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City of Fridley, Minn. MEWING PERMIT r LO TION ILDING No. Street Part of Lot Lot JSlock Addition or Sub -Division Corner Lot Inside Lot _ _ — Setback of Sideyard _ Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING T , as: M Front Depth _� Height Sq. Ft. Cu. Ft m, t — - Depth Freight - Sq. F t. Cu. Ft. j"40 Type of on Est - op be Completed consideration_ f b cribed above I to do Ino the issuance to me of a permit to construct the building des agree ordinancof the city of Fridley. with � description above set forth and in compliance with all provLsions oftt In consideration of the payment of a fee of$_A02 permit is hereby granted to qw— to construct the building or addition as described above. This permit is granted upon the express condition that theperson 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 viol�tign of any of the provisions of said ordinance. — A NOTICE: 'this peneh does not corer the eonstruefloe, in ftHWon for wirtati, plumbing, gat hoathm awes or water. Be sore to we the Buibih* hnpeeter for aparete pwWft for thea henm r, t Owner's Name APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Address Address LOCATION OF BUILD;rl, No. Streetj__,J,<. > z,_: �„ Part of Lot Lot Block Addition or Subdivision Corner Lot Imide Lot 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. DESCRIPTION OF BUILDING To ed as: Frontes Depth`7�-`--Height Sq. Ft. Cu. Ft.-, ,. �✓ o.i �)-'' Front ` Depth Height GSq, Ft. Cu. Ft. Type of Construction Estimated C 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. 6 DATE - � ,,— e�' � _ SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). SUBJECTN 0. City of Fridley 02 18461 AT THE TOP OF THE TWINS BUILDING PERM f RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/30/86 JOB ADDRESS 6131 Rainbow YXKK Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14,15 2 Sylvan Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mike/Leslie Sokol 6131 Rainbow Drive N.E. 571-1135 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. . Kando Enterprises RR#1, Box 239C, North Branch, M 674-8660 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 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 24" x 18' Addition to Duelling 9 CHANGEOFUSEFROM TO STIPULATIONS Install fire alarms in basement and bedroom hallway on existing house. WARNING 80%p, g tali #alcalr u hies Ma EtEGIK}.OAS Et;. � ' T _ ]�` 1IRED FOR + W1RJNGA F-ATfiVGy MBJN 'a AM SP41 Y LAW 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. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY T AT I HAVE RE AND EXAMINED THIS APPLICATION ISTALLS GARAGES TOB AND KNOW THE SA tO BE TRUE D CORRECT: ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCE3� OVERNING T IS TYPE OF tirc WILL BE COMPLIED :yVPTH WHETHER SPE IFIED HERE I OR NOT. E daFt NTING OF A PERMIT �OLATE $19,150 $9.58 PERMIT FEE SAC CHARGE DOES NOT PRESUM TO GIVE A THORITY O OR CANCEL THE PROVISION OF AN OTHER STATE OR FOCAL LAW REGULATING CON- STR OR THE ERFORMACE OF O�ISTRUCTION. $1[�Q, rjQ None / � AY ®�® AP � �`� /' PLAN CHECK FEE TOTAL FEE D '14 r -X35.13 $185.21 SIG®,ATC - OF CONT ORORA RIZEDAGENT IDATEI WHEN PROPERL VALIDATED THIS IS YOUR PERMIT BLDG INSP 0ATE SIGNATURE OF OWNER 0F OWN ERBUILDER) IDATEI NEW [ ] City of Fridley Effective 4/1/86 ADDN. [ ] �R-1 AND R-2 ALTER. [ ] Building ppPermit Application Construction Address. 6131 Legal Description: Owner Name & Address : " '' Kr 4- L -e-5 // c Tel. # 5171 //35 Contractor: aha L>Lc rp r' SPS�1/ r Tel. # &97Y-,F(,6D Address: �iL° `JdXa�-�Re A0 r L1 �rzn Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT 7 LIVING AREA: Length �/ Width Height Sq. Ft. e �� GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: X 1'4q.2)9 q �y Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: k i F{� e Estimated Cost: $ 7A`C- .® Approx. Completion Date: xj� /9' /J Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: f APPLICANT • ✓ � ' Tel. f CITY USE ONLY $ go.00 7S.13 $ $ '03 z�:_ 1_�_ t'e. Fee Schedule on Reverse Side 25$ of Building Permit Fee $.50/$1,000 Valuation $475 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 11 SUBJECT City of Fridley 20811 AT THE TOP OF THE TWINS BUILDING PE MIT COMMUNITY DEVELOPMENT DIV. ti0 PROTECTIVE INSPECTION SEC. / y®/ r � , CITY HALL FRIDLEY 55432 NUMBER REV, DATE PAGE OF APPROVED BY j 612-571-3450 910-F15 5/9/91 JOB ADDRESS 6131 Rainbow Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 2 Sylvan Hills SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Mike Sokol 6131 Rainbow Drive NE 571-1135 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D & D Home Improvement 7401 Central Avenue NE, Fridley 784--7543 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION [j REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof (tear -off) 24 Squares. 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 SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 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. 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $1e248 $,62 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 PROVISIO OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $31,00. Fire SC $1,25 STRUCT NOR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $32,87 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEIWHE I PROP RL V DAT HIS IS YOUR PERMIT DG INSP 17) A TIE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI 11 NEW [ J Effective 8/16/90 ADION [ ] R-1 AND R-2 ALTER [ ] Building Permit Application Construction Address: legal Description: Owner Name & Address: /,`6`i! � cso�� Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. D—� LIV3= AREA: Length Width Height Sq. Ft. GRRAGE AREA: length Width Height Sq. Ft. DECK AREA: Length Width OTHER: Hgt/Groiuxl Sq. Ft. Corner lot [ ] Inside lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction:/�ed70- Estimated Cost: $_�/ � Approx. Completion Date: y a?zl S!? - Proposed Driveway Width If New Opening Is Desired: Ft. $. $. Width + 6' See Back Page DATE: APPISCMU: ATel. # Permit Fee Fire Surcharge $ %, State Surcharge SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main (urge $ TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th %) $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Effective May 1, 1990 Job Address �8f'6v1g 4-e. Me q.) Department of Buildings City of Fridley Tel. 1571-3450 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 facts and representations stated in this application are true and oorrect Fridl�v_ rs 7-1s / Ig OWNER M I CHREL 6131 RA I h80l4 DRI UE NORTHOW KIND OF W FRIDLEY , MR 55432 H 571-1135 U USED AS TO BE COMPLETED ABOUT RATE SCHEDULE ESTIMATED COST '0/00- " PLUMBING FIXTURE RATES: NO. RATE TOTAL OLD - NEW BUILDING PERMIT NO. PERMIT NO. New Fixtures $ 5.00 $ Future Fixtures $ 3.50 $ Old Opening, New Fixture b 1.50 U Beer Dispenser K 6/ $ hater $ 5.00 $ Catch Basin a 5.00 �G I b ►� 5.00 a 4 b. 0. 4i $ Sump or Receiving Tank Neater w S Water Treating Appliance $ 7.00 $ Hot Water Heater c It 8 Gas Range 10.00 U Gas Dryer d 10.00 $ 'lec W ) Type w H 6) ta 6j LqC $ State Surcharge u a a a TOTAL o S� w u c� <' s 3 o :as Iat 2nd 3rd 4th (R) - Future Connection Opening Connected with Sever (0) - Now Fixture, Old Opening Water Effective May 1, 1990 Job Address �8f'6v1g 4-e. Me q.) Department of Buildings City of Fridley Tel. 1571-3450 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 facts and representations stated in this application are true and oorrect Fridl�v_ rs 7-1s / Ig OWNER M I CHREL 6131 RA I h80l4 DRI UE NORTHOW KIND OF W FRIDLEY , MR 55432 H 571-1135 U USED AS TO BE COMPLETED ABOUT RATE SCHEDULE ESTIMATED COST '0/00- " PLUMBING FIXTURE RATES: NO. RATE TOTAL OLD - NEW BUILDING PERMIT NO. PERMIT NO. New Fixtures $ 5.00 $ Future Fixtures $ 3.50 $ Old Opening, New Fixture $ 1.50 $ Beer Dispenser S 4.00 $ Blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Water Leader $ 5.00 $ Hydraulic Valve $ 5.00 $ Sump or Receiving Tank S 5.00 S Water Treating Appliance $ 7.00 $ Hot Water Heater $ 5.00 $ Gas Range g 10.00 $ Gas Dryer $ 10.00 $ Back Flow Preventer Required. . . Yes ( ) No ( ) Type ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Filature or Appliance $ State Surcharge Reinspection Fee $_ IS15:[a0) TOTAL FEE S� ROUGH INSP. Signed By M5 GAS AVENUE SOUTH JAMCAMAMe Tel. No. Date FINAL INSP. Date r APPROVAL FOR PERMIT 2r MINIHIIM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE 0 SuBjECT PE City of Fridley 2 8 AT THE TOP OF THE TWINS BUILDING PERMIT 25 r R COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC -'-n CITY HALL FRIDLE`1 55432 ".j NUMBER REV DATE 7/10/97 PAGE OF APPROVED BY 612-571-3450 910-F15 JOB ADDRESS 6131 Rainbow Drive NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 14 2 Sylvan Hills I SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mike Sokol 6131 Rainbow Drive NE 571-1135 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Theyson Construction 2938 Taylor St NE, Mpls., MN 55418 789-4083 20011251 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 ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside 18' x 24' Addition to House 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. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING MOT. 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 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 $1 600 $.80 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERISyT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TH`E PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $51.25 Fire $1.60 STRUCTION OR THE PE FORMA F CONSTRUCTION X�2&� ��� %—��` PLAN CHECK FEE License 12r' $5.0 TOTA 8.65 SIGNATURE OF CONTRA TOR OR AUTHORIZED AGENT (DATE)W P Qp IS YOUR PERMIT�r_ ! BLO )NSP 2LIDAT �jH'II cJ y/ `r �/D GATE SIGNATURE OF OWNER) IF OWNER BUILDER) )DATE) NEW [ ] Effective 1/1/97 ADDN ( ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: `� 3 1� Legal Description: c Owner Name & Address: J bkin Tel. # 71 - r ( 3 5 - Contractor Contractor: J��T � SC�ti �C MN LICENSE# e>?00 //o2� Address: 13 off' f f t� i . Tel. # Attach to this application, a Certificate of Serve �1Iif lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EWPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: �-�`i 0 CMCJ .-, L Construction Type: Estimated Cost: $ 00 (.dee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft_�x $ _ $ DATE: APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY, $-�� Fee Schedule on Reverse Side $ .001 of Permit Valuation (1/10th%) $ t $.50/$1,000 Valuation $ $950 per SAC Unit $ -S) - $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ -$450-00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ J Not Necessary [ ] $ �00 DATE 01) SUBJECT P City of Fridley 27670 AT THE TOP OF THE TWINS BUILDING PERMIT Ir? ' RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. /717 r � � NUMBER REV. DATE PAGE OF APPROVED By E /"'1 CITY HALL FRIDLEY 55432 IL ----A, J 612-571-3450 910-F15 9/10/98 JOB ADDRESS 613.1 Rainbow Br I LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 2 1 Sylvan Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE X!dxxdUA Mike Sotai Same 571-1135 3 CONTRACTOR iMAIL ADDRESS ZIP PHONE LICENSE NO. New HavenConstru tion Co 4208 83rd AveN Brooklyn Park 55441 566-5225 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK I Reroof house & izarage 28S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment 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 80 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 1 HEREBY CERTIFY THAT 1 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 $2,399.00 $1.20 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 PROWSTOt,kS OF ANY OTHER STATE LOCA AW REGULATING CON- $ 74.75 Fire SC $2.40 STR TION OR THE P ORMANCE F CON RU TION. PLAN CHECK FEE TOTA F E � L SC $5. $83.35 )GNATURE OF ONT RACTOR OR AUTHORIZED AGENT (DATEI EN ROP ALIDAT BL G INSP ISIS Q R P RMIT �rze SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI DATE 01) 5.ep 09 98 06:22a Kerri 566-7183 p.5 Efive 1/1/98 ADl$hf t l CATV OF FR®LEY �p ALTER t ] MNGLE FAMY AM DUFLEW R-1 AM R-2 BUILDING PERMIT APPLICATION 6 ConstructionAddress: Legal Description: owner Name & Address: _ 9 Tel. #S%/ Contractor: C MN LICENSE #_X6 `�i -S_o la r Address: C ear 1�- A Tel. # Attach to -this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAG19-AREA: DECK AREA: OTHER: Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Construction Type - a I—for 9—e IC e ° 1'— E.stianated Cost: $ JL, (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: �' �' ��APPLICANT: s. 6/1/2'u-,-j'Pel. # STIPULATIONS: CITY USE ONLY Permit Fee $ j / Fee Schedule on Reverse Side Fire Surcharge _,_,_,J• $ .001 of Permit Valuation (1110th%) State Surcharge $ f $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $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 [ j Not Necessary i ] 3.3 TOTAL $ STIPULATIONS: Building Inspections 763-572-3604 BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY DATE ' ;? 0 `' YOUR E-MAIL ADDRESS SITE ADDRESS / /_�- c `i BOW a k. /X ° � THIS APPLICANT IS: ❑ OWNER kTCONTRACTOR Permit No.: Received By: Date Rec'd: PROPERTY OWNER/ NAME: A77 scioo/ ADDRESS: lid'. CITY k c ai Ae Y STATFiy/ ZIP S SCI -?--5— TENANT PHONE: 7 CONTRACTOR NAME: C - STATE LICENSE # J/ 3% EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: D W , NWY /� CITY�i li /i I9SU��/^� STAT�ZII' �SSR3� WITH APPLICATION PHONE SSS— S_'rt*( -3GOC) FAX S ❑ SINGLE FAMILY/NEW CONSTRUCTION Sy � .r' ��% — 0 9'vd SIZE PROPERTY TYPE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION >� ❑ MAINTENANCE/REPAIR ❑•REMODELING DESCRIBE WORK BEING DONE: A eiaad2 GAP �Sc�, aCcxuas SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used 3. 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 Aces ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS AT T VVFc ARV TIAQV" nN VAT.TTATrnN_ TNCT.TTnTNG THF, COST OF LABOR AND MATERIALS: TOTAL JOB VALUA (USING THE 1997 U.B.0 FEE SCHEDULE) IN $ 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 $ ej $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft= ftx $20 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $)Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATIO14FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permt�nd 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 which-rNuire review and approval of plans. / SIGNATURE OF APPLCC NT- i`! �— PRINT NAME '�/ p G !'Y�Yl�C, 0' - r DATE 1 G� -1jilding $ I , BUILDING Plan Review Permit No' _6619q Inspections Fire Surcharge RESIDENTIAL APPLICATION Received By: 763-572-3604 $ c;Z .3 � CITY OF FRIDLEY License Surcharge Date Rec'd: & &e-6 763-502-4977 FAX SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ EFFECTIVE 1-1-08 $ $450 Conservation Plan Review DATE (0 G ) 6 YOUR E-MAIL ADDRESS j h� li r ®�✓t ecA e`o V� , C SITE ADDRESS (51 1's l cry 6,0 IS -i"9__ Agreement necessary ( ) Non Necessary ( ) THIS APPLICANT IS: ❑ OWNER ),6CONTRACTOR $ _ `1 PROPERTY OWNER/ NAME: © TENANT o3 c"Lui CITY L_ZIP PHONE: % i( l % &S- NAME: Ceawn CONTRACTOR �� �.CITY /%IQ/S STATEkW ZIP JaYW_ ADDRESS: s� SUBMIT A COPY OF PHONE 763 71/9 9 �o FAX -26 3 YOUR STATE LICENSE STATE LICENSE # RO 108 ( e EXP DATE PROPERTY TYPE INGLE FAMILY/NBW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION EJ ADDITION ❑ MAINTENANCE/REPAIR EMODELING DESCRIBE WORK BEING DONE: op -to Wx `� told— �bKs� SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE I. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used. PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS & PORCHES SUBMIT: ❑ Vinyl []Soffit l . Site Plan/Survey showing the existing structures ❑ Aluminum ❑Trim and proposed project. ❑ Other ❑ Fascia 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 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ �`��l®11 01 to OCCUPANCY TYPE Permit Fee $ I , See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation - Surcharge $ c;Z .3 � .0005 x Permit Valuation Minimum $.50 License Surcharge $ �, $5.00 (State Licensed Residential Contractors)' SAC Charge $ $1825 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 $ _ `1 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 ackno ledge that th n oPInde 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 Co traction ode att d this isnot a permit but only an application for a permit and work is not to start without a permit on site; that the=PA a rdancew the a provs of all work which requires review and approval of plans. SIGNATURE OF _ P ME DATE_ • I f .�.� _ �1 y'_ City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 MEC CAL Permit No.Building Inspections RESIDENTIAL APPLICATION Received E' 763-572-3604 D CITY OF FRIDLEY c: 763-502-4977 FAX CIL 122.5q O EFFECTIVE 2-19-09 DATE marcvN0&3 &010 YOUR E-MAIL ADDRESS SITE ADDRESS , �ai n \.. D L>a- M Lo I � THIS APPLICANT IS: ❑ OWNER NCONTRACTOR PROPERTY NAME: Q p OWNER/ ADDRESS:�avakQ CITY �Yl ` .I STATEMOZIP $Sq*3 TENANT PHONE: -11,03- S 71 l- N 3 S CONTRACTOR COMPANY NAME: CENTERPOINT ENERGY SUBMIT A COPY OF CONTACT PERSON: JOANN ZI NKEN 08/19/2009 STATE LICENSE # BOND 22013346 EXP DATE YOUR STATE LICENSE WITH ADDRESs:9320 EVERGREEN BLVD NW SUITE B ciTYC00N RAPIDS STATE MN ZIP 55433 APPLICATION PHONE 763-757-6202 FAX 763-757-6701 PERNIIT TYPE .SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW 1REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, CEPT HERE NOTED. FIXTURES:IN�D� ICCATE TOTAL NUMBER OF EACH BELOW) LOW) Equipment Installed MFG: MODEL: RA9.,- SIZE/BTU , .jQM j5rL MFG: MODEL: SIZEIBTU MFG: MODEL: SIZEBTU A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGEIOVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _BOILER $35.00 _FURNACE $35.00 UNIT HTR $10.00 _GAS CHIMNEY LINER $10.00 _GAS DRYER $10.00 HEATER $35.00 _POOL DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 .,x'4��s ._h>. .+.. .? �. �4x ,m'.Y-.� L �<a �s'�� N;•YT' �3�.,x %, �£,. � �1,3,'.x� 3�.'C.:,. ';� ""t. ,� :;l � .1f i� a)r. �az. �����.°��+_. sE 3 �� ! �iEi � 'a'� � �'. $•}at,�� R{3�f "3 f"�' �• q �, \ k{b J i�` k�� p � V �'A i+• "" .h � w�iq�c3k1°Cys ��, y_ i i S�. 5t:, a,�� � "A' ^�» ^ttr�`' t d �nF f J� �i,E -�s';A, �pI� �! 3+; .'� ,��'�,�4° i k woo„•}' '�� @t� 9 Cr3i° �St � � N .' � �"L S Iti .�^v�'4 'f-e?.�-±,.,-�`�s��. 9 .:'. .`�'. 'S• C➢ iii � a'F'Cr�`��3��prvi „y+ �r'�a8U.�.t',�' �S* `J3 :/� �. as � T. ?'c"s �1 �S£ �.,I-+� ,�,v, �`. a a �r-��xZ ��" •5 w 'S �� 3��'w�*� iii" i.r,�q" � :� � j'S��`': $s � l .�"F.0 �^�"���R.�`�4w stt`��,� .T ,w-E�� .F•2�R�''t�..�r3' tial �Y� .:Y�... Let'S��-a'•} :V�: C'b,s�:�al?z.< .J3 LS L�>ryM;jt��x.�z"t�:l..F^i-r�',.;'}:."Lt a {� :J.e:. iv -iYz�. �'��' 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 all work which r uire eview and approval of plans. SIGNATURE OF APPLIC� a PRINTNAME ROGER HOFFHEIN DATE .vw... City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977