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PRE 2010 DOCSCity ®f Fridley, Minn. BOWING PERMIT N?(E62413) Date: /n A Owner: �sur A I 4V Address Address LMT 0 !9101DING NO. StreetPart o Lo Lot Block Addition, or Sub -Di on Comer Lot Inside Lot A!!!!� Setback r S1�4d Sewer Elevation Foundation Elevation DESCRIPTION OF, BUILDING U Front Depth Height Sq. Ft. r' -'Or Cu.' rt.00=110 Fro t Depth Heisq. ght Ft 10 Cu. Ft. —4W40V Type of ruc��n Est. 4j&01j-.jjj'A Ji go; Ir J,2W:'Tio be Completed In consideration of the issuance to me of accordance with the description above to construct the building, described above I agree to do the work In pti above set forth and, In compliance with odl* provisions of a the city of Fridley. In consideration of the payment of a fee oft 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 rt t6�f, shall conform in all respects to the ordinances of t ctr ]L moving Fridley, Minnesota regarding location, construction, alteration, maintenance, repair 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.1 0-) NOTICE: Me p*mk does not 40VW the Construction, IndaRaffm for witbig,,phoublag, gas hmdinW was, or water. Be sure to sea the Building Inspector for separate permit for then ftenm City of Fridley App ication for Plumbing and Cas Fitting Permit Dept. of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Location PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ..................... —2412 x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. N N Catch Basin ............................ x 3.25 w Z ` $ WATER HTR. x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... iq H3 m Z VI ;� 'T L- g0 LL N J� LL O a~� u m S� �S �6° UG �aZ U 6' �a UO F N GAS ELEC. Base 1st 2nd 3rd 4th • Future Connection Openings Connected with Sewer E] New Fixture, Old Openings Cesspool 0 PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ..................... —2412 x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Nater Heater (Up to 200,000 BTU) ...... ✓ x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ '/40 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ -57 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 true and correct. Fridley, Minn '%" --L-- 1g��3 Owner Kind of Building Used as To be completed about — Estimated Cost, $ Old—New. Building Permit s ROUGH FINAL .01D042 2M 7-59 City of Fridley Apps cation few PluniVing and Cas Fitting Porn it Dept. of Bldgs. Phone SII 4-1 DESCRIPTION OF WORK Number, Kind and Location of Fixtures PLUMBING FIXTURE RATES: N��O//. RATE TOT ® � Number Fixtures ...................... x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ 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 Description ........... $ TOTAL 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 true and correct. Owner Kind of Building Used as To be completed about Estimated Cost, $ 99 Old—New. Building Permit No Permit No. ®Z Z. Signe B- Business Phone No �6 �J ROUGH FINAL d2 2M 7-59 0 K N Y i-: y NU' ? a F N WATER HTR. GAS ELEC. iii �� n 3� o� ao t� a3 G°d Uma C O Base 1st 2nd I_ 3rd _ 4th Future Connection Openings Connected with I Sewer � New .Fixture. Old Openings Cesspool Ej PLUMBING FIXTURE RATES: N��O//. RATE TOT ® � Number Fixtures ...................... x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ 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 Description ........... $ TOTAL 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 true and correct. Owner Kind of Building Used as To be completed about Estimated Cost, $ 99 Old—New. Building Permit No Permit No. ®Z Z. Signe B- Business Phone No �6 �J ROUGH FINAL d2 2M 7-59 0 Application for rower Plants and Ideating. Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 . ................ 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU 2.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR. Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ jEach add. 200 sq. ft. EDR Steam ...................... 