Loading...
PRE 2010 DOCSApplication for Power Plonts and. Heating. Cooling, Ventilation, ReMgeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL , Furnace Shell & Duct Work 8.00 $o`— Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ........................ 2.00 $ _ Replacement. of Furnace ............................. P.00 $ Repairs & Alterations—up to $500.00 ................ 5.00 $ Repairs & Alterations each add. $500.00 .......:....... 2.50 $ STEAM or HOT WATER SYSTEM NO RATE TOTAL Furnace Shell & Lines—to 400 sq. ft. EDR Steam_ ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule AIR CONDITIONING $ GAS BURNER (up to 400,000 BTU) ............ I .......... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $� Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ �� ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL Dept. of Bldgs. Phone SU. 4-7470 Location( ®� City of Fridley: 3 w 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. Fridley, Minn 19 Owner Kind of Building Used as To be completed about' Estimated Cost, $6 Old—New. Building Permit No. Permit No. `O R % DESCRIPTION OF WORK HEATING or POWE —Steam, Hot Water, Warm Air—No Trade Name Size No 2_6 CapaciSq. Ft. E.D.R BTU - A.P. Total Connected Load 3 7 ?--5 d Kind of Fuel BURNER — Trade Name . Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS—OVER) a z 2M 7.59 X10 W. Business Phone Y 'k HEAT LOSS CALCULAY10N, MINN. Weathersirjps� A.511.! . F� Construction No. Insulation Guidt" latera,l blow Applied Yindows Doors Out Fi 't�in t W, I I Rool Reference ,',-s--No YesNo1 19 h I R—I'Ll Length, -Wid h eig it F.L Widthc", �c I j Room I Lcng��,' I Windows and Doors—Crackage and Area Window, and Doors- Cia,kage and Arra N 'i, Hei eft 4.a id t 11 �i g, h t x No. pane .f r, of ,,I, k Fs-�q it 'ghte otcravi, sq. It 3 LL Coef I3tu Coef. Bk U ---------- Infiltration Infilliatt.on Y Glass Exp. wall r:_ N 0 Width lietitht of pane of pane Net c,.(p. wall Ti—e.,I F.— of crack _Ar�,W_ sq, ft. 2, Int. Wall Net exp- wall Ceiling Coef. Btu Infiltration Floor Total Btu. -Required sq. ft. E.D.R. or sq. ins. W.A. Leader area V -)-'0 A Room lLength 1 -70 -,Width C/ --Height Windows and Doors--Crackage and Area N 0 Width lietitht of pane of pane No. lights Ti—e.,I F.— of crack _Ar�,W_ sq, ft. 2, L/ Net exp- wall Int. wall Coef. Btu Infiltration rJass Total Btu. ITT Expwall ,7/ 72:2, 17 Roorri Length— Coef. Net exp. wall int. wall Infiltration _W1_,_1tWr_H;1KiTt No. or pa no I _T_ tJ,: of Lineal Pt. of Pane 110,18 1 !� I C,80, 1-4 .... .. . .... i . otal Btu. ILI 0 ins. Required sq. ft. E.D.R. or sq. - W.A. Leader area f FlIr/ A �,l Room I Length I/ _ _Width Height K adDoors—Crackage and Area __Windows I. Width of pane Height No. of of pane lights Lineal 6. of crack Wr" aq. it. 2, L/ Net exp- wall Int. wall Total Btu. Required tq. ft. E.D.R. or sq. Ins. W.A. Leader area F1 Roorri Length— Coef. Btu Infiltration _W1_,_1tWr_H;1KiTt No. or pa no I _T_ tJ,: of Lineal Pt. of Pane 110,18 1 !� I C,80, Area sQ. ft. Glass._.__. 5`� t�—L Exp. wall Net exp. wall Int, wall Ceiling Floor '7 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area If Glass 5 c% A-1 Exp. wall 6" Net ell). wall Int. wall 1. loot Total Btu. Required $(I. ft. E D.R. or sq. 1;is. W.A. Leader area Fl, IHx,w II,_ngttll �. Width height Win L, a .s Doors---Crackage and Area Lit e g htNc t, Linaul ft Area No- of pn« of pa?.e lights of crack sq. ft Infiltration Glass Exp. wall Net exp. wall ]rit, wall Poor lotal Btu. Required sq- 4. E.D.R. or sc Coef ins. W.A. Leackir area Height RIM Glass Net exp- wall Int. wall Total Btu. Required tq. ft. E.D.R. or sq. Ins. W.A. Leader area F1 Roorri Length— Width Windows and Doors. and Area _W1_,_1tWr_H;1KiTt No. or pa no I _T_ tJ,: of Lineal Pt. of Pane 110,18 1 !� I C,80, Area sQ. ft. Infiltration Glass Exp. wall Net exp. wall ]rit, wall Poor lotal Btu. Required sq- 4. E.D.R. or sc Coef ins. W.A. Leackir area Height RIM P ABANDONED WELL RECORD 1. LOCATION OF WELL -1 County Name AN OK A Township Name Township Num Range Number Section No. Fraction FRIDLEY N E h hof h 30 Sr 24 or 27 NWSESE Numerical Street Address and City of Well Location or Distance from Road / Intersection 4610 2 1/2 STREET N.E. Show exact location of well � (in section grid with -X-) N Sketch map of well location N L I W E Elm �x W •J 4N W 6 1 '� w ESL 2. PROPERTY OWNER'S NAME Nailing Address if d1 fe nt than LOWELL °96e t a 2 s1�2 TboveN.E. WEINAND FRIDLEY, MN. 55421 HARDNESS OF 3. FORMATION LOG COLOR FORMATION FROM TO If not known, indicate formation log from new well or nearby well. SAND BROWN. 0 11 GRAVEL BROWN 11 14 CLAY GRAY 14 60 GRAVEL DARK 60 77 SAND BROWN 7 GRAVEL DARK 95 105 ST.PETER S.S. YELLOW 1.11 140 S. REMARKS, ELEVATION, SOURCE OF DATA - CASINGS REMOVED, CASINGS PERFORATED, ETC. GEOLOGY WAS TAKEN FROM THE WELL AT: 4849 UNIVERSITY AVE. N., FRIDLEY,MN. WATER LEVEL IN THE ABOVE WELL 34' DATE WATER LEVEL WAS TAKEN: 5-12-46 NOV 12 1991 SEALED According to MN State Regulations E -3Z iFFICIAL ABANDONED WELL RECORD (May be used for Property Transfer) INPORTAHT: PILE MITB'DSSD UNIQUE WELL N0. k if not known) ' 4. N L DEPTH (completed) Date sealed ?O ft. 7t7nr _ 12, 199: S. DRILLING METHOD (if known) 1[J Cable tool aQ Reverse 7[] Driven 10C1 Dug 2[] Hollow Rod 5EJ Air 8[] Bored llj] _ 3E] Rotary 60 Jetted 90 power Auger 6. OBSiRUCTI0N5 Well obstructed 13 YeMf s No Obstructions removed o es [] No If abstractions cannot be removed, contact. NOH before sealing. 7. USE 9Domestie 4[] Monitoring BQ Heat Loop 2=j Irrigation 50 Public gD Industry 30 Test Well 60 Municipal 100 Commercial 7(] Air Conditioning 110 1�Biack Threaded 7[] 20 Galy. 5[] Welded 30 Plastic 6(] Stainless Steel 2 in. to 67 ft. , in. to ft. 9. SCREEN XSereened well from 6 7 ft, to 7 � ft. (If known) Open Hole fro m ft. to ft. Lam=' fL.;Kbelow El above '1 -land surface nate Measuf8j — 12 — 9 1 11. WELLHEAD COMPLETION — 10 Pttless Adapter 4[- 30 ] Found Buried Basement offset 3[� Well Pit 12. GROUTING INFORMATION 1 BAG �eFteat Cement 2[J Bentonite Grout material PORTLANDfrom 7 0 LaSUPrIF tu. yds_ NEAT GROUT 13. NEAREST SOURCES OF CONTAMINATION 4_5, feet ,E directiorCl TY SEWER type Well disinfected before sealing? Yes 14. PUMP XRembved [] Not Present Type: 1[lSubmerslble 30 L.S. Turbine Reciprocating 2Q Jet 4=] Centrifugal 6[] IS. EXISTING YELLS (Please sketch locations of abandoned and active walls in remarks section or on back.) Other unused well(s) on property? [] Yes �No Abandoned: [j Permanent E] Temporary [j of Baled 17. PATER WELL CONTRACTORS CERTIFICATION This well was sealed under my jurisdiction and this report is true to the best of my knowledge and belief. E.H. RENNER & SONS INC. 71015 Licensee Business Name License No. 15688 JARVIS ST. N W Addr 427-5100 Signed Date` l— 13 — 9 1 STEVE IND 1-12--91 Name of Griller P:EVIN HUPPE � w S. REMARKS, ELEVATION, SOURCE OF DATA - CASINGS REMOVED, CASINGS PERFORATED, ETC. GEOLOGY WAS TAKEN FROM THE WELL AT: 4849 UNIVERSITY AVE. N., FRIDLEY,MN. WATER LEVEL IN THE ABOVE WELL 34' DATE WATER LEVEL WAS TAKEN: 5-12-46 NOV 12 1991 SEALED According to MN State Regulations E -3Z iFFICIAL ABANDONED WELL RECORD (May be used for Property Transfer) INPORTAHT: PILE MITB'DSSD UNIQUE WELL N0. k if not known) ' 4. N L DEPTH (completed) Date sealed ?O ft. 7t7nr _ 12, 199: S. DRILLING METHOD (if known) 1[J Cable tool aQ Reverse 7[] Driven 10C1 Dug 2[] Hollow Rod 5EJ Air 8[] Bored llj] _ 3E] Rotary 60 Jetted 90 power Auger 6. OBSiRUCTI0N5 Well obstructed 13 YeMf s No Obstructions removed o es [] No If abstractions cannot be removed, contact. NOH before sealing. 7. USE 9Domestie 4[] Monitoring BQ Heat Loop 2=j Irrigation 50 Public gD Industry 30 Test Well 60 Municipal 100 Commercial 7(] Air Conditioning 110 1�Biack Threaded 7[] 20 Galy. 5[] Welded 30 Plastic 6(] Stainless Steel 2 in. to 67 ft. , in. to ft. 9. SCREEN XSereened well from 6 7 ft, to 7 � ft. (If known) Open Hole fro m ft. to ft. Lam=' fL.;Kbelow El above '1 -land surface nate Measuf8j — 12 — 9 1 11. WELLHEAD COMPLETION — 10 Pttless Adapter 4[- 30 ] Found Buried Basement offset 3[� Well Pit 12. GROUTING INFORMATION 1 BAG �eFteat Cement 2[J Bentonite Grout material PORTLANDfrom 7 0 LaSUPrIF tu. yds_ NEAT GROUT 13. NEAREST SOURCES OF CONTAMINATION 4_5, feet ,E directiorCl TY SEWER type Well disinfected before sealing? Yes 14. PUMP XRembved [] Not Present Type: 1[lSubmerslble 30 L.S. Turbine Reciprocating 2Q Jet 4=] Centrifugal 6[] IS. EXISTING YELLS (Please sketch locations of abandoned and active walls in remarks section or on back.) Other unused well(s) on property? [] Yes �No Abandoned: [j Permanent E] Temporary [j of Baled 17. PATER WELL CONTRACTORS CERTIFICATION This well was sealed under my jurisdiction and this report is true to the best of my knowledge and belief. E.H. RENNER & SONS INC. 71015 Licensee Business Name License No. 15688 JARVIS ST. N W Addr 427-5100 Signed Date` l— 13 — 9 1 STEVE IND 1-12--91 Name of Griller P:EVIN HUPPE SUBJECT PERM City ®f Fridley 813 AT THE TOP OF THE TWINS BUILDING PERMIT 0 •COMMUNITY DEVELOPMENT DIV.�� r PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE Of APPROVED BY i CITY HALL FRIDLEY 55432 612-571-3450 910-F15 4/26/93 JOB ADDRESS 4610 21-2 Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11^13 11 Plymouth. Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Barb Inman 4610 2z Street NE 571-6843 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Top Gun Roofing 9644 Ximines Ln, Maple Grove, MN 425-1455 3388 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 Cj REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof House & Garage (_16 $�quareaj Tear-oJ'f 9 CHANGE OF USE FROM TO STIPULATIONS Underlayz4ent i4us:t comply with.the State Building Code, 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 SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $864 $,5(l WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOP§ NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PR SIONS OF ANY OTHER STAT OR LOCAL LAW REGULATING CON- $23.00. Fire SC $.86 ST U TION OR THE RERFOR NCE OF N TRUCTION. PLAN CHECK FEE TOTALFEE License SC $5,00 $29.36 TSIGNA URE OFCONRORAUTHORIZEDA T GATE) WHE P ERLY V LI TED THIS IS YOUR PERMIT r 4-2 yam _ S,GNATURF OF OWNER ))F OWNER BUILDER) )DATE) BLDG )N __ BATE NEW [ ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: -V &//) " ` .S-� - '�) �--_, Legal Description: Effective 1/1/93 Owner Name & Address: -7 b t2 q � d �? �a s • �!g. Tel. # S -7 / - % q 3 ---, V:�� Contractor: p LLA 0 1'.'19' MN LICENSE ,# .3 <.3 9 Address: a�INt �� .4. Tel. # -71-1?1!�', 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. DECD AREA: Length Width ' /Hgt/Ground Sq. Ft. OTHER: I r- nF�'- 5' �� �[9r�cg !'Jffi u-,-, -1;'- X21 cs,o S Comer Lot [ ] Inside Tt-ocroC4 ] Ft. Yd Setback _ Type of Construction:S 6f�1 Approx. Completion Date: Side Yard Setbacks Estimated Cost: $ — r v�� (Cost on Back) Driveway Curb Cut Width Needed:+ 6 Ft = Ft x $ _ $ DATE: �! .� APPLICANT: d- Tel. it CITY USE ONLY Permit Fee $ LSC' Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,00 Valuation SAC Charge $ $750 per SAC Unit License Surcharge $ 5 . o o $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ j TOTAL STIPULATIONS: SUBJECT P �-- City of Fridley 21850 AT THE TOP OF THE TWINS BUILDING PERMIT i � RECE PT N0. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/13/93 JOB ADDRESS 4610 211 Street NE I LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 12 , 13 11 Plymouth Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Barbara Inman 4610 - 21� Street NE 5 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. TKIN CITY STORM SASH INC 10825 Greenbrier 3090 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 REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Install sashes & tr%J4 9 CHANGE OF USE FROM TO STIPULATIONS Replacement sashes can not reduce the open size of egress windows unless the reduced size still meets Code recluirements. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. 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. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $3 00a $1„50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT r' PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $ 54.00 Fire SC $3.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE License SC $5.00 $63,50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN ROP LY VA IDAT D THIS IS YOUR PERMIT LDG INSP GATE SIGNATURE OF OWNER!IF OWNER BUILDERI IDATEI NEW [ ]� Effective 1/ 1/93 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: % 'a -F Legal Description: Owner Name & Address: ` �y2iYYt� Tel. Contractor: TWIN CITY STORM SASH, I MN LICENSE .a825 i+.RGE N Q ROAD Address: MINNETONKA, MSI 55345 _ Tel. # L 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: _ (% Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: a otz(11 Estimated Cost: $, e%a Approx. Completion Date: Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ (Cost on Back) DATE: APPLICANT: Tel. # l� Permit Fee $ Fire Surcharge $ 5.00 State Surcharge $ .1. S o SAC Charge $ License Surcharge $ ,�_ D G7 Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL * ' $ -5 -D CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.501$1,000 Valuation $750 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ j STIPULATIONS: t 1 SUBJECT PERMIT NO City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT �. Ir T NO. rr _ ____ i COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC f' 4 1 -I NUMBER REV DATE PAGE OF APPROVED BY 1 CITY HALL FRIDLEY 55432 I'' 612-571-3450 910-F15 4/14/95 JOB ADDRESS 4610 2 1 2 Street N 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 I12 13 11 1 Plymouth SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Barb Inman 4610 2 1/2 Street 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Ideal Construction Inc757-3101 4240 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 ❑ REPAIR ❑ MOVE ❑ REMOVE x 8 DESCRIBE WORK Construct a 14' x 12' Addition to Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. VIVAl. Before digging call for 811 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 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 $4,116 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2.06 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- $72.00 Fire SC $4.12 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTALFEE /y ,s- , License SC $5.00 $83.18 SIGNATURE OF CONTRACTOR OWAUTHORIZED AGENT IDATEI JHEN PROPER LIDATED THIS IS YOUR PERMIT INSP BATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEIG NEW [ Effective 1/1/95 ADDN (] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 -(3 T-17— Building vBuilding Permit Application Construction Address: Legal Description: Owner Name & Address: ,tea,. Tel. # Contractor: ` MN LICENSE # �/a yc) Address: /a �/' �/L� ��� �� 1'C �2 Q.�� .�1�, s yTel. # 2s- 7- _'3 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 i' / Width / a- Height 10 Sq. Ft. /L � Y_1`13 GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Comer Lot [ ] Inside Lot [4 Ft. Yd Setback Type of Construction: 3 S�-- 6.2 G A` c Approx. Completion Date: Q IY_ (Cost on Side Yard Setbacks Estimated. Cost: $ /01 C)e> c) q %%6' ¢au Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 'fy- 75' APPLICANT:Tel. # 7����� CITY USE ONLY Permit Fee $ ` 7*2 f Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $___,). $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit License Surcharge $, 'yv $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 [ ] Not Necessary [ ] TOTAL $ 93, / S STIPULATIONS: SUBJECT IT NO. City Of Fridley26980 AT THE TOP OF THE TWINS BUILDING PE IT P RECEIPT NO. ____ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. �ry r NUMBER REV DATE PAGE OF APPROVED BY iCITY HALL FRIDLEY 55432 ----/"';•� L J\ 612-571-3450 910-F15 8/3/98 JOB ADDRESS 4610 2 1/2 St 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DescR. 11,12 13 11 Pl outh Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tracie Smith 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Dahl Builders & Remodeler784-4930 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20050777 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION X3 REPAIR ❑. MOVE ❑ REMOVE B DESCRIBE WORK Finish porch (12x12)• kitchen remodel 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. SEPARATE PERMITS REQUIRED FOR W111INGe HEATING,, PLUMBING AND SIGNS, 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 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 $10,000 $5.00 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- SC $10.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $162.25 Fire PLAN CHECK FEE TOTAL FEE 5 License SC $5.00 $182.25 S-IGNAYURE OFC TRACTOR OR AUTHORIZEDAGENT (DATE, WHEN PROPERVYVALIDOkTED THIS IS YOUR PERMIT do BL G INSP ryATE SIGNATURE OF OWNER 0F OWNER BUILDER) (DATE) NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION) q36 ConstructionAddress: L&/a �� 5 Legal Description: Owner Name & Address: Tel. # Contractor: ,ir�L - �1� MN LICENSE # 0 -1;0 ?�_ Address: Tel. # ]ggjl� '3® 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: Construction Type: Estimated Cost: $ //J ®= (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: Permit Fee Fire Surcharge State Surcharge SAC Charge APPLICANT: $ G2` z $ A vo $ u'r, ro"J License Surcharge $ S-, U`' Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: r Tel. # CITY USE ONLY 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 [ ] Dahl Builders and Remodelers Smith Job Finish Existing Porch 4610 2 1/2 ST N.E. Finish porch for four season use Existing porch 12x12 Install dog house on Exterior of porch l gas Fireplace Existing walls 16" O.0 • 'ur out walls 1"1/2 to get R-19 ' r =1oor R-36 :ailing R-44 a nstall new Double hung windows 1/2" Drywall w -Vapor barrier )pen up exterior wall of house into Oorch and Install micro lam beam ! -1 3/4" x 12' LVL U •4 fisting kitchen ew cabinets SUBJE& P City of Fridley 28685 THE TWINS BUILDING PERMIT 2T - � /~ ' ` RECEIPT . � ; � COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC 1 � CITY HALL FRIDLEY 55432 NUMBER REVDATE PAGE OF APPROVED BY 612-571-3450 910-F15 12/1198 JOB ADDRESS 4610 2 1 2 Street 1 LEGAL LOT NO. BLOCK I TRACTOR ADDITION SEE ATTACHED DESCR. 111, 12 13 11 Plvmouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mark & Tracy Smith 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Greg Wills Exteriors 4246 Royce St NE M is 55421788-0529 20037840 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 O ADDITION O ALTERATION Rk REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reside house (Vinyl siding & Alum, trim.) - hail damage (partial) 9 CHANGEOFUSEFROM TO STIPULATIONS Call for building wrap inspection before covering. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 4610 $2.30 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $99.75 Fire S 4.60 PLAN CHECK FE TOTA;FfIE' �11G' 11.65 CON'RACTOR ORA UTHORIZED A AGENT IDATEI EN O LIDATED T IS YOUR PERMIJ 8 ! 2A SIGNATURE OF OWNERoF OWNER BUILDERI iDATEi BLO INSP 11 IE NE* [] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Effective 1/1/98 Owner Name & Address: , �� %��� ---e- Tel. # Contractor:( r` f,<� MN LICENSE # L0 0 3 7 ?4C? Address: 1) �/ L Tel. # 7" �- '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: / J -r7- %/ 1l Construction Type: y �/ S'iai Al L P � 7'C/mss imated Cost: $ G e9 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: ,/� �,r� L� Tel. # 7��S CITY USE ONLY Permit Fee $ 062 25 Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ �� C� $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 [ ] Not Necessary [ ] TOTAL STIPULATIONS: $ l (1. &!� CITY OF FRIDLEY 7071UNIVERSITY AVENUE NE FRIDLEY, MN55432- // ISSUED:02082006 (763)572-3604FAX: (763)502-4977 Permit #2006-00241 4610 2 1/2 ST NE ADDRESS: PIN:263024330038 LEGAL DESC:UNAVAILABLE :LOT 1 BLOCK 1 PERMIT TYPE:BUILDING PROPERTY TYPE:RESIDENTIAL CONSTRUCTION TYPE:ROOFING VALUATION:$1,965.00 NOTE: REROOF AND TEAR-OFF SHINGLES ON HOME AND GARAGE - 16 SQUARES H.O. #763-571-2496 UNDERLAYMENT AS PER STATE BUILDING CODE. BUILDING PERMIT FEE69.25 APPLICANT FIRE SURCHARGE1.97 SMITH TRACIE L & MARC R STATE SURCHARGE, BLDG VALUE0.98 4610 2 1/2 ST NE LICENSE SURCHARGE0.00 FRIDLEY, MN 55421 TOTAL 72.20 Payment(s) CASH315672.20 OWNER THOMPSON, VANESSA 4610 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________ 2/8/06 Bldg Insp____________________________Date ________ SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY 7071UNIVERSITY AVENUE NE ISSUED:02/08/2006 FRIDLEY, MN55432- (763)572-3604FAX: (763)502-4977 Permit #2006-00241 4610 2 1/2 ST NE : ADDRESSPERMIT APPLICANT: PIN:263024330038SMITH TRACIE L & MARC R LEGAL DESC:UNAVAILABLE4610 2 1/2 ST NE :LOT 1 BLOCK 1FRIDLEY, MN 55421 PERMIT TYPE:BUILDING PROPERTY TYPE:RESIDENTIAL CONSTRUCTION TYPE:ROOFING : VALUATION$1,965.00 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. BUILDING INSPECTION RECORD 24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS. CALL FOR INSPECTIONS WEEKDAYS: 8 AM TO 4:30 PM INSPECTION TYPEDATEINSPECTORCOMMENTS Pitures on site. ICE & WATER BARRIER02/17/06PDAVE Roof Final FINAL02/17/06PDAVE 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. Building BUILDING Permit No.: - %L&V-- U` Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Recd: �®G DATE 0, o u YOUR E-MAIL ADDRESS SITE ADDRESS I D 9112- N [/ THIS APPLICANT IS: JeGwNER ❑CONTRACTOR PROPERTY OWNER/ NAME:Lr e,J ADDRESS: D Z ✓VL -CITY STAT J TENANT PHONE: _ CONTRACTOR NAME: SUBMIT A COPY OF STATE LICENSE # EXP DATE YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE FAX PROPERTY TYPED29-SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH jIg ROOF ❑ DRAIN TILE PERMIT TYPE ❑ DECK MIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: A �e - r , x)f l SIZE OF IMPROVEMENT LE. ROOFING NUMBER OF SQUARES d GARAGES PROPOSED SIZE: PROPOSED HEIGHT: ❑ HOUSE ONLY ,OUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE HEIGHT Ft. BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used G FOR NEW CONSTRUCTION INCLUDING DECKS, SIDIN c Vinyl ❑Soffit ADDITIONS & PORCHES SUBMIT: Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures Other ❑ Fascia and proposed project. 9 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 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION -$ 60 OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $65% of Building Permit Fee Fire Surcharge $ �e �{` .001 times the total job valuation Surcharge $ v _ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances d codes f the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application a p t d work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all rk w e s view and approval of plans. ` �j�, SIGNATURE OF APPLI ANT \ PRINT NAME t " ' DATE `� a CITY OF FRIDLEY 7071UNIVERSITY AVENUE NE FRIDLEY, MN55432- // ISSUED:12162008 (763)572-3604FAX: (763)502-4977 Permit #2008-02080 4610 2 1/2 ST NE ADDRESS: PIN:263024330038 LEGAL DESC:UNAVAILABLE :LOT 1 BLOCK 1 PERMIT TYPE:PLUMBING - FIXTURE BASED PROPERTY TYPE:RESIDENTIAL CONSTRUCTION TYPE:WATER HEATER NOTE: CALL FOR FINAL INSPECTION COMBUSTION, VENTILATION AND DILUTION AIR PER MN RULES 1346.5304 IFGC STATE AMENDMENTS MAKEUP AIR PER 1346.0501 IMC STATE AMENDMENTS VENTING OF EQUIPMENT PER 1346.5503 IFGC STATE AMENDMENTS CALL FOR FINAL INSPECTION WITHIN 10 DAYS REPLACE WATER HEATER. WATER HEATER FEE35.00 APPLICANT STATE SURCHARGE, PLBG FLAT0.50 GAVIC & SONS PLUMBING TOTAL 35.50 12725 NIGHTINGALE STREET NW Payment(s) COON RAPIDS, MN 55303- CREDIT CARD108435.50 (763) 755-6468 Minnesota State License #: 0004004PM OWNER THOMPSON, VANESSA 4610 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________ 12/16/08 Bldg Insp____________________________Date ________ SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY 7071UNIVERSITY AVENUE NE ISSUED:12/16/2008 FRIDLEY, MN55432- (763)572-3604FAX: (763)502-4977 Permit #2008-02080 4610 2 1/2 ST NE : ADDRESSPERMIT APPLICANT: PIN:263024330038GAVIC & SONS PLUMBING LEGAL DESC:UNAVAILABLE12725 NIGHTINGALE STREET NW :LOT 1 BLOCK 1COON RAPIDS, MN 55303- PERMIT TYPE:PLUMBING - FIXTURE BASED PROPERTY TYPE:RESIDENTIAL(763) 755-6468 CONSTRUCTION TYPE:WATER HEATER BUILDING INSPECTION RECORD 24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS. CALL FOR INSPECTIONS WEEKDAYS: 8 AM TO 4:30 PM INSPECTION TYPEDATEINSPECTORCOMMENTS PLUMBING FINAL02/20/09PDAVE 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. /-)'-ffi c /V1 -t/ �<--- <r `Cc Building PLUMBING Permit No.:2 b D Inspections RESIDENTIAL APPLICATION Received By: L� - 763-572-3604 CITY OF FRIDLEY >aat r 763-502-4977 FAX >+;FFECrIVE 1-1-08 / (� DATE P c YOUR F. -MAR. AD1?R_ESSYj 7 ✓JL ! n oa A-0 gp-el f ! � - C a "'Al SITE ADDPUS L16 t f /� TH[5 APPLICANT 15: 0 OWNER CONTRACTOR PROPL'RTY NAME: sem" �! rOWNEW TENANT ADDRESS: �'d c�c� - %G� cITY ' / E STATE WZIP T1 �%s)/ • PHOriTF,•_ �� � ' � �"• I "ash f .�" f •• CONTRACTOR NAMU-L R c. n© � � ., `i• SUBMITOUR .STATE OF 91-AXE LICENSF #rw EXP DATE t 3. LICENSE. BOND AND 917ATL-' BOND :_ 3 % EXP DATET - �• CL•RTIMCATEOF ]INSURANCE ADDRESS: L( tY� 514 1tr"' CITY '"7t>rS' PHONE _ / — /� [ ty [ $, CAX PERMIT TYPE XSINGLE 1,AMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPIC OF WORK: ❑ NEw1$l 1t1-PLACEM lff DETAILED DF.SMIPTION Ol' WORK 9e, �•� -T i PER, MS 16B.665 the permit fee is a minimum of $15.00 or $% of the total cost up to 5500,00, whichever is greater. for the improvement, installation or replacement of a residential fixture, excluding the fixtures. {This should reflect only the cost of labor) Labor cost udder $300 = $15.00. Labor cost between $300 to $500 - cost of labor X.05 = _ plus .50 surcharge OR FOR PROJEC78 WHFRF I.AROR EXCEEDS 5500, FL'L'S ARL' RASED ON $10.00 PER FIXTURE F.XrF.PT WHF.RF. NOTF.D. FIXTURES: (INDICATE. TOTAL, NUMBER OF EACH BF.i3OW), Mrh IMTJM FEE $15.50. _ BATH StNKlI.AV _l'LOOR DRAINS_ SHOWER _ WATER PIPING _ BATHTUB _ GAS PIPING (NEED CITY LIC) SWIMMING P001•. WATP.R SOFT-NER ($•95) _ _ CLOTHES WASHER _011C:HEN SINK WATER CLOSET RAC.'KFLOW PREY. ($15) _ DISHWASHER _ LAUNDRY TRAY _TWATF.R I-TEATElk ($35) FOR IRRIGATION _.�WATER METER 0THF..R yy s ? i'l.. a- C ii• S y Str7iiila i• •}.. i - :.i :, v ,%4i8`I=YJ:/•i 4FF .. ,yy�j�/' j� '4 • NfM'�1f T: a Permit Fee $ Number of fixtures a $10.00 x $10.00 = $ sure], a .50 Number of fixtures @ $15.00 x $15.00 = S OR Number of fixtures @ $35.00 t x$35.00=$ 3 S'• e& TOTAL DUE $ _ State Surcharge = $ 50 MINIMUM $15.50 MINIMUM $15.50 Total = $ 7F -K -:( 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 offridley and with the Minnesota Construction Codes. that 1 understand this is not a permit but only an application for a pel'tlllt and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the a of all wo k Elsie requires review and approval of plans. SIGNATURE OF APPLIC PRINT NAME�L%.� �G C,' eZATE Ved .)- APPROVED BY DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAQ{: 763-502-4977