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PRE 2010 DOCSBUILDING PERMIT Village of Fridley, Minn. N° 2 q 9 3 Date 1:''.b. ���. .............. . Owner......... Builder ..�.... .... ......................... 0 Address3..... ... Address ......................................... LOCATION OF BUILDING No. ..... Street .. ... .. ....... Part of Lot ...... ......... a Lot ..... �........ Block ......` �I ....... Addition or Sub -Division ... ........... . Corner Lot ............ Inside Lot ... ... Setback .. ,3�� ..... Sideyard ........ . ............ . DESCRIPTION OF BUILDING To be Used as: Front iu Front AQ... Type of Construction k -m s.. r Depth OR 4... Height .. Sq. Ft. .. Cu. Ft. ........ Depth .... Height Sq. Ft. ��s'� Cu. Ft. ........ Est. Cost... 11VAe............ To be Completed ...... In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description'above set forth and in compliance with all provisions of ordinances of the village of Fridley. �_In c ns' motion of the payment of a fee of permit is hereby granted to to construct the building or addition as described above. This permitUs grarAad 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 ther conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alter �1( on, m inten RA_Aand oving of buildings with- in the village limits and this permit may be revoked at atime pon io any f the provisions of said ordinances. ' OV uMng Inspector NOTICE: This permit does not cover the construction, installation or alteration for wirig, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. I Date: '6ugust 2, 1965 Mr. Fred Mulvihill Builder N? 3303 .Andrew P. Gawel coast. Co. Address 632QWashingt9n St. N. E. Address 2407 Washington St. N. E. Fridley, Minnesota Minneapolis, Minnesota. LOCATION OF BUILDING No. 6320 Street WASHINGTON STREET N. E. Part of Lot Lot 7 Block 3 Addition or Sub -Division Christie Addition Corner Lot Inside Lot Setback ........... Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Fst. cost $i ,700.O0 To be Completed Repairs - Storm Damage In consideration of the issuance to me of a permit to construct the building the proposed work in accordance with the description above setyforth and in c o ordinances of the city of Fridley. I A I agree to do provisions of In consideration of the payment of a fee of $ 10.00 , permit is hereby granted to ANDRZWP• GAWEL CONST. to construct the building or addition as described above. This permit Ii 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 n all respects to the ordinances of Fridley, Minnesota location, ynbe etfoked attaany�� violation off anyyoof tthhe�gOf vissions R is within the city limits and this ordinances. ALLEN G. JENSEN Building hupector NOTICE: r0h porn* don trot sown the eondoatke, heron for WhfiM plwAlne, gas hea8ng, sewn er wafer. es ane to nes tin BUNdIng icor fer ssparats psmdts for then Nems. APPLICATION FOR BUILDING PERMIT CITY.OF FRIDLEY, MINNESOTA ANDREW P. GAWEL CONTRACTORS, INC. Mr. Fred Mulvihill 2407 WASHINGTON ST. N. E. OWNER'S NAME BUILDER .,a FAeol 1A 1A, MINNESOTA ADDRESS 6320 Washington St. N.E. ADDRESS LOCATION OF BUILDING N0, STREET PART OF LOT , 9 � LOT BLOCK ADDITION OR SUBDIVISION_. CORNER LOT - INSIDE LOT SETBACK SIDE -YARD SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To be used as; DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Dept + Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost�49 �® 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 rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing any permit for the erection of any building or structure, or for any'addition to any existing building or structure, or for any alterations or repairs to any existing building or structure; upon application therefore, require, the,,payment by the applicant for,isuch permit of fees'to the amount herein below set forth and in the manner herein provided to -wit; 2.1. F'or 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. HOOSES 2.3. For any such permit for.the erection of any non -fireproof building, 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 -fire -proof addition, for similar occupancy, -to any existing building or for each such- building uchbuilding or addition - ninety cents ($0.90) for each one thousand cubic feet or fraction thereof, in.the cubical contents thereof with the minimum of $4.00. For the purpose of computing fees for building permitsy the cubical contents of any building or addition to a uniform height throughout by multiplying the ground area covered from a point six (6) inches belowthe•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 Section 2 be less than $4.00. STORM REPAIR DAMAGE FEES: Residential: Estimated Cost of work up to $500..00..-.$5.00 Estimated Cost of work over $500.00 - $10.00 Commercial; Estimat Cost of work up to (500.00 - y 00 Estimat Cost of work over $500.00 - $_ .00 City of Fridley Appliccsilvn for Plumbing mrd Gas Fos:ai'n j Pers;t Depi. of Bldga. Phone SSA -34$0 DESCRIPTION OF WORX. 6 a s Number, Kind and Locr!ien of Fixtures Locate '� Z C» It1 x 52.E /TOTAL $-- 11, I�'� x $1.50 v O � J o � � � 3 V � ` N x $3.00 $ WATER MTR, x $3.25 Eloctric Plater Matar..... ' ........ x $2.00 $�� :1.3 FITTING FEES: NO. RATE TOTAL Ist3Fixtures ......•••••••••••• x$2.00 $ . Additional Fixtures ............... x $ .75 $ Gas Range to I99.000 BTU ........... x $5.00 $ --- Bast So :'gar PARTIAL RAI E SCHEDULE PLVMSING FIXTURE RATES: NO. RATE Number Fixtures ................ x 52.E /TOTAL $-- Future Fixture Opening .......... . x $1.50 $-- New Fixture Old Opening.....:.... x $1.50 Catch Basin .................... x $3.25 $ Water lieater 'Up to 99,000 BTU).... x $3.00 $ New Ground Run Old Bldg. ....•.. •.. x $3.25 $ Eloctric Plater Matar..... ' ........ x $2.00 $�� :1.3 FITTING FEES: NO. RATE TOTAL Ist3Fixtures ......•••••••••••• x$2.00 $ . Additional Fixtures ............... x $ .75 $ Gas Range to I99.000 BTU ........... x $5.00 $ --- City of Fridley: The undersigned hereby snakes application for a permit for the work herel specified, agreeing to do all work in strict accordance with the City Ordiraact and ruling of the Department of Buildings, and hereby declares that all the fact and representations s:1 in this application are true and correct, Fridley, Minn Owner Kind of Building UseJ -,Ls 1 u bc comple'trd abs v` Estimated Cost, $ Ol ' New. Building Permit No. permit No. - Signed e By Business Phone No - ROUGH FINAL P,EPAIRS it ALTERATIONS—Refer to Cede .50 State Surcharge Description .... ,....................................$ TOTAL FEE . S- SUBJECT PE RMff City ®f Fridley ' 2 AT THE TOP OF THE TWINS BUILDING PERMIT no. � COMMUNITY DEVELOPMENT DIV. V_ I 146 r e � PROTECTIVE INSPECTION SEC. t ` CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV 612-571-3450 910-F15 6/18/91 JOB ADDRESS 6320 Washington Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 3 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David Schwartzbauer 6320 Washington Street NE 574-0361 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. American Remodeling 370.0 Annapolis Lane, Plymouth 55447 553-0020 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 B DESCRIBE WORK Cover 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 60 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 1 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 $3,000 $1.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $54.00 Fire SC $3.00. STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $58.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHE PROP LWIA THIS IS YOUR PERMIT SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI LOG INSP GATE ,fV NEW [ l ADEN [ J ALTER [ ] construction Address: Legal Des .3ption• - Owner name & AddXjbss: Address: CI-9ZIM RUM R-1 AND R-2 Building Permit Application Effective 1/1/91 Tel Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn cn it to scale. T, 37=2i OF MUROVEMM ISVIM AREA: Length Width Height Sq. Ft. GARAGE AREA: Ia gth Width Height Sq. Ft. DECK AREA: Length Width Agt/Gr=*d Sq. Ft. �•1�'��1 Corner Lot [ ] Inside -;9t [ ] Ft. Ydtback _ Side Yard Setbacks Type of ConstructieaZ• ev e `/ �7.a� Estimated Cost: $ �. r Approx. Completion Date: Proposed Driveway Width If New Opening Is Desired: Ft• $ $ Width + 6' See Ba Pa e f/Tel DATE: ��` �� APPIZCAX6::-4 Permit Fee $ Fine Surcharge $ State Surcharge $ SAC Charge $ Driveway Es=uw $ Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: CITY USE �Y Fee Schedule cm 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 Engj neer' ng Agreement Necessary [ ] Not Necessary [ ] SUBJECT-P9RIIA'i�: City of Fridley `'2 5 6 6 4 AT THE TOP OF THE TWINS BUILDING PERMIT NO. �IPT COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r 1 e I CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 11/4/97 JOB ADDRESS 6320 Washington Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 3 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David Schwartzbauer 6320 Washington Street NE 502-0931 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Sela Roofing & Remodeling 4100 Excelsior Blvd, St Louis Pk, MN 55416 1050 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 Ek REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house & Garage (22 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 $1,834 $.92 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $59.50 Fire SC $1.83 STRUCTION OR THE PERFORMANCE 9F ONSTRUCTION. PLAN CHECK FEETAL FEE &Mi� AVAI "SIG%IATURE Lic SC $5 0 f$67.25 OF 04NTRA66ROR Al TMORIZED AGENT IDATEI HE P Y VA TED THIS I X ERI?7 866G INSP �R MATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW (] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY LP ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application J-41 ConstructionAddress: 3;}� 1,. � 6 Legal Description: fro ; .F Owner Name & Address&;- k���v s Tel. # D Contractor: 4100 EXCELSIOR BLVD. MN LICENSE # $T: - LOUIS PARK, MINNccA4vvrna.�i�" Address: IID# 0001050 Tel. #�j Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EIAPROVEMENT LIVING AREA: Length Width 'Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER:. /`)� = l�FP Corner Lot [ ] Inside. Lot [ ] --„,Ft. Yd Setback Side Yard Setbacks Type'of Construction:ea r o� roof 1nVA_S�stimated Cost: Approx. Completion Date: (Coston Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft Ft x $ $ DATE: Z APPLICANT: - Tel. # CITY USE ONLY Permit Fee $ , S-0 Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $900 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 $ ®. old STIPULATIONS: From: 763 565 3311 Page: 2/2 Date: 12/31/2009.9:50:04 AM Building MECHANICAL Permit No.. JU" Inspections RESIDENTIAL APPLICATION Re 763-572-3604 CTff OF ERIDLEY D d: 763-502-4977 FAQ EFFECTIVE 2-1s 09 DATE t2 2P� CIS YOUR E-MAIL ADDRESS -'V JJ - C� or?LSQJ'-4; C) S -(Icon, SM ADDRESS 2,--� JA THIS APPLICANT IS: 0 OWNER CTOR PROPERTY NAME: TENEW ADDRESS: jr�LV t/1,R CITY STATE�ZIP� PHONE: " �'� %% CONTRACTOR CO,,� Nom: CONTACT PERSON: SUBMIT A. COPY OF YOUR STATE LICENSE WPCFI STATE LICENSE # ptp DATE APPLICATION ADDRESS:t Cg �!/j •Jt 3� c1TY STATE�zII' S� PHONE -?A 'o - 1 1� FAX PERMIT TYPE XSI NGLE FAMILY LZ TWO FAMILY 13 TOWNH01 ISE TYPE OF WORK: O NEW REPLACEMENT D ALTERATIONMEMOE EL DETAILED DESCRIPTION OF WORK rw rr2 c FEES ARE BASED ON $10 -OD PER FIXTURE, JXCEPT WHERE NOTED FIXTURE5: EgaiprmentIasiatled MFG: jlr (�ICj�T� orn�..N[>Mat�aaF>�ACHB�LOW� ,, MODEL. v d- •oA 3to SIZESTU�yfJt7-? MFG: MODEL: SI23'16 W MFG: MODEL. FIREPLACE (GAS) $15.00 AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 SIZBBTU _GAS RANGWOVDi $10.00 AiEW GAS GRILL $10.00 —WMER S35•00 WURNACE$35.00 _CHMI NE'Y' LINER $10.00 GAS DRYER $10-00 --W UNIT HTR S10.00 POOL HEATER $35.00 Dua WORK $10.00 GAS PIPING $10,00VEN rQ.ATOR $15.00 Number of fixtures @ $10.00 ' x $10.00 : $ Number of fixtures @ $15.00, x $15.00 = $ Number of figures @ $25.00 x $25.00 = $ Number of Mures @ $35.00 _L x $35.00 = $ State Surcharge = $ SO �� ) FEE §"j Total = $ THIS IS AN APPLICATION FOR A PERMT-NOT VALID UNTF PROCESSED I hereby apply for a building permit and I acknowledge that the information above is c implete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the NUnneso a Construction Codes; that I understand this is not a permit but only an application for a pwnit and work is not to start without a perm • that the work will be in accordance with the approved plan in the can of ork which rewires review and approval of plans. f . (J�.,, J f SIGNATURE OF APPLICANT PRINT NAME . 17 o DATE PLEASE NOTE: SUARATE PEllM17S ARE REQUIRED FOR BU LDING, ELEUMCAL AND MECHANICAL, WORK Ulty 01: k rIcHey BuRding IIISpeCtiOnS Departme1 6431 University Avenue NE, Fridley, MAI 5432 7.63-572-3604 FAX: 763-502-4977 From: 7635742044 Page: 2/3 Date: 1/25/2010 3:48:37 PM Building $ BUILDING Man Izvicw Pennit No. D Inspections Fire $Uroharge RESIODENTIAL APPLICATION Received By 763-572-3604 $ CITY OF I+ DLEY License Surcbarge D J 763-502-4977 FAx SAC Charge $ _-_-- Curb Cut Escrow $ EFFECTIVE 1.1.2010 Erosion Control $ 1 DATE 14 � t 0 YOUR E-MAIL ADDRESS Set=E' 5�► .� d ev. .` r_ off.... STTEADDR.Ess. -Q LOQ56i o -i, : t A.91 - �t'�:t',+s+r�r, 'CFU.$ APPLICANT IS: ❑ OWNER &ONTRACTOR PROPERTY OWNRE NAIVJE:�` � a SP1, TENANT ADDRESS:�CITY—ad-k--1,v 9"Cr�TI�� ZiF PROM 63 2 -Y7 CONTRACTOR NAME: -W i ft tu16w tea_. SUBMIT A COPY Or YOUR STATE LICENSE STATE LICENSE N 20 4 � �z to � "� . 8XP DATE. �G+"► AND CERTIFICATE OF _..F_ ADDR1:53: QL9p.��•�, ,? -- a RTATEWZI& INSURANCE &p7 G raI PROPERTY ME SINGLE FAMILY. /1�li:W CONSTRUCTION STZI „_ , TWOFAMILY/1NEW CON:TRtIC',I"lON STORTE$ . PEIQT TYPE 13 ADI')M. ON ® GARAGFA, RED wumWks C1 BASEMENT PTNT.914 0 ROOF DRAIN TILE C1 DECK CI SIDING CI 011 -MR awpoIIING PqOJ TWE OF WO a ❑ NEW H011+IE CONSTRUCTION 13 ADDITION CI MAI NTENANCE4WAIR 0 REMODELING DESCRME WORK BEING NONE: � r 11� P,{.&UM-CLW.r„.1'� t.iILSP1;;� _iD �n• W 6170' OB IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT $D-93axG CI HOUSE ONLY MJMBER OF SQUARES I] I.10USI;, a GAfiAGC 1. Ex;stiria I+14.r man RAM 4 ATTACHED GARAGE 2. Propbsmd Dom plan MOM$.FD STYX: _ _ _-- _ 0 DETAaIED GARAGE 3. List of strmtvral mEmlam to bo used PROPOSED FIL'IGHT: SmIN , FOR NEW CONSTRUCTION INCLUDING DECKS, Vinyl © Ahwdnum E3,59t it O Trim I, Site PlawsSurmy ah.vAts the existina structures O Other CI Fasoia and pwPosed p01ca' 2. Two Sets of construction plans UWS�/ 3. Enemy Calaniarions IN EXISTING OPENNCTIq ®Yes ON. LOCATION Ol WINDOWS FOR WINDOWS -PRMDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON W NDOW. OPM14ING CHANGES &$ Q' Q I}, a �{' TYPE OF NINDOW TO M MSTALLED LR QF WINDOWS L ALL FEES ARE BASED ON VAUTAX"ION, INCLUDING THE COST OF LABOR AND MA'iZMMALS: (V ING THE 1997 U.B.0 FEE SCHEDULE) Permit Fee $ C.i_ l._ `� See Back Page for Fee Schedule Man Izvicw $ 65% of Building Permit Fee Fire $Uroharge $ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum x.50 License Surcbarge $__ $5,00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ R -I- 6 fl = ft X$22 = $ Erosion Control $ $450 Conservation Pian Review Park Fee $ Fee Detemined by Engineering Sewer Main Charge $ _-- Agreement necessary ( ) Non Necessary ( ) TW,9 .Is AN APPLICATION FOR A PERMIT -NOT VALID UNTIL..PRC?M$E?t3 I hereby apply for a buildings permit and I, acknowledge that the information above is complete and accurate; that the work will be i -a conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that J understand this is not a permit but only an applicatioor a pe a'd work is not to start without a permit on site; that the work will be in accordance with the approved plan in the cm of ork whrequires review and approval of plains. SICNA7m OF APPLICANT FRUSIT NA?�Ierxvv--DATE lc'�i tPi Building MECHANICAL Permit No'C® Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 44-9-M 763-502-4977 FAX EFFECTIVE 1-1-2010 DATE ,io XOUR E-MAIL ADDRESS SITE ADDRESS -:S 2� (N F 1 il���t`1 Aj C THIS APPLICANT IS: 0 OWNER tCONTRACTOR PROPERTY NAME: 4A ADDRESS: CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR COMPANY NAME: V13 °y CONTACT PERSON: I v SUBNET A COPY OF YOUR STATE STATE LICENSE # —"&9 EXP DATE LICENSE WITH ADDRESS� I to 1 k • 4j kiW CITY 612-- 126-APPLICATION APPLICATION PHONE L03 4n FAX PERMIT TYPE SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK' 0 NEW C EPLACEMENT 0 ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK arc FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK Equipment Installed MFG: MODEL: SIZEBTU MFG MODEL:U N- a 111-7 SIZEBTU MFG: MODEL: SIZE/BTU A/C $25.00 (GAS) $15.00 _GAS RANGEIOVEN $10.00 _FIREPLACE TO AIR EXCHANGEER $15 (WOOD) $35.00 _NEW GAS GRILL $10.00 _AIR $35.00 _FIREPLACE $35.00 _GAS UNIT HTR $10.00 _BOILER _FURNACE LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.00 _CHIMNEY DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 �F, 6�"' � �i �' k. � 1` _ice �^ �im"�' y�•�r � � F�� a - '�'" ��a£ JS%�u"'� �� yi A F „%�''�• ^� x _ Ge�� ?. k" yea .., ` h �Eg.,., ¢ "'� s: .S sa-h� ,,,p' N� •' d- t �,}' MVkb W_ 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 c e o all wort hi a uire eview and approval of pl a A~ C SIGNATURE OF APPLIC PRINT NAME t"i� APPROVAL INSPECTORS SIGNATURE DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977