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PRE 2010 DOCSCity of Fridley SUBJECT 16247 AT THE TOP OF THE TWINS BUILDING PERM i r REC IP 1 ai -------- COMMUNITY DEVELOPMENT DIV. D r 1 PROTECTIVE INSPECTION SEC. 34 O 1 ,'� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 6419/81 JOB ADDRESS 5760 -3rd St. N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. t 4, 5, 6 2 1 City View Add SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Bullick Homes 9133 Van Buren St. N.E. Blaine 780-3400 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Ernie Bercrstcm 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 CA NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 24' X 40' house. 9 CHANGE OF USE FROM TO STIPULATIONS i There areno water and sewer sevice.for this lot. The nearest mains are at 57 and 2h St. N.E.. The design for the service must be approved by the City Engineerin Dept. The sewer design must include a manhole (see attached sketch). The owner I ust bear all the expense including the restoration of the street. Provide a hard surface driveway. provide sod in thefront and side yards. Provide the City with a copy of a varifying survey before capping. b DRIVEWAY DEPRESSION ESCROW: 18 x ENAW24FERMITS REQUIRED FOR WIR`p M HEATING. PLUMBING AND SIGup_ CALL FOR All < IM9P�(`MOft Rett ddikeng call local- utilities r mal Inspections of ell , i do WM, E --ELECTRIC-GAS Eta: 7wor :�quir-ed t0 . 1 p`• TYPE OF CONST. OCCUP C C SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Wood Frame 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 R 1 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 $ 40,350.00 $20.78 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 F ANY OTHER TATE OR LOCAL LAW REGULATING CON- PROVISION,e,­R $76.80 $425.00 STRUC 10 THE PERFO ANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE Y/ $19.20 P 541.18 =S%.= SIGNATU OF NTRACTO OR AUTHORIZED AGENT (DATE) WHEN PROPP/JERLY VALIDATED THIS IS YOUR PERMIT � �j/ I o . is BLDG INSP (/(�/l �j ) OA E _ SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) 01 M r ♦ w CITY 01' FRIDLEY APPLICA•CIO;J FOR RESIDENTIAL BUILDING PER41TS (Nevi, Alterations, Additions, or Repairs) OW14ER: ��,1�,�1r f� �,-Cvhr� ,(,�r�s yon-, BUILDER: ADDRESS: ADDRESS: (�";., d& 1? -.7 d'��j•ti TEL NO: TEL 140: fro 3 N a J Construction Location STRBET NO: �'-% E 0 STREET: LOT: See BLOCK: �Y v T BLOCK: ADDITION : o Corner Lot: Inside Lot: Setback: 3 7 Sideyards: %G 30 Apl-ilicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION lilOevs e, Front: ;: y Depth: L/ Height: ?d Square. Feet: 9G d Cubic Feet: 19,200 Front: Depth: Height: Square -Feet: Cubic feet: 9i6o X -{'L.0 'i_ : y p 3'3�j 2.c� yr ©e Type of Construction: Ak z Estimated Cost: $ To Be Cbrapleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ 2�3.d� $ SEB REVERSE SIDE OF SHEET . Tie 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�zre true and correct. 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RATE TOTAL Number Fixtures 1� x $3.00 $ 3oo Future Fixture Opening x x m New Fixture, Old Opening Water aei a� H x $5.00 $ E sp $ m� N a w Water Softener x Heater $ New Ground Run Old Building x $5.00 $ Electric Water Heater x' $5.00 $ GAS FITTING FEES: 1st 3 fixtures x '$3.00 $ 3,00 Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS 4 ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 U o M o� W S a w W g uasa 3 0 ($10.00) O s lec 1st 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures 1� x $3.00 $ 3oo Future Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water Heater - to 99,000 BTU _� x $5.00 $ 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater x' $5.00 $ GAS FITTING FEES: 1st 3 fixtures x '$3.00 $ 3,00 Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS 4 ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE `y $�J 9c, REINSPECTION FEE ($10.00) Job Address Zee C. 3 W- T" Department of Buildings City of Fridley Tel. #57173450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct '/ Fridley, Mn. -07, 19_L if OWNER 1-3L., `1, C C- /� Aelpo'OL-ti ry KIND OF BUILDING t4-9 ODd 0 USED AS TO BE COMPLETED ABOUT ESTIMATED COST 7 - OLD OLD - NEW BUILDING PERMIT NO. PERMIT NO. 6( company /�rL �-6-�a Kim T PAC- G -- Signed By Tel. No. ROUGH INSP. Date I FINAL INSP. 1 Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE /f - _ C-= TY Mr- 7-MEMLEY 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE ( 612)571-3450 September 9, 1981 SEP 10 19 Bullick Homes 9133 Van Buren Street N.E. Blaine, MN 55434 FE: Final Inspection at 5760 - 3rd Street N.E. Dear Sirs: A final inspection was made on September 4, 1981 of the above address and the following items were noted which must be completed before the structure can be finaled out; Q� Provide City with a copy of the verifying survey. ('L}. Post address numbers on structure{ on the front of structure) . Install nuts and washers on anchor bolts. U4. Install frost footings on deck posts. 5. Provide sod in the front and side yards. We will expect items #1, #2, #3, and #4 to be completed by October 1, 1981 and item #5 to be completed by June 1, 1982 when reinspections will be made to determine compliance. If you have any questions on these items, please feel free to contact me at 571-3450. Sincerely, DARREL G. CLARK Chief Building Official Darrel: I believe the first few items have been taken care of and homeowner is aware he has to sod or seed in allotted time. If I goofed up any place else, please phone and let me know. Thank you. HOMES, INC. Larry W. Scheidegger SUBJECT City of Fridley 179 W3 TWINS !0-- BUILDING PERMIT r ECEIPT NO. r.L _ COMMUNITY DEVELOPMENT DIV. VE INSPECTION SEC. r PROTECT 1 1 NUMBER REV, DATEPAGE OF APPROVED BY ` 1 1 CITY HALL FRIDLEY 55432 IL.... f �'� 612-571-3450 910-F15 4/11/85 JOB ADDRESS 5760 - 3rd Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt. 4, 5, 2 City View Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ernest Bergstrom 5760 - 3rd Street N.E. 571-1012 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO, Pacific Pool & Patio 6922 - 55th XK Street N., Oakdale, MN 55109 770-1313 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. I NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 16' x 321 In-ground Swimming Pool 9 CHANGE OF USE FROM TO STIPULATIONS See letter dated April 11, 1985 (attached) with stipulations. may+ 11,15 �' n ��k T�®R Before SEPARATE TE cr ;'h` -�i WIRING, G, �� ;DTII J—' o LUVABING AND S9GNS., LE �,%oaf HCAl -.I 14', '.5 a' RIC BYLAW 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 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 $10,000 $5.00 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- $80.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $85.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI WHEN ROPER Vj%L1PPT D T IS IS Y UR P RIT -I ��rf G INSP MATE SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ J R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: 57y O A Legal Description: Owner Name &Address: ✓��� /�� ,��5 °� ' Tel. i �%l' 04,2- Contractor: �r� �o 1` �/ � Tel. # Z O -/Z/ Address.: 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. 3 OTHER: ��0� �✓c�/%3 Sze,;�� �.u,�C 1—yo-6,6. � � �- Corner Lot [ ] Inside Lot _[ ] Ft. Yd. Setback Side Yard Setback JJll Type of Construction: V e --y S '�S -��' Estimated Cost: $ Z e_Cw Approx. Completion Date: �� /5___ Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: 5 1�S APPLICANT: L12� Tel. * l� CITY USE ONLY Permit Fee $ O U -Sb Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ d $•50/$1,000 Valuation SAC Charge $ $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge a _ essary [ 7 Agreement Necessary [ �_No-t-1� TOTAL $ STIPULATIONS: 90 -_ . i a.% CITYOF FRIDLEY CIVIC CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 - PHONE (612) 571-3450 April 11, 1985 Pacific Pool & Patio 6922 - 55th Street North Oakdale, M 55109 Re: Swimming Pool Construction at 5760 - 3rd Street N.E. Dear Sirs: This letter is to make clear this department's requirements for the swimming pool construction at the above address. 1. As indicated, two (2) skimmers approved by the National Sanitation Foundation will be provided. 2. As indicated, three (3) inlets of approved design for fresh and/or repurified water will be provided. 3. As indicated, a main drain of approved construction will be provided. 4. The filter and pump shall be approved by the N.S.F. and be of sufficient capacity to provide a minimum turnover of at least two (2) times in 24 hours. This department recommends a turnover rate of 6 - 8 hours. 5. A deck of at least three (3) feet wide, measured from the pool waters edge, shall be provided which extends completely around all private residential pools. Above ground private residential pools may be provided with decking of a minimum size of 4 feet by 4 feet at pool entry points and provided that such decking has the approval of the City. 6. The diving area will be acceptable provided there is no overhead obstruction. 7. Fencing or other effective means including but not limited to walls or buildings, acceptable to the City, shall be provided to positively control all access to public and private residential swimming pools. Fencing shall meet the following criteria: (a) The fencing shall prevent the entrance of children and be without hand or foot holds that would enable a person to climb over it. (b) The fencing shall be at least 6 feet high and entrances shall be equipped with self-closing and self -latching gates capable of being locked. (o) Self-closing and self -latching devices shall be placed at the top of the gate or otherwise inaccessible to small children. (d) The opening between the bottom of the fence and the ground or other surface shall be not more than four inches. April 11, 1985 Pacific Pool h Patio Re: 5760 - 3rd Street N.E. Page 2 8. An automatic chlorinator should be provided with a suitable test kit. 9. All electrical and plumbing installations shall be inspected and approved by the City Inspection Department. 10. All overhead electrical lines must be a minimum of 10 feet horizontally from the pool surface, and 18 feet straight line distance from the waters edge. An alternative is to bury said lines. 11. The pool fill spout must be protected by a vacuum breaker or air -gapped. 12. Suitable safety equipment to include but not limited to a ring buoy and rope that is 1-1/2 times the pool diameter and shepherds crook pole must be provided and maintained with the pool at all times. Furthermore, these and any other requirements must meet the provisions of the Fridley City Code, Section 115, Swimming Pools. The building permit is approved contingent on final inspections and approval of the City. If any questions or problems arise from this letter, please feel free to contact me at 571-3450. Sincerely, DARREL G. CLARK Chief Building Official SJO/mh CC: Mr. Ernest Bergstrom 5760 - 3rd Street N.E. ,5910 - '34co AKANSON professional engineers and surveyors NDEP SON ASSOCIATES, Inc. Anoka, Minnesota 55303 612/427-5860 CERTIFICATE OF SURVEY l Survey for: Bullick Realty 2 IN-PLACE FOUNDATION LOCATION 5760 3rd St. N.E. J. /ZQ 40® VACA / P-72 7-1 %n 40.d I Fouivovri, �I I DESCRIPTION: The north 37 feet of Lots 4, 5 and 6, CITY VIEW, Anoka County, Minnesota, and' -that part of vacated 57 1/2 Ave. N.E. adjacent to said lots. Scale: �,•� 3O� Bk. 70 pg, ze Sec. -,T.- , R. o Denotes iron monument I hereby certify that this survey, plan or report was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota. Reg„ No. Date Job No. %n DESCRIPTION: The north 37 feet of Lots 4, 5 and 6, CITY VIEW, Anoka County, Minnesota, and' -that part of vacated 57 1/2 Ave. N.E. adjacent to said lots. Scale: �,•� 3O� Bk. 70 pg, ze Sec. -,T.- , R. o Denotes iron monument I hereby certify that this survey, plan or report was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota. Reg„ No. Date Job No. SUBJECT City of Fridley IFI99591 AT THE TOP OF THE TWINS BUILDING PERMIT Ir � RE • COMMUNITY DEVELOPMENT DIV. ^ l/a r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/13/88 JOB ADDRESS 5760 - 3rd Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION Block 2, City View Addition SEE ATTACHED DESCR. N 37' of Ihots 4,5,6 & Part of 5711 Vacated Street SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ernie Bergstrom 5760 - 3rd Street N.E. 571-1012 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 ❑ NEWl ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 28.1.x 26' Garage and a 121x 6t Living Area Addition 9 CHANGE OF USE FROM TO STIPULATIONS provide a hard surface driveway. See notations on plan. SEPARATE PERMITS REQUIRED FOR WIRING. HEATLN0, PLUMBING AND SIGNS, ���;�itttttttt� Bef"M dfggklg catl local utilitres MERpp�, ELECT W Eta. ' REE-I u$ QED B'Y LAW 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 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 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 $12,500 $6.40 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- $144.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTA�U Li $19b. 40 GNATURE OF CONTRACTOZOUTNOR12ED AGENT IDATEI HEN PROPERLY VA ATED THIS ISYOUR PERMIT SIGNATURE OF OWNER [IF OWN-ER BUI DER) iDArEi BLDG INSP O TE NEAT I ] ADDN AMER [ ] Construction Address: 5 7 City of Fridley R-1 AMID R-2 Building Permit Application 3 RO S 7r /L2 < Effective 5/1/88 Legal Description: Loi' -w 3? ' Of- AQec- ®/= S`7% 0,4c,9°rVo s 7 - Owner Owner Name & Address: EhU I E- Tel. # .S71- /o/ 2 QDntractor: Tel. $ Address: Attach to this application, a Certif icate of Survey of the lot, with the proposoed construction drawn on it to scale. IZ DESCRIPPION OF IMPROVEMW LIVIR; ARFA: Length M Width Height Sg. Ft. GARAGE AREA: Length a� Widur. Height a 7 9I. Ft. DMX AREA: Length Width Hgt/Ground Sg. Ft. Qbrner Lot Inside Lot 1� Bt d �tback 8� _'Side Yard Setbacks Type of Construction: )PAw t Estimated Cost: Approx. Completion Date: F/30/,93- 1 'L I fad a Proposed Driveway Width If New Opening Is Desired: / $ Alt. A $ Alt. B Width + 6' See Back Page DATE: Z / APPLICANP: Tel. $ 57J -10/ Z If CITY USE OILY Remit Plee S Jqq►® Flee Schedule on Reverse Side State Surcharge $.50/81,000 Valuation SAC Charge $ $550 per SAC Unit Driveway Escrow 8 Alt. "A" or Alt. "B" Above Park Plee $ Plee Determined by Engineering Sewer Dain Charge $ Agreement Necessary I ] Not Necessary I I TOTAL $ ��®•�0 STTFULAXMMS: to . . , 12,9010 1gq,ot) 3uilding BUILDING Permit No.: inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 • CITY OF FRIDLEY Date Rec'd: )ATE z �JOT E-MAIL ADDRESS a ft/1 A% >ITE ADDRESS S`7 CPa gYOUR 3 ® T /�- HIS APPLICANT IS: O OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: E'/2n tr-- & li (71S 1 Rd w— _'^ ADDRESS: 5:J L, C) 3 AQ S 7, A), � CITY 1 "'IC C -,- a STATF A TENANT PHONE: 7 3^ a O S '- y —&^7 g CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE MSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ABROOF ❑ DRAIN TILE ❑ DECK 0 SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING Cl HOUSE ONLY NUMBER OF SQUARES &HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ 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: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 'PQ 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 $ 1. .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ vo C?q Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances 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 tet► 171, PRINT NAME G1QWJr & f &C 1 L¢ ,DATE /o � ` 1 FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (763) 571-3450 • FAX (763) 571-1287 BUILDING PERMIT APPLICANT: PROPERTY OWNER 1, C--)ePU I -- se e&s i �o L, - - 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 g exemption from the licenI—, requirements. As the owner of the property at 7 too 3Rrd S I 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. o NameAZL. �— Date /-Z `( /c, (P 3uilding BUILDING Permit No.: U nspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Recd: 0 - )ATE YOUR E-MAIL ADDRESS ;ITE ADDRESS -5 0 r V1 > L HIS APPLICANT IS: 'XOWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: P— TENANT y ADDRESS:-5--1 [a CD f CITY 7 STATE�IP /�/ PHOliL �D� i� 5 - �-t-3-6 �jS CONTRACTOR NAME; STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION PHONE FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED IWWINDOWS ❑ BASEMENT FINISH O ❑ DRAIN TILE 1[3 ❑ DECK SIDING ❑ OTHER STF SWI]VDANG POOL TYPE OF WORK: ❑ NEW ❑ ADDITION MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: QJ I N to ° `'P�)s ✓000'en ' S 1 /'U C— SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum Trim Other CrtrK£a 1 60A,1 13 KFascia I. Site Plan/Survey showing the existing structures and proposed project 2. Two sets of construction plans WINDOWS IN EXISTING OPENINGS KYes ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED C�Zm nJ % 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, 6,n o _ ® cd 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 $ 1 �z i5-0 $ 5„ OD See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .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 savable 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 requires 9view ani q_aRproval of plans. SIGNATURE OF APPLICANT " PRINT NAME _d&f' �G tl? - �fE Building Inspections 7.63-572-3604 DATE SITE ADDRESS -Z3 -o THIS APPLICANT IS: PROPERTY OWNER/ TENANT 5760 CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS Permit No Received By: Date Rec'd: D%'(eic7% 17 OWNER 6;QNT7ACTOR NAME: Cp at! I L� �-eGl & ADDRESS: SQA CITY STAT , m�-�! • �% ZIIL PHONE: /11o3- a -e-5'- 5137 f COMPANY NAME: CONTACT PERSON STATE LICENSE Il p 4 ayD STATE ZIP — ADDRESS: ADDRESS: � ax (<) 7 PHONE TYPE OF WORK: I 0 NEW DETAILED DESCRIPTION OF FAMILY 0 TWO FAMILY `LACEMENT r— D TOWNHOUSE ❑ ALTERATION/REMODEL -I--- Pr/ G 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 = 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: G i �D t71%/�-{S MOD U�Z SIZE/BTU MFG: MODEL: MFG. MODEL: SIZFJBTU _FIREPLACE (GAS) $15.00 _GAS RANGEIOVEN $10.00 A/C $25.00 NEW GAS GRILL $10.00 AIR TO AIR EXCHANGEER $15 L�FURNACE $35.00LACE OD) $35.00 GAS UNIT HTR g 10.00 BOILER S35.00YLIN —POOL HEATER $35.00 CHIMWEY LINER $10.00 —GAS DRYER $10.00 DUCT WORK $10.00 —GAS PIPING $10.00 VENTILATOR $15.0D �1CAr/:11Cr\�Z'�if�^i�1Mssz+r�'aarae; rt+....,....e .r:..m: r» ..:;moo-........�„_. .,,. ._.�.,__.... .-.._....._.... Permit Fee $ Number of fixtures @ $10.00 x $10.00 = Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $Number of fixtures @ $25.00 x $25.00 = $wALK'-0.0 Number of fixtures @ $35.00 x $35.00 = $ 1 K'_00 State Surcharge = $ .50 Total = $ &n !a) 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 allw rk which quires review and approval of plans. DATE ;?°73� -7 /� SIGNATURE OF APPLICANT %I ® " PRINT NAME City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 T7. A v. '7r_2S117_AQ77 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMESIADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEWIEXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/TGC 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 airy calculations Engineering WATER AND SEWER Permit No.; 763-572-3552 PERMIT APPLICATION Received By;�l 763-571-1287 fax CITY OF FRIDLEY Dc EFFECTIVE 7/1/2010 c J �� O� d APPLICATION DATE: YOUR E-MAIL/FAX: THIS APPLICANT IS: ❑ OWNER �rCONTRACTOR JOB ADDRESS: -526 � 5 V NEW CONSTRUCTION PERMIT# (IF APPLICABLE): PROPERTY NAME: �l�ti, �P.�c, s �✓� v-� ADDRESS: 5-74; 6 � h d S *� . CITY �i STATE ZIP TENANT PHONE: Zy S — `i ? 7 T CONTRACTOR NAME: �y� , d cu •� 4e 4 SUBMITA COPY OF DRESS: 7 7 rIV �� l�il CITY E' STA ZIP S � 3�p YOUR STATE LICENSE WITH PHONE `7 G til - Cn 7 / 2 _ CELL PHONE: APPLICATION STATE LIC # STATE BOND: EXP DATE: 1. Narrative/written description: � -ey & C —4.-" A--t' Sig r, , c R-- - N w P 9 x r �-- 2. Please attach sketch showin curb line, utility line, building, etc. with distances on back page. 3. Stipulations: r Z( — t6e6' N T-C . D� QLD CoPOE� m PERMIT TYPE ❑ SEWER CONNECTION PERMIT $50 XWATER CONNECTION PERMIT $50 Sf� ❑ WATERLINE REPAIR $40 ❑ SEWER LINE REPAIR $40 ❑ ADD STATE SURCHARGE $5.00 ❑ SAC CHARGE @ $2100 = TOTAL $ OTHER CHARGES (IF APPLICABLE) PAY TO UTILITY BILLING NEW WATER METER COST — SEE UTILITY BILLING SPECIAL ASSESSMENTS — SEE FINANCE WATER TAP — SEE ENGINEERING NOTE: WATER METER REPAIR, INSP OR SHUT-OFF / EVENINGS, WEEKENDS & HOLIDAYS $125/HOUR-BILLED THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a water or sewer (new connection or repair) 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. I understand this is not a permit but only an application for a permit a l work is not to start without a permit. 4Kr�Z t-V DATE: SIGNATURE OF APPLICANT PRINT NAME: ° APPROVED BY: DATE: COPY G T : ❑ UT ITY BILLING (only if new meter) ❑ PUBLIC WORKS ❑ EN E RING V City of Fridley Engineering Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3552 FAX: 763-571-1287 i � ` n