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PRE 2010 DOCSCity of Fridley, Minn.. BUR DING PERMIT N° 5 4 8 5 Date: .�. Jr Owner:IV I Builder oe --- - Address Address _ LOC TON OF BUILDING No. t SZr�— Part of Lot Lot_ _ Addition or Sub -Division ._.-Y�'`�:� Corner Lot � � Inside Lot _ ""''_ _ _ Setback idea; rd Sewer Elevation Elevation — _ Foundation Elevation DESCRIPTION OF BUILDING To b)gused +a�"'': Front Depth'�;71eight Sq. Ft �r Cu. Ft Front Depth Height Sq. Ft Cu. Ft Type of Construction Le Lt--- '-'0. Fit. C&,'IIr 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 compliance with all provisions of ordinances of the city of Fridley. �AJ, s, 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. -.1^, Building Inspector NOTICE: This permit does not cover the Construction, hotalintion for wiring, plumbing, gas heating, sower or water. Be sure to we the Butiding Inspector for separate permits for these items. 11 A: -. --__'.P APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, M]MWOTA Otrner Is Name Builder Address Address LOCATION OF BUILDING No. ` StreetZ4=Z;Eg� &2� Part of Lot Lot lock Addition or Subdivision Corner Lot Inside Lot Y Setback j- Side-Yard„%S SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be 3fsed as: s 'J Sq. Ft. Cu. Ft. �7 Front Depth height Sq. Ft. Cu. Ft. ® V Type of Construction Z��Estimated Cost To be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. (A Schedule of Fee Costs can be found on the Reverse Side.) 9 0 City of Fridley Application for Plumbing and Gan Fitfiing Penna Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK4 Number. Kind and Location of s PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: el NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ 20, Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $� New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: 1st 3 Fixtures .......................... Additional Fixtures .................... Gas Range to 200,000 BTU .............. REPAIRS & ALTERATIONS --Refer to Code NO. RATE TOTAL V x $1.50 x .50 $ x 2.00 $ City of Fridley: V/J The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all. work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this applicatioyare true and correct. _ Fridley, Description ................................................$ TOTAL FEE $�� Kind of Building n Used as To be completed about Estimated Cost, It Old New. Building Permit No �'? Permit No.—.Z--,/--.- Signer' By C� e Business Phone No. ^1 15^-- 44 `/3L ROUGH FINAL 4z 1M 19 4O - �� l)m �j ,i<�i�if V w ? O • F • N WATER HTR. GAS ELEC Base o� 1st 2nd 3rd 4th ion Openings I Future Connection New Fixture, Old Openings with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: el NO. RATE TOTAL Number Fixtures ...................... x $1.50 $ 20, Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $� New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: 1st 3 Fixtures .......................... Additional Fixtures .................... Gas Range to 200,000 BTU .............. REPAIRS & ALTERATIONS --Refer to Code NO. RATE TOTAL V x $1.50 x .50 $ x 2.00 $ City of Fridley: V/J The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all. work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this applicatioyare true and correct. _ Fridley, Description ................................................$ TOTAL FEE $�� Kind of Building n Used as To be completed about Estimated Cost, It Old New. Building Permit No �'? Permit No.—.Z--,/--.- Signer' By C� e Business Phone No. ^1 15^-- 44 `/3L ROUGH FINAL 4z 1M 19 4O - Application for Power Plants and Healing, Coding, Ventilation..Rehigmation and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ each add. 60,000 BTU ....................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 .... �............ . Repairs & Alterations each add. $500.00 .............. STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. IDR Steam ...... Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... I Each add. 200 sq. ft. EDR Steam ...................... Each add. 320 sq. ft. IDR Hot Water .................. • OIL BURNER—to 3 gal. per hour ........................ over 3 gal. per hour—See Fee Schedule 8.00 $ 2.00 $ 5.00 $ 5.00 $ � �� � Kind of Fuel Dept. of Bldgs. Phone SU 4-7470 City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Owner Kind of Building Used as 2.50 $ f 8.00 8.00 2.50 2.50 5.00 GAS BURNER (up to 400,000 BTU) ....................... 5.00 01 To be completed about �/ /�f� f ofs $ Estimated Cost, $ ee Old Ne . Building Permit No. Permit No. $ DESCRIPTION OF WORK HEATING or POWER PLANTS—Ste Hot :WaRWarm Air—No> $ 1e'00– rade Name �- Size No Capacityb- ® ® 0 Sq. Ft. E.D.R BTU H.P. GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ J, S40 Total Connected Loa �� � �� � Kind of Fuel Additional Fixtures ................. x .50 $ BURNER —Trade Name Size No Gas Range to 200,000 BTU ........... x 2.00 $ Capacity Sq. Ft. E.D.R BTU H.P. AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ �® ALTERATIONS & REPAIRS TOTAL FEE $ Signe By 4Ze� ROUGH �4z zM 7_59 Business Phone No�� a . k �— (REMARKS-OVER) � "er i HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN. A.S.H.V. E. Weatherstrips Guide Construction No. Insulation _ WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof . Floor Kind How Applied Yes—No L Yes—No 19— Fl.� � L� Room I Length --.O'--V,Width Height JV II --!P M-1 Room I Lenath // Width / % Heiaht Windows a oors—Crackage and Area Glass 60 .'® Width Height No. of Lineal ft. Area No. of pane of pane lights of crack ea. ft* �cJ Net exp. wall Int. wall Btu Coef.1 Btu Infiltration Glass 0 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Z,9 1 Glass Exp. wall g _ r� / 0 a Net exp. wall Net exp. wall Int. wall C Inc. wall Net exp. waA11; Ceiling Ceiling t? Floor 7 7,&1 Ceiling Total tutu Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Gx,,& Room I Length 6 Width Windows and Doors—Crackage and Area W1dl.h Helght No. of Llneal it. Area No. of pane of pane ifahts o[ crack M. ft. Infiltration W-0 Glass G Exp. wall Net exp. wall `® Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Room I Length Width Wi dows oors—Crackage and Area of pane I of -Vol Btu Btu - Pff-joI �i I Infiltration I— Glass 60 .'® Exp. wall Net exp. wall Int. wall Btu Ceiling Infiltration Floor Glass Tbtal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Z,9 1 Windows and Doors—Crackage and Area I— -- Width Height No. of Lineal ft. Area No. of pane o[ pane lights of crack sq. ft. xg Coef. Btu Infiltration Infiltration Glass ® G Exp. wall / 0 a Net exp. wall /� C Inc. wall Net exp. waA11; Ceiling t? Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area �p .a 1171 1 77 — r)__. 11 __�L o, R/.1L s 1' U -M.. /moi i. Windows and Doors—Crackage and Area I— -- Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack eq. ft. xg Coef. Coef. Btu Infiltration Glass Glass Exp. wall / 0 a Exp. wall Ile ±Jle Int. wall Net exp. waA11; 1 Int. wall Floor Ceiling d Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.ALLeader area • • � ��, N1 I /. 2— 11 ..e►t. A W rittt V r7�lO�f Y Windows and Doors--Crackage and Area Width Height No. of Lineal [t. Area No. of pane of pane lights of crack eq. ft. xg Coef. Btu Infiltration Glass 0 Exp. wall Net exp. wall jly Ile ±Jle Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sa. ins. W.A. Leader area I /' . 41 Ddb rJ°c�p� ©I /� VO 4 r���% L� Y HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN. i Weatherstrips Infiltration A.S.H.V.E, Guide Construction No. Insulation Windows( Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes—No Yes—No Exp. wall 19_ 0 Fl.l a, f� 9 . Room I Length Width Height II FLI Rnem I length Width Heinht Winc1ows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of Dane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. i I 4Q/JCoef.j Infiltration Btu Infiltration Exp. wall Net exp. wall Glass 4 Int. wall Ceiling Exp. wall Floor 0 Net exp. wall`. Int. wall Ceiling Z Floor 1 otai Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ,�! F1.1 Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of Dane lights of crack sq. ft. i I Coef.1 Btu Infiltration Glass Exp. wall Net exp. wall 4 Int. wall Ceiling Floor 1 otal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Height f Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef.1 Btu Infiltration Glass Exp. wall Net exp. wall Int. wall i Ceiling Floor ! btal Btu. Required so. ft. E.D.R. or so. ins. W.A. Leader area Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FU Room I Length Width Height Windows and Doors--Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. itis. W.A. Leader area F1.1 Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft.Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 30 a -7.0 City of Fridley, Mian.. N° 8407 BUILDING PERMIT • Date: AUGUST 26, 1965 Owner: MPLS FEDERAL SAVINGS & LOAN Builder B & H CONSTRUCTION, INC. Address Address 2516 • 35th Avenue N. E. Minneapolis, Minnesota LOCATION OF BUILDING No. Street 4th Street N. E. ___ 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: Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Est.Cost $5, 700._4_.._ Tobe Completed • REPAIRS DUE TO STORM DAMAGE n L J 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 compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ 10.00 , permit is hereby granted to B & H CONSTRUCTION, INC. 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 rega location, construction, alteration, maintenance, repair and moving of buildings within the city lboll uns permit may be revoked at any time upon violation of any of the provisions oP said ordinances. ALLEN G. JENSEN NOTICE: Me permit does act error the eonstracdoe, hotaii on for whing, phumhine, Bas heethrg, senor or wrier. Be sure to no the Be Mh* tespedor for apm to perm6s for these Rou. I OWNER'S NAME ADDRESS APPLICATION FOR BUILDING PERMIT r CITY OF FRIDLEY, MINNESOTA C LOCATION OF BUILDING 011 NO, STREET PART OF LOT LOT BLOCK ADDITIO14 OR SUBDIVISION CORNER LOT INSIDE LOT SETBACK SIDE -WARD SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To be used as; DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost S Oy A d`'V To be completed The 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 are true and correct, u• j (Schedule of Fee Costs can be found on the Reverse Side). W • • • City of Fridley, Minn. BUILDING PERMIT Date: Sept. 25, 1969 Owner: M. P. Bozony Builder Address 5820 nth St. N. E. Address Same Same LOCATION OF BUILDING No. 5820 Stet 4th St. N. E. — Part of Lot Lot Partof 1 _ Block 29 Addition or Sub -Division ._ Hyde Park Addn. Corner Lot , Inside Lot — Setback _r._ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Garage Front 16' Depth 30' Height —10! Sq, FL 480 Front Depth Height Sq. Ft. Type of Construction Frame E,yt, Cost $140000 __ To be Completed Surfaced Driveway required. In consideration of the issuance to me of a permit to construct the the proposed work in accordance with the description ab t forth a ordinances of the city of Fridley. k -Ae j/ N° 10427 4800 Cu. Ft. Cu. Ft. I above I agree to do with of 1 provisions of In consideration of the payment of a fee of 8.00 , permit is hereby gran to M. P. Bozony 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 7SEda ordinances. �� Building Inspector Hank Muh&ch NOTICE Tib pem* does not ewer the conamcdon, hatallaMon for wiring, plumbing, gag heating, sewer or water. Be ams to we the Building hupeetor for anparah pwndh for these hems. APPLICATION FOR BUILDING PERMIT OWNER 'S NAM&017� ADDRESS . --? Ae'"Cl " NOr�� STREET CITY OF FRIDLEY, MINNESOTA BUILDER * ADDRESS LOCA ION OF BBUILDING 1 V.,- LOT BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT-4—SETBACK SIDEYARD . �4-- 7T SEWER ELEVATION TOP OF FOOTING Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: (? Front Depth Height Square feet ffr Cubic Feet Front Depth Height Square feet Cubic Feet Type of Construction Estimated Cost �® To Be Completed The 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 are true and correct. r DATE ^�S SIGNATURE (Schedule of Fee Costs can be found on the Reverse ide tl `' c' "I . '-ft CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE m N0. M m Number Fixtures m $3.00 u Future Fixture Opening x a) $ Water r. $2.00 $ 4 x W r. 0 _1 M p q $5.00 .N 1-4 per., 0 $ Heater x $7.00 $ New Ground Run Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: •.i H a) 0 C W $3,00 X 4-3 0 a) 8 Ya O .0 C U ••i m O 4 r•C U w a) REPAIRS $ ALTERATIONS }a a) N •rl 1) N $5.00 a) •,q 8 O o -W M !-) N N N N 4 TOTAL FEE $� o A we CD w u mrtl 3 U as lec nil 1st 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: N0. RATE TOTAL Number Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ New Fixture, Old Opening r. $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: y 61y 1st 3 fixtures x $3,00 $ ® Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $10.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $� REINSPECTION FEE ($10.00) Job Address Department of Buildings City of Fridley Tel. #571-3450 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 ap��lication are true and correct Fridley, Mn. moi"` C 2_ '19-76 OWNER '--4 6 C -K /✓ OZ KIND OF BUILDING 'q JtfW ,-W USED AS TO BE COMPLETED ABOUT `J — 76 60E MATED COST /� /� J� - NEW BUILDING PERMIT NO. PERMIT NO. (Q / 67' Company Signed By e Tel. No. ROUGH INSP. Date FINAL INSP. Date qq APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND CTAS FITTING PERMIT RATE SCHEDULE {qq PLUMBING FIXTURE RATES: NO. N m O M New Fixtures a 7.00 - u Old Opening, New Fixture S o $ water d1 W e 7 S 7.00 = M Catch Basin (a 7.00 = S 44+ G a 5 Buap/Raceiving Tank Neater 7.00 s S Mater Treating Appliance S 10.00 = S Mater Heater - Electric S 7.00 S Mater Heater - Gas S 10.00 $ Gas Range S 10.00 S Gas Dryer $ 10.00 = $ Back Flow Preventer Required ( ) Yes ( )• No Type S 5.00 $ ws V a a g 4. u o� 3 chi lec lot 2nd 3rd 4th (R) - Future Connection Opening Connected with Sewer (*) - Now Fixture, Old Opening water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures S 7.00 - $ Old Opening, New Fixture S 4.00 = $ Beer Dispenser S 5.00 = S Blow Off Basin S 7.00 = $ Catch Basin S 7.00 = S Rain Water Leader $ 7.00 - $ Buap/Raceiving Tank S 7.00 s S Mater Treating Appliance S 10.00 = S Mater Heater - Electric S 7.00 S Mater Heater - Gas S 10.00 $ Gas Range S 10.00 S Gas Dryer $ 10.00 = $ Back Flow Preventer Required ( ) Yes ( )• No Type S 5.00 $ Effective Date January 1, 1991 Job Address -':5LLnr r `$ C—�' � V �ro Building Inspection Div. 6431 University Ave NE Tel. No. 572-3604 Fridley MN 55432 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 ``,,�� L ` 19� OWNER —qy ' BERGS, JEAN _ 4TH STREET N. E. KIND OF BUILDI! FRIDLEY, M 0 _ OSED AS H 571-2491 W _ TO BE COMPLETED ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. Company Signed By" - b,: Tel. No. ROUGH INSP. Date �j 7 FINAL INSP. V2— Date APPROVAL FOR PERMIT CIO-) ALL OTHERS AND/OR REPAIRS AND ALTERATIONS MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT I8 $15.00 It of Value of Fixture or Appliance $ / 5�� PLUS THE $.50 STATE SURCHARGE REINSPECTION PEE $30.00 State Surcharge $ .50 TOTAL FEE S /S • SO Building $ 1 7.,), j BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604Date. .001 times the total job valuation CITY OF FRIDLEY UN 2007 ' DATEOUR E-MAIL ADDRESS (f SITE ADDRESS D A St / $ a THIS APPLICANT IS: ❑ OWNER AONTRACTOR Curb Cut Escrow PROPERTY OWNER/ NAME: D r1?Ae rC7a $ TENANT ADDRESS: 2 C7 — CITY STAT4! 3 2 Sewer Main Charge PHONE: �26 3— S -7 1r Y c Total Due CONTRACTOR NAME: l OF STATE LICENSE # � j D b EXP DATE A�%Lfi/� ? SUBNIIT A COPY `V YOUR STATE LICENSE ADDRESS: Q u (/U ITY WITH APPLICATION PHONE — ZZZ -(15" FAX PROPERTY TYPE ❑ S ULYINEW CONSTRUCTION SIZE O F W CONSTRUCTION STORIES PERMIT TYPE ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH IROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMNIDNiG POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: --,Ce 6:1 D 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 DgCKS, ❑ 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: (USIN9 THE 1997 U.B.0 FEE SCHEDULE) Aja 1,7f TOTAL JOB VALUATION $ -:?9 30 OCCUPANCY TYPE Permit Fee $ 1 7.,), j See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ -3-18 .001 times the total job valuation Surcharge $ �_ �("o .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ a $1675 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 $/� T, l 4 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 time approved plan in the case of all work w' h requires review and aroval of plans. SIGNATURE OF APPLICANT <--PRINT NAME �� Glir� ! DATE '�- —7—o:2 tip 1 -?Ie)-a-(-A9�) e�; Building Permit Fee * 113UYLDING j See Back Page for Fre Schedule Permit No.: l�b -� Inspections --�- 65% of Building Permit Fee RESIDENTIAL APPLICATION Received BytA 763-572-3604 Suruharge CITE' OF FRIDLEY � _ .0005 x Permit Valuation Minimum $.50 Date S E 3 0 763-502-4977 FAX $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow I EFFECTIVE$ -19-08 ft + 6 ft = ft x $22 = $ Erosion Control DATE YOUR E-MAIL ADDRESS Park Fac SITE ADDRESS_ �►�Tl��*�' WGr_ ��% �2,�- THIS APPLICANT IS: El R. OCONTRACTOR Total Due PROPERTY OWNER/ NAS; TENANT ADDRESS:CITY STATE zip PRONE e0102 P7 ij-n CONTRACTOR NAME i SUIJMIT A COPY OF YOUR STATE LICENSE 9 STATE E STA7E LICENSE EXP DATE --,-,A AND CERTIFICATE OF SSE ADDRESS: !w '7—? Cri' i10*WAT¢191P iNSURANCB PHONE FAX PROPERTY TYPE O SINGLE FAMILY/NEW CONSTRUCTION SIZE O TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ 71—MITION ❑ GARAGEISHEDRT ws ❑ 13ASVMENT FINISH 0 ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING d OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW IrONZ CONSTRUCTION ❑ ADDITION ❑ MA.KfUNANCEIREPAIR E3 REMOPEL!N0 DESCRIBE WORK BEING DON)r:F, i SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SO FT ROOFING O HOUSE ONLY BAS NG_SUBMIT: REMODELING NUNnER OF SQUARES ❑ HOUSE & GARAGE 1. E Flow 1. ExistingFltmrPlan GAILAC95 ❑ ATTACHED GARAGE Z. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SMJ NG FOR NEW CONSTRUCTION INCLUDING DECKS, Q Vinyl ❑ Aluminum OSotit G Trim 4=23ONS_ & PORCr3ES SUBMIT: 1. Sita Plan/Survey showing the existing structures ❑ Odra Oproposed Fascia jvA and DCO Prptw ets 2. Two soFconstrtrotion plans yyymows IN EXISTING OPENINGS lees ON, LOCATION OF WINDOWS 3. Energy Calculations FOR WINDOWS - PROVIDE U -VALUE AND t� OR FOR NEW OPENINGS -DESCRIBE SIZE OF -SOV%e 7 '�` • /4=) MANUFAMRP, STICFMt. ON WINDOW, OPENING CHANGES diCSI�� S��M �� TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASTED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS; (USING TiCE 1997 U.&C FEE SCHEDULE) TOTAL JOB VALUATION $ 396 X fo OCCUPANCY TYPE Permit Fee * $, j See Back Page for Fre Schedule Plan Review $ --�- 65% of Building Permit Fee Fire Surcharge $ " .001 times the total job valuation Suruharge $ � _ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fac $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) -Cl Total Due $ 1 (75, 1 Make checks payable to: City of Fridley Attach Stipulations 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 tonformanco 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 M)rkwht r uires revre � d approval of plans.��Q�.� !jSIGNATURE OF APPLICANTeC. PRINT NAMY ��DATE jQ 2R;% !' Wd Z0: LZ: L 600Z/9Z/6 :GIRO 92 :96ed umouNun :wa j Building PLUMBING Permit No. s Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DATE <� I I 0 YOUR E-MAIL ADDRESS SITEADDRESS Joann Berg THIS APPLICANT IS: ❑ OWNER *ONTRACTOR 5820 4th Street Northeast PROPERTY NAME: Fridley, MN 55432 OWNER/ ADDRESS: 7635712491 ZIP TENANT — PHONE: CONTRACTOR NAME: IV- STATE LICENSE # SCJ, // EXP DATE ADDRESS a t/'r� S CITY DI/1 STATE 61P ssy SUBMIT A COPY OF YOUR STATE i' . LICENSE WITH PHONE 7- y03 FAX 2 APPLICATION - PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY 11 TOWNHOUSE TYPE OF WORK: 0 NEW REPLACEMENT DETAILED DESCRIPTION OF WORK PER MS 161B.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. CThis.should_reflect only-the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FO"ROJECTS WHERE LABOR EXCEEDS�Si00;TEES ARE BASED ON $10.00 PER FIXTURE,'EXCEP•T..:WIIERENDTED-%,F-%,F(MIC-ATE TOTAL NUMBER OF EACH BELOW) . BATH SINK/LAV _FLOOR DRAINS _ SHOWER _ WATER PIPING —BATHTUB _ GAS PIPING (mmo cmumss) _ SWIMMING POOL _ WATER SOFTNER ($35) CLOTHES WASHER —KITCHEN SINK_ WATER CLOSET BACKFLOW PREV. ($15) _ _ _DISHWASHER =LAUNDRY TRAY TWATER HATER ($35) FOR IRRIGATION WATER METER OTHER 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 x $35.00 = $ 3S.Oo TOTAL DUE $ 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 applic ' n 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 1 o w ' r uires review and approval of plans. SIGNATURE OF APPLICANT(�O*rj PRINT NAME J g N0,41001 DATE �3/ s / CG /� t City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 E WATER AND SEWER Permit No.: -0 QYbL " -5,72-3552 PERMIT APPLICATION Received By: 763-571-1287 fax CITY OF FRIt���AP �8�8 EFFECTIVE 10/27/20102010 APPLICATION DATE: �(O �o �� YOUR E-MAILIFAX: — THIS APPLICANT IS: ❑ OWNER`S CCON,T�RIACTOR - C JOB ADDRESS. S T � 10 17 - ' ✓I NEW CONSTRUCTION PERMIT# (IF APPLICABLE): PROPERTY NAME: 'P OWNER/ ADDRESS: 2. N CITY a STATE�P��Z TENANT �/may PHONE: ? -^ S�7/ "- 2 7 / i CONTRACTOR NAME: C - IC-&' !.(/%}t ele ae't s �q / Y ,rj y�!/STATE/JAIP s' 1D G .S ADDRESS: SoZa� ly�l'1 I SUBMITACOPYOF YOUR STATE LICENSE WITH ' PHONE le % -' %ZZ"' 9770 CELL PHONE A //2 - AaI � SG APPLICATION STATE LIC # ®6 4 STATE BOND: EXP DATE: 1. Narrative/written description: ! b 2. Please attach sketchshowingcurb line, utility line, building, etc. with distances on back page. 3. Stipulations: /) ��i C C,,-rg PE2 /i%WJTC0 ( QA) r �0444 / AM D F I LL tai I.tJicTF.i� C 1 ,rT '. " 5I��� J / 3 " 8 , y UDA- U PM COU PdJZ�A 4,rr\. 7"t S C, �--�.�-�ee� a '5% frr� s-rvc4 � 5 �f $/*'.-� G wfz Z lin rn.a- T TYPE�?$ 7b357Z 3jSZ t""rs C SEWER CONNECTION PERMIT SEWE DISCONNECT P l WATER CONNECTION PERMIT;:: SEWER DISCONNECT PERMIT $50 ❑ WATERLINE REPAIR $40 k SEWER LINE REPAIR $40 F ADD STATE SURCHARGE $5.00 for each permit U 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 and workeis not to start without a permit. ,J %� \ �%J AlO C/ / l' (/ DATE: /-3.-/K— Z 0/0 SIGNATURE OF APPLICANT PRINT NAME: �/ APPROVED BY: . - DATE: 001 D IT COPYT0. ❑ UTILI BILLING (only if new meter) -1 PUBLIC WORKS - ENGINEERING City of Fridley Engineering Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3552 FAX: 763-571-1287 4miLl ss .moo CIA, I X-16 opto cu, o IVIK