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City of Fridley, lE BUILDING PERMIT N95 6 � 9 Date:_ Owner:` Buildert! Address _ Address -- -- �, ,�I� , QCAT ON BUILDING No.. . _�`'Streetlee_ _._ " _Part of Lo Lot _ _ Block Addition or Sub -Division Corner Lot . Inside Lot _ _ _ Setback Sideyard 4 Sewer Elevation _ _ __ __ Foundation Elevation DESCRIPTION OF BUILDING To bo Used ,� , 1 . Front' - Depth+' Height Sq. Ft. Cu. Ft. . Fron Depth _ .`" Height __ Sq. Ft....__ Cu. Ft. Type of Construction � _ i— Est. Cost � � � T be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of, ordinances oY the city of Fridley. s In consideration of the payment of a fee of $ , permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances., Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to neo the Building Inspector for separate permits for these items. — --A 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLE'Y, MINNESOTA Owner's Name Bu LOCATION PF BUILDING No.Street Part of Lot _ Lot_ �,'( Block % Addition or Subdivision Corner Lot Inside Lot t/ Setback,^.Side-yard,, f r SEVER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: ..J,7 C- -,4-jl J'J L Front _„____Depth Height Sq. Ft o cu. Ft._ Front epthh Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be Completed The undersigned hereby makes application for a permit for the work herein specified* agreeing to do all work in strict accordance with the City of Fridley Ordinances and ruling of the Department of Build- ings, and hereby declares that all the facts and representations_ stated in this application are true and correct. DATE �l ' I SIGNATURE (Schedule of Fee Costs can be Mound on the Reverse Side). BUILDING PERMIT PEE SCHEDULE Section 2. The inspector of Buildings shall, before issuing any permit for the erection of any building or structure, or for any addition to any existing building or structure, or for any alterations or repairs, to any existing building or structure, upon application therefor, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: 2.1. For any such permit for the erection of any fire -proof building, other than a garage, warehouse, factory or grain elevator, or for the erection of any fire -proof addition, for similar occupancy, to any existing building shall be at the rate of $1.40 for each one thousand cubic feet, or fraction thereof, in such cubical contents. 2.2. For!any such permit for the erection of any fire -proof garage, warehouse,, factory or grain elevator, or for the erection of any fire- proof addition, for similar occupancy, to any existing building shall be at the rate of $1.25 for each one thousand cubic feet, classified as "fireproof" by Section 502 of the Minneapolis Building Code. HOUSES 2.3. For'any such permit for the erection of any non -fireproof build- ing other than a garage, warehouse, factory or grain elevator, or any non -fireproof addition, for similar occupancy, to any existing building Permit $1.00 for each one thousand cubic feet. GARAGES 2.4. For any such permit for the erection of any non -fireproof garage, warehouse, factory or grain elevator, or for the erection of any non --fireproof addition, for similar occupancy, to any existing, building or for each such building or addition. Ninety Cents for each one thousand cubic feet or fraction thereof, in the cubical contents thereof with a minimum or $4.00. For the purpose of computing fees for building permits the cubical con- tents of any building or addition to a uniform height throughout by multiplying the ground area covered from a point six (6) inches below the •floor' line 'of the basement or cellar to the average height of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. 2.5. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each Five Hundred Dollars ($500.00) or fraction thereof in the cost of all proposed work. 2.6. in no case shall the fee charged for any ,permit as set forth in Sectioh '2' be less tr $4.00. City -of Fridley eAp 'cation for Plumbing and Cas Fitting Permit Dept. of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK "tr- &- Number, Kind and Location of Fixtures Location q m NO. RATE TOTAL Number Fixtures ...................... e- x $1.50 $C) Future Fixture Opening ................ x 1.20 $ N $8,Z y iQ�3 Z �j O Catch Basin ............................ W G Z Z O + F N WATER HTR. GAS ELEG Base GAS FITTING FEES:� RATE TOTAL Z' >� 1st 3 Fixtures .......................... x $1.50 It / Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ 1st 2nd _ 3rd 4th • Future Connection Openings New Fixture, Old Openings Connected with Sewer fU Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... e- x $1.50 $C) Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ......—�� x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $- GAS FITTING FEES:� RATE TOTAL Z' >� 1st 3 Fixtures .......................... x $1.50 It / Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE City of Fridley: M The undersigned hereby makes application for a permit for the work herein 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 facl and representations stated in this application are true and correct. �d--- � Fridley, Mian- 1 ®a Owner Kind of Building Used as 6 -LZ J To be completed about®� Estimated Cost, $ Old Ne uilding Permit No Permit No. Q---9- / Signe Business Phone No ROUGH tY ^ 4 - 6 2 -- FINAL 545511- . SUBJECT - P T City of Fridley a 16586 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r RECEI NO. L' L .y__ COMMUNITY DEVELOPMENT DIV. INSPECTION 0 PROTECTIVE SEC. -'1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/19/82 / JOB ADDRESS 5861 Washington Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15 1 Lyndale Builders 7th Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Robert L. Morin 5861 Washington Street N.E. 571-0672 3 CONTRACTOR MAIL ADDRESS ZIP PHONELICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential. Z CLASS OF WORK Ej NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 101. x 20-0 Shed 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. Wood Frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, -OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 7 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 $700 $.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 CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $15.00 PLAN CHECK FEE TOTAL FEE $15.50 BIGNA UR COFRACTORORAU ZEDAGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PE MIT V/ J / K BLDG 4� / 9FATE SIGNATURE OF OWNER IIF OWNER BUILDER) 1IDATEI CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDENTIAL BUILDING PER14ITS (Nw, Alterations, Additions, or Repairs) ONJNER: 4,0e�V'r ADDRESS: 09// TEL NO: _sr7 l — py&122- BUILDER: C ADDRESS: TEL NO: Construction Location - STREET NO: STREET: LOT: / ,S BLOCK: ADDITION: �(y ax A,& sLts �s.K� Corner Lot: Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTIOIJ OF CONSTRUCTION �7✓+� & Front: /do Depth: 'Z -d Height: / T Square Feet: Cubic Feet: - Front: Depth: Height: Square -Feet.- Cubic Feet: Type of Construction: Estimated Cost: $ ?0 (3, ®d Tb Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET Mie undersigned hereby masses application for a permit for the %cork herein specified, agreeing to do,all work in strict accordance with the City of Fridley Ordinances and rulings of the Delwirtment of Buildings, and hereby declares that all the facts and representations stated in this application a u'b and correct. DATE: .r� SIGNATUFZ: Stipulations: S� �/y O , upper surface or to the average height of the roof surface of the main gable of a pitched roof. 2.5. For repairs or alterations'to an existing structure, the fee shall be at the rate of $3.00 per each Five Hundred Dollars ($500.00) JNj__.:/lYlU:fIIVI �1Vj %YY?1 Ctrl �wII: ` -__ - - - T�I� 0 % ' )iW - sV jW Fg pa`ra'AJns sy PUD/ pros ca .Io u�al�'bio jr ` s�uaury�ao xn a/q{su //o ppm ' Loam# ` riwppa9 I/cio U00M/ a ')k /w `PU I P-1-ri ° a+ogn -VU* sa'�.Iopunoq 404 fiaA rs- o joual�c fuasa�a� ��aJ�m pw WLq o sq f1w Pw 91ij" Aq"y / i 6N i 'OJ iN31AJO 3AM W ' H w ;off f aAMMS JF® a�IV3g T�Ta3 D1/GIaaUTAV — s✓o�ian.�ns 3 swaauful 3 W09-P,;xuff - /adV!Ufijy-g/IAU 101001191f 'ON1 'JNW32N1 JN -9- sglmtslos n SY dvx�Iw 6u/fia4-"S'PW7 �n 59: f�y�H-S189 6uluu%PM PER SUBJECT City of Fridley 2 0 6 4 8 AT THE TOP OF THE TWINS BUILDING PERMIT r LJ COMMUNITY DEVELOPMENT DIV. ~ PROTECTIVE INSPECTION SEC. O 3,f/ r CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY "'4 612-571-3450 1 910-F15 10/26/90 JOB ADDRESS 5861 Washington Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15 1 Lyndale Builders 7th_ Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Morin 5861 Washington Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Richard Wright Siding 11241 Magnolia N.W., Coon Rapids, 55433 755-5754 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION [�C REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Reside Dwelling 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 SO. 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 NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. 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 $6 500 $3,25. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT t PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL L. W REGULATING CON- $90e 00 STRUCTION OR THE PERF RMANCE OF CONSTR C ON. PLAN CHECK FEE TOTALFEE ire SC $6.50 $99.75 GNAT4RENTRACTOR OR AUTHO IZED AGENT IDATEI WHEN PROPERLY V DATED THIS IS YOUR PERMIT BLDG INSP DAT SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) NEW [ ] ADr-N [ ] ALTER [ ] Construction Address: Legal Description: Effective 8/16/90 R-1 AND R-2 Building Permit Application Owner Name & Address: Tel. # Contractor: /?,(,c4Z9A 42 1 u /.s S 1,0Z a42 Tel. Address:. Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LTV3M AREA: Length Width Height Sq. Ft. GAME AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. 07HER: Y i D .4 4 Corner Int [ ] Inside Lit [ ] Ft. Yd Setback side Y/�etbacks ` �,qe of Construction: = i �L Est;noted Cost: $ (�� 5 © ® ® '::�p Approx. Cmpletion Date: Proposed Driveway Width If New Opening Is Desired: Ft. $ $. Width 6' See Back Page( ® APP71ICAlVrI': 'Z ` Tel. # CITY USE CNLY Permit Fee $ 90 -0 6 Fee schedule on Reverse side Fire Surcharge $ (o S ��_ .001 x Permit Valuation (1/10th �) State Surcharge $.� $.50/$1,000 Valuation SAC Charge $ $600 per SAC Unit Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] T IAL $ STIPUTATIMS: __-�- 0 SUBJECT IT NO. of Fridley 4 4 6 1 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. Ir?City L -------COMMUNITY DEVELOPMENT DIV. _ �J r i PROTECTIVE INSPECTION SEC, // CITY HALL FRIDLEV $5432 NUMBER REV DATE PAGE OF APPROVED BY J 612-571-3450 910-F15 8/16/96 JOB ADDRESS 5861 Washington Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15 1 1 Lyndale Builders 7 Addn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bob/Marty Marin 5861 Washington Street NE 571-0672 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Bremar Company 740 Northwood Dr, Delano, MN 55328 972-6890 20064213 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (15 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,237 $•62 WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $43 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION / PLAN CHECK FE TAL FEE R '/� - (� Licens SC . oo $49.86 7 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI PR LY V I, D THIS IS RR PERMI J MOG INV DATE SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI 0 NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress : Legal Description: Owner Name & Address: Contract Address: i Effective 3/1/96 Tel. # 62/ - O69%? Z ENSE # ,,,2®0 6 c/,,? / 3 Tel. # '')a c9 g LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF Il"ROVEMENT Length Width Length Width Length Width _ Height Sq. Ft. Height Sq. Ft. Hgt/Ground Sq. Ft. Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: cL D o f j stimated Cost: $ 41( A, Approx. Completion Date: 5 Driveway Curb Cut Width Needed: DATE: APPLICANT: (Cost on Back) Ft. + 6 Ft = Ft x $ Tel. # STIPULATIONS: CITY USE ONLY Permit Fee $ p, 00 Fee Schedule on Reverse Side Fire Surcharge $ /. 'd Y .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $900 per SAC Unit License Surcharge $ QQ $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 $ V9 c�6o STIPULATIONS: SUB�E�T FAST . City of Fridley 3 6 448 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT • COMMUNITY DEVELOPMENT DIV. ter,. •--•- r PROTECTIVE INSPECTION SEC. a/ ` "f,`� CITY HALL FRIDLEY 55432 NUMBER REv DATEPAGE OF APPROVED BY _•_-�,�� L 612-571-3450 910-Fll 10/5/00 JOB ADDRESS 5861 Washington Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 15 1 Lyndale Builders 7th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Morin 5861 Washington Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Don's Weatherout Assoc Inc 2808 W 72 St, Richfield, MN 55423 869-3746 9155 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION? REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Shed (20 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 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 $2,045 $1.02 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOTRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIO S OF ANY OTHER TATE OR LOCA AW REGULATING CON. $83.25 ire $2.05 R THE PE RFOR NCE CONST CT10N XCTI PLAN CHECK F Lice e S $5.0 TOTAL fEV $9 .32 ' .GNATURE OF CON'RACTOR OR AUTHORIZED AGENT IDATEI EN V 10 INsb ATE IS IS YAUP PEc�J f RATE S-GNATUAE OF OWNER OF OWNER BUILDER. IDATEI NEW I l Effective 1/1/2000 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: ,� � %—zyli5 # /iv lf= T c,,kl Legal Description: Owner Name & Address: Tel. # MN LICENSE # # 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/Grou n S' Ft. OTHER:I- Construction Typ�4olr '"✓ Estimated Cost: $ Driveway Curb Cut Width Needed: Ft 6 Ft = Ft x $ _ $ DATE 61�o dd APPLICANT. Tel. # 3 019 e 5 ;W'� t. CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing In application Permit Fee Fee Schedule on Reverse Side Fire Surcharge $ - CSS .001 of Permit Valuation (1/10th%) State Surcharge $.50/$1,000 Valuation SAC Charge $ $1100 per SAC Unit License Surcharge $ . 00 $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 $ 2/,b3 STIPULATIONS: Building MECHANICAL Permit No. ' 6b8 bo l8 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Dat DATE 13-6b YOUR E-MAIL ADDRESS kG 5 a'Lc . VQ L L 6C K. l Y SITEADDRESS 5 361 V�/aLS�L me THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: i'_n " ADDRESS: 5P-61 �JGSh S-f Nr- r CITY '� STATE "NZIP_ 55A32— OWNER/ TENANT PHONE: 6)52 --151 - 3:3-,-156 CONTRACTOR COMPANY NAME: U*-ba , SUBMIT A COPY OF CONTACT PERSON: 4&i5—and wi R-er-y-A YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH r �" ADDRESS: 1211b B ( t b0,r L Eec- 6-& CITY r I lG z1STATElid1 ] ZIP 5543 2- APPLICATION PHONE`I - 64-b10 U FAX _163= 7F_A-4-%°r4 PERMIT TYPE 4INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK &22 rr10 a ci!J JL, "dLe , L41 1 il4W PER 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: 3550A,4CA 0k.0 SIZEIBTU W, 000 MFG: MODEL: SIZEIBTU MFG: MODEL: SIZE/BTU A/C $25.00 IREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 $35.00 FURNACE $35.00 _GAS UNIT HTR $10.00 _BOILER LINER $10.00 DRYER $10.00 _POOL HEATER $35.00 _CHIMNEY _GAS DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 100 SIR Permit Fee $ t' .0 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 = $ State Surcharge = $ 50 Total = $ ✓?P 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. / J - PRINT NAME 0- l b k )ATE l 3 SIGNATURE OF APPLICAN ._ r a_ - t City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 1 1. ki Heating Cooling, EQUI PM ENT SI ZI NG CALCULATI ONS FOR: 5861 Washington St NE, Fridley Zone Descri pti on _ SqFootage Heating Requirements Cooling Requirements Ventilation Requirements Basement 900 13,500 BTUH Tons CFM per Sq Ft Main 1,200 42,000 BTUH 1.71 Tons Bedrooms Totals BTUH Tons BTUH Tons 0 BTUH Tons 2,100 55,500 BTUH Prepared by Suburban Air -1/2/08 1.71 Tons 15