2.50 $ 1 Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures..... x $1.50 $ Additional Fixture's 4✓ x .50 $ Gas Range to 200,000 BTU x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH- OUGH FINAL— FINAL Dept. of Bldgs. Phone SU 4-7470 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 true and correct. / Fridley, AUnn 19 Owner'�'�✓ Kind of Building Used as To To be completed about Estimated Cost, $ 1. Old—New. Building Permit No. _ 6 57 � Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS -Steam, of Water, arm Air—Na Trade N—P Size Capacity Sq. Ft. E.D.R BH.P. Total Connected Load Kind of Fuel BURNER — Trade Name"d J Size No Capacity ��� Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signe By a 4 Z 2M Business Phone No &� �`•�a gig=bi` J ®.® = ry � J u� a �`•�a gig=bi` J ®.® 9 c u xF r W I 16 O 61 O —.= z L® ■ • L U Q �' ` b if �i ' = n s� q 3 z D J 7 o e ; W m 0 � r o M xF r 16 O 61 O W [ri • L ` b if �i ' = o e ; � r x Y IW $ z8 B M a J i Z LU; 2 fi # 0, 1J J tZ r r I ® Ueg— J Z Do r° Its IJP .j tm; ; I f J IT o 0 , P i II i = r r s � It it = rs T J 17 J Z U U. 19 f �` Y ; 4c C xF 91 1.010 I q �i o e ; � B M a i r I r° _ ; I f IT i = r s � it rs T ; 4c o 0 i i. t $ � Z z u I- ®=$t�tt;at6A 0 i® w � I lei SUBJECT City of Fridley (,-25 7 3 4 AT THE TOP OF THE TWINS B U I L ®INC; I T r rnlu�ma-- 116 _ COMMUNITY DEVELOPMENT DIV. .�__ , ~ PROTECTIVE INSPECTION SEC. _ r & f 16-&t iA NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 . 12/16/9 JOB ADDRESS 15 Rice Creek Way NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 2 1 Edgewater Gardens SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE William Ficentso 15 Rice Creek Way NE 571-2633 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Cities Home Improvement 6148 Olson Memorial Hwy, Golden Valley, MN 55422 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 591-0332 20076441 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION C1 REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Replace windows 9 CHANGE OF USE FROM TO STIPULATIONS Install smoke detectors to meet the State Building Code - on each level adjacent to sleeping areas and in each sleeping room. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,800 $1.40 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- ON- R C ION OR THE PERFORMANCE OF CONSTRUCTION RUCTION $74.75 FiA SC $2.80 �. PLAN CHECK FEE TO AL fEE ai L cen p4C 0 $83.95 SIGNATUREOFCONTRACTORORAUTHOR12EDAGENT )DATE) EN R VALIDA0b THIS IS YOUR PERMIT , S)GNATURE OF OWNER)IF OWNER BUILDER) IDATEI B INSP MATE NEW ( j ADDN [ ] CITY OF FRIDLEY ALTER ( ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: Contractor: 7Te- Address: IcPcLy-S6 Effective 1 / 1 /97 Tel. # /MN LICENSE # /1--e4 Tel. #5j / 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 q. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type.:- �UZI, �; ®ws Estimated Cost: $ (Fee. Schedule on Back) Driveway Curb Cut .Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: I �-�fG �i APPLICANT:✓ —O . ��-- Tel. # � ll 3 3 CITY USE ONLY Permit Fee $ . 7� Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ /, $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit '.icense Surcharge- $ „S'DD $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 [ J TOTAL $ 8�•9.� • SUBJECT P - --- -_ City ®f Fridley 3 2 7 7 41) AT THE TOP OF THE TWINS BUILDING PERMIT � ` RECEIPT NO. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. y I r PROTECTIVE W 1 � � CITY HALL FRIDLEY 55432 NUMBER REV DATEPAGE OF APPROVED BY 612-571-3450 910-F15 7/11/02 JOB ADDRESS 15 Rice Creek Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 1 Edgewater Gardens SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Dianne Ficenko, 15 Rice Creek Way, Fridley, MN 55432 763-571-2633 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO RMA Home Services Inc, 3200 Cobb Galleria Pkwy, Ste 200, Atlanta, GA 30339 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 763-542-8825 20268247 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK NEW O ADDITION O ALTERATION O REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Replace 2 windows within existing openings. 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulking and flashing for all exterior openings. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAO 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 $3,950.00 $1.98 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTALFEE L' ease $ .00 $108.18 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WH PROPERLY VALIDATED THIS IS YOUR,,PERMIT _ d' LD 'INSP l —? BATE S-GNATURE OF OWNEROF OWNER SUILDERI IDATEI NEW( ] Effective 5/10/99 ADDN [ J CITY OF FRIDLEY ALTER I l SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: -,S• ; C.Q. Cf -k• V, W Legal Description: Owner Name &Address: C-P.�to Tel. # —f • c -)l033 Contractor:. RMA HOME SERVICES INC. l LICENSE # Home Depot Installed Sales Address: 3200 Cobb Galleria Pkwy., Ste. #too Tel. # Atlanta, GA 30339 A 763-542-8826 urvey. of the k BC -20268257 - r -r----. ------------- �-•»••.. JII•.lt t0 SCale. DES.QRNW. OI+'R!�V9ENIENT . . LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width' Hgt/Ground Sq. Ft. OTHER: t� , a Construction Type: Estimated Cost: $ '519 Driveway Curb Cut Width Needed: Ft. + 6 Ft = _ Ft x $_ _ $ DATE: • S u `4S.O•a. APPLICANT• Tel. #tea •'3y� • Wq0 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ 14•Q E1 CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 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 [ J Building Inspections 7.63-572-3604 PATE &ITE ADDRESS THIS APPLICANT TS: PROPERTY OWNEW TENANT SUBMIT A COPY OF YOUR STATE LICENSE WrM APPLICATION PERM[T'TYPE TYPE OF WORK: MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR FrMAIL ADDRESS El OWER `%,CONTRACTOR COMPANYN"Z!S CONTACT PERSON• l ` P STATE LICENSE it PHONE _ -24i -'2f-2 j FAX S&dLE FAMILY 0 TWO FAMILY 0 NEW p4mAcmaw Permit NQ" - CO tail Received BY:� Date Reed: ATE `�Z]P,'S -?©2 EXP DATE C ry .(. = STATE�eO ZUE6 r Off, Q TOWNHOUSE 0 A ZERAT10NUMODEL DETA MED DESCRIPTION OF WORK r --?Q v lef4- PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to 5500.00, whichever is greater, for the improvement, installation or replacement of a residential fiixtvre, excluding the fixtures. ('his should reflect only the cost of labor) Labor cost under $300 = S15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE $ASED ON 510.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) ��� Equipment h�tatled MFG: MODEL: SIZE/ETU MFG: �._ MODE':. SIZFXTU ' WO: MODEL: ... AIC $25.00 FIREPLACIr (GAS) $15.00 GAS 1tANGElOVEN ^IR TO AM EXCHANGEER $15 FIMLACE (WOOD) $3S.00 NEW GAS GRILL $10.00 W -SR 535-00 �FMACE 535.00 GAS UNIT HTR S10.00 HMINEY LINER $10.00�GAS DRYER 510.00 BOOL HEATER $35.00 near WORK S10.00 �cZ mroo $Io.00 = VI;NTQ.ATOR $15.00 6. Permit Fee $ Number of fixtures @ $10.00 I XS10.00=S V4V Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE S _ Number of fixtures @ S25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35,00 - $—T -S-7777 State Surcharge - $ 50 Total = $ ,60 THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit atld I aclmowledge 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 aWic#on 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 ca f aH ork which requires view and approval of p4p. SIGNATURE OF APPLICAk,dZLI AlePRINT NA ��� DATE City of Fridley Building Inspections Department 6431 University Avenue NB, Fridley, MN 55432 763-572-3604 Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 m DAK' d0 C T V1 7, 2007 CITY OF FRIDLEY % L' % DATE . YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: A I.P.Q.. b - TENANT ADDRESS: %�` ������1 , �I.� CITY i0 L.S STATE�i�ZIP L PHONE: �� _ .S� ®—.� (J) CONTRACTOR NAME: e-, -f STATE LICENSE # cay .2 � / �/ EXP DATE � � - -� � 2 .'U � SUBMIT A COPY OF YOUR STATE LICENSE _ ADDRESS: %S j I` CITY -STATE—ZIP— TATEZIPWITH WITHAPPLICATION PHONE '� 7 ; l/ - �7 ! FAX �) - 1- — Cr 7 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 DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING NUMBER OF SQUARES e;2 ❑ HOUSE ONLY ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES 11ATTACHED GARAGE 1. 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: PROPOSED HEIGHT: ❑ DETACHED GARAGE 3. List of structural members to be used 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: D (USING 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $c�4� OCCUPANCY TYPE Permit Fee Plan Review Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due See Back Page for Fee Schedule 65% of Building Permit Fee $ a3 .0005 x Permit Valuation Minimum $.50 $ $5.00 (State Licensed Residential Contractors) $ $1675 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ I Lf- Make checks savable to: Citv of Fridlev Attach 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 codeso�fithe City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit:�nd work isnot to start without a permit; that the work will be in accordance with the approved