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PRE 2010 DOCS• • 0 City of Fridley, Minn. BUILDING PERMIT Date: _ Jan. 7, 196 Owner: _... William McClish Builder Don Michnowski Address Address 4423 Reservoir Blvd. N° 10075 LOCATION OF BUILDING No. 5360 ASo 5th S t . N. E. _ _ part of lot Lot s i of 4 _Block 14 Addition or Sub -Division _—Hamilton's Addn. to Mechanicsville Corner Lot _ Inside Lot — x Setback 35' T_ Sideyard — 10' 10' Sewer Elevation ___ ___ _ 855.80 Top of Footing DESCRIPTION OF BUILDING To be Used as: Dwellins Front 40' Depth 26' Height 20' Sq. Ft. 1040 Cu, Ft 20, 800 Front Depth Height _ _ Sq. Ft. Cu. Ft. Type of Construction _ _ . game Est. Cost —11.Z 000 ________ To be Completed Water has to be tapped. In consideration of the issuance to me of a permit to construct the building described above I agree to do the proposed work m accordance with the description above set Orth and in compliance with a'll provisions of ordinances of the city of Fridley. . A _ '�, 7) n .IJ Connection'Charge In consideration of the payment of a fee of $ 31 .00 , pmt is hereby granted to Don Michnowski 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. Clarence Belisle /, NOTICE. This permit does not corer the construction, installation for wiring, plumbing, sac hoatbrg, sewer or water. Be sun to see the Building inspector for separate pormha for these hems. 1 APPLICATION FOR BUILDING PERI` CITT ' Off' FRIDLEY, MINN:SSOTA UILMER D®� SS._3_..:�3e�v LOCATION OF BUILDING t6T 414ALI or. ADD'iTION -OR, SUAD1#ISiON CORNER LOTS, FIDE Lgj�_SETBACK SIDEIrARi� _ SEWER EVATi'1i1 :' 'fUP OF FOOTING Applicant attach to this form Two ­Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OFtlBUILDING To Be Used Ast . j•'� A— C4 rti: y Front�,.� Depth Height _ Square feet %D Lf 0 Cubic Feet x 81&0 r : E'ront �epth' + $eight SgZtsre"feat . Ctibic Feet "Tyge`-of 'CouetructionF:r+„:Z' Elstl,iated Cost To Be C9 ►pleted %P► � �_ The uadeicsigti c� hereby makes aj�jlication for a `permit for the work herein specified, agreeing to do all worli'''in'strict accordance with the City of Fridley Ordinances, and rulings of the Department of Buildings, and hereby declares that alfrthe facts 6d rep esentations stated .in this application are true and correct. DATE o° -v _SIGNATURE ' _ ----.— (Schedule of Fee Costs can be found on the Reverse Side). lop Onom • • PERMIT for Power Plants and Ideating. Cool- ing. Ventilation. Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of l Heating Plants `�- to b 'nstalle ltered—repaired Make ,Size 1 r ® Oil fired ; Coal fired—, Gas fared—; Gas Authorization No. Remarks Approved Final Inspection 19_ Em Inspector Permit Ni 4401 Fee Office of the Inspector of Buildings City of Fridley City of Fridley, Minn., Q?- S3 8 Owner �✓-°`�"-�`'Q-r-� Location Kind of Buildin-d How Occupied Work to be Commenced—, 19— To be Completed ,19_ Estimated Cost, $ Old -New, Building Permit No. Lp ® -7 -s' Permission is hereby granted to o install—erect—use the material and devices described in the above statement. This permit is granted upon Ae express condition hat the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of tHe devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein narAed, and to the specific ns set forth in the approved application for this permit on file in the office of the Inspector of Buildings. Inspector of Buildings 42 2M 11-67 d U City of Fridley Application for Plumbing and Comas Ruing Permit Dept. of Bldgs. Phone 8M -34M DESCRIPTION OF WORK — 3 s . Number, Kind and Location of Fixtures Location pa 47Z NO. RATE TOTAL Number Fixtures ....... .............. _ ii i ZFz o2 $ O �'c tTjz S •� OS <3 , t�9 °1 (W9 0 Z �p F t N WATER HTR. GAS ELEG Base New Ground Run Old Bldg. ............ x $3.25 $ Electric Water Heater a $2,00 $ p� GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .................. ........ Z x $2.00 $ Additional Fixtures .................... x $ .75 1st Gas Range to 199,000 BTU .............. x $5.00 $ 2nd 3rd 4th • Future Connection Openings New Fixture, Old Openings I Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... .............. x $2.00 00 C/ O® $J� Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ...... .................... x $3.25 $ Water Heater (Up to 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg. ............ x $3.25 $ Electric Water Heater a $2,00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .................. ........ Z x $2.00 $ Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ...................................$ TOTAL FEE _ , �° City of Fridley: The undersigned hereby makes application for a permit for the work herei 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 facl and representations stated in this application are true and correct. Fridley, Minn IMP -c. 19 L Owner �4�- Kind of Building Used as To be completed about Estimated Cost, $ Old—euilding Permit No_ /� - l� �� Permit No. ROUGH q 01 FINAL U By Business Phone No N? 4855 original Permit for PLUMBING AND GAS FI'I$ING N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for Permit inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit., Fee e -e DESCRIPTION OF WORK Number. Bind and Location of Fixtures .y City of Fridley Zaa z��� ! ,19-o Stories F 0 Q J 3 U Z d' 7 �_ m Q 7 m F m Q m x Z N G 6 Q C 3 F Z 7 E O O LL W O S y R O Q J K LL O _ F N Q Q U M z X Q O 0: .1 m % f LL m y Q d e Q W m Z Q Q b K WATER HTR. GAS ELEC. Basement ist 1 1 2nd 3rd 4th Connected with Sewer -Cesspool Gas Piping for Openings Permission is hereby granted ' I r% , to do the plumbing and gas fitting in the building described in the statement JUreto attached, upon the express condition that the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and this permit may be revoked at any time upon the violation of any of the provisions of said ordinances. By Order Of The Inspector Of Buildings Roughing in Inspection Date Inspector. Final Inspection Date Inspector. a te' 42 Ins -6-65-v Owner zzze— py e—� Location \53 (cc j� Find of Building Used as To be Completed .19— Estimated 19_ Estimated Cost Old -New. Building Permit No. /CC. D i Inspector of Buildings. p for Payer Pkmft wd HSR Cools". Venh'taton. Re%igera"cn ®nd Air Condie%ning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ...........................$10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ....... 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AM Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & sines—to 400 sq. ft. EDR Steam .. .$10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 10.00 $ Each add. 200 sq. ft. EDR Steam ...............: ..... 3.00 $ Each add. 320 sq. ft. IDR Hot Water ..... ............ 3.00 $ OIL BURNER—to 3 gaL per hour ... .:... . .... ..... 6.00 $ over 3 gal. per hour—See Fee Schedule /D® GAS BURNER (up to 199,000 BTU) ....................... 8.00 $ over 199,000 BTU See. Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ..... ................ x$ 200 $-�— Additional Fixtures x .75 $ Gas Range to 199,000 ........... is 5.00 $ AIR CONDITILoNIIfa FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH— OUGH FINAL— FINAL see see Fee schedule a TOTAL FEE $ - _- Dept. of Bldg& Phone 8804480 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 Ordinance: 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, Kind of Building — Used t- Used as 1& — To be completed about Estimated Cost, $ 17 Old—New. Building Permit No. Permit No. 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 Bind of Fuel BURNER — Trade Name Size No Capacity Sq. FL E.D R- BTU $R (REMARKS-OYHR) Original • • PERMIT for Power Plants and Heating. Cool- ing. Ventilation. Refrigeration and Air Fee 100 N° _ 4722 Conditioning Systems and Devices Office of the Inspector of Buildings DESCRIPTION OF WORK No. o. Heating Plants to be installed–altered—repaired Make Oil fired—, Coal fired ; Gas fired ; Gas Remarks Approved by Final Inspection 19_ Inspector City of Fridley City of Fridley, Minn. 1 , 19_10 Owner -A M/ ✓ -,a Location 15:3 �0 ® A Kind of Building - TAa,rn p 2 How Occupied Work to be Commenced—, 19— To be Completed—, � ,� 19_ Estimated Cost, $ LGA , 0 6 Old -New, Building Permit Permission is hereby granted Co • A J . g _1L11 tato install—erect—use the material and devices described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respocts to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specificatio set rth in the approved application for this permit on file in the office of the Inspector of Buildings. Inspector of Buildings 42 2MIWV 53--91!-9915C51 CRY Of • 6666 . • Dopt. of Bldgs. Phone 8.NJ•3450 17,-360 DESCRIPTION 0: V10111: Lo:.nLI' and Locraor. Of Fl-vtures City of Fridley: I� � Wl�T(! wT�l. • s i e e c 1< i 7 7 }�' 7 " r ►+ oas niG The undersigned hereby makes applkation for a permit for ttir oor): hi y o a i; . = a �w t u o • t° specified, a� eeing to do all work is strict acco.das:ce with the CiL7 0.--- 1n; in i 1 and ruling of the Depa::r.^.ent of Luily.'nZ% and hereby declares that all t.`se Es:r • , and trepresertations stated is _':is application are true std eo:rett' in t:� 1 ril 6-22-76 1! 1A I Fridley, b.iaa Owner Std ;., • Kind of Building Cra;1n e Ce-ees.ea Cr?T•G'- Ce:rtti:.d �iYz ros, • pL ucaoz Used as s }t•v Fixturo. Old C=7001 0 6-29-76 _ -.-- -- To be completed about PARTIAL RATE SCHEDULE P LtvM- 31110 FIXTUAF. RATES: NO. RATE TOTAL Number Fixtures ......... .. • • • • •----.-.- � x +��_.0.0. $ *-- Future Fixture Opening 9 9 • • • • • • • • • ---- x $1.50 S • -.-- Iew Fixture Old Opening• ••• • • • • • • • -- x $1.50. i_.-�-- Catch NasinO.6699696666069690♦• ���•• x $3.25 $ «'ater Ifeater'Up to 99.000 BTU).... -- x $3.010 S ' New Ground Run 01i BIdg. 11.25 S Ei.ctto Water Hastsr... S2.00 S H0. RATZ TOTAL 11S 11TTING FEES: 5----- • lst3Fixtures ••••••••••••••'•••----xS2.00 �.ddltlanal Fixtures ...............---------- x S .75 $ C:s Fts :;e to 199.000 BTU ........... ------ x gsifir`r`.�te��.� ��0 10,00 P.:est xa. Old --New. Duilding Permit Na. _ - SiZned By 1� Businu-..s Ph-jrc No . ' ROUGH FINAL �-�o`%�• ,50 State Surcharge . ALTERATIONS--P.sfer to Code 11 TOTAL Frzt S— . SUBJECT P City of Fridley 19487 AT THE TOP OF THE TWINS BUILDING PERMIT _ IPT ' ` COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ----� ��'���,•� L 612-571-3450 910-F15 I I 5/24/88 JOB ADDRESS 5360 - 5th Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt. 4, 5 14 Hamiltons Addn. to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Michael Anderson 5360 - 5th Street N.E. 572-8143 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. American Remodeling 3700 Annapolis Lane 553-0020 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Soffit & Facia Repair 9 CHANGE OF USE FROM TO STIPULATIONS _ TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION 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 $4,608 $2.30 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISION ANY OTHER STATE OR LOCAL LAW REGULATING CON- $72.00 STRUCT, OR HE PERFO NCE OF C ST ION. LAN CHECK FEE TOTAL FEE C $74.30 t IGNATURE CONTRALTO RAUTHORI _DAGENT (DATE) WHEN PROPERLY V ATED THIS IS YOUR PERMIT 1/7 SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI BLDG INSR fiATE Prepaid Plan Check $ Estimated Cost City Of Fridley Receipt # :BWtXg Permi�Appl�icati�on Construction Address: X364 'r 4�— '57- Effective 5/1/88 Zoning. Legal Description: Property Owner & Address: ��iy�E'L i9tiDE�iP�SO2� Tel. # �7� .3 CDNTRACPOR C! Cc Tel. # ozao Architect & Address: Reg. # Engineer & Address: Re j. # Type of Work [ ]New [ l Addition [ ] Alteration 00ee��ii� Af USE 0 B NG: APPLICANT S IGNMrURE : ��2Tel. # L5'X.:F GdVa Date: BUILDING DIMMIONS Size of Structure Length Width Height Sq. Ft. OEC. AREA: Length Width Height WHSE. AREA: Length Width Height OTHER AREA: Length Width Height VALU TION Sq. Ft. X $ Cost/Sq. Ft. = Valuation Sq. Ft. X $ Cost/Sq. Ft. = Valuation Sq. Ft. X $ Cost/Sq. Ft. = Valuation # of Stories Sq. Ft. Sq. Ft. Sq. Ft. Total Type of Const: Occup. Group: A/C [ ] Yes [ ] No Fire Prot. [ ] Yes [ Mo Performance Bond Amount $ See Reverse for Schedule Received [ ]Yes [ ]No. 0 Permit Epee $ See Fee Schedule on Reverse Side Plan Check $ In excess of Prepaid Plan Check -See Back Pg. State Surcharge $ 2 $.50/$1,000 Valuation (See Sched. for > $1 mil) SAC Charge $ $550 per SAC Unit Park Fee $ Fee Determined by Engineering Spec. Assessments $ Agreement Necessary [ ] Not Necessary [ ] Driveway Escrow $ feet at $13.50/foot TOTAL $ ., STIPULATIONS: w CITY• DF FRIDLEY APPLICATION FOR POWER P ANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTE14S AND DEVICES RATE SCHEDULE no crnVW.'rr a T_ Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping \ (piping needed with new furnace) Gas Range Gas Dryer * Air Conditioning (all sizes) IALL-c Clve Auq. 1, 11x1 RATE TOTAL Job Address 5360 NE 5 St. #5728143 $ 20.00 $ Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley $ 10.00 $ 10.00 Tel. #571-3450 $ 10.00 $ 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 $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. $ 10.00 $ Fridley, Minn. 23 Oct 89. , 19_ All Others/Repairs and Alterations 1% of Value of Appliance or Work Direct Vent Space $tr COMMERCIAL/INDUSTRIAL 1% of Value of Appliance or Work State Surcharge TOTAL FEE Reinspection Fee ($15.00) Rough Insp. Date Final Insp. // —c� f �N Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $a.00 PLUS $.50 STATE SURCHARGE $ 15 to E $ .50 $ 25.50 Attach stack verification form with replacement furnace permits *Air Conditioners can not be placed in side yard without written permission.fram adjoining neighbor. OWNER Michael 7 Andprean KIND OF BUILDING frame USED AS res TO BE COMPLETED ABOUT 23 Oct 89 ESTIMATED COST 600, OLD - QWBUILDING PERMIT NO. PERMIT NO. ILIL DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name Perfection Wall Htr size No. WASV-730 Capacity Sq. Ft. EDR BTU 30.000 HP Total Connected Load Kind of Fuel Nat, Gas BURNER - Trade Name Size No. Capacity Sq. Ft. E BTU � HP � v m Signed By Tel. No. Minngascu :073- 700 W' • Linden Avenue 700 Yr P. 0. Box 1165 Minneapolis, MN 55440-1165 SUBJECT PERMIT NO. City of Fridley 27659 AT THE TOP OF THE TWINS BUILDING PERMIT + RECEIPT NO. COMMUNITY DEVELOPMENT DIV. ______ 1 v PROTECTIVE INSPECTION SEC. r 1 � 1 NUMBER REV DATE 9/9/98 PAGE OF APPROVED BY I CITY HALL FRIDLEY 55432 1'' 612-571-3450 910-F15 JOB ADDRESS 5360 5th St NE i LEGALLOT NO. Sjof4, 5 BLOCK 14 TRACTOR ADDITION SEE ATTACHED Hamiltons Addn. to Mechanicsville SHEET DESCR. 2 PROPERTY OWNER MAIL ADDRESS Mike Anderson SAme ZIP PHONE 572-8143 3 CONTRACTOR MAIL ADDRESS Four Seasons Roofing & Remod 7930 Univ Ave NE Fridley ZIP PHONE LICENSE 55434 795-9410 201387 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 ❑ NEW ❑ ADDITION ❑ ALTERATION W REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house & garage (27SQ) Tear-off 9 CHANGE OF USE FROM TO. STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, 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 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 $2,313.00 $1.16 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $74.75 Fire SC $2.31 S R TI OR TH FORMANCE OF CONSTRUCTION. .41 PLAN CHECK FEE TOTA Licens C $5. $83.221�j SIGNATURE OF CO CTOR R AUTHORIZED AGENT IDATEI EN P OP A ]DAT HI$ I$ U PE T 8L INSP SIA 7E SIGNATURE OF OWNER OF OWNER BUILDER] IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] ` iTY OF FRIDLEY ALTER [ J SINGLE FrUvli V -AND DUPLEXES R-1 AND R-2 7� �— y BUILEI e G PERMIT APPLICATION ConstructionAddress:5366 6�h S�. N- - Legal Description: C Owner Name & Address&kc AnCC Pet'533 � h �;t /Cls Tel. # 611ol Contractor:;pUr s-eAs( 15 Pcc��n_ !) cam. o&Avxc, MN LICENSE # Address: 7q -21) „ems �v I ct � Tel. # o�` 9el10 Attach io o}r lin, a Certificate of Survey of the lot, wkb11v_pmpc5§d02oVmction drawn on it to scale. P0CAJP=N OF IMPROVEMENT LIVING AREA: \N Height _ Sq. Ft. GARAGE AREA: : ' L — 1��d�1� Height Sq. Ft. DECK AREA: LMQAh WAW Hgt/Ground Sq. Ft. OTHER: 2.VVl_mJ �e_ 4 1 tAnn"a Al ,dfa '0.. Vj,e_.�_��b.A Construction Type: Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needd: ,R., }- 6 Ft = Ft x $ _ $ DATE: APPL1 -` Tel. # / C 1TV__V_S9ONLY Permit Fee $ / `t, �� FSehedug, on Reverse Side Fire Surcharge $ (tel o� 9err { Valuation (1/10th%) State Surcharge $ $.SQ/$1,009%1uation SAC Charge $ SL0009U SAC. Onit License Surcharge $ $$AO(,S%.Licensed Residential Conmictors) Driveway Escrow $ AIAL" All cx AW "$" Above Erosion Control $ &40.00 CbCwvation Plan Review Park Fee $.Detr ,. ' by Engineering Sewer Main Charge $ _CZfr'6@;2sary [ ] Not P%q [ ] TOTAL STIPULATIONS: 01 SUBJECT P City of Fridley �95 AT THE TOP OF THE TWINS BUILDING PERMIT i • I COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC �� 1 r ; CITY HALL FRIDLEY 55432 NUMBER NEV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 2/25/99 JOB ADDRESS 5360 5 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. IPt 4,5 14 Hamilton's Addn. to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mike Anderson 5360 5 Street NE 572-8143 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Twin City Exteriors Co 9060 Zachary Ln N #108, Maple Grove, MN 55369 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 425-4737 2595 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION O ALTERATION REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Fascia & Trim 9 CHANGEOFUSEFROM TO STIPULATIONS SEPARATE PERMITS ARE REOUIRED 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 1 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 $1,600 $.80 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $51.25 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION Fire SC $1.60 PLAN CHECK FEE E TOT718.65 License $5.00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT tOATE, P P R ALIO IS IS YOUR PERMIT �V S,GNATURE Of OWNERoF OWNER BUILOEA, iDATE, BLOG dNSP GATE 01 NEW [ ] Effective 1/1/97 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �(� ✓ �- ; ConstructionAddress: �� 7t Legal Description: M Owner Name & Address: / ' l E Tel. Contractor:L5140 MN LICENSE #_ p� Jar Address: 4v 1 Tel. #�/a Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA:' Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: _ 06 Construction Type:_1L0.1,9,, y1 Estimated Cost: $ % @� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE:42 ZZ- APPLICANT: Tel. # &49-�� f 2 ,? CITY USE ONLY STIPULATIONS: Permit Fee $/,�� Fee Schedule on Reverse Side Fire Surcharge $ / 60 .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) 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 $ STIPULATIONS: SUBJECT PER City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT 312 2 8 r? NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC /S® 1 ld NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 7/21/00 JOB ADDRESS 5360 - 5th St. NE 1 LEGAL ILOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. I S 2 4 5 14 Hamilton's Addn. to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Linda & Michael Anderson 5360 - 5th St. NE 763-572-8143 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Renewal by Andersen 350 - 73rd Ave. NE Fridley,MN 55432 763-572-8143 20130983 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 ❑ NEW ❑ ADDITION ❑ ALTERATION LX REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 3 windows within existing openings 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Permit Inspection Cards Will Be Mailed To Homeowner T® Post 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 '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 $2 980.00 $1.49 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK F TOT FEE Lice e E $5 92.72 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATE. E P VALID T THIS I )UR PER IT ; �'� _ S,GNATURE OF OWNER,IF OWNER BUiLDERi IDATEi -y 8 1 INSP gAtE NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FREDLEY ALTERf f j SINGLE FAMiI Y AND DUPLEXES R-1 AND R-2 �� v� BUILDING PERMIT APPLICATION �� Construction Address: S•�lDi� GJ ", • � C, • . Legal Description: &NOA - Owner Name & Address: L� m i l,� A 1NfN& f 5p Tel. • -Rf g 3 Contractor:; RENEWAL BY ANDERSEN MN LICENSE # 350 -73RD AVE. NE Address: FRIDLEY, MN 55432 Tel. # (612) 502.-4777 `� LICENSE #20130983 rvey. of the lot, .........., ra��,.,�.,...,.,..�u.�..u�u ..yaru .,u it to scale. DESCRIPSI{. N OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: p�n,, 4 l s.� TSi lY1 V<}`(`i _q 1�� � n Alis, Construction Type: Estimated Cost: $ a, 1 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE:) ..:S APPLICANT: Tel. # � • $ � { CITY USE ONLY Permit Fee $ 33s- Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) 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 [ ] a TOTAL $' 2 -4 en STIPULATIONS: . CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Effective On January 1, 2000 JOB ADDRESS c5_36Z OWNER 11111 � / V TOTAL BUILDING USED AS ` CfL'c AJ ESTIMATED COST `� �PERMIT NO. DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units_ Circle One (Steam) (Hot Water) Warm Air $ Trade Name C($eR i Size No. �`�'A o BTU HP EDR $ p0 Fuel A -r— Total Connected Load Burner Trade Name Size No. BTU HP EDR $ 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 $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. $ cUPERIOR r.0',JTh V'aCP-,rte Pf\• 6129 42nd Avenp_9n: EfiE Crystal, Beira 5 A _ HEATING Signed Approved By/`L.Z Rough -In Date TEL # Final Date COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, 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 (,I'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-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes (/�'No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes KNo ( ) 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 Type and Size/Common Vent and Vent Connector Information Appliance #1 Type C A Rkc &K BTU Input &-D, 000 Fan Assisted or Nat FAQ - Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type ' Vent Height I Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) IN �B�'�2�E� CCI,�91PA(� T(7,-- � 61211 42nd Avonuo 1,yu. HEATING CO: Crystv9, EJUJ Signed By: Date SuBjECT MIT NO. City of Fridley 33893 AT THE TOP OF THE TWINS BUILDING PERMIT I COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r NUMBER REV GATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 It "" 763-571-3450 910415 9 117103 JOB ADDRESS 5360 5 Street NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt 4, 5 14 1 Hamilton's Addition to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Michael & Linda Anderson 5360 5 Street NE 763-572-8143 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Kitchens By Design 201 Silver Lake Rd New Brighton, MN 55112 651-636-5266 a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20315240 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION ❑ ALTERATION ❑ REPAIR X ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Kitchen remodel 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan. Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. 