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PRE 2010 DOCS• 11 City of Fridley, Minn. N® 3733 BUILDING PERMIT . �bt . Date: ........ � . .... dam/ ..._ ...... . Owner ....................................... Builder 9."L44..L*?9 . Address ...................................... Address .. �Q �.7... l�.:. .. ......... LO�CAATION OF BUILDING No. 0../,.� Street ....' ...��...... Part o t ............ ................. Lot . L4....... Block ............. Addition or Sub -Division ....�... Corner Lot ...,rX ...... Inside Lot ............ Setback... Sideyard '.o ............... DESCRIPTION OF BUILDING To Wus as:Deptha A�QUeight/. 5.VzSq.l•t.% 6Y a cu.l± t./9..2�G as; .. ... . ....... Front 1. ®Depth' �� Heig//ht Type of Construction ................... Nst. Cost.] i %!4:.. To be Completed ................... In consideration of the issuance to me of a permit to construct a building desribed above, I agree to do the proposed work in accordance with the description above set and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $.®�..,�� permit is hereby ed to •� P Y grant ................... ......................... 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 with- in the city limits and this permit may be revoked at any tame upon violation of any of the provisions of said ordinances. �- ..,. ! ...,4.... Building Inspector NOTICE.- This OTICE.This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items io. Application for Power Plants and Heating. Coding, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: Furnace Shell & Duct Work .......................... Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 .................. Repairs & Alterations each add. $500.00 ........... NECK. 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 RATE TOTAL 8.00 $ 5.00 $ 5.00 $ 2.50 $ 8.00 $ J, 0 Q 2.00 $ 5.00 $ 5.00 $ 2.50 $ Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ + REMARKS: Dept. of Bldgs. Phone SU 4-7470 �7`7 t 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. p may/ Fridley, 1ltfinn 4&eore195E Owner � A '�'/ zwil4�t 195— Kind of Used as To be completed about Estimated Cost, $ zs� p Dk&—New- Building Permit No. 195— DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Name— Pdf,44V Size No- 4 0-0-6 Capacity. Total Connected Sq. Ft. E. .R BTU H.P. Load Kind of Fue' BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. -01MBD-11 POST IM -12-58 Business Phone Xo� D•16 z. '. e MEAT LOSS / CALCULATIO DEPARTMENT OF BUILDINGS Width Height No. of Lineal ft. Area No. of pane of pane- lights of crack sq. ft. WeatherstripsA.S. �� GuideH. e.E. Reference 19— Construction No. Coef. Btu Infiltration WindowsI Doors Out. Wall I Int. Wall Ceiling Roof Floor Kind E Yes—No a No Int. wall I , Ceiling F1.1 Room Length Width Height F1.1 Off Room I Length Windows and Doors—Crackage and Area Width Height No. of Lineal 11. Area No. of ane of pane - light,, of crack sq. ft. B Y 0 , kLIM9f, 0 aA, 0 jCoef.j Btu Infiltration � Glass Exp. wall Net exp. wall Int. wall Ceiling -L_ `,?' Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Lensdh /-3-.. Width /,;?- Height Windows and Doors—Crackage and Area p Width Height No. of Lineal ft. Area No. of pane of pane- lights of crack sq. ft. t, �� Coef. Btu Infiltration Infiltration Glass Glass 39 Exp. wall Glass Net exp. wall ILI S Int. wall �V Ceiling Net exp. wall Floor Int. wall Total Btu. ®5 1 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 6 F1.1 1 Room I Length F Width 6 Height ff Windows and Doors—Crackage and Area p Width Height No. of Lineal ft. Area No. of p ne of pane lights of track sq. ft. Ares sq. ft. �� Coef.1 Btu Infiltration Glass 17-7 v 39 Exp. wall Net exp. wall' Glass - Int, wall Ceiling Floor Exp. wall �V Tbtal Btu. tf Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FRIDLEY, MINN. Insulation How Applied Width / Height Windows and Doors—Crackage and Area Doors—Crackage and Area Width Height No. of Lineal M No. of pane of pane lights of crack Ares sq. ft. �� Coef. Btu Coef. Btu sit ,j% 17/0 Glass Coef. B Infiltration Glass Exp. wall .10 Net exp. wall Exp. wall Int. wall Int. wall Ceiling Ceiling Net exp. wall ` Floor �! Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 7 ni Room I Length /,X Width /_7 Heistht Windows an Doors—Crackage and Area ` Width Height No. of Lineal ft. Area No. of Vane of plLne lights of crack� �� Coef. Btu Coef. Btu Infiltration ,j% 17/0 Glass �C Exp. wall Exp. wall Net exp. wall Net exp. wall / /r Int. wall Int. wall Ceiling Ceiling Floor ` Floor Total Btu. Required sq. ft. ED.R. or sq. ins. W.A. Leader area F1.1 Room I Length /A Width ,7- Heiaht 9 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 r Glass➢ �C Exp. wall Net exp. wall / /r Int. wall Ceiling ` Floor Total Btu. sq. ft. ED.R. or .sq. ins. WA. Leader area CIA"63 ; Application for Poorer Plants and: Heating, Coding, Ventilation, .Refrigeration 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 $ MECIL WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ ,r each add. 60,000 'BTU ... .................. 2.00 $ Replacement of Furnace .............................. .§.00 $ Repairs & Alterations—up to $500.00 ... ............ 5.00 $ Repairs & Alterations each add. $500.00 . . ............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. IDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ....................... 2.50 $ Each add. 320 sq. ft. IDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ Q C) GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL $ See Fee Schedule $ TOTAL F$E $ ;--�'� G �61 Dept. of Bldgs. Phone SU, 4-7470 .s�P- 71- X 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. Fridley, Unn— Owner Kind of Used as To be completed about Estimated Cost, $ Old—New. Building Permit No. '-3 2,_-_�_5 Permit N DESCRIPTION OF WORK HEATING or POWER PLANTS -Steam, Hot Water, Warm Air—No Trade Name Size No Capacity Sq. Ft. E.D.R. BTU H.P. Total Connected Load Sind of Fuel BURNER — Trade Name . Size No Capacity. Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) SUBJECT IT NO. City of Fridley 2 9 54 6 AT THE TOP OF THE TWINS BUILDING� PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. f PROTECTIVE INSPECTION SEC. 9/0? � f CITY MALL FRIDLEY 55132 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 5/25/99 JOB ADDRESS 5871 4 Street NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 5 Bennett Palmer SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mary Schultz 5871 4 Street NE 572-3811 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Banner Roofing 6001 Lyndale Ave- 20012044 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION O ALTERATION REPAIR O MOVE O REMOVE X B DESCRIBE WORK Reroof House & Garage 22 SO Tear—off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. Plft ermit inspection Car W"' Be *8110d�s �° Hem®Owner To 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 SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $.94 WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT $1,885 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $ STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TO L FEE Licen S $5,,0 $74.02 SIGNATURE Of CONTRACTOR OR AUTHORIZED AGENT [DATES EN PR 0V,9 VALID D/THIS IS Y P MI lit SIGNATURE 00 OWNERoF OWNER BUILDERi IDATEs B G INSP QAtE N [ ADDN TS ALLTE[ J R Effective 1/1/99 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION A�p ConstructionAddress: 71 Legal Description: -•%Q.tk caner Name & Address: m+ X0ntractor: I nn�n Tel. #_ 38/1 MVLICENSE# :0100WV-91 Address: oy �UfitlajL'j l- S . , /gyp/S Tel. # _77Y- 1X7b Attach to this application, a Certificate of Survey of the ' lot, with the proposed construction drawn on it to scale. DESCRIPTION. OF W_ .W WT LIVING AREA: Length Width Height Sq. Ft. . GARAGE AREA: Length - Width Height Sq. Ft. DECK AREA: Length Wid Hgt/Ground Sq. Ft. OTHER: Construction Type: rlq Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: /�n APPLICANT: WIZU26 14 Tel. # Af - Yft CITY USE ONLY TOTAL $ :Loz STIPULATIONS: Permit Fee $ �� Z10 Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ �9e $.50/$1,000 Valuation ` SAC Charge $ $1050 per SAC Unit , License Surcharge $ fir_ $5.00 (State Licensed Residential Contractors) q Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main' Charge $ Agreement Necessary '[ ] _, Not Necessary [ ] ' . TOTAL $ :Loz STIPULATIONS: i SUBJECT 4FE RM City of Fridley 33001 AT THE TOP OF THE TWINS BUILDING PERMIT r COMMUNITY DEVELOPMENT DIV. RPIPT NO06 PROTECTIVE INSPECTION SEC NUMBER REV DATE PAGE OF APPROVED BY i = ;"',•� CITY HALL FRIDLEY 55432 •--• L f\ 763-571-3450 