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PRE 2010 DOCS1-1,,23,:23 3 City ®f Fridley, BUILDING PERMIT N? 6930 AMMOMM MCI No. Street mart t Lot —,4.!e– .._ Block Addition or Sub -Division . Corner Lot _ �^ Inside Lot — Setback Sewer Elevation on Elevation 7- y,.' aca--i rJf DESCRIPTION OF BUILDING T Used a :�/�� 161 Front c2 f" Depth Height Sq. FtP�V' Co. Ft. Front — Depth Height � Sq. Ft. Cu. Ft. i O0 Type of ction Est. _ � To be Completed .......... In consideration of the issuance to me of a permit to c the proposed work in accordance with the description above ordinances of the city of Fridley. In consideration of the payment of a fee of described above I agree to do upliance witty i') provisions of a 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 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. NOTICE: This permit doss not ao"r the eondmcftn, hataliaMon for wiring, plmnbing, gn big, sewer or water. Be sire to see the Building hupestor for mpanft permits for thm items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY,- MINNESOTA LOCATION OF $VILDINd No. Street Fart of Lot Lot., O Black _ Addition'or Subdivision,,_ Corner Lot Inside Lot Setback Side -Yard. SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey.of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used es: Front Depth�Height Sq. Ft. Cu,. Ft._� Front �L;L Depth Height % (� Sq. Ft. Cu. Ft. Type of Construction_ Estimat:ed Cosh� .--_... 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, o£ Buildings, and hereby declares that all the facts and representations stated in this applicati correct. _(Schedule of Fee Costs can be found on the Reverse Side). in a 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 garagep 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. HOUSES 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 non -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, -€or --similar occupancy, to any existing building or for each such _...-building 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..charged. for. -any -permit, -a# set forth in Section 2 be less.than $4'00. City of Fridley Appiication for Plumbing and Cas Fitting Pwndt DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE ZG Number Fixtures ...................... x $1.50 °pppCQz � z p '�' $ � �U' (9 Z �U' • F • N WATER HTR. GAS ELEC. New Ground Run Old Bldg . ............ x 3.25 $ p Q S Q 3 U�' nd O t / Base 1st ® p 2nd _ 3rd 4th • Future Connection Openings Connected with Sewer New Fixture, Old Openings Cesspool 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 ............................ Water Heater (Up to 200,000 BTU) ...... x 3.25 x 2.00 $ q/ $ 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 .. .. $ E Dept. of Bldgs. Phone SII 4-7470 Location /0 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. " / ' 190 Owner �� /,V/zzff Kind of Building� Cc– Used as�� To be completed about`' Estimated Cost, $ OldCNjewuilding Permit No. Permit No Signe By Business Phone No ROUGH j �q FINAL 'ekllx /' I X'�eq_� pmvc7e az 2M 7-59 97.-8h -h165051 CITY OF FRIDLEY . . • APPLICATION FOR PLUMBING AND GAS FITTING hVIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. }• M 2rusber Fixtures X $3.00 UaI Future Fixture Opening x $2.00 $ ` Water x $2.00 $ W •A m . Q. po', �n s+ x w $ 100,000 BTU to 199,000 BTU Heater r+ $ Water Softener x n $ Hew Ground Run Old Building fc( $5.00 $ Electric Water -Heater ©� Q •� $ GAS FITTING FEES: J VI x' '$3.00 $ Additional Fixtures X $1.00 $ Gas PAnge to 199,000 BTU x $10.00 $ REPAIRS $ ALTERATIONS 61 First $100.00 4 ° $ jJ Ul $2.00 $ ••i 7 0 O N 1J VI N TOTAL FEE -.� u a , w Q coo vii w u w R u O 0 as lec 1rt d e "n3 ,rd � h tR) a Future Connection Opening Connected with Sewer t°) - New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL 2rusber Fixtures X $3.00 S Future Fixture Opening x $2.00 $ ` New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water Heater - to 99,000 BTU x 45.00 $ 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ Hew Ground Run Old Building x $5.00 $ Electric Water -Heater x $5.00 •� $ GAS FITTING FEES: lst 3 fixtures x' '$3.00 $ Additional Fixtures x $1.00 $ Gas PAnge to 199,000 BTU x $10.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or traction $2.00 $ State Surcharge $ .5o 8.00 TOTAL FEE $ REINSPECTION FKF Job Address 132 Stoneybrook Way AE ' Department of Buildings City of Fridley Tel. #571-3450 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 application are true and correct • Fridley, Mn. 1-3-79 , 19 OWNER M ERS , KIND OF BUILDING f rime USED AS res. TO BE COMPLETED ABOUT 1-11-79 ESTIMATED COST 1-1.1-79 30,00 OLD - NEW BUILDING PERMIT.NO. RMIT NO.. � Company Signed By Tel. No. ROUGH INSP. ' Date FINAL INSP. Date APPROVAL FOR PERMIT L MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.S0 pLUs $.50 STATE SURCWL-,= &A SUBJE& PE City of Fridley 2 9 213 AT THE TOP OF THE TWINS BUILDING PERMIT r E • COMMUNITY DEVELOPMENT DIV. � LV r � _e_ee; PROTECTIVE INSPECTION SEC. ILA ��"�';,� CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE Of APPROVED BY ---- L J` 612-571-3450 910415 4/14/99 JOB ADDRESS 132 Stonybrook WY NE 1 LEGAL LOT NO.BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 10 8 Pearson's Craigway Estates 2nd Addn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kristin Benson 132 Stonybrook Way NE 571-6438 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 O NEW O ADDITION O ALTERATION 1 REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof House & Garage (28 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 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@ � $1.20 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,399 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. $74.75 Fire$2.40 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION ,#c PLAN CHECK FEE TOTAL E $ .35 iGN URE OF CON'RACTOR AUTHORIZED AGENT iOATE, ^ EW p 0 A D T IS IS YP PERMIT 6 oe J b-GNo E OW NER.w OWNERBwLOER� 'iDATE,' TATE &A NEW [ l NEW[ ] CITY OF FRIDLEY ADDN ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: N c Effective 1/1/99 Legal Description: � ( ' Owner Name & Address: �/c Tel. # �o S 7/ 4 e 3 Contractor: _ �j �' / MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq.` Ft. OTHER: 0"�jOGtSe �- aau��� Construction Type: Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: � l `T APPLICANT: ����� /��,rr�n..1 Tel. # A lL S %/-�0 5�AK Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $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 [ ] BUILDING PERMIT FEE SCHEDULE The Chief Building Official 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 repair to any existing building or structure, upon applicatign 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: TOTAL VALUE FEES $1 to $500 $21 (Minimum Fee is $21 plus surcharge) $501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION 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 Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. 01 City of Fridley 30703` AT THE TOP OF THE TWINS BUILDING PERMIT r � RECEIPT NO. COMMUNITY DEVELOPMENT DIV. v ______ O L sI® f E PROTECTIVE INSPECTION SEC. (/6 f/ E i , CITY HALL FRIDLEY 55432 NUMBERREv DATE PAGE OF A0PROVEO BY 612-571-3450 910-F15 3/3/00 JOB ADDRESS 132 STONYBROOK WAY NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 10 8 Pearson's Craigway Estates 2nd Addn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kris Benson 132 Stonybrook Way NE 571-6438 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Northern Crest Inc 7401 Central Ave NE, Fridley, MN 55432 792-9364 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20098415 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Reside House & Garage; Aluminum trim 7 CLASS OF WORK O NEW ❑ ADDITION 0 ALTERATION ❑ REPAIR 0 MOVE O REMOVE B DESCRIBE WORK 9 CHANGEOFUSEFROM TO STIPULATIONS Call for building wrap before covering. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT 1 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 $10,708 $5.35 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION THE OR PERFORMANCE OF CONSTRUCTION PLAN CHEC54rVE FEE TZ216.31 Lic s SC 5 0 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI THIS IS YOUR PERMIT H P Y VALID%4,11,10 3_3�4)$,GN4LURE OG INS MATE OF OWNEROrt OWNER BU40ERI IDATEI 01 NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [x] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 132 Stoneybrook way NE Legal Description: Owner Name & Address: Kris Benson Contractor: Northern Crest, Inc. Tel. # 571-6438 MN LICENSE # 20098415 Address: 7401 Central Ave. NE Fridley, MN 55432 Tel. # 792-9364 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEN[ENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: Re- side, alum. trim , e Cost: $ �L2� l�, �7y C7 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 3-3-00 APPLICANT: ,L Tel. # STIPULATIONS: 792-9364 CITY USE ONLY Permit Fee $�5� Fee Schedule on Reverse Side Fire Surcharge $ l�. �%% .001 of Permit Valuation (1/10th%) State Surcharge $ S'3 $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ -S-00 $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: 792-9364 BUILDING PERMIT FEE SCHEDULE The Chief Building Official 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 repair 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: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000. $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION 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 Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572.3604 REFRIGERATION AND AIR dONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential 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 *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Effective On January 1, 2000 JOB ADDRESS 45.4 OWNER ,s 5 Rate TOTAL BUILDING USED AS $ 30.00 $ ESTIMATED COST PERMIT NO. - $10.00 O.$10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ 10.00 $ Trade Name k41ze No. BTU X3.3, HP � EDR $ 25.00 $ Fuel. Total Connected Load Burner Trade Name Size No. $ BTU HP EDR State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ 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 $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE Cry HEATING CO�/d�0/�r�.�;a TEL # Approved By Rough -In Date Final Date COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing 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 existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) 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 installing 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-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 Type and Size/Common Vent and Vent Connector 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 ALTERATIONS: (Describe) HEATING CO: Signed By: Date : Building BUILDING Permit No. �� Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Recd: DATE �] � a S- Q CP YOUR E-MAIL ADDRESS O k e— m 5n i ccyr SITE ADDRESS THIS APPLICANT IS: ❑ OQER 'CONTRACTOR PROPERTY OWNER/ NAME: R P (f7 6'an 50y -- TENANT ADDRESS:1-3,9 5foriLAbroo CITY 'E-(/' I d j W.i.r1 STATIZIP s� � r PHONE: CONTRACTOR NAME: STATE LICENSE # EXP DATE 2 pp ketA3oZ SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 1'5 -CS?CQH lA-Jlo-,� /U t:5 CITY ST nLO—IP� WITH APPLICATION PHONE i - S 300 FAX 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 ❑ SW N04ING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: +y a Ir - O C47 f P r OCA SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING NUMBER OF SQUARES ao ❑ HOUSE ONLY ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes [No LOCATION OF WINDOWS 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: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 3193 ® OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $� . $ $ 6 fit+ $ 5,00 See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks savable 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; that the work will be in accordance with the approved plan in the case of all work y0hich requires Ireview and approval of plans. y SIGNATURE OF APPLICANT 11Md�.1 V ld PRINT NAME4A&a,q�W�-Ce—I DATE l "� r y IPage 2 - Building Residential Application BUII.DING PERMIT FEE SCHEDULE The Chief Building Official 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 repair 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: TOTAL VALUE FEES $1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for 1' $500 plus $3.05 for each additional $100 or fraction, to and including $2,000 $2,001 to $25,000 $69.25 for 1' $2,000 plus $14 for each additional $1,000 or fraction, to and including $$25,000 $25,001 to $50,000 $391.25 for 1 $25,000 plus $10.10 for each additional $1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for 1s` $50,000 plus $7 for each additional $1,000 or fraction to and including $100,000 $100,001 to $500,000 $993.75 for 1 K $100,000 plus $5.60 for each additional $1,000 or fraction to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the 1' $500,000 plus $4.75 for each additional $1,000 or fraction to and including $1,000,000 $1,000,001 and up $5,608.75 for the I- $1,000,000 plus $3.15 for each additional $1,000 or fraction VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977