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PRE 2010 DOCSCity of Fridley, Mm. BUILDING PERMIT Date: DECEMBER 30, 1966 Owner: Builder R CHARLES JOHANSON -347aa �;® 9123 Address Address 160 HARTMAN CIRCLE N. E. FRIDLEY, MINNESOTA 55432 LOCATION OF BUILDING No.._.. 5 01 _ Street _ _ RICE CREEK. BOULEVARD _ _ part of Lot Lot _ 9 _—Block 2Addition or Sub -Division ._ H�IDAY HALLS Corner Lot — X Inside Lot _ _ Setback 35' _ _ Sideyard — 10 and 20 Sewer Elevation .T�24.91 FElevation 838.5 TOP OF FOOTING DESCRIPTION OF BUILDING To be Used as: DWELLING Front 5 7 Depth 30 Height 20 Sq. Ft. 1, 710 Cu. Ft. 34,200 GARAGE & PORCH Front 13 Depth 30 Height 10 Sq. Ft. _ _ Cu. F't. _ 4 73 0 Type of Construction �� Est. Coast �. ._S.oO x..00 __ To be Completed In the propose consideration in of the with the issuance to med description ab torip 7el in ordinances of the city of Fridley. r I agree to do provisions of In consideration of the payment of a fee of $ 39.00 , pelt is h 'y granted to CHARLES E. JOHANSON to construct the building or addition as describe 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 thereof, shall conform in all respects to the ordinanoes of Fridley, Minnesota regarding location, conatruchon, alteration, maintenance, repair and moving of buildings within the dty limits and this permit may be revoked at any time upon violation of any of the Provisions of said ordinances CLARENCE BELIE Building Inspector NOTICE: This pend does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building inspector for separate permits for these Items. a • a APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MESOTA Al OWNER'S NAME L,. &&X. !a gi ��/��ti�� ► �i BUMDER ADDRESS ADDRESS :._ �......,.. LOCATION OF BUILDING NO., —STREETIL PART OF LOT t LOT BLOCK jj 0 e�,�, ADDITION OR SUBDIVISION &1 CORNER L INSIDE L SETBACK J!57— SIDE -YARD A�„ �` SEWER ELEVATION 1 , N ELEVATION f2 �• Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESC7PTION OF BUILDING To Be Used Ae; Front Depth Height )_0 Sq. Ft. �� _ Cu. Ft. ` 2. �.`Front .�..�epi _.,.Height Sq: Ft. Cu. Ft. Type of Construction Estimated Cost,, To Be Completed The undersigned hereby makes application for a permit for the.work herein specified, agreeing,to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of.Buildings, and hereby declares that all the facts and representations stated -in this application e true and corrgct. (Schedule of Fee Costs can be found on the Reverse Side s�2 C.;xs, .t'�zrp``�?�Y,�,;._, �h`}s 5`x j:' •.,t 4 . � .� ;. r� r }} r hers' +vim pates !i Ll 3 + E 1^^�{S�{N •, _ "> ` _ A / EIG'1NEERING, INC- p11•TR i� ��,x� ; 'f� _., ; 5 n STSs✓7: 1k i'Gi - a J M �'. f ..t k �R�. 5 di• °� %cox" `�ar , ineers ve�/ors 3� -- /y (�'t� EVE te tp Ui IItAy �r � 7 F rz 'g ata �ro y \' Of Al arc, �a -p�� 4��`S �'r�°� ��a , •, j �• a�, � 5y.. ,t t k { q �; #�) � �`1 p M� 'h x r' '"✓x a .''`y +�" `�D J' � r� O } �,y taxa �}� s t � ^•. / 7 ' n �r i ,��. �.r • � � q,.0 r IV 91 � a�h� t•>` .1 n f f �k {a Y R GN �- i a��,dr�,^rS�x y�Y ty r r� n t "�ro�+' �c rSs•. x r�� ,rafk nta�y�'r5frow A 1� 0and GOI7b'Gl lISB/lf6IfQ/%O StA'wy f .!.I�V/JI�OH�S; qC& 4�d 4tA�►j ri t �a� _. AP 011 J01d l� As .!{N'1� L� A� . ,�'`- i/�y7 y ✓' 4 7 s ,S al1 ' r + � t. Application for Power Plants and Healing, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldge. Phone 560-3450 GRAVITY WARM AIR: RATE TOTAL Location�e ! C Furnace Shell & Duct Work ........................... $10.00 $ City of Fridley,: Replacement of Furnace ............................. 6.00 $ Repairs &Alterations—up to $500.00 ............. .... 6The undersigned hereby makes application for a permit for the work herein .00 $ specified, agreeing to do all work in strict accordance with the City Ordinances Repairs & Alterations each add. $500.00 ................ 3.00 $ and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ f each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—ta 400 sq. ft. EDR Steam ...... $10.00 $ Furnace Shell & Line --to 640 sq. ft. EDR Hot Water 10.00 $ Each add. 200 sq. ft. EDR Steam ..................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $ OIL BURNER—to 3 gal. per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) .................... .. 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 2.00 $ op.�� Additional Fixtures ................. x .75 $ Gas Range to 199,000 ......... x$ 5.00 $ AIR CONDITIONING X $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH ° FINAL Fridley, NL1 19 — Owner Kind of Building In . I ? 7 Used as To be completed about Estimated Cost, $ New. Building Permit No. > ✓ Permit No. DESCRIPTION OF WORK HEATING or POWER , Warm Air—No Trade Name Rte. -..-� Size No. id 3-A 6V " Capacity. Sq. Ft. E.D.R BTU -� H.P. Total Connected Load A � Kind of Fuel2k BURNER —Trade Name dAae2l�-Size No- Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signed By GOID.42 Business Phone No- D16 az HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E, Construction No. Guide FRIDLEY, MINN. Insulation Windows Doors Reference Out. Wall Int. Wall 1. Ceiling Roof Floor Kind How Applied Yes—No I Yes—No 1 19— 1 II Room l Lenath I Width 1-4 Height C L Rmm i Lenath V' Width Heialit Windows and Doors—Crackage and Area Width 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. Coef. Btu Coef. Btu Infiltration 1 &0 Of ly Glass Net exp. wall C00vo b Exp. wall I Net exp. wall P ti�. Ceiling Int. wall O Ceiling J�72 Floor Net exp. wall Floor 11901 17 G9 I n /Y/ 0_ r0___ I f ___L /ltfP�.i / 1'9 Lr_[_L. fz! Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. IT- Coef. Btu lCoef.1 Btu lCoef.1 Btu Infiltration Infiltration Glass Exp. wall a Net exp. wall C00vo b Glass Exp. wall Net exp. wall Int. wall I q4 1 P ti�. Ceiling Ceiling Uloor30 O 01/40 Floor Net exp. wall 11901 17 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader areaI F1.1 AI. V Aar 1 Room I Length % ZF Width 1-7 I-leiaht 9' Windows and Doors—Crackage and Area Width 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. Coef. Btu lCoef.1 Btu Infiltration Btu Infiltration Glass Exp. wall a Net exp. wall 60 Net exp. wall jgq I '-bale. wall Floor 6`6 "y! '2 Ceiling Uloor30 trrsz 1 btal Btu. Required so. ft. E.D.R. or so. 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. Width Height No. of Lineal ft. Area No. of pane: of pane lights of crack sQ. ft. Coef. Btu Infiltration Coef. Btu Infiltration Net exp. wall 60 CIO Glass Ceiling AT /t? Floor 6`6 "y! '2 Exp. wall (o Net exp. wall 17 L el Int. wall s Ceiling Floor 9 Total Btu.6-:s ;a Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l IZA k Room I Lenath 9 Width "7 Heistht 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 AT /t? Floor 6`6 "y! '2 Total Btu. I a 13 r 94 Required sq. ft. E.D.R. or sq. iris. W.A. Leader area I F1.1 Room I Length Width Heiaht 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 D-564, "' �'--42 HEAT OSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN. Weatherstrips TS. H —V. E. I I Construction No. Insulation Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes—No Yes—No 19— FI.1 :/,. Room I Length / Width 6 Height II Ft_I /�►;a.sa: %� Reom I Length / i Width '/ Height Windows an Doors—Crackage and Area Width 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 Dane of pane lights of crack sq. ft. IV 9 ® 8 Coef. Btu Infiltration Coef.1 Btu Coef. Btu Infiltration C) Exp. wall & 0 1A d 0 Glass Exp. wall A: '- J /,I'- Exp. wall Floor 329 Net exp. wall Exp. wall Net exp. wall -2 ®® Int. wall ®® Int. wall FT— f Ceiling Ceiling % ZVZ ; t („/ Q Floor 1®�" Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI.1 T—rA , Room l Length 7 Width it— Height 1 A Windows a d Doors—Crackage and Area m ngth Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq, ft. /,;?/ elg t —7-.7r— im p Coef. Btu Infiltration Coef.1 Btu Infiltration Glass C r - Exp. wall Glass 1 Net exp. wall Int. wall Exp. wall d /(060 Exp. wall Glass ; Js - Floor 1 Net exp. wall Exp. wall Floor -2 — Int. wall Net exp. wall Int. wall FT— f Ceiling Ceiling Floor % ZVZ 67,410 Floor 1®�" 1 otal Btu. squired sa. ft. E.D.R. or sq. ins. W.A. Leader area R -I , e.,; M`03't Room I Length '7 Width i Windows and' Doors—Crackage and Area m ngth Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. P r l' elg t Windows and Doors—Crackage and Area Coef. Btu Infiltration Btu f2 /40,70 Glass C r - Exp. wall 916 1 Net exp. wall Int. wall Exp. wall d /(060 Ceiling Glass ; Js - Floor 1 ;Z Total Btu. Required $q. ft. E.D.R. or sq. ins. W.A. Leader area Roo I Le / Width H ' h Fl.1 / m ngth 1 Width Height No. of Lineal ft. Ares No. ofpane of pane lights of crack sq. ft. elg t Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 3C 30 Btu Infiltration Infiltration Glass Exp. wall ro 0 1 2 6 0 Coef. Btu Infiltration j Exp. wall Int. wall . ov Glass Net exp. wall Ceiling 1 Exp. wall Floor -2 7 Ceiling 1 loon. Net exp. wall Int. wall FT— f Ceiling Floor % ZVZ 2. i C i eP k Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Height FV l o",A®�* Room i Length 1 `% Width / Height Sr Windows and Doors—Crackage and Area rs--Crackage and Area Width Height No. of Lineal ft. Ares No. ofpane of pane lights of crack sq. ft. &A- (`v 1 lCoef.1 Btu Infiltration Infiltration Glass Exp. wall ro 0 1 2 6 0 Glass Net exp. wall ^ j Exp. wall Int. wall Net exp. wall Ceiling 1 --Int. wall Floor -2 7 Ceiling 1 loon. a f - Tbtal Btu. ft. E.D.R. or sq. ins. W.A. Leader area Windows an rs--Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack SQ. ft. 1 Coef. Btu Infiltration Glass Exp. wall Net exp. wall j Int. wall Ceiling Floor -2 7 q,-16. Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. leader are& Application for Power Plants and Healing. Cooling. Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone 560-3450 GRAVITY WARM AIR: RATE TOTAL Location^� GS2� Furnace Shell & Duct Work ........................... $10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECIL WARM AIR , 00 Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $� each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $ Furnace Shell & Lane—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $ OIL BURNER—to 3 gal. per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule y O GAS BURNER (up to 199,000 BTU) ......... I . ............ 6.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 200 $ d o Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING it FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE A ROUGH FINAL 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, 9n S-19 , 19 Owner � i✓ Kind of Building _ e/I�Gi sl�n Used as 'C To be completed about Estimated Cost, $ ` 6 IN& --New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No Trade Name Size No_p p , � -/3I- Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load 6/ 3, LV ®® Kind of Fuel_ _'&d,:a BURNER —Trade Name Size No. / -5— "j Capacity Sq. Ft. E.D.R BTU H.P. Signed/!%(✓.� `��®//�=2%�-1 By A:C, . <a Business Phone No- �7.t5�- (REMARKS—OVER) SUBJECT PERMIT City of Fridley 12423 AT THE TOP OF THE TWINS BUILDING PERM 1 ` r I CEIPT NO. ti� COMMUNITY DEVELOPMENT DIV. Y--'--- INSPECTION r PROTECTIVE SEC. f < / 1 ; i NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-560-3450 910-F15 14/74 JOB ADDRESS 501 Rice Creek Boulevard N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DES I 9 x 2 Holiday Hills SHEET I 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Kenneth Gasper R 501 Rice Creek Boulevard N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Robert Norberg Construction 3316 Hillsboro Avenue North 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION Z ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 9 CHANGE OF USE FROM TO STIPULATIONS y 1 SEPERATE PERMITS REQUIRED FOR WIRING, 14EATING, PLUMBING AND SIGN& TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $1a800 •90 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISION$- q OTHER STATE OR LOCAL LAW REGULATING CON- $12.00 STRUC PON OR THE PERFORMA,JCE OF CONSTRUCTION. ! 7 PLAN CHECK FEE TOTALFEE eZ 12.90 op NATURE OF CONTRAC-r0F1 OTI AUTHORIZEDAGENT (DATE) W4tFN PROPERLY VALIDATE THIS S OUR PERMIT SIGNATURE OF OWNERIIF OWNER BUILDER) (DATE) G. INS. DATE APPLICATION FOR RLSIDENTIAL, ALTERATIi1N, OR ADDITION BUILDING PERMIT CI'T'Y OF I-I:I DLLY, MINNESOTA OWNER'S NAME: �i`��' �� BUILDER: � ° � ✓' � /V®,%��i�i� � L£JVS 77, ADDRESS:5-0/'0�ei5: � � �4' ADDRESS: �- S'ffd oto '5-r x/o •, :. , ATO° � STREET: /\ LOT: BLOCK: ADDITION: CORNER. LOT INSIDE LOT: SETBACK: SIDEYAED: 0 Applicant attach to this form Two Certificates of Survey of Lot and proposed buildiaig location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front: _Depth: Square Feet: Cubic Feet: Height: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: Estimated Cost: $ �� To Be Completed: /pz The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stficL accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that ,ill the facts and representations -stated in this application are true and correct. - � DATE: Vv ® P, SIGNATiJRE: (See Reverse Side For Additional Information.) .o It r CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES ®� g �� 41E A4 a,!�5 JOB ADDRESS RATE SCHEDULE The undersigned hereby makes application for a permit for the work Residential Rate TOTAL herein specified agreeing to do all work in strict accordance with the Furnace Shell and Duct Work, Burner - city codes and ruling of the Building Division, and hereby declares Also Replacement Furnace $ 20.00 $ ® that all the facts and representations stated in this application are true and correct.199r, Gas Piping (Needed with new furnace) $10.00 $ OWNER Gas Range $10.00 BUILDING USED AS Gas Dryer $ 10.00 $ �® Y�S—Z— *Air `� ESTIMATED COS® _ PERMIT N0. Conditioning - All Sizes $10.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ No. of Heating �Jnits l Circle One (Steam) (Hot Water arm Air) Trade Name ao Size No. Commercial/Industrial BTU ED R 1 % of Value of Appliance or Work $ Fuel�� -7— Total Connected Load State Surcharge $ .50 Burner Trade Name Size No. C20BTU TOTAL FEE $ HP EDR Z;' 40 7-/0�'i4iLo- HEATING COMPANY MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 Signed By !ley Tel No. PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 Approved By, -GRE Rough -In Date Final Date !�I 2 '7 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes Qpr No ( ) 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 /® 014 0® c;, All other BTU's TOTAL BTU's Remarks List Alterations Being Done: COMPANYHEATING - o _ -- Signed By Date NEW [ ] Effective 3/1192 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application l�{ Construction Address: .S ®l 1 ! e C_/` rj L �1 Legal Description: Owner Name & Address: j b � jja 0 z b Ldi- Tel # Contractor: _ on, 1l c�,l�Gl MN LICENSE # Address: Y71/'? 1�-5 /j AJ5_ 614r Tel # e ?a Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION -OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: o'L° Sewer Main Charge $ Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ Approx. Completion Date: ° (Cost on Back)0-0Xpriveway Curb Cut Width Needed: �Ft. + Ft = %-Ft x $ = $ DATE: APPLICANT: Permit Fee $ Fire Surcharge $ State Surcharge $ SAC Charge $ License Surcharge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: Sit P LI -1 Fee Schedule on Reverse Side ( qq q ( .001 of Permit Valuation (1/10th%) U i2 $.501$1,000 Valuation $700 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] SUBJECT PERMI City ®f Fridley �26 AT THE TOP OF THE TWINS BUILDING PERMIT r R E CliPT*O' COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. �� r NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/23/93 JOB ADDRESS 501 Rice Creek Blvd NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 2 Holiday Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Nordstrom 501 Rice Creek Blvd NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Ron Williams Construction 600 Janesville St NE, Fridley 55432 784-6497 2350 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 Ci ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Add two skylights in porch; one skylight in main bath. 9 CHANGEOFUSEFROM TO STIPULATIONS Provide smoke detectors as per UBC 1210 adjacent to all sleeping areas and in basement. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $2,500 $1.255 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT r 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- ' $54.00 Fire SC $2.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License . C $5. Q $62.75 WH R ALIDATED THIS IS YOUR PERMIT BLDt INSP DATE SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI 1 SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI y IS I NEW [ ] Effective 3/1/92��0 ADDN [ ] CITY OF FRIDLEY ALTER V] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: ,-'"®/ "RI e_ d? C .j@ee./e Rio ot. AA4V Legal Description: Owner Name & Address: An, -To h A -,; Ale e d/s -rey o% Tel. # ,5,7/-, d/V o Contractor: �f I ,� AZZZ1-A S �� w5 MN LICENSE #11 -31 -le Address: J 4 Ate ..S' a / //e -9 r— ME Ae/;a1VX M Al Tel. # 7 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF 1WROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. 'Ft. OTHER: i,v "Og oee , ,A/zei IVAIA'l OA/A Corner Lot [ ] Inside Lot j ] Ft. Yd Setback Type of Construction: Approx. Completion Date: Ne t- 9 9 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Side Yard Setbacks Estimated Cost: $ o2S-dd (Cost on Back) Ft x $ = $ DATE: 9-il APPLICANT. /_v Tel. # ;7f e/ Y P 7 Permit Fee $ SLI, oo Fire Surcharge $ 2, 0 State Surcharge $ SAC Charge $ License Surcharge $l'�� Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL $ STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.501$1,000 Valuation $700 per SAC Unit $5.00. (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ J SUBJECT PERMIT NO. City of Fridley �- = 213 5 AT THE TOP OF THE TWINS BUILDING PERMIT ' , RE CE I COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r i � .d NUMBER REV DATE 9/27/93 PAGE OF APPROVED By -'1 CITY HALL FRIDLEY 55432 612-571-3450 910-F15 JOB ADDRESS 501 Rice Creek Blvd NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 2 Holiday Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Nordstrom 501 Rice Creek Blvd NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Richard Hastings Contr 6331 Riverview Terrace NE, Fridley 55432 574-9966 4051 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 ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroo,f Dwelling (34 Squares) 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. Install adequate attic ventilation. Provide smoke detectors as per UBC 1210 adjacent to all sleeping areas and in basement. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 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 $2 720 $1,36 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT IF 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- $54.00 Fire SC $2.72 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE License SC $5,010 $63.08 SIGNATURE OF CON. RACTOR ORA HORIZED AGENT DATEI WH, a R VALIDATED THIS IS Y UR PERMIT BLDG INSP GATE SiGNATUREOFOWNER(IF OWNER BUILDER) (DATEI J NEW [ ] Effective 5/26/93 ADDN [ ] CITY OF FRIDLEY� ? y ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: -55 1 /�'�c c ?L,� f� 6 L V P Legal Description: Owner Name & Address: -J-oA A/ Nva q/ s fr,,A Tel. # Contractor: E c /� �2 f ��7` f`i� j VIN LICENSE # ®% % Address: Tel. # S 7 �lG Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF II"ROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length// Width Hgt/Ground Sq. Ft. OTHER: �� biq � IL. Corner Lot [ ] inside Lot [ ] Ft. Yd Setback Type of Construction: Z - F Approx. Completion Date: Side Yard Setbacks Estimated Cost: $ -2-1 - - a WO -3� sg, (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 7A 7 -S APPLICANT:.r��6� Tel. # 5 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge S $ 5� 60 $ S Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $750 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Conservation Plan Review $450.00 Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: I/ SUBJECTPER . City of Fridley 2 3 344 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO./?�� • _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r � � 1 i NUMBER REV DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/25/95 JOB ADDRESS 501 Rice Creek Blvd NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 8 2 I I Holiday Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE M. John & Della Nordstrom 501 Rice Creek Blvd NE 571-4554 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Ron Williams Construction 600 Janesville St NE, Fridley 55432 784-6497 2350 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 O NEW P ADDITION Ck ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 22' x 22' Garage Addition and alter an 18' x 10' Porch 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARNING Before digging call f0c all utility 10,0000 454.002 REQUIRED RO.Y. LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS I 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 $ 12,570 $6.29 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC $5.00 $167.86 SIGNATURE OF CONTRACTO/R OR AUTH DAGENt IDATEI WHEN PgOP RLY VALIDATED THIS IS YOUR PERMIT OAT SiGONATUK OF OWNER 160WNE DE IDATI I/ Effective 1/1/95 NEW (] NEW[ ] CITY OF FRIDLEY ADDN ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: 12,e:, e- Legal Description: L.Of/ ry Owner Name & Address: ..� N � �e ND Tel_ # /" .�Q Contractor: V �P l l /n S �', x �� MN LICENSE # Address: 6 ea �� IJ�Sy � f/,. s i' %--''/fes/� � Tel. # Attach to this application, a Certificate ;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 ZZ' Width 2 Z.' Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: PORC-P L ISI W I O 1 1%/ �_12—a. Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: L-drr L'r�7�� / ooa� Estimated Cost: $ OOa w�'/4 96 - Approx. Completion Date: w (Cost on Back) /o°�� Driveway Curb Cut Width Needed: Ft. + 6 Ft = F x $ DATE: �� APPLICANT: -- Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY $ / Fee Schedule on Reverse Side $__Z2, y"7 .001 of Permit Valuation (1/10th%) $ G, $.50/$1,000 Valuation $ $850 per SAC Unit $ Pj $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review S $—&2l 96 Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ STIPULATIONS: ' CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Furnace Shell and Duct Work, Burner — Also Replacement Furnace e Vent — Fill Out Back) Gas Piping'Oleeded with new furnace) Gas Range Gas Dryer *Air Conditioning — All Sizes All Others/Repairs & Alterations (LIST ON BACK) I% of Value of Appliance or Work Commercial/industrial 1.25% of Value of Appliance or Work JLO Effective On August 1, 1995 State Surcharge TOTAL FEE PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Trade Name. Size No. BTU HP EDR $ Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR shore HEATING COMPJ&Yting and Air Conditioning 4854 Central ve. NE Signed By C mb' Heights. N 554 f J1 No. Approved By Rough—In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE JOB ADDRESS �i L' �' ��/✓ t�� a 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. a ,1995 $10.00 I VA� OWNER $10.00 $ _ BUILDING USED AS �s�� 6._ ✓ lGc- 6 $10.00 $ ESTIMATED COSTO PERMIT NO. $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) State Surcharge TOTAL FEE PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Trade Name. Size No. BTU HP EDR $ Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR shore HEATING COMPJ&Yting and Air Conditioning 4854 Central ve. NE Signed By C mb' Heights. N 554 f J1 No. Approved By Rough—In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 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: SUBJECT PERMIT NO. City of Fridley 32316 AT THE TOP OF THE TWINS BUILDING PERMIT r ` RECEIPT NO. _ COMMUNITY DEVELOPMENT DIV. P r E PROTECTIVE INSPECTION SEC. 1 . , CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED B L 612-571-3450 910415 11/13/01 JOB ADDRESS 501 Rice Creek Boulevard NES 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 2 Holiday Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Nordstrom, 501 Rice Creek Blvd, Fridley, MN 55432 763-571-4554 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Bill & Tony's Home Helpers, 9033 Lyndale Ave S, Bloomington, MN 55420 612-328-7239 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20262484 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Dwelling 7 CLASS OF WORK IX NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct new deck. 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plans. WA R N 114 SEPARATE PERMITS Before digging call for REQUIRED FOR: all utility locations WIRING, HEATING 4E,4.0002 PLUMBING AND SIGNS RWIRED BY dAW SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING. TYPt 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 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING HIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED H OR NOT. THE GRANTING OF A PERMIT $11, 132.00 $5.56 DOES NO 5UM O E UTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVI NS OF ANY T R TATE OR LOCAL LAW REGULATING CON- STR TION OR T PER MAN E OF CONSTRUCTION $209.25 Fire SC $11.13 PLAN CHECK FEE FEE Lic e 5.00 I 4TTAL 230.94 SIGNATU E O ACTOR OR AUTHORIZED AGENT iDATEj HE PR VA ID E -D THIS IS YOUR PERM OG lNS ATE SIGNATURE OF OWNER iiF OWNER BU40ER� [DATE, NEW [ ) ADDN [ J CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & A Contractor: J611t Address: 90% Effective 1/1/2001 ,(763) 572-3604 Bldg Insp La, t 9 &M. & Z dress: Mb"J790,017 Tel. # 'i�o3� llr Le -/?LRIIOJ -L !J MN LICENSE # Tel. # /` —21Zj 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 r Width =,i=� I�tbw4F .!�'� Hgt/Grro�unndd Sq. Ft. OTHER: C� y +� oZ 4 A Aid Estimated Cost: $ Construction Type: x- Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 13C /CV APPLICANT: Tel. # CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee a169 aJ -$' o �• ® ee Schedule on Reverse Side Fire Surcharge /A 13 $ , .001 of Permit Valuation (1 /10th%) State SurchargeE`�-'/O$ $.50/$1,000 Valuation SAC Charge $ $1150 per SAC Unit License Surcharge $ . DO $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 S STIPULATIONS: a 3o. 9y1. Building PLUMBING Permit No.. - Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd-15 10 763-502-4977 FAX EFFECTIVE 1-1-08 DATE -31,6 /J s' YOUR E-MAIL ADDRESS SITE ADDRESS 50 / A, C.6 IC f2 P 61c 6 C 16 THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: -YU H �j OWNER/ _ ADDRESS: t5 0 / a C. E C /Z L P IC AI eJ � CITY �� • � C = �/ STATE�+�ZiP � 5 y 3 $ TENANT PHONE: CONTRACTOR NAME: STATE LICENSE #G, d ori L/ � � �, EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND & 1 r 3 3 STATE BOND # EXP DATE CERTIFICATE OF ADDRESS: 6-0 CITY �4/J d° °c •4 STATE -d ZIP --TC 3 0 3 INSURANCE PHONE "7 b 3 15'7 'a- f Yd" L) FAX i 6 3 a, PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW REPLACEMENT DETAILED DESCRIPTION OF WORK- 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 = plus .50 surcharge .0 FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10000 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $15.50. BATH SINK/LAV DRAINS SHOWER _ WATER PIPING _ _FLOOR _ GAS PIPING (NEED CITY LIC) SWIMMING POOL _ WATER SOFTNER ($35) —BATHTUB _ _ CLOTHES WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREY. ($ 15) _ _ _ DISHWASHER LAUNDRY TRAY I WATER HEATER ($35) FOR IRRIGATION _ WATER METER —OTHER W. F , -00 Permit Fee $ N umber of fixtures @^$10.00 I x$10.00=$ 35 Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ OR Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 (MINIMUM $15.50) (MINIMUM $15.50) Total = $ 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 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 of all work which requires review and approval of plans. A C k- ' G DATE SIGNATURE OF APP PRINT NAME -% , DATE `-$ APPROVED BY til.' City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building BUILDING a See Back Page for Fee Schedule Permit No.: InspectionsRESIDENTIAL APPLICATION Received By: 763-572-3604 06L4 .001 times the total job valuation Surcharge $ 763-502 FAX CITY OF FRIDLEY ecPd -4977 SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow EFFECTIVE 7-1-2010 ft + 6 ft = ft x $24 = $ Erosion Control DATE 0-1 0(6. Co ADDRESS @O i3®W1oye.`� uA5. CoSITE VOE-MAIL ADDRESS J0,yl $ THIS APPLICANT IS: ❑ OWNER kCONTRACTOR Sewer Main Charge PROPERTY OWNER/ NAME: tO Pt ti9 t3®V Total Due TENANT ?, iii o Make checks vavable to: Citv of Fridlev Attach Stipulations ADDRESS: CITY STATE ZIP PHONE: CONTRACTOR NAME: 1 SS UAIZq, 1EXAQ V ► ® V SUBMIT A COPY OF YOUR STATE LICENSE STATE LIC SE # JI,\® (a AQ q 01 EXP DATE �'� ,�' . a 012•. AND CERTIFICATE OF ADDRESS: CITY QSSeC�' STATL�O ZIP SS A INSURANCE PHONE -10 :2. LAZ6 . @ l @, FAX 1 �°� "�i "— ( i-1 PROPERTY TYPE VISINGLE FAMILY/NEW CONSTRUCTION SIZE TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH OOF ❑ DRAIN TILE ❑ DECK IDING R03 ❑ OTHER WIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ DITION ❑ MAINTENANCE/REPAIR #REMODELING DESCRIBE WORK BEING DONE: VQ V'2,0 �r 4J gn1 SIZE OF IMPROVEMENT LENGTH WIDTH IGHT SQ FT ROOFINGC.��❑ USE ONLY NUMBER OF SQUARES 0 USE &GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl Xrsoffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminuc m�❑ Trim 1. Site Plan/Survey showing the existing structures A�� X' Q Other —�' `U ascia II and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USIN E 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ a See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 06L4 .001 times the total job valuation Surcharge $ q .0005 x Permit Valuation Minimum $5.00 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ ?, iii o Make checks vavable to: Citv of Fridlev Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of 'irk w ich requires review and approval of pl ` \ s SIGNATURE OF APPLICANT l PRINT NAME XQ (� ��-fV ir1r9i9 DATE '>l