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PRE 2010 DOCS-- CITY OF FRIDLEY� FOR PLUMBING AND GAS FI-TTING pFR`^IT APPLICATION Job Address_ +' o Water r [L licateY waf Buildings p . ;; i .+ �_- f <. o N f FrdleyCi.y i ; X71-3450 t, .. :a.: ;lcc T el. f r •he b -x herein makes app ezzit o w _ Codes lication fora 2 ' The undersigned hereby n «of c in s accordance w: h the City ::ereby declares that al.. arrec•ing to do all I l spccifiea f Buildings, and s and rulings of the Dcpartmcrt o and corse-. in this applic±t-� t=ae a.g, the facts and representations stated �e � •-� I , I � I I I � Fridley. AL1. ` 014NER ��� I l � I KIND OF BUILDING `•i } jth e CC^ :ec _lon. Opening Co '.ectcd wi Se4/e Water USED AS Old rr_ nirg t TO BE CO:IPLETED :90'1-- E ESTIMATED COST 17e 17 PARTIAL RATE SCHEDULE pZRmIT ::o. !®CVJ PER`:IT NO. RATE TOTAL OLD NEW BUILDING ______-- PL'J:3I\G FIXTURE RATES: $21,)- =. .0 Company - x $3.00 r' x $2.00 $ — Sian ed By - Kt re Opening ..._ire i --- x $2.00 $ — ;;e4 .ixturc, Old opening _ x $;, 00 $ — Tel. NO. Catc:i Bas -n / x $5.00 $ water ?Gator - to 99,000 BTU Y_ $10.70 $ --- 1C0.�vS LTJ to 199.000 STU --- — $7.00 $ r _-- ROUGH INSP. cc -er $5.00 Date ^ t;C l4ateGso-`?=.. Old Building _ x $5.00 $ — Electric irate= Heater x -?7 FINi+L I.NSP. Date GAS FITTI::G FEES: V. :,3.00 � a '3 — lst 3 fixtures x $1.00 $ — APPROVAL FOR PEIudIT F' nditi0 :al Fixtures '-' —� Y. $10.00 $ Gas R.nge to 199,000 BTU — ? ;LRS $ ALT $ 00 $ �_ : ItiIN.0-4 FEF FOR AlY PLUM'•-tiG PE? :IT ZS $7.50 t_ -tet LlCO.GO ad3. $100.00 or fracon $2.00 a — ea=a State Surcharge $ _ •50 �D a S --- TOT:+'.+ FEE -- City of Fridley SUBJECT PERMI-T ' 14190 AT THE TOP OF THE TWINS PERMIT , r BUILDING ECEIPT NO. COMMUNITY DEVELOPMENT DIV. ! r � � PROTECTIVE INSPECTION SEC. 1 O . � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 6/30/77 JOB ADDRESS 5201 St. Imier Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DES. 5 1 Innsbruck 5th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James Manthis 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Rodney Billman, Inc. 151 Silver Lake Road, New Brighton 633-0536 -7-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 ❑ MOVEff X 8 DESCRIBE WORK Bef0te dining call 8 (� I Construct a 50' x 25' Dwelling and a 24' x 24' Garage TrLM.ONE -ELECTRIC -GK R Er 9 CHANGE QF USE FROM FOR WIRING, MEATI W NIN 0 STIPULATIONS Provide a hard surface driveway. Provide sod in the front and side yards. Provide a verifying survey before capping. Provide soil tests. Provide firedoor with closer into lower storage area. Provide City with copy of truss design. SEWER LOCATION: (Approx. 13' Deep in Street) 58' North of Manhole (N. Inv. 959.47) WYE ELEV: 959.77 TOP OF FOOTING: 962.97 Minimum WATER LOCATION: 10.3' North of Sewer Service DRIVEWAY DEPRESSION COST: N/A Existing surmountable curbing in CtiY Of Pb" KIN - NOT OUAR TMs ACCURACY OF 11MM W.AWM AND I WAACRIS. THIS DATA IS ICOR WORMAWN WKNISIS ONLY AND pjaSONS uSING It SHOULD YEISFY INN WORVIATION 014 THE SITE SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 R-1 1328 + 576 36,928 Total ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ] STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATIONSURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. $/�rj, 32O $22.66 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE ORLOCALLAW REGULATING CON- $147.71 $375.00 STRUCTIO OR THE PERFORMAA6E, OLS" NSTRUCTION. �✓ G PLAN CHECK FEE TOTAL FEE $582.30 GNATUREOF CONTRACT ORA HORIZEDAGENT (DATEI r � N W E PE Y VALIDATED THIS IS YOU PEOMIT 4 [ �� BLDG INSP DATE ' SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) Itl$S Eta ;11�+' CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER: Gy Address: No.: S02 Q / Street: BUILDER: Address; Tel. No. LOT: 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 these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front: Depth: eight: Square Feet: 3 Cubic Feet: G�GL�/✓iK/ Front: L( D t.:h: Z Height: Square Feet:�Cubio Feet: Type ..of . Construction: jj�jEstimated Cost: ��® To Be Completed: Alt. Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (S E REVERSE SIDE OF SHEET) 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 mare true and correct. See reverse side�or additional information. 14 DATE: e i SIGNATURE: ' Stipulations: �9 t4;- UQ -- deft, UP Lem;;A5ef c5 c3 ��• Gc� 10 'bwuj /�o z z C �C UJ uj w I � . V y°= /77 i 913 I i ' 34� 92 8 a SO d 4(ec) I f i5.4 C. , I j ' I i I : CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE GRAVITY Wti R.\1 AIR: RATE TOTAL Furnace Shell & Duct Work $12.00 $ Re: lacx=e nt of rn rrace 7.00 $ Repairs & Alterations -up to $500.00 7'00 $ Repairs & Alterations each add. $500.00 4.00 $ NIECHANICAL WARM AIR: AIR CONDITIONING Furnace Shell & Duct Work to 100,000 BTU $12.00 4.00 $ each add. 50,000 BTU $ $ .$� Rcp' acemert of Furnace 7.00 $ Repairs & Aizerations-up to $500.00 7.00 $ .,c airs & Alterations each add. $500.00 4.00 $ STEUM OR WT WATER SYST01: BURNER - Trade -Name Size No. Boiler s Lines up to 100,000 BTU $12.00 $ each ad n. 53,OGO BTU 4.00 $ Boiler only up to 100,000 BTU 7.00 $ each addn. 50,000 BTU 6.00 $ CIL BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $_/D�'O ' (over 199,999 BTU see Fee Schedule) $ Job Address Department of Buildings City of Fridley Tel. x#571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correctt.. Fridley, Minn. --,9 _� 19� OWNER KIND C USED AS TO BE COMPLETED ABOUT. ESTIMATED COST E - 7 C / lJ r OLD - NEW BUILDING PERMIT NO. PERMIT NO. GAS FITTING FEES: � / 1st 3 Fixtures x` $ 3.00 x $ 1.00 $y2a_b $ DESCRIPTION OF FURNACE/BURNER Additional Fixtures Gas Range to 199,000 BTU x $10.00 $ HEATING or POW LANTS, Steam, Hot Water Jaren AirNo. AIR CONDITIONING Trade Name Size No. V Z " 1 3 FAX HEATING SYSTEMS See VENTILATING SYSTEJIS Fee schedule $ $ 1 Capacity �� it ( jSq• Ft. EDR BTU HP ALTERATIONS & REPAIRS- S State Surcharge $ $ .50 l Total Connected Load 3, 711 Kind of Fuel TOTAL FEE $ O BURNER - Trade -Name Size No. PLUGbi INSP. REINSPECTION FEE Date ($10.00) FINAL INSP. `� ��,�•' Date AP."#I*--VAL FOR PEX%.%SIT L x1%1I.%rw . FEE FOR Ati'Y HEATING PERMIT IS $7.50 Capacity Sq. Ft. BOR BTU HP Company Signed By /7/ C. (J U �7 /� `� • Tel. NO. �i Ov °CRONS�TR®MS HTG. & 141 R CON D., i . Job Nome to F D46 4410 Excelsior boulevard, Minneapolis 16, Minn. MEAT LOSS CALCULATIONS Job Addres Weatherstrips A.S.H.V. E. _ Guide Construction No. � Insulation � 10// �t WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor ( Kind How Applied Yes—No Yes—No 19_ Fl. e;W oom I Length l Width / Height Fl.� Room Length Width 0 Height ` Windows and Doors—Crackage and Area I S" 0 ICoef.1 Width Height No. of Lineal ft. Area No. off pane of pane lights of crack sq. ft. Infiltration °t I 17, t i 3 1 -7 Glass Coef. Btu 1coef.1 Btu � - Net exp. wall �� ®.�' - 3 2.111 6- 6 _ Glass Wass Exp. wall i, I X C—r 0 Exp. wall 0° ,Y vW.0, e 91�� R Total Btu. Net exp. wall -1 e / Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Floor T S' Height I 1 % F Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.j E e 71 Room I Length Width ,?� Height Windows and Doors—Craclfage and Area wldth Helght No. of Lineal ft. Area No.''gg of pane of pans lights of crack ,.t, b _ - 'Z "(f- 9, / 1 ,)% ® I IC*ef.1 Btu Infiltration Glass Exp. wall Net exp. was Int. wall Tbtal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area width Height No. of Lineal tt. Area No. of pane of pane ligbte of crack aq. [t. Coef. Btu Infiltration. a�_'' Glass j®. � e) /6 S-0 Exp. wall Net exp. wall - j 16 P' 3 Int. wall —oar Total Btu. t� % Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI.IAF A.T Room 1 Lenath / - Width Height %` windows and cors—Crackage and Area I S" 0 ICoef.1 Btu Infiltration ..� 3 1 -7 Glass Coef. Btu Exp. wall / Q, $ LL Net exp. wall ®'T 1-7 J. 4 Int. wall J-0 Exp. wall Ceiling i�F/till Net exp. wall Int. wall Floor e 91�� R Total Btu. -1 e / Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Floor 171.1 &A, 7' Room I Length /® Width Windows and Doors,-Crackage and Area width Helght No. of Lineal it. Area No. of Wane of Dane llahts of crack sa. ft. S' Height I IC*ef.1 Btu Infiltration Glass Exp. wall Net exp. was Int. wall Tbtal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area width Height No. of Lineal tt. Area No. of pane of pane ligbte of crack aq. [t. Coef. Btu Infiltration. a�_'' Glass j®. � e) /6 S-0 Exp. wall Net exp. wall - j 16 P' 3 Int. wall —oar Total Btu. t� % Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI.IAF A.T Room 1 Lenath / - Width Height %` windows and cors—Crackage and Area I S" 0 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Width Height No. ofLineal ft. Area No. of pane I ofnPalms lights of crack sq. ft. F1.1 Room I Length 1 Width 437, Height ,; Windows and Doors—Crackage and Area e, �a width Height No. of Lineal ft. Area No. of Dane of Dane 1* 1. of crack sq. ft. Coef. Btu Infiltration `�� ® LL Ori Glass J. 4 J-0 Exp. wall Net exp. wall Int. wall S Floor Total Btu. I S" 0 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length 1 Width 437, Height ,; Windows and Doors—Crackage and Area e, �a width Height No. of Lineal ft. Area No. of Dane of Dane 1* 1. of crack sq. ft. Coef. Btu Infiltration �— ,f'Ezp. wall fit' A- f) AT //' A 'Y r I 4 re -1 9 I V --,' A, - Int. wall Ceilin. - Floor Total Btu. Required°sq. ft. E.D.R. or sq. ins. W.A. Leader area C CRONS-'ROMS HTG. & AIRCOND., INCWob b Name ' °'" D•56 4410 Excelsior Boulevard, Minneapolis 16, Minn. f HEAT LOSS CALCULATIONS Addre Weatherstrips A.S.H.V. , Construction No. 1 Insulation Guide 1 Windows Doors Reference I Out. Wall I Int. Wall Ceiling Roof Floor Kind How Applied Yes No I —Y—es---o— 19— I Fl. s�,- , A oom I Length Width / VHeight Fl. " R Room I Length 777 Width' Heighe .s. Windows and oors—Crackage and Area Width Height Width Height Noof Lineal ft. Area No. of pane of pane ilgihte of crack sq. ft. Area No. of pane of lights off crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Icoef.1 Btu Infiltration 7, QB If" N S, 111�f Glass y/. W yo ur o Exp. wall �' � ®`� ;� a � ®`' 0 Net exp. wall�� Irrc�_v�all Net exp. wall IF31 Exp. wall ?IV 7 Int. wall Ceiling cl Net exp. wall Floor 4 /V-3 Windows and DoorCrackage and Area Width Height No. of Lineal ft. Area No. of pane of lights off crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. ppane Btu Infiltration 7, QB Coef. Btu Infiltration `�� a'_ 0,. Glass 0. S b Exp. wall ' _ Net exp. wall Int, wall e►ling G� Ceiling Floor s-- Floor © // Total Btu. I L 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 R.1 Room I Length Width Height �,I Room ( Length Width Height Windows and Doors--Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane llghts of crack &Q. ft. Btu II Infiltration Glass o r 0 Exp. wall 5 Net exp. wall Int., all Bilin� 0 Floor Total Btu. 3 ,. E r Infiltration Glass Exp. wall Net exp. w Int. wall Ceiling Floor Tbtal Btu. Required 3 Windows and Doors—Crackage and Area I Required sq. ft. E.D.R. or sq. itis. W.A. Leader area Room I LengthWidth ® Height, Width Height No. of Lineal ft. Area No. of Dane off lights of crack sq. ft. ,pane / 1 Windows and Doors-Crackage and Area Helght No. of Lineal ft. Area of Dane lights of crack5. it. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration 7, QB Glass gyp... K—b A Exp. wall ®`' 0 Glass Net exp. wall IF31 Exp. wall ?IV 7 Int. wall Ceiling cl Net exp. wall Floor 4 /V-3 Total Btu. ' 3 ft.' E.D.R. or sq. ins. W.A. Leader area I Required sq. ft. E.D.R. or sq. itis. W.A. Leader area Room I LengthWidth ® Height, Room I Length Width Height kqd Doors,—Crackage and Area / 1 Windows and Doors-Crackage and Area Helght No. of Lineal ft. Area of Dane lights of crack5. it. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. ® x v N- Coef. Btu Coef. Btu 3 . V / T Infiltration Glass Exp. wall S� 3 cl Net exp. wall Int. wall Ceiling o ERE 1 Floor ` , �1 otal Btu._ ft. E.D.R. or sq. ins. W.A. leader area Required`sq. ft. E.D.R. or sq. ins. W.A. Leader area CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE Nu7-',er Fixtures 13 x $3.00 Future Fixture neeninq x $2.00 New Fixture, Old Opening x $2.00 N x $5.00 N � fu $5.00 100,0^.0 BTU to 199,000 BTU % e Water Softener Water x $7.00 New Ground Ran Old Building x $5.00 Electric Water Y_eater x $5.00 Heater J •.i uN. L M C N N •'1 M X y 14 N W N A rC3 4S $4 Q'. W 74 ro N O x .0+ rtS rtf ro rt Nro .$4 +� w D m c m S o w w cv U m 3 O C7 O as lec 1st 'nd 3r 4 th (R) = Future Connection Opening Connected with Sewer t*) = New Fixture, Old opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE Nu7-',er Fixtures 13 x $3.00 Future Fixture neeninq x $2.00 New Fixture, Old Opening x $2.00 Catch Basin x $5.00 Water. Heater - to 99,000 BTU � x $5.00 100,0^.0 BTU to 199,000 BTU x $10.00 Water Softener x $7.00 New Ground Ran Old Building x $5.00 Electric Water Y_eater x $5.00 GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas 1ta-ge to 199,000 BTU REPAIRS f, ALTERATIONS First $100.00 each add. $100.00 or fraction TOTAL $3.00 S Job Address 7 0 S - Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. V /'! , 19-= �r OWNER KIND OF BUILDING;' USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD( -:-N EW UILDING PERMIT NO. PERMIT NO. / (y Company Signed By Tel. No. 3 1/ - ,s ROUGH INSP. Date FINALINSP. x $3.00 $ -3-00 ' Date X $1.00 $ x $10.00 $ APPROVAL FOR PERMIT $5.00 $ $2.00 $ MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 pLUS $.50 STATE SURCHARGE State Surcharge $ .50 TOTAL FEE $ 1/ • REINSPECTION FEE ($10.00) I 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 "W0VnWW.1M7xT 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 18 of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 18 of Value of Appliance or Work RATE TOTAL $ 20.00 $ $ 10.00 $ $ 10.00 $ 10.00 $ 10.00 State Surcharge TOTAL PEE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. Date Approval for Permit4g.—d MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. Job Address sol®\ alk. 1Mi < )6") Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Tel. #571-3450 $ 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. $ )®. 00 Fridley, Minn. �'a� , 191-9 OWNER )��(1Q $ KIND OF BUILDING(Y�m USED AS $ TO BE COMPLETED ABOUT ESTIMATED COST \1S®® $ .50 OLD - NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name l _'rs e u- Size No. �%� ��„V P e Capacity .\. Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company Sign Tel. No. C.A Fill out back side for stack verification on replacement furnaces ,1 CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes ( ) No 2. 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 SUBJECT , RMIT NO. City of Fridley 30036 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. i `y _ COMMUNITY DEVELOPMENT DIV. -___ INSPECTION SEC. r � PROTECTIVE ����,'� CITY HALL FRIDLEY 55432 i : NUMBER REV DATE PAGE OF APPROVED BY -__• ; 612-571-3450 910415 8/10/99 JOB ADDRESS 5201 St. Imier Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 Innsbruck 5th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Helminiak 574-0088 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Suburban Exteriors 9701 Penn Ave S Ste 107 Bloomin ton.55431 881-8232 4289 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 x® REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (29 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTflICAL, PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2535 $1.27 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 PERFORMAN E OF CONSTRUCTION $53.25 ire SC $2.54 PLAN CHECK FEE TOTAL FEE Licens "C5.00 92 6 S�GNA RE Of AC OR AUTfIOR�2 °GENT iDATE, EN OPE LIDATE L .NSR IS IS Y R PERM n PATE S.GNATURE OF OWNEROf OWNER BUILDER, IDATE, NEW[ ] .r ADDN ALTER Effective 5/10/99 [ ] CITY OF FRMLEY [, SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION P Construction Address: Legal Description: MW6 Owner Name & Address: o`ylM �Pd Tel. # 6 9 Contractor: MN LICENSE # Address: ? DQ / P - Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type:__ Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: � , 5 -9 S APPLICANT: 1)",1e - ' Tel. # 8 & l - � 0 c3 q, STIPULATIONS: CITY USE ONLY Permit Fee $ ,j. �S` Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ U h $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: /7d• ;z 5 - Building Building AND MATERIALS: BUILDING Permit No.: k6 440 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 4j'Z3 . - "' See Back Page for Fee Schedule CITY OF F+RIDLEY $ Da 'A 9 763-502-4977 FAX $ 00 .001 times the total job valuation Surcharge $ 4.00 .0005 x Permit Valuation Minimum $.50 EFFECTIVE 1-1-08 $ .5-. o O $5.00 (State Licensed Residential Contractors) DATE D O $ $1825 per SAC Unit (Plans to MWCC for determination) YOUR E -AMA ADDRESS $ SITE ADDRESS — D Erosion Control THIS APPLICANT IS: 17 OWNER CONTRACTOR Ci PROPERTY OWNER! NAME: 4, $ TENANT n ADDRESS: Jr rib CITY STATELM n•ZIP S�oL I Make checks Davable to: City of Frldlev Attach Stipulations PHONE '74P / I ' 78q L? NAME: ADORES : 7 C l/N a STATL�! i%1 CONTRACTOR SUBMIT A COPY OF PHO:710S 10S 1 9 a Co FAX YOUR STATE LICENSE STATE LICENSE l7 IVEXP 91811617 # DATE PROPERTY TYPE SINGLE FAMILY N SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHEDOWS ❑ BASEMENT FINISH 13ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ANCDREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE ht SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT 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 ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures 17 Other 17 Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS `,Yes ❑No LOCA ON OF WINDOWS o� I I ' OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & �n 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 $ (' 0o OCCUPANCY TYPE Permit Fee $ 4j'Z3 . - "' See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 00 .001 times the total job valuation Surcharge $ 4.00 .0005 x Permit Valuation Minimum $.50 -License Surcharge $ .5-. o O $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 $ Make checks Davable to: City of Frldlev 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 will bein acro with the ved p in the case of all work which req ' revi and ap al o plans. SIGNA O L CANT PRINT NAME d DATi LA_