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PRE 2010 DOCSri SUBJECT O. City of Fridley 16599 AT THE TOP OF THE TWINS BUILDING PERMIT _ rp RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/25/82 JOB ADDRESS 4916 - 3rd Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 20 3 MrlsonI s Summit Manor South Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Joe J. Mike 4916 - 3rd Street N.E. 572-8702 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. S ane 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 Expand an existing 16' x % 201 Garage into a 20' x ' Garage 9 CHANGE OF USE FROM TO STIPULATIONS Side yard variance approved on M=M= 8/25/81. Provide a hardsurface driveway. There are to be no openings in the north wall, except for a wire glass window, There be a 5/8" sheetrock fire wall on the inside. The roof overhang be limited to 12 Inches maximum. foR wfRfl 'E PEaM"s pEQuIaED SEPERAT AMO S"AS' HEATING. PE,tJ1+iAp* 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4,532 $2.27 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. $50.50 PLAN CHECK FEE TOTALFEE $52.77 SIGt4ATUREOFCONTRACTORO;RA�UTHORI'EOGENT (DATE) WHEN PROPERLYVALIDATEDTHIS IS YOUR PERMIT �7 iLy� �5 J 1 'Si ATURE OF WNER IIF OWNER BUIL ERI (DATE) BLDG WSP DA jtt ri CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDENTIAL BUILDING PEIUiITS (New, Alterations, Additions, or Repairs) OWNER: ��O � � A' ! � BUILDER: C' ro /— ADDRESS: y 9 I ` `� S i- ADDRESS: TEL N0: '�" 7G9 — 'F%0 TEL NO: ✓� Construction Location - STREST NO: / STREET: LOT: o2 (9 BLOCK: _�_ ADDITION: 0i4, �sonl .0 3 v /4f n,,l / OX y a,, - S'(s , AA Corner Lot: Inside Lotsy Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. Pmbo DESCRIPTION OF I L, Front: Square Feet: 410 ONSTRUCTION Y C)C, Depth: �_ Height: /® Cubic Feet: 44ld p Front: Depth: Height: Square -Feet: Cubic Feet: Type of Construction: = - e� Estimated Cost: $ a 10 006, bin .To Be Completed: 6z%'�f D 1� d d / r -e 5 Q^� � 7 r 7fi� fJ I6eT9 �r. Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: SEE RF.VER`;E SIDE OF SHEET . Mie undersigned hereby makes application for a permit for the work' herein specified, agreeing to cb ,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: a4-44 a MK/ SIGNATURE: Stipulations: F. Ole io M d •3"N 3nN3AV 0% Sir � �� � � , �� �- �, .P� � .env . p �Cae� a0� `/, / �s6 CITY OF FRIDLEY Effective May 1, 1990 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE lob Address `T /��p RESIDENTIAL RATE TO'PAL Furnace Shell and Duct Work, Burner (Also replacement furnace) $ 20.00 afi $ Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Gas Piping $ 10.00 $ Tel. #571-3450 (piping needed with new furnace) Gas Range $ 10.00 $ 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 Gas Dryer $ 14.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are trule� and correct. Fridley, Minn. Air Conditioning (all sizes) $ 10.00 $� J ml ke All Others/Repairs and Alterations OWNER 10 of Value of Appliance or Work S� KIND OF BUILDING COMMERCIAL/INDUSTRIAL USED AS 1% of Value of Appliance or Work $ TD BE COMPLETED ABOUT ./ ESTIMATED COST State Surcharge $ .50 it ZZ $ OLD - NEW BUILDING PERMIT NO. PERMIT NO. / TOTAL Reinspection Fee ($15.00) S DESCRIPTION OF FURNACE/BURNER Rough Insp. HEATING or POWER PLANTS, Steam, Hot Water, Wars Air- No. Date (� Final Inep. ate ` / Trade Name zewA k Size No. 7-L oeo Date Capacity ?S 04® Sq. Ft. EDR_BTU HP Approval for Permit i Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq, Ft. EDR BTU HP / MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00 Company/)/ PLUS $.50 STATE SURCHARGE Signed By Z Tel. No. ! *Air Conditioners can not be placed in side yard without written permission from adjoining nc►yldx,r. Fill out back side for stack verification on replacement furnaces 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 connected Yes No ( ) 6. Has Total heating BTU I s of ®cis All other BTU's ® 4 TOTAL i XD 6 Od Com pa ny Signed E Da to SUBJECT ERMIT NO. City of Fridley 27464/ AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT COMMUNITY DEVELOPMENT DIV. _ PROTECTIVE INSPECTION SEC. NUMBER. REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 18/31/98 JOB ADDRESS 16 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 20 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mike 3 CONTRACTOR MAIL ADDRESS 4R3? 2 119 st NE Xpis MN 55421 ZIP PHONE LICENSE NO. 972-1820 4772 4 ARCHIT CT 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 ❑ ADDITION ❑ ALTERATION 3a REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage (22 Sq) Tear -off; Siding and trim 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Call for building wrap inspection before covering. 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 1834 .92 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. $59.50 Fire SC $1.83 PLAN CHECK FEE TOTAL EE Licens 5. 6 .25 SIGNATURE OF ftONTRACTORORAUTHORIZED AGENT IDATEI EN PRORRYI 001, VALIDATED HI$ I U S,GNATUREOFOWNER (IF OWNER BUILDERI IDATEI BL INSP ocyE NEW [ J Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION M/0 0 ConstructionAddress: I-lifo' 3AJ Are , Legal Description: Owner Name & Address: Ai Tel. # Contractor: 01e-r-,j� Rg ,,F 2" ja MN LICENSE # Address. 'ye -7,;z .s T- '�v a-1 Tel. # .5 2 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: R 6 /. c' IF z 2 z°d Construction Type: & t nr-. j� Txx Estimated Cost: (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft . = Ft x $ = $ DATE: - r- APPLICANT: Tel. # 572 -42 c) TOTAL $ / •� . STIPULATIONS: CITY USE ONLY Permit Fee $ �, 9L 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 [ J TOTAL $ / •� . STIPULATIONS: PLUMBING RESIDENTIAL APPLICATION City of Fridley Permit Number Received By Date Received NOTE: IF PROPERTY IS NOT OWNER/OCCUPIED- A LICENSED CONTRACTOR MUST OBTAIN THE PERMIT. ' 0-05 DATE YOUR E-MAIL ADDRESS S F SITE ADDRESS THE APPLICANT IS: (CIRCLE ONE) OWNER ON RACTOR -?� NAME CIp, PROPERTY OWNER/ ADDRESS TENANT CITY i _STATE ZIP C 9 - PHONE # NAME LICENSE # v ` (( ADDRESS . 1� R CONTRACTOR ' CITY ems& STATE ZIP PHONE # rD�I-2jaC]— aJ�'{l� FAX# PERMIT TYPE )'� SINGLE FAMILY TWO FAMILY TOWNHOUSE TYPE OF WORK p NEW REPLACEMENT f ,`� DETAILED DESCRIPTION OF WORK RqAacf- (A Wtr r — FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED FIXTURES: (INDICATE TOTAL NUMBER OF EACH) BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING (Need City License) SWIMMING POOL WATER SOFTENER ($35) CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREY. ($15) DISHWASHER LAUNDRY TRAY WATER HTR ($35) FOR IRRIGATION WATER METER OTHER 55 Permit Fee $ o o MINIMUM: $15:00 or 5% of cost of the improvement -whichever is Plan Review $ greater on work less than $300 Surcharge $ .50 TOTAL DUE $ �J �J(,� Make checks payable to: City of Fridley 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; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. R lf9l �S Cmoi' S oI NAME OF APPLICANT r I 1 DATE orF lease type print SIGNATURE OF APPLICANT PLEASE NOTE SEPAF; �47E #'EMITS AR�lJ1Ft�D k 5111+t� fiwTgL,�'D,�f�iCkLlj1aR j 5 i 7 �r ekL r y1 �j7 4 `.s, w ; Fa, Y CITY OF FRIDLEY COMMUNITY DEVELOPMENT DEPARTMENT 6431 UNIVESITY.AVENUE NE, FRIDLEY, MN 55432 �/�^ �� (763)572-3604 3 J 0 Building MECHANICAL Permit No.: " Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec' 763-502-4977 FAX EFFECTIVE 1-1-08 DATE—fa - a01- o R YOUR E-MAIL ADDRESS 3PR 4 A N SC H O L 1 L S C 1-hTnoAA I L. Cons SITE ADDRESS i.( A 16 3 P -o 577 Oy E T 2t OL—)L-1 M r,-$ 5_S" a THIS APPLICANT IS: V OWNER ❑CONTRACTOR PROPERTY NAME: QLLl AY -N S C t+oL i if 5 OWNER/ ADDRESS: LA� l b Tg p c.T N � CITY 7= L r"I a � p E"1 STATE M� $S TENANT �2 PHONE: b I'a - 30 01-6 tot G CONTRACTOR COMPANY NAME: NOTE: SEPARATE CITY CONTACT PERSON: STATE LICENSE # EXP DATE LICENSES ARE REQUIRED FOR GAS AND HVAC. ADDRESS: CITY STATE ZIP SUBMIT COPY OF BOND PHONE FAX AND INSURANCE PERMIT TYPE ASINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW PLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK _per! E- w G A jr-i s L -L} -I-) o/y w C �J F L SSL-°- (,A-. t-ta s E 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: SIZE/BTU _A/C $25.00 _FIREPLACE (GAS) $15.00 GAS RANGEIOVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _BOILER $35.00 FURNACE $35.00 UNIT HTR $10.00 _GAS CHIMNEY LINER $10.00 GAS DRYER $10.00 HEATER $35.00 _POOL _DUCT WORK $10.00 _GAS PIPING $10.00 _VENTILATOR $15.00 PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ 10 .00 Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ _i s- . S0 OR Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 MINIMUM 15.5 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 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 accordancewi pproved pl in the case of all work which requires review and approval of plans. SIGNATURE OF APPL PRINT NAME Q �` ( S C r{�L�i 3 DATE aq 8 APPROVEDBY DATE PLEASE NOTE: SEP TE PERMITS ARE RE UIRED FOR BUILDING, ELECTRICAL AND MECHANICAL ORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION 0 _" OCCUPANCY TYPE Received By: 763-572-3604 See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee CITY OF FRIDLEY $ Date Rec'd: 763-502-4977 FAX $ �i �. .0005 x Permit Valuation Minimum $.50 License Surcharge $ EFFECTIVE 1-1-2010 SAC Charge $ DATE — � � vZ (� 1 0 YOUR E-MAIL ADDRESS SITEADDRESS 1 I Fi%'-€3 Si- Sb1 F r� i $ THIS APPLICANT IS: IWOWNER ❑CONTRACTOR Erosion Control PROPERTY OWNER/ NAME: - 21iA r`1 SC t-1 vt-- s_ S Park Fee TENANT ADDRESS: % 47/ G 'SP -0 ST GV CITY__] �L Q L �� STATE MT1 Zip_ $ PHONE: 6 1,3L - 30,9 - 6 (� 6 Total Due CONTRACTOR NAME: SUBMIT A COPY OF IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE MINGLE FAMILYINEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGFISHED .WINDOWS )WBASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR AMMODELING DESCRIBE WORK BEING DONE:-AS6M6"—i r (,J1S }1, 'a a,;omS SIZE OF IMPROVEMENT LENGTH 6a, S F -r WIDTH I S'P-HEIGHT FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES 13 HOUSE & GARAGE BASEMENT REMODELING SUBMIT: ]. Existing Floor Plan ✓ GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan w - PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑sow ADDITIONS, & PORCHES SUBMIT: O Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed Project. 2. Two sets of construction plans WINDOWS IN EXISTING OPENINGS ❑Yes)KNo LOCATION OF WINDOWS 3. Energy Calculations FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF S t O & 6 D RM MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & C X LY -55 TYPE OF WINDOW TO BE INSTALLED :2,0KCIX NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 0 _" OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ �i �. .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ ---- $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Al Agreement necessary( ) Non Necessary ( ) Total Due $ Make checks payable to: of Fridley Attach T 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 all work which requires review and approval of plans, SIGNATURE OF APPLICANT PRINT I_ PLEASE NOTE: SEPARATE PERMITS ARE RE UIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK No FA, M ME M ;:r7- ; loom 0 a 0 0 No ME No Him 7Q 4p. pre-md Wall Cross -Section Ceiling: 1/2" gypsum sheetrock ;� uo�uuKf Flooring: vinyl the Bryan Scholtes 4'r ry S� 612-309-6196 (A^ aj szcA VVE May 25 2010 601)SE soft, 00 Pt" r � 1 Insulation AND vapor barrier: iq Spray foam polyurethane, applied into joist cavities too r m = Interior fire barrier: 1/2" gypsum sheetrock 0 L 0 ;� uo�uuKf Flooring: vinyl the Bryan Scholtes 4'r ry S� 612-309-6196 (A^ aj szcA VVE May 25 2010 601)SE soft, 00 Pt" r � 1 .AM Electrical Plan Scholtes 4916 3rd St NE Basement Finish 612-309-6196 Coaxial13 12/3 12/3 12/3 12/3 -- —-1-,/3— Coaxial 1-,/3 Coaxial ■■■■■ ■■■� ' ■■■■■■�� ■■ ■■■■■■■■ [©■■■■■M■►RM■■ ■■■■■■ ■©■■ ■■■■SMAMM■----� ■It ■■ ■■■■■►/■■■ ` ■ ■■■Ew■■■■A■■■ w■■■■A Coaxial13 12/3 12/3 12/3 12/3 -- —-1-,/3— Coaxial 1-,/3 Coaxial Building MECHANICAL permit No.: tbbolq InspectionsRESIDENTIAL APPLICATION Received By:taiA 763-572-3604 CITY OF FRIDLEY Dal��'d: 763-502-4977 FAX ZUT EFFECTIVE 1-1-2010 1 u u I v DATE �j - oZ S - a©1 O YOUR E-MAIL ADDRESS _ _ `M N S c N U c-<—L-rS Q GMA 1 L , CoM SITE ADDRESS GI 16 3 X17 S4-"E rn rN S-S� —Q( THIS APPLICANT IS: OWNER 13CONTRACTOR PROPERTY NAME: S (Z"AA sQ ONVNER/ TENANT ADDRESS: licl ((7 3[Lo ST GV 0E CITY q--42 t Lts ( STATEM(11ZIPSn� "lD 1 PHONE:b t ori - S eD n - & (c:tG CONTRACTOR COMPANY NAME: CONTACT PERSON: SUBMIT A COPY OF STATE LICENSE # EXP DATE YOUR STATE LICENSE WITH ADDRESS: CITY STATE ZIP APPLICATION PHONE FAX PERMIT TYPE ASINGLEFAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: O NEW ❑ REPLACEMENT ;KALTERATION/REMODEL DETAILED DESCRIPTION OF WORK S�✓�t , �s,�vtc�p L> L �,�/ v c N v G e x icYvS ►�� i FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) PROVIDE HEAT LOSS CALC'S PER MANUAL J 20% ASHRAE HANDBOOK. Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU A/C $25.00 _FIREPLACE (GAS) $15.00 RANGEIOVEN $10.00 _GAS AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 GAS GRILL $10.00 _NEW BOILER $35.00 _FURNACE $35.00 GAS UNIT HTR $10.00 _ _CHIMNEY LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR$15.00 Number of fixtures @ $10.00 x $10.00 = $ 10 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 TyMMIUM FEE $3550 Total = $ S5-50 THIS 1S 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. SIGNATURE OF APPLICANT � PRINT NAME 2`14r S f -14 72SS DATE APPROVAL INSPECTORS SIGNATURE DATE M lk6 PLEASE NOTE: SEPARATE PERMIT UIRED FOR BUILDING, ELE&VCAt AND MECHANICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977