PRE 2010 DOCSCity of Fridley
Application for Plumbing and Gas Fitting P
Dept. of Bldgs. Pho 4A!
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
y
Number Fixtures ......................
x
$1.50
$
Future Fixture Opening ................
x
1.20
$
New Fixture Old Opening ..............
x
1.00
UN'
Catch Basin ..... ......... ...........
N
WATER HTR.
GAS
ELE
ELEC.
x
2.00
$ 52 —
New Ground Run Old Bldg . ............
x
3.25
$
GAS FITTING FEES:
NO.
RATE TOTAL
1st 3 Fixtures ..........................
x
$1.50
$ 5
�0
x
.50
$
Gas Range to 200,000 BTU ..............
x
2.00
$
Base
1st
gg
2nd
3rd
4th
° Future Connection Openings
Connected with
e New Fixture, Old Openings I
Sewer E]
Cesspool E]
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
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
$ 52 —
New Ground Run Old Bldg . ............
x
3.25
$
GAS FITTING FEES:
NO.
RATE TOTAL
1st 3 Fixtures ..........................
x
$1.50
$ 5
Additional Fixtures ....................
x
.50
$
Gas Range to 200,000 BTU ..............
x
2.00
$
REPAIRS & ALTERATIONS—Refer to Code
Description ................................................$
TOTAL FEE o
City of Fridley:
1
,
W
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 feel
and representations stated in this applicatioom are true and correct.
.--1 Fridley, Minn hig
19
Owner
s
To be completed about
Estimated Cost, $
Oldl9killding Permit
ROUGH—
FINAL
d2
By
Business Phone
M
M
City ®f Fridley,
BURDING PEPMT NA 6915
Date:
Owner: Builder
Address Address
L IO B I DI G
No. 7 Street, Part Lot
Lot --__ Block Addition or Sub -Division
Corner Lot _ Inside Lot h—Setback —t _ ldeyard
Sewer Elevation -- Foundation Elevation
DESCRIPTION OF BUILDING
To Used
Front Depth �' Height Sq. Ft Cu. Ft.Front Depth eightSq. Ft. Cu. Ft.
Type of Construction � Est. Cost %X _.�.— I o 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 f9rthAmi,,d in mpliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of o , permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota reg location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and permit may be revoked at any ft upon on of any of the provisions of said
ordinances. �'
NOTICE:
'Ibis permit don not cover the com *mcdon, homiliaion for wiring, plumbing, gn heating, wwor or water. Be sure to as
the Building Inspector for separate permhs for these hems.
APPLICATION FOR.BUILDING PERMIT
CITY`OF FRIDLEY, MINNESOTA
OWNER'S NAM9 BUILDER t�/
ADDRESS
LOCATION OF BUILDING
-` i
art of Lot
No. Street
i
Lot Block Addition or Subdivision
Corner . Lot Inside Lot Setback Side -Yard .r
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed build-
ing location drawn on these Certificates.
To be used as:
DESCRIPTION OF BUILDING
Front Depth G.P Or� Height old s
Sq. Ft. Cu. Ft.
Front Depth Height,
Sq. Ft. Cu. Ft.
Type of Construction �� Estimated Cost
To be Completed
The undersigned hereby makes application fora 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_ --/-.q
(Schedule of Fee Costs can be found on the Reverse Side).
U
BUILDING PERMIT FEE SCHEDULE
Section 2. The Inspector of Buildings shall, before issuing any permit for
the erection of any building or structure, or for any addition to any exist-
ing building or structure, or for any alterations or repairs to any existing
building or structure, upon application therefor, 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;
2.1. For any such permit for the erection of any fire -proof building, other
than a garages warehouse, factory or grain elevator, or for the erection of
any fire -proof addition, for similar occupancy, to any existing building
shall be at the rate of $1.40 for each one thousand cubic feet, or fraction
thereof, in such cubical contents.
2.2. For any such permit for the erection of any fire -proof garage, warehouse,
factory or grain elevator, or for the erection of any fire -proof addition,
for similar occupancy, to any existing building shall be at the rate of $1.25
for each one thousand cubic feet, classified as "fireproof" by Section 502 of
the Minneapolis Building Code,
MOUSES
2.3. For any such permit for the erection of any non -fireproof building other
than a garage, warehouse, factory or grain elevator, or any rion-fireproof
addition, for similar occupancy, to any existing building - permit $1.00 for
each one thousand cubic feet.
GARAGES
2.4. For any such permit for.the erection of any non -fireproof garage,
warehouse, factory or grain elevator, or for the erection of any non -fireproof
addition, far similar occupancy, to any existing building or for each such
t,uj_lding or addition- ninety cents ($0.90) for each one thousand cubic feet
or fraction thereof, in the cubical contents thereof with a minimum of $4.00..
For the purpose of computing fees for building permits, the cubical contents
of any building or addition to a uniform height throughout by multiplying the
ground area covered from a point six (6) inches below the floor line of the
basement or cellar to the average height of the upper surface or to the
average height of the roof surface of the main gable of a pitched roof.
2.5. 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.
2.6. In no case shall the fee chargad for any permit as set forth in
Section 2 be less than $4.00.
s , .
Application for Power Plants and Healing. Cooling. Ventilation. Refrigeration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL e �
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
NO RATE TOTAL
1st 3 Fixtures ......................
Furnace Shell & Lines—to 400 sq. ft. EDR Steam .. ..
8.00
$
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ...
8.00
$
Each add. 200 sq. ft. EDR Steam ......................
2.50
$
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
s V V
GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ �__ I
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
1
VENTILATING SYSTEM
$
ALTERATIONS & REPAIRS
TOTAL FEE
$
ROUGH
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.
Owner
i Fridley Agm :� 19
Kind of
Used as
To be completed about
Estimated Cost, $
Old ew. Building Permit No. Permit No. c�
DESCRIPTION OF WORK
HEATING or POWER team, Hot Water6 No
Trade Names- Size No
Capacity d Sq. Ft. E.D.R BTU H.P.
Total Connected Loa �✓� ,�— Kind of Fuel
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS—OVER)
a
Signe
UB AN [
Bye CENTER D _IVE M
� 42 '1M Busin
, N11NNESOTA �.
HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN.
Weatherstrips A.S.H.V.E. Construction No. Insulation
Guide
dowsoors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied
N) No I a No
I F1.1 / I/ Room I Lenath aL.* 'Width Heistht P'' II 7 Fl.I Room I Lenath X V1 Width /g / HeightF
Windows and Doors—Crackage and Area
Width Height
No. of pane of Dane
No. of Lineal ft. Area
lights of crack sq. ft.
Coef. Btu
Infiltration
Glass
za-
Exp. wall
Net exp. wall
Int. wall
Coef.1 Btu
Infiltration
Floor
13
Glass
Exp. wall
Net exp. wall
p
Int. wall
Ceiling
-
d
Floor
1 otal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
'Fl.I _ oom ( Lengthq.0ee Width
Windows and Doors—Crackage and Area
Wtdth Height No. of Lineal ft. Area
No. of pane of pane light' c ack sc"t.
/a6Jz.
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
Floor
. Total Btu.
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of Dane of pane tights of crack sq. ft.
(
Coef. Btu
Infiltration
Glass
za-
Exp. wall
Net exp. wall
Int. wall
Za.
Ceiling all,%Q
Floor
js
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Height / Fl.l � Room I Length Width Heisrht
Coef.l Btu
) 1+
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I r
/ r 1.1 — RMm I t .Pnoth /9 ® W AA filj -- r-i.;A& fl -
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Ares
No.. of pane of Dane lights of crack 1 sq. ft.
(
Coef.1 Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
js
'naor
Tbtal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of pane lights of crack eq. ft.
rG2�1 /0,/1
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wall
Ceiling
js
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
f F1.1 ✓ Ranm I Lenath l e Width -V `Heistht ir—Y
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of pane of panne lights of crack sq. ft.
rG2�1 /0,/1
Coef. Btu
Infiltration
23;�!
Glass
b
Exp. wall
Net exp. wall
Int. wall
Ceiling Ara-
Floor
z6—
Total Btu.
Required sq. ft. E.D.R. or so. ins. W.A. Leader area
City of Fridley, Minn.
BUILDING PERMIT
Date: October 17, 1967
Owner: James A. Cover Builder
Same
Address 6348 Starl,ite Address Same
�i'I'KS
9,508
LOCATION OF BUILDING
No. 6348 Street __._ Starlite Blvd. Part of Lot
Lot ._ 5 _ Block 4 Addition or Sub.Division — Sylvan Hills, Plat 3
Corner Lot . Inside Lot _.__ X Setback 35 Sideyard — 31
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Garabe Front 22 ' Depth 221 Height 10' Sq. Ft. 484 Cu. pt 4840
Addition Front 121 Depth 14' Height 12' sq. Ft. 168 Cu. Ft 2016
Type of Construction _ li ramp Est. Cost _ $3000 To be Completed
In consideration of the issuance to me of a permit to construct the building described above I agree to do
the proposed work in accordance with the description above set forth and in comynce it all provisions of
ordinances of the city of Fridley. /�
In consideration of the payment of a fee of $ 10.00 , permit is hereby granted to James Cover
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work.
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
M_ L M F0.164 -ft
.
NOTICE:
This permit doe not cover the construction, Installation for wiftg, Plumbing, gas hosting, sewer or water. Be sore to see
the Building Inspector for separate permits for then hum
Ci -i
OWNER'S 2yAi;is �.� %ya- o F;Z
ADDRESS .� _aS � �: ALy ATS IZE, S
LOCATION OF BUILDTNcl
LOC BLOCK ADDI'.i.'TON OR SUBDIMSION vz L)'I u F6713
CORNER LOT INSIDE LUT SETBACK SIDE -YARD
SEWER ELEVATION
FOUTDIDAT f Oiv
FL,EVAT1011
Applicant attach to this
form Two Certificates of'Survey
of Lot and proposed
building location draiTri on these Certificates.
DESCRIPTION OF
BUILDING
To Be Used Ag:
'�
Front
Depth
Height
Sq. Ft.
Cu. Ft.
l.. 1
Front
Depth
Height
Sq. Ft. -
Cu. Ft._
Type of Construction '
-71 _
Estimated Cost
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 rulings of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
DATE /;. 16 //(0 -7 SIGNATURE��
(Schedule of Fee Costs can be found on the ieverse Side).
�a .3G6,43
1�o of
/9
Original
PERMIT for Power Rants and Heating,o
C of-
ing. ventilation. Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No. of Heating Plants [�-t-1) c t, to b instal altered—repaired
_ ��
Make ' ,size �6 ;
Oil fired_; Coal fired-, Gas fired ; Gas Authorization
/;No -
Remarks � �� t�C -) � /L6,C�.�� l `.�
Approved
Final Inspection Date , 19_
Inspector
#_�5-eI67
Pest N° 4656
Fee $ 2-60
Office of the Inspector of Buildings
City of Fridley
City of Fridley, Minn. JW W / 5 , 19 '26
Owner 4e /f),4.1U 6 L to, 4 Q_ Qo Ere
Location 6:j"4 e 4 LA/3
Kind of Building Fk0jq aM) _
How Occupied A til E,Lx-1 rU C,,
Work to be Commenced—, 19—
To be Completed �i�1 � LCi4
Estimated Cost, $ 606. 6 Ll
(New, Building Permit No.
Permission is hereby granted to to install—erect—use the material and devices described in the
above statement. This permit is granted upon VF express condition that t74 person to whom it is granted, and his agents, employees and workmen, in all the work
done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley
relating to or governing the work to be done and the operation of the devices herein named, and to the speciftcatipo set forth in the approved application for this
permit on file in the office of the Inspector of Buildings. ��/✓� � ��
Inspector of Buildings
.01�42 2M11 -67V
Appleafta for Power Fkaft and HeathM CoWing. Vendladon. a
Air Conditioning Systemns and Devices
PARTIAL RATE SCHEDULE
GRAVTff WARM AIR:
MTN TATA_
Furnace Shell & Duct Work ..........:.................
$10.00 $
Replacement of Furnace .............................
6.00 $
Repairs & Alterations—up to $500.00 ..................
6.00 $
Repairs & Alterations each add. $500.00 ...............
3.00 $
MECIL WARM AIR
Furnace Shell & Duct Work to 120,000 BTU
............$10.00 $
each add. 60,000 BTU .......................
3.00 $
Replacement of Furnace ............................
6.00 $
Repairs & Alterations—up to $500.00 .............
`... 6.00 $
Repairs & Alterations each add. $500.00 ..............
3.00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam . $10.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 10.00 $
Each add. 200 sq. ft. EDR Steam ........ ....... :...... 3.00 ' $
Each add. 320 sq. ft. IDR 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 189,000 BTI) ..... .:................. 800 $
over 199,000 BTU SeeFee Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures u$ 100 $
Additional Fixtures ................. x .78 $
Gas Range to 199,000 ............. -� ` xffi `800 $
AJM
CONDitONIIiG`"/
PAN HEATING SYSTEM See Fee Schedule
ATING SYSTEM $
ALTERATIONS & REPAIRS TOTAL FEE
Dept. of Bldgs. Phan® 560-3480
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 Ordinanm
and ruling of the Department of Buildings, anereby declares that all the facts
and representations stated in this application rue and correct.
Fridley,
r
Kind of Building
Used as A
To be completed about
Estimated Cost,
ME
Building Permit No. Permit No. A14 -s-
DESCRIPTION OF WORK
HEATING or PLANTS—Steam Hot Water, Warm Air—Nom
Trade Names Cz1'-.A Size No
Capacity ®C ® .R- Ide d CAW BTUeB 2r ® :
Total Connected
Kind of Fuer
BURNER — Trade Namp Size No
Capacity Sq. Ft. E.D R BT EI H.F.
(REMARKS-ovetl
7"
City of Fridley
Applicalfon for PhwA&g and
Dept. of Bldg@. Phone SM -3490
DESCRIPTION OF WORN
Number, Kind and Locatlon of Fbftres
1 I
TER NTR
I$ I' I O I F 1 111 S I U I< I t�9 f I� 1 C79 Ell
:1
N I GASC.
■AMEN I
Sewer
Cesspool
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 ..............
: $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
1st 3 Fixtures x $2.00 $
Additional Fixtures .................. x -$ .75 $
Gas Range to 199,000 BTU ....... •.. , ... x $5.00 $
REPAIRS & ALTERATIONS --Refer to Code
Description . • ........ •..... • ....... a .... ► .•.............« ..$
TOTAL FEE $
City of Fridley:
The .undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the Cit? Ordinance
and ruling of the Department of Buildings, and hereby declares that alit the fact
and representations stated in this application are true and correct
Fridley, Minn 19!�
Owner
Kind of Building
Used as �� -- —e_e-_�
To be completed about
Estimated Cost, $
t' d
Old—New. Building Permit No. Permit No. W8
Signed. ,�C
By
Business Phone
ROUGH
FINAL
CITY OF FRIDLEY
FIRE DEPARTMENT
FIRE MARSHAL'S OFFICE
DEPARTMENT OF FIRE PREVENTION
NOTICE OF BUILDING FIRE
To: Building Inspection
Assessing
Water Billing
City Manager
From: Ralph Messer, Fire Marshal
Date: July 25, 2007
Subject: Fire Damaged Building
Location of Fire: 6348 Starlite Boulevard, N.E.
Date of Fire: July 24, 2007; 1930 hours
Other pertinent details:
This incident was reported as a fire in a residential basement. Rags being used during floor
refinishing is believed to be the cause of the fire. Although there is no significant structural
damage to the residence, the building appears to be in some stage of renovation and no City
building or electrical permits were evident. Smoke and water damage was minimal.
There were no injuries to residents or firefighters.
If you have questions concerning this fire, please contact me at x3621.
From: Ralph Messer, Fire Marshal
Date: July 25, 2007
Subject: Fire Damaged Building
Location of Fire: 6348 Starlite Boulevard, N.E.
Date of Fire: July 24, 2007; 1930 hours
Other pertinent details:
This incident was reported as a fire in a residential basement. Rags being used during floor
refinishing is believed to be the cause of the fire. Although there is no significant structural
damage to the residence, the building appears to be in some stage of renovation and no City
building or electrical permits were evident. Smoke and water damage was minimal.
There were no injuries to residents or firefighters.
If you have questions concerning this fire, please contact me at x3621.
From: Ralph Messer, Fire Marshal
Date: July 25, 2007
Subject:. Fire Damaged Building
Location of Fire: 6348 Starlite Boulevard, N.E.
Date of Fire: July 24, 2007; 1930 hours
Other pertinent details:
This incident was reported as a fire in a residential basement. Rags being used during floor
refinishing is believed to be the cause of the fire. Although there is no significant structural
damage to the residence, the building appears to be in some stage of renovation and no City
building or electrical permits were evident. Smoke and water damage was minimal.
There were no injuries to residents or firefighters.
If you have questions concerning this fire, please contact me at x3621.
16Y.XT
Building WELDING
Permit No.: ?` �
Inspections RESIDENTIAL APPLICATION.
Received By:
763-572-3604
CITY OF FRIDLEY
Dat4M: Omni
763-502-4977//FAX
1. See Back Page for Fee Schedule
EFFECTIVE 1-1-08
$
'GO
Fire Surcharge
DATE L!� YOUR�
E-MAILL ADDRESS
Surcharge
Srm ADDRESS .� O z�-&Z / / J
2 . 00 .0005 x Permit Valuation Minimum $.50
THIS APPLICANT IS: 0 OWNER I IONTRACTOR
$
PROPERTY OWNER/
NAME: O
$
TENANT
ADDRESS 3 Ni_ , CITY
STATEN- ZIPVa�
ft + 6 ft = ft x $21= $
PHONE to O
$
$450 Conservation Plan Review
NAME:
$
CONTRACTOR
ADDRESS: C
STAIB�?%7ZiP5S0/
SUBMIT' A COPY OF
PHONE ,4 7 FAX
$
YOUR STATE LICENSE
p
STATE LICENSE # % 7 O EXP DATE
0/9// JD
PROPERTY TYPE
INGLE FAmiLyrPwvP=m=== SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED WINDOWS
13BASEMENT FINISH 13ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWRyRdING POOL
TYPE OF WORK:
❑NEW HOME CONSTRUCTION ❑ ADDITION
ANCEIREPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: IM
AJD
SIZE OF BeROVENIENT LENGTH WIDTH HEIGHT SQ FT
OR 13HOUSE ONLY
NUMBERNMER OF SQUARES ❑HOUSE &GARAGE
BASEMENT
REMODELING SUBMIT:
GARAGES ❑ATTACHED GARAGE
1,
. 2.
Existing Floor Plan
Proposed floor plan
PROPOSED SIZE: ❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl ❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum ❑ Trim
1.
Site Phm/Survey showing the existing structures
• Other 17 Fascia
and proposed project
2.
Two sets of construction plans
WINDOWS
3.
Energy Calculations
IN EXISTING OPENINGS ❑ Yes ElNo Lo� jTIOI2I OF WINDOW /,
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES & / a 1L `Sip
^
TYPE OF. WINDOW TO BE INSTALLED - NUMBER OF WINDOWS o—
r..... rr,r,.1 rune, Dr10r,JJ Vt% ♦twVAllViN, L1ml:LUmuNky -L-UL q,•Ub"1• OF LABURA1ND 1yjKFF.RIAi S:
(USING THE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION $
erAm OCCUPANCY TYPE
Permit Fee
$
1. See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$ 4. D .001 times the total job valuation
Surcharge
$
2 . 00 .0005 x Permit Valuation Minimum $.50
License Surcharge
$
.5-.6b $5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1825 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $21= $
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
10 Make checks payable to: Clty 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 info 'on 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 NCmneso nst uctum Codes; I understand this is not a permit but only an application for permit and work is not to start without a
permit on site; that the Werk will be in acro ce 'ih the ved 1 in case of all work which requires re ew sad pprov pl s.
SIGNATURE OF APPLICANT PRINT NAME DATE'/
APPROVED BY DATE
�....� �� From: unknown Page: 212 Date: 12/4/2009 3:02:27 PM
Building
MECHANICAL
Permit No., Uv
Inspections
RESIDENTIAL APPLICATION
Reee'V fB: MIN,
01.
763-572-3604
CITY OF FRIDLEY
Da d6m
763-502-4977 FAX
EFFECTIVE 2-19-09
DATE 12M= YOUR E-MAIL ADDRESS dav9@daveshaWInganda1r.com
SITE ADDRESS 6348 STARLIGHT BLVD
THIS APPLICANT IS: ❑ OWNER DCONTRACTOR
PROPERTY
NAME: JAY WOOD
ADDRESS: 6348 STARLIGHT BLVD CITY FRIDLEY STATE MN ZIP 55432
OWNER/
TENANT
PHONE: 1.402-99x0252
CONTRACTOR
COMPANYNAME: DAVE'S HEATING, AIR & ELECTRIC
SUBMIT A COPY OF
CONTACT PERSON: AMY MADVIG
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE WITH
ADD g:1801 37TH AVE NE. COLUMBIA HEIGHTS STATE MN ZIP 88421
APPLICATION
PHONE 763-781-8901 FAX 763-789-880&
PERMIT TYPE
WINGLE FAMILY O TWO FAMILY 0 TOWNHOUSE
TYPE OF WORK:
D NEW
REPLACEMENT D ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK REPLACE FURNACE BRYANT M#359AAV036060
FEES ARE BASED ON $10.00 PER FIXTURF„ EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
Equipment Installed MFG: MODEL: SIZEIBTU
MFG: MODEL: SIZEMTU
MFG: MODEL: SIZWBTU
ailinC $25.00 ,,FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00
t TO AIR EXCHANGEER $15 REPLACE (WOOD) $35.00 __NEW GAS GRILL $10.00
_
$35.00 ACS $35.00 CAS UNIT HTR $10.00
,_-_BOILER
_C HIMNEY LINER $10.00 AS DRYER $10.00—POOL HEATER $35.40
DUCT WORK $10.00 GAS PIPING $1040 VENTCLATOR $15.00
Number of fixtures aC3 $]0.00 x $10.00 = $
Number Qf fixtures ® $15.00 x $15.00 — $
Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35,00 1 x $35.0o.- $350
State Surcharge = $
MINIMUM FEE 535.50 Totai=$35.50
THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a bu' g permit and I acknowledge that the information above is complete and accurate, that the work will be in
conformance with the rdin etas and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an ap cation for a pormit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the or res Wh c 'res reviewand approval of pans.
1 �,
SIGNATURE OF APPLI ANT PRINT NAME DATE
PLEASENOTE: SEPARATE PERJI�TS ARE REQ! =D FOR BU1I40INIJ, hLl t;FKIf;A1, ANtrLM %.J1^V4s1-.AA,6. W -5a;
City of Fridley
Building inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977