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PRE 2010 DOCSCity ®f Fridley, Minn. BUILDING PERMIT Date: March 2 1971 Owner: Iven Dostaler Builder Same Address - 6358 Willow Lane Address Same LOCATION OF BUILDING No. - 5720 Street ._.._..Washington Street N.E. — part of Lot Kt fact D __Block Addition or Sub -Division Bees stared Land fj=vey_1o_ 14 Corner Vete Inside Lot — % Setback 35 _ __ Sideyard — 16' & 7' �EleVation 654.87 _ 857.87 (Approx.) KEDon Top of Footing DESCRIPTION OF BUILDING To be Used as: Dwe 11 i ng Front _ 33 Depth _ _42 Height 2D__.._.. Sq. FL _115 2 Cu. Ft. 23,04 Garage Front 20 Depth 22 Height 10 Sq. Ft. 440 ctL Ft. 4400 Type of construction Frame Est. Cost $21,500. _ To be Completed 6/15/71 Verified Survey Required. Hard surface drive. Sewer Location - 50' S of Manhole Water Location - 40' S..of Manhole 10' N. of Sewer Service In consideration of the issuance to me of a permit to construct the building described above I agree to do the proposed work in accordance with the description above set forth and mpliance with a'll provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ 51 QQ , 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 andmoving 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. l� Building Inspector HANK MUNICH NOTICE: This peenit does not cover tits construction, Installation for wiring, plumbing, on headns, sewer or water. Be sure to we the Building Inspector for soparate pernft for these teems. r APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME:� r� Qa,,' , , BUILDER:_,_ ADDRESS : & 33 S 4f���,� ��, P ADDRESS J NO•. STREET: / • Jv a- - % %I9E�:ADDITI N: CORNER LOT: INSIDE LOT:SETBACK: SIDEYARD: (p ¢ Applicant attach to this form Two Certificates of. Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front:_ Depth : Height: a Square Feet:Zl.5-'3-, Cubic Feet: 7 � ®A10 e` � Z {— Front: 2.2 Depth: 2- Z. Height: /111; �— Square Feet; 11q 0 Cubic Feet:_7 ®-� Type of Construction: Estimated Cost:-$2L.s�®® �J To Be Completed: /,s /9' Z0 The undersigned hereby makes application for a permit for the work herein 23 0' v-6 specified, agreeing to do all work in strict accordance with the City of 1h 019 Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application 2- 7 are true and correct. DATE : ' _ a-?, i SIGNATURE : 1 L�2, (See Reverse Side For Additional Information.) 6 Ue; k��1 � j � ^�iF' � ,,t�`Y �°��� ���14 Pfi �� ;�n�'1 f'• BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings 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: UNIFORM BUILDING CODE: Type 1, 2 & 4 - $2.15 for each one thousand cubic feet, or fraction thereof, in such cubical contents. Type 3 & 5 - $1.85 for each one thousand cubic feet. ADDITIONAL INFORMATION For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average., height of the roof surface of the main gable of a pitched roof. 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. In no case shall the fee charged for any permit as set forth in Section 2 be less than $5.00. VERIFICATION OF FOUNDATION NOTE: 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 Certified Survey of the lot,.showing the location of the foundation, once it has been constructed, will be required before Rroceedint with the framing. CERTIFICATE.OF OCCUPANCY Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Odcupancy has been issued. I I City of Fridley Appiication for Plumbing and Gao Rte Permit Dept. of Bldgs. Phone 9804450 DESCRIPTION OF WORK Number, Kind and Location of Fixtures IrAwatien 14- 220 PARTIAL RATE SCHEDULE F1LUbdBING FIXTURE RATES:• TOTAL Fixtures ............. . . -__� x �� —.L�—Number $ Future Fixture Opening ............ —c2- x $1.50 $� New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater ;Up to 99,000 BTU) .... x $3.00 $s New Ground Run Old Bldg......... x $3.25 $ Eleatric Water heater .............. s $2.00 $ GAS FITTING FEES: NO. RATE TOTAL No NONE 0 ............... PARTIAL RATE SCHEDULE F1LUbdBING FIXTURE RATES:• TOTAL Fixtures ............. . . -__� x �� —.L�—Number $ Future Fixture Opening ............ —c2- x $1.50 $� New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater ;Up to 99,000 BTU) .... x $3.00 $s New Ground Run Old Bldg......... x $3.25 $ Eleatric Water heater .............. s $2.00 $ GAS FITTING FEES: NO. RATE TOTAL lot 3 Fixtures x $2.00 $ Additional Fixtures .................. x $ .75 $ Gas Range to 199.000 BTU ............... x $5.00 $ REPAIRS & ALTERATION8 --Refer to Code Description ..........................................,...$ TOTAL FEE $� City of Fridley: The .undersigned hereby makes application for a permit for the- work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that alk the fact and representations stated in this applicati are true and correct e�� A Fridley, Mien ���� c-? / , l9z Owner Kind of Used as To be completed about Estimated Cost, $ Q d Old—New. Building Permit No. Permit No.� Signed. By Bus' Phune No ROUGH 171 if Applicafta for Power Pkmft and HeathM Codings VeNiMicas ReUgerafta cmd Air Con0loning Sptems -and Devices PARTIAL RATE SCHEDULE aRAVY" WARM AM: RATS TOTAL Furnace Shell & Duct Work .................... $10.00 $ Replacement of Furnsee ....................... 6.00 $ Repairs & Alterations—up to $500.00 ........... 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $L— MECIL WARM AM $ Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ 140"00 each add. 60.000 BTU ............ 3.00 Replacement of Furnace ............................. &OD Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500A0 .............. 9.00 $_ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam 410.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00 $ Each add. 200 sq. ft EDR Steam ............... : ...... 4.00 , $�_ Each add. 320 sq. ft. EDR Hot Water 3.00 $ OIL BURNER—to 3 gal. per hour ...... I ........... ...... 6.00 $ over 3 gal. per hour --See Fee Schedule GAS BURNER (up to 199,000 BTU) ...................... 8.00 $ over 199,000 BW See Fee Schedule GAS FITTING FEES. NO RATE TOTAL 1st 3 Fixtures ...................... X$ zoo Additional Fixtures .................. x .75 ft Gas Range to 199,000 .......... xE 5" AIR - FAN HEATING SYSTEM See Fee schedule V WrILATING SYSTEM ALTERATIONS & REPAIRS TOTAL FEE ROUGH— rMAL_ &-1-7/ - Dept. of Bldgs. Phone 560-3480 a 4- '__'71� ej Vj 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 an the facts and representations stated in this application are true and correct. Kind of Building Used as To be completed about -7wna:�� Estimated Cost, $ Old—New. Building Permit No. Permit No. DESCRIPTION Or WORK BEATING or POWER PLANTS—Steara, Hot Water, Warm Air—No Trade Namez Size No­ZLK 'L FA Capacity Sq. Ft E.D.R BTU— H.P. Total Connected Load go2 t/' C - Kind of Fuelf.9�_ BURNER — Trade Name Sin No CapacitySq. Ft. F.D-R- BTU Hip., (NMARKS-OVER) By� L L - Business Phone 9 Z 2 L- Compliments of North Central Public Service Co., "Your Natural Gas Company" CIT HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS VIIL Weatherstrips A.S.H.V.E. Construction No. Guide indows I Doors Reference Out. Wall IInt. Wall Ceiling I Roof I Floor Kind No No 19........ Insulation How Fl I oom I Length Width Height Fl. I ' , : '. Room Length Width Height Windows and Doors—Trackage and Area. 1 11 No. Width of pane Height of pane No. of lights Lineal ft. I of crack Area sq. ft: No. of lights Lineal ft. Area of crack sq. ft. �22 '5 6 _ Coef. Btu Infiltration Coef. Coef. Coef. Btu Infiltration Glass Infiltration Glass Glass Glass Exp, wall Glass ® Q Net exp. wall 1114 f ( Int. wall ® Exp. wall Ceiling Int, wall Floor Net exp. wall Ceiling 1 Net exp. wall Ile Floor ® ` Floor Int. Wall Required sq. ft. E.D.R. or sq. ins. W.A. Fader area TotaflftlL Ceiling ® Ceiling Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Floor ® x /',t' Floor Ig;�e . Total Btu. Total Btu. Required sq. ft. E.D.R. or sq. Ins. W.A. Leader area Fl. I ?. v mom Length /,,I Width /,.,9 Height Windows and Doors—Crackage and Area Height of pane No. Width of pane Height of pane No. of lights Lineal ft. Area of crack sq. ft. �22 '5 6 _ Coef. Btu Infiltration Coef. Coef. Btu Infiltration Glass Infiltration Glass Glass Glass Exp, wall ® Q Net exp. wall 1114 f ( Int. wall ® �� /e Ceiling Int, wall Floor Net exp. wall Ceiling 1 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. I oom I Length Width �_,A Height Windows and Doors—Crackage and Area I No. Width of pane Height of pane No. of lights Lineal ft. of crack Area sq. ft. Lineal ft. I of crack Area sq. ft. �22 '5 6 _ Coef. Btu Infiltration Coef. Btu Infiltration Infiltration Glass Infiltration Glass Glass Exp. wall ® Q Exp. wall Net exp. wall Net exp. wall ® �� /e / �� 0 Int, wall Ceiling 117 15e /® Net exp. wall Ceiling 1 Ceiling Ile Floor ® ` Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Fader area TotaflftlL Ceiling ® 5 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Doors—Crackage No. Width of pane Height of pane No. of lights Lineal ft. I of crack Area sq. ft. Lineal ft. Area of crack sq. ft. 6 Coef. Btu Infiltration Infiltration Coef. Btu Infiltration Glass Glass Glass ® Q Exp. wall Net exp. wall ® /® Int. wall Int. wall Ceiling 117 15e /® Net exp. wall Ceiling 1 Floor .0 Ile Total Btu. Required . ft. E.D.R. or, sq. ins. W.A. Leader area Fl InU Length ® Width /f Height p Win ws and Doors—Crackage and Area _ I Height of pane No. Width of pane Height No. of of pane lights Lineal ft. Area of crack sq. ft. 6 Coef. Btu Infiltration Infiltration Glass Glass Exp. Wall ®' Exp. wall /e Int. wall Net exp. wall Ceiling 1 q( Ile Floor ® ` Int. wall Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Fader area Ceiling ® x Floor ® x /',t' Ig;�e . Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. Room I Length./' Width,// Height Windows and Doors--Crackage and Area Width No. of pane I Height of pane No. of lights Lineal ft. of crack Area sq. ft. Coef. Btu Infiltration Glass Exp. Wall Net exp. wall /e Int. wall Ceiling 1 Ile Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Fader area J53 -s4 -s-915.51 City of Fridley Appliadion for C"s RNkg Pan* Dept. of Bldgs. Phone 9®0-3450 DESCRIPTION OF WORK LoestM_ 5720 N. E. Washington Street Number. Kind and Location of Fixtures • Future Coansction Openings Sewer * Now Fixture, Old Openings Cesspool Cl PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ..... • . • • • .. x $1.50 $ _ New Fixture Old Opening .......... x $1.50 e -0 I � N WATER HTR. GAS ELEC. Base x $3.00 $ New Ground Run Old Bldg. ........ x $3.25 $ Electric Water heater .............. z $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st x $2.00 $ Additional Fixtures .................. x $ .75 $ Gas Range to 199,000 BTU ............ 1 x $6.00 .00 2nd 3rd – 4th • Future Coansction Openings Sewer * Now Fixture, Old Openings Cesspool Cl PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ..... • . • • • .. x $1.50 $ _ New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.26 $ Water Heater :Up to 99,000 BTU) . • • • x $3.00 $ New Ground Run Old Bldg. ........ x $3.25 $ Electric Water heater .............. z $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .............. x $2.00 $ Additional Fixtures .................. x $ .75 $ Gas Range to 199,000 BTU ............ 1 x $6.00 .00 REPAIRS A ALTERATIONS—Refer to Code Description ...................................... o .........$ TOTAL Fm .00 City of Fridley: The .undersigned hereby makes application for a permit for the' work herei specified, agreeing to do all work in strict accordance with the Cit,B Ordimnce and ruling of the Department of Buildings, and hereby declares that all. the tact and representations stated in this application are true and correct Fridley, Minn 5-27-71 19, Owner Rand Construction Co. Kind of Building Frame Used as ReS. To be completed about 6-4-71 Estimated Cost, $ 10.00 COW–New. Building Permitil it No �e P By -- - Business Dune No ROUGH FINAL t % 7 I SUBJECT PERMIT City of Fridley 'BUILDING AT THE TOP OF THE TWINS � I (I L D I � I %� D [ D � A I T .17471 Dv 'v v r LR'v' I R Ir? � • _____ COMMUNITY DEVELOPMENT DIV. INSPECTION % ®� r PROTECTIVE. SEC. / I . � -- �,� CITY HALL FRIDLEY 55432 i---- NUMBER REV. DATE PAGE OF APPROVED BY �� L 612-571-3450 ' 910-F15 4/23/84 JOB ADDRESS 5720 Washington St. N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Tract D RLS #14 SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE D. C. Schlottman 5720 Washington St. N.E. Fridley 55432 574-9456 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Homes 8510 Central Ave. Blaine 784-3910 —Dailey 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 EJC NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 12' X 12' screened Porch. 9 CHANGE OF USE FROM TO STIPULATIONS -JEPERA I E PLRN--1i 1b RLwijjL-D s fJR 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 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 R-1 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION I 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 $3,000.00 $1.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW STRUCTION OR THE PERFORMANCE OF CONGAgSTRUCTION. 38. 50 PLAN CHECK FEE TOTAL FEE aA "% 9.63 49.63 gIGNAT OFC 7R ACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT SIGNATURE OF OWNER 0F OWNER BUILDER) (DATE) BLDG INSP DATE NEW [ City of Fridley Effective 4/1/84 ADDN. [ ] rR-1 AND R-2 ALTER. [ ] Building Permit Application i Construction Address: Legal Description: T hP'C'k o Le-olA Se I r- QT�u Property _PAddre0'�_s!: Tel. # S ' � wnerl Contractor Address 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: n c-), R r 01 Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: 0j Estimated Cost: $ nil ® 0 Y Approx. Completion Date: 5 C Proposed Driveway Width If New Opening Is Desired: Alt. A Alt B $ $ See Back Page for Explanation DATE: �(�a3_ APPLICANT: Tel. %�f^3q`® CITY USE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $425 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 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 Valuation Fees $1.00 to $500.00 $10.00 (Minimum Fee is $15.00) $501.00 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. $2,001.00 to $25,000.00 $32.50 for the first $2,000 plus $6.00 for each additional $1,000 or fraction thereof, to and including $25,000. $25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $50,000. $50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each additional $1,000 or fraction thereof, to and including $100,000. $100,001.00 and up $433.00 for the first $100,000 plus $2.50 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 $13.50 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 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 been constructed will be required before proceeding with the framing. ®CSV I d, dV v iCl� SSG c�/ `► ���-JG.vG �c- 4 i -7.2 O -G� s'� ��'J /`�,✓ S' SCJ �' 1175 EAST HIGH1,7AY 36 9 ST. PAUL, MINNESOTA 55109 M PHONE (612) 464-0281 ago t Fult�'�vaer� o- °s l co I air STRUCTURAL WOOD ®ACORPORATION 1175 EAST HIGHWAY 36 ■ ST. PAUL, MINNESOTA 55109 O PHONE (812) 484-0281 7i 7E I p�P�c 4 4Mip►o-4.ft5 A, - lrl . • J f STRUCTURALWOOD ®CORPORATION 1175 EAST HIGHWAY 36 ■ ST. PAUL, MINNESOTA 55109 ■ PHONE (612) 484- 81 1 I i i I Are CITYOF FRIDLEY CIVIC CENTER • 6431 UNIVERSITY AVE. N.E., FRIDLEY, MINNESOTA 55432 PHONE (612) 571-3450 November 19, 1984 Mr. Howard Thorsen Dailey Hanes 8510 Central Avenue N.E. Blaine, NN 55434 Re: Final Inspection of Porch Addition at 5720 Washington Street N.E. Dear Mr. Thorsen: A final inspection was made on November 16, 1984 of the above listed construction and it was noted that the following item needs to be completed before the structure can be finaled out: Install joist hangers on the outside ends of the floor joist. We will expect this item to be completed by December 3, 1984 and a reinspection called for to deter -mine compliance with this letter, If you have any questions on this item, please feel free to contact me at 571-3450. Sincerely, DAR G. CLARK Chief Building Official DGC/mh CC: D. C. Schlottman 5720 Washington Street N.E, CITY OF FRIDLEY Effective Date May 1, 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE or-arnOL.MrA T Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer * Air Conditioning (all sizes) All Others/Repairs and Alterations 1% of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 1% of Value of Appliance or Work RATE TOTAL Job Address 5720 Washington St. NE $ 20.00 $ 20.00 $10.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ $ State Surcharge $ .50 TOTAL FEE $ 20.50 Reinspection Fee ($15.00) $ Rough Insp. Date Final Insp. Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT TS $15.00, PLUS $.50 STATE SURCHARGE Attach stack verification form with.replacement• furnace permits *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn. September 12 19 88 OWNER Duane Schlotlman KIND OF BUILDING Frame USED AS Residential TO BE COMPLETED ABOUT ESTIMATED COST $ 3100.00 OLD - NEW BUILDING PERMIT NO. PERMIT NO. O®�L061 DESCRIPTION OF FURNACE/BURNER REPLACEMNT**fie HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. ohe Trade Name Carrier Size No. 58SX08OBC Capacity Sq. Ft. EDR BTU 8Q, 00.0__ HP Total Connected Load _ Kind of Fuel nat . gas BURNER - Trade Name Capacity Carrier Size No. Sq. Ft. EDR BTU HP Company , Dependable Heating and A/C Signed Signed By �LrL J l �C�ii A �1111L-t /1 Tel. No. 757-5040 CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes No ( ) 2. Is free from rust or deterioration Yes (,i) No ( ) v 3. Has no foreign objects lodged within Yes No ( ) 4. Is securely supported Yes No ( ) 5. Meets all current Code requirements for size and total BTU connected Yes No ( ) 3 �� 6. Has Total heating BTU's of All other BTU's TOTAL S Rema rk s A P SUBJECT PE City ®f Fridley ! 0"3' AT THE TOP OF THE TWINS B U I L D I� PERMIT i � 1J R _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC.II �p ®� r CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY "'j 612-571-3450 910-F15 5/21/91 JOB ADDRESS 5720 Washington Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Tract D Registered Land Survey #14 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Vic & Sons Construction 10020.Olive Street NW', Coon Rapids 55433 754-8647 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. r., 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION C REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install soffit & Fascia 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. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2,195 $1,10 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SACCHARGE DOE T PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO ISI NS OF ANY O ER STATE OR LOCA LAW REGULATING CON- $54.00 Fire SC $2.19 STRU ON OR T FORMANCE OF CO CTI EE TOTAL FEE . P $ .29 SI NATURE OF C NTR CTOR OR AUTHORIZED AGENT IDA 1 yVN PR PERLY VA E T I IS YOUR PERMIT P GATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI legal Description: R-1 AND R-2 Building Permit Applicaticzi e? � ' G✓i4'Sh � a� �p ToN Effective 1/1/91 Owner Name & Address: " _ L / Tel. )# Contractor: 11 /4 C° 9- c�� C,O�Tv�Gt �I-11i� Tel. IMP1A G.J. Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. L1vnr. AREA: Length Width height Sq. Ft. MUM AREA: lerrfth Width height Sq. Ft. DECK AREA: length Width Hgt/Ground Sq. Ft. Corner ict [ ] Inside Int [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ Approx. Coupletion Date: Permit Fee $ "y 06 Fire Surcharge $ "2,11 State Surcharge SAC Marge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ STIPULA'T'IONS : CITY UN QTY Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th �) $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by RV n Bering Agement Necessary [ ] Not Necessary [ J The Chief Building Official shall, before issuing permits for the erection of arty building or structure, or for any addition to any existing building or sbmcture, 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 anent herein below sat forth and in the manner herein provided to -wit: $1 to $500 $15 Pl nim mi Fee is $15 plus surrharge) $501 to $20000 $15 for first $500 plus $2 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $45 for first $2,000 plus $9 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $252 for first $25,000 plus $6.50 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $414.50 for first $50,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $639.50 for first $100,000 plus $3.50 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional $1,000 or fraction thereof DRIVEWAY DEPT SSICH ESCRW (C'oncrete 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. pe 04*IW*�-�Icwkll Permits for oonastrwcticn will be issued a minimamt 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. suBjECT(,O-ERMIT NO. City of Fridley 23969 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • COMMUNITY DEVELOPMENT DIV w. -------, r I PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED B� CITY HALL FRIDLEY 55432 ��� 612-571-3450 910-F15 1/31/96 JOB ADDRESS 5720 Washington St. NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Tract R.L.S. NO. 14 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Duane & Jeanine Schlottuen, 5720 Washington St. NE 574-9456 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Midwest Restoration & Construction 1628 Highway 10 NE SLP 55432 784-2772 5267 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 N REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Roof repair 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 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 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 00 $1,000.00 $ �)ro WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE HORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHE TATE LOCAL LAW REGULATING CON. $34.75 Fire SIC $1.00 STRUCTION OR THE P F MANC OF CONSTRUCTION `s PLAN CHECK FEE TOTAL FEE / �� , $5.00 License SC $41.25 Olef Si NATURE OFCON-R TOR OR AUTHORIZED AGENT (DATE) WHEN PROPER VALIDATED THIS IS YOUR PERMIT i BL G )NSP — r'ATE S�GNATUREOF OWNER0F OWNER BUILDER) )DATEI NEW [ l ADDN [ ] CITY OF FRIDLEY ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: -1 "/ i Z / k /') . n ��' y— Legal Description: I 0 Effective 8/l/95 Owner Name & Address: t'1110 <5>� /?PlTel. # 7 Contractor: All ��� %?i {�� 9(- �?� ��"yG �'y�1 _ MN LICENSE # 5d Address: 5 5;CZel. # 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: � /� Vic' G�dDG� eek/ e - Pe'e'l 7L - Comer Lot [ ] Inside Lot [j Ft. Yd Setback Side Yard Setbac Type of Construction: Po® ./ ��,/�� � s^ , Estimated Cost: $ Approx. Completion Date: (Cost on Bac Driveway Curb Cut Width Needed:Ft. + 6 _ ` , $ _ $ DATE: /'�/ APPLICANT: G ; Tel. # CITY USE ONLY Permit Fee $� . ��� Fee Schedule on Reverse Side Fire Surcharge $ C .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit License Surcharge $ �S , d $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 PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for struycatudrdel,tiontoanyexistingbuildingorstructure,orforanyalteration or repair to any existing building or 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 $21 (Minimum Fee is $21 plus surcharge) $501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,00 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $100,001 to $500,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5012.25 for the first $1,000, 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 $13.50. 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. 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 ration of the foundation once it has it has been constructed will be required before proceeding with the flaming. 1 s..'EcT PE , , A City of Fridley 2 7 512 AT THE TOP OF THE TWINS BUILDING PERMIT rp ` RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9198 JOB ADDRESS 5720 Washington Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Tract D Registered Land SurveyNo. 14 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Duane Schlottman 574-9456 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Town & Country Roofing 9403 Minnesota Ln N Maple Grove 55369 545-4233 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 jc REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage 30 SO 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 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 $2571 91.29 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE R LOCAL LAW REGULATING CON- STRUCTION OR THE PERFO NCE CONSTRUCTION. $74.75 Fire SC $2.57 PLAN CHECK FEE TOTAL F Llcen 5.00 83 1 GNME C NTRACTO ORAUTM ED AGENT IDA EI N P P LIDATE I$ is R PERM) B )NSP s J 0 GATE SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI r AUG -13-1998 08:42 FROM CITY OF FRIDLEY TO 8589320 P.01i02 """ L t'.liCXV0 i/l/`Jb ADDN I ] CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES lI,-1 AND R-2 I BUILDING PERMIT APPLICATION ConstructionAddress:�-C) k �D Legal Description: u Owner Name & Address- -\-*) P \\ Ty\A ' at) Wc'`� el A ContractorMN LICENSE # � d8 ti a ok Address•(fX4 Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCREMON OF IDdPROVF.MENT 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:_ C `'P"�' tsq Estimated Cost: $ q7 (Fee Schedule an Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: Q I APPLICANT: JTel. # Permit Fee $ CITY USE ONLY Fee Schedule on Reverse Side Fire Surcharge $ �'S� .001 of Permit Valuation (1/10th%) State Surcharge $ o $.50/$1,000 Valuation SAC Charge $ $1000 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 ( l TOTAL $ �3,91 10- j-= t'' SUBJECT R M I T NO-. City of Fridley3L0250 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. f PROTECTIVE 4 I i CITY HALL FRIDLEY 55432 �.__.11: '•� NUMBER REv DATE PAGE OF JAPPROVED BY 612-571-3450 910-F11, 9/21/99 JOB ADDRESS 5720 Washington Street NE 1 LEGAL I LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 'tract D Registered Land Survey No. 14 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Duane & Jeannine Schlottman 574-9456 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO PTL Contracting 2526 N Ferry St Anoka MN 55303 323-7400 5294 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 X REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Repair fascia and wrap 2 windows 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling SEPARATE PERMITS ARE REOUIREO 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 $5OO $.50 DOES NOT RESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISI SOF ANY OTHE TATE OR LOCAL LAW REGULATING CON- STRUCTQN R THE RF ANCE OF CONSTRUCTION $23.50 Fire,#C $.50 PLAN CHECK FEE IOrAEE Lice C $5 $0 SiGNATU E OF CO cRACTOR O AUTHORIZED AGENT IDATEI / HE THIS I$ 11 _ 9A&MV S,GNATURE OF OWNEROF OWNER BUILDERI -,DATE I BL G INSP DACE NRW ' - [ ] ADDN [ ] ALTER [ ] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/98 ConstructionAddress: Legal Description: Owner Name Address: Tel. #—� Contractor: MN LICENSE # Address:' Tel. #-� ®� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF BIPROVEMENT 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: Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. +A Ft = Ft x = $ DATE: ')- APPLICANT: el. # 2 ^7 4-1* CITY USE ONLY Permit Fee $ S?� Fee Schedule on Reverse Side Fire Surcharge $�, .001 of Permit Valuation (1/10th%) State Surcharge $' $.50/$1,000 Valuation SAC Charge $ $1000 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 $ U . STIPULATIONS: BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $21 (Minimum Fee is $21 plus surcharge) $501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $574.75 for first,,1025 for each additional $1,000 or fraction thereof, to andtincluding $100,000 $100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $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 $13.50. 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. 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. CITY OF FRIDLEY INSPECTION DIViSION Effective On May 10, 1999 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS a- 7ZO (AAS1*c 1--� Cad ST RATE SCHEDULE —7 -IN OWNER � (L(--5 a C S CLQ Lois Mpt Residential Rate TOTAL Furnace Shell and Duct Work, Burner - BUILDING USED AS X0 ra Also Replacement Furnace $ 30.00 $ (Side Vent - Fill Out Back) ESTIMATED COST ZZ �D PERMIT N0. /0 Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of Heating Units _ Circle One (Steam) (Hot Water) (Warm Air) Gas Dryer $ 10.00 $i Trade Name Size No. BTU HP EDR *Air Conditioning - All Sizes $ 25.00 $S ®o Fuel Total Connected Load_ All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR Commercial/Industrial 1.25% of Value of Appliance or Work $ 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 an State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and �� representations stated in this application are'true and correct. TOTAL FEE $ Z eJ RESIDENUL HEATING & AIR, INC. MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING 0 'i /71815 East 41st Street, Suite A. REFRIGERATION/AIR CONDITIONING PERMIT IS, $25.001Minneapolis, N 55407.3425 PLUS THE $.50 STATE SURCHARGE Signed P21 REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved By Rough -In Dat Final Date written permission from adjoining property owner. Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CEWWgEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes O No ( ) 3. Has no foreign objects lodged within Yes O No (') 4. Is securely supported Yes O No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( } 8. Has combustion air been provided for water heater Yes () No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CI I Y vf- I MULL) INLA I i i ION 1AV 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" Gas Dryer" Back Flow Preventer Required ( )Yes () No Type Reinspection Fee $47.00/Hr NO. RATE $ 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 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE TOTAL JOB 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. . 20 Owner v Don boa Building Used As_jbn,0 Estimated Cost_ PERMIT NO.� �A PLUMBING COMPANY (p 1KY1 A, M SIGNED BY TEL N0. FAX #�� Approved By Rough -In Date Final Date 50: MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $2000.= r `` $ 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 ,� I THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When nrlfurant-A, 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 plasticlPVC 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 manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing rnmhustion air is sized and installed to meet the current codes and manufacturers specifications. Yes () No ( ) When required to install a npw rnmhioction air it will be sized and installed to meet the current codes and manufacturers specifications. Yes () No ( ) When installing a ne y renting syytttam, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturers 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( ) Apnldance TVnP and Sipe/CommonVent Vent and Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Apoliance #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 HeightDiameter_ inches 1 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 A[ TFIRATI HEATING CO: Signed By: Date : ,2�,6 -W713"' City of Fridley 6431 University Ave NE Fridley MN 55432 (763) 572-3602 or Fax (763) 502-4977 -- -Water and Sewer Permit Application ❑ New Connection ❑ Existing Date: Q- ® CQ XWtility Line Repair/Relocation and Sewer Connection Job Address: S-)dy W(A��/Vtdn, A Name of Applicant (Plumber): /of" — �d Name of Property Owner: Existing Structure Permit # Permit Type: Sewer Fee: Water Fee: Meter Fee: Repair Fee: Relocation: State Surcharge: SAC Charge: Special Assessment Fee: Total: $ %,0 Applicant Signature: Inspector approval: d 1>ie vV_ sc k L p i f/t't u v1 Water Meter Repair — Weekend & Holidays $125/hour Water Connections Permit $50 Sewer Connections Permit $50 Inspection Fee for Water/Sewer Line Re air $40 Special Assessments See Engineering Cost of Water Meter See Utility Billing SAC Charge $1550 State Surcharge $ .50 Water Tap See Engineering 04/04/05 Buildingq MECHANICAL PermitNo.:' l Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 FaMeNT 2, 2007 CITY OF FRIDLEY DATE toU YOUR E-MAIL ADDRESS SITE ADDRESS i ?' U W CMy1Aj pn ST THIS APPLICANT IS: ❑ OWNER ]CONTRACTOR PROPERTY ` NAME: aL�h `Y 0. OWNER/ ADDRESS. '@L® CITY ' i \-e-q.n STATEMOZI S7Zq TENANT PHONE: �c0� ` S � � ' q LI SL CONTRACTOR COMPANY NAME: CENTERPOINT ENERGY SUBMIT A COPY OF CONTACT PERSON: JOANN I INKEN YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: 9320 EVERGREEN BLVD STE BITY "COON'`RAP.IDS sTATEMN zIP55433 APPLICATION PHONE 763 — 757 -- 6202 FAX 763--757~6701 PERMIT TYPE M4MIGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW 04EPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORKPER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZEIBTU (oV) 006 MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU A/C $25.00 _FIREPLACE (GAS) $15.00 _. GAS RANGEIOVEN $10.00 _ _IR _AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _BOILER $35.00 FURNACE $35.00 _GAS UNIT HTR $10.00 _CHIMNEY LINER $10.00 _GAS DRYER $10.00 _.POOL BEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 p hermit Fee $ Wj5 Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 �_ x $35.00 = $ 3SM State Surcharge = $ .50 Total = $ 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 which requires review and approval of plans. SIGNATURE OF APPLICANT eA. �' NAME ROGER HOFFHEIN DATE 10 2 r .�,., .,l d ��k rh eJ ok's .,Y �. E. f '�. Gxa •�� �©„�� �R- 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 >�XISTING HOME ❑ MAKE-UP AIR REO=D 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 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 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. a r uilding spections 1763-572-3604 BUILDING � lRe rmit RESIDENTIAL APPLICATION c eiv d113y: CITY OF LEY F UATE_,. ` .�. •� _ �Y,QU�R,E.MAR ADDRMS SI'rE Alla?RESS —X,-;--2.�'. o `t • � �' � THIS APPLICANT IS: 0 OWNER C NTRAGI p'ROPEIt'rY OWNERI NAmE; TENANT ; PHONE r U'�1.® S MMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERNUT TYPE TYPE OF WORK: DESCRIBE WORK SIZE Of' IMPROVE SQUARES STATE LICENSki ft _OW DR'I'B --CITY.. PIION . FAX '5- (1 r pdC W MIMUTRI W-71(IN Sfl•E_ _ — 0 EIASEmENT FWISH Q DECK 'A PROI'I:)SFD SIZE:_ . PROPOSED HEIGH r: r 0 Vinyl 0 Alumiawn El Offs e 30MUZO IN IMSTINQ ()PLMNtiS OYcs ONO ok FOR NF.W Ol'8NWGS-DFgCRIEK "'M' OF OPENING CHANGES & TYPEOF WINIIOW TO BE INSTALLkl7 BASED ON VALUAMM INCLUDING THE COST OF (USING THE 199,O,C FEE SCHEDULE) . ,. ra„ srr• G iO(F ❑ Dm N 11LE 17 SIDINCI ❑ O'IYI1 K Ci M MMINCi POOL 0 ADC MON - Q RENIpOMING '�1a1 Q HOUSE & C)ARAUF 01�ITACHW OARAGE a vErACHKu GARAOF CaSslillt 13 Trim I] Fi meia LOCATION UI' WINDOWS FEES TOTAL JOB VALWION S - I e I. Existing Flo PdrMit Fee 2. Proposed fla 6.4% of Building Permit Fee 3. List of strut $ FOR NL•W C ONSTRU Fire Sttrcltarge AUDams- & ^ .0005 x Permit Valuation Minimum S50 i. Site PhWSV S'D� and propose Surcharge Licenseffi 2. Two sets of $1675 pea SAC Unit (Plans to MWCC for dLtenr 3. Energy Crlr FEES TOTAL JOB VALWION S - I e v •• "` ",•" ` " - - – See Hack Page for Fes Schedule PdrMit Fee $ / $ 6.4% of Building Permit Fee Plan Review $ .001 times the total job valuatlon Fire Sttrcltarge $ l� ^ .0005 x Permit Valuation Minimum S50 Surcharge Surchar S'D� $5.00 (Saila Licensed Residential Contt'aotors) Surcharge Licenseffi $1675 pea SAC Unit (Plans to MWCC for dLtenr SAC Charge ftx$21 $2! _ $_ fl = � _ ._ Curb Cut a;aCroW S $450 Conservation Plan Review Erosion Control $ Fee Determined by Engineering Park tee $ Agreement necessary ( ) Noa Necessary ( ) Sevier Main Charge. ..r.—Ili r.nvahle to: City of Fridley 1 V{pl J/Pc HITS LS AN APPLKC ATION FOK A PFf,*&r-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accur cotrfotmanoe with the ordinances aadpeeodesrinit a d work Isof the Citv o of to Startnd with the MiTmes0ta C witllout a permit; that tho worle will be in permit but only an aP plat in the case of al ork 'c quires roview and ruv or plans. `, i I�A9 pRIDITNAM - it — SIGNAII.� OF APPLIC plan uI membon to 'bo =4 g0'N, INC I IMI dG DFMS, SUB y s1lowipg tie existing cracwras rcojwt. nWtruetion plans that the, work 4aill be in 1 understmtd this is not a rdance with the approved Td Wd90.Po Z00Z ZZ '430 L8Z-TTZS29L: 'ON }&id halATuA .to fi;TO: WO2H Building BUILDING Permit No.: r �% Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF PRIDLEY Date Rec'd: 763-502-4977 FAX EFFECTIVE 1-1-2010 - 16 DATE q ^ S YOUR E-MAIL ADDRESS SITE ADDRESS SIR) l„)A Y� !1-41, cS+ THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: ':3'eaKiv�� TENANT ADDRESS: S -72-v tJA 31. S CITY L,) ( STATE—ZIP— TATEZIPPHONE: PHONE: CONTRACTOR' NAME: , cL� Z L C SUBMIT A COPY YOUR STATE LICENSE STATE LICENSE # �D(0 ZR ad C EXP DATE AND CERTIFICATE OF n ADDRESS:_ KS3 � } , / CITY 6��&he STATE /hwZIP INSURANCE PHONE 0 - Ll �(3 (n� ( FAX FAma Y/NEW CONSTRUCTION SIZE PROPERTY TYPE1NGLE ❑ TWO FAMILYINEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH 09 IPOOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR REMODELING DESCRIBE WORK BEING DONE: SUE OF IMPROVEMENT LENGTH WIDTH HEIGHT S_Q FT ROOFING q ElHOUSE ONLY NUMBER OF SQUARES_. ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL. FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: SING THE A997 U -B.0 FEE SCHEDULE) COTAL JOB VALUATION $_ fj—fj—' a 56044 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 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) ftt6ft= 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 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 whi requires 'ew and approval of plans. SIGNATURE OF APPLICANT PRINT NAME_Sjn�� DATE _ S - '0 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 $39125 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 1 s' $100,000 plus $5.60 for each additional $1,000 or fraction to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the V $500,000 plus $4.75 for each additional $1,000 or fraction to and including $1,000,000 $1,000,001 and up $5,608.75 for the 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