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PRE 2010 DOCSCity of Fridley, Mum.. BUILDING PERMIT N9 Date: _.=---„.e”, Owner: fir. ` Build LOCM 18F B D IVG No. Street _ """-�+ Pat of Lot Lot. Block+ Addition or Sub -Division ._ µf {' _ .._ -- __ . - f Corner Lot _..__*'*`�Inside Lot Setback __ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To Used Front ~4a , ...... epth eight Sq. Ft. z6KCU. Fro _ Depth _ Height _ Sq. Ft. _ _ _ Cu. Ft. Type of. Construction Est. Cd`_'o be Completed _. In consideration of the issuance to me of a permit to construct . th::du 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,. J Inconsideration of the payment of a fee of $..V4""'�" ' , 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 P e in,dley,hin thinances.° 'Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sower or water. Be sure to see the Building Inspector for separate permits for these items. .460o4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING No.—Z3 / Street ,.Part of Lot ___:._._ Lot 17 Block �' Addition or Subdivision Corner Lot Inside Lot Setback -3S Side -Yard I8 EWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To /be used as: " - Front ; Depth v G T3eight sq. Ft. CU. Ft. Front�Dep �h- Height sq. Ft Cu Ft.— Type. t.Type. of. ConstructionEstimated 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 ruling of the Department of Build- ings, and hereby declares that all the facts and representations s ated.in this application are true and correct. DATE -3 - - SIGNATURE (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 the 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 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 any fire -proof building, other than a garage, warehouse, factory or grain elevator, or for the erection or 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 00fireproof" by Section 502 of the Minneapolis Building Code. HOUSES 2.3. For any such permit for the erection of any non -fireproof build- ing 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. GAGES 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 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 con- tents 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 no case shall the fee charged for any permit as set forth in Section 2 be less t , , $4.00. City of Fridley Application for Plumbing and Gas Fitting Permit Dent_ of SLinsL Uhn„e CTT d_7d7n DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...... ................ Z x $1.50 $ / 6 o 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) ......5ak— x 2.00 $ New Ground Run Old Bldg. x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.5o $ / Additional Fixtures x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer 2o_Code Description ..........$ TOTAL FEE $ Liiy o= rriatey: The undersigned hereby .makes application for a permit for the work heret 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. Owner Kind of Used as To be completed a�put Z Estimated Cost, $�, 6 Old Ne . Building Permit No -Permit No. Signe i By Business Phone No'v ROUGH FIN -OW42 2M 0 Z Z` z a UO R N WATER HTR. GAS FLEC Base 1st r 2nd 3rd 4th Future Connection Openings New Fixture, Old Openings Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...... ................ Z x $1.50 $ / 6 o 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) ......5ak— x 2.00 $ New Ground Run Old Bldg. x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.5o $ / Additional Fixtures x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer 2o_Code Description ..........$ TOTAL FEE $ Liiy o= rriatey: The undersigned hereby .makes application for a permit for the work heret 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. Owner Kind of Used as To be completed a�put Z Estimated Cost, $�, 6 Old Ne . Building Permit No -Permit No. Signe i By Business Phone No'v ROUGH FIN -OW42 2M 0 Application for Power Plants and 'Heating. Cooling, Ventilation,. . . Air Conditioning Systans and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 1-7470 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 $ MECIL WARM AIR Furnace Shell & Duct Work to 120,000 BTU ......... . each add. 60,000 BTU ....................