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PRE 2010 DOCS5 PpIr 3, City of Fridley, Minn. BUILDING PERMIT N° 3 310 Date: .. .®:.... t'. ................... . Owner ....................................... Builder ........ 1: ....`.�.. ...... : b ....... Address ...................................... Address ............................................. LOCATION OF BUILDING No. .....� Street ......................... Part f Lot .......... ............ ...... Lot .... Block .................. Addition or Sub -Division .. ... .... -. ...... .. ... . Corner Lot/''......... Inside Lot ..... S®.... Setback .. . ®... ideyard ..,�`1.....4 . !....... . DESCRIPTION OF BUILDING To be Used as: + :........ Front ... � Depth .31'.�. Height ... ... Sq. Ft. & 14 Cu. Ft. .................... Front ........ Depth .......A.ei t .. �.� . Sq. Ft......... Ft. ........ Type of Construction , y S t ...... Inst. Cost.. �! � . � To be Completed .. . ... B.. 6..)" ........ In consideration of the issuance to me of a permit to construct the building de bed above, I agree to do the proposed work in accordance with the description above s4forthWIn cewith all provisions- of ordinances of the city of Fridley. ....................... i co' UP 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 � he 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 with - In the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. e A 4 e 1fiy)Fffg Inspector NOTICE: This permit does not cover the construction, Installation or alteration for wlri , umbing, gas hdating, sewer or water. Be sure to see the Building Inspector for sepa444 permits for*# 14o Rema City of Fridley, Minn. BUR DING PERMIT N® 3807 Date: ........�............ ...... Builder ....... . ......;.... Owner ................................. ...... ... Address ...................................... Address ............................................. LOCATION OF BUILDING No. ... Street. ..... �?^::..�, ........ Part of Lot .......... Lot ..�P�..... Block ... .... / ....... Addition or Sub-Divisi ....� Corner Lot ............ Inside Lot ............ Setback Ifi% ideyara .................. DESCRIPTION OF BUILDING ,�jTo be Used as: « , ... Front �V." :0 �' Depth . : ®' Height ®. �� ~ Sq. Ft. .1. �P Cu. Ft. .r r(PP .................... Front ........ Depth ...... Height . .. Sq. Ft. ........ Ca. Ft. ....... . Type of Construction ................... Eat. Cost..Y�yo ......... To be Completed .................... In consideration of the issuance to. me of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description above set forth and i/Comm rce with all provisions of ordinances of the city of Fridley. .!` .. .................................... 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 with- in the ordinances. limits and this permit may be revoked at any time �pon violation of any of the visions of said I_ 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 item& APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA a Owners Nan �' Builder Addroas 6- _ °� ..� Address LO ATION OF BUILDING 4 No. Street Part of Let Block- Addition or Sub. Div. -6orner Lot ,. Inside Lot K Set Back ® ` Applicant attach to this form Certificate of Survey of Let and proposed building location. DESCRIPTION OF BUILDING To be used as r � Z ` - Front ' Depth_.,..,,.. ..Height Sq:" y't. _,_.____,_ Cu. Ft. Front Depth _._..Height — Sq. Ft. Cu. Ft.. Type of Construction Estimated Cost. To be'eginpleted The'iindersigned hereby maies 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. Bate ` Signature"'' (.A.Schedule of Fee Costs can be found on the Reverse Side) BUILDING-PERMIT.FEE.SCHEDULE Section.2� The Inspector of Buildings shall, before issuing any permit for thed.erection of any building or structure, or for any addition to any existing building or structure, .or for,any alterations or repairs.to any existing building or'structure, upon application thereforx.requ3xe 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.l For any such permit for the erection of any fireproof building, other than a garage, warehouse, -factory or grain elevator, or for ,.the erection of any fireproof addition, for similar occupancy, to any existing building shall be at the rate of 41,x:0 for each one thousand cubic feet, or fra ction thereof, in such cubical contents. 2,2 For any such perma.t for the erection of any fireproof garage, ware- house, faotory•.or grain elev atDr,•cr for the erection of any fireproof 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 trya erection of any non -fireproof building other than a garage, warehouse. factory.or grain elevator, or any non -fireproof additicn, for c"Mi'_ar occupancy, to any existing building. Permit $1,00 for each cne thousand cubic feet GARAGES 2-.4 For any ouch permit for the erection of any non -fireproof garages warehouse, factory or grain elevator, or for.the erection of ani non- firenroof addition, for similar occupancy; to any existing building or for each such.. b4ilding•or• addition:, Ninety Cents for each one thousand cu'aic feet or fraction thereof, in the cubical contents thereof w th 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) indhes below, the.floor l-ne of the basement or cellar to the average height of the upper surface er.to the average height of the roof surface of the main. gable of a pitched roof, 2,,� For repairs or altera-6,*:>ls to an existing structure, the fee shall beat the rate of 63.00 fow each Five'Hundred Dollars (6500.00), or fraction thereof in the co , -,U c,f all proposed work., 206In no case shall the fee charged for any permit as set forth in Section 2 be less than -$4.00• SUBJECT Q City of Fridley 1 3050f, AT THE TOP OF THE TWINS BUILDING PERMIT T NO. COMMUNITY DEVELOPMENT DIV. /�� I L V ____ - r PROTECTIVE INSPECTION SEC. `l9 71 1 . � i "'�� CITY HALL FRIDLEY 55432 NUMBER REv DATE PAGE OF APPROVED By .-_•�; L 612-571-3450 910415 11/15/99 JOB ADDRESS 145 Sylvan Lane 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED OESCR. 12 1 Sylvan Hills Ad.dn. Plat #3 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE William Zurbe 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO New Haven Const. 4208 83rd Ave N Brooklyn Pk 55443 566-5225 0 950 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION X REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage 25 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIREO 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 $21851.09' DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATELO AL LAW REGULATING CON- '40R STRUCTION R THE PERFORMANCYPF CO STRUCTION 83.25 j Fire 2.19 PLAN CHECK FEE TOTAL F E e7 e7, _mORq Licen SC 5.0 91 SIGNATURE OF C NTRACTO R AU D AGENT IDATEI N PRbPE LIDAT D kS YOUR ERMIIL.- BLDG ASP � C Y MATE SIGNATURE OF 0W NEROF OWNER SUILDERI IDATEI NEW[ ] ADDN ALTER Effective 5/10/99 [ ] CITY OF FRIDLEY [ ] SINGLE FAMIELY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: 121 Owner Name & Address: Tel. # Contractor: � &V&4.MN LICENSE # Address: klao n Y-4 Am u,& N 6 Nq Tel. # za Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. S OTHER: Construction Type: i� C)e: Estimated Cost: $l� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: it li5l J APPLICANT: Tel. # !S(,o S2 2j� TOTAL $ STIPULATIONS: CITY USE ONLY Permit Fee $ o Fee Schedule on Reverse Side Fire Surcharge $ lq .001 of Permit Valuation (1/10th%) State Surcharge $ , Q $.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 PERNHT 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. sue�ECT MIT NO. City of Fridley 32389 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPMr COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 . , NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 L J` 612-571-3450 910-F15 1/15/02 JOB ADDRESS 145 Sylvan Lane NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 1 Sylvan Hills Addition, Plat #3 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Maria Zurbey, 145 Sylvan Lane NE, Fridley, MN 55432 763-571-2824 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Renewal by Andersen, 350 73rd AVe NE, Fridley, NN 55432 763-502-4777 MN20130983 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Dwelling 7 CLASS OF WORK Cj NEW ❑ ADDITION ❑ ALTERATION O REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 9 windows within existing openings 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulking and flashing for all exterior openings. Permit inspewian Cams Will Be Mailed Tis e Home,owpor Th, Post SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OFCONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 QE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $9,500.00 $4.75 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 $181.25 $9,510 Fire SC PLAN CHECK FEE $5.00 ns TrL'FEE 0.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI HEN PRO VALI T 0 THIS IS YOUR PERMIT BLfG ,NSP riAtE S-GNATURE OF OWNERJF OWNER BUILDER, IDATEI ADDN CITY OF FREDLEY ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: • ly, Legal Description: Owner Name & Address: TYW;o., c.�,t1�c v� Tel. #.4 `S 1 •a�ay Contractor:. Renewal By Andersen _ MN LICENSE # Address: LIVING AREA: GARAGE AREA: DECK AREA: [all 0!: r '. Construction Type: Attach t4 lot, with 350 -73rd Ave. NE Fridley, MN 55432 763-502-4777 #MN20130983 if the - -- -- �. scale. DES.. _ ON OF UW790VEM7.NT. _ Tel. # Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. r Estimated Cost: $ Driveway Curb Cut Width Needed: _Ft. + 6 Ft = Ft x $ = $ forTliaice► . imi.. I,•. � • ! s'rrncn.P.norrs: S -0404F C%�£ lis�� F'bn� CITY USE ONLY Permit Fee $ f 'Dl • 3f Fee Schedule on Reverse Side Fire Surcharge $ ,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 [ 1 TOTAL $ s'rrncn.P.norrs: S -0404F C%�£ lis�� F'bn� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 PLUMBING Permit No.: XOOS - U I Building Inspections RESIDENTIAT, APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: DATEYOUR E-MAIL ADDRESS / SITE ADDRESS _/c /!///-tA " THIS APPLICANT IS: ❑ OWNER 'CONTRACTOR PROPERTY NAME: ADDRESS: `5-ViO �� CITY Ekit- STATE °i&JZIP3�i OWNER/ TENANT PHONE: 7/,;, 3 CONTRACTOR NAME: STATE LICENSE # �/ dcj EXP DATE QI S SUBMIT A COPY OF ,n CITY / STATE/(�1P YOUR STATE ADDRESS: LICENSE WITH PHONE_ FAX APPLICATION PERIVIIT TYPE (SINGLE FAMILY ❑ TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: 0 NEW REPLACEMENT DETAILED DESCRIPTION OF WORK ��%�f% J(�p �Y ®tel0 r 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 WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV FLOOR DRAINS _ SHOWER _ WATER PIPING — BATHTUB _ GAS PIPING fAzw cnrrrc _ SWIMMING POOL —WATER SOFTNER ($35) WATER CLOSET BACKFLOW PREV. ($15) _ CLOTHES WASHER _ KITCHEN SINK _ ^ DISHWASHER LAUNDRY TRAY ,WATER HEATER ($35) FOR IRRIGATION _ — WATER METER —OTHER r _} $10.00 $10.00 = $ Permit Fee $ Number of fixtures @ x Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ State Surcharge = $ 50 Total = $ 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 revie and approval of plans. ` SIGNATURE OF APPLICANT PRINT NAME-�� o `� ✓�`'7 7� r�DATE /)ZgSC�v y50 y _:��rr. City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL PermitNo.: - Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY - I - ® YOj4R E-MAIL DATE I ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑ WNER ''PEONTRACTOR PROPERTY NAME: c4— rYl C� ADDRESS: CITY U TATEZIPTENANT OWNER/ TENANT -STATE-ZIP- PHONE: L®`�; 'S—I CONTRACTOR COMPANY NAME:rr`-"-- ` }i.;c� r�,pt,aA ocr-" F CONTACT PERSON: VA- SUBMIT A COPY OF �qa, 3 YOUR STATE STATE LICENSE # LC"°1 O EXP DATE LICENSE WITH ADDRESS:NSQom. W I (39 `i4l /U CITY CA �.- STATFJiWtI ZIP-553A0 APPLICATION PHONE�IC95- 91- a5;)) FAX 71(,03 - SrIC0 --13R PERMIT TYPE PSINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: %[PEW ❑ REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK PER MS 16B.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 $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) SS$O -�� SIZE/BTUEquipment installed MFG: MODEL: MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEIBTU _A/C $25.00 &ii PLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 TO AIR EXCHANGEER $15 (WOOD) $35.00 _NEW GAS GRILL $10.00 _AIR _FIREPLACE $35.00 $35.00 _GAS UNIT HTR $10.00 _BOILER _FURNACE LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.00 _CHIMNEY _DUCT WORK $10.00AS PIPING $10.00 VENTILATOR $15.00 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 = $ay'm 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 r quires review and approval of plans. � G SIGNATURE OF APPLICA RINT NAME DATE1. City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Frorn: City of Fridley To 7635712746 page: 2!3 Date: 10/22/2008 3.57:22 PM Building BUILDING Pmnit NII.;l7 Inspections RESIDENTIAL APPLICATION R=ived By: _ 6 763-572-497 763-5U2-45177 7 FAX CITY OF,FR;I�DLEY n doff COQ DATE . , l a 1 YOUR E MAID R.I _ , ft„]f� '4 20k i I� C • 15�,1`E..t,��..1q..--�-L1�.�—_�.•:.. .. !C0N!,rRA!C,ro7H� ❑ OWNTsR `TOR NAaq 1 L RAY ADDRR39:I•� _(`1TY_J '[��—S'rATEIZIP irn6 in P110NE 7�- 1+� t c. Ae1/1r j0K1"V1% l�.tut• _4.. t� lt.„ •--+f. /' SUBMIT A COPY OF YOUR STATE LICENSE ANTI C17RTIrIC'ATr (11: INSURANCE PROPkif V TYPE ki5fiT 7'VP0 'I'Ypi•; of wolim, NAM}; • .1 l.. STAIR LICENSE t► EXP DATr (•rTv /' SMOLF, FAMTLY/NEW CONSTRIX-MN S17,F( _ O TWO FAMILY/NEW CCIN5TRUC'TION ST ORSRS A..._.._.. 1J41t1{1 ) _._.. E3 WH")WS ❑ IIAMM ENT FINISH 1r 0 DRAIN TILE 0 DECK 0 SIDING 0 OTIiER 0IRWIMMING POOL ❑ F;W HOME CONSTRI10-ION 0 ADDITION XMAINTIINANCIUREPAIli . T3 REMODELINCI ll DL+SCIUIIIi WORK BEINU Ix)NEi SI1.k OF, IMPROV!(MF(N'I' I,tlNti�il! ROOFING 0 DOUSE ONLY NUMBER OF SQUARF,S HOUSE & OARAO£ CAILAGES PROPOSED SIZE: PROPOSM HEIGHT: t3 A'fTA,'HgD 0ARAGE 17 DETACIIC-D OARAGE P'r $Ai9EA+ ,J�jrMQDh'L[Nt] SUBMM;; 1. riristing 1710cr Pian 2. Proposed flour plea 3. List of structure} members to be used $[DINti FOR NRW CONSTRUCTION INCLUDIN0 Drsr)(R. 13 Vinylg AL)1)1T1UN5. ae 1�()arliLa SULiALI'�; ❑ Aluminum ❑ Trim I. Site P(aWflurvey showing the existing structures ❑ Usher _-- ❑ Fsscia sad proposed proictx. Z. Two sets of rondructine piatw INS 3. Energy C'alculadom F.XISTINU UPRNTNUtS ❑Yes WNu OR FOR NEW UPFXrNGS-DfiSMTRr; SIZE OF IOCATION OF WINDOWS OPENING CHANGES & " "�— TYPTd 0P WlNDnW TO 11F. INSTALLED NUNI RRR OP W1NII()V!5_ ALL FEES ARE B ] I? ON VALIDATION, INCLUDING THE COST OF LABOR AND MATERIALS: T G yiE 1"7 U•11,C FEL( ,SCHEDULE) c'149 TOTAL. J0H VALUA'T'ION it? (X. '1JPANCY Permit Fen $ i (• See Back Page rot- Fee Schedule Plan Review $ 65% of Ridding Permit Fee Fire Stu'cluirlto $ ~— xK11 fillies (tic (41181 doll vult18Oull Surcharge $ 01.1(15 x i'ermit Valuation I'vlirlimum $. SC1 License :iure}torga _ $ _ �� $5.00 (State Limnsed Retidcutial Contrwms) SAC Charge $ $11125 per SAC'' ()nit (Plans to MWC.'(..' for ddtormirlation) Curb Cut I sLTow $ It •+ 6 !t R x $21 1Sroeiun Control $ _ $A 50 C 011sorvation flat) Review Park Fee $ _ _. ._ Fee DeterrnitW by RnginCering _...._.. __ .- .Sower Mau, Charge $ Apreemeul natlessary ( i Nt�n Neoaesary ( ! Total Due $ %L a, 1 Make checks parable to: City of Fridley Attach Tiff$13 AN APPI.I('ATION FOR A PERMIT -NOT VALID (INTIL PROCESSF,D 1 hereby apply for a bulldulR permit altd I acknclwladge that the ullormation Alxlve is complete and accurate; that the work will be in conformance with the ordinoncos and codes of the Cit of Fndley and with the Minnesota Construction C'.odes$- that 1 understand this is not e permit but only an application for a permit work is nut to start without it permit on site, that the work will be in accordance with the aPllroveti MMI ill the caseif a nr whictl r tlt ' es i� ' at Id approval ofpl la. stONATURL OF APPr.ICAN, PRINT NAME. .� , `*��, (�ftkATH t' tI 6� U —_... 11)Ai1VS!L: 31PAkA!L N3RM1I6 ARE .,M,W...G..3...1.i..,1.1.._. ,........ c •.ggra,T Ad 99471':b 900Z/ZZ/0L :948(7 U£ :abed umouNun :wojj WeT CT:bn Qnn7'77'M0n Building "� See Back Page for Fee Schedule BUILDING 65% of Building Permit Fee Permit Ivo.: -. � � 16 Inspections $ RESIDENTIAL APPLICATION $ Receive 763-572-3604 $2000 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$22=$ $ $450 Conservation Plan Review $ CITY OF FRIDLEY $ Date Rec' : 763-502-4977 FAX Make checks payable to: Citv of Fridlev Attach EFFECTIVE 1-1-09 DATE �t%` YOUR E-MAIL ADDRESS jest trft,fG L :jT✓ U✓� %- , °'"� SITE ADDRESS j%s 5y l va v� I THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: Q {-r t c-t'e- M C Co 4 TENANT ADDRESS: CITY FP o � —, STATE"",,, ZIP Y3 L PHONE: '7 So 2 ' Z `( Z 1 CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE rLr SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ,§SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: `^� V\ %'J I CXC c SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: �IDJ G FOR NEW CONSTRUCTION INCLUDING DECKS, ,MVmyl ❑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 $ , 5'0 0 OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ f �j , "� 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) $ $2000 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$22=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ I Agreement necessary ( ) Non Necessary ( ) $ Make checks payable to: Citv of Fridlev 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 1 understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all4_)tn__n wor which 7ires review and approval of plans. n SIGNATURE OF APPLICANT PRINT NAME Pfn�-C t ci•Z �y l C C DATE { J Page 2 - Building Residential Application 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 (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 15` $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 1- $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 " $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 l" $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 Fax: 763-502-4977 Building MECHANICAL Permit No.:` WrW5 �Vl Inspections Received By: , p RESIDENTIAL APPLICATION 763-572-3604 CITY OF FRIDLEY Date 763-502-4977 FAX r..., R..,r , , DATE SITE ADDRESS — THIS APPLICANT IS: PROPERTY OWNER/ TENANT E -//MAIL ADDRESS.7YL—Vpd ❑ OWNER CONTRACTOR CONTRACTOR I COMPANY A SUBMIT A COPY OF CONTACT PERSON: Q.V HEATING & AIR IN YOUR STATE STATE LICENSE # 5162 WEMMOADWAY LICENSE WITH ADDRESS: CRYSTAL, IMM STATE ZIP APPLICATION PHONE -635-2000 PERMIT TYPE TYPE OF WORK: I ❑ NEW FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE DETAILED DESCRIPTION OF WORK ❑ ALTERATION/REMODEL FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK. /_"� j],� P�` �P 077 } Equipment Installed MFG: C MODEL: �[% / 7 f SIZFJBTU �f '0P;'/SIZE/BTU MFG: MODEL: / SIZE/BTU MFG: MODEL: SIZE/BTU XA/C $25.00 FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 _AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 GAS GRILL $10.00 _BOILER $35.00 Z>< FURNACE $35.00 _NEW _GAS UNIT HTR $10.00 _CHIMNEY LINER $10.00 _GAS DRYER $10.00 HEATER $35.00 _DUCT WORK $10.00 GAS PIPING $10.00 _POOL 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 pe it approved plan in the case of all worrhiand work is not to start without a permit; that the work will be in accordance with the �uire�wnd approval of SIGNATURE OF APPLICANT PRINT NAME �. DATE WIHR APPROVAL DA 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 REQURIED 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 MN Rule 1346 Sec. 501 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments 4. Heat loss & cooling load per room a. MN Rule 1322, Sec. N 1104.4.13 5. Ventilation a. Per MN Rule Chapter 1322. Sec. 1104 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. Building PLUMBING Permit No.n15 Inspections RESIDENTIAL APPLICATION Received By: owt 763 -572 - CITY OF FRIDLEY Dat 763-502-49774977 FAX EFFECTIVE 7-I-2010 DATE L YOUR E-MAIL ADDRESS SITE ADDRESS i Su1toaes L -✓i E,�dte�j i-LIV THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: ADDRESS: CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR NAME: 'T e -a c S y - ,O, i STATE LICENSE # Ob t rl'i lf,I�� EXP DATE %� LAI 0 SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS: I;z E KeA111 CITY ,a STATE H 4V ZIP w730_ INSURANCE FAX �1 s} •`� -% % C� PHONE (. • S-7 - Z11-6 SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE PERMIT TYPE NEW ❑ REPLACEMENT TYPE OF WORK: DETAILED DESCRIPTION OF WORK j —._,(A w4:4,, ( c�k yA f FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. BATH SINK/LAV DRAINS SHOWER _ WATER PIPING _ _FLOOR _ GAS PIPING (NEED CITY LIC) SWIMMING POOL WATER SOFTNER ($35) —BATHTUB _ _ WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREY. ($15) —CLOTHES _ _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION —DISHWASHER _ WATER METER —OTHER i� k al b s Pr,ttG 1 1. -. t! i t 16u� i ftX'•:kiir'4SJM, 1•i' 1,1. 4,F¢�s , i; 6 ; P '4i t 1 ] -' t d J t `\ ,aFt i� "W 1.:', 5 �§ N J �F Vit: aV A alp ! .,. 1.' �., � i} 4f iy� 'I i��`'^ wX. jtl"'�1�P5{4i RfillY IY-�i. 1 .V �i i11R11V 1 ➢'i fN S�t `Ydt'"]�i' S FY�S '�i�i'iF5� \eN Y .4CF �� `S4N9�Ci;l,G�}Ff� �e 1N1 Jl{Yr A1�j��y�/14y yiY 1 tYit�7.i ��u"A.. }hV 14 'Z� ',:J4 4" �j;{X t ]Y Sft�J' 11F Y'_ 1•` 9 ..3�'""y I a?,� h �.t,li 1 �'.rdr„1 : , „, t wr; Xtmp�"t7� q�: ti \ n }._,r�.. 1 F . ' 1 Y >7 a els �!'�. r �"w 1 r��d..pnh�1 "�iA "'I v t „c�.lL'{ Ir Y,�qs �1�1b 4�`'�ere�' �°^�'{+i1 � .}.F �' s,`vi�iv i`S}i'S!f r ur#�`lyrtl'?ft �"�?� r<t��i. "'`�r"1� i4✓ ��'�h,(;: d 'rGw f. o`,,'�, � l;a"f IAI '9d;� '.. �'�'.d i �d�1r "ia b �J; a+'�' ��'4j'��: / -t "�, I* -� n 5 4rk "�E. :� t•,�;e n Hr 4.: aq^^' n',�.. ! h'��7''�"�'...: � i ,i fK?v,�: n P , �„ .r vk •Y�.r V : r.« A i ��;,. pc ` hr t � � ♦-S4 n TA �y r ! � 1 t ',. 1 `�fA � A� t r 5 J I'a � v 3kSM1 �'� e' .. Jl .r✓ '-:'�. ly ��S Y9 � fY!'.� 1%„ F 'F 2� i V: t y�!,.�k1�V�k�V S „'r 4 j i ,Y f �1 1(J hA _�tt` t�%r{ `�� ' ?�+" i 1 fn1 Vly l!(f �'4 }IY3 Y/ ,'Jr ��,I �: 7r '} �5{ rr TS dJk.Y �' 1 y)YV Y'7 �,r 4f� F N�MS�i., 1,4iq ', h�11 1 t i 4... :yy-3 Yl-"7Y�,?� t V, \l)✓YY �1' R !'L l'/,i1V1 1 N Y }::: Rt } 4t "Q ii f F THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 on site; that the work will be in accordance with the approved plan in the case of 11 work w ich req r re iew and approval of plans. SIGNATURE OF APPLICANT R T AME k, R y� !til DAT f [O APPROVAL INSPECTORS SIGNATURE �y s City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977