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PRE 2010 DOCS• City of Fridley, Minn. BUILDING PERMIT Date: ..... .��� 9 ........ ......... Owner ....................................... Address ...................................... • N® 3'74'7 Address ............................................. LOCATION OF BUILDING No. .6170.. Street ..Cfi. .. ....... Part Of Lot .. . . Lot ...� .®�...... Block .... R........... Addition or Sub -Division . . a Corner Lot ............ Inside Lot ... X....... Setback ..... .. Sideyard .�a..:�................. DESCRIPTION OF BUILDING To Used �. r p �/fr .. .... Front 7 �. Depth R! :'® Height /� Sq. Ft. Cu. Ft. � r 41y ................. Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ... ........ Type of Construction ................... Est. Cost. �. ' To be Completed ................... C, In consideration of the issuance to me of a permit to construct the buil' desribed above, I agree to do the proposed work in accordance with the description above set forth an compliance with all provisions of ordinances of the city of Fridley. ie.,. ....................................... . In consideration of the payment of a fee of permit is hereby granted to ................... ......................%.. to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildi4gs with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. 4. -- NOTICE: This permit does not cover the construction, Installatlon or alteration for wiring, plumbing, gas 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 Owners Norse' Builder A- _ Address Address ` LOCATION OF BUILDING No, street....; Part of• Lot LotArl Block— --Addition or Sub. Diva Corner Lot Inside Lot Set Back Applicant attach to this.form Certificate of Survey of Lot and proposed ' building location,, DESCRIPTION OF BUILDING To be d' a.a .. • Fron+ • _ ... Depth Height ....L� Sq. Ft, Cu, Ft. Front ..,___..,.Depth Height Sq. Ft.,, Cu. Ft. �._.. .... 1TP"` . _ J-+ Toil. 3.v 1..-. 5 -', n+•/ _ . r. -t 4 1 •i -A Cos ....r�wr.� Tu bo "completed The uAdartigned hereby.nakes application fora pprmit 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, thaw al' the facts and representations stated in this application are true and c recd .. L=5�, - — Date a .,�.,,�..���, .� . _ ..... � �`ignataxe (A.Schedule of Fee Costs can be found on the Reverse Side) `. a Ci f Fridley tY o� Application for Plumbing and Gas Fitting Permit Dept. of Bldg. Phone SU 4-7470 DESCRIPTION OF WORK Number, Sand and Location of Fixtures Location G " C� ` 4 :± 'jay Fw y x `�U z Ox O Z WATM HTR. GAS ELEC �' 3Ci z �� a 3� o� 8� S Q3 J �� �4n �O F N Base 0 1st 2nd 3rd 4th Future Coanecialon Openings Connected with New Fixture, Old Openings I Sewer � Cesspool ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ......................7 x $1.50 $142, 5-0 Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTIA ...... x 2.00 New Ground Run Old Bldg . ............ x 3.25 $ 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 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE o 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. Frildley, Minn '�'� 19�% Owner �,. l f -%P-e , 19— Kind 9Kind of Building s� f -IWC" -r , 19— Al Pi l Used as l' To be completed about Estimated Cast, $ 6 t C� e� Old—New. Building Permit Connection Permit No . ....................................................... 11 IM -8-58 Water Sewer Meter Deposit 0 City of Fridley, Minn.. BUILDING PERMIT N® 7278 Date: Owner' - Builder Ad Address — —------- LWI! BUILDING No. Street s r e Part of Lot Lot _ _ _ ._ Block Addition or Sub -Division Corner Lot . _ Inside Lot S.etb=dation _ Sideyard Sewer Elevation . _ ...... evation DESCRIPTION OF BUILDING T as: "'T Front i2al Depth Height Sq. Ft. Cu. Ft. //-- Fro Depth eight _ Sq. Ft. Cu. Ft. Type of Construction 1.9 _ Est. co = 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. n A In consideration of the payment of a fee of $ ,permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. — _ I'll NOTICE: • Thb pooch does not cover the constrection, hatallaMon for wM h& phnAbo, gas heaft, sewer or water. Be sore to iso the Botldhtg Inspector for separate permih for there hems. )�Xf 1�� '1W 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME J e - R O M e ka ;S O.4/ BUILDER L ,417'C r 61'�� 1 a R& g P ADDRESS ,/-? / 7P -6 017.* ADDRESS �� IP MR C. _5 3 LOCATION OF BUILDING No. bl ` 76 Street 14 Part of Lot ��- Lot Block Addition or Subdivision Corner Lot Inside Lot--L—Setback Side Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: Gal? 9 -ad a ,-P Front D pth Height Sq. Ft. -'/'g V Cu. Ft. 53 7 Front Depth Height 7 Sq. Ft. Cu. Ft. Type of Construction ���� Estimated Cost To be Completed A0 /t) ^ 6 The undersigned hereby makes application for a permit for -the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE D G SIGNATURE. Schedule of Fee Costs can be found on the Reverse Side). • 0 9 .. 1. r • .- a CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES 10 70 P JOB ADDRESS RATE SCHEDULE The undersigned hereby makes application for a permit for the work Residential Rate TOTAL herein specified agreeing to do all work in strict accordance with the Furnace Shell and Duct Work, Burner - Dp city codes and ruling of the Building Division, and hereby declares Also Replacement Furnace $ 20.00 $ '� that all the facts and representations stated in this appl' atio are true and correct. 1/ �' Gas Piping (Needed with new furnace) $10.00 $ �1 OWNER Gas Range $ 10.00 $ n BUILDING USED AS Gas Dryer $ 10.00 $ ESTIMATED COST PERMIT NO. "Air Conditioning - All Sizes $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water Warm Air) Trade Name Size No. IT pm Commercial/Industrial BTU HP EDR 1 % of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge $ .50— Burner Trade Name Size No. �� BTU HP EDR TOTAL FEE $ � ROYALTON HEATING & COUP HEATING COMPANY 4120 - 85TH AVENUE N, MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION onvunLnv rr%nnl nnrvl 94"a REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 Signed By nun0 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 Approved By Rough -In Date Final Date *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: Remarks LL _o l l_N J bva /1-L u . List Alterations Being Done: HEATING COMPANY� V�� TOyN HEATING & OOOU O Signed By a y ffiK MN 55443 Date PHONE 424f 1. Has been carefully examined Yes (.,rNo ( ) 2. Is free from rust or deterioration Yes (A-,*'*' No ( ) 3. Has no foreign objects lodged. within Yes 4. Is securely supported Yes ( /� No 5. Meets all current Code requirements for size and total BTU's connected Yes (� No ( ) 6. Has total heating BTU's of All other BTU's ® (7 ov TOTAL BTU's Y00V 0 Remarks LL _o l l_N J bva /1-L u . List Alterations Being Done: HEATING COMPANY� V�� TOyN HEATING & OOOU O Signed By a y ffiK MN 55443 Date PHONE 424f Dad HEAT LOSS CALCULATIONS DEPARTMENT OF INSPECTION MCAPOLLS. 14IM Weatherstrips Guide candrudion No. lumlation Windows ( Doon Refereaae Out. Wall Int. Wall Ceiling Roof Floor K'md How Applied Y Sen-ZNo 0 1 19 FU Room I Length W Width LY Height Y Windows and Doors--Craclrage and Area rvldth Hage, Na of Linea fL And, x. of pane of pane lights of amek so. tL /`e/J �V, nZ ✓ �6G I .J OO/L I ��i. � .i%�i 7 7J � Glass Goof. Btu 69tration Net cqL wall int. wall Gins Ceiling . Exp. wan Net eap. wall fit. wall Ceiling Floor Total Btu. - Required sq. ft. ED.R. or sq. ins. W.A. Leader area _ N Room Length WHth Height Irmdows and Doors—Crackage and Area width sleight Ne. of Uncal tL Area W46 of pane at Pane lights of Greek se. fl. 2(L/ Y /7, j I,_,7 2- r. l Cod. Btu Nitration y3 3,5 D Gla" ro 717e Exp- tall Nd CqL wall ! / /"I v 7 6L wan Cling 97 7 Floor w ' 7 7 7 / Y Total Btu. %Z440" � Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Room I Length Wild: Height Windows and Doors- trackage sad Area wata Height Na of Llaeai CL Arn ly of pane of Pane lights at crack p. ft. Cmf.1 Btu 6filtration Glass EqL wall Nd esp. wall 6L wall Ceiling Floor Total Btu. Required sq. ft. E.DR or sq. iris. WA Leader area 10005T Room 1 Leooth Width Hee Windows sad Doon—Crackage and Area width Height H4.6c 11aw eL lAres xs of pave of paw 11"ts of eraek q. tL Ctief. Btft Infiltration Glass ExF6 Wall Net cqL wall int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R, or sq. ins. WA. Leader area FIj Room I Length Width HeWit W'mdows Aad Doots--Craeltage sad Area Width Height•Na. of Lasa tt. Area xe,et pane of Pane Ifghts of crack no. CL Cftf. Btu Infiltration Glass Exp. wall Net esp. wan UL wall Ceiiing Floor Tota} Btu. Required sq. ft. EDR or sq. ms. WA Leader area Pi Ream I Lea4th Width Height Windows and Doors--Craekage and Area Wth Hettkt Ne. at USGW tL Ana x. of Pane at pale rights at crack ea M Coe Btu Iftm ation Glass Exp. wan Net ems. wall Int. wall Ceiling Floor Tow mu. Required sq. ft. LDR or sq. las. WA Leader area r HOUSE HEATING TEST RECORD ADDRESS APT. _ OCCUPANT OWNER HEAT LOSS DATE HTG. INST. FLOOR CITY SUBURB SOLD BY INSTALLED BY Electrical Work By Gas Line By TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE - ' - MAKE OF BURNER Model r Model Serial Max. BTU Rating INPUT MAKE OF FURNACE Model CONTROLS THERMOSTAT Heat Plug ell '- Vent Size Valve KIND OF LINER SIZE NONE Limit Draft Hood Regulator Limit Setting Filters Size Number Fan Setting Chimney Location r lnside Outside Pilot Type Chimney Construction Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing Draft Y' d ^ F' Test Tag L.W. Cut Off Door Pressure Lighting Inst. Pressure Percent CO r,' Date Tested r Input CFH Percent 02 Company Testing ' `✓ Stack Temp.", Percent CO Name of Tester Form 235 SUBJECT City of Fridley 2 5 7 21 AT THE TOP OF THE TWINS BUILDING PERMIT(: r L COMMUNITY DEVELOPMENT DIV. ------ r I PROTECTIVE INSPECTION SEC. f0l14{If CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 12/9/97 JOB ADDRESS 6170 6 Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 12 2 Upland 2nd Addition I SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Richard Thompson 6170 6 Street NE 574-7397 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Seal Guard Systems Inc 11464 Robinson Dr NW, Mpls, MN 55433 757-0097 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20093688 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION XU REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside, soffit & fascia 9 CHANGE OF USE FROM TO STIPULATIONS Install building wrap and have inspection of same unless manufacturer's specifications state it is not required. Install ventilation to meet the State Building Code. 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 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 $1.72 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3,447 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW $87.25 Fire SC $3.45 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC $5.00 $97.42 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI WHEN PROPERLY IDATED THIS IS YOUR PERMIT _ BL INSP /2,1 MATE SIGNATURE OF OWNER,,F OWNER BUILDER) (DATE) NEW [ ] ADDN [ ] ALTER [ ] ,• n ConstructionAddress: Legal Description: Effective 1/1/97 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Owner Name & Address: —f-/) (; Tel. # %. Contractor: r MN LICENSE # 2_�)(3 Address: �l-(GC-�Tel. # X57- l) 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: Construction Type: �ISCA Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 t = F x = $ DATE: APPLICANT: Tei. #�� - C CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $� Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $ : 1, $.50/$1,000 Valuation $ $950 per SAC Unit $_ J $5.00 (State Licensed Residential Coi $ Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Nece: SUBJECT PERMIT NO. City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT 8 6 5 r N , (RECEIPT `v COMMUNITY DEVELOPMENT DIV. _____ PROTECTIVE INSPECTION SEC I /fid r 7e� NUMBER REV DATE PAGE OF APPROVED BY ,'� CITY HALL FRIDLEY 55432 L 612-571-3450 910-F15 11/25/98 JOB ADDRESS 6170 6th Street NE I LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 12 2 Upland 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dick Thompson 574-7397 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Midwest Roofing & Sidiniz 18416-4804 20010277 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 Pc REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 27 S Tear—off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION I 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 2313 $1.16 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHAR PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $74.75 Fire 2.31 PLAN CHECK FEE TOTAL F Lice S $5..00 83 22 SIGNATURE OF CON'RACTOR OP AUTMORIZEO AGENT IOATEI EN ROP ALIDATE YO R PER IT I � SIGNATURE OF OWNER,IF OWNER BUILDERI IDATEI LO -NSP DAtE ELA*--i!8-15W 10=04 FRUM CITY OF FRIDLEY TO 41EAM P.01OM NM I I eve 111198 A1DDN [ l CYC Oy VRVKXT -.R ALTM MXGM FAMLY AND R-1 AM A -'Z � J ` E1L%�,DIl�o PsRAIi!r AP LICATE(#l�t 1(r� q\D V� LIVEW aae.a GAVAGE A1ZA: OEM A=A: tmgtb Width now Sq. Ft. Sq- Pt- So. Ft. free Scbeaule on Mels) Dfiveway Cueb tut Width Nom: ___PL + 6 Ft $ �.. DATEs 114,13 s. „.� TQ. 0cm l 11 n� .. Fee v FW Schede on Rev Fm sv=bup o0' $ .Cal of Fbmk Pa an (1/10th%) staft sw $ $.SOISI.OW Vahisdan SAC CNWO $ :=LX - $10M pa SAC Unit Lice s od $3.00 + Lkxmwd RusWenfial C M1220 ors) Driveway E=Ow $ Ah. 'A" or Ah. 'B° Ab► Bj*&s Centr©l $ $450.00 Ca'mrvation 1 Review Fatk pm Fee DMadeadby BOOUmft Sourer Main Charp ApsemeM Nwomy N 1 11,01 LOUa Building AND MATERIALS: BUILDING Permit No.: p - Inspections TOTAL JOB RESIDENTIAL APPLICATION Received By: 763-572-3604 X41, 7S`' See Back Page for Fee Schedule CITY OF FRIDLEY Date Recd: DATE ^ ® YOUR E-MAIL ADDRESS Surcharge SITE ADDRESS (P --10 .q F-T 1 �LA THIS APPLICANT IS: ❑ OWNER WONTRACTOR .001 x Permit Valuation (1/10%) PROPERTY OWNER/ NAME: \ a Y^ _ - TENANT-- ADDRESS:1p CD to - 's -t CITY V:--f C k TATO Curb Cut Escrow PHONE 45 % 4 — a S (o C( ft + 6 ft = ft x $20 = $ CONTRACTOR NAME: Z, cl t �� C ©y\ S -E C LAL O STATE LICENSE # Q<— c18 EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: Leo `-1 ` `3 4y e Imo{ CITY U S STAT044 WITH APPLICATION PHONE 19a �O �l " frig FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED WS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: R ;q. SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Ft.LA-3 0y c ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. WINDOWS IN EXISTING OPENINGS Yes ❑NoATION lOF WINDOWS `3a �� 2. Two sets of construction plans 3. Energy Calculations OR FOR NEW OPENINGS-DESCRIBE SIZE OF ( � ) a•� �`J � �g OPENING CHANGES & �,//JJ C (rAJMBER TYPE OF WINDOW TO BE INSTALLED in 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 $ 4".1000,60 OCCUPANCY TYPE Permit Fee $ X41, 7S`' See Back Page for Fee Schedule Plan Review $ �_ 65% of Building Permit Fee Surcharge $ o - % /(.0005) times the total job valuation —Minimum $.50 Fire Surcharge $ .001 x Permit Valuation (1/10%) License Surcharge g $ S-60 $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 "'7 Make checks payable to: Ci 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 whiSquires r ie approval of plans. ^� y �0.1, SIGNATURE OF APPLICANT `"J� PRINT NAMEdJc-k�$ iA DATE Building PLUMBING Permit No.: ' Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604Dat CITY OF FRIDLEY eRec'd:� DATE 1 ©(gyp YOUR E-MAIL ADDRESS SITE ADDRESS Co170 0 THIS APPLICANT IS: ❑ OWNER 06ONTRACTOR PROPERTY NAME; �juk_ ADDRESS: 6 f76 - CITY i STATE 03ZIP�`�Zi OWNER/ TENANT PHONE: 3 -22 -Z� CONTRACTOR NAME: STATE LICENSE # �C)-q /C� \ EXP DATE ^ TEP SUBMIT A COPY OF YOUR STATE ADDRESS: l U�P-� 4�'� LTTY LICENSE WITH PHONE 7r !i FAX APPLICATION PERYHT TYPE D -S GLE FAMILY ❑ TWO FAMILY O TOWNHOUSE 0U L? C MENT TYPE OF WORK: O NEW DETAILED DESCRIPTION OF WORK PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV FIAOR DRAINS —SHOWER _ WATER PIPING _ BATHTUB PIPING (Am OnUc�v 0 _ SWIMMING POOL —WATER SOFTNER ($35) _ —GAS CLOTHES WASHER KITCHEN SINK —WATER CLOSET _ BACKFLOW PREV. ($15) _ _ DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION _ _ WATER METER§ _ OTHER �v- .�+... . .... .� } :..: i. �g��,yP'Y A�E�'. m'F ,.. � .. 3 .2 `' f - �w Permit Fee $ Number of fixtures @ $10.00 x $10.00^= $ Surch a .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ ¢ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 ---- Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an 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 a.11Wbrk which requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME .3 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 From: 612 822 5408 Page: 212 Date: 91161201012:39:17 PM Building PLUMBING Permit NO.: Inspections RESIDENTIAL APPLICATION Received B 763-572-3604 CITY OF FRIDLEY RNP 763-502-4, 9.77 FAX EFFI crlvE7_, �a,o / DATE J'f! L O YOUR EMAIL ADDRESS SITE ADDRESS a`�' . THIS APPLICANT IS: 0 OWNER fiftNIRACTOR PROPERTY NAME. 2. / ADDRESS: f h CITY IJ7' STAIF�.r.�IP `�'Tz' TENANT PHONE: 0 —z_ra CONTRACTOR NAME: Aloh � 2,' SUBMIT A COPY OF YOUR STNre STATE UCEN51; # �9�r [r/ EXP LICENTSE, BOND AND STATE BOND #�S V EXP DATE CERTIFICATE OF ADDRESS. / ri ' G� CITY .�%/f6ZIP INSURANCE _STATE PHONE _ �12, - kU,2-Or- FAX 6L2 ' .�A+� ^ 74EP6 PERMIT TYPE [�IlNGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK, o NEW +LACEMENT DETAILED DESCRIPTION OF woRK FEES ARE BASED ON S10,00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINZO M FEE $35.50. _ BATH SINK/LAV _FLOOR DRAINS —SHOWER _ WATFA PIPING BATHTUB PIPING (NEED Crry uC) FOOL WATER SOFTNER ($35) —GAS —SWIMMING _ —CLOTHES WASHER KITCHEN SINK WATER CLOSET _BACKFLOW PREV. (51.57 DISH WASHkR _ LAUNDRY TRAYWATER HEATER (S35) FOR IRRIGATION WATm METER _OTHER, }}i g l d , '• '� :+'jjji?i', _ ., , ='x'4rt.'6? a i} It 4,�`r'7ie,,r,w:. • " ++��,( ��{{ i}• ,""riSi.•:: r.:: •: , i.....; :.rr + A :'SPF r i : r .71 + ?e4.•T�r• . Si1�e FF7:N:+61L� r++' ` H . , Jr +. •-„ i�'+r: ;1. y F Y :.:,.:ts?p 3y :':'u: y*{+ t ..:'�;::av:•1; •,.�•: �_ ::•.:�: �,�'t, :l .11rfr,{:?' _ `k•'.�:.i'.•ic ••'':::i �'�:.:: :•::.+. 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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 codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an applicatin for a pelZrrit and work is not to start without a permit on sl e; that the work vv�7l be in accordance with the approved plan in theme vi6 of l work c quires review and approval lans. 1 SIGNATUREOFAPPUCANT PRINTNAME .--DATE APPROVAL INSPIIORS SIGN E r City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, 55432 763-572-3604 FAX, 763-502-4977 D� �6 �� �29