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PRE 2010 DOCSCity of Fridley, Mm. BUILDING PERMIT N°53'79 Date: 6w.. '9 l_ Owner ' Builder ..._.. Address _ _ _ _ _ _ _ _ Address _ - - -- --- L CATI OFA.ILDING Ift Street _Part of Lot Lot _...,: ._.....__ Block Addition or Sub-Divisio Corner Lot _ _. ___ _ Inside Lot - Setback_ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING Topa,e Used _ 7 y Front r Depth" Height 5q. Ft: Ca Ff Front Depth ..W eight Sq. Ft. Cu. Ft. 46 Type of ` nstruction,s� �°" Est. Cost _ "fo 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 city of Fridley. In consideration of the payment of a fee of $ ,,,A t ! ".; -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. ., 'n -' Inspector NOTICE: This permit does not cover the construction, installation for wiring, phunhing, ,gas heating, sewer or water. Be sure to see the Building Inspector for separate pennIts for these henm A-PPLICATION FOR BUILDING PERMI°P CITY OF'FRIDLEY, MINNESOTA Owner's Name ®,11- C� % Builder u. Address Address a OF BUILDING No. b7 S 6 Street Part of Lot Lot Block Addition or Subdivision h / Corner Lot Inside Lot L/ Setback Side -Yard Z'® SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used DESSCRIPTION OF BUILDING Sq. Ft. Cu. Ft. 9 FrontZQdCepth Hei 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 Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this appli tion are true and correct. DATE 1� t SIGNATME (A Schedule of Fee Costs can be found on the Reverse Side.) ♦ - 1 City of Fridley A►ppiication for Plumbing and Cas Fitting Permit DESCRIPTION OF WORK Number, Kind and Location of Fixtures O yy�� Y- <Y� ay Z�a Qfi'y y N ~v�Z y. O` �Z U0' �a N WATER HTR. GAS ELEG 3i1 ;S �F w 3F cLL o �= 33 c7 °d Goa c90 Base 01 0 1st 2nd _ 3rd _ 4th ' Future Connection Openings Connected, with Sewer ❑ New .Fixture, Old Openings Cesspool ❑ DepL of Bldgs.. Phone SU 4-7470 / , I ,�s® Location (O 2.3 e. l"U �� ✓`�G �® �� �� �Y 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 and correct. AUG 3 1961 �p Fridley, .Minn 19—. Owner ®'a /',� LC /-/-Y l' ®'.2,5 Kind of Building /14 Used as To be completed about PARTIAL RATE SCHEDULE Estimated Cost, $ Old—New. Building Permit No v^� Permit No. PLUMBING FIXTURE RATES: NO. RATE TOTAL L ®IV p �J P L U (Vi B 11V to CO. Number Fixtures ...................... x $1.50 $ �' Signed Future Fixture Opening ................ y x 1.20 $ ©® By G � New Fixture Old Opening .............. x 1.00 $ Business Phone No. Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ 2-1 &V ROUGH New Ground Run Old Bldg. x 3.25 FINAL GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 Additional Fixtures x 50 $ U Gas Range to 200,000 BTU .............. x 2.00 REPAIRS & ALTERATIONS—Refer to Code Description................................................$—�.S°� TOTAL FEE $ 711 42 2M 7_59 Application for Power Plants and Heating, Coding, Ventilation..Rehigerceand Air Conditioning Systems and Devices k PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, S 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 ............ 8.00 $—iC/— each add. 60,000 BTU ....................... 2.00 $ _ Replacement of Furnace . §.00 $ Repairs & Alterations—up to $500.00 .... a ............ 5.00 $ Repairs & Alterations each add. $500.00 .............. 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 Size Nc2��� d Capacity Sq. Ft. E.D.RBTU H.P. All Total Connected Loa Rind of Fuel `✓fes V GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ Sq. Ft. E.D. 00w BMTUH.P. GAS FITTING FEES: NO RATE TO L 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ 42 Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL See Fee Schedule TOTAL FF E Dept. of Bldgs. Phone SII. n 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. WUG a - �16i Owner Kind of Used ac To be c ...r...... ,� Estimated Cost, $ e,' aj New. ' ding Permit No Permit No. t6 DESCRIPTION DESCRIPTION OF WORK HEATING - -"" "�� sP Warm Air—No- , Trade Name Size Nc2��� d Capacity Sq. Ft. E.D.RBTU H.P. All Total Connected Loa Rind of Fuel `✓fes Name Size N BURNER —Trade Capacity Sq. Ft. E.D. 00w BMTUH.P. S GEO. SE®GWIC HTG. & AIR-COND. CC>> q ( 1001 Xenia Av. S. Minneapolis 16, Minn. Signe ®? r 42 2M 7-59 Business Phone �o (REMARKS—OVER) 6- wz V, HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MJNNEAPOLIS. MINN.. Weatherstrips A.S. id . Construction