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PRE 2010 DOCSCity of Fridley, A inn.. BUILDING PERMIT N°5 446 Date: J--/-A�� Owner a Builder Address Address 4# LrlTIC�1y F BUILDING No.__ P Street _ _ Partt Lot ----.__ Block __ _ ddition or Sub -Division ._!� d' Corner Lot M__ Inside Lot Setback —----- Sideyard Sewer Elevation _ _ _ Foundation Elevation DESCRIPTION OF BUILDING To Used A' , Front Depth Height._ Sq. Ft. Cu. F t.�._,_., X_rojt DepthHeight Sq. Ft. Cu. Ft. dz Type of Construction Est. Cost �---- To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above. set forth and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ ,permit is hereby granted fo— 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 70d ordinances Building Inspector NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, Bae heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name Builder_; - Address Address �4�-V LOCATION OF BUILDING No. 1Z &r Street Part of Lot Lot 37,- Block Addition or Subdivision . Corner Lot Inside Lot �/ Setback a�� Side -Yard /J / SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: DESCRIPTION OF BUIIDING Front f D@DthZrf' / Heieht Sq. Ft. fj:�D Cu. Ft.�c�-ta--- Front Depth Height Sq. Ft. Ou. Ft. Type of Constructioni ��_�✓ Estimated Cost To be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE g: �� SIGNATURI;„',�,:�� S S (A Schedule of Fee Costs can be found on the Reverse Side.) G .. 0 MINDEPLENGR+MERING C0.'q1?4c'v ENGINEERS AND SURVEYORS LAND ®URVBYING SOILS TESTING CIVIL d, MUNICIPAL EN43INEE91ING LAND PLANNING 6418 -SGT" AVENUE N. MINNEAPOLIS 2T, MINN. KE 7- SG37 CQ�ir aiIijC4alife *IF 1S 10m` ey 5URVE°Y Fop, TOM 51LerI s L1 p - - 131.=a-- - — — I 99 N SSCALE gyp' LCAT 32 EL'r-\. 2 (JP L_�'.ND c `4D /(!'\DD'N. WE HEREBY CERTIFY THAT TH15 IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF THE LAND ABOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGS, IF AMY, THEREON , AND ALL VISIBLE ENCROACHMENTS, IF ANY, FROM OR ON SAID LAND. MINDER ENGINEERING CO., INC. MTED TKIs (MY of 1\1 Oy EN61►JE,EQ$ AMD $iJRVEaROQS by Application for Power Plants and. Heating, Coding, Ventilation, .Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL, 1. 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 e Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ .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. 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 BTL) ....................... 5.00 $� GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $— i,5 Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN DATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL See Fee Schedule TOTAL FEE Dept. of Bldgs. Phone SII. 4-7470 Location 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, Minn �-,1 i ne , ;) '196L Owner 1 P)Y1f� �—u t S. l� l Ove Kind of Building t T MS) Used as To be completed about Estimated Cost, $ Old—NawPermit No. � Permit No. � DESCRIPTION OF WORK HEATING or POWER steam, Hot Water, Warm Air—NOS J� Trade Name 1" 'no Size No 3X_,)C0 H 100o Capacity Sq. Ft. E�yD.R BTU -10,002 U H.P. Total Connected Load s—� �(� Kind of Fuel t . G BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signed By X3,42 2M 7_59 Business Phone No- M a — y l �qc7 _ 1 City of Fridley for, bG W ' d as wob" P nrdt APPlrcai'9U um rng an so e Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Location Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: O. RATE TOTAL Number Fixtures Z x $1.50 $ z® Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTL) ...... �L_ x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. O. RATE TOTAL � 1st 3 Fixtures .......................... x $1.50 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ...................$ TOTAL FEE $.� 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. J Fridley, .Minn0 1�©/ Owner 1 Used as To be completed about /f Estimated Cost, $ �• 61d-•,Wew. Building Permit No Permit No. Signe G� By Business Phone No ?� ROUGH !D FINAL dz 2M 7-59 zZ �?a QQZ �n [aTajz iu O J w O ? z �O • F • N WATER HTR. GAS ELEC. Base 1st �` I 2nd _ 3rd 4th • Future Connection Openings Comaeded with Sewer New Fixture, Old Openings Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: O. RATE TOTAL Number Fixtures Z x $1.50 $ z® Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTL) ...... �L_ x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. O. RATE TOTAL � 1st 3 Fixtures .......................... x $1.50 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ...................$ TOTAL FEE $.� 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. J Fridley, .Minn0 1�©/ Owner 1 Used as To be completed about /f Estimated Cost, $ �• 61d-•,Wew. Building Permit No Permit No. Signe G� By Business Phone No ?� ROUGH !D FINAL dz 2M 7-59 • City of Fridley, Minn. -7 9 BUILDING PERMIT "NO 6853 Date: Owner: Builder — Address Address -- LO ION OF BUILDING No. �� Street ____ Part of Lot Lot _ Block Addition or Sub -Di n . __— Corner Lot _ Inside Lot -tback Sideyard ^ Sewer Elevation — — Foundation Elevation DESCRIPTION OF BUILDING T as: -� e Front Depth Hei ht Ft. '� Cu. A�' �-� P g Sq Depth -i-- Height Sq. Ft. Cu. Ft. Type of ConstructionEst. Cffst/�M-�To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set fo and in compliance with all provisions of ordinances of the city of Fridley. Ap" I— In consideration of the payment of a fee of $6-) ' , permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon ydtion of any of the Pm�� of said ordinances. �1fi' / 1 Building Inspector is I NOTICE: Ibis permit does not cover the construction, Installation for airing, Plumbing, gas hoatleg, moor or water. Be arra to an the Buihling Inspector for separate permits for them Bons. LOT Nf-,.hIE 14�"; X� SIZE X ZZ- BTAICx--- ADDRESS 6zzz S- A/Sl VlLTThTT0IT ADD. T Y Ile as 5 A, C3 S t 40 usz 1-0-- 1, 1 b, 31 0 ),q If Im 40 • City of Fridley, Minn. BUILDING PERMIT Date: _ June 2, 1965 oar: Dennis R. Norsten Builder Address 6221 5th. Street N. E. Address 4 Qualitg Homes, Inc. 3701 Frmont Ave. No. N° '632 LOCATION OF BUILDING No. 6221 Street 5th' Street N. E. part of Lot Lot _ 32 __ Block 2 Addition or Sub -Division Uplands, 2nd. Addition Corner Lot _ Inside Lot Setback ___ Sideyard Sewer Elevation _ Foundation Elevation To be Used as: DESCRIPTION OF BUILDING Front Depth Height Sq. Ft Cu. Ft Front Depth Height Sq. Ft. Cu. Ft Type of Construction Est Cost To be Completed Storm damage repair In consideration of the issuance to me of a permit to construct the building described above I agree to do the proposed work in accordance with the description above set rth and in compliance with a'il provisions of ordinances of the city of Fridley. /) - n In consideration of the payment of a fee of S 10• , permit is hereby granted to Quiulit3i Homes Inc' to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota location, constr�tctlon, alteration, maintenance, repair and moving of buildings withing city limits a� permit may be revoked at any time upon violation of any of the provisions of said ordinan AUen Jensen NOTICE: 'lilt pwmb don net sorer tbs otnwudlon, hntaWen for whing, phmrbing, gas boating, wwor or wdter. Be din to sM the Badding impactor for sopor to p=ft for d wn hems, APPLICATION FOR 1 ING PEPIM CITY OF F'RI aO , • NNESOTA OWNER'S NAME,,-, BUILDER ADDRESS yA D D 9. t S S* . LOCATION OF BIUDYNG No, Street part of Lots_, Lot Black Addition° or Subditri.Viou 46(r Corner Lot Inside Lot _,.:Seek Side Yard SEWER ELEVATION FOUNDATION EL `A°1TOfii Applicant attach to this form; Two Certificates of Survey of Lot and proposed-i�d-- ing location,drAwn on these Certificates. DESCRI�NOFBUILDING JTo be used as: Proal Depth Height_ f" Sq. Ft. Cu. Ft. .Front` Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work iit strict accordance with the City of Fridley Ordinances and rulings if the Department -'-of Buildings, and hereby declares that'All the facts and representations stated in this application are true and correct. .of Fee Costs can be found on the Reverse Side). 0 .w i APPLICATION FOR 1 ING PEPIM CITY OF F'RI aO , • NNESOTA OWNER'S NAME,,-, BUILDER ADDRESS yA D D 9. t S S* . LOCATION OF BIUDYNG No, Street part of Lots_, Lot Black Addition° or Subditri.Viou 46(r Corner Lot Inside Lot _,.:Seek Side Yard SEWER ELEVATION FOUNDATION EL `A°1TOfii Applicant attach to this form; Two Certificates of Survey of Lot and proposed-i�d-- ing location,drAwn on these Certificates. DESCRI�NOFBUILDING JTo be used as: Proal Depth Height_ f" Sq. Ft. Cu. Ft. .Front` Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated Cost The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work iit strict accordance with the City of Fridley Ordinances and rulings if the Department -'-of Buildings, and hereby declares that'All the facts and representations stated in this application are true and correct. .of Fee Costs can be found on the Reverse Side). 0 .w Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices e z ;L / �s , GRAVITY WARM AIR: Location FurnaceShell & Duct Work............................................................$ ................................. Replacement of Furnace .................................................. _................. $ ............................. City of. The undersigned hereby makes application for a permit for the work herein Repairs &Alterations—up to $500.00 ........... . ....................... $...,-.__..__- "' specified, agreeing to do all work in strict accordance with the City Ordinances Repairs & Alterations each add. $500.00 .......•..............._--... $....._....---- _.._.......... and ruling of the Department of Buildings, and hereby declares that all the facts and represe tations stated in this application are true and correct. MECH. WARM AIR �— . Minn ...................._. �.. Z.............., 19..7..-.. Furnace Shell &Duct Work to 120,000 BTU .................. $............. _................ � � •�•••-••-•-• eachadd. 60,000 BTU ................................................... $...... _........... _........... .......... Owner ............ ............... _............. ............................. . Replacementof Furnace ....................... __.......................................... $..... _.......................... Repairs& Alterations up to $500.00 $....._....._------ ._......... Kind of Building ...... ...................................... _........................................................ ........................... _.......... Repairs & Alterations each add. $500.00 ..............................$............ ............ _....... Used as .................(d'....... '� STEAM or HOT WATER SYSTEM 7 Furnace Shell &Lines—to 400 sq. ft. EDR Steam ...... To be compeletd about..........................<.........._...................................................._....... q$.._.._.................... Furnace Shell &Line—to 640 sq. ft. EDR Hot Water $_._...__----------------- Estimated Cost,$......a...........v..."®.Vv..............._............. _................... ........ ............ �..T'.2:.......�.�... Each add. 200 sq. ft. EDR Steam _ ................................._ ..... $....._................... _..... Each add. 320 sq. ft. EDR Hot Water ...... ................. ........... ........... DESCRIPTION OF WORK OIL BURNER—to 3 gal. per hour ...................... _..... __...... __ $.......... _.................. HEATING or POWER PLANTS. (underline) Steam, Hot Water, Warm Air over 3 gal. per hour—See Fee Schedule Trade Name Size No. GASBURNER .................................... ............. _............. ........................ BTU $........ ..... ................. GAS FITTING FEES: NO Capacity Sq. Ft. EDR BTU u.P. 1st 3 Fixtures ........... _........... $...... .............. _........... Total Connected Load Kind of Fuel Additional Fixtures ..... _...... AIR CONDITIONING Gas Range to 200,000 BTU ........................ $._--------- _................. "�es VENTILATING SYSTEMS Trade Name "0"�� Size No. Duct work etc. not to exceed 2,000 cfm ........................ _.._$ ..... ................ _......... Electric Gas Each additional 1,000 cfm................. _ .............................. _ $._.._...._.................. AIR CONDITIONING '� Signed ....... ......................... ........................................... .................... _............. $ ................ _... _.......... By.... �,-. :.._..............._.............................. _. ALTERATIONS & REPAIRS $--- ------------- _........ Business Phone No ....... .U..-/ l (10 ..................... . .r.......... TOTAL FEE $------`�� -= Business Address..V T ......... _ ../� J—_ Z —7 0" (remarks—over) SUBJECT PER City of Fridley O 16480 AT THE TOP OF THE TWINS B U I L D I N G P E R M I T r RE IP • _ COMMUNITY DEVELOPMENT DIV. SEC. r PROTECTIVE INSPECTION 1 i � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY j, 612-571-3450 910-F15 1 /21/82 JOB ADDRESS 6221 5th Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 32 2 Upland 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ross A. Martinson 6221 5th Street N.E. 574-9226 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 EX ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK install built in fireplace in basement Majestic WM 14 36 9 CHANGE OF USE FROM TO STIPULATIONS 1. Provide combustion air to fireplace or existing furnace 2. Install products of combustion alarm in bedroom areas. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. metal & W od 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 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 11000 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .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- 17.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE 18.00 S1 NATURE OF CO CTOg0H1ORIZ IDATEI WHE PROPERLY A IAOUR PP/HERMIT 1dNAT!U!E;!.!F::0VqNERIIF G I N S P DATE OWNER BUILDER) IDATEI CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDENTIJIL BUILDING PERMITS (New. Alterations, Additions, or Repairs) 01114ER: ADDRESS: TEL NO: �Z �- BUILDER:( ADDRESS: TEL NO: �--a— ( Construction Location STRIET NO: STREET:lt� 54 LOT: �j '� BLOCK: ADDITION: Corner Lot: Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. [� 1 DESCRIPTION OF CONSTRUCTION l 'e_f k 0- e--– "'.j 174 L- " Front: Depth: Height: C_ Square. Feet: Cubic Feet: �Y �•J j'1� ,'� Front: Depth: Height: Square -Feet: Cubic Feet: _ Type of Construction: r—r�— JI ! To Be Ooripleted: Estimated Cost: $ /0-5p �— Alt. A Alt. B Proposed Drivo•ray Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET . Mie undersigned hereby makes application for a permit for the tork*herein specified, agreeing to do,all work in strict accordance with the City of Fridley Ordinances and rulings of the Delh-irtment of Buildings, d hereby declares that all the facts and representations stated in this applic do are true_and cqXpc1Vt. 4 DATE: 1' / SIGNATURE Stipulations: /-7, Y0 Building BUILDING Permit No.: Z Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: DATE —J p -e YOUR E-MAIL ADDRESS _10 SITE ADDRESS &2591 S S t IV F_ THIS APPLICANT IS: ❑ OWNER ONTRACTOR PROPERTY OWNER/ NAME: �y,,,,,,,� U 2l9- TENANT ADDRESS: (o �L.2 I S` AA S o#- Ai e- CITY PHONE: Z( 3 5—f 2 - $702 0 CONTRACTOR NAME. Im mil— NO= 1M® INC SUBMIT A COPY OF STATE LICENSE # : ZN0M#AMnV1J&XP DATE YOUR STATE LICENSE ADDRESS: a Mae&CITY STATE ZIP WITH APPLICATION PHONE AX - 7 2 -Z S"7 �( PROPERTY TYPEINGLE FAMILY/NEW SIZE ❑ TWO FAMII,Y/NEW CO STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE:�-a!/es-r( /L�i/Lv�Ck•�-� r-�' SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES 4202- MOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. 2. Existing Floor Plan Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 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 FFE SCHEDULE) TOTAL JOB VALUATION $ .-COQ OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge,S�� $ %, A((_3,c — (.0005) times the total job valuation — Minimum $.50 Fire Surcharge $ ,� .34 7,0 .001 x Permit Valuation (1/10%) License Surcharge $ Sr ®d $5.00 (State Licensed Residential Contractors) SAC Charge $ $1450 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $Agreement necessary ( ) Non Necessary ( ) Total Due $ r� . - Make checks Davable to: Citv of Fridlev Attach Stiaulations 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 d code of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application a pe and rk 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 ' e re and approval of plans. J SIGNATURE OF APPLICANT PRINT NAME/�ON����0�� ti✓ DATE_- A.6)50 `6) S Pluilding MECHANICAL Permit Ivo.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 11 V CITY OF FRIDLEY 763-502-4977 FAX EFFECTIVE 2-19-09 DATE 1 YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑ OWNERCONTRACTOR PROPERTY NAME: OWNER/ TENANT ADDRESS: STATE Z PHONE: CONTRACTOR COMPANY NAME: SUBMIT A COPY OF CONTACT PERSON: YOUR STATE STATE LICENSE # A DATE LICENSE WITH ADDRESS: CITY_ STATEZ APPLICATION PHONE PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW ❑ PLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK V&m 00 jam V(ju FEES ARE BASED ON $10.00 PER FIXTURE XCEP ED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BT#� Equipment Installed MFG: MODEL: SIZEIBTU MFG: MODEL: SIZEBTU MFG: MODEL: SIZE/BTU A/C $25.00 _FIREPLACE (GAS) $15.00 RANGEIOVEN $10.00 AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 _GAS GAS GRILL $10.00 _BOILER $35.00 FURNACE $35.00 _NEW _GAS UNIT HTR $10.00 CHIMNEY LINER $10.00 _GAS DRYER $10.00 HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 _POOL VENTILATOR $15.00 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977