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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT No y� 4749 Date: _ y�-� _.._. _..__. Owner: .._. '. 14' Builder AddressIt? _..... , �.._. rs- Address _......_.._" *� _+.... _.............. ................. LO Nf BUILDING No .. •Street.. -----_----_ Part of Lot Lot , =: ...... _ .. - Block ........---• `................._...... Addition or Sub -Division ... ......... ... .:.:: ..'k k.._..... ' Corner Lot .....................--- ......... Inside Lot ........... .-'--._........ Setback ..- -- --.. ,.�;;� ._........ SewerElevation---......----••------•-----------....-----.._.._-•----•--_...................................... Foundation Elevation .................................. _......... _............. _.......... ..._......._.------ DESCRIPTION OF BUILDING To iUsed as: ..._ ;.. Front Depth ...i..--- Height _...... Sq. Ft. -_ '+ Cu Fi _.................... ron Depth ........ , Height Sq. Ft. ...................... Cu. Ft. ..... _.............. ... Type of. Construction + °._. Est. Cost.._ . .......... To be Completed ............. _............. THIS PERI`411 l �.)" - N01 r �,UTHORIZE' Viol -AT - ION 0- ANY PRI VATE LAND COVENANTS AND BUILDING RESTRICTIONS. In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $. ::........._, permit is hereby granted to..... .............. _............:_......................_.. ._.. ......... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time union violation,of Any of the provisions of said ordinances. ' uilding Inspector r NOTICE: This permit does not cover the construction, installation for wiring,'plumbing, gas hrtidg, sewer or wafer. Be sure to see the Building Inspector for separate permits for these items. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name 27 )u Builder_„c Address LOCATION OF BUILDING No. S' 9 Street _��? �" Part of Lot LotBlock. _ IAddition or Sub -Div. 6,6 ~� Corner Lot_Inside Lot Z-' Set Back Side -Yard_ /,__ . SEWER ELEVATION i A/ FOUNDATION ELEVATION __,_ l_ �A Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: Front A/e Depth Sq. Ft... .ZtJ , Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost 1-9 4 d'd To be completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representa- tions stated in.this application are true and correct. SIGNATURE DATE- - ( Schedule of Fee costs can be found on the Reverse Side.) i City of Fridley Application for Plum ing and Gas Fitting Perntitt Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures q� 07 K r TOTAL Number Fixtures ...................... (� x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 w Catch Basin ...... ..................... x 3.25 Z Water Heater (Up to 200,000 BTI) ...... z x 2.00 WATER HTR. New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL � x $1.50 $ /• '2 Additional Fixtures .................... x .50 ;; Gas Range to 200,000 BTU .............. x 2.00 $ a f90 R N GAS ELEC. Base 1st 2nd _ 3rd 4th ' Future Connection Openings Connected with Sewer New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: X10. RATE TOTAL Number Fixtures ...................... (� x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTI) ...... z x 2.00 $ ` New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ /• '2 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ City of Fridley: The undersigned hereby .makes application for a permit for the work herein specified, agreeing to do 011 work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this applicationjare true and correct. Fridley, Owner Kind of Building - —A fl Used as -"�A To be completed about — Estimated Cost, $ Old New- uilding Permit ROUGH AI) — 2 0 --&0 FINAL 4 2 2M 7-59 19Z By_ L--ff o' Business Phone City of Fridley, Ylbm- BUILDING PERMIT N° 5277 Date: IlIf Owner: Builder— Address Address —•-- Lt'�,�Y P B. (WING No _ treet _��--� _._ Part nafLot Lot �;Block _ Addition or Sub- ivion~ •- -- Corner Lot ,... ....__.._.._._ Inside Lot _ ek v deyard Sewer Elevation _ _ Fo dation Elevation DESCRIPTION . OF BUILDING T011F U Front 4 Depth , L - Height tt-- Sq. Ft..� Cu. Ft, Fron DepthHeight Sq. Ft. Cu. Ft. Type of Construction _ Est. Cos To be Completed OF In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances,of the city of Fridley. In consideration of the payment of a fee of $ , 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, Mumesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation f y of the provisions of said ordinances. Inspector NOTICE: This permit does not cover the construction, installation for wiring, ploinhing gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these hems. 4 .-A .. ,; .01 APPLICATION FOR BUILDING PMIT CITY OF FRIDIEY, MINNESOTA Owner's Nrti+zilder Address ` - ' Address LOCATION OF BII IDING No. Street �`��'� �- Part of Lot Lot:;�fw 07 //Z � rBlo-/c-k� d Addition or Subdivisio Corner Lot Inside Lot Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: Type of To be Completed DESCRIPTION OF BUILDING Devth - Height / 6 Sq. Ft. Cu. Ft.i Front Depth Height Sq. Ftp Cu. Ft. ted Cost The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. (A Schedule of Fee Costs can be found on the Reverse Side.) Building $ ]BUILDING Plan Review Permit No.: lg -7 q Inspections Fire Surcharge RESIDENTIAL APPLICATION Received By: 763-572-3604 $ CITY OF FRIDLEY Date •SEP 0 9 200 763-502-4977 FAX SAC Charge $ Curb Cut Escrow $ EFFECTIVE 1-1-08 Erosion Control $ DATE !;�t -9- . Z Q O YOUR E-MAIL ADDRESS $ SITE ADDRESS fff Z R Z qoD 11k l E" $ Total Due $ THIS APPLICANT IS: ❑ OWNER WONTRACTOR PROPERTY OWNER/ NAME: OW.SKI* TENANT ADDRESS: I'4 Z 9 ZohQ S �r�/. E~ CITY .' 7�S PHONE: NAME: MRL W O 1 ADDRESS:/-#q/,o QoSSil CITY Pa ff&5 STATIC&LZ CONTRACTOR SUBMIT A COPY OF PHONE44),- FAX YOUR STATE LICENSE STATE LICENSE #%D/~ ",33..::F' EXP DATE PROPERTY TYPE #0 SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH XROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SO FT ROOFING IS HOUSE ONLY �' / BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES JR HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS & PORCHES SUBMIT: ❑ Vinyl ❑Soffit I . 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 v�'j0 -7)_ OCCUPANCY TYPE Permit Fee $ Plan Review $ Fire Surcharge $ t Surcharge $ License Surcharge $ SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Total Due $ �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 onstruction 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 approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME/ /a! 4,-f0/Zr11 DATES 60 APPROVED BY DATE Building $ /95 • ZS BUILDING Permit No.: Inspections $ 10-67— 0•$Z.Surcharge RESIDENTIAL APPLICATION Received By: 763-572-3604CITY $ 5.00 OF FRIDLEY Date s : A Curb Cut Escrow $ Erosion Control $ Park Fee M n't'sU+a-- r u S C C> • C U r -n DATE J YO E-M4IL ADD S 1CC lf/1 Total Due $ IJIL . 4,19 8 SITE ADDRESS // NV THIS APPLICANT IS: 0 OWNER CONTRACTOR PROPERTY OWNER/ NAME: D TENANT ADDRESS: CITY STATE-ZIP�c�C� PHONE: —T a 3� •� �� CONTRACTOR NAMEIALn AJAD NAMEot, STATE LICENSE D A173 EXP DATE 13/9//07 L 3 SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: SSSS - CITY-�Y�fSTATE ZIP558` WITH APPLICATION HONE qSZ • 935 • -7!v!e 9 FAX -?5Z • q35 . gS-yq PROPERTY TYPEGLE FAMILYINEW CONSTRUCTION SIZE 0 TWO FAMILYMEW CONSTRUCTION STO PERMIT TYPE Q ADDITION 0 GARAGEISHEDDOWS EJ BASEMENT FINISH 0 ROOF ❑DRAIN TILE 0 DECK 0 SIDING 0 OTHER 0 SWIMMING POOL TYPE OF WORK: I w 0 ADDITION ANCE/REPAIR 0 REMODELING DESCRIBE WORK BEING DONE: ujiAdaw &Ad(/-) O y SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S . Ft. ROOFING 0 HOUSE ONLY NUMBER OF SQUARES 0 HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES 0 ATTACHED GARAGE I. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: 0 DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, 0 Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: O Aluminum 0 Trim 1. Site Plan/Survey showing the existing structures 0 Other 0 Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS es ❑No LOCATT N O WINDOy}v+'S �s� OR FOR NEW OPENINGS -DESCRIBE SIZE OF -Fl D0 Y OPENING CHANGES & /� / V O�I`/Q L ` IQ TYPE OF WINDOW TO BE INSTALLED DF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATIONS /0.07L/ ! OCCUPANCY TYPE Permit Fee See $ /95 • ZS Plan Review $ ' Fire Surcharge $ 10-67— 0•$Z.Surcharge Surcharge $ 5 •SIJ License Surcharge $ 5.00 SAC Charge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ - Total Due $ IJIL . 4,19 8 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 oavable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work whi i eq//uiras reg a and a p v of plans. A"yi SIGNATURE OF APPLICANT (� �RINTNAME yj� DATE �SZk /10