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PRE 2010 DOCSBuilding $ 1 191 cl BUILDING Permit No.: t a Inspec4ions 65% of Building Permit Fee RESIDENTIAL APPLICATION Received By: 763-572-360 Surcharge CITY OF FRIDLEY Date Recd License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge DATE �� YOUR E-MAIL ADDRESS Curb Cut Escrow SITE ADDRESS �� I Erosion Control THIS APPLICANT IS: ❑ OWNER ONTRACTOR Park Fee PROPERTY OWNER/ NAME: Sewer Main Charge ADDRESS: CITY STATE ZIP TENANT $ 53"1 1 . -41 PHONE: CONTRACTOR NAME:� STATE LICENSE # 007-7ZD/3 EXP DATE �l SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: /��Z lZ %3�' CITY &61A,'Z_ STATIAe WITH APPLICATION PHONE en ZZ FAX Z6� -Z PROPERTY TYPE GLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STO PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: W ❑ ADDITION ❑ MAINTENANCE/REPAIR 13 REMODELING `/, DESCRIBE WORK BEING DONE: AAEW 42 E SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2. Existing Floor Plan 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 357U70 FEE SCHEOCCUPD ANCY TYPE TOTAL JOB VALUATION $ Permit Fee $ 1 191 cl See Back Page for Fee Schedule Plan Review $ `C S (. 65% of Building Permit Fee Fire Surcharge $ l �i . .001 tithes the total job valuation Surcharge $ . (' .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ i5�y t $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 $ Vic . a." a Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 53"1 1 . -41 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 applica '�ffbramit and work' t to start without a permit; that the work will be in accordance with the approved lan in the case of all w rk es MJ& aWapproval of plans. Building . $ BUILDING Permit No.: Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION Received By: 763-572-3604 Surcharge CITY OF FRIDLEY Date Rec'd: DATE 7® (si0 YOUR E-MAIL ADDRESS $5.00 (State Licensed Residential Contractors) SITE ADDRESS ' &E / ZW 4 i#/V $1550 per SAC Unit (Plans to MWCC for determination) THIS APPLICANT IS: ❑ OWNER ONTRACTOR R + 6 ft = ft x $21 =$ PROPERTY OWNER/ NAME: A $450 Conservation Plan Review ADDRESS: CITY STATE ZIP TENANT Sewer Main Charge PHONE: Agreement necessary ( ) Non Necessary ( ) CONTRACTOR NAME: &MW Make checks savable to: City of Fridley Attach Stipulations STATE LICENSE # ZOZ92©/3 EXP DATE3v ® yy� �✓�5 SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY �sAoye- STATiZr// WITH APPLICATION PHONE 4a Z, FAX 6,4 s Z r PROPERTY TYPE GLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK:W ❑ ADDITION ❑ MAINTENANCE//R,E�P/AIR ❑ REMODELING DESCRIBE WORK BEING DONE: AIEW hkysE SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S . 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 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 $ /501-35-7-70 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 $ .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 $ R + 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 $ Make checks savable 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 applica ' fora ermit and work ' i t to start without a permit; that the work will be in accordance with the approved plan in the case of all w rk whi Ims e ' a approval of plans. e Received Fax un 30 2006 11:38AM Fax -Station : BLULPRINI HUMLS Jun 30 06 11:37a Croix Custom Concepts (763)323-e660 REScheck Software Version 3.7 Release 1b Compliance Certificate Permit # Permit Date Project Title: KELLY RESIDENCE Report Date: 06/30/06 Energy code: 2000 Minnesota Energy Code Location: Anoka County, Minnesota Construction Type: Single Family Glazing Area Percentage: 10% Construction Site: Owner/Agent: Designer/Contractor. FRIDLEY, MN BLUEPRINT HOMES, INC. Ing Ceiling 1: Flat Ceiling or Scissor Truss: 750 44.0 0.0 20 Wall 1: Wood Frame, 16° o.c.: 1776 19.0 0.7 91 Window 1: Above-Grade:Vlnyl Frame:Doubie Pane with Low -E: 191 Door 1: Solid: 38 0.350 0.077 67 3 Wall 2: Wood Frame. 24° o .c.: 296 10.0 0.7 25 Basement Wall 2: Masonry Block with Empty Cells: 928 10.0 0.0 54 Window 2: Basement > 5.6 ft2:Vinyl Frame:Double Pane with 18 0.350 6 Low -E: Floor 1: All -Wood Joistrrruss:Over Outside Air: 46 0.0 30.0 1 Furnace 1: Forced Hot Air: 90 AFUE Air Conditioner 1: Electric Central Alr. 13 SEER Compliance Statement: Statement of Compliance: The proposed building design described here Is consistent with the building plans, specllications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 2000 Minnesota Energy Code requirements in REScheck Version 3,7 Release 1b and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Builder/Deslgner Project Notes: CROM #06216......512412006 Company Name Date KELLY RESIDENCE Page 1 of 1 City of Fridley 6431 University Ave NE Fridley MN 55432 e©` (763) 572-3602 or Fax (763) 502-4977 - - - - - ---Water and Sewer Permit Application 04New Connection FlUtility Line Repair/Relocation ❑ ExistingWater and Sewer Connection .." 5q Date: 911-710 U Job Address: 6""14- 1 - 3YCI S -t. NF, Name of Applicant (Plumber): 3b E�X C (ANa.t V1� G, 1 h L Name of Property Owner: 6 1 j t (D Y 1 V)t VM IMICS , M C - Existing Structure Permit # Permit Type: Sewer Fee: 5b . °D Water Fee: 151D. °c Meter Fee: Repair Fee: Relocation: State Surcharge: t 5 D SAC Charge: Special Assessment Fee: Total: $ ( DO s 0 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 PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By:`� 763-572-3604 CITY OF FRIDLEY Date Rec'd: �i DATE `' %- YOUR E-MAIL ADDRESS SITE ADDRESS r l ST THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: OWNER/ ADDRESS: CITY STATE ZIP TENANT PHONE: CONTRACTOR NAME: o d AI G STATE LICENSE # 3194/5 EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS: 4aa U%A/IA 1113, ArI tl L. CITY C FAQi9< STATE M/JZIP _Ual% LICENSE WITH PHONE &3- 213-Ak } FAX 2a - v3y- �,7Ff�6 APPLICATION _ PERMIT TYPE �g� INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: W ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK opus J 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 PRGIECTS WHERE LABOR EXCEEDS $500, FEES ARE -BASED ON-$'k(kOO PER-;FWURE,.EX�EPT WHERE NOTED. FIXTURES; MMICATE TOTAL NUMBER OF EACH BELOW) BATH SINKILAV / FLOOR DRAINS 2 SHOWER WATER PIPING _ BATHTUB _T GAS PIPING (NEED crrrucENsE) SWIMMING POOL WATER SOFTNER ($35) _ _ / CLOTHES WASHER 1 KITCHEN SINK WATER CLOSET _BACKFLOW PREY. ($15) DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER —OTHER y , _. .,. :c.:• . '. iv'.. �..:..,`,k".,. ,, MINA i '.:i'4S �..bS 3 a, L{ `T . _g i .L.f '. Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures @ $35.00 C x $35.00 = $ 3S.00 TOTAL DUE $ State Surcharge = $ .50 Total = $ 1.SCJ 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 r u' es r Iew and approval of plans. SIGNATURE OF APPLICANT PRINT NAME/%/ DATE r,- fir. a City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building Inspections 763-572-3604 DATE `� � SITE ADDRESS TRIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: f Permit No.' i� MECHANICAL RESIDENTIAL APPLICATION Received By: CITY OF FRIDLEY Date Recd: YOUR E-MAIL ADDRESS O OWNER FICONTRACTOR NAME: ADDRESS: CITY STATE ZIP PHONE: COMPANY NAME:_ CONTACT PERSON: STATE LICENSE #_ IkSINGLE FAMILY 0 TWO FAMILY •NEW 0 REPLACEMENT DETAMED DESCRIPTION OF WORK e T� EXP DATE CITY r FAX .3 a 13 — L 0 TOWNHOUSE 0 ALTERATION/REMODEL. STATE )�L—" 2�7" 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) MODEL: SIZEBTU Equipment Installed MFG: SIZEIBTU MFG: MODEL: SIZE/BTU MFG: MODEL: A/C $25.00_FIREPLACE (GAS) $15.00 •_GAS RANGE/OVEN $10.00 _AIR TO AIR EXCHANGEER 515 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOILER 535.00 =FURNACE $35.00 _GAS UNIT HTR $10.00 CHIMNEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 _GAS PIPING $10.00 _VENiiLATOR $15.00 i DUCT WORK 510.00MIS, —0034-11 i .stn 3y 4ilYS11PV�?vve�z, ar k u <: ., • ,::._ Permit Fee $ Number of fixtures @ $10.00 ,� x $10.00 = c�. 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 l x $35.00 = $ State Surcharge = $ 50 Total = $ 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 APPLIC PRINT NAME DATE `3 O City of Fridley Building Inspections Department . 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 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 propaneUGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances TGC 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 Building ANCHANICAL Peni tN Inspections RESIDENTIAL APPLICATION Received By: � 7.63-572-3604 CITY OFFRIDLEY Date Rec"d: DATE YOUR EMAIL ADIm as ,(l�'S�,�G�l r [ [ �Q�f��/�!�(l! SITE ADDRESS 35f.✓ T TMS APPLICANT Is: a OWN M- `WONTMCTOR PROPERTY NAME: OWNER/ TENANT ADDRESS: CITY STATE - ZIP. PHONE: - CONTRACTOR COMPANY NAME: SUBMIT A COPY OF CONTACT PERSON, LA:04ti YOUR STATE STATE LICENSE Yt )ri— i 4_S -b EXP DATE es 3/0-z LICENSE WTITI ADDRESS: V,prz 1 -'!/Jf CITY STATEN lAfZlP_� APPLICATION ,�j _ PHONE J( 0!5 -1. Q =&54 FAX PERMU TYPE 'PfINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE 4 TYPE OF WORM, / D REPLACEMENT 0 ALTERATIONI8EMODEL - DETAILED DESCRIPTION oy woRKVv 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 furtures. (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 $5 , FEES ARE BASED ON S1 0,0D PER. FIXTURE, EXCEPT WHERE NOTED, FD' TURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Squipmant Installcd MFG. O MODF,L: Gb0 G SIZEIBTU 527" AUG: MODEL: SIZE/BTU MFG: MODEL:SV-EMTU W.... NC $25.00 REPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER S 15 FIREPLACZ (WOOD) $35.00 NEW GAS GRILL $10.00 _BOILER 535.00 FURNACE $35.00 „_,_GAS LWT HTR 310.00 CHINMY LINER $10.00 `GAS DRYER 510.00 POOL BEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VIiTILATOR $15.00 Permit Fee $ Number of fixtures @ $10.00 x S10.00!= S _ Surcharge 50 Number of fixtures @ $15.00 x $15.00 T $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $. Number of fixtures @ $35.00 x $35.00 = S State Surcharge $ .50 Total c $ 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 ttte Minnesota Construction Codes; that I understand this is not a permit but only an appli 'on 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 a k whic s review d approval of plans. SIGNATURE OF APPLICANT PRINT NAME DATE - I City of Fridley .Building Inspections Department . 6431 University Avenue NE, rridley, MN 55432 763-5723604 FAX: 763-502-4977 Td WUL£:L0 900E LZ 'daS LBETTLS£9L: 'ON Xdd fialptad do fil-10: WOdA ,,