No. Insulation Windows Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind T How. Applied Yes—No I Yes—No I r' Height 11 F1.1 _n Height F1.1 o�", Room I Lenath -v'� i Width Room I Length s Width 11 Windows and'-600rs--Crackage and Area Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Width Height No. of Lineal fi. Area No. of pane of pane lights of crack sq. ft. F1.1.i,,,j-'-,,,vj Room I Length 74 Width Height Windows and Doors--C'rackage and Area Width Height No. of Lineal ft. Area Coef. No. of pa ne of pane lights of crack sq. ft. Coef. Btu Btu Infiltration Infiltration Glass Glass Glass Jk 6 Exp. wall Net exp. wall '717 Exp. wall Int. wall .7 Y" Net exp. wall Int. wall .1 �� o' - Floor Int. wall Floor Ceiling j Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Width Height No. of Lineal ft. Area No. of pane of pane lights acrack sq. ft. F1.1.i,,,j-'-,,,vj Room I Length 74 Width Height Windows and Doors--C'rackage and Area Width Height No. of Lineal ft. Area Coef. No. of pa ne of pane lights of crack sq. ft. Coef. Btu -- Btu Infiltration Coef. I Btu Infiltration Glass Exp. wall v Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. iris. W.A. Leader area F1.1 Room ILenath b -!k Width '—'Y Height Windows andDoors—Crackage and Area ti Width Height No. of Lineal ft. Area No. of pane of pane lights acrack sq. ft. - Coef. Btu Coef. Btu -- Btu Infiltration Infiltration Glass Glass Glass Jk 6 Exp. wall Net exp. wall '717 Exp. wall Int. wall .7 Y" Net exp. wall Int. wall .1 �� o' - Floor Int. wall Floor Ceiling ?, 2� Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area ti Width Height No. of Lineal ft. Area No., of pane of pane lights of crack sq. ft. Width Height, No. of Lineal ft Area No. of pane of pane lights of crack sq. ft. Coef. Btu Coef. Infiltration Btu Infiltration Glass Glass Glass Jk 6 Exp. wall Net exp. wall - ;s Exp. wall Int. wall Net exp. wall Int. wall .1 �� o' - Floor Int. wall Floor Ceiling Floor Total Btu. AL 1" k:. L Required sq. ft. E.D.R. or sq. ins. W.A. Leader area '_-�'RoomlLenjzth-n—, Width Height Windows and Doors—Crackage and Area ti Width Height No. of Lineal ft. Area No., of pane of pane lights of crack sq. ft. __of_pa" P� -,fj� 1 Coef. Btu Infiltration Infiltration Glass Glass Exp. wall Jk Exp. wall Net exp. wall Int. wall Ceiling Int. wall .1 �� o' - Floor Ceiling k Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area � F1.1 Room I Length a i,'" Width .4f t,, Height Windows and Doors--Crackage and Area �� '7 Width Height No. of, Lineal ft.Area No. of pane lights of crack sq. ft. __of_pa" P� -,fj� 1 Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling k Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area D46 x r its HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E, Construction No. ' _ Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Yes—No Yes—No 19_ ` FI i Room I LengthI Width tHeight .,. II Fl.l Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal Y . Area No. of pane of pane lights of crack sq, ft. L12 -1 C' 7 ��fi �,,}' Et•F' �+r gip' ( �v,y:-' �y Coef. Btu Infiltration Glass Coef. Btu Infiltration Int. wall Ceiling Floor Glass-<' y ' �*a Exp. wall Net exp. wall Net exp. wall K 15 Int. wall Int. wall . Ceiling Ceiling Floor Floor Total Btu.1-? y" ,e> Required sq. ft. E.D.k or sq. ins. W.A. Leader area Ir F1.1 r ,a * Room I Length 01 Width H Height I° Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. L12 -1 C' 7 ��fi �,,}' Et•F' �+r gip' ( �v,y:-' �y Coef. Btu Infiltration Glass Coef.1 Btu Infiltration Int. wall Ceiling Floor Glassy y Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. ( +W ;+ ``Z Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area MINNEAPOLIS. MINN. Insulation Kind E How. Applied Roem I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.I Room I Length Width Height Windows and Doors--Crackage and Area Width HeightNo. of Lineal ft. Area No. of pane of pane - lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI -1 Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. I Required sq. ft. E.D.R. or sq. ins. W.A. Leader area SUBJECT PERMIT NO. City of Fridley5 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC 1 i NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 10/11/9 JOB ADDRESS 6736 Washington Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR, 2 6 Rice Creek