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 ................. Repairs & Alterations each add. $500.00 ............. . 8.00 $� 2.00 $ _ 5.00 $ 5.00 $ 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) ................... A .. 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $-4 Additional Fixtures ................ x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & ,REPAIRS ROUGH— OUGH FINAL— FINAL See See Fee Schedule $ TOTAL FEE $ 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 true and correct. Friday, Minn MAR 2 6 1962 19 - / 9 Owner Kind of Building Used as To be completed about p, 6 ;oo Estimated Cost, $ M ilding Permit No. s Permit No. f �7 e d HEATINGW_ POW s "'_` ,Warm Aix—No -$✓jai o,7 Trade Nam �P �-� Size i - -j� Capacity Sq. Ft. E.D.R 4� BTU H.P, Total Connected Load a �" °� '� Kind of Fuei e BURNER — Trade Name Si Capacity Sq. Ft. E.D.R 7 % "H.P, EO. SEDGWICK HTG. & AIR -GOND. CO 1001 Xenia AV. S. / Minneapolis 16, Minn. Signe By_ �• �� G"1y.3ie: 42 2M 7-59 Business Phono No- (REMARKS—OVER) w 0If 714' 40 .10 4 7.Q OSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS, MINN. Weatherstrips A.S.H.V.E. Construction No. Insulation - Guide Windows Doors Reference Out. Wall llnt.WaR I Ceiling I Roof Floor Kind F How. Applied Yes ---No -Ye—s--No 19— 1 � I I - T. �Ste: ,X Fl. I L Width IV Heiaht 722w II ^ FUAPNWIJA.,i_. R.. I Leriirti ;ve Width P '� Heiaht A& Windows and Doors—Crackage and Area Width Height No. of Lineal fi. Area No. of pane of pope lights ofcrack sq. ft. ato LL Ae if' �4J ie"L I Coef. Btu jCoef. Btu Infiltration ",1, 1 y hA Glass Zoe, Glass Exp. wall v - Net exp. wall Exp. wall 4b, �5 iv, Net exp. wall 74 7 Net exp. wall C -elft tl -,#K 5Z Q- 0 Int. wall 777'" Uft- 0' A 7 Floor lc' I Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. 4 Room FL—enffihl,)� Windows and Doors--Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft* ato I Coef. Btu Infiltration Btu 15 ",1, 1 y Glass Glass Zoe, Glass Exp. wall Exp. wall Net exp. wall Exp. wall 4b, �5 iv, Net exp. wall Int. wall Net exp. wall C -elft tl Ov Floor 777'" Total Btu. ader area Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Width toU Height` t*$�, , A M - V 1 Room I Length ".% Width Windows and Door rackage and Asea Width Height No f Lineal ft. Area No. of pang of pane lights of crack sq. ft. ato I jCoef. 1 Btu Infiltration Btu 15 ",1, 1 Glass Glass Glass Exp. wall V, Exp. wall Net exp. wall Exp. wall o *A,,, iv, Net exp. wall Int. wall, Net exp. wall C -elft tl Ov 7� Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area X';,,Fl.1 4� A Room I Length , 5."' Width , AHeiaht 7 - Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. _7 V, Coef. Coef. Btu Infiltration Glass Glass Exp. wall eo ao Exp. wall o *A,,, 7;�"! Net exp. wall Net exp. wall Int. wall tl Ov Int. wall Uft- 0' A 7 Floor Total Btu. Required so. ft. E.D.R. or so. ins. W.A. Leader area 17,0' hxhV . Windows and Doors—Crackage and Area. Width Height No of Lineal ft. Area No. of pane of pane lights of crack sq. ft. ve Coef. Btu Infiltration Glass Exp. wall Net exp. wall Vol Int. wall Floor 0' A 7 Total Btu. 7 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length .,2 Width Windows and Doors—Crackage and Area Width Height No. of Lineal ft Area No. of pane of pane lights of crack sq. ft. 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 Height Btu Windows and Doors--Crackage and Area r ",e! Width Height No f Lineal ft. Area No. of pane of pane lights of crack sq. ft. - -7— Width Height No. of Lineal fi Area No. of pane of pans lights of crack • sq. ft. rr D46, p wed Ve ex. 112 cly f Coef. 1 Btu Infiltration Coef. Coef. Btu Infiltration HEAT LOSS CALCULATIONS- DEPARTMENT OF BUILDINGS iLYf, WNNEO-0133-. MINN. Weatherstrips, A.S. . . . Glass Construction No. 11 Insulation - Guide Exp. wall 6 - Net exp. wall Te N , , ows Poors I Reference Int. Wall Ceding +�f Floor Eloor How. Applied %4 -WY' J No �,Y;-;PTo 9_ 20ut.Vall i 0 FU 0' Room Fl;—nathI Width ;hw He; -ht It i F1 v' Room lLength Width �4,;, Height Windows and Doors--Crackage and Area r ",e! Width Height No f Lineal ft. Area No. of pane of pane lights of crack sq. ft. - -7— Width Height No. of Lineal fi Area No. of pane of pans lights of crack • sq. ft. Ile. V 112 Coef. 1 Btu Infiltration Coef. Coef. Btu Infiltration 4 1� iLYf, I Glass "W" Glass vo V6 - Exp. wall, 1 -1 -- Net exp. wall Exp. wall 6 Ceiling Net exp. wall Te N Floor Net exp. wall Int. wall Eloor Y 'If Int. wall Ceiling C-61ing I J_ -1 otal ]Jtu. !