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PRE 2010 DOCSCity of Fridley, Mian.. BUILDING PERMIT N® -402 Date: .......... _. ¢ ..�'.....__.#...... ...:._..__._______.._.._...._.. Owner: Address Builder.....�Af.L. .___:........._................... _._........ Address....... . ............. _...... ........ _................... _.__......_..._.._................... _......... OCATI N QF BUILDING No... ..„1...._... Street .._.........._....... ...._.... ....... ............... Part of Lot ...... Lot........................ ..... Block ......---...................---.......----.......... Addition or Sub -Division ..... _............................. Corner Lot ....................... ........... Inside Lot .................... -....... - ...... Setback ....._............._............:_..... ... Sideyard Sewer Elevation ............. ............................................. _......._...-............._........ Foundation Elevation .................. J DESCRIPTION OF BUILDING To be Used as: 5 Front Depth:.....:.:.`. Height ... Sq. F .3 .. Cu. F .. ... ............... -............ ....................... Front .................... _.. Depth ....._......... eight Sq. Ft....................... Cu. Ft. ..................... .. Type of Construction...................................................... .... Est. Cost.._^�!"...._..__.:....... _........ 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 forth and in compliance with all provisions of ordinances of the city of Fridley. ............. _.......... _.._ _......._._._...__...__._._ ..._...__------ --- ......................... _ .. permit is hereby In consideration of the payment of a fee of $........................_--- pe y 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 violation of any of the provisions of said ordinances. , '` Building Inspector 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. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name z: Builder _ .. Address 4-Ldress LOCATION OF BUILDING No., treet .V,-°`� Pert of Lot Lot Block Addition or Sub'.Div. Gorner,, of Ipside -Lot Set Back Side -Yard - SEWEk; ATIONFOUNDATION ELEVATION Appli6ant attach to this form,Certifica.te of Survey of Lot and proposed building location. DESCRIPTION OF BUILD, NG To be used as: • + Front �� m ®Depth L Height-- Sq.. Ft. '�Cu. Ft. -36 7 �— Front _.Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be completed The underald hereby makes applica•tion''for a permit for the work here�n:specifie#, .gneagreeing to'do all work.in stript accordance with..,the City Ordinances and ruling of the Depa3�-6 n 'of Buildings, and hereby declares that 9,11 the facts and representa- tions stated inhthis application are true and 'correct. DATE" SIGNATURE : Y (A Schedule of Fee costs'can be found on the Reverse Side.) APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA r OWNER'S NAME: ` i fiI5411"IftlYdBUILDER: - ADDRESS: (n f s -o ��� 4 �l �?f `kc� I�t� 1 {.�� ADDRESS : NO:. LOT: STRE ET: BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of. Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As 14,6'/fe, C—recr. klcf wtJ B jif `° s' Front: Square Feet: Front: Depth: freight: � J Depth: Cubic Feet: Height: Square Feet; Cubic Feet 4 of Construction: E 2'yP' 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. DATE: SIGNXEURE : (See Reverse Side For Additional Informati q ) Com° 560-3450 Ifity 0/ .7raley ANOKA COUNTY 6431 UNIVERSITY AVENUE NE May 29, 1974 FRIDLEY, MINNESOTA 55421 Mr. John.O. Stanford 6150 Rainbow Drive N.E. Fridley, Minnesota 55432 Re: Swimming Pool at 6150 Rainbow Drive Dear Mr. Stanford:. This letter is to make clear this departments requirements for the swimming pool construction at the above address; 1. As indicated, one (1) skimmer approved by the National Sanitation Foundation will be provided. 2. As indicated, one (1) inlet of approved design for.fresh and/or repurified water will be provided. 3. The filter and pump,shall be approved by the N.S.F. and be of sufficient capacity to provide a minimum turnover of at least two (2) -times in 24 hours. This department recommends a turnover rate of 7-8 hours. 4. A fence or other suitable barrier, a minimum of four (4).feet high, that affords no external hand or foot holds and which is impenetrable by toddlers, must be provided around the entire perimeter of the pool. All gates and other accesses shall be equipped with self-closing and latching devices which are capable of being locked. 5. An automatic chlorinator should be provided with a suitable test kit. 6. All electrical and plumbing installations shall be inspected and approved . by the City Inspection Department. 7. All electrical lines must be 10 - 20 feet or more away from the pool surface. 8. The pool fill spout must be air gapped or protected by a vacumn breaker. 9. Suitable safety equipment to include but not limited to a ring buoy and rope -that is 131 times the pool.diameter, shepards crook pole, must be provided and maintained with the pool at all times. Furthermore, these and any other requirements must meet the provisions of the Fridley City Code, Section 115, Swimming Pools. The building permit is approved contingent on final inspections and approval by the City. If any questions or problems arise from this.letter, please feel free to contact me at 560-3450, Ext. 41. Sincerely, STEVEN . LSON Environmental Officer 560-3450 (fig o 5riclley ANOKA COUNTY 6431 UNIVERSITY AVENUE NE May 29, 1974 FRIDLEY, MINNESOTA 55421 Mr. John 0. Stanford 6150 Rainbow Drive N.E. Fridley, Minnesota 55432 Re: Swimming Pool at 6150 Rainbow Drive Dear Mr. Stanford: This letter is to make clear this departments requirements for the swimming pool construction at the above address; 1. As indicated, one (1) skimmer approved by the National Sanitation Foundation will be provided. 2. As.indicated, one (1) inlet of approved design for fresh and/or repurified water will be provided. 3. The filter and pump.shall be approved by the N.S.F. and be of sufficient capacity to provide a minimum turnover of at.least two (2) times in 24 hours. This department recommends a turnover rate of 7-8 hours. 4. A fence or other suitable barrier, a minimum of four (4).feet high, that. affords no external hand or foot holds and which is impenetrable by toddlers, must be provided around the entire perimeter of the pool. All gates and other accesses shall be equipped with self-closing and latching devices which are capable of being locked. 5. An automatic chlorinator should be provided with a suitable test kit. 6. All electrical and plumbing installations shall be inspected and approved by the City Inspection Department. 7. All electrical lines must be 10 - 20 feet or more away from the pool surface. 8. The pool fill spout must be air gapped or protected by a vacumn.breaker. 9. Suitable safety equipment to include but not limited to a ring buoy and rope that is lh times the pool diameter, shepards crook pole, must be provided and maintained with the pool at all times. Furthermore, these and any other requirements must meet the provisions of the Fridley City Code, Section 115, Swimming Pools. The building permit is approved contingent on final inspections and approval by the City. If any questions or problems arise from this.letter, please feel free to contact me at 560-3450, Ext. 41. Sincerely, STEVEN J. OLSON Environmental Officer SUBJECT NCity of Fridley iFi; 2565 AT THE TOP OF THE TWINS BUILDING PERMIT r R IPT COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION.SEC. t � CITY HALL FRIDLEY 55432 NUMBER REV, DATE PAGE OF APPROVED BY 612-560-3450 910-F15 15/29/74 JOB ADDRESS 6150 i w Drive 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 3 Sylvan Hills Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Ramp 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 Install above ground swimming pool. 9 CHANGE OF USE FROM TO STIPULATIONS See attached letter of stipulations from the Environmental Officer dated 5/29/74 PERMITS REQUIRED FOR MIRING, SEPERATE AND. SIGNS. HEATING,. PLUMBING 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 SQ. 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 R-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. $899 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS ANY OTHER STATE OR LOCAL LAW REGULATING CON- $6.00 STR�TIONIILHEERFORMANCE 901 CONSTR TION. PLAN CHECK FEE TOTALFEE 'ef5W'fx1V1L" IS A,1/7�$6.50 TUREOFC70NTRACTORORAUTHORIZED AGE + I ATEI WHEN PROPERLY VALIDATED THIS IS YOUR PIERMIT I BLDG. INSP DAT SIG URE OF OWNER (IF OWNER BUILDER) (DATE) I APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME : 1," O h I� e5faPIT6 9® BUILDER: ADDRESS :1 15]Q V`a1'K LAW 9j- i O ADDRESS: :5Z Vfell NO STREET: LOT: IS BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDE -YARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. r DESCRIPTION OF BUILDING j� To Be Used Asp° 1 A60 pw d a 1�I.G1 '��C iij 0 0 Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: Estimated Cost: $ �� To Be Completedt The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict 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: SIGNATURE: IS Lt (See Reverse Side For Additional Informati ) ,574 M ob SUBJECT City of Fridley ®R3 03 i 8 AT THE TOP OF THE TWINS BUILDING PERMIT ' CEIPTNO. • rCOMMUNITY DEVELOPMENT DIV. -------. PROTECTIVE INSPECTION SEC. X31 1 j i IL CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ---- 612-560-3450 910-F15 10/4/76 JOB ADDRESS 6150 Rainbow Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 3 1 1 Sylvan Hills Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Stanford 6150 Rainbow M Drive N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Potvin Sales Company 7341 Commerce Lane N.E., Fridley 571-3201 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 X 6 DESCRIBE WORK Cover trim and aluminum siding 9 CHANGE QF USE FROM TO STIPULATIONS SEPERATf PERA1ITS AE4U1RE1) F OR HEATING« PLUWNG AND sIGNS. wIf ING,. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS:ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Aluminum num THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 ] 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. $1,450 $.72 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $9.00 PLAN CHECK FEE TOTLFEE y�A9e 72 SIGNATUFX OF CONTRACTOR OR AUTHORIZED AGENT (DATE)( WHEN PROPERLY VALID T D THIS JS YOUR PERMIT /Q C SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) BLDG INSP DATE CITY OF FRIDLEY APPLICATION FOR. RESIDENTIAL BUILDING PERMITS (NEW., ALTEIRATIONS, ADDITIONS, OR REPAIRS) OWNER'S NAME: BUILDER: ADDRESS: 6/0 ��^ i? ADDRESS :,713 2f TEL. NO.: 7 l NO:. ��t D STREET:_ t.. LOT: BLOCK: -3 ADDITION: 1'- r. t CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form 2'go Certificates of Survey of Lot and proposed building location drain on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front: Depth: Height- Square Feet: Cubic Feet: Front: Depth: Height: Square Fee; Cubic Feet: Type of Construction: ,;.rte,,,_ = Estimated Cost: To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do alllwork in stxict accordance with the City of Fridley 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. ��i7 SIGnT DATE: � � 6 II'ATURE. (See Reverse Side For Additional Information.) d i I City of Fridley SUBJECT 14'734 AT THE TOP OF THE TWINS PERMIT ' BUILDING RE COMMUNITY DEVELOPMENT DIV./dR-23 r i PROTECTIVE INSPECTION SEC. 1 �--- NUMBER REV. DATE PAGE OF APPROVED BY � CITY HALL FRIDLEY 55432 612-560-3450 910-F15 6/1/78 JOB ADDRESS 61550 Rainbow Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 3 Sylvan Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Sanford 6150 Rainbow Drive N.E. 3 CONTRACTORMAILADDRESS ZIP PHONE LICENSE NO. Potvin Sales Co. 7341 Commerce Lane N.E., Fridley, MN 571-3201 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 Ek ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE S DESCRIBE WORK Reside 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. Alum. THISPERMIT 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. $2,500. $.125 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- STRUCT) R THE A E OF CONSTRUCT) $9.00 P(q PLAN CHECK FEE TOTAL FEE SU $10.25 SIGNATU E OF COWRACTOR OR AUTHORIZED AGENT (DATE) -,\ \ WHEN PROPERLY VALIDATED THIS IS YOUUR PERMIT WHEN BLDG INSP DATE SIGNATURE OF OWNER IF OWNER BUILDER) (DATE) CITY OF FRIDLEY APPLICATION FOR RES1l)t=tdTIAL BUILDING f'11MITS GIEW, ALTERATIONS, ADDITIONS, OR REPAIRS) 01112);R: . JIUILDER: Andress: Address:��1 Tel. No.: s 7 1 Street: LOT: m6cy,.: ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS: Applicant attach -to this form IiVo Certificates of Survey of Lot and proposed building location dra,,,n on these Certificates. DESCRIPTION OF BUILDING To Be Used As: F Front: Depth: Height: _ Square Feet: Cubic Feet: Front.. Depth: Height: Square Feet: Cubic Feet: Type of Construction: f Estimated Cost: $ To Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) 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. See reverse side for adSl Tonal information. DATE: �&,kP SIGNATURE: Stipulations: 0 • t4 97-8h4a6051 CITY OF FRI DLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE H PLUMBING FIXTURE RATES: N0. RATE m Number Fixtures x $3.00 u Future Fixture Opening x a� $ -� 4later 0 u $ Catch Basin x $5.00 b>a, F .�.{{ uuu� A N N a w $ Water Softener Heater $7.00 $ - x qmq .1 $ A r C 3 N 'a p A U• 15t 3 fixtures x $3,00 $ Additional Fixtures o 0 •a a'0.1 N R h • 4 p 0 8 0 4J 0 0 I'm 0 each add. $100.00 or fraction u1 U p q -4 ro N 0 C7 ,c ti ro ro a ro m ;as 'lec u1 ,'i G. u1 w V W fC 3 O 1st p® 2nd 3rd 4 th (R) - Future Connection Opening Connected with Sewer (') - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: N0. 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 $ Hater Heater - to 99,000 BTU x $5.00 $ 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: 15t 3 fixtures x $3,00 $ Additional Fixtures x $1,00 $ Gas Range to 199,000 BTU x 40.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FCC $ 8.00 Job Address 6150 Rainbow Drive Department of Buildings City of Fridley Tel. W1-3450 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 factu and roprusontaL•ions stated in this application aro true and corroct Fridley, Mn. 8-3-79 , 19 i OWNER Stanford KIND OF BUILDING frame USED AS res, TO BE COMPLETED ABOUT 8-10-79 ESTIMATED COST 4)_00 OLD - NEW BUILDING PERMIT NO. PERMIT NO. lot Company Signed By MINNEGASCO Tel. No. ROUGH INSP. Da to FINAL INSP. Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUKBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE AN REINSPECTIO14 FEE ti ITY OF MIDLEY INSPECTION DIVISION Effective On January 1, 2000 431 University Ave NE ridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 7&1).-)72-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES IL JOB ADDRESS---- &/So �iGzi'r���� �i' • �, [� RATE SCHI•DULE .t esirlerniai Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) tias Piping (Needed with new furnace, but not replacement) Gas Range G ~ Gas Dryer Air Conditioning All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1%, of Value of Appliance or Work OWN ER_. /-Q UGC Gi Rate TOTAL. BUILDING USEf) AS $ 30.00 -/— ESTIMATED COST ._4 PERM NO. $ 10.00 $ _ DI=SCRIPTIOPd 0117 FURNACE AND QR BURNER $ 10.00 $ 10.00 $ 25.00 W ,J-, commercial/Industrial 1.25% of Value of Appliance or Work LL G State Surcharge Q TOTAL FEE. " WIWI M FEE FQR ANY HEATINGIONLINGz/_VEIL LATION N, EFRIGERATiOWAIR CONDITIONING PERIT IS$25.00 c" :LIDS HE $.50 STATE SURCHARGE 9 0 EINSPECTON FEE $47.00/Hr s, Air Conditioners can not be placed in a side yard without Pritten permission from adjoining property owner. G .33 2 �76 No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Narne Size (No. BTU HP _ EDR f=uel Total Connected Load _ Burner Trade Nance Size No. $ _ BTU --_ — HP FDR—__ ..- CCA�, 3aT x(avaL� g.-tc'T, t3 aEEP A lC $� +he undersigned hereby makes application for a permit for the work herein soxified agreeing to do all work in strict accordance with the City Codes an .50 rulings of the Building Division, and hereby declares that all the farts and representations stated in this application are true and correct. DATE`/�_�� HEATING CO Signed eZ TEL if rU �l Approved G _ Rough -In Date __._ ___.._ _ Final Date 2 �76 SUBJECT �ERMIT City of Fridley ' 23842 AT THE TOP OF THE TWINS P, BUILDING PERMIT Ir • RECEIPT NO. `- COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. / q6 ^ irv}� NUMBER REv DATE PAGE OF APPROVED BY "'1 CITY HALL FRIDLEY 55432 �""� 612-571-3450 910-F15 10/24/95 JOB ADDRESS 6150 Rainbow Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. I 3 3 1 Sylvan Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Patrick Hinnenkamp 6150 Rainbow Drive NE 571-4571 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Dave Wiger Contr 901 Rice Creek Ter NE, Fridley, MN 55432 572-8403 8392 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 E REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (14 Sq) Tear-off; Replace windows and patio door and service door 9 CHANGE OF USE FROM TO STIPULATIONS Replacement bedroom windows must meet the State Building Code. 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 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 $4.9500 $2.25 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- $99.75 Fire SC. $4.50 T UCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTALFEE License SC $5.00 $111.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERL ALIDATED THIS IS YOUR PERMIT BLDG INSP a DATE SIGNATURE OF OWNER OF OWNER BUILDER, IDATEI MTN ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: (��0e«e Legal Description: Effective 8/1/95 4o7 a - Owner Name & Address: o'rg Pc k H e N "N AO- A-0 Tel. # - r'S' 7/ Contractor: Des Ua W /G"'4r, re MN LICENSE # '?6%2 Address: TO( cegeA- i->;-.ee*-- r Tel. # (5-7 A '3.-/d 3 - LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height ,Sq. Ft. Length. Width Hgt/Ground Sq. Ft. IZEC)boF,, 1<7-ge ,?,e-AZAcff' LvIN964vs4- R10-10 Corner Lot [ ] Inside Lot [ ] Type of Construction: Aliprox. Completion Date: _ Ft. Yd Setback Side Yard Setbacks a timateii Cost: $ Y (Cost on Back) ;Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ Tei. # 5 7„2 -,5-,5W47DATE: 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 $ $850 per SAC Unit License Surcharge $ , D Q $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 STIPULATIONS: City of Fridley AT THE TOP OF THE TWINS SUBJECT - BUILDING PERMIT PER 2 7 4 8 9 COMMUNITY DEVELOPMENT DIV. r L __O-_-� PROTECTIVE INSPECTION SEC. 1 = �_T CITY HALL FRIDLEY 55432 612-571-3450 RECEIPT NO. 577 NUMBER 910-F15 REV DATE 9/1/98 PAGE OF APPROVED BY JOB ADDRESS 6150 Rainbow Drive 1 LEGAL DESCR. I LOT NO. 3 BLOCK 3 TRACT OR ADDITION iSylvan Hills SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Patrick & Karen Hinnenka 571-4571 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO David J Wi er Constr.972-94ni 1911C)9 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof overlay 25 S house and garage 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be 2nd layer but not 3rd. 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 80 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 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED VALUATION SURTAX WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1609.50 .80 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 - STRU TION OR TH ERFORMAN� E OF CONSTRUCTION. 54.00 Fire SC 1.61 � PLAN CHECK FEE TOTAL FE V/ c 5.00 61. SIGNATURE OF CONTRACTO OR AUTHORIZED AGENT IDA E1 'IS YJ�iji PERMITSIGNATURE BLDryATE �INSP OF OWNER OF OWNER BUILDERI IOATEI NEW Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 e� BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: P.47-1?1c�,P Tel. # -7 f - V-5- 7/ Contractor: l/t) Ccrw; MN LICENSE # 33 ?A Address: C76 ( R lc4- QtCIS t cif', Tel. # 5-2oZ - 5-1/ ® 3 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height Length Width Hgt/Ground N6® P Driveway Curb Cut Width Needed: Emu AN Estimated Cost: $ _ Sq. Ft. _ Sq. Ft. _ Sq. Ft. (Fee Schedule on Back) Ft. + 6 Ft = Ft x $ = $ r cTel. # �7o2-�Y® 3 DATE: � p� APPLICANT: �/ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ 'C -c') CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 [ ] NEW [ ] CITY OF FRIDLEY ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: W 115 D _ _ V.w IDY1 Legal Description: i l - Owner Name & Address: eU�,IL( t� UCa LA C, — Stdw-.-_ Tel. # Contractor: 141f-Qk 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 Width Hgt/Ground Sq. Ft OTHER: Construction Type: '22 255�'/ Q I d I Estimated Cost: $ ® 0 C) - ®� l� Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ —=$ DATE: 4 12(,1 US- APPLICANT: ftkJ0&'--- (SkV0a e+Al) Tel. # *1 10-s- SI? -,2M-11 Call (763) 572-3604 for Permit Fees If mailing in application. Fax to 763-671-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1450 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 [ ] STIPULATIONS: NEW [ ] CITY OF FRIDLEY ADDN [�� 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION 3 ®0-5 Construction Address: 0 A ` ej bo V-11 Legal Description: e -k Owner Name & A+ Contractor. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: fri,oye,IiL Tel.# %o3-5-71-%0-e�q C i f- ( MN LICENSE # 03 G ")-0.3 Far/_? 'v- o Or if- Tel. # 6 1 2-- t? d y ® 4 0 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to *scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length% % Width �� Hgt/Ground / Sq. Ft. Construction Type: IAO c ® Estimated Cost: $ -57 4) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _-$, DATE: Or APPLICANT: Ic ( 1"4 -r'j - Tel. # 6 (4) - A>6 q o Co % oe Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY - Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1450 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 [ ] TOTAL $ / 7l° Q r STIPULATIONS: Building BUILDING Permit No.: ( W, Ce Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Dat'0d Q% DATE LA' S- 01 YOUR E-MAIL ADDRESS i1Q (JlR-COC, 17� I I�-Ci�►�'� srrEADDRESS 10150 FV-kCJL)r:>i 5 S i 3 a THIS APPLICANT IS: ❑ OWNER .CONTRACTOR PROPERTY OWNER/ NAME:Ctrw� 1�vAGG _ ADDRESS: U\ SO V -0-t t-NbO�. f C)Y 0 V C— ()F CITY V— ( 1 C 1 f VI STATE] IP S S I ia. TENANT PHONE: CJU 3) 512 — Zobl CONTRACTOR NAME: Q` d rV--?`,� V, STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE 1 U 3--7 4 S — 120 FAX to3 114S — l Z PROPERTY TYPE P1 SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED OdWINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK, ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR KREMODELING DESCRIBE WORK BEING DONE: pV,� a tAA , I Fr-eOL, d*0f2- , `a sftr VnCX00(5 - spk'n e S► -;y- y pe h i n 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, O Vinyl❑Soffit ADDITIONS & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. Two sets of construction plans WINDOWS )(Yes 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) TOTAL JOB VALUATION $ 15. 1 ??Ip, Jr OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge. Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ $-1.5-1 See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1675 per SAC Unit (Plans to MWCC for determination) —ft +6 ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach 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 which requires review and approval of plans. I� I PA _ SIGNATURE OF APPLICANT :J (t2 e� PRINT NAME 30J e I V 07-0 r 00 DATE Building $ 21q , BUILDING Plan Review Permit No.: Inspections Fire Surcharge RESIDENTIAL APPLICATION .001 times the total job valuation Received By: Nil 763-572-3604CITY .0005 x Permit Valuation Minimum $.50 OF FRIDLEY $ '5.09 eJ�! L - 2007 I DATE d YOUR E-MAIL ADDRESS 0 k $1675 per SAC Unit (Plans to MWCC for determination) SITE ADDRESS C7 ` 5 N '� ft + 6 ft = ft x $21 = $ THIS APPLICANT IS: ❑ OWNER )]CONTRACTOR $450 Conservation Plan Review PROPERTY OWNER/ NAME: 4 G dC\ C Fee Determined by Engineering '' ADDRESS: t D 6c) 1141- V --,c,, � 1 CITY -t"fu d � STA 411` TENANT Agreement necessary ( ) Non Necessary ( ) PHONE: $ CONTRACTOR NAME: E u SUBMIT A COPY OF -7 STATE LICENSj< #1© —'A EXP DATE L 1 5�l YOUR STATE LICENSE ADDRESS: I t>scb C!) -,S CITY I m STATd,&IP WITH APPLICATION PHONE 5 -95S - I500 FAX PROPERTY TYPE USTNGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED at-VnNDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW 11ADDITION ❑.kAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: -6?n w� me -- 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 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 MYes ❑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 $ OCCUPANCY TYPE Permit Fee $ 21q , See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 460 .001 times the total job valuation Surcharge $ Ff" 0 .0005 x Permit Valuation Minimum $.50 License Surcharge $ '5.09 $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 $ 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 which requirep review and approval of plans. 7'-1 ' fUJll�uAM- _lr �Q 1S _C�Il- I ' h n lzhu L DATE 191 Ci SIGNATURE OF APPLICAN PRINT NAME �CaC 1 l I Building PLUMBING Permit No.:11 Inspections RESIDENTIAL APPLICATION Received By... L-9 763-572-3604 G CITY OF FRIDLEY D'a: DATE - YOUR E-MAIL ADDR S SITE ADDRESS I , NJ 6 THIS APPLICANT IS: 13OWNER CONTRACTOR PROPERTY NAME: OWNER) TENANT ADDRESS: � � CITY ] (�'1 1STATJZIP PHONE: 2,00 CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS: CITY STATE 3' LICENSE WITH PHONE APPLICATION PERMIT TYPE I INGLE FAMILY E3 TWO FAMILY 17 TOWNHOUSE l� TYPE OF WORK. 'r ❑ NEW REPLACEMENT i DETAM�D OF O 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 r ) Labor cost under $300 = $15.00. Inbar cost between $300 to $500 = cost of labor .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 DRAINSSHOWER WATER PIPING _ -BATHTUB GAS PIPING mw =Lxar&) - SWIMMING POOL WATER SO ($35) _ _ CLOTHES WASHER KITCHEN SINK_ WATER CLOSET _ BACKFLOW PRE . ($15) -DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IItRI ATIO _ WATER METER 7MM�r RPERMIT FEE PRO7ECI'S FOR UNDER $500 PERMLT FEE FOO Numberoffixtures@$1000 I x $10.00 = $500Permit Fee $ Surc a .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 woj i will be in conformance with the ordinances and codes of the City of Fridley and with the Nimesota Construction Codes; that I mider stand 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 accordm ice with the approved plan in the case of all work. hich uire review and approval of n1ans. Q ; ^^ '": y" "' " Va 19a 10 q SIGNATURE OF APPLICANT *.. P PRINT NAME DATE CJ PLEASE NOTE: SEP PERMITS AREREQUIRIM, FOR BUILDING, ELECTRIC AND MECHANICAL ORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 77 A Y. 1742 Cn7 An77