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PRE 2010 DOCSO O OF B ILDING No. Street e .oP o zo Lot __ Block Addition or Sub vi" Corner Lot._ Inside Lot Setback Sideyard Sewer Mevation — Z �z • Q C'w evgtion DESCRIPTION OF In consideration of the issuance to me of a permit to const the proposed work in accordance with the description above set ordinances of the city of Fridley. In consideration of the payment of a fee of $ , permit is granted to above, I agree to do rith all provisions of 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 Bart thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construct►on, alteration, maintenance, repair and moving of buil�inga within the dty limits and thins permit may be revoked at aqy tune upon violation of aay of the provisions of said NOTICE: 'This permit don not serer the construction, indaMen for whing, phunbing, gas heating, sewer w water. Be sore to we the Building Inspector for separate permit for these Item& Application for Power Plants ants and Healing, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL 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 $ MECH. WARM AIR Furnace Shell & Duct Work to 124,000 BTU ............ $10.00 $/ C) 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 & 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$ 200 $ ®® Additional Fixtures ................ x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS &REPAIRS TOTAL FEE $ ROUGH FINAL Dept. of Bldgs. Phone 880-3480 •pp City of Fridley: The undersigned hereby makes application for a permit for the work hereir. specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn 19 6 e Owner ,r0 Kind of Building e_ Used as To be completed about Estimated Cost, $ —New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Name n �a..a"� L Size No-/® 2.AV d -42 o Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load F> 6 Kind of Fuel , &jrj- • — BURNER — Trade Name Size No. / a C7 0 Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signed.i%/�1eLcA By Ly « Business Phone No City of Fridley Application for Piumbing and Gas Fitting Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Localtio 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 applicati n are true and correct. Ir Fridley,` Nrmn. Al If 19K e Owner VIAOO Kind of Building Future Connection OpeningsI t,onnocaea wun New Fixture, Old Openings Sewer El Used as Cesspool El PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....................... � x $1.50 $ �' –�^a 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 $ _ O 0 New Ground Run Old Bldg. ............ x 3.25 $ To be completed about I Estimated Cost, $ Cf � � Old a ding Permit No Permit No. Signe 9i a o�0� Business Phone No, !y ROUGH �Q— FINAL GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ /-5-0 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ [1 TOTAL FEE $ e"' ' a 42 a[ w w Z O ® R N WATER HTR. GAS ELEC. Base r / 44 f. 1st 2nd 3rd 4th 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 applicati n are true and correct. Ir Fridley,` Nrmn. Al If 19K e Owner VIAOO Kind of Building Future Connection OpeningsI t,onnocaea wun New Fixture, Old Openings Sewer El Used as Cesspool El PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....................... � x $1.50 $ �' –�^a 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 $ _ O 0 New Ground Run Old Bldg. ............ x 3.25 $ To be completed about I Estimated Cost, $ Cf � � Old a ding Permit No Permit No. Signe 9i a o�0� Business Phone No, !y ROUGH �Q— FINAL GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ /-5-0 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ [1 TOTAL FEE $ e"' ' a 42 1 suedEcr PER NO. City ®f Fridley AT THE TOP OF THE TWINS BUILDING E R M I T r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r � 1 . � NUMBER REV DATE 8/13/97 PAGE OF APPROVED BY CITY HALL FRIDLEV 55432 ' 612-571-3450 910-F15 JOB ADDRESS 521 Rice Creek Blvd NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 Z Holiday Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David/Monica Keding 521 Rice Creek Blvd NE 574-0825 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 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 LR REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (22 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 1 I HEREBY CERTIFY THAT I 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,834 $.92 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- $59.50 Fire IC $1.83 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL E $ .25 SIGNATU OF ORORAUTH RIZEDAGENTI IOA EI - /I N P P ALIDAT IS IS UR PERRMIITT�j -'G r G��✓ / B .GI SP DATE S.GGNA� OF OWNER IIF OWNER BUILDERI IDATEI 1 NEW [ ) ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress:_ 566 J x�� %�c,Q Legal Description: 1- 0 % % po f A1) Owner Name & Address: I) Id Tel. # S 2 ZSR Contractor: 6 MN LICENSE # Effective 1 / 1 /97 Address: I Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF E%1PROVEMENT Tel. # LIVING AREA: Length WidthHeight _; Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 8,croor ✓' ® f' vZ ; , Construction Type: Driveway Curb Cut Width Needed: Ft. + 6 Ft = Estimated Cost: $ % �-- (Fee Schedule on Back —Ft..ix $ _ $ DATE: -9// j /� - APPLICANT:Tei. # _ c 5 � y v Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ S-�% SD Fee Schedule on Reverse Side 83 .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $950 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 [ ] $ . Ir Building 0o3 BUILDING Permit No. -266 --Q It 40 Inspections RESIDENTIAL APPLICATION Received By: v 763-572-3604 CITY OF FRIDLEY Date Rec'd: -7 - rG 763-502-4977 FAX EFFECTIVE 7-1-2010 /� .j DATE < — '� ��lO YOURE-MAILRESS +CJ1X1'F'0%"V C, (ti✓ C®l4vl c4s4w Ai SITE ADDRESS I P" i CE' Cd lL16 V THIS APPLICANT IS: M -Pi ER ❑CONTRACTOR PROPERTY OWNER/ NAME: 1)1 1',=b1 C TENANT ADDRESS. �� ' tct (ame— QP1C CITY S STATE 1ZIP 2/ PHONE: (9 3 '`2 SIM— 21 Le101 CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX 16 PROPERTY TYPE SINGLE FAMILY SIZE GO S'a G ❑ TWO FAMILY/NEW CONSTRUCTION STORIE PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK:�OME CONSTRUCTION 13ADDITION ENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: C cD O cS�(�4J SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING U-90USE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES_ El HOUSE & GARAGE 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 ❑Soft ADDITIONS. & PORCHES SUBMIT: ❑ 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 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: S G 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 Fire Surcharge $ .001 times the total job valuation Surcharge $ .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 2a $ o Make checks payable 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 applic. " or a permit and zip of to start without a permit on site; that the work will be in accordance with the approved plan in the case ch vi and approval of p1A� SIGNATURE OF APPLICANT PRINT NAME f^ t DATE / Lr APPROVAL INSPECTOR SIGNATURE Building MECHANICAL Permit No.:646- ' W - Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY 'e'3 0 763-502-4977 FAX EFFECTIVE 7-1-2010 DATE SITE ADDRESS THIS APPLICANT IS: PROPERTY OWNER/ TENANT El OWNER ADDRESS: A CONTRACTOR COMPANY NAME: SUBMIT A COPY OF CONTACT PERSON: JJU/a YOUR STATE STATE LICENSE #EXP DATE LICENSE WITH ADDRESS:CiO5� CITY C STATEU 9_0 APPLICATION PHONE V412 7<=IE�FAX PERMIT TYPE SINGLE FAMILY ❑TWO FAMILY TOWNHOUSE TYPE OF WORK: C3 NEW REPLACEMENT 0 ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) PROVIDE HEAT LOSS CALC'S PER MANUJ 2006 SSE HANDBOOK Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 IREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00 NEW $35.00 _ FURNACE $35.00 UNIT HTR $10.00 _BOILER CHIMNEY LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.00 DUCT WORK $10.00 -GAS PIPING $10.00 _VENTILATOR $15.00 THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building pe an cknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances codes the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an applic 'on o a pe it work is not to start without a permit- thatWorkwp"lbecordance withbe approved plan in the case of al wor c Pu�iodsd approval of s SIGNATURE OF APPLICANT X P PRINT NAME ((�� APPROVAL INSPECTORS SIGNATURE DATE City of Fridley 144'ilding Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977