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PRE 2010 DOCS0 • Village of Fridley, Minn. BUILDING P NO S O O Office of INSPECTOR OF BUHM11VGS Owner _ �'as-'•_ x fid; ¢ r. ,_ M Architect Fridley, Minn., Builder LOCATION OF BUILDING No. e,17,3 9 Street I7 Part of Lot Lot °~ Block Addition or Sub -Division•." o� DESCRIPTION OF BUILDING Front_%g Depth __-f JHeight Stories ` Manner of Construction To be used as d= -w To be completed y °' R Estimated Costa F Permit is hereby granted to t.r'' ,mom, r 7. +�r ,.- 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. 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 ai}d sworn to before me at Fridley, Minnesota, this - day of " . �- A.D. 19: r +""� ,, t � l - , �. City of Fridley, Minn. BUILDING PERMIT N° 4142 Date: ....._.. .......... L...._....._....._6 _f.- Owner:�...-•-------------- Builder ............ ..........:�'�:. ...... _ ......._.._.__ _ _.... Address....._............._........._.._..._..-...._..-........._.... __ _.__...__._......_--- Address ON OF BUILDING No. Y.17_159 Street ....._..�:.............�!W.-;;..L._......._..... Part of Lot Lot ...................................... Block ............ ..................... _................. Addition or Sub -Division ...... ............. ............... Corner Lot .................................. Inside Lot ... - ............................ Setback ..... _............................. ...... .. Sideyard Sewer Elevation ..... .............. ----------......-----------._............._...................................... Foundation Elevation .................. DESCRIPTION OF BUILDING To be Used as: 1 i/ r` •�.-------......-----........._.... ........... Front�..Q.'-:.�.. Depth ��..:...._�' Height ��_�- Sq. Ft..7..�C Cu. Ft.��C�►L� -.............._...................................... Front ........................ Depth ................... - Height ................... Sq. Ft. ..... _................. Cu. Ft. Type of Construction .................... ...... .................. ............... Est. Cost ......_/3]P Q... L'""'-- To be Completed ....._............._..... In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compHpye with:all P/ro of 6_21� ordinances of the city of Fridley. Dc� In consideration of the payment of a fee of $ ....-��.... ........ permit is hereby granted to----------------------------------------------------- -....._-..... _......... .......... ............................ to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. 4 01 SUBJECT City of Fridley _ 72 - el AT THE TOP OF THE TWINS Q U I Z D I� f i� D[ D� A I T BUILDING r IVv rCR'v1 I • COMMUNITY DEVELOPMENT DIV. r 1 PROTECTIVE INSPECTION SEC. 1 i � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 1 612-571-3450 910-F15 6/1/81 JOB ADDRESS 4739 - 3rd Street N.R. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 22,23 8 Plymouth. Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Michael Barland 4739 - 3nd Street N.E. 566-9619 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 IF ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Remodel Dwelling (Add dormer & vaulted ceiling) 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE � t 1 FOR WWW. HEATIN% PLS` .4gt 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 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 $.60 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,200 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. $9.00. PLAN CHECK FEE TOTAL FEE $2.25 $11.85 SIGNAT RE OF CONTRACTOR AUTj5DR1ZEDAGENT tD TE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT i -4 Let SI AT RE OF OWNER OF OWNER BUILDERI (DATE) BLDG INSP 0AjrE 01 CITY OF FRIDLEY APPLICATION FOR i;ESIUNTIAi_ BUILDING PER4ITS (New, Alterations, Additions, or Repairs) OWNER: 'YL6WwL ADDRESS: �r TEL NO: STREET NO: BUILDER: ` L/ '0AV -Alo ADDRESS: TEL NO: Construction Location STREET: f 57-- a LOT: BLOCK: ADDITION: Corner Lot: Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTIO14 OF CONSTRUCTION Front: Depth: Height: Square.Feet: Cubic Feet: Front : Depth: Height: Square - Feet: Cubic Feet: Type of Construction:Em'0 04*V%rhd1ISC- Estimated Cost: $ Zb Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET . The undersigned hereby makes application for a permit for the vork-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. DATE: SIC7NATUF.'r:: St:1Z�LL1at1�nS : - �Q I.J�Xj C. Q. 00 f C 2. Z'C - 1__/_1 _- Y!r - SUBJECT PER City of Fridley 21904 AT THE TOP OF THE TWINS BUILDING PERMIT ' , RE COMMUNITY DEVELOPMENT DIV. i�_ r PROTECTIVE INSPECTION SEC. AV\ CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF A PROVED BY j 612-571-3450 910-F15 6/11/93 JOB ADDRESS 4739 3rd Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 22,23 $ Plymouth. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Michael Barland 4739 3rd Street NE 572-8925 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 101 x 121 Shed in Rear Yard 9 CHANGE OF USE FROM TO STIPULATIONS Shed to be.at least 3 feet from property lines (back & side) and off from any easements. 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 NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $400 $.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- $15.00 Fire SC $.40 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $15.90 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEi WH N ROPE VALIDATED THIS IS YOUR PERMIT 6 BLD SP DA7E SIGNATURE OF OWNER OF OWNER BUILDERi IDATEI NEW { ] Effective 5/26/93 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: -7,59 --34 s-1 A/' e— Legal Description: Owner Name & Address: K MALL L 'eIk2 L -AU !-) Tel. #iia Contractor: MN LICENSE # X177,n LIVING AREA: Length Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Width Height Tel. # Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: /D X t 2- Sf-(E� Cornea Lot [ ] Inside Lot { ] Ft. Yd Setback Side Yard Setbacks Type of Construction: �,�6vo %Axis'' Estimated Cost: $ �Uc� Approx. Completion Date: 7—( (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: (� �� APPLICANT: G '!/ �"`� 7' Tel. # %72 --JS' 011 U- CITY USE NLY I F Z OGI� � Ct lam% Permit Fee $ /°� 0 Fire Surcharge $ State Surcharge $ S SAC Charge $ License Surcharge $ Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Fee Schedule on Reverse Side (r F,,,. .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $750 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Conservation Plan Review $450.00 Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: CITY OF FRIDLEY PERMIT NO.: 2004-00080 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 01/22/2004 572-36U4 k'AX: (763) 571-1287 ADDRESS : 4739 3RD ST NE PIN : 263024320119 LEGAL DESC : PLYMOUTH : LOT 22 BLOCK 8 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL EXCEL ENERGY SAVERS SWITCH # INSPECTIONS 1 APPLICANT HUNT ELECTRIC CORP 2300 TERRITORIAL RD ST PAUL, MN 55114-1614 (651) 646-2911 OWNER KANIS, MICHAEL 4739 3RD ST NE FRIDLEY, MN 55421 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date, STATE SURCHARGE, ELEC FLAT 0.50 ELEC PERMIT FEE - MIN (RESI) 20.00 TOTAL 20.50 PAID WITH CHECK # 113375 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Building BUILDING OCCUPANCY TYPE Permit No.:dU) Inspections RESIDENTIAL APPLICATION Received By, ,a 763-572-3604 65% of Building Permit Fee Fire Surcharge $ .6 .001 times the total job valuation CITY OF FRIDLEY $ -00 va 'd; 763-502-497�j7 FAX $ 5,113-0 $5.00 (State Licensed Residential Contractors) SAC Charge $ EFFECTIVE 1-1-08 Curb Cut Escrow v DATE 2f3 , of ' YOUR E-MAIL ADDRESS 2/r L)J—/ � to-'!SA4 CrJ-M SITE ADDRESS N73-30 S"T. /)E RIDLEY Mt1J 1:6S-yZj $450 Conservation Plan Review THIS APPLICANT IS: ❑ OWNER CONTRACTOR $ PROPERTY OWNER/ NAME: M.IVE / S $ TENANT '9 I� ADDRESS: "( �3 7 ,? p1D S%- hJE CITY_Ek STATE,&ZIP;5S2!�/Z Make checks uavable to: Citv of Fridlev Attach Stiaulations PHONE: % ^ —:6— _U NAME: yJ CONTRACTOR ADDRESS: a CITY STATE&)ZIP . z //Q SUBMIT A COPY OF PHONE — 7L/7— 8 LI S_ FAX 6S'1— 776 ` 6/8,S._ YOUR STATE LICENSE _6-57 STATE LICENSE # EXP DATE PROPERTY TYPE INGLE/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION CiARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH OOF ❑ DRAIN TILE I ❑ DECK SIDING ❑ OTHER Cl SWIMMING POOL TYPE OF WORK: ❑ YEW HOME CONSTRUCTION ❑ ADDITION V'MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: i JOL SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING❑ H USE ONLY NUMBER OF SQUARES MOUSE &GARAGE BASEMENT REMODELING SUBMIT: " 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: G FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS_ & PORCHES SUBMIT: inyI ❑Soffit ❑ Aluminum CJ ❑ Trim 1. 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: _(USIW THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ 1 1p 1 4.). OCCUPANCY TYPE Permit Fee $ ar]�j, S� See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .6 .001 times the total job valuation Surcharge $ -00 .0005 x Permit Valuation Minimum $.50 License Surcharge $ 5,113-0 $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 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 $ 3 U Make checks uavable to: Citv of Fridlev Attach Stiaulations 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 accor an with the approvAplan in the case 9f all work which requires review and approval of plans. % SIGNATURE OF APPLIC� . RINT NAMEP �� ' . t h e(( DATE Jb PLEASE NOTE: SEPARATE PERMITS ARE REOUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL M From: 763 315 4435 Page: 215 Date: 612/2008 2:16:38 PM % �� log Building BUELIDI}11'+G Permit No.* x'45.4 0c insp ions RESIDENTIAL APPLICATIONR�ivedBy 763-572-3604F 763-502-4977 FAX CITY UP FRIDLEY Dale riaCA.' 1tATs 0SI3712008 YOUR14"MAbDRms ieseke12Wixom SMADZ)iiW 4739 'tree�l4`E—&dieMN 5533? TMAPAWANrIS' 130WIMIR OCONFRACUM -- TENANT P1 cm CrONTRACrOR. alms• 10650- C*dh— # T , a e rove susMrr jS�; S;f r A COPY ofPIKM Tsg j - YQUR'.RTA7Y:I.liCdVSE FAX ,� ,� s srwrra mcmm # 20494354 E'r7C1' oA'te 0313 V200F Cr.%NME FAbMT& V O IKTION- d'1"FMII uawt7uTcfTR;wMN 3>I�1tIFw�4 "r` UADMON O t c s►s�18d ►wn�mo►YB 17 USEME 'FIMSK D ROOF 111]RAM TQ.E 131 MCK O 3SVINR Q ,rYtz OF WORX: Q lv1W mom CON.M .Rurc fum 13 ADMON D MAUffENANCEWAIR a II0mvii-No DEKWVU WORKBEWa B SOUARof � OMY Nuh�ACARAOs Q ATTAt�tW OARAiOR PRcgtOSLD alis, 01WfACM0GAAA" MOS WW a1:11gsr: o vlatl 4 Alnnietyn O Tum O CMber O Fango 1N Ia7cIsl7NU OPEi�LGS ty'Itaa +ONo tZA" mmmws O��NN �W��111� /R�IM t: �p�%Mp�4gs.DHSG71MK SIZ15O OPEN WO,QW(ma M , Mrs OFw)h1DOWTOHRINpAujmCasement MJUnMeFw1wtv9mu 1 2000.00"'He M7 ultc F= AMRcylaw Eta Tsla bw p .%Mk,Oge LIMM SMhslse SAC Clangs Curb Clut Est row Pa& %.ee Soww Main +Qqww 1 hwrY e10v bar a bad un wil at and l of the 4:11Y or F'tw* and WIM 1hr M1nlr 1e1m11allft68 dKwq*VAba.iaam APPltOVKU BY eMM I. lhttloat+too nN t Propane flow Pam I l iduf al aw mbn► labs wad F=NEW CgNS=M(Wttfr IMB*urclCl<, t. sia. rl.�rst,�,dy +I,a.;,� u. nisema sauelwns gad lamom.sM pN9om 7. 'eVroaal.ormnra. nphrr. 1. FaalNL"alFtrlleia2B Seo Batik Paso fpr Feo .%hcdu1a 6S'�eofBal�tliftlRFelmitF,00 .tll?1 demes ft totaljob valuation .Mi x Permit Valw9k a Mieif um .�►.Sp $,F,W (Stela I.iOORled RrlddeelEitR1 Gunlraet�} _ $10-5 Per SAC Unk (Plans t1D MWM Or mon) ft+BBm RXS21-S _ $451) Comovatioa No R oview — Fe- d by cnJias Awmnxw ==my( ) N63a Nwcmq{ MAIM clleC6 LmynbiL t1f: iL^7ri of [tsidlev Mies THIS MAN AP161J 'ATIONFMA PRRMIT NarvAtau ltFrl71 pw_%CESM � i1lYtF � 011111 [URl an�0e: thu'Ibf Wlii bel ed Isof11i11M191s1'A'ooid! #bC' doduullcCs at■t aaiaa I W*ntw Mi. a Md a wMah bw ►1111 4pfl6011M4 fir n pmarit IRW vwk b w 16 awl wilbrnl a in llrtalye ofa11 vralll ww togttii tNvanv#N d rt k.DA7R From: 763 315 4435 Page: 4/5 Date: 6/2/2008 2:16:39 PM -rrsralKiv a map or me city of mcuey Property Information Addr,.5: 4739 3RD ST NE PIN: 263024320119 FEMA Map Panel: 270013 0004 B FEMA Map Date: 31219981 PPTI EI:] City of Fridley Zoning Certificate .a0u-1c-+r\ . I,& This certMes that this property located nt 4739 3RD ST HE i% Zoned R-1 The property is designated by FEMA to be In Flood 7-one(s) - C. DISCLAIMER This map is ncitlher a IMIly recorded reap rior a survHy and Is not intended In he usW as ona. USE AT YOUR OWN RISKI li Sq 1 of 1 REFERENCE MAP t4, 4��a C.,.4e-ct-', I (UvAb, MF -c UV \'n � C) irk l`� a� a��- bie')1 1 s dr" Svm4 df-�t�S (Q cec� c*j sac -k (*ut ( cS+ 4F 4USE'. http://w%,a%,2.ci.fridley.mn.us/cgi-bin/mlapsm.exe?.map reference %IaftLs—On&mapsice-640... 6/2/2008 From: 763 315 4435 Page: 5/5 Date: 6/2/2008 2:16:39 PM ua��ll fz��orJ *- ,r,- %. (,4 4rtz4 6f wz6 1 40 0 <gf� *>C(J,2 "It\ tolv_l w C -l\ - G C�A u 0,�r, - J-:"� " REVIEWED '*INFOR[C®DE x5l C PLIAN E . � �t'� BL=®� In J City of Fridley ]Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 PLUMBING Permit No.:0 �$ Building Inspections RESIDENTIAL APPLICATION Received By: At 763-572-3604 CITY OF FRIDLEY D,'dLJN 19 7006 763-502-4977 FAX EFFECTr E:1-1-08 DATE YOUR E-MAIL ADDRESS SITE ADDRESS i wz THIS APPLICANT IS: e!VNER ❑CONTRACTOR PROPERTY NAME: AC_ k A /I 1�3 _ ADDRESS: �f 7 , 9 3 rl I Nle CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PERMIT TYPE C GLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK f ct t2 6,,!p r'ia ' 9 4 1 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 = plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $50 FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL ER OF EACH BELOW). MINIMUM FEE $15.50. BATH SINK/L/� _FLOOR DRAINS _ SHOWER ,_WATER PIPING ��CHTUB _ GAS PIPING (NEED CITY LTC) _ SWIMMING POOL WATER SOFTNER ($35) BACKFLOW PREY. {$IS) _CLOTHES WASHER _ KITCHEN SINK _ WATER CLOSET — DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER _ OTHER �, Vii: Permit Fee $ Number of fixtures @ $10.00 5 x $10.00 =$ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ OR Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 QAMMUM $15.50 (MINIMUM $15.50) Total = $ 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 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 all work which requires review and approval of plans. SIGNATURE OF APPLICANT / //G-�L PRINT NAME I r ��I DATE APPROVED BY DATE NOT-2-MME, City of Fridley ]Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 BUILDING PERMIT APPLICANT: PROPERTY OWNER I, r7kc kc -lis , understand that the State of Minnesota requires that all residential building contractors, remodelers and roofers obtain a state license unless they qualify for a specific exemption from the licensing requirements. As the owner of the property at 4O 9 � ' 410 , Fridley, I am exempt from the state licensing requirement only if I am not building or improving this property for purposes of resale. By signing this document, I attest to the fact that I am improving this house for my own use and do not intend to sell it. I hereby claim to be exempt from the state licensing requirements because I am not in the business of building or remodeling on speculation or for resale and that the house for which I am applying for this permit, isl the first residential structure I have built or improved in the past 24 months. I also acknowledge that because I do not have a state license, I forfeit any mechanic's lien rights to which I may otherwise have been entitled under Minn. Stat. 514.01. Furthermore, I acknowledge that I may be hiring independent contractors to perform certain aspects of the construction or improvement of this house and I understand that some of these contractors may be required to be licensed by the State of Minnesota. I understand that unlicensed residential contracting, remodeling, and/or roofing activity is a misdemeanor under Minnesota law, and that I would forfeit my rights to reimbursement from the Contractor's Recovery Fund in the event that any contractors I hire are unlicensed. I have also been informed and acknowledge that by listing myself as the contractor for this project, I alone will be responsible to the City of Fridley for compliance with all applicable building codes and city ordinances in connection with the work being performed on this property. Name 11`d (�-Jcwle Date 6 a BuildingO dAi BUILDING Permit No.: - - ® to l Inspections - i\ RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: __7 —11 _�. 763-502-4977 FAX $ $1825 per SAC Unit (Plans to MWCC for determination) $ EFFECTIVE I-1-08 $ DATE —0 YOUR E-MAIL ADDRESS $ SITEDAD RESS V 7.3 3,60 ^s- � $ Agreement necessary ( ) Non Necessary ( ) $ D THIS APPLICANT IS: ❑ OWNER OeONTRACTOR PROPERTY OWNER/ NAME: )VIK� TENANT ADDRESS: qJ 3 �9/) JT /✓C--- CITY l—'fDL TATE,!!!WIPS-S A_ PHONE: 74? �K 6'� 9-f-- NAME: 0 Z' c Z t ADDRESS: 5'.i-® ,C,tl Eg f On CITY STATE ZIP CONTRACTOR SUBMIT A COPY OF PHONE 7 FAX YOUR STATE LICENSE STATE LICENSE # /21 ey /0./ Z-5— EXP DATE ,�Ji'� C1 ti PROPERTY TYPE I@ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS 1R BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR MREMODELING DESCRIBE WORK BEING DONE: &.9459--m /i f9 a'� OF_ D rR c O SIZE OF IMPROVEMENT LENGTH ` L 2 WIDTH 2 " HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used. PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS. & PORCHES SUBMIT: ❑ Vinyl ❑Soffit 1. Site Plan/Survey showing the existing structures ❑ Aluminum 13 Trim and proposed project. ❑ Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ 913"?, 1 ? 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 $ t 65% of Building Permit Fee $ .001 times the total job valuation $ 1-1 S .0005 x Permit Valuation Minimum $.50 $ / $5.00 (State Licensed Residential Contractors) $ $1825 per SAC Unit (Plans to MWCC for determination) $ -ft +6ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ D 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 nstruction 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 a anc wi a prov I the case of all work which requires review and approval of plans. SIGNATURE O AP CAN PRINT NAME 0o C ?_e DATE,p _ // —0 ct APPROVED BY DATE -7—// City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 0I MECHANICAL Permit No.mi t 1 Building Inspections RESIDENTIAL APPLICATION Received By:, 763-572-3604CITY OF FRID_ LEY Dated 763-502-4977 FAX EFFECTIVE 1-1-08 DATE YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: TENANT ADDRESS: 7 3g �3� 2T AIC CITY STATE IP Z PHONE: CONTRACTOR COMPANY NAME: �/ L CONTACT PERSON: NOTE: SEPARATE CITY LICENSES ARE REQUIRED FOR GAS STATE LICENSE # EXP DATE, DRESS: .�ifr� CITY f �r�STAT6' �L'�i AND HVAC. SUBMIT COPY OF BOND C PHONE FAX ANDINSURANCE PERMIT TYPE YSINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW ❑ REPLACEMENT KALTERATION/REMODEL DETAILED D SCWTIONN OF O S �1, 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 ) OR 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: SIZE/BTU MFG: MODEL: SIZEBTU A/C $25.00 (GAS) $15.00 _GAS RANGE/OVEN $10.00 _FIREPLACE TO AIR EXCHANGEER $15 (WOOD) $35.00 _NEW GAS GRILL $10.00 _AIR _FIREPLACE $35.00 $35.00 _GAS UNIT HTR $10.00 _BOILER _FURNACE CHIMNEY LINER $10.00 DRYER $10.00 POOL HEATER $35.00 _GAS XPUCT WORK $10 00 _GAS PIPING $1000 VENTILATOR $15.00 y�yY f *,3 �u!� x..iz, 'Y. �x ,x �, •s.� .&h'C..e axs. X.x,.. Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge S 50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ /5_. OR Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 MINIMUM $15.50 MINIMUM $15.50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a mechanical 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 o ' ey 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 ork will be in a rd ith the pproved plan in the case of all work which requires review approval of plans. �j v� PRINT NAME T G/� DATE6'Zd_i�g SIGNATURE OF APPLIC N APPROVED BY DAT 1. RUXIM City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 0I 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/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 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.