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PRE 2010 DOCSCity of Fridley, Minna BURDING PERMIT N? ( s25 3)) PJ of LO'CAJION !D&BWILI NG j of Jn NO. street -9 Part t ld Lot lock --Addition or Sub Jr Comer Lot Inside Lot Setback Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING Ui Front Depth Height Sq. Ft Cu. Ft Mront Depth Height Sq. FL Cu. Ft Type of n"on Fit. be Completed In consideration of the Issuance to me of a permit to construct the building described above, 'a=otno do the proposed work In 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 $_j9_7, _'-, permit is hereby granted to, * - . to construct the building or addition as described above. This permit Is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, In all work done in, akound and upon said building, or an art thereof, shall conform In all respects to the ordinances of construction, Fridley, Minnesota regarding location, constru on. alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at" u ,jon violation of any of the provisions of said ordinances. .---% Building Inspector NOTICE: 'Whis penuft don not cover the construction, IndaWen for whing, plumbing, gn heafte, sow" or vmftr. Be wn to no the Building kqmftr for separate permits for these hams. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S 17M4K BUILDER ADDRESS ADDRESS LOCATION 0E--$UILDING� No. �� Street, Q a. a—�<� /.'�'.)Part of Lot �/ l Lot _1 a Block Addition or Subdivision__ ��a. Q a ,� Corner Lot Inside Lot Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to.this form Two Certificates of Survey.of Lot and proposed build- ing location drawn on these Certificates. To be used as; DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth 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 rulings of the Department of Buildings, and hereby declares tk" 1 the facts and representations stated in this application are true co ct. DATE S ZGNAxitRE (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley Application for Plumbing and Gas Fitting Perndt DESCRIPTION OF WORK Nlumber. Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: �0. 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) ......Z x 2.00 $ New Ground Run Old Bldg. x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... �� x $1.50 $ • `� D Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description................................................$�� TOTAL FEE $ Dept. of Bldgs}. Phone SU 4-7470 6 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 acid representations stated in this application are true and correct. Fridley, Minn. Owner W/lG ll Kind of Building Used as To be completed about Estimated Cost, $ Old New. Building Permit No -Permit No. Signe By Business Phone No ��-4- --211-1-2- ROUGH—L2 l-1a2 ROUGH FINAL .41�42 2M 7-89 U' z • • WATER HTR. 3fi �'F �+� �'c a3 . c�'d O �a F N 00 GAS ELEC. a 3� eLL c�m Base 1st 2nd _ 3rd _ 4th • Future Connection Openings Connected with Sewer � New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: �0. 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) ......Z x 2.00 $ New Ground Run Old Bldg. x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... �� x $1.50 $ • `� D Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description................................................$�� TOTAL FEE $ Dept. of Bldgs}. Phone SU 4-7470 6 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 acid representations stated in this application are true and correct. Fridley, Minn. Owner W/lG ll Kind of Building Used as To be completed about Estimated Cost, $ Old New. Building Permit No -Permit No. Signe By Business Phone No ��-4- --211-1-2- ROUGH—L2 l-1a2 ROUGH FINAL .41�42 2M 7-89 r— -1� d1-1 1-1 Application for Power Plants and HeCooling. Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: Furnace Shell & Duct Work ........................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 .................. Repairs -& Alterations each add. $500.00 ............... MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ each add. 60,000 BTU ....................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 ................. Repairs & Alterations each add. $500.00 .............. STEAM or HOT WATER SYSTEM jFurnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ o U �e 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 $ . D 0 GAS FITTING FEES: NO RATE TOTAL Dept. of Bldgs. Phone SII 4�-7470 x $1.50 $ Additional Fixtures ................. RATE TOTAL Location�`�� 8.0.0 $ AIR CONDITIONING $ City of Fridley: 5.00 $ VENTILATING SYSTEM $ The undersigned hereby makes application for a permit for the work herein 5.00 $ specified, agreeing to do all work in strict accordance with the City Ordinances 2.50 $ and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this applicationtrue and correct. �jar /6'� dley, AUnn_ 194 8.00 $ // /r/� 2.00 $ Owner ze /!ld® 195— 5.00 $ Kind of Building 195- 5.00 $ � Used as 2.50 $ jFurnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ o U �e 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 $ . D 0 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 FEE $ REMARKS: To be completed about Estimated Cost, $ Old--(Rew. wilding Permit No. "Z HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Name Size No Capacity. Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R. BTU H.P. Sign i B3-��' 11 POST 1M-12-58 Business Pone No ,%�/ �� HEAT Laos CALCULATIONS - A BURMAN COMPANY Weatherstrips A. Guide Reference 1 19_ Coef.1 Zo. Insulation Windows( Yes—No Doors Yes—No 'Out. Wall Int. Wall Ceiling Roof Floor land How Applied ,* X-rx FI.�,C,►�afao� Room I Length fV Width A 7J Height F ® F1.I AAoom Length Width j Y Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft Area No. of pane oL pane lights of crack sq. ft a,b Windows and Doors--Crackage and Area I I -a-- Width Height No. oL Lineal ftArca No. of pane oP pane lights oY crank sq: ft EWA Windows and Doo Coe£ Btu I I I I Coef.1 Btu Infiltration /f 1 —'/0 -7 t, v Infiltration Infiltration ,* X-rx Glass Glass's Glass a,b 10 0 Exp. wall j ad *2 7 Exp. wall g ey Int. wall Net exp, wall jo Net exp. wall dam- d 77-75— Int. wall Int. wall Floor 1 Floor Floor Ceil. ® Ceil. Total Btu. Total Btu Required sq. ft, E.D.R. or sq. ins. WA. Leader area Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Flog Room Length Width 3 Height2- Fl.l _- ® Room Length d Width Height Windows and Doo rackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 3o Coef. Btu Infiltration Coef.1 Btu Infiltration Vo I ty r 0 Glass's Exp. wall i ®� *11 Net exp. wall 7- g ey Int. wall Floor Int. wall gp Ceil. Windows and Doors--Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. / 3 _ Width Height No. of Lineal ft. Area No. of pane of p/ane lights of crack ".ft. Coef. Btu Infiltration Btu I- Vo I ty r 0 Class Exp. wall t F0 C Exp. wall 17 *11 Net exp. wall 7- , �. Net exp. will Floor Ceil. Int. wall gp Floor 1 Ceil.® Total Btu. _ Total Btu. 06 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I F1.1 RA. -;-14 Room I Lennth R Width � Height A- , _ -m I "!:�w �, Room I Length - /- Width i ->-- Height Windows and Doors--Crackage and Area 3 Width Height No. of Lineal ft. Area No. of pane of p/ane lights of crack ".ft. Coef.1 Btu Infiltration Vo 0 Glass' Exp. wall Net exp. wall /0 �. Int. wall Floor Ceil. gp Total Btu. t,! 7-0 Required sq. ft. E.D.R. or sq. ins. W.A. Leader, area ws and Doors—Crackage and Area dth Height No. of Lineal ft. Area )ane ofdmne lights I of crack A. ft. ® job. toef.1 Btu Infiltration 7i Glass '3 Exp- wall 4 G t f .2 Ir Net exp. wall 177 10 1720 Int. wall Floor Cell: a Total Btu. ® �! Required sq. ft. E.D.R., orsq. ins. W.A. Leader area =-I - .A40 - HEAT LOSS CALCULATIONS m Weatherstrips A Guide Cons"- n No. XWVindows ` Yes—No 19_._._. Doors Reference ' Out. Wall Int. Wall Ceiling Roof Floor Find Yes—No I —A�ARoom I Length q Width Height 2 ` SL Room I I I otal ISM Required sq. ft. E:D.R. or sq. ins. WA. Leader area Fl.1 m Room I Length Width 1 e. Height Windows and Doors---Crackage and Asea � Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Windows and Doors—Crachge and Area s' Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. d 4 Btu Infiltration l_ Coef.1 Btu Infiltration Coef. Btu Infiltration Glass ®® � Glass O y0o. Exp. wall Floor f a 700 Net exp. wall /77-1 /0 1 7 � �2 Int. wall 