 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 compliance with all provisions of ordinances of the city of Fridley. r / A....../�'' 't :.' A®� .:.`.� ~ ............ In consideration of the payment of a fee of $.1.17 g? ..., permit is hereby granted to A./ri4:, ......... ......................... 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 provisionsof said ordinances. ,e7 Inspector NOTICE: t17 - This permit does not cover the construction, Installation or alteration for wiring, p i heating, sewer or water. Be sure to see the Building Inspector for separate permits for th Date: June ll t 1965 Owner: Noel A. Lein Builder Reco Construction Adder 6810 Plaza Curve N. E. Address 1311 South 5th Street N? 7852 LOCATION OF BUILDING No. 6810 Street Plaza Curve Part of Lot Lot 11 _ Block 3 Addition or Sub -Division Rice Creek Plaza South Add. Corner Lot Inside Lot Setback. Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Front Depth Height Sq. Ft Cu.. Ft Front Depth Height Sq. Ft Cu. Ft Type of Construction Est Cost _. -QQ--_ To be Completed Storm damage repair the proposed ct the building work in accordance with the descripconsideration of the Issuance to me of a tion abovet to ose�fo and ,i n co orclinancxa of the city of Fridley. /� I agree to do provisions of In consideration of the payment of a fee of $x.0..96, permit is hereby granted to $eco Const. Co. to construct the building or addition as described above. This permit is granted upon the �Lddib7d that the it is done in, aaupon saidleta �y limits permit may be revoked at any time upon violation of any of the provisions of said Allen Jensen Building Inspector NOTICE: U b permb dou not saver the constmcaw, bnf&M= for wbhM plumbing, ®w heatie8, =war or water. Be are to see the Building hnpa r for separate permits for these Mems. APPLICATION FOR BUILDING PERMIT CTTY OF FRIDLEY, MINNESOTA OWNER'S NAME e L g f /__1L'' BUILDER e ADDRESS 61/00 -ADDRESS LOCATION G LOCATION OF BUILDING No.�� VC—IStreet Part of Lot LOT I BLOCK ADDITION OR SUBDIVISION Corner 1ot�inside LOTS Setback 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. 01-0 /Z' DESCRIPTION OF BUILDING To be used as; Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft: Type of Construction Estimated Cost t -To be completed The undersigned -hereby makesapplication fora 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 repres-eutations stated in this ap atidn are true.and correct . DATE SIGNATURE r n (Schedule of Fee Costs can be found o tf Reverse Side). r � C City of Fridley, Minn. -11224 6431 University Ave. N.E., Minneapolis, Minn. 55432 BUEWING PERMIT Mate: _ October 21, 191 Cerner: -Noel A. Lien Builder House Clinic Store Addr, 6810 Plaza Curve N.E. Address 3918 West 492 Street, Mpls. No: 6810 Street Ut 11 Block Corner Lot Omer nevation LOCATION OF BUILDING Plaza Curve N.E. Part of Lot 3 Addition or Sub-Divisior Inside Lot Setback Rice Creek Plaza South Addition Sideyard Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Patio Enclosure Front .181 _ Depth 12' Height ....._,.10' Sq, Ft,_126' 2a 160' Front Depth Height Sq. Ft. _— Cu. Ft. Type of Construction Frame Fat Cost_ $1, 950.00 To be Completed ___ Dec. l s t, 1971 In consideration of the issuance to me of a permit to constructbuilding described above, I agree to do the proposed work in accordance with the description above set d in mpliance with all provisions of ordinances of the city of Fridley. 8 Sr to urchar e In conddemtion of the payment of a fee of $--.§. 50 permit is hereby granted to ouse Clinic Store to construct the building or addition as described above. This permit is granted upon, the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects -to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings city limits and this permit may be revoked at any time upon violation of any of the provisions of said Building Inspector K HANK MUNICH NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building inspector for separate permits for these items. 1 APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NM: �E/_ //, Z1f5A_1 BUILDER: 1-104JSe- I//c ADDRESS: _/O AZ,42.4- C_,_JfJe ADDRESS: NO:. "'c's/0 STREET: X44 -Z4 C-LfeV6_�' LOT: /I BLOCK: I? ADDITION: 'e"e-'zr A44-2,4 CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: ApplicAut attach to this form Two Certificates of Surv2x of Lot and proposed building location drawn on these Certificates., To Be Used As: DESCRIPTION OF BUILDING Front: Depth: Height:_ a Square Feet: -2/d Cubic Feet: 2) � � Front; —Depth; Height: Square Feet; Cubic Feet: Type of Construction: 6: n. 5- Estimated Cost: '$ To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in attict 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: Z2 SIGNATURE: ./ (See Reverse Side For Additional Information.) i""Alp 4 Land Planning %�iU I/GG(�`W/G 6875 Highway No. 6S N. E. Land Surveying• ��/h• �j Minneapolis, Soils Testing ��nIQeu" V ci• Minn. 5$432 Civil Engineering Telephone 784--6066 Municipal Enginepring Engineers & Surveyors Area Code 613 Mortgage Loan Survey, for HOUSE CLINIC Tdr�' Dro%irk-A s4 i1T E l l r c r t(1 �.L4 LLJ 1 1 u� r 6b.•25 � � � LU � l `t- N ( StorJ Fr�lt�� j i g N N Ut�f� l -- m � ++ n J" CUR\vr= LOT it,BLV 3 PQ C P- CREEK PLk-LA\ (;OU714 A\DDITIOW This is a true and correct representation of a survey of the boundaries of the land above described and of the location of all buildings, If any, thereon, and all visible encroachments, if any, from or on said land. This survey is made only in connection with a mortgage loan now being placed on the property and no Liability is. assumed except to the holder of such mortgage or any other interest acquired by the reason of such mortgage. It .is understood and agreed no monuments have been laced for the purpose of establishing lot lines or boundary corners. Dated this l6 day of Q4 a e A. D. 14T. SUBURBAN ENGINEERING ANC Engineers /y / Y Sur �r rs `- 2 4 bye/. L4 1f6- L+ p� c� 11 C -27Y or - 8431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE ( 612)571•3450 01 . OBSTRUCTION: Lot Block Addition Nose- 4, Lie& Property Ow cr-.'address RE -CORD OF ( )MMU: U -M ONTS 2. J. 4. 5. G. 7. CITY OF FRIDLEY INSPECTION DIVISION 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Rate TOTAL X Furnace Shell and Duct Work, Burner — Also Replacement Furnace $ 30,00 $ 36 .00 (Side Vent — Fill Out Back) of Gas Piping (Needed with new furnace) $10.00 Gas Range $10.00 $ Gas Dryer $10.00 $ �! *Air Conditioning — All Sizes $ 25.00 $ 2S • 00 All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ Commercial/I ndustrial 1.25% of Value of Appliance or Work $ State Surcharge $ .50 Effective On January 1,. 1998 JOB ADDRESS (.05 10 'P LYS -Z R C U I' 1x - 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 Building Division, and hereby declares that all the facts and representations stated in this application ar true and correct. �y` ,1998 OWNER .ver BUILDING USED AS eRCS %_Q e.^Le . ESTIMATED COST ? , �Sb = v PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units , Circle One (Sty Trade Name AQrnsT�y BTU 1cx�,000 HP Fuel MxN . Cams . Total Connected Load am) (Hot Water)arm Air Size No. uL.TQ.� EDR Burner Trade Name Size No. BTU TOTAL FEE S� HP EDR �2--1. 1 MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. HEATING COMPANY OlOCfNS®s� M\xt. . 'A`O— Signed Tel No. 6 T-) - ollk9 (o Approved By A Rough—In Date Final Date1 FILL OUT BACK SIDE FR STACK VERIFICATION ON e� . I REPLACEMENT FURNACE 9 6 Has total heating BTU's of 1410. u®o All other BTU's 1c) a 66X,3 TOTAL BTU's 1 0 0co 7. Has a liner been provided for water heater Yes () No 8. Has combustion air been provided for water heater Yes (, No ( ) Remarks:, 'Floe 15 ale 'b S„ List ALTERATIONS Being Done: t < n,ni ac%,nNC �v�.� ae� , �►iQ �0,3� i.LS 1 me �b`7,y rrv2�3 �- iO See2 AiCL �dJ� . HEATING CO: Signed By: Date: CHD4NEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes ( No ( } 2. Is free from rust or deterioration Yes (✓S No ( ) 3. Has no foreign objects lodged within Yes No ( ) 4. Is securely supported . Yes (✓) No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes ( No ( ) 6 Has total heating BTU's of 1410. u®o All other BTU's 1c) a 66X,3 TOTAL BTU's 1 0 0co 7. Has a liner been provided for water heater Yes () No 8. Has combustion air been provided for water heater Yes (, No ( ) Remarks:, 'Floe 15 ale 'b S„ List ALTERATIONS Being Done: t < n,ni ac%,nNC �v�.� ae� , �►iQ �0,3� i.LS 1 me �b`7,y rrv2�3 �- iO See2 AiCL �dJ� . HEATING CO: Signed By: Date: l SUBJECT i P City of Fridley 31971 AT THE TOP OF THE TWINS B U I L D 1 N P M I T r • DIV. �� ®3� RECEIPT NO. _ COMMUNITY DEVELOPMENT ~ e__-- INSPECTION SEC. r II PROTECTIVE � NUMBER REV DATE T PAGE OF APPROVED BY I CITY HALL FRIDLEY 55032 612-571-3450 9t0-F15 7/10/01 JOB ADDRESS 6810 Plaza Curve NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 3 Rice Creek Plaza South SHEET 2 PROPERTY OWNER MAIL ADDRESS IIP PHONE Lori Stasik 6810 Plaza Curve NE 763-571-8909 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Renewal By Andersen 350 73 Avenue NE, Fridley, MN 55432 763-502-4777 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20130983 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW 0 ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 1 bay window and 7 window inserts within existing openings 9 CHANGE OF USE FROM TO STIPULATIONS Provide _smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. WillOed Wner To an, 11 UN SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 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 $4.33 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $8,668 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- Fire SC $8.67 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $167.25 PLAN CHECK FEE TAL FEE Lic e SC $ .00 $185.25 S-GNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE. HE PR LV VALI TED THIS IS YOURERT 7-�1P1�M � 8 OG iNSP - gAtE S-GNATURE OF OWNEROF OWNER BUILDER, IDATEt l NEW[ ] Effective 5/10/99 ADDN [ ] CI'T'Y OF FRIDLEY ALTER [ l SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: - (0116" Mo as C Legal Description: -- Owner Owner Name & Address: Jae, 5 '- - Tel. # }103.511- Contractor:, Renewal By Andersen MN LICENSE # 350 -73rd Ave. NE —' Address: Fridley, MN 55432 Tel. # 763-502-4777 Attach #MN20130983 of the DATE: Ap -moo •®l APPLICANT: AoAX% s Tel. #CfS,-4, NS;-(c,0u'+ 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 $1050 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 [ ] N STIPULATIONS: !� !/ �J�" �• a. ¢'� , ...i''TC''�d'- f ��- ` ' lot, wits. �., r>..Y... ---_—__-_-- scale. DESCRU7 ON OF ROVEMENT LIVING AREA: Length width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width HgdGround Sq. Ft. OTHER: ® % rt a a A W, �. .,q} C ! �J1 K&OW l �,� �81► Construction Type: Estimated Cost: $ 74 (QLQYSCy- Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: Ap -moo •®l APPLICANT: AoAX% s Tel. #CfS,-4, NS;-(c,0u'+ 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 $1050 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 [ ] N STIPULATIONS: !� !/ �J�" �• a. ¢'� , ...i''TC''�d'- f ��- ` ' CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 7631572-3604 FAX: (763)571-1287 PERMI(NO.. 2004-00367'.J// DATE ISSUED: 03/22/2004 ADDRESS : 6810 PLAZA CRV NE PIN : 143024230034 LEGAL DESC : RICE CREEK PLAZA SOUTH ADD : LOT 11 BLOCK 3 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 200.00 # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE 0 # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS I # GAS DRYERS 0 # GAS RANGES 0 # OF NEW FIXTURES 0 # WATER TRMT APPLIANCES 0 tAS i �f APPLICANT PLBG PERMIT MINIMUM FEE 20.00 H P PIPEWORKS PLBG FIXTURES (NEW OPENINGS) 0.00 3670 DODD RD STE 100 PLBG FIXTURES (EXIST OPENINGS) 0.00 EAGAN, MN 55123- WATER TREATMENT APPLIANCE 0.00 (651) 365-1340 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 0.00 GAS RANGE FEE 0.00 OWNER GAS DRYER FEE 0.00 STASIK LORI L PLBG REPAIR/ALTERATIONS 0.00 6810 PLAZA CRV NE STATE SURCHARGE, PLBG FLAT 0.50 FRIDLEY, MN 55432 TOTAL 20.50 PAID WITH CHECK # 8368 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construytion or the performance of construction. r Bldg SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. A 131 University Ave NE idley, MN 55432 63) 572-3604, FAX (763) 571-1287 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT KAADIt All IBARF=R tl = )=1YTI iRGC Tn RF 1NgTA1 1 i=n ON FACH FLOOR 30MBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE 44 (D ) P C11 � LUMBING FIXTURE RATES: NO. RATE TOTAL �fflr_rmp ew Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein r'? $ 4.00 specified agreeing to do all work in strict accordance with the city codes eer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts ,low Off Basin $ 7.00 and representations stated in this application are true and correct. :etch Basin $ 7.00 �1°� �� 2Q lain Water Leader $ 7.00 _0�f :ump/Receiving Tank $ 7.00 / _ - r I`�"C 1 Vater Treating Appliance $10.00 Owner Vater Heater -Electric $ 7.00 Vater Heater - Gas** $10.00 I ' Building Used As B Sas Range**$10.00 00 A- 004- 0-1030 Sas Dryer** $10.00 Estimated Cost (/�� PERMIT NO. Sack Flow Preventer Required( )Yes ( ) No n Type $15.00 PLUMBING COMPANY teinspectlon Fee $47.00/Hr f SIGNED BY TEL N01051 P3(0 f �$Y-0 kLL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough -in Date Final Date State Surcharge $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00 TOTAL FEE $ .� PLUS THE $.50 STATE SURCHARGE 30MBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE 44 (D ) P C11 � LUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 2f l Q/2,0 r VQ-- ew Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein ►Id Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes eer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts ,low Off Basin $ 7.00 and representations stated in this application are true and correct. :etch Basin $ 7.00 �1°� �� 2Q lain Water Leader $ 7.00 _0�f :ump/Receiving Tank $ 7.00 / _ - r I`�"C 1 Vater Treating Appliance $10.00 Owner Vater Heater -Electric $ 7.00 Vater Heater - Gas** $10.00 I ' Building Used As B Sas Range**$10.00 00 A- 004- 0-1030 Sas Dryer** $10.00 Estimated Cost (/�� PERMIT NO. Sack Flow Preventer Required( )Yes ( ) No n Type $15.00 PLUMBING COMPANY teinspectlon Fee $47.00/Hr f SIGNED BY TEL N01051 P3(0 f �$Y-0 kLL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough -in Date Final Date State Surcharge $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00 TOTAL FEE $ .� PLUS THE $.50 STATE SURCHARGE 30MBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE 44 Building $ BUILDING Plan Review Permit Ivo.1 Inspections Fire Surcharge RESIDENTIAL APPLICATION Received By 763-572-3604 $ CITY OF FRIDLEY License Surcharge D 'd 0 DATE-W7Y UR E ADDRESS $ SITE ADDRESS 'i/� l $ THIS APPLICANT IS: ❑ O ER CO TRACTOR $ PROPERTY OWNER/ NAME: % I4E, $ TENANT ADDRESS: C[TY � I G+ `"V STAT Agreement necessary ( ) Non Necessary ( ) PHONE: $ - CONTRACTOR NAME STATE LICENSE #EXP DATE ADDRESS: �'10-dr. ® �//n 7 j/ CITY � �L P. STATE,! l/bYP SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PHONE �' � FAX PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILYINEW CONSTRUCTION STORI S PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED NDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: leZ,/12,,&5 SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. 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 ❑ Vinyl ^� ` ❑Soffit FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS, & PORCHES SUBMIT: ❑ Aluminum S ❑ Trim I . Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. WINDOWS( )Yes 2. Two sets of construction plans IN EXISTING OPENINGS ONo 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 9 7 U. C FEE SCHEDULE) TOTAL JOB VALUATION $ 100 OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .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 $ 1,17 :2 Agreement necessary ( ) Non Necessary ( ) Total Due $ - Make checks Davable 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 form permit and w k is not to start without jaa permit; that (the (work will be i�nnaccordance with t approved plan in the case of all wor w ' "v it ie rov f plans. Nti� �� G"� l L V �� (/lc� 6 iE SIGNATURE OF APPLICAN TNA A 4U 7 le5 tr Building BUILDING Permit No.. Inspections RESIDENTIAL APPLICATION qql Received By: 763-572-3604 CITY OF FRIDLEY 1 i 2 - See Back Page for Fee Schedule D='JAAR 9.qMffg 763-502-4977 FAX 10' 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation EFFECTIVE 1-1-09 $ .0005 x Permit Valuation Minimum $.50 P� DATE 0 YOUR E-MAIL ADDRESS � , e pp SITE ADDRESS 1 uC zA_ SAC Charge THIS APPLICANT IS: OWNER CONTRACTOR I�LeC $2000 per SAC Unit (Plans to MWCC for determination) PROPERTY OWNER/a NAME: ft + 6 ft = ft x $21 =$ TENANT ADDRESS: PJIJ�7/a &aLW CITY 1 STATE LIP ' Park Fee �b?lb PHONE: t4,3— 511 ^ ® r Fee Determined by Engineering CONTRACTOR NAME: Agreement necessary ( ) Non Necessary ( ) SUBMIT A COPY OF $ / a a01 ID Make checks Davable to: Citv of Fridlev Attach StiDulations YOUR STATE LICENSE STATE LICINSE # EXP DATE /Q S AND CERTIFICATE OF ADDRESS: CITY STAT)ZIP INSURANCE PHONE —5 i QS' FAX PROPERTY TYPE 0SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGT WIDTH HEIGHT SQ FT ROOFING�J ❑ HOUSE ONLY NUMBER OF SQUARES 3 HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGESn 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 OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPINING 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 $ qql 13 OCCUPANCY TYPE Permit Fee $ 1 i 2 - See Back Page for Fee Schedule Plan Review $ 10' 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ 500 $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 $21 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ / a a01 ID Make checks Davable to: Citv of Fridlev Attach StiDulations 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 al rrjk whic equires review and approval of pllanns. SIGNATURE OF APPLICANT PRINT NAME'1-0/el� S5A DATE '3 Building PLUMBING permit No.: Inspections RESIDENTIAL APPLICATION Received By:. 763-572-3604CITY OF I+ RIDLEY D ' DATE li l " i YOUR E-MAiL ADDRESS SITE ADDRESS \('P, THIS APPLICANT IS: 0 OWNER 1000NTRACTOR PROPERTY NAME: 66 i i ADDRESS: �A.Vn V e CITY STA ZIl' TENANT PHONE: CONTRACTOR NAME: briampion PIUMbing STATE LICENSE # 65631 866 1349 EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS: 3670 Mdd Rd_ CITY STATE -ZIP - LICENSE WITH PHONE ��g3n: MN 55' APPLICATION PERWM TYPE TGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: ❑NEW'REPLACEMENT i DETAILED DESCRIPTION OF ®YORK 42 4 42 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 improvement, installation or replacement of a residential f dare, excluding the futures. (This should reflect only the cost of tabor) 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: (INDIC TE TOTAL NUMBER OF EACH BELOW) _ BATH SINK/LAV " FLOOR DRAINS _ SHOWER _WATER PIPING WATER SO ($35) _ BATHTUB _ GAS PIPING (AMM U7 ) _ SWIMMING POOL _ c CLOTHES WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PRE V. ($15) _ _ _ DISHWASHER _ LAUNDRY TRAY WATER HEATER (S35) FORIR WATER METER -OTSS _ PERl�T FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS VER $500. Permit Fee $ &-)- Number of fxdues @ $10.00 x $10.00 = —S-- SurcIarge .50 Number of fxtures @ $15.00 x $15.00 = TOTAL DUE $ h5 6 Number of fxtures @ $35.00 x $35.00 = 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 wor i will be in is conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I undertmd this the 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 acco with approved plan in the case of all work 'ch 'ew and approval of plans. SIGNATURE OF APPLICANT :PRINT NAME J DATE L= y PLEASE NOTE: SEPARATE PERmas ARE UI1tED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 V AN'. ^/<') CA -1 An,7,7