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PRE 2010 DOCS"Inv®h0_ ® "1 a I , in Building ` . Permit Fee BUILDING See Back Page for Fee Schedule Permit No.. rJns$PCt* ' 65% of Building Permit Fee RESIDENTIAL APPLICATION $ - I $ S , O9 Received By: 7f-3-572-3604 -.00 $ — 91 , X CITY OF FRIDLE�Y License Surcharge Date Rev'd: 110251 $5.00 (State Licensed Residential Contractors) - 6 $ 1 SCS, 00 DATE bV • t Lbw YOUR E-MAIL ADDRESS T $ SITE ADDRESS 46 $ THIS APPLICANT IS: tR'ONNER 13eONTRACTOR $ oo, PROPERTY OWNER/ NAME: S ,ng- , $ TENANT S7 &S*'— A4 0. 061hy- 4 g Make checks Davable to: Citv of Fridiev Attach StiDnlations ADDRESS:- I I Z I -1Q.. I?v'7CITY STATItZIPJ ca PHONE -7k3'— -767- 01 -In CONTRACTOR NAME:'&J=, _ y� x STATE LICENSE ii d (3 tl % 0 Q ) :7 EXP DATE — 51 — o l SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY - --STATE-ZIP--WITH APPLICATION p NE p PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ IN TILE ❑ DECK ❑ SIDING THER ❑ SWIMMING POOL TYPE OF WORK: W ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: I WAl 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 PROPOSED SIZE: ❑ DETACHED GARAGE 2. 3. Proposed floor plan List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vmyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: O Aluminum ❑ Trim L Site Phm/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. WINDOWS 2_ Two sets of construction plans IN EXISTING OPENINGS ❑Yes EINo LOCATION OF WINDOWS 3. Energy Calculations 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: (USTOTAL JOB VALUATION $DING T 0 � -60 C FEE SCHEDULE) PT Permit Fee $ 4 S . —9 See Back Page for Fee Schedule Plan Review $ q q 0. 06 65% of Building Permit Fee Fire Surcharge $ - I $ S , O9 1 times the total job valuation Surcharge -.00 $ — 91 , X .0005 x Permit Valuation Minimum $.50 License Surcharge $ 5,00 $5.00 (State Licensed Residential Contractors) SAC Charge $ 1 SCS, 00 $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 =$— $Erosion Erosion Control $ $450 Conservation Plan Review Park Fee $ oo, Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Dae $ 513 q.'t Ll Make checks Davable to: Citv of Fridiev Attach StiDnlations 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 F ' and with the Minnesota Construction Codes; that I understand this is not a permit but only an appli on is start without a permit; that the work will be in accordance with the approved plan in the case of all rk whi f rev' d P' val of plans. _ �t� SIGNATURE OF APPLIC PRINT NAME,/-7We /y � DATE l /zl:—Fza— H you will be selecting a standard paint and stain, please complete the Standard Paint / Stain Form, and fax to Blueprint Homes - (763) 862-9728. Refer to your specification sheets. Buyer: Job Address: Interior Selections Wall Color (1) standard paint color: Millwork / Cabinets / Interior Doors (1) standard stain: Front Entry Door and Trim (Interior Side): Steel door will be painted same as wall color, (1) standard color. Trim around door will be stained same as Millwork / Cabinets / Interior Doors, (1) standard stain. Exterior Selections Garage Bucks (1) standard color: Garage Doors - Refer to specifications: Front Entry Door and trim (Exterior Side): Steel door and trim around door will be painted (1) standard color: Buyer Date 0 Irl REScheck Software Version 3.7 Release 1 b Compliance Certificate Project Title: CROIX #06391 Report Date: 11/20/06 Energy Code: 2000 Minnesota Energy Code Location: Anoka County, Minnesota Construction Type: Single Family Glazing Area Percentage: 9% Construction Site: Owner/Agent: FRIDLEY, MN Designer/Contractor: BLUEPRINT HOMES Permit # —W Permit Date Ceiling 1: Flat Ceiling or Scissor Truss: 1272 44.0 0.0 34 Wall 1: Wood Frame, 16" o.c.: 2432 19.0 0.7 126 Window 1: Above-Grade:Vinyl Frame:Double Pane with Low -E: 261 0.350 91 Door 1: Solid: 40 0.070 3 Wall 2: Wood Frame, 24" o .c.: 456 10.0 0.7 38 Basement Wall 1: Masonry Block with Empty Cells: 992 10.0 0.0 59 Floor 3: All -Wood Joist/Truss:Over Unconditioned Space: 312 30.0 0.7 10 Floor 5: All -Wood Joist/Truss:Over Outside Air: 56 30.0 0.7 2 Furnace 1: Forced Hot Air: 90 AFUE Air Conditioner 1: Electric Central Air: 13 SEER Compliance Statement. Statement of Compliance: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 2000 Minnesota Energyqu rements in REScheck Version 3.7 Release 1 b and to comply with the mandatory u're is lis i R eck Inspection Checklist. B i r/ s' her Company Name Date Project Notes: 1688 SQ.FT. 2 STORY 416 SQ.FT.(UNFINISHED) CROIX #06391 Page 1 of 1 City of Fridley 6431 University Ave NE Fridley MN 55432 (763) 572-3602 or Fax (763) 502-4977 -- - - - Water -and Sewer Permit Application New Connection ❑ Existing Date: 1) .(, 2u OU Job Address: 59 d 1 - 3'011 ST . DUtility Line Repair/Relocation Pwater and Sewer Connection Name of Applicant (Plumber):1%` '��j�� I� / is l�l�!' %3��c �� 1 ,PWA Name of Property Owner: Existing Structure Permit # Permit Type: Sewer Fee: * rqU Water Fee: Meter Fee: Repair Fee: Relocation: State Surcharge: St.eD SAC Charge: Special Assessment Fee: Total: $ t 0 1. ®b Applicant Signature; Inspector approval: Water Meter Repair — Weekend & Holidays $125/hour Water Connections Permit $50 Sewer Connections Permit $50 Inspection Fee for Water/Sewer Line Repair $40 Special Assessments See Engineering Cost of Water Meter See Utility Billing SAC Charge $1550 State Surcharge $ .50 Water Tap See En ' eerin 04/04/05 Building MECHANICAL Permit Noc-"1— Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 1',FO -7 DATE ` o2 D -o 7 YOUR E-MAIL ADDRESS SITE ADDRESS O — 5'k THIS APPLICANT IS: ❑ OWNER JaCONTACTOR PROPERTY NAME: ADDRESS: CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR COMPANY NAME: SUBMIT A COPY OF CONTACT PERSON: S YOUR STATE STATE LICENSE # LZ' J�,3 EXP DATE 1a _ 't ` LICENSE WITH ADDRESS: , .3 < CITY STAT�`nZIP APPLICATION PHONE f'7/s 3) al? - �8 9 G FAX '- 1 -7d PERMIT TYPE [SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: NEW ❑ REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU lil/—' 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 7FURNACE $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 = $ Permit Fee $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ 5sE 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 whic requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME � �� DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC o NEW HOMES/ADDITIONS o EXISTING HOME o 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. cL City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 PLUMBING Permit No.' 7 ^ ! Building Inspections RESIDENTIAL APPLICATION Received By: " av; 763-572-3604 CITY OF FRIDLEY Date Rec' DATE -2 — �� YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: 0 OWNER 791CONTRACTOR PROPERTY NAME: ADDRESS: CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR NAME: N► el STATE LICENSE # 3 c/S EXP DATE STATED -/ ZIPJSa 1/ SUBMIT A COPY OF YOUR STATE ADDRESS: /®� - �'� -,00y<-CITY Cj5 LICENSE WITH PHONE V'�S$ FAX APPLICATION PERMIT TYPE INGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: W 0 REPLACEMENT DETAILED DESCRIPTION OF WORKic 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 -ABER OF EACH BELOW) BATH SINK/LAV __/FLOOR DRAINS Z SHOWER WATER PIPING WATER SOFTNER ($35) BATHTUB GAS PIPING (xEEDcrrrrrcEvsE) SWIMMING POOL _ CLOTHES WASHER KITCHEN SINK WATER CLOSET _BACKFLOW PREV. ($15) DISHWASHER / LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION WATER METER —OTHER 7 77 s 3 03- .,., 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 @ $35.00 x $35.00 = $ ' State Surcharge = $ .50 Total = $ o 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 wort w is r qui s eview and approval of plans. h SIGNATURE OF APPLICANT PRINT NAME DATES r ._ City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 IdiDg TV[ECH.ANICAL PennitNo. 95.7 -00_;� Ins eCtioas P RESIDENTIAL APPLICATION Received By: 7.63-5723604 CITE' OF FRIDLEY bate Recd: Qpi -7 DATE ) v% YOUR rr-MAI! AI)DJtSSS SITE ADDRESS 912f —' , 7� _,-- THtS APPLICANT IS: O OWNER `CONTRACTOR PROPERTY NA S; OWNER/ TENANT ADDRESS: CITY STATE ZIP PHONE: CONTRACTOR COWAW N,, I,r - SUBMIT A COPY OF CONTACT PERSON' -- 4A6/}- - - YOUR STATE STATE LICENSE Y 6f. -'?� �_ (� EXP DATE LICENSE WITH ADDRESS CITY..-.. - STATEAL16 �al APPLICATION PHONE PAX PERMIT TYPE 1 °SINGLE FAMILY 0 TWO FAMILY O TOWNHOUSE TYPE OR WORK:PIC-WD REPLACEMENT O ALTERATIONIREMODEL DETAILED DESCRIPTION O)F WORK Sej= PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fvttures. (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 $51, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED, FIXTURES: (INDICATE TOTAL NUMMER OF EACH BELOW) F.quipmattlnstatlod MF �i-(b MOM: k&k26� SIZEBTU D00 MFG: MODEL: SIZFJBTU MFG:MODEL:— SIZEJBTU NC $25.00 , CE (GAS) $15.00 GAS RANGE/OVEN $10.00 AIR TOA)R EXCHANGEFR S15 CS (WOOD) $35.00 _NSW GAS GRILL $10.00 BOILER $35.00 _FURNACE $35.00 :::GAS UNIT HTR $10.00 CHIMNEY LINER $10.00 `GAS DRYER 510.00 POOL HEATER $35.00 DUCT WORK $10.00 0A5 PIPING $10.00 VENTI[ ATQR $15.D0 Permit Fee $ Number of fixtures @ $10.00 x $10.00 $ Surcharge S .50 Number of fixtures @ $15.00 TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 _ x $35.00 = S State Surcharge c $50 Total - $_j5_-50 THIS 1S AN APPLICATION POR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and 1 ackAowledge 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 1 understand this is not a permit but only an Application for a permit and work is not to start without a perrnit; that the work will be in accordance with the approved plan in the case o wor ich requires review and approval of plans. , �/ SIGNATURE OF APPLI PRINT NAME%& / o QC DATE_�"O City of Fridley Building Inspections Department . 6431 University Avenue NR, Fridley, MN 55432 Td WdL2:L0 900E LZ 'daS 763-5723604 FAX: 763-502-4977 LGZZT2_SR9L: 'ON XUA halmuj Jo RITO: WONJ