6,900 Int. wall Floor Floor Ceil. 2`4',o `7 >, /® 0 I otal ISM Required sq. ft. E:D.R. or sq. ins. WA. Leader area Fl.1 m Room I Length Width 1 e. Height Windows and Doors---Crackage and Asea � Width 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 of pane lights of crack E4. it. / f 1 Coef.1 Btu Infiltration l_ Coef.1 Btu Infiltration -5-0 �� Yo ®® � Glass Int. wall Cell. Floor Exp. wall 700 Net exp. wall 47 42 Required sq. ft. E.D.R. or sq. ins. W.A. Lead. -r --area /0 6,900 Int. wall Floor 2`4',o Cell. I otal Btu. I/ 10, Required sq. ft. E.D.R. or sq. ins. W.A. Leader area *)— FI.I I', ®-0 Room l Length B P Width . ; Hecht 7f/ Windows and Doors—Crackage and Axea Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. d G < r AR dit, 3 16 Coef.1 Btu Infiltration l_ Vo V Glass -5-0 �� Exp. wall S`— Net exp. wall ®/ /01 L9 Int. wall Cell. Floor Cell. Total Btu. 47 42 Required sq. ft. E.D.R. or sq. ins. W.A. Lead. -r --area Windows and wrath (�1 No. of Wane I c Infiltration Glass Exp. wall Net exp. ;all Int. wall Floor Cell. Total Btu. BURRMAN COMPANY Insulation How Applied Width Height and Area seal ft. Area crack sq. ft. ICoef.1 Btu Required sq. fL E.D.R. or sq. ins. W.A. Leader area . F1_I Room l Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. ofDano of pane lights of crack sq. ft. Coef. Btu Infeltratirin Glass Exp. wall Net exp. will Int. wall Floor Cell. Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FlTJ Room I Length Width Windows and Doors--Crackatte and Area j Y IlAff IAIPQ d ® FU Infiltration Glass Exp. wall Net exp.:wa11 Int. wall Floor Cell: Total Btu. Required sq. £e. E.D.R., or sq. ins. W.A. Leader area Btu $60.3450 0, C., 4 V f j"id 4y ANOKA COUNTY 6431 UNIVEF;SITY AVENUE NE September 19, 1978 FRIDLEY, MINNESOTA 55432 Minneapolis Post Office Department Superintendent of Delivery 1st & Marquette Avenue Minneapolis, Minnesota 55402 Re: Change of Address ` City of Fridley Gentlemen: y 0 s Tire are listing the following change of address in the City of Fridley; NAME Hs 3-ehRueppmueller- Timothy L. Hutchson FRONT: 8051 Riverview Terrace N.E. , Fridley, MN 55432 TO: 8021 Riverview Terrace N.E., Fridley, MN 55432 LEGAL DESCRIPTION: Lots 21-24, Block V, Riverview Heights We have notified the occupant of this change and we would appreciate it very much if you would change your records accordingly. Sincerely, DArX-,EL G. CLARK Community Development Adm. DGC/mh CC: City Water Billing Dept. City Assessing Department Minneapolis Cas Company - Brooklyn Park Office Northern States Power Company Northwestern Bell Telephone City Voters Registration Homeowner Dear Mr. Hutchinson: It has been necessary for.this office to change the address of your house FROM 8051 Riverview Terrace TO 8021 Riverview Terrace N.E. LEGAL DESCRIPTION Lots 21-24, Block V, Riverview Heights We have notified the Post Office Department, Minneapolis Gas Company, Northern States Power Company, Northwestern Bell Telephone Company and various departments in City hall of this change_ r Sincerely, DARREL G. CLARK Coz unity Development Adm. DGC/mh SUBJECT PERM) City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT _ _ R IPT NO. Ir � COMMUNITY DEVELOPMENT DIV. ' ter,: --_.-_ r PROTECTIVE INSPECTION SEC. 23 NUMBER REV DATE PAGE OF APPROVED By /'--1 CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/22/96 JOB ADDRESS 8021 Riverview Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 21-24 V Riverview Heights SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dan McShane 8021 Riverview Terrace NE 783-8709 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Sela Roofing & Remodeling Inc 4100 Excelsior Blvd, St Louis Park 55416 823-8046 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 1050 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR X ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof House & Garage (27 S) Tear -off 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 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 $1.08 WITH W HER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,160 DOES OT ESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVI ONS ANYAT ER STATE OR LOCAL LAW REGULATING CON- Fire SC $2.16 STRUCTI O PER M NC OF CONSTRUCTION $74.75 PLAN CHECK FEE TOTAL FEE License SC $5.00 $82.99 SIGNA\URE F CONTRACTOR OR AUTHORIZED AGENT (DATEI WHEN PROPERLY LI DATED THIS IS YOUR PERMIT 7 y BLDG )NSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI NEW [ ] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application �a'3qi ConstructionAddress: TV C mac/) Pcy Legal Description: Owner Name & Address: %� d '-- u?", Tel. # %F 576 cr Contractor: SELA B00FwG R REMODELING, INS MN LICENSE # / a5'Z Address: 4100 EXCELSIOR BLVD. Tel. # 7zYC ST LOUIS PARK, MINNESM 554 !6 A&HUMB application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EVIPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: c C1,�i vetft 111 a Corner Lot [ ] - Inside Lot [ ] Ft. Yd Setback . Side Yard Setbacks Type of Construction: Estimated Cost: $ C / Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $900 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 [ ] v SUBJECT City of Fridley M�5 AT THE TOP OF THE TWINS BUILDING PERM IP, RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. NUMBER nEv DATE PAGE OF APPROVED Br CITY HALL FRIDLEY 55432 763-571-3450 910-F15 6/30/03JOB ADDRESS 8021 Riverview Terrace NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 21-24 Riverview Heights SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mike Wall 8021 Riverview Terrace NE 763-786-7151 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Mike Otto Construction Inc 1676 Hazel St N, St Paul, MN 55119 612-245-5826 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20365478 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential.7 CLASS OF WORKO NEW ADDITION O ALTERATION O REPAIR ❑ MOVE O REMOVE 8 DESCRIBEWORK Construct a 28T x 6' Deck in Front Yard 9 CHANGE OF USE FROM TO IMBIBES STIPULATIONSSee notations on plan. Front setback approved by Planning Department. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING,VENTILATING OR AIR CONDITIONINGTHIS 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 GARAGESAND KNOW THE SAME TO BE TRUE AND CORRECT. ALLPROVISIONSOF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2,086 $1'04 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-$83.25 Fire SC $2.08 STRUCTION O THE PERF MANCE OF CONSTRUCTIONPLAN CHECK FEE TO L FEE�0jLice s $5.00 $ 1.37It J S'� NA TU CONOA OR AUTHORIZED AGENT AT o MEN OP ALID T THIS IS YOUR P MIT S-GNATUAE OF OvVNER,,F OWNER BUILDER, (DATE, BLD SP NEW [ ] CITY OF FRIDLEY Effective 1/1/2003 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg In ALTER [ J SINGLE FAMILY AND DUPLEXES R4 AND R-2 (763) 5714287 Fax BUILDING PERMIT APPLICATION Construction Address: ® �J�� ' ��°t^^� �'d ✓fie f1 J ` '4� Legal Description: Owner Name & Address:; �t �.�� I ( t�2 I Q , ,.��- v,'e�T el. # 793— '791— Contractor 91--Contractor: , n i ic_ ® i -Ah e,,At f ro c. -- cao.° Ste, MN LICENSE # & C - '2o l Address: fir; 1 04 z cC sgo- v .5�- pn-j ( Tel. # (2- - 2- YJ --S'% Z 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 WidthHeight Sq. Ft.° GARAGE AREA: Length - Width, i Height Sq. Ft: �S DECK AREA: Length Width=== Hgt/Ground I Sq. Ft. --' OTHER: /it 0•4j Construction Type: tw Estimated Cost: $ — Driveway Curb Cut Width Needed: _ DATE: i'� 1y-®3 APPLICANT: Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. ..,, CITY USE ONLY - Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ � <_ e01 of Permit Valuation (1/10th%) �- State Surcharge $ :50/$1,000 Valuation SAC Charge $ $1275 per SAC Unit License Surcharge $ -- $5.00 (State Licensed Residential Contractors) Curb Cut 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 $ .5 STIPULATIONS- Building Permit Fee BUILDING See Back Page for Fee Schedule Permit No. - Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION $ Received By: 763-572-3604 $ CITY OF FRIDLEY License Surcharge DKIRWAY 763-502-4977 FAX SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ EFFECTIVE 1-1-08 Erosion Control $ DATE o 0'0 O _ YOUR E-MAIL ADDRESS $ SITE ADDRESS�G ✓�?Ul+t' GCi le Q.G �_ I-- $ THIS APPLICANT IS: __//--1 WZWNER CO CTOR s •� �— Make checks pgable to: C of Frid!ey Attach Stipulations PROPERTY MMIM NAME: IVI 1 THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED TENANT ADDRESS D t t,' STATE PHONE:�� .3 zfLp 7141 NAME: ADDRESS: CITY STATE ZIP CONTRACTOR SUBMIT A COPY OF PHONE FAX YOUR STATE LICENSE STATE LICENSE # ER DATE PROPERTY TYPE INGLE FAMILYINEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHm ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADOffiON ❑ MAINTENANCE/REPAIR afEMODELING 1 AST)e DESCRIBE WORK BEING DONE: d ~ Q aN► S 6 Ci. SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S 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 Ci ADDITIONS. & PORCHES SUBMIT: ❑ 1. Site Plan/Survey showing the existing structures Al �'� Tand proposed project. 2 . Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS es QNo LOC ON p}i%S OR FOR NEW OPENINGS -DESCRIBE SIZE OF O R L { teA - GC ltL OPENING CHANGES & l TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MA7 p RiAi 4: (IT ENG TE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION OCCUPANCY TYPE Permit Fee _�_ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ -0o .001 times the total job valuation Surcharge $ '3_0 .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 s •� �— Make checks pgable to: C of Frid!ey Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledgnthat the information ve is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minneso n Codes; that I derstand this is not a permit bat only an application for a permit and work is not to start 'tho a permit on site; that the work will be " a v p the case of all work which requires review and approval of plans. SIGNATURE OF APPL C P AME DA APPROVED BY DATE PLEASE NOTE: SEPARATE PERMITS ARE REOUIRED FOR kLUMINo. ELECTRICAL AND MECHANICAL WORK Building TOTAL JOB VALUATION $ BUILDING Permit Fee Permit No. Inspections Plan Review RESIDENTIAL APPLICATION 65% of Building Permit Fee Received By: 763-572-3604 .001 times the total job valuation, CITY OF FRIDLEY $ D c'd-U L 1 000 763-502-4977 FAX $ tl!2n $5.00 (State Licensed Residential Contractors) _ $ $1825 per SAC Unit (Plans to MWCC for determination) EFFECTIVE 1-1-M $ ft + 6 ft = ftx $21 =$ DATE — 6 -as YO MAIL ADDRESS r—:50,6 oIS� D G2 c Less;SITE ADDRESS te^ I �� P Fez Determined by Engineering THIS APPLICANT IS: 0 OWNER CONTRACTOR Agreement necessary ( ) Non Necessary ( ) PROPERTY OWNER/ NAME: Make checks 12Uable to: CLty of Fridle Attac ADDRESS: 190a E CITY STATE ZIP TENANT PHONE: 7&S 79�6— 7/ S% NAME. C. ADDRESS: W -/Oe TATEN% ap- CONTRACTOR SUBMIT A COPY OF PHONE '76.3 -4R.S7-, !9 23 % FAX 1( 3F -4d5'!- Aq;5- YOUR STATE LICENSE STATE LICENSE # 9S34'5' EXP DATE PROPERTY TYPE O SINGLE FAMILY/NEW CONSTRUCTION SIZE O TWO FAMILY/NEW CONSTRUCTION STORIES PERhM TYPE O ADDITION 0 GARAGE/SHED 0 WINDOWS 0 BASEMENT FINISH O ROOF O DRAIN TILE 0 DECKSIDING O OTHER SWIMIVIING POOL TYPE OF WORK: 0 NEW HOME CONSTRUCTION 0 ADDITION ANCE/REPAiR 0 REMODELING DESCRIBE WORK BEING DONE: -5—i-zm14 SIZE OF RVIPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING 0 HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES 0 HOUSE & GARAGE 1. Existing Floor Plan GARAGES 0 ATTACHED GARAGE Z Proposed floor plan PROPOSED SIZE: 0 DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SING 0 Vinyl OSoffrt ADDITIONS. & PORCHES SUBMIT:. O AM� 0 Trim 1. Site showing the existing structures Other 5 CEL— 0 Fascia proposed �°�oJ pr 2. Two sets of constradion plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS OYes ONo 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: TOTAL JOB VALUATION $ THE 1997 UBC FEE SCHEDULE) OCCUPANCY TYPE Permit Fee $ 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 $ tl!2n $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ftx $21 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fez Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks 12Uable to: CLty of Fridle Attac THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aelmowledge 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 underatan 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 a w' m th a of all work which requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME LCDATE 09 APPROVED BY PLEASE NOTE: SEPARATE DATE FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK