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PRE 2010 DOCSCity of Fridley, tt BUILDING If �. Date: •' I .:�.,w.,�. r ..i. i. ..ail i .rl� .....�Address Address LOC�►TIO OFA ILD G No. Street kart of All Lot _ _Block Addition or Sub -Division .A. Corner 1-t _ inside Lot Setback fi Sideyard Sewer Elevation _ ---,Foundation Elevation DESCRIPTION OF BUILDING. T Used T Front Front Type of Construction Depth .... IA4,eight _ :Z& Sq. Ft. /Cu­ Depth Height _ _ Sq. Ft. _ _ Cu. Ft. JOL Est. ""''"� 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. ek 14 In consideration of the payment of a fee of $—permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, e»iployees 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 thus permit may be revoked at any time uponviola any of the provisions of said ordinances., :_ , 1 I21.1j.-.-Poore'. NOTICE: We pence does not eorer the eondmetion, installatlon for why, plumbing, on hes&& sewer or water. Be sore to as the Building hupeeter for separate permits for these items. owner's Address APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING No.Street art of Lot Lot Block Addition or Subdivision Corner Lot Inside Lot ti Setback Side -Yard /D SEWER BLEVATIO14 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 used as: l ' f r nt Depth 'Height Sq. Ft, Cu. Ft. Front Depth Height Sq. Ft. Cu* Ft. Type of Construction �L/ Estimated Cost ©e d—oZ Tobe 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. DA r (Schedule of Fee Costs can be found on the Reverse Side). 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: O. RATE Number Fixtures ...................... 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 New Ground Run Old Bldg . ............ x 3.25 Dept. of Bldgs. Phone SII 4-7470 Location 'j-4 03 City of Fridley: z 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 a and correct. '?v Fridley, Minn �12 19ck Owner / 'y Kind of Building Used as��� To be completed about Estimated Cost, $ Old—New. Building Permit No .it No. TOTAL el $,/(/ , J` 0 Signe vs $ -� 1661 $ Business Phone No- �✓�/ 6 $ V $ ROUGH °� m G FINAL GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... �7� x $1.50 (-J Additional Fixtures .................... x .50 $ -- Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $/�� � Z�� Y 8� LLa ~� t�m S� a3 �a. t9 °d t9 Z �n c90 F ♦ N WATER HTR. GAS ELEC. Base 1st / 1 2nd 3rd 4th Future Connection Openings New .Fixture, Old Openings Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: O. RATE Number Fixtures ...................... 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 New Ground Run Old Bldg . ............ x 3.25 Dept. of Bldgs. Phone SII 4-7470 Location 'j-4 03 City of Fridley: z 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 a and correct. '?v Fridley, Minn �12 19ck Owner / 'y Kind of Building Used as��� To be completed about Estimated Cost, $ Old—New. Building Permit No .it No. TOTAL el $,/(/ , J` 0 Signe vs $ -� 1661 $ Business Phone No- �✓�/ 6 $ V $ ROUGH °� m G FINAL GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... �7� x $1.50 (-J Additional Fixtures .................... x .50 $ -- Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $/�� � Application for Power Plants and Heating. Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE RAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 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 TO AL 1st 3 Fixtures ...................... x $1.50 $ 7 Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ SIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ''t!LTERATIONS & REPAIRS TOTAL FEE $ '� ROUGH FINAL 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 ared t. Nov I ® Fridley, Owner Kind of Used as To be completed about o� Estimated Cost, $ New uilding Permit No. c;)- ,//Cl ­—Permit N DESCRIPTION OF WORK 19 — HEATING or -P - ) et -W; Warm Air—No yL-- Trade Name SizeNo2i. 2_ 7 /off Capacity Sq. Ft. E.D.R �O �� BTU H.P. Total Connected Loa ® /�' Rind of Fue BURNER —Trade Name Size No Capacity Sq. Ft. E.D.P/, TU H.P. GEO. 5EDG+V1CIC HTO. & AIP-GOND. CO 1001 Xenia AV. S. Minneapolis 16, Minn. Signed -1611 By 42 2M Business Phon No (REMARKS—OVER) Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FIA .V t 4eche d` Room l Lensfth /f Width !l Heiuht Windows and Doors—Crackage and Area g �y 7, Oro n•36 9 �i Ale,( - S- /, a"I HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E. Infiltration .. Construction No. Glass Exp. wall Guide Reference 19— Net exp. wall W 3 ? Net exp. wall+'` lowsoors I —No Out. Wall Int. Wall Ceiling Roof Floor Kind Y No A SOF Floor F1.1 Room I Length Width Height F1.11h Room I Lel Windows and Doors—Crackage and Area Windows and Doors—frac] Width Wldth Height No. 01 No. of Wane of pang lights Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FIA .V t 4eche d` Room l Lensfth /f Width !l Heiuht Windows and Doors—Crackage and Area g �y Height No. of Lineal f . Area No. of p ne o pane Iigh� of crack sq. ft. Voly 16 Fl.jJJsA/i-VC Room l Length 7 Width ` Height iS Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. / p Coef. Btu Infiltration Infiltration .. / Glass Exp. wall Exp. wall Net exp. wall W 3 ? Net exp. wall+'` Ceiling 5x Int. wall Floor e� Total Btu. Ceiling , i) 77 S-0,70 Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FIA .V t 4eche d` Room l Lensfth /f Width !l Heiuht Windows and Doors—Crackage and Area - _ Width Height No. of Lineal ft. Area No. of p ne ,ofane lights of crack eq, it. Fl.jJJsA/i-VC Room l Length 7 Width ` Height iS Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. / p Coef. Btu Infiltration .. JC.ef.j Btu Infiltration Exp. wall Net exp. wall W 3 ? Glass Ceiling 5x 3 Floor e� Total Btu. Exp. wally- x `a Net exp. wall Int. wall Ceiling /t PRI;7 Floor Total Btu. - Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.jJJsA/i-VC Room l Length 7 Width ` Height iS Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. / p Coef. Btu Infiltration .. / Glass Exp. wall Net exp. wall W 3 ? Int. wall Ceiling 5x Floor e� Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Sam Total Btu. MINNEAPOLIS, Insulation How. Applied l Width and Area .meal ft. Area of crocW sfl• ftp U Coef. Btu o i� f Fl. /, Room ( Length /.3 Width ! Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of p no lighta of crack sq. ft. Coef. I tu Infiltration' t"' / l Glass o° Exp. wall `` 1� 0 Net exp. wall 7 t Int. wall Ceiling y 17 F Total Btu. . Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FlV Y i t Room I Length I Width 1_3 Height 6 Windows and'Doors-Crackage and Area Width Height No. of Lineal ft. Area No. of p e of pane lights of crack_.sq. ft. �p Coef. 44 - Btu Infiltration c e Glass S -O Exp. wall ,�. 0o Net exp. wall Int. wall Ceiling f , •Ihl Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 44— D-36 4 D-36 HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS, MINN. Weatherstrips A.S.H.V.E; Construction No. Insulation Guide Windows Doors Reference Out. Wall Int. Wall Ceiling RoofFloor Kind How. Applied Yes—No I Yes—No 19— F1F` « r _-A? Room I Lenath a Width Height II R.1 Room I Lensth Width Height Windows and- Doors—Crackage and Area Sp Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal f . Area No. of pane of pane lights of crack eq ft. -y..-. r .ri A�r`` , C N' Coef. Btu Infiltration Coef. Btu Coef. Coef. Btu Infiltration Glass m 1 3 e "7 ! Glass i„ � Net exp. wall a Exp. wall Int. wall Net exp..wall Int. wall Net exp. wall t,a� g s Int. wall Floor ad Ceiling f Flraar -1 otal Btu. 1471a> Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ''! Fl - Room ( Length , Width 4 Height Windows and Doors—Crackage and Area Sp Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 0.. �� rte,. r- .t f n 1 r .ri A�r`` , C N' Coef. Btu Infiltration Coef. Btu Coef. Btu Infiltration 11LI `e;. ice, Glass 1 ' "` s Glass i„ � Net exp. wall Exp. wall Int. wall Net exp..wall Int. wall . �r Floor g Ceiliag.– •- `�� Floor ad Total Btu. y Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 6,7. FI r :: Room I Length V Width -e"– Height Windows and Doors—Crackage and Area q Width Height No. of Lineal ft. Area No. of pane of pane lights ofcracksq. ft. Coef. Btu Infiltration Coef. Btu Infiltration Exp. wall 11LI `e;. ice, Glass 1 r a `�- Exp. wall i„ � Net exp. wall Int. wall . �r Floor •- `�� 1 otal-13tu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights 'of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. 'ins. W.A. Leader area I ;i F1.1 Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling, Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 I I Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ' • PARTIAL RATE ,SCHEDULE e PI.WMING, FIXTURE RITES; N0, • u TOTAL, u X u $ u $1,0o Water New Future, O1d'Oponing , ._..� x $9.00 5 ;scch Bisin' .� x :+ % i Water Hosur - t4 99,000 BTU -`' x A u .4j.. i' R" c, 110.00 Ileator Nater Sof taner „ X 17.90 1 ' Nev Gro at. d• Raan Old Buildinq x u $ �� El4ccx1c Nater Heater - a = ' CAS FITTING FEES; t let a fixtures x J 0 . 2 JJditicaal fixtures -,_„rX •N 51,00 N .., 0 a h S l� ++ N Nu ' b N A lcn w ai as leo ,- • 17— s c d at eao d, (Ri - Future C4Maction Opening Connected with 54unr (-j - Nev T19turoo Old Opening Wgtut ' • PARTIAL RATE ,SCHEDULE PI.WMING, FIXTURE RITES; N0, RATE TOTAL, !!.�� FLxcutet • .._.._._-� X :x.00 $ lutura P!.xture Oponing •• $1,0o S^�� New Future, O1d'Oponing , ._..� x $9.00 5 ;scch Bisin' .� x $5,00 >{ i Water Hosur - t4 99,000 BTU -`' x $5..00 ; 1003001TU to 199,000 BTU x 110.00 S Nater Sof taner „ X 17.90 1 ' Nev Gro at. d• Raan Old Buildinq x $5.00 $ �� El4ccx1c Nater Heater - X $5,00 $ CAS FITTING FEES; let a fixtures x $7.00 9 JJditicaal fixtures -,_„rX 51,00 _ ,W a RAA98 to 199j000 BTU x $10.00 $ �- RF�AAI RS ' 4 A I L; A,A'f I Uri S rt rs t :100.00 each Acl. $100.00 or fraction S.taCo Surchargo • TOT)LL FEC 930b1Adgdre0sol -5603 Regis -Trail Department of Uuildingo ' '• City of Fridley I Tal. M571-1450 � � e I Tjh"undersigned hereby makgs application for A permit for t.hq w opgaified agruoing•to do 411 work in strict accordanco with Cho 0 and rulings at the OopartM04 of BuildLnge, and hereby docldrof t Cho fa0te and roprgountations stated in this appllcatlon are truc I Fridley, Ki, 1-13•-78 01411RR • TUNSU -- I KIND OP UUILDIIIG -�� frame I ' USED AS res. !M BE C014PLETED ABOUT �20-7b_, R PTIMATVQ COSH' 20:100 OLD - NUW UUILOIIIG PERMIT NO, PE IT 110. compaly AINN. EGASCQ Signed Dy' 1 Tol'. No. pupil INSP, • Onto ' rillkL Date ° APPROVAL FOR PERMIT $5.00 $1,00 $ MIIIIMUM PEt FOR NIY PLUMBING PERMIT 15 11.50 ' .50 8.00 ' SUBJECT O City of Fridley 2'. PAT THE TOP OF THE TWINS BUILDING PERMIT I T r O' 1 L COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 11/25/97 JOB ADDRESS 5603 Regis Trail NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 2 Parkview Oaks 1st Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Sand Adams 5603 Regis Trail NE 571-4917 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Z Roofing 1814 Quarry Rd St Cloud 1 320-654-1115 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20040160 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 Reroof House & Garage (21 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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. OWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 TALLS 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 $1,751 $.88 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT OT PRE UME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROW 10 OF NY OTHER STATE OR LOCAL LAW REGULATING CON- $56.75 Fire SC $1.75 STRU R T E PERF071MANCE OF CONSTRUCTION PLAN CHECK FEE TO AL FEE // 59.38 SIGNAT F CONTRACTOR OR AUTHORIZED AGENT IDATEI HEPR D T IS YQUU PERMIT_ MPALI OG INSP qA TE S,GNAT RE OF OW NER pF OWNER BUILDEpI IDATEI NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: -5^�00 -7;% - 4�rQ j S �' `4 i Legal Description: Owner IN Contract Address: Effective 1/1/97 U VIC? Tel. #1, / ^ �-j C(`� MN LICENSE # Tel. # of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EWPROVEMENT LIVING AREA: Length Width GARAGE AREA: Length Width DECK AREA: Length Width / r. OTHER: I Height Sq. Ft. Height Sq. Ft. Hgt/Ground Sq. Ft. Construction Type: Estimated Cost: $ 7 S�D (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 1' / APPLICANT: CITY USE ONLY Tel. # D Permit Fee $ 3 -Ko. 75' Fee Schedule on Reverse Side Fire Surcharge $ 1.76- .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $ C ,.. $5.00 (State Licensed Residential Contractors) Driveway Escrow $ t. "A" or Alt. "B" Above Erosion Control $ 50.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary, f ] TOTAL $ S , :3 9 STIPULATIONS: Building Inspections 763-572-3604 BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY DATE I� !T� YO E-MAIL ADDRESS SITE ADDRESS 5'6o:3 Qy;5 4 -fix; I r,,,A > Az THIS APPLICANT IS: 19 OWNER PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE TYPE OF WORK: IL ADDRESS CITY Bi' f STATE PHONE: Permit No.: Received By: Date Rec'd: NAME: STATE P( SINGLE FAMILY/NI ❑ TWO FAMILY/NEW ❑ ADDITION BASEMENT FINISH ❑ DECK • NEW ❑ MAINTENANCEIREPAIR DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING )iLVinyl ❑ Aluminum ❑ Other FAX ❑ ROOF SIDING SWIMMING U HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia EXP DATE 1" ,Aoo - T _ i ❑ DRAIN TILE ❑ OTHER HEIGHT Ft. BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS & PORCHES SUBMIT: 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 ❑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 $ G5X':�:'® I ®� OCCUPANCY TYPE V-13 Permit Fee See Back Page for Fee Schedule Plan Review $ e9k 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge Agreement necessary ( ) Non Necessary ( ) Total Due $4AN e Make checks payable to: Ci of FridleyAttach Sti IS PP ATION 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. '11 o SIGNATURE OF APPLICANT Building Inspections 7.63-572-3604 SITE ADDRESS _ t�, THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS A ADDRESS: 6 `f',2 ,�2 &1GG; ®R yLZIM PHONE: Z�a3r'5'7/= y2/-7 COMPANY NAME:.L CONTACT PERSON: STATE LICENSE #_ • . ' �i r,• 1 rFAX (SINGLE FAMILY ❑ TWO FAMILY 0 NEw O REPLACEMENT DETAILED DESCRIPTION OF WORK EXP DATE O TOWNHOUSE Y+AL.TERATI ON/REMODEL. Permit No.. Received By: Date Rec'd: ATEMi✓ZIP �S X32 PER MS 1613.665 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 labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 =cost of labor -x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES' (INDICATE TOTAL NUMBER OF EACH BELOW) MODEL: SIZEBTU Equipment Installed MFG: SIZE/BTU MFG: MODEL: SIZE/BTU MODEL: A1C $25.00 —FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 _AIR TO AIR EXCHANGEER $15 —FIREPLACE (WOOD) $35.00 AS NEW GAS GRILL $10.00 NIT HTR $10.00 BOILER $35.00 —FURNACE $35.00 —GBEER $3500 OFMONEY LINER $10.00 _GAS DRYER $10.00 _POOL HEAT o DUCT WORK $10.00 —GAS PIPING $10.00 VENTILATOR $15.00 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Number of fixtures @ $15.00 x $15.00 = $ Surcharge TOTAL DUE Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the 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 SIGNATURE OF APPLICANT City of Fridley Building Inspections Department . 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 ,TE REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC [] NEW HOMESIADDITIONS ] EXISTING HOME Ej MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or PropanoUGC Chapter 3 with MN Amendments 2, Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances 1FGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per 1MC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations Building PLUMBING PermitNo.:<z�)M6- L� �J Inspections RESIDENTIAL APPLICATION Received By: Rec'd: ' 763-572-3604 CITY OF FRIDLEY Date DATE - 7-6(42 YOUR E-MAIL ADDRESS �►ti� p' 1 k4 Cows. cros+. P SITE ADDRESS �, !v©3 1� eQ , 5 I f ' dley 5:�zl 3 7- R TIIIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR THIS PROPERTY NAME: OWNER/ ADDRESS:=. CITY 4 STATI ZIPSSS�32 TENANT PHONE: 7453--_'477 CONTRACTOR NAME: SUBMIT A COPY OF STATE LICENSE # (n P W` EXP DATE 2 aj STATEUIJIv`ZIP S� cf YOUR STATE ADDRESS: b i �9 �" L /v N L CITY rA LICENSE WITH PHONE ?63 aZSg' % I FAX %42 3 21O_,( APPLICATION PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK V siW AQw SjA 6 Wef° V eAl' ,-�— ue—L-u � 1" 1A0 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 labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor 650. x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV FLOOR DRAINS X SHOWER _ WATER PIPING _ BATHTUB GAS PIPING (nim tmuCEAMO _ SWIMMING POOL —WATER SOFTNER ($35) _ _ KITCHEN SINK —WATER CLOSET BACKFLOW PREY. ($15) CLOTHES WASHER ^ _ _ DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION _ _ WATER METER —OTHER . i ME Permit Fee. $ �_ . 00 Number of fixtures @ $10 00 x $10.00 = $ Surcharge .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 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 ofa ork which requires review and approval of plans.f� 1 PRINT NAME J O 1� u�ln 1 tAo%- DATE q -2 7 - B A SIGNATURE OF APPLICANT w9*0 WIN ME= r- RO City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977