*�,Jh Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I F1.1 t, lot,, Room I Lenitth k V Width AK Heistlit ty Windows and Doors—Crackage and Area r ",e! Width Height No f Lineal ft. Area No. of pane of pane lights of crack sq. ft. - -7— Width Height No of Lineal ft. Area No. of pane of pane Jlff�ts of crack sq. ft. JA Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 112 Coef. 1 Btu Infiltration Coef. Btu Infiltration Glass 4 1� iLYf, I Glass "W" Required sq. ft. E.D.R. or sq. ins. W.A. Leader area vo V6 - Exp. wall, 1 -1 -- Net exp. wall 6 Ceiling Net exp. wall Te N Floor Int. wall Eloor Y Ceiling Total Btu. - f -TI-N, 6 "'0 Required sq. k E.D.R. or sq. ins. W.A. Leader area 1,�,# Room I Lenffth i Width Ili,) Height 4' Windows and Doors—Crackage and Area r ",e! Width Height No f Lineal ft. Area No. of pane of pane lights of crack sq. ft. - -7— , 11 01 .*fit';,., iv 14 JA Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 112 Coef. 1 Btu Infiltration Bt Coef. Btu Glass 4 1� Glass Exp. wall "W" Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Net exp. wall U 2 Int. wall Net exp. wall 6 Ceiling v" �3, Te N Floor Ceiling Total Btu. Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Room I Length � 1-0" Width Height 1",;" Windows and Doors—Crackage an=�Ar=ea ,I :1= e f HNo. of I Lineal ft. I Area No. f vane lights, of crack sq. ft. F Infiltration r ",e! Windows and Doors—Crackage and Area JA Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 112 Net exp. wall Coef. Bt Coef. Btu Infiltration 4 1� Glass Glass Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Exp. wall 2", "1, Net exp. wall Net exp. wall 6 Int. wall i Int. wall Ceiling f &-, V Ceiling Eloor Y Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Room I Length � 1-0" Width Height 1",;" Windows and Doors—Crackage an=�Ar=ea ,I :1= e f HNo. of I Lineal ft. I Area No. f vane lights, of crack sq. ft. F Infiltration r ",e! Glass v- Exp. wall Net exp. wall Coef. Bt Int. wall Ceiling fv 1� Glass Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Exp. wall Windows and Doors—Crackage and Area I Width Height No. of Lineal ft. Area No. of pane, of.pa a lights of crack w1sq. ft. v- Coef. Bt Infiltration fv 1� Glass Exp. wall Net exp. wall 6 1 111 i Int. wall Ceiling -4. Y Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area r Required sq. ft. E.D.R. or sq. ins. W.A. Leader area June 20, 1979 I CITY OF FRIDLEY 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPNONE ( 612)571.3450 Ronald and Janet Pillard 7301 University Avenue Northeast 'Fridley,.Minnesbta 55432 Dear Mr. and Mrs. Pillard: We would like to take this time to inform you of the City Ordinance that requires all driveways in Fridley to be paved. (See enclosed copy of pertinent Section, of the Code.) Address of property -or properties not in co.mpliancs_: 7301 University Avenue.N.E. We urge you to contact several V tuminrus contractors, in order to obtain the lowest estin;ate from a. reputable company. The driveways of a number ofdouble bungalows in phis area are presently unim- proved; and perhaps could all be impt-oved by one contractor at the lowest possible cost. Please call us with any questions you might have regarding this re-- quired upgrading of your property. Ver truly yoars, 10 CLY� E V. MORAVETZ Engineering Division CVM: i k Enc, 1 SUBJECT City of Fridley4® AT THE TOP OF THE TWINS BUILDING PERMIT r- RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 9 1 � � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 3/20/95 JOB ADDRESS 7301 University Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17 5 Melody Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lloyd Smith 7301 University Avenue NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Jim Beaudry Construction 17995 Fillmore St, Elk River MN 55330 441-8241 8140 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Q REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling (24 Squares) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 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 $1,800 .90 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- $41.00 Fire SC $1.80 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTALFEE License SC $5.00 $48.70 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI W ENCS LY V l ATED THIS IS YOUR PERMIT ,+' • ` ,7B'-L{'C®i IN! OI/TATE `Pa\T S)GNATURE OF OWNER OF OWNER BUILDER) (DATE) NEW ( ] ADDN (� ALTER (] Construction Address: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application 0 Effective 1/ 1/95 Legal Description: r°Z Owner Name & Address: �wi Tel. # Contractor: �� MN LICENSE # �P -ft-6-e:>65 C� Address: %y�� j��'z �- Tel. # /-gzq l Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width . Hgt/Ground Sq. Ft. OTHER: Corner Lot { ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks �� Type of Construction: Estimated Cost: $ Approx. Completion Date: (Cost on Back) ' Wc Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x DATE: APPLICANT: Tel. # CITY USE ONLY Permit Fee $ 41-06 Fee Schedule on Reverse Side Fire Surcharge $ �. 0 .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit License Surcharge $ 'S $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 STIPULATIONS: FA SUBJECT City of Fridley 25326 AT THE TOP OF THE TWINS � U I L I C PERM BUILDING I. r ` �J d� RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. �� r NUMBER REV DATE 7/29/97 PAGE OF APPROVED BY "'1 CITY HALL FRIDLEY 55432 i.A, '•J ---- 612-571-3450 910415 � JOB ADDRESS 7301 UNIVERSITY AVE NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 17 5 I Melody Manor I SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lloyd E Smith 8327 Able Street NE, Spring Lake Park, MN 784-8747 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. First Glass 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Duplex 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Ck REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install tempered glass in all windows 9 CHANGE OF USE FROM TO STIPULATIONS Install smoke detectors to meet the State Building Code. Must be tempered safety glazing on sliding windows. P SEPARATE PERMITS ARE REQUIRED 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 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. OWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 2 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 $1,000 000 $ . 50 W WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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. PLAN CHECK FEE TOTAL FEE Z1411 11 $36.25 Si Tu OFCON DATEi ',KSWMR joORQEDAGENT/O��y, WHEN PROPERLY LIDATED THIS IS YOUR PERMIT J�ei AL BL ' If, GATE SiGNATUR OF O ER p OW ER BUILDERSiDA Ei FA NEW [ l ADDN [ ) CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Addres Contractor: Address: n�„4"" Effective 1/1/97 Tel. # ZF�%S� TENSE # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF E%IPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Gro nd Sq. Ft. OTHER: 40&;� Construction Type: Estimated Cost: $ I coi. (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Fux $ _ $ DATE: APPLICANT: Tel. # �d�✓c CITY USE ONLY Permit Fee $ , Fee Schedule on Reverse Side op' Fire Surcharge .001 of Permit Valuation (1/10th%) 6 6P State Surcharge $ $.50/$1,000 Valuation 0vw SAC Charge $ $950 per SAC Unit ,'p.,,,/ License Surcharge $ $5.00 State t/+� ( Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above SIJ Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ J TOTAL $34=, 2 STIPULATIONS: BUILDING PERMIT FEE SCHEDULI!', 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 $21 (Minimum Feels $21 plus surcharge) It $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $15,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for fust $50,000 plus .