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PRE 2010 DOCSVillage of Fridley, Minim. ]MU11M]ING PEM" N. 777 Office of INSPECTOR OF BUILDINGS owner Architect— Ij Builder Fridley, Minn.,. 19 LOCATION OF BUILDING No.art Street — P of Lot Lot Block_- Addition or Sub -Division DESCRIPTION OF BUILDING Front -=5 -,!''— Depth Height Stories Manner of construction,,---,"- To be used as, R a -C,,' T.�5Estimated Co - To be completed -���'V-�'411 Permit to hereby the building uponthe express c the work done in, nances of Fridley, within the city ft ordinances. et %Z'i5� -" � ted to tQ described In the above statement. This permit Is granted tion that the person to whom It is granted, and his agents; employees and workmen, In all Lind and upon said building, or any part thereof, shall conform In all respects to the ordi- 3n., regarding the construction, alteration, maintenance, repair and moving of buildings and this permit may be revoked at any time upon violation of any of the provisions of said of Buildings. AGREEMENT AND SWORN STATEMENT In conmside *on of the issue and delivery to me by the Inspector of Buildings of Fridley of the above permit, I hereby agree to do the proposed work in accordance with the description above set forth band according to the provisions of the ordinances of Fridley, and, being first duly sworn, I hereby state and say that the facts stated by me and contained in the above permit are true as therein stated. sworn to before me at Fridley, day of A.D. 19 Minn (_7,, ^thls APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER IS NAME BUILDER. ADDRESS J �ADDRESS A�Q l LOCATION OF BUILDING NO. / / STREET tz-3 u /J � (S 6. A e iy c LOT BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT SETBACK SIDEYARD SEWER ELEVATION TOP OF FOOTING 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: - -S: f . C E Front Depth Height Square feet Cubic Feet Front Depth Squaxe feet Cubic Feet Height Type of Conatruction�,i„�.a�.�, Estimated Cost) F-1- 00 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 %Q -// _ / q SIGNATURE LU .(Schedule of Fee Costs can be found on the Reverse Side.) '9' -�U 91 BUILDING PERMIT FEE 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 structure or building,.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 - $1.75 for each one thousand cubic feet, or fraction thereof, in such cubical c.ontents. Type 3 & 5 - $1.50 for each one thousand cubic feet. For the purpose of computing fees for building permits, the cubical contents of any 'build.ing -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 the 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. 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. NSSSD Connection Charges based on location - Area 1 or 2. 1) SUBJECT IT City ®f Fridley ®-17569 AT THE TOP OF THE TWINS BUILDING PERMIT R E C E I . Ir • __ __ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r PROTECTIVE � 1 = /---1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY j 612-571-3450 910-F15 6/2] /84 JOB ADDRESS 6121 Sunrise Drive N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. $ 1 1 Sylvan Hills SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Amar 6121 Sunrise Drive N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Richard Hastings Contr. 6331 R%verview Terrace N.E. 574-99b6 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd layer but not 3rd. Install ridged galvanized, valleys. 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 ] STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,100 $.55 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SACCHARGE PRO ISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRU TION OR THE PERFORMANCE OF CONSTRUCTION. $19.00 ' PLAN CHECK FEE TOTAL FEE %2P T $19.55 SIGNATURE OF CONTRACTOR ORA VORIZED AGENT (DATE) WHEN PROPERLY V DATED THIS IS YOUR PERMIT 1. �� At SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) BLDG INSP DAT 1) NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ ] R-1 AND R-2 ALTER. I ] Building Permit Application Construction Address: 6/21_ _ )R - - Legal Description: Owner Name & Address: M ks, AAAA P, Tel. # T Contractor: Tel. # 5 7 `(- 914 Address: 6 3'/ �i ��� V`ee:�a 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: Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: ?P- (Zoo - Estimated Cost: $ /100 - Approx. 