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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT ' N® 3281 Date: 5 ............................ Owner ....................................... Builder.. .......... Address ...................................... Address ............................................. . LOCfATION OF BUILDING No.�.Street.��` :................... Part of Tot .......... ......... Lot .....0 ... Block ... ............. Addition or Sub-Dlvisioij,,- . Corner Lot ............ Inside Lot ......... Setback ...��.. ` ... Sideyard .../... . ...... DESCRIPTION OF BUILDING To be Used aa: ... Front Depth A �4. Height ... 6 .. Sq. Ft. . !. k Cu. Fi.-F� t .................... Type of Construction nt ....... Depth ........ Hei t ........ Sq. Ft. ....... .. • . .... lust. cost.. !.. q.®..... To be Completed . Cu,m®Ftp., ....... . L J.'.'f 0 ........ 6 � bt"d 114 OL &.-A4. I In consideration of the issuance to me of a permit to construct the building desribed 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. 0 C7 In consideration of the payment of a fee of $. Y. -, permit is hereby granted to �a•c� • / J[ ......................... 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 time upon violation of any of the provisions of said ordinances. % j� ....... s . i.........gilding Inspector NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas sewer or water. Be sure to see the Building Inspector for separate permits for these Itema F• n LJ • City of Fridley, Minn. BUILDING PERMIT Date: June 29: 1965 Owner: Vernon D. Nygard Builder N° 8073 Dalberg BuildersSs Inc. Adder 5957 5th St. N. E. Address 71,72 stinson Blvd. N. E. LOCATION OF BUILDING No. 595 _ Street 5th Street N. B. Part of Lot Lot 1,; _ Block 4 Addition or Sub -Division BAS Add. Corner Lot _ Inside Lot Setback Sideyard Sewer Elevation — Foundation Elevation To be Used as: Front Front Type of Construction DESCRIPTION OF BUILDING Depth Height Sq. Ft. Cu. Ft. Depth Height Sq. Ft. Cu. Ft. __._ Est Cost , 13.500.00 To be Completed Storm Damage Repair Rebuild from Deck 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 s rib d in compliance ail provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ 10.00 , permit is hereby granted to Dalber,Bld l S. 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 wiordawes. city limits and this permit may be revoked at any time upon violation of any of the provisions of said Allen Jensen Building Inspector NOTICES Ibis pnmb don not sora tia eendrudbq, hwh9dloe for Y►bht& pbenbinA, on bedhm nwa or wets. Be an to no die Bupdiea l **Mr fa apuaU psm % for tbm hese. i APPLICATION FOR WOMPERMIT CITY OF FRIDLEYO &NNESOTA OWNERS NAME BUILDER ADDRESS�"Zi .@ ADDRESS t LOCATION OF RING Street ,� �� Z46 11 Part of Lot . Lot Block Additioat br Subdivision, Corner Lot Inside Lot 14 Setbktk Side -Yard SEWER' ELEVATION FOUNDATION ELEVATION Applicant attach to thin form, Two Certificates of. Survey of Lot and proposed-build— ing location drAvn on these Cattificates . DESCRIPTION OF BtTILDING Ta be used as: 1. PrenC40t a .Depth Leight 3q. Ft. Cu. Ft. �^ Front Depth Height Sq. Ft. Cu. Ft.' Type of Construction Estimated Cost 00 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work iri 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. _%Schedule.of Fee Costs can be found on the Reverse Side). CID. Application for Power Plants and. Hearing. Cooling, Ventilation, Reh igeration 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 ............ 8.00 $ each add. 60,000 BTU ........................ 2.00 $ Replacement of Furnace ............................. 0.00 $ 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. 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 & f X 7 4pa / $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM % ALTERATIONS &REPAIRS TOTAL FEE Aczloew --� `r SIV& ROUGH }� FINAL 01 Dept. of Bldgs. Phone SII. 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 Minn 19 — Kind of Used as To be completed about Estimated Cost, $ (ONew. 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. EM.R BTU H.P. Total Connected Load Kind of Fuel BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signerl A"i�e By 42 2M 7.59 Business Phone No 4/!,0 W - OK& 0 11,6e S -V o SUBJECTMIT City of Fridley f o_ 178i3 AT THE TOP OF THE TWINS BUILDING PERMIT i 1 • COMMUNITY DEVELOPMENT DIV. I ��--•---� 1/, r PROTECTIVE INSPECTION SEC. �' 1 � ` CITY HALL FRIDLEY 55432 NUMBER REV. DATE OF APPROVED BY 612-571-3450 910-F15 3 27 81 T;PAGE DC JOB ADDRESS 5957 - 5th St. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 13 4 Bonny Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Vernon and Eileen N aard 5957 - 5th St. 55432 571-4271 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Self 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION #7 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof 9 CHANGE OF USE FROM TO STIPULATIONS Reshingling can be the second layer but not the third. 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 ATR_ ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,000.00.50 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 TOTALFFEE 18. OO SIG ATURE OF CONTRACTOR OR AUTHORIZED AG T (DATE I WHEN PROP BLDG INSP RrYAWDATED T IS IS YOU PERMI �- 111TE Si NATURE OF OWNER IIF OW R ILDERI vIDATEI NEW [ ] City of Fridley Effective 4/1/86 ADDN. [ ] �R-1 AND R-2 ALTER. [ Building Permit Application Construction Address: 6-'7 7 �''f A - Legal Description: Owner Name & Address: '� Tel . S y/ Contractor: Tel. # Address: 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: Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: "I"& Estimated Cost: $ /42 Q)6' C) C) Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: 3-,' 7-97 APPLICANT: L Tel. CITY USE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL $ STIPULATIONS: Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $ 525 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] a °®fid 0.0c) .Vc) SUBJECT PERMIT_NQ._ City of Fridley (` 2646 AT THE TOP OF THE TWINS IILDINr PEQAAIT BUILDING � ^` RECEIPT NO. COMMUNITY DEVELOPMENT DIV. v PROTECTIVE INSPECTION SEC. 9o? r NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 �.__.11.' �•� 612-571-3450 910415 7 / 7 / 98 JOB ADDRESS 5957 5 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 13 4 1 Bonny Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Vernon Nygaard 5957 5 Street NE 571-4271 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 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] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (20 Sq) 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 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 $1 668 $.83 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 FEE TOTAL FEE $56.50 SIGNATURE OF CONTRACTOR OR AUTHORIZ D GENT IDATEi WHEN/P®RROOPERLY LIDATED `BL NSP THIS IS YOUR PERMIT DUTE �GNATUREOFOWNEROF OW SUILDERI iDATEI NEW [ l ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ,;)ConstructionAddress: -6--4 �1 .;_4k !izt, I, Legal Description: Owner Name & Address: Effective 1/1/98 Tel. #.5'7/— A( 71 Contractor: MN LICENSE # Address:. Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: X OTHER: Construction Type: DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height Length Width Hgt/Ground Driveway Curb Cut Width Needed: Sq. Ft. Sq. Ft. Sq. Ft. -U - - �- 0- Estimated Cost: $ C� (Fee Schedule on Back) , Ft. + 6 Ft = Ft x $ _ $ PATE: - APPLICANT: Tel. X" �l STIPULATIONS: � s i CITY USE ONLY L f Permit Fee $ ` Fee Schedule on Reverse Side Fire Surcharge $ r .001 of Permit Valuation (1 / 10th %) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 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: � s i PLUMBING COMMERCIAL APPLICATION City of Fridley DATE SITE ADDRESS -7 TENANT If I 2A/® Af / YOUR E-MAIL ADDRESS NO. C�&DS" [pt Permit Number Received By Date Received NAME V s-:7,4em o f Ar V C Rare D PROPERTY OWNER/ ADDRESS 51 S 7 57774 S' e e -A -LE A y'_ TENANT CITY /D 4-9 STATE -1/V' ZIP SSAY3-2- PHONE# 2&3- 571- -IA ? / CONTRACTOR NAME _ ADDRESS LICENSE # CITY STATE ZIP PHONE#_ _ _- FAX PERMIT TYPE ❑ INSTITUTIONAL ❑ MULTI -FAMILY ❑ SWIMMING POOL ❑ TOWNHOUSE ❑ COMMERCIALANDUSTRIAL ❑ OTHER TYPE OF WORK ❑ NEW ❑ REPLACEMENT ❑ ALTJREMODEL DETAILED DESCRIPTION OF WORK FIXTURES: (INDICATE TOTAL NUMBER OF EACH) FEES BASED ON $10 PER FD(TURE, EXCEPT WHERE NOTED URINAL CLOTHES WASH FLOOR DRAINS RPZ VALVE/ ($15) HEATER ($35) DISHWASHER GAS PIPING BACKFLOW PREY. --,AATER WATER METER DRINKING FOUNTAIN GREASE TRAP ROOF DRAINS WATER PIPING FAUCET KITCHEN SINK SHOWER WATER SOFTENER ($35) FLAMMABLE WASTE LAUNDRY TRAY SLOP SINK WATER CLOSET TANK LAVATORY SWIMMING POOL Permit Fee $ �� S� Minimum: $35.00 Plan Review $ Surcharge $ $.50 on permits less than $1,000 Total Due $ %� ' Make Checks Payable to: City of Fridley THIS IS AN APPLICATION FOR A PERMIT — NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the Information above is complete and accurate; that the work will be in conformance with the ordinances and odes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. NAME OF APPLICANT V f 1e1VP 1Nf Af S 69fgl %e -D DATE SIGNATURE OF APPLICANT 4 � G Z— 6431 UNIVERSITY AVENUE NE, FRIDLEY, MN 55432 (763) 572-3604 City of Fridley 6431 University Ave NE Fridley MN 55432 (763) 572-3602 or Fax (763) 502-4977 Water and Sewer Permit Application ❑ New Connection Existing Date: cf5JU41ity Line Repair/Relocation ❑Water and Sewer Connection Job Address: X55`7 �5 l;;n rYO9 n Name of Applicant (Plumber): Name of Property Owner: Existing Structure Pennit # Permit Type: Sewer Fee: Water Fee: Meter Fee: Repair Fee: 4 Relocation: State Surcharge:�; SAC Charge: Special Assessment Fee: Applicant Signatui Inspector approva Water Meter Repair — Weekend-& Holidays $125/hour Water Connections Permit $50 Sewer Connections Permit $50 Inspection Fee for Water/Sewer Line Repair $40 Special Assessments See Engineering Cost of Water Meter See Utility Billing SAC Charge $1450 State Surcharge $ .50 Water Tap See En ' ing 04/04/05 Building $ 3b'. 7SS BUILDING Permit NO.: -- Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 Surcharge CITY OF FRIDLEY Date Rec'd: �7 SATE "� YOUR E-MAIL ADDRESS 774J 4--d a3 C4 ft,,.4yt- SITE ADDRESS `j 'S7 NE SAC Charge THIS APPLICANT IS:I OWNER ❑CONTRACTOR Curb Cut Escrow PROPERTY OWNER/ NAME: o-c.a Nde( Erosion Control TENANT ADDRESS: 57? •S% S -M Si -CITY o ey STA ZIP $ PHONE: AI.5'71 f1to0 — CONTRACTOR NAME: Total Due STATE LICENSE # EXP DATE Make checks'payable to: City of Fridley Attach Stipulations SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WITH APPLICATION 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 ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ANCEIREPAIR n2R4ODELJNG DESCRIBE WORK BEING DONE: e me vd- 13 C (o.S P SIZE OF IMPROVEMENT l �� LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project 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 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $too O OCCUPANCY TYPE Permit Fee $ 3b'. 7SS See Back Page for Fee Schedule Plan Review $ XS' --(R 65% of Building Permit Fee Fire Surcharge $ 1,00 .001 times the total job valuation Surcharge $ . S® .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $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 $ ;7 a 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 the approved plan in the case of all work w r uires review and approval of plans. `- SIGNATURE OF APPLICANT * ' ' PRINT NAME nt�P� DATE 2 I a-8 I �� Cl In -n -4 C) > r U 40 a rn l all it' FE, r, Building BUILDING Permit No.. Inspections RESIDENTIAL APPLICATION Received By: o 763-572-3604 CITY OF FRIDLEY Date Recd: 763-502-4977 FAX EFFECTIVE 1-1-09 DATE JP U00q YOUR E-MAIL ADDRESS srrE ADDREss S--qS 7 5-01114:F THIS APPLICANT IS: AOWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: oA S L u i en , ( Ae Cl ADDRESS: S q S 7 St A.,' CITY 5647- STATES ZIP TENANT PHONE: % 3 - 5'71 — /�10® CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED WS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION KMAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: ge,2 kctn5 � j�c�flit`C idt; o w4 C A Ao W &Je lftr4GJ'ows -L►+►^ e S3p SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ 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: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGSXYes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & Ct TYPE OF WINDOW TO BE INSTALLED C Se Men NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: S THE 1997 U.B.0 FEE SCHEDULE) 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) $2000 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) 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 work hic�h �renquires review and approval of plans. ( f SIGNATURE OF APPLICANT ;W:= PRINT NAME/ DATE k/ --w JJC)dC? I PLEASE NOTE: SEPARATE PERMITS ARE REOUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK I n .�! � �lJ t %14 I �-GDci ��•t ----------------- T�4 Mt tL) t nrt 1j"- t4 -terr � -� r � —• � • :�UC�/—ala- ► tU r V �t�°, /� %�r/A,.•. Gc✓R..y ''�;. l�ES"`s,C( %i/fc.� �#r_ /�t+Cs�-o�4 �°a�F�:�c+�..Y t.�..4:no�Gkia.% �/� �eF �'� i,,h(t 2 s -f -,a. S 6 ) CSED f2 i`�t-�Q� �2+'✓1 �2t� S ` �� ,� so (IDS 164 cfriz�� 4�"C�o Q (:!k Ki VAI -A i y E � __- AL C._ C J-1-1-- . 5g57 5 s - 401AF AO& CAL "/ /vc(,j ZI 7 Cc 6 tt,lref, IJ C'eou�- l2epG-C,rz -ey 3)"1 t(q " f'., y Ll'`' 1-1 Building MECHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 1 763-502-497[7 FAX EFFECTIVE 2-19-09 / DATE Q /� (aiom YOUR E-MAIL ADDRESS SITE ADDRESS SYS-7 Sf"Lff A1j6__ THIS APPLICANT IS: OWNER ❑CONTRACTOR PROPERTY NAME: I�cx ,F. Ly,A M -, (ci Sy,,,d� l l �-- ADDRESS:,5-7 .S;-s S-.#-Ar CITY & e! STAT'12 ZIP 55yf-L OWNER/ TENANT _,!J PHONE: % 3 - y %/ - /,too CONTRACTOR COMPANY NAME: CONTACT PERSON: SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: CITY STATE ZIP APPLICATION PHONE FAX PERMIT TYPE NINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: PENEW ❑ REPLACEMENT ❑ ALTERATION/REMODEL C.stT DETAILED[DE_S1C_RIPTIONO®FWORK `�llecdf�4�r !4-S `t"k'��V- i t fsff 4r r /� -I-o �1 E" t �2 Aft i h ACJ' 0 ''- FEES ARE BASED ON $10.00 PER FIXTURE, E CEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) 01A9Equipment InsWlled MFG: kleeft n) &Id MODEL: T t i4✓t i l SIZE/BTU f K 67& v� 1 MFG: MODEL: SIZEIBTU MFG: MODEL:� SIZFJBTU A/C $25.00 ! PLACE (GAS) $15.00 v//GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 NEW BOILER $35.00 _FURNACE $35.00 UNIT HTR $10.00 CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 Number of fixtures @ $10.00 x $10.00 = $ Number of fixtures @ $15.00 x $15.00 = $ Number of fixtures (a; $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Ss- sTHIS FEE $35.50 Total = $ THISIS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT PRINT PRINT NAME—_Q .j4�c�� DATE/� �o�� PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR BUILDING ELECTRICAL AND MECHANICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977