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PRE 2010 DOCSCity ®f Fridley, Mni& BURDING PERMIT Date: sr w.+ ,1 -.0 Owner: Builder Address 77 Address _ C�4TION JB LDING No.� Stre :. r ,�, :� P , Lot Lot Block ,. Addition or SUb=Division .0. Comer Lot . _ Inside Lot ___ Setback s — Sideyard Sewer Elevation _ _ Foundation Elevation DESCRIPTION OF BUILDING .t T Used Front Depth _� 1`Ieight _ Sq. Ft.t„ Front Depth _ height Sq. F't., Cu. Ft. _ Type of Constructiott � ��, Est. Cost �o be Completed <, r 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 It �" , permit is hereby granted to to construct the building ora;ddition as described above. This permit is granted upon the express conditiott that the person to whom it 3s granted and his agents, employees and workmen, in all work. done m, around grid upon sand building, or any art thereof, shall cronform in sil respects to the ordinances of Fridley, Minnesota, regarding location, construction, alteration, maintenance, repair and moving of buildings within the dty limits and this permit may be revoked at any tinge u violatio of any of the provisions of said OPdinailceti. " a ii E� Building Inspector NOTICE: TMs pwmh does not sever the eonatwettoe, hestaUMen for 'whb& 'phM&1ng, oaheating, sower or waMr. sure to see the Buthgng higmwor for separate peewits for those Roma. OWNER ° S IMME ADDRESS APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA: ADDRESS LOCATION OF BUILDING ��i�✓�t %�,� moi'Part of Lot LotBlock Addition or Subdivision Corner Lot Inside Lot Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of. Survey of Lot and proposed-build- ing roposed build- ing location drawn on these Certificates. To be used as: DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height, Sq. Ft. Cu. Ft. Type of Construction Estimated Cost 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 of Fridley Ordinances and rulings of the Department of Buildings, and here declares that all the facts and- representations ndrepresentations stated in this application ar a and correct. DATE (:schedule of Fee Costs can be found on the Reverse Side). A BUILDING PERMIT FEE SCHEDULE 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 exist- ing building 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 manner herein provided to -wit: 2.1. For any such permit for the erection of ahj fire -proof building, other than a garage$ warehouse., factory or grain elevator, or for the erection of any fire -proof addition, for similar occupancy, to any 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 fire -proof garage, warehouse.., factory or grain elevator, or for the erection of any fire -proof 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 the erection of any non -fireproof building other 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. GARAGES 2.4. For any such permit for the erection of any non -fireproof garage, warehouse, factory or grain elevator, or for the erection of any non -fireproof addition, for similar occupancy, to any existing building or for each such building or addition - ninety cents ($0.90) for each one thousand cubic feet or fraction thereof, in the cubical contents thereof with 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) 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 per each Five Hundred Dollars ($500.00) or fraction thereof in the cost of all proposed work. 2.6. In nocase shall the fee charged for any permit as set forth in Section 2 be less than $4.00. City of Fridley Application for Plumbing and Cas Fitting Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK / %4/ 0 Number, Kind and Location of Fixtures Location— WATER ocation l L PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: 0. RATE TOTAL Number Fixtures ....... Z x $1.50 $, Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... New Ground Run Old Bldg . ............ GAS FITTING FEES: 1st 3 Fixtures .......................... Additional Fixtures ..................... Gas Range to 200,000 BTU .............. REPAIRS & ALTERATIONS—Refer to Code x 2.00 $ x 3.25 $ NO. RATE TOTAL x $1.50 $ x .50 $ x 2.00 $ 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, M/inn e 1 5 19J Owner /✓/ //%'t aa; Kind of Building Used as To be completed about Estimated Cost, $ Old—New–Building Permit No i / Permit No. Signe By Business Phon o_ hle 1'S/�✓- ROUGH FINAL Description ................................................$ TOTAL FEE $ 42 2M ?iN aZ 6 Z O ,ij`ii w 2 • • WATER HTR. GAS ELEGWto Base1st I 2nd 3rd 4th • Future Connection Openings * New Fixture, Old Openings Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: 0. RATE TOTAL Number Fixtures ....... Z x $1.50 $, Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... New Ground Run Old Bldg . ............ GAS FITTING FEES: 1st 3 Fixtures .......................... Additional Fixtures ..................... Gas Range to 200,000 BTU .............. REPAIRS & ALTERATIONS—Refer to Code x 2.00 $ x 3.25 $ NO. RATE TOTAL x $1.50 $ x .50 $ x 2.00 $ 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, M/inn e 1 5 19J Owner /✓/ //%'t aa; Kind of Building Used as To be completed about Estimated Cost, $ Old—New–Building Permit No i / Permit No. Signe By Business Phon o_ hle 1'S/�✓- ROUGH FINAL Description ................................................$ TOTAL FEE $ 42 2M Application for power plants and Heating. Cooling, Ventilation, ReFrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE a .GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ........................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ..... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ......... I ............. 5.00 $� GAS FITTING FEES: NO RATE TONAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures . ............... x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ J ROUGH FINAL Dept. of Bldgs. Phone SU 4-7470 City of Fridley: 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 tr�ue and correct. idley, 1Vfinn / FEB 1 ® 1963 19 _ Owner ! 1 Kind of Build' Used as To be completed APR 7 - 1963 Estimated Cost, $ ®✓r ew uilding Permit No. �' Permit No. dLvZ Col DESCRIPTION OF WORK HEATING , Warm Air—No' Trade Name Size No_✓�=✓" Capacity Sq. Ft. E.D.R- & 00 -0 BTU H.P. Total Connected Loa Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft.E D. �'✓ BTiT H.P. GEO. SE®G CEe 6 iTG. & AIR-COND5. CO 1001 Xenia Ass. S. Minneapolis 16, Minn. Signed 2-1 9 1411 By 42 2M Business Phone o (REMARKS -OVER) Windows and Doors—Crackage and Area Width Height No. of Lineal ft, Area No. ofpane of pane lights of crack sq. ft. 9 rR'iIle D•56 s Btu Infiltration Iflfiltration .� i'x HEAT LOSS CALCULATIONS' DEPARTMENT OF BUILDINGS MINNEAPOLIS. MINN. Weatherstrips A.S.H.V.E. ti d� Construction No. Exp. wall KV'' Net exp. wall Insulation R P Guide t .C, a Ceiling ° Int. wall WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How. Applied Yes—No --Ye—s--No— Ceiling 19— d Floorof"' I F1.1 BED I Room I Length apt.; Width a*i:, Height Room I Length Width ,'',`Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft, Area No. ofpane of pane lights of crack sq. ft. 9 rR'iIle Coef. Btu Infiltration Iflfiltration .� i'x P� ., gV- Glass 1. Glass, /r Exp. wall a GC C'8 ti d� +:_3 Exp. wall KV'' Net exp. wall lei, R P Int. wall t .C, a Ceiling ° Int. wall Floor F "e O � , ! otal litu.,_r 1 !w'� . Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I FI.Io d, s Room I Length Width Height Windows and Doors—.Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 9 rR'iIle Coef. Btu Iflfiltration Infiltration" 1. Glass, # ti d� +:_3 Exp. wall KV'' lei, Exp. wall`' s0 Net exp. wall`.' t .C, a Int. wall a' Ceiling ry Floor .: Ceiling d Total Btu. I s (J 1 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1 F1.14W.4? `kms" Room I Length .4 Width X61 Height "" Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane Ifghts of crack sq. ft. 71 Coef. Btu Infiltration Infiltration" 1. Glass # ti d� +:_3 Exp. wall 40 lei, Exp. wall`' s0 Net exp. wall t .C, a Int. wall a' Ceiling I Floor Ceiling d Total Btu. y , Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 71 Coef.1 Btu Infiltration Infiltration" Glass # ti d� Exp. walla Exp. wall`' s0 Net exp. wall t .C, a n Int. wall a' Ceiling Floors"'.C� Ceiling d Total Btu.' Required sq. ft: E.D.R. or sq. ins. W.A. Leader area Y FIT r4Vs ci 1, Rnnm I Length Width Heistht Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq.. ft. 71 Coef. Btu Infiltration" Glass Exp. wall`' s0 t .C, a Net exp. wall a' Int. wall Ceiling Floorof"' ` t~a Total Btu. y e Required sq". ft. E.D.R. or sq. ifis. W.A. Leader area FI_ x?t. -..9' s ::, > Rnnm I Length /i� Width 9 Height '` Windows and Doors-Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall t Net exp. wall`o Int. wall Ceiling Floor. e.o74 t~a Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I) Required sq. ft. E.D.R. or sq. ins. W.A. Leader area �"'�, T -i6 s HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H. .E, Construction No. ` Guide Windows I Doors Reference `Out.'Wall Int. Wall Ceiling Roof Floor Yes—No ee Yes -1 o 19—■ ate' / yYJ } l }ry 11 J i MI I'I aG.AI a -.A RMn'1 ,t /...th i� �1;Ath •:V^ 14I ;. t II MI,.I Windows and Doors—Crackage and Area Coef. Btu Width Height No. of Lineal ft, Area No. of pane of pane tights of crack sq. ft. 17" Glass Exp.. walb 9 Coef. Btu Ilifiltration . .-; j Glass 640 a2c 5Cf Exp. ,wall . Floor Net exp. wall 1 51. 7 j Itlt.wall D_..:__J _.. t,C. ` C rl DVVI A Ceiling Floors Totall3tu. 'Required sq. ft.'E.D.R. or "sq. ins. W.A. Leader area F1.1 Room ( Length Width Height Windows and Doors-.Clrackage and Asea Width Height No. of Lineal ft. Area No. of pane of pane ' lights of crack sq. ft. MINNEAPOLdS. MINK. Insulation Kind How. Applied Room I Length Width Height Windows and Doors--Crackage and Area Coef. Btu Infiltration 17" Glass Exp.. walb 9 C� Net exp. wall Glass Int. wall Net eip. wall Ceiling Int. wall Floor 'floor Total Btu. D_..:__J _.. t,C. ` C rl DVVI A r ___1-- --..- MINNEAPOLdS. MINK. Insulation Kind How. Applied Room I Length Width Height Windows and Doors--Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net eip. wall Int. wall Ceiling 'floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I FI_I Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No: of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. Room I'LenQth Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration ` Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Reailired sa. ft. E.D.R. or sa. ins. W.A. Leader area 1r T-25-2005 1.5; 11 C I TV OF FP I DLEY ldii)g PLIMI TANG. rrAYeIO.NT 3-572-3604 CITYa0- v na-1 is ADDRSaSrft rrR.4CTOR n r1V.T1ER. S APPLKsA,n 1 ,a: - PROPERTY OWNERf TENANT JJSWT A COPY OF yot )R ST 0.TE C.ICF�`1GF. r74'1'fN pHdNE: y 4Mt: TCP DATE STATE i ICIN'SE ��� � ! QTY ADt�lti' . 6-' ��- FAMILY D TWO F'AMIL - P'F�P r MT TY'M j 171dF`7' TYPE C5C't�'Cil�t: i DESCTtiP'I'ION Op WORK_ Ul Sri'LACMAS! iT Permit r1o.. Received Py. atc.Rec,d:--I- -0_ _, :>Ej ^IL1 A frr the permit fee is a mmum of$15.t)0 �r 5°% al the t0fol cost np to g;f�n•b4, t�'}tichever is ;titer, . R AqS 1613.665 the P residefltial fixture, tx�ltadin the Cta�tireR. (This sl°ts'std "enact crly ehe cast ^f tabor 1 cnl of 0 improvetitem' in"Tallation or mplacem _ , _ _ Wi Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 36 763-572-3604 CITY OF FRIDLEY Date Rec'd: —j 763-502-4977 FAX EFFECTIVE 1-1-2010 DATE �' "),O(o YOUR S -MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME:1640W TENANT ADDRESS: I Kglb T9&C U -h "J / CITY 'r-41)-aP STATE 4/ ZIP 6,�r_ PHONE: (i-' b"—to?o CONTRACTOR NAME: 2ltJrr�G c°uCPCZaPi SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # abs �atl �l EXP DATE Y5 2010 AND CERTIFICATE OF ADDRESS: LW I (65AV6- klub CITY 690 STATEMN ZIP `�Oi/ INSURANCE PHONE °Z� �-97`(a FAX Ao3 —5-76 --a 455— PROPERTY TYPE OSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ G GE(SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION MAINTENANCE/REPAIR '❑ REMODELING DESCRIBE WORK BEING DONE: 95 SQJaW-�— Q£ 5TH SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES�ls�%rfw� 13 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: 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 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: 4 (USING THE 199 -B-C FEE SCHEDULE) rOTAL JOB VALUATION $ � i'l `'� `3 A 7U OCCUPANCY TYPE Permit Fee $ jGk Plan Review $ Fire Surcharge $ Surcharge $ License Surcharge $ SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ -7,79 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) $2100 per SAC Unit (Plans to MWCC for determination) f1+6ft= ftx$24=$ $450 Conservation Plan Review Fee Determined by Engineering 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 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 al=rwhich re T7�z' /view and approval of plans. SIGNATURE OF APPLICANT 4`� PRINT NAME_ N� ti*1 DATE 5d 414'Zeff 8o/b 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 s' $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 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 V $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 15` $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