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PRE 2010 DOCSCITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: ADDRESS : 1305 SKYWOOD LN NE PIN : 243024340061 LEGAL DESC : UNAVAILABLE LOT 10 BLOCK 94 PERMIT TYPE SEWER & WATER PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE SEWER/WATER CONNECTION VALUATION NOTE: PH:763-478-6712 APPLICANT GROTH SEWER& WATER 775 TOWER DRIVE HAMEL, MN 55340- (763)478-6712 OWNER BRICKNER BUILDER 152 15TH AVE NE NEW BRIGHTON, MN 55112 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulatitfg construction or the performance of construction. Applicant Date Bldg Insp 571-1287 PERMIT NO.: 2004-02331 DATE ISSUED: 12/28/2004 SEWER PERMIT FEE SEWER PERMIT SURCHARGE WATER PERMIT FEE WATER PERMIT SURCHARGE TOTAL PAID WITH CHECK # 11057 86673 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 25.00 0.50 25.00 0.50 51.00 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 F63) 572-3604 FAX: (763) 571-1287 ADDRESS : 1305 SKYWOOD LN NE PIN : 243024340061 LEGAL DESC : UNAVAILABLE : LOT 10 BLOCK 94 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : NEW CONSTRUCTION PERMIT NO.: 2004-02340 DATE ISSUED: 12/29/2004 VALUATION : $ 245,747.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. PROVIDE SOD IN FRONT AND SIDE YARDS. PROVIDE HARD SURFACE DRIVEWAY. PROVIDE CITY WITH VERIFYING SURVEY BEFORE CAPPING. SEWER AND WATER LOCATIONS AVAILABLE FROM CITY ENGINEERING DEPARTMENT. STATE LICENSED CONTRACTOR I SAC UNITS APPLICANT BRICKNER BUILDERS INC. 6230 HWY 65 NE STE 103 FRIDLEY, MN 55432 OWNER BRICKNER BUILDER 152 15TH AVE NE NEW BRIGHTON, MN 55112 BUILDING PERMIT FEE PLAN CHECK FEE FIRE SURCHARGE STATE SURCHARGE, VALUE SAC CHARGE LICENSE SURCHARGE TOTAL PAID WITH CHECK # VISA AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 1,811.35 1,177.38 245.75 122.87 1,350.00 5.00 4,712.35 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 Effective April 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank --- - Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range** NO. RATE TOTAL JOB ADDRESS A 5X - O 1=z' NO Ell] T Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $15.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $35.00 $35.00 $35.00 $10.00 $10.00 Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance i � ZID State Surcharge $ TOTAL FEE 0029 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. DATE: MmoaA ?A _,200S OWNER BUILDING USED AS ESTIMATED COS VFSP� a � PERMIT NO.__ PLUMBING COMPANY SIGNED BY Approved By ba#zarLLW nl Qumbing and heating Anc. 9174 Isanti St. NE • Blaine, MN 55449 Office: (612) 784-4792 • Fax: (612) 784-9136 Rough -In Date Final Date OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date: CITY OF FRIDLEY PERMIT NO.: 2004-02275 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 12/14/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS 1305 SKYWOOD LN NE PIN 243024340061 LEGAL DESC UNAVAILABLE LOT 10 BLOCK 94 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : NEW CONSTRUCTION VALUATION : $ 245,747.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651454-0002 FOR UTILITY LOCATIONS. PROVIDE SOD IN FRONT AND SIDE YARDS. PROVIDE HARD SURFACE DRIVEWAY. PROVIDE CITY WITH VERIFYING SURVEY BEFORE CAPPING. SEWER AND WATER LOCATIONS AVAILABLE FROM CITY ENGINEERING DEPARTMENT. STATE LICENSED CONTRACTOR 1 SAC UNITS I APPLICANT BUILDING PERMIT FEE PLAN CHECK FEE 1,811.35 1,177.38 BRICKNER BUILDER 152 15TH AVE NE FIRE SURCHARGE 245.75 NEW BRIGHTON, MN 55112 STATE SURCHARGE, VALUE 122.87 SAC CHARGE 1,350.00 LICENSE SURCHARGE 5.00 TOTAL PAID WITH CHECK # VISA 4,712.35 OWNER BRICKNER BUILDER 152 15TH AVE NE NEW BRIGHTON, MN 55112 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application 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 does not pre ume to give authority to violate or cancel the provisions f any other state or local law regulating construct' or the erform ce of construction. Applicant If Date Bldg Ins D ,,- SEPARATE PERMITS 6QaRED FOR WORK OTHER THAN DESCRIBED ABOVE. C NEW ( CITY OF FRIDLEY Effective 1/1/2002 ADDN j 6431 University Ave NE, Fridley, MN 55432 (763) 5723604 Bldg Insp ALT ] SINGLE FAMILY AMD DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Can ructions cess: Legal Description: ' Owner Name & Address: f� jl I C_ k kA _ � � kK1 �_ t) L� d L_. Tel. # 76, 3 -5 l -2 L Contractor: 60 C lC ru L Iti 6W L D L= (5 2�Lc MN LICENSE # 'S 1/ `/ 0 Address: CX30 Nu(JY A,5 /l�C� ;IrlO3 Tel.