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PRE 2010 DOCSDate .+� : .... . Owner+'°', • Builder ............................................. Address .%t - Address .......... ........... ........... LOCATION OF BUILDING JAI � No. Street , ' 6,;u a .. Part of Lot ........... ... . Lot ...... .. Block ......... ""'... Addition or Sub -Division .................... . Corner Lot Inside Lot ..... Setback ............ Sideyard ..................... ... DESCRIPTION OF BUILDING To be Used as: �..Front Depth .. Height Sq. Ft....... , , Cu. Ft. ........ . Front ........ Depth ........ Height ...... Sq. Ft.. .... Cu. Ft, ........ Type of Construct!, n - Est Cost ...... ............ To be Completed In consideratio of the issuance to me of a permit to construct the building described above, I agree to do the proposed work accordance with the description above set forth and in compliance with all provisions of ordinances of the v age of Fridley. ,° J� A � cansideratio of the payment of a fee of $ `., .permit is hereby granted to ....... :& '....... to construct the building, or addition as described above. This permit is granted upon t e express conditi that the person to whom .it is granted and his agents, employees and workmen, in all work done in, around anc upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota egarding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. .e? 6 16-4 Building Inspector NOTICE: . This permit does not cover the construction, installation or alteration for Wiring, plumbing, gas heating, sewer or water. Be sure to see the Building, Inspector for separate permits for these Items. ��' City of Fridley, YHnn. BUILDING PERMIT N° Q5 33 Date: Owner: AddressAddress L-- --- WCATION OfSJBUILDING No. Street ' `' ._ Part of Lotir _ Lot _ _ _ .__ Block Addition or Sub-Divis:$n' Corner Lot . _ Inside Lot _ ._ –qWtbaer �y_:.d,-.,,--XWSideyard ......_--- Sewer Elevation on Elevation _ — --- DESCRIPTION OF BUILDING T *Used _s:711, YJ 7Y4 A, .� Front Depth . Height 412-412—Sq. Ft..r Cu. Ft.;,y,�=�. From, Depth Sq. Ft. Cu. Ft. Type of Constructionv __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 compliance with all provisions of ordinances of the city of Fridley. A, In consideration of the payment of a fee of $ �„ _ , 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 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. .. Building Inspector NOTICE: This permit does not cover the construction, Installation for wiring, 'plumbing, gas heating, sower or water. Be sure to we the Building Inspector for separate permits for these Items. 4 P SUBJECT P City of Fridley 717 8 AT THE TOP OF THE 'TWINS BUILDING PERMIT r RECEIPT NO. ` • COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. I � NUMBER REV DATE PAGE OF APPROVED BY i CITY HALL FRIDLEY 55432 ' 612-571-3450 910-F15 8/13/98 JOB ADDRESS 140 Sylvan Ln 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 2 Plat 3 SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Bill Reshiler 574-9433 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Tabor & Sons 3716 St Francis Blvd Anoka 55303 789-1902 20014248 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 XX REPAIR O MOVE O REMOVE 8 DESCRIBE WORK -Reroof house and garage 28 S Tear-off 8 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with State Building 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 MOT. 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 I 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 1.16 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. 2,33 PLAN CHECK FEE TOTAL F E 8 24 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATEI P OPER IDAT S IS YOUR PERMIT BLO INSP a � MATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI P 'NEW" [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: �� _ Legal Description: Owner Name & Address: %��/� _���� Tel. # Contractor: Jc.�� y� o 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: zz; �r r` 6" al—pe —0 Construction Type: Estimated Cost: $ _91� _33S (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: CP- J3 APPLICANT: Tel. # 29 2-49a,2 CITY USE ONLY Permit Fee $' %� Fee Schedule on Reverse Side Fire Surcharge $ 3 .001 of Permit Valuation (1/10th%) State Surcharge $ /• $.50/$1,000 Valuation SAC Charge $ $1000 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: $ `� 3 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. CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 S Effective April 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range** IZ16)1111111111111111:70tI 0i1rMI Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $35.00 $35.00 $35.00 $10.00 $10.00 $15.00 Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge TOTAL FEE y� $ C,o JOB ADDRESS I S V1% Vl '' (,,.V1 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: ,20 O� OWNER \Xf I I � ('A VVI F)f SkR_-tZi BUILDING USED AS i.5 (de- VTl.q I ESTIMATED COST 4 200• 00 PERMIT NO PLUMBING COMPANY b P SIGNED BY TEL N0. 754 Approved By Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF CO $ 7_-� P 5 (R) OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. � COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE 0 FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby 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 :