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PRE 2010 DOCSH i- BUILDING PERMIT N° 2005 Village of Fridley, Minn. DateMfr ...... .......... Owner b Builder .. .�" ...................... Address "' .. �^� Address .. .................., l LOCATION OF BUILDING l No. . . Street . P, of Lot ....................... a ezw Lot ......: ..... .. Block ........''c ... Addition or Sub -Division . .......... ...... . Corner Lot . .Inside Lot .. Setback Sid;!' g::',�r* . .. . , A�d1 I DESCRIPTION- OF BUILDING To be Used as: .,- Front . . Depth . Height .. Sq. Ft......... Cu. Ft........ . . I. ............... .. Front ........ Depth Height ......... so. Ft.. ... Cu. Ft........ . Type of Construct n .. .. Est Cost ..t ........... a Completed, To b V i I I In considerati n of the issuance to me of a permit to construct the building described above, I agree to do the proposed wort in accordance with the description above set forth and in compliance with all provisions of ordinances of the age of Fridley. In considerate ........... ........... n of the payment of a fee of $. „�, permit is hereby. granted` to Q-- to construct the build n 'addition as described abgve. Th -01 h, ed upon e express condi on that the person to whom it is granted and his agents,emPioyees and workmen, in all work done in, around , d upon said building, or any part thereof, shall conform In all respects to the ordinances of Fridley, Minneso regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the village lin and this permit maybe revoked at any time upon'violatiori,, of any of the provisions of said ordinances. wilding inspector NOTICBO This peri n, i does not oover the construction, installation or alteration foil wiring, plumbing, gas heating, sewer or wate II Be sure to see the. Building Inspector for separate permits fpr these items. H SUBJECT PER City of Fridley 15.5_ AT THE TOP OF THE TWINS BUILDING PERMIT. r RECEIPT NO. ° COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 11/27/79 JOB ADDRESS 100 Sylvan Lane NSE. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 1 Sylvan Hills Plat 3 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Emmett Rice 100 Sylvan Lane N.E. 571-1536 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. David R. Baerg 3109 N. 73rd Lane, Brooklyn Park, MN 55443 561-5988 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 X 8 DESCRIBE WORK Construct a 1111 x 151 Breezeway and a 261 x 22' Attached garacte 9 CHANGE OF USE FROM TO STIPULATIONS Garage is to be set back 40 feet from back of curb. Provide a hard surface driveway. SEPERATE PERMITS REQUIRED FOR WIRING. HEATING, PLUMBING AND SIGNS. WARNING Before digging call local utilities TFLEPHGNE - ELECTRIC - GAS EACs REQUIRED BY LA TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Frame VENTILATING OR AIR CONDITIONING. Wood 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 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 $121500. $6.25 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- $75.00 NONE STRUCT ON OR THE PERFORMANCE OF CONSTRUCTION. X PLAN CHECK FEE TOTALFEE 11-d7-7,0 ONE $84.25 SIGNATURE OF CONTRACTOR OR AUTHORIZEDAGENT (DATE) WHEN PROPE RL VALIDATED THIS IS YOUR PERMIT PA BLDG INSP. DA SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OWNER:`' lei ADDRESS: �, U a'711 '-�177 TEL NO: 5�2J—/Jj> BUILDER: - �� �� 6-4— ADDRESS: 31® 23 TEL NO: ,ssk Construction Location STREE, T NO : 0 _ STREET: L U A fJ Ut&J `v LOT: % BLOCK: ADDITION: -.a 9tJ ILLS PL Corner Lot: Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION �TQ IJ r 7—/ ®4-) Front: l/ Depth: Height: Square.Feet: Cubic Feet: o Front: o2. ( ! Depth: o�o� r Height: /C) Square - Feet: Cubic Feet: Type of Construction: lits a 0 -, h cr�--e, Estimated Cost: $ �a � Zo Be Completed: J < Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET 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 e true and correct. DATE: ll — %— % 9 SYGNA'ruRE : ' Stipulations: (1 "�� Qy_r) BUJLDI14G PERMIT FEE SCHEDULE, SECTION 2. The In:,pector. of Luildincjs 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. thb amount herein below set forth and in the manner herein provided to -wit: I NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet. . PLAN CIECK: 25 percent of building permit fee. DRIVEWAY DEPRESSION: (Concretc,Curb Streets Only) Alternate A: Removal and replacement of concrete curb and gutter only; Driveway width plus 6 feet- x Y15®75 Alternate $: Removal and replacement of concrete curb and gutter and install a 3 foot- wide approach with 6 inch depth; Driveway width plus 6 feet x $17.85 ADDI I10 \AL 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 sir. (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 $7.50 plus $.50 state surcharge. • M01=1111►1# 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 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. 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. r l9`' r1i Xslz -Y, 2 Pet -A r"'. 'L, CITY Of' FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OWNER: et c -e ADDRESS: I De L UA rtJ C�at1� � TEL NO: S 9 1 ` STREST NO: L) 0 LOT: s BUILDER: ADDRESS: TEL NO: Construction Location STREET: Z L U " L,+/j BLOCK: ADDITION: Corner Lot: Inside Lot: Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION Front: Sauaue.Feet: Depth: Height: Cubic feet: Front: Depth: Height: Square - Feet: Cubic Feet: Type of Construction: Estimated Cost: $ 7b Be Oampleted: Alt. A Alt. B Proposed Driueway Width if New Opening Is Desired: ,°Y $ �C,� $ I� 4 -IDI = +�U IS' !fir SEE REVERSE SIDE OF SHEET The undersigned hereby makes ij3plication 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: %— P, I/- f -v SIGNATURD : Stipulations: )j 1) ) L J))NLi r I MPJ I I - LL Zj WI LIJUr t; ;;ECTIOJ) 2. `Ifie In�cpccLor. of 1wil.di.n',J , "Al;11.1, before; i su:irl(,J penni.t s fos: the eroction of filly or "Aruct:urc, or for ally .lddit-J-an to Ally 0Jti:.:ti.ng building or structure, or for any al.tcraLion or: to -any uxi.stiiig building or ..truct.urc, upon application thcreforc, regni.r:e Ule payinent• by the apj.-Aic:ant: for. such permit- of fees to the amount herein below set forth and in the manner herein provided to -wit: 1113M C'OI1SURUC7VIOI1: Single Yamily Homes and Garages: $4.00/1,000 cubic feet. PLAN CH K: 25 percent- of building perini-t fee. D)tIUWAY DBTRLSSION: (Concrete. Curb Strcet� Only) ' Alternate A: )removal and replacement of concrete curb and gutter only; Driveway width plus 6 feet- x ;x,5075 Alternate B: Removal and replacement of concrete curb and gutter and install a 3 foot wide approach wit)) 6 inch depth; Drivcway width plus 6 feet x $17.85 . AD�). I T i 0 N f Z r- 0 }1 AiL 1QN— 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. Fox repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 ler 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 $7.50 plus $.50 state surcharge. VERT F.CI ATIQN OF FOUrdDATIOil 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 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. _JLT_1F) Q TF OF 0 UJUEMr�CI, 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 J�ermit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. 01 SUBJECT P City of Fridley 2863 9 ` � E � THE TWINS BUILDING PERMIT R N0. • _ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. �� y� j PROTECTIVE 0 � � NUMBER REv OATS PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 It....A.� �J 612-571-3450 910-F15 11/24/98 JOB ADDRESS 100 S Ivan Lane " 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Plat 3 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jeane Rice571-1536 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Peak Roofing 11506 S Oak9313-8150 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LIC NSE N0 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW 0 ADDITION 0 ALTERATION ®x REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage 28 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2399 $1.20 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 $74.75 Fi4 SC $2.40 / PLAN CHECK FEE73.35 FEE �s Licen SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT IDATEI 1. EpR 71 A THIS I$ Y.O R PER 9 9 G INS !// r FATE S,GNATUREOFOwNERJFOWNERSUILDERI IDATEI 01 NEW a [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 0� ConstructionAddress: do J� G �� Legal Description: Owner Name & Address: '4". Tel. #_ Contractor: �cy woe : �,•q MN LICENSE # r ' Address:��fa �, ®�. ��.�. /t ��� ��✓ s- S 3a� Tel. # _ Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. <T ?/- / s-, ?-c ,too yx—$cr / TOTAL STIPULATIONS: $ A3 3S DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. t., GARAGE AREA: Length FCC Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: a C E P 61(c d Construction Type: o �� �< < e wa 1(-c- C-AfEstimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: �l �/ f� APPLICANT: �✓/�---- Tel. # CITY USE ONLY Permit Fee $ ,j Fee Schedule on Reverse Side Fire Surcharge $ d .001 of Permit Valuation (1 / 10th %) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ S. 0 0 $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: $ A3 3S 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 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 $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. PERMIT TYPE >kS111GLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: 0 NEW &WLACEMENT =RATION/REMODEL DETAILED DESCRIPTION OF WORK PER MS 1613.665 the permit 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 W„HE,R�E NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Gr7�1%3�/rte sIZEIBTU Equipment Installed MFG: MODEL: SIZEIBTU MFG: MODEL: MFG: MODEL: SIZB/BTU A/C $25.00 FIREPLACE (GAS) $15.00 . —GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 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 PVENTILATOR $15.00 POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = Surcharge $ 50 Number of fixtures @ $15.00 = 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 = $ 1 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 which requires review and approval of plans. /y l SIGNATURE OF APPLICANT A4-24WPRINT NAME DATE 7 �ZA -0� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 MECHANICAL 2 00 Permit No.:Building Inspections RESIDENTIAL APPLICATI®N Received By: Date Rec'd: r 7.63-572-3604 CITY OF FRIDLEY DATE Z /-- o YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: 0 OWNER dkWrRACTOR PROPERTY Nom: /dpi OWNER/ ADDRESS:/", .C.g CITY. T _STATTZIP_S�,,� TENANT PHONE: CONTRACTOR s COMPANYNAME: over 197. 01 yipce SAI SUBMIT A COPY OF CONTACT PERSON: YOUR STATE LICENSE WITH STATE LICENSE # ADDRESS: (763) 754-2199 Fax (763)(77¢-2906 STATE zIP APPLICATION PHONE FAX PERMIT TYPE >kS111GLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: 0 NEW &WLACEMENT =RATION/REMODEL DETAILED DESCRIPTION OF WORK PER MS 1613.665 the permit 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 W„HE,R�E NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Gr7�1%3�/rte sIZEIBTU Equipment Installed MFG: MODEL: SIZEIBTU MFG: MODEL: MFG: MODEL: SIZB/BTU A/C $25.00 FIREPLACE (GAS) $15.00 . —GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 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 PVENTILATOR $15.00 POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = Surcharge $ 50 Number of fixtures @ $15.00 = 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 = $ 1 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 which requires review and approval of plans. /y l SIGNATURE OF APPLICANT A4-24WPRINT NAME DATE 7 �ZA -0� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 1. REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMESIADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel TMC Chapter 7 with MN Amendments b. Natural Gas or Propane/TGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances 1FGC 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 TMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1.346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used .for combustion and make up air calculations From: 7634344933 Page: 213 Date: 8/21/2008 4:00:07 PM Building'BL1�DL`V"+G pehispermit No.: � 1 RESIDENTLAL APPLI .A.TIONN Rc"*iv«t sy: 763-5 2-3 i 63-572�36Q4 CITY C3I'+' FR�DL iG Y j Z) 00 rilS APIFLICrti7 tS! L '�'7WFr�. OP."t�CTCIt ?ROP'ERTY OFr'ivpA, { vAv F.1 tr.S TEtiAVT .4DD+7.`-. I C-0.. _`�`1� I �+ht►�i iri`% rir . M. NE: -7% i. - ri i _l 5 ISO CONTRACTOR ; NA.\VM. V6%� 6W VA,; S SU`3MTT A COPY Of - S'rATH LICENISM s 0 o ! r. DA?:3 Vt L v 11 "�P�'Z OCA STATE LICL A; S S C ( tv;- CI'"C 6%M I N 4 STAMti %Tl. -i APPLICATION FmoNR ` d z- =.mac lP 3 - 4,3L4- ,q 3 PROPERTY TYPE alMEW >w Jra� X.wSTRucnflrl s'rfl. PER.* -v if TY11E cADI?STIflN QGARAOLSH WIIv730W5 MAH -AW © 3ASF ISR O ROOF ❑ DR11 TILE 0 DF, G 0 SIDING O Oil © EM24EO ?OOL TYPE OF Wt3M, 1 C N'W 13 ATJDMON 0 ARANi`. ANCu/REPAZ 0 PzmoD-. •G DESCRIBE WORT{ BEING DOi,M: t +5 V Z� 4 tj &5TtAjk- 6;:ls.r kM 6 5 1MGMT Sc. F., SI2.z OF IIHfi R©vRtiiEvT LENGTH WMTH R G 0 HOUSE CN -1Y `TJ Eit OF SQt:ARES O ROUSE & GARAGE RASP -%f1%7 st—uo�F Cst QA9-4 E$ PR,O005Efl Sias: D ATrA*M GPASGE 0 DIs'.�CI- n G0N�jWl•E I F-WAin.- flxr Pian 2. Fzopcsed :loatFlan PROPOSED MIG:?i: 3 Lint o£ aaa+taJ a ambem to be U.—.d SrOrwG ( FOR Ne -W CONSTRtitMON L•vCLLMING 0 Vinyl ❑Suit Dz-=, `` AMM0-14 & MRCS�'S 3tiz3;lf�f � A1,0111 am �7 Trim r L. Sim MM/ft shaw+m„the � a Adst3.n„3L: arfd prfsFoscd �ro,Txt SVL`TDOSVS �. 7%* ut of P=jty axr. p;z s N EXISTING OPENW- GS OYc* 0,,No LOCA710V OF V�i?si:OWS 3, End CJtulawors OR FORN>;W 0?M040S-Di:S PJSv-s 5� OF OPEEND'G CH&NG? S & TY?: OF W—INDOW TO 8R IDiSTALL$D NUMBER OF W'L WWS Af LL.,FZES ARZ BASED O`+ VALUATION, 1XCLTj-DL-;(; T; COST i (UM. i THE I997 U.B.0 FEE SCHEDUL TOTAL JOBV UATI014 5 7577W OCCUJPAII Permit Fee $ See Back Page for Fee f Plan Reviaw S -- 63% of B i:Jdxtlg Petxait Surcharge $ (.0005) tines the total jt Fire Surcharge S ,001 x ?emit Yalua#ion joense Surebarge _S _ $5.00 (SW-. l iccased R SAC Charge S S1450 per SAC Unit (PI :urb Cut Escrow S ft + 6 ft Erosion Control S 5450 Conservation Plan ?ark Fee S _ Fee D -t=ined by Engi Sewer Maui Charge $ Agreement necessary ( rotas Due - _ S b'7 ,el ® Makc checks nsvgbte t LA..tOR AND MATERIALS. - valuation -- vikn =Um 5.50 /I0%) idential Contractors) s to MWCC for detomInation) ftx$20=$ )I Non Necessary ( City of Fridley M5 IS AN APPLICATION FOR A PEP -MIT -NOT VALID hereby apply for a building permit and I acknowledge that the infortnativn aboi :onformance with the ordinances and codes of the City of Fridley and with the Min-ne ,enrtit but only an application for a permit and work is not to stars, without a permit; .tan in the vase of Q.�+esrqu' ev wand approval of plans. lGNATL7REOFAPPLtC N7--.. us ft L PROC>r W is complates snd accurate; that the *ork will be in opt: Canstruction CoaoS; that I understand this is not n halt the work will be in accordance with the approved ,-XI-0