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PRE 2010 DOCSSUBJECT PERMI: - City of Fridley -. 1496 AT THE TOP OF THE TWINS BUILDING PERM IT r 1 4 COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 . � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 /®_ /9_ i JOB ADDRESS 5495 West Danube Road 1 LEGAL LOT NO. BLOCK T RACT OR ADDITION SEE ATTACHED DESCR. 7 2 Innsbruck North - 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE R. K. Gupta - 3407 Droft Dr. N.E. - M 1 . 55418 3 CONTRACTOR MAIL ADDRESS Gilbert & Sons - 2064 Fry Strimpt. St- Pail] ZIP PHONE LICENSE NO. 631-0106 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Dwelling & Garage 7 CLASS OF WORK C$ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 9 CHANGE OF USE FROM TO STIPULATIONS Hard surface driveway. Provide verifying survey. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Framek THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT.1536 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 1456 14,112 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED, WITH WHETHER SPECIFIED HEREIN -OR NOT. THE GRANTING OF A PERMIT $59,800 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER S ATE OR. LOCAL LAW REGULATING CON- STRUCTIO .OR T E P OR A E CONSTRUCTION.�176-77 $400.00 PLAN CHECK FEE TOTAL FEE us SIGNATURE OFC - TRACTOR OR AUT ORIZED AGENT (D'ATE) - WHEN I OPERL V ID T S IS YOUR PERMIT BLDG INSP DATE SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) •f CITY OF FRIIA.EY APPLICATION FOR RESIDENTIAL BUILDING PEII14I TS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER:• + . MILDER; � :e 1° Address: ress: Tel(.—No. ®®� Street: q-,kJQ4-r J2 LOT: }STACK: ADDITION: CORNER LOT: _ INSIDE TAT: SETBACK: SIDEYARDS: Applicant attach to this form Tvio Certificates oL Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front: Depth: 0.2J' Height: ^ISIT Square Feet: ILA, Cubic Feet: Height: �® Front: Depth: Hei g Square Feet:'. Cubic Feet: 1q-VeA � L� Type of Construction: RL 44 Estimated Cost: $ To Be Completed: G Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired } $ $ (SEE REVERSE SIDE OF SHEET) 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. See reverse side for additional information. DATE: �'S ✓ SIGNATURE: ® � Stipulations: d 44, 44. PC -- L9 .(To C..i9.(To (oho •g � l9,ti • rvw> b1-)0)411 G x X51 �. Z, *J161 '&A.IM X I E51 � .II ce I' ---------- ------------ -- �- ENERGY CONSERVATION SUPPLEMENT '1'O- BUILDING PERMIT APPLICATION PLANNING AND INSPECTION DEPARTMENT CITY OF FRIDLEY,MINNESOTA This supplement is provided to assist the applicant in computing EXTERIOR ENVELOPE AVERAGE "U" FACTOR INFOPMATION. This -information is required so the BUILDING OFFICIAL can determine that submitted plans comply with the ENERGY CONSERVATION DESIGN CRITERIA of the STATE BUILDING CODE (Section 6000). It is the APPLICANT'S responsibility to accurately compute the data; reflect the proper DESIGN CRITERIA in the plans; submit product specifications, if needed to support the "R" and "U" factors used; and to assure construction is per approved plans. JOB LOCATION: OWNER/CONTRACTOR: V P -r ADDRESS: °��4,y _D'Y , ' ., H PHONE: - 7 , c,7 °,, A. "Deterjiine the Total Exposed Wall Area as follows: 1. Total wall windo°a area 2. Total door area 3. Total sliding glass door area 4. Total fireplace wall area 5. Total wall framing area(average 10%) 6. Total net wall area above floor(average 90%) 7. Total rim joist area Subtotal: Total exposed wall area above floor irncN CA -@A 9. Total net foundatiorY area above grade Subtotal: Total exposed foundation area GRAND TOTAL EXPOSED WALL AREA _2!_LF --7 a t4 .G lev ZOOS- FF2- B. Multiply the GRAND TOTAL EXPOSED WALL AREA X .17 = C. Determirke tha Total Exposed Roof/Ceiling Area as follows: 10. Total skylight area (� 11. Total roof/Ceiling framing area (10%) IS70____ 12. Total net Insulated roof/ceiling area? GRAND TOTAL EXPOSED ROOF/CEILING AREA 1dC_ D. Multiply the'GRAND TOTAL EXPOSED ROOF/CEILING AREA X .05 = . Item 'T Item II ADD 1-9'FOR TOTAL WALL SEGMENTS ITEM III P. Determine the "U" value of each segment (10-12) and multiply by the area as follows: 10. E. Determine the "U" value of each, segment (j,-% and multiply.,by the area as 11. follows: 12. fS C WU 2. X nun 3. x "use J C3 149, ij 4. x -us- 5 x flun 6.____ l_3 p ., X null 7 7. X "Un 8. x nun 9. til x Huff ADD 1-9'FOR TOTAL WALL SEGMENTS ITEM III P. Determine the "U" value of each segment (10-12) and multiply by the area as follows: 10. 11. )so 12. fS C X nun x "Us' Oslo X Hull ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS ITEM IV G. If Item III is the same as, or less than Item I, you have met the intent of State Building Code 6006 (a) 2. H. If Item IV is the same as, or less than Item II, you have met the intent of State Building Code 6006 (c) 1. I. Add Item I A4d* Item III + Item II "Y 71 + Item IV 139 K. If the sum of Iteims III and IV are less than, Items I and 11, you have met the intent of the 05de fdr total envelope system. The undersigned, as applicant for a building permit, hereby affirms the above information has been prepared and submitted by himself or under his direction, hereby acknowledges the information to be correct and accurate; and hereby presents the information with required plans in support of the building permit applicatioA—. DATE: CITY OF FRIDLEY It APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE ® /� �� �° ���� � GRAVITY WARM AIR: RATE TOTAL Job Address 7 /l�%"gv Furnace Shell & Duct Work $12.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Department of Buildings Repairs & Alterations each add. $500.00 4.00 $ City of Fridley Tel. #571-3450 MECHANICAL WARM AIR: The undersigned hereby makes application for a permit for the work herein Furnace Shell & Duct Work to 100,000 BTU $12.00 $specified agreeing to do all work in strict accordance with the City Codes each add. 50,000 BTU 4.00 $ OO and rulings of the Department of Buildings, and hereby declares that all the Replacement of Furnace 7.00 $ facts and representations stated in this application are true and correct. Repairs & Alterations -up to $500.00 7.00 $ 7A0 Repairs & Alterations each add. $500.00 4.00 $ Fridley, Minn. 19 70h 87S-? STEAM OR HOT WATER SYSTEM: OWNER rAM �4�-s Boiler & Lines up to 100,000 BTU $12.00 $ KIND OF BUILDING each addn. 50,000 BTU 4.00 $ / Boiler only up to 100,000 BTU 7.00 $ USED AS ` e each addn. 50,000 BTU 6.00 $ TO BE COMPLETED ABOUT 7 OIL BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ ESTIMATED'COST ce) GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ OLD -a BUILDING PERMIT NO. PERMIT NO. (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: 1st 3 Fixtures x $ 3.00 Additional Fixtures x $ 1.00 Gas Rahge to 199,000 BTU x $10.00• AIR CONDITIONING FAN HEATING SYSTEMS See Fee schedule VENTILATING SYSTEMS ALTERATIONS $ REPAIRS State Surcharge TOTAL FEE ROUGH INSP. REINSPECTION FEE Date ($10.00) FINAL INSP. Date APPROVAL FOR PERMIT $ $ $ .50 14XNIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE DESCRIPTION OF FURNACE/BURNER BEATING or POWER PLANTS, Steam, Not Water, Warm Air- No. Trade Name I-AEA446011- Size No. /-----,��� Capacity Sq. Ft. EDR BTU OW HP Total Connected Load Kind of Fuel /at ( 7A -s BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company Signed By O Tel. No. L- M.RQ. Length IS ' Width 13' Height R 1 RUPKILFl.l D wm t? -T4 Room I Length %k Will, I I Hegrht Windows and Doors—frac sad Area Floor Width Height No. of .Lineal ft. Area No. of pane of Pane lights of crack sq. It. `'No. No. of Lineal !t. Area Width Htan'* of Paas of lights of crack sq. ;t. 9 , �. sy-�.rt drp 'a h 16 Coef. &n r 1" to Clan luo 72.r .wan KYC' 21i� Coef. Stn .�ITM6ltrstion f Calais104-0 rc it "; .. _. t It Nettarp. Wan Int. Net up. wan r'w;l Cp: WAII240 Net up. Wall Cedta 11 c `.i Int. Wan ` s rel 56M - r- ,- w A tL ttt. Wan Ceiling �..t? 14 6o Floor Ceai�gC , Cailiag e } 1 r.,'p, r� t � Floor Width Height No. of .Lineal ft. Area No. of pane of Pane lights of crack sq. It. Reatured sa. ft. E.D.R. or sa. ins. WA L*a&r area Wiadowa andDoot4--CradEa0 and Area VVIdth Heighto. of 1,14841 ;t. No. of pane Of pane lights of Crack Width Height No. of .Lineal ft. Area No. of pane of Pane lights of crack sq. It. Coefl ilea Coef. &n 1" to Clan luo 72.r .wan 3*. Glam too , p� i < ap.. is _. t It Nettarp. Wan Int. Net up. wan r'w;l �i .� Cedta 11 c `.i Int. Wan ` s rel 56M - r- ,- w A tL Ceiling �..t? 14 6o Floor Total Btu. I � 0 Required sq. ft. E.D.R. or sq. ins. W.A. leader area tip Fl.i V'- 1! A U Room I Lentrth width Hem,Lt Windows and Doors-- Crackage and Area VVIdth Heighto. of 1,14841 ;t. No. of pane Of pane lights of Crack Area sq. ft. Coefl ilea Infiltration 1" to Clan luo 72.r .wan 3*. Net exp. wall IQL wan Glau i < (, It Nettarp. Wan Int. ,,. r'w;l �i .� Cedta 11 c `.i P ` s rel 56M - r- ,- w A tL 11 loc-11 �..t? Total Btu. _ Z 0 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area UP Alb> K. Room I Ungth I n Widthl I Height Vfmdows and Door—Cackage and Are+ Width Height No. at U&W ft. Aran NO. of pane of "lights of crack p. tL 2 Coefl ilea Infiltration 1" to Clan luo 72.r .wan 3*. Net exp. wall IQL wan i < Floor Total atm Required sq. ft. E.D.R or sq. ins. WA Leader am LOSS CALaJl.AIIONS +W{eakerWDoors Guide ^ down Reference 19— 1-C kir-4 Room I Lensdi to \iiinrlefwu and DmtS--CraCkaQ! and Area DEPARTMENT OF Cautruction No. Int. Waq Ceiling F 11 Heirrht II Windows and Doors-Crackil and Area - 14th rrs ght o. of lineal tt. Area Na of no ormean llfhts of crack On. M Width Neliht NO. at .- lineal ft. Arms, No. or Dane ofpan* lights of Mack W. ft: . f' :' 1 Cod. Wo WItratim rRiC[. Gla" Exp. wall Gla" RIO • Ceiling Floor Net exp. wan 04C i oo!Jgx 1, 1 l Ceiling 100 .041 Floor IOU G Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. leader area 1.1_I' eaeetnll�n>:tlt� W�.,... Hdaitt Windows and Doom--Crackage and Area 14th rrs ght o. of lineal tt. Area Na of no ormean llfhts of crack On. M Cod. Wo WItratim Gla" Exp. wall Net exp. wan Int. wall Ceiling Floor Total Btu. Required sq. ft. EDJL or sq. iis. WA. header area Fl. Room 1 Length Width �ht Windows dtl of per Fxp. wd Net exp. waU Int. wall Ceiling Floor Reodred sq. & ED.Jt or sq. ins. WA. Leader area i 'Windows and Doors--Craekage and Area Roam I Length Width elubt o. of I.Ineal tt Area 1110. of pane of Pone lights of eroak eq. ft. bi Height Q °�. 177' —width Height Na of sal tt. Area r10. of Pone of pans lights ofw%*k eq. ft e Coef� Bin labltration s d q Exp. wall e) thus �� d >T TT •�'i+�l�r ri e. t Ii .1 � p DD 0 � Q Net "O wall OMail t = Net up. wan OIL A 0— r w t Int. wall wswlag � 14' door t 2-51Y 61 Total Btu. Required sq. ft. E.D.R. or sq. ins. WA Leader area i a Fl. 1 Roam I Length Width Width Height No. of ` Lineal !t. Area, No. of ss of s lights of eruk a¢. ft. Height Q Window" and Doors—Craekage afsd Area —width Height Na of sal tt. Area r10. of Pone of pans lights ofw%*k eq. ft e Giass r in6iltration Exp. wall ". Btu } = �ila� Ceiling t . 910 Gi z 4 K, Net up. wan OIL A 0— int. wail Int. wall Coiling Floor 14' t m .P Windoaro aW Doors—Craekage and Ares tht o. of AA [t. Area No. of be Ot L•NH llebts of crook 09. tt Width Height No. of ` Lineal !t. Area, No. of ss of s lights of eruk a¢. ft. CME Bin EfaEltsatioll Giass r in6iltration Exp. wall Nd ev. wall Glass IOL Wali Ceiling ►. wall rj� �5 S Net up. wan Int. wall Ceiling Floor c Total Btu. v Regniratl sq. ft. E D.R. or sq. itiL W.A, leader area c1 R....n. 1 1 smolt ` width Heislit. Windows and Doors—Cra and Area tht o. of AA [t. Area No. of be Ot L•NH llebts of crook 09. tt CME Bin EfaEltsatioll Giass Exp. wall Nd ev. wall IOL Wali Ceiling Floor Total Btu. R!eired sq. k. E.D.R. or sq. ice. WA Loader arca CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE m PLUMBING FIXTURE RATES: a m RATE TOTAL o // k d $3.00 Water 01 Future Fixture Opening M4)+� '4 x tlf $ E New Fixture, Old Opening pl x N b H 004 w b,Heater x $5.00 $ (d Water Heater - to 99,000 BTU / x $5.00 $ 3 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener N N N $7.00 $ ? .I C $5.00 Q U0 Electric Water Heater U N $ GAS FITTING FEES: .W N b N O _� x $3,00 m rt y ro m M N °' L' .°u y .0{ O a W ..i y 3 caw f9'. m .-1 w U rA 3 c� O as lec 'I � --2- 1 lst 1 1 2nd 3rd S 4th T46 (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures // x $3.00 $ 33 p 6 Future Fixture Opening .3 x $2.00 $ (o.0 G New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water Heater - to 99,000 BTU / x $5.00 $ -Uo 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater X $5.00 $ GAS FITTING FEES: lst 3 fixtures _� x $3,00 $ j Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS & ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ REINSPECTION PEE ($10.00) LP Job Address / L V IA- �f Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. ( , 19 7 OWNER KIND C USED AS TO BE COMPLETED ABOUTCJ / ESTIMATED COST CJU OLD-(NEWiBUILDING PERMIT NO. PERMIT NO. Company Signed By Tel. No."C p ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE SUBJECT PER City ®f Fridley 9 5.8 5 9 AT THE TOP OF THE TWINS BUILDING PERMIT rp RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 8/1/80 JOB ADDRESS 5495 West Danube Road N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR: 7 2 N. Innsbruck 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ramesh K. Gupta 5495 West Danube Road N.E. 574-7369 3 ' CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW E� ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct a 10' x 10' Screen House and an open deck 9 CHANGE OF USE FROM TO STIPULATIONS WAG Sew digging cell Incel 9011061 VLEPHONE • (LECTRIC _ 04 E14? REQUIRED LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $18800. $.90 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON -2.00. STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $ 3:Q0 $15.90 SIGNATUAEGIf CON. ACJVRORAUTHORIZEDAGENT (DATE) .WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT SI A URE OF OWNER OF OWNER BUILDE I (DATE) BLDG INSP OA E CITY OF FRIDLEY - APPLICATION FOR RESIDLNTIAL BUILDING PERMITS (Nevi, Alterations, Additions, or Repairs) OWNER: BUILDER: ADDRESS: ADDRESS: TEL NO: Jr 7q —73 65 TEL NO: Construction Location STREET NO: % STREET: loll ° / (J� �, . RD ,6 LOT: 7 BLOCK: ADDITION:k Corner Lot: Inside Lot: Setback: Sideyards: Applicant attach to this form tvo Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION / Front: -/01/ Depth: 0 Height: Square. Feet: Cubic Feet: rl�qD spa&) Q"Front: Square- Feet: > C Cubic Feet: Depth: Type of Construction: --� k • rYe_a1 / A L G Tb Be Completed: Proposed Driveway Width If New Opening Is Desired: Height: Estimated Cost: $ Alt. A Alt. B SEE REVERSE SIDE OF SHEET 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 her"declares that all the facts and representations stated in this application are ue fhnd jcorregt, DATE: Z7 � � o SIGNATURE: Stipulations: �` K• vv ! ala. �o AMS gv. q;-uo S®, 9d CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1991 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 7.00 _ Old Opening, New Fixture $ 4.00 _ Beer Dispenser $ 5.00 _ Blow Off Basin $ 7.00 _ Catch Basin $ 7.00 _ Rain Water Leader $ 7.00 _ Sump/Receiving Tank $ 7.00 _ Water Treating Appliance $10.00 _ Water Heater -Electric $ 7.00 _ Water Heater - Gas $10.00 _ Gas Range $10.00 _ Gas Dryer $10.00 _ Back Flow Preventer Required (v)Yes () No Type r'; N $5.00 _ Reinspection Fee $30.0//011 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance _ State Surcharge .50 TOTAL FEE $ i A JOB ADDRESS The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. 2 , 1991 Owner C n �� t` q Liz, ,j', C Building. Used As b- a e c P Estimated Cost 7 C1 0 PERMIT NO. PLUMBING COMPANY J `� SIGNED BY Approved By _&&Rough -In Date TEL N Final Date ` 0 SUBJECT P City of Fridley2 5 2 0 AT THE TOP OF THE TWINS BUILDING PERMIT f RECEIPT NO. � • ______ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r NUMBER REV DATEP 6/30/97 AGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 1013 ADDRESS 5495 West Danube Road NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 2 Innsbruck North 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Leroy Corgard 5495 West Danube Road NE 571-3087 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Midwest Siding & roofing 18979 Gladstone Blvd, Maple Grove MN 55311 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 416-4804 20010277 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 (29 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 SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLGi UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2,392 @ $1.20 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION 4' PLAN CHECK FEE TOTAL FEE License SC $5.00 $83.34 SIGNATURE OF CON: RACTOR OR AUTHORIZE D AGENT IDATEI WHENPROPERLY IDATED THIS IS YWR PERMIT d BLD9f INSP GATE _ SIGNATURE OF OWNER IF OWNER BUILDERI (DATE) NEW ( l 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: W Effective I/l/97 �337d-- R OF I'MD► MN LICENSE # 1 .. Attach to this application, a Certificate of Survey ofrge-wj f -nn ss -3) 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 W d /c� eHgt/Ground Sq. Ft. OTHER:rL Construction Type:_°� vv Estimated Cost: $ J (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: �L 0 (7APPLICANT: �r� 8 TOTAL $ C STIPULATIONS: CITY USE ONLY Permit Fee $ S� Fee Schedule on Reverse Side Fire Surcharge $ -001 of Permit Valuation (1/10th%) State Surcharge . LO $.50/$1,000 Valuation SAC Charge $ $950 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 $ C STIPULATIONS: Building �A MECHANICAL Inspectio RESIDENTIAL APPLICATION 7.63-572- 604CITY OF FRIDLEY � ' 9 DZDDRESSt_JS;; — ®6 YOUR E-MAIL ADDRESS S + , THIS APPLICANT IS: ❑ OWNER jjCONTRACTOR PROPERTY NAME:r r le- OWNER/ ,e ADDRESS: TENANT PHONE: CONTRACTOR I COMPANY SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: CONTACT PERSON: J'OANN ZINKEN CITY Permit No.: Received By: Date Rec'd: ATEJN t PSS 43 STATE LICENSE # EXP DATE ADDRESS: 13562 AVE NE CITY A(JOBA STATE ZIP 55304 PHONE 763-757-6202 FAX 763-757-6701 q SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE ❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK PER MS 16B.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)SIZE/BTU Equipment Installed MFG: v MODEL: I� P 4 ` ® SIZE/BTU l O c7dLJ MFG: MODEL: lA 5 6LA a SIZE/BTU MFG: MODEL: l A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGEIOVEN $10.00 AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOILER $35.00 1 FURNACE $35.00 _GAS HE HTR $10.00 _CHIMNEY LINER $10.00 _GAS DRYER $10.00 POOL HE $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VEI.TIII,ATOR $15.00 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = Surcharge $ SQ Number of fixtures @ $15.00 x $15.00 = $ TOTAL Surcharge $ Number of fixtures @ $25.00 = x $25.00 = $ SbD Number of fixtures @ $35.00 1 x $35.00 = $ .00 State Surcharge = $ .50 Total = $ i.9©.SU 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. c SIGNATURE OF APPLIC10' PRINT NAME ROGER HOFF)3ETR DATE O jqjC)(,, City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel ]MC Chapter 7 with MN Amendments b. Natural Gas or PropaneUGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation . a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 .a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations