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PRE 2010 DOCSCity of Fridley, Minn.. BU11 DING PERMIT No. 5951 Date: Owner: /5&/S.Y Builder Address Address LOCA P B%11 NGNo. Street " ]? of Lot Lot _ Block _ _ %2__ r _ _ Addition or Sub-Divisi� T. Corner Lot ____ Inside Lot Setback 1 _..._.._.. Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To Used Front Depth Height Sq. Ft Cu. Aron Depth 4Height - Sq. Ft Cu. Ft ...../f._P Type of nstruction or Est stbe 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 $. ,permit its hereby granted to thto construct the building or addition as described above. This permit is granted upon e express condition that the person to whom it is granted and his agents, employees and worl�nen, 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 ]units and this permit may be revoked at 'any time upon violation of any of the pI'ovuions of said ordinances. .,, .;� 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. cOW4 V'- APPLICATION FOR BUILDING PERMIT CITY OF'FRIDLEY, MINNESOTA Owner's Name��'".S Builder_ a & Address Address�� ®® LOCATION OF BUILDING NO., Street Part of Lot Lot Block Addition or Subdivision Corner Lot Inside Lot m�� Setback Side -Yard Ae SWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: i � o 0,66,1.el Front -Depth ae,/ ,0 Height - sq. Ft. Cu. Ft. Frontes epth ,&�� Height 4 Sq. Ft.a;e/ Cu. Ft. Type of Construction 2 Estimated Cost r 0 t 6 To be Completed The undersigned hereby makes application for a permit for the work herein specified,,agreeing to do all work in strict accordance with the city of Fridley Ordinances and ruling of the Department of Build- ings, and hereby declares that all the facts and representations stated in this application are true and corgi. A•°°� DATE �� / / SIGNAT 17 *� (schedule of Fee costs can be found on the Reverse Side). ra „ City of Fridley ApPYcation for Plumbing and Gas Pitting Permit � 1 DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE /T��OTAL��yy 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 $—L_ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................ TOTAL FEE $�� Dept. of Bldgs. Phone SII /V V0 Location- City ocation 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, brinn 19 Owner �-&& Kind of Building Used as To be completed about Estimated Cost, $ Old—New. Building Permit No G Permit No. ROUGH % - a6 - 4 y FINAL _Q0.42 2M 7-54 By /f s Business Phone No. Z'a� g� a WATER HTR. 'z O � S� �d �Z 4a as t9 0 F N GAS ELEG Base 1st I 2nd _ 3rd — 4th •Future Connection Openings Connected with I Sewer � New .Fixture, Old Openings Cesspool E] PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE /T��OTAL��yy 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 $—L_ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................ TOTAL FEE $�� Dept. of Bldgs. Phone SII /V V0 Location- City ocation 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, brinn 19 Owner �-&& Kind of Building Used as To be completed about Estimated Cost, $ Old—New. Building Permit No G Permit No. ROUGH % - a6 - 4 y FINAL _Q0.42 2M 7-54 By /f s Business Phone No. Application for Power Plants and Heating, Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept, of Bldgs. Phone SU 4-7470 GRAVITY WARM AIR: RATE TOTAL LwSn / J d–/ Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ City of Fridley: Repairs &Alterations—up to $500.00 $ The undersigned hereby makes application for a permit for the work herein 5.00 specified, agreeing to do all work in strict accordance with the City Ordinances Repairs & Alterations each add. $500.00 ............... 2.50 $ and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. 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 $ Owner Kind of Building Used as STEAM or HOT WATER SYSTEM To be completed about �� / Y Furnace Shell & Lines—to 400 sq. ft. EDR Steam ..... 8.00 $ Estimated Cost, $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 8.00 $ Ol —New Building Permit No. �a Permit No. Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ DESCRIPTION OF WORK 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 Fixtures . ............... 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 FINAL HEATING or PO , R PLANTS—Ste Mtwat<Wwarm Air oTrade Name �-�4_ a / Size No _ l � Capacity Sq. Ft. E.D.R k/11 BTU H.P. Total Connected Load `��,- / Kind of Fuel i BURNER — Trade Name Size No Capacity Sq. It. E.D.R BTU H.P. (REMARKS-OVER) si RAY N. WELTER HEATING CO. Signed 4637 . By MINNEAPOLIS 7, MINNESOTA 4'+w42 2M Business Phone No , "�jc�, �� e' c City of Fridley Application for Plumbing and Comas ming Permit Dept. of Bldgs. Phone 360-3450 DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $2.00 $ Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ............................ N s`� Water Heater (Up to 99,000 BTU) ...... w ? �p • F • N WATER HTR. GAS ELEC. Base GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ...... ................... 1 x $2.00 $ 2.00 Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ install (1) grill gas 3.00 REPAIRS & ALTERATIONS—Refer to Code 1st 2nd 3rd 4th • Future Connection Openings e New Fixture, Old Openings I Connected with Sewer El Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $2.00 $ Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ............................ x $3.25 $ Water Heater (Up to 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg . ............ x $3.25 $ Electric Water Heater s $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ...... ................... 1 x $2.00 $ 2.00 Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ install (1) grill gas 3.00 REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ 5.00 Location 7410 Tempo Terrace City of Fridley: 53-84-5915.51 The undersigned hereby makes application for a permit for the work herei 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 fact and representations stated in this application are true and correct. Fridley, Minn JUy 15, 1970 , 19— Owner Robt. Devries Kind of Building Used as re s ide cne To be completed about sLyly 200 1970 Estimated Cost, $ gv ®vu Old New. Building Permi PArmit No. gne 01 By Business Phone ROUGH ep 9 FINA36,1—;IP�% 42 City, Fridley, Y i'n'n , . 11-4 9. e 6431 University Ave. N. E., Minneapolis, Minn. 55432 BU"ING PERMIT Date: .Tune_ 9, 1972 owner: B. A. Steeves Builder Same Address 7410 Tempo Terrace N.E. Address Same No. 7410 ____ _ Street _ Tem2o Terrace N. E Part of Lot Lot ._.. _ Block 3 _ _ .._.._..._._ Addition or Sub -Division - . Melody Manns A d d i, inn Corner Lot ___ Inside Lot — _ X Setback Sideyard Sewer Elevation__ _ Foundation Elevation _.__.._. t ; FOR IreTs..R To be Used as: S lab ______ Front ' Depth _ 301 Height Sq. Ft. Cu. Ft. Front . _ Depth Height Sq. FL Cu. Ft. Type of Construction Concrete Est. Cost _.$100, QQ To be Completed 6/9/72 No fee for permit for slab with frost footings for future garage addition. 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. .50 State Surge In consideration of the payment of a fee of $ NO FEE ,permit is he granted to Mr • S teeyes 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 ordinane is 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 add ordinances. Inspector CLARENCE BELISLE NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas beating, sewer or water. Be sure to as t�e Building Inspector for separate permits for these items. t APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: �' !Y ® „e,,, BUILDER: -5,e z �v ADDRESS: 7 9� 0 7—foy'4 D TfA ' ' gADDRESS : NO:. STREET: LOT: BLOCK: ADDITION: e � 0 V ,y 4 � CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn 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: CC) A � � Estimated Cost: $ r To Be Completed:7/? The undersigned hereby makes application for a permit for the work 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 true and correct. DATE :)—_ SIGNATURE: i Tel (See Reverse Side For Additional Information.) jy 0 i ` r ' A " 1 BUILDING PERMIT FEI SCHEDULE SECTION 2. The Inspector of Buildings 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 repairs 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: UNIFORM BUILDING CODE: Type 1, 2 & 4 - $2.15 for each one thousand cubic feet, or fraction thereof, in such cubical contents. Type 3 & 5 - $1.55 for each one thousand cubic feet. ADDITIONAL INFORMATION For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. In no case shall the fee charged for any permit as set forth in Section 2 be less than $5.00. VERIFICATION OF FOUNDATION NOTE: Permits for construction will be issued a minimum of 24 hours from the time of application, to allow for proper review of the proposed structure and of the construction site. A Certified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before proceeding with the framing. CERTIFICATE OF OCCUPANCY Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. a 711 1 f 1 4 I iia l! r l� 1 1 y r ,z 4 I 19 t � 1:' e d •� � h�' 1 2 �`i § adF Ps 3ra, XV � y ri I r r� If J d r' a t: y rl la II nlNttlR 11 N. 1 t s^. ri 1 I 7 yt(n a r I A. 1, I , , q �nP a17 p ill All, i�t 1ar 1, tit! Ji.�sJ'M ra11 SI t z n..r ?i`y fhYnf ,t�fv i` r I a _ ri I'P f t 1 I i i I4t 1r ,t , 7ta dI rl II dJ� 1p 1F y t h Pr 1 'iF (IS til '.1 t 1 �•1 i ; �IF i { it I 71, / 4 yfLI v fy to t rdZ S r 1 .I a�f fll feta I� �..- PJj � I O i4ultADINC$ a •,t r te{ r''yAggq: .ui��er thcS, �c%s^'�e�",;pflan� dr . luny Registered xuds�I6 An i aznesa �T '.LL rs Oa under,tfc� �� .mT^�'!n'�+i Y •�� J r I �. FF��p��pg�9pp��'ge� ®® �@@8g� NO r{tpRGIST +:f 4,0 41`�W 61Fe 9s� 1 I t I A r dIb r.; e 1 4• i.tt� 4 , I a; 11 , I SUBJECT P IT City of Fridleyo 19641 AT THE TOP OF THE TWINS BUILDING PERMIT -------- COMMUNITY DEVELOPMENT DIV. r � PROTECTIVE INSPECTION SEC. - � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 8/19/88 JOB ADDRESS 7410 Tempo Terrace N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 3 Melody Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Eric Vaughn 7410 Tempo Terrace N. E. 784-6733 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 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 B DESCRIBE WORK Reroof Dwelling (Tear Off and Replace) 28'. Squares) 9 CHANGE OF USE FROM TO STIPULATIONS On all new roofs or tear -offs and replacement state Code requires ro ofs, that 2 layers mopped`�tOgether, Of t 5 Ib' felt, be installed to a 24 inc Up frond, exterior wall line, hes or the use of other "'roved underlayment membrane. 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,400 $.70 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. $33.00 PLAN CHECK FEE TOTAL FEE . $33.70 SIATUREOFCONTRA TOR RAUTHORIZEDAGENT (DATEI WHEN PROPERLY (DATED THIS IS YOUR PERMIT Iva, Al SIGNATURE OWNER11F OdOCRBUILDER) IDATEI -- BLDG it OAT I NEW AMN ALTER Construction Address Legal Description:® City of Fridley R-1 AND R-2 Building Permit Application Effective 5/1/88 Owner Name & Address: 7 9/0 a 7eAet —Tel. ODntractor : _S e-1— xe- Tel. # 7V- d�'2?_Y Address: Attach to this application, a Certificate of Survey of the lots, with the proposoed construction drawn on it to scale. DESqMfblt=CIF IMPROVEMMT— LMMG AMe Length Height ag. Ft. GARAGE AREA: Length Widbi Height Sg. Ft. DECK AREA: length i Hgt/Ground S9- Ft. Tz CDrner Lot I I Inside Lot I I Ft. Y setback-_-* Side Yard Setbacks Type of Construction: d Ps all; Estimated Cost: Approx. Completion Date: 4; -4 Proposed Driveway Width If New Opening Is,Ddsired-f` Width + 61 DATE :ZZSTAPPLIGM: CITY USE ONLY Permit Fee 33, o o State Surcharge .170 SAC Charge Driveway Escrow Park Fee Sewer Main Charge TOTAL Alt. A Alt. B See Back Page Tel. Fee Schedule on Reverse Side $.50/$1,000 Valuation $550 per SAC Unit Alt. "An or Alt. OB" Above Fee Determined by Engineering Agreement Necessary I I Not Necessary ra SuBjECr P IT NO. City of Fridley C 5 AT THE TOP OF THE TWINS BUILDING PERMIT ;r • _ COMMUNITY DEVELOPMENT DIV L PROTECTIVE INSPECTION SEC. r ; ; CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By 612-571-3450 910-F15 5110/96 JOB ADDRESS 7410 TemDo-Ter—re NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR.1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Douglas Deluca 7410 Tempo Terrace NE 784-4061 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Twin City Exteriors Co 9060 Zachary Ln N 4108 Ma le Grove 55369 425-4737 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 2535 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION 0 ALTERATION REPAIR ❑ MOVE ❑ REMOVE x❑ 8 DESCRIBE WORK Reside House 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 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 @)r'QOQ ``II'' $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 PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $99.75 Fire SC $5.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEEOTAL FEE Lice e S 5.0 $112.25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI N P RLYA TED THIS IS YOUR PERMIT BLDG I SP rJATE SIGNATURE OF OWNER of OWNER BUILDER( (DATEI ra NEW [ ] Effective 3/1/96 ADDN [ J CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 A- 7, Building Permit Application _ a1 ConstructionAddress• ` rMl., Legal Description: Owner Name & Address: Dn,)6� t Tel. # Contractor: T Y MN LICENSE # Address: Attach to flgs ppliclation, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height' Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Comer Lot [ ] Inside Lot [ Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: Approx. Completion Date: (Cos,t on Back) Driveway Curb Cut Width Needed: DATE: APPLICANT:Tel. Ft + 6 Ft =. Ft x,,.$ _ $ #y�� CITY USE ONLY' Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $_:. ®® .001± of Permit Valuation (1/10th%) State Surcharges $ _ $.50/$1,000 Valuation SAC Charge $ $900 per SAC Unit ' License Surcharge $ <!5- $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: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER of FIXTI IRI=S Tr) RF INSTAI 1 Fn nm FAC_I-I m nnR Effective On May 10, 1999 Stones .# .Uri nal ;1,;::>> = Shower Wash Tray i<::>:::::. Floor Drain itii€N: :Washer Auto. ��- Gas ! '«rr> Water Heater Gas Elec Basement nt :.: Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader . Floor loo 1 _ Sump/Receiving Tank $ 7.00 7410 TEMPO TERRACE NORTHEAST Treating Appliance $10.00 FRIDWater Owne (763) 7 6 35 55432 (763)786-6351 Water Heater -Electric Floor 2 Water Heater - Gas" �_ $10.00 Building Used As Gas Range' Gas Dryer" $10.00 TV F r3 foo Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes () No Type - PLUMBING COMPANY IJQ Reinspection Fee $47.00/Hr Floo r4 SIGNED BY EL N0.0.2 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough -in Date Final Date State Surcharge $ .50 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS S �LWJJ New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 WITHROW, SHELDON Z 0 Sump/Receiving Tank $ 7.00 7410 TEMPO TERRACE NORTHEAST Treating Appliance $10.00 FRIDWater Owne (763) 7 6 35 55432 (763)786-6351 Water Heater -Electric $ 7.00 Water Heater - Gas" �_ $10.00 Building Used As Gas Range' Gas Dryer" $10.00 TV $10.00 Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMPANY IJQ Reinspection Fee $47.00/Hr SIGNED BY EL N0.0.2 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough -in Date Final Date State Surcharge $ .50 TOTAL FEE $20-50 MINIMUM ANY PLUMBINGIGAS PERMIT IS $20.00 PLUS THE $_5_TE SURCHARGE "COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ INCHES. :ITY OF FRIDLEY INSPECTION DIVISION 431 University Ave NE ridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 763) 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES V RATE SCHEDULE !esidential Furnace Shell and Duct Work, Burner Also Replacement Furnace (Side Vent:- Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer Rate TOTAL $ 30.00 $ $ 10.00 $ $ 10.00 $ 10.00 'Air Conditioning • All Sizes ({� $ 25.00 All Others/Repairs & Alterations (LIST ON BACK) 1% ofValue "of Appliance or Work ommerclal/industrial 1.25% of Value of Appliance or Work State Surcharge TOTAL FEE IINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION EFRIGERATION/AIR CONDITIONING PERMIT IS $25,00 LUS THE $.50 STATE SURCHARGE EINSPECTION FEE $47.00/Hr air Conditioners can not be placed in a side yard without ritten permission from adjoining property owner. W JOB A Effective On January 1, 2002 MUZAJOHIN BUILDING USED AS k6&i'd.96,h'A�L ESTIMATED COST ��a PERMIT NO.. 12ESCRIP119N OF FURN&GE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size'No. BTU HP EDR <: Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR• 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 an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE 0 COHEATING t` 4, WA is/ Signed 64MVA'NO i Approved Date TEL # °�� '® o&- Final. Dat G v� ILi nwr nr-ni,e.nr-rkir•wrr r a imheA^r THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED CO16 MODY `SIAL 'F _MB AND CI MB ISMM AIR MERIEIGATION When replacine an pxistino ,ran w, the undersigned hereby_verifiees that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported :and flrestopped where required. Yes( No { ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes( ) No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. - - -Yes( ) No( ) The exist! g comeugfinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to install a new camblistionAirft will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When Installinga new Mon ing„rvataln, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( ) No ( ) Appliance IWIM and AIZ _/ .®mmnn Vent and Vent Gnnngdar Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: Signed By. Date: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: (763)571-1287 ADDRESS 7410 TEMPO TER NE PIN 113024240021 LEGAL DESC MELODY MANOR WATER TREATMENT APPLIANCE LOT 1 BLOCK 3 PERMIT TYPE PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION q3 PERMIT NO.: 2004-00027 DATE ISSUED: 01/09/2004 VALUATION NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A INSTALL A WATER SOFTENER # ELEC WATER HEATERS # NEW FIXTURES (EXIST OPENINGS) # GAS DRYERS # OF NEW FIXTURES APPLICANT SHILOAH WATER CO 7319 166 AVE NW RAMSEY, MN 55303- (763) 753-9244 OWNER DELUCA DOUGLAS J & CHRISTINE J 7410 TEMPO TER NE FRIDLEY, MN 55432 0 VALUE OF FIXTURE/APPLIANCE 0 0 # GAS WATER HEATERS 0 0 # GAS RANGES 0 0 # WATER TRMT APPLIANCES 1 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Bldg Insp PLBG PERMIT MINIMUM FEE 20.00 PLBG FIXTURES (NEW OPENINGS) 0.00 PLBG FIXTURES (EXIST OPENINGS) 0.00 WATER TREATMENT APPLIANCE 0.00 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 0.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 PLBG REPAIWALTERATIONS 0.00 STATE SURCHARGE, PLBG FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 9630 SEPARATE PERMITS FPQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 Stories Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range" Effective On Jan 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR = Wash �3r:��:tk<<::;:;: Floor at�l�::>;::: Auto.ji*!..G-.O$.**..*..'..iiiiiiiiiiiiii!IGas I Ur nal 'ttt;> Shower }:: �i�..... Tray ............ Y ..::tt�t...�:::. Drain �i'> Wash ti<� Ran, NO. RATE TOTAL Gas Dryer** Back Flow Preventer Required ( )Yes () No Type, $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge .50 ��4A�� TOTAL FEE Ll JOB ADDRESS 7Yo s Pnejn,� Water Heater Gas I Elec The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. /_ P , Way Owner - G A e C Ly o)-fPs Building Used As[2PS Estimated Cost c3m) �� PERMIT NO. 40� ' PLUMBING COMPANY c SIGNED BY TEL NO. Approved Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00 PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED MMMON VENT, VFNT r.QNNFCTQR AND CQUIRMSTIM AIR V RIFICATM When reIn aninp an _xisting furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The exit ing cnmhistinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new cmmhustinn air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When inc alling_a np-w yanting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: Signed By: Date : CV- (r'64�t� v CITY OF FRIDLEY BUILDING INSPECTION 9 3431 University Ave NE i 9=ridley, MN 55432 L 763-5723604 FAX 763-571-1287 Effective 4/9./2004 APPLICATION FOR POKIER PLANTS AND HEATING, COOLiNG, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES 9 D n RATE SCHEDULE Fee Tota Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace $35.00 $ 3S,w Gas Piping (New Furnace, Fireplace, Insert) $10.00 $, Gas Range $10.00 $ Gas Dryer $10.00 $ *Air Conditioning -All Sizes $25.00 $ All Other Repairs or Alterations (Ust on Back) >- 1% of Value of Appliance or Work $ A Minimum Fee $15.00 for Residential or 5% of cost of Y .Improvement whichever is greater on work less than $300.00 L � Commercialjlndustrial/Institutional > 1.25% of Value of Appliance or Work (List on Back) $ i Minimum Fee $35.00 for Commercial/tndustriai/institutional Y State Surcharge .50 i TOTAL FEE $ 3s" v REINSPECTION FEE $50.00/HOUR IT *Air Conditioners can not be placed in side yard without written approval N from adjoining property owner - copy to City N FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE EL cc JOB ADDRESS y d r� I �e rrcu~ Ivy Owner Q�li"raT Building Used As _Re5 cCA-e0c, ESTIMATED COST ADO OC PERMIT NO DESCRIPTION OF FURNACE AND BURNER # of Heating Units 1 Circle One (Steam) (Hot Water) .ti rm Air Trade Name �R i) 0 l U G PM 0'7 Size No. BTU --1510 C)C:) HP EDR Fuel c --- Total Connected Load Burner Trade Name BTU Size No. HP EDR The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application Rra to ip a►id correct. CENTERPOINT ENERGY BEATING CO 13562 CENTRAL AVE NE BLAINE, MN 55304 Signed Tel # 763-757-6202 FAX 0'763-757-6701 Date Approved by Rough -in Date Final Date Z0'd luloi FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verrfies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes (3� No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( No( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes (30 No ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes No( ) When installinq a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA -LAMA Category I Central Furnace Yes No( ) Venting Tables for fan assisted and natural draft appliances. Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes, Yes (�) No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type mesL BTU Input r(154CC) Fan Assisted or Nat Appliance #2 Type WGA hecAy BTU Input 40,ceD Fan Assisted or Nat -1 t Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances ��. Total Btu Input \\S,cgO Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height G ft Length G ft Diameter 4" in Type Appliance #2 Vent Connector Height =ft Length =ft .Diameter 4 n Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) CENTERPQINT ENERGY HEATING CO:13562 CENTRAL AVE NE BLAINE, MN 55304 Signed By: Date: p 1 6 ?A/?A' A. IpIJA1SL 01 A. iia 1 dd An Alm woN-i (7: T T b00Z-L2-8db FROM :City of Fridley FAX NO. :7635711287 Jul. 25 2006 01:33PM P2g ;-%A, - Build' 9' BUILDING PermI` l it No.° ��0 ' Inspections RESIDENTIAL APPLICATI®N Received By: 763-572-3604 CITY OF F'RIDLEY Date Rec'd.: �z�-�� DATE — Lit YOUR E-MAIL ADDRESS -T�e IAJ - SITE ADDRESS :2 41 C) _1 vv' ® y- V-"- Fire Surcharge THIS APPLICANT IS: ❑ OWNER NTRACTOR 'cls .001 times the total job valuation PROPERTY OWNER/ NAME: 1, +1 .0005 x Permit Valuation Minimum $.50 License Surcharge TENANT ADDRI?SS; l t; e �► e gCITY FYA tl e �P. STATE P 5el j� $1550 per SAC Unit (Plans to MWCC for determination) PHONE: $ ft + 6 ft - ft x $21 = $ CONTRACTOR NAME: o n —40M10 r 0-J m y F-VJ- STATE LICENSE N X31 y �- EXP DATE " 31 — "� 60-7 s e� C" V0 STAT4- t� se"'! SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 5i' CITY5 / WITH APPLICATION PHONE ®— a _ �, 4 61 FAX PROPERTY TYPE GLE FAMILYAMW CONSTRUCTION SIZE TWO FAMILYINEW CONSTRUCTION $TORIES PERMIT TYPE O ADDITION O GARAOFISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ DRAIN TILE O DL -CIC .,*ROOF ❑ SIDING ❑ OTHER [3 SWIMMING POOL TYPE OF WORK,: 0 NEW ❑ DIT1oN ❑ MAR-rMANCE/RLPAIR ODRLTNG DESCRIBE WORK BEING DONE: — (' UD SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Ob S . Ft, ROO]MiG NUMBER OF SQUARES ��__ USE ONLY [I HOUSE 10USE & GARAGE HAS � EMODELING SURM[[� _ GARAGES .brATTACHEDGARAGE 1, FloorPlin Proposed PROPOSED SIZE; ❑ DETACHED GARAGE 3. List of Mudurallmembers to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, 1] vinyl ❑ Aluminum elSaffit ❑ Trim ADDITDNS, 1. & PORCHES SUBMIL' Sift Plnn/Survey showing the existing structures p Oar 17 Fascia 2, and proposed projeol. Two scts of construction plans WINDOWS 3, Energy Calculations IN EXISTING OPENINGS ❑Yes [No LOCATION OF WINDOWS OR FOR NEW OPENrNGS•DESCRIBE UZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING= THE COST OF LAtsUK AINiu MA x rwm'- -3; (USING THE 1997 .. C FEE SCHEDULE) TOTAL JOB VALUATION $ � `'OCCUPANCY TYPE Permit Fee $ 2=. � See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge 'cls .001 times the total job valuation Surcharge 1, +1 .0005 x Permit Valuation Minimum $.50 License Surcharge _$ $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 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 Dae $ �.(®�_ _ Make checks payable to: City of Fridley Attacl 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 applicati for a permit d 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 ch req i s r view and approval of plans. �,� `rd� SIGNATURE OF APPLICANT PRINT NAME �IC �/Tvi t DATE P �% Received Time Jul, 25. 2:23PM Building Inspections 7.63-572-3604 DATE I � SITE ADDRESS THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS 0 OWNER COMPANY NAME:_ CONTACT PERSON: STATE LICEN 9 #_ MMMUCAW FAMILY 0 TWO FAMILY 0 NEW 0 REPLACEMENT WORK CITY Permit No.: Received By: D '( W ATE ZIP 0 TOWNHOUSE 0 ALTERATION/REMODEL PER MS 16B.665 thepermit 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) MODEL: SIZE/BTU Equipment Installed MFG: SIZE/BTU MFG: MODEL: SIZE/BTU MODEL: A/C $25.00_FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 _AIR TO AIR EXCHANGEER $IS _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _BOILER $35.00 _FURNACE $35.00 _GAS UNIT HTR $10.00 _CHIMNEY LINER $10.00 _GAS DRYER $10.00 _VENTILATOR $15.00 POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 � nc..u...nn .c. sssx4,sir•."+riihiiw�,ti�ly3t�'i.+t2snx^�^C�.aa''�'1��"� 'Y.�++.'�±` i�,�`. - .. .r"CY�d6-AiY.,l�l�.'/d.r1C,^`9 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 __L_ x $15.00 = $— TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ 50 Total = $ THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an appl'cation for a permi7es work is not to start without a permit; that the work will be in accordance with the. approved plan in the case. �ftu work which rec�u review and approval of plans. SIGNATURE OF APPLICANT r—PA City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 A Building 'BUILDING Permit NoA �I Inspections RESIDENTIAL APPLICATION Received ByA 763-572-3604 CITY OF FRIDLEY DatdQCT 0 7120) 763-502-4977 FAX $ $5.00 (State Licensed Residential Contractors) EFFECTIVE 8-19-09 $2000 per SAC Unit (Plans to MWCC for determination) DATE 6 0(-r ®q YOUR E-MAIL ADDRESS S L 0,0 Lv GS G MA I L, &O M SITE ADDRESS 79 10 _ ew„oe To-, N r_ - $ THIS APPLICANT IS: [9 OWNER ❑CONTRACTOR Agreement necessary ( ) Non Necessary ( ) PROPERTY OWNER/ NAME: S k a I k t� i QWe- S ADDRESS: _71-1 10' Te,"to 0 Ter � CITY Cr, c) I � v STATE M IV ZIP TENANT PHONE:4f 2 961/ 1601iS C-02 s9q 2y�sy CONTRACTOR NAME: Ho"e- Owvie.e' SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE MrSINGLE FAMILY/NEW CONSTRUCTION SIZE J U `1(. ❑ TWO FAMILY/NEW CONSTRUCTION STORIES_ PERMIT TYPE ❑ ADDITION 91 49A HED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ® ADDITION --:>- SkeJ ❑ MAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: �� (�jca iLav� S k - SIZE OF IMPROVEMENT LENGTH 14 WIDTH to HEIGHT 9 S FT `L10 ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES I 13 HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE:®° ! 14 ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: 9 SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS & PORCHES SUBMIT: ® Aluminum ❑Trim 1. Site Plan/Survey showing the existing structures IN Other i- I t 1 13 Fascia and proposed project. 2. Two sets of construction plans WINDOWS 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 eve'' 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 Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due ¢J C V>o I OCCUPANCY TYPE $E 14 See Back Page for Fee Schedule $�� 65% of Building Permit Fee $ d , SV .001 times the total job valuation $ 76 .0005 x Permit Valuation Minimum $.50 $ $5.00 (State Licensed Residential Contractors) $ $2000 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$22=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $l Make checks payable to: City of Fridley 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 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 wprk w_4ich mires re wand approval of plans. SIGNATURE OF APPLICANT NAME cJ ly 1�a <, DATE _ UL1 - Q9 Building BUILDING Permit No::Q i— QI Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Da d®CT 0 763-502-4977 FAX $ i , GG .001 times the total job valuation EFFECTIVE 8-19-09 $ e 76 DATE—6 CJC.`i— ®q YOUR E-MAIL ADDRESS S L QB LV GS e &OAM L , &OM SITE ADDRESS 7 Ll 10 Tew„o® 7a r NE SAC Charge THIS APPLICANT IS: IK OWNER ❑CONTRACTOR Curb Cut Escrow PROPERTY OWNER/ NAME: S k,I k , Roes Erosion Control TENANT ADDRESS: -N i C3 Te.vwya o 70-r j CITY Fr'.'J 1 Q -Y STATE 04 IV ZIP G aq 3 a. $ PHONE: (3. 969 150 G t Z 55 Z 4 fty Sewer Main Charge CONTRACTOR NAME: Nn+Me. owple - Total Due SUBMIT A COPY OF Make checks payable to: City of Fridley Attach Stipulations YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE EiSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES_ PERMIT TYPE ❑ ADDITION 181 HED ❑ WINDOWS El BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ® ADDITION —* SkeJ ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: Tool/ 6,fO a..rn S k-8 SIZE OF IMPROVEMENT LENGTH 14 WIDTH to HEIGHT 9 S FT Igo ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY 13 HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES t® 14 ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: -Qi PROPOSED HEIGHT: 9 ❑ DETACHED GARAGE 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl []Soffit ADDITIONS. &.PORCHES SUBMIT: N Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures 91 Other. i - l I 1 ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 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 V%v,^J NUMBER OF WINDOWS i ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 15CY3,"`y ISCCUPANCY TYPE Permit Fee $ S 44 See Back Page for Fee Schedule Plan Review $ o_ 65% of Building Permit Fee Fire Surcharge $ i , GG .001 times the total job valuation Surcharge $ e 76 .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 $ 1 Make checks payable to: City of Fridley Attach Stipulations e 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,,vprk wich rqVires re*w and approval of plans. SIGNATURE OF APPLICANT NAME S11eikV rWCaS DATE L- 0L'I' - G'J N0113,1401MI WMIA NI Hoi Q '.40 31"'01M CJNV sr V-)-Oq �Ivws tcrj I Iq \A^10.9 V . , �Eso�a�3s I ;��10110-3dSI41 IVNIIJ GNV swi ddb w� �P4 V 801 311S qor, 3HI NO 312-V AV TiVHS ),dOD 00r' - ---ft ob r-4 I tol r"��dW c �% r4vb -101 V), -k2-6 \)e 1AW - -2 \A �,)5 , t 0 57' I\ 1 ->-1 5 n ILA 0 57' I\ 1 ->-1 5 n e - e r'� j ley=ii.".Ta$r}?,� 4CALC- I INCH— FEET E�3 �t/S"iy c� r9 i9 f•w.s mNY� �, s!t �y �"w�J„.'r�PSu.T: SeI �•dV �L'•^a: :'1 `1� i�c�a �'"+8:i..i``J'iP rl�aj�L�'.•, CroB�r•i=i1yL �iH��i.ii Bernard A,5teeVos OF . PROPER -IN OF Temp_ i��azaz>>3sp?� 71�jo o Terrace2 b rldloyp asvtoFa ____ c 1oc k 3, i= ol6dy Nanor. k c auaa't y___ 0x2 qts,=> Am FOLLOWS kit. XN - FZ_7�ze� Z 1 1 OD " .. . is C M �` L 1 C TL2i+` LOCATION E� BUILDING CERTIFICATE ti / I lzereb crtif I herFhy certify t?z �� on 1 _ 1, Y ti,ia stt:rey, pian, or report was prepared by me dr under this $aarvcl, y that on �0 p'•an, or relaor$ was pze:pared by nie t>it >r 4a=:z3 (; Try rti.rcc6 sul� .�vi:'ic�K acid that i titan a duly Registered Land my direct supervision and that I ani d duly Rik, z Ft>L�d Surveyor under theoaf' tile, Mate tai S4tintar>��u I Surva>y. i Under Y tile laws ai - Vie State cz Cj1in►iEsota. .laws r �.w.:—T^ e�—.N^•....�.. r _ .. r..s w w • TS f+.P� P.�.•t.: o�t+m r. • a....w_. � .... ... ..__..... _ Building AND MATERIALS: BUILDING Permit NO.: I (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ Q b tb v OCCUPANCY TYPE �rmit Fee s Inspections See Back Page for Fee Schedule RESIDENTIAL APPLICATION Received By' 763-572-3604 65% of Building Permit Fee CITY OF FRIDLEY reway 1 71 5(/q / I o E-MAIL (.0005) times the total job valuation — Minimum $.50 NATE YOUR ADDAR`ESS SITE ADDRESS -7410 Tt M p o 7-e r e n u / Y $ --FUS APPLICANT IS: ❑ OWNER CICONTRACTOR .icense Surcharge PROPERTY OWNER/ NAME: 'Z o k J o h n `a v �l $5.00 (State Licensed Residential Contractors) ADDRESS: -7 4 0 -rfM pa To r CITY . r -N d I t v STATE ZIP TENANT $1450 per SAC Unit (Plans to MWCC for determination) PHONE: 1,191 '5q R - pq �g! $ CONTRACTOR NAME:_ I'HD At- Home Services, Inc. Jodi ep EM c t Jon < s $ STATE LIC 2690 Cumberland Pkwy, Ste 300 4 g sa 12 gs . (, o t4,7 SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS Cumberland Office Park CITY STATE ZIP WITH APPLICATION i PHONE Atlanta, GA 30339-3913 ❑ SINGLE Lic# 20268257 Ph. 763/542-8826 rE PROPERTY TYPE Agreement necessary ( ) Non Necessary ( ) ❑ TWO FA - .'ORIES PERMIT TYPE QADDITION ❑ GARAGE/SHED WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ANCE/REPAIR ❑ REMODELING )ESCRIBE WORK BEING DONE: i (�t/1 Pf•Ow /�! A� ft G tl1� /ij l x/ S �/ /14 0 D l i i1 Ci 'IZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. >_OOFING ❑ HOUSE ONLY vVMBER OF SQUARES 0 HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan 'ROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used 'ROPOSED HEIGHT: +LDING FOR NEW CONSTRUCTION INCLUDING DECKS, Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: -1 Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures Other ❑ Fascia and proposed project. -II�DOwS 2. Two sets of construction plans ' EXISTING OPENINGS [Wes ❑No LOCATIQN OF WIND—OWS 3. Energy Calculations '.: FOR NEW OPENINGS -DESCRIBE SIZE OF L t V J A Q K o o M PENING CHANGES & Co+.ntrnF�P�►lide/ i'PE OF WINDOW TO BE INSTALLED On. ER 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 $ Q b tb v OCCUPANCY TYPE �rmit Fee $ G 1,2 S See Back Page for Fee Schedule 'Ian Review $ 65% of Building Permit Fee ',urcharge $ ® bu (.0005) times the total job valuation — Minimum $.50 re Surcharge $ .2, Do .001 x Permit Valuation (1/10%) .icense Surcharge $ 5 .av $5.00 (State Licensed Residential Contractors) AC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) ,urb Cut Escrow $ ft + 6 ft= ft x $20 = $ .rosion Control $ $450 Conservation Plan Review 'ark Fee $ Fee Determined by Engineering ewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Iotal Due $ -77 2< Make checks vavable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in nnformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a �rmit but only an application for a permit and wo not to start without a permit; that the work will be in accordance with the approved Ian in the case of all work which requires eview pproval of plans. -f �( / r y bo GNATURE OF APPLICANT N"__ PRINT NAME ! t Mi S C / 1 �1 DATE l