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City of Fridley, Minn. BUILDING PERMIT Date: Oct. 31, 1967 Owner: Richard Schillinger Builder Address 6201 Trinity Drive Address X9 9531 Kermit A. Hill Const. 1566 Rhode Island No. LOCATION OF BUILDING No. 240 Street — Rice Creek Blvd part of Lot Lot 11 Block 4 Addition or Sub -Division _ Rice Creek Plaza North Addn. -3r-1 Corner Lot _ Inside Lot x Setback Sewer Elevation Sideyard Foundation Elevation DESCRIPTION OF BUILDING To be Used as: n' Diel l ing_ Front _7V V Depth __35 1. Height 30_ Sq. Ft. Cu. Ft Garage Front 23' Depth 25.6'Height 10, Sq. Ft. Cu. Ft. Type of Construction Frame Fst Cost _ 35,000.00 __ 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 com liance -th all provisions of ordinances of the city of Fridley. $100.00 Sewer Connection Charge In consideration of the payment of a fee of $ 72.00 , permit is hereby granted to Kermit Hill 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. CLARENCE BELISLE Building Spector NOTICE: 19ds permit does not cover the construction, instaMon for wiring, Plumbing, gas hoeing, sower or water. Be sure to we the Building Inspector for separate permits for these Rena. APPLICATION FOR BUILDING PERMIT - CITY OF FRe-:.EX, MINNESOTA OWNER'S NAME+ �2 BU.DER; I C S r l ADDRItt ' V //f_ .- 2:l / J' f �y/�rP• ..+.t i ! ' ' o*+�, �i5�� (/ / S i0CATIOM' OF- bU10196 a No. RT'O.UV �� BLOCK ADDITION OR SUBDIVISION LOT Ott n LOTS NSIDE SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates.of Survey of Lot and proposed buildfit� Iocat'iem draiari`•►n these` �Cer�ifitstes`' ` .. ," • : •� /13 F To be' UBed q O " . Sq. grant D�ptb, CO PHe ht P1.. Sq . Ft. ....A....�r� i...8+r.iw... .Cu p� • Type of Construction/` Estimateit Cost_# +ge) 0t o v /, r / arrr �w�li�w�..Fr.1► slP 6 To Be Completed _ 6_0 N i / -__ j,__1_Y 6 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. (Schedule of Fee Costs can be found on the Reyerse Side). l�® C, �, City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Locehon C�!® ��- Number, Kind and Location of Fixtures pp C-7 V2 I TOTAL Number Fixtures ......................el x $2.00 $ Future Fixture Opening Y Z $ ° Z 2v� p 2 x $1.50 c Z z • • N WATER HTR. GAS EIEC - Base $ J C� New Ground Run Old Bldg. ............ x $3.25 $ j Electric Water Heater z $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ e 1st x $ .75 $ Gas Range to 199,000 BTU .............. l $ 2nd 3rd 4th • Future Connection Openings Fixture, Old Openings Connected with 1Sewer E]New J spool E] PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ......................el x $2.00 $ Future Fixture Opening x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ... ........................ x $3.25 $ Water Heater (Up to . 99,000 BTU) ...... x $3.00 $ J C� New Ground Run Old Bldg. ............ x $3.25 $ Electric Water Heater z $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ e Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description .................. . . . . . . . ..........TOTAL FEE /6 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 •7:1, M- Kind of Building Used as mp To be completed about 3 4 Estimated Cost, $ ��� •® - Old New. uilding Permit No_ � Permit Noo..%� 4520 Signe Business Phone No :5T G G ROUGH FINAL 42 SUBJECT PE, -7 City of Fridley , AT THE TOP OF THE TWINS BUILDING PERMIT --M i � RECEIPT NO. te• COMMUNITY DEVELOPMENT DIV. e: -_�.__, 3 13`119 r � � PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 ,'j NUMBER REV GATE PAGE OF APPROVED By L J` 612-571-3450 910-F15 9/28/93 JOB ADDRESS 240 Rice Creek. Blvd NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 4 Rice Creek Plaza North Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Richard 5chillinger 240 Rice Creek Blvd NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Minnesota Exteriors 8600 Jefferson Hwy, Osseo S -E.