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 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $2,500 $1.25 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $83.25 Fire SC $2.50 S�TRU,QqN OR THE PERFORMANCE OF CO STRUCTION PLAN CHECK FEE TO L FEE ���1 T�03 Licens $5 $92.00 SIG URE OF CON-RAC TOR 0 AUTNOR,ZED.GENT ,DATE, EN OP VALI T THIS IS YO R P RMT S-GNATURE OF OWNER ,,F OWNER BUILDER, ,DATE, NEW [ ] ADDN [ ] ALTER ' Construction Address: Legal Description: Owner Name & Address: Contractor. bi -" CITY OF FRIDLEY 6431 University Ave NE, Fridley, MN 55432 SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION `". rN r Effective 1/1/2003 (763) 572-3604 Bldg Insp (763) 5714287 Fax Q� 1 J L,--Yv tsov\, Tel.# 763--572 -81��' Ea MN LICENSE #2031S2-gd J _ A3 "U,, //" A) Tel. # 6-5l- 63(o - zSz "' Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width t( Hgt/Ground �uyKy Sq. Ft. OTHER: ' t )C d e y Construction Type: �e-v� o��� Estimated Cost: $ o" Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 9 /oJ2003 APPLICANT: Tel. # 76 3-7/7` �'3D 7 Call (763) 572-3604 for Permit Fees if mailing in application. 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 Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Aft" r 60 TOTAL $I Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1275 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 [ ] H 107+" 27T � 634 �..� I N �' SLI P / ----- ENTRY TO LOWER LEVEL iGI" � L i� C . �(�C✓ ------------------------------------ 4' . l Tiflis JOB COPY SHA' L Sr I A± AILABLE ON THE JOE ,SITE FOR THE FRAti iN"% ------------------------------------------------------ - -- L INSPECT 10 N ------------ = ----- - AND FINAL WWW � tN j SMV o WALLS R CMM EWEd FO ODS LIANCE tl`� g�t�BL Ins tOr .®- A I 1 1034" S 1 52- A ��Opr << All dimensions -size designations given are Designed BY: This is an original design and must not be Designed: 8/3/2003 subject to verification on job site and Gene Klaphake released or copied unless applicable fee Printed: 8/27/2003 adjustment to fit job conditions. FOR has been paid cr job order placed. Aaderson's 5360 5th St NE NM TRA Kitchen I Qma ruction Plan I Drawing #: 1 r 1� All dimensions -size designations given are Designed BY: This is an original design and must not be Designed: 1/16/2003 subject to verification on job site and Gene Klaphake released or copied unless applicable fee Printed: 8/27/2003 adjustment to fit job conditions. FOR has been paid or job order placed. Anderson's 5360 5th St NE ML Kitchen Existina Floor Plan I Drawina #: 1 Y OF FRIDLEY INSPECTION DIV %1 University Ave NE liey. MN 66432 3) 572.3604, FAX (763) 571-1287 19 IL Effective On Jan 1, 2o03 APPLICA710H FOR PLUMBING AND GAS F1TT1NG PERMIT JMBING FIXTURE RATES; NO. RATE TOTAL P x Fixtures $ 7.00 1 Opening, New Fixture $ 4.00 er Dispenser $ 5.0Q W OH Basin $ 7.00_ :ch Basin $ 7-00 w 'n Water Leader s7 -6o *nP/Recelving Tank $ 7.00 H dar Treating Apolance $10.00 LL o iter Heater -Electric $ 7.00 �: iter Heater. Gas" $10.00 u a Range" $10.00 , D E s Dir" $10.00 :.k Flow Preventer Required ( )Yes () No type $18.00 N inepedion Fee W.001Hr L OTHERS ANDIOR REPAIRS AND ALTERATIONS. .6% of Value of Fixture orAppilance �i r State Surcharge TOTAL EEE JOB ADDRESS 5 3 (0© .5-te cS14 A) The undersigned hereby makes appilcalton for a permit for the work herein specified agreeing lo do all work In strict accordance wtLh the city codes and ruings of the Bonding Dlvision, and hereby declares that all the facts aid representations stated In this application are true and correct. Owner Building Used As A$ Esumated Cosl PERMIT NO ,•- r PLUMBING SIGNED 6Y,� Approved By $ .50 MIND S� P S T TEL Ha_ &1491-777--7.3 2S Raujh4n Date_ Final Dais )MBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 5W) ANO TABLE G.A. CO MON Vf-:KT INFO ON BACK SIDE ,(,o ISS Building BUILDING Permit No.: —® Inspections RESIDENTIAL APPLICATION Received By: ffi�f'a. 763-572-3604OU Date��: MAY CjTy OF FRIDLEY VkR `A URGE ADDRESS 4150,V\CL @ C���%JC • CCJYYI SITE ADDRESS�Q ,MAIL _ ' C� Ga� THIS APPLICANT IS: ❑ OWNER OCONTRACTOR PROPERTY OWNER/ NAME: Q% V\&C . \A VNCJ-ei SO ry TENANT ADDRESS: CITY STATE ZIP ^^n PHONE: 6?p - IS7 d ' 14 3 'f NAME: Renewal By Andersen CONTRACTOR SUBMIT A COPY OF STATE LICENSE # 1920 County Road "C" West YOUR STATE LICENSE ADDRESS: Roseville, MN 55113 STATE ZIP WITH APPLICATION PHONE License #20130983 13SINGLE FAMILY/NE` PROPERTY TYPE ❑ TWO FAMILY/NEW C 651-264-4777 _ ❑ ADDITION ❑ GARAGE/SHED _.B'WINDOWS PERMIT TYPE ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION INTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE:&UD Y.CL_.[ a C- V!taLz xr,— op:" --n 1:5 ...Q'x: -nix'-- - SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT "Sci. Ft. ROOF-INROOF-ING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2• Proposed floor plan PROPOSED HEIGHT: 3. List of structund members to be used SIDING ❑ Vinyl FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Aluminum ❑Soffit ❑ Trim ADDITIONS. 1. & PORCHES SUBMIT: Site Plan/Survey showing the existing structure ❑ Other ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No 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: (USING THE 1"7 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ tv , O00 — OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attac THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be i conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approve plan in the case of all work whi 4r uir iew and approval of plans. �n ,, SIGNATURE OF APPLICANT PRINT NAME/{ 1Qt(y,Ic�t y�Gn y�� DATE 7$� (-:Log IN Building BUILDING Perinit No.: IUA& aZ8L1 Inspections RESIDENTIAL APPLICATION Received B 763-572-3604 CITY OF FRIDLEY Date Juvul 763-502-4977 FAX EFFECTIVE 1-1-09 DATE 11 YOUR E-MAIL ADDRESS IM NQ,I� & 4-UJ1A1G14U/'00fA pp 1 - CO&AiA. SITE ADDRESS �� ��J1 k N THIS APPLICANT IS: ❑ OWNER 'CONTRACTOR PROPERTY OWNER/ NAME: 4c M er5i'# I TENANT ADDRESS: S S k- '3 !,ifCITY �vjfo STATE/1W ZIP 55Y2� PHONE: M_ $�y3 CONTRACTOR NAME: W Al [9 SUBMIT A COPY OF ®� pe YOUR STATE LICENSE STATE LICENSE # EXP DATE I 15tt 7 AND CERTIFICATE OF ADDRESS: T,t/ UIJ. CITY cc, STATE ZIP INSURANCE PHONE (05 1- fv — G FAX PROPERTY TYPE %SSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK gSSIDING ❑ OTHER LaLlim-1 ❑SWIMMING POOL NS C.0 TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION gMAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: Gt - L Q II` SIZE OF IMPROVEMENT 61-t,Gpi 6.4,k, LENGTH G WIDTH HEIGHT SOFT 4c ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: C, H 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: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS & PORCHES SUBMIT: ❑ Aluminum Trim '� 1. Site Plan/Survey showing the existing structures and proposed project. Other ❑ Fascia 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: TOTAL JOB VALUATION $ Clio, ,SHE 1997 U.B.0 FEE SCHEDULE) OCCUPANCY TYPE Permit Fee $�, ll 1 X15 See Back Page for Fee Schedule Plan Review $ _ 65% of Building Permit Fee Fire Surcharge $ +C¢y .001 times the total job valuation Surcharge $J .0005 x Permit Valuation Minimum $.50 License Surcharge $ a ®® $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 $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge ' $ Agreement necessary ( ) Non Necessary ( ) Total Duel $ Make checks Davable to: Citv of Fridlev 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 on site; that the work will be in accordance with the approved plan in the case of all or wth 7red fires review and approval of plan,s._SIGNATURE OF APPLICANT PRINT NAME /y(�Gl�jIGL� /J. / r �6 u1 DATE PLEASE NOTE: SEPARATE PERMITS ARE REOUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK F F