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PRE 2010 DOCSCity of Fridley, A inn.. BUILDING PERMIT M5094 Date:_', Owner: A�- uilder Address _ ___ Address L® �►®N a 4F BUILDING No. Street .�;.,'e + ._ Part ot-Lot 11 141 Lot :__.:_... _ __ Block _ Addition or Sub -Division' Corner Lot _ Inside Lot __._ "_ __ __ Setback t Sideyard __ _1� Sewer Elevation __M Foundation Elevation DESCRIPTION OF BUILDING To� Used "`�' Front 14 CAS . Depth Height _ Sq. Ft.'r Cu. Ft. `r"�'.— =rw Front _ _ Depth ` _ HP)qt Sq. Ft. Cu. Ft. Type of Construction _ c�,c. _ Est. Cost �` l 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. let In consideration of the payment of a fee of $ r� ...._'._ ,permit is hereby granted to— to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings 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 $ee the Building Inspector for separate permits for these items. 4 APPLICATION FOR BUILDING PRUM CITY OF FRIDIEY, MINNESOTA Owner's Name ate, i�ar✓�`�oid✓, �Zd®r Address �� `��`S9 Address LOCATION OF BUILDING No. � J/ � Street l0 ��?�s �//�f`''� Part of Lot ' Lot Block Addition or Subdivision ':-'—"L-U✓ Corner Lot Inside Lot Setback �� Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: Type of To be Completed DESCRIPTION OF BUILDING X 2-F /9 r Sq. Ft. //3 _ Cu. Ft. Ali d Front Depth Height Sq. Ft. Cu. Ft rze Estimated Cost /�,^ ZJl) The undersigned here * makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. /I DATE SIGNATURE (A Schedule of Fee Costs can be found on the ReveiWe Side.) F� V 1`L City of Fridley Application for Plumbing and Gas Fitting Perndt DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ��=0 C,' 6 x $1.50 $—�—= Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ �Z �� z QQZ O J C9 NU' Z • F • N WATER HTR. GAS ELEG 3 � RATE TOTAL 1st 3 Fixtures .......................... x $1.50 DOLL N x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ Base 1st 2nd _ 3rd _ 4th • Future Connection Openings Connected withI Sewer � New Fixture, Old Openings Cesspool E] PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ��=0 C,' 6 x $1.50 $—�—= Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ a New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ ✓� -_v Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $-/ Dept. of Bldgs. Phone SU 4-7470 Loca+v City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn � � 19-L/ Owner Kind of Building r Used as To be completed about Estimated Cost, $ Old a Building Permit No �Z%�' Permit No. Signed d �- By ROUGH 7 FINAL .QSW42 2M 749 Business Phone 52-84-s915.51 City of Fridley Application for Plumbing and Comas Fitting Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Location 551 Regis Dr epp $ x $1.50 $ x $1.50 $ x $3.25 $ X $3.00 am aaz U o� <3 d � 0 NU z �o e F s N WATER HTR. GAS ELEG Base 1st 1 2nd 3rd 4th ° Future Connection Openings I d,onnecaea wa:a Sewer [] s New Fixture, Old Openings Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ..................... Future Fixture Opening ............... New Fixture Old Opening ............. Catch Basin ........................... Water Heater (Up to 99,000 BTU) ..... New Ground Run Old Bldg. .......... Electric Water Heater GAS FITTING FEES: x $2.00 $ x $1.50 $ x $1.50 $ x $3.25 $ X $3.00 $ x $3.25 $ z $2.00 $ NO. RATE TOTAL 1st 3 Fixtures ...... ................... x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. ,` x $5.00 s— 3; • 00 REPAIRS & ALTERATIONS—Refer to Code City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn 4-17-69 19_ Owner Richard Nusenbrook Kind of Building frame Used as res To be completed about 4-22-69 Estimated Cost, $ LU.UU Old—New. Building Permit No Permit No Signe a., MINUS S CO - - ROUGH FINAL Description ................................................$ TOTAL FEE $ e0- ae Business Phone N Applicelon for Power Plants and Heating. Coaling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: Furnace Shell & Duct Work .......................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 .................. Repairs & Alterations each add. $500.00 ............... MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ each add. 60,000 BTU ....................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 ................. Repairs & Alterations each add. $500.00 .............. RATE TOTAL 8.00 $ 5.00 $ 5.00 $ 2.50 $ 8.00 $ 2.00 $ 5.00 $ 5.00 $ 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ GAS FITTING FEES: NO RATE T 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ as Range to 200,000 BTU , . ... --- - -'--x -2.00- $-_ - - - AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS 1 tEMARKS: See Fee Schedule $ TOTAL FEE $ Dept. of Bldgs. Phone SII City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Owner Kind of Building Used as To be completed about Estimated Cost, $ �. d_ O&IiF wilding Permit No. — 195— 195- 95._ 195— 195— DESCRIPTION DESCRIPTION OF WORK HEATING , voter Warm Air—No� Trade Name -�- Size No 7 S Capacity Sq. Ft. E.D.R !4 Off- BTU H.P. Total Connected Load '®®� Kind of Fue BURNER Trades Name- -- - - Size No-� Capacity Sq. Ft. E.D.R BTU H.P. EO. SEDC ICK IPTG. & AIR-COND. CO 1001 penia Av. S. Minneapolis 16, Minn. Signe By 11 POST IM -12-58 Business Phone Ko- SOS �`.�o�J /��a/ HEAT LOSS CALaXATIONS DEPARTMENT OF BUILDINGS V&GdF sr SONY, MN. i Weatherstrips Construction No. Insulation Windows IDoors Reference Ont. Wall Iat. Wall Ceiling Roof Floor How ' Guide ZEEer s a� Fl.jW. t/ Rooms I Length Width.Z Height Fl.p Room I Length Width 9 Height Windows and Doors—Crackage and Area / s/ Windows and Doors--Cracimp and Area Width I Height No. of Ineal t Area `5 /� {%/y Width Height No. Of 'Lineal ft. At" G% No. of pane of pane lights of crack sq. ft. Cj No. of pane of pane lights of crack sq- Rt. Btu fl Glass Sp Exp, wall y.k 7 Nei exp. wall Int. wall Ceiling .Floorj' .0-0 , ; 13 ?J& 114 e Total Btu. la Required sq. ft. E.D.R. or sq. ins. W.A. Leader arta. Room Length I. -f Height 17 Wipdows and Doors—Crackage and Area t'' / v' Width Height No. of Lineal ft. Area No. of pane of pane lights of crack ft. ft. T% Infiltration 22 Glass 02J Exp. wall Coef. Btu Infiltration Ceiling Floor /-11 D Glass 872 4 W SO Exp. wall lr- Width Height No. of Lineal ft. Area No. of pane' of Daae lights of crack sq. ft. Net exp. wall Int. wall Ceiling Floor ,a° TotallBtu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI. Room ILength Width Windows and Doors-Crackage and Area Width Height No. of Llnaal tt. Area do. of pane of pane Ilgbts of crack eq. it S3 Coef. 'Btu Infiltration Masai EXP - wall all ' >-A Net ib p. hall Int. wall �eilli46 Floor' 'sf Total Btu. Required sq. ft. E.D.R. or, sq,=ms. W.A. der area. > 911-0-4 --V — — Rnnm l Lenath e.9 --Width ® Heilzhtf/ Windows and Doors—Crackage and Area t% v Coef. Btu Infiltration 22 Glass 02J Exp. wall JD SO Net exp. wall Int. wall _ Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l o Room I Lengih idth Hetet Windows and Doors--Crackage and Area h /� Width Height No. of Lineal ft. Area No. of pane' of Daae lights of crack sq. ft. > 911-0-4 --V — — Rnnm l Lenath e.9 --Width ® Heilzhtf/ Windows and Doors—Crackage and Area t% v k Area Width Height ane No. of of No. of pane ofpanelights of onck p. ft. A o 141 Coef.1to Infiltration Glass U Exp, wall JD SO Net exp. wall 9 Int. wall Ceiling Floor 'y L > 911-0-4 --V — — Rnnm l Lenath e.9 --Width ® Heilzhtf/ Windows and Doors—Crackage and Area k Area Width Height ane No. of of No. of pane ofpanelights of onck p. ft. A o 141 Coef. Btu Infiltration Glass Exp • wall Net exp. wall Int.wall '0 ZIA Ceiling Floor Total Btu. Required sq. ft.. E.D.R. orr sq. ins. WA. Leader area 01 SUBJECT PERMIT City of Fridley i43s-6 AT THE TOP OF THE TWINS BUILDING PERMIf, COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. �� 1 . i CITY HALL FRIDLEY 55432 L NUMBER REV. DATE PAGE OF APPROVED BY J` 612-560-3450 910-F15 9/1-6/77 JOB ADDRESS 5541 Regis Drive N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 5 3 Parkview Oaks lst Addn. SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Musenbrock 5541 Regis Drive N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. King's Brian Construction Co. 5516 Regis Drive 574-0036 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 Q. ❑ NEW ❑X ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Ip'oom Construct a 20' x 10' Family Addition to Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Provide 2" x 6" rafters for full 20' span area. Provide 5/8" particle board underlayment. g' call tocat ul�l.,�. Bitfore GIBS tic - ITS REQUIREFOR V�IIRtNG, iEIEPHONE-ELECSRIc S PERA' PEI �AR BY LAYS HEA ANG, PLOMBfW AND -SIGNS. QUjjtED SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES. NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SQ. 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 [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 $7,200 $3.60 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING,OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR I CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $ 45.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE f% ne $48.60 �—sidNATURE OF ONTRACTOR OR AUTHOR) ED AGENT (DATE) TrWHEN P PERKY VALIDATED THIS IS YOUR PERMIT BLDG. INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) 01 CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS,.OR REPAIRS) OW14ER: fill S��l fPo /� /� ,"C ��2er BUILDER: "Up �iP�"rs s� ae c Address:, V % . Address: .5 14 ,"s �iP�'t�ic Tel. No. d C No. 5_�S-V / LOT: .57 - street: BLOCK: J -ADDITION: CORNER LOT: INSIDE LOT: s- SETBACK: SIDEYARDS.- 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: f�a s:a --Front: Depth: /P Height: Square Feet: ® Cubic Feet: 7936:2M .c/000 Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction: Estimated Cost: $ '7_2 a 0 a To Be Completed: / -° J - Y 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 additional information. DATE: �-/S"%% SIGNATURE: Stipulations: �,,®t 4 4-ry WV, 3 11 f v 3 �dvr a /11�j�� INOYSTRIAL BUSINESS CITY LOTS TOPOGRAPHIC MAPPING %"Or7 /ra 17 PAe3�/ w OAX's Firms T Ad»I7lam C. E. COULTER PLATnNG FARM SYRYEYS.._ LAND SURVEYOR LAKEs11ORE REGISTERED UNDER LAWS OF STATE OF MINNESOTA JUOICIAI. LICENSED ST ORDINANCE OF CITY OF MINNEAPOLIS 3300 LYNDALE AVE. SO. MINNEAPOLIS S. MINN. TAYLOR 4.0370 1 SURVC Y /or Y/F C'._G�.�wLso�v it SoN �urur�ar'� �Irx#.ifra#r �Cd I� l �'= 2D /rssea /rvi'7 I hereby certify that the above is a true and correct plat of a survey of: Lot Five (5), Block Three (3), PARKVIEW OAKS FIRST ADDITION, Anoka County, Minnesota. As surveyed by me this 30th day of December 1960 A. D. Signed Minnesota Registration No. 2584. I a� O'q Z UOT1099 UT t}soj -4as sB %Twed Atm soI taa2 • r ENERGY CONSERVATION SUPPLEMENT TO BUILDING PERMIT APPLICATION t PLANNING AND INSPECTION DEPARTMENT GCITY OF .FRIDLEY, MINNESOTA 0I This supplement is provided to assist the applicant in computing EXTERILOPE AVERAGE "U" FACTOR INFORMATION. This information is required so the BUILDING t OFFICIAL can determine that submitted plans comply with the ENERGY CONSERVATION W tlb Alp - DESIGN CRITERIA of the STATE BUILDING -CODE (Section 6000). It is the APPLICANT'S responsibility to accurately compute the data; reflect the proper DESIGN CRITERIA in the plans; submit product specifications, if needed