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PRE 2010 DOCSCity f Fridley, Mm. BUILDING PERMIT N® 6434 73 Date: W" JF / ; Owner:' - Builder Address Address ® ® IL®ING No. Street F Part Lot _ _ __ 81ock ____ Addition or Sub -Division Corner Lot ._ Inside Lot � � Setback _.. - Sideyard Sewer Elevation Foundation Elevation t DESCRIPTION OF BUILDING In consideration of the issuance to me of a permit to construct a ding described a ve, I a oy the proposed work in accordance with the description above set fo in compliance o ordinances of the city of Fridley. 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, employees and workmen, fn all work done in, around and upon said building, or any part Thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regardinng location, construction, alteration, maintenance, repair and moving of buildings within the city ]units and this permit may be revoked at any time upon violation of any of the provisions of said ordinances Building Inspector NOTICE: M permh don not cover the construction, hntaMan for wiring, plumbing, gas headag, sewer or water. Be am to we the BWldiq ftMw for for separate permbs for these hems. City of Fridley Application for Plumbing and Cas Fitting Permit �p Dept. of Bldgs. Phone SII 4-7470 (� DESCRIPTION OF WORK -ex 4 � % C" -e P Number, Kind and Location of Fixtures Location �1 47 NO. RATE TOTAL_ Number Fixtures ...................... x $1.50 Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 U' Z �UO R - • N WATER HTR. GAS ELEC. Base GAS FITTING FEES: NO. RATE TOTAL 6 1st 3 Fixtures ..........................___zx $1.50 $ . e Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ 1st 2nd 3rd 4th • Future Connection Openings New Fixture, Old Openings I Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL_ 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 $ —1 a New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 6 1st 3 Fixtures ..........................___zx $1.50 $ . e Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ............................................... TOTAL 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 feel and representations stated in this application are true and correct. Fridley, Minn %� 6- ! " 19�-*-- Owner � � - � � en ! � e Kind of Building Used as To be completed about ��1 9•^7 Gj d Estimated Cost, $ Old—New. Building Permit No Permit No. �'J Signe By Business Phone No i ROUGH FINAL 4 2 2A: Application for Power Plants and Hearing, Cooling, Ventilation, ReMgeratlon and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY 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 $�_r 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 $ nP Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 8.00 $ i 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 $ S GAS FITTING FEES: NO RATE TOTAL - 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL Dept. of Bldgs. Phone SU 4-7470 Location 4l� l C e �� e e 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, A&inn �� le, 3 19 Owner Kind of Building Used as _ To be completed about Estimated Cost, Old—New. Building Permit No. Permit No. r..>_ Q DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No Trade N Size No Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fuel BURNER —Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS—OVER) l r Signe By 42 2M Business Phone No HEAT LOSS CALCULATIONS BURMAN COMPANY Weatherstrips A G Construction No. Insulation Windows � Doors Reference 'Out. Wall Int. Wall Ceiluag Roof Floor Kind How Applied Yes—No Yes—No 1 19_ 11 F1.1 p Room Length p oIidth Height f j' j F1.I boom Length Width Height clo , Bund Doors—Crackage and Area 14t Height No. of Lineal ft. Area No. pane , of pane lights of crack sq. ft.