$6:25 for each additional $1,000 or fraction thereof, to and including $1007000 $887.25 for first $100,000 plus $5.00 for each additional $1,000'or fraction thereo;t to .and including $500,000 $2887.25 for the first $500, -000 -plus -$4.25 fol= each additional` $1,000 or fraction thereof; to and including $1,000;000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only -- Driveway width plus 6 feet times $13.0. 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.minimuzn 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 construe required before proccedino �;,,th the framing*. CITY OF FRIDLEY BUILDING INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-36'04 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer S 6Z?,:S.-:;3 1, Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS Fee Total 0 _ � $35.00 $ •00 Building Used As $10.00 $10 - C-0 ESTIMATED COST tl J l - l�l� PERMIT NO t $10.00 $ DESCRIPTION OF FURNACE AND BURNER $10.00 $ *Air Conditioning - AllSizes $25.00 - $ All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work $ Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater. on work less than $500.00 # of Heating Units --1- Circle One (Steam) (Hot Water) (Q� Trade Name Size No. BTU U G ,00'. J HP EDR Fuel K)c N Cas Total Connected Load Burner Trade Name BTU HP Size No. EDR The undersigned hereby makes application for a permit for the work herein Commercial/Industrial/Institutional specified agreeing to do all work in strict accordance with the City Codes 1.25% of Value of Appliance or Work (List on Back) $ and rulings of the Building Division, and hereby declares that all the facts Minimum Fee $35.00 for Commercial/Industrial/Institutional and representations stated in this application are true and correct. State Surcharge $ .50 HEATING CO NORTHERN HEATING A AIP ( ONDITIONING, INC. TOTAL FEE $45 . �0 Signed 4ZTel # REINSPECTION FEE $50.00/HOUR • FAX # 7b3 �S�aZ� "7s%1' Date flu/�Y *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved by Rough -in Date Final Date FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMQN VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes.,,, No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes- No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes No( ) When required to Install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yesj' 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. Yep 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. Oc, - , Yes No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type �a�" BTU Inpute1 Fan Assisted or Nat `Ec( 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 Aj /0 Vent Height - Diameter r�T/ 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: NORTHERN HEATING 9 AAP CONDITIONING, INC. Signed By: Date: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 t AX: ( 763) 5 71-128 7 PERMI �200L�0038��,- DATE ISSUED: 03/25/2004 r ADDRESS : 7301 UNIVERSITY AVE NE PIN : 113024240089 LEGAL DESC : MELODY MANOR WATER HEATER - ELEC : LOT 17 BLOCK 5 PERMIT TYPE : PLUMBING PROPERTY TYPE : DUPLEXES CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 3,485.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A THREE BASEMENT FIXTURES # ELEC WATER HEATERS # GAS WATER HEATERS # GAS RANGES # WATER TRMT APPLIANCES :11-WQ 1ITNWM B & D PLUMBING HEATING & AC INC 4091 MACIVER AVE NE ST MICHAEL, MN 55376 (763) 497-2290 Cl 1A'j►I M :7 SMITH LLOYD E & ARDYS J 8327 ABLE ST NE SPRING LAKE PARK, MN 55432 0 VALUE OF FIXTURE/APPLIANCE 0 0 # GAS DRYERS 0 0 # OF NEW FIXTURES 3 0 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 wort 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 regula in ons"ction or the performance of construction. Bldg PLBG PERMIT MINIMUM FEE 0.00 PLBG FIXTURES (NEW OPENINGS) 21.00 WATER TREATMENT APPLIANCE 0.00 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 0.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 PLBG REPAIR/ALTERATIONS 0.00 STATE SURCHARGE, PLBG FLAT 0.50 TOTAL 21.50 PAID WITH CHECK # 526531 SFPARATF, PFRMJTS RFOIJJRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 Effective January 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLFD ON FAr.H F1 nnQ PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas" Gas Range`* NO. RATE TOTAL Gas Dryer*` Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge .50 TOTAL FEE JOB ADDRESS -7361�%toPV�rS�P+�y �%ve� The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. Owner C rr'% �tC5K_ Building Used As g-al-f7'L I an Estimated Cost yg N2 ,20®y PERMIT NO. 00,9. 06)3&3 PLUMBING COMPANY BAT) P 11 Y116, h9 l" � +�'►� SIGNED BY it !�/� y TEL NO. '7&-5- aj-1. zZ96 < LA Approved By Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBINGIGAS PERMIT IS $20.00 PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE `APPLICATION WILL BE RETURNED 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 manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( ) No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Hei0ht ft Length ft Diameter in Type Appliance #3 Vent Connector Hei0ht ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 k'AX: ( 763) 571-1287 ADDRESS : 7301 UNIVERSITY AVE NE PIN : 113024240089 LEGAL DESC : MELODY MANOR : LOT 17 BLOCK 5 PERMIT TYPE BUILDING PROPERTY TYPE DUPLEXES CONSTRUCTION TYPE ADDITION/ALTERATION PE O.: 2004-00440 DATE ISSUED: 04/05/2004 VALUATION : $ 4,600.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DUPLEX PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. REPLACE 7 WINDOWS IN LOWER LEVEL - FIVE WITHIN EXISTING OPENINGS, TWO ARE CHANGED TO MEET EGRESS CODE STATE LICENSED CONTRACTOR 1 APPLICANT HADLEY CONSTRUCTION INC 18850 GARNET ST NW ANOKA, MN 55303 OWNER SMITH LLOYD E & ARDYS J 8327 ABLE ST NE SPRING LAKE PARK, MN 55432 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 work 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 consti tion or the performance of construction. Appli Date Bldg Insp DatA L5 BUILDING PERMIT FEE FIRE SURCHARGE STATE SURCHARGE, VALUE LICENSE SURCHARGE TOTAL PAID WITH CHECK # 2711 CF.PARATF. PF.RMTTI.R RROTTiRF.D FOR WORK OTHER THAN DESCRIBED ABOVE. 111.25 4.60 2.30 5.00 123.15 if NEW [ ] CITY OF FRIDLEY Effective 4/1/2004 ADDN [ j 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: 30/ Legal Description: rJ Owner Name & Address: R' f Tel. # 7193 - lz Z -"0 qa Contractor: ��( ey ��IT��CilC . MN LICENSE # J6(2'!z-"762?%7 Address: / S�� q�n e4� S� . N• w Tel. # 61 Z - 6 V y V 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: DECK AREA: OTHER: Length Width Height Length Width Hgt/Ground Sq. Ft. Sq. Ft. 1 See ed e /?e4oy) yea®, as Construction Type. 7 Estimated Cost: $ Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE:W"'—/a�lAPPLICANT: 6i�6�Tel. # Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge CITY USE ONLY - License Surcharge $ , Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ /- � Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 [ ] STIPULATIONS: Te�Ca ce �� leo w,�C4 C1 P? i 7 �y �qre (7) ",I:t Rer-o ol,7-e c r - 2�c� '4e q" -e 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 CURB CUT ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined rate 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 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 163) 572-3604 FAX: (763) 571-1287 ADDRESS : 7301 UNIVERSITY AVE NE PIN : 113024240089 LEGAL DESC MELODY MANOR LOT 17 BLOCK 5 PERMIT TYPE PLUMBING PROPERTY TYPE DUPLEXES CONSTRUCTION TYPE : ADDITION/ALTERATION _,�_ , PERM NO.: 20 737• DATE ISSUED: 05/19/2004 VALUATION : $ 2,500.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. INSTALL THREE FIXTURES AND VENTING BATH FAN. # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE 0 # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS 0 # GAS DRYERS # OF NEW FIXTURES APPLICANT B & D PLUMBING HEATING & AC INC 4091 MACIVER AVE NE ST MICHAEL, MN 55376 OWNER SMITH LLOYD E & ARDYS J 8327 ABLE ST NE SPRING LAKE PARK, MN 55432 0 # GAS RANGES 0 3 # WATER TRMT APPLIANCES 0 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. Bldg PLBG PERMIT MINIMUM FEE 0.00 PLBG FIXTURES (NEW OPENINGS) 30.00 PLBG FIXTURES (EXIST OPENINGS) 0.00 WATER TREATMENT APPLIANCE 0.00 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 0.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 PLBG REPAIR/ALTERATIONS 0.00 STATE SURCHARGE, PLBG FLAT 0.50 TOTAL 30.50 PAID WITH CHECK # 526964 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. PA M�- CITY OF.FRIDLEY INSPECTION DIV. Effective April 1, 2004 643t University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT (763) 572-3604, FAX (763) 571-1287 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR F%1 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures j Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $35.00 $35.00 $35.00 $10.00 $10.00 Type $15.00 Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge $ TOTAL FEE $ -� JOB ADDRESS —7301 (A in N e -r R -.-e N € The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: S-13, , 2p OWNER C i K" e, BUILDING USED AS ESTIMATED COST 2 j OO c, PERMIT NO. O?C!C'L/` PLUMBING COMPANYB'�"F 1 ,, Y11 SIGNED BY1L_-eA- `✓ a'' TEL N0. -7(93- q1 -722n Approved By Rough -In Date Final Date to MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date : Building BUILDING Permit No.: i Inspections RESIDENTIAL APPLICATION Received ny( 763-572-3604 CITY OF FRIDLEY A � 200 763-5+02-4977 FAX EFFECTIVE 1-1-08 DATE { ��A Q� YOURE-MAIL ADDRESS SITE ADDRESS 30 , �11 ViY 6"k il1C . THIS APPLICANT IS: ❑OWNER' CONTRACTOR PROPERTY OWNER/ 1 _ NAME: l��trl �V►o,.t`� $a,Ve TENANT 1®� ADDRESS: 13co 1 (kewmpc./S 1�'J CITY--,) �STATE M*jp PHONE: ��'� -' `l 0403 NAME: 01 s CONTRACTOR ADDRESS: _2.35-3-r o r+•al y' k 3 7y CITY C%V— U.✓ STATE A�ZIP SSS 3 Q SUBMIT A COPY OF PHONE - AS l'j"l *4 *° FAXTOt' �'I X11 s"tI YOUR STATE LICENSE _J`o STATE LICENSE # a * qQQ Q a„ EXP DATE 'rj ! 3 l J O A PROPERTY TYPE WSINGLE FAMILYINEW CONSTRUCTION SIZE l4 aq, ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH IVROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ j!lEW HOME CONSTRUCTION ❑ ADDITION 19MAINTINANCE/RF.PAIR ❑ REMODELING DESCRIBE WORK BEING DONE: �{� j '`° jkt, co SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S FT ROOFING NUMBER OF SQUARES &HOUSE ONLY ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES if 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 I . Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed p%lect. 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 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ 10 OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ l T_ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge it s ( 02 $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 $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) 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 ordinance 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 m accordance with the approv, ylan in the case of all work which requires review and approval of plans. SIGNATURE OFrAP� IC 1T ,J��/'APRINT NAME C�4Y' 1 � t\ Ck DATEJ' APPROVED BY}:��i/` DATE-� PLEASE NOTE: SIEPMATE PERMITS ARE REOUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK Building BUILDING Permit No.: L � o 3 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 $ CITY OF FRIDLEY Date e 201 763-502-4977 FAX EFFECTIVE 1-1-2010 DATE 3 _,-22 " /0 YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑ OWNER 'CONTRACTOR PROPERTY OWNER/ NAME: TENANT pp ADDRESS: % a% Ulu,'ye 'Sd 1a, CITY f'�al� t°Gc� STATE ^A) ZIP PHONE: CONTRACTOR NAME: AO -L rooz"Y?x) /-S SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSEt�# EXP DATE AND CERTIFICATE OF ADDRESS: ITY GrL'(a o Pe- STATE! , J ZIP_ INSURANCE PHONE FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED MVINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR 0 REMODELING DESCRIBE WORK BEING DONE: 1, 6J UJI I i @ � 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: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Outer 11 Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS lyes ❑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 GceAi r NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (LYSING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $Cif , OU OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $!-?5 $ $ 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) ft+6ft= ftx$24=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley 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 all work which requires re iew and approval of plans. ��oo°°�� SIGNATURE OF APPLICANT � z MZ - PRINT NAME r/1C �+5 P &-,( �.p_. DATE 3 - o /0