100Approx. Completion Date: z y A Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: -(____L___�� APPLICANT: Tel. # Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side 25$ of Building Permit Fee $.50/$1,000 Valuation $425 per SAC Unit 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 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 Valuation Fees ' $1.00 to $500.00 $10.00 (Minimum Fee is $15.00) $501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,000. $2,001.00 to $25,000.00 $32.50 for the first $2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and including $25,000. $25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $50,000. $50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each additional $1,000 or fraction thereof, to and including $100,000. $100,001.00 and up $433.00 for the first $100,000 plus $2.50 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 $13.50 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 $15.75 VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. SUBJECT City of Fridley ;� 755171 AT THE TOP OF THE TWINS BUILDING PERMIT f i -0. • COMMUNITY DEVELOPMENT DIV PROTECTIVE INSPECTION SEC. NUMBER REV DATE 6/13/97 PAGE OF APPROVED By CITY HALL FRIDLEY 55432 �.j 612-571-3450 910-F15 JOB ADDRESS 6121 Sunrise Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 1 Sylvan Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Rosella Amar 6121 Sunrise Drive NE 571-1318 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Lloyds Home Improvements Inc 1012 42$ Ave NE, Col. Hgts, MN 55421 788-5602 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 1798 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION El ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 1 bedroom window with egress and two slider windows 9 CHANGE OF USE FROM TO STIPULATIONS Replacement window in sleeping room must meet the State Egress Code. 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 1 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,189 $.59 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- $40.25 Fire SC $1.19 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC $5.00 $47.03 IGNATURE OFCONT RACTOR OR AUTHOP@Vb AGENT IDATEi WHEN PROPERLY IDATED THIS IS YOUR PERMIT SLOG NSP 11TE SIGNATURE OF OWNER of OWNER BUILDERi iDATEi NEW [ ] Effective 1/1/97 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �/ ConstructionAddress: 6121 SUNRISE DRIVE NE. Legal Description: Owner Name & Address: ROSELLA AMAR Tel. # 571-1318 Contractor: LLOYDS HOME IMPROVEMENTS, INC. MN LICENSE # 0001798 Address: 1012-421-2 AVE. NE., COLUMBIA HEIGHTS, MN. 55421-3159 Tel. # 788-5602 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. NW BEDROOM 1 EGRESS & TWO SLIDER WINDOWS Estimated Cost: $ 1,189.00 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: (� 1 / j PPLICANT: Tel. # CITY USE ONLY TOTAL $ !2,03 STIPULATIONS: Permit Fee $ 416, dS Fee Schedule on Reverse Side Fire Surcharge $ /,/9 .001 of Permit Valuation (1 / 10th %) State Surcharge $ -,5-9 $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ !2,03 STIPULATIONS: 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 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 fust $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 $1()0;000 $100,001 to $500,000 $887.25 for first $100,000 phis $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 $13.50. 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 $15.75. 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. i PRIME WINDOWS $�, f , 610 a. Replace prime windows in northwest bedroom with window that conforms with egress codes. Anderson or equal. Match existing siding, _ finish interior walls and trim ready for light sanding and painting. r.:\dda\60ntaft _ r„ta- u` ` • A CITY OF FRIDLE'Y INSPECT40N DIV. Effective On January 1, •1997 6431 University Ave NE 3 Fridley, MN 55452 APPLICATION FOR POWER PLANTS AND HEATING, COOLING. VEN11LATION, '. 572--3604 REFRIGERAMON AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS_/Zl75(2Wr,"5em J i RATE SCHEDULE i The undersigned hereby makes application for a permit for the worts herefn ' Residential Rate TOTAL specified agreeing to do all work Irt strict accordance with the Chy Crudes and Furnace Shelf and Duct +dark, Burner - rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 representations stated in this application are true and a rrect. (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace) $10.00 s_ 0 OVYN ER • :Y -c I 10 Gas Range $10.00 $ - -Gas BUILDING USED AS �'�e �,` d-e�✓7�� ` � Cas Dryer $ 10.00 $ _ ESTIMATED COST ®d P - � PERMIT NO. ,'Air Conditioning - All Sues $ 25.00 $__ 2� -- '�- Q SCRIPTION OF FURNACE AND OR BURNER y All OtherslRepairs &Alterations (LIST CSN BACK) a i°wo of Value of Appliance crWork $ No, of Healing Units Circle One (Steam) (HotWater) arm Ai Commerclal/Industrial Trade N raeN e ��4®ea SizeNo. H P EaR _ 1. 25% of Value of Appliance or Work $ F'ueI %d./. ��Total Connected Load Slate Surcharge .5th Burner Trade Name Slz$lJo, TOTAL FEE BTUHP EDR �S� HEATING COMPANY_ &es - i MINlM(JM FEE FOR ANY HEATING) OUNGN-ENTILATiON .-- - " REFRiGERATION}AIR CONDITIONING PERMIT IS $25.00 SJ€gned By Tel No. 2- PLUS Til: $.5D STATE SURCHARGE REINSPECTtON FEE $42.001Hr ApprovedSy Rough --Irl Date Final Date " *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE 4 STACK VERIFICATION ON written permission from acgdning properly ower. REPLACEMENT FURNACE JUN -17-1997 1154 CITY OF FR I DLEY 612 571 1287 P.04/04 s 14 e • 6 Has WW bm ming Bi"CT°s of All oftr BIVs TOTAL BTUs r®� 7. Has a. Inver been provided for wmer heater Yes () No S. HAs combusWn sir iaeen provkled for waw Mer Yes NO t � Reim ; . • List AL•s1iINg i/ViW.•• a •• ' • • i••t. .�ij ew. .:..•y,• .. Signed $p. Dite: . TOTAL P.04 A (UMMY AM MM 9EMON The undagped hemby valfies &athec&ftchkmyor madc 1. • Hsi been + ox"y' commined yes N 2. is free from rust or do tkmadm 'Yes No { 3 •3. Has no fare o** lodged with ices No i 4. Is seemly sWported Yeas f No { S. Metes sU cum at for she and toW BTtrs counerted Yes { No 14 e • 6 Has WW bm ming Bi"CT°s of All oftr BIVs TOTAL BTUs r®� 7. Has a. Inver been provided for wmer heater Yes () No S. HAs combusWn sir iaeen provkled for waw Mer Yes NO t � Reim ; . • List AL•s1iINg i/ViW.•• a •• ' • • i••t. .�ij ew. .:..•y,• .. Signed $p. Dite: . TOTAL P.04 A CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Stories Basement Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES Effective On January 1, 1997 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Beth Wash Drirtk Floor Oatch Auto Gas Gas MISc,'<' Water Heater Urinal Tub Shower SFnk Tray Fi�uht Drain Barri Washer Appl. , :Range Flxt........ Gas Elec NO. RATE TOTAL New Fixtures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Ba§in $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater —Electric $ 7.00 Water Heater — Gas** $10.00 Gas Range" $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance �,_ 01 JOB ADDRESS V S� � � g .411 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 c rrect. AyI4 1997 Owner s S`� c- v Building Used As L , l L Estimated Cost PERMIT NO. M6 PLUMBING COMPANY J P/s SIGNED BY EL NO.+7��� 3 Approved ByTFR Rough—In Date Final Date State Surcharge $ .50 MINIMUM FEE ANY PLUMBI g GAS PER T --IS— 20.00 TOTAL FEE $ ..S7 PLUS THE $.50 STATE SURCHARGE (� **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. sueiEtr P N City of Fridley 29208 AT THE TOP OF THE TWINS BUILDING PERMIT ftGEJT COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r PROTECTIVE NUMBER REV DATEPAGE OF APPROVED BY I = : CITY HALL FRIDLEY 55432 "'' 612-571-3450 910415 4/14/99 JOB ADDRESS 6121 Sunrise Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 1 Sylvan Hills SHEET 2 PROPERTY OWNER MAIL ADORESS ZIP PHONE Rose Amar 6121 Sunrise Drive NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Richard Hastings Contr 6331 Riverview Ter NE, Fridley, MN 55432 574-9966 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 4051 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION j] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (19 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 REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPt 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 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $1,628 $•81 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- $54.00 Fire C $1.63 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION e PLAN CHECK FEE TOTALPEE LicensePq $5.001.IF 44 SIGNATURE OF CONTRACTOR JR AUTHORIZEO AGENT t ATEI PR ER ID TED IS IS Y U PERMIT 1 s � SIGNATURE OF OWNER OF OWNER BUILDERL IDATEI 50 OArE NEW [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALS [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ' �' � ConstructionAddress: Legal Description: Owner Name & Address: A MA Tel. # Contractor: o l A MN LICENSE Address: 9 3-1 < �-> 'FOITel. # 7 �l -���6 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: / � $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Construction Type: ���4 $ Estimated Cost: $ /(/ter $ Fee Determined by Engineering Sewer Main Charge (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: i APPLICANT: Telel . # STIPULATIONS: CITY USE ONLY Permit Fee 0 $ 0 Fee Schedule on Reverse Side Fire Surcharge $ / L .001 of Permit Valuation (1/10th%) State Surcharge $ / $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: BUILDING 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 -wits TOTAL VALUE FEES $1 to $500 $21 (Minimum Fee is $21 plus surcharge) l $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 M-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 $t 3 • ;Z 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. NEW [ ] CITY OF FRIDLEY Effective 4/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ .] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: (012-) 54 IV A, I S r Legal Description: Owner Name & Address: ®5 A Z Tel. # Contractor. A(' i _s MN LICENSE # �tb S Address: 6331 V9-9-0t9Tel.# 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. FL DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 110 542 e Construction Type: TOA -Z ® F F 4- 9--0" F Estimated Cost: $ Flt®t•!"--- 0 kms ,- .3 Driveway Curb Cut Width Needed: Ft. + 6 Ft= Ft x $ _ $ DATE: 0 65 APPLICANT: Tel. # Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - ' Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $� S $ $ _ 2_ Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 [ ] STIPULATIONS: 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 CURB CUT ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined rate 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. VERIFICATION OF FOUNDATION 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 NEW [) CITY OF FRIDLEY Effective 4/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 5714287 Fax BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: %� ��' AM, A e Tel. # Contractor. R` t Chi /) !e 1� )4A-,+ " I G � MN LICENSE # , Lv S j Address: '� �1 t L a Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVINGAREA: Length _ Width Height _ Sq. Ft. GARAGE AREA: Length _ Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: r �LGr�aa St K e�� Construction Type: XEMooE cF ZeP64c-� Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x DATE: f t z to A APPLICANT: � 4 �27 Tel. # Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 [ ] STIPULATIONS: 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 FEES $1 to $500 $23.50 $501 to $2,000 $23.50 for'first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $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 $1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof CURB CUT ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined rate 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. VERIFICATION OF FOUNDATION 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 Building MECHANICAL Inspections RESIDENTIAL APPLICATION 763-572-3604 CITY OF FRIDLEY 763-502-4977 FAX EFFECTIVE 2-19-09 DATE `L� YOUR E-MAIL A SITE ADDRESS U M nm oy d THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: OWNER/ ADDRESS: TENANT CONTRACTOR COMPANY NAME: SUBMIT A COPY OF CONTACT PERSON: YOUR STATE STATE LICENSE # LICENSE WITH ADDRES APPLICATION PHONE! 01-1 " r �c / cl FAX CITY PERMIT TYPE *INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK- ❑ NEW ❑ REPLACEMENT ❑ ALTERATION/REMODEL Permit No.i �k:J Received By" DatewW STATE ZIP, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU MFG: A/C $25.00 MODEL: (GAS) $15.00 SIZE/BTU XGAS RANGE/OVEN $10.00 —_AIR TO AIR EXCHANGEER $IS _FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00 $35.00 _FIREPLACE _FURNACE $35.00 _GAS UNIT HTR $10.00 _BOILER CHIMNEY LINER $10.00 DRYER $10.00 _POOL HEATER $35.00 DUCT WORK $10.00 _GAS GAS PIPING $10.00 —VENTILATOR $15.00 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 ofa!1llvork which reyirP review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME 61 L1—j k DATE — q ; f City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME' ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments. 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations.