The URL can be used to link to this page

PRE 2010 DOCSe Village ®f Fridley, Minn. BUILDING PERMIT N? 1763 Date: .. ...... �.......P�.......... Owner.. :. guilder .......... ........ ....................... Address..... .® �..... .`t........... . 4d°dress............................................. p LOCATION BUILDING No. .. ° .0 ..... Street .. ......... .. ,... Part of Lot ... a ..... Lot ...... �...... Block ...... ......... Addition or Sub -Division C• • • • • • • �/° Corner Lot ........... Inside Lot ...!l ..... Setback 5 deyard ........... .... . . . DESCRIPTION OF BUILDING TtheUsed as: Vii, !.. g., f .e. .. Front ... �. Depth ..?' .... Height .. Sq. Ft. Cu. Ft. ........ V ..................... Front ........ Depth ........ Height,; ...... Sq. Ft. ........ Cu. Ft. ........ Type of ConstructionEst. Cost .................... To be Completed .................. E 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. a In consideration of the payment of a fee of $....... permit is hereby granted to ...: ......................... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding locatio33 construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this pe". it may be revoked at any time upon violation of any of the provisions of said ordinances.' . 1.. ... ............... Building Inspector NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. u . a. f A0 u SUBJECT PERMIT N City of Fridley ®1301'7 AT THE TOP OF THE TWINS D[ D PERMIT A A I T19 r BUILDING R'v t I RECE . _____ COMMUNITY DEVELOPMENT DIV. L -� r ,PROTECTIVE INSPECTION SEC. f CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 6/13/75 JOB ADDRESS. 580C West Moor Lake 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Harry Nawrocki 5800 West Moore Lake Drive 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. G. H. Roofing 18125 County Road 24 Wayzata 4 ARCHITECT OR DESIGNER MAILADDRESS 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 X ❑ MOVE E] REMOVE 8 DESCRIBE WORK Re-roof 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. shingle 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. 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $785.00 .50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 6. 00 PLAN CHECK FEE TOTALFEE eInSn,,7 6.50 SIGNATURE OF CON ACTOR OR AUTHORIZED AGENT (DA E) HEN PROPS Y YOUR PER IT &L70 SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) BLpG )NSP DATE u . a. f A0 u APPLICATION FOR RESIDENTIAL,, ALTERATION, OR ADDITION.BUILDING PERMIT CITY OF 'FRIDLEY, MINNESOTA OWNER'S NAME BUILDER: % t ADDRESS S'��® r�,� ADDRESS: % frlA 5 NO • . ®` STREET • LOT: BLOCK: i ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD Applicant attach tr. this fory-m Two Certificates of Survey of Lot. and. -propose.' building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front: Depth: Height: Square Feet: Cubic.Feet: Front: Depth: Height: Square Feet; Cubic Feet: Estimated Cost: $ Type of Construction: To Be Completed: .The undersigned hereby makes application for a •permit for the work herein specified, agreeing to do all work in stxict 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 (Se "Revea Side For Additional Information.)' el 0 s . 6,2 RAF SUBJECT ERMIT NO. City of Fridley 24684 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV PROTECTIVE INSPECTION SEC. r NUMBER REV DATE PAGE OF APPROVED BY /-'-t CITY HALL FRIDLEY 55432 612-571-3450 910-F15 10/15/9 JOB ADDRESS 5800 West Moore Lake Drive NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 4 Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Barb Bergseth 5800 West Moore Lake Drive 572-0669 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Minnesota Roofing & Remodeling 6130 Olson Memorial Hwy, Golden Valle 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 55422 593-9373 3983 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION O ALTERATION REPAIR ❑ MOVE ❑ REMOVE X 6 DESCRIBE WORK Reroof House (20 Sq) Tear -off; gutters 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. ' TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 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 $.83 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,650 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- $54.00 SC $1.65 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. Aire PLAN CHECK FE TAL FEE jj/G� ��'�.6 Licens SC Woo 7$61.48 r SIGNATUR OF COte ACTOR OR AUTHORIZED AGENT IDATEI PRO Y VA ID D THIS IS YOUR PE M SIGNATURE OF OWNER iIF OWNER BUILDER)_ IDATEI DG INSP r1ATE RAF NEW [ ] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY ALTER [ l SINGLE FAMILY AND DUPLEXES R-1 AND R-2 ��>c Building Permit Application ConstructionAddress: S(foo ( 44d Legal Description: Owner Name &Address:Pd,pSP Tel. # Contractor: MN LICENSE # Address: 61 6o/ r% Tel. # �7-7 "1.3 Attach to this applica on, aCertificate of Sury of the aS-)r,2 lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks.�s Type of Construction: &, , e—hv� 4 '4 Estimate Cost: $ Approx. Completion Date: Driveway Curb Cut Width Needed: _ DATE: APPLICANT: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: (Cost on Back) Ft. + 6 Ft = Ft x $ _ $ Tel. # CI'T'Y USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $900 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 [ J CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2001 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 763-572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS SMO MQQF_r,. RATE SCHEDULE OWNER Residential Rate TOTAL Furnace Shell and Duct Work, Burner - �® BUILDING USED AS�- Also Replacement Furnace $ 30.00 (Side Vent - Fill Out Back) $ / ESTIMATED COST 1�7UO PERMIT NO. Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of Heating Units_ Circle One (Steam) (Hot Water) arm Gas Dryer $ 10.00 $ Trade Name CAA(✓4^% Size No. BTU :2OfWO HP ]% EDR *Air Conditioning - All Sizes $ 25.00 $ Fuel AIA+ -1,41 Total Connected Load IC22 06o All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR 91Qo CommerciaDl�us�� Com' � trial �� 1.25% of Value of Appliance or Work $ 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 an State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and '._� representations stated in this application are true and correct. TOTAL FEE $ cI A 11 ( DATE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. HEATING CO Signed TEL # 765 -?$U -v2 L -X 4K Approved By Rough -in Date Final Date 9-9-o / BACK SIDE MUST BE FILLED IN ON VENT SIZE, VENT CONNECTORS AND COMBUSTION AIR VERIFICATION COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes (� No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes /, No The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes No ( ) The existina combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes No ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturers specifications. Yes e No( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes V) No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes ki) No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input )0 'o Fan Assisted Nat Appliance #2 Type G 4kj— BTU Input nAssisted o at Appliance #3 Type BTU Input Fan Assisted or at Total Appliances Z Total Btu Input 7501Go Common Vent Type LX_ d-- Vent Height /!!57 Diameter � inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING Signed By: / .. Date : -A Building BUILDING PerinitNo.: _® Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: p �ry - DATE YOUR E-MAIL. ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: �,� A.; TENANT ADDRESS:r� L`� AaOCITY JTo d le -j STATEMAZIP PHONE: Yi (,3 - -1;3Q, 0 CONTRACTOR NAME:��'4 &'r � � EO C 5 -t =L P'3C- SUBMIT A COPY OF STATE LICENSE # 13 & - �b 3 y 3 S / EXP DATE YOUR STATE LICENSE ADDRESS: d I y k r S1 CITY b STATE` ZIP 5 WITH APPLICATION PHONE ° _ '-KU.-e A PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIM1vIING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR MODELING DESCRIBE WORK BEING DONE: 3- fe S S �'3--;"A0 SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2• 3. Proposed floor plan List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations 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 TJIE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee Plan Review Surcharge Fire Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due U See Back Page for Fee Schedule 65% of Building Permit Fee (.0005) times the total job valuation - Minimum $.50 .001 x Permit Valuation (1/10%) $5.00 (State Licensed Residential Contractors) $1450 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks vavable to: Citv 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 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 ich re es review and approval of plans. SIGNATURE OF APPLICANT 4 PRINT NAME k°f a� � � DATE /0-) 1 �'� BWIding BUILDING PermitNo.: ;,)66 (4 �og2� Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: DATE _ ' A> '� YOUR E-MAIL ADDRESS SITE ADDRESS :aaQ WQa_C 1 &12- 10r THIS APPLICANT IS: ❑ OWNER 260NTRACTOR PROPERTY OWNER/ NAME: ^ &Ytn P -f -r k - See Back Page for Fee Schedule ADDRESS: 1q". -,W7 7 " T `? 12 r S4 NZ CITY !'t�^ti ° STATLI�LIP SS 3D l/ TENANT Fire Surcharge PHONE: %3 - 3a 3 - q 3fonn0 .001 times the total job valuation CONTRACTOR NAME: .0005 x Permit Valuation Minimum $.50 STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS CITY STATE—ZIP WITH APPLICATION PHONE � la- - 411 - 0 V3 N FAX GLE FAMILY/NEW CONSTRUCTION SIZE PROPERTY TYPE $ ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS $ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE $ %/ , (Sd ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCEIREPAIR ErREMODELING DESCRIBE WORK BEING DONE: &Iroonn5 Aow v, 54,, t rS 0LVJ _f�,r 0w+- Fob Nu A-u.re -f�`,n � I y i? SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT° Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 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: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 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 LABOx Alvis Iv1A1<r.K U A L3: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ =�_5W 679 OCCUPANCY TYPE Vi* Permit Fee $f `/. z See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ L% .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 Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ %/ , (Sd 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 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 c re • 'ew and approval of plans. SIGNATURE OF APPLICANT �` �C� PRINT NAME (�1%D DATE Building Inspections 7.63-572-3604 DATE SITE AD—DBEs, S C THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY x/10% OWNER E-MAIL ADDRESS OCONTRACTOR PHONE: COMPANY NAME:_ CONTACT PERSON: CENSE # STATE LI DATE — ADDRESS: CITY STATE ZIP Permit No.: Received By: Date Recd: `J PHONE P%INGLE FAMILY ❑ TWO FAMILY O NEW O REPLACEMENT DETAILED DESCRIPTION OF WORK FAX 0 TOWNHOUSE rMRATION/REMODEL y3, 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) MODEL: SIZEBTU Equipment Installed MFG: SIZEBTU MFG: MODEL: SIZE/BTU MODEL: 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 v DUCT WORK $10.00 GAS PIPING $10.00 _VENTILATOR $1500 RnWERMIZ s e51± I Permlt Fee .00 Number of fixtures @ $10.00 x $10.00 = $ $ ._�. Surcharge $ 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 = $ 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;�ork which requ�es re iewjnd approval of plans.12 A ' L 41 A SIGNATURE OF APPLICANT City of Fridley Building Inspections Department . 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 P DATE REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMESIADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC 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 TGC 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 Building BUILDING Permit No. "Oug 5 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DAEMAUG Ir200 763-502-4977 FAX EFFECTIVE 8-19-09 DATE D gJg� �n,,�r�f /� �A E-MAIL ADDRESS Jt 144L6140 �C4M V47 YOUR SITE ADDRESS tsw 10 M0,091— I KE 7)C THIS APPLICANT IS: 'OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: /1kol .STLVERO-b 57' eVAI crry ay RwiPamc STATE G,IAI ZIP, PHONE:- CONTRACTOR NAME: L SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE WSINGLE FAMILY/NEW CONSTRUCTION SIZE 9(p ❑ TWO FAMILY/NEW CONSTRUCTION STORIES_ PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING OTHER �,,1 19 / n ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION AINTENANCE�/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: Rr-Aarlz BnsfimW% &$ SIZE OF IMPROVEMENT LENGTH /O WIDTH /O HEIGHT S FT 100 ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 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: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS_ & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS Abb TEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: SING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $. OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ o Com.' �_ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ IS -t Make checks payable to: City of Fridley Attach Stiuulations 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 on site; that the work will be in accordance with the approved plan in the case of all work which qui` s review` and a roval of plans. Dc nirlle tfa�l/bcz<c K SIGNATURE OF APPLICANT NAME14$ E N/ L. /YAL�f n '?,A18/09 8 a I DP c1'eate and share your own +diagram s at 91iffy. Com 1 3' long ti smeep elbow 42AK 0. 2"vH-' T' vert.vent up thru ro of snower AW 312 wq e ko sink V 3/2 wye exist. 3' sewer line 0144, .I;.o r.v e nt c o nn. Dot, water supply waste Exist. vent up 1 st trap floor bath, then thru roof 4D vert. vent amain stack 1 c reate and s hare y ou r own di aq ram s at 9 1 iffy. c o m I —'�Vgfiffy Building MECHANICAL Permit No.: �l Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 D AUG 2 200 CITY OF FRIDLEY 763-502-4977 FAX EFFECTIVE 2-19-09 :'1` % DATE ®r YOUR E-MAIL ADDRESS SIADDRESS 4 MO W 1l A®ff 4X RR :roc , �, ISL /�P TE THIS APPLICANT IS: PrOWNER ❑CONTRACTOR PROPERTY NAME: ) A) ft E dAG' + SaS�P1 � ADDRESS: Iib t o b G7 /V W CITY dovvDSSTATE i N ZIP ,y.? OWNER/ TENANT ®SzWtR PHONE: CONTRACTOR COMPANY NAME: Sai CONTACT PERSON: SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: CITY STATE ZIP APPLICATION PHONE FAX PERMIT TYPE 'J SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW ❑ REPLACEMENT AALTERATION/REMODEL DETAILED DESCRIPTION OF WORK ADD M -f# RO014 6X #AK57 "4 _Z0 8&&441VT MZY FEES ARE -BASED ON $10.00 PER FIXTURE; EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF°EACHBI W) PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE -HANDBOOK Equipment Installed MFG: MODEL: SIZEIBTU MFG: MODEL: SIZEBTU MFG: MODEL: SIZE/BTU A/C $25.00 (GAS) $15.00 _GAS RANGE/OVEN $10.00 _FIREPLACE AIR TO AIR EXCHANGEER $15 (WOOD) $35.00 _NEW GAS GRILL $10:00 _FIREPLACE $35.00 $35.00 _GAS UNIT HTR $14:00': _BOILER _FURNACE LINER $10.00 DRYER $10.00 POOL HEATER $35.00 _CHIMNEY _GAS DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 veu :. 33111 �' I All a• �?'�� -- d �`�i F $5� f Z • � 3t� 3 y �� ;GE 4�TTY i J��_ Ym r e THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which re ui es review and approval of plans. O i e.Af- t allm0% SIGNATURE OF APPLICANT/1%, 'PRIN5oT NAME,s�:�9t L A2-8DATE A,? APPROVAL INSPECTORS SI ATURE DATE 37 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential. Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments MN Rule 1346 Sec. 501 _ 3. Venting .-a , , Gas appliances IFGC Chapter 5 -with MN Arft-g dents b Fuel other, than gas IMC Chapter 8 with MN Amendments 4. Heat loss & cooling load per room a. MN Rule 1322, Sec. N1104.4.13 5. Ventilation a. Per MN Rule Chapter 1322. Sec. 1104 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations. Building PLUMBING Permit NoAC �JAF Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DateU�: AU G YfF201 763-502-4977 FAX EFFECTIVE 2-19-09 _T4�' o P� ��OZP 941 v 10Q DATE YOUR E-MAIL ADDRESS SITE ADDRESS 6$O® W Iy W kt 4 K "Dk 70370r#-, ' THIS APPLICANT IS: XOWNER OCONTRACTOR PROPERTY NAME: � L &VR �> , 4 16961P9 m41.eA 4 OWNER/ ADDRESS: J//,001 sm–wQm ST NkJ CITY 000A/ A4PzZ),5 STATE/WZIP ,? TENANT PHONE: -7/0;?. 9 /3 - sw?e CONTRACTOR NAME: S'CL/c SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY O TOWNHOUSE TYPE OF WORK: 11 NEW REPLACEMENT DETAILED DESCRIPTION OF WORK RC PLUMS 6hStA4&)7' A7 -1j 7-40 A4494f xr 44446V FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35 50. ✓BATH SINK/LAV _FLOOR DRAINS SHOWER WATER PIPING _ —BATHTUB _ GAS PIPING (NEED CITY LIC) SWIMMING POOL SOFTNER($ —WATER _ CLOTHES WASHER _ KITCHEN SINK V WATER CLOSET _ BACKFLOW PREV. $ I ) —DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER W "' ME 3 ! � � £ c '�4 &;,, i>.:- ¢ '£ �' �- � � �� 5 ..'. . v� i... -b .n .e i .,,^u ,✓a ,s..�a>� 9:d e�y�C.a�G ,»s,:e < ;➢2h 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 case of all work whi requires review and approval of plans.Dan:c�te }kalb+ SIGNATURE OF APPLICANT VA 1.6,499 DATE ®i �Xo ..a 1 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977