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PRE 2010 DOCSCity of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number. Kind and Location of Fixtures Location PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ............................ Water Heater (Up to 99,000 BTU) ...... New Ground Run Old Bldg. ............ Electric Water Heater GAS FITTING FEES: 1st 3 Fixtures .......................... Additional Fixtures .................... Gas Range to 199,000 BTU ............. REPAIRS & ALTERATIONS—Refer to Code — x $2.00 $ — x $1.50 $ ZZ $ — x $3.25 .1 �U' a� z 0U' O • F + N WATER HTR. GAS ELEG Base 1st 2nd 3rd 4th _ ` Future Connection Openings * New Fixture, Old Openings I Connected with Sewer E] Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ............................ Water Heater (Up to 99,000 BTU) ...... New Ground Run Old Bldg. ............ Electric Water Heater GAS FITTING FEES: 1st 3 Fixtures .......................... Additional Fixtures .................... Gas Range to 199,000 BTU ............. REPAIRS & ALTERATIONS—Refer to Code — x $2.00 $ — x $1.50 $ — x $1.50 $ — x $3.25 $ — x $3.00 $ — x $3.25 $ — z $2.00 $ NO. RATE TOTAL x $2.00 $ x$.75 $ x $5.00 $ Description ........................................ ......$ TOTAL FEE $` City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn` Owner Kind of Building Used as To be completed about Estimated Cost, $ Old—New. Building Permit No Permit No. Signe By �/ 1 1 l Business Phone No.' 7 D' ` `� ROUGH FINAL--/ 42 19— Applicaflan fw Pow a ,.ft CoangM Air0x-2 and 001a C&RA'FYT"r' WARM AM: MTM !T07JUL Furnace Shell & Duct Work, ... ... .810.00 $ Replacement of Furnace 6.00 g Repairs & Alterations—up to $500.00 600 $ Repairs & Alterations each add. $.500.00 300 3 HEML WARM AM rurnsce Shell & Duct Work to 120,000 BTU ..$10.00 $ e2ch add. 60,000 BT'BJ 3.00 3 Replacement of Furnace 6.00 � Repairs & Alterations—up to $500.00 6.00 $ Rapairs & Alterations each add. $300.00 3.00 Furnace Shell & Lines—to 400 sq. ft. FMR Stearn $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00 $. Each add 200 sq. ft. EDR Steam 3.0f1 $. Each add. 320 sq. ft. EDR Hot Water 3.00 $ ®IL MURNER—to 3 gal. per hour 6.012 $._______ over 3 gal. per hour --See Fee Schedule CAS BXMNER (up to MOM BTU) 6.00 $ oyer I99,0M MU See Fee achadula CAS FITTING Fr` M NO RATE TOTAL Ist 3 Fixtures x$ 200 3 Additional Fixtures a .75 $� Gas Range to 10,E x3 5.00 rnmL 57_p%'J State Surcharge .50 1 Fee schadab TOTAL $ City of Mdley: The undersigned hereby makes application for a permit for the work hereW specified. agreeing to do all work in strict accordance with the City cev and ruling of the Department of Buildings, and hereby declares that all the facts - and representations stated in this application are true and correct. chvner d Kind of B Used as To be Corr Fridley. Afinn_ --� ® - � 1w � -- Estimated Cast; $ Old—New. Building Permit No. ___ Pormit No. e� HEEA71NG or POWER M --steam, Not Water, Warm Air—No Trade Names a Sbe N® Capacity—_ .— Sq. Ft. E.D.R EMUMr- PIP Total Connected ® of 1 "ft fm— Sine No em. -1 SUBJECT P City of Fridley 3045 5 AT THE TOP OF THE TWINS BUILDING PERMIT E�TN COMMUNITY DEVELOPMENT DIV. � r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By J\ 612-571-3450 910-F15 10/29/99 JOB ADDRESS 5865 Tennison Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 1 Parkview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David Ferguson 586-0846 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Added Value Exteriors 1607 University Ave St Paul 55118 651-647-6777 5945 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 ❑ ALTERATION ®x REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house (24 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. 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 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 � $2098 $1.05 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- STR CTION OR THE PERFO A E OF CONSTRUCTION $83.25 + $83.25IF SWX.Jire SC $2.10 PLAN CHECK FEE TOTAL F V -;r 5' Lice S 5.0 $17 .65 ATUitE OF CO CTOFr OA AUTMOR�ZED AGENT [DATE, EN ROP L ALIDAT BL ,NSP IS IS YOUR PERMIT av �. pAtE S.GNATUFIE OF OW NEA OF OWNER Bu40M t -OA TE r I .. NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 4��1 lh Construction Address: Legal Description: Owner Name &Address: z4; ,/ Tel. # l sz - 5"�'/ Contractor: MN LICENSE # OS' 9L'5' Address: Z6d 7 Tel. # a7 7 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: i,; �- /e oaG lwd� s-5- % y S & 1� Construction Type: Estimated Cost: $ d6 9� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: r APPLICANT: Tel. # % �5 ( 777 CITY USE ONLY Permit Fee $ 83, Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ / (j�` $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ y O 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 i $ 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. FA sueJECi PERMIT NO. City of Fridley 32799 AT THE TOP OF THE TWINS BUILDING PERSIIIT r - COMMUNITY DEVELOPMENT DIV. r � PROTECTIVE INSPECTION SEC. 1 NUMBER REV DATE PAGE OF APPROVED er CITY HALL FRIDLEY 55432 612-571-3450 L 910-FlS 7/18/02 JOB ADDRESS 5865 Tennison Dr NE a 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 4 1 Parkview Manor SHEET 2 PROPERTY OWNER MAIL ADp DESS ZIP PHONE Peter Ralston, 5865 Tennison Dr,.Fridley, MN 55432 763-502-8390 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Peter Ralston (same as above) a 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 C:k NEW ❑ ADDITION O ALTERATION O REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Install new deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plans. WARNING sefore digging call fOT all utility locations 454.0002 R[EQUIRED BY LAW TYPE OFCONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING. HEATING. VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 12Q DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $931.50 $ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .50 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- $38.75.. Fire SC $.93 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOT FEE 1-01 0.18 R TURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI HE PROP VALIDAT THIS IS YOUR PERMIT S,GNATURE OF OWNER OF OWNER BUILDER) ATEI OG INSP GATE FA NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2-,- BUILDING PERMIT APPLICATION Construction Address:b� / °L,�1�'I l /vl ADZ Legal Description: Owner Name & Address: 7-,, z, 7w;'v� Tel. # � �a` �6 Contractor. Nnhe MN LICENSE# Address: NIA Tel. # /V/74 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�l ' r� Width /O ej HgtiGround /'7 ", Sq. Ft OTHER: .l Construction Type: (� �� Estimated Cost: $ l Driveway Curb Cut Width Needed: Ft + 6 t= Ft x $ =$ DATE: 16 4V- APPLICANT: Tel. # JLD- S,3 100 Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by 'Engineering Agreement Necessary [ ] Not Necessary [ ] $ TOTAL i� A i _ 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 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 $50,00 $643.75 for first $50,00 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 $1,00,001 and up $5,60$.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) Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $17.00. Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. VERIFICATION OF FOUNDATION A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only A. �-,, S;�, : % 1 0 cx>riner Foo�in5 i�22s; " dlo , ZAe.rme-aickfalI a.r „ • _ �• ,�� pig • � f � o ' .be'• �.,:1. C . P05V s,w- : u x y Ael ' �o►s�s ► �X6'' x IQ' o'' PosfS Spo�l�y op 361%% s�, G, -rye L D&k 5 AC 2 trmAtA f -I . HIP -.1P DV DIt&- N� IoNje. 6 (&-a e. . 'L. No �uaYdYa► � 0 Nc�es', I.edy-Y �100: -A is le &y r &Iord� Rosso op u� le &y r &Iord� Ap,0 ' � f ell op u� Ap,0 ' � f ell I 110/lEg- Building MECHANICAL Permit Inspections RESIDENTIAL APPLICATION Received BXN 763-572-3604 CITY OF FRIDLEY Da 4_201 763-502-4977 FAX EFFECTIVE 1-1-08 DATE --n- OS YOUR E-MAIL ADDRESS ra S 00�,L Y y M. 0, t o SITE ADDRESS 5 $6'� U1Pu3*; THIS APPLICANT IS: *OWNER ❑CONTRACTOR PROPERTY NAME: S D' OWNER/ TENANT ADDRESS: 01-S Ct CITY STATE ZIP PHONE: V ')- 3S O - M_R CONTRACTOR COMPANY NAME: NOTE: SEPARATE CITY CONTACT PERSON: LICENSES ARE STATE LICENSE # EXP DATE REQUIRED FOR GAS AND HVAC. ADDRESS: CITY STATE ZIP SUBMIT COPY OF BOND PHONE FAX AND INSURANCE PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: NEW. ❑ 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 ) OR 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) Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU A/C $25.00 _FIREPLACE (GAS) $15.00 X 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 HEATER $35.00 _POOL DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 PEST EI PRC ,. u F©R. NI ER P i iT FE -,,,F ,o .: .. .. .., s a „Pty .... ...