-3% 493-8987 2877 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 ❑X REPAIR [3MOVE ❑ REMOVE S DESCRIBE WORK Reside Dwelling; add soffit & fascia 9 CHANGE OF USE FROM TO STIPULATIONS Provide adequate attic ventilation. Provide smoke detectors. as per UBC 1210 adjacent to all sleeping areas and in basement. r TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR. AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 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 VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $12(840 $6.42 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $144.00 Fire SC $12.84 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE License SC $5.00 $168.26 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WH PE ALIDATED THIS IS YOUR PERMIT BI DC> INSP DATE SIGNATURE OF OWNEROF OWNER BUILDER) IDATEI NEW [ ] ADEN [ ] ALTER] R-1 AND R-2 Building Permit Application Effective 1/1/91 • - _ - .. - �' �i - — VMS AttacWto this application, a Certificate of Survey of the lot, with the pr posed construction drawn on it to scale. LIM43 AMM: Length Width Height Sq. Ft. GRRAGE AREA: Length Width Height Sq. Ft. DEM AREA: Length Width Hgt/Gxmu-d Sq. Ft. OAR: Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Gbizstruction:P A,Estimated Cost: $ , Approx. Coupletion Date: ID Pzcposed Driveway Width If New opening Is Desired: Ft. $ $ Width + 6' See Ba c Page DATE: d APPLICAt�iI': _ 't,�-ems Tel. # � —kc?? Permit Fee $ r �✓ � Fire Surd=ge $ /cad - State Surd=Ve $ • I,G�L SAC Charge $ Driveway Escrow $ Park Fee CT6 Sewer Main Charge $ STIHI=CNS : QTY USE CINLY Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th �} $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Nary [ ] I SUBJECT City of Fridley 6 95 AT THE TOP OF THE TWINS BUILDING P E R M I T r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. ~ e �g r PROTECTIVE INSPECTION SEC. l a CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY �""'11•� �'d 612-571-3450 910415 11/19/97 � JOB ADDRESS 240 Rice Creek Blvd NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 4 Rice Creek Plaza North Addition SHEET 2 PROPERTY OWNER MAIL ADDRES$ ZIP PHONE Dick Schellinger 240 Rice Creek Blvd NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Ashlann Builders PO Box 421114, Plymouth MN 55442 531-0320 20062310 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION [j REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (38 Sq) Tear -off 8 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 OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3,169 $1.58 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- STRUCTI OR THE PERFORMANCE OF ONSTRUCTION $87.25 Fire SC $3.17 !�/License PLAN CHECK FEE TOTAL FEE SC $5.00 $97.00 SIGNATURE OF CONTRACTOR AUTHORIZED AGENT IDATEI HEN PROPERLY VA TED THIS IS YO R PERMIT -OLOG I p ryATE SIGNATURE OF OWNERUF OWNER BUILDERI IDATEI I ADDN [ ] CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 2 V,/) Z ",. �rrc/ Legal Description: Owner Name & Address: Contractor: L�1(14 Address: 4o. b . a, LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Tel. # Effective 1/1/97 —MN LICENSE # Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. LenNyidth Hgt/Ground Sq. Ft. Construction Type: /(• /b b Estimated Cost: $ v b • f n 11 za (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: – APPLICANT: �SG ��yti�1, Tel. # CITY SE ONLY Permit Fee $ Z Fee Schedule on Reverse Side Fire Surcharge $ l .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $950 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 3uilding $ AT- BUILDING Permit No.: Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION Received By: 763-572-3604 Fire Surcharge CITY OF FRIDLEY Date Rec'd: )ATE I. I " YOUR I, M41,L ADDRESS $5.00 (State Licensed Residential Contractors) nn t :ITE ADDRESS C 'r-1! Q A\u i ` �-4 $ $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ 'HIS APPLICANT IS: ❑ OWNER CONTRACTOR $ PROPERTY OWNER/ NAME; &. a $ ADDRESS: -a ©'t°�C� Y U CITY STA IP TENANT Agreement necessary ( ) Non Necessary ( ) PHONE: o`er " c -1M ` «—�d $ //W- / CONTRACTOR NAME; v\y" p 1 STATE LICENSE # �C. �� �� O�� EXP DATE LO '�p SUBMIT A COPY OF ADDRESS: 3S� v Ci' R k; � LTi' STA* YOUR STATE LICENSE WITH APPLICATION PHONE 3 - �52�� ��3 FAX � ' ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE PROPERTY TYPE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS BASEMENT FINISH ❑ DRAIN TILE [I� ❑ DECK SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: LQ�l7v�_ S SIZE OF IMPROVEMENT LENGTH TH HEIGHT ZSZSq. Ft. 200FING❑ HOUSE ONLY \TUMBER OF SQUARES �� MOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 3ARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan ?ROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used 'ROPOSED HEIGHT: >IDING �� FOR NEW CONSTRUCTION INCLUDING DECKS, :3 Vinyl ❑Soffit / ADDITIONS & PORCHES SUBMIT: 7 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 N EXISTING OPENINGS ❑Yes ONO LOCATION OF WINDOWS JR FOR NEW OPENINGS -DESCRIBE SIZE OF DPENING 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 $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $ (.0005) times the total job valuation - Minimum $.50 Fire Surcharge $ .001 x Permit Valuation (1/10%) License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ R + 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 $ //W- / 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 conformance with the ordinances and codes permit but only an application for a permwE plan in the case of all worktvkhiOl fWcFiro re SIGNATURE OF APPLICANT acknowledge that the information above is complete and accurate; that the work will be in the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a I work is not to start without a permit; th the rk will a IIl rdancewith the approved ew and approval of plans. BiAlding Inspections 763-572-3604 DATE_] f ~ M, — SITE ADDRESS THIS APPLICANT IS: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS OWNER ❑CONTRACTOR Permit No. Received By: Date Rec'd: PROPERTY OWNER/o; �, f r .NAME: ADDRESS: i24r2 i e 1 Ce �tl'� �1 �� CITY /' / A 1E' 0 STATF.i�%�LIP��S�-Z— TENANT PHONE: CONTRACTOR NAME; STATE LICENSE #_ EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: -CITY STATE ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE %IDECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: PIEW❑ ADDITION ❑ Jv AINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE:_, SIZE OF lIv1PROVEMENT .9.7 `lair NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other WINDOWS IN EXISTING OPENINGS ❑Yes ONO OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED a - C1 P of bdeLIe LENGTH WIDTH HEIGHT v Sq. Ft. ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia LOCATION OF WINDOWS 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: 1. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 'Y 7 �t /, 3LO OCCUPANCY TYPE Permit Fee Plan Review Surcharge Fire Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $�°' See Back Page for Fee Schedule $ ` a . 3 1 65% of Building Permit Fee $ �J . 7 (.0005) times the total job valuation — Minimum $.50 $ .001 x Permit Valuation (1/10%) $ $5.00 (State Licensed Residential Contractors) $ $1450 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$20=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) S n-1 Make checks Davable 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 whi requiresAeview an pr val f plans. SIGNATURE OF APPLICANT /tee T NAME 1�1 f� V e DATE Building PLUMBING Permit No.: )_00 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604CITY OF FRIDLEY Date Rec'd: 7 b DATE B `�-ri 'r - �� YOUR E-MAIL ADDRESS SITE ADDRESS ��i /Ice e'fe__ THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME; OWNER/ ADDRESS: CITY ��� STATF�GIP'yi,� TENANT PHONE: Z4a3 J 74(—A�/D CONTRACTOR NAME; SUBMIT A COPY OF STATE LICENSE # i2 _4VdP EXP DATE %a -3)- C CITY TATE YOUR STATE ADDRESS: - LICENSE WITH PHONE FAX APPLICATION PERmrr TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW REPLACEMENT DETAILED DESCRIPTION OF WORK re -IOM" LLQ �:h� 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 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 —SHOWER _WATER PIPING _ GAS PIPING (x� =uc&vA _ SWIMMING POOL _ WATER SOFTNER ($35) —BATHTUB CLOTHES WASHER `_ KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREV. ($15) _ DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION WATER METER —OTHER 1 .} 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 of all work whiQh requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME DATE I r �': IN_ _ City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 t -f- vo /o!o< Building 5i BUILDING See Back Page for Fee Schedule Pen -nit 1Vo.: Inspections RESIDENTIAL .APPLICATION Fire Surcharge Received I3y: r4n 763-572-3604 .001 times the total job valuation CITE' OF FREDLEY $ Da.MdAUG T� .0005 x Permit Valuation Minimum $.50 YO 4>r -MAI A131)KFSS $ SITE ADDREss $5.00 (State Licensed Residential Contractors) SAC Charge THIS APPLICANT 15; _ ❑ OWNER )`CONTRACTOR _ PROPER'1"it OWNERI NAME:—I? c `tr,n►I eAr- 4 TENANT / ADDRESS; 1 e- 'fi rKIM GIT'Y,. !i j� � `i'� A'I'h JPi� } FIIONE:. _. 769 "" �r%7 � la �® .— NAME; Window Concepts of MN, Inc. .... _4 l a rg) ......r ,, o.^ CONTRACTOR fiOJP1MIT A CVPY OF STATE LiC:FNSE 990 Lone Oak Road Suite 114 �,V—q S - ®/ S YOUR STATE LICENSE ADDRESS:. _ Eagan, Minnesota 55121 _.TTY w _STATE ZIP _. WITH APPLICATION p� PHONE License # 20163493 ' Make Checks payable to: City of Findley Attach Stipulations PROPERTY TYPE NGLE FAM II -- d Two FAMILY) www.windowconceeptsnm.com ❑ ADDII'I()N Q GARAG53IIEDWINDOWS PERMIT TYPE 17 SA,SEMEidT FINISH 11 ROOF ❑ DRAIN TILP. 13 DECX C3 SIDING ❑ (YrHFR ❑ SWIMMING; PC)VL TYPE OF WORK: 0 NEW ❑ —AD-5—ITTONN 0 MAINTENANC WK"AIR til REMODELING DESCRIBF WORK BFING DONE: % SIZE OF IMPROVEMENT LHNG I'H WWII HIrIGHT Sq. Pt. ROOFING ❑ HOUSE ONLY NUMBM OF SQUARES _ ❑ HOUSE & (3AKAGE !J,6.5 -hM1 REMODELING SIJTJhdlT: GAUGES A ATTAC-H131) GARAGE 1, Existing Floor Plan PRCPOSED Sly: IR OPOSED HEIGHT: ❑ DF.TACNET) GARAGE 2. 3. Pruposed floor plan List of sin4urul membcts to be used MINING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Ytnyl ❑Sonia ADDITIONS. & ?08L-PJE SSS UBI��II'r: M Aluminum O Trim 1. Situ PIaWSurvey ahowin r the existing suvonu�s C3 Other ❑fascia s+nd proposed project. WINDOwb 2. Two scts of construction plans 1N lrX1STL4G OP9'NINGS Vary ❑Ivo ? WIS11,1:)wS OR FOR NEW OPENINGS sCRmF sim OF 7 3, Energy Galculatiorn OPENING CI4AMES & _ TYPE OF W1NIX)W TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, LNCLUDITIG TF1 G COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FtE SCHEDULE) JOB VALiL A-FlUN $ OCCUPANCY TYPE rermn i"ee 5i yam/ See Back Page for Fee Schedule Plan Review 550/a of Building Permit Farr Fire Surcharge $<© .001 times the total job valuation Salydtarge $ ), j� T� .0005 x Permit Valuation Minimum $.50 License Surcharge $ 5.0 D $5.00 (State Licensed Residential Contractors) SAC Charge _ $1550 per SAC Unit (Platys to MWCC for determination) Curb Cwt I?gcrow $ fl +6 ft= fix $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 Findley Attach Stipulations THIS IS AN APPLICATION FOR A PERMf'r-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 cosies of the City of Fridley and with the Minnesota Construction Codes; that 1 understand this is not a permit but only an application for a pertnit and work is not to start without a perntit; that the work will be in accordance with the approved plan in the case ofalI work whicl requires review and approval of plans. SXINATURE OP A1,112LICAN'r PRINT NAME eA�i_a � `(c ,dA' DATt 0 6/0 7�� Vd W1Jz2:tiT 90OF so °Urf �19Z1:ti=L: 'CIN XbA Fia1•p "A JC h-�to: woI u Building MECHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION Rece' y: 763-572-3604 JuffffTzo CITY OF FRIDLEY Date ec. 763-502-4977 FAX EFFECTIVE 2-19-09 DATE D'1 YOURE-MAILEr-/MAIL ADDRESS SITE ADDRESS Zy ® k � e— COOK 8 Ly THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: OWNER/ ADDRESS: Zi Lfb Ce LIAO CITY STATEPAkIP�Lf TENANT PHONE: b CONTRACTOR COMPANY NAMEL 1 SUBMIT A COPY OF CONTACT PERSON: 1394&f YOUR STATE STATE LICENSE # DATE LICENSE WITH ,,//EXP ADDRESS: � ( UJ`t�A Ic CITY STATiI�AfZIP_� APPLICATION PHONE 7C,?--a-7,Z- T76b PERMIT TYPE INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW PLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL T,O�TAL NUMBER OF EACH BELOW) Equipment Installed MFG: L� k K MODEL: )C��-teaa- �1 �- Q SIZEBTU ,tet ' �1d,Zj g MFG: -� MODEL: �L J V n V �6r1 `a?�`L$IZE/BTU C MFG: MODEL: SIZEBTU A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGEIOVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 GAS GRILL $10.00 _NEW _BOILER $35.00 _ URNACE $35.00 ^GAS UNIT HTR $10.00 CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 _DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 vo a � Vii` S �"'4 ��,:�� � �; � 'k .�8 •'yF�1 ? . S�i �� St`2 ±' � T. � F ` ✓ �, � � ��'€,�`",�S b�� � '.. '. i �,5 � � is d � _. �, �' Y _ i tz S 5 �� � �"s✓� l '� R3 �� � S n`i Vii" ��T'°q�{x� Y�R'1� �z�'��a �`�%4 1Y �� �.� ��T .� .. Aj 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 applicatio or a pelTrli w kis not to start without a permit; that the work will be in accordance with the approved plan in the case of all w Whic quire iew and approval of plans. n� , / / SIGNATURE (321 * �1� S ®F" tO OF APPLICANT PRINT NAME I DATE it x, City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW *REPLACEMENT DETAILED DESCRIPTION OF WORK K r ✓)& G 1', /cf s" c- 5e f V n l G •�— FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. BuildingZ.,Z;�.� PLUMBING DRAINS Permit No.: o --&Y) WATER PIPING _ _FLOOR GAS PIPING (NEED CITY LIC) —SHOWER SWIMMING POOL Z WATER SOFTNER ($35) Inspections _ _ KITCHEN SINK RESIDENTIAL APPLICATION Received By: 763-572-3604 _ LAUNDRY TRAY CITY OF FRWLEY FOR IRRIGATION Date Rec'd: 763-502-3604 FAX WATER METER OTHER EFFECTIVE 2-19-09 A� DATE1 Ala./ (0 YOUR E-MAIL %DRESS�OS� /+9Cga.ti {f ✓! f'r fv tpayi SITE ADD�0 9C..rpC % 6(, �l ~ THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: SNATADDRESS: � - e CITY- STATIV �A PHONE: ! 6 ,1- § 72 ^ Ion VQ CONTRACTOR NAME: SUBIVIIT A COPY OF YOUR STATE STATE LICENSE # S -- EXP DATE 1-2 " ?/ LICENSE, BOND AND STATE BOND # "p� F ®163 r EXP DATE /,1 CERTIFICATE OF ADDRE SS:LY.2Y S'� S6 /Iii CITY -//,Kq� STATE&141 i�.g INSURANCE PHONE %j ct. e-, S FAX PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW *REPLACEMENT DETAILED DESCRIPTION OF WORK K r ✓)& G 1', /cf s" c- 5e f V n l G •�— FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. BATH SINK/LAV DRAINS WATER PIPING _ _FLOOR GAS PIPING (NEED CITY LIC) —SHOWER SWIMMING POOL Z WATER SOFTNER ($35) —BATHTUB _ CLOTHES WASHER _ _ KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREV. ($15) —DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER THIS IS AN APPLICATION FOR A PERMrF-NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case f all work which requires review and approval of of plans. SIGNATURE OF APPLIC - � PRINT NAMF. -f City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-5024977 Building PLUMBING Permit No.: O 11-31 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Dat"'dilli 763-502-4977 FAX EFFECTIVE 7-1-2010 DATE I Q E-MAIL ADDRESS c (Y1OUR SITE ADDRESS a°Z ' xc,_ C� `a,\, GG4_-'. THIS APPLICANT IS: ❑ OWNER 5kEONTRACTOR PROPERTY NAME:!z:J',(__a OWNER/ TENANT t� ADDRESS `"\AC> , � �`y,� -CITY�f,d STAT0-1d ZIP�a PHONE: CONTRACTOR SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS;ky\a\k 2`LS1c ice- CITY�Ap\S STATEMN ZIP.65` I\ INSURANCE PHONEEly3-i� � "lo Ud! FAX PERAM TYPE KSINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW .REPLACEMENT DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. _ BATH SIN)ULAV FLOOR DRAINS SHOWER 1 WATER PIPING _ GAS PIPING (NEED CITY LIC) SWIMMING POOL WATER SOFTNER ($35) —BATHTUB _ _ _ WASHER KITCHEN SINK CLOSET _ BACKFLOW PREV. ($15) _CLOTHES _ —WATER LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION —DISHWASHER _ A_ WATER METER Va\_ —OTHER §*4 , F,. '• tf., � ti" ``''�' �A �`�`��" �d� 5� 3"X"f+ iii ll "il �s F '"t'5.�`}� y�`�,4 �"` cbi � -� j 4"'�1 x Y 4 .. tri �, K _ �` � � �' � ���S � �� '.� h� h �.�� �% '/'� � �`l .�"7 7 W✓� 'rh�"� �2 � '�lYl i �`.A i � s THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an a�cationfor mit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in which requires review and apprgvalo plans. e ' 1$ SIGNATURE OF APPLICANT PRINT NAMES Q: r—ga DATE APPROVAL INSPECTORS SIG A City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977