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PRE 2010 DOCSCity ®f Fridley, Minn. BUILDING PERMIT N° C57 s 4 Date: Owner: �' Builder Address _ : _ _ Address -- ----• -- LOATIIF� UI$�DI No. r Streetd -. ' ,r aft of Lo Lot Block Addition or�u Corner Lot _ _ _ Inside Lot A--� Setback* __ _Sid d — Sewer Elevation --- Foundation Elevation DiiSCRIPTION OF BUILDING__ To Used Depth Height ce i . _ Sq. F Cu. Ft.- Front LI � n _ Depth Height Sq. Cu. Type of -.... nstruction *'' , `' Est. _ . To be Completed _NT In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of grdinances of the city of Fridley. In consideration of the payment of a fee of $a. _ —, permit is hereby granted Co— to construct the building or addition as described above. This permit is granted upon the express condition that theperson 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 moving of buildings witi i nthe city limits and this permit may be revoked at any upon violati of any of the provisions of said cesn ord Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heatkg,, sewer or water. Be sure to we the Building Inspector for separate permits for these Mems. .Q104 s..,— -� , -? APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner °s Name `� Builder Address Address No. J7.3 ' Street LOCATION OF BUILDING LotBlock ,Addition or Subdivision Corner Lot Inside Lot P*"'- Setback 15 SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To used as: ffle-e Front Depth d Height Sq. Ft,_ -_9 Cu. Ft. v ZFront +-Depth Height Z C5 Sq, Ft. Cu. Ft. Type of Construction Estimated Cost To be Completed The undersigned hereby makes application for a permit for'the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE_3 ° �SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). a M r City of Fridley Application for pinenbing and Gas Pitting permit Dept. of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures O6O� y Z �� Y F Z� o: N 8� ~� u°fi o ��' w �a Z �a �! R ` N WATER HTR. GAS ELEC. 3Ci m� cz t LL o Sm3 c9 °d t9�c UO rn Base / 1st 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 ....... x $1.50 $ 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 $ 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 $ City of Fridley: The undersigned hereby .makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn. Owner Kind of Building Used as To be completed about Estimated Cost, $ Old—New. Building Permit No Permit No. ROUGH 11-11 6 — FINAL a z 2M 7-59 By � Business "6 Application for Power Plants and;: Healing. Cooling. Ventilation..Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE 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 $ y . .each add. 60,000 BTU ....................... 2.00 $ _ Replacement of Furnace .............................. %.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 TOTAL 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 ALTERATIONS & REPAIRS TOTAL FFE ROUGH FINAL Dept. of Bldgs. Phone SII. 4-7470 City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley,_Nfinn &� Y , 194—f- 1 94f—s 01 Owner Kind of Building Used as To be completed about Estimated Cost, $ Old—New. Building Permit No. 'W -4 /— Permit DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No j Trade NamI, Size No. Capacity Sq. Ft. E.D.R._ BTU ��; H.P. Total Connected Load dwe4�� Kind of Fue BURNER — Trade Name Size No Capacity Sq. Ft. EM.R BTU kP. (REMARKS -OVER) By0 / J �a2 9M 7-59 Business Phone No. HEAT JOSS CALCULATIONS BURMAN COMPANY Weatherstrips G t V Construction No. Insulation Windows Doors Reference ' Out. Wall Int. Wall Ceiling j Roof I floor Kind I How Applied Ye11s—No Yes—No 19_ FI Room Length a Width Height 11 1 F1.1 W.,,, sO . Room I Length �v Width .1c.1 Heisht of 1 otat tstu. 1 7*y Required sq. ft. E.D.R. or sq. ins. WA. Leader area " .f t Fl -1 ,: r..z.4a m I Lenath 'y Width .ae Height Windows and Doors—Crackage and Area Width Height No, of Lineal ft. Area No. of pane of pane lights of crack sq. fG Windows and Doors—Crackage and Area J 4I WldtE7 Height No. of Lineal ft. Area No. of pane of pane lights of crack sq, ft. Width Height No. of Lineal ft. Area No. of pane ofpane—Iighte of crack sq. ft. V Btu Infiltration Glass Infiltration Coef. Btu Infiltration', Glass -;Y113 Glass, Exp. wall Net exp. wall _y1 Exp. wau 94 Aft Int. wall Net exp. wall ? Int. wall Int. wall Ce11. /a Floor 00 Ceil. 1 otat tstu. 1 7*y Required sq. ft. E.D.R. or sq. ins. WA. Leader area " .f t Fl -1 ,: r..z.4a m I Lenath 'y Width .ae Height Windows and Doors—Crackage and Area Width Height No, of Lineal ft. Area No. of pane of pane lights of crack sq. fG ae5k,4w :.ECT J 4I WldtE7 Height No. of Lineal ft. Area No. of pane of pane lights of crack sq, ft. Coef.1 Btu Infiltration Glass Infiltration , d '� z Exp. wall Net exp. wall -;Y113 Glass, Exp. wall Net exp. wall Int. wall Net exp. wall Int. wall Aft Int. wall Floor Floor Int. wall Ceil. Ce11. /a I otal btu. � Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ` F1 4C j Room I Length .," Width t -? Height. Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of o�f`f pane lights of crack nq. ft. pane J 4I WldtE7 Height No. of Lineal ft. Area No. of pane of pane lights of crack sq, ft. Coef. Coef. Btu Infiltration , '.r" Glass Exp. waIl Glass, Exp. wall Net exp. wall @; Net exp. wall Int. wall Aft Int. wall y& Floor Int. wall Floor Ceil.+ Ce11. /a Cell. Total Btu. Required sq. ft. E.D.R. or sa. ins. W.A. Leader area +�J#!g. 0 Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. vz T WldtE7 Height No. of Lineal ft. Area No. of pane of pane lights of crack sq, ft. Coef. Btu Infiltration Btu , Glass Exp. waIl Exp. wall Net exp. wall Int. wall Aft Net exp. wall y& Floor Int. wall Ce11. /a Cell. Total Btu. IM ve Required sq. #t. E.D.R. or sq. ins. W.A. Leader area _ a " a ion - -- IT ___.t_JSft Ver_ -].L Aft ur_!_t. Total Btu. 4' ; 4 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area " FI.1 Room 1 Lengthy Width 07 Height -S Windows and Doors—Crackage and Area Width Height No. or Lineal ft.Area Na of Wane of.nane liahte I of crack I aa. ft. Btu Infiltration .gyp Glass Exp. wall Net exp. wall �. Int. wall Floor arl001 0 Total Btu. Required sq, ft. E.D.R.,or sq. ins. W.A. Leader area *' Windows and Doors—Crackage. and Area T WldtE7 Height No. of Lineal ft. Area No. of pane of pane lights of crack sq, ft. Coef. Btu Infiltration' Glass Exp. wall Net exp. wall 1100 Int. wall Floor Cell. 00 Total Btu. 4' ; 4 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area " FI.1 Room 1 Lengthy Width 07 Height -S Windows and Doors—Crackage and Area Width Height No. or Lineal ft.Area Na of Wane of.nane liahte I of crack I aa. ft. Btu Infiltration .gyp Glass Exp. wall Net exp. wall �. Int. wall Floor arl001 0 Total Btu. Required sq, ft. E.D.R.,or sq. ins. W.A. Leader area *' HEAT 4AOSS CALCULATIONS s s , Btu Infiltration Weatherstrips A.S.dV Reference 11 19— Construction No. Exp. walk Net exp. wall i 14 27,00 Windows Yes—No . Doors Yes—No ' Out. Wall Int. Wali Ceiling Roof Moor Kind Ceil. Net exp. wall Fl. / Room I Length Width /.$0 Height II IRoom I Length Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane llahte of crack sq. ft F1.1 Room Length � Width / Height Windows and Doors—Crackage and Area Coef. Btu Infiltration r Glass p az d Exp. walk Net exp. wall i 14 27,00 Int. wall Btu Floor 2 b -2 ' drl Ceil. Net exp. wall Total Btu. Int. wall Required. sq. ft. E.D.R. or sq. ins. WA. Leader area Floor p Cell. F1.1 Room Length � Width / Height Windows and Doors—Crackage and Area T - Width Height No. of Lineal ft. Area No. of pa�ne of pane lights of crack eq. ft. Js Coef. Btu "Infiltration Coef. Btu Infiltration Exp. wall Net exp. wall Glass Int. wall Sol Floor p Cell. Exp. wall Cell. Int. wall Net exp. wall _;?+ 70 0 Int. wall to Floor Ceil. I otal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area S F1.1 � Room l Length J -2 -Width o fe HP4Qht Windows and Doors—Crackage and Area T Width Height No. of Lineal ft. Area No. of pane of pane lights of crack, sq. ft Coef. Btu "Infiltration Infiltration Glass Exp. wall Net exp. wall #a Int. wall Floor p Cell. ! Q Total Btu. ( t "' Required sq. ft. E.D.R. or sq. ins. I.A. Leader area BURMAN COMPANY Insulation How Applied Width Heiaht Windows and Doors—Crackage and Area T Width Height Na of Lineal ft. Area No. of Bane of pane lights of crack eq: ft. Coef.1 Btu Infiltration Infiltration Glass Exp. wall Net exp. wall 40 't1 Int. wall Floor Cell. Int. wall Total Btu. Required sq. f t. E.D.R. or sq. ins. W.A. Leader area FI -1 ` — " Rnnm I Length 47 Width 10 Height .t Windows and Doors—Crackage and Area T Width Height No. of Lineal ft Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Floor 70 0 Ceil. to Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Windows and Doors-Crackage and Area Width Height No. of Lineal ft Area No of pane of.Bane lights I of crack I sq. ft Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Floor Ced: Total Btu. Required sq. ft. E.D.R., or sq. ins. W.A. Leader area SUBJECT PE City of Fridley 16 9.8 3 AT THE TOP OF THE TWINS BUIL®ING PERMIT _ r ECEIPT � • _ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. �c-57� t♦ PROTECTIVE CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY a 612-571-3450 910-F15 /19/83 JOB ADDRESS 85 Rice Creek Way N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 16 1 Edgewater Gardens SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE F. E. Halverson 85 Rice Creek Way N.E. 574-7460 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE 0 REMOVE X 8 DESCRIBE WORK Reroof Dwelling. 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Fiberqlass 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 $800 $.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 PRQVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW $15.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $15.50 SIGU4,T.WREOFCQ AUTHORIZED AGENT (DATE) WHENRO YMDDIS IS YOUR PERMIT /RA�CjTJOR�OR BLDG WSP DATE SIGNATURE OF OWNER IIF OWNER BUI ERI (DATE) P 0 1 e OWNER: ADDP.ES TEL MC CITY OF FRIDLEY Effective Aug. 1, 1961 APPLICATIM FOfi RESIDENTIAL BUILDING PERMITS (NEw. Alterations. Additions, or Repairs) BUILDER: ADDRESS: TEL NO: Construction Location • STRITT N0: 6T12EET: IAT: BLOCK: ADDITION: Corner Lot: Inside Lot: 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: Square Feets Front: Square Feet: Depth : Height: Cubic Feet: Depth: Height: Cubic feet: � Type of Construction: Estimated Cost: S C;�7 4Q Tb Be Obrapleted: Alt. A Alt. 8 Proposed Driveway Width If New Opening Is Desired: SEE MERE SIDE OF SHEET The undersigned hereby makes application for a permit for the %rork herein specified, agreeing to do.all Work it, strict accordance with the City of Fridley Ordinances and rulings of the Derartment of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DENTE: SIGNnTUIC : Stipulatio - N OS- G-�%�� .�%f/ v'GP �(N//C�o%✓fif/,�G�"!V '�!Ly V /L.GVO.�`^- .L/�' � .,e.-cru-,�2�-�� '� � R:� : %• t,�v v4, til . ��/ %' Al%CC� Gt.B�•L%7L .,mai �j �� 4L�"1iL(�liL �sN./L'.r�Q/J`�L.'a ^�vYf2,e ..�./?L/YGE�ci �'UcC� �L�,u�L� �.r,�-e�� ..L-c�.��.� .uc.• �cr .2u/L'u�� .�� ./lrbCc.�•rr�ew� .I. 41710-AI. aw- elz sue,iECr IT NO. City of Frialey 049s AT THE TOP OF THE TWINS BUILDING PERMIT RE O. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r � � PROTECTIVE 1 . � NUMBER REVDATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 L 612-571-3450 910-F15 11/10/99 10B ADDRESS 85 Rice Creek Way 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 1 Edgewater Gardens SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Fred Halverson 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Richard Hastings Contr. 6331 Riverview ToT NE Fridley 5-54S2 -1;74-()966 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 Rk REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (25 Sq) Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. EPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD ENTILATING OR AIR CONDITIONING. HIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. F7 CU FT. UTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION R WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES ND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX ND OR GOVERNING THIS TYPE OF WORK WILL BE COMPLIED ITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2185 $1.09 OES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE ROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON. SC TRUCTION OR THE PERFORMANCE OF CONSTRUCTION $83.25 Fire $2.19 01 PLAN CHECK FEE TOTA EE fb 9 Lice $5.00 $ .53 SIGNA TUBE OF CON.PACTOR OR AU OpIZEO AGENT DATEI EN ROPE INSp ALIDAT HIS IS YOUR PERMIT v9 rIAiE S�GNATU qE OF OW NEp iiF OWNER BUIL DEiii IDATEI NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 / � 0 U BUILDING PERMIT APPLICATION ��°O1XA Construction Address: 35 /Z" c L e ti UJr� Legal Description: Owner Name & Address: 6Zi�"D 11A L af-p s vy Tel. # Contractor: i� : Az c-" '44 s MN LICENSE # Address: 3 1 ZL i2 r.�� i`� R. Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF LIAPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: S S 2, Construction Type: '72,4tZ cl" i- +2E Xoz: e' Estimated Cost: $ � Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: Ar c) ff APPLICANT: � ` .,mss ��_ Tel. # CITY USE ONLY Permit Fee $ -S7 Fee Schedule on Reverse Side Fire Surcharge $ ( .001 of Permit Valuation (1/10th%) State Surcharge $ /. QQ $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ Q $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/-,S 3 STIPULATIONS: City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 ;q Mechanical -Permit# Residential Application City of Fridley See Back Side For Required Information Date it Site Address: Theapplicant is: (cirice one) Owner Contr 2or Property Owner: Address: City: / St e: Zip: Phone: — ell: Fax: Contractor Information Company Name: 1x01 Contact Person: ti Address: L City: 64 AA State: 1/ Zip: Phone:{ �' C ' ' Cell: . Fax: Email: MN Bond# & Exp Date Type of Work circle one): New Replacement Alteration/Remodel / Detailed Description of work: ' I Equipment Installed: MFG: Model: Size/BTU: MFG: Model: Size/BTU: MFG: Model: Size/BTU: Please check all that apply: _Fireplace (gas) $15.00 New Gas Grill $10.00 A/C $25.00 _Fireplace (wood) $35.00 _Gas Unit HTR $10.00 _Air to Air exchanger $15.00 _Furnace $35.00 _Pool Heater $35.00 _Boiler $35.00 _Gas Dryer $10.00 _Ventilator $15.00 _Chimney Liner $10.00 _Gas Piping $10.00 Duct Work $10.00 Gas Range/Oven $10.00 Permit Fee $ (Total from above -Minimum fee $35.00) Surcharge $, 0.50 Total Due $ Make check payable to City of Fridley 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 in accordance with the approved plan in case of all work which requires review and approval of plans. zv& Signature of Applicant: Date: Approval Inspector Signature: Date: Please Note: Separate permits are required for Building, Plumbing, and Electrical work Revised 6/14/2005 . tt Inspections 763-572-3604 2of-c-;0", RESIDENTIAL APPLICATION Received By: CITY OF FRIDLEY Date Recd YOUR E-MAIL ADDRESS ;ITE ADDRESS �6 5 K l C-Q� (–, r 'HIS APPLICANT IS: ❑ OWNER PROPERTY OWNER/ NAME: KO" 5 k&ffl-K', u .S Plan Review TENANT ADDRESS: S T R r GAP Cc NO-A,N _e -C CITY �� ! Q I -tAA STA 559 3 a. .001 times the total job valuation PHONE: SO a -g 5"' $ .0005 x Permit Valuation Minimum $.50 CONTRACTOR NAME: H p ', ( (� Pjoey- CM -5 - ',r u C r CM STATE LICENSE # 30H 4 � oZ S o EXP DATE 3-31- ao O a SUBMIT' A COPY OF YOUR STATE LICENSE ADDRESS: -1-A - L9(1+ -AL (Ada to /V e- CITY ';:'Y STATE IP $S K 3a WITH APPLICATION PHONE ip 3 -Lp i 0 - 9 1 9- FAX 70 3 - -7 U -1 - 1 PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE Total Due ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING S,OTHER ❑ SWIMN[IIJG POOL TYPE OF WORD: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR %a REMODELING 7ESCRIBE WORK BEING DONE: 50 E q,4 1 � a5 C 1 t1, 31M OF 4UMBER OF SQUARES - n — :;MUGFS 'ROPOSED SIZE: ?ROPOSED HEIGHT: 'SIDING D Vinyl :3 Aluminum 3 Other ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE '®Soffit ❑ Trim IB Fascia WINDOWS N EMSTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS :)R FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & G'LI�I :4 HEIGHT BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used Ft. 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 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ a 4 9.7 - 00 OCCUPANCY TYPE Permit Fee $ pr, See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.