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PRE 2010 DOCSC TICI 01'_ JUNG No. �! Street " A�/ part of Lot .. ... ?;? .; Lot Block ' •Addition or Sub -Division ° Corner Lot ....... Inside Lot .. Setback.. Sideyard . 4 ................. DESCRIPTION OF BUILDING To be Used a .. Front Depth Height . :�! Sq. Ft. Cu. Ft. .... Front . Depth ...... Height , Sq. Ft. . Cu. Ft. ........ Type of Construction�."-n-*" Est. Cost' .......... To be Completed .. erm it is lie In consideration of the payment of a fee of $ ...: , p y gr • : ::: • •:. hereby anted to r"` ............................ to construct the building or addition as described above: This permit is granted Upon the express condition that the person to whore it is granted and his agents, employees and workmen, ,in all work done in; around and upon said building, or any part thereof, shalll conform in all respects to the ordinances of Fridley Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit may be'revoked at anytime upon violation of any of, the provisions of said ordinances. Building Inspector NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to sed " Building Inspector for separate permits f ese items. j j Air Condbioning ! and Devices G1 ®ITT WARNS AYR: RATE TOTAL Furnace Shell & Duct Work ............... I .......... $10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add, 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. &00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 8.00 S STEAM or HOT WATER SYSTEM Furnace Shell & Lines --to 400 sq. ft. EDD Steam .. . $10.00 $ Furnace Shell & Line --to 640 sq. ft. EDR Hot Water .. 10.00 $ Each add. 200 sq, ft. EDIT Steam ............... :...... 3.00'$..— .00'$.Each Eachadd. 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 BTT See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x$ 200 $ Additional Fixtures x .78 $ Gas Range to 199,000 i 500 $ Dept. of BIdge. Phone 880 -UW City of Fridley: The undersigned hereby makes application for a permit for the work hereic specified, agreeing to do all work in strict accordance with the City Ordinance; and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. j Fridley, Minn- � � � � 1& 2-1 Owner, % , f x8 ( Find of Building Used as a� To be completed about1. Estimated Cost, $ '� /- �J O d New. Building Permit No. Permit No. (0 DESCRIPTION OF WORK HEATING or POWER \PLANTS --SS team, Not Water, Warm Air—No Trade Name— Size No Capacity Sq. Ft. E.D.R BTU2�`--0 H.P. Total Connected Load Rind of Fuel BURNER — Trade Name Size N� Capaci Sq. FL E.D R BTU H.P: AIR CONDITIONING FAN HEATING SYSTEM See Fee $chadnie VENTILATING SYSTEM$ s `tel - ALTERATIONS & REPAIRS TOTAY $ f ®• �� Sign UGH Business Phone Na /e",- (REMARKS—ovEe1 SUBJECT PER of Fridley0 17 313 AT THE TOP OF THE TWINS BUILDING PERMIT ipCity R • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. i-_-- I CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 110/31/83 JOB ADDRESS 6151 Starlite Boulevard N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17 2 Sylvan Hills Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ray Minard 6151 Starlite Boulevard N.E. 571-9656 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Window & Door Sales & Sery ice 4612 Columbus Avenue South 827-7347 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X .8 DESCRIBE WORK Reside dwelling and add trim 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. 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 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $6,800 $3.40 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LO L LAW REGULATING CON- $62.50 T OR E PERFO AN F CO TRUCTION. PLAN CHECK FEE TOTALFEE _31-93 $65.90 SIGNATURE OF CONTRACT0k04i<UTH EDAGENT (DATE) _ WHEN PROPERLY LIIDgATED THIS IS YOUR PERMI BLDG WSP I OATEI SIGNATURE OF OWNERUF OWNER BUI OERI (DATE) CITY OF FttIDLCY Effective Aug. 1, 1981 ' APPLICATIM FOR RESIDENTIAL BUILDINIG PER141TS (New, Alterations, Additions, or Repairs) OWUER: PWV— zKr/'/'Zr'/ ADDRESS: ,110 ` � Self %, t TEL 110: 21— ��� BUILDER: Wi�W-'VW ADDRESS: %�t „�12 ( c%1 CoS /�z� Sr TEL IIO: 9A — ? 13 fJ 7 Construction Location STREET NO: STREET: �^ LOT: ? BLOCK: ADDITION: J 1' EA1 74.Z Corner Lot: Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION l O� Front: Depth: Height: Square Feet: Cubic Feet: Y 1 Front: Depth: Height: Square Feet: Cubic feet: _ n 71pe of Construction: Estimated Cost: $ �� 7b Be clorapleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE PZVF.RSE SIDE OF SHEET . Zile undersigned hereby makes application for a permit fcr the %.nrk herein specified, agreeing to do•all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are Vrue ppd corregt. Z--,) UWE: �Ci l � � IGNhTUM — Stipulations : SUBJECT PfrITMIT NO. City of Fridley 24767 AT THE TOP OF THE TWINS BUILDING PERMIT r • COMMUNITY DEVELOPMENT DIV I PROTECTIVE INSPECTION SEC. r � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By �j 612-571-3450 910-F15 11/12/96 JOB ADDRESS 6151 Starlite Blvd NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17 2 1 Sylvan Hills Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ray Minard 6151 Starlite Blvd NE 571-9656 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. John Harty Inc 9403 Minn Ln N, Maple Grove MN 55369 545-4233 9387 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 jI REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (20 Sq) Tear -off 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 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 1STALLS 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 $•82 WITH THER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,650 DOES 'NO PRESUME TO GIVE AUV VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PRO ISIO S F ANY T ER STAAL LAW REGULATING CON- U0 Fire SC $1.65 STR CTIO THE P F RMANTRUCTION $54. / PLAN CHECK FEE TOTAL FEE AN, o114 Lic se SC $5.00 1 $61.47 sI TUFi-E OF Cb.WTAACTOR ORAUTHO 2EDAGENT (DATE) N WHEN PROPERLY IDATED THIS IS YOUR PERMIT BLDG SP v DATE SIGNATURE OF OWNER OF OWNER BUILDERi )DATE) NEW [ ] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: Legal Description: Owner Name & Address: Tel. Contractor: /�� J MN LICENSE # Address: G" �/ L �., . Tel. # f S 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,/GGround Sq. Ft . OTHER: � =R �I e d � i (�� C – / � d Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side*Yard Setbacks _ Type of Construction: Estimated Cost: $ A rox. Completion Date:— 4 PP P / - ost, on Back) Driveway Curb Cut Width Needed: t. +' = Ft x = $ DATE: APPLICANT• L-7— Tel. # �' – Permit Fee $ E460:' Fire Surcharge $ State Surcharge $ SAC Charge $ License Surcharge $ Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL , STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $900 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 [ ] SUBJECT R TT of Fridley 2 � 6 7 3 ?City AT THE TOP OF THE TWINS B I I L ®I N G P C R A A I T PERMIT I _,572-3 � �Mt)NITY DEVELOPMENT DIV. v ' v REC/h r a. PROTECTIVE INSPECTION SEC lot/ (/ NUMBER REv DATE PAGE OF APPROVED By i ,'J CITY HALL FRIDLEY 55432 -__•� L 612-571-3450 910415 11/30/98 JOB ADDRESS 6151 Starlight Blvd NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 17 2 Sylvan Hills Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ray Minard571-9656 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO New Haven const. Co. 4208 83rd Ave N Brooklyn - 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 Jac REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (18 S) Tear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING - THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 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 1542 .77 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 PERFORMANCE OF CONSTRUCTION $51,25 PLAN CHECK FEE TOTAL FEE SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATEi ENP O ALIO E THIS IS YOUR PERMIT BLC SP )f FATE S-GNATURE OF OWNEROF OWNER BUILDERI iDATEi Ndv 37198 11:02a NEW t , ADDIf I l ALTER [ ] Construc tionAdd,m: Legal Drscription: Kerri 566-7183 SINGLEFqM�, Y OF FRY XEV BUILDING p� MPLEAS R-1 AM R -z T APPLICATION p.3 Effective 1/I1% Owner Name & Addr58. Canttactor. t�p� � v Tel. # s'7f— 9 �" C_. o Address; 24�' 8,3�d MN LICENSE A 0-o a Attach to this application, a Certif Tel. # lot, with the propos f the rons�tion drawn on it o UrVCY oscate, D�C�Pi"IOIY OF �'ROVEMF11tT I.1'VL1TG AREA. GARAGE ARP � Length �-----„�_ Width HeightDEC$ AREA. ~'--�--- Widtfi S9- Ft. —�.,_ Height S9 Ft OTR: •-----__.._ Width Hgv . � — Sq. F't—'-- .._. Const:uctioA TYpe:/�cS�+Z Estimated Cost: s��?. 400 Driveway Curb Cut Width Needed:Ft. +-5 Pt epee Schedule On JMcki � x $ DAYN.11--3p sj g $ "ftJCAM%. G;C� Tel. # CIM V 1 E N Permit Fee FireS�baz&e Fee Schedule on Reverse Side State Surd $ •00I of Permit Valuation (I/10th%) SAC Charge ' $--'Ol$1,000 Valuation License Surc1age $ �- $1000 per SAC Unit 1%I' F crow $ $5•0() (State lAceumd Residential Contractors) Rrosion Control $ Alt. "A" or Alt. "R" Above $450.00 co Park $ conservation Plan Review Sewer Main Charge S Fee Determined by Pnginftnng Allem nt Necessary I l Not Necessary [ I TOTAL$�3. ST(PU AT.IONS: SuBJE�T R . om City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT "915 1 1 `- _ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r � PROTECTIVE 1 . 1 = 1 CITY HALL FRIDLEY 55432 ,'' NUMBER REV DATE PAGE OF APPROVED 6V 612-571-3450 910-F15 2/16/99 JOB ADDRESS 6151 Starlite Boulevard NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17 2 Sylvan Hills Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ray Minard 6151 Starlite Boulevard NE 571-9656 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO B C Exteriors 8417 Regent Ave N #115, Brooklyn Park, MN 55443 598-4311 CITY 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside House 9 CHANGEOFUSEFROM TO STIPULATIONS Call for building wrap inspection before covering. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 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 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 $5,000 $2.50 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 ISIONS ANY OTHER STATE OR LOCAL LAW REGULATING CON- $99.75 Fire $5.00 O THE PERFOR NCE F CONSTRUCTION YTRCO t PLAN CHECK FEE/ TOTAL EE j:1� ®`ti CI CE SE 107.25 SIGNATURE OF CON' AG OR ZED AGENT OATS HEN P P ALIDAT T IS IS YOUR PERMIT S-GNATURE OF OWNER i F OWNER SUMDEAt tDATE, BLDG NSP r�AtE NEW [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 a(�� BUILDING PERMIT APPLICATION ConstructionAddress: �,� [ 1— �,�-0.e-�, �.P N v 2 Legal Description: S LA .c r t fi Owner Name & Address: CL vc Tel. # -5---?t1 91 Contractor: C, r -L Sc C l 4.4, 5 - C - x , MN LICENSE # /)0 � Address: & ( -ojc . �00" it Tel. # 5--1 _ 43 11 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: Lengt4 Width Hgt/Ground Sq. Ft. OTHER: e- s i Construction Type: Estimated Cost: $ .SG 0 ®. �l (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ Q DATE: APPLICANT: Tel. # 5-117 4311 STIPULATIONS: CITY USE ONLY Permit Fee $ , �f Fee Schedule on Reverse Side Fire Surcharge $ 6�(D .001 of Permit Valuation (1/10th%) State Surcharge $ $.501$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ $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: Building $ 49S-. -25 BUILDING Plan Review