Loading...
PRE 2010 DOCSVillage of Fridley, Minn. BUILDING PERMIT OMce of INSPECTOR OF BUILDINGS Rw n owner,F¢:Y p y* Architect Fridley, Minn., Builder LOCATION OF BUILDING �: ✓, No. street', " " Part of Lot Lot '�$lock Addition or sub -Division -'DESCRIPTION OF BUILDING wont Depth_ Height StoriesLL-,- - Manner of Construction_ - Y k' To be used as !� "Y °'" To completed r- Estimated Cost it I� Permit is here granted to -* by grad the building "':` ' described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, Minn., regarding the 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. ro` x inspector of Buildings. AGREEME_N7' AND SWORN STATEMENT - In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of the above permit, i hereby agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Fridley, and, being first duly sworn, I hereby state and say that the facts stated by me and contained in the above permit are true as therein stated. l Subscribed and sworn to before me at Fridley, Minnesota, this s day of 2 A.D. 19 s . , • : ,. r ,. - I SUBJEci PE City of Fridley 2 151 AT THE TOP OF THE TWINS B U I L D I N G PERMITC r COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 1 � NUMBER REV DATE PAGE OF APPROVED By = CITY HALL FRIDLEY 85432 612-571-3450 910415 10 8 98 JOB ADDRESS 6076 Woody Lane 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Moore Lake Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE K 111f-*ingxxxfi xExgi xkxSmdixX ix i-a"XXilumfifliuX 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Halek Roofing 6258 Eagle Lk Dr Maple Grove 55369 535-8835 5010 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION O ALTERATION SEc REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof house and garage (25 Sq) Tear -off 9 CHANGEOFUSEFROM 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 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $2142 $1.07 DOES PRESUME O GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE' SACCHARGE PRO SION OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- ST UCTIO OR THE ERFORR AANCE OF CONSTRUCTION $74.75 Firvy 5C $2.14 PLAN CHECK FEE TOT FEE Licen C 5. 0 .96 SIGN TU E F CONTRACTOROR AUTHORIZED AGENT IOATEI N P OP A ID THIS IS YOUR PE MIT / SIGNATURE OF OWNEROF OWNER BWLDERI IDATEi So BLD IN - Ile OAtE r NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION glo vq ConstructionAddress: Legal Description: Owner Name Contractor: Address: Address - Tel. # MN LICENSE # �O t G Tel.# X35- �&�35 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: $ $.50/$1,000 Valuation SAC Charge $ o� License Surcharge $ $5.00 (State Licensed Residential Contractors) Construction Type: e-4 it $ Estimated Cost: $ Alt. "A" or Alt. "B" Above Erosion Control $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: L,— Tel. # STIPULATIONS: CITY USE ONLY Permit Fee $ �j, ` - / 7 %� Fee Schedule on Reverse Side Fire Surcharge $ a2 I'V .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ J Not Necessary [ ] TOTAL $ STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. / �� Effective On Jan 1, 2000 6431 University Ave NE e e s �o Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTINf PERMIT 572-3604 MARK NUMBER OF FIXTURtS TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. 0 RATE TOTAL JOB ADDRESS A -s 6�j New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that ail the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 DONNA/SCOTT, 20� Sum /Receivin Tank $7.00 6076 WOODY LANE NORTHEAST Water Treating Appliance $10.00 Owner_ FRIDLEY, MN 55432 Water Heater -Electric $ 7.00 -7. c (612) 574-2499 Water Heater - Gas"" $10.00 Building Used As re i c e-�— Gas Range** Gas Dryer** $10.00 $10.00 > �7 Estimated Cost � PERMIT NO. Back Flow Preventer Required ( )Yes () No �jb ° `1� Type $15.00 PLUMBING C P NY � �► Reinspection Fee $47.00/Hr SIGNED BY TEL N0. 92-7-14633 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Cj'0z �.J Approved ByRough-In Date Final Date State Surcharge $ .50 TOTAL FEE $ .so MINIM M F4EEOR ANY PLUMBINGLGAS PERMIT IS $20.00 PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE 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 existing 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 manufacturer's specifications. Yes () 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 () 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( ) No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height 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 CO: Signed By: Date: s Ia ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: ' (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $1.9 a. o r, . o 6 OCCUPANCY TYPE Permit Fee $ / J �Z BUILDING Permit No.: 30ding Inspections Surcharge RESIDENTIAL APPLICATION Received By 763-572-3604 $ , ' CITY OF FRIDLEY Date Rec'd: )ATE YOUR E-MAIL ADDRESS SAC Charge .ITE ADDRESS $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control 'HIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR Park Fee PROPERTY OWNER/ NAME; Sewer Main Charge ADDRESS: % C SATE ZIP�p� TENANT $ PHONE: CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE FAX SINGLE FAMILY/NEW CONSTRUCTION SIZE PROPERTY TYPE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDMON ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING E3OTHE ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION or ❑ MAINTENANCEMEPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. kOOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 3ARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan ?ROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used 'ROPOSED HEIGHT: 3IDING FOR NEW CONSTRUCTION INCLUDING DECKS, :1 Vinyl ❑Soffit ADDITIONS & PORCHES SUBMIT: Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures :3 Other ❑ Fascia and proposed project 2. Two sets of construction plans WrgDOWS 3. Energy Calculations N 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 $1.9 a. o r, . o 6 OCCUPANCY TYPE Permit Fee $ / J �Z See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $ e (.0005) times the total job valuation — Minimum $.50 Fire Surcharge $ , ' .001 x Permit Valuation (1/10%) License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1450 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 $ Make checks payable to: City of Fridle 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 which requires revie v and approval of plans. SIGNATURE OF APPLICA /-2')—h4e6 1. PRINT NAME DATE v5S f - G C GNU/ R. C v5S f Engineering WATER AND SEWER Permit No.: ffim 763-572-3551 PERMIT APPLICATION Received BA. 763-571-1287 fax DaRWAPR 2 4,2009 CITY OF FRIDLEY EFFECTIVE 4/8/09 APPLICTATION DATE: � YOUR E-MAIL ADDRESS: THIS •APPLICANT IS: ❑ OWNER CONTRACTOR _ JOB ADDRESS: 07Q ® /L1 L— NEW CONSTRUCTION PERMIT# (IF APPLICABLE): PROPERTY NAME:_ 3;tm t at 01,-1 OltQ�®�1 / STATE a°� IPADDRESS: F OWNER/ TENANT PHONE: C¢ 4 - 715 - I (99 CONTRACTOR NAS; ®+� — ®� SUBMIT A COPY OF ADDRESS: I 5 3 � c�`% f CITY Y� ® ^ STAT�ZIP -� 5��� YOUR STATE LICENSE WITH PHONE 703- ,, - 3jio'% CELL PHONE: APPLICATION STATE LIC # on 7f STATE BOND: XP DATE: 1. Narrativ written deseri tion: ( ! / �. f g Ci f%%l^ tJ e pie'% 2. Please attach sketch showing curb line, utility line, building, etc. with distances. PERMIT TYPE ❑ SEWER CONNECTION PERMIT $50 ❑ WATER CONNECTION PERMIT $50 ❑ WATER LINE REPAIR $40 SEWER LINE REPAIR $40 t o ❑ ADD STATE SURCHARGE $.50 = ❑ SAC CHARGE @ $2000--q01'5U OTHER CHARGES (IF APPLICABLE) PAY TO UTILITY BILLING NEW WATER METER COST — SEE UTILITY BILLING SPECIAL ASSESSMENTS — SEE FINANCE WATER TAP — SEE ENGINEERING NOTE: WATER METER REPAIR, INSP OR SHUT-OFF / WEEKENDS & HOLIDAYS $125/HOUR-BILLED THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a water or sewer (new connection or repair) 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. I understand this is not a permit but only an application for a permit work is not to start without a permit. G/ G� SIGNATURE OF APPLICANT � ��_.• PRINT NAME: ' "' V'° �J DATE: rl ' OJ APPROVED BY: DATE: COPY GIVEN TO: ❑ UTILITY BILLING (only if new meter) ❑ PUBLIC WORKS ❑ ENGINEERING City of Fridley Engineering Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3551 FAX: 763-571-1287 C� `4 Building MECHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 Da - d CITY OF FRIDLEY , 763-502-4977 FAX EFFECTIVE 2-19-09 DATE YOUR ADDRESS pE-MAIL SITE ADDRESS I v THIS APPLICANT IS: O ❑CONTRACTOR PROPERTY NAME:' OWNER/ ADDRESS: TS` CITY +� STATELIP� TENANT PHONE: .— CONTRACTOR COMPANY NAME: CONTACT PERSON: SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: CITY STATE ZIP APPLICATION PHONE FAX PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK' ❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK ff 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 VENTILATOR $15.00 a� '6 4 � ii v4RA._- \.- £ 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 /Wb PRINT NAME C' - 5/1C..0h DATE a, i, f 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/ADDITIONSEXISTING 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 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. Engineering WATER AND SEWER Permit No.: 763-572-3551PERMIT APPLICATION Received By: 763=571-1287 fax CITY OF FRIDLEY DEM �P 0 EFFECTIVE 6/9/09 APPLICTATION DATE: 'L �% YOUR E-MAIL ADDRESS: THIS APPLICANT IS: El OWNER 'CONTRACTOR / JOB ADDRESS: 0,-7 b L--� o ^J'e 6 NEW CONSTRUCTION PERMIT# (IF APPLICABLE): PROPERTY NAME: A tal �, \ t OWNER/ ADDRESS: uz:'-1 6 4 64^a CITY STATE IP �� TENANT PHONE: .111&11 -* o q � CONTRACTOR NAME: S --in 4N< a_j SUBMITA COPY OF YOUR DRESS:'I..4 CO3L `F vn�ea ��' dVT- CITY � � �' j STATE`'-^ ZIPS STATE LICENSE WITH PHONE ( 012 - 17 t I 37 77 CELLPHONE: &, -L P APPLICATION STATE LIC # STATE BOND: EXP DATE: 1. Narra�tive/w ritten description �� n 2. Please attach sketch showing curb line, utility line, building, etc. with distances. PERMIT TYPE ` ❑ SEWER CONNECTION PERMIT $50 ❑ WATER CONNECTION PERMIT $50 WATER LINE REPAIR $40 SEWER LINE REPAIR S40 �g , ❑ ADD STATE SURCHARGE $.50 ❑ SAC CHARGE @ $2000 = 41,) OTHER CHARGES (IF APPLICABLE) PAY TO UTILITY BILLING NEW WATER METER COST — SEE UTILITY BILLING SPECIAL ASSESSMENTS — SEE FINANCE WATER TAP — SEE ENGINEERING NOTE: WATER METER REPAIR, INSP OR SHUT-OFF / WEEKENDS & HOLIDAYS $125/HOUR-BILLED THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a water or sewer (new connection or repair) permit and I acknowledge that the information above is complete and accurate; that the work will be in conformInpe with the ordinances and codes of the City of Fridley. I understand this is not a permit but only an application for a permit of to start without a permit. �r SIGNATURE OF APPLICANT PRINT NAME: DATE: APPROVED BY: DATE: ®9 COPY G TO: ❑ ILITY BILLING (only if new meter) ❑ PUBLIC WORKS ❑ ENGINEERING ro ,�,j:5T �"'.4-r10 ' City of Fridley /�� �� ��.- Engineering Department �W Pi 69t6e 6431 University Avenue NE, Fridley, MN 55432 763-572-3551 FAX: 763-571-1287 T4 Building ]PLUMBING Permit No.. Received By Inspections RESIDENTIAL APPLICATION 763-572-3604CITY OF FRIDLEY Da S E P DATE & — YOUR MAIL ADDRESS SrrE ADDRESS ° THIS APPLICANT IS: ❑ OWNEW CONTRACTOR PROPERTY NAME:„a a STAT TENANONVNET ADDRESS:. CITY PHONE: CONTRACTOR Nom: SUBMIT A COPY OF STATE LICENSE # 6F�'�.38&134g_—EXP DATE YOUR STATE ADDRESS: 3670 Dodd Rd. IQCL_cny STATE 21P LICENSE WWII PHONE n, MN 5512isA*339 APPLICATION PERNHT TYPE IfSINWIEFAMILY O TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW gREPLACEMENT DETAILED DESCRIPTION OF WORK PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost np to $500.00, whichever is greater, for th 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: (INDIC TE TOTAL NUMBER OF EACH BELOW) _ BATH SINK/LAV ” FLOOR DRAINS _ SHOWER _WATER PIPING SO ($35) _ BATHTUB _ GAS PIPING 000 nTLKZW) _. SWr4M[ING POOL —WATER c CLOTHES WASHER KTTCIN SINK WATER CLOSET _ BACKFLOW . ($15) _ _ 11 DISHWASHER LAUNDRY TRAY TWATER HEATER ($35) FOR EUUGATIO _ — _ WATER METER —OTHER PERMIT FEE PROJECTS FOR UND $500 PERMIT FEE FOR PRC?JECTS OVEEL $500. Permit Fee $ Number of fixtures @ $10.00 x $10.00 = Surcharge .50 Number of fixtures @ $15.00 x $15.00 = TOTAL DUE $ Number of fixtures @ $35.00 x $35.00 = State Surcharge = .50 To.= 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 wox c. will be in is conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I underiland this the 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 accordm tce with approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT 5 PRINT NAME S .Q DAT�E'- PLEASE NOTE: SEP RFIJIR® FOR BUII DING ELECTRICAL AND MECHANICAL ORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 V A v. 17« CAI) An77 WA Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received Y. 763-572-3604 Date O: N ®U I 20 CITY OF FRIDLEY 2 ® 9 C DATE N®:J YOUR E-MAIL ADDRESS t.-S50,rdd @'J e00l.r p C • -0y", SITE ADDRESS 7- t® W®kXiW d .CJ\^_q, THIS APPLICANT IS: ❑ OWNER "CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: CITY STATE ZIP ® PHONE: t o m NAME: Renewal By Andersen CONTRACTOR SUBMIT A COPY OF STATE LICENSE # 1920 County Road "C" West YOUR STATE LICENSE ADDRESS: Roseville, MN 55113 t —STATE—ZIP- STATEZIPWITH WITHAPPLICATION PHONE ❑ SINGLE FAMILY/NEi License #20130983 PROPERTY TYPE ❑ TWO FAMILY/NEW C 651-264-4777 ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS PERMIT TYPE ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE to I & v CI.��� ul1,-n ,.QQ� fX C% CP=A ;nR' 2 %SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES 13 HOUSE &GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan Proposed floor plan PROPOSED SIZE: 132. 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 I. Site Plan/Survey showing the existing structure ❑ 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 THE997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION S U 1 1®4 c?-' 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 payable to: City of Fridley Attac THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED )9 I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will ben 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 approve( plan in the case of all work wh' h requires r iew and approval of plans. p SIGNATURE OF APPLICANT-P�i/lf� (/� PRINT NAME1Q�(CA�1I�S� Ifs`, DATE bIUU V o9 Building Permit Fee BUILDING � See Back Page for Fee Schedule Permit No.: Inspections j } 1 ag; l 65% of Building Permit Fee RESIDENTIAL APPLICATION Received By: ' 763-572-3604 Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) CITY OF FRIDLEY Dat 763-502-4977 FAX Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ EFFECTIVE 1-1-2010 Park Fee $ DATE ^ L/ �G YOURE-MAIL ADDRESS ©4z CJ Lza h oo AC®Gvy SITE ADDRESS . 7 6 We, r' d+ < 1-17, / /V E' eT THIS APPLICANT IS: '<O R ❑CONTRACTOR s,/; Make checks savable to: Citv of Fridlev Attach Stipulations PROPERTY OWNER/ NAME: �7(h ADDRESS:, rlad n - CITY ^�^ •' cr STATE_riZIP TENANT PHONE: /2/ CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE '®SINGLE FAMILY/NEW dONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ DITION ❑ GARAGE/SHED ❑ WINDOWS BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER. ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCEMEPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: F+h>5A n gSemeN4- gym;/ 6 -Goof — redo Oki /Oc'th SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING °'HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES 13 HOUSE & GARAGE .�� Existing Floor Plan GARAGES Cl ATTACHED GARAGE , �l L 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 ALL FEES ARE BASED/ ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ f 1% f6 (UV CP TYPE Permit Fee $ � See Back Page for Fee Schedule Plan Review $ j } 1 ag; 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 $ $2100 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 $ s,/; Make checks savable 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 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�vork which requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME ('I a k t' :%n6; h DATE �I l FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 BUILDING PERMIT APPLICANT: PROPERTY OWNER understand that the State of Minnesota requires that all rdsidential building contractors, remodelers and roofers obtain a state license unless they qualify for a specific exemption from the licensing requirements. As the owner of the property at �� /'�� �, ,�, _ /V � , Fridley, I am exempt from the state licensing requirem t only if I am not building or improving this property for purposes of resale. By signing this document, I attest to the fact that I am improving this house for my own use and do not intend to sell it. I hereby claim to be exempt from the state licensing requirements because I am not in the business of building or remodeling on speculation or for resale and that the house for which I am applying for this permit, isl the first residential structure I have built or improved in the past 24 months. I also acknowledge that because I do not have a state license I forfeit any mechanic's lien rights to which I may otherwise have been entitled under Minn. Stat. 514.01. Furthermore, I acknowledge that I may be hiring independent contractors to perform certain aspects of the construction or improvement of this house and I understand that some of these contractors may be required to be licensed by the State of Minnesota. I understand that unlicensed residential contracting, remodeling, and/or roofing activity is a misdemeanor under Minnesota law, and that I would forfeit my rights to reimbursement from the Contractor's Recovery Fund in the event that any contractors I hire are unlicensed. I have also been informed and acknowledge that by listing myself as the contractor for this project, I alone will be responsible to the City of Fridley for compliance with all applicable building codes and city ordinances in connection with the work being performed on this property. Name —7�� Date � - �- /0 t n'' V7 CJ -0 i w V. I v�- of J q4 19 a4 p At Building PLUMBING Permit No.l Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY e 763-502-4977 FAX EFFECTIVE 1-1-2010 DATE — 0 YOUR E-MAIL ADDRESS SITE ADDRESS G o y�, $�� 3 2 THIS APPLICANT IS: ❑ OWNEk^ ❑CONTRACTOR PROPERTY NAME: n ADDRESS: U 7 G CITY Y e STATE.,,—ZIP OWNER/ TENANT PHONE: CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PERMIT TYPE _k4lNGLE FAMILY . O TWO FAMILY ❑ TOWNHOUSE O NEW EPLACEMENT TYPE OF WORK: DETAILED DESCRIPTION OF WORK bne_, Jy re -,p o id FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. I BATH SINK/LAV DRAINS /SHOWER _ WATER PIPING _LFLOOR I BATHTUB GAS PIPING (NEED CITY LIC) _ SWIMMING POOL _ WATER SOFTNER ($35) _ WASHER SINK WATER CLOSET _ BACKFLOW PREV. ($15) _CLOTHES —KITCHEN DISHWASHER LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION _ WATER METER —OTHER .� 2 ice` �, if � i •;. S,�A Faiitl 3 Y �, � £ 2 3^ � -.. .� yr , -` hal, � � C�,�` %Y ..£',g�* N }- T h, � p3� R` _1 �,�� � �� f �' } a` �'�' � 3.. �E��vX' SF.�����L ���� $ •��� 5 '^°, ..h; 1 P ; f : SIV �%'� & Z h'a �. Y` R q� G }f -. •�+GRLSMr�l�I�.. AA Y t r R3 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 c e of all work which requires review and approval of plans. -- -y,10 SIGNATURE OF APPLICANT to 4� PRINT NAME G?vr DATE r; 11 u zr. City of Fridley V 7 Building Inspections Department \/ 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL Permit No.: a Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 DREMAD CITY OF FRIDLEY 763-502-4977 FAX EFFECTIVE 1-1-2010 DATE - �� YOUR E-MAIL ADDRESS 6, I-iff I h 4,e4 SITE ADDRESS O% 4-v O O h N e, - P% THIS APPLICANT IS: kawNEKrI OCONTRACTOR PROPERTY NAME: 4 P e- 5o a vi n _ ADDRESS: foG �� G%�UcI �j G ✓� N CITY ' °' ` �e STATE yn a ZIP 5 Sit 3 OWNER/ TENANT PHONE: %l0 3 " V 3 a - -/17 CONTRACTOR COMPANY NAME: CONTACT PERSON: SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: CITY STATE ZIP APPLICATION PHONE FAX GLE FAMILY O TWO FAMILY O TOWNHOUSE PERMIT TYPE O NEW iEPLACEMENTALTERATION/REMODEL TYPE OF WORK: DETAILED DESCRIPTION OF WORK �� n d- �+ ✓ �,y e a fs FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK. Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEIBTU MFG: MODEL: SIZEIBTU A/C $25.00 (GAS) $15.00 _GAS RANGE/OVEN $10.00 _FIREPLACE TO AIR EXCHANGEER $15 (WOOD) $35.00 _NEW GAS GRILL $10.00 _AIR _FIREPLACE BOILER $35.00 $35.00 _GAS UNIT HTR $10.00 _FURNACE CHIMNEY LINER $1000 DRYER $1000 POOL HEATER $35.00 _GAS DUCT WORK $10.00 GAS P4PING $10 00 ENTILATOR $15.00 � - ,�. � �'�. � k"" '. s ra ; ���,t 2 x ,; � � < � �` � ��H �.kzE� n x'ro���„ ,-'k•�`"y,-k .. � h ��"`" ei4" •� d �? � �. � f ..i* i - � 3a� iL !' � � � 3 ,Eye. s $.�y� � �Ly �-. ..rc.� ¢ 14 3�S �c !.✓ � g Yg��C F f. .fi Y fl � � � S',S 4J2 Yy3 ? 11" an 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 w rk which requires review and approval of plans. SIGNATURE OF APPLICANT PRINTXAME He_ c4 h H DATE APPROVAL INSPECTORS SIGNA RE `O DATE MET mow.,, •a� . ._M al im- 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 0 NEW HOMES/ADDITIONS 0 EXISTING HOME 0 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 Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments 4. Heat loss & cooling load per room a. MN Rule 1322, Sec. N 1104.4.13 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. Z D®I. LIT 6� 7 uj 0. / 'y 7',2+-V D 40P -ru _70 WIC im M,' F, _I