910-F15 8/20/02 JOB ADDRESS 5871 4 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 16 5 Bennett Palmer SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mary Schultz 5871 4 Street NE 763-572-3811 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO Home Pride Builders Inc 8535 Central Avenue NE, Blaine, MN 55434 763-784-2944 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 20072528 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION Q. ALTERATION O REPAIR O MOVE O REMOVE B DESCRIBE WORK Convert existing garage into living area - separate permit for new garage 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. R BERATE PEHIgm QUIRE® FOR. WI RIN� -n0jG qEA 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 SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $ 23, 000 @ 11 50 `Y WITH WHETHER SPECIFIED HERE, T. THE GRANTING OF A PERMIT DOES NOT PRESUME TO G AUTHO Y TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISI E TAT OR L L LAW REGULATING CON- $363.25 Fire SC $23.00 TIO E M E O STRUCTION PLAN CHECK FEE TOTAL FEE License SC 5.00 $402.75 NATURE OF CON! RACTOR OR AUTHORIZED AGENT I ATE, W PR PERL DATED T IS YOUR PERMIT S,GNATURE OF OWNER dF OWNER BUILDER, (DATE, BLD INSP FIATS i NEW () CITY OF FRIDLEY 0 ADDN (J 6431 University Ave NE, Fridley, MN 55432 ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Effective 1/1/2002 (763) 572-3604 Bldg Insp Legal Description: Owner Name & Address: /19pw-s" � � �� % � Tel. # -a&/ Contractor. �s�0��ton�° MN LICENSE # Address: _ e' el. # 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 ',L Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length width Hgt/Ground Sq. Ft. OTHER: Construction Type: S r- 1db *0? Estimated Cost: $ ° Driveway Curb Cut Width Needed: -L-Ft + 6 Ft = Ft x $ _ DATE: APPLICANT: Tel. # Call (763) 572-3604 for Permit Fees if ma g In application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge $_ 3.2� Fee Schedule on Reverse Side $3 tao .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1200 per SAC Unit $ o a $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: Phone: GReenwood 3-8352 ARLEIGH C. SMITH Registered Professional Engineer and Land Surveyor 16215 Wayzata Boulevard Wayzata, Minnesota /' SLATOF Ve' 376"? I, z/ OF PROPERTY -- described as follows, d Scale: 1 inch feet. SP r....�._..... 14 e WN 5*7 1 - 4 _.._._._r... — Lb Cy •, (j�rc�o:y CERTIFICATE OF LOCATION OF BUILDING CERTIFICATE OFSURVEY I hereby certify that on 19— I hereby certify that ��"4j �a - I made a survey of. the proposed location of the I surveyed the property described above and that building on the above described property and that the above plat is a correct representation of said the location of said building is correctly shown on survey. the above plat. a SuBjECT P IT NO. City of Fridley 3 3 0 0 0 AT THE TOP OF THE TWINS BUILDING PERMIT Ir ` R T NO. tr �___�_ COMMUNITY DEVELOPMENT DIV. f PROTECTIVE INSPECTION SEC NUMBER REV DATE PAGE OF APPROV BY i � CITY HALL FRIDLEY 55432 ---- L 763-571-3450 910-F15 8/20/02 JOB ADDRESS 5871 4 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1C 5 Bennett Palmer SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mary Schultz 5871 4 Street NE 763-572-3811 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Home Pride Builders Inc 8535 Central Avenue NE, Blaine, MN 55434 763-784-2944 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 20072528 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK fel NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 22' x 22' Detached Garage 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Provide a hard surface driveway. Separate permit issued to convert existing attached garage to living area. WARF4114G Before digging call for all utility locations SEPARATE PER11Z 454.0002 REQUIRED FOR: REQUIRE® BY LAW HEATING UNMDSGPLMBOd 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 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $5.47 WITH WHETHER SPECIFIED H NOT E GRANTING OF A PERMIT $10,953 DOES NOT PRESUME TO E AUTHORITY T VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS F ANY OT ERS E OR AL LAW REGULATING CON. STRUC TION $195.25 Fire SC $10.95 NCE o ON PLAN CHECK FEE TOTAL FEE ® License S .00 $2 .67 SI TURE OFCONTRACTOR ORAUTHORIZED AGENT IDATEI E ROP RLY ATED TH IS YOUR PERMIT S-GNATURE OF OWNER.IF OWNER BUILDER) IDATEI BLDG -NSP gAiE NEW ADDN ALTER Pf [l Construction Address: Legal Description: Owner Name & Address: U CITY OF FRIDLEY Effective 1/1/2002 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ' SINGLE FAMILY AND DUPLEXES R-1 AND R-2 _I BUILDING PERMIT APPLICATION Q)� "s .?>/ e'o� � 's%pe / /v0 e- - S,. Tel. # "�&> Contractor c— , i-cev-:- 1/'Q/C a- MN LICENSE # 2!00"Pa-'a&7 Address: -T � �Y-va - e)0 � Tel. #IV 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 zz Width Zz -- Height /3 Sq. Ftp DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: Construction Type: �� 4� �— Estimated Cost: $ / Driveway Curb Cut Width Needed: l/ Ft + 6 Ft = _�7_Ft x $ _ $ DATE: �6;7— APPLICANT: %' Tel. # ® If e,✓ Call (763) 572-3604 for Permit Fees N mailing In application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by'Engineedng Agreement Necessary [ ] Not Necessary [ ] TOTAL $ • 4 7 STIPULATIONS: -,naaood 3-3332 ARLEIGH C. SMITH Registered Professional Engineer and Land Surveyor 16215 Wayzata Boulevard Wayzata, Minnesota 0 l° ko% Z f3�•Z.? �O, ® � 3�a►K9 � CERTIFICATE OF LOCATION OF BUILDING CERTIFICAT 'E or SURVEY I hereby certify that o� 19_ I hereby certify that �+"&Z a I made a survey of. the proposed location of the I surveyed the property described above and that building on the above described property and that the above plat is a correct representation of said the location of said building is correctly shown on survey the above plat. -.0-4-46g7 NEW (J CITY OF FRIDLEY Effective 1/12002 ADDN (J 6431 University Ave NE, Fridley. MN 55432 (763) 572-3604 Bldg Insp ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 5'9-% / 9' 7 k 54- h> Legal Description: E, �:X(u,1+ 2-- Owner Name & Address: S 8 '7 I ` �-/- Tel. # '7 & 3 S7.,13 :f /Contractor- MN LICENSE # Address: Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width . Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Construction Type: Estimated Cost: $ /\/Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $-r,2 E-9. Uo = $ DATE: APPLICANT: Tel. # Call (763) 572-3604 for Permit Fees if mailing in application or Fax o 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by*Engineering Agreement Necessary [ ] Not Necessary [ ] Cu STIPULATIONS: _ Phone: GReenwood 3-8352 ARLEIGH C. SMITH Registered Professional Engineer and Land Surveyor 16215 Wayzata Boulevard Wayzata, Minnesota �/y/O/Y !/PLAT OF SURVE /Lf%Es`�eS ,SNI. OF PROPERTY 0117- �- — - -- described as follows* �' d / :57/v c RJ - .164 s' — Scale: 1 inch 3 '* feet. CERTIFICATE OF LOCATION OF BUILDING CERTIFICATE or SURVEY I hereby certify that on , 19_ I hereby certify that wj_., I made a survey of. the proposed location of the I surveyed the property described above and that building on the above described property and that the above plat is a correct representation of said the location of said building is correctly shown on survey. the above plat. �. . • r' Cr J` _Q Z 2 X ,12 ,S NZ { CERTIFICATE OF LOCATION OF BUILDING CERTIFICATE or SURVEY I hereby certify that on , 19_ I hereby certify that wj_., I made a survey of. the proposed location of the I surveyed the property described above and that building on the above described property and that the above plat is a correct representation of said the location of said building is correctly shown on survey. the above plat. �. . • CITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2002 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572.3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 5571 ST. E. RATE SCHEDULE �GhLy OWNER Residential Rate TOTAL Furnace Shell ad Duct Wor urner - _ _l BUILDING USED AS�We1(1 A� ' Also Replacemen n $ 30.00 $ • yr/ ^^ ,� (Side Vent - Fill Out Back) ESTIMATED COST 10 X2. �" PERMIT NO. AS 13 Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Gas Dryer $ 10.00 $ Trade Name Size No. BTU _HP EDR *Air Conditioning - All Sizes $ 25.00 $ Fuel Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR Commercial/Industrial 1.25/0 of Value of Appliance or Work $ 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 an State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and TOTAL FEE $ ',so representations stated in this application are true and correct. DATE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATI CO BATH H ATING & AIR CONDITIONING REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE Signed x.71 TEL # (651)484-3325 FAX # (651)484-8136 REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved B Rough -In Date Final Date written permission from adjoining property owner. THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When red arming an existing f� urance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA -LAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The exic ing cnmhustinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new _nmh istinn air ^it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) Appliance #1 Type._ Appliance #2 Type Appliance #3 Type _ Total Appliances BTU Input BTU Input _ BTU Input Total Btu Input Fan Assisted or Nat Fan Assisted or Nat. Fan Assisted or Nat Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Veni Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type HEATING CO: Signed By: Engineering WATER AND SEWER Permit No.. U t n i CO 763=572-3552 PERMIT APPLICATION Received By: 763-571-1287 fax CITY OF FRIDLEY EFFECTIVE 7/1/2010 APPLICATION DATE: YOUR E-MAIUFAX:Or _ THIS APPLICANT IS: ❑ OWNER�CQ O/NTRACTOR *a�/ JOB ADDRESS: S $w 5 A% X. NEW CONSTRUCTION PERMIT# (IF APPLICABLE): PROPERTY NAME: ADDRESS:I.-S&On CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR NAME: DRESS: I STA"_Z�Z-/ SUBMIT A COPY OF YOUR STATE LICENSE WITH PHON]f7k,- - I�F✓ CELL PHONE: 1p%,eq a36 4 3._ APPLICATION STATE LIC # STATE BOND: EXP DATE: 1. Narrative/written description: 2. Please attach sketch showing curb line, utility line, building, etc. with distances on back page. 3. Stipulations: So R c011¢,bdlt �l.R.. d— PERMIT TYPE ❑ SEWER CONNECTION PERMIT $50 ❑ WATER CONNECTION PERMIT $50 ❑%WATER LINE REPAIR $40 SEWER LINE REPAIR $40 L 9/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 ehance with the ordinances and codes of the City of Fridley. I understand this is not a permit but accurate; that the work will be in confo only an application for a pe rk is not s without a permit. �/ /'� % / J - SIGNATURE OF APPLIC PRINT NAM&JOIA � !�L GQ� Y DATE: APPROVED BY: / DATE: ICS COPY GIVEN TO: VfLTIDLITY BILLING (only if new meter) ❑ PUBLIC WORKS ❑ ENGIN ERING City of Fridley Engineering Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3552 FAX: 763-571-1287 MR ROOTER OF TWIN CITIES 5155 EAST RIVER ROAD, SUITE #412 FRIDLEY, MN 55421 TEL 763 551 0555 FAX 763 551 2555 Account # / AP Inv # Name KELLY JETSEN Address 5871 5TH ST NE City/State/Zip FRIDLEY, MN 55432 Main Phone/2nd (507) 202-6759 Map/Directions Z -Unknown Make Product Model ,qre-k 41� M--1 �wve Gv A -r Tck # 35608 Received 9/4/2010 8:09:03 PM Dispatcher KUNZA Promise Date/Time 9/6/2010 10:00 PM Technician HANSON, KEVIN Our PO# Dispatch Code ML -Camera 3rd party PO# ServiceFee 3rd party Auth# $0.00 MFG# Serial # Building BUILDING Permit No.: 9Q4 IX '7 (P Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date )REMS E ly 0 8 2 , 763-502-4977 FAX EFFECTIVE 1-1-2010 ® DATE1,41 YOUR E-MAIL ADDRESS SITE A KESS 579N THIS APPLICANT IS: ❑ OWNER 01 ONTRACTOR PROPERTY OWNER/ NAME: ADDRESS: CITY STATE ZIP TENANT PHONE: CONTRACTOR NAME: SUBMIT A COPY OF STATE LICENSE # 1 EXP DATE YOUR STATE LICENSE �O STATEt AND CERTIFICATE OF ADDRESS:."!�% , INSURANCE PHONE FAX PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING FATHER ❑ SWIMMING POOL TYPE OF WORK: ❑ rTEW HOME CONSTRUCTION ❑ ADDITION INTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING O HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS & PORCHES SUBMIT: E3 Vinyl ❑Soffit 1. Site Plan/Survey showing the existing structures ❑ Aluminum 11 Trim and proposed project. 13 Other ❑ Fascia 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. 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 $ 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 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) ft+6ft= ' ft)Ct24= Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED ination) 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 fo pe it d work is of to start without a permit on site; that the work will be in accordance with the approved plan in the case of wo c ich r qui re w and approval ��of....plann SIGNATURE OF APPLICAUtr_00-v _PRMNA �I DATE I