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PRE 2010 DOCSI City of Fridley, Minn. BUILDING PERMIT Date: ....._.... _...._...__/... ..._---------- _....... Owner: Address N° 4114 Builder ...._.v......._..� _......�_.... Address........_............._.._---•--•-•---__....----..........----.._._.__....._.....__......._..._.._..__--_.... _// L ATION O BUI ING No.-----.�a .J--, Street ..-- .... _..... .........." Part o t ............_...._....... _...... ._- - .._ _......._ __ Lot ...............-....... Block ....._.. , ............. _....... .......... Addition or Sub -Division .. ............... :•�se•••��2�i /i� _' w 0 9 Comer Lot ........................... ......... Inside Lot .._ ............................ Setback .. ...._........ S. and ..... --. _..-............__....... Sewer Elevation _ ...... ...... _................... _...... _.............. ......................... ......... _........ Foundation Elevation DESCRIPTION OF BUILDING To be Used as: ,/� 1- .. .......... Front -- V:._ `Depth .�:..e) Height .../..... .`� Sq. Ft. � Cu Ft /�. tf no ......................................................... Front ........................ Depth .................... -.. Height ........................ Sq. Ft....................... Cu. Ft. .............. _........ Type of Construction .............. _........... ........................... ..... Est. Cost..-� .:.. To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set h and in comp ' ce with all provisions of ordinances of the city of Fridley. eAv In consideration of the payment of a fee of $. f ..... .-., 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 see the Building Inspector for separate permits for these items. �e MtNNEGASCO 53-84-S-915' . 51 , City of Fridlay APPiicaticn for Plumbing ens; Gas rrhf �n•, Permit - - -- -_- ---- - -^ m= Dept. of Eldgs. Phone 560-3450 DESCRIPTION O: wonx. Number, Kiad seed Lrc:!ien of rlxtures c;onx*e:oa eaxxn - - • Future Coaaa:13crs pyanings Savor • H®v rixturo, Old Op4nino Ccr-spool PARTIAL RATE SCHEDULE L13'AV8ING r1XTUnE RATES: 1. I I x $2.00 $ I'u>uceFixture Opening ............ x $1.50 N -ew Fi;xtute Old Opening........... x $1.A50 a_._-._-- Catch Basin ... .......... ,...... s x $3.25 $ Nater Beater '.Up to 99.000 BTU) • • • • x $3.00 $ New Ground Run Old Bldg......... x $3.25 $_ Eleetric,YJatas Heater. . . ..:........ �.+, s $2.00 +AS iE'ITTING tEg3: WATER MTl. GAS ncc $ . Additional Flxtures ............... x $ .75 $ Gas R&441 to 199.000 BTU ......... « x55.00 b 5_00 a 2nd - 3rd 4th c;onx*e:oa eaxxn - - • Future Coaaa:13crs pyanings Savor • H®v rixturo, Old Op4nino Ccr-spool PARTIAL RATE SCHEDULE Locad.- . 7656 N. E 'Ian Buren Street City of Fridley: The undersigned hereby makes applfcaticn for a permit for the work herei specified, aZreeing to do all work in strict accordance with the Cita Ordinance and ruling of the Der—hent of Buil&ngs, and hereby declares that all the fact and representations stated in this application. are true and correct Fridley, Minn 11-11-75 19� Owner William Jonfps ' Kind of Building Frame Used as Res. To be completed about 11-a18-75 Estimated Cost, $ 10.00 Old Building Permit No. Permit No. 603 Signed •ate ROUGH FINAL A - L. - i 14 - P.F•PAIRS & ALTERATIONS --Refer to Code .50 State Surcharge Dezcrlptgotf..........................................550$ TOTAL FLE ,— ?Class surcharge .500 - By MINIIMA= . _- Business Phone No L13'AV8ING r1XTUnE RATES: NO. RATE TOTAL I wrlber Fixtures ........... • .... x $2.00 $ I'u>uceFixture Opening ............ x $1.50 $ _. -ew Fi;xtute Old Opening........... x $1.A50 a_._-._-- Catch Basin ... .......... ,...... s x $3.25 $ Nater Beater '.Up to 99.000 BTU) • • • • x $3.00 $ New Ground Run Old Bldg......... x $3.25 $_ Eleetric,YJatas Heater. . . ..:........ �.+, s $2.00 +AS iE'ITTING tEg3: HO. RATE 'TOTAL #st3Tixtures ...;•••••••••••••• x32.00 $ . Additional Flxtures ............... x $ .75 $ Gas R&441 to 199.000 BTU ......... « x55.00 b 5_00 Locad.- . 7656 N. E 'Ian Buren Street City of Fridley: The undersigned hereby makes applfcaticn for a permit for the work herei specified, aZreeing to do all work in strict accordance with the Cita Ordinance and ruling of the Der—hent of Buil&ngs, and hereby declares that all the fact and representations stated in this application. are true and correct Fridley, Minn 11-11-75 19� Owner William Jonfps ' Kind of Building Frame Used as Res. To be completed about 11-a18-75 Estimated Cost, $ 10.00 Old Building Permit No. Permit No. 603 Signed •ate ROUGH FINAL A - L. - i 14 - P.F•PAIRS & ALTERATIONS --Refer to Code .50 State Surcharge Dezcrlptgotf..........................................550$ TOTAL FLE ,— ?Class surcharge .500 - By MINIIMA= . _- Business Phone No sueJEcr_-PERMIT N -- City of Fridley 4 7 4 AT THE TOP OF THE TWINS r BUILDING PERMIT _-17 � COMMUNITY DEVELOPMENT DIV. •� r PROTECTIVE INSPECTION SEC. t iCITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 4/25/84 JOB ADDRESS 7656 Van Buren Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 2 Shaffer's Subdivision #1 SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Todd Krueger 7656 Van Buren Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Milton L. Johnson Co. 2513 Central Avenue N.E. 781-9548 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Install aluminum trim and gutter 9 CHANGE OF USE FROM TO STIPULATIONS 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 SQ. 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 ISTALLIS 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 $1,500 $.75 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- $25.00 STRUCTION OR THE PER RM NCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE fig- �y $25.75 SIGNATURE OF CONT CT R OR AUTHORIZED AGENT (DA EI WHEN.PROPERLY VALIDATED THIS IS YOUR PERMIT w BLDG WSP DATE SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) CITY Or- FRIDLEY ; Effective Aug. 1, 1981 APPLICATI94 FOR RESIDENTIAL BUILDING PER141TS (New, Alterations, Additions, or Repairs) ONINER: J P9 �' —, !� ADDRESS:? �'6—` VA jJ13-( 6-� /V TEL N0: BUILDER: i cA"�1 J6/f Pv CO A/ Of ADDRESS: &AI i /LA TEL NO: % F / L�q e Construction Location STREET NO': ,E "" STREET: eti LOT: BLOCK: ADDITION: .e 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. DESCRIPTION OF CONSTRUCTION Front: Square Feet: Front: Depth: Height: Cubic Feet: Depth: Height: Square Feet: Cubic Feet: _ U Type of Construction: 1 cJ T act ev To Be Cbr,ipleted: d Proposed Driveway Width If New Opening Is Desired: Estimated Cost: Alt. A Alt. B SEE PEVF:R.3E SIDE OF SHEET . Zie undersigned hereby makes application for a permit for the %:vrk herein specified, agreeing to do.all work in strict accordance with the City of Fridley Ordinances and rulings of the Delwirtment of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: - `Z— 57 SIGNATME: � /�.�`-'�'Y•� Stimulations: -7 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 11 Total Valuation $1.00 to $500.00 Fees $10.00 (Minimum $15.00) $501 to $2,000.00 $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,000 $2,001 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-,0.00 or fraction thereof, to and including $100,000 $100,001 and up $433.00 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 $15.75 Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. f12/21i1999 13:26 E H RENNER & SONS 4 5711287 W �T (\1 NO.368 D01 MINNESOTA OEPARTMENT OF HEALT}i Minnesota in ns Nowell and Soong H 155572 'a" NW" '�UI►ELL AND BORING SEALING RECORD Minnesota Unique No. Nanta or W- r y�, p M(rnlesore Statures. Chapter I Ost c� W0 w4afn4es-0 T-- .is No. letlron .) dols see% .t�'3,..i x999. Date Well or Baring 6w�tmetee 95m B :W Sbeof AWe M W Rre Nwnbel ew0 Cily of Wtdl or boons Loaf '765fa vAN MUM sTR Y� shaw eamct Imfon of well or owl" simmiit mop of wet is section gm wlth'1tI.)=Soon, ohowmg *y N I*$.108.5, ontl D N a E q fop S i �-MW---+ onyony e.ft,G mwv'dd eee S dilwom then watt k"11*01 0001151110k and 7656 VAN BURN MEM W rR.IOLLry, !o *x54132 7 DOM Solve Sealing — 75 11� Original OWN h. AOWfERiS) STATIC (MATER LEVEL It Single A01041 p AAulasgwter �fe WEL11MRING Id Measures p C9041,e4 4 water Smly Wen ❑ Mwdt. Well 35 ❑ EnY. Bore MWe ❑ Cmar K. ❑ oelow C)808Ve land 9W18a9 *stool p Plea4a 0 T'de ❑ Omw "One � Oeoth 72 Jr- Sot in o erst" nnoie9 Anular a Mwtio� u nk— in. from g T to k. ❑Yes ❑ in 1mru to It, O Yes ❑ No ❑ Yes ONO ❑ urkrofte In. from to n. O Yee ❑ No ❑ Yos O No ❑ Unknown t,1CREEK0P9k kOLE Sween from 72 to 75 h. Open Holo kom - 1x Ywo...... ". I hfELL OWNERS NAME ❑ Ro W,*P PIPS p Cheek VOWS) ❑ oedne ❑ Flo No Obmtnlabn SAME noowwxffw padeNSP7lmttereaPtenromwawmror6oft Smoits"amm. Type ofobttuetionalOsaerbo{ Obetrudwe ramavmo ❑ Yo. ❑ No oesarltte PUktP Ty{►e JET MARDNe$SOO FROIII TO 19 Removed ❑ Not Proettl ❑ other OEOLOOIGIL YATtR1Ai COLOR FOWATI USEO TO sPAL AN1tULAR SPACE BETWEEN2 CpStMo9.OR CA9M0 AMD lORE MOLE m drid W tkiftSoerueWM%WbgnonewbrfOO No Annular Spew Exists LAY BROWN 2 ❑ Annular space grouted W M tIOMID Pipe CI.AYISAND 7 AR Ceeing Poeoraedn1ft"'oVel AHA� —2— in. ifont to H. ❑ PaAerense O RemorSd c-Ih from to it. ❑ PeetOtnNd L)Rerreewed '1499 of perfer8mr _ $aw PORTLAND 75 0 CN• OU111ijI fV�8181�1 frdnl w h• fps bw from to iBt& bw from to n. yanm bm tram to M. yeraa Pegs DSAy(gm Doum OF DATA. OfFfmULT"IM soma OTMER WELLS AND 1s100MG G 3�.C;04 8� AVE Oster mmsmeiea ane unfree. Wed or norblo on pmperly? O Yea 9 No Now marty? uCENSCOOR jR=V EREDCONTRACTOR CRIN 1 rATIOM DATE ��� js1'a�► tee+ �� : MAY �l � l WOIYllnndaootn Rules. Chapter 472G- 71t0 mhlbr►natien oeraelrwd Ih Rtrs MW IS MAP CODE- U-31 PJDMR %wst 1w.. 71015 EALEDcaftim for Beed tlp Name -, _... —_ ixem. w Asa ae�a m 1w, 8/25/99 According to MN Stfle Regulations A„e ,;vim s M:[TE9L=N/XEV-1X ItOFPE ,,��.•--.•�� J � or Ursa, same wlratt w .otos tefeg F sueJEtr MIT N City of Fridley 30871 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. � r � PROTECTIVE 1 0 � 1 CITY HALL FRIDLEY 55432 NUMBER REVDATE PAGE OF APPROVED BY L J\ 612-571-3450 910.F15 4/27/00 JOB ADDRESS 7656 Van Buren Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 2 1 Shaffer's Subdivision NF1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mark/Carla Heckathorne 7656 Van Buren Street NE 763-785-9096 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Window Lite 8400 89 Ave N STE 460, Brooklyn Park, MN 55445 763-425-2227 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 20039258 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION O ALTERATION 52 REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Replace two windows in existing openings 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWI,G. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $3,100 $1.55 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- $97.25 FireSC $3.10 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TO FEE $5.00 L nse SC 106.90 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI E THIS ISYO P R �ENeROPEF30ALIDA IN P BATE S-GNATURE OF OWNERIIF OWNER BUILDER) IDATEI NEW ADDN ALTER Effective 5/10/99 [ ] CITY OF FRIDLEY [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: "pC\4\,kCnpka Tel. # 7C,,3 - 79'S -Ci69(r, Contractor: W i c\dnw U +e MN LICENSE # Zoa39 ZSk Address: $y a $ +h Aje N. SU t�11_ Li LOD Tel. # (763) - tiZ5 -?—Z 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: Construction Type: R e. oG b\acememh Estimated Cost: $ 31OG Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: Li — ka -zao® c Tel. # C116 l2 c CITY USE ONLY Permit Fee $ 97,1 Fee Schedule on Reverse Side Fire Surcharge $ 0 .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ <5i OD $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 $ 9 JZ4 STIPULATIONS: `Lfir�ar L1�� yy1�. �t .cls � i��� .Gr�1��G� ©� '�/�� ���-SLG/•� �-- G 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 $3,23.3.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. Building $ BUILDING See Back Page for Fee Schedule Permit No. Inspections RESIDENTIAL APPLICATION Surcharge Received By;: - 763 -572-3604 (.0005) times the total job valuation - Minimum $.50 CITY OF FRIDLEY $ Date R DATE (' i - 3� YOUR E-MAIL ADDRESS $4. SITE ADDRESS 76 56 ,1 U cvJ V i` eN �. NC �r: rJ 1 esi' /Li J a 5 S`I SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) THIS APPLICANT IS: ❑ OWNER 5CONTRACTOR PROPERTY OWNER/ NAME: t�t-t� 9 ::::q t / 4 If 4P c- Kci -�-A or -v.- $ TENANT �1 ADDRESS: -76!PG UouJ 13u", -j 54, -t-r-, CITY Fn'aple STATE/ IP Z Park Fee PHONE: 6 / CONTRACTOR NAME:' w�' �I /tea ^'� s •'aQ: �c w ,` ra� �sS $ STATE LICENSE W Aw l ®,2`Z % - EXP DATE ^' ^ 3 Agreement necessary ( ) Non Necessary ( ) Total Due SUBMIT A COPY OF 3� 3 ����ed'�o.J fes.) CITY.EZ b eJ STATBf V4IPS5-yG YOUR STATE LICENSE ADDRESS: WITH APPLICATION PHONE 76 3 - 4a'? -q 696 FAX FAMILY/NEW CONSTRUCTION SIZE PROPERTY TYPE95-SINGLE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH WROOF-- ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIARVRNG POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR Z REMODELING DESCRIBE WORK BEING DONE: 1& 9- Ce -mc -p SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING 1KHOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2• Existing Floor Plan 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 OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ A 6S9 00 OCCUPANCY 1 TYPE Permit Fee $ g 5 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $ C) (.0005) times the total job valuation - Minimum $.50 Fire Surcharge $ C)(Q-.001 x Permit Valuation (1/10%) License Surcharge $4. ;®� $5.00 (State Licensed Residential Contractors) SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota 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 whic requ es review and approval of plans. SIGNATURE OF APPLICANT ,,& PRINT NAME � r 6� K 1' - NR C DATE ^ _®`� 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 1b` $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 I' $100,000 plus $5.60 for each additional $1,000 or fraction to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the 1' $500,000 plus $4.75 for each additional $1,000 or fraction to and including $1,000,000 $1,000,001 and up $5,608.75 for the I' $1,000,000 plus $3.15 for each additional $1,000 or fraction VERIFICATION OF FOUNDATION Pen -nits 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 PLUMBING RESIDENTIAL APPLICATION City of Fridley Permit Number Received By Date Received IF PROPERTY IS NOT OWNER/OCCUPIED- A LICENSED CONTRACTOR MUST OBTAIN THE PERMIT. gNOTE: DATE YOU E-MAIL ADDRESS SITE ADDRESS— • THE APPLICANT IS: (CIRCLE ONE) OWNERCONTRACTOR � NAME hA ar 14- He c,k& IOi -P7 PROPERTY OWNER/ ADDRESS Same 4--s TENANT CITY STATE ZIP PHONE # e:� _ NAME H P. PIPE RKS LICENSE # oS-51%A4 ADDRESS �itDD ROAD CONTRACTOR CITY FAGM,AIV 55123 STATE ZIP PHONE # FAX# PERMIT TYPE SINGLE FAMILY TWO FAMILY TOWNHOUSE TYPE OF WORK ❑ NEW < REPLACEMENT DETAILED DESCRIPTION OF WORK �q FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED FIXTURES: (INDICATE TOTAL NUMBER OF EACH) BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING (Need City license) SWIMMING POOL WATER SOFTENER ($35) CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREY. ($15) DISHWASHER LAUNDRY TRAY WATER HTR ($35) FOR IRRIGATION WATER METER OTHER Permit Fee $ .2s", MINIMUM: $15:00 or 5% of cost of the improvement -whichever is Plan Review $ greater on work less than $300 Surcharge $ .50 TOTAL DUE $ '36-. �:� Make checks payable to: City of Fridley THIS IS AN APPLICATION FOR A PERMIT - NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the Information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit 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 approvalof plans. NAME OF APPLICANT % &M i m i11 . 4e,- < DATE 1 2 - - �NeEqe typ r print SIGNATURE OF APPLICANT t; -4, ..�T.{MCiqA%1"1t 4RMI; � i^'r! ?r 9I'PLAWaTE (.... ? I'll ' CITY OF FRIDLEY COMMUNITY DEVELOPMENT DEPARTMENT 6431 UNIVESITY,AVENUE NE, FRIDLEY, MN 55432 (763) 572-3604 Building $ BUILDING PermitNo.: —0 141 Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION Received By: 763-572-3604 Fire Surcharge CITY OF FRIDLEY Date : S,FP 2 �QQ DATE ? . 9, YOUR E-MAIL ADDRESS $ SITE ADDRESS ? 6 VU -1 it 1 $ THIS APPLICANT IS: ❑ OWNER TRACTOR $ PROPERTY OWNER/ NAME: $ $ ADDRESS._ 'r '%' / C JQ - JCI ! 3TY_r iq i°il CJ� ® STATE IP e37 TENANT Agreement necessary ( ) Non Necessary ( )� PHONE: ®? $ i��� . CONTRACTOR NAME: STATE LICENSE #-&C ® 'Die EXP DATE SUBMIT A COPY OF ADDRESS: J-s/a U CITY STATE IP 0�9 YOUR STATE LICENSE WITH APPLICATION PHONE e S -3i S FAX %G ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE PROPERTY TYPE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ArWINDows ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION iff MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 1 SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT _Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 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 `e IN EXISTING OPENINGS s ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION S '/ Lf 00 ®— OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $ (.0005) tunes the total job valuation — Minimum $.50 Fire Surcharge $ .001 x Permit Valuation (1/10%) License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1450 per SAC Unit (Plans to M'WCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control Park Fee $ $ $450 Conservation Plan Review Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( )� Total Due $ i��� . Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an applicatio a permit and w r to start without a permit; that the work will be in accordance with the approved plan in the case of all wor ch r es vi oval of plans. SIGNATURE OF APPLIC Page 2 - Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building Oficial 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 1s` $500 plus $3.05 for each additional $100 or fraction, to and includin $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 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 1s' $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 1s' $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