•: Permit Fee $ Number of fixtures @ $10.00 H x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ OR Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ G .50 MINIMUM $15.50 MINIMUM $15.50 Total = $ THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a mechanical permit and I acknowledge that the i ormation 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 Construct. n 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 with approved plan in the case of all work, which requires review and approval of plans. ®' SIGNATURE OF APP C PRINT NAME 1-514"A Al DATE -ad APPROVED BY DA FRSE NQS EI'` . ,.. IE PEII If'S . iTIRl; FORCEIING, ELECIRICAL1Dv1CHtN1CAI :: Q City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Addendum to Homeowner Request for Electrical Inspection Project Description I will be removing my existing fuse box and replacing it with a breaker box. I will also be splitting several existing circuits and adding others during the course of a kitchen remodel. Building BUILDING Permit NoD6 "bb Inspections RESIDENTIAL APPLICATION Received By 763-572-3604 CITY OF FRIDLEY DaRMdAP6 763-502-4977 FAX EFFECTIVE 1-1-08 aS— Q S ) ��ryry fa OV 3 ° `JT DATE r YOUR E-MAIL ADDRESS USW I n . C.d-A� SITE ADDRESS 52� Q, Q4!� THIS APPLICANT IS: 24OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: Wy- �Z S ADDRESS: S CITY STATE ZIP TENANT PHONE: NAME: ADDRESS: CITY STATE ZIP CONTRACTOR SUBMIT A COPY OF PHONE FAX YOUR STATE LICENSE STATE LICENSE # EXP DATE PROPERTY TYPE NGLE FAMI /NEW CONSTRUCTION SIZE ❑ TW Y/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED >1WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING X76fHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCEIR//EP IR 3REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH 11 WIDTH11q,, HEIGHT 76 SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 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: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ❑ Vinyl _ ❑Soffit� p D aa ADDITIONS. & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures 13 Aluminum ❑ Trim �J Le, ' ❑ 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: "SING THE )j99_T�BC FEE SCHEDULE) V Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due TYPE 457 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) $ $1825 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ rn . (i Make checks savable 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 a 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 MinnesotaCo n n Coc s; t 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 accor the a plan in the case of all work which requ!Nsreview and approval of plans. SIGNATURE OF APPLICAN�i ' — �—� PRINT NAME , 5 ��» DATE �' �- APPROVED BY DATE 11 Addendum to Building Residential Application: Describe work being done: This permit will cover work done on the kitchen area of the house. In general terms the area will be gutted to the studs/exterior sheathing and rebuilt from there. This will include new plumbing lines, new electrical, reroute of existing ductwork, new insulation, and new drywall. Additionally, two of the smaller windows in this room will be removed while the larger window will be centered on the wall and replaced with one slightly smaller and more energy efficient. Of �.� course this change in the arrangement will neccessitate some patchwork on the existing cedar lap siding. Due to the change in location of the cooktop, a new exhaust vent will run through the roof while the old is closed and patched. Building PLUMBING Permit No.: _ 60 Inspections RESIDENTIAL APPLICATION Received By 763-572-3604CITY OF FRIDLEY Date 9 APR . 3 21 0pp2-4977 977 FAX 763-5q-2-3-C) EFFECTIVE I-1-08 i DATE - 2- J -C) � YOUR E-MAIL ADDRESS g CkSITE ADDRESS (,5- Te_,yAF11So D, NE' THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY app® NAME: W r VOL(40-r' ADDRESS: Same Ct> Ck yV-0' CITY STATE ZIP OWNER/ TENANT PHONE: ` ( -0514 CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS:. CITY STATE ZIP INSURANCE PHONE FAX PERMIT TYPE INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ANEW UKPEPLACEMENT DETAILED DESCRIPTION OF WORK Q 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 = plus .50 surcharge OR FOR PROJECTS WHERE LABOR. EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $15.50. BATH SINK/LAV FLOOR DRAINS SHOWER - WATER PIPING _ _ BATHTUBPHaWG (NESS CITY LIC) _ SWIMMING POOL k' WATER SOFTNER ($35) WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREY. ($15) _K DCLOTHES ISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATIQN Y, _ WATER METER OTHER td++ I B ? y PEII Vii; .".. E.R(7ECTS EOR T71�1DER'uww ', PERMT'I IIiE`F F»�CT Q „ It (}__ Permit Fee $ Number of fixtures @ $10.00W x$10.00=$ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ OR Number of fixtures @ $35.00 ?_ x $35.00 = $ 1 TOTAL DUE $ State Surcharge = $ .50 $15.50 $15.50 Total = $ N6<0 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 anwork is not to start without a permit on site; that the work will be in accordance with the approved planin theof a ork whi r quires review and approval of plans. SIGNATURE OF APPLIC / PRINT NAMEJ ! !� s d� DATE APPROVED BY DATE PERE . ..Tl PE ,` . 1 A,RF F©R;B%TL D1NG E1Eti1CAL AND';Mll`11AN1C W1{ City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 3 Addendum to Plumbing Residential Application Detailed description of work: A new water softener and water heater will be installed. Except for the main incoming line, all existing copper pipe accessable from the unfinished basement will be removed and replaced with pex. Additionally, a new clothes washer, gas dryer, utility tub, kitchen sink, two dishwashers, and gas cooktop will be installed. The installation of the sink may require rerouting of an existing vent stack — final determination will be made at tear out. Building $ BUILDING Permit No.: Inspections 65% of Building- Permit Fee RESIDENTIAL APPLICATION Received By: ' 763-572-3604 Surcharge CITY OF FRIDLEY Dat 9 763-502-49r7�7 FAX $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) EFFECTIVE 1-1-08 $ DATE 1117-10 9 YOUR E-MAIL ADDRESS ' $ SITE ADDRESS SGS Temm l6oy, � C Park Fee $ Fee Determined by Engineering. Sewer Main Charge Total Due THIS APPLICANT IS: II OWNER ❑CONTRACTOR Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach Stipulations PROPERTY OWNER/ NAME: P,_,� a�5}b� ADDRESS: 'k,^Vost" by Ng CITY ("A_4 _4 STATE PAU ZIP 5"—q32 TENANT IL PHONE: NAME: ADDRESS: CITY STATE ZIP CONTRACTOR SUBMIT A COPY OF PHONE FAX YOUR STATE LICENSE STATE LICENSE # EXP DATE PROPERTY TYPE NINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED DKWINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: R106-IM Alm Pock w cr4., 4'jQ�dtSS t"""1�"� SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES O HOUSE & GARAGE 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: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS. & PORCHES SUBMIT: ❑ Vinyl ❑Soffit I. Site Plan/Survey showing the existing structures ❑ Aluminum ❑ Trim and proposed project. ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ONo L ATION 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 UBC FEE SCHEDULE) TOTAL JOB VALUATION S 55_0 8 00 OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building- Permit Fee Fire Surcharge $ 05A) .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $2.1= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering. Sewer Main Charge Total Due $ $ "7 aU 0 Agreement necessary ( ) Non Necessary ( ) Make checks payable 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 Construct' r- o; that I understand this is not a permit but only an application for a permit and work is not to startwithout a permit on site; that the work will be in accordartce.wiYla e plan in the case of all work which requires review and approval of plans. SIGNATURE Oii A_�,ICANT PRINT NAME P� /?9/5& DATE / -Zzfti ' APPROVED BY ';e\ DATE (��