Loading...
PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N® 4 2 4 0 Date: _ _ _ _ _.._.._......... ............. 1,J..__..7 ............... ........ ...:.. r-'° � Builder .- - �._...F .._........... _._._ . Address Address r . LOCATION Of BUILDING No. Street Street _.�. -.... ...........- .................... art f Lot ................ ....... ... _.._..._.__._...._... ..........__ Lot ..__.:........ _........ Block ` .............................. Addition or Sub -Division - - ,+. i_.._.. Corner Lot --- --. ................-........ Inside Lot ... ............................. Setback -3-75....- .......... Sideyard . ... .....------..-............._............_.._..__. Sewer Elevation .... ................................. .........._.............-...................................... Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Front . Depth .. Height . ..-.. Sq. Ft .� .... � ' Cu. Ft. .4 ...-- .............. - ............. . ................. ...... Front .............................-Depth .....:............ Height ........................ Sq. Ft. ....._............. _.. Cu. Ft. ..... - .............. ... Type of Construction .......................................... �` ��"���_....... To be Completed ---............._.............-......._........ .. Est. Cosr �. 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 Wrth and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ _g,,j.... °.......... permit is hereby granted to....._ ...................... .... ......................... ...... __._.... _._................ _....... ................... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. _`1 Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. 4 BUILDING PERMIT Village of Fridley, Minn. Date!•.......................... Owner... ......... Address. ✓� . ?: N° 2780 Builde I .: !....#..&.... a ........... . " °o�'�C ' �'L,""'4 LOCATION OF BUILDING NA5. AIr.. tx''ee .. .5�� .................. Part of Lot ....................... Lot ................ Block ................ Addition or Sub -Division. .. . ... .....I..r........... . Corner Lot ............ Inside Lot ............ Setback ............ Sideyard .......................... DESCRIPTION OF BUILDING To be Used as: 4"691, ... 3V Front �� �... Depth '" .... Height ......... Sq. Cu. Ft. ........ Front ..... Depth ........ Height ......... Sq. Ft......... Cu. Ft. ........ Type of Construction w: Est Coirt7.®©............. To be Completed. .. ... .... Arole- 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 ordinances of the village of Fridley. 4. 44. ..... 52 consideration of the payment of a fee of$. . , pe is hereby grant to to construct the building or addition as described above. ermit is ted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit may be revoked at any tirr>, p�on olatio of any of the provisions of said ordinances. /J, Building Inspector NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate perniits for these items. CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE RESIDENiTIAL ` RATE TOTAL .� Job Address Furnace Shell and Duct Work, Burner (Also replacement furnace) $ 20.00 $ Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Gas Piping $ 10.00 $ Tel. #571-3450 (piping needed with new furnace) Gas Range $ 10.00 $ 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 Gas Dryer $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. • Fridley, Minn. 7 1 Air Conditioning (all sizes) $ 10.00 $� 4ove All Others/Repairs and Alterations OWNER 18 of Value of Appliance or Work $ KIND OF BUILDING COMMERCIAL/INDUSTRIAL USED AS V4— -//; , LA 18 of Value of Appliance or Work $ TO BE COMPLETED ABOUT ESTIMATED COST State Surcharge $ .50 e OLD - NEW BUILDING PERMIT NO. PERMIT NO. TOTAL FLE $ Reinspection Fee ($15.00) $ ��, ` �=� �_'_.� DESCRIPTION OF FURNACE/BURNER e'e-V%, Rough Insp. HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Date Trade Name �A� Size No. ��41 7,3e Final Insp. Date `` Capacity Ft. EDR BTU 7 HP Approval for Permit Total Connected Load Kind of Fuel BURNER - Trade Name Size No. w v- Capacity Sq. Ft. EDR BTU HP oy �� , 7 NIMUM FEE FOR ANY HEATING PERMIT IS $15.00 Company PL $.50 STATE SURCHARGE Signed By Tel. No. *Air Conditioners can not be placed in side pard without written permission from adjoining neighbor. Fill out back side for stack verification on replacement furnaces CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; I. Has been carefully examined Yes (,) No ( ) Z. Is free from rust or deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes ( ) No ( ) 5, Meets all current Code requirements for size and total BTU connected Yes ( ) No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL Rema rk s Company Signed By Date CITY OF FRIDLEY Effective Date January 1, 1991 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE 'RESIDENTIAL Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer *.Air Conditioning (all sizes) All Others/Repairs and Alterations 1% of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 1% of Value of Appliance or Work REINSPECTION FEE $30.00. Rough Insp. RATE TOTAL Job Address �%% $ 20.00 $ Building Inspection Div. 6431 University Ave NE Fridley MN 55432 Tel. No. 572-3604 $ 10.00 S/J. a� $ 10.00 $ 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 $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. $ 10.00 19� State Surcharge TOTAL FEE Date Final Insp. �� %% � / - Datel Approval for Permit MINIMUM FEE FOR ANY HEATING/COOLING/VENTING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. OWNER KIND C USED AS n05 A C�-eY7CC0-- o TO BE COMPLETED ABOUT // ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. b' DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANT S, Ste , Hot Water Warm Air- No. Trade Name ctr07 g1 Al Size No. � -A Trade Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel C150-3 BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company endlh'A3. 14ositna Signed By n 9-1 Tel. No. � m � 1/61 Z Fill out back side for stack verification on replacement furnaces CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes (,01-11 No ( ) 2. Is free from rust or deterioration Yes (Jj No ( ) 3. Has no foreign objects, lodged within Yes (vJ No ( ) 4. Is securely supported Yes (PT' No ( ) 5. Meets all current Code requirements for size and total BTU connected - Yes No ( ) 6. Has Total heating BTU's of /-34 �- eV All other BTU's ,V/OL42�2) TOTAL 14 O OZ Remarks Company Signed B Date 0 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1991 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB New Fixtures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric $ 7.00 Water Heater - Gas I $10,00 Gas Range $10.00 Gas Dryer $10.00 Back Flow Preventer Required ( )Yes () No Type $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance _ State Surcharge $ .50 D The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. �C, " '1991 Owner Building Used A Estimated Cost PLUMBING CO SIGNED BY IN PERMIT NO. / 0 9/ 6�' ov"X' Approved By ON,Rough-In Date TEL N0. Final Date e `�� MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 TOTAL FEE $�� S� PLUS THE $.50 STATE SURCHARGE iHOUSE HEATING TEST RECORD /— (- /ie " ADDRESS / FL0 OCCUPANTOWNER — HEAT LOSS DATE, HTq, INST. _L SUBURB SOLD BY INSTALLED BY M t7a PzIr a' Electrical Work By Gas Lino By V VA Z a - TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN MAKE yl a 01*_ Model"'�4 — Gt% Serial % INPUT 3c MAKE OF BURNER Model CONVERSION Max. BTU Rating MAKE OF FURNACE 41 1 Model �NTROLS !•._- �f THERMOSTAT Heat Plug Vent Size Valve KIND OF LINERy tiy�-- '' NONE SIZE P NONE— Limit. Limit Limit Setting Draft Hood r Filters Size Regularor .I um er Fan Setting — = Chimney Location Pilot Type c r)::� P c, Chimney Construction Pilot Make Pilot Model Pilot Timing L.W. Cut Off UtG �r Pressure ,` wG Percent CO2 Input CFH �%�' Percent O2 r Stock Temp. �-77 Percent CO. Spillage A/ Smoke Bomb Draft Test Tag Door Pressure f� Lighting Inst. Inst. Date Tested .. 14 r Company Testing Nome of Tester Li C - Certificate of Compentency # 7e sue.lEcr IT NO. City ®f Fridley � i 513 AT THE TOP OF THE TWINS ? BUILDING PERMIT r -R-E�� _ COMMUNITY DEVELOPMENT DIV. Yr PROTECTIVE INSPECTION SEC. G/,F r NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 8/26/92 JOB ADDRESS 7170 Riverview Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 Mississippi view SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Edith Thompson 7170 Riverview Terrace NE 571-1144 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Kesler Construction & Drywall 9779 64th. Ave N, Maple Grove 537-3231 4373 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 O ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (23 Squares) Tear-oi;,f 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with.the State Building Code, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANYTIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $1,219 $`, 61 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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- $31.00 $ Fare SC $1.22 STRUCTI THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE `L License SC $5,00 $37,83 URE OF CONTRACTOR OR AUTHORIZED AGENT ID I HE PR R VA ATED THIS IS YOUR PERMIT SIGNATURE OF OWNER 0F OWNER BUILDERi 1OATEI LDG 1NSP SATE NEW [ ] ADDN [ ] ALTER[] Construction Address: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Effective 3/1192 Legal Description: Owner Name & Address: 9� Tel. # / ` 11'27 Contractor: c r� y/ MN LICENSE # 12"7 -6 Address: / Tel. # Attach to this application, a Ce tate 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: Len Width H�Ground Sq. Ft. OTHER: � n �2' 1 CS Comer Lot [ ] Inside Lot [ J Ft. Yd Setback _ Type of Construction: 1P, p Approx. Completion Date: Driveway Curb Cut Width Needed: Ft. + b Ft = Side Yard Setbacks Estimated Cost: $ — (Cost on Back) Ft x $ . = $ DATE: 1Ke--Z� Tel. #';t -APPLICANT: C13:Y USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Park Fee b Sewer Main Charge $ TOTAL $) STIPULATIONS:. Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.501$1,000 Valuation $700 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary t I Not Necessary i l SUBJE6T City of Fridley 30268 AT THE TOP OF THE TWINS BUILDING PERMIT i COMMUNITY DEVELOPMENT DIV. _ _ j PROTECTIVE INSPECTION SEC. �� F CITY HALL FRIDLEY 554$2 NUMBER REV DATE PAGE OF APPROVED BY L J\ 612-571-3450 910415 9/23/99 JOB ADDRESS 7170 Riverview Terrace 1 LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 Mississi i View SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Edith Thompson 571-1114 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Reliant Energy, Minnegasco 6001 L dale Ave S Mpls 55419 321-5238 20169856 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 0 NEW 0 ADDITION 0 ALTERATION N REPAIR O MOVE 0 REMOVE 8 DESCRIBE WORK Reroof house and garage (21 S) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Permit Inspection cards Will Be Mailed To Homeowner Tq post SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL SE COMPLIED � WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1835 $.92 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON. STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $6.6.20 Fire SC $1.84 PLAN CHECK F TOT FEE -AGENT Lice S 5.0 .96 SIGNATURE OF CONTRACTOR ORAUTNORIIE IDATE, HE FPRO VALID THIS IS P M T BLIAG IN!o qA S,GNATURE OF OWNERoF OWNER BUILDER& IOATEI NEW [ l ADDN ALTER [ ] # 0001 D # 13.90 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: -100 94 VYn 01; Effective 1/ 1/98 Legal Description: ftA 4- aJL_"o Owner Name & Address: ��� j � . r,,� Tel. # 5-9) -111q Contractor: 9JV, n� LAL44e-Z MN LICENSE # 0 yT tp Address: boor twdci.h 4o.S. MA., MAJ 55LIIA Tel.# Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF L IPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: Len /Width Hgt/Ground OTHER: F'P ( ') /TS 2 '+r� - w -f Construction Type: Sq. Ft. Sq. Ft. Sq. Ft. Estimated Cost: $ /c9jS— (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ . _ $ DATE: fLYd1fj APPLICANT: t Tel. # Permit Fee Fire Surcharge $ State Surcharge $� SAC Charge $ License Surcharge $ 5-,00 Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL s___2_,3. e) (, STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 [ ] Building MECHANICAL Permit No.:.a Inspections RESIDENTIAL APPLICATION Received By: 7.63-572-3604 CITY OF FRIDLEY D�i°�S DATE g 2 �� YOUR E-MAIL ADDRESS SITE ADDRESS ® � Lf .J`i � `� C `f'• THIS APPLICANT I5: O OWNER CONTRACTOR PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: NAME: ADDRESS: �1 `7 O u c� J rre CITY �'ra <,� STATWN_ZIP PHONE: COMPANY NAME: CONTACT PERSON:4 STATE LICENSE fl ADDRESS: ass ld PHONE_ KSINGLE FAMILY O TWO FAMILY ANEW O REPLACEMENT DETAILED DESCRIPTION OF WORK EXP DATE FAX O TOWNHOUSE O ALTERATIONIREMODEL r) Fir.-DIAr-e STATE ZIP 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 fixture Sf should reflect only the cost of labor) Labor cost under $300 = $15.00. Labor cost between $300 to $500 =cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (LAIDICATETOTAL NUMBER OF EACH BELOW)x SIZFIBTU MFG: Lc.a � MODEL: .� � SIZEBTU � Equipment Installed MODEL: MFG: SIZEBTU MFG: MODEL: A/C 525.00 FIREPLACE (GAS) 515.00 GAS RANGEIOVEN SI0.D0 —AIR TO AIR E}tCHANGEER 515 FIREPLACE (WOOD) 535.00 NEW GAS GRILL 510.00 _BOILER S35.D0 _FURNACE $35.D0 _GAS UNIT HTR 510.00 POOL DATER 535.00 _CH NNEY LINER $10.00 _GAS DRYER $10.00 —VENTILATOR $15.00 _ DUCT WORK $10.00 p'_GAS PIPING 51000 Permit Fee $ Number of fixtures @ $10.00 x $10.00 _ Surcharge $ .50 Number of fixtures @ $15.00 a— x $15.00 = $�D TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ 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 wo k which requires review and approval of plans. SIGNATURE OF APPLICANT ..��� PRINT NAMES '..5 �' 'r DATE , O D City of Fridley ]Building Inspections Department . 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEWIEXISTING HOMESoft"I so a�rWWI is 1. Combustion Air (See note below) .4 v a. Oil or solid fuel WC Chapter 7 with MN Amen tr i b. Natural Gas or propanoUGC Chapter 3 with MN Amendments 2, Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances 1FGC Chapter 5 with MN Amendments b. Fuel other than gas TMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat. loss & cooling load per room a_ Required on new construction WC 1346.0312 5. Ventilation a_ Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. RCCA Manual. D NOTE: Centerpoin.t Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations Building BUILDING Permit Ivo.:'P3 Inspections RESIDENTIAL APPLICATION Received By:OA 763-572-3604 CITY OF FRIDLEY SEP 2 9 Z008 763-502-4977�,�FAX EFFECTIVE 1-1-08 DATE— i YOUR E-MAIL o� ADDRESS 'Pu) SITEADDRESS 41170 ery %62Ie_,4'C' lM/ll 55.L13A THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: ti•� �C �7 ADDRESS' /'W K I�/ Q/Z l%l �� 7_e11 fCe CITY �!C'� STATE,&k�.ZIP TENANT PHONE: o% Q q' -L/--/ NAM 01:717 / / ADDRESS: l9 /d f 4 � CITYSJ , k l STAT130/ IPc CONTRACTOR SUBMIT A COPY OF PHONE 4o Q a0b %#q FAX YOUR STATE LICENSE STATE LICENSE # EXP DATE c� 0 PROPERTY TYPE ffiSINGLE FAMILY efI'%41'r9 SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK XSIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION )WMAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: /I? cSI it) 1ju in SIZE OF IMPROVEMENT LENGTH WIDTH HEIG T SQ FT ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY ❑ 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: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl `mSoffit – A ILA m I' n U M ADDITIONS, & PORCHES SUBMIT: ❑Aluminum ❑Trim Other eln'e!24 � r' o Fascia – f�r'�t rr1 I.n U I ] . Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans i; !�2/Z� 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 $ F I&q 42a® OCCUPANCY�4� TYPE Permit Fee $ to oac), 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 $ $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 $ Agreement necessary ( ) Non Necessary ( ) Total Due $ b Make checks pavable to: Citv of Fridlev Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work Aill be in accordance with i , approved plan in the case of all work which requires review and approval of plans. SIGNA CAN /� �1 /� PRINTNAME IVA)yey &r ,i7n DATE g E' �• �AK APPROVED BY DA TkAv�p PLEASE NOTE.§EPARATE PERMITS ARE REQUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL VWO