Terrace Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Irene Song 6736 Washington Street NE 474-7984 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Viking Home Improvement Co 4832 2 1/2 St NE, Fridley 55421 572-1820 4772 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 (16 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 I 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 $1,280 .64 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 $43.00 Fire SC 1.28 �pn PLAN CHECK FEE TOTAL FEE License SC $5.00 49.92 SIGNATURE0DONTFACURORAUTH IZEDAGENT (DATE) WHEN PROPE qY VALIDATED THIS IS YOUR PERMIT f2-fr SIGNATURE OF OWNER OF OWNER BUILDER) iDATEi 80bG )NSP DATE NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: 11V �3 to Legal Description: Owner r Contract. Address: Effective 8/1/95 MN LICENSE # Z Tel. # n 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 GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground OTHER: Corner Lot [ ] Inside Lot ] Ft. Yd Setback Type of Construction: Approx. Completion Date: Sq. Ft. Sq. Ft. Sq. Ft. Side Yard Setbacks Cz Estimated Cost: $ a6 0 0 (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft= t x $ _ $ DATE: 1 D -�� APPLICANT: Tel. # -7 2- - lfz-O CITY USE ONLY Permit Fee $` Fee Schedule on Reverse Side% P Fire Surcharge $ .001 of Permit Valuation (1/10th%) 'y State Surcharge $ , �' — $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit License Surcharge $ 15, 6t $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 [ ] �/ t� TOTAL $ / STIPULATIONS: Kj1 unnrersny Ave r4t =ridiey, MN 56432 '63-672-' APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS _._,.. �_.. $ 7.00 The undersigned hereby makes application for a permit for the work herein New Fixtures ., $ 4.00 specified agreeing to do all work in strict accordance with the city codes Old Opening, New Fixture _..._,_ $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Beer Dispenser $ 7.00 and representations stated in this application are true and correct. Blow Off Basin �_.__.. Catch Basin ,,,.,,._ $ 7.00 12 , ac. Rain Water Leader $7.00 Sump/Receiving Tank $ 7.00 'j,,� Water Treating Appliance ,_,._-._ $10.00 owner Water Heater -Electric $ 7.00 Water Heater - Gas"* $10.00 Building used As Gas Range" Gas Dryer"' $10:00 $10.00 . . Estimated Coat PERMIT NO. Back Flow Preventer Required { )Yes () No/ aF -I le ®�� �� C �Z e AJC Type $15.00 PWMBING COMPANY Reinspection Fee $47.00/1 -Ir SIGNED BY, ALL OTHERS ANDIOR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By State Surcharge TOTAL FEE $ aELUS. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE S-A. TEL N0. -16 3- -f �� - f' ?,?0-� 11cr—I Rough -In Date Final Date NY _PLlJtV aINOIGA►S PERMIT IS 82atno COMMON VENT INFO ON BACK SIDE CITY OF FRIDLEY PERMIT NO.: 2004-00345 6431 UNIVERSITY AVENUE NE FRMLEY, MN 55432 DATE ISSUED: 03/17/2004 572-36U4 YAX: (763) 571-1287 ADDRESS : 6736 WASHINGTON ST NE PIN : 143024130036 LEGAL DESC : RICE CREEK TERRACE PLAT 4 : LOT 2 BLOCK 6 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION APPLICANT JACOBS TECHNOLOGY 1710 DOUGLAS DR #204 NIINNEAPOLIS, MN 55422 - OWNER HILLUKKA HATTIE A & MICHAEL R 6736 WASHINGTON ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date STATE SURCHARGE, ELEC FLAT ELECTRIC FORM FEE ELEC AMP SERVICE FEE TOTAL PAID WITH CHECK # 3043 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0.50 1.00 30.00 31.50 11Y OF FROLEY iN ?S' E, ti{ ()IV, L9niversifu Ave NI. (j3) 572-3804 FAA (763) 5"r ? _ i 287 Ur"I Floor 'I Floor 2 Floor 3 Floor -4 sa[�IP�d"to !h z-{� IlR(}il a NUNIBER.OF FIX—TU )LUMBiNG FIXTURE RATES: NUJ. RATE TOTAL $ 7.00 Vew Fixtures $ 4.00 Did Opening. New Fixture Beer Disper— 7.00 Blow off Basin$ Catch Basin $ 7.00 Rain Water Leader _ $ 7.00 sump/Repeiving Tank $ 7.00 $10.00 atbt,, rig App ante ���� Water Heater -Electric $ 7.00.— Water Heater - Gas's` $10.00 Gas Range* $10.00 �— Gas Dryer`" ,. � $10.00 Back 1"Iow Preventer Required ( )Yes (} No $15.00 Type Reinspection Fee $47.0011-1r ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 't,5% of Value of Fixture or Appiianoe State Surcharge 50 TOTAL. FF.L yo BE INS CALLED ON EACH FLOOR Auto. Floor J _ MINE Washer Drain a J013 ADDRESS c aid ^fir FO M. CS) W =� I., The undersigned hereby makes applicatiOn for a permit for the warts herein -c speed agreeing to do all work in strict accordance with the city odes n and rulings of the Building pNislon, and hereby declares That all the facts tion are hire and correct. and representations slated this appy m owner Building Used Estimated COs( PERMIT 140. PLUMBING v —v A pproved By Rough -tri Date _ Final Date IMUM FES R AN'Y`PLUM 3IN9iGAS PERM P . 