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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: N® 4080 Owner: ....._..... -....... - - - - .._........._....... - Builder. .................... Address ......... Address ..........................•------........._. LO TIO OF U LDING No..... .. Street .....- ........_.........----•-..._.....:.........._......................._.............. Part of Lot ..... _..._.._.._...._.. _ -- . _..-----.......... _ Lot .....__ ......... Block .-------••-- ............................. Addition or Sub -Division ...., ., ........ . ...... .......... Corner Lot .................................... Inside Lot ........................ Setback.4 Sideyard ............................................. SewerElevation.._..---•....................................._....-......................._....................... Foundation Elevation .................... - DESCRIPTION OF BUILDING. T be Used as: 7/ i � P a s�......_...------------- Front.�.``J� Depth �!_' � Height ._' q. t. �� Cu. Ft! PJ S F - - -. ..1-- •----------- ----.-......._...._......._.................... Front ...__...-.....-... Depth......--.-...._ Height --------------- ___ Sq. Ft......................... Cu. Ft. .............. ....... j, Type of Construction .............................................. .. Est. Cos .......To be Completed ....._ ............. ............. ............ ..... In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of$...r...................... permit is hereby granted to ........................... .._._.._....._._.........._............._......__............. to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. _ I Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see / I the Budding Inspector for separate permits for these items. J �f �,'� �✓9(� �a1ry 1 City of Fridley, Minn.. BUILDING PERMIT a Date: _. _.._ _._.....__�`...._G . _ _...._.......__._. Owner: ........ ................................................... ....................__._.._..._....------.._...... Address-..._...... .............. ._.._...._....._ _ .....__.._.. ___..._.._._ N® 4111 Builder s�''$^_a",�..._... Address.............. -_--........ .................. ............... _......_......_......._ .__.....__..._. LOCATION OF BUILDING No. ..1....3-�.... Street ........ r . ........ L - ` '- - Part of Lot ....................... __------ ---------------- ...._......_..._ _ Lot ......._ .._-.......... Block ..... ........ ..................................... Addition or Sub -Division......_.. :' ,.._... ... --••----- Corner Lot .....- ................... --- .... Inside Lot .................... _.... ............. Setback ..... -............................ ...... .. Sideyard Sewer Elevation ..... .......... ...._...-----....._.............-.....----------------------.....---------•----.. Foundation Elevation ..............---- DESCRIPTION OF BUILDING To be Used as: -- ........_..... Front . Depth ®...9.. Height 1....�?...' .� Sq. Ft. /ej.. Cu. Ft. Front ----.......... .... _...................................... Front ..... - ......... ..,... Depth .................. Height ...................._.. Sq. Ft......................... Cu. Ft....................._.. Type of Construction ...................... -... ................................ Est. Cost...,/;?,.. To be Completed .................................................. In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. %l 011P In consideration of the payment of a fee of $1Z �._ , permit is hereby granted to.....-.............-.............---------------------._.. _...._._._..._..------•.--_-------•-•_....-........ to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. ry, o �ff d City of Fridley Application for Ph mbing and Gas Fititing Permit DESCRIPTION OF 'MORS Number, Kind and Location of Fixtures PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ......................7— x $1.50 $ / d/• Future Fixture Opening ................ x 1.20 $- A New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ c' New Ground Run Old Bldg. ............ x 3.25 $ 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 $ REPAIRS & ALTERATIONS—Refer to Code Dept- of Bldgs- Phone SII 4-7470 City of Fridley: The undersigned hereby les 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 and representations stated in this application are true and correct. Fridley Minn 19 /® �f Owner Kind of Building Used as To be completed about Estimated Cost, $� ria Ol New uilding Permit No42 Signe B Business Phone N Description................................................$ s TOTAL FEE$ ll POST IM -12-58 19- 19— y o2 z Z 4�� w s �'d w �� U' z �p F N WATER HTR. GAS ELEG Base 1st 2nd 3rd 4th • Future Connection Openings New Fixture, Old Openings Connected with Sewer Cesspool PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ......................7— x $1.50 $ / d/• Future Fixture Opening ................ x 1.20 $- A New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ c' New Ground Run Old Bldg. ............ x 3.25 $ 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 $ REPAIRS & ALTERATIONS—Refer to Code Dept- of Bldgs- Phone SII 4-7470 City of Fridley: The undersigned hereby les 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 and representations stated in this application are true and correct. Fridley Minn 19 /® �f Owner Kind of Building Used as To be completed about Estimated Cost, $� ria Ol New uilding Permit No42 Signe B Business Phone N Description................................................$ s TOTAL FEE$ ll POST IM -12-58 19- 19— J ®DJ n IJ Application for Power Plants and Heating. Cooling. Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE wept. of Bldgs. Phone 5�-3450 GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ..........................$10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECK. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 $ 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 GAS BURNER (up to 199,000 BTU) ....................... 5.00 $ over 199,000 BTU See Fee Schedule 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 and representations stated in this application are tri and correct. Owner �7 //% Kind of Building Used as _:� 4 To be completed about Fridley Minn- > 19 �< 3 Estimated Cost, $ /�� ®• �r / Old—New. Building Permit No. Permit No. 96 71S DESCRIPTION OF WORK or POWER PLANT'S -Steam, Hot Water, Warm Air—No Trade Name�& 19 I Size No Capacity, —16 � Sq. Ft. E.D.R BTU HP GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 200 $ Total Connected Load Kind of Fuel Additional Fixtures ................. x .75 $ BURNER —Trade Name Size No Gas Range to 199,000 ........... x$ 5.00 $ o Capacity Sq. Ft. E.D.R BTU H.P. AIR CONDITIONING_ FAN HEATING SYSTEM VENTILATING SYSTEM See Fee Schedule $ ALTERATIONS &REPAIRS TOTAL FEE $ ®• !� Signe — ROUGH By <x Business Phone No FINAL --/--/2 a 26 (REMARKS -OVER) 53-64-s-915.51 �f1�fA ��11e� i =:"4'5,13 �•s3� )�"v':.;A�!'. PARTIAL RATE SCHEDULE FLWAMWQ U> '. M e3:. RATZ 1 bt 3 .................. Use 6 ®� i! a•.! i.. i/ i. i -ZO-75 6 am toM.Oftsii.iii6.; Zan state surcharge $ .50 OFJ,td f iLlQa?iOWS-4b*w tCwt 0 JIM.......Gas i�1111 •w.iii �....►.i ! x75.0000 �= � OM "A® 6trcharga .a0 f city and reprewntatlow stated in Uab rco we tome oud ewrwt .cwt: ' 3"I'vv«, 6-27-73 chrmw Le Roy R. "u lin A Kmd ®p oundift Frame used as Res. E f 53 -8h -s-915.51 Kind of BuDding Frain Umd as Res. PARTIALSCHEDULE F PLVSMMC* TIXTUM MATM mm MIM TOM • W .... o ........... } :. 8 ... SIM�. Mw Oxkm am Op"lift .......... ............. ® ...... qgyj �5 New Ground mm cu im........ • $lam ............. o an M3�t� ................ ®� ............... Apd� t� d® � �g an ymw pW dam. w {d ...�s.�....... i = am @@mo ate rchane BWAM` ft O ..... "0 0.0 � e �................. 5.00 TOML I= K_n QUM "A® Surcharge .50, a, SUBJECT PE -City of Fridley 14'716 AT THE TOP OF THE TWINS I L ®I N G P E RM I T r � BU R COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 i ; 1"'1 CITY HALL FRIDLEY 55432 IL NUMBER REV. DATE PAGE OF APPROVED BY L---- A"f ,�� 612-560-3450 910-F15 JOB ADDRESS 1364 Skywood Lane N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 5 2 SWanstraa l S Court Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Leroy Kuglin 1364 Skywood Zane N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Lindstrom Construction 775 Colorado Avenue So., Golden Valley, MN 544-8761 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 C. REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Fire repair to dwelling 9 CHANGE QF USE FROM TO STIPULATIONS SE-PLVA71 PERMITS REQUIRED FOR WIRING, HEATING,, PLUMBING AND 5IGM SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING.: Wood Frame 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. $151000 $7.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR LCANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $90.00 ST CTION OR THE PERFORMAN OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $97.50 SIGNATURE OF CONT R OR AUTHORIZED AGENT (DATE) EN PROP LY VALIDATED THIS -IS YOUR PERMIT BLDG. INSP DATE SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) t CITY OF FRIDLEY . APPLICATION FOR RESIDENTIAL BUILDING PEA MITS ON, ALTERATIONS, ADDITIONS, OR REPAIRS) OVINER: MILDER: Address: /,3(94/,3(94� �,�� J Lla . Address: % 3 ed -oO � ® m Tel. No. �A' -7 e i ' No.: LOT: Street: BLOCK: ADDITION: -�SW CORNER LOT: INSIDE LOT: SET13ACK: SIDEYARDS: Applicant attach to this form 'lVo Certificates of Survey of Lot and proposed building location dram on these Certificates. DESCRIPTION OF BUILDING -, To Be Used As :1 °�— Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: • ' Square Feet: Cubic Feet: Type of Construction: To Be Completed: "? — Estimated Cost: $ Prciposed Driveway Width If New Opening Is Desired Alt. A Alt. B (SEE MWEF.SE SIDE OF SKEET) The undersigned hereby makes application for a permit for the work herein specified, agroeing.to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Dcpartment of Buildings, and hereby - declares that all the facts and representations stated in this application . are true and correct. Sec reverse side for additional - information. DATE: SIGNA`1'URE% Stipulations: < Ix vd - �n 90 �, � It CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: e RATE Number Fixtures b. a Future Fixture Opening x $2.00 v x $2.00 ma water aJ 'to d/ Water Heater - to 99,000 Bw ° x $5.00 fr C ++ '' a Water Softener / x $7.00 New Ground Run Old Building x $5.00 Electric Water Heater Heater 4 GAS FITTING FEES: go ¢ a ."� M "' M ►+o = av roa aro N g o vii U D a� y o w vy w V as Ft 3 ti as leo 1st r 8 2nd 3rd 4 th (P.) - Future Connection Opening Connected with Sewer M - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE Number Fixtures x $3.00 Future Fixture Opening x $2.00 New Fixture, Old Opening x $2.00 Catch Basin x $5.00 Water Heater - to 99,000 Bw x $5.00 100,000 BTU to 199,000 BTU _ x $10.00 Water Softener / x $7.00 New Ground Run Old Building x $5.00 Electric Water Heater x $5.00 GAS FITTING FEES: 1st 3 fixtures �` x '$3.00 Additional Fixtures x $1.00 Gas Range to 199,000 BTU x $10.00 REPAIRS & ALTERATIONS First $100.00 $5.00 each add. $100.00 or fraction $2.00 State Surcharge TOTAL FEE REINSPECTION FEE ($10.00) TOTAL S00 $ 3.Co S Job Address Department of Buildings City of Fridley Tel. #571-3450 Lkw W 61) L,40 L The undersigned hereby snakes application for a•permit for the work herein specified agreeing to do all work in strict accordance with the City Godes 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. Ca -o�'i , 19� OWNER (YIC" 1 . ) AJ KIND OF BUILDING,( 1�1 USED AS TO BE COMPLETED ABOUT -(meq ESTIMATED COST ff ) , ()0 OLD — NEW BUILDING PERMIT NO. PERMIT NO. ROUGH INSP. Date 0 FINAL INSP. Date Company {AkCL ' Signed By Tel. No.C)044�., ).WCQ, $ APPROVAL FOR PERMIT $ r ' $ MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 pLUS $.50 STATE SURCHARGE $ .50 $ i00,5� CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND $12.00 .AIR CONDITIONING SYSTEMS AND DEVICES 4.00 PARTIAL RATE SCHEDUIF GRAVITY WARM AIR: RATE TOTAL Job Address/ 3� _ / Furnace Shell & Duct Work Replacement of Furnace Repairs & Alterations -up to $500.00 Repairs & Alterations each add. $500.00 $12.00 '7.00 7.00 4.00 $ $• O CJ $ $ Department of Buildings City of Fridley Tel. #571-3450 MECHANICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTU $12.00 $ each add. 50,000 BTU 4.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Repairs & Alterations each add. $500.00 4.00 $ STEAM OR HOT WATER SYSTEM: Boiler & Lines up to 100,000 BTU $12.00 $ each addn. 50,000 BTU 4.00 $ Boiler only up to 100,000 BTU 7.00 $ each addn. 50,000 BTU 6.00 $ OIL 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 $ (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: 1st 3 Fixtures x $ 3.00 $ Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00 $ AIR CONDITIONING $ FAN HEATING SYSTEMS See Fee Schedule $ VENTILATING SYSTEMS $ ALTERATIONS $ REPAIRS $ X5,00 x State Surcharge $ .50 TOTAL FEE $) ROUGH INSP. FINAL INSP. REINSPECTION FEE Date ($10.00) � I -C APPROVAL FOR PERMIT ilt:49- MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE .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. l Fridley, Minn. / 3 ' , 19 L _ OWNER - e- KIND OF BUILDING ` USED AS v � f_ L \ i! � TO BE COMPLETED ABOUT C //•ni ESTIMATED COST �2 OLD - NEW BUILDING PERMIT NO. PERMIT NO. 'L DESCRIPTION OF FURNACE/BURNER BEATING or POWER PLANTS, Steam, _Hot Water, Warm Air- No. n ! Trade Name L t Size No. v 0 Capacity Total Connected Load BURNER - Trade Name Sq. Ft. EDR BTU HP Kind of Fuel Size No. Capacity Sq. Ft. .EDR BTU HP Company �c? ,~ , ^� Signed By �r�, Tel. No. Aoa� d-a-. CITY OF FRIDLEY INSPECTION DIVISION ® qa Effective On January 1, 1998 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 3 ©((�JC�cS Lo'M� RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — ruliggs of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ d representations stated in this application are true and correct. (Side Vent — Fill Out Back) ,1998 Gas Piping (Needed with new furnace) $10.00 $ ¢ r OWNER �T VG L row 8 Gas Range $10.00 $ j�{(2S I �B,r BUILDING USED AS Gas Dryer $10.00 $ ESTIMATED COST d ® PERMIT N0. *Air Conditioning — All Sizes $ 25.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. Commercial/Industrial BTU HP EDR 1.25% of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge $ .50 Burner Trade Name Size No. TOTAL FEE $ BTU HP EDR ��-. S� HEATING COMPANY C(a (r MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By ,, Tel No, 7 /° 010 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved ByRough—In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE OR STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE Remarks: . List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CHMMY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes (liYo ( ) 2. Is free from rust or deterioration Yes q,�'No ( ) 3. Has no foreign objects lodged within Yes (dNo ( ) 4. Is securely supported . Yes (L,�-No ( ) 5. Meets all current Code requirements for size Yes 'No ( ) and total BTU's connected (tJ 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No 8. Has combustion air been provided for water heater Yes (c4- No ( ) Remarks: . List ALTERATIONS Being Done: HEATING CO: Signed By: Date: 0 -le 11 lei Building MECHANICAL Permit No.: q Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 DaWZdJAN CITY OF FRIDLEY DATE 1-7-09 YOUR E-MAIL ADDRESS SITE ADDRESS 13 (A SACLtL'Ie�,� Lc�, Ne THIS APPLICANT IS: 0 OWNER ]CONTRACTOR PROPERTY NAME: \_ e r o" V_%,CA . n ADDRESS: ``-SL ��C W00a CITY �ri STATEMOZIP_Q_ at TENANT PHONE: i1 U-3 - S-1 I - AP -3 CONTRACTOR COMPANY NAME: CENTERPOINT ENERGY CONTACT PERSON: JOANN Z INKEN SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: 9320 EVERGREEN BLVD STE BTIY "COON:°RAP.IDS sTATEMN ziP55433 APPLICATION PHONE 763 - 757 - 6202 FAX 763--757--6701 PERMIT TYPE gSINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK' 0 NEW ,REPLACEMENT 0 ALTERATION/REMODEL �va "S� DETAILED DESCRIPTION OF WORK r�� a.\� �e� 0.e ra � � (���OC� l`3. Tu 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 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: ia. MODEL: u 0,(ZL• ICA- SIZEIBTU 60 ACC) MFG: MODEL: SIZEIBTU MFG: MODEL: SIZEIBTU A/C $25.00 FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 TO AIR EXCHANGEER $15 (WOOD) $35.00 NEW GAS GRILL $10.00 _AIR _FIREPLACE $35.00 VfURNACE $35.00 _GAS UNIT HTR $10.00 _BOILER CHIMNEY LINER $10.00 DRYER $10.00 _POOL HEATER $35.00 _GAS _DUCT WORK $10.00 GAS PIPING $10.00 _VENTILATOR $15.00 PERMIT FEE PROJECTS FOR UNDER $500. : = PERMIT FEE FOR PROJECTS OVER $500: 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 @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 1 x $35.00 = $ 35. CO State Surcharge = $ .50 Total = $ 35.50 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 I DINT NAME ROGER HOFFHEIN DATE ( ' 09 PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR BUILDING, ELECTRICAL; AND MECHANICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building BUILDING Permit No.: 20 -(19 Inspections RESIDENTIAL APPLICATION Received By: AA0b 763-572-3604 Plan Review $ CITY OF FRIDLEY D WM 763-502-4977 FAX $ ' 50 .001 times the total job valuation Surcharge EFFECTIVE 8-19-09 .0005 x Permit Valuation Minimum $.50 DATE Z V. C: 'J YOUR E-MAIL $5.00 (State Licensed Residential Contractors) SITE ADDRESS sri �5� OADDRESS .31��9[.t!<;1%Y Idissc� v tLl�J�7 �.?'(✓CO $2000 per SAC Unit (Plans to MWCC for determination) THIS APPLICANT IS: OWNER ❑CONTRACTOR ft + 6 ft = ft x $22 = $ PROPERTY OWNER/ NAME: c c✓ $450 Conservation Plan Review TENANTADDRESS: A 76S1ry'WC+r4,112 CITY r5� STATE�ZIP Sewer Main Charge PHONE: 163 Agreement necessary ( ) Non Necessary ( ) CONTRACTOR NAME: Make checks Davable to: Citv of Fridlev Attach Stipulations SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH WROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: �gcc, SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING 0 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 ❑Soffit ADDITIONS_ & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WENDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. 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 Fire Surcharge $ ' 50 .001 times the total job valuation Surcharge $ %V .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ ' Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 1til -1 o1 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 on site; that the work will be in accordance with the approved plan in the case of all, w�oywhich utres review and approval of plan SIGNATURE OF APPLIC NT -_ter PRINT NAME e ? 4 Alai DATE Page 2 - Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for 1' $500 plus $3.05 for each additional $100 or fraction, to and including $2,000 $2,001 to $25,000 $69.25 for 1" $2,000 plus $14 for each additional $1,000 or fraction, to and including $$25,000 $25,001 to $50,000 $391.25 for 1" $25,000 plus $10.10 for each additional $1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for 0 $50,000 plus $7 for each additional $1,000 or fraction to and including $100,000 $100,001 to $500,000 $993.75 for 1' $100,000 plus $5.60 for each additional $1,000 or fraction to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the 1' $500,000 plus $4.75 for each additional $1,000 or fraction to and including $1,000,000 $1,000,001 and up $5,608.75 for the 0 $1,000,000 plus $3.15 for each additional $1,000 or fraction VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977