to support the."R" and "U" factors used; and to assure construction is per approved plans. r JOB .LOCATION:. `� 7��(DIS ((fF Af_ OWNER/CONTRACTOR: ADDRESS: PHONE: 4V 0/15 7.. d/, 5 A. Determine the Total Exposed Wall Area as follows: 1. Total.wa dow area 2. Total doomsarea; "_ f , - �pA 3. Total s1'd glass door area -- 4. Total f ace wall area 5. Tot wa framing area (average .10%)W -t ��, _ �(• f 6. Total t all area above floor(average 90%) 31 a �'� v 11' 7. To�� rim joist area. � �, �' tal: Total exposed wall area above floor 8 tal foundation window area 9 tal net foundation area above grade Subtotal: Total exposed foundation area. GRAND TOTAL EXPOSED WALL AREA B. Multiply the GRAND TOTAL EXPOSED WALL AREA X .17 = Item Ir e. / .• C. Determine the Total Exposed Roof/Ceiling Area as follows: FM �A 10. Total skylight area 11. Total roof/ceiling framing area (10%) 12. Total net insulated roof/ceiling area GRAND TOTAL EXPOSED ROOF/CEILING AREA Multiply the GRAND TOTAL EXPOSED ROOF/CEILING AREA X .05tow = Item II 1-00v9/ . A I q A. E. Determine the "U" value of each segment (1-9) and multiply by the area as follows: 1. toll, 3 x ovule 00 2. x "u" _ 3. x "u °' _ 4. x "u" egy 5. 6. 7.®Ix fluff OW x fluff 9. x „}T„ / ��' = rte® ADD 1-9 FOR TOTAL WALL SEGMENTS F. Determine the "U" value of each segment (10-12) and multiply by the area as follows: 10. x "u" _ il. x Ifu'° _ 12. x fluff _ ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS = ITEM IV G. If'Item III is the same as, or less than Item I, you have met the intent of State Building Code 6006 (c) 2. H. If Item IV is the same as, or less than Item II, you have met the intent of State Building Code 6006 (c) 1. I. Add Item I + Item II = J. Add Item III + Item IV = K. If the sum of Items III and IV are less than Items I and TI, you have met the intent of the Code for total envelope .system. The undersigned, as applicant for a building permit, hereby affirms the above information has been prepared and submitted by himself or under his direction, hereby acknowledges the information to be correct and accurate;'and hereby presents the information with required plans in support of the building permit application. By: DATE: SUBJECT N City of Fridley 29428 AT THE TOP OF THE TWINS BUILDING PERMIT `v -------COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. �® r PROTECTIVE C976 1 � = CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By 612-571-3450 910415 /10/99 5/1 0199 JOB ADDRESS 5541 Regis Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 3 1 Parkview Oaks First Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Richard Musenbrock 571-1545 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Pro -Exteriors 11792 Chisa o Blvd. Chisa o MN 55013 651-257-1697 6094 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 Pgx REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage (25 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State BBilding Code. SEPARATE PERMITS ARE REOUIREO 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 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 I 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2142 $1.07 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- STR CTION OR THE PERFORMANCE OF CONSTRUCTION $83.25 Fire SC $2.14 PLAN CHECK FEE TOTAL FEE .� License SC $5.00 $91.46 NA TU�11N'RACTOR ORAUT EOAGENT (DATE- WHEN PROPERLY IDATED THIS IS YOUR PERMIT ' /%� ✓i./ 'T S,GNATURE OF OVy NER..F OWNER BUILDERI IDATEI BLOC -NSP gAiE NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: � -5— , ✓1 p-1 ✓ / rt C! [e Legal Description: Xe 49, Owner Name & Address: T� ��rf �� ti 1jY� �,� Tel. # Contractor: - 'e fe MN LICENSE # ® �% Address: Tel. # % 2 - Attach 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: Len Width Hgt/Ground Sq. Ft. OTHER: Construction Te: yp ,� v o �� .� Estimated Cost: $�_�� ,� �® Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: APPLICANT: Tel. #� CITY USE ONLY STIPULATIONS: A , r . Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ l .001 of Permit Valuation (1/10th%) State Surcharge $ / d $.50/$1,000 Valuation SAC Charge $ $1050 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 [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: A , r . &1q 1Q-0Lo k t1 -,-P^ toff Ctc 4 Ge -P: ZCO ' z0 C "cC4�s-izz building $ BUILDING $ Permit No.: �Zspections Surcharge RESIDENTIAL APPLICATION Received By: 7163=572-3604 SAC Charge CITY OF FRIDLEY Date Rec'd: DATE 0_7-1-7-0(_,* YOUR E-MAIL ADDRESS $ SITE ADDREss '55W Qin � S (.fir i - Sewer Main Charge THIS APPLICANT IS: ❑ OWNER CONTRACTOR $ ® _ __LP) PROPERTY OWNER/ NAME: P6kt 1 C 1 g M USC'iJ 10�_®C C ADDRESS: - d 4CA l S Dr i V'Q U CITY IF -1' 1 d I P C STAT04ijZIP S 5q e TENANT PHONE: ° to.3' -5-7 1 - 1 Sz%s— CONTRACTOR NAME: STATE LICENSE # EXP DATE I ► 1 Z C07 SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS:_1�6 1 y- s r l' RC1 LcaVn.P SU � + l -0:3 G CITYMA D � ' (�YCII . STATE th Z�ZIPS�j / WITH APPLICATION PHONE ?(o3 --iw3-os i FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH OOF ❑ DRAIN TILE ❑ DECK SIDING ❑ W]MMING POOL ❑OTHER TYPE OF WORK: 13 ADDITION �❑�`�EW _, MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: M VJ S l (11 na, 61 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 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: ❑ Alumi IQ Othernum ax e ( `elm ` ❑ Trim m I I 1 ❑ Fascia I. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS !es ONo 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 $ q e 3nO.0 Q OCCUPANCY TYPE Permit Fee $ Plan Review $ Fire Surcharge $ '-2jo Surcharge $ y , (p License Surcharge $ . SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ ® _ __LP) 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) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks pavable 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. SIGNATURE OF APPLICANT // (,r.&l i/,f&,�r � _® PRINT NAME ICS A ' DATE i � State of Minnesota Construction Godes and Licensing Division ' Y Department of Labor and Industry Telephone: (651) 284=5065 -� 443 Lafayette Road.N. mail address: dli.contractor@state.rnn.us St Paul, MN 55155-4344 1Nebsite address: www.doli:state.mn.us Residential Building Cott actor License Legal.Name: RENAISSANCE EXTERIORS INC Business Structure: DBA: CORPORATION Address: 7351 KIRKWOOD LANE N MAPLE GROVE, MN 55369 License Identification Number: 20220285 Qualifying Person: RONALD R SIMON License Expiration Date: • 3/31/2007 Continuing Education: 7 hours due by 3/31/2007. ...L.wk r�,ra^� �. r:,. r:rnz.' .,�? ,:r°,.seta':.r,"e'vel=�,�i�'i,`'4"��.�"�i;:3xa�:za�ea- a�', '�,'`�'�"4't`,{t".•. ' 7 _. NEW [ ] IM U _ S3+3WCITY OF )-5V104 EY Effective 1/1/2003 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: `I1�C 1 `� ®I' I �d� �A�- Legal Description: 1534I Val `spars D" Tel. # _71, o5-5-71-ISgS Owner Name &Address: Contractor: S i`C tuif-rlC r_ S MN LICENSE # 269d0a,65 Address: 1351 Yar4uxrrd Lane.'5U1K.i_50 Tel. # "V_GLr0Ve, W 9 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 GARAGE AREA: Length Width DECK AREA: Length OTHER: Width Height Sq. Ft. Height Sq. Ft. Hgt/Ground Sq. Ft. Construction Type:�QT-6P W� Estimated Cost: $ ( D(°(3Q' Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 0d1';)NDV APPLICANT: Tel. # 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 Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ to, 53 $ 2�, CITY USE ONLY - TOTAL Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $:50/$1,000 Valuation $1275 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 [ ]