-' !of I—AV IS /0 C Width Height I No. of Lineal ft. Area No. of pane of pane ,_ ligphts of crack sq. ft. ? P6 Height of pane I No. of Lineal ft.. Area lights of crack sq: it. Coef. Btu Infiltration ¢ p _I q 0 o Bass Exp. wall Net exp. wall Int. wall i 0 0 Floor I'1 d Ceil. Glass Exp. wall 1 otal situ. I Required sq. ft. E.D.R. or sq. ins. WA. Leader area FlJff?,w,,r, AFa^ Room I Length ®,, /i Width % A Height r Windows and Doors--Crackage and Area �v, ®; i V Width Height I No. of Lineal ft. Area No. of pane of pane ,_ ligphts of crack sq. ft. ? P6 Height of pane I No. of Lineal ft.. Area lights of crack sq: it. Width Height No. of Lineal ft. Area bio. of pane ofene lights of crack sq. ft. coet.1 Coef. Btu Inftltrati g Exp. wall J?6 Glass Exp. wall Jd ® fdo Net exp. wall Exp. wall Yq I Floorlz Int. wall InfiltratiQ� Ceil.` _ Floor Total Btu. 1 2 , a� Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Ceil. 1 otal Btu. 1 Wla Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / F1.I ,,.,,o�.,Room I Length P Width i Height V Windows and oors—Crackage and 4rea �v, ®; i V Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. ? P6 Height of pane I No. of Lineal ft.. Area lights of crack sq: it. Width Height No. of Lineal ft. Area bio. of pane ofene lights of crack sq. ft. coet.1 Btu Infiltrationove Glass � Inf Itratidn ; Exp. wall J?6 Glass Exp. wall Net exp. wall Glass Int. wall Exp. wall Yq I Floorlz Btu InfiltratiQ� Ceil.` _ Floor Total Btu. 1 2 , a� Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Ceil. Windows and, Doors—Crackage and Area . 4e T 9 r !� Width No. of pane Height of pane I No. of Lineal ft.. Area lights of crack sq: it. Width Height No. of Lineal ft. Area bio. of pane ofene lights of crack sq. ft. 3 3 Btu Inf Itratidn Coef.1 Btu J?6 Glass Exp. wall d Glass Net exp. will Exp. wall Yq I Coef. Btu InfiltratiQ� _ Floor ��a Class F Ceil. Exp. wall T Net exp. wallz".01 Floor Ceil. ® �� Total Btu. ZL6 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I FI_I A,," , :,. ,,Room I Length i Width 941,E Height V Windows and Doors—Crackage and Area 4e T 9 r !� Width Height No. of Lineal ft Area No. of pane of pane lights of crack I eq. ft. is d PJ � IL Width Height No. of Lineal ft. Area bio. of pane ofene lights of crack sq. ft. Coef. Btu Inf Itratidn Coef.1 Btu Infiltration Glass Exp. wall vol 0 Glass Net exp. will Exp. wall Yq I lof' ,& Int. wall Floor Floor Or refs F Ceil. Total Btu. dzo i Required sq. ft. E.D.R. or sq. ins. W.A. Leader area T1.I . Room,l Length LLrl Width Height 1 Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area bio. of pane ofene lights of crack sq. ft. Coef.1 Btu Infiltration 1 3sr vol 0 Glass a"& I Z, ' " 0 Exp. wall Z Net exp.:wall Floor Or refs F ?,o, Total Btu. Required sq. ft. E.D.R., or sq. ins. W.A. Leader area HEAT LOSS CALCULATIONS Weatherstrips A.S.H.V.E. Construction No. Guide Windows Doors Reference ' Out. Wall lInt.Wall I Ceiling Roof Yes—No I Yes—NO 19. / Fl.1 A �� ..s Room l Lenath t®i/, Width U Height 11 A F1.1 Winch -and Doors—Crackage and Area �� /- y Width Height No. of Lineal ft. Area No. of pane oY pane lights of crack sq. ft. W h Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 11-51,16, Net exp. wall Coef.1 Coef. Btu Coef. Btu Infiltration Glass d 0/0 Glass � 15rif Net exp, wall Exp. waR .� Int. wall Net exp. wall Floor �f z e c Int. wall Int. wall Floor Floor Ceil. Ceil. Windows and Doors—Crackage and Area.. �� /- y Width Height No. of Lineal ft. Area No. of pane oY pane lights of crack sq. ft. C� ® 2 k Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 11-51,16, Net exp. wall Coef.1 Coef. Btu Infiltrati� ' .®-- "jam ac) Glass d Exp. wall � , � Net exp, wall 131 .� Int. wall �.� Floor �f Ceil. Int. wall Total Btu. " Required sq. ft. E.D.R.-or sq. ins. WA. Leader area / Fl.1 /1/,/ A i'w. Room I Length Width l I Height Windows and Doors—Crackage and Area �� /- y Width Height No. of Lineal ft. Area 6 No. of pane of pane lights of crack sq. ft. C� ® 2 k Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 11-51,16, Net exp. wall Coef.1 Btu Infiltration Glass Exp. wall Net exp. wall Int. wall 3 "jam ac) Floor 13 e) &I Ceil. 4 w � , � Total Btu. 131 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area BURMAN COMPANY Insulation Floor rind, How Applied Windows and Doors—Crackage and Area ...-.-.-o.-- Doors--Crackage and Area Width Height No. of Lineal ft Area No. of pane ofpanelights of crack 6c1: ft. C� ® 2 k Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 11-51,16, Net exp. wall f/- 0 Coef. Btu Infiltration' 3 "jam ac) Glass 13 e) &I Exp. wall 'Wass Net exp. wall.,Q re 131 LZi C �.� Floor .. _.. Total Btu. I ZVOIZ Required sq. #t. E.D.R. or sq. ins. W.A. Leader area s9 z1 i j4--1 . n__— IT __..,L Z W -1.l. t 4Ie:..l.► i iz ,. i Windows ad ...-.-.-o.-- Doors--Crackage and Area Infiltration ® 6 r Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 11-51,16, Net exp. wall f/- 0 Int. wall v� Coef. Btu Infiltratidn Total Btu./ 71 v 'Wass ,06 Exp. wall Net exp. will ' ,0 Int. wall Floor Ceil. Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.j eri f Room l Length j' Width Height'°' Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area J No. of pane of„pane lights of Crack aq. &. Coef.1 Btu Infiltration ® O Glass Exp. wall, 11-51,16, Net exp. wall f/- 0 Int. wall v� Floor Ceil: ted, Total Btu./ zlaa Required sq. ft. E.D.R., or sq. ins. W.A. Leader area s HEAT LOSS CALCULATIONS BURMAN COMPANY Weatherstrips A.S.H.V.E. � Guide. Construction No. Insulation Windows Doors Reference 'Out. Wall Int. Wall Ceiling Roof Floor Itlnd How Applied Yes—No I Yes—NO 1 19_ A F1.1 0,ae,j4 Room l Length 1.4"Width // Height -7Y-z,# F1.1 Room I Length Width Height Wind nd Doors—Crackage and Area Width Height No. of Lineal ft Area No. of pane of pane lights of crack eq. ft. Ile C e W th Height No. of Lineal ft. Area No. of pane of pane lights of crack sq, ft. 2 Coef. Btu Infiltration Cocf. Btu Infiltration Coef.1 00 114(c Glass a in Glass D dio Exp. wall Net exp. wall Exp. wall Z,,A Int. wall 7 ,O a Int. wall Floor Ceil. Floor �i 6 Total Btu. �i Required sq. ft. E.D.R. or sq. ins. WA. Leader area M.I L za tim 004,Room I Length Lhr Width i -7 Height -7 Windows and oors—Crackage and Area Width Height No. of Lineal ft Area No. of pane of pane lights of crack eq. ft. No. Width Height No. of Lineal ft. Area of pane of pane lights of crack a,. ft. Q9 6 i Av Coef. Btu Infiltration Glass Glass Coef.1 Btu Infiltrate Int. wall a in Glass D dio I ' A Exp. wall Net exp. wall r t a o 7 ,O a Int. wall Floor Required sq..ft. E.D.R. or sq. ins. W.A. Leader area Wil. 0, Total Btu. a Required sq. ft. E.D.R. or sq. ins. W.A. Leader area -- - F1.1 Roam I I aPnath Width 14eight Windows and Doors—Crackage and Area Width Height No. of Lineal ft Area No. of pane of pane lights of crack eq. ft. Coef. Btu Infiltration Glass Glass Net exp. wall Exp. wall Int. wall Net exp. wall Ceil. , Int. wall Floor Ceil. Total Btu. Required sq..ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Cracka--e 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 Floor Ceil. , Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI -I Rnnm I Length Width Height ' Windows and Doors—Crackagn 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 Floor Ceil. Total Btu, Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Height Windows and Doors—Crackage and Area Infiltration Glass Exp. wall Net exp. wall Int. wall Floor Ceil: Total Btu. Required sq. ft. E.D.R., or sq. ins. W.A. Leader area Btu 01 SUBJECT P 20474 City of Fridley AT THE TOP OF THE TWINS BUILDING P E R M I T LLii RECEIPT NO. _ COMMUNITY DEVELOPMENT DIV. v PROTECTIVE INSPECTION SEC. � I CITY HALL FRIDLEY 55432 REV DATE PAGE OF APPROVED By j 612-571-3450 rNUMBER -F15 7/12/90 JOB ADDRESS 286 Rice Creek Boulevard N.E. I LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 2 4 Rice Creek Plaza North. Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Wayne Resemius 286 Rice Creek Blvd N.E, 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Ron Conrad Construction Co. 5913 Pleasant Avenue South, .N! ls. 55419 866-3577 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 Z ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct a 211 x 61 Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notationson plan. WARNING Before digging call for all utility locations 454-0002 REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. 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 NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $15,000 $7.50 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- $162.