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PRE 2010 DOCSVillage of Fridley, 311nm BUILDING PF.RMi7` No 903 i Office of INSPECTOR OF BIJHMMS i owner',..� �N. Architect Builder Fridley, Minn.,, , 19, *�� LOCATION OF BUILDING ,i(` ,fit s h ,. f� �-. Part of Lot No. Street Al Loix=' ` ° „n Block b Addition or Sub -Division - - DESCRIPTION OF BUILDING p � Front De tb - Height Stories Manner of Construction - To be used as,` -" r 'i To be completed < a Estimated Cost z. Permit is hereby granted tq II the building described In the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, In all the work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, 1!![inn., regarding the construction, alteration, maintenance, repair and moving of buildings within the city limits, and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. � ± inspector of Buildings. AGREEMENT AND SWORN STATEMENT In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of the above permit;,, I hereby agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Fridley, and, being first duly. sworn, I hereby state and say that the facts stated by me and contained in the above permit are true as therein stated. Subscribed and 'sworn to before me at Fridley, Minnesota, j this u day iJ BUILDING PERMIT ' Wage of Fridley, lien. N° 2126 Date y .... Owner Builder .. Address •,,'il:. , ..�•dr�,.. Address - LOCATION OF BUILDING No.. Street ... ,, . , �' .. .... ... Part of Lot .. . ............. . Lot ................ Block ................ Addition or Sub -Division ......... ............................ Corner Lot ............ ..... . ..... .. Inside Lot Setback `s+;/yard e�'r DESCRIPTION OF -BUILDING To be Used as: , Front Depth .' ..Height ........ Sq: ]♦'t......... Cu. Ft. ' .... ..... Front ... Depth ... Height ........ Sq. It. . Cu. Ft, ....... . Type of Construction Est. Costa, To be' Completed ej .I In consideration o ! the issuance to me of a permit to construct the building described above, I agree to do the proposed work in Ceordance with the description above set forth and in compliance with all provisions of ordinances of the villa of Fridley. in consideration ofaopa AM yment of a fee of $ :.�. .... permit is hereby granted to t construct the buildingaddition as described above. This t is granted upon re con t the person to whom. it is granted and his agents, employees and workmen, in all work done in, around u Fridley, Nti mesoia reg n said building, or any part thereof, shall conform in all respects to the ordinances of ding location, construction, maintenance, repair in the village limits an alteration, and moving of buildings with- this permit may be revoked at any time upon violation of any of the - provisions of said ordinances. 4 'Building Inspector M NOTICE: This permit does 11not cover the.00nstruction, Instatlation or alteration for wiring; 'p'lu'mbing, gas heating, sewer or water. 'Be s re to see the Building Inspector for separate_ permits for these items. I 01 SU8JEtT PE City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT 2 003 r COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC 1 ` . CITY HALL FRIDLEY 55432 j 612-571-3450 IPT NO. NUMBER 910-F15 REV OATE 9/28/98 PAGE OF APPROVED BY 10B ADDRESS 4712 2 1/2 Street NE 1 LEGAL DESCR. LOT NO. 13 BLOCK 6 TRACTOR ADDITION Plymouth SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Wade Anderson 571-8709 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 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 8 DESCRIBE WORK Reside house and garage 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 AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION ZONING SO. FT CU. FT. 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED 'VALUATION SURTAX WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,000 $1.00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- PERMIT FEE SAC CHARGE STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $62.25 Fire SC $2.00 PLAN CHECK FEE TOTAL F E A / $ 6 . 2S SGNA RE OF CR�C?�RIZED AGENT iDATE EN R VALIpATF� T IS IS R P R IT SGNArURE OF OWNEROF OWNER SU4DER� �DATE� 8SDFE 01 NEW P [ ] Effective 1/1/98 ADDN [ J CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 ®� BUILDING PERMIT APPLICATION ConstructionAddress: '(Y7/a- % s _ NG_ P7;4-101-C -� ,,m,-j .$3CO- Legal Description: Owner Name & Address: A^yt-A-s0.'•1 Tel. # S71—k701! Contractor: MN LICENSE # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # 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: .f-5 , or- P t -s, o& -'e -Z- Estimated Cost: $ -�L , 00e ) (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: -7/�/g8(- APPLICANT: Tel. #&12-) S'71-8?,P g Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ Sewer Main Charge $ TOTAL . STIPULATIONS: 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 [ ] ( & "') 7 7 a- 3 3 -j L BUBJEtr PERI�!ll�l0...•.- .,� City of Fridley 29159 AT THE TOP OF THE TWINS BUILDING PERMIT `L COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 . � NUMBER REV OTE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 L J` 612-571-3450 910-F15 4/8/99 10B ADDRESS 4712 2 1/2 Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 13 6 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Sherri/Wade Anderson 4712 2 1/2 Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO M J Lodemeier Construction 851 Hwy 10 NE, Blaine, MN 55434 780-5214 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 780-5214 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION 1J REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House (15 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. 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 ISTALLS 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 $.64 WITH WHETHER ECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,285 DOES NOT PR U E TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACC RGE PROVISIONS F A Y TH STATE OR LOCAL LAW REGULATING CON- $43.00 Fio SC $1.28 STRUCTION, T PERF OF CONSTRUCTION PLAN CHECK FEE TO AL FEE L e C $5$49.92 /AO IGNATUR N• CTOR OR AUTHORIZED AGENT IDATEt HEN OP VALIDAT HIS IS Y P 17 B� Sa s BATE S-GNATURE OF OWNERJF OWNER BUILDERI IDA TEt NEW [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION v3 ��Gf 1 Cid ConstructionAddress: 71 Legal Description: Owner Name & Address: z2 � z�Af 11 � /fz/ s��r/ Tel. # Contractor: e,i . MN LICENSE # Address: f ' / /6) we(—, Tel. # Attach to this application, a Certificate of Sury lot, with the propgsed 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 f Width Hgt/Ground Sq. Ft. OTHER: OS cel Construction Type:,1,q,1,Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. # CITY USE ONLY Permit Fee $ U O Fee Schedule on Reverse Side Fire Surcharge $ �- o� U .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ L-00 $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: SUBJECT PER . - City of Fridley29772 AT THE TOP OF THE TWINS BUILDING PERMIT T NO. t � ; � -------COMMUNITY DEVELOPMENT DIY. r PROTECTIVE INSPECTION SEC. 1 . ` CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By L.___�% �•� 612-571-3450 910-Fl5 6/25/99 JOB ADDRESS 4712 2 1/2 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 13 6 Plymouth SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Wade Anderson 571-8709 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 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 )ff ALTERATION O REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Refinish basement 2.bedra 9 CHANGE OF USE FROM TO STIPULATIONS See stipulations on plan Provide smoke detectors on all levels and in all sleeping rooms and adjacent rooms. I;EPARATE PERMITS REQUIRED FOR WIRING, HEA.TINC4 PLUMBING AND SIGNS. 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 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 1500 r $35 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 $54.00 Fire SC $1.50 PLAN CHECK FEE TOTAL FEE 56 25 SIGNATURE OF CON TRACTOR OR AUTHORIZED AGE NT IOATEI WHEN PROPERLY xf � BLD INSP LID TED THIS IS YOYR PERMIT A ' GATE S,GNATURE 09 OWNERLF OWNER BUILDER. (DATE, NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER ' SINGLE FAAMY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION O ct0 Construction Address: 7/L- -3L '6L sl IU J Legal Description: S'i,v 4 g -L Owner Name & Address: eJA*r- /allo ao� � � Tel. # (&i2j !71 -S-2o7 Contractor: ® L-) /V C -k MN LICENSE # A- S3(, -n & 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 Hgt/Ground Sq. Ft. OTHER: �n>N�S a .��1 s�Me•��i— �v©M I SATA Construction Type: Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 64-;- h � APPLICANT: Tel. # �y)171- S-7®1 STIPULATIONS: CITY USE ONLY Permit Fee $ l'% c� Fee Schedule on Reverse Side Fire Surcharge $ �� .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ � STIPULATIONS: A.5' j ,5' Bedroom ##2 N� Uig Every sleeping room shall- have at least one 1" window with,.a sill height of not more than 44 above the floor and shall provide not less than 5.7 sq, ft. of-openable area. Min. width 22". min, height 24".- trFurnace roo ISI SEI gll !moi 4.5' 2.5' 7.5' M T CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 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 (UST ON BACK) 1% of Value of Appliance or Work Commerc iallindustrial 1.25% of Value of Appliance or Work Effective On March 1, iW6 _yLb r, '-f State Surcharge ASO Burn BTU HP EDRer Trade Name Size No. TOTAL FEE --� J�� WN-11ROM—FEE FOR ANY E TINGJCOOUNfiNENTILATION REFRIG ERATIOfVNIA R CONDITIONING PERMIT IS $25 QO PLUS THE 3.50 STATE SUR HARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner, HEATING COMPANY 2ErJ CSi;9_�, ti` 14 0— Signod B ( Lir No• 0'7?*3—LJ Approved By Hough—in Date Final Date FILL OUT BACK SIDE OR STACK VERIFICATION ON REPLACEMENT FURNACE JOB ADDRESu A /ori 3 /> IV The undersigned hereby makes application for a permit for the work herein Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and $ 60.00 rulings of the Building Division, and hereby declares that all the facts and $��� representatione stated in this application are true and correct. $ 10.00 $ _ OWNER Wade A_&r !E71 - 17 021 $ 10.00 $ BUILDING USED AS $ 10.00 $ ESTIMATED COSTA, mo oy PERMIT NO. $ 25.00 $, DESCRIPTION RE FURbIM Aa !QR BU� RNgB $ No. of Heating Units / Circle One (Steam) (Hot Water) arm AI Trade Name 7-Z0TP5779R.. Size No. STUQ HP EDR S Fuel Total Connected Load State Surcharge ASO Burn BTU HP EDRer Trade Name Size No. TOTAL FEE --� J�� WN-11ROM—FEE FOR ANY E TINGJCOOUNfiNENTILATION REFRIG ERATIOfVNIA R CONDITIONING PERMIT IS $25 QO PLUS THE 3.50 STATE SUR HARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner, HEATING COMPANY 2ErJ CSi;9_�, ti` 14 0— Signod B ( Lir No• 0'7?*3—LJ Approved By Hough—in Date Final Date FILL OUT BACK SIDE OR STACK VERIFICATION ON REPLACEMENT FURNACE y CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On January 1, 1996 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric $ 7.00 Water Heater - Gas** $10.00 Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 JOB ADDRESS A�. The undersigned hereby makes application for a permit for the work herein specified agreeing to do all 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 truce, and correct. 1996 Owner I—JAoc- /41-Pz:,2-So-J Building Used As I-Aom r_. Estimated Cost PERMIT NO. PLUMBING COMPANY Reinspection Fee $42.00/Hr SIGNED BY r TEL NO.(!�12- ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By Rough -In Date e '/ - Final Date State Surcharge $ .50 MINIMUM FEE OR ANY PLUMBING GAS PERMIT IS $20.00 TOTAL FEE $ PLUS THE $.50 STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES. roomm"W C17YOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 January 18, 2001 Wade Anderson 4712 21/2 Street NE Fridley, MN 55421 Re: Final Inspection at 4712 2 1/2 Street NE Contractor: Owner Dear Mr. Anderson: A plumbing permit was issued on September 15, 1998 to install three basement bathroom fixtures at your address. A rough -in inspection was completed on April 12, 1999. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the plumbing authorized by this permit. As of this date no inspection has been called for. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, we will expire the permit and any inspections on this installation will require a new permit. Please contact me at (763) 572-3603 if you have any questions concerning this matter. Sincerely, ,VE J�NSEN ildin nspector DJ/mh SUBJECT ERMIT NO. City of Fridley 33735 AT THE TOP OF THE TWINS BUILDING PERMIT f RECEIPT NO. COMMUNITY DEVELOPMENT DIV. Liu�• ...... r � PROTECTIVE INSPECTION SEC E NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 763-571-3450 910415 7/24/03 JOB ADDRESS 4712 2 1/2 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 13 6 IPlymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Wade Anderson, 4712 2 1/2 St NE Fridley, MN 55421 763-571-8709 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO same as above 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 O NEW O ADDITION O ALTERATION O REPAIR O MOVE O REMOVE x B DESCRIBE WORK Construct new deck. 9 CHANGEOFUSEFROM TO STIPULATIONS See KKXXX M notations on plans. SEPARATE PERMITS REQUIRED FOR® WARNING AND��S!�N �����NN� Before dogging call f0T all utility locations 454.0002 10"IRM UP" 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 ISTALLS 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 $2,385.00 $1.19 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE $86.82 SIGNATUA OF CON. RACTORORAUTHORIZEDAGENT IDATEI 1 2 b 1 WHEN PROPERLY VALIDATED THIS IS YO)JR P /RMIT V _ S-NATURE OF OWNER,IF OWNER BUILDERI IDAT I J BLDG INSF' GATE NEW [ ] CITY OF FRIDLEY Effective 1/1/2003 ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: -q -7 0- -)-'12- a-03,- Legal Description: ° Owner Name & Address: &JAor- IIDLA401 -- 5AI-IL- Tel. # 7&3-.S7l "�r7 ®i Contractor. MN LICENSE # Address: Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length 1(o Width r Hgt/Ground 30 ! � Sq. Ft. .� dv - IV - Estimated Cost: '$ :2ZO C" - Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: L3 APPLICANT: Tel. #7(-3-571 "2-70 Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1275 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Curb Cut 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 [ ] § V-� F KL co c m 0 sb -n La c� co CL CD c wlrkqg x 4PLL Cg � 0 CL713 cu � sa ALL FEES ARE BASED ON VALUATION, INCLUDING UFHE CUNT OF LABOR aiv„ ivm I (USING THE 1997 PC F M SCHEDULE) TOTAL JOB VALUATION $ -21 , t900 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 $ of 9 .001 times the total job valuation $ 1 .0005 x Permit Valuation Minimum $.50 $ $5.00 (State Licensed Residential Contractors) $ $1550 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ , Make checks payable to: City of Fridley 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; that the work will be in accordance with the approved plan in the case of all work which recWires review and approval of plans. DATE 3 —126SIGNATURE OF APPLICANT PRINT NAME �' BUILDING Permit No.: -- Building Inspections Ins p RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 0 - 0& DATE 4 — 3 ®Le YOUR E -h ADDRESS WX U 4,k ®e- �i� cl G KN SITE ADDRESS Li -11 _ �� Fr `a k,-,4 THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: o. TENANT ADDRESS: I� ami= CITY STATED` k4P 5a�2l PHONE: (e51'eg4-5—(e-1 CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE FAX SINGLE FAMILY/NEW CONSTRUCTION SIZE PROPERTY TYPE ❑ 0 FAMILYINEW CONSTRUCTION STORIES PERMIT TYPEDDITION LlGARAGE/SHED ❑ WINDOWS 9;BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWDAMING POOL TYPE OF WORK: ❑ NEW 0 ADDITION ❑ MAINTENANCE/REPAIR JVREMqRLLG DESCRIBE WORK BEING DONE: a rra,Aas SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING NUMBER OF SQUARES ❑ HOUSE ONLY ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: I. 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 ❑ Vinyl ❑Soffit ADDITIONS & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Surmy showing the existing structures ❑ Other ❑ Fascia and proposed project 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ♦ TTT1T / T C. ALL FEES ARE BASED ON VALUATION, INCLUDING UFHE CUNT OF LABOR aiv„ ivm I (USING THE 1997 PC F M SCHEDULE) TOTAL JOB VALUATION $ -21 , t900 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 $ of 9 .001 times the total job valuation $ 1 .0005 x Permit Valuation Minimum $.50 $ $5.00 (State Licensed Residential Contractors) $ $1550 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ , Make checks payable to: City of Fridley 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; that the work will be in accordance with the approved plan in the case of all work which recWires review and approval of plans. DATE 3 —126SIGNATURE OF APPLICANT PRINT NAME �' Building PLUMBING Permit No.• -fid Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: f 3 2) DATE I I — -1 —0 YOUR E-MAIL ADDRESS n �3egW ® 11 d -rre 'LOW) SITE ADDRESS THIS APPLICANT IS: WNER ❑CONTRACTOR PROPERTY NAME: ADDRESS: 9--o rz - 'l-Pl- ITY 0&Cy' STA IP S'JV2-4 OWNER/ TENANT PHONE: &-, 5 7/ -2,2--3 —G7e_1 � CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS: CITY STATE—ZIP— TATEZIPLICENSE LICENSEWITH PHONE FAX APPLICATION PERMIT TYPE /INGLE FAMILY 0 TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ✓"' ww ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (Thisshould reflect only. the cost of labor) Labor cost under $300 = $15.00. Labor cost between $300 to $500 =cost of labor __X.05= =.FOWPROJECTS WHERE LABOR EXCEEDS -5500; -'EES ARE BASED ON $10.00 PER FIXTURE, EXCEPT Vf RE NOTED :'RDC FURF (INDICATE T(}TAL ER OF EACH BELOW) BATH SINK/LAV DRAINS SHOWER _WATER PIPING _FLOOR ATHTUB GAS PIPING (mEeD cmuCENZ) "'SWIMMING POOL _ WATER SOFTNER ($35) _ _ CLOTHES WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($15) _ _ _ LAUNDRY TRAY—WATER HEATER ($35) FOR IRRIGATION —DISHWASHER WATER METER —OTHER INaH Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ State Surcharge = $'x.50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. B PRINT NAME &­AftOt A1',,0t4SqPJ DATE SIGNATURE OF APPLIC;����� .k , .amu. ._.. _ .. _,.n_. City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: (I 3 0(9 c Le YOUR E-� ADDRESS SITE ADDRESS 9-11 a - e; 1 P1 eQ 9 6P 25LAk THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: c_ i ADDRESS: 4-\-1- 2 t S' CITY STATES Z 24 TENANT PHONE: S r JL 33 - (P-1 H CONTRACTOR COMPANY NAME: CONTACT PERSON: SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: CITY STATE ZIP APPLICATION PHONE FAX PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE ❑ NEW 0 REPLACEMENT ALTERATION/REMODEL TYPE OF WORK: DETAILED DESCRIPTION OF WORK PERMS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, 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 under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL- SIZE/BTU MFG: MODEL: SIZEBTU MFG: MODEL: SIZE/BTU A/C $25.00 FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00 —_AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 $35.00 FURNACE $35.00 _GAS UNIT HTR $10.00 _BOILER LINER $10.00 DRYER $10.00 POOL HEATER $35.00 _CHIMNEY _GAS DUCT WORK $10.00 _GAS PIPING $10.00 VENTILATOR $15.00 Number of fixtures @ $10.00 x $10.00 = $ Permit Fee $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total= $ 5u THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work 7hich requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME G .� DATE 3 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/lFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations.