The URL can be used to link to this page

PRE 2010 DOCSk4l i . City of Fridley AT THE TOP OF TH9 TWINS tU-------COM MVNITY DEVHLOMENT OIY, 1 / moTECTIVi; edeftcyton GgPT. r- . CITY HALL FQI0L4Y DW$ ....d`�I i.J 61$-000-3630 Job Address/ ner, ; BIum.7Cotr to � eZla9% Kind f Building Comp etion Date II Qlu W J � W W W a o BaNral ova 'lddtll - eve i ',81NI 'oaa� •MNlva d f. 8N18Y8I KHotrol I 1z ;O C BNIYNa� ,� q � aoo�d 0 0 •U I saaMoasl o.0 '1 b q •.LNnod U kNIMO b sAYat I� •w NStlM "`� ,,,NISI 1 x CN18Va NaVBI I I I 89rNlanl ( fI I I elasoia 1 II II I aa1rM III � a X Cr - Permit No. PLUMBING PERMIT APPLICATION s ress se + Plumbing Fixture Rates: NO. RATE TOTAL ! Number Fixtures / _ x $2.00 $14,00 {I I Future Fixtures _ x $1.50 New Fixture -Old Open. x $1.50 Catch' Bastn x $3.25 Water Heater -99,000 BTU x $3.00 3/eo �I Ground Run Old Bldg. x $3.25 Elec. Water Heater x $2:00 j Gas Fitting Fees: 1st 3 Fixtures �_ x $2.00 a'00 I - Additional Fixtures x $ .75 i Gas Range -199,000 BTU x $5.00 Repairs &•Alterations See Description: Code State Surcharge .50 TOTAL FEE !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 rulinj of the Department of Buildings, and hereby declare that all'P4 f t and representations stated in this app i ati n re true and correct. -Signature r ate -SUBJECT P City of Fridley ®1258 AT THE TOP OF THE TWINS BUILDING PERMIT i � L • ______ COMMUNITY DEVELOPMENT DIV./t®7 INSPECTION 1 PROTECTIVE SEC. I i i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 ,910-F15 16/12/74 JOB ADDRESS 8160 Ruth Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR: 1 3 Bourdeaux ' S Spring Brook Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gary Johnson 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. The Rottlund Company, Inc. 1581 Rice Creek Road N.E. 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 J NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 26' x 40' Dwelling and a 26' x 26' Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. Provide a verifying survey before. capping. Additional bank improvements may be required. SEWER LOCATION: Wye may not be extended to property line. 32' South of Manhole (Inv. 841.05) Wye Elev: 841.14 (There may be a riser at wye) Top of Footing: 3.5' above wye or riser. WATER LOCATION: Must be tapped 6" CIP 10' West of sewer line SEPERATE PERMITS REQUIRED FOR WIRING, HEATING TYPE OF CONST. OCCUPANCY RO ` OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood. Frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 1066 NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION I 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. 12.60 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $25,109 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISION ANY OTH STATE OR LOCAL LAW REGULATING 'CON- STRUCTI THE PE MANCE OF NSTRUCTION. $52.00 300.00 PLAN CHECK FEE TOTAL FEE $3§4.60 SIt , TI1R,EfI�F NTRACTTOORORAU IZED AGENT (DATE) - E PROPERLY VALID AT I A YO R PERM BLDG. INSP DATE SIGNATURE 0F OWNER IIF OWN R Bl! L ERI (DATE) APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: *1 V BUILDER'.-/ ig V b=IFAA by �• �WC� ADDRESS: ADDRESS: I! -PI Oeier (VAt . dc/. NO:. ® STREET: LOT: J BLOCK: ADDITION: ZQ UaV Ssn ld L It. F� i CORNER LOT: INSIDE LOT: X SETBACK: 3SSIDEYARD:.p sw Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: S104GLE FAPA• Front: ;) ` Depth: V0 Height: 4:Q0 Square Feet:. 45 (1 to Cubic Feet: �d/LIA (, £ —Front: L � Depth: 2 (i Height: T' {' Square Feet; Cubic Feet: Type of Construction: �t�®D J 2A^L Estimated Cost: To Be Completed: /0 -JO �7 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and.hereby declares that all the facts and representations stated in this application are true and correct. ll� /Pj k 'P --p -P DATE: G ®I L " ' SIGNATURE: z9 G �,�0'�(Se Reverse Side For Additional Information.) l%e 5 DOLAN ENGINEERiNG.- INC* ENGINEERS LAND -SUP%V;:--YCRS 900 W EST " -,10a 9ORNSVILLE, MINNESOTA Cortlf icate of Survey Eos. 0aye — 'n -� I &"DRAI NAGE -* UTJUTy EAS E ME'NT 0 q i ro �; x �N ti Ld co f 4), I$.0; EAST Q -IN DI CATE5 IRON ALL ..--:-BEA►-R I.N6�.._,__.'ASSU MED DESCRIPTION I hereby certify that this survey, plan or report was prepared by me or under my direct LOT 1 BLOCK 3 - supervision and that I am a duly*registered 50U R D E A UX'SSPRING: BROOK Ap®l"T7®N • land Surveyor under the laws of �he State ANOXA C-0UNl'y-,MINNE507A of M nesota. N ' Dat 2-� �� Iie�. I`To.. "I * See,o (A) 34j-5 122V Wor %�tvz>,wo !® F Ale, /-4 Crnl Y A �F,Vm -- F 1 1, I tl L4,) / Fee 77/ IV C- 3. S- &PV -e, le P /mer-, W ,pe a s <=� ; V,. yf € CMATr-ry WARM AMR: RATIC TOTAL Furmw It & Dud Work ... ... ..... .. $10.00 $ Replacement of Furnace 6.00 41— Repairs. Repairs & Alterations --up to $ 0.00 6.00 $---. -- — Repairs & Alterations each add. $500.00 300 IL_ . SIML WARM AIR Furnace Shell & Duct Work to 120,000 BTU .410.00 ,J6, ®® each add. 30,000 FM ......... 3.00 $ RePhMement of Furnace 6.00 $_ Repairs; & Alterations—up to $500.00 6.00 IL Repairs & Alterations each add.4500.00 3.00 $— Furnace Shell & Lines—to 400 sq. ft. F.DR Steam $20.00 Furnace Shell & Line ---to 640 sq. ft. EDR Kot Water 10.00 $• ._.._--_..__ Each add. 200 sq. ft. EDR Steam xnn--- Each add. 320 sq. ft. EDR Hot Water 3.00 $—. __--- OIL BURNER—to 3 gal per hour 6.00 $--_--- over 3 gal. per hour—See Fee Schedule B (up to 199AM BTU) &00 $—SACO_ over 195,000 RM See Fes SchwfWe GAS FrMNG FEES. NO RATE TOTAL 1st 3 natures 2_W $ Additional Fixtures x .75 $ _ Gas Range to MMAM 500• $ Of City of Tddley: �-,2iuq 4114S09 The undersigned hereby makes application for a permit for the work hereie: specified, agreeing to do all work in strict accordance with the City and ruling of the Department of Buildings, and hereby declares that an the faeft and representations stated in this application are true and / b' V _ .jl Fridlen, l)qn_—_ Kind of Building..--- Used uilding..--_ Used as To be completed about -------•----- vi�,�� /FY Estimated Cont, Oldflew- Building Permit No. Psrffiit Ida. f',"71' �� .19v n/+Cnr'-`pn -fi ra n71' Pa 0171 N' loin P I4 !�. c,t 1d l Infiltration �} Infiltration _ 2e' Glass Exp. wall Net exp. wal I HEAT COSS CALCULATIONS HEATING & iR CdN61TOOMIMS CO. MINNEAPOLIS, MINN. 7' Int. wall Weatherstrips A•S.H.V.E. Guide Reference g # Construction No. Insulation Windows Doors Out. Wall Int. Wall Ceiling Net':exp: !welt Roof Floor Kind How Applied Yes—No Yes—No #Qt.'tn+a## inti - wall _u. Ge#Iftig Room Length Widt / Height FI. Room Length Width Height Windows and Doors--Crackage and Area Windows and Doors–Crackage and Area No Width Height of ane of pane No. of Lineal ft. Area lights of crack sq• ft. No. Width Height No. of Heal ft. Area of pane ofP lie lights f crack sq. 1t. 7ota1Btu.. l Infiltration �} Infiltration _ 2e' Glass Exp. wall Net exp. wal I Infiltration all Int. wall _ i Glass Int. wall Glass A 1_6z # Eap• wall 411 dZ. --- Floor Exp, wall " ...T'otat Birt: Total Btu. Net':exp: !welt Required sq. ft. E.D.R. or sq. ins. W.A. Leader area . Net exp. wall #Qt.'tn+a## inti - wall _u. Ge#Iftig 9� : Floor. 7ota1Btu.. Tota! Btu." Ri~qutred Sq,..ft. E.D.R, or sq. ins. VH.A. Leader area Required sq.'ft. E.D.R. or sq. ins. W A, Leade area 777 Width Fleight FIJ/�� Room Lerjgth idth/ ffeight _ 'llindows and Doors–Giackage and =Area Windows and Doors–Crackage and Area + '' "Width Height :. 'No. mf Lineal f . Area of pane' of pa a lights of crack sq. ft. Width Height No, of Lineal ft. Areg No.of ane of pane lights of crack sq, ft k _ Coef Btu Coef -,QtU- Iftfa`Itration Infiltration Mass 0/tv IGlassCy ; sip:3nralI176 Exp. wall -5 Net°exp well Net exp. wall AILX Fnt. wall Ceiltn9 a Ceiling Lf�C �hsor .Floor cE4 Z ictal 6tu., Tc3f81 Btu. 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 FI •I.0 Room Length ' Width Height F1. ,�� Room Length Width eight Windows and Doors–Crackage and Area Windows and Doors- Crackage and Area yy�1r drh ��Nelght No. of Lineal ft. NO' of ppane�'� oaf vane lights of crack I s7- 1 9— Area sq. ft. e� PJo. Width Height No. �f Lineal ft. of pane of panve� lights of crank Area sq. ft. / i.1 .,.3� - /17 1 0 A Coef Btu i i E jCoefj Btu Infiltration i �' Glass wail ��--.`_— Net exp. wall �} Infiltration _ 2e' Glass Exp. wall Net exp. wal I G C-° Int. wall _ Int. wall ceiling �f�tL -- Ceiling s® 0 _ —Floor 411 dZ. --- Floor " ...T'otat Birt: Total Btu. ,Req€ired,5q. ft: "E,D.R. or sq. iTTs. W.A. Leader area Required sq. ft. E.D.R. or sq. ins. W.A. Leader area . an tg" HEAT Lr'6SG.4LCLILATIONS HEATING& AIR dG O Y I®NING CO. Weatherstrips A.S.H.V.E. Construction No. Windows Doors Guide out. Wall Int. iNali Ceiling Roof " Floor Kind MINNEAPOLIS, MINN. Insulation How Applied Reference , Yes—No Yes—No !g ,f Fl.�Length /it*) Width Height Fl. Room Length Width Height Windows Ad Doors—Crackage and Area Windows and Doors—Crackage and Area No. Width Height No. of Lineal ft. AreaWidth Height No. of Lineal ft. Area of of p lights of crack sq. ft. NO' of pane of pane lights of crack sq. ft. 01 Icoefr Btu I I I I I I Icoe`° Btu Infiitrat)on _ � Glass Coef Btu Infiltration Glass Exp. wall Coef Btu Infiltration ® Infiltration - Glass® — Int. wail Glass . _ Int. wail i Exp. wall Exp. wall Ceiling Floor - Net.exp. waft - Net exp. wall Total. Btu.: lnt., vyal I Required sq. ft E:D.R. or sq. ins. W.A. Leader area lnf. inial I _ Required sq. ft. E.D.R. or, sq. ins.. W.A: Leader area Ceiling Q Ceiling Floor Floor. Total Btu. Total Btu. Required sq. ft. -E.D.'8, or sq. ins..W.A. Leader area _ _ Requited sq. ft. E,D R. or sq. jns. W.A. Leader area FI. > Room Length` . Width fleight, ; Ff.' :: Roam °° Length Width Height Windows and .Doors—Crackage and Aria, No Wirth Height No. of Lineal ft. Area' of ane of pane lights of creek sq• ft: Windows and Doors=Crackage and Area = . Width Height;' .No. of Lineal ft: Area NO' of pane of pane tights- of crack- sq. ft. Coef `. Btu " Coef '° 6 to ., lnf i ltration I of i ltrat,i on Glass:, Glass Exp. wall Exp. wal Net :exp. wail Net exp. wall Int. mal l Int. wall _Ceiling r Ceiling Floor, Floor' Total Btu. Total Btu. 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 . F►. Room Length Width Height FI. Room Length Width Height Windows and Doors—Crackage and Area No Nr din Haight No. of L Heal ft. Area of pane of pane fights of crack sq. ft. Windows and Doors-Crackage and Area Width Height No. of Lineal It. Area NO' of pane of pane ❑ghts of crack sq. tt. Icoefr Btu I I I I I I Icoe`° Btu Infiitrat)on _ � Glass I Infiltration Glass Exp. wall _i I Exp. wall Net exp. wall - Net exp. wall — Int. wail _ Int. wail i Ceiling — Ceiling Floor - Floor Total. Btu.: Total Btu. . 