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $169.50 SIG UR FC 1TRACTOR0 UTHORIZ' GENT tDATEI WHEN ROPER Y(A(IMTED IS YOUR PERMIT q G WSP GATE SiGNATU OWNERU OWNER BUILDERI IDAT I 01 NEW [ ] Effective 1/1/90 ADDN [ ] 1-1 AND R-2 ALTER [ ] Building Permit Application Construction Address: 28.9 Legal Description: Owner Name & Address: (it/'a ��-i�/°els Tel. # Contractor: rryc�✓t �nr1` ° - Tel. # 6�A-z Address:/� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. F F =cN OF nwtwamm LIVIM AMM: Iength Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length o"7 (� Width H#/Ground 7' Sq. Ft. OTMM: Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: Approx. Cmipletion Date: F _ V -9y Proposed Driveway Width If NewOpening Is ired: Ft. $ $ dth 6' See Back Page DATE: j,, APPLICANT: Tel. # Permit Fee $ 00 State Surcharge $_ . SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Marge $ CITY USE ONLY Fee Schedule on Reverse Side $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] TOTAL 9 STIPULATIONS: CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUNGING FIXTURE RATES: NO. RATE N New Fixtures 3 i. IA Future Fixtures 4 $ 3.50 U Old Opening, New Fixture K N °, $ Water AI u� a slow off Basin $ 5.00 N F c 4 H Q S u p, w $ Hydraulic Valve Heater $ 5.00 S Sump or Receiving Tank _ S 5.00 S Water Treating Appliance YC $ 7.00 $ Not water Heater R � $ Gas Range $ 10.00 $ Gas Dryer ~ 0 $ Back Flow Preventer Required. . . Yes ( ) No Y C A� O p O N Nq ai W W ui 4 u a State Surcharge ni ao�y A of w u 4 3� FEE $ 5 o as lec vsi oa o0 3t w° as t� 1 1 1 1st 2nd 3rd 4th (R) - Future Connection opening Connected with Sewer (•) - New Fixture, Old Opening Water RATE SCHEDULE PLUNGING FIXTURE RATES: NO. RATE TOTAL New Fixtures 3 $ 5.00 $ 15.00 Future Fixtures $ 3.50 $ Old Opening, New Fixture $ 1.50 $ Beer Dispenser S 4.00 S slow off Basin $ 5.00 $ Catch Basin $ 5.00 S Rain Water Leader $ 5.00 $ Hydraulic Valve $ 5.00 S Sump or Receiving Tank _ S 5.00 S Water Treating Appliance $ 7.00 $ Not water Heater $ 5.00 $ Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ Back Flow Preventer Required. . . Yes ( ) No ( ) Type $ 5. UO $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance $ State Surcharge $ .50 Reinspection Fee $ ($15.00) TOTAL FEE $ 5 Effective May 1, 1990. Job Address 286 Rice Creek Blvd. Department of Buildings City of Fridley Tel. 0571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. July 19 1990 OWNER Ron Conrad Consttuction KIND OF BUILDING Residential - Single Family USED AS Residence TO BE COMPLETED ABOUT 8/3/90 ESTIMATED COST 800.00 OLD - NEW BUILDING PERMIT NO. PERMIT NO. Company Richfield Plumbing Co. Signed By Tel. No. ROUGH INSP. _ Date FINAL INSP. _ Date APPROVAL FOR PERMIT !1INIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE S.50 STATE SURCHARGE SUBJECT NO. City of Fridley 5 5 3 0 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. i COMMUNITY DEVELOPMENT DIV. <: ______ PROTECTIVE INSPECTION SEC. #q7/ r -I NUMBER REV DATE PAGE OF APPROVED BY `-_-_ "';•� CITY HALL FRIDLEY 55432 L J\ 612-571-3450 910-F15 9/19/97 10B ADDRESS 286 Rice Creek Blvd 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 4 Rice Creek Plaza North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mel/Deb Smyre 286 Rice Creek Blvd. NE 571-8377 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Panelcraft of MN 3118 Snelling Ave S, Mpls., MN 55406 721-6628 2179 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 O ADDITION ❑ ALTERATION] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Soffit/Fascia 8 CHANGE OF USE FROM TO STIPULATIONS Install soffit ventilation to meet 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 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 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 $3,100 $1.55 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- $87.25 Fire SC $3.10 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC $5.00 $96.90 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT tOATEI WHEN PROPERLY V BLDG tSP DATED THIS IS YO R/nnPERMIT GF7ATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI `� NEW I I Wlective 1/1/94 ADDN I I CITY OF FRIDLEY ALTER I4t� SINGLE FAMILY AND DUPLEXES R-1 AND It -2 � a� Building Permit Application Construction Address: ®'6 Legal Description: Owner Name & Address:CtP C' Tel. // Contractor: AQ\ MN LICENSE # Address: aww.�.�; ,; i1n ` qcko Tel. # l D LIVING AREA: GARAGE AREA: DECK AREA: OTHER: '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 Sq. Ft. Sq. Ft.- Sq. t.Sq. Ft. Corner Lot j ] Inside Lot Ft. Yd Setback Side Yard Setbacks Type of Construction: ��, °� `�<< Estimated Cost: $ 2j, ICU Approx. Completion Date: (Cost on Back) Driveway Curt) Cut Width Needed: Ft. + G Ft = Ft x $ _ _ $ _ DATE: 'OD�r APPLICANT: Q 41- Tel. # CITY USE ONLY Permit Fee $ GG►► Fee Schedule on Reverse Side Fire Surcharge $_ .001 of Permit Valuation (1/1001%) State Surcharge $—�— — $.50/$1,000 Valuation SAC Charge $ _ $800 per SAC Unit License Surcharge $_ 0 0 $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 I I Not. Necessary TOTAL STIPULATIONS: a / SUBJECT ER City ®f Fridley 27 69 2 AT THE TOP OF THE TWINS BUILDING PERMIT NO. COMMUNITY DEVELOPMENT DIV. __ __ ------ I e PROTECTIVE INSPECTION SEC. r I., � 1 � I NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 ' 612-571-3450 910-FIS 9/10/98 JOB ADDRESS 286 Rice Creek Blvd 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 4 1 Rice Creek Plaza, North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Deborah Sm re Same 571-8377 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Town & Country Roofing 9403 Minnesota Ln Maple Grove 55369 2RU545-4233 20091282 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ® REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house & garage (25SQ) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST, OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 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 1 HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2,142.00 Y' $1.07 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- $74.75 Fire C $2.14 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PIAN CHECK FEE TOTAL F E d License RC $5.0 $82.96 SIGNATURE OF CONTRACTOR OR AUTH RIZED AGENT IDATEI P PER I BLD INSP ATEW IS PERMIT 11GATE S,GNATU RE OF OWNERIIF OWNER BUILDERI IDATEI a / AUG -13-19% 08:42 FROM CITY OF FRIDLEY - TO -- 8589320 P.01/02 CAMUVO a liya ADDN [ ] CITY OF FRIDLEY '�- ALTER [ 1 SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING FERbUT APPLICATION ConsmuctionAddress:...... L _� Lo ®� r, Ixgal Description: Owner Name & Address: <!;N i A A e 1 Tel. # Con. , ► ,: no i Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCREMON' OF DoIFROVEMENT LIVING AREA: Length __ Width Height � Sq. Ft. GARAGE AREA: Length _ Width _ Height Sq. FL DECK AREA: Length _ Width HgtlGround Sq. Ft. OTHER: Construction Type:-- Estimated Co.: $ �� (Fee Schedule on Back) Driveway Curb Cut Width Needed: —FL + 6 Ft = _Ft x $ = S DATE: ' f APPLICANT: A j Tell CITY USE ONLY �S Permit Fee $ �oIS7 Fee Schedule on Reverse Side Fire Surdwge $ 141 .001 of permit Valuation (1/loth%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ S,00 $5.00 (State Licensed Residential Contractor,) 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 [ J TOTAL. $ -)F % STIPULATIONS: CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 1999 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES %I Ya $ JOB ADDRESSLMIL (P #� �C �`�e RATE SCHEDULE Residential Furnace Shell and Duct Work, Bumer - Also Replacement Furnace (Side Vent -Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *4 Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work Commercial/industrial 1.25% of Value of Appliance or Work The undersigned hereby makes application for a permit for the work herein Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and rulings of the Building Division, and hereby declares that all the facts and $ 30.00 $ representations stated in this application are true and correct $10.00 $ OWNER / SA11 �4 i �- $10.00 $ ' BUILDING USED AS 51 -e45 -P- $10.00 $ ESTIMATED COST '1-7 PERMIT NO. $ 25.00 $ d P-6 DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR $ Fuel Total Connected Load State Surcharge $ .50 TOTAL FEE $ A S S-0 MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Burner Trade Name BTU HP Size No. EDR HEATING COMPANY C CL e� Signed By Tel No. Approved By Rough -In Date Final Date Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CBIVMY AND STACK VERIFICATION The undersigned. hereby verifies that the existing chimney or stack: L Has been carefully examined Yes () No ( ) Y 2. Is free from rust or deterioration Yes () No (. ) 3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes () No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 August 9, 2000 Mel Smyre 286 Rice Creek Blvd NE Fridley, MN 55432 Re: Final Inspection at 286 Rice Creek Blvd. NE Contractor: American Heating and Air Supply Dear Mr. Smyre: A mechanical permit was issued on June 21, 1999 for the property located at 286 Rice Creek Blvd. NE for an air conditioning unit. According to Section 305(a) of the 1991 Uniform Mechanical Code a final inspection shall be performed on the mechanical system. As of this date no inspection has been called for. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, we will expire the permit and any inspections on this installation will require a new permit. Any questions can be addressed to myself at (763) 572-3603. Sincerely, SUBJECT N City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT 31675 r ______ COMMUNITY DEVELOPMENT DIY. 7724 R r PROTECTIVE INSPECTION SEC. 1 . � NUMBER NEv DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 L 612-571-3450 910415 3/12/01 JOB ADDRESS 286 Rice Creek Blvd NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 4 Rice Creek Plaza North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS. ZIP PHONE Deb SMyre 286 Rice Creek Blvd NE 763-571-8377 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Panelcraft of MN Inc 3118 Snelling Ave S, Mpls., MN 55406 612-721-6628 2179 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 JJ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace windows and install a 3 unit slider 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Flashing and caulking all exterior openings. Permit Inspection Cards Will Be Mailed T® Homeowner To Pott 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 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 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 $2,000 $3'46 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. $69.25 Fire SC $6.92 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOT FEE Licee SC $5 0 $84.63 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT #DATE, HE PROP VALIDAT THIS ISjOSOUR P IT 4;Y � �-' 9L (I P IFIA1E S,GNATURE OF OWNER,IF OWNER BUILDER, IDATEI NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE 'DI II,'ER ND TC R-ANDR-2BUILFADINGYPERMDITAPPLEATION1 A)0003 Construction Address: 61vd, rp,IdL-ao�- Legal Description: Owner Name & Address: Utt �'OLUI & Tel. 043 -5-2 / E37-7 Contractor:7(tn j= j CrLf1 4 M/)' te MN LICENSE # Address:56FA-t)- A](--, c�, L42� o55L/Oa Tel. # (�G/� �� Q (Z W Attach dthis application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IIPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Width Hgt/Ground Sq. Ft. —f4 OTHER: p �Length - V 4Li1lC� ��1 Ql')'10 1 3 (��` I (`�` M, Construction Type: Estimated Cost: $ [� ' Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: J_ Tel. #_(Z QITYISE ONLY Permit Fee $ C.��'J , Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ (,¢ $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ . CSU $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 $ EN a-5 STIPULATIONS:"J�5' 5L.A=. 5f20. 9.1.2- 117 7 SEPARATE PERMITS REQ7ED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY PERMIT .c 2004-0092 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 06/11/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 286 RICE CREEK BLVD NE PIN : 143024220044 LEGAL DESC : RICE CREEK PLAZA NORTH ADD : LOT 2 BLOCK 4 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DECK VALUATION : $ 3,726.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CONSTRUCT A 30'X 10' DECK. APPLICANT BUILDING PERMIT FEE PLAN CHECK FEE 97.25 63.21 TAD JUDE 286 RICE CREEK BLVD NE FIRE SURCHARGE 3.73 FRIDLEY, MN 55432 STATE SURCHARGE, VALUE 1.86 TOTAL 166.05 OWNER TAD DUDE 286 RICE CREEK BLVD NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEME This permit becomes null and void if work or co on authorized is not commenced witin 60 days or if con ction or work is suspended or abandoned for a period of 1 0 days at any time after work is commenced. I hereby certify that I have read and examined thi application and know the same to be true and correct All provisions of laws and ordinances governing this typ of work will be complied with whether specified herein or no . The granting of a permit does not presume to give autho ty to violate or cancel the visio y other state or ocal lawregulating cons ion r the ance of cons �;�! do . Applicant Date Bldg jIInsp Da SEPARATE PERMITS REQ7ED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW [ ] CITY OF FRIDLEY K`F Effective 4/1/2004 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: -Z<g �_ (2 o -fe_� L o p ` . � °® Legal Description: 4" z V& Owner Name & Address: —r4A 5A .,4 � A QDAA S Tel. # 76'& 57 Contractor. 5; &_ L -r- 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 3 , Width l ®` Hgt/Ground `l Sq. Ft. QTHER: v� Construction Typ . w ` vrn.R+ Estimated Cost: $ ? a o ® � Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ 612 96!;"692 DATE: 6 i APPLICANT: Tel. # 6571 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 $1350 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 [ J s TOTAL $ STIPULATIONS: w test A"*"7;..,.; Y. I�rli 1-�EERIN INCeta Sclr . . . . . . . . . . . . . . El! veyol", yineer Alo An t kaeate os. SU3?--. ow 6ernar Wolke o Oe 7. If .01 rr- ON Te. Ek PL A -LA NO(ZTH kDOITION kt *15 is a Irw - Awvw, A.0 A-12. '$"011 qr*f dove dWvVS q("*OAOW ohwv,4dlwdwd .1 rhmmls /,,.f or w mid kne. As curve ed 'jw giv SU,6UA8",fM61NE4ER1JVO-, PVC. I I N CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 763) 572-3604 FAX: (763) 571-1287 ADDRESS : 286 RICE CREEK BLVD NE PIN : 143024220044 LEGAL DESC : RICE CREEK PLAZA NORTH ADD : LOT 2 BLOCK 4 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOW/DOOR REPL PE T NO.: 2004-00920 DATE ISSUED: 06/16/2004 VALUATION : $ 5,000.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS.. REPLACE 6 WINDOWS WITHIN EXISTING OPENINGS. STATE LICENSED CONTRACTOR 1 APPLICANT TWIN CITY HOME REMODELING (20385210 6527 CENTRAL AVENUE FRIDLEY, MN 55432- (763) 572-2577 FIYAT%T'1_11 TAD DUDE 286 RICE CREEK BLVD NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied 'th wh er specified herein or not. The granting of a p t oe of presume to give authority to violate or can pr ons of anyet er state or local law regulating c ormance of cons n. Applic Date Bldg Ins p Datb o BUILDING PERMIT FEE 111.25 FIRE SURCHARGE 5.00 STATE SURCHARGE, VALUE 2.50 LICENSE SURCHARGE 5.00 TOTAL 123.75 PAID WITH CHECK # 22335 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. (�-, �27 3i(a NEW [ ] CITY OF FRIDLEY Effective 4/1/2004 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 els �'� u Construction Address: g2Y& b ce CnwA X/ -- Legal Description: ?? Owner Name & Address: -�v _ c/ W -44 SS`7,2 /73y Contractor: 710 CITY HOME REMODELING MN LICENSE # 960512.7f OW WN Aw. Add 'KININ CITY HOME REMOQ 6527 Old Central Avi Fridley, MN 55432 Ph. 763-5722577 ;Y a MN Lic. 20385210 LIVING AREA: Length GARAGE AREA: DECK AREA: OTHER: Tel. # ion, a Certificate of Survey of the construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Width Length Width Length Width Height Sq. Ft. Height Sq. Ft. Hgt/Ground Sq. Ft. Construction Type: i)i fVd ®tWS 4-- Estimated Cost: � D. &V Driveway Curb Cut Width Needed: Ft. + F = Ft x $ _ $ 76 -?DATE: r / `D 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 Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - $ f A 2, Fee Schedule on Reverse Side $ 65% of Permit Fee $ 1 c9-3. 75� .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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: