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PRE 2010 DOCSi. Village of Fridley, Minn. BUILDING PEVJ= N° 8 21 Office of INSPECTOR OF BUILDINGS FridIeY Minn., ~ �'``�- " 18 Builder LOCATION OF BUILDING NO.,.Street 7+ Part of Lot Block Addition or Sub -Division f-�'' DESCRIPTION OFy BUILDING Front - I - Dgjp�h Height Stories A '� Manner of Construction To be used as4: To r- To be completed �' Estimated Cost f 4 Permit is hereby granted �. "' = c > "�" _ �. s ,.:, 2.� Id.,.to 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, Minn., 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. I' AGREEMENT AND SWORN STATEMENT In consideration bf 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. VIII �, _. � �;,-•; - Subscribed and'; sworn to before me at Fridley, Minnesota, this- k da of .`�►`�r-k.. A.D. 1� tl I Ili � • City of Fridley, Minn. • BUILDING PERMIT Date: — SEPTEMBER 26, 1966 • • DOYLE CEROLL Builder Address 4651 - 3rd. St . N. E. Address Fridley, Minnesota 55421 M 4651 LOCATION OF BUILDING No. Street - 3RD ST. N. E,s _ ____ Part of Lot Lot _ :_.. 5'&--2E_ Block 9 Addition or Sub -Division . PLYMOUTH Corner Lc ._5 Inside Lot --Setback Setback Sideyard _ Sewer Elevation _ _ _.._ Foundation Elevation N9 9028 DESCRIPTION OF BUILDING To be Used as: 624 DET. GARAGE Front _ _ 24 Depth 26 Height 10 Sq. Ft. Cu. Ft. 6,240 Front Depth Height _ Sq. Ft. Cu. Ft. Type of Construction _ _ Frame Est. Cost _500 -________ To be Completed VARIANCE GRANTED - CERTIFICATE OF SURVEY ATTACHED COUNCIL ACTION SEPTEMBER 19, 1966 In consideration of the issuance to me of a permit to construct the building described above, I agree to do the propo�d 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 $ 6.00 , permit is hereby granted to DOYL3 CEROLL 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 building - within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. CLARENCE BELISLE Building, Inspector NOTICE: " permit does not cover the construction, Installation for wiring, Plumbing, gas heating, awer or water. Be sure to no the Building Inspector for separate permits for thea Items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA. OWNER'S NAME, '" �� 9: �N BUILDER ADDRESS eY, Z' ADDRESS LOCATION OF BUILDING NO. , , e/` PART OF LOT St �� - STREET � .. � > � , ; ,� r^ e LOTS,:' gd r s Z -S- BLOCK ADDITION OR SUBDIVISIONS CORNER LOT INSIDE LOT SETBACK SIDE -YARD SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: r Q Front `{ Depth Height Sq. Ft.-- �w C'. Cu. Ft . j0 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost To be completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE411 �� d� SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). r f° E'_ City Cit of Fridley SUBJECT IT NO. ® 1233'7 AT THE TOP OF THE TWINS BUILDING P E R M I T r � i.y _••___ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 . � /•-•1 CITY HALL FRIDLEY 55432 --•• �`j 612-560-3450 ECEIPT NO. NUMBER 910-F15 REV. DATE 10/2/73 PAGE OF APPROVED BY JOB ADDRESS 4651 - 3rd Street N.E. 1 LEGAL DESCR. LOT NO. 24,25 BLOCK 9 1 TRACT OR ADDITION SEE ATTACHED Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Doyle Ceroll 4651 - 3rd Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION X ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBEWORK Construct a dormer 9 CHANGE OF USE FROM TO STIPULATIONS Framing lumber to be #2 or better. AOR S R�Q�1R� S. ?VIP 1'� G pNp $tG� S�p�pG, P1.��iN SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood Frame— ZONING R-1 SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION Z 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $700.00 SURTAX .50 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. $6.00 PLAN CHECK FEE TOTALFEE " - $6.50 SIGNATURE OF CON CTORORAUTHORI GENT (DATE) W N PROPrRLrALIU ED HIS IS YOUR PERMIT -23 INSP I k DATE S GN TURE OF OWNER IIF OWN B IL ERI ATE) APPLICATION FOR RESIDENTIAL, ALTERATI(I)N, OR ADDITION BUILDING PERMIT C 1 1'Y OF PRI DLLY, X11 NNESOTA OWNER F S NAME : „�,�T� p�. �, BUILDER: ADDRESS CPO j 3 A f, f: , ADDRESS Cf rn e. NO:. STREET: LOT: Zi, s Z%;:- BLOCK: �% ADDITION: 62 lid m a uT 11, T �14 CORNER. LOT: INSIDE LOT: SETBACK: SIDEYARD; Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING —Front: Depth: Square Feet: Cubic Feet: Front: Square Feet; Height: Depth: Height: Cubic Feet: Type of Construction: �®)-rn er Estimated Cost: $ %(j0, Ii.0 To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in sttict accordance with the City of Fridley Ordinances and rulings of th(� Department of Buildings, and hereby declares that •i11 the facts and representations stated in this application are true and c arrt.c t . DATE: �eT z _ 11-73 5 I C; NATiIRE : (See Reverse Side For Additional Information. ?�r SUBJECT City of Fridley 1256 AT THE TOP OF THE TWINS BUILDING PERMIT r � CEIPT NO. • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION r � � SEC. 1 � � ILCITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ._-- �;,� L A 612-560-3450 910-F15 5/30/74 JOB ADDRESS 4651 - 3rd Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR, 24,25 9 1 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Doyle Ceroll 4651 - 3rd Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK Construct a 16' x 14' Addition 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 R-1 224 3508 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. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4,323 2.16 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 S^®' % 9.16 SIGNRE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) HEN PROPERLY VALiD E THI IS UR PERMIT BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA c` OWNER ` S NAME := ,,-�- -SBU ILDER : t_ ADDRESS : )-/( -/ J�' N t, ADDRESS: NO:.. I_ STREET: V oTt LOT: t� J ,��y BLOCK: ADDITION: CORNER LOT: INSIDE LOT: --SETBACK: SIDE -YARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: pA ..f�2�v, Front :Depth : Height: i Square Feet: a ; // Cubic Feet:_ , Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: Estimated Cost: c2%57 A To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stiict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE :j SIGNATURE: .(See Reverse Side For Additional Information. L.ja ,ror repairs or aLuerauiuuo 4v be at the rate of $3.00 per each Five Hundred Dollars ($500.00) or fracLi,:n thereof in the cost of all proposed work. 2.6. . In no case shall the fee charged for any permit as set forth in Section 2 be less than $4.00. STORM REPAIR DAMAGE FEES: h� / sn� aw, pafian✓ns s d pu°/ Pros uo .ro tu� ' fiuo jr ` s/uaw pao o ra aJgrsJ� po puo ' uaa�aty s u,PJ!M lJn, f o u°y�'I �/{��a ®'W i rnsap aroga ayf sairapur,oq ay¢ f7aAxnS OJO uor fu fuasaJdaf f�a a puv an n si sryf fv �f��Ja� jigafay J �.��Cl - 7 �f� `'gid �rc7 '✓% 9U'6�1 F . e a J � ,,a Ci Ili c -; q� r+J'�•.�e-v-. .r �; of ul7 _s{.:Od • c'..=:f/` /AGS o%.ia'✓.i� 1 -/",7.fG 1-7/"/� SJaaUSU -- f,., aau,6u7 hurt sal silos fu,/aAJ'15 J;u^I �t,rt,uDlcJ Pua] 01 SUBJECT PE City of Fridley 20806 AT THE TOP OF THE TWINS BUILDING PERMIT�1' COMMUNITY DEVELOPMENT DIV. v PROTECTIVE INSPECTION SEC. r 1 = I CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/6/91 JOB ADDRESS 4651 - 3rd Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 24,25, 9 Plymouth. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Terry Flygare 4651 - 3rd Street NE 574-2148 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 O ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace flat roof with -3/12 pitch. roof on 18" x 18r Addition 9 CHANGE OF USE FROM TO STIPULATIONS See notations. on plan. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED 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 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 STALLS I 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 $SO,O $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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- $21.00 Fire SC $.80 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $22.30 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEM PROP RL A D THIS IS YWR PERMIT INSP GATE SIGNATURE F OWNER OF OWN ILOERI IDATEI 01 NST [ ] Effective 1/1/91 ADM [ ] R-1 AND R-2 AMER [ ] Building Permit Application pianAddress: �r� �� f. �� r/lam v /V///, Legal Description: G n �S G f js "G ��1r, a�1 f1a .ddre s�: Owner Name & Address: Oontraetar: .S � �� Tel. � Attach to this application, a Certificate of Survey of the lot, with the proposed oais xuctian drawn an it to scale. UMM ARBA: Leigth Width height Sq. Ft. G RRAGE AREA: Length Width Helc It Sq. Ft. DBM AREA: Length Width Hgt/GYoound Sc Ft. o►aHER: re,I lee 1-ee'4b- w,' fh 00eak-ed�c�i�l= Corner lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Cmwtzuctian: r (f h a,` ml An Estimated Cost: $ Approx. Ccupletion Date: ftWosed Driveway Width If New opening Is Desired: Ft. $ $ Width + 6' See Back Page rAM: 6 v APPLICANT: �/� /%fir%ice! /div �^ Tel. -T Permit Fee $ C) o Fire age $ . �4 0 State Surcharge $ ,� SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main charge $ $ zl o STIPULATIONS: wyy III:j- SAIily Fee Simile an Reverse Side .001 x Permit Valuation (1/10th �) $.50/$1,000 Valuation $650 per SAC Unit Alt. "A" or Alt. "B" Above Free Determined by ski Terri ng Agreement Necessary [ ] Not Nary [ ] tF CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1991 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Water Water Stories Closet Urinal Bath Tub Shower Wash Sink Tray Drink. Floor Catch Fount. Drain Basin Auto. Gas Washer Ap I. Gas Range Misc. Water Heater Fixt. Gas Elec Basemen Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas Gas Range Gas Dryer Back Flow Preventer Required Type NO. RATE TOTAL $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 �-. $10.00 a2000 $10.00 )Yes ( ) No $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance 4V D State Surcharge TOTAL FEE $ .50 JOB ADDRESS Gnu O —30 5 ;;;:-- 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 true and correct. a ,1 qu Owner Building Used As /*V --s f- c%rz C' 'e Estimated Cost PERMIT(0� Affni 700 W Linden Avenue PLUMBING COMPANY P. Q Rnx l lid Minne-ia:011s. MN 55440-1165 SIGNED BY TEL N0. Approved By Rough-MWW. ® Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 $,s ® PLUS THE $.50 STATE SURCHARGE CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave ME Fridley, MN 55432 572-3604 RATE SCHEDULE APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Furnace Shell and Duct Work, Burner — Also Replacement Furnace (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning — All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/industrial 1.25% of Value of Appliance or Work Effective On August 1, 1995 JOB ADDRESS a (o 571 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 rulings of the Building Division, and hereby declares that all the facts and $ 30.00 $ representations stated in this application are true and correct. ,199 $10.00 $ OWNER $ 10.00 $ BUILDING USED AS $ 10.00 $ l ESTIMATED COST l fo STS , 00 PERMIT NO. d $ 25.00 $ a S V u DESCRIPTION OF FURNACE AND OR BURNER State Surcharge 50 TOTAL FEE a g, Sz MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR STANDARD HEATING AND AIR CDNDRIONIHti CO. 410 WEST LAKE STREET HEATING COMPANY_ NNVEAPOLIS,NN &WO -M 612-82 Signed By��,, Tel No. Approved ByRough—In Date Final Date FILL OUT BACK SIDE OR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No ( ) S. Has combustion air been provided for water heater Yes () No ( ) Remarks: List ALTERATIONS Being Done: HEATING --CO::. _ _ . Signed -By: Date: SUBJECT City of Fridley 5 9 21 AT THE TOP OF THE TWINS BUILDING PERMIT � � RECEIPT NO. _ COMMUNITY DEVELOPMENT DIV. ~ PROTECTIVE INSPECTION SEC. '10' CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY j 612-571-3450 910415 4/10/98 JOB ADDRESS 4651 3 Street NE I LEGALLOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 24, 25 9 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Diane Ferreira 4651 3 Street NE 574-9464 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. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Construct a 2'6" x 5'8" Front Stoop Roof Canopy 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 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 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 $1,000 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $34.75 Fire SC $1.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $36.25 SIGN TUBEQFCONTRACT O AUTHORIZEDAGENT (DAT I HEN PROPERLY LIDDATED THIS IS YOUR PERMIT •y) - BL G NSF' ^ 4/�Y 1 ip, /v rJATE SiG A U OF OWNER O OWNER BUILDER) IDA EI NEW [ ] ADDN [ ] ALTER [ ] ConstructionAddress: `4 Legal Description: Owner Name & Address: Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION � _ 51. Effective 1/1/98 -J�P4109'14 7r 2 ii • Q!MN LICENSE # Attach to this application, a Certificate of Survey of the- lot, helot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width �-- Hgt/Ground �j Sq. Ft. dr �'P�rr IC!�`r Construction Type: Estimated Cost: $7G� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: 3 - APPLICANT:,�� Tel. # 9 - 76(Ce 6 CITY USE ONLY Permit Fee $ `� 7� 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 $ $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 $ J�' 2 . STIPULATIONS: 0 1 2 3 4 5 6 7 8 9 10 .T 12 13.-- 14 3-14 0 1 2 3 4 5 6 7 9 10 11 12 13 14 15 16 17 18 Date: Store: Name: Address: City: pUl Color/Style: Salesman:_ SO L'/0 /D J- f n I . I Total Cabh Total T Total Appliar Sales CERTIFICATE OF OCCUPANCY Application- for a;Certificate of Occupancy shall• be made .ten_ (10),days-,-prio-i-, to the use or occupancy of any structure for which a building permit has been .issued; and said structure shall not,be used or occupied untiY`a Certificate``' of Occupancy has been issued. STORM 4mPAIR DAMAGE FEES Fiuo i ` t uaur• cairn a/q!su !!a fwv ' uoafx{I S6urP1kV /lo�a uogmol aye �o pa�iaAJns SV ' PI �4 � � `> f f � f a v s� • tirr�oo9a ayf Jo a' a�.ms n a ua o uasauda� �auva p an-q. yf f f y PFJ° PUDI ps y L • rr u' /.n/ - � aw mac' qua -ke v a�u ,r oo,•sf� 9 0.6 I t SL tN i p./ / f d.•%t1JrC �+%" !/.f '•+�".� ter..-:r � ...r . - t mac'' . ��, low .3 so s.�ontm in C 3 SJaauSu (iuiraaur�u� 990.91 n/ocau4y 'zEc�oc%nauu�y{I �n 51v A0,W0,y-57/89 t,, ` �: Y,• F: ERMI�1 SUBJECT T NO. City of Fridley 25982 5 9 8 2 AT THE TOP OF THE TWINS BUILDING PERMIT ` RECEIPT NO. 1 `y __��_ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r 1 NUMBER REV DATE /27/98 PAGE OF APPROVED BY i CITY HALL FRIDLEY 55432 612-571-3450 910-F15 JOB ADDRESS M 4651 3rd Street 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 24-25 9 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Diane Ferreira, 4651 3rd Street, Fridley 55421 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Standard Water Control, 5337 Lakeland Ave. N, Crystal 55429 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 Install drain tile system. 9 CHANGE OF USE FROM TO STIPULATIONS 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 SQ. 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 $1,400.00 $.70 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 License $5.00 $52.85 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI WHEN PROPERLY ALIDATED THIS IS YOUR PER . MIT /J� BL INSP DATE S.GNATURE OF OWNER OF OWNER BUILDER( (DATEI ERMI�1 APR -24-98 FRI 04:42 PM STANDARD WATER CONTROL 612537``1882 P.01 pwt W Fax Note 7672 N0.01P9es r To0ay9DBtB C/��/jBBT �i (�C' To Aly l 4 e "' 1 �; ►� Fear m -I-s �epf~ -cawrS w c 5 —r rr looa6on Des` MAIP Fax 0 TelBpe tl Fax # Te aphm a A CORP" or4nal [] DWay L_.1 Realm ❑ CaA IOf p11Nv o%Aaom ,baa Cages 0, Cafe ujAul nla�,, ^ ,SY76 11910a 91090 "? Y2a no 6AP JAN -21-1998 11'17 FROM CITY OF FRIDLEY TO 5371882 P.01/02 A1495" t 1 i3ttCCt1 YC r / 11SIt4 ADDN (] CITY OF FRIDLPY ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUIL(D'IING PERMIT APPLICATION ConstructionAddress: 7Q� Legal Description: o°) V - D 6- _ r , Owner Name & Address: -;�/7 arPr/-,e Tel. Contractor: / MN LICENSE #s�-- Address:^v 33 �la��/1/0�%T�G1�� Tel. #`Gy_ Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVE RENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AMC- Length Width _ Height Sq. Ft. DECK AREA: Length Width HgtlGround Sq. Ft. _ OTHER: Construction Type -:aa I r" -k 1,52+e, M Estimted Cost: $ Z�M 4M (Fee Schedule -on Back) Driveway Curb Cut Widt MIX: 7/a Permit Fee $ �� Fee Schedule on Reverse Side Fire Surcharge $�_ .001 of Permit Valuation (1/10th%) Stats Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $_ r $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. °B" Above Erosion Control $ $450.00 Conservation flan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ —2 - ' 5 STIPULATIONS: ' 1 SUBJECT PE City of Fridley /33346 AT THE TOP OF THE TWINS BUILDING PERMIT NO. ______ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 97 U0r 1 NUMBER REV DATE PAGE OF APPROVED 8V I /"'1 � CITY HALL FRIDLEY 55432 A, ' 763-571-3450 910415 2/21/03 JOB ADDRESS 4651 3 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 24,25 9 Plymouth SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Diane Ferreira 4651 3 Street NE 651-214-3502 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO RMA Home Services Inc 3200 Cobb Galleria Pkwy STE 200, Atlanta GA 30339 20268257 A ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 763-542-8826 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW D ADDITION O ALTERATION REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Replace three windows within existing openings 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. permit Inspection Cards Will Be Mailed TO Homeowner To Post 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,839 $.92 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- $66.20 Fire SC $1.84 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE Licen§.aISC $5. 73.96 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI H Pq Y VALIDATE THIS IS YOUR P RMZ45 _ �` ; S,GNATURE OF OWNER SIF OWNER BUILDER) IDATEI G INSp fIA NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF 0MLEY ALTER [ ] SINGLE FAMILY AND PUPLEXES R-1 AND R-2 BUILDING PFRMq APPLICATION Construction Address: -H [eS S �,<A- Legal Description: Owner Name & Address: �cq'l_. -J�o(t-evo .�i Tel. #(c -S-) • aly Contractor:; RMA HOME SERVICES INC. MN INCENSE # Home Depot Installed Sales Address: 3200 Cobb Galleria Pkwy., Ste. #200 Tel. # Atlanta, GA 30339 A 763-542-8826 urvey. of the k BC -20268257 • in,.it to scale. DESCRO.Uiv OF IIVJPR!OVE A aN'I' LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length �- Width _ Height Sq. Ft. DECK AREA: Length Width' Hgt/Ground Sq. Ft. OTHER: $ cJ;. 00 l •,c V . A.lA _ ..._ - , ti • r 1_ '1% Construction Type: �stimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft k $_ _ $ DATE: 1Q-T*V%-QS APPLICANT: m Tel. #55 •Sys•locq: ' TOTAL $ � _5910 STIPULATIONS: b r CITY US ONLY Permit Fee $ LoLp. at) Fee Schedule on jReverse Side Fire Surcharge $ .`ay .001 of Permit valuation (1/10th%) State Surcharge $ .90L $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ cJ;. 00 $5.00 (State Lionsed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt."B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined �y Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ � _5910 STIPULATIONS: b r I SUBJECT P City of Fridley 3382 AT THE TOP OF THE TWINS BUILDING P E R M I T r ` RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. / 01- E 1 � i NUMBER REv DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 L J ` 763-571-3450 910-F15 3/21/03 JOB ADDRESS 4651 3 STREET NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 24,25 9 1 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Diane Ferrera 4651 3 Street NE 651-214-3502 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO RMA Home Services Inc 3200 Cobb Galleria Pkwy STE 200 Atlanta Ga 30339 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20268257 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Replace 13 windows within existing openings 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. PTfib Inspection Cards Will SOMalled To HomeownerTa wt 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 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 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 $11,000 $5.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $195.25 Fire SC $11.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE Lice se SC $5.00 $216.75 SIGNATURE Of CONTRACTOR OR AUTHORIZED AGENT IDA TE, MEN PROPERLY VALIDATED THIS IS Y UR PE MIT Cr 8 OG IN$� DATE SGNATURE Of OWNERIF OWNER BUILDER, (DATE, I NEW[ ] ADDN [ ] ALTER [ l Construction Address: Legal Description: CITY OF SINGLE FAMILY AND Owner Name & Address: Contractor:. RMA HOME SERVICES INC. Home Depot Installed Sales Address: 3200 Cobb Galleria Pkwy., Ste. #200 Atlanta, GA 30339 A 763-542-8826 kBC-2026825 =__r____ DES.CRIFT-10 OP Effective 5/10/99 PLEXES R-1 AND R-2 APPLICATION Tel. # &751.914.350a. MN INCENSE # . urvey. of the ...... in -it to scale. Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length r Width j Height Sq. Ft. DECK AREA: Length Width j Hgt/Ground Sq. Ft. OTHER: -2 _ .r,\ $ , .:. �-, _ A .... � i .. cflc� 'Ile Construction Type: Estimated Cost: $ jL jo(r '' Driveway Curb Cut Width Needed: Ft. + 6 Ft = _ f Ft k $_ _ $ DATE: )8- rY\CAA • 03 i APPLICANT: Tel. # NP -3 Permit Fee $ J9 Fire Surcharge $ l 1 . QO State Surcharge $ S-50 SAC Charge $ License Surcharge $ r„a . 00 Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $ STIPULATIONS: CITY U ONLY Fee Schedule on jReverse Side j \ .001 of Permit Valuation (1/10th%) �-- $.50/$1,000 V�luation $1050 per SAC Unit $5.00 (State Lic*nscd Residential Contractors) Alt. "A" or Alt. j"B" Above $450.00 Conservation Plan Review Fee Determined �y Engineering Agreement Necessary [ ] Not Necessary [ ] Building BUILDING Permit No.: iffspections RESIDENTIAL APPLICATION Received By: 763-572-3604CITY OF FRIDLEY DAEM'MIAR 763-502-49774977 FAX EFFECTIVE I-1-09 DATE "— 2 YOUR E-MAIL ADDRESS 6 p*FPif 44.� z)4 (J aLoz� o C <:"!J SITE ADDRESS L4 sj 3 r,4 NE THIS APPLICANT IS: ❑ OWNER P9CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: 6 131-d 4f we: CITY r, STATEZIP PHONE: CONTRACTOR NAME: V o ect 4 ^6' SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # 3G 7 7 EXP DATE AND CERTIFICATE OF ADDRESS: 0-�.,®�., 6tt."e CITY Taj STATE XIZIP S 5''f/ INSURANCE PHONE b I -) VUeJ FAX PROPERTY TYPE &SINGLE FAMILYNEW CONSTRUCTION SIZE 12-,u ❑ TWO FAMILYNEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH PIROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR 4qREMODELING DESCRIBE WORK BEING DONE: U i ✓/ SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING�j ❑ HOUSE ONLY NUMBER OF SQUARES 1 `� E 4OUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: Ie pETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS, & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey 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 ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: SING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ Gly io — OCCUPANCY TYPE Permit Fee $ 3 • Q See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ 9? .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Ott . i(p Make checks payable to: Citv of Fridlev Attach StiDUlationS 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 with the approved plan in the case of 11 work whi rev' and approval of pl S. SIGNATURE OF APPLICANTcwirv! _ PRINT NAME u1 iz,'l l i�/ilf 7��ti�yyle DATE � Q� City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC J NEW HOMES/ADDITIONS KEXISTING HOME U MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) & Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC 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 1FOR NEW BIOMES 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 maize -up air calculations. Date: 11/3/2010 Revision Date: 11/3/2010 Site Information Address 1: Rochelle Milbrath Address 2: 4651 3rd St NE City: Fridley County: Anoka Application Information Business Name. Standard Heating & Air Conditioning Inc. Contact Person: Jeff Bohnine Office Ph: Fax: Cell Ph: 612-290-9514 Address 1: 130 Plymouth Avenue North City: Minneapolis State: MN Zip Code: 55411 Existing Construction: Pre 1994. Project #: Lot: Block: Subdivision: MN Contractor License #: Combustion AQipliance Water Heater: Natural Draft Input BTUs: 32,000 Independently Vented Combustion Zone 2 Combustion Zone 2 Furnace/Boiler: Direct Vent/Sealed Combustion Input BTUs: 60,000 independently Vented Other Combustion Appliances Gas Fired Direct Vent Fireplace(s): No Gas Fired Power Vent Fireplace(s): No Gas Fired Natural Draft Fireplace(s): No Solid Fuel Appliance(s): No Exhaust Eauinment Continuous Exhaust Ventilation Capacity (cfm): NA Clothes Dryer (cfm): 135 Exhaust Fan Rating (elm). 50 Make -Up Air No Make -Up Air Required by Code Combustion Air Combustion Zone One: Minimum Combustion Air Requirements Met. Combustion Zone Two: Minimum Combustion Air Requirements Met. Applicant Name (print)62kin t FL Signature/Date: { WL Code Official (print): Signature/Date: Imck voll r6V ry7 le-- X, 7 x7 � Lx-a'x7 0 2004 Centerpoint Energy h innepwo. 2004 Mechanical Code Guidelines. - 1 oUv&'-P'9 M-" r w\.e Ad 9Z:OZ:6 060Z/6Z/Z1, :91eG Z1Z:abed 0009M 1,9 :wojzl Page i Building PLUMBING PermitNo.: Inspections RESIDENTIAL APPLICATION Received By: fi 763-572-3604 D 4 V 10. CITY OF FRIDLEY ® DATE YOUR E-MAIL ADDRESS SITEADDRE s Rochelle/JoeyMilbrath THIS APPLICANT IS: 13 OWNER *ONTRA6TCR 4651 3rd Street Northeast PROPERTY NAME: Fridley, MN 55421 OWNER/ ADDRESS: 7635740162 TATE ZIP TENANT PHONE: CONTRACTOR NAME: STATE LICENSE # C% EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS 4 l / S CITY �' � la STATE�LIP s'.$'W LICENSE WITH PHONE %— V033 FAX APPLICATION PERMIT TYPE SINGLE FAMILY 13 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: NEW REPLACEMENT DETAILED DESCRIPTION OF WORK PER MS 16B.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 = >•FORNROJECfS WHERE LABOR EXCEEDSV500,_FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT-AIiERENOTED-.'F- ICR-,MES,,AWDICATE TGTAL NUMBER OF EACH BELOW) BATH SINK/LAV _FLOOR DRAINS _ SHOWER _ WATER PIPING —BATHTUB _GAS PIPING (mEmcnyLi vst)^SWIMMING POOL _ WATER SOFTNER ($35) _ CLOTHES WASHER _ KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREV. ($15) _DISHWASHER _-LAUNDRY TRAY TWATER HEATER ($35) FOR IRRIGATION WATER METER OTHER 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 = $ 3COo TOTAL DUE $ State Surcharge = $_ Total = $ W 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 applic n 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 1 o w ' r uires review and approval of plans. // rn SIGNATURE OF APPLICANT00F PRINT NAME Je. A ldellory DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-5024977