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PRE 2010 DOCS(0bio � City of Fridley, Minn. -11834 6431 University Ave. N. E., Minneapolis, Minn. 55432 BURDENG PERMIT ,Datq; _ December 11, 172 + D. Deyp-lopment,_ — Builder Same Addr= - 9901 Brooklyn ignu I - LOCATION OF BUILDING jy0 1565 Stmt South Oberlin Circle .parr of Lot Lot - 1 Block 6 Addition or Sub -Division Innsbruck Nor T-14- 2nd Addn . . Corner Lot Inside Lot - X Setback Sideyard Sewer Elevation Foundation Elevation To be Used as: 1240' Tnwnbouse Front - 20` _ Depth 311 Height _201 Sq. Ft. 62D ._ Cu. Ft. 1 0' .1' rage Front 20' _ Depth 22' Height 10', Sq. Ft. 440' Cu. Ft. - 4.40Q r 'hype of Construction .Wood _frame FsL Cost $210417,00 To be Completed _ JUly- 1, 197 Stipulations: Owner/contractor to be responsible for elevations and for drainage for all structures and the City shall be held blameless. Construction must comply with UBC 501, C1, C2 and C3. See attached sheets, use figures 5, 9 or 10. In consideration of the issuance to me of a permit the proposed work in accordance with the description t ordinances of the city of Fridley. e building described above, I agree to do and in compliance with,,4tl1 provisions of In consideration of the payment of a fee of - 61.5Q _ , permit is hereby granted toDarrel A. Farr Devel . 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 vithin nthe city limits and this permit may be revoked at any time upon violation of any of the provisions of said Building Inspector DAlkL CLARK NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Bulk: ;rInspector for separate permits for these items. APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY ORFRIDLEY, MINNESOTA OWNZRVS NAME: Vf&cp, ILDER: ADDRESS: IL?ol Z?PaaA/jn 93#uJ. ADDRESS: NO:. IS&S- STREET:50,1VAJ 99,60,14-:V 0?40�C& LOT; —BLOCK: (0 ADDITION :._1;V'Vr'4""W4-x '410""A CORNER LOT: INSIDE LOT: tff SETBACK: _SIDEYARD: Applicant attach to this form Two Certificates of RanLej of Lot and proposed building location drawn an these Certificates. DESCRIPTION OF BUILDING To Be Used As: ®5 .v ®".'r- Front: 20 Depth: SM Height: Z Square Feet: 62C Cubic Feet: I?Jf@O A 41' A 2 (M -'Front: 20 -Depth: zz Height; /0® Square Feet, 440 Cubic Feet: 4400 Type of Construction: A100d O " A.Ofte, Estimated Cost: S 214/60. 80 To Be Completed: 197.3 The undersigned hereby makes application for a permit for the.woxk here'W specified, agreeing to do all work in sttict accordance with the City of Fridley 0-2dinances and rulings of the Department of Buildingso and hereby declares that all the facts and representations stated in Chia application are true and correct. D1TF,: /A ® 44D - 7 z SIGNATURE: (See Reverse Side For Additional Information.) o ri P W�- City of Fridley rombbe md sm maht raw* DOS& a 31dow. Phone M3 DZSCMPIA120H or WORE mumbw, Kim& amd L-a--aflam @)9, FaMBUM) 7 7-7-77, FLUMMING rAZ74M RATES- MCL RATS TOTAL aw Numbef Fixtures ................ x ftture nXture C%Wnimff .... © . . . . . . - x 51.60 ffi New Fixture Old Opening ......... Catch Basta . . . . . . . . . . . . . . . . . . 83.0 Water Nester 'Up to 99,000 EMP .... z 03.00 8 3 New Ground Run Old Bldg. . . . . a . . . x 25F ERectdo Watar Hmtw .............. x $100 S_ GAS PITTING FEES: NO. RATE TOTAL lot 3 Fixtures ................ M09 $ Additional llztum .......... $ 35 $- an RAW to 10.0m Wm $6.00 • State Surcharge 72 -FT � I I - - - - TMAL TU The undersigned b�7fehy ze-o- OPPReaUen 90F 0 Wmait 900 91-- WOO& speciffe,-6, eyveng to do an work ho 9det accardame with the MN 0Ydin8-QLq =a nEW a2 thr, �partmea% oi' Sufldky_p% and hemby dsOarez that &Z �he F&M and stated* to Ws appucam= an %me =d eorrec% Ommr A01a Mind of BWIdimg Used " i rrrws rtirnace Shen & Duct Work to 120,000 BTU .11000 1 U 0-.0 each add. 60,000 2M . ......... 3.UD $ Replacement of Furnace 6.00 Repairs & Alterations -up to $500.00 0.00 �- Repairs & Alterations each add. $33.00 3.00 Furnace Shell & Lines -to 400 sq. ft. FMR Stearn $10.00. - Furnace Shell & rane-to 040 sq. ft. EDR Hot Water 10.00 Each add. 200 sq. ft. EDR Steam A.00 Each add. 320 sq. ft. EDR Hot Water 3.00 OIL BURNER -to 3 gaL per hour MO $.� over 3 gal. per hour -See Fee Schedule GAS D (up to $ owes 199,0W 9M go* Fee schedule GAS P T°MNG F =. NO RATE TOTAL 1st 3 Fixtures x$ 2.w $-,A- `- Additioaai Fixtures x M $- _ Gas Range to MM x; &001 : Fridley, Agin -------s lg Owner Kind of Building.. e� Used as To be completed about Estimated Coat, $ Old -New. Building Permit No. __ Pormit No. HEATING or POWER team, Not Water, Warffi Trade Name_ LSize AT®- ft -A, J Capacity—_',k_a-M_— Sq. Ft. F.D R- BTU IMP - Total Connected t—d Kind of BURNER - Tft&Rlaa Size No, .lamW1111,01 11 SUBJECT ERMIT NO. City ®f Fridley AT THE TOP OF THE TWINS BUILDING PERMIT 2251 i � • COMMUNITY DEVELOPMENT DIV. _ r ~ PROTECTIVE INSPECTION SEC. o , NUMBER REV. DATE PAGE OF APPROVED BY = CITY HALL FRIDLEY 55432 •--' �'' 612-571-3450 910-F15 JOB ADDRESS 1565 South Oberlin Circle NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 6 1 Innsbruck North Townhouse 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. DIcks Fire & Storm 864 19 Ave SE Minneapolis MN 55414 791-6170 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 X REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof House & Garage (Tear -off); Install gutters 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS I GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2,172 $1.09 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON. $54.00 Fire SC $2.17 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC $5.00 $62.26 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI PROPERLY VALIDATED THIS IS YOUR PERMIT 1;;WHEN S L. DATE $iGNATURE OF OWNER IIF OWNER BUILDER) IDATEI NEW [ ] ADDN [ ] ALTER [ ] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building. Permit Application ConstructionAddress: 1565 - South Oberlin Circle Legal Description: Owner Name & Address: Contractor' Dicks Fire and Storm Address: 864 - 19th Ave. S.E. Effective 1/1/94 Tel. # MN LICENSE # 2481 Tel. # 781-6170 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: Remove and replace roofing on house and garage. Install gutters. Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: roofing /gutters Estimated Cost: $ 2 ,17 2 .0 0 Approx. Completion Date: (Cost on -Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $_ DATE: 5/15/94 APPLICANT: Dicks Fire and Storm =It Tel. # 781-6170 STIPULATIONS: CITY USE ONLY Permit Fee $ ® Fee Schedule on Reverse Side Fire Surcharge $ r .001 of Permit Valuation (1/10th%) State Surcharge $ 1 1 ®1 $.50/$1,000 Valuation SAC Charge $ $800 per SAC Unit License Surcharge $ • 0 $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: F I SUBJECT PE NO. City of Fridley AT THE TOP OF THE TWINS. B U /� ("31041 I L D I N G PERMIT � Vo. r COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r 1 . r r--11 CITY HALL FRIDLEY 55432 NUMBER REv oATE FPAGE of AVPRoveo BY j 612-571-3450 9104156/8/00 JOB ADDRESS 1537, 41, 45, 49, 53, 57, 61, 65 South Oberlin Circle NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6' 1 Innsbruck North Townhouse 2nd Addn SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Innsbruck Townhome Association 651-224-5482 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Garlock -French Roofing Corp 2301 E 25 St, Minneapolis,>MN 55406 612-722-7129 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. S ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Townhouse Building 7 CLASS OF WORK 0 NEW 0 ADDITION 0 ALTERATION j] REPAIR O MOVE 0 REMOVE ° 8 DESCRIBE WORK :,-Reroof Building 9 : CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. P it U"'It inspection Cn� ds SEPARATE PERMITS N/iei Be pati®d REQUIRE® FOR: To �O�n®®n®i �® post PLUMBINN ANDHEAnSIG100 TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATC.PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 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. DW, G. 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 $19,160.76 $9.58 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 OR LOCAL LAW REGULATING COW $321.25 Fire SC $19.16 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE 1-1 , / I 49.99 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT -DATE- N O VALID T THIS IS YOUR 7MIT_D - NSo OArt —S-GNATURE OF OWNER -IF OWNER BUILDER- -DATE- I 7 SUBJEtT MIT City of Fridley 321 8 1 AT THE TOP OF THE TWINS BU I LD IN QrfY� T r 16'COMMUNITY DEVELOPMENT DIV. 0)-94 RECEIPT NO. r PROTECTIVE INSPECTION SEC. I 1 � � NUMBER REV DATE PAGE OF APPROVED BY i ��"' �•� CITY HALL FRIDLEY 55432 _---� L 612-571-3450 .1 1ee 910 -FIS 9/19/01 JOB ADDRESS 1.537 - 1565 South Oberlin Circle NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 - 8 6 1 Innsbruck North Townhouse 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Various 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Columbus Exteriors 2131 111 Ave NW, Coon Rapids, MN 55433 763-757-7530 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP. PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING 8 Unit Townhouse ? CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION GAd REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reside Building; Soffit/Fascia; Window Wrap B CHANGE OF USE FROM TO STIPULATIONS Per Section 1402, 1997 Uniform Building Code, requires that a weather resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions for this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer stag this in th& application guidelines. Call for inspection of wrap before covering. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 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 $ 55,192 $27.60 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 OR LOCAL LAW REGULATING CON- $685.75 Fire SC $55.19 STRUCTIO OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTALFEE 768.54 lL9-19- 0 SIGNATURE OfCON'RAGTORORAUTMORIZEOAGENT iDATEi ENMRORYVALI A ED THIS IS UR PERMIT O � BLDG NSP' ri&yt _ S,GNATURE Of OWNER,19 OWNER BUiLDERI iDATEs 7 Building MECHANICAL Permit No. 9V Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY D 763-502-4977 FAX EFFECTIVE 1-1-08 DATE E-MAIL ADDRESS ' PYOUR r �6o UPer, I 1 SITE ADDRESS 92– THIS APPLICANT IS: WNER ❑CONTRACTOR PROPERTY NAME: f�`C�iTYC%%0 ✓ STA E ZIP OWNER/ADDRES TENANT — PHONE: CONTRACTOR COMPANY NAME: CONTACT PERSON: NOTE: SEPARATE CITY LICENSES ARE STATE LICENSE # EXP DATE REQUIRED FOR GAS AND HVAC. ADDRESS: CITY STATE ZIP SUBMIT COPY OF BOND PHONE FAX AND INSURANCE PERMIT TYPE ❑ SINGLE FAMILY ❑ TWO FAMILYWNHOUSE TYPE OF WORK: ❑ NEW ❑ REPLACEMENT >14LTERATION/REMODEL DETAILED DESCRIPTION OF WORK L 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 t e improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) OR 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: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU $25.00 (GAS) $15.00 _GAS RANGEIOVEN $10.00 _A/C _FIREPLACE TO AIR EXCHANGEER $15 (WOOD) $35.00 NEW GAS GRILL $10.00 _AIR _FIREPLACE $35.00 $35.00 _GAS UNIT HTR $10.00 _BOILER _FURNACE LINER $10.00 DRYER $10.00 _POOL HEATER $35.00 _CHIMNEY _GAS DUCT WORK $10.00 _GAS PIPING $10.00 _VENTILATOR $15.00 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ OR Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 MINIMUM $15.50 MINIMUM $15.50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a mechanical permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances .but and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit only an application for a permit and work is not to start without a permit; that the work will biaccordance a approved plan in the case of all work whic equires review and approval of plans. S 1 �d h U Gi DAT ; 17V SIGNATURE OF APPLICANT -� AME I APPROVED BY DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 -REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations. C17YOF. FRIDLEY COMMUNITY FDEVELOPM1W DEPARTMENT TOTAL P.01 uy ry i C PLUMBING Perrnit Nurnt�er SIDENTI.s4i! APPLICATION Rgdarved 6y City Of Fridley Date Rocoved NOTE: IF PROPERTY IS NOT OWNEPJOCCUPIM)- A LICENSED CONTRACTOR MUST OBTAIN THE PERMIT. 7 Dj DATE "D YOUR E-MAIL ADDRESS SITE ADDRESS1 Itri eo;t THE APPLICANT IS. (CIRCLE ONE) OWNER CONTRACTOR NAME e. Ck - e,• r PROPERTY OWNERJ TENANT ADDRESS C CITY STATE Z1P I ^� PHONE #—1 NAME LICENSE # CONTRACTOR ADDRESS River City Plumbing CITY 8290 Main St. N.E. # 39 STATE Zr PHONE # Eridley. MN 554.32 FAW 63 754-2199 Fax 763 754-2908 TYPE SINGLE FAMILY TWO FAMILY TOWNHOUSE TYPE OF WORK ❑ NEW 21"'4EPIACEMENT' I DETAILED DESCRIPTION OF WORK (! W.0 FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED FOCBURES: (INDICATE TOTAL NUMBER OF EACH) BATH SINK(LAY FLOOR DRAWS SHOWER WATER PIPING BATHTUB GAS PIPING ((Peed =y Ucenw) stntelleasurut POOL WATER SOFTENER ($35) CLOTHES WASHER KITCHEN SINK WATER CLOSET 13ACKFLOW PREY. (415) —DISHWASHER LAUNDRY TRAY � P�TER HTR (SM FOR IRRIGATION WATER METER OTHER Permit Fee $ C,; -OD MINIMUM: $15.00 or 5% of cost of the improvement -whichever is Alan Review $ greater on work less than $=O Surcharge $ .SG TOTAL DUE $ 3 s • so Make checks payable to: City of Fridley THIS IS AN APPLICATION FOR A PERMIT— NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledges that the information above is complete and aocurme: that the mark vw71 be in conformance with the OrdinanOw and codes Of the City of Fridley and with the Wrinesota Construction Codas: that I understand shin is not a permit but only an application for a permit and work is not to start withwrt 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 plana. / /� NAME OF RPPLIGfWT iG! (.CLS PA DATE Please type or ' SIGNATURE OF APPUCANT RMS 1710. 1 .01d C17YOF. FRIDLEY COMMUNITY FDEVELOPM1W DEPARTMENT TOTAL P.01 Building BUILDING Permit Ivo.: _0(® Inspections RESIDENTIAL APPLICATION Received By: MW 763-572-3604 763-502-4977 FAX CITY OF FRIDLEY D EFFECTIVE 1-1-08 DATE j IL ADDRESS SITE ADDRESS M BYOJJRE- Yi % THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS:��`L r e�S �� CITY _�� '�-// STATpY"�ZIP PHONE: 0 NAME: (#)- T W CONTRACTOR ADDRESS:z9J 3 AP^604CITY JI -< STATE IP SUBMIT A COPY OF PHONE�,} I Fi j3 3 ot FAX IV 1 a-351, A YOUR STATE LICENSE STATE LICENSE # / EXP DATE PROPERTY TYPE 0,$INGLE FAMILYINEW CONSTRUCTION SIZE TWO FAMILY/NLW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCEIREPAIR R REMODELING DESCRIBE WORK BEING DONE: ✓J t n SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS. ❑ Vinyl 0soft ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. WINDOWS r°hI �� 2. 3. Two sets of construction plans Energy Calculations IN EXISTING OPENINGS lies []No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED 1• �� (1 t.p} NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: TOTAL JOB VALUATION $ coo OCCUPANCY THE 1997 UBC FEE SCHEDULE) OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ (j .001 times the total job valuation Surcharge $ Z 5 .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ fi5 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 on site; that the work will be in accordance wi h the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME_ 1440 DATE /Z -11—t) APPROVED BY PLEASE NOTE: SEPARATE PERMITS ARE DATE FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK