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PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT Date: November 5, 1970 Owner: _ Roger Brenny Builder Address 6011 3rd Street N.E. Address Same Same LOCATION OF BUILDING No. 5790 Street _ Washington Street N.E. Pari of Lot Lot _.1.._& _2 __ Block 2 Addition or Sub -Division . Adams Street Addition Corner Lot __X_ _ Inside Lot _ Setback — Sideyard zxiwr Elevation 859.17 — 09RPF&P9R?2M 862.15 Wye Top of Footing DESCRIPTION OF BUILDING To be Used as: Dwelling Front 26' Depth 40 20, 800' Height 20' S9. Ft 1040' Cu. Ft Garage Front 24' Depth 22' Height 10' Sq. Ft 528' Cu. Ft 5280' Type of Construction Frame Fast Cost A28,000_ _ To be Completed May 1st, 1971 WATER LOCATION: 64' South of Manhole, 10' North of Sewer SEWER LOCATION: 74' South of Manhole Varification of Location of basement by survey required. Provide Hard Surface Driveway. 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 aboveforth and in compli ce with all provisions of ordinances of the city of Fridley. n_Z /�� In consideration of the payment of a fee of a 50.00 , permit is hereby granted to Roger Brenny 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. NOTICE: This permit does not cover the construction, hataMen for wiring, plumbing, gas heating, cower or water. Be euro to we the Building Inspector for separate permits for these ttenm APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: BUILDER: ADDRESS: 4 3 ADDRESS: NO:. 57 / P STREET: /- LOT: / BLOCK • - ADDITION: CORNER LOT: �—INSIDE LOT:—r SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To a Used As: t Front: Depth: O Height: =20 ° Square Feet: /'041() Cubic Feet: Front: `f / Depth: Z— r Height: /0 r Square Feet; Z�2 jr" ° Cubic Feet: Type of Construction: Estimated Cost: $ o r To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stfict 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 correct. ,0A1 Aernj/7- , g 11 6-�j� f- � DATE: R� / ® SIGNATURE: �® (See Reverse Side For Additional Information. try � � {✓ _ P n 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 averages 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 Proceeding 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 Occupancy has been issued. Application for Power Plants and Heating. Cooling. Ventilation. RalWigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ each add. 60,000 BTU ....................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 ................. Repairs & Alterations each add. $500.00 .............. 8.00 $ 2.00 $ 5.00 $ 5.00 $ 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour . ..................... 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ............... x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL ROUGH FINAL Dept. of Bldgs. Phone SU 4-7470 Location 5790 Washington St, NE, City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true an correct. Fridley, Alinn 197 Roger F. Erenny Owner Kind of Building Frame Used as Dwcr, e To be completed about Estimated Cost, $ Old—NewXBuilding Permit No. Permit No. ea'� DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air­yNo 1 Trade Name AFCO Size No. CL 1104-OITR Capacity. Sq. FL E.D.R. 8 0 , 0 0 0 BTU H.P. Total Connected Load 58,161 Kind of Fuel Nat , Cas BURNER —Trade Name Size No - Capacity Sq. Ft. EDA BTU H.P. (REMARKS—OVER) SignMill Citv Heating Co Ba y E 42 Business Phone No 544-1501 2WAWA OV �.l MALMMI �Iw* � aM wt®r".rr'm If W Fl A-11 5W im �cwo I�''- 5L �I �=Rtff, —,WAW 'YAWjW?x, Wall �� f= /L/� , _ ,/i� FEN -2 1 Pid f L-A VA I WAJ- VA Wlwt-3 -9 AV "', wj�"- WA WAVI WTM MASWA L Glass Exp. wall Net exp.-wall Into wall Infiltration Glam Ettp. wall Nei exp. wall .wall ailing Floor .�— Total Btu. Ceiling z Floor Total Btu, Raauirei rq.. fit. E.D.R. or �. ins. W.A. I.Aider area Required sq. ft. E.D.R. or sq. inn. W.A. Leader area Fl• R m I Length Width Height FIJ Room I Length Width Windows and Door—brackage and Area tats•art o asa t Ares Na of Dano at Oaa• lights of Crack sq.s Witidows and Doors—Craehage and tea Idt •Is t o a•a r•a No. of ae of e• 1 ata of crack sq, tt. ONO Btu Infiltration I�Itratin Clan Gass Exp, wall Nd exp. wall. Ian. wall Exp. wall Net exp. wan Int. wallCeiling Floor Ceiling Floor Total Btu. Total Bt' a Required sq < ft. E.D.R. or sq. ins. W.A. Leader area Required sq. ft. E.D.R. or sq. ilia. W.A. Leader area F1.1 Room j Length Width Height Fl. Room 1 Length Width Wiadoan`and Doors--Noackage and Area NAA* No of n•st ft. Area No of HaIQtwoR of ban• Ilsht• of Crack 04. . tt. Windows and Doors--Crackage and Area Idth Hdaht No. f Ltaeal tL Arca o Na of ®ane • of pang tlahto of crack oi, ft. Coef. -Btu C®ef Infiltration Infiltration Glen Clan Exp' wall Exp. wall Not cip' wall TNet exp. wall Int. wall Int. wall Ceiling Ceiling Floor Floor Total Ste, Total Btu. sq. ft. E DJL or sq, ks. W.A. Leader area I ReauimiL o. F n Q .. :a. W a s __.L_ _--_ City of Widley Dept. of Bldg Phone 550-3450 DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: .� 0 �gQ F $�® 0 3 # 1 Z C �.(�9 New Fixture Old Opening a i $ Catch Basin x $3.25 W � C7! � s / s N WATER HTR. GAS ELEG Base a $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ..... ..... 11_ x $200 Additional Fixtures ... .............. x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ lot -- — 2nd 3rd 4th _ ° Futuro Connec&m Openings` Connected With New Fixture, Old Openings I ��l ❑ Cessp ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $2.00 $�® Future Fixture Opening x $1.50 $ s New Fixture Old Opening x $1,50 $ Catch Basin x $3.25 $ Water Heater (Up to 99,000 BTU)_ x $3,00 Q 4 $_ New Ground Run Old Bldg. x $3.25 $ Electric Water Heater z $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ..... ..... 11_ x $200 Additional Fixtures ... .............. x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Reiss to Cods Description .................................. ..........$ TOTAL FEE '� ; �1' " i�R I City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, B+Iinn R 19 OwnerJ�� .��•' Kind of Building Used as To be completed about Estimated Cost, $ / 016—New. Building Permit No.— _. Signed ROUGH �J FINAL By- Busi CITY OF FRIDLEY INSPECTION DIV. Effective On March 1, 1996 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 �fZ RATE S�HEDUL,� The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work In strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ representations state_ d In this application are true and correct, --- (Side Vent — Fill Out Back) �— X1996 Gas Piping (Needed with new furnace) $10.00 $ �� �� ® �� ➢ OWNER ���r Gas Range $ 10.00 $ BUILDING USED AS AFI,9a�,�,�" Gas-Ciryer $ 10.00 $ ESTIMATED COSTGr PERMIT N0. ✓���'� *Air Conditi ning —,All Siz s n $ 5.00 `� `�;�C'L� $ � CRIPTION OF FURNACE AND OR BURNER„ L 1 Other epirs c &te at n (LI T 01 BACK) 1% of Value of lianc or ANP $ No. of Heating Units 'Circler One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Commercial/industrial 1.25% of Value of Appliance Work $ Fuel Total Connected Load State Surcharge 50 Burner Trade Name � Size No. BTU U7 HP EDR TOTAL FEE $ S HEATING COMPANY�/kms/Z MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION Tel No. REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved By Rough—In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE HEATING CO: Signed By: Date: CMMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: I . Has been carefully examined Yes ( ) No ( ) 2. Is free from rust or deterioration Yes ( ) No ( ) 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's connected Yes ( ) No ( ) 6 Has total heating BTU's of All other BTU's TOT 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: SUBJECT PE.E_d#Ifift3:'" City of Fridley 24804 AT THE TOP OF THE TWINS BUILDING P E R M I T Ir? RECEIPT NO. • _ COMMUNITY DEVELOPMENT DIV rr r PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 11/27/96 JOB ADDRESS 579 Washington Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,2 2 1 Adams Street Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gerald Ilstrup 5790 Washington St NE 571-4331 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Fireplace Showroom 225 Co Rd 81, Osseo MN 55369 425-9656 20062055 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 _Q ALTERATION ❑ REPAIR X ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install a Kozy Heat, 741, Fireplace 9 CHANGE OF USE FROM TO STIPULATIONS Install per testing agency's specifications. 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4,000 $2.00 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- Fire SC $4.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $87.25 PLAN CHECK FEE TOTALFEE P-7 - License SC $5.00 $98.25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PAOPE RLY LI DATED THIS IS YOUR PERMIT BL IN$P O TE S.GNATUREOF OWNERIIF OWNER BUILDER) (DATE) NEW [ ] ADDN [ ] CITY OF FRIDLEY - ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress:� Legal Description: i Effective 3/1/96 -V- 'S7 ? 3 Owner Name & Address: Tel. # Contractor: /�� ,�% �1 �. n MN LICENSE # �4) o-;, Address: c).-) 1E"'06) ?� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # e2 S "-�� S -f LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 7�/ f � A ee Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ 41kt29-a Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width. Needed: Ft. + 6 Ft = Ft x $ — $ DATE:�� 02 Z- A� APPLICANT: — Tel. CITY USE ONLY Permit Fee $ , dS7 Fee Schedule on Reverse Side Fire Surcharge $ ', CSC .001 of Permit Valuation (1/10th%) ` State Surcharge $ $.50/$1,000 Valuation �V4 SAC Charge g $ _ $900 per SAC unit 1 (, Z License Surcharge $ C�(,� $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above f Erosion Control $ $450.00 Conservation Plan Review .Park Fee $ Fee Determined by Engineering V� L Sewer Main Charge $ Agreement Necessary j ] Not Necessary [ ] TOTAL $ ase 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 $50,000plus $6.25 for each additional $1,000 or fraction thereof, to and including $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 FWLEY INSPECTION DIVISION Effective On Jammy 1, 1998 6431 University Ave NE Fridley, MN 55432 APPUCATION FOR POWR PLANTS AND HFATING, COOLING. LA , 572e -36D4 FEFHGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS RATE SCHEDULE The undersigned hereby mantes aWicdon for a permit for the work herein Pholderrtial Hate TOTAL seem agreeing to do all work in strict w=dance with the City Codes and Furnace Stell and Duct Work, Bumer — rulings of the Building Divtion, and hereby ores that all the acts and Abo Replacement Furnace $ 30.00 $ representations stated in the application are true and correct. (Side Vent — Fill Out BI _ go. Z�f_ ,19% Gas Piping (Needed with new A mace) $10.00 $ a t w( OWNER 1 3 Gas Range $10.00 $ { ,� BUILDING USEDAS eSi cxe rtc Gas Dryer $10.00 $ ESTIMATED CAST®. PERMIT NO. *Air Conditioning — All Sixes $ 25.00 $ DESCRIPTION OF RJRNA+i E AND OR BLMER AD Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliarm or Work $ No. of Heating Units Circle One (Steam) {Hot Water) (Warm Air) Trade Name Size No. Commercialfimiustefal BTU HP EDR 1.256 of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge $ 50 Burner Trade Name Size No. BTU HP EDR TOTAL FEE 5� REINSPECTION FEE WOW *Air Condtioners can not be planed in a side yard without, wd ten permissw from ac%ning Property owner. FEATING COUPMY App By Rough—kt Date Final mate / FILL OUT BACK SIDE FOR ST VERiRCATION ON REPLACEMENT CE Rem ks: TWO A Ti!''iMQ T2n3�n Yln.,a. HEAI ING CO: Sigm, By: Date: i j YAND S'lI'ACJK 'VE MVAgrin i The undersigned hereby verifies that the existing chimney or stack: I f Has been carefully examined i Yes { } No ( } 2. ( Is free frotn rust or deterioration Yes w ) No { } 3. Has no foreign objects lodged within No ( ? 4. Is securely supported Yes (} No ( } S. Meets all current {Code requirements for size and total BTU's connected Yes {) No ( } 6 'Has total heating RTU'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 ( } Rem ks: TWO A Ti!''iMQ T2n3�n Yln.,a. HEAI ING CO: Sigm, By: Date: PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 7,00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7,00 Catch Basin $ 7.00 Rain Water Leader _ $ 7.00 Sump/Receiving Tank $ 7,00 Water Treating Appliance $10.00 Water Heater —Electric $ 7,00 Water Heater — Gas** $10.00 Gas Range" $10.00 Gas Dryer** $16.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 TOTAL FEE $A).6 f JOB ADDRESS -0 t Effective On January 1, 1999 "OSS® Gas Misc : Water ft6de-r Range ,Ftxt Gas Elec The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. Owner Building Used Estimated Cost (::Y60 PERMIT NO. p I McGuire & Sons PLUMBING COMPANY S05 - 12th Ave So Hopkins, MN 55343/ SIGNED B TEL N0. qbg>q31- qle-74-- Approved By Rough—In Date Final Date MINIMUM FEE F R ANY PLUMBING/GAS PERMIT IS $20.00 PLUS THE $.5o STATE SURCHARGE "COMBU,STION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. Building $ BUILDING See Back Page for Fee Schedule Permit No.: Inspections RESIDENTIAL APPLICATION .urcharge Received By: (A", 763-572-3604 (.0005) times the total job valuation — Minimum $.50 CITY OF FRIDLEY $ Date Rec'd: 6— Tcj 'SATE % iZ l IQ YQUR E-MAIL ADDRES,. D cd 1`Aid (t/l r ® 16 . C o M SITE ADDRESS R s I? / 1 ? 4, / V $5.00 (State Licensed Residential Contractors) THIS APPLICANT IS: ❑ OWNER VCONTRACTOR ?RO-PERTY OWNER/ NAME: t d u Y 0 $ TENANTADDRESS: '✓ 7 4 ® tt�3 I /) a Ii CITY �,(�l� STATE ZIP'S �Li 3 2 $ PHONE: L S l I :?ID- tl O-7 3 $450 Conservation Plan Review CONTRACTOR NAME:_ THD At- Home Services, Inc. Lodi m FM c t J b n c s Fee Determined by Engineering STATE LI( 2690 Cumberland Pkwy, Ste 300 ; q sa 12 YS . L o Y 7 SUBMIT A COPY of and Cumberland Office Park Agreement necessary ( ) Non Necessary ( ) STATE LICENSE ADDRESS CITY STATE ZIP STATE—ZIP WITH APPLICATION PHONE Atlanta, 30339-3913 SINGLE Lic# 20268257 Ph. 763/542-8826 PROPERTY TYPE ❑ TWO FA. _.'CRIES PERMIT TYPE QADDITION ❑ GARAGE/SHED -RWINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER _ ❑ SAT&%IING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION [R-MAINTENANCE/REPAIR ❑ REMODELING ,J SCRIBE WORK BEING DONE: p / Q / -1,p p SIZE OF IMPROVEMENT LENGTH WIDTH 1 HEIGHT Sq. Ft. ' OOFING ❑ HOUSE ONLY UMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODEUNGSUBMIT: YARAGES 11 ATTACHED GARAGE 1. Existing Floor Plan 'ROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan `ROPOSED HEIGHT: 3. List of structural members to be used CDING 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 r`TDOWS 2. Two sets of construction plans _ EXISTING OPENINGS)RYes ❑No LOCA Q)''�_��jjTT�� WINDOWS 3. Energy Calculations FOR NEW OPENINGS -DESCRIBE SIZE OFQT/1!'� 'ENING CHANGES & 'PE OF WINDOW TO BE INSTALLED W n • A 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 / 3 5"5- OCCUPANCY TYPE 'ermit Fee $ fib, 4 S See Back Page for Fee Schedule 'Ian Review $ 65% of Building Permit Fee .urcharge $ .4 (.0005) times the total job valuation — Minimum $.50 'ire Surcharge $ 431, .001 x Permit Valuation (1/10%) .icense Surcharge $ $5.00 (State Licensed Residential Contractors) AC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) 'urb Cut Escrow $ ft + 6 ft = ft x $20 = $ .rosion Control $ $450 Conservation Plan Review ark Fee $ Fee Determined by Engineering ewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) 'otal Due $ 61-419 Make checks Davable to: Citv of Fridlev Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in Dnformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a -rmit but only an application for a permit and o k is not to start without a permit; that the work will be in accordance with the approved ! an in the case of all work which requir r e d approval of plans. 1 % GNATURE OF APPLICANT PRINT NAMEDATE O Page 2 - Building Residential Application BUILDING PERNUT 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 $23.5.0 plus surcharge) - $501 to $2,000 $23,50 for 1`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 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 JR $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 for the I- $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 $ I;3 BUILDING Platt Review Pcimit No.: Inspections Tire Surcharge RESIDENTIAL APPLICATION Received By: 763-572-3604 $ CITY OF FRIDLEY gate Rcc'd: L 763-5//0��2-4,�977 FAX $5.00 (State Licensed Residential Contractors) SA(' Charge $ $2100 per SAC' t:nit (Plans to iMWCC fur determination) Cub Cut FvxT tw $ tirrl:rT1v1:1-1-3t11I1 Frosion Control $ DA7E YOI:R E MAIL ADDRiiSS.»!h. fiS.Q.4. nuc eval� . ;,•aw, _..._ ..._.._____...._... ... SrTF ADDROSS --_ Fee Dcterininvd by Engineering Till% APPLICANTIS: `l,I O W NUR cir(TN"rRAC r0R Agreement neematy ( ) Non Necessary ( ) PROPERTY OWNEW �AVIIi: ?timet' Make checks payable to: City of r'ridtey Attach Stipulations _ TENANT ,M� ADUKtiSS: 7�C? �y?W�ti+ � �r TY rQtl Qin �SrArF/ /6f-r.1P t�a'2 ._ dtM PHONE:: CONTRACTOR NAME' _ ....._ ............ .... _ ............. _.._. 5ClBMIT A COPY OF -• - --.. ... ... S't'ATt L1rrxsl: INXP DAT C Yom STATE Lf('F,NSI^ ....._.._» r, AND cERTIFIC'ATEOr AI)DRI:S,9:-M.-__ C'1'rY .... STAT) M_ZIP INSURANCE; PHONL FAx PROPERTY TYPE SINrTA I:AMII.Y!\Fw CONSTRUCTION SIZE 'CWt7FA_MILN'IN'BW CONSTRUCTION SPORni'+ PERYIi€l' "TYPE ❑ ADDITION' ❑ FURAGN-51.11:1) ❑ WINDOW'S �1 HASHMENT FINIS11 O ROOF ❑ DRAINT11,11; ❑ ORCK ❑ SIDIN0 70'I.HER _ i_! SWIMMING 1'(M)L_ O N7 W I10V4I: CONKIAUCTION 0 AIMITION __• TYPE OF WORK: ❑-MAI MT%AN%CfigRfL'•PAIR RI•iU�lt71)I.1.h;Ci 316 WO HFI DONE: 4 UL— Wei,. Qa IS E ,111k .. Cl""yit'1'"Oj t � 1 ) 1., 0I' V' F\(iQI iLi� -,Q FT R(X)FtNV(; ❑ 11O11SIi 0NI,Y HASIi1AF-N-I' RHMODELIN(i SI;HNTI'r: \'I'kT13Git OF S()t;AKfiS NUMBER n FfOi;Sli .Yt tiARA<'il'. I. I.CiAlig Ploer Plan GARAGES ❑ A'rl'AC'I lKD CiARAW: Prgw�-d floor plan PROPOSED SIZ1W ❑ DETACHED ED GARAOU i. IJ%t orntruetural members to he used PROPOSED I FOR NF C'ONSTRUC" 101 INCLUDING WICKS.Is ❑ vinvl (ISnilit Ai}DITIONS. & PORCHES SIJRVII'f: 13Almilinum ❑Trim I. Site Plan/Survey slowing dic cxisling structurox ❑ 01hur a ruYcia anti el ProtiC. ?.rw0 sCL,4 ofCUnstrUCtOn glens WI\I)()WS L E•nergyCalculatiam. IN EXTSTI!NG012KNI\CrS ❑ us t7No LOCATION OIT W1NIX)WS FOR WIXD0WS—PROV10F, II.VAI,t;I: AND OR FOR NT-,W OPENINGS-DEWRIBE SIZE OF __.._...__._.__....._._.-_ .._.._ MANU AC-MR13 S`iIC'KRR ON WINIX=W. OPENING (1IAVCH-S & TY4-, Or WINTX)W TO HE INSTALLED NUMBER OF WINDOWS ALL MS ARE BASED ON VALUATION, INCLUDING TIM COSTOF LABOR AND MATERIALS: -4:SiNG THE 1997 L{.B.0 FEE SCHEDULE:) TOTAL JOB VALUATION $ OCCUPANCY _ TYPE.._ Permit fee $ I;3 Sec: Back Page for Fee Schedule Platt Review S 65% of R1111111ng Permit Fee Tire Surcharge $ .001 times the: total job valuation Surcharge $ 0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SA(' Charge $ $2100 per SAC' t:nit (Plans to iMWCC fur determination) Cub Cut FvxT tw $ ft + 6 ft - ft x $24 Frosion Control $ $00 Conservation Plan Review Park Fee $ _ _ Fee Dcterininvd by Engineering `icwer Main Charge $ Agreement neematy ( ) Non Necessary ( ) 'Total Dile $ 3'l Make checks payable to: City of r'ridtey Attach Stipulations _ THIS 1S AN APPLiC'ATION FOR A PI:RM17'-::(TI' VALID CSTI1, PRO(TISSED 1 I hereby apply for a building permit and i acknowledge that the infunnatioll above is complete and accurate: that the Work will be in conformance xAth the ordinance:; and codes of the City of Vridluy and with the Minnt-wta Constniction Codes; that I understand this is not a pormit but only an application for a permit and work is not to statrt withaut a lu rinit on site:: that the Work will be in accordance with the !J approved plan in the: case: of work hie t t'cttluires review and approval of planA A+ t Pit 7 i!('r\A'1'E:ItI: 01, Al E\1 \A�11T 1 i DATE :..._-._._...rl� i PL.GASENOT"E: 15EPARATC T'ETCMI 'S AR.C.REQUiRBl) FOR Pi,E)MOTNOt. ELEC.TRiCAI.. ANl').VE('1.1•ANl('iNL_W()RK NV 6Z:LZ:6 0402/ML :0180 9/Z :06ed 6t?6ZL9Z69 :W0JA From: 612672949 Page: 4/5 Date: 7/28/2010 9:27:30 AM 4L. O OS IShower f Cp CJ 9666 W" RIM A N A Building PLUMBING Permit r No.:v2 � 98 Inspections p RESIDENTIAL APPLICA,'TION Received By: 763-572-3604 CITY OF FRIDLEY Date Ree'd: 763-502-4977 FAX kFFI;( nvE 1-1-21110 DA'rl _.b/ - !� _ �_... _._. YOUR r-MAIL ADDRL'SS MAO� SITEAT)DRESS-_.x-794 THIS APPLICANT r5: Xow%. r-.R OCONTR AC TOR PROPERTY NA Mr-.:_..�t���r� AI))RSS:� � Q.S ._.... CITY.. _ � STATrM#%_I_P a- 4OWVER/ TENANT _ [_tONTRACTOR -A, SIJBMIT A COPY OF STATE LICHNSE it HXP DATL' YOURSTATE' . _ . _.._ __.... ._ .. _ .. .....__..._ ___... _.-.._... ......_..._._. . LICENSE. BOND AND STATI•i BONI) N .._..._ ., .... ._._._... r.XP T)A'E'I: „_ __...... ....... C'FRTIF[CATIiOF Ai)I)RiiSS; _ CI'iY 5'1A'I'Ii __Ttp INSURANCE PIIONF, ..._... FAX ...__...._ . ...--- - PERMIT TYPE AMNGLE FAVt1IN 0 TWO FAMILY ❑ TOWNHOUSE TYPF' OF WORK* D NEW PRE-PLACEMENT DErAILLD DESCRIPTION OF WORK t 61AM'Aq FEES AKE i;AAE130N $IU.QQ PFR FIXTURE'. 1; WH ERF ~(-1121). FIaTURIN: (INDIC'AT E TOTAL NUM15L'R OF EACH BI:I.Ow), MINiMr 1A FEE $35.50. 4. 13A7H SINKILAV FLOOR DRAINS SHOWER WATER PIPING 11ATHTuH (;AS PIPI\C� (NEFI) CITY IJC) SWI.WNci P(X)I. __ WATI11t SOFTNER (835) _ Cr.oTi•II:S WASHER _ i rrC i-w*N' SINK. WAXER CLOSET HACKYLOW PREV. (SIS) DISHWASHER LAU-NDRY TRAY WA'T'ER HEATER ($31) , FOR IRRIGATION - WATER ML71IR OTHER ...r:...v..rVv.:.. •.. ....v:,, •n.•.: ro::.Tir.... r.,.r. ✓ r. :•': .: :• V...Wi:: .. ... . "•" .v:: u.Tk••,:•:v.:.• ... ..... V.....•..n,. v.try k vu•v••vT}'•;9v:v:.v,: ••V;✓•,M•,.•. ... V.2 hRv.rv..n.{n:giu.t:rA.:✓.•4n.:: V.Y. •: ... , t WvT.v. ta�vvv.:iG'•vig4TN..:.vntG,t.4W.::.l.n.✓... 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City of Fridley and with the Minnesota Construction Codes; that i understand this is not a pertnit but only an application for a permit and work is not to start withour n permit on site; that the work Wil[ be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGMA ; 1-" of APPL;CAN"I' ......_. ... PRIG r `A�4E , a ' pDATr _6&y110 ... __ tiv•vvn»AaEgmgg, 11Miy.tr^.„`YyIIY.Ti'.`, Dt• •'•�P/•YilrylY'• •.Ctv Vk •t T'M7•YCv, iii`t4:'A%•.4P City of Fridley Building inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Wd 0£:LZ:6 060 /ML :94BG 9!9 :abed 6b6ZL9Zl,9 :ul01d