# 70—,5-%y-9S?7/ Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LMNG 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: %� /0'VAPPLICANT: 6Tel. #--)X3-5-75/_ - 7) Call (763) 572.36 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge rl'K" �E v ieto ;E�F TOTAL $ 'i �! $ 14'715.07 Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1 .00 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 [ ] STIPULATIONS: . , r City of Fridley 6431 University Ave. NE Fridley, MN 554324383 763-571-3450 28 -oar -04 Special Assessment Search And Statement of Charges TO: On all that tract or parcel of land lying and being in Anoka County, Minnesota described as follows to wit: Parcel No: 24-30-24-34-0061 1305 SKYWOOD LN Lot:, Block:, AUD SUB NO 094 LEVIED SPECIAL ASSESSMENTS This is to certify that I have examined the records in the office of the Clerk, City of Fridley, Anoka County, Minnesota, and for such search, certify that the following special assessments appear unpaid with respect to the above described tract or parcel of land: Term Certified Initial Interest Remaining Current Current Proiect Number Protect Descrintion Type (Yrs) Date Amount Rate Balance Principal Interest 9100-0000-00 00 REG SA(Water/Sewer 3100 15 12/31/1960 6000-1960-20 01 ST 6400 20 10/01/1962 6000-1969-01 00 ST 6400 10 05/11/1970 3300-1976-00 00 W/S-S 3300 15 09/20/1976 6000-2003-01 002003 Street Improveme6400 10 11/03/2003 $79.87 5.00% $0.00 $0.00 $0.00 $503.37 6.00% $0.00 $0.00 $0.00 $428.48 7.50% $0.00 $0.00 $0.00 $719.39 7.50% $0.00 $0.00 $0.00 $1,656.20 6.50% $1,490.58 $165.62 $124.76 Amount Certified to Anoka County Auditor for Current Year Taxes Is: $290.38 PENDING SPECIAL ASSESSMENTS For the purposes of this document, the City of Fridley has determined that an assessment is considered pending after the City Council passes a resolution ordering the improvement, the approval of plans and the advertising for bids. This is prior to the City Council adopting the final assessment roll. If you seek further information, you should do so upon your own independent inquiry. Any amount given as to pending assessments is informational only and may or may not be the amount ultimately assessed. Term Initial Interest Estimated Proiect Number Proiect Description (Yrs) Year Rate Pending Amt. NONE MISCELLANEOUS FEES Description Status Date Fee Amt. Park Fees Paid 1/19/1999 $750.00 Water and Sewer Lateral 1/22/1999 $0.00'7.1 pyiQ 5 eP v 1w UTILITY CHARGES You shall be responsible to verify the status of any outstanding utility charges. To check utility charges ( water and sewer) contact Fridley Utility Billing Department at 763-572-3529. The records referred to above are public and may be inspected by anyone during regular business hours. The search of these records was made by the undersigned as a public service on request. The undersigned certifies that the above indicated searches were made and are believed to be accurate, however, the undersigned or the City of Fridley does not insure the accuracy of the above statements and does not assume liability for errors and/or omissions. The above figures are good through November 15, 20 Date Prepared: Thursday, October 28, 2004 By Page 1 of 1 NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADON [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: �J(31 1 5k: y � L11 Legal Description: ' L let ��� Owner Name &Address: �- � -ClCO/ -�. '�'� l L �J Tel. # '76• -S z Contractor �� CICI"�➢ �= 6 ` is MN LICENSE # `/ Address: C�-; 3 0 LU � &� 2�rjl_r 3 Tel. # 26 3 -6-7 V/ -9,17 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 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 $ —=$ o ) DATE: % APPLICANT: ��S.�l �lCIVe� Tel.#%&J Call (763) 572.36 for Permit Fees If mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge -License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge H Ate tJ I ENV -3EF- TOTAL Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $'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 [ ] STIPULATIONS: Building $ BUILDING Permit No.: ®�2� 36 Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION Received By: 763-572-3604 Fire Surcharge CITY OF FRIDLEY Date Rec'd: DATE Y UR E- ADDRESS SITE ADDRESS O's THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: a'N GtCY�'-% E r,-- X� �k TENANT ADDRESS: 0&W CITY F&IPL e\" STATTt&P-5�!�-3Z $ PHONE.—Z 03— 5-7 0 - !� 0a , CONTRACTOR NAME: 0 R \ c lC 1-t% t V-� Q Ll l C STATE LICENSE # '3 V y ('-3 EXP DATE y++ f ,y�j SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: ® /��� /0 CITY I'�Z U:� STAT1a�AIP WITH APPLICATION PHONE FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING 00 a DESCRIBE WORK BEING DONE: I oh :5 SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 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 ❑ Other ❑ Fascia and proposed project WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations 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 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $ (.0005) times the total job valuation - Minimum $.50 Fire Surcharge $ .001 x Permit Valuation (1/10%) License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ 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: 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; that the work will be in accordance with the approved plan in the case of all work w h re ireess review apd approval of plans. ) / $IGNATURE OF APPLICANT 1%%G�'v 0/�''� PRINT NAME,K, «DATE M NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572 604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 68 �i LA Construction Address: 13z>5 S K g w iia t> L.A � 5vo-TA yo,o© 8ie C, 0' int w4ST 15'0.0 of:; rsgE C—U13 petJislo^P 0f Legal Description: Lo -r to of- A s/ C "cogs s v B jD t Vi �'J' 64 4,F --- As ra ��,su�tE b A �,7 f R� vas T A,v e L- S 7U 1,KL 50L' -P"+ �sis Ti-4uAt& L xis ®� T)4L �.1.00 'cE r rHce� or Owner Name & Address: quvA►CJA Tel. Contractor: vim, (,tA MN LICENSE # A&2, 0-1 6& Address: _U'3 2 cv 1-h A d F-- jQ A,)® VAA ; SS 3v3 Tel. # '7 1� - S.3- b o ,,S 1 Attach to this application, a Certificate of Survey of the Mo 97CE lot, with the proposed construction drawn on it to scale. & 12 — 3 T& DESCRIPTION OF IMPROVEMENT Lo"; LIVING AREA: Length _14 i. Width .214 Height Sq. Ft / IL') Z'/ GARAGE AREA: Length Qo �cZ® Width lcl x ftp Height Sq. Ft. 550 DECK AREA: Length Width Hgt(Ground Sq. Ft. OTHER: 1 ca FOV4AA4 Z16 XQ 9 --Zl.0 Construction Type: 5 i.,..) 6, L t- fA!"% .t c -Lt .-1,S. Estimated Cost: $ a Driveway Curb Cut Width Needed: '4 -<Ft + 6 Ft = Ft x $ _ $ DATE: 13. 62,- APPLICANT: 0...2,Av 9c_+fl LbNc Tel. # -16 3 - 7 S3- 60 $" 1 Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY - $ -'909-7,5- Fee Schedule on Reverse Side $ 50 .001 of Permit Valuation (1/10th%) $ 7,5-$.50/$1,000 Valuation $ / c?,00, 0 $1200 per SAC Unit $ 5, 00, $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 [ ] TOTAL $ B STIPULATIONS: IM] CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Fireplace insert Gas Range Gas Dryer *Air Conditioning - All Sizes Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS � �� � U 4-0©Cl 4/_Af Fee Total 0 _1'7 ; , All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work $ Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater on work less than $500.00 Commercial/Industrial/Institutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/Industrial/Institutional Burner Trade Name BTU E Size 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. State Surcharge $ 0.50 (if permit fee is over $1,000 multiply by .0005) TOTAL FEE $ *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE HEATING CO Signed 6 4CTel #2-5'-3 _ y� FAX # 3— 7/JW Date � s 17Z/ Approved by Rough -in Date Final Date Owner I,/ f'; C A J'1-ef / > I/ C/ $35.00 c5c $_ Building Used As5 , b 011111 /J $10.00 $ p® ESTIMATED COST PERMIT NO $15.00 $ $10.00 $ DESCRIPTION OF FURNACE AND BURNER $10.00 $1 # of Heating Uni Circle One (Steam) (Hot Water) (War�Air Trade Name v:*- �� Size No. $25.00 $�_ BTU �% ��c� HP EDR Fuel r° Total Connected Load All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work $ Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater on work less than $500.00 Commercial/Industrial/Institutional 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/Industrial/Institutional Burner Trade Name BTU E Size 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. State Surcharge $ 0.50 (if permit fee is over $1,000 multiply by .0005) TOTAL FEE $ *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE HEATING CO Signed 6 4CTel #2-5'-3 _ y� FAX # 3— 7/JW Date � s 17Z/ Approved by Rough -in Date Final Date FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMM!2N VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacina an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and tirestopped where required. Yes () No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes ( ) No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No( ) The existina combustion air is sized and installed to meet the current codes and manufacturers specifications. Yes () No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes (} No( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter. in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date CITY OFFRIDLEYBUILDING INSPECTION-_ Effective 4/1/20D4 N 6431 University Ave NE �;? 6o Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION 763-5723604 FAX 763-5714287 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS o TE �HEDULE Fee�.I Residential Owner ✓ Furnace Shell and Duct Work, Burner & also Replacement Furnace $35.00 $ Building Used As,Si Gas Piping (New Furnace, Fireplace, Insert) $10.00 $ ESTIMATED COST PERMIT NO Fireplace insert $15.00 $ Gas Range $10.00 $ DESCRIPTION FURNACEAND BURNER w A LL u- 0 IN XT 2 aa.. cc Gas Dryer *Air Conditioning -All Sizes $10.00 $ $25.00 $ All Other Repairs or Alterations (List on Back) 196 of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater on work less than $500.00 �r� I ndI nd ustrilaI% f nstitUtiona 1 1.25% of Value of Appliance or Work (List on Back) Minimum Fee $35.00 for Commercial/industrlaVinstitutional State Surcharge (if permit fee is over $1,000 multiply by .00057 TOTAL FEE # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Narne I Size No. BTU HP EOR Fuel Total Connected load Bumhr Trade Name J 76o 214 Size No. BTU 0.3,;,y HP EDR The undersigned hereby makes application for a permit forthe work herein specified agreeingto do all work in strict accordance with the City Codes $�Q3 and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. Howth & Hoare Tecmologles„ bid. $ 0.50 HEATING CO dba Fireside Hearth & Hoare 0o 2700 N. Felrvi�r Ave. ruxz WjZ�, Roseville, uX 88113 $ Signed 881/833.2881 Tel # FAX ff &SI- 63�- 2,FR-1 Date ll- c) *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK. SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE it Approved by Rough -in Date Final Date 0 FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 (763) 571-3450 • FAX (763) 571-1287 • TIT)rM (763) 572-3534 April 13, 2006 Brickner Builders Inc. 6230 Hwy 65, ste 103 Fridley Mn. 55432 Re: Final Inspection 1305 Skywood La Dear Sir: A final inspection was conducted on May 16, 2006 for the completion of the dwelling at the above address. The inspection noted that the construction was completed according to the approved plan but the following item need to be completed before the building permit can be finaled out; Provide a verified survey. We will expect the above item to be completed by the scheduled dates and a reinspection called for. The dwelling is approved for occupancy. If you have any questions concerning this matter, please feel free to contact me at 763- 572-3603. DAVE JEEN Building I eci DJ/mh Building PLUMBING Permit _ Inspections RESIDENTIAL APPLICATION Received By: Date Rec'dj v-7 763-572-3604 CITY OF FRIDLEY �– UR E-MIAI ADDRESS DATE �� �y ADDRESS 0C SITE THIS APPLICANT IS: ❑ OWNER CTOR PROPERTY NAME: Zrn Z( OWNER/ ADDRESS: c CITY STATEg^ TENANT PHONE: S CONTRACTOR NAME: 'j STATE LICENSE # L(Cr k EXP DATE 1 �` ��11 L STATQY,2,kIP SUBMIT A COPY OF YOUR STATE ADDRESS: �1�� LttZ�f'/'tj CITY LICENSE WITH PHONE FAX APPLICATION ,� / ag GLE FAMILY 0 TWO FAMILY ❑ TOWNHOUSE PERMIT TYPE TYPE OF WORK: EH49W ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK^f PER MS 1613.665 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 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) WATER PIPING _ BATH SINMAV _FLOOR DRAINS _SHOWER POOL WATER SOFTNER ($35) —BATHTUB _ GAS PIPING (� crrruc�) _ SWIMMING ACKFLOW PREV. ($15) CLOTHES WASHER KITCHEN SINK _ WATER CLOSET —BOR _ _ IRRIGATION DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) WATER METER —OTHER a „, Permit Fee $ Number of fixtures @ $10.00 x $10.00 $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ 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 allyA ly,whic r ires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME DATE ' Cl 3 y „ME 6/ 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 $ 3.5-0 DateM Y 200 .Surcharge $ CITY OF FRIDLEY .0005 x Permit Valuation Minimum $.50 DATE 1`►_u -41- -Z ii YOUR E-MAIL ADDRESS $ SITE ADDRESS 0130 �KV LOC CTr k SAC Charge THIS APPLICANT IS: OWNER ❑CONTRACTOR $1675 per SAC Unit (Plans to MWCC for determination) PROPERTY OWNER/ NAME: 1+.UrJG JNGO TENANTADDREss: L� �; ea r. C — E CITY \ STA ZIP��C j Z /� ,a1, PHONE--IL-,-5 ? I _t3`96 �• 163 i °� 9 g"1n Park Fee CONTRACTOR NAME: Fee Determined by Engineering STATE LICENSE # EXP DATE $ SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE—ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE XSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE *CDECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ,ANEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING I DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH—J 44 � HEIGHT Sq. F . ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE I . Existing Floor Plan Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other . ❑ Fascia 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: 3,503"�') (USINTHE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $__I� 01_ 'L41 OCCUPANCY TYPE Permit Fee $ C1'7. 'PS See Back Page for Fee Schedule Plan Review $ G 3 . e3I 65% of Building Permit Fee Fire Surcharge $ 3.5-0 .001 times the total job valuation .Surcharge $ k '15 .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 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 $ co�. —(� Make checks payable to: City of Fridley 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; that the work will be in accordance with the approved plan in the case of all work whi�hr'e wires review and approval of plans. SIGNATURE OF APPLICANT V d Z: PRINT NAME (.f° Cli 6 !�I (Z DATE�/}�,a ;A I , ?"004 -- SIGNATURE F, ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: /iTCI1VC__ TNF 1007 IT R !" FFF. Cr14l .n1TI.F.I TOTAL JOB VALUATION Permit Fee Plan Review Fire Surcharge I Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ $ �e $ LW $ Jac OCCUPANCY ve' TY 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 Davable to: Citv of Fridlev Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED lations I hereby apply for a building permit and 1 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 case of all wort hich res review and approval of plans. y� h SIGNATURE OF APPLICANT PRINT NAME N JI Q t P -A 11I DATE J _ Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604CITY OF FRIDLEY Date Rec'd: 5 <q z)y 763-502-4977 FAX EFFECTIVE 1-1-09 DATE J J Q YOUR E-MAIL ADDRESSi��'i'I DV SITE ADDRESS THIS APPLICANT IS: OWNER CONTRACTOR PROPERTY OWNER/ NAME: diI ADDRESS: i 0o 6CITY_rn y16_ he STATE ZIP TENANT PHONE: -16;— CONTRACTOR NAME: STATE LICENSE # 0 (7 EXP DATE 0�lqll 0/0 SUBMIT A COPY OF YOUR STATE LICENSE STATE ZIP_ AND CERTIFICATE OF ADDRESS: CITY 0UL INSURANCE PHONE FAX _ Q4 0 PROPERTY TYPE ftSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑y ADDITION ❑ GARAGE/SHED ❑ W DOWS U LBASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR RREMODELING �r DESCRIBE WORK BEING DONE: 2//spa, kJ3Q4en'VPik- SIZE OF IMPROVEMENT f__ LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 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: FOR NEW CONSTRUCTION INCLUDING DECKS_ SIDING ADDITIONS. &PORCHES SUBMIT': ❑ Vinyl ❑Soffit 1. Site Plan/Survey showing the existing structures D Aluminum ❑Trim and proposed project. ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS P?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: /iTCI1VC__ TNF 1007 IT R !" FFF. Cr14l .n1TI.F.I TOTAL JOB VALUATION Permit Fee Plan Review Fire Surcharge I Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ $ �e $ LW $ Jac OCCUPANCY ve' TY 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 Davable to: Citv of Fridlev Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED lations I hereby apply for a building permit and 1 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 case of all wort hich res review and approval of plans. y� h SIGNATURE OF APPLICANT PRINT NAME N JI Q t P -A 11I DATE J _ Building Inspections 763-572-3604 763-502-4977 FAX DATE M ) SITE ADDRESS d1'3 THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND CERTIFICATE OF INSURANCE PERMIT TYPE Q1 PLUMBING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 2-19-09 YOUR E-MAIL ADDRESS ❑CONTRACTOR Permit No STATE LICENSE # EXP DATE STATE BOND # EXP DATE ADDRESS: CITY PHONE FAX _ SINGLE FAMILY NEW DETAILED DESCRIPTION OF WORK ❑ TWO FAMILY ❑ REPLACEMENT ❑ TOWNHOUSE TE_"1 P ATE ZIP, M FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEF.' $35.50. BATH SINK/LAV DRAINS 4K, SHOWER _ WATER PIPING BATHTUB _FLOOR GAS PIPING (NEED CITY LIC) SWIMMING POOL _ WATER SOFTNER ($35) CLOTHES WASHER _ KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREV. ($15) _ DISHWASHER _ LAUNDRY TRAY _ _WATER HEATER ($35) FOR IRRIGATION _ _ _ WATER METER —OTHER 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 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 c7t7' ork which requires review and approval of plans. SIGNATURE OF APPLICANT ~j`,o® PRINT NAME �lf Ccs 4�1 Cy DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL Inspections RESIDENTIAL APPLICATION 763-572-3604 CITY OF FRIDLEY 763-502-4977 FAX EFFECTIVE 2-19-09 DATE Kzpq I SITE ADDRES THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: YOUR E-MAIL ADDRESS ❑CONTRACTOR PHONE: -7 3 S%/ 0 3 . i 2f L® COMPANY NAME: CONTACT PERSON: STATE LICENSE #_ ADDRESS: PHONE j 0 SINGLE FAMILY ❑ TWO FAMILY 9 NEW ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK FAX �c�e�f CITY EXP DATE CITY ❑ TOWNHOUSE ❑ ALTERATION/REMODEL Permit No.: Received By: �I ,R Da - Mill, A. TE STATE ZIP, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU A/C $25.00 (GAS) $15.00 _GAS RANGE/OVEN $10.00 TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00 _AIR $35.00 _FIREPLACE $35.00 _GAS UNIT HTR $10.00 _BOILER CHIMNEY LINER $10.00 _FURNACE DRYER $10.00 _POOL HEATER $35.00 iVDUCT WORK $10.00 _GAS GAS PIPING $10.00 _VENTILATOR $15.00 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 work which requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME 4�J DATE J — City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 _A