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PRE 2010 DOCSt "- City of Fridley, Minna BUILDING PERMIT N® 4134 Date: . --.. ...... // Owner: -------- ------------ Builder Address..... ....................... --_......._.__.._.._....._......._...._......_..._-•__........._.... Address............................................................. ..... ......................................... LOCATION OF B ILD!��G No.Street _...- _ ....,�...� ....artof t ------ ---- --............ Lot ...........�................... Block ....._.........-..............._ Addition or Sub-Divisio � ...... G'-'_'... Corner Lot ..........................------... Inside Lot ....._X .............. ......... Setback ..... .I.. 2............... Sid d .. ,/ L ._'...!................._............._.._.._.. Sewer Elevation ............ ....................... _............. _............................ __..................... Foundation Elevation DESCRIPTION OF BUILDING To be Used as: .� .._............ Front �,�(.....'...Depth .�f.....1..'�/ ._PHeight ...1.. -.'.'Sq. Ft.._.. Cu. Ft. ..._.............:_..................... Front ....................... Depth ...__......... .. Height ........................ Sq. Ft. ..... _........... .._.. Cu. Ft. ..................... Type of Construction ... ................................................. _..... Est. Car -12t. -W? To be Completed .......... ........................................ In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above sett forth and in compliance with all provisions of ordinances of the city of Fridley. ". In consideration of the payment of a fee of $.. /./._.... ............. permit is hereby granted to--------------------------------------------------------- ..— ...__. ..._.._.._.........._............._......._...._..._.. to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, 'shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. /---- Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for these items. r APPLICATION. FOR BUILDING PERMIT CITY OF F'RIDLEY, MINNESOTA Owner`s Nanie ,� Builder Addre5we-.0 :' r Q xAddress LOCATION OF BUILDING No. a ,(o_. S,tr� t' ® -Part of .Lot Lot, Block a Addition or Sub.Div. - Tr 71 Corner Lot Inside Lot I- Set Back S Side -Yard 14__._Q (� SEi "ELEVATION �',-FOUNDATION ELEVATION 44 ,V cant: a tta ch to this form, = Certificate of Survey o La.t and' propos ui ding locati�ii. DESCRIPTION OF BUILDING To '4e 'used ast. cYr' Front Al .P �j P� Depth I Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft Cu. Ft. Type of Construction Estimated Cost_„�j' To be completed `go The un0ersigried''hereby" makes application for a permit for the work herein,specified, agreeing' *toy do -,A-11 work in strict. accordance with the City 'Ordinances and 'ruling of the De�ent•of`Buildirigs, and -hereby, declares that all the facts and'r'epresenta- tions:sitated in this application are true and correct. DATE r o SIGNATURE Side.) (A Sc edu]e of Fee costs can be found on the Reverse 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,,.r_ppair,,,_s to Ir �.tructure, upon application the�refon,'j To 'u ag� - �,* A q, g �uilding �qr the payment , by the applicant for such permit of fee's to the amount herein below set forth and in the manner herein provided to -wit: pre 2.1 For any of any fireproof building., other than a g-aLr4ge.i.,,.yarqi�oT fKrAb'_r;y, or grain elevator., or for - the erection of any fireproof addition, for similajr'occupancy, to any existing building shall be at the rate of $1.40 for each one thousand. cubic feet, `or fra ction. they-eof in .such- cubical., -contents, - 2.2 For any such permit ...�qp�!,the erection of.-aTl-v.-.fir-epr-oof--W-age, -6r grain.. elevator, . .. ­ o . r _ for . . . the . . erection of any fireproof addition for similar occupq�icy _-,3�y,.e61sting building shall be at the rate of J1.25 for each 'O"n'e.".'t-ho"tc'a':t.d:dubi'b feet, classified as "fireproof" by Section 502 of the Minneapolis Building Code. — Hi 2.3 For any such. pea-,�it:*for- .�he!:*e*r-ectior-r--o-ff-7any-mcii;-PirePFoof-be ildng n otne­__:Ei�a'a garage, warehouse, factory or grain ,elevator.,: or any,, ­ non­f13jeprOO_D_ARjdi1ion)-- -for similar'' occuPa=Y, to any existrQ-building. $1.00 for each one.thousand cubic feet. For any --such pei-mi:t f&the er'ec'tion of any non -fireproof ga:pa warehouse, factory or grain elevator, or for the erection of any non - fireproof addition..? _for simil.q;-.'-000,aP4ncyj 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 cont6fi-Es!th0reof- with a minimum of U-00, For-t�i`e' purpo s -s- of fees for di permits the cubical contents of any building or addition to a un fori__heilght..throughou by multiplying the ground area'covered from a point six (6) indhes below z. the floor cline of the bappmqnt or cellar to tho-avarage_heigbt of. the . t . of . average t I he roof surface of the main, gable of a pitched roof, tions to an existing, s 2.5 For repair.� or. pl-ra 0-'':P' Hundred Dollar or be--a--t--the .-rate of 43 00 -6, e s (6500-00), fraction thereof in the cost of all proposed, 2.6 In no case­p.hll Qr,,_.arjy.:.--per�t dt'---Ibet far h iri can -Section 2' q; bel T'. !:T� v, SUBJECT PERM City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT f RECEIPT NO COMMUNITY DEVELOPMENT DIV. r 1 PROTECTIVE INSPECTION SEC. 1 I = 1 "1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 6/7/83 JOB ADDRESS 7630 Van Buren Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 2 Shaffer's Subdivision #1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Richard Pouliot 7630 Van Buren Street N.E. 780-2533 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Fullerton Zumber Co. 5737 —37th Avenue South, MPLS. 727-2904 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 ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Reroof Dwelling and Install Escape Window in Basement 9 CHANGE QF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $1l OO $, 55 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT OES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE P OVIS NS OF ANY OTHER STATE OR LOCA AW REGULATING CON- $19e OO ST U ION OR THE PERFORMANCE OF CONS CTION. PLAN CHECK FEE TOTAL FEE $19.55 SIGNATURE OF CONTRACTOR OR AUTHORED AGENT (DATE) WHEN PROPERL VALIDAT D THIS IS YOUR PERMIT SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) BLDG INSP D E Effective Aug. 1, 1981 CITY OF FRIDLEY APPLICATIM FOR RESIOENTIAL BUILDING PER 141TS (New, Alterations, Additions, or Repairs) OtsrIER: ADDRESS: S ri U,A A Ut �F"'j S %/; ADDRESS: S'7 S `2- 3 71' Vj MALS-; TEL n0: '7 F- c,� ® 2- 3S TEL NO: 7 Z 7 -- L "� a'f Construction Location STRICT -NO: STREET: LOT: BLOCK: ADDITION: Corner Lot: Inside Lot: Setback.: Sideyards: `Applicant attach to this form two Certificates of Survey of lot and ':proposed building location drawn on certificates to scale. F ' DESCRIPTION OF CONSTRUCTION Front: p4q_S t_AI t T Square Feet: Front: Square Feet: Depth: Height: Cubic Feet: Depth: Height: Cubic Feet: Type of Construction-. O ui c k- ejt-*= 2A, `v_Estimated Cost: $ /Q C) Rb Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE jEVF.RsE SIDE OF SHEET - ?Sie undersigned hereby makes application for a permit for the %:,ork herein specified, agreeing to do.all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correc . DATE: �. � � '"� ,.� SIGN2ITUF.e^� : v Stipulations; 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 repairs 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: $1.00 to $500.00 $10.00 (Minimum $15.00) $501 to $29000.00 $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $32.50 for the first $2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $170.50 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $283.00 for the first $50,000 plus $3.00 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 and up $443.00 for the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof Plan Check: 25 percent of building permit fee. Driveway Depression Escrow: Concrete curb streets only. Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50 Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75 Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. CITY OF FRIDLEY APPLICATION FOR PWMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL_ New Fixtures g 5.00 g Future Fixture* g 3.50 $ Old Opening. Now Fixture $ gam_ seer Dispenser $ 4.00 $ Blow Off Basin g 5.00 g Catch Basin g 5.00 g Rain Nater Leader $ 5.00 g Hydraulic Valve $ 5.00 $ Sump or Receiving Tank 8 5.00 g Nater Treating Appliance $- 7.00 $ Not Water Neater $ S.00 $� Gas Range $ 10.00 g Can Dryer $ 10.00 g ALL OTHERS AND/OR REPAIRS AND ALTERATIONS is of Value of Fixture or Appliance $ Reinspection Fes $ State Surcharge $ .50 ($15.00) TOTAL FEE $ Krtectave Aug. 1, 1981 Job Address ® j� r-� 4 Department of Buildings City of Fridley Tel. 0571-3450 The undersigned hereby slakes 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 Department of Bu.1dings. and hereby declares that all the facts and representations stated in this application are true and correct Fridley. Nn. el"q . l OWNER zv�e " 116 KIND OF BUILDING USED AS ROUt.11 INSP. Date FINAL INSP. 6 -1 (I & Date APPROVAL FOR PERMIT 6 MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE u �i' a Mater .ci a a G" gg� Heater " � 8m a. 0'1 " o A w di 8 aim g e too a" 6 lot 2nd RAN 3rd NN 4th (R) - Future Connection opening Connected With Sewer V) - New Fixture, Old Opening Mater RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL_ New Fixtures g 5.00 g Future Fixture* g 3.50 $ Old Opening. Now Fixture $ gam_ seer Dispenser $ 4.00 $ Blow Off Basin g 5.00 g Catch Basin g 5.00 g Rain Nater Leader $ 5.00 g Hydraulic Valve $ 5.00 $ Sump or Receiving Tank 8 5.00 g Nater Treating Appliance $- 7.00 $ Not Water Neater $ S.00 $� Gas Range $ 10.00 g Can Dryer $ 10.00 g ALL OTHERS AND/OR REPAIRS AND ALTERATIONS is of Value of Fixture or Appliance $ Reinspection Fes $ State Surcharge $ .50 ($15.00) TOTAL FEE $ Krtectave Aug. 1, 1981 Job Address ® j� r-� 4 Department of Buildings City of Fridley Tel. 0571-3450 The undersigned hereby slakes 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 Department of Bu.1dings. and hereby declares that all the facts and representations stated in this application are true and correct Fridley. Nn. el"q . l OWNER zv�e " 116 KIND OF BUILDING USED AS ROUt.11 INSP. Date FINAL INSP. 6 -1 (I & Date APPROVAL FOR PERMIT 6 MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE SUBJECT City ®f Fridley 28649 T 664F THETWINS E BUILDINGPERMIT R `�,� , i fr ��e�e _ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC /., E NUMBER HEY DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 1 910-F15 11124198 JOB ADDRESS 7630 Van Buren St ret NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 2 IShaffer's.subdivision #1SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ken Duba7,94-7199 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Top Gun Inc. 5014 Parris -428-4559 20128233 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 D NEW 0 ADDITION 0 ALTERATION Qx REPAIR 0 MOVE 0 REMOVE 8 DESCRIBE WORK Reroof house and garage 12 SO Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT THE GRANTING OF A PERMIT 1028 .51 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�QT.HE PERFOR IAN E OF CONSTRUCTION $37.50 Fire SC $1.03 PLAN CHECK FEE TOTALFEE Sd Liense SC $5,0Qj 1$44.04 SlNATURED ONTRACT OR OR AU7-Hbo4IZEq AGENT iDA WHEN PROPERL ALIDATED THIS IS YOUR PERMIT S.GNATURE OF OWNER pF OWNER BUILDER, iDATE, BL G NSR BATE NEW (' Effective 8/1/95 ADDN (( CITY OF FRIDLEY ALTER () SINGLE FAMILY AND DUPLEXES R-1 AND R-2 1: --+,, on Building Pernut App d s: ; IA)257, ConstructionA dres 113 Legal Description: Owner Name & Address: -7(,0-3 Tel. # Contractor: 7-C P 6 CMU - /l)C MN LICENSE # �%�� �l�_ Address: —�®/� ��/S1t lge7 Tel. # V2- 2 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. FL 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: �/!— 01 Estimated Cost: $C��• ot Approx. Completion Date: (Cost -on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: / _APPLICANT: Tel. #���%(4&A A USE ONLY Permit Fee $ /, ) " Fee Schedule on Reverse Side Fire Surcharge $, t6 .001 of Permit Valuation (1/10th%) State Surcharge $ p S� $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by' Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: Building BUILDING $ �C' I -;)"T Permit No.: ':20 ow ,I Inspections RESIDENTIAL APPLICATION Received By: ffy�b 763-572-3604 CITY OF FRIDLEY .001 times the total job valuation Dat 2011 763-502-4977 FAX- .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) EFFECTIVE 1-1-2010 $ $2100 per SAC Unit (Plans to MWCC for determination) DATE ' t [ YOUR E-MAIL ADDRESS k d\-)t)a.\1 ' . V\4 VyLAI ( � TEC SIADDRESS 7 Lo3 ti: oQ" t:S .�' -1k-I) , . E t S c '-A-0 P a ti� w -3 THIS APPLICANT IS: V.OWNER ❑CONTRACTOR $450 Conservation Plan Review PROPERTY OWNER/ NAME: Fee Determined by Engineering TENANT ADDRESS: `"7Lra�b6= A !U ITY_ L s � STATE &% ZIP Total Due PHONE: Make checks savable to: Citv of Fridlev Attach Stiaulations CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE WSINGLE FAMILY/NEW CONSTRUCTION SIZE L-A • t A. 3 . t ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF IJ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: f SIZE OF IMPROVEMENT LENGTH '74, IDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES 13 HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ° ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: %EOETACHED 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 project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes Olo LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF 4VO } Lk MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS Of)f-. ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: SING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ -M OCCUPANCY TYPE Permit Fee $ �C' I -;)"T See Back Page for Fee Schedule Plan Review $ QS 4 1 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ g E} • .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary( ) Total Due $ UFaiA 3Y Make checks savable to: Citv of Fridlev Attach Stiaulations 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 aU work which requires^ fevvNw d approval of plans. SIGNATURE OF APPLICANT�� ��� i� L-)- d INT NAME �tAftA kk bQ1-i DATE la' 1z Page 2 - Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for 1' $500 plus $3.05 for each additional $100 or fraction, to and including $2,000 $2,001 to $25,000 $69.25 for 1' $2,000 plus $14 for each additional $1,000 or fraction, to and including $$25,000 $25,001 to $50,000 $391.25 for I" $25,000 plus $10.10 for each additional $1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for 1' $50,000 plus $7 for each additional $1,000 or fraction to and including $100,000 $100,001 to $500,000 $993.75 for 1' $100,000 plus $5.60 for each additional $1,000 or fraction to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the 1' $500,000 plus $4.75 for each additional $1,000 or fraction to and including $1,000,000 $1,000,001 and up $5,608.75 forthe 1' $1,000,000 plus $3.15 for each additional $1,000 or fraction VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 Building Permit Fee BUILDING ��� See Back Page for Fee Schedule Permit No.:SX16 0 10' Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION Received By: 9?k 763-572-3604 Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge 763-502-4977 FAX CITY OF FRIDLEY ec'd: , $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ � Erosion Control $ EFFECTIVE 1-1-2010 Park Fee • DATE YOUR E-MAIL ADDRESS � , vk&e� SITE ADDRESS L46J l�C,-- r � c o J`Cr��� ,� A� S� Z THIS APPLICANT IS: AWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: —T TENANT ADDRESS:`i to3 Z�, LSCS,y CITY �f zi�g� STATEAAAZIP S L432- .P 2PHONE: PHONE:—IRS -14 CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE J&SINGLE FAMILY/NEW CONSTRUCTION SIZE Olt x `2.W ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCEIREPAIR PIZEMODELING DESCRIBE WORK BEING DONE: Ra1i u'l, SIZE OF IMPROVEMENT LENGTH L4� WIDTH ( HEIGHT , 5 SO FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: Floor1. Existing 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 l . 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 f4No 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: e S N�HE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ ��� See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $_ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 5 1, ! Make checks savable to: Citv of Fridlev Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of 1 work which re ti es re ew and approval of plans. c� , SIGNATURE OF APPLICANT PRINT NAME -3 D ATE )b — PL� —10 Page 2 - Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for 1' $500 plus $3.05 for each additional $100 or fraction, to and including $2,000 $2,001 to $25,000 $69.25 for 1' $2,000 plus $14 for each additional $1,000 or fraction, to and including $$25,000 $25,001 to $50,000 $391.25 for 1s` $25,000 plus $10.10 for each additional $1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for 1' $50,000 plus $7 for each additional $1,000 or fraction to and including $100,000 $100,001 to $500,000 $993.75 for 1" $100,000 plus $5.60 for each additional $1,000 or fraction to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the 1g $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 0 $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 1 l/1 A,,,66X t i i2 _ i r714/.i� �24" Dia. base Structural Details by Becklin & Whitney Consulting Engineers, Inc. P.O. Box 471 Cambridge, MRI 55080 763-689-5631 0 I ' CC/'se-fes' O� , 1 HVRERY CERTIFY TILAT THIS PLAN, SPECIFICATION, OR REPORT WAS PREPARED BY ME OR UNDER my DIRRC't SUPERYI.SION THAT AND AM A. DULY REGISTERED PROF MtONAL ENGINEER UNDER THE LAWS OF THE STATE OF iENGREEN - MINNESOTA. �1 VYII:I wi A. IIF Kj, N, P:£. DATE: June 25, 2010 REG. NO, IS494 Structural Details by Becklin & Whitney Consulting Engineers, Inc. P.O. Box 471 Cambridge, MRI 55080 763-689-5631 0 I ' CC/'se-fes' O� , BC6 Post Cap C'Oly 4'Ioly 2 y r 2x6 Brace - ��' (2)1.75x9.5 LVL or (2)11.875 LVL L90 both sides �. 24" ' 2x6 SP #2 braces both directions at each corner (8) locations ABA66 Simpson or equal -� /L 1, sR 2x6 SP #2 (3) 31/2" Ledgerl-ok 7 ft minimum 9 Structural Details by Becklin & Whitney Consulting Engineers, Inc. P.O. Box 471 Cambridge, MN 55080 763-689-5631 �-- BC6 Post Cap 21_0" 6x6 SP #2 treated ABA66 Simpson or equal ,1 42" Below outside grade 24" l 1 IIERF.D\' CFRI IFY TIIAT THIS PIAN. • i �, SPECIFICATION. OR REPORT WAS PREPARED BY ME UR INDFR MY UIRFLT SUPERVISION AND TIIAT 1 �•~��� •'•,�/2 ����'r AM A DULY REGISTERED PROFS ZONAL ENGIYEERUYIIF.RTUE LAWSOFTIIESTATFOF ENCiUVEER mINNF.S(TI'A. �N9. IH434 .�A4� �iii144�it1, � �'pF•••••�Nf9,•` Fix i,� MIN WII.tJ.VAI A. BF.CI:I.IN. P.E. i,.• DATE. June 28, 2010 Rm No. 18494 9 Structural Details by Becklin & Whitney Consulting Engineers, Inc. P.O. Box 471 Cambridge, MN 55080 763-689-5631 �-- BC6 Post Cap 21_0" 6x6 SP #2 treated ABA66 Simpson or equal ,1 42" Below outside grade 24" l CITY OF FRIDLEY MOVING [ ] DEMO [ ] PERMIT APPLICATION 6431 University Ave NE Fridley MN 55432 (763)572-3604 FAX (763)571-1287 ft 2016 Job"+' Legal Description: J° 2 Owner & Address: Tel. Contractor: Tel. # Address: State License # DESCRIPTION OF BUILDING HOUSE: Length Width Height Sq. Ft. Cu. Ft. Cu. Ft. GARAGE:Length Z,21 Width ��� Height �\s Sq. Ft. OTHER: Length Width Height Sq. Ft. Cu. Ft. Estimated Cost $ 9 Approx. Completion Date c ?—R -l0 CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CALL ALL UTILITIES FOR DISCONNECTS BEFORE WRECKING MOVING STRUCTURE. Moving Route: APPROVALS) REQUIRED PRIOR TO ISSUANCE: MPCA: NOTIFICATION OF INTENT -TO PERFORM A DEMOLITION ( ) YES ( ) NO ❑ Wat�Or %dill Paid: Yes[ ] or Collect [$ n cial Condit Engineering Conditions Fire Marshal Conditions ]Signature The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Building Division, and the State Code which requires any water well on the property to be sealed by a State licensed water well driller, and hereby declares that all facts and representations stated in this application are true and correct. A7 7 TIVXXnT rrnN nFRRic- TNrT TTniNG FOIINDATION & SLAB, SHALL BE REMOVED FROM SITE. (.0- ZE -l0 Date Signature Moving Wrec ' Principle building into Fridley .... $300.00 For each 1,000 cubic feet or fraction ...... $1.25 Accessory building into Fridley ... $ 42.00 For structures which would be impractical to Through or within the City ...... $ 20.00 cube, the fee shall be based on the total cost Move a building out of City ...... $ 20.00 of wrecking at the rate of $6.00 for each $500.00 or fraction. Effective 1/01/2010 MINIMUM $20.00 Office Use Only: SAC -D form completed Building MECHANICAL Permit No I Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY McUp 0 " 763-502-4977 FAX I EFFECTIVE7-1-2010 DATE q " ,7- /I YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION t OWNER ❑CON77TRACTOR NAME: v v iJG•� ADDRESS: i, �Ct n Yl� Sri CITY F{ ' 4 PHONE: (q) 1 It, 7 1 i'7 ATE )ylla ZIP COMPANY NAME: CONTACT PERSON: STATE LICENSE # EXP DATE ADDRESS: CITY STATE ZIP PHONE FAX PERMIT TYPE OVSINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: JQ NEW ❑ REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORKS/"i FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) PROVIDE HEAT LOSS CALCIS PER MANUAL J 2006 ASHRAE HANDBOOK Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEIBTU MFG: MODEL: SIZE/BTU $25.00 (GAS) $15.00 _,GAS RANGE/OVEN $10.00 _A/C TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00 _AIR $35.00 _FIREPLACE _FURNACE $35.00 GAS UNIT HTR $10.00 _BOILER LINER $10.00 DRYER $10.00 _POOL HEATER $35.00 _CHIMNEY DUCT WORK $10.00 _GAS TGAS PIPING $10.00 VENTILATOR $15.00 THIS IS AN APPLI ATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work -which requires review and approval of plans. SIGNATURE OF APPLICANT �.;`� i:. t. G / �/ PRINT NAME T s / I /QL'/J1_=^DATE INSPECTORS SIGNA' City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments MN Rule 1346 Sec. 501 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments 4. Heat loss & cooling load per room a. MN Rule 1322, Sec. NI 104.4.13 5. Ventilation a. Per MN Rule Chapter 1322. Sec. 1104 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations.