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PRE 2010 DOCSSUBJECTERMI City of Fridley 15 3 60 AT THE TOP OF THE TWINS BUILDING PERMIT f RE COMMUNITY DEVELOPMENT DIV. 49 r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/31/79 JOB ADDRESS 1481 Rice Creek Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 1 Heather Hills 3rd Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Commercial Erectors 5298 Fillmore Street N.E. 571-8865 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. SEPERATE PPR 6 USE OF BUILDING •RED HEATfA�f;. PLIJ O IVIRi1 Residential 7 CLASS OF WORK 7 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ UOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 26' x 48' Dwelling and a 20' x 25' Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. Provide sod in the AdN front and side yards. Provide City with_) copy of verifying survey. SEWER LOCATION: (Approx. LO' Deep In Street) 101' E. of M.H. (Inv. 920.05) WYE ELEV: 917.02 TOP OF FOOTING: 920.02 Minimum WATER LOCATION: 8' W. of Sewer Service SERVICES OFF RICE CREEK DRIVE WG Before digging can Local utilities *0" "y "' MKIM D" WOT GIMAMR ;r�r: ACCUTAl" IN 'MM M &MAM 6LaYAVC TELEPHONE - ELECTRIC - GAS Etc 'MIS ' ; OATS IS RM JV"V a �WOUS oNLr ,wM.> REQUIRED BY LAWP1*vats s�tcuxa r sus uoanc,�a ON ME , TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 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 $41,100 $20.55 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE A T RITY TO VIOLATE OR CANCEL THE pERMITFEE SAC CHARGE PROVISIONS OF ANY OTHER R LOCAL LAW REGULATING CON- $102.75 $425.00 STR N O THE PER O E OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $25.69 $573.99 S NATUR OF HORIZEDAGENT (DATE) VALIDATE=D TTHIS)) IS YOIUR� PERMIT ��W^^yyHE��N��PROPERLY 0.4 BLDG INSP DATE SIGNATURE OF OWNER 0F OWNER BUILDER) (DATE) CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OWNER: C,G�/e✓t���c�.'o, ADDRESS: � 'Fd zq ►-<� a TEL NO: STREET NO: STREET: BUILDER: ADDRESS: r TEL NO: Construction Location LOT:�L BLOCK: Corner Lot: 7—Inside Lot: A ADDITION: Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION t� Front: Depth: Height: Square. Feet: Cubic Feet: G RM PCo (R. Front: -TOCaL pth: Height: Square Feet: Cubic Feet: ���%'�`'� Estimated Cost: $ Type of Construction: .� To Be completed: zz / Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: ^o $ $ SEE REVERSE SIDE OF SHEET' The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and cor e. DATE: SIGNATURE: P ✓�����` �� Stipulations: TX za s*.T S?3.99 D T S �1Gfs, CQ.Il VT, I Lower, L'k'.uzz , ZG. 33A 48 Imxg v I®� 1►Z cam.... UPMk LFi\,iLL + ism '2, ►c� = 129,9 x lZ. cm xZai 3Z,4 (i 1, 0916.3'V ck- Lt 1, 160 P yi.1 NC . Sd Z®. 5Pic CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Number Fixtures Future Fixture Opening New Fixture, Old Opening Catch Basin Water Heater - to 99,000 BTU 100,000 BTU to 199,000 BTU Water Softener New Ground Run Old Building Electric Water Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS & ALTERATIONS NO. RATE TOTAL $3.00 x $2.00 $ x x 0 x Water N m m o x $10.00 $ c-4 m 4 x 4J k. w w 5 $ Heater sa GJ m G .0 $ x $10.00 r 3 U 'O +i O .[ ro mp m'�o oe $ roroyro.11 rt aoi to .0 U a W 07 N 3 A W ul W U P7 a 3 L1 � c7 O as lec .1st 2nd 3rd 4th (R)'= Future Connection Opening Connected with Sewer (*} New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Number Fixtures Future Fixture Opening New Fixture, Old Opening Catch Basin Water Heater - to 99,000 BTU 100,000 BTU to 199,000 BTU Water Softener New Ground Run Old Building Electric Water Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS & ALTERATIONS NO. RATE TOTAL $3.00 x $2.00 $ x $2.00 $ x $5.00 $ x $5.00 $ 6— x $10.00 $ x $7.00 S x $5.00 $ X $5.00 $ x $3.00 $ x $1.00 $ x $10.00 $ First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ REINSPECTION FEE ($10.00) Job Address Department of Buildings City of Fridley Tel. #571-3450 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. 2 , 19 OWNER ` =�'1 KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD NEW UILDING PERMIT NO. PERMIT NO. Company 1 t5n✓ ut, Signed By l Q��1Ji'1 ( C' Tel. No. � /c b ROUGH INSP. Date FINAL INSP. 1- 2 f- -60 Date APPROVAL FOR PERMIT d� MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND Furnace Shell & Duct Work to 100,000 BTU AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE 4.00 $ Replacement of Furnace GRAVITY WARM AIR: RATE TOTAL `� Job Address '7 �� �./L Furnace Shell & Duct Work $12.00 $ $ Replacement of Furnace 7.00 $ Boiler & Lines up to 100,000 BTU Repairs & Alterations -up to $500.00 7.00 $ Department of Buildings Repairs & Alterations each add. $500.00 4.00 $ City of Fridley each addn. 50,000 BTU 6.00 $ Tel. #571-3450 MECHANICAL WAIM AIR: Furnace Shell & Duct Work to 100,000 BTU $12.00 $=J each add. 50,000 BTU 4.