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 63-84-116051 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE rLUU3ING FIXTURE RATES: r0. RATE `,:�er Fixtures rFliv. re F: xture Opening New Fixture, Old Opening Catch Basin :later Heat.r - to 99,000 BTU -3,000 B:J to 199,000 BTU Water Softener New Ground H.zn Old Building lectric Stater Heater G.:S FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS & ALTERATIONS x $3.00 x e x $2.00 >, e x rio x $10.00 x $7.00 x $5.00 Water $5.00 a m - 544 a rn o .N b 14 w Heater U •.4 a� U ..•� 'S C: C N H .,4 t0 X :-J H U S4 [If .0 C � U W iC i4 . B W Q M ii N C N •� U O Q W 4J N N N .0 y .4 $4 r b -.4 .4 41 r, O b b tN�qq C7 41 dS 1@C ri 1 3 4 �"L 7L (-1) - tiLture Connection Opening Connected with Sewer (;) - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE rLUU3ING FIXTURE RATES: r0. RATE `,:�er Fixtures rFliv. re F: xture Opening New Fixture, Old Opening Catch Basin :later Heat.r - to 99,000 BTU -3,000 B:J to 199,000 BTU Water Softener New Ground H.zn Old Building lectric Stater Heater G.:S FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS & ALTERATIONS x $3.00 x $2.00 x $2.00 x $5.00 x $5.00 x $10.00 x $7.00 x $5.00 x $5.00 x $3.00 x $1.00 x $10.00 TOTAL Y First $103.00 $5.00 $ _ each add. $100.00 or fraction $2.00 S State Surcharge $ .50 TOTAL FEE $ 8.00 REI.'QSPECTION FEE Job Address 8160 Ruth Circle Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work :erein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares t:.at all the facts and representations stated in this application are true and ccrrect Fridley, Mn. 4-30-81 19 OWNER-_-Burers KIND OF BUILDING frame USED AS res. TO BE COMPLETED ABOUT 5-7-81 ESTIMATED COST 50.00 OLD - NEW BUILDING PERMIT NO. PERMIT NO. ComPan:T�� Signed By Tel. No. ROUGH INSP. Date FINAL INSP. 11 -15 -Sl Date APPROVAL FOR PEXSIT lF®� MINIMUM FEE FOR ANY PLUbMING PERMIT IS $7.50 PLUS $.50 STATE SURCHApf.E City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING PERMIT ® 118494 Ir `y _ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. �'_ "1� CITY HALL FRIDLEY 55432 L J\ 612-571-3450 fttMTPrN_ 3/ NUMBER 910-F15 REV. DATE 6/16/86 PAGE OF APPROVED BY JOB ADDRESS 8160 Ruth Street N.E. 1 LEGAL DESCR. LOT NO. 1 BLOCK 3 TRACT OR ADDITION SEE ATTACHED Bouxdeaux's. Spring Brook Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Burris 8160 Ruth. Circle N.E. 786-2886 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. American -Remodeling 3000 Annapolis, Mpls., MN 553-0020 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 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside Dwelling 9 CHANGE OF USE FROM 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 AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SO. FT, CU. FT. 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 AND,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $5,670 SURTAX $2.83 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PERMIT FEE $56.50 SAC CHARGE PLAN CHECK FEE TOTALFEE �- $59.33 i'1_GN_ATLT_RE ICONTRW6TOR 6R AUTHORIZED AGENT (DATE) WHEN PROPERLY (DATED THIS IS YOUR PERMIT ' BLDG (NSP rr A. q. TE SIGNATURE OF OWNER IIF OWNER BUILDER)- (DATE) NEW [ ] City of Fridley Effective 4/1/86 ADDN. [ ] �R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address Legal Description: p _9� - Owner Name &Address: 4,,� SQ-� L'+ Tel . # g �OY Contractor: 93L/V)de&L Mn La ^n►AA�LQa r' Tel. # Address LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Length Length Corner Lot [ ] Inside Lot [ ] Height Sq. Ft. Width„ Height Sq. Ft. Width Hgt/Ground Sq. Ft. Ft. Yd. Setback Side Yard Setback Type of Construction: 54. c%. Approx. Completion Date: 02eg Estimated Cost: $ .5-6 "7 0 Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: APPLICANT:X12 �c�1 Tel. # Q� 7 Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side 25% of Building Permit Fee $•50/$1,000 Valuation $475 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] Building PLUMBING Permit No. 3 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Dat : MAR 2amu 763-502-4977 FAX EFFECTIVE 1-1-08 DATE 3�a 4'(0 Q YOUR E-MAIL ADDRESS SITE ADDRESS �® THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR PROPERTY NAME: ' ADDRESS: C: � CC) ��I C CITY Y- xAkP. L4 STATERkZIP n OWNER/ TENANT PHONE: -i G CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PERMIT TYPE 'a° SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: 0 NEW D REPLACEMENT DETAILED DESCRIPTION OF WORK PER MS 16B.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 = plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $15.50. BATH SINK/LAV DRAINS SHOWER _ WATER PIPING _ _FLOOR _ —BATHTUB _ GAS PIPING (NEED CITY LIC) _ SWIMMING POOL _ WATER SOFTNER ($35) WASHER KITCHEN SINK _ WATER CLOSETBACKFLOW PREY. ($15) '' _CLOTHES _ DISHWASHER LAUNDRY TRAY HEATER ($35) FOR IRRIGATION _ _WATER WATER METER —OTHER s 51 Permit Fee $ 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 (MINIMUM $15.50) (MINIMUM $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 be in conformancewftthe ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but on�, an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved pl in the case of all work which requires review and approval of plans. SIGNATURE OF APPLIC PRINT NAME b�� • �(�Ql� ke7 DATE - Z So _ U (�� APPROVED BY DATE �l ��.�OI A% G7 �., I? �k, �i�� . �. � I�� R��ii ,tom+ _ ,.� � . � ��`�� . City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Dat PAR 02009 763-502-4977 FAX EFFECTIVE 1-1-09 DATE YOUR E-MAIL ADDRESS SITE ADDRESS -S'7, :v'E THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME:'\�` v'^� TENANT ADDRESS: STATEMO ZIP_� -r-k_ PHONE:,-? CONTRACTOR SUBMIT A COPY YOUR STATE LICENSE STATE LICENSE # EXP DATE 3 AND CERTIFICATE OF ADDRESS: \®_-) ? ��j Ci`) ®:�I . CITYL -17L< �TATE C-r� ZIP -S -_.X 4 INSURANCE PHONE "� 5- � - %— FAX PROPERTY TYPE -MINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ;E HIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR 1;VREMODELING DESCRIBE WORK BEING DONE: �� ' CG & S�'�i N y e;rj , SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ 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 '15soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other 15Fascia and proposed project. 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: Q� ING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 100V 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 $ ?17(D $ 146 $ c✓ 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) $2000 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: Citv of Fridlev 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 accordance with the approved plan in the caseI work( ch requires review and approval of plans. _11A_11A� SIGNATURE OF APPLICAN PRINT NAME ' `'�c�ei °oJAs��. DATE