20efifi L.iSS THE $.50 5 � . )R -CHARGE �cal��l•�E�}l•� VENT INFO ON BACK GC3t�t�t� :'C 1(*l I"IIl SHALL bL pF-z V(Dt -D 1`1.lt g "[4qC SECT -10N 506(A) PND -i"ABILF 6-A. a p�ppp m ru to 04/02/2004 FRI 13:21 M NEW [] ADDN [ j ALTER [ ) Construction Address: Legal Description: _ ELDER JONES171001/001 CITY OF FRIDLEY •$431 University Ave NE, Fridley, MN 55432 SINGLE FAMILY AND DUPLEMS R-9 AND R-2 BUILDING PERMIT APPLICATION Owner Name & Address: Effective 4/1/2004 (763).572;-3604 Bldg Insp 63) 571-9287 Fax cryw s ltd&t � TeL # _ Contractor. - The Home Depot A.H.S. Inc. MN LICENSI; # Address: 3200 Cobb Galleria Pkwy. Atlanta, GA 30339 Tel. 763-542-8826 1 Certificate of Survey of the License #20268257 truction 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:' • T � � V Y Construction Type: Estimated Cost: $ I T s Driveway Curb Cut Width Needed: Ft + e = Ft = DATE:v..7 APPLICANT: Tel. #I-• 3 -, &V r, Call (783) 672-3604 for Permit Fees if mailing in application: Fax to 763-571.9287 N using credit card and we will call you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - $ I Fee Schedule on Reverse Side $ 65% of Permit Fee $ .001 of Permit Valuation (1/10th%) $ ® $.50/$1,000 Valuation $ $1350 per SAC Unit $5.00 (State licensed Residential Contractors) Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] ®� STIPULATIQNS: CITY OF FRIDLEY PERMIT .: 2004-011588 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 07/20/2004 (763) 572-3604 FAX: (763) 571-1287 REPRINTED ON 7/21/2004 ADDRESS : 6736 WASHINGTON ST NE PIN : 143024130036 LEGAL DESC : RICE CREEK TERRACE PLAT 4 : LOT 2 BLOCK 6 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. VENT BATH FAN, REDO DRYER VENT, INSTALL DUCTWORK, RELOCATE DUCTWORK. VALUE OF APPL OR WORK 2895 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) 2895 APPLICANT HEATING PERMIT MINIMUM FEE 0.00 ST PAUL PLUMBING & HEATING GAS RANGE FEE 0.00 640 GRAND AVE GAS DRYER FEE 0.00 ST PAUL, MN 55105- HEATING REPAIRS/ALTERATIONS 28.95 STATE SURCHARGE, MECH FLAT 0.50 TOTAL 29.45 PAID WITH CHECK # 039983 OWNER JENNIFER HANSON 6736 WASHINGTON ST NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of anyof er state or local law regulating construction or the p dorm ce of construction. Applicant Dattee� Bldg Ins p �Date , l 0 SEPARATE PERMITS REOUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY BUILDING INSPECTION 64,q1 University Ave NE Fridley, MN 55432 763-572-3604 FAX 763-571-1287 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Effective 4/V2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS CoI e— Fee Total Owner $35.00 $ Building Used As \o` 410 $10.00 $ ESTIMATED COST PERMIT NO l/® -6/ ("-O $10.00 $ DESCRIPTION OF FURNACE AND BURNER Gas Dryer $10.00 $ # of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. *Air Conditioning -All Sizes $25.00 $ BTU HP EDR Fuel Total Connected Load All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work $� Burner Trade Name Size No. Minimum Fee $15.00 for Residential or 5% of cost of BTU HP EDR Improvement whichever is greater The undersigned hereby makes application for a permit for the work herein Commercial/Industrial/Institutional 56N specified agreeing to do all work in strict accordance with the City Codes specified 1.25% of Value of Appliance or Work (List on Back) $ rulings of the Building Division, and hereby declares that all the facts Minimum Fee $35.00 for Commercial/Industrial/Institutional and representations stated in this application are true and correct. State Surcharge $ ~�' HEATING CO TOTAL FEE Signed ��%�'`�//�✓���!/i✓� Tel REINSPECTION FEE $50.00/HOUR �'I �'� FAX # Date 7- Id " 0-� *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved b _ Rough -in Date Final Date Building. BUILDING �ermu i�ro.. - Inspections RESIDENTIAL APPLICATI Received By 763e' Date Rec'd: 763-572-3604 CITY OF FRIDLEY �1 .t^\ DATE &A/ i c t! (a ., ^^ YOUR E-MAIL ADDRESS SITE ADDRESS Vu S1 THIS APPLICANT IS: OWNER PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE STATE M�4 S SL1.3 a -- PHONE: -jlo3- 5-11— 49Y 10 STATE LICENSE # EXP DATE CITY S ZIP ADDRESS: FAX LE FAMILY/NEW CONSTRUCTION FAMILY/NEW CONSTRUCTION PERMIT TYPE ❑ ADDITION LJ UA eACitr 6=1J u uviv BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK:I ❑ DESCRIBE WORK BEING SIZE OF IMPROVEMENT NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other -C-A- LENGTH ;13'5-4 ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia K 'j HEIGHT BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used Ft. FOR NEW CONSTRUCTION INCLUDING DECKS, ,ADDITIONS & PORCHES SUBMIT: I . Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes [No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION S. OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 7° a l 65% of Building Permit Fee Fire Surcharge $ , ®® .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review At Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ i O(� Make checks payable to• City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only anap 'on f ;Tit d 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 h ew and approval of plans. L a i 2A 1R law C%IO U N R - L v! > en 7- _ p 'a D cn rn--� zomm r r�rna a --4rn� -4 > M > fes" ' Z Z o Cn G� L3J m un Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DATE /Z 11 7 ®6.% `7 YOUR E-MAIL ADDRESS SITE ADDRESS &736 THIS APPLICANT IS: ❑ OWNER OWONTRACTOR PROPERTY NAME: aI. .V"� r ; ' ,e- A w S OWNER/ ADDRESS: 6' '131, Ltj'qS H rn+6 : e ed r' -CITY L (--Z TENANT -STATE/4- PHONE: L-7&3 S-7) 4f 9`1c CONTRACTOR NAME: P..LiJ ODIG, INC STATE LICENSEJA2 E MAIN ST. EXP DATE �� MN 553U3 SUBMIT A COPY OF YOUR STATE ADDRESS: CITY STATE ZIP LICENSE WITH PHONE :26 3 a '7 ?_ `P PITO FAX -7 �6 3 a Z_ 1' g�* APPLICATION PERMIT TYPE [INGLE FAMILY. ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW ff4EPLACEMENT DETAILED DESCRIPTION OF WORK e r 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) _ BATH SINK/LAV _FLOOR DRAINS —SHOWER _ WATER PIPING —BATHTUB _ GAS PIPING /nEwcrryLicaysE) _ SWIMMING POOL WATER SOFTNER ($35) _ _ CLOTHES WASHER _ KITCHEN SINK —WATER CLOSET _ BACKFLOW PREV. ($15) _ DISHWASHER _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER PERMIT_ FEE PROJECTS',FOR�UNDER 5500 P]3F T bVER$S'Q&' Permit Fee $ 3s-- P9 Number of fixtures @ $10.00 x $10.00 = $ Surcharge_ .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ J .5- 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 PRINT NAME iay `�°�- DATE / -) C 0 7 x ' PLEA ;E NOTE: SEP �RATI `PERM T5 A U b FOR, 1# ° I1�T '_, ELEC Z`RYCA1� C IA1�lICAT -V ORR City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 0 A61, a S, Building $ , BUILDING See Back Page for Fee Schedule Permit - o.: Inspections Jb r RESIDENTIAL APPLICATION Fire Surcharge Received By: 763-572-3604 .001 times the total job valuation CITY OF FRIDLEY $ DatRa 763-502-4977 FAX License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ EFFECTIVE 1-1-08 $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow DATE -7 ®0 YOUR E-MAIL ADDRESS ft + 6 ft = ft x $21 = $ SITE ADDRESS 3(o \ R \ c W Q.SY 1t J+ . t� e � d {V s S `t ll THIS APPLICANT IS: OWNER 0&&TRACTOR Park Fee PROPERTY OWNER/ NAME: 1 Yis 4Y1 Fee Determined by Engineering (0 STATEW ZIP SS TENANT Agreement necessary ( ) Non Necessary ( ) ADDRESS: 3b 5W r1 Si CITY c� $ PHONE: - IA 3— 5 7 1— 4996 NAME: ADDRESS: CITY STATE ZIP CONTRACTOR SUBMIT A COPY OF PHONE FAX YOUR STATE LICENSE STATE LICENSE # EXP DATE PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING P<OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR �tEMODELINGI DESCRIBE WORK BEING DONE: ;:�___room t r I^ f ob i - SIZE OF IMPROVEMENT LENGTH '� 9 WIDTH HEIGHT V fitQJ7 SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 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: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS & PORCHES SUBMIT: ❑ Vinyl ❑Soffit 1. Site Plan/Survey showing the existing structures ❑ Aluminum ❑ Trim and proposed project. ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: S4�g�NG THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ 6`t�so _ OCCUPANCY TYPE Permit Fee $ , 5 951,1, See Back Page for Fee Schedule Plan Review $ Jb r 65% of Building Permit Fee Fire Surcharge $ _ I- , .001 times the total job valuation Surcharge $ d .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks payable to: City of Fridley Attach Sti ulatious 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 Constmction odes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in a ce wi e a roved plan in the case of all work which requires reviewandapproval of plans. p SIGNATURE OF APPLICANT PRINTNAMES 97_P i1&6 9J� � DATE -1b) t1 APPROVED BY DATE co I ---------- sv THIS JOB COPY SHALL BE AVAILABLE ON THE JOB SITE FOR THE FRAMING AND FINAL INSPECTIONS L '5' r. REVIEWED ZDR CODE IFAANC-C- -4" a cLe s-5 bF, ams� p4*-, 4w 1 jq 11 Obyl- -Z vp,c 'A (CC, 13uilding PLUMBING Permit No.: (t`o Inspections RESIDENTIAL APPLICATION Received By,: , fl 763-572-3604 CITY OF FRIDLEY 4 763-502-4977 FAX EFFECTIVE 1-1-118 DATE A9 YOUR E-MAIL ADDRESS Y i C k m e I'^no c% rn$ ti GO rY) SITE ADD S yjasiTor) S" 1 THIS APPLICANT IS: ElOWNER 0900 CTOR PROPERTY NAME: J M H a i n rso 1 ADDRESS: b731nYVaS hi r1Q-Ion .3+. CITY Fr i d l ev STATE M�6__W_�3Z OWNER/ TENANT PHONE: 71h3.571. 419 `i b CONTRACTOR NAME: m b + a r STATE LICENSE # b O o3 - PM EXP DATE 12-08 " SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND STATE BOND # 7o 2 oo3bb EXP DATE I • o F ADDRESS: ?Z217 �•*V ,5-h Irl . E. CITY M 12 12% STATE�ZIP &5 1 INSURANCE PHONE to 19-. 74.70. 970 b FAX 612.788-1181 PERK HT TYPE ISI SINGLE FAM LY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW 1I REPLACEMENT DETAILED DESCRIPTION OF WORK 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 = plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $15.50. 1 BATH SINK/LAV FLOOR DRAINS SHOWER _ WATER PIPING 1-BATHTUB _ GAS PIPING (NEED CITY LIC) SWIMMIING POOL —WATER SOFTNER ($35) _ CLOTHES WASHER _ KITCHEN SINK I WATER CLOSET _ BACKFLOW PREV. ($15) _ DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER illl PEE PROJEC POR ;� 50Q ,, „° i E p OR PR4CTS O�rER $50fl', Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $40.6n Surchar a .50 Number of fixtures @ $15.00 x $15.00 = $ OR Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ State Surcharge = $ .50 (MINIMUM $1550 MUM $15.50 Total = $ 0 THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the cas of all work which requires review and approval of plans. l i e_ A {�,Ju SIGNATURE OF APPLIC PRINT NAMEy I I fir- 9:$ AGATE APPROVED BY DATE 1,Es>✓ Nrr> -t� 1> REa� fax"$izAz ►ECIr1cAI:t y City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL Permit No. -90 _60101 Inspections `` RESIDENTIAL APPLICATION Received By. 763-572-3604 CITY OF FRIDLEY DW AU 763-502-4977 FAX EFFECTIVE 1-1-08 DATE 9111108 - YOUR E-MAIL ADDRESS I I SITE ADDRESS 3 LSCA THIS APPLICANT IS: OWNER OCOMRACTOR PROPERTY NAME: TENANT ADDRESS: au W 0, CITY STATES ZIF�� �°�� PHONE: 7 �"' S,? I _uj CONTRACTOR COMPANY NAME: CONTACT PERSON: NOTE: SEPARATE CITY LICENSES ARE STATE LICENSE # EXP DATE REQUIRED FOR GAS AND HVAC. ADDRESS: CITY STATE ZIP SUBMIT COPY OF BOND PHONE FAX AND INSURANCE PERMIT TYPE `INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW ,REPLACEMENT ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK O A C _VS- m 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 ) OR Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x .05 = FOR PROJECTS WHERE OREXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU $25.00 (GAS) $15.00 _GAS RANGE/OVEN $10.00 _A/C _FIREPLACE TO AIR EXCHANGEER $15 (WOOD) $35.00 NEW GAS GRILL $10.00 _AIR _FIREPLACE $35.00 $35.00 _GAS UNIT HTR $10.00 _BOILER _FURNACE LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 _CHIMNEY WORK $10 00 GAS PIPING $10 00 VENTILATOR $15.00 _DUCT SE�. fixture Permit Fee $ Number o @ $10.00 x $10.00 $ Num f Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ OR Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 MINIMUM $15.50 MINIMUM $15.50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a mechanical permitand 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 PRINT NAME DATE APPROVED BY DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL Permit No. ' r Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DaM'cAlla. 19.,l 2nnj� DATE - I - YOUR E-MAIL ADDRESS SITE ADDRESS 3 S �; S�At el, THIS APPLICANT IS: E3 OWNER CONTRACTQR PROPERTY NAME: A ADDRESS: S-h. !t .. CITY STATEN bS� OWNER/ TENANT - p k PHONE: 1 CONTRACTOR COMPANY NAME: 00' SUBMIT A COPY OF CONTACT PERSON: YOUR STATE LICENSE WITH STATE LICENSE #_ EXP DATE 9� A-/ ZIP��b� ADDRESS: 7de�� VAPid1fQSt ll lt. e, CITY Fe Ie4 APPLICATION -STATE PHONE ��- i7� �- O�S� FAX PERMn TYPE KSINGLE FAMILY ❑ TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: 0 NEW 13 REPLACEMENT ))(ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK FqCf ILDR: PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total 'cost up to $50.0.00, 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: SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEIBTU A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 _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 HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENTII.ATOR $15.00 Permit Fee $ Number of fixtures @$10.00 1 x$10.00=$ 10. 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 = $ 10-GO THIS IS AN APPLICATION FOR 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 a lication for a permit and work ' of to start without a permit; that the work will be in accordance with the approved plan in the case o all work ch ices revie d approval of plans. SIGNATURE OF APPLICANT PRINT NAME_jaMa DATE_ City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building $ BUILDING Plan Review Permit No.: Inspections Fire Surcharge RESIDENTIAL APPLICATION Received By: ALO _ 763-572-3604 $ CITY OF FRIDLEY License Surcharge DateAUG �• V hno 763-502®-4977 FAX SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ EFFECTIVE 1-1-08 Erosion Control $ DATE ® �1 YOUR E-MAIL ADDRESS $ Fee Determined by Engineering SITE ADDRESS $ Agreement necessary ( ) Non Necessary ( ) Total Due THIS APPLICANT IS: OWNER 000N66CTOR PROPERTY OWNER/ NAME: t o-yN ADDRESS: -1 I® I J0_ W SI16 CITY t n STATE IP TENANT PHONE:X1®3^ "J71 _L4 q q 6 NAME: ADDRESS: CITY STATE ZIP___`_ CONTRACTOR SUBMIT A COPY OF PHONE FAX YOUR STATE LICENSE N —� STATE LICENSE # EXP DATE _ i. PROPERTY TYPE INGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED INDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE q ❑ DECK ❑ SIDING ❑ OTHER I ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR REMODELING DESCRIBE WORK BEING DONE: Ve D GCCIQ 4- "WI&L W n SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT .ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 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: CONSTRUCTION INCLUDING DECKS, =NEW SIDING Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing struct irc , G ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS �p EXISTING OPENINGS []Yes 3. Energy Calculations IN o LOCATION OF WINDOWS OR OPENINGS hLV_ Lk `'�"K) 1� FOR NEW -DESCRIBE OPENING CHANGES & SIZE OF 16i4.6`C %L)f a,� �� TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS I X q Z ®'t l ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION OCCUPANCY Permit Fee $ See Back Page for Fee Schedule �1r Plan Review $ 65% of Building Permit Fee ! Fire Surcharge $ :L40 .001 times the total job valuation Surcharge $ M.0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 9 4L4 Make checks navable to: Citv of Fridlev Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowled a that the i formation above is complete and accurate; that the work will be in conformance with the ordinances anc' zodc: of the City of Fridley and with the Mi ne to Cons do C s; that I understand this is not a permit but only an application for a permit and work is not to start wi �o4t a permit on site; that the work will be in a cor nce w th e o plan in the case of all work which req uiresreview and a(�p�rova�l Pf plans. SIGNATURE OF APPLICANT NAME : =,n Y11 +e-�! tt'&, A � DATE Z� APPROVED BY DATE Building Inspections 763-572=3604 BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY DATE '9 RIP ( `0 YOUR E-MAIL ADDRESS SITE ADDRESS (07 3L W4Shc *d,n ,;f NF_ THIS APPLICANT IS: ❑ OWNER 1000NTRACTOR Permit No., Received By: t: DatiM.AUG102009 PROPERTY OWNER/ NAME: 7:�bh rSV^ TENANT ADDRESS:_ _ (013, I,uc h cr+r S'F NAE * CITY STATr7=�ztP �j Z, PHONE: w3'� 511—CN $A CONTRACTOR NAME: C- a to r W Co- 0 O•Lpl) SUBMIT A COPY OF STATE LICENSE EXP DATE lt7 YOUR STATE LICENSE ADDRESS:{® CITY9,�CII" WITH APPLICATION PHOSh w 3L%S?LL—ZaS'q F 7(03 S7" -L Zft4 _STATv ZIP PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE TWO FAMILY/NEW CONSTRUCTION STORIES I PERMIT' TYPE O ADDITION ❑ GARAGE/SHEDJ�WINDOWS 0 BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCUREPAIR It REMODELING DESCRIBE WORK BEING DONE:_ 2" 61" f i w C�t�,�r-(—� HEIGHT Sq. Ft. SIZE OF IMPROVEMENT LENGTH WIDTH —0 OB O�MG HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2• Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING ❑ Vinyl ❑Soffit FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Aluminu. Other ❑ Other ❑Trim ADDITIONS. 1. & PORCHES SUBMIT• Site Plan/Survey showing the existing structures ❑ Fascia and proposed project WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS FYes. ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF nLV— (ice - 6gdf06& LO 1, C-4M5,e OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED M Z VL NUMBER OF•WINDOWS 7 Ai,T FEES ARE BASED ON VAL UATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING,THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 'Y4 37 -CA -6 0 OCCUPANCY TYPF. Permit Fee $ Plan Review $ Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ s $ 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) $1675 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridlev 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 applicatio or a pe I 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 w i h requ' a review and approval of plans. t� SIGNATURE OF APPLICANT PRINT NAME 60 [ �� DATEF16 (D From: +763 428 6779 Page: 1/1 Date: 3/24/2010 10:06:42 AM MK-94-4ulu ua:cunm rxuvrv6i VIOMOAL arty T(0Y-4L0—011b I-400 r•uul/uul r-011 Building LOMD LST Permit No.9.,t 0*� W Inspections MODIFICATION APPLICATION Received B 763-572-3604 CITY" OF FRiDLEY D R 72 763-502-4977 fax EFFEc 1,1418 %�jAa OR _M AnPLICATIQN DATE: J (!0 YOUR E-MAIL ADDRESS: tjgg=iT+rilM. THIS APPLICANT IS: AULSR ❑ PROPERTY OW JER PROPERTY OWNER: JOB ADDRESS: MATERIAL TO BE HAULED: �`�'iy� �l� i+Ct✓�lll ,li4414r+7"r � r` MATERIAL BEING HAULED BY: � � �nt oc v DATES TO BE HAULED (UP TO 3 DAYS): i THTS PERMIT tS ISSUED TO ALLOW AN INCREASE OF AXLE WEIGHT FROM FOUR (4) TONS PER AXEL TO FIVE (5) TONS PER AXEL OVER THE FOLLOWING DESIGNATED ROUTE: ! i NOTICE: This permit is valid only for vehicles en route to construction address during the hours of 8:00 am to 5:00 pm. See Resolution #01-2004 and State Statute Section 169.87 PERMIT MUST EE IN VI+ fUCLE WHILE HAULING ON ESTABLISHED ROUTE. PERMIT FEE: $25.00 THIS IS AN APPLICATION FOR A PERULT-NOT VALID UNTIL PROCESSED 1 hereby apply for a Iead limit modification pam it and I ackrnowledge 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. T understand this is not a permit but only an application fora pctmi d hauling outricted e0 s is not to start without permit. SIGNATURE OF APPLICA pnt T NA , E_%RRH r+ l4,'l L DA �l AI'MOVED BY DA COPIES GIVEN T - ❑ POLICE ❑ EI•f-INEERING City of Fridley Building Inspections Department~ 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 7,53-502-4977 Building BUILDING Permit No.: ` ,, -a�` (-",I Inspections RESIDENTIAL APPLICATION Received By: s - d 763-72-3604 CITY OF FRIDLEY Date57/9 3I0 YOUR E-MAIL DATE SITE ADDRESS ADDRES I e- S5 THIS APPLICANT IS: 0 OWNS CONTRACTOR PROPERTY OWNER/ NAME: 6CgA�W 1A, TENANT ADDRESS: CITY STATE ZIP PHONE: !q,,0 -6-7(• q•7// y& CONTRACTOR NAME,fflM STATE LICENSE # A173 EXP DATE 319/47 mW SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: SSSS 1- CITY STATE zIP 553`3 WITH APPLICATION PHONE LIS2 . 935 • grG(e ? FAX 45Z .,?a5 - 95y4l PROPERTY TYPE J2 SINGLE FAMILY/NEW CONSTRUCTION SIZE 0 TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE Q ADDITION 0 GARAGE/SHED 0 WINDOWS 0 BASEMENT FINISH 0 ROOF 0 DRAIN TILE 0 DECK irSIDING 0 OTHER 0 SWIMMING POOL TYPE OF WORK: I ONEW 0 ADDITION MAINTENANCE/REPAIR 0 REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH TH HEIGHT Sq..Ft ROOFING 0 HOUSE ONLY NUMBER OF SQUARES 0 HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES 0 ATTACHED GARAGE I. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: 0 DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SED G FOR NEW CONSTRUCTION INCLUDING DECKS, rayl ❑Soffit ADDITIONS. & PORCHES SUBMIT: Aluminum Trim I . Site Plan/Survey showing the existing structures 0 Other El Fascia and proposed project 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS OYes ONo LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ I %i Aq3• oc 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) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks savable 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; that the work will be in accordance with the approved plan in the case of all work whi equire r view an ap roval of plans. SIGNATURE OF APPLICANT PRINT NAME f -ax I � • uy' U