plan in the case of all work whiclequire�s i`eview"an approval of plans. SIGNATURE OF APPLICANT % . %" [ PRINT NAMEZleDATE A 7 '� From: unknown Page: 1/1 Date: 8/12/2010 7:33:19 AM Building PLUMBING Permit No.: z� Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRMLEY Data Rev'd. 763-502-4977 FAX EFFECTIVE 7.1-2010 10 DATE v YOUR E-MAIL ADDRESS , a SITE ADDRESS i c P �P i ✓ THIS APPLICANT IS: 0 OWNER CONTRACTOR PROPERTY OWNER/ NAME: cela n + t? STATPJ '! ZIP Si ADDRESS:° TENANT %(0 2i -".aZ Fi g PHONE: ^ •�7I CONTRACTOR NAME: OU STATE LICENSE 4G EXP DATE I U SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND STATE BOND # EXP DATE _ CERTIFICATE OF ADDRESS: -3 Co q Q , CITY </ <� C7 STATE !Y ZIP-!!57- IPS -INSURANCE INSURANCE PRONE 7a ?_,, �1 s' FAX �Sa►t� S 'G % PERMIT TYPE ❑ SINGLE FAMILY El TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: 0 NEW O REPLACEMENT DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. PIPING BATH SWK/I.AV FLOOR DRAINS _ SHOWER WATER SOFTN r BATHTUB GAS PIPING (NEED CITY LIC) SWIMMING POOL _WATER SOFTNER — _ . ($15 _ CLOTHES WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($IS) DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION _ WATER METER —OTHER Number of fxtures @ $10.00 — x $10.00 = $ Number of fadures @ $15.00 x$15.00=$ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge $ 5.00 $40.00 Total - $ q0100 THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 pe nit a d w rk ' not to start without a permit on site; that the work will be in accordance with the approved plan in th se of all wo PIi re ire eview an caval of plans. r _ �G SIGNATURE OF APPLICANT Ol ; P N ME [_ DATE APPROVAL INSPECTORS SIGWAM PLEASE NOTE: SEPARATEWELARE ELECTRICAL AND City of Fridley Bu ding Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 fl,o.5k,r Cwr4 S 3�q 0(�3 7q.55 .3(035 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $ Future Fixtures S 3.50 S Old Opening, New Fixture $ 1.50 $ Beer Dispenser S 4.00 S Blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Water Leader $ 5.00 $ Hydraulic valve S 5.00 $ Sump or Receiving Tank S 5.00 S Mater Treating Appliance g 7.00 g Hot Water Heater g 5.00 $ Gas Range $ 10.00 $ Gas Dryer g 10.00 $ Back Flow Preventer Required. . . Yes ( ) No ( ) Type S 5.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1t of Value of Fixture or Appliance $ State Surcharge $ .50 Reinspection Fee $ �^ --77�� ($15.00) TOTAL FEE $ JC -1 SD Effective May 1, 1990. Job Address `j 1 1.FCe Ct e04- (-, Al ` Department of Buildings City of Fridley Tel. 1571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this applica/t on are true and correct Fridley. Mn. b , 190 OWNER _ II o &. ®e"ti/t KIND OF BUILDING n o-�We'e USED AS TO BE COMPLETED ABOUT ®1 7 I qb ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. ROUGH INSP. Date Company Signed By -" Tel. No. j 43 FINAL INSP. &— v 940 Date APPROVAL FOR PERMIT !1INIMU4 FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE in T p e I A u M v a water ei H c a NE p W Heater d �tl �yy" �Y(4 �~p U .aqni 6 t U W is qq y yyC A W u rop 'lec t9A U D Oq 00 i N f�.Oi U 07 4 3 C7 O as lot 2nd 3rd 4th (R) - Future Connection Opening Connected with Sewer (") - New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $ Future Fixtures S 3.50 S Old Opening, New Fixture $ 1.50 $ Beer Dispenser S 4.00 S Blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Water Leader $ 5.00 $ Hydraulic valve S 5.00 $ Sump or Receiving Tank S 5.00 S Mater Treating Appliance g 7.00 g Hot Water Heater g 5.00 $ Gas Range $ 10.00 $ Gas Dryer g 10.00 $ Back Flow Preventer Required. . . Yes ( ) No ( ) Type S 5.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1t of Value of Fixture or Appliance $ State Surcharge $ .50 Reinspection Fee $ �^ --77�� ($15.00) TOTAL FEE $ JC -1 SD Effective May 1, 1990. Job Address `j 1 1.FCe Ct e04- (-, Al ` Department of Buildings City of Fridley Tel. 1571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this applica/t on are true and correct Fridley. Mn. b , 190 OWNER _ II o &. ®e"ti/t KIND OF BUILDING n o-�We'e USED AS TO BE COMPLETED ABOUT ®1 7 I qb ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. ROUGH INSP. Date Company Signed By -" Tel. No. j 43 FINAL INSP. &— v 940 Date APPROVAL FOR PERMIT !1INIMU4 FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE