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PRE 2010 DOCS0 0 Village of Fridley,, Brhm BUILDING PFALIM '7'© Office of WSPECTOR OF BUMMMS Lot F'ont-A-L—L'I - D To be used as Fridley, Minn., LOCATION OF BUILDING Street —Part of Lot, Block---A-� Addition or Sub -Division DESCRIPTION OF BUILDING Height— Stories Manner of Construction 2– To be completed Estimated Cost w Permit to hereby 11 granted for to. the building– described in the above statement. This permit to granted upon the express 1�ondition. that the he person to whom it is granted, and his agents, employees and workmen, in all the work done ' around and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridle ' repair and moving Of buildings Minn., regarding the construction, alteration, maintenance, p within the city limits, I is, and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. inspector of Buildings. AGREEMENT AND SWORN STATEMENT In consid ration of the issue and delivery to me by the Inspector of Buildings of Fridley of the above pe I , I hereby agree to do the proposed work in accordance with the description above set and according to the provisions of the ordinances of Fridley, and, being first duly f 0-'� sworn, I here y state and say that the facts stated by me and contained in the above permit are true as there'stated. t Subscled d sworn to before me at Fridley, Alinnesota,, this fZ- A.D. 19 Cr4 d of, F� suaIEcr PERM City of Fridley 16 0 3 9 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. 1 t: ------ INSPECTION SEC. r � � PROTECTIVE 1 i /--'1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ,.' 612-571-3450 910-F15 1/6/81 JOB ADDRESS 4880 - 2nd Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,2 4 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Susan Borries 4880 - 2nd Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Viking Home Improvement Co.' 4832 - 22 Street N.E. 560-3794 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 ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Remodel Kitchen - Install new cupboards. & Soffits 9 CHANGE OF USE FROM TO STIPULATIONS 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3,000 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- $18.00 STRUCT1014 OR THE PER ORMANCE OFC NSTRUCTIOW PLAN CHECK FEE TOTAL�EE 19.50 SIGNATUREIOF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT P l BLDG )NSP TE SIGNATUREOF OWNERIIF OWNER BUILDERI (DATE) F� CITY OF FRIDLEY APPLICATIO'.4 FOR RES1101TIAL BUMMING PEP4'1ITS- (New, Alterations, Additions, or Repairs) OWNER: 13dale"s BUILDER: , %�� ����—rte ��wp co ADDRESS: -A% ADDRESS: `AL3 TEL NO: L7--� TEL 140: ��'C9 - 3 7 Construction Location STREET NO: T STREET: � �✓� ,s J� a LOT: BLOCK: ADDITION: Corner Lot: u Inside Lot: Setback: Sideyards: Aplilicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION front: Square. Feet: Depth: Height: Cubic Feet: Front: Depth: Height: Square- Feet: Cubic Feet: _ Type of Construction Estimated Costs $ ewe $e lete _ Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVEF.SE SIDE OF SHEET Mie undersigned hereby makes application for a permit for the trork' 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 applica D,'NTE: SIGNATURE: Stipulations: :60 1.'S6 �q: �2' City of Fridley SUBJECT PER _. 2 6 6 AT THE TOP OF THE TWINS ? BUILDING P I T I RECEIPT NO. __o_e_, COMMUNITY DEVELOPMENT DIV. 16yr �j r 0 e PROTECTIVE INSPECTION SEC. 1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE Of APPROVED BY ,•� 612-571-3450 910415 12/3/90 JOB ADDRESS 4880 - 2nd Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,2 4 Plymouth. Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James Leonard 4880 - 2nd Street N.E. 571-8274 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D.M. Sather Co., Inc. 7920 Powell Rd, Hopkins, MN 55343 938--7989 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 XO ADDITION O ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK Construct a 121 x 161 Addition to Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS See notations; on plan. Provide smoke detectors• on both.levels of existing house, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $9+700 $4.85 WITH WHETHER SPECIFIED HEREIN OR NOT. THE I OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO V O TE' O CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCA W REGULATING CON- $117.00 Fire SC $9.70 STRUCTION OR THE PERFORMANCE OF CON CTIOIV. PLAN CHECK FEE TOTAL FEE $ .55 WHEWPROPERV AT D T I S YOUR PERMIT SIGNATURE OF -CONTRACTOR OR AUT o IZEDAGENT IDA I f DG INSP DATE SIGNATURE OF OWNER OF OWNER BUILDER) (DATE) 2a' i 16 ADpi�aJ �z No�SE 2�` 3 2' 0 i 76-o E%4 4eeD ZNo ST. N.t NEW [ ] CITY OF FRIDLEY Effective 1/1/go ADDN [ R-1 AND R-2 AL'PEF2 [ ] Building Permit Application Construction Addrees : 4 e;2'N® ':�;ae e -F Q Legal Description: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. IPTIC K OF MUMEMM zavnm AREA: Langth [ ' .' Width 1 � Height �� Sq. Ft. GARAM AREA: Length Width Height Sq. Ft. DEM AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 14 z �'®Zp% ?-9.- °Q S Corner Lot [vl' Inside Lot [ ] It. Yd Setback Side Yard Setbacks Type of Construction: LWD T -9,6 -ME Estimated Cost: $ Approx. C mpletion Date: ) S,Sk P q. i' � Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page DATE: `t' Q-9) APPLSCWr: LaA Tel. # Permit Fee $ 111.06 t rU guQ:t�g,< Drivewa $ Park F $ Maintharge, $ 115C t Pav ? STIPUTATIC�LS a (sC raj 'SM*.o- ®rwrirzo.6 CITY USE CNLY Fee Schedule on Reverse Side $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] ,,N %, l." C'4s Gr- 9X "'6 -&ZR -FOU S%! gxq Y EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER: T SITE ADDRESS: 4 5e ',2r-4 0 ST. K,L CONTRACTOR: DATE: - Z.- ® PHONE: DETERMINE WORKING SQUARE FOOTAGE OF EACH: 1. TOTAL EXPOSED WALL AREA ,.,,,..,� •11 � sq f " t x U 2. TOTAL ROOF/CEILING AREA...... , . ' q I,- sq f t x "U" • 026 3. TOTAL EXPOSED WALL AREA CALCULATIONS: Total exposed wall area above floor........ sq ft a) Total wall window area: glazed...... 4to,� sq ft x "U" glazed...... sq ft x "U" _ b) Total door area ......... sq ft x "U" _ c) Total sliding glass door area: h) Total foundation window area............ sq ft x "U" _ i) Total net foundation area above grade........ sq ft x "U" 3 • TOTAL a) t h ru I) If item #3 is the same as, or less than item #l, you have met the intent of S.B.C. Section 6001 (c) 2. glazed...... sq ft x "U" ' ' �Z•'�' glazed...... sq ft x "U" _ d) Total fireplace wall area sq ft x "U" _ e) Total wall framing area (Average l0%).......... rjCj, sq ft x "U" _ f) Total net wall area above ff floor (insulated)...... 4�ojo sq ft x "U" .0�:D g) Total rim joist area...... 40 sq ft x "U" Total foundation area (Exposed)......... sq ft h) Total foundation window area............ sq ft x "U" _ i) Total net foundation area above grade........ sq ft x "U" 3 • TOTAL a) t h ru I) If item #3 is the same as, or less than item #l, you have met the intent of S.B.C. Section 6001 (c) 2. 4. TOTAL EXPOSED ROOF/CEILING CALCULATIONS: Total exposed roof/ceiling area........ sq ft J) Total skylight area......., sq ft x "U" _ k) Total roof/ceiling framing area (Average 10%) ..... t 2- sq ft x "U" , 03(e = , L, 1) Total net insulated roof/ceiling area....... sq ft x IOU" '02-5 = 4• �jZ 4. TOTAL j) th ru 1) If total of #4 is the same as, or less than #2, you have met the intent of S.B.C. Section 6006 (c) 1. -ALTERNATE BUILDING ENVELOPE DESIGN To utilize the total envelope system method, the values established by the sum of Items #3 and #4 shall not be greater than the sum of items #1 and #2. 1. CoD.-72 + 2. 5,0 = (,or,72 3. 53 , 9-9 + 4. 5, 0 _ 5e). C E R T I F I C A T I O N I hereby certify that I have calculated the "U" factors and "R" values herein and that the building here described meets or exceeds the State of Minnesota Energy Conservation Act. S ature (Date) ONSTRUCTION RAMING SECTION: R VALUE 1 Interior air film 0.68 2 3 3' IZ inches soft wood 4 35 4 1,'T (L -I 1'f- 5 6 Exterior air film 0.17 TOTAL R ""'' `rCT1ON (INSULATED) Interior air film U = 1/R = ,Cn - 0.68 U = 1/11 = ,©59- ST SECTION: Interior air film n.68 Exterior air riim u.i/ TOTAL R = 7.7& ION SECTION: Interior air film 0.68 Exterior air film 0.17 TOTAL R = SLAB ON GRADE U= 1/R= 14 4 .. ' • g CL • , ej -�16 VENTED CONSTRUCTION R VALUE s . CEILING SECTION (INSULATED): 1' Interior air film O.F1 2 3 12" FCa.{NSUi,. 3� .4 Exterior air film (still) O.Al TOTAL R = 39.7 U = 1/R CEILING FRAMING SECTION: 1 Interior air film 0.61 2 Sig" Si6--''T12CX.L .SCS 3 F,Ca. NSUi, , 4 Interior air film still 0. 1 4 5 5'/y. inches soft wood (P.57 TOTAL R r U = 1/11 .O o CEILING SECTION (INSULATED): V Interior.air film 0.61 2. 3 -4 Exterior air film stili o.61 TOTAL R = U= 1/R= CEILING FRAMING SECTION: 1- Interior air film 0.61 3 4 Exterior air film still 0.6-1 5 inches soft wood TOTAL R = U= 1/R= 1 Inside air film n.F1 2 3 4 5 Outside air film x.17 TOTAL R = U= 1/R= CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, ivv:' 4 55432 572-3604 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATioN, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.00 $ ai0 $ 10.00 $ $10.00 $ $ 10.00 $ $ 25.00 $ A,. $ State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION FiEFRIGERA AON(A IP 7INDITIONING PERMIT IS $25.00 PLUS THE $,50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Effective On August 1, 1995 JOB ADDRES- ��-V, 4- The undersigned hereby makes application for a permit for the work herein specified agreeing to do ail' 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. _._.�;JEW/0- 3 ,1995 OWNER ���� s ��®�s.�� 5- 71 - %2 7,-/ BUILDING USED AS— ESTIMATED COST s-, PERMIT NO. A� r No. of Heating Units�r C rcle One (Steam) (Hot Water) arm it Trad6 NameF ,�v,�v vc r� Size No.&. BTU �o P. / - HP EDR Fuel�i/% Total Connected Load_ .;r3 L e_ o Burner Trade Name Size No. BTU HP EDR HOME ENERGY CENTER HEATING COMPANY 15200 25TH AVE. N. #129 . MR 55W Signeo By Tel No. Approved B Rough -In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes '(v) No ( ) 2. Is free from rust or deterioration 3. Has no foreign objects lodged within 4. Is securely supported S. Meets all current Code requirements for size and total BTU's connected 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: HEATING CO: Signed By: .Date: IS= HOME � VE. N. TER 0128 PLYMOUTH, MN 65447 Yes) No ( ) Yes No ( ) Yes No { ) Yes No ( ) Yes (b�) No ( ) Yes (-�,) No ( ) HEAT TRANSFER CALCULATIONS HEAT LOSS: + 750 INSIDE + 75 ° INSIDE o - 20 OUTSIDE HEAT GAIN: + 95" OUTSIDE SQ. FT. COEF. BTU's SQ. FT. COEF. BTU's 1. GLASS o - 90 7!, ® 1. GLASS 2. DOORS - 4000/ea. 9,00'9 3. CEILING 12" 9 6 9o® 3 4. WALLS 3" 11/2" /moo 5. BSMT Below grade ®® Walkout 6. Subtotal 7. TOTAL S. FURNACE SIZE 9. FURNACE MODEL 3 4 5 8 7 10 /o ®B 5 oto 0 0 10 N � 25 at— E/W /z�/ 75 q3 .5, S 40 ��®® 2. DOORS 300/ea.®y 3. CEILING 12" 9 6 3 4. WALLS 3" It/2" 5. PEOPLE 6. APPLIANCES 7. Subtotal �.3 ® 8. TOTAL 9. A/C SIZE e:;;'AJToO9®s�E�/e—> 10. A/C MODEL 1 2 A©0 3 a�Do 4 3 4 3 600 oz�® 2500 �^�{OXo 19Z SUBJECT City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT r CEI 1 Lu • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC 1 � � NUMBER REV DATEP AGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910 -FIS 519197 JOB ADDRESS 4880 2 Street NE I LEGALBLOCK LOT NO. TRACTOR ADDITION SEE ATTACHED DESCR. 112 4 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jim Leonard 4880 2nd Street NE 571-8274 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 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 CIX ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 16' x 10' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARHl 102 Before digging call for all utility -locations 454-0002 REQUIRED BY 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 1 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 $1,419 $.71 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- $48.50 FSC $1.42 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE YOTAL FEE $50.63 IGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI EN�181�VAL THIS ISYOURPERMIT r e. BLOO 1NSP �AD DATE 'SIGNATURE OF OWN F�ERIUIL.1111 1 ATEi NEW [ ] Effective I/I/97 ADDN [ ] CITY OF FRIDLEY ALTER ( ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Vto BUILDING PERMIT APPLICATION lJ" ConstructionAddress: -i T l/� , Legal Description: ,� L,7— P� Nom" Owner Name & Address: `moi „�anar�Jd VXS� ��� �s s+lv Tel. # �7/ — 8a �� Contractor: MN LICENSE # Address: Tel. # 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 o `' Hgt/Ground60 Sq. Ft. 1e-4' OTHER: Construction Type: tl-'e Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE:ga - e'j V-7 APPLICANT: Tel. # CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control 19 Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.501$1,000 Valuation $950 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 ( ] SUBJECTO. City ®f Fridley2� 02 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 1 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 10/16/97 JOB ADDRESS 4880 2 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1, 2 4 1 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James/Deena Leonard 4880 2 Street NE 571-8274 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 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 Q REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (11 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $917 $.50 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- $34.75 Fi SC $.92 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TO AL FEE $36.17 IGNATURE OF CONTRACTOR O UTHORIZ D AGENT IOATEI EN ROP�VVALI_DTyD THIS IS YOUR PERMIT '� � �Q���•�w 5 GNATURE OF OWNER SIF OWNER BUILDERI IDATEI BIAG INSP DATE NEW [ ] Effective 1/ 1/97 ADDN [ ) CITY OF FRIDLEY ALTER [ ] SINGLE FAI IILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION�?D h� ConstructionAddress:��? p%dc S T A/G Legal Description: Owner Name & Address: c Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Tel. # �"�/ - �� 7d MN LICENSE # Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground_ Sq. Ft. Estimated Cost: $ �� (Fee Schedule on Back) Driveway Curb Cut .Width Needed: Ft. + b Ft = Ft x $ = $ DATE: APPLICANT: Tel. # 7 CITY USE ONLY Permit Fee $ 3 41, 17s' Fee Schedule on Reverse Side Fire Surcharge .001 of Permit Valuation (1/10th%) State Surcharge $ S-0 $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge, $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or AIt. "B" Above rosion Control $ -$450.00 Conservation Plan Review ?ark Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ 5(o. �'rrt�Ur_n�rtoNs: suejEtT City of Fridley (- 3297 9 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. s1® r PROTECTIVE INSPECTION SEC 1 i NUMBER REV DATE PAGE OF APPROVED BY = � /'�'1 � CITY HALL FRIDLEY 35432 ti""""�� ��' 763-571-3450 910 -Ft 5 18/12/02 106 ADDRESS 4880 2 Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1,2 4 I Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James Leonard 4880 2 Street NE 763-571-8274 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO MN Rusco Inc 5558 Smetana Dr, Minnetonka, MN 55343 952-930-9669 2173 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential T CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 9 windows within existing openings 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. perm"t Inspection Cards Will Be Mailed T Homeowner To Post SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 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 $6,673 $3.34 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- $139.25 Fire SC $6.67 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FE License $5.00 $15 .26 S-GNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATE, HENP OPER V [DATED THI IS YOUR PERMIT 01 oogc3.13 BLDG NSP e gArt S,GNATURE OF OWNER,IF OWNER SUiLOERi iDATE� NEW [ ] 9®'AU- 1) ' '2002 Effective 1/1/2000 :tADDN [ ] CITY OF FRIDLEY 612-572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: JV0 9E &d2 Legal Description: 5F Owner Name & Address: ILMUs 4LvI04'® Tel. # 'Af3 5`7/` M 7 Contractor: e MN LICENSE # Address: �J� I I �r �%i� Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: 67 �� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIP 10N OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. csumaiea Vost: --P ly1( U /'j Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: ® APPLICANT: Tel. #�� CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (612) 572-3604 for Permit Fees if mailing in application $g!j?? Ar Fee Schedule on Reverse Side $ 4.4 % .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $ $1100 per SAC Unit $__2S 4O v $5.00 (State Licensed Residential Contractors) "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary j ] $ �& C CITY OF FRIDLEY PERMIT.: 2004-01393 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 08/23/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 4880 2 ST NE PIN : 263024320045 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : BUILDING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE WINDOW/DOOR REPL VALUATION $ 2,209.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS. REPLACE ONE PATIO DOOR WITHIN EXISTING OPENING. STATE LICENSED CONTRACTOR 1 APPLICANT BUILDING PERMIT FEE FIRE SURCHARGE 83.25 2.21 RENEWAL BY ANDERSEN (20130983) 1920 W CO RD C STATE SURCHARGE, VALUE 1.10 ROSEVILLE, MN 55113- LICENSE SURCHARGE 5.00 (763) 502-4777 TOTAL 91.56 PAID WITH CHECK # 36797 OWNER LEONARD JAMES M & DEENA K 4880 2ND ST NE FRIDLEY, MN 55421 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 any othpr state or local law regulating construction or the p orman a of construction. Applicant Date Bldg has D450,31.,4 SEPARATE PERMITS AQIAR16D FOR NvoRK OTHER THAN DESCRIBED ABOVE. 04/02/2004 FRI 13:21 FAX -4,44 ELDER JONES y� � 14001/001 NEW [ ] CIN OF FRIDLEY Effective 4/1/2004 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: 4 S Z ® - a I� S4 , r\--� , E . Legal Description: Owner Name & Address: Tel. P4 Contractor. MN LICENSE # 20 IW9S 3 Address: RENEWAL BY ANDERSEN Tel. # 1920 COUNTY ROAD "C" WEST ROSEVILLE, MN 55113 State of Survey of the ;i drawn on it to� stele: LMNG AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IMPROVEMENT Length Width Height sgo. Ff Length Width Height Sq. Ft, Length Width HgUGround Sq. Ft. Construction Type: Estimated Cost: $ a , ®9 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ =$ DATE: Uo ® APPLICANT: �1 �� °� � �� -� Tel. #c9S ~`SMS- Lo®q Call (763) 672-3604 for Permit Fees if mailing in application. Fax to 763-671-Vp7,., if using credit card and we will call you for card number. Crit USE ONLY - Permit Fee $ 3. a S Fee Schedule on Reverse Side Plan Review $ 2E24k 65% of Permit Fee Fire Surcharge $ .001 of Permit Valuation (111 Oth%) State Surcharge $ b. s C ' $.50/$1,000 Valuation SAC Charge $ $1350 per SAC Unit License Surcharge $ 0 ® $5.00 (State Licensed Residenfial Contractors) Curb Cut Escrow $ Alt. "A" or Aft. "B" Above Erosion Control $ $450.00 Conservation Plan Review Paris Fee $ Fee Determined by Engineering Sewer -Main Charge $ Agreement Necessary [ ] Not Necessary [ 3 Building ���BUILDING Permit No. Inspections IINDUSTRIAL Received By: It - 763 -572-3604 CITY OF FRIDLEY vatexec'd: DATE _ f ��j YOUR E - WL ADDRESS SITE ADDRESS � % �� .f w�; TENANT l eeW ,0 1— Suite No. PROPERTY OWNER NAME: -r ey ADDRESS:,CITY -STATE—ZIP .0005 x Permit Valuation Minimum $.50 SAC�ge L UMgj- PHONE: ARCHITECT NAME: ADDRESS: CITY STATE ZIP $ CONTRACTOR NAME: /,/ifs�& Park Fee ADDRESS: (r0e� CITY" TAT9(&� IP �y PHONE: FAX Special Assessments *NOTE: CITY LICENSE REQUIRED FOR MULTI FAMILY/COMMERCIAL/INDUSTRIAL JOBS PROPERTY TYPE ❑ TOWNHOUSE ❑ COMMERCIAL/INDUSTRIAL ❑ INSTITUTIONAL Curb Cut Escrow ❑ MULTI -FAMILY PERMIT TYPE /�;�OITION 11 NEW CONSTRUCTION ❑ OTHER Total Due ® 'Rj MODEL ❑ ROOF ❑ SWIMMING POOL PLEASE SUBMIT: 1.4 SETS OF DRAWINGS 5. CONTRACTORS LICENSE OR 6. SPECIAL INSPECTION 2. SURVEY/SITE PLAN LICENSE APPLICATION SCHEDULE 3. LANDSCAPE PLANS 7. PERFORMANCE BOND 4. ENERGY CALCS AMOUNT $ BUILDING TO BE USED AS: ►i OFFICE SF WHS SF OTHER SF TOTAL SIZE: STORIES FIRE PROTECTION (Y/1) AC(Y" DETAILED DESCRIPTION OF WORK U Q 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. without a permit; that the work will be in accordance with the approved plan in the case of all work whiph w a �proval of plans. .- SIGNATURE OF APPLICANT SPRINT (/ NAME ! DATE ( / (d777 ALL FEES ARE BASED ON VALUATION Sq. ft. x $ Cost/sq. ft. = Valuation $ Sq. ft. x $ Cost/sq. ft. = Valuation $_ Sq. ft. $ Cost/sq. ft. = Valuation $_ TOTAL JOB VALUATION: $ USE OCCUPANCY TYPE Permit Fee $ qjpl, o2,5 See Back Page for Fee Schedule Plan Review $ V ob , `1 ( 65% of Building Permit Fee Fire Surcharge $ `` 3 .001 times the total job valuation Surcharge $ L4 I al .0005 x Permit Valuation Minimum $.50 SAC�ge L UMgj- $ S, &rJ $1675 per SAC Unit (Plans to MWCC for determination) Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Special Assessments $ Agreement necessary( ) Non Necessary( ) Curb Cut Escrow $ ft + 6 ft = ft x $21= $ Total Due $ `OLO(' Make checks payable to: City of Fridley Attach Stipulations OWENS CORNING BASEMENT FINISHING SYSTEM From: City of Fridley To: 952440-1740 Page: 416 LAW. 4:4ZUU 1-M Buflftg CW, MECRAM-1-CAL PennitNo.'�-1 -&01,44 4-( Inspecdons RESEDENTUL APPLICAT 10N R. emved By. 763 -572-36M CM OF ISL EY Date Ree'd: 4-47 TOURE-MA-M ADDENS Z's DATE WEADDRESS 2j--,c� THIS APPLICANT M 0 OWNER �DMACTOR PROPERTY NAME bb OWNER/ ADDRESS: -4�0C ,—Zpn� Ale- • CITY Ita Cj ..-�—;TAT9ALh,0,t!5A3Z TINAM PHONE:17� 12� �-, - CONTRACTOR COWAWNAM A/--h/,L CONTACT PERSON: SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DXTE -7 =T6 Z STATE zlpq52 LICENSE WITH ADDRESS: 07 CITY , APPLICATION PHONE *S2 FAX J-74-0 PMMIT TYPE -O�MNGLII FA14ILY 0TWOFAMMY 0 TOWNHOUSE TYPE I OF WORD: 0REPLACEhIENT . DETAILED DESCRIMONOFWORK 11-2 W 9-- S& V PER MS 16B.665 the permit fee is a minimum of 915M or 5% Of this tort con up to $$MOO, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtum (This should reflect only the cost of labor) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost df labor X.05 FOR PROEM WHERE LABOREXCEEDS $500, FEES ARE BASED ON sio co PER mmm ExcEPT WHERE N6TED. Fm ruRks- (INDICATE TOTAL NUMBEROF EACH BELOW) Equipmet baffed we MODEL UFO., MODEL- SMEWU WG. T MODEL- SNESTU A/C $25.00 OE (GAS) 515.00 _%AS%TVM$10.60 —AIRTOADLEXCHAtMEERS15 :A=CE (WOOD) $35.00 — W 0 0.00 BOILE&S35.00 FURNACE $35.00 _GASUNIT: $10.00 —CHIMNEYLINER$10-00 —GASDRMSIO.00 POOHEATER DUCT WORK $1 0.00 PIPMOSIM $15,00 Number of fixtures 0, $10.00 x $10.00 - $ Permit Fee $ Urherge, $ Number of fiftras @ $15,00 x $15-00 - $ TOTAL DUE $ y,,S Number of firs @) $25.00 x $25.00 = $ Number of 'finawas 4b, $35.00 x. $35.00 = $ State Surcharge = $ 50 Total = $ THIS IS AN APPLICATIONFORA PmwT-x6,r vAuD UNTIL PRocEsm I hereby apply for a building permit and I acknowledge that the inkrzaton above is complete and accurate; that the work will be m owfmaenice with the ordmances and codes of the City of Fridley and with the Mmnevota Cmdructim Codes; that I understand this is not a permit but only an application for a permit and work is not to start 4fticut a permit; Out the work will be in accordance with the approved plan in the case o work which �rs eyw and approval 16f plan. PRINT NAMS, SIM&TUREOFAMICANT11!Z)H6. f tj G d yy ' DATEj - 2a 1 4 7- I =1 3W ma 8f *y Betiding Impectimn likep"firimt 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building BUILDING Permit No. -. Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: (0'1 763-502-4977 FAX EFFECTIVE 1-1-08 DATE 6 ® YOUR E-MAIL ADDRESS SITE ADDRESS 4ql � �d THIS APPLICANT IS: ❑ OWNER WONTRACTOR PROPERTY OWNER/ NAME: 13-444,00 ADDRESS: CITY STATE ZIP TENANT PHONE: 76 3 65-11 9.27Y ei7YNAME: NAME: ADDRESS:CITY STATE ZIP�.S CONTRACTOR SUBMIT A COPY OF PHONE Ifo 3 4i.;27 1626 FAX 763 YA 7 4oe� YOUR STATE LICENSE STATE LICENSE # "BOO I®��=� EXP DATE alw/a % PROPERTY TYPE XSINGLE FAMILYINEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION IQ-MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: - hov-SC —Se SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING❑ NUMBER OF SQUARES �_ HOUSE ONLY gHOUSE & 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: 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: (USING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ 3 11 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 $ 9 , .0005 x Permit Valuation Minimum $.50 $ �� $5.00 (State Licensed Residential Contractors) $ $1825 per SAC Unit (Plans to MWCC for determination) $ ft + 6 ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ Make checks Pavable 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 a permit and work is not to start without a permit on site; that the wo . be in accor a with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF AP) IC \ , _ PRINT NAME R7�-,'Ck o �ee� DATESZ, _V16— .7 D % Building g I BUILDING Permit Nod 6 Fire Surcharge $ Surcharge $ License Surcharge Inspections SAC Charge RESIDENTIAL APPLICATION Received By: 763-572-3604 Erosion Control CITY OF FRIDLEY Da 'd:IU 1—�tM 763-502-4%977 FAX Sewer Main Charge $ Total Due $ r5t i L? - 1 EFFECTIVE 1-1-08 DATE / �� l ®� YOUR E-MAIL ADDRESS SITE ADDRESS��� � -s- z '4 r THIS APPLICANT IS: ❑ OWNERONTRACTOR PROPERTY OWNER/ -ZC-- NAME: C'18,9t e'v'e �. e TENANT ADDRESS: 0 °" '9e .S7 CITY STATBMZIP S��S'J- / PHONE: 2 'g — 5 %1- tK) 7 V CONTRACTOR NAME: / ADDRESS: 9 se�- 2!h"6 w. -y CITY o', STATE"IP SUBMIT A COPY OF PHONE ,F 17 3 FAX �� -' ��✓ �� �' YOUR STATE LICENSE STATE LICENSE # d9S2 OC -3 EXP DATE Z r / z o PROPERTY TYPE iffNGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROS— ❑ DRAIN TILE ❑ DECK 2'9IDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ 6DDMON ❑ MAINTENANCE/REPAIR ZrREMODELING DESCRIBE WORK BEING DONE: �/ e S. ` / w, r7w"23 J f¢ t ` u 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: FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS & PORCHES SUBMIT: iffS Vinyl _ 1. Site Plan/Survey showing the existing structures ❑Aluminum[,a,,'T� 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: SING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ ®4:9® , e ® OCCUPANCY TYPE Permit Fee g I Plan Review $ Fire Surcharge $ Surcharge $ License Surcharge $ 0 SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ r5t i L? - 1 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) $1825 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 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 on site; that the work will be in accord with the approvedplan' the cage of all work which requires review and approval of plans. SIGNATURE OF APPLICANT % PRINT NAME Js�, �� ��-s�DATE APPROVED BY DATE