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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N® 4 s o 1_-g Date: ....._.._.A .._." ._ _.. "` —.__.....__._. Owner: ..._ ...:.... �� ...:._. __....._ .. Builder ............. .........•. _......_ - - •--.._._..._...__ ._._...... _........ __..... .._.....___ Address ..... _... ,. i _ !i Address _....._.. ae_..... ....._............. :.-�- LOCA�'I OF BUI DING No... Al _ Stredt .. Part o ......._._ Lot ................._ Block _--- _ clition or Sub- vision ...._... ..,, ..... ._....._._.. CornerLot .................................... Inside Lot .................................... Setback ........................... _............. Sideyard............................ .................. ......................... Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To s� as: ..._...... ...:..:. - - •.- -.... Front .. ... ...._.. Depth ..... ...t Height ............. Sq. Ft. .............. ....... Cu. Ft. .... ............... of Construction .-.Front_ . ............ Depth st. Cos ..._...... eight ..........�. Sq. Ft. ..... _................. Cu. k't. Type _......... ...... 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. 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 ',--*d moving of buildings within the city limits and this permit may be revoked at any time4`po on of ' of the provisions of said ordinances. �. a��1`� / Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. 4 �, --".M APPLICATION FOR BUILDING PERMIT CITY OF FRIDIBY, MINNESOTA LOCATION OF BUILDING No. . E h- Street s L, ,,; Part of Lot Lot Block Addition or Subdivision 2��2 �24a Corner Lot Inside Lot Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction &de Estimated Cost —V-3 2_6, 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 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. n A W rl , .A /7' %.� — / 4 SIGNATURE .P /i" • �� (A Schedule of Fee Costs can be found on the Reverse Side.) 1 J M' ' D 1 f;J l 1 Section 2. The Inspector of Buildings shall, before issuing any permit for the erection of any building or structure, or for,.any addition to any e#,st3ng build- ing or structure, or for any alterations or repairs to any existing building or structure, upon application therefor, require the payment by the applicant for such permit of fees to the amount herein below set forth and'in the meaner herein provided to -wit: 2.1. 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 fire- proof addition, for similar occupancy, to W existing building shall. be at the rate of $1.40 for each one thousand cubic feet, or fraction thereof, in such cubical contents. 2.2. For any such permit for the erection of any fireproof garage, warehouse, factory or grain elevator, or for the erection of any fireproof addition, for similar occupancy, -to any existing building shat 3 be at the rate of 41.25 for each one thousand cubic feet, classified as "fireproof" by Section 502 of the Minneapolis Building Code. 2.3. For any such permit for the erection of any non -fireproof building ether than a garage, warehouse, factory or grain elevator, or any non, -fireproof addition, for similar occupancy, to any existing building. Permit $1,00 for each one thousand cubic feet. 2.4. For any such,pe'rmit for the erection of any nor. -fireproof garage, warehouse, factory or grain elevator, or for the erection of ant noefireproof addition, for similar occupahoy, to any existing building or for each such building or addition. Ninety Cents for each one thousand cubic feet or fraction thereof, in the cubical contents thereof with a minimum of $4.009 For the purpose of computing fees for building permits the cubical contents of aW building or addition to a uniform height throughout by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or cellar to the average height of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. 2.5. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 for each Five Hundred Dollars ($500.00)9, or fraction thereof in the cost of all proposed�vark. 2.6. In no, case shall the fee charged for any permit as set forth in Section 2 be less than $4.00. 01 SUBJECT PE RMIT City ®i Fridley o " 17 5 3 6 AT THE TOP OF THE TWINS BUILDING PERMIT f ' , RE COMMUNITY DEVELOPMENT DIV. L r PROTECTIVE INSPECTION SEC. /:3 NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/6/84 JOB ADDRESS 48 Talmadge Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR: 4 Lund Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mark Baland 48 Talmadge Way N.E. 571-9694 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. All Seasons 2717 E. 32nd Street, Mpls., MN 729-0717 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 Ej ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling 9 CHANGE OF USE FROM TO w. STIPULATIONS Roof can be the 2nd roof but not the 3rd. Install ridged galvanized valleys where necessary. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Asphalt ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,400 $.7O WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $23.50 AR,LICTION OR THE PERFORMANCE.OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE > a >;� °- ?1GNA?TU?R0a/1' "(DATE) $24.20 FCONTRACTORORAUTHORIZEDAGENT WHEN PROPE5LY VALIDATED THIS IS YOUR PERMIT BCD -G1 N -S TE SIGNATURE OF OWNER IIF OWNER BUILDER$ (DATE) 01 NEW [ ] ADDN. [ ] ALTER. [ ] Construction Address: Legal Description:_ Owner Name & Address: Contractor: rf Address LIVING AREA: GARAGE AREA: DECK AREA: OTHER: City of Fridley R-1 AND R-2 Building Permit Application Te - I Effective 4/1/84 Tel. � / �J'l Tel. #%2-9-1 70 Attach to this application,,a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length Length DESCRIPTION OF IMPROVEMENT Width Width Widti Height Height Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot ['] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: TOO g*Cr Estimated Cost: $ �"�`�• Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation DATE: Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS• APPLICANT: Tel. CITY USE ONLY $ 'A3 Fee Schedule on Reverse Side $ 25% of Building Permit Fee $ '7U $.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. FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 June 28, 1995 Property Owner/Occupant 48 Talmadge Way N.E. Fridley, MN 55432 RE: Property at 48 Talmadge WAy N.E. Dear Property Owner: Fridley Zoning Code requirements state: "No land shall be altered and no use shall be permitted that results in water runoff causing flooding, erosion, or deposits of minerals on adjacent properties." Recently, I observed some driveway/retaining wall construction activities at the above listed address that may be in violation of the City Code. Please review this situation and take whatever action may be necessary to correct this problem. Feel free to call me at 572-3595 if you have questions or wish to discuss this further. Thanks for your cooperation. Sincerely, Kurt Schneider Code Enforcement Officer KS: da CE -95-147 September 10, 1997 Mr. Clayton Berg Building Inspector 2015 First Avenue Anoka, MN 55303 I prefer to remain anonymous but given the circumstances it will b=Talmadge ate..-.� a. However, I feel it is necessary to inform you that the property 4Way, , _ Fridley, MN is being altered significantly and without building perm The current owner is Mark S. Dalbotten and he has significantly remodeled his kitchen (which is done) and is currently working on remodeling his basement - already creating a bedroom (complete with wall and a door), a living area, and is in the process of making a kitchen and bathroom also. Had I not been renting from him while he was doing this work, I wouldn't have known of his activities, but I was present. This man believes he is above the law in all aspects of his life and disregards any rules that apply anywhere. For this reason, I am reporting this whole scenario to you because not only is he scamming the welfare system, but he is avoiding paying property taxes. He will tell you that he has done no work on the house since purchasing it, but this is a blatant lie! He has done significant wiring and plumbing in the basement and kitchen. If you should need further assistance, please feel free to contact me at 313-1074. Sincerely, Becky Behlen sue.iEtr MIT NO. City of Fridley 3 16 59 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. _ COMMUNITY DEVELOPMENT DIV. � INSPECTION SEC. r � PROTECTIVE CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 9 3/5/01 JOB ADDRESS 48 Talmadge Way NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 1 Lund Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 'N Mark Dalbotten 48 Talmadge Way NE 763-413-8797 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Ron Novak Construction 18410 Jackson St, EaSt Bethel, MN 55011 763-413-8797 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO - 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION O ALTERATION j] REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Fire Repair 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. SEPARATE PERMITS WINED FOR: WIRD HEATING PWMBIN6 AND SIGHS 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 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $40,000 $20.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS F ANY OTHER STATE LOCAL LAW REGULATING CON - RUCTION R THE PERFORMANC CO UCTION $.542.75 ire SC $40.00 PLAN CHECK FE OTAL FE Lice S $5.00 $ 07.75 SIGNATURE OF CON�RACTO OR AUTMOR12EDAGENT �DATEI N P O E LY A DATED H1 15 YOUR PERMIT SLOG SP DATE SIGNATURE OF OYYNER IIF OWNER SUILDERI IOArEI NEW [ ] Effective 1/1/2001 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: � �� L ��7 7 �'l C Y fit d la Legal Description: Zc 7- �{ L UNCI A w.� z e�"t"1>/C w C ' Owner Name & Address:' �'/� �° 11 / <1 a� t �ks �, e� . Tel. Contractor: he 4A �' � ,-�,� MN LICENSE # Address: /` `Il C= TA e /< r�. �, ; e Fg,T �3� t�,«L `7 / / Tel. # y// 3 y 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 3 Width Height Sq. Ft 7 2 0 - GARAGE GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgfi/Ground Sq. Ft. OTHER: Construction Type: Pig) w '� ele-% �. Estimated Cost: $ fa2Z! `,6A A4 6, Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $. DATE: A6 d - / APPLICANT: Ro ✓ �c �C �c.�� r. Tel. # 7(-,3 3 -c ✓ `� CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge .001 of Permit Valuation (1/10th%) State Surcharge $ Du $.50/$1,000 Valuation SAC Charge $ $1150 per SAC Unit License Surcharge $ - Ga $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 $ 6167• 7G - 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 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. New Houses Only /NST 0 >OV*--jS ��-elW - — .4; -- O000%�Iopve 0 11'5 LIVING AREA 720 sq ft �--- 64 � 8' - 4' — — -1, — 5'1 -- 67 �I 18'4 I 1118 30' v Avo .00�Vo .004e Z4!5Vge� e000 10 R b' • � M N CIlYOf' FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 February 15, 2002 Ron Novak Construction. 18410 Jackson St East Bethel, MN 55011 Re: Final Inspection at 48 Talmadge Way NE, Fridley Dear Sirs: A final inspection was conducted on February 15, 2002 for the fire repair at the above address. The inspection noted that the construction was completed according to the approved plan and occupancy of the building is approved. If you have any questions concerning this matter, please feel free to contact me at 763-572- 3602. Sincerely, RON JU Building RJ/mh A. CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 YAX: (763) 571-1287 ADDRESS : 48 TALMADGE WAY NE PIN : 103024140038 LEGAL DESC : LUND ADD : LOT 4 BLOCK 0 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-01827 e�q I DATE ISSUED: 10/06/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL A SAVERS SWITCH. # INSPECTIONS 1 APPLICANT HUNT ELECTRIC CORPORATION 2300 TERRITORIAL RD ST PAUL, MN 55114 - OWNER ANGIE WOLTERMAN 48 TALMADGE WAY NE FRIDLEY, MN 55432 ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 118132 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ,ITY OF FRIDLEY INSPEC'I iON DIV. 431 University Ave NE 'ridley, MN 55432 -63-572-3604 Urinal 3 11 �"(J( 1 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR NOW Floor cv Auto. C Tr2v Washer V� as Wash r Drain n rain Effective On Jan 1. 2001 Heater FE1_(i;_ Moor ---- [Floor 2 Floor 3 Floor 4 001 e166 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS New Fixtures $7.00 The undersigned hereby makes application for a permit for the work herein $4.00 specified agreeing to do all work in strict accordance with the citycodes Old Opening, New Fixture $5.00 and rulings of the Building Division, and hereby'declares that all the facts Beer Dispenser $7.00 and representations stated in this application are true and correct. Blow Off Basin $7.00 20 Catch Basin $7.00 -------- -----• Rain Water Leader SumplRecelvilng Tank $7.00 Water Treating Appliance $10.00 Owner Water Heater -Electric $7.00 Building Used A Water Heater - Gas** $10.00 Gas Range" $10.00 PERMIT NO. Gas Dryer** $10.00 Estimated Cost L, �_00 Back Flow Preventer Required )Yes O No $15.00 PLUMBING COMPANY Type$15.00 TEL NO. e le Reinspection Fee $47.00/Hr SIGNED BY ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By --M Rough -In Date Final Date State Surcharge LA— LREJ'�'1111111 IS $20.00 TOTAL FEE $1)3.S-0 MINMUIM-EE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes ( ) No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes ( ) No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When Installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( ) No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date: Building ®� BUILDING �' See Back Page for Fee Schedule Permit No.: Inspections RESIDENTIAL APPLICATION Fire Surcharge Received By: 763-572-3604 CITY OF FRIDLEY $ Date Recd: S a, DATE `� v2 - C� % YOUR E-MAIL ADDRESS $ SITE ADDRESS Ll 9 C c SAC Charge THIS APPLICANT IS: 10 OWNEReONTRACTOR $1550 per SAC Unit (Plans to MWCC for determination) PROPERTY OWNER/ NAME: ,(\ f'2,�- t'k ft + 6 ft = ft x $21= $ TENANT ADDRESS: '5-- Me CITY STATE ZIP Park Fee PHONE: Fee Determined by Engineering CONTRACTOR NAME: I Me C�4et *"c S� Agreement necessary ( ) Non Necessary ( ) STATE LICENSE # �6 ?7 (o EXP DATE -3 ' 3I -d '7 $ SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS:_/3SZx�) Sr. CITY AnAnVc, STATE01AZIP5'S WITH APPLICATION PHONE a42-3 . 77-IS FAX PROPERTY TYPE -13zsINGLE FAMILY N SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH -ZROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION NkkINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE-_)kt, � ��(vc�S . SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2• 3. Proposed floor plan List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations 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 $ OCCUPANCY TYPE Permit Fee $ �' See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ f .001 times the total job valuation Surcharge $ 1. d .0005 x Permit Valuation Minimum $.50 License Surcharge $ 6-m $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ / , Make checks vavable to: Citv of Fridlev Attach Stipulations 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 whAre u and approval of plans. SIGNATURE OF APPLICAN G L PRINT NAMBC h-�I rf <C 6�,Q r\, DATE Page 2 - Building Residential Application I:Iia_1610l ft93" IaS51W16iIIm111)61 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 1a $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 I' $100,000 plus $5.60 for each additional $1,000 or fraction to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the 1' $500,000 plus $4.75 for each additional $1,000 or fraction to and including $1,000,000 $1,000,001 and up $5,608.75 for the I' $1,000,000 plus $3.15 for each additional $1,000 or fraction VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 Building $ BUILDING Plan Review Permit No.W--gpt Inspections Fire Surcharge RESIDENTIAL APPLICATION E, !S'CD .001 times the total job valuation Received By: 763-572=3604 !, .0005 x Permit Valuation Minimum $.50 c CITY OF FRIDLEY $ Date Rec'd:AD-7 DATE Q� YOUR E-MAIL ADDRESS CVJYN LJ- tJC.l-MU $1675 per SAC Unit (Plans to MWCC for determination) SITE ADDRESS _ 45 —TO -1 m GdC e- W 0k� 1.1 t— $ THIS APPLICANT IS: 'OWNER ❑CONTRACTOR $ PROPERTY OWNER/ NAME: A -K 12 S-} $ TENANT 4 ADDRESS: V s 1 (J (/ V N F CITY E IL �.¢ t� STATi�lP S "-+?2— Agreement necessary ( ) Non Necessary ( ) PHONE: —7 % 9 -5 $ CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE—ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE INGLE FAMILYMEW CONSTRUCTION SIZE t to TWO FAMILYlNEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ((BASEMENT FINISH 11 ROOF 13 DRAIN TILE °❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCEIREPAIR REMODELING no wylokws DESCRIBE WORK BEING DONE: Cd C. ' GtS'#ver• f' --IbUlivq In GLV WGt IO a` SIZE OF IMPROVEMENT 2-02 -3 LENGTH 2 WIDTH Z.� HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. 3. Proposed floor plan List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other . ❑ Fascia and proposed projecL WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations 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 $ tJQLk35C0 OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ , 65% of Building Permit Fee Fire Surcharge $ E, !S'CD .001 times the total job valuation Surcharge $ !, .0005 x Permit Valuation Minimum $.50 c ( License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ e -1Make checks oavable to: City of Fridley Attach Stipulations 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 w 'ch requires review and approval of plans. SIGNATURE OF APPLICANt PRINT NAME A`i YO f WC)1 e1R4 W, DATE I �/ 7 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 1'$25 , 000 plus $10.10 for each additional $1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for 1s` $50,000 plus $7 for each additional $1,000 or fraction to and including $100,000 $100,001 to $500,000 $993.75 for 1" $100,000 plus $5.60 for each additional $1,000 or fraction to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the 1' $500,000 plus $4.75 for each additional $1,000 or fraction to and including $1,000,000 $1,000,001 and up $5,608.75 for the 1' $1,000,000 plus $3.15 for each additional $1,000 or fraction VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-5024977 E bax ow�SiL-Ac WOL I 0 IE F - k X900 ��5 tj � w ��` a q. ,G Lel �1 c� Oi va OR Ce EQua` 0 4-A. -ftocop 4 -ral oci ae- lk�j �cAl . Im 11-v+1 ZA sc 2-)oL i JVN 69 -Fru-nn i�`� c Esc' Ana -�) ti C) C) P. (74- e4c,")',e i tip hr -.'e of 2�-� CSS �CA � 4b ��lr- ti a `t olo0P-- �e jhi- nnbch . — etj 2q4