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PRE 2010 DOCSSUBJECT PERMIT NO. City of Fridley 28436 ®TSE ° THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. ` r I PROTECTIVE INSPECTION SEC. 16 NUMBER REV DATE PAGE OF F/ APPROVED BY CITY HALL FRIDLEY 55132 '•� L____�% 612-571-3450 910-F15 10/27/98 JOB ADDRESS 1601 Rice Creek Road 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 Auditor's Subdivision #22 SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Judith Hartman571-3095 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LI I EENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage 31 SO Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCU ANCY 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 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 2656 $1.33 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 $74.75 Fire SC $2t66 PLAN CHECK FEE TOTAL FEE 78.74 SiGNATu EO CONTRACTOR OR iDATEi a WHEN PROPERLY LI DATED THIS IS YOUR PERMIT ii e $ NA R OF OWNE .� OW B LO iOAT i BLD 11 NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION \� ConstructionAddress: 14701 Legal Description: Owner Name & Address: -7T� LAS) Tel. # Contractor: MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the PP Y lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. Height S GARAGE AREA: Length Width Hei g q. Ft. DECK AREA: Length Width Hgt/Ground Sq. OTHER: 1 Construction Type: �00 �/ Estimated Cost: $ , � (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ /j/2,7 7/ ---3 F.S� DATE: � � APPLICANT: � �L,A Tel. # . STIPULATIONS: CITY USE ONLY Permit Fee $ / �% %3l Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ �7 . STIPULATIONS: SUBJECT . City of Fridley 874 AT THE TOP OF THE TWINS BUILDING PERMIT f NO. EE7I COMMUNITY DEVELOPMENT DIV. -____ PROTECTIVE INSPECTION SEC. u'_ jPT r 1 1 . e e® NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 763-571-3450 910415 9/11/03 JOB ADDRESS 1601 Rice Creek Road NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 5 Auditor's Subdivision #22 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mike Corbett 1601 Rice Creek Road NE 763-502-1018 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO First Landmark Builders 255 Roselawn Ave E STE 48, Ma lewood, MN 55117 1992 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 651-699-3135 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK p P X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct a 24' x 23' 2nd Garage 9 CHANGEOFUSEFROM TO STIPULATIONS Special Use Permit #03-11 approved for second accessory building. Permit issued subject to special use permit stipulations and stipulations on plan. WAR111pi(i 3ef0re digging call f®r all utility 10cetions oo� ff EUI By A 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 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 $12,207 $6.10 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 PROVI NS OF ANY OTHER ST4E OR LOCAL LAW REGULATING CON- @223.25 W Fire SC $12.20 STR TION R TH P E CONSTRUCTION t PLAN ECK FEE TOTALFEE #,-Inse SC $5.00 $246.55 SIGNATURE OF CONTR TOR AUTHORIZED AGENT tDATE, WHEN PROPERLY VALIDATED THIS IS UR PERMIT G ,N pA TE S,GNATURE OF OWNERof OWNER BUiLDERi iDATEi NEW [ ] CITY OF FRIDLEY Effective 1/1/2003 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (76 ) 572-3604 Bldg t sp ALTER [ ] SINGLE FAMILY AND DUPLEXES R4 AND R-2 (76 } TVr12 7`' BUILDING PERMIT APPLICATION. Construction Address: I c `%r Oa Legal Description:' Owner Name & Address: I Tel. Contractor. � J�(R eMN LICENSE # Tel. # Address:�S M�-r 1wook Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LNING AREA: Length Width Height _ Sq. Ft. GARAGE AREA: Length Width — Height _ Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: OP Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE Tel. # .�_ APPLICANT: pk4 r�- Call (763) 572-3604 for Permit Fees if mailing in application. Fax to Q3-571-1287 if using credit card and we will b call you for card number. CITY USE ONLY- NLY-Permit PermitFee $ 3e ;;6 Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ .10 $.50/$1,000 Valuation SAC Charge $. $1275 per SAC Unit License Surcharge $ 5 00 $5.00 (State Licensed Residential Contractors) Curb Cut Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ 1 $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ) a"I (00 55 STIPULATIONS- TOTAL $ CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1287 JOB ADDRESS Rice RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1%0 of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.00 $ _CD —IM $ 10.00 $� $ 10.00 $ $ 10.00 $ $ 25.00 $ State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATIO REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Effective OWNER MI L-- (26 c-- L�1 0 BUILDING USED AS S�G���- ESTIMATED COST A ZD PERMIT NO. 6/2W DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units I Circle One (Steam) (Hot Water' A' Trade Na a a Size No. BTU 006 HP EDR Fuel NK Total Connected Load Burner Trade Name Size No. BTU HP EDR 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 an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE HEATING CO CWNe- Signed _�tTEL # -76 3 -56-3, FAX # F L ' Final Date 3 Approved By Rough -In Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When rye la _finnan axistin0 ftiranra, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes (i No ( ) The venting system is plastidPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes( ) No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) The pY_ intina r nmhuS inn alr is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to ina+ali a naw rnmhnnfinn air.,it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When installing a new ventingcpm, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type M HEATING CO: Signed By. Date G7YOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 June 15, 2004 Mr. Michael Corbett 1601 Rice Creek Road NE Fridley, MN 55432 Re: Final Inspection at 1601 Rice Creek Road NE Contractor: Homeowner Dear Mr. Corbett: A mechanical permit was issued on September 30, 2003 to install a furnace in your garage. According to the 1991 Uniform Mechanical Code a final inspection shall be conducted on the work authorized by this permit. As of this date the inspection has not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Codes. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for by homeowner after notification" and the permit will be expired. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. CinrerPly DJ/mh Building MECHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: to— CITY _ YOUR E-MAIL ADDRESS p SITEADDRESS k DOI 1Ce, Q(te Y, YQ1A C l V'V" t dkey W M F)51A�)'L THIS APPLICANT IS: 0 OWNER CONTRACTOR PROPERTY NAME: OWNER/ TENANT ADDRESS: ��R-O O �,�_ C,1� _� CITY V 0 _®j STATAgZIP � PHONE: -y645CONTRACTOR COMPANY COMPANY NAME: SUBMIT A COPY OF CONTACT PERSON: YOUR STATE STATE LICENSE #_C,k0111y �p EXR DATE LICENSE WITH - ADDRESS: Wyk c1lad d Lin WE CITY blainL STATKWz P�b_44 APPLICATION PHONE --IU?) — 1 %') - IT5 Q !) FAX ILL?) - -1 %?) - Li b U W PERMIT TYPE X SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORT` • 0 NEW ;REPLACEMENT 0 ALTERATION(REMODEL DETAILED DESCRIPTION OF WORK� ( _k l 0j Qtk 1 G Q n(i j t ®_ 1 n Q p PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the t-tal cost up to $500.00, whichever is greater, for the improvement, installation or *:placement of a residential fixture, cxcludir.; the fixtures. (This should reflect only the (ost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 =. cost of labor x.05 = FOR PRO.IECTS WHERE LABOR EXCEEDS 5500. FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL- S"EBTU NIFG: ___ —. MODEL: S! 7E,3TU _ MFG: _ MODEL: SI"LE'BTU _ _ �~- )(A.0 525.00 _FIREPLACE (c?.;S);15.00 RANG:,OVEN SIU `iO _GAS -AIR TO AIR EXCHANGEER S15 _FIREPLACE (WOOD) $35.00 GAS GRILL S10.00 _NEW _BOILER 535.00 FURNACE $35.00 UNIT IiTR 510.00 _GAS CHIMNEY LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.00 XDUCT WORK $10.00 _GAS PIPING $10.00 _VENTILATOR 515.00 PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL. DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures a, $ 35.00 x $35.00 = $ State Surcharge = $ .50 Total = THIS IS AN APPLICATION FORA PERMIT-NOT VALID UNTIL PROCESSED � I hereby apply for a building and I that information is permit acknowledge the above complete and accurate: that the N ork will be in conformance with the ordinances and codes of the City of Fridley and %ith the Minnesota Construction Codes; that I understand this is not a permit hilt Only an application for a rmit and work is not to start without a permit; that the v ork will he in accordance with the approved plan in the case «ork wh h requires eview and approval of ans. Sly NArLREc�rrAPPLI( :�N " NTN:��1L•' DA'I J70 _ PLEASE NOTE: SEPA RATR,LiITS ARE REQUIRED FOR BUILDING, EL ,CTRICAL AND)`IECHANICA L WORK Cite of Fridley Buildin(y hispections Department 6-131 University Avenge NE, Fridley, MN 53432 763-572-3604 FAX: 763 -30? -4977 0 Building $ BUILDING See Back Page for Fee Schedule Permit NoQ-66 i -603.a4 Inspections &S';o RESIDENTIAL APPLICATION Fire Surcharge Received By: 763-572=3604 1 times the total job valuation CITY OF FRIDLEY $ Date Recd: 3h S-7 ® License Surcharge $ DATE — �'p YOUR E -MAI DRESS SAC Charge SITE ADDRESS $1675 per SAC Unit (Plans to MWCC for determination) THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ Nom: $ TENANT $450 Conservation Plan Review Park Fee $ ADDRESS: CITY STATE ZIP Sewer Main Charge PHONE: CONTRACTOR NAME: $ STATE LICENSE # EXP DATE 0 -,q 00 7 - SUBMIT A COPY OF YOUR YOUR STATE LICENSE ADDRESS: d '� dt r7Ce e5®ice `/� _ CITY STA IP WITH APPLICATION PONE Z16 -21 FAX - PROPERTY TYPEINGLE FAMILYMEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING 'MOTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ,!REMODELING DESCRIBE WORK BEING DONE: / -142MV E�%� SIZE OF IMPROVEMENT °rv'° LENGTH WIDTH J HEIGHTSq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE -y rc C I • 2. Existing Floor Plan 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. &PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other . ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS�;&s ❑No LOCATION OF WINDOWS 3. Energy Calculations 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 THE 9 TOTAL JOB VALUATION $ 9 7!2Q FEE OCCUPANCY TYPE Permit Fee $ 3-1, Q5 See Back Page for Fee Schedule Plan Review $ &S';o 65% of Building Permit Fee Fire Surcharge $ 1 times the total job valuation Surcharge $ —.00 .0005 x Permit Valuation Minimum $.50 License Surcharge $ 1:5®6 $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 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 $ 1-1(.44 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 for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work whic)ftAuires revue ;ppoval of plans. .--, SIGNATURE OF APPLICANT Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: ULZO 763-572-3604 CITY F FRIDI,EY ..eTeCc�d:_ DATE ' T "%0 Y� E-MAIL Affs SITE ADDRESS THIS APPLICANT IS: ❑ OWNER ONTRACTOR PROPERTY Nom: OWNER/ ADDRESS: Mot FA CITY WOLUM STA Z TENANT PHONE: CONTRACTOR NAME: 41� ilel STATE LICENSE # i i `C t !1✓ f E DATE -—�-'�---- / % SUBMIT A COPY OF YOUR STATE ADDRESS ,� /1, C /'L %�� i�� t5� , CITY ✓ �� �' ��JG `��"i �Gf! STATT&; ZIP LICENSE WITH PHONE ' FAX APPLICATION " PERMIT TYPE SINGLE FAMILY I] TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: )(NEW ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK )I VIA 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$300 -FEES ARE BASED ON $10.00 PER FDCTURE, EXCEPT WHERE NOTED :FI)CRJRES;. INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV _FLOOR DRAINS _ SHOWER WATER PIPING _ —BATHTUB ,� GAS PIPING (VEw crirucEaE) _ SWIMMING POOL _ WATER SOFTNER ($35) CLOTHES WASHER .KITCHEN SINK_ WATER CLOSET _ BACKFLOW PREY. ($15) DISHWASHER AUNDRY TRAY :WATER HEATER ($35) FOR IRRIGATION ,� WATER METER _ OTHER R Yn [' T t }3` � � :;iA' �.�� g�av n+3a'i�yd',c ��• A ;h�:�"� .�.. _ y. Number of fixtures @ $10.0010 X$10-00 $ Permit Fee $ Surcharge .50 Number of fixtures @ $15.00 x$15.00=$ Number of fixtures @ $35.00 _� x $35.00 = $ TOTAL DUE $ State Surcharge = $ .50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all r h re s re w and approval of plans. v DATE SIGNATURE OF APPLICANT PRINT NAME MINOR' 2, ullpfflga=1101 A City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 W Building PLUMBING Permit No.:(� Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date 763-502-4977 FAX EFFECTIVE I-1-2010 M c DATE YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: OWNER ❑CONtTRACTOR PROPERTY NAME: A t OWNER/ ADDRESS: I CITY C11 e LA STA ZIP TENANT PHONE:�LP CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX SINGLE FAMILY O TWO FAMILY ❑ TOWNHOUSE PERMIT TYPE . 11 NEW ARFPLACEMENT TYPE OF WORK: DETAILED DESCRIPTION OF WORK e kaCa FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. L BATH SINK/LAV DRAINS _ SHOWER _ WATER PIPING _FLOOR BATHTUB —GAS PIPING (NEED CITY LIC) _ 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 LIZ } � � ''F'k �..�� ir`}�3,. ��-•;* eJ�`ka�¢��',k� ' � �L �f �' +, ig'^.A'�a �, ��z ��� ��t� } z S'r �1 h 6A �' °%' � � } h '@�' 1�a �' E 2 4iy U d r• Si � �S T 3 k E �� a 2 �� S. 11 •',�t %" kA3��.:f5 $ CR, r 3 y �i P A, N.ia�E i'.e r�1� g,Z 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. - pn� � tf �^+�-► ` , PRINT NAME ` p', (WW DATE SIGNATURE OF APPLICA �? @Wl5e- a City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 E Building MECHANICAL Permit No.:, (A' Received B: ' Inspections RESIDENTIAL APPLICATION 763-572-3604 CITY OF FRIDLEY A 763-502-4977 FAX EFFECTIVE 1-1-2010 //�� DATE YOUR E-MAIL ADDRESS 0 MC -S-56 &MCAM, N er SITE ADDRESS lbol Rice— c&_,W RA THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY NAME: M ICfiNWL -4 WN de– OWNER/ ,ICOR n ADDRESS: Itao I Q (� �etL CITY ti'=M D[.e�( STATEjNAjZIP U TENANT 263 -- 5601 —16 l8" PHONE: CONTRACTOR COMPANY NAME: CONTACT PERSON: SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: CITY STATE ZIP APPLICATION PHONE FAX SINGLE FAMILY ❑ TWO FAMILY O TOWNHOUSE PERMIT TYPE TYPE OF WORK: 0 NEW 0 REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK ill XL- A-' I�'TfMQdOM_ lie: "B (NReIQp FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK ' lid MODEL: sizvBTU C Equipment Installed MFG: 6 NK QN�Tr1N MFG: MODEL: SIZEIBTU MFG: MODEL: SIZEBTU $25.00 FIREPLACE (GAS) $15.00 _GAS RANGEtOVEN $10.00 _A/C TO AIR EXCHANGEER $15 (WOOD) $35.00 NEW GAS GRILL $10.00 _AIR _FIREPLACE $35.00 $35.00 _GAS UNIT HTR $10.00 _BOILER _FURNACE LINER $10.00 DRYER $10.00 _POOL HEATER $35.00 _CHIMNEY _GAS DUCT WORK $10.00 _GAS PIPING $10.00 VENTILATOR $15.00 Sn j1 4 2'5 Yk �ac��fii"' �5 ,� 9 'i�`5. ,. y c+*1J. 3: - � ���F �ir.✓Y - .� b 3� � f .�� '3�3. �, 'hid ti2� 'y"9 d r `�N5�ay zi Tr kOR MS. THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT'-) "— PRINT NAME L C4 DA � I APPROVAL INSPECTORS SIGNATURE ' DATE ty of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments MN Rule 1346 Sec. 501 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments 4. Heat loss & cooling load per room a. MN Rule 1322, Sec. N 1104.4.13 5. Ventilation a. Per MN Rule Chapter 1322. Sec. 1104 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations. Building BUILDING Permit No..20lD - C35� Inspections RESIDENTIAL APPLICATION Received By: 1 763-572-3604 CITY OF FRIDLEY DaAD 9"' 763-502-4977 FAX EFFECTIVE 1-1-2010 /0 DATE YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: Q WaCZr Z?' TENANT ADDRESS: % &` ' ITY�®�' STATEIP PHONE: 7,o CONTRACTOR NAME: 0 a- x -e . SUBMIT A COPY OF YOUR STATE LICENSE ®pad STATE LICENSE #ter i"`1�� , �I - EXP DATE AND CERTIFICATE OF ADDRESS:_ m _?"�:,�`; ). g v &rte _CITY'4;'2 PPJTATE IP INSURANCE PHONE �-" FAX — PROPERTY TYPE PAINGLE FAMILY/NEW dONSTRUCTION SIZE /13 TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF 0 DRAIN TILE ❑ DECK ❑ SIDINGOTHER. /',/ ❑ SWIMMING POOL / /VA_rt1 TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR AREMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH O 9 WIDTH ® HEIGHT J SQ FT 27 ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ 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 ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I . 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: (USIN Rp 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ J OCCUPANCY TYPE Permit Fee $ d 5. :; L5 See Back Page for Fee Schedule Plan Review $ 2 1. 41 65% of Building Permit Fee Fire Surcharge $ 3 AQ.001 times the total job valuation Surcharge $ 2. ` .0005 x Permit Valuation Minimum $.50 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 $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due _214 $ Make checks payable to: Citv 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 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 wor /which rs}uir s review and approval of plans. 00, SIGNATURE OF APPLICANT PRINT NAME��� DATE �� _4� tt + j �C it rj 1.