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Repairs & Alterations each add. $500.00 4.00 $ STEAM OR HOT RATER SYST11M: Boiler & Lines up to 100,000 BTU $12.00 $ each addn. 50,000 BTU 4.00 $ Boiler only up to 100,000 BTU 7.00 $ each addn. 50,000 BTU 6.00 $ OIL BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 S GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: 1st 3 Fixtures x $ 3.00 $ Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00• S AIR CONDITIONING $ FAN HEATING SYSTEMS See Fee Schedule $ VENTILATING SYSTEMS $ ALTERATIONS & REPAIRS $ State Surcharge $ .50 TOTAL FEE $ �- 'S ROUGH INSP. REINSPECTION FEE Date (510.00) FINAL INSP. •- 11 ` kj Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE The undersigned hereby makes application for a Rermit 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, Minn. 19&9 OWNER KIND OF BUILDING'/�% USED AS�2�[1-C<L�.� TO BE COMPLETED ABOUT e, ESTIMATED COST _r?C5 eO OLD /- NEW BUILDING PERMIT NO. PERMIT NO. n— DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Ai _ No. G�-/oSTJa.c Trade Name Size No. c G Zd_ JW Capacity Sq. 7t. EDR BTU HP Total Connected Load Kind of Fuel 1 _ /o BURNER - Trade Name 3.422ki Size No. 04-)C- Capacity Sq. Ft. EDR BTU HP Company �=4_17_1/jyj &C_0 4✓C:.. Signed By Tel. No. SUBJECT City of Fridley 29745 AT THE TOP OF THE TWINS BUILDING PERMIT r � � RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r I I � � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/22/99 JOB ADDRESS 1481 Rice Creek Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 1 I Heather Hills 3rd Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jerry Andrewski 3 CONTRACTOR MAIL ADDRESS Burnsville 55331 IP PHONE LICENSE NO Four Seasons Roofing & Rem. 2107 1/2 W. Burnsville Pkwy. 890-1899 20138780 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 Rk REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 17 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP 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 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1486 $.74 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 PERFORMANP4 OF CONSTRUCTION $54.00 Fire SC $1.49 PLAN CHECK FEE TOTAL FEE License SC $5.00 $61.23 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPE VALIDATED THIS IS YOUR d BLOt INSP /per%PERMIT - f)ATE S-GNATURE OF OWNER „F OWNER BUILDERi IOATEI NEW[ l Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY A ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R -2Q BUILDING PERMIT APPLICATION Construction Address: c f- C- A F Legal Description: Owner Name & Address: aK RzLj5K CM k Tel. # Contractor: S ®� � � �0,,� MN LICENSE # ,2b133 "780 Address: 25�� �� �d ��..r���a��� �W�/� ►gh,�d��e Tel. #G !.-,4, 8'`l®--1 P1Y Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF L%4PROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: 1 q OPP�- kc - l -,R (-?0 Estimated Cost: $ e _ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: A'2 - APPLICANT: Tel. # 612, ? 9 0 -- ► ? R 4 STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ 1q2_ .001 of Permit Valuation (1/10th%) State Surcharge $ `%� $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ 5- $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 [ ] 61-23 TOTAL $ STIPULATIONS: Building BUILDING Permit No.: �)O� � Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Da"ff : UN 0 A ME DATE 0?SLA\—Q ® YOUR E-MAIL ADDRESS l,�Sc��.t�l� a ooI r pC • C.CmI SITE ADDRESS 04'91 ?N tt-e- $ $5.00 (State Licensed Residential Contractors) SAC Charge $ THIS APPLICANT IS: ❑ OWNER 9CONTRACTOR. $ PROPERTY OWNER/ NAME:�t,\ $ ADDRESS: n CITY STATE ZIP TENANT Fee Determined by Engineering PHONE: I A I NAME: Renewal By Andersen $ CONTRACTOR SUBMIT A COPY OF STATE LICENSE #_ 1920 County Road "C° West Make checks payable to: City of Fridley Attac YOUR STATE LICENSE ADDRESS: Roseville, MN 55113 t STATE ZIP WITH APPLICATION PHONE License #20130983 Cl SINGLE FAMILY/NM 651-264-4777 PROPERTY TYPE ❑ TWO FAMILY/NEW G ❑ ADDITION ❑ GARAGE/SHED`WINDOWS PERMIT TYPE E3 BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION 6ZMAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 5 CA -In t/ SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE &c 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 ❑Soffit ADDITIONS &c PORC S SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structurc ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES &c TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING—Tiff.1997 U.B.0 FEE SCHEDULE) AL JOB VALUATION S ®lot , `i I LO — Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $.001 times the total job valuation Surcharge $ ., ci .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks payable to: City of Fridley Attac THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED 7 I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not permit but only anapplication f r a permit and work is not to start without a permit; that the work will be in accordance with the approve plan in the case of all work whl h requires rqfl#w and approval of plans. SIGNATURE OF APPLICANT L-'�/,�B11�I' NAME9t 1 (o� Q y%SC% V',_� DATI / Building Inspections 763-572-3604 BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY Permit No. Received By: Date Rec'd: DATE _ 6 Z YOUR E-MAIL ADDRESS SITE ADDRESS JLe P ee o' r' �e THIS APPLICANT IS: ❑ OWNER IRCONTRACTOR PROPERTY OWNER/ NAME: r'/i (' �* TENANT ADDRESS, ��7 I R tc G1r CITY Vi -e STATEPUIP—f-:5—y3e;> CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE TYPE OF WORK: STATE LICENSE # ffe -ZG3�X7� lL EXP DATE -Tar, _ ADDRESS: ZU e'l`t u y+- C - _CITY STATF IP S S .� J� 02SINGLE FAMILY/NEW ❑ TWO FAMILY/NEW CC ❑ ADDITION ❑ BASEMENT FINISH ❑ DECK DESCRIBE WORK BEING SIZE OF IMPROVEMENT. NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING Vinyl Aluminum ❑ Other ■ i ■', ❑ GARAGE/SHED ❑ ROOF +SIDING ❑ SWIMMING POOL ❑ ADDITION LI HUUSh U1NLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ']Soffit Trim Fascia SIZE_ STORIES ❑ DRAIN TILE ❑ OTHER HEIGHT Ft. BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING VM 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $Z —302 OCCUPANCY TYPE Permit Fee $ qS' See Back Page for Fee Schedule Plan Review $ d 65% of Building Permit Fee Fire Surcharge $ jj. •001 times the total job valuation Surcharge $� .0005 x Permit Valuation Minimum $.50 License Surcharge $� $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I 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 fora permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work whic uir w and pproval of plans. SIGNATURE OF APPLICANT ' PRINT NAME �` �" f S `I`= /2 DATE Building BUILDING Permit No.: D' 6Q''�� Inspections RESIDENTIAL APPLICATION Received By:./C_TL 763-572-3604 CITY OF FRIDLEY Date Rec'd:t, 763-502-4977 FAX EFFECTIVE 1-1-09 DATE YOUR E-MAIL ADDRESS -'e n G k4r kens 6 45ryn _m P1. com SITE ADDRESS M/ Rr c e Creek Or THIS APPLICANT IS: ❑ OWNER 9CONTRACTOR PROPERTY OWNER/ NAME: ADDRESS: CITY STATE ZIP TENANT PHONE: CONTRACTOR NAME: ; +C IevI S 8V 0eir!in STATE LICENSE # 404108'70 EXP DATE 3/31 /J010 SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF 1' /I ADDRESS: X 01 Si I r er " R pGo(. . -c C CITY A[,oAl i3rfcA4on STATEPff ZIP Si'11 d INSURANCE PHONE 6Ll6 36- 5 Id FAX &/ Z4-3_317 PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ref ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION WADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: &5e oe a nOI Main l e lle / add; 40A SIZE OF IMPROVEMENT LENGTH 1,E " WIDTH17-1— HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE , 2. Proposed floor plan PROPOSED SIZE: PROPOSED HEIGHT: ❑ DETACHED GARAGE 3. List of structural members to be used NEW CONSTRUCTION INCLUDING DECKS, SIDING e ❑Soffit _FOR DDITIONS. &PORCHES SUBMIT: ❑ Vinyl G. 1. Site Plan/Survey showing the existing structures ❑ Aluminum ❑ Other ❑ Trim ❑ Fascia "� and proposed project. S 2. Two sets of construction plans WINDOWS - 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBOF WINDOWS ALL FEES ARE BASED ON VAL TOTAL JOB VALUATION Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due ,.J CLUDING THE COST OF LABOR AND MATERIALS: 1997 U.B.0 FEE SCHEDULE) OCCUPANCY TYPE See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $2000 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$22=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all work P' is qu review and approval of plans. // SIGNATURE OF APPLICANT % /)% � PRINT NAME _JOna� 4an 6f'75 Lt, DATE V4&q C[iYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 (763) 571-3450 • FAX (763) 571-1287 • TTD/TTY (763) 572-3534 May 8, 2009 Kitchens by Design 201 Silver Lake Road Suite C New Brighton MN 55112 Re: Permit application for 1481 Rice Creek Drive Dear Jonathan Crenshaw: After review the plan you submitted for the property above we are in need of additional information to be included on plan. 1. Foundation design: re -bar location per wall height. Ch 404.1.1.4 2006 IRC 2. Foundation wall design for walls with unbalanced load on opposite sides of the building, such as the daylight walkout basement. The rim board shall be attached to the sill with 20 gage metal angle clips 24" on center. See section R404.1, 2006 IRC amendments. 3. Size and type of header for removal of block wall. 4. Size of all headers in addition, and existing walls that will be removed. 5. Rim joist detail and energy truss design over top plate. Per Minnesota Energy code 7670-7672. 6. Atttic access location Ch 9 IRC. 7. Show detail of framing/fire stopping around existing masonry fire place. If you have any questions please feel free to give me a call at 763-572-3603. Sincerely, Dave Jensen Building Inspector From: 6512861263 Page: 1/4 Date: 5/21/2009 9:03:42 AM f 1-t 9 j (5� iG "G Cew-. r 0r NO, 714 MARCH 2008 MEL -ROI. Rolled, Self -Adhering Waterproofing Membrane DESCRIPTION MEL-ROL waterproofing system is a flexible, versatile, dependable, roll -type waterproofing membrane. It is composed of a nominally 56 mil thick layer of polymeric waterproofing membrane on a heavy duty, four -mil thick, crass-Iaminated polyethylene carrier film. The two components are laminated together under strict quality - controlled production procedures. A handy overlap guideline is printed 2 A" (63.5 nun) in from the material edge on each side to assure proper overlap coverage and to assist in maintaining a straight application. Special exposed polymeric membrane strips are provided on both sides for positive membrane -to - membrane adhesion in the overlap area. The membrane strips are protected by a pull -off release strip. All components of the MEL-ROL waterproofing system work together to provide a cost-effective, positive waterproofing system that's quick and easy to apply. W. R. MEADOWS accessory products included in the MbL-ROL waterproofing system are: MEL-ROL LIQUID MEMBRANE, MEL -PRIME_ primers (solvent -based and water-based), POINTING MASTIC, DETAIL STRIP, CATALYTIC BONDING ASPHALT, TERMINATION BAR, PROTECTION COURSE and MEL -DRAIN_ drainage board USES MEL-ROL waterproofing system provides a cost- effective answer to properly waterproof foundations, yertical walls and below -grade floors in residential and commercial construction. It is equally effective for use as between -the -slab waterproofing on plaza decks, parking decks and structural slabs. Use it as a waterproofing membrane to isolate mechanical and electronic rooms, laboratories, kitchens and bathrooms- MEL-ROL offers positive protection when "wrapped around" major rapid transit, vehicular, utility and pedestrian tunnel projects. Installation of PROTECTION COURSE from W. R. MEADOWS is recommended before backfilling. MEL- ROL can also be used with drainage boards when (Supersedes February 2007) FEATURESIBENEFITS • Provides cost-offective, flexible, versatile, dependable, positive waterproofing protection against damaging moisture migration and the infiltration of free water. • Offers a quick and easy -to -apply system for maximum productivity. • Special membrana -to -membrane adhesion provides additional overlap security. • Meets or exceeds the test requirements of all currently applicable specifications. • Components work together for positive waterproofing protection. • Handles with ease on the jobsite. • The product will help meet and maintain the maximum slab moisture transfer rate of 3 Ib./1000 fL2/24 hours required by the flooring industry's specifications. • Available in a low temperature version, for use when air and surface temperatures are between 200 F (-7° C) and 60° F (16° C). PACKAGING 38.5" (.98 m) wide x 60' (18.29 m) long, one roll per carton. COVERAGE Provides 180 fl:.'' (I7.88 m2) per roll. Gross coverage is 192.5 ft.2. (Net coverage is 180 ft 2 with overlap of 2 'h".) STORAGE AND HANDLING Store membrane cartons on pallets and cover if lett outside. Keep materials away from sparks and flames. Store where temperature will not exceed 90° F (32° C) for extended periods of time. SPECIFICATIONS • A.R.E.M.A. Specifications Chapter 29, Waterproofing ADDITIONAL WATERPROOFING -MEMBRANES FROM W. R. MEADOWS CAN BE FOUND BY VISITMNG OUR WEBSITE: www.wrmeadows.com specified. CONTINUED ONREVEP*SE SIDE... d rs�.a; s-�-a:y:. ax.,.,.ua�. w�r��,w .�. a•�=..„-x. e�.,.a s, .,, �.r...,... s .sr,a:«::i mow:•--s.-4,�.aw_:�c*:x�m:rs�°w._.W.:a-,n ..,m¢�»�.;m:aax ., .;_.,-..:. :,exrv..r,� .._:_. w,. �; W. R. MEADOWS, INC. P.O, Box 338 • HAMPSHIRE, IL 60140-0338 Phone: 847!214.2100 - Fax: 8471683-4544 1-800-342-5975 www.wrmeadows.com HAMPSHIRE, 1L / CARTERSVILLE, GA 1 YORK, PA FORT WORTH, TX ! BENICIA, CA/ POMONA, CA GOODYEAR, AZ / MILTON, ON / ST. ALBERT, AB From: 6512861263 Page: 2/4 Date: 5/21/2009 9:03:43 AM W R. MEADOWS. �� i"ll ilis'H7f PAGE 2 ... MEL-ROL #714 ... MARCH 2048 MEL-ROL COMBINES POSITNE WATERPROOFING PROTECTION WITH EASE OF HANDLING EXCLUSIVE FEATURES A handy overlap guideline is printed 2'h" (63.5 mm) in from the material edge on each side, assuring proper overlap coverage and assisting in maintaining a straight application. The polymeric waterproofing mernbrane is protected by a special, easy -to -remove release paper. The exposed membrane strips on the material edges are protected by a pull -off release strip. Exposed polymeric membrane strips are provided on both sides of MEL-ROL for positive membrane -to - membrane adhesion in the overlap area... note the detail, as shown in inset photo. 1.90% peal alter 7 days at 70° F plus 7 days at 120° F plus 7 days at 70° F (dry) (-00- 2. Membrane placed over a parous base in a test ccfl wd edges sealed Water was placed over test specimen. Cell fastened and scaled and placed under 105 psi (.73 MPa) (approx. 240' (73.1 m) water bwa) pressure for 24 hours. Test specimen did not show any water to pcnrmw the membrane. MEL-ROL IS QUICK AND EASY TO APPLY APPLICATION SURFACE PREPARATION... Concrete should be cured at least 72 hours, be clean, dry, smooth and free of voids. Repair spalled areas, fill all voids and remove all sharp protrusions. TEMPERATURE* ... Apply in dry, fair weather when the air and surface temperatures are above 40° F (4e Q. Do not apply to frozen concrete. *MEL-ROL LOW TEMP can be used when air and surface temperatures are between 20° F (-7' C) and 60° F (16° C). PRIME... Prior to application, prime all surfaces to be covered in one working day with applicable MEL -PRIME primer. Uncovered, primal surfaces must be re -pruned the next day. Follow all instructions and precautions shown on primer containers. FOOTING DETAILS ... Use DETAIL STRIP for impaction sheet coverage. First, fold strips lengthwise and then cut at the fold. Material is then ready to install as 4 A" (114.3 min) strips on either side of the rebar. Any excess can be turned down on the face of the footing. Next, fill the voids around rebars in the keyway with CATALYTIC BONDING ASPHALT. Pour the walls. Install DETAIL STRIP horizontally along the wall where it meets the footing, placing half the material up the wall and the other half onto the footing. Extend the material 4 h" (114.3 ram) beyond outside corners. Slit extended portion of DETAIL STRIP lengthwise. Place the horizontal flap out onto the footing and bend the vertical flap around the wall. (See Diagram A.) Repeat this procedure in the opposite direction as shown in Diagram B. REMOVE release paper from MEL-ROL from the top edge of the roll and firmly press exposed area to the wall. Remove the release paper wood, insulated can w applied to concrete, 1. All su surfaces, from the rolls in a downward direction, pressing MEL-ROL into place wood, insulated wall systems and metal. All substrates must an the wall. be clean, dry and free of all surface irregularities. DIAGRAM B DIAGRAM A Outside Corner -3.1do Corner Concrete Well fall UetallS9rlp.;ti•-; -Footing y Detail SOp TECHNICAL DATA PROPERTY TYPICAL VALUE Tu sr METHOD COLOR... Carrier Film Polymeric Membrane White aleck THICKNESS ... Carrier Film Polymeric Membrane 4 mils 56 mils TENSILE STRENGTH ... Carrier Film Polymeric Membrane 5900 psi min. (40.71 MPR) 590 psi rain. 0.07 MPe) ASTM D412 (the ELONGATION ... Polymeric Membraw 4551/.min. ASTM D 412 le C PERFORMANCE OF COMPOSITE MEMURANE PEEL ADHESION Dry Wet 7 Itelin. (125 81mm) 7lbAn. 125 mm Footnote I ADHESION Dry S lblin. (90 91—) _LAP PLIABILITY 180° Bend, 1° 25.4 mmMandrel -25° F -32° Unaffected ASTM D 146 WATER VAPOR PERMEABILITY 0.019 Perms ASTM E-96, B WATER ABSORPTION 0.11%, 72 In. vwx ASTM D 1970 RESISTANCE TO HYDROSTATIC HEAD Equty, to 240' (73.1 m) ofwater Footnote 2 PUNCTURE RESISTANCE 67 lb, (2.98 kN) ASTM E 154 EXPOSURE TO FUNGI Paas, 16 weeks Soil Test 1.90% peal alter 7 days at 70° F plus 7 days at 120° F plus 7 days at 70° F (dry) (-00- 2. Membrane placed over a parous base in a test ccfl wd edges sealed Water was placed over test specimen. Cell fastened and scaled and placed under 105 psi (.73 MPa) (approx. 240' (73.1 m) water bwa) pressure for 24 hours. Test specimen did not show any water to pcnrmw the membrane. MEL-ROL IS QUICK AND EASY TO APPLY APPLICATION SURFACE PREPARATION... Concrete should be cured at least 72 hours, be clean, dry, smooth and free of voids. Repair spalled areas, fill all voids and remove all sharp protrusions. TEMPERATURE* ... Apply in dry, fair weather when the air and surface temperatures are above 40° F (4e Q. Do not apply to frozen concrete. *MEL-ROL LOW TEMP can be used when air and surface temperatures are between 20° F (-7' C) and 60° F (16° C). PRIME... Prior to application, prime all surfaces to be covered in one working day with applicable MEL -PRIME primer. Uncovered, primal surfaces must be re -pruned the next day. Follow all instructions and precautions shown on primer containers. FOOTING DETAILS ... Use DETAIL STRIP for impaction sheet coverage. First, fold strips lengthwise and then cut at the fold. Material is then ready to install as 4 A" (114.3 min) strips on either side of the rebar. Any excess can be turned down on the face of the footing. Next, fill the voids around rebars in the keyway with CATALYTIC BONDING ASPHALT. Pour the walls. Install DETAIL STRIP horizontally along the wall where it meets the footing, placing half the material up the wall and the other half onto the footing. Extend the material 4 h" (114.3 ram) beyond outside corners. Slit extended portion of DETAIL STRIP lengthwise. Place the horizontal flap out onto the footing and bend the vertical flap around the wall. (See Diagram A.) Repeat this procedure in the opposite direction as shown in Diagram B. REMOVE release paper from MEL-ROL from the top edge of the roll and firmly press exposed area to the wall. Remove the release paper wood, insulated can w applied to concrete, 1. All su surfaces, from the rolls in a downward direction, pressing MEL-ROL into place wood, insulated wall systems and metal. All substrates must an the wall. be clean, dry and free of all surface irregularities. DIAGRAM B DIAGRAM A Outside Corner -3.1do Corner Concrete Well fall UetallS9rlp.;ti•-; -Footing y Detail SOp From: 6512861263 Page: 314 Date: 5/21/2009 9:03:43 AM PAGE 3 ... MEL-ROL #714 ... MARCH 2008 HORIZONTAL APPLICATION ... Remove release paper on edge, then position the KIEL-ROL membrane. Pull balance of release paper off, running the roll from low to high points, so all laps will shed water. Stagger end laps and overlap all seams at least 2 %s" (63.5 mm). Apply a double -thickness of the MEI.-ROL membrane over construction, control and expansion joints and over cracks greater than 1/16" (1.59 mm) wide. VERTICAL WALL APPLICATION ... Masonry walls may require the application of a cementitious parge- coat Allow the parge-coat to dry before priming and applying MEL-ROL. When applied, the pargc-coat will produce a smooth, uniform and well -bonded surface. Remove release paper, then apply vertically in lengths approximately 8'(2.44 m) long over the top of the horizontal DETAIL STRIP at the footing. Overlap seams at least 2 %:" (63.5 mm). Tightly butt edges of membrane and apply POINTING MASTIC in corner applications. (See Diagram C). $rd. POINTING DETAIL 8TR1p"7 MASTIC t t DIAGRAM C ••.., - �,, To the top terminations, apply POINTING MASTIC at least 1/8" (3.15 mm) thick and 1" (25.4 mm) wide. As an option, TERMINATION BAR may be used to mechanically fasten the membrane. HAND -RUB AND ROLL PRESS ... Once positioned, immediately hand -rub the MEL-ROL membrane firmly to the surface, removing any bubbles or wrinkles, then pressure roll the complete surface to assure positive adhesion. INSIDE CORNERS.- Before MEL-ROL is applied, place a vertical DETAIL STRIP on inside comers extending the material 4 Ih" (114.3 mm) beyond each side of the corner. (See Diagram D.) Terminate at the footing and finish the corner with POINTING MASTIC. POINTING ..4 concrete MASTI Well 3rd. • :`a , ,a4 .v DETAIL STRIP I St ,.j" „s DIAGRAM D DETAIL STRIP „p'°"• Inside Corner 400thg' OUTSIDE CORNERS ... Bend DETAIL STRIP vertically over the outside corner and extend 4 1h" (114.3 mm) beyond each side of the corner. Terminate the material at the footing. Finish the corner with POINTING MASTIC. (See Diagram C.) W R. MEADOWS. ��ATf IC��iIIo Wb- 16.350m) ow riep aw ca6an) POMINO MOM Hand or *VW. , TERMINATION "a A �. HOMEONTAL hKINEHANE 4-i- 111.43 en wide 116TAIL STRIP with a AVM(11.4aom) NUMIPNIN3i VAG*owrleP Nolde P.Imur and outside coraara DETAIL VMP - MELAWL a- (22ASC e) wide watarprao/iep Meawreee SONDINO ASPHALT or PawnN6 ISAsaO Asad Rdlad MaINx wahrage System or PROTECTION coukee Orae Tao DRAINS AND PROTRUSIONS ... All protrusions should be sealed with two layers of membrane applied at least 6" (152.4 mm) in all directions. Seal all terminations with POINTING MASTIC. Around drains, apply two layers of MEL-ROL and put a bead of POINTING MASTIC between the membrane and clamping rings and at all terminations, drains and protrusions. See ASTM D 5898. INSPECT AND REPAIR ... A thorough inspection should be made before covering and all necessary repairs made immediately. Tears and inadequate overlaps should be covered with MEL-ROL ... slit fishmouths and patch. Seal edges of all patches with POINTING MASTIC. Where applicable, horizontal applications can be flood - tested for 24 hours. All leaks should be marked and repaired when membrane dries. PROTECT THE MEMBRANE,.. on all vertical and horizontal installations with the immediate application of PROTECTION COURSE if no drainage system is used, or MEL -DRAIN. To secure PROTECTION COURSE, use POINTING MASTIC as an adhesive, and/or physically attach at the top edge using TERMINATION BAR. Backfilling should be done immediately, using care and caution to avoid damaging the waterproofing application. a" From: 6512861263 Page: 4/4 Date: 5/21/2009 9:03:43 AM PAGE 4 ... MEL-ROL t/714 ... MARCH 2008 PRECAUTIONS Avoid the use of products that contain tars, solvents, pitches, polysulfide polymers, or PVC materials that may corse into contact with MEC.-ROL. The use of MEL-ROL does not negate the need for relief of hydrostatic heads. A complete drain file system should be placed around the exterior of footing and under slabs, as required. Read and follow application information, precautions and Material Safety Data Sheet. ACCESSORIES MEL -PRIME WB ... This water-based primer prepares concrete surfaces for MEL-ROL application. Arrives ready to use. Requires no additional mixing. MEL -PRIME WB emits no unpleasant odors and works with all W. R. MEADOWS waterproofing membranes. Applies easily with manual sprayer or roller; VOC-compliant. MEL- PREVIE W/B is for use at temperatures of 40° F (4° C) and up. COVERAGE: 250 to 350 ft?/gal. (6.14 to 8.59 m2/L) PACKAGING: 1 Gallon (3.79 Liter) Units (4 units per carton) and 5 Gallon (18.93 Liter) Pails MEL -PRIME ... This solvent -based primer is for use at temperatures of 25° F (-4° C) and above. Apply by roller, COVERAGE: 250-350 ft.'tgal. (6.14 to 8.59 m�/L) PACKAGING: 5 Gallon (18.93 Liter) Pails MEL-ROL LIQUID MEMBRANE ... A two -component material used as a flashing to form fillets at corners and at protrusions. May be used as a substitute for POINTING MASTIC. COVERAGE: As a fillet, approximately 135 lineal feet per gallon (10.87 meters per liter) PACKAGING: 1 Gallon (3.79 Liter) Units, 4 Units per carton, POINTING MASTIC ...Used as an adhesive and for sealing top edge terminations on DETAIL STRIP and membrane, and to adhere PROTECTION COURSE. COVERAGE: 1/8" x I" x 200'/gal. (3.18 mm x 25.4 mm x 16.10 nil). PACKAGING: 5 Gallon (18.93 Liter) Pails or 29 Oz. (857.65 m1) Cartridges, 12/ctn. CATALYTIC BONDING ASPHALT ... Easy -to - apply, one -component material for sealing around rebar. COVERAGE. 5 gal./1000 R.Z/gal. (4.9m'/L) PACKAGING: 5 Gallon (18.93 Liter) Pails. DETAIL STRIP... Convenient, easy-to-use DETAIL STRIP provides an economical and effective method for sealing vertical and horizontal butt joints, i.e. inside or outside corners and where walls and footings meet. PACKAGING: 9" x 50' (.23 x 15.24 m) roll, 4 rolls per carton. PROTECTION COURSE ... Use for vertical and horizontal applications. Adhere with POINTING MASTIC or use mechanical fasteners. PACKAGING: 4' by 8' (1.22 by 2.44 m) panels. MEL -DRAIN ... is a dimple -raised molded polystyrene fabric designed to provide high flow capacity to reduce hydrostatic pressure buildup around waterproofing and vaporproofing membranes. Choice of drain types are available for vertical, horizontal and site applications. TERMINATION BAR ... is a high strength, pre- formed, multi-purpose, plastic strip designed to support vertical membrane systems and PROTECTION COURSE at their termination point. PACKAGING: 10' (Holes every 6" o/c, 2" from either end), 25 pieces per carton. MAINTAIN ENERGY EFFICIENCY Wet insulating materials lose much of their "R factor performance characteristics, reducing the energy efficiency of the structure. W. R MEADOWS thermal and moisture protection products play a key role in maintaining the structure's energy efficiency and aiding in the integrity of other structural systems, such as insulation. FOR MSDS AND MOST RECENT TECHNICAL DATA SHEET, VISIT www.wrmendows.com. LINIITED WARRANTY "W. R. MEADOWS, INC. warrants at the time and place we make shipment, our material will be of good quality and will conform with our published specifications in force on the date of acceptance of the order." Read complete warranty. Copy furnished upon request. Disclaimer The information contained herein is included for illustrative purposes only, and to the best of our w knowledge, is accurate and reliable. W. R. MEADOWS, INC. cannot however under any circumstances make any guarantee of results or assume any obligation or liability in connection with the use of this information. As W. R. MEADOWS, INC. has no control over the use to which others may put its product, it is recommended that the products be tested to determine if suitable for specific application and/or our information is valid in a particular circumstance. Responsibility remains with the architect or engineer, contractor and owner for the design, application and proper installation of each product. Specifier and user shall determine the suitability of products for specific application and assume all responsibilities in connection therewith. 0 W. R. MEADOWS 2002 3/084M Building MECHANICAL Permit No.: 0C( Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DIEMAJUN 1j 0 763-502-4977 FAX EFFECTIVE 2-19-09 DATE 06/05/09 YOUR E-MAIL ADDRESS wnelsonCa7larson_plumbing.com_ _ SITE ADDRESS 1481 Rice Creek Drive THIS APPLICANT IS: 0 OWNER HCONTRACTOR PROPERTY NAME: OWNER/ ADDRESS: CITY S'rATE ZIP TENANT - PHONE: CONTRACTOR COMPANY NAME: Larson Plumbing. Inc. _ CONTACT PERSON: Wendy Nelson SUBMIT A COPY OF STATE LICENSE 11 58757 (3341) EXP DATE YOUR STATE LICENSE WITH ADDRESS: 3095 162nd Lane_ NW CITY Andover STATEhffiZIP5MQ4 APPLICATION PHONL 763-427-7680 FAx 763-427-9448 PERMIT 'TYPE IN SINGLE FAMILY O TWO FAMILY Q TOWNHOUSE TYPE OF WORK: NEW O REPLACEMLNT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TUrAL NUMBER OF EACH BELOW) Equipment Installed MPG: MODEL: SIZEIBTU MFG: MODEL: SIZIYBTU MFG: MODI-sl.: SI7..E/i3TU AJC $25.00 _ - T7REPLACr (GAS) $15.00 _GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 (WOOD) $35.00 —NEW GAS GRILL $10.00 —FIREPLACE BOILER $35.00 FURNACE $35.00 --GAS UNIT I•ITR $10.00 CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL NEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 TVrNTILATOR $15.00 Number'af fixtures @ $10.00 LL x $10.00 0t Number of fxWres ' a $15.00�L x $15.00 = $ 17 Nui'-66e of fixtures @ $25.00 x $25.00 = $ : - N6ber of fixtures State Surcharge = $ :50 " 50 MINIMUM FEE $35.50 Total = $ .: e THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance will, the approved plan in the case of 1 ork whicgh requires review and approval of plans. SIGNATURE OF APPLICANT G� 1I PRINT NAME. Amy Arvidson DATE 06/05/09 PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building PLUMBING Permit No.'Myl Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 Da='dUN 11200 CITY OF FRIDI1E DATE 6/10/09 YOUR E-MArL ADDRESS wnelson(M-larsonplumbing.com SITEADDRESS 1481 Rica C:rAAk Drive THIS APPLICANT IS: E) OWNER WCONPRACTOR PROPERTY NAME: OWNER/ ADDRESS: CITY Fridley .STATEMNzip 55432 TENANT PHONE: CONTRACTOR NAME: Larson Plumbing, Inc. STATE LICENSE # 3341 PM EX? DATE 12/31/2008 SUBMIT A COPY OF YOUR STATE ADDRESS: 3095 -162nd Lane NW CITY Andover sTATEMN zip 55304 LICENSE WITH PHONE 763/427-7680 FAX 763/427-9448 APPLICATION PER UT TYPE ® SINGLE FAMILY 0 TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: 0 NEW REPLACEMENT DETAILED DESCRIPTION OF WORK PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500,00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL 13UMBER OF EACH BELOW) BATH SINK/LAV —FLOOR DRAINS —SHOWER WATER PIPING _ 'g9 BATHTUB GAS PIPING (NEED crfyvcF. mo SWIMMING POOL WATER SOFTNER ($35) _ CLOTHES WASHER KITCHEN SINK `�' WATER CLOSET BACKFLOW PREV. ($15) —DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION _ WATER METER OTHER ����xi/-��Tr �f .� J,G�.l' . ;.i`. ''�• `.,<�Dt�©� >. ..•�,� ...ft.. .•..nk:r.< . .;'•r; s.': �. m. � <..:.. ,,.s?"'r4��,a„ •:..%?: „-1 �{i..... , . _ ...T; .; >i' ::"� ..,.:� ...,,.-;..e.. .r ..-:....r..3Y t, j «� W /�*� �'�l�j,�?� (�' •c:l,.•t7 r.....•.>Fh9..,.:5.....+:....NF.:f.<:'.•'rr.Y-.. k.n. R , :`.Jr.'" 7 ' . "'%.,4'.t5;%i'....Ti l:flt aL-:+'�•V'C�' ',y ,� I,_00 i Permit Fee . $ Number of fixtures @ $10.00 x $10 00 = $ c✓ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ State Surcharge = $ .50 Total = $ THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED WV'WW1o'- I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of v hi c requires. review and approval ofpi �° L SIGNATURE OF APPLICANT PRIM NAME �• DATE r ? ::circ/�•�y'+';i'.�+ . i, • :r- - y}�,-� •,.' ::i*'s' rg:l.:.� L: ✓:13'Q .... �:;� .. �';'�'-.i•. > . ,l" i'iT]:fu/� ' 4k727,:.,` 1 L. City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977