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 Attach Stipulations THIS IS AN APPLICATION FOR A PERMITNOT 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 rhich requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME 14 DATE 0 Buildi .g, , BUILDING Permit No.: — U Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Da 'd. 763-502-4977 FAX $ .0005 x Permit Valuation Minimum $.50 License Surcharge EFFECTIVE 1-1-08 F e o u $5.00 (State Licensed Residential Contractors) DATEL YOUR E-MAIL ADDRESS $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow SITE ADDRESS ft + 6 ft = ft x $21 = $ THIS APPLICANT IS: ❑ OWNER ;EONTRACTOR $ PROPERTY OWNER/ NAME: $ ADDRESS: STATE IP TENANT or Agreement necessary ( ) Non Necessary ( ) PHONE::4iC'�—St>a Ao� $ �, ;tke checks payable to: City of Fridley Attach NAME: ADDRESS:(CITY STATE IP CONTRACTOR SUBMIT A COPY OF PHONE G' FAX '):,t; YOUR STATE LICENSE STATE LICENSE # 4?::o _0:54zr EXP DATE PROPERTY TYPE :9SINGLE FAMILYINEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES_ PERMIT TYPE ❑ ADDITION 0-GARAGEtSHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR XREMODELING DESCRIBE WORK BEING DONE: ill. SIZE OF IMPROVEMENT 2. 7' 2 LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES , ,6ATTACHED 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 1. Site Plan/Survey showing the existing structures ❑ Aluminum ❑Trim and proposed project. ❑ Other ❑ Fascia 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 THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ 2-Q cao OCCUPANCY TYPE Permit Fee $:9s See Back Page for Fee Schedule Plan Review $ d P 65% of Building Permit Fee Fire Surcharge $T 0 - .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ F e o u $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 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 $ or Agreement necessary ( ) Non Necessary ( ) Total Due $ �, ;tke 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 accorodanCrAwith the approv plan in the case of all work which re wires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME DATEatt o APPROVED BY __ ATE 4, . memorandum Date: July 8, 2008 To: Crosstown Concrete Attn: Greg Pietig From: David Macdonald Project: 85 Rice Creek Way, Fridley Minnesota Proj No. 08329 Subject: Garage Slab Replacement Greg: As you requested, I have reviewed the existing garage slab at the above referenced address. As a result of the deterioration of the existing concrete slab, the owners would like to have that concrete removed and replaced. It is my opinion that this is a proper course of action since I believe that the existing concrete slab has delaminated and it is likely that existing reinforcing bars in the slab have started to oxidize and deteriorate. I have performed calculations in accordance with the Minnesota State Building Code to determine the requirements for a replacement slab. The result of my design is illustrated on the attached drawing S1. If you have any questions concerning the above, please do not hesitate to contact me. Sincerely, Mattson Macdonald Young, Inc. David H. Macdonald ntm07-08a.doc Page 1 of 1 I hereby certify that this plan, specification or report was prepared by me or under my direct supervision and that I am a duly licensed Professional Engineer under the laws of the State of Minnesota. A/ David H. Macdonald P.E. 7/8/2008 MN Reg. No. 14751 PROPOSAL Dollars OAK material is guaranteed to be as specified. All work Authorized Signature to be completed in a workmanlike manner according to Greg Pledg, President standard practices. Any alterations from the above ® Bid may be Withdrawn if not accepted in 60 days. specifications involving extra cost, will become an extra 010% down and balance on completion of work. charge over and above the estimate. All agreements Q Workers are covered by Workman's Compensation. contingent upon strikes, accidents or delays beyond our 21 We are licensed, bonded and insured. control. Crosstown Concrete & Brick, Inc. has the right to ® Repair of any utilities or sprinkler system is an extra charge. file for Lien rights against the property worked at, to ElWarranty does not cover any pealing from chemical or deicer use. Muse be notified within collect any moneys not paid. Warranty will be void for 60 days of any peeling. All concrete exposed to chemicals & deicers should be sealed every 3 any balance not paid. Owner to carry fire, windstorm, hail years. NEW concrete should NOT be exposed to deicer chemicals for 2 years. Use sand. Rock and other necessary insurance. pops are not peeling. ACCEPTANCE OF PRDp?3SAL: The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the Work as specified. Payment will be made as outlined above. Date of Acceptance: Signature: r