Permit No.: Inspections Fire Surcharge RESIDENTIAL APPLICATION Received By: 763-572-3604 $ -75;— CITY OF FRIDLEY License Surcharge Date Rec'd: (� 763-502-4977/ FAX SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ EFFECTIVE 1-1-2010 Erosion Control $ DATE J/ ® YOUR E-MAIL ADDRESS $ SITE ADD S 40/S/ ,5 7fa0 Lt ?c /�G �'�(� A/' 4- , $ THIS APPLICANT IS: ❑ OWNER CONTRACTOR $ - PROPERTY OWNER/ NAME: m 4 o t%L My id- 12 u /m A r -- TENANT ADDRESS: _JQ / S / 6 7'14 /L L, t E L &'SCITY �� G i STATE `. t4/ZIP PHONE: CONTRACTOR NAME:/�✓ ; a °� z >t T �n ; SUBMIT A COPY YOUR STATE LICENSE STATE LICENSE # a 1✓ EXP DATE AND CERTIFICATE OF ADDRESS: �(�'�'�� %,Ryns� CITY-5/'00'jSTATER ZIP -3S'/ -?V INSURANCE PHONE 69S1 - '7 '7 Y - �- 5 $' FAX 61Sl - .77 Y- PROPERTY TYPE ❑ SINGLE FAMILY/NEW dONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED JZT WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER. ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ;V REMODELING DESCRIBE WORK BEING DONE: 7y SIZE OF IMPROVEMENT 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: 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 ZlYes ❑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 $ . 5 ,5'0 c9 OCCUPANCY TYPE Permit Fee $ 49S-. -25 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ -75;— .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 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 $ - Make checks Davable to: City 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 workk ich require view and approval of plans. gyp/ SIGNATURE OF APPLICANT ?��� `��% L PRINT NAME t �I t ✓f ��/ Z LG 6RC DATE Building PLUMBING Permit NO.: �b Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 763-5024977 FAX EFFECTIVE 1-1-2010 / DATE / IYO/UR JE-MAIL ADDRESS j a n( 'j Pl l �l� / k C ha �j o®a GGyvi SITE ADDRESS 6 5— j S �� 1 �1 h t bS 1 u O� �e . THIS APPLICANT IS: ❑ OWNER f9CONTRACTOR PROPERTY NAME: OWNER/ ADDRESS: CITY STATE ZIP TENANT PHONE: CONTRACTOR NAME: t` 6'1 14 liKe U .S al'? SUBMIT A COPY OF STATE LICENSE # EXP DATE YOUR STATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS: ��l% G2%/nfie,5o S CITY s vh0, Q fe STATEJ?J/UZIPSj�, INSURANCE PHONE C' 5- U G ' vZ S`f3 FAX 9n—VO-6-7`%0 PERMIT TYPE IR SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: 13 NEW ff-REPLACEMENT DETAILED DESCRIPTION OF WORK P to v1Q C e 5 4 v ` - o �T_S � e re .i­ Gt Ger 14'7 e Js r FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. —BATH SINK/LAV _FLOOR DRAINS —SHOWER _ WATER PIPING —BATHTUB _ GAS PIPING (NEED CITY LIC) _ SWIMMING POOL _ WATER SOFTNER ($35) _ CLOTHES WASHER _ KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREY. ($15) —DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER Number of fixtures (a, $10.00 x $10.00 = $ Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00= $ State Surcharge $x_.50 $35.50 Total= $ THIS IS AN APPLICATION FOR A PERMrr-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 case of all work wjiic requires review and approval of plans. SIGNATURE OF APPLICANT'/ ✓ U L `' ' PRINT NAME/ h 1S Jh'qS Ove DATE 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 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 ADDRESS : 6151 STARLITE BLVD NE PIN : 153024440058 LEGAL DESC : SYLVAN HILLS PLAT 2 : LOT 17 BLOCK 2 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-01765 �Jl� DATE ISSUED: 10/05/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL A SAVERS SWITCH. # INSPECTIONS 1 APPLICANT HUNT ELECTRIC CORPORATION 2300 TERRITORIAL RD ST PAUL, MN 55114 - OWNER SUSAN RUFFENACH 6151 STARLITE BLVD NE FRIDLEY, MN 55432 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 ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 118132 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.