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PRE 2010 DOCSCity ®f Fridley, Miun. BUILDING PERMIT Date:. Owner: x Address N4 5959 Builder Address _AJ BUII"C�IfVG : No. Street _ F Pari Lot Addition or Sub-nivition µ Corner Lot _ Inside Lot __ _ aback ___ _ Sidegard Sewer Elevation ____ F undation Elevation DESCRIPTION OF BUILDING T�x Front . Depth , Height '1'Q— Sq. Ft l _ Cu. Ft. Fro r Depth t .� fight Sq. FCu. Ft Type of Constructio Est. Cost . �_ __ To be Completed 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 to 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 timeupon violation of any of the provisions of said ,+ ordinances. . l—% t;+� "") Building Inspector NOTICE: This permit does not cover the construction, installation for whing, plumbing, gas heating, sewer or water. Be sure to see the Building Impeder for. seperato permits, for these items. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY.. MINNESOTA Owner's Name Address 10,0j-,74% Z -r MF-,, Address LOCATION OF BUILDING No. Street S r d Afa A Part of Lot /,;Z -7j Block / Addition or Subdivision10 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. DESCRIPTION OF BUILDING To be us ed as• (, Front Depth V' Height � Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. ®o Type of Construction *A^ r Estimated Cost 6 5-0 To be Completed AV 4 &ss -r 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. DATE (4 d ® G� SIGNATURE (A Schedule of Fee Costs can be found on the Reverse Side.) i FUM TOTAL was `4.J ..11 t7— Dace Smell & Duct work ... ... p� r,,©7 ii Li.i Co l.:7 �mmJ e_. rf.: �..rawa ryy. .:.su «.... rs WJ'-✓'+Ju.. t-ya W�s.ar.«w3u`..i•�iJ� 4�mLJm/JL �r'`Sr \du:r•Ja 6YD "Q,.Ga:j- ' G�i�d .✓Lr�,w13:JLv�....��..`d iL/4 UL„�J�L'�J �.ca.Br..J0.:�si'r`«aw::9 -Repairs & AW -rations each add. $500.00 STEAM or HOT WATER SYSTE"Id Furnace Shell 3s, Lines—to 400 sq. ft. FMR Steam $10.30 $ Furnace Shell & Lire- -to 640 sq. ft. EDR Hot Water 10.00 $. Each add 200 sq. ft. EDR Steam 3.4X1 $ _- Each Each add. 320 sq. ft. EDR Hot Water 3.00 $ OIL BBRNMR—to 3 gal. per hour 6.00 $. over 3 gal. per hour --See Fee Schedule GPX BUMIZER (up to M3,000 BTU) fs.0f1 $ o. 153.033 BTU So,- Fee Sch>aulw G.21Z FITTING r�r.S: NO RATE TOTAL 1st 3 Fuxtures Additional TSxture:s _ x .75 $_— - Gas Ran e to 1.4==3,= mW &M $ Jun CC.1MM Mr13 �Su.i.:J cYG ✓L:..:..t r-1- m --I -- zst- ZL State Surcharge .50 f� soo Poo z eetod!* 1 Ott. 0221,430Z. Pho= coq- 2, LA 144,A City of Fridley: The undersigned hereby makes application for a permit for the work hertxe specified. agreeing to do all work in strict accordance with the City Orrin, cer= and ruling'of the Department of 13uildin;s, Lrd hereby decisr2s t_h_-t an tha Lei, and representations stated in this application are true an correct. Fridley, Minn-' Owner Kind of Used as To be completed about. Estimated Cost, $ Od New. Building Permit No. _� _ Permit No.� DMOMMMOX 0? WO= HEA77NG or POWER l?LAMS—Steasn, Hot Wates, Warm. Air—No / Trade Name " Size No Capacity--- — Sq. n E.D.R ' O 0 ® BTU Mp Total Connected La,:d1 of R�U_-_ BURNER — Tr"44 Nasue Pam Capacity Sq. FL 1 7 d2a�]ARti3.w�7S�1 FUM TOTAL Dace Smell & Duct work ... ... . ..... ..810.403 Replacement of rurnace 5.03 A Repairs, & Alterations—up to 4500.00 6 fl0 $ -Repairs & AW -rations each add. $500.00 300 $ 1 6 3. WJ.aMI AM Furnace Shell & Duct Work to 123,000 BTU ..Slow each add.. 60,M BTU ......... 3.tX P.eptyceTnent of Fuirraace 6.00 $ ,Repairs & Alterations --up to $500.00 6.00 $ R, --pairs & Alterations each add. M.03 3.00 STEAM or HOT WATER SYSTE"Id Furnace Shell 3s, Lines—to 400 sq. ft. FMR Steam $10.30 $ Furnace Shell & Lire- -to 640 sq. ft. EDR Hot Water 10.00 $. Each add 200 sq. ft. EDR Steam 3.4X1 $ _- Each Each add. 320 sq. ft. EDR Hot Water 3.00 $ OIL BBRNMR—to 3 gal. per hour 6.00 $. over 3 gal. per hour --See Fee Schedule GPX BUMIZER (up to M3,000 BTU) fs.0f1 $ o. 153.033 BTU So,- Fee Sch>aulw G.21Z FITTING r�r.S: NO RATE TOTAL 1st 3 Fuxtures Additional TSxture:s _ x .75 $_— - Gas Ran e to 1.4==3,= mW &M $ Jun CC.1MM Mr13 �Su.i.:J cYG ✓L:..:..t r-1- m --I -- zst- ZL State Surcharge .50 f� soo Poo z eetod!* 1 Ott. 0221,430Z. Pho= coq- 2, LA 144,A City of Fridley: The undersigned hereby makes application for a permit for the work hertxe specified. agreeing to do all work in strict accordance with the City Orrin, cer= and ruling'of the Department of 13uildin;s, Lrd hereby decisr2s t_h_-t an tha Lei, and representations stated in this application are true an correct. Fridley, Minn-' Owner Kind of Used as To be completed about. Estimated Cost, $ Od New. Building Permit No. _� _ Permit No.� DMOMMMOX 0? WO= HEA77NG or POWER l?LAMS—Steasn, Hot Wates, Warm. Air—No / Trade Name " Size No Capacity--- — Sq. n E.D.R ' O 0 ® BTU Mp Total Connected La,:d1 of R�U_-_ BURNER — Tr"44 Nasue Pam Capacity Sq. FL 1 7 d2a�]ARti3.w�7S�1 HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTION WeatherstripsGuide A.S.H.V.E. Construction No. Windows Doors Reference Out. Wall Int. Wall Ceding, Roof Floor Yes—No I Yes—No 19_ Room I Length Width I-Ieight II Fl.I / 1YI4' Windows and Doors—Crackage and Area Width Height No. of No. of pane of pane llghts Width Height No. of Lineal ft. Noe of pane of pane lights of crack Area sq. ft. a' Lineal ft. of crack Area eq. ft. 62 A Coef.1 Btu Coef. Btu Infiltration Coef. Btu Infiltration (� Glass 1 Glass 4 ;: , iv ; ✓ UJ Exp. wall Net exp. wall flet exp. wall Int. wall Exp. wall ' '® Net exp. wall Int. wall Ceiling Ceiling Glass C Floor s ,± Floor _-.77 _Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Loader area " iota! btu. 0 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Room I Lenath % V/irlth le NP;oht Windows and Doors---Crackage and Area Width Height No. of No. of pane of pane llghts Lineal ft. of crack Area sq. ft. a' Lineal ft. of crack Area eq. ft. 62 A Coef.1 Btu Infiltration Coef. Btu Coef. Btu Infiltration (� Glass 1 0 _19 4 ;: , Exp. wall ` ' — 70 ac -P. Net exp. wall flet exp. wall Int. wall Exp. wall ' '® Int. wall Ceiling int. wall, Glass Floor s ,± Int, wall _-.77 _Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Loader area " I tl.l bfl7' f Hoom I Lenath 1 Width A- eioitt Windows and Doors—Crackage and Area Width Height No. of Llnoal M No. of pane of pane lighto of trach Area aq. ft. 9 2- Lineal ft. of crack Area eq. ft. 62 A Coef.1 Btu Infiltration Coef. Btu Infiltration /;; T ?. ? O t / e Glass o ac -P. flet exp. wall Int. wall Exp. wall ' '® Ha --asp. Net exp. wall int. wall, Glass Int, wall Floor i'±:*' Floor Ceiling `'• j' ,ra Ceiling Floor°{ Ti —7 a 1 otal btu. ft. E.D.R. or sq. ins. W.A. L*namr area IX" MINNEAPOLIS. MINN. Insulation Kind How Applied Room I Length /. Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Area sq. ft. Height No. of of pane lights Lineal ft. of crack Area eq. ft. 62 A Coef.1 Btu Infiltration Btu g ✓ - T ?. ? O Glass 9mo. wall / o ac -P. flet exp. wall Int. wall Coef-I Btu Ha --asp. Ceiling int. wall, Glass CeilingG', Floor i'±:*' Floor Net exp. wall Int. wall `'• Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area `r Fl.1 F T r� Room I Length a Width fie4aht Windows and Doors--Crackage and Area Width Height No. of Lineal ft. No. of pane of pane lights of crack Area sq. ft. Height No. of of pane lights Lineal ft. of crack Area eq. ft. 62 A Coef. Btu .0T ,x 7 Glass / o ac -P. Coef-I Btu Ha --asp. d int. wall, Glass CeilingG', Exp. wall 0 i'±:*' Floor Net exp. wall Int. wall � j' Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area I " FIT ,,� /) Rooms I Length /rs Width r°1 Height le Windows and Doors--Crachage and Area No. Width of pane Height No. of of pane lights Lineal ft. of crack Area eq. ft. 62 A aL Coef-I Btu Infiltration d 1 p Glass Exp. wall 0 j4/' Net exp. wall Int. wall j' ,ra Ceiling Ti e Floor4 o r' 01' ;7 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Lwder arra,��_ d A... CLtA� W rte 4-'(m(o �--kn ,- WELL OR BORING LbCATIM MINNESOTA DEPARTMENT OF HEALTH Minnesota Welland Boring ' ..H WELL AND BORING SEALING RECORD = Sealing ' MinnesotataUnique No, Minnesota Statutes, Chapter 1031 or W-b�not If known) 1020210 County Name - Township s hip Name Township No. Range No. Section No.. Fraction (sm. - Ig.) Date Sealed Date Well or Boring Cons tructed.: - w g 'A X Y° Numerical Street Address or reaw umber and City o Well or ng Luca on r Aizn4% AM. ,fi112 g Depth Before Sealing, .ft. Original Depth ft. Show exact location of Well or bo n Sketch map of well or boring in section grid with °X°. location, showing property line, roads, nbuildings. AQUIFERS) Q Single Aquifer ❑ Muitlaqu'rfer STATIC WATER LEVEL Measured ❑EstimatedN LL BORING 141 I I I -T- -T- --"1-- i I I I W - - -� - --�-- -- -- Mj Water Supply Well ❑ Montt Well ❑ Env. Bore Hole ❑ Other ft below ❑ above lend surface CASING TYPES) tSteeI ElPlastic E]Tile ❑ Other Ya mile CASING Diameter Depth Set in oversize hole? Annualar space initially grouted? S �6 t mile i � - In. from — — "o 44 ft. ❑ Yes VNo ❑ Yes ❑ No ❑ Unknown I in. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown PROPERTY OWNER'S NAME aF& in. from to ft ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown Property owner's mailing address H different than well location address Indicated above. 46AD9 = 21/2 ST SCREEWOPEN HOLEFRIDIM-. Y a NN 55421 Screen from 47to50ft. _ Open Hole from to ft. rO�rB��STRUCTION/DEB RIS/F'ILL y,Obstruction ElDebris El Fill El No Obstruction Type of Obstructlon/Debris/Fill WELL OWNER'S NAME I " s mailing address If different than property owner's address indicated above. Obstruction/Debda/Ffll removed? ❑ Yes ❑ No PUMP Type iff Removed ❑ Not Present ❑ Other GEOLOGICAL MATERIAL COLOR HARDNESS OF FORMATION FROM TO If not known, Indicate estimated formation log trom nearby well or boring. METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS, OR CASING AND BORE HOLE: No Annular Space Faits S Annular space grouted with tremae pipe ❑ Casing Perforallon/Removal in. from to ft. ❑ Perforated ❑ Removed In. from to fL ❑ Perforated ❑ Removed GIMM BROW 1-4— W -P. M It 14 Type of perforator ❑ Other GROUTING MATERIAL(S) Grouting Material from 50 t ft. yards 1 bags from to ft. yards bags from to ft. yards bags from to ft. yards bags REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING UNSEALED WELLS AND BORINGS Other unsealed well or boring on property? ❑ Yes 3 No GEOLOGY m 4849 WI V a AVE N LICENSED OR REGISTERED CONTRACTOR CERTI ATiON NATIM LEVEL IN ABILWE WELL: 1401 This well or boring was sealed in accordance with Minnesota Rules, Chapter 4725. The information contained in this report Is DATE WWM LEVEL05-04-46 true to the best of my knowledge. 4 DO3 . 13 9DI a 9 1 Co sf MAINT, . AAM&oViRegisftflon No. 32 '— EA "" 5 Autho r " Date rrnlrftl t MT C' 1 1(i LOCAL COPY JH 102020, am -P HE -01434-02 10/95R SUBJECT City ®f Fridley 8 9 7 AT THE TOP OF THE TWINS BUILDING E R M I T r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r NUMBERREV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 4/3/98 JOB ADDRESS 4609 2 1/2 Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 17,18 10 Plymouth SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE William Hanson 4609 2 1/2 Street NE 586-9719 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION 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. 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 1 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 $•50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $917 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- Fire SC $92 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $34.75 PLAN CHECK FEE TOTAL FEE $36.17 TUBE CONTRALTO A T R12EDAGENT IDATEI WHEN PPR/O�PERLY ALIDATED THIS IS YOURPERMIT �,gSIGGNN X14W '' BLO INSP PATE SIGNATURE OF OWNERp N UILDERI IDATEI NEW ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 19, a /� S / Effective 1/1/98 Legal Description: Owner Name & Address: Tel. # ✓� ��� Contractor: MN LICENSE # Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: 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. Estimated Cost: $ q1-7 -7 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: (1-7 � f 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: $ . �7S� Fee Schedule on Reverse Side $ .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1000 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 [ ] CITY OF FRIDLEY 7071UNIVERSITY AVENUE NE FRIDLEY, MN55432- // ISSUED:08052008 (763)572-3604FAX: (763)502-4977 Permit #2008-01159 4609 2 1/2 ST NE ADDRESS: PIN:263024330026 LEGAL DESC:UNAVAILABLE :LOT BLOCK PERMIT TYPE:BUILDING PROPERTY TYPE:RESIDENTIAL CONSTRUCTION TYPE:GARAGE, DETACHED VALUATION:$6,100.00 NOTE: CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. PROVIDE HARD SURFACE DRIVEWAY. SEE NOTATIONS ON PLAN. CONSTRUCTION IN THE CITY IS UNLAWFUL EXCEPT BETWEEN THE HOURS OF 7:00 AM AND 9:00 PM, MONDAY THROUGH FRIDAY AND BETWEEN THE HOURS OF 9:00 AM AND 9:00 PM ON SATURDAYS. NO WORK IS ALLOWED ON SUNDAYS OR ANY LEGAL HOLIDAY UNLESS AN ALTERNATE WORK HOUR PERMIT HAS FIRST BEEN ISSUED. NEW GARAGE - GARAGE DAMAGED BY TREE. NO SITE PLAN REQUIRED REBUILDING ON EXISTING SLAB. BUILDING PERMIT FEE139.25 APPLICANT PLAN CHECK FEE90.51 HAMMER WILLIAM J FIRE SURCHARGE6.10 4609 2 1/2 ST NE STATE SURCHARGE, BLDG VALUE3.05 FRIDLEY, MN 55421 TOTAL 238.91 Payment(s) CASH238.91 OWNER HAMMER WILLIAM J 4609 2 1/2 ST NE FRIDLEY, MN 55421 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 180 days or if construction or work is suspended or abandoned for a period of 180 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 other state or local law regulating construction or the performance of construction. Applicant____________________________Date________ Bldg Insp____________________________Date ________ SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY 7071UNIVERSITY AVENUE NE ISSUED:08/05/2008 FRIDLEY, MN55432- (763)572-3604FAX: (763)502-4977 Permit #2008-01159 4609 2 1/2 ST NE : ADDRESSPERMIT APPLICANT: PIN:263024330026HAMMER WILLIAM J LEGAL DESC:UNAVAILABLE4609 2 1/2 ST NE :FRIDLEY, MN 55421 PERMIT TYPE:BUILDING PROPERTY TYPE:RESIDENTIAL CONSTRUCTION TYPE:GARAGE, DETACHED : VALUATION$6,100.00 BUILDING INSPECTION RECORD 24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS. CALL FOR INSPECTIONS WEEKDAYS: 8 AM TO 4:30 PM INSPECTION TYPEDATEINSPECTORCOMMENTS PROVIDE ANCHORS PER PLAN.. FORMS FOR SLAB08/14/08PDAVE WALL SHEATHING APPEARS OK. FRAMING08/07/08PDAVE PROVIDE FLASHING( DRIP CAP) OVER OVERHEAD GARAGE DOOR AND SERVICE DOOR. FINAL08/14/08FDAVE CALL FOR FINAL. Original failed on 8/14/2008. History: PROVIDE FLASHING( DRIP CAP) OVER OVERHEAD GARAGE DOOR AND SERVICE FINAL DOOR. OPEN PERMIT LETTER SENT01/13/09PMARY OWNER CALLED WILL COMPLETE BY 6/1/09 EXTENSION01/14/09PRONJ EXPIRED. NO REQUEST FOR FINAL REINSPECTION. EXPIRED PERMIT12/20/10RONJ INSPECTION COMMENTS: IN ACCORDANCE WITH CITY ORDINANCE, NEW OR SUBSTANTIALLY REMODELED BUILDINGS SHALL NOT BE OCCUPIED UNTIL ALL WORK HAS BEEN APPROVED, AND A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED BY THE BUILDING DEPARTMENT. THIS CARD MUST BE POSTED AND VISIBLE AT ALL TIMES UNTIL WORK IS COMPLETE. - , 13uilding BUILDING $ Permit No. Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 46G 763-502-4977 FAX $1825 per SAC Unit (Plans to MWCC for determination) $ ft+6 ft= ftx$21=$ $ EFFECTIVE 1-1-08 $ Fee Determined by Engineering DATE Y9OUR E-MAIL ADDRESS Agreement necessary ( ) Non Necessary ( ) ems- SITE ADDRESS ®9 A Make checks payable to: City of Fridley Attach THIS APPLICANT IS: =DWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: W i TENANT ADDRESS: �" / CITY fSTATF&ZIP PHONE: ? NAME: ADDRESS: CITY STATE - ZIP CONTRACTOR SUBMIT A COPY OF PHONE FAX YOUR STATE LICENSE STATE LICENSE # EXP DATE PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION `AGARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH EROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION '4uW ❑ MAINTENANCE/REPAIR ❑ REMOD G allr11zK1 zx DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT e/® ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE &,G 1. Existing Floor Plan GARAGES s, ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAC-E 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 6 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 $,"67/2>40 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 P $ q 15, See Back Page for Fee Schedule $ 65% of Building Permit Fee $ .001 times the total job valuation $ .0005 x Permit Valuation Minimum $.50 $ V $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 ( ) $ o 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 accordance witoe approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF PRINT NAME The Home Depot # 2802 5650 MAIN ST, NE, FRIDLEY, MN 55432 (763)571-9600 Fri Aug 01 16:12:02 2008 WILLIAM HAMMER REDESIGN 203859 Drawing: flan View 22' J CITY OF FRIDLEY 7071UNIVERSITY AVENUE NE FRIDLEY, MN55432- // ISSUED:08052008 (763)572-3604FAX: (763)502-4977 Permit #2008-01177 4609 2 1/2 ST NE ADDRESS: PIN:263024330026 LEGAL DESC:UNAVAILABLE :LOT BLOCK PERMIT TYPE:BUILDING PROPERTY TYPE:RESIDENTIAL CONSTRUCTION TYPE:DEMO-GARAGE NOTE: DEMO GARAGE. 24 X 22. DEMOLITION FEE (PROJ COST)20.00 APPLICANT STATE SURCHARGE, OTHER FLAT0.50 HAMMER WILLIAM J TOTAL 20.50 4609 2 1/2 ST NE Payment(s) FRIDLEY, MN 55421 CASH20.50 OWNER HAMMER WILLIAM J 4609 2 1/2 ST NE FRIDLEY, MN 55421 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 180 days or if construction or work is suspended or abandoned for a period of 180 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 other state or local law regulating construction or the performance of construction. Applicant____________________________Date________ Bldg Insp____________________________Date ________ SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY 7071UNIVERSITY AVENUE NE ISSUED:08/05/2008 FRIDLEY, MN55432- (763)572-3604FAX: (763)502-4977 Permit #2008-01177 4609 2 1/2 ST NE : ADDRESSPERMIT APPLICANT: PIN:263024330026HAMMER WILLIAM J LEGAL DESC:UNAVAILABLE4609 2 1/2 ST NE :FRIDLEY, MN 55421 PERMIT TYPE:BUILDING PROPERTY TYPE:RESIDENTIAL CONSTRUCTION TYPE:DEMO-GARAGE BUILDING INSPECTION RECORD 24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS. CALL FOR INSPECTIONS WEEKDAYS: 8 AM TO 4:30 PM INSPECTION TYPEDATEINSPECTORCOMMENTS NEW GARAGE BUILT ON OLD SLAB. FINAL08/07/08PDAVE INSPECTION COMMENTS: IN ACCORDANCE WITH CITY ORDINANCE, NEW OR SUBSTANTIALLY REMODELED BUILDINGS SHALL NOT BE OCCUPIED UNTIL ALL WORK HAS BEEN APPROVED, AND A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED BY THE BUILDING DEPARTMENT. THIS CARD MUST BE POSTED AND VISIBLE AT ALL TIMES UNTIL WORK IS COMPLETE. CITY OF FRIDLEY MOVING [ ] DEMO [ ] PERMIT APPLICA �ON 6431 University Ave NE a Fridley MN 55432 (763)572-3604 FAX (763)571-1287 Job Address: 7 CO 9 � �� 5 % 1Y r-5 /fi7- O Legal Description: Owner & Address: Contractor: Address: State License # DESCRIPTION OF BUILDING HOUSE: Length Width Height Sq. Ft. GARAGE: Length QAidth Height Sq. Ft. OTHER: Length Width Height Sq. Ft. Estimated Cost _ $ r06 ®® Approx. Completion Dat Tel. # 76 3 Tel. # Cu. Ft. Cu. Ft. Cu. Ft. 6 2,� L g CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CALL ALL FOR Moving Route: APPROVAL(S) REQUIRED PRIOR TO ISSUANCE: Bldg Official Conditions ❑ Engineering Conditions Fire Marshal Conditions ❑ Water Bill Paid: Yes[ ] or Collect[$ ]Signature The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Building Division, and the State Code which requires any water well on the property to be sealed by a State licensed water well driller, and hereby declares that all facts and representations stated in this application are true and correct. Date REMOVED FROM Moving Wrecking Principle building into Fridley .... $300.00 For each 1,000 cubic feet or fraction ...... $1.25 Accessory building into Fridley ... $ 42.00 For structures which would be impractical to Through or within the City ...... $ 20.00 cube, the fee shall be based on the total cost Move a building out of City ...... $ 20.00 of wrecking at the rate of $6.00 for each $500.00 or fraction. PERMIT FEE: _ MINIMUM $20.00 Office Use Only: SAC -D form completed Effective 3/29/07