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PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT No (5i Date: Owner: ,► Builder I ._.... _....... __._._._..._ _ Address _ _ __ _ _ _ _ _ Address L T9 OP BUILDING _ __ No. „..`"" p,..._.:.... Street .Part of Lot _ ....._�,.. ...-..... Block ....._ _ _. _ Addition or Sub-Divisio A r +� Corner Lot _ _ Inside Lot 'R''R _ Setback __ _ W Sideyard — ---- Sewer Elevation ___ _ _ ._._ Foundation Elevation DESCRIPTION .OF BUILDING To UsedOaL,�rr_�_'.:;^FrontDepth Height: Sq. F't.A7 Cu. F'Depth 5Height Sq. Ft.. Cu. Ft.s Type of �"ction .� Est. Cost ,r _ __. To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work m accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ T� _'� ., permit is hereby granted to to construct the building or addition as described above. This permit is granted upon ' he 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 part thereof, shall conform in all respects to -the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and movingof buildings pvithin the city limits and this permit may be revoked at any tune upon viola of any of the provisions of said OT== � �;�' Building Inspector NOTICE. This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure, to see .... parete permits for these items. APPLICATION FOR BUILDING PERMIT CITY OF FRRIDLEY# MINNESOTA Owner's Name Builder. Address Address, LOCATION OF BUILDING No. Street Part of Lot Lot Block Addition or Subdivision Corner Lot Inside Lot Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as DESCRIPTION OF BUILDING Front _ Depth Height Sq. Ft. Cu. Ft. FrontDepth 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 ruling of the Department of Build- ings, and hereby declares that all the facts and representations stated in this application are true and correc . DATE�—�..,SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley Application for Plumbing and Geis Fitting Permit Dept. of Bldgs. Phone SII 4-1 DESCRIPTION OF WORK � / Number, Kind and Location of Fixtures Location � PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures .................... f� x $1.50 $ . d D Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... y I� ` zz�gO...t�aa y Z x _ ZZ New Ground Run Old Bldg . ............ x 3.25 $ tu 2 Z • F • N WATER HTR. GAS ELEG Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 N LL O U m �S L7 Q i7 C C9 O Base ` 1st 0 2nd 3rd 4th • Future Connection Openings Connected with I sewer [� New Fixture, Old Openings Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures .................... f� x $1.50 $ . d D 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 $ a d New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $��=� Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $Q�27/- :;' ;;5: City of Fridley: The undersigned hereby makes application for a permit for the work heret 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 facl and representations stated in this application are true and correct. i Fridley. Nf3nn. 2 f 5 _ 194—� Owner Kind of Used as Tobec Estimated Cost, $Ot a Old jNew. uilding Permit No Permit No. �d Signe By I Business Phone No ROUGH 3 _ / 6 - & Z FINAL Application for Power plants and. Heaft. Cooling, Ventilations Refflgeraflon and Air Conditioning Systems and Devices `a PARTIAL RATE SCHEDULE Dept. of Bldgs. Pho SU 4-�4 _7 GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ..........:.... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ GAS FITTING FEES: NO RATE TONAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM f ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH— OUGH FINAL— FINAL City 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 Ordinance` and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this applicatio1p fl � true a correct. 92 0 Owner Kind of Building Used as s I — To be completed about lYI�V g ®c} Estimated Cost, $ ,4e1Q uilding Permit No. NS -7/ Permit No._ l DESCRIPTION OF WORK HEATING or POWXR PLANTS—Steam, Hot Water, arm Air No/_2e Trade Name 4 Size N0/3 Y �? "d � Capacity. Sq. Ft. E.D.R & 4-C- BTU - H.P. Total Connected LoadKind of Fuel BURNER — Trade Nam > _ Size No Capacity Sq. Ft. E D. BTU P. GEO. SEDC CK C 1TG. & AIR-COND. CS 1001 Xenia Av. S. erJ�iY�Za�i�ii� ii:' d'Aiirii. Signe By y 42 2M 7-39 Business Phona No G (REMARKS—OVER) D-56 79 HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS i? aIiNNEAPOLIS. MINN. Weatherstrips A.S.H.V.E. Construction No. Insulation Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How. Applied Yes—No Yes—No 19— I Fl.I s:; e V I Yf�,Aoom I Length !y /_ Width � x,.,— Height T II 9 Fl.l AFAf Room I Length i # 4, Width I Height Windows and Doors—Crackage and Area Width - Height No. of Lineal f . Area No. of pane of pane. lights of crack sq. ft. E3 6 13, dl g "Y, 1 J ;� moo¢ qqI- 1 p ,7 3 JCoef.j Btu Infiltration z 3 e a3 �s Glass Glass Sol az' ; ) Exp. wall y, 0 r Exp. wall ``r `a' Q' P y Net exp. wall /Z 1 ' �•�' 7-5 Int. wall 74 9 y 6-7� y, &j Int. wall Ceiling_. Floor G, 1?g _ Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area / F1.1 FA �,Wf V Room I Length 7; Width i f & Height ' Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. E3 6 13, B 4 12 17 Kia Coef. Btu Infiltration Infiltration 3 e a3 �s Glass Glass ,01. ,z, Exp. wall " Exp. wall ``r `a' Q' P y Net exp. wall /Z 1 ' Net exp. wall Int. wall 74 9 y 6-7� y, &j Int. wall Ceiling Floor G, 1?g _ Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I If 6 I F1.1 ev A -` Room I Length ,t d Width d Heiaht V Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. E3 6 13, B 4 12 17 Kia Coef. Coef. Btu Infiltration TCoef.tBtuInfiltrationGlass Glass ,01. --li-1,126 ;2 qszd Exp. wall ``r `a' Q' P y o /Z 9 3 Net exp. wall Net exp. wall Int. wall 74 9 y 6-7� y, &j Int. wall Int. wall Ceiling G, 1?g _ . Floor Floor Total Btu. 1 7 i 7�y ,7 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I I Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. ly7'' B 4 12 17 Kia Coef. Coef. Btu Infiltration, TCoef.tBtuInfiltrationGlass Glass ,01. Exp. wall a' ,... Exp. wall P y <1 /Z 9 3 Net exp. wall Net exp. wall Int. wall 74 9 y 6-7� y, &j Int. wall Int. wall Ceiling Ceiling' 1?g _ . G Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area R 0 1 --d 5 i�'2, T-- A RMm I l Pnoth ®,P_ Wlrlth ®. i-ie;aht °V Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane light! of crack sq. ft. B 4 12 17 Kia Coef. Coef. Btu Infiltration, v? Glass ,01. Exp. wall a' ,... Exp. wall*' <1 9 3 Net exp. wall Int. wall 74 9 y 6-7� y, &j Int. wall Ceiling I/ Ceiling Floor Total Btu. r; M Required sq. ft. E.D.R. or sq. ins. W.A. Leader area r, FLI 1 a�, --,N R.. I Length I< OWidth i V. Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane f.pane lights of crack sq. ft. 36 � l� Coef. Btu Infiltration Glass ,01. Exp. wall a' ..v' z Net exp. wall 9 3 Int. wall Ceiling I/ Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area IDr6 9 HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS AUNNEAPOLIS, MINN. Weatherstrips A.S. V. Construction No. Insulation Guide WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How. Applied Yes—No Yes—No 19_ I F1.1 �4 it T 44 Room I Length Width �1_ Height II Fl.l Room I Length Width Height Windows andboors—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 f . Area No. of pane of pane liggphts of cra`c aq. Pt. dk Coef. Btu Infiltration Coef. Btu Infiltration ' Net exp. wall �a ` f Glass Ceiling ? 1 tea t-- F 5 Exp. wall ^= Ceiling , Floor Net exp. wall Ceiling , ' 4 Ci Int. wall Ceiling Floor Total 13tu. 1 3 `(, Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I I F1.I Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Height No. of Lineal ft. Area of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Infiltration Net exp. wall Glass Int. wall Exp. wall Ceiling Net exp. wall Floor Int. wall Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Height No. of Lineal ft. Area of pane lights of crack sq. ft. Coef.1 Btu Infiltration Glass Exp. wall Infiltration Net exp. wall Glass Int. wall Exp. wall Ceiling Net exp. wall Floor Int. wall Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Width Noe of pane Height No. of Lineal ft. Area of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Coef. Btu Infiltration Net exp. wall Glass Int. wall Exp. wall Ceiling Net exp. wall Floor Int. wall Net exp. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights - of crack sq. ft. Area eq. ft. Coef. Btu Infiltration Glass Exp. wall Infiltration Net exp. wall Int. wall Ceiling Exp. wall Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I Fl_I Rnnm I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. No. of pane of pane lights of crack Area eq. 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 rtes. �rf�r�m��a9 �p•+wty alvy-'.>y. �"�-,--a.. �n.....r? P 4.. .. � �°. ®y ®, _- .m, _e __�® �^��yy . i�fi :soli f, Ye�Y L as ss vr.i C -6•a_.. .d L..a..:i �t o..-... e.� 'orcY� ta�� SQL �: ta�i...�tam� %«�..�v]V•®r�� B�+sc� 6°tl/d SSd m+.e�v�t s.os.es. m: �..d :oo.o�i iuio: L.i Dz r 8ww.,A PARTIAL RATE SCS 47,MULE I?trpt. of aa_ -,m 117hw MMU= `��, cI=<��YT� c�AF';sa �>: Z `Y'OTAL �. :� /Daly . A-r� �iy 7� �/ 4 Re *e-e-rtrt cf Furna^e Prpe,-- !4 A:,t ra: rrr-- up tc S30o.00 ;:r,ry cac:1 add. a"O.C4 -461MCIL WAMM AM ruma e She'll & L`uct Wnrlc to MOM BTU e, -ch add. C-3,Doo BTU RepLtce-nemt cf-:rracr gtr;airz gt to isM.0o Rs-,zIrs & Ahrratiow each add. $-'00.00 Z AI4 as HOT WAT R SYS -IMM 31000 3 6.00 4i 3W 1.1010 $ 3 tYJ S 6.00 $ 3.00 $ /Co,000,e)ro 112,00 :•-8Cf S :a:1 °a :..;;rg__ to 4•vt .ac.• 34*—. Q _42,00 Fur -mc- S> -,Z & Lme,--to G40 sq f: EDP, 'riot Water Tom S. Each add :50 eq 4t EitR Steq-n I m $ Each add 32: sq. ft MR fret Water 3.00 $ OIL BUP&'EP—to 3 gaL per hour over 3 gal. per hour --- See F'ee Schedule GA$ 37ii1"7_,R (up to LK3.(rJ BTU) over y^-1.000 BTU so* rem schoauls GAS III IING FrEz. Mn RAY'S 'rO:AL 204 .75 State Suz:charae .50 City of Fricil,g: hcre�.%t• -na{e- applica j"_ for a permit for the mors her - 1r, a!1 % crk ,rt -,roc, acccr3arce with the City C.- ^i t:' =21 h ^`'y dt•c1--r-s t:2t a:1 .at,d :n ,t:is a,;::rcaw;n are true aad correct Fridley. ciwrPr . Kird of Building Used ae 7n h ECtimveti Cosmo. �S �OQ• O /vid New f3ul:d:7n Parti t No P®emit NO. Z Ca:+ eiG:T OF w®atm. 6.CO 3 cr F'cJ^? :'I.,A :"'--c'-a.'n, pct F•�a.+er Warm Air—No 5-00 $ L0.00 Tradm :;alre � G��r ©/�22 Size NO, /—/C-- Ifb 1st 3 Fixtures Add,ljonal r..ztures Cas Ra r ge to 1 ?.CCD AM MI'MM AL d -71,1 G 4 ]"M et 7_Z—r;U7xZ Capacity_zD©jOcO _ STFL-R� BTU H Total Cc:ux�*ed Ta__ Br_md of Fxcl ,4ya� B0P_','ZR —. ?awn Size :go Catps�++ty — So- FL B.D.R BTU B n T OTLL : Z. tc:��xs-�ttl Community Development Department PLANNING DIVISION City of Fridley DATE: December 20, 1993 TO: Carl Newquist, City Prosecutor FROM: Steven Barg, Code Enforcement Officer SUBJECT: Catherine Moss / Citation #582-990 On August 12, 1993, I issued the above referenced citation to Ms. Moss for unlawful storage of solid waste at 1021 Rice Creek Terrace. A recent reinspection revealed Ms. Moss has brought her property into substantial compliance. Please dismiss the charges against Ms. Moss in this matter. (It is my understanding that this matter is scheduled for trial on December 21, 1993.) Please call me at 572-3595 if you have questions or wish to discuss this further. Thanks for your assistance. SB:ls CEM -93-108 SUBJECT PERMIT �. City ®f Fraley 2 2 319 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. � `� _.�___ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r " NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 3/4/94 10B ADDRESS 1021 RICE CREEK TERRACE NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 BROOKVIEW TERRACE 2ND ADDITION SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Catherine Mass 1021 Rice Creek. Terrace NE 571^1342 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION !� REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof (louse (20 Squares) Tear-off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 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 $1 $' 75 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT ►5QQ 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- $35.00 Frie SC $1.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $37.25 SIGN TUREOFCONTTRAACTORORAUTHORIZEEDgGLNT (DATEI WHEN PROPER VALIDATED THIS IS YOUR PERMIT N'U DG INSP DATE SI 'URE OF OWNER 0F OWNER BUILDER) (DATE NEW [ ] Effective 1/1/94 ADDN [ ] CITY OF FRIDLEY ALTER. [ ] ,SINGLE FAMILY AND DUPLEXES_ R-1• AND R-2. Building Permit Application . ConstructionAddress: 1k�(f (,,ree,K / & r ra Ce Legal Description: Owner Name & Address: _ h e r yi Tel. #��7-1- I l l Contractor: MN LICENSE # Address: Tel. # Attach to this. application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Wa r_IQ 2f +- � a Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ cc Approx. Completion Date: Driveway Curb Cut Width Needed: _ DATE: `3 APPLICANT Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ (Cost on Back) Ft. + 6 Ft = Ft x $ _ $ e r h SS Tel. # �IE M1 Y Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $800 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: 1 -0 7 SUBJEtT P IT NO. City of Fridley 133 AT THE TOP OF THE TWINS BUILDING PERMIT r ` IPT NO.EC R��� COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 NUMPEn nEv DATE PAGE OF APPROVED BY 1 "'1 CITY HALL FRIDLEY 55432 612-571-3450 910.F15 9/11/00 JOB ADDRESS 1021 Rice Creek Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 Brookview Terrace 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Greg Bijold 1021 Rice Creek Terrace NE 763-574-9083 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 3p ALTERATION O REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install exterior draintile along the front and side of house 9 CHANGEOFUSEFROM TO STIPULATIONS 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 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 1 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 $500 $.50 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 FE TOTA EE $,14.50 0N'WA(, C O UTHORiZEDAGENT iDATEi HI� S IS -R PER IT_� ,�/VQSJ�1�\riS� XSi &U10 4ENROPEI�&ZD er 8P pAtE uRE OF w ER�w OWNER BUILDER. (DATES 7 NEW [ ] Effective 1/1/2000 ADDN [ ] - CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION � 'qf 3a Construction Address: t/ �.� 0ap[� -e// i Legal Description: q Owner Name & Address: C S Tel. # 5� C Contractor. MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width --� — Hgt/Ground Sq. Ft. OTHER: _L__®'S 71�%'Z Construction Type: Estimated Cost: $��=' Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ =$ DATE: —I(. -C�0 APPLICANT: C ` Tel. #a).-Sz � CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing In application Permit Fee $ ��. �� Fee Schedule on Reverse Side Fire Surcharge $ e .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1100 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 STIPULATIONS: �� � r�<<b q-�� -�o /(oM u�/�a-LsK�� �e.l s-�s 000 �A�a.a_ �QS6 `l SUBJECT MIT NO. City of Fridley30939 AT THE TOP OF THE TWINS BUILDING� PERMIT RECEIPT NO. � `v ______ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r PROTECTIVE ' 11 CITY HALL FRIDLEY 55432 "'' NUMBER REV DATE PAGE OF APPROVED By 612-571-3450 910-F15 5/15/00 JOB ADDRESS 1021 Rice Creek Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 Brookview Terrace 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Greg Bejold 1021 Rice Creek Terrace NE (763) 574-9083 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 X] ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE B DESCRIBE WORK Construct a 24' x 16' Patio with full footings that tie into house 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. WARNING Before digging Call for all utility locations Permit Inspection Cards 4%0002 Will Be Mailed REQUIRED BY LAY, To Homeowner To Post 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 $4,000 $2'00 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- $97.25 Fire S $4.00 STRUCT N R 2-4E- PERFORM NCE OF CONSTRUCTION �.� `_ PLAN CHECK FEE PTOTAL FE 'S —lam`. $103.2 SIGNATURE OF N'RACT OR AUTHORIZED AGENT IOATEIN P PERL IOATED THIJIrA YOUR PERMIT qA it S-GNATURE OF OWNER OF OWNER BUILDERI IDATEI `l 0k," ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Ac---e�c Legal Description: ccC Owner Name &Address: Contractor. WA Effective 1/1/2000 (763) 572-3604 Bldg Insp A�' to &OTel. # IZ4, Z U6 MN LICENSE (9 6 -5 8 Tel.#M 21E -'C Wg 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: Construction Type '.," 6e, ZZ -1.9—C& Estimated Cost: $ Driveway Curb Cut Width Needed: F + Ft = Ft x $ =$ DATE: �- % S �-� APPLICANT: Tel. CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ $1100 per SAC Unit $ $5.00 (State Licensed Residential Contractors) "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ 03- s s �y, „�: 6873-Niyhwvy SCS /v.�. MiIAWoPWfi 2/, G l IelEE R i N G! NCO . Miwwaa EN Enyneers Sur ve ors NORTONCON/V,ET7 . l ate of survey NORTON �• p Y!i{. Wit / t SCALA "1'63d M. S �p N a, Do ',.t FTURRAC E - � � Q�o90 ■ ltr t4, AITIO }: Y' t �. 30 0 o lrw"amw W rv.d're reser a iw ore Sw y q�' x 6ia►ndories q(7& oba�rr d�,y6e►d lar a, and ` �✓ j° or wmid land. As serve ed no. fh�s atl daildrn9s;I*vw, and d/ lis b/t -aar novimenfs , � 'a J: f u'" j �f A o r SUBUR8AN: ENGINEERING, INC. { , Eagineers Fr Surr�orrs,�..,. 1511/ • �. r.✓'��anr�"'"n�... •t' � i7 �r•. otifLu i{A'�,E'.w sf .� ,z+,� .ra,� kt+F\,,a.f..1,+..�i:�i...n°J':e>.1�.:.4 �,4.,Y.P.1��..�.J..iJn..i.1a`.'�e,t.�.h!5°.'...4i..t..�..f.4.1�'14>.'�• .t$'•i�.{Y°'. .,i,{.T:lc�&•: Yt.�'� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 MECHANICAL Permit No.:A-t Building Inspections RESIDENTIAL APPLICATION Received B763-572-3604 CITY OF FRIDLEY Date Rec'd�� DATE YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: O OWNER ONTRACTOR PROPERTY NAME: Alzvc ldill OWNER/ ADDRESS:'KierCITY STATE. ZIP ✓iS TENANT PHONE: C ' - CONTRACTOR COMPANY NAME: S SUBMIT A COPY OF CONTACT PERSON: YOUR STATE WITH STATE LICENSE # EXP DATE STATE6ZIP� LICENSE ADDRESS: V S�-��Crry__f i APPLICATION PHONE I a j(SINGLE FAMILY ❑ TWO FAMILY 0 TOWNHOUSE PERMIT TYPE TYPE OF WORK: ❑ NEW REPLACEMENT 0 ALTERATION/REMODEL 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 $50 ,FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) " � MODEL: d 7 a�'/l� 70, Equipment Installed MFG: PTN SIZFJBTU SIZE/BTU MFG: MODEL: MFG: MODEL. SIZE/BTU jA/C $25.00 FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 $35.00 FURNACE $35.00 GAS 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 $15.00 FIX_VENTILATOR Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $25.00-7—x$25.00 = $ TOTAL DUE $ Number of fixtures @ $35.00 1 x $35.00 = $ e ion/ State Surcharge = $ 50 _U Total = $ 3d 3D 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 F ' ey and with the Minnesota -Construction Codes; that I understand this is not a permit but only an app ication for pe 't and work i of to start without a permit; that the work will be in accordance with the proval of approved plan in the case o all work w ch fires revietPIR'INTNAMEMn� �� SIGNATURE OF APPLICANT I —9DATEfv- City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building $ -rt e BUILDING Permit Nor"", Inspections $ RESIDENTIAL APPLICATION Received By:� 763-5112-3604 $ r ®— CITY OF FRIDLEY Da 'd• 763-502-4977 FAX $ Erosion Control $ Park Fee EFFECTIVE 1-1-08 -• DATE 14!:2- R_ YOUR E-MAIL ADDRESS $ /91 . SITE ADDRESS C t _"(3 THIS APPLICANT IS: Kf OWNER OLCONTRACTOR PROPERTY OWNER/ NAME: JLL � 2400 ADDRESS: I- / AgnjSj''12 &r ` CITY CZk ._ STATE4(Q ZIP TENANT • PHONE: %b3— gScf — ZI ( L4 NAME: ADDRESS: I tL Q' ii. -e--, CITY CQ1~ _STATE_011 CONTRACTOR SUBMIT A COPY OF PHONE % 6—'s —e �I — �1�I3 FAX YOUR STATE LICENSE STATE LICENSE # \d ® I 9 S!j EXP DATE -"31 — 09 PROPERTY TYPESINGOLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWFAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS PI L- UJOJDQ�re )KBASEMENT FINISH ROOF ❑ DRAIN TILE S > Z 0ik, CC ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑t MAINTENANCE/REPAIR REMODELING DESCRIBE WORK BEING DONE: K,�&orn —kg m1 Ce.1F,t=m SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES 'Z$ .HOUSE & 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: jj ®d U ALUPM O e'V _ ICES aef ���1 r FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ❑ Vinyl Ob offit �O� 3 ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum rim��/✓!1� i� AE Fascia ,1� (I. Site Plan/Survey showing the existing structures Ick and proposed project. ❑ Other 2. Two sets of construction plans WINDOWS 1 tmc f` j — of G;*S W3. Energy Calculations ��jN IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS J.�—Yyt 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 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ ' OCCUPANCY TYPE Permit Fee $ -rt e Plan Review $ Hi Fire Surcharge $ Surcharge $ 11 `1 License Surcharge $ r ®— SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ /91 . 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) $1825 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks savable 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 acknowledgeth the information above is complete and accurate; that the work will be in conformance with the ordinances and Godes of the City of Fridley and with the Minnesota Constructi n 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 accor ance ith approved plan in the case of all work which requires review d approval of plans. SIGNATURE OF PP CANT RINT NAME im achk� DATEq-7 —0 APPROVED BY i� / M r�i_ DATE' Building PLUMBING Permit No.: Inspections RESIDEN TIAL APPIIICATION Received By: � 763-572-3604 CITY OF F�ifEY D 763-502-4977 FAX EFFECTIVE 1-1-08 DATE_ YOUR E- ADDRESS Lk U (A 1 SITE ADDRESS a I a-- L �n > THIS APPLICANT IS: 0 OWNER (CONTRACTOR PROPERTY NAME: ADDRESS: CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR NAME: r� r STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND CERTIFICATE OF STATE BOND # EXP DATE ADDRESS: M %3 �f�3 PA n UI l.� CITY yq'.� STATE�ZI INSURANCE . PHONE 6I a - &1q-Ii-N9 FAX YPE SINGLE FAMILY 0 TWO FAMILY ❑ TOWNHOUSE ORK:❑ P NEW REPLACEMENT ESCRIPTION OF WORK v�_ PER MS 16B.665 the permit fee is a minimum of 515.00 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 FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON 51®0o PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $15.50. 1 SHOWER WATER PIPING 3 BATH SINKILAV DRAINS _ _ _FLOOR IBATHTUB GAS PIPING (NEED CITY LIC) _ SWIMMING POOL _ WATER SOFTNER ($35) I KITCHEN SINK WATER CLOSET BACKFLOW PREY. ($IS) 1 CLOTHES WASHER „3_ I DISHWASHER I LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER —OTHER BRIM OWN Permit Fee $00 Number of fixtures @ $10.00 x $10.00 - $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ OR Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 (MMIM[JM $15.50 (MIMMUM $15.50) Total = $ 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 b]irl conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand thnot 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 accord with the approved plan in the_ a of a 1 work which requires review and appr va of plans. J SIGNATURE OF APPLICANT PRINT'NAMT -Pb'e U'Ir' ' DATE APPROVED BY DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION R dg 763-572-3604 CITY OF FRIDL Ei Y Date Rec d 763-502-4977 FAX EFFECTIVE 1-1-08 DATE Y UR E-MAIL ADD SS �. SITE ADDRES . THIS APPLICANT IS: 0 OWNER WONTRACTOR PROPERTY NAME. ADDRESS: CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR COMPANY NAME: dL bwA76'-, CONTACT PERSON: NOTE: SEPARATE CITY LICENSES ARE REQUIRED FOR GAS STATE LICENSE # '' ll EXP DATE �� ` CITY GI'Y1 STAT15�t, Zlp�� 3 AND HVAC. SUBMIT COPY OF BOND ADDRESS: i) 1�7� "` W PHONE 6) )-' 61 Q `S-7 0 FAX ANDINSURANCE PERMIT TYPE Dp SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: 0 NEW 60 REPLACEMENT 0 ALTERATION/REMODEL DETAILED DESCRIPTION OF WORKS d 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 ) OR 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 NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU MFG: MODEL:/ SIZE/BTUA/C $25.00 (GAS) $15.00 �! GAS RANGEIOVEN $10.00 _FIREPLACE TO AIR EXCHANGEER $15 (WOOD) $35.00 NEW GAS GRILL $10.00 _AIR _FIREPLACE $35.00 FURNACE $35.00 _GAS UNIT HTR $10.00 _BOILER LINER $10.00 L/ GAS DRYER $10.00 _POOL HEATER $35.00 _CHIMNEY DUCT WORK $10.00 _GAS PIPING $10.00 VENTILATOR $15.00 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ fixtures $25.00 x $25.00 = $ TOTAL DUE $ OR Number of @ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 MINIMUM $15.50 MINIMUM $15.50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a mechanical 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 i accord,with the approved plan in the case of all work which equires revie and approval of plans. aPRINT NAM *0 Q SIGNATURE OF APPLICANT _DATE APPROVED BY DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 e a 15 C2 BUILDING Permit No.: 3uilding [ns&tions RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Da 'W r? 2005 763-502-4977 FAX EFFECTIVE 1-1-08 )ATE ? —07-0k YOUR E-MAIL ADDRESS ;ITE ADDRESS %6 Z 1 i� CHIS APPLICANT IS: DOWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: �AK- e—t� � ADDRESSA-Z, AP— oSTS N &- CITYC0(— STATE S ZIP TENANT PHONEQG NAME: I N-1 — v ADDRESS:!42S-1i Aen4j -SST iQCITY C®L, 14 rS _ STATE ZIP CONTRACTOR SUBMIT A COPY OF PHONE -7 b 3 --7 9l — q'7 3 E FAX 7 (0 3 —:2R-1 7& 1 06 YOUR STATE LICENSE Z-0 O ( C? 93 EXP DATE 3 —3 k STATE LICENSE # / PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHEDWINDOWS ❑ BASEMENT FINISH ❑ ROOF DRAIN TILE 2 ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL c O es 6J ALL' TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION vIAINTENANCE/REPAIR JkREMODELING DESCRIBE WORK BEING DONE:1COA�tAfe 0*4W O -Is 3 SPdki 0CMDLkY � � fma 0 E SIZE OF IMPROVEMENT LENGTH WIDTH 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: ❑ DETACHED GARAGE 3. List of structural members to be used. PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS & PORCHES SUBMIT: ❑ Vinyl ❑Soffit I . Site Plan/Survey showing the existing structures ❑ Aluminum ❑ Trim and proposed project. ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS Li 3. Energy Calculations IN EXISTING OPENINGS Xes ❑No LOCATION OF WINDOWS ® Art OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & INDOWS TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS-3— ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 UBC FEE SCHEDULE) COTAL JOB VALUATION $ !'�g (3,63(3 c' = OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ a 15 C2 $ 40 0 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) $1825 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21 =$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary Make checks payable to: City of Fridley THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED Attach 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 accordan a wi the approved plan in the case of all work which requires review andapproval of plans. SIGNATURE OF APPLICANTAmi,"', PRINT NAME5fZ' A 4 t-3 Zk c(b DATE - S-10 APPROVED BY DATE e til