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PRE 2010 DOCSat BUILDING PERMIT Village of Fridley, Minn. N° 2 Q 3 9 Date..� - .�i. � ...� ? ......................... Builder �✓Y- ......................... Owner . Lg � ... ��J.�l. t':........ �1.� 4� .......... . Address ..................... Address ...� .!r? .... .. .. ............ ^47 . • LOCATION OF BUILDING No. .. ..... Street .... .�� ........................... Part of Lot ......... .......... . Lot ........ Block ...... ....... Addition or Sub -Division .. ...... Corner Lot ............ Inside Lot ...G/ .... Setback ............ Sideyard .......................... DESCRIPTION OF BUILDING To be Used as: .`"- �.s ..... Front ..�.. Depth . a �.. height Sq. Ft. ./W ? Cu. Ft........ . .................... Front ........ Depth ........ Height ......... .Sq. Ft......... Cu. Ft......... Type of Construction .R".C... Est. Cost ... % 4 5 P ......... To be Completed .... (r..-e�t.� ...... 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 village of Fridley. /J1 it - 7 onsideration of the payment of a fee of $ �. /tom, permit is hereby granted to . A?. , ... �!!VL .......... . (� .9 4.r YL ...... 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, alterationnjamimatenance, repair and moving of buildings with- in the village limits and this permit may be revoked at any ju violati y of the provisions of said ordinances. Building Inspector NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Items. V7 City of Fridley, Minn.. N° 10241 BUILDING PERMIT • Date: May 21 1969 • • Owner; Robert S. Ledermann Builder Same Address 548 532 Avenue N. E. Address Same LOCATION OF BUILDING No. 548 Stmt 532 Bit Avenue N. E. _ part of Lot Lot _L2 12 .._._.__ Block 2 Addition or Sub -Division Temple Terrace 2nd Addn . Corner Lot _ Inside Lot Sewer Elevation Setback __ Sideyard __ Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Garage Front _.._30 r Depth 24 r Height 10, Sq. Ft. Type of Construction 720 Cu. Ft 7200 Front Depth Height Sq. Ft. Cu. Ft. Frame Est. Cost _ $25 00.00 _ 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 f and in comp ance wi all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ 11.00 permit is hereby granted to Robert Ledermann the express condition that tom construct the building or addition as described above. This permit is granted upon 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. r Inspector Clarence Belisle NOTICE: 'Ibis permit does not cover the construction, installation for wiring, Plumbing, gas heating, ewer or wafer. Be wre to no the Building inspector for separate permlh for these hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME D{�,� BUILDER ADDRE$84_d 2 57- ADDRESS LOCATION OF BUILDING NO, STREET , � �� z d CQ LOT - BLOCK ADDITION OR SUBDIVISION i CORNER LOT INSIDE LOT (SETBACK/SIDEYAB.p 3 SEWER ELEVATION TOP OF FOOTING Appliga4t attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: GAG' -�1L I Front 3 V Depth Height / C) Square feet 7.2-c Cubic Feet % Front Depth Height Square feet Cubic Feet Type of Construction �Ira 11n P Estimated Cost ,�P- To Be Completed 4 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 IGNATURE'�G�-y�� R I 1� I II I (Schedule of FeeCosts can 7 o 3 (® be found on the Reverse Side.) Lmditnin9 raF?3-H SCS ,NF. _ Mi�tnPuPnl(s32 � I NEERING INC. saws &e tiny - EN G Owl b.M+�i l SUnJefQ6466 En ineers Surveyorw cer'tif'icate of survey few FRIL�i.E Y s7 -ATE BANK 4- 53 ,oa E . N. L 75 ,. 2l. S 'J Q C; ` 54 A L - 4:r o. I fV-Y�,'s�° �/ y p 75 { Low TE iv I I I i /fiVa6y cer jpy Not Phis S a hx and OWYVcf repfVsw& ion opscdwey et Goraido�ies q�'fhe aba Rr de�crn6rd lmld, and to d&7 cr'a// aeldmys , lhrreon and d/ ms a tnaoa bweds , r%ny, f vn or wy and lod. As wrveyed by me #16- .. °l�j 'M " - A `9' SUB URBAN ENGINEERING , INC. L311(.0� En,,�errs fr redo ,� .df City of Fridley APpkaflon for Phmddng ood Cv= Ruing Ponce Dept. of Bldgs. Phone SM -3480 DESCRIPTION OF WORK Number. Kind and Location of Fixtures I.ocaltes PTE. 53 Avenue PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...... .. Future Fixture Opening .... ... .... New Fixture Old Opening . _ ...... .. Catch Basin . x $2.00 $ x $1.50 �3Q x $1.50 y�` Y ygT�j °t $ • • WATER HTR. GAS ELEC. Base lot lat 9d IY G 1 2nd 3rd — - 4th _ ° Future Connection Openings Connected with • Now Fixture, Old OpeningsI sower C] Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...... .. Future Fixture Opening .... ... .... New Fixture Old Opening . _ ...... .. Catch Basin . x $2.00 $ x $1.50 $ x $1.50 $ x $3.25 $ Water heater (Up to 99,000 BTU) x $8.00 $ New Ground Run Old Bldg. x $3.25 $ Electric Water Heater : $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ...... ................... x $2.00 $ 2.00 Additional Fixtures . .......... ,....... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ 3.00 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 fact and representations stated in this application an true and correct. Fridley, ?Mnn- Q Ur, 2 3 1969 Owner Robert S. Ledermann Kind of Building �e Used as _ RAs To be completed about __AUG 2 9 1969 Estimated Cost, $ O1dl-New. Building Permit No. Permit iad®. "50 -->,S' MINNEAPOLIS PAS CO. Si Business Phone ROUGH FINAL CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL / /�� Job Address �� 3 `� ��l%. I " _� , Furnace Shell & Duct Work $12.00 $ _ Replacement of Furnace Repairs &Alterations -up to $500.00 7.00 7.00 $ $ Department of Buildings Repairs & Alterations each add. $500.00 4.00 $ City of Fridley Tel. #571-3450 MECHANICAL WARM AIR: The undersigned hereby makes application for a permit for the work herein Furnace Shell & Duct Work to 100,000 BTU $12.00 $ specified agreeing to do all work in strict accordance with the City Codes each add. 50,000 BTU 4.00 $ and rulings of the Department of Buildings, and hereby declares that all the Replacement of Furnace 7.00 facts and representations stated in this application are true and correct. Repairs & Alterations -up to $500.00 7.00 4.00 $ $ idley, Minn. [® 19� Repairs & Alterations each add. $500.00 , STEAM OR HOT WATER SYSTEM: OWNER 4/7-7 er Boiler & Lines up to 100,000 BTU $12.00 $ RIND OF BUILDING each addn. 50,000 BTU 4.00 $ r Boiler only up to 100,000 BTU 7.00 $ USED ASyt��/�� each adds. 50,000 BTU 6.00 $ 7-77 TO BE COMPLETED ABOUT OIL BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ /(A04 ESTIMATED COST �`2( GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $r®� OLD - NEW BUILDING PERMIT NO. PERMIT NO. (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: 1st 3 Fixtures x $ 3.00 $ Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00- $ AIR CONDITIONING $� FAN HEATING SYSTEMSsee Fee schedule $ VENTILATING SYSTEMS $ ALTERATIONS $ REPAIRS $ State Surcharge $ .50 TOTAL FEE $�-If ROUGH INSP. REINSPECTION FEE Date ($10.00) FINAL INSP. DateZe APPROVAL FOR PERMIT MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 PLUS $.50 STATE SURCHARGE DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Ai No. / Trade Name Size No. WA - ds' Capacity Sq. Ft. EDR BTU _HP Total Connected Load Kind of Fuel .& (5-14's BURNER - Trade Name Size No. Capacity Sq. Ft. EDR /6r/Va BTU HP Company FR � 1W Signed By FRANK'S HEATING AND AIR. CONDITIONING. INC. 3107 CALIFORNIA STREET NORTH EAST MINNEAPOLIS, MINNESOTA 55418 TELEPHONE 781-9636 HEAT LOSS CALCULATIONS;'&& DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E. Construction No. Guide Wi ows I Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind -s—No Y No 19— F1.1 Room I Length d Width �? Height 14, �[ Room J! Windows and Doors—Crackage and Area Windows and Doors—Cr + width Height No. of Lineal ft. Area Infiltration 3 Q Width Height No No. of pane of pane lights of crack eq. ft. Btu � :FO, ® ,g, ;Z No. of cane of vane Ila' 1 otal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l Room I Length Width Height Windows and Doors—Crackage and Area f 1� 4 Infiltration Glass Infiltration 3 Q 4Intration Coef.1 �o Btu � :FO, ® ,g, ;Z Coef. Btu Int. wall Ceiling Net exp. wall' Int. wall Glass 0 Exp. wall XxxA11 Net exp. wall Floor a Int. wall Ceiling Floor 1 otal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.l Room I Length Width Height Windows and Doors—Crackage and Area f 1� Width Height No. of Lineal ft. I Area No. of pane of pane ligh s of crack W. ft. 4 Infiltration Glass Infiltration 3 Q M16 Coef.1 �o Btu � Exp. wall �p'' Int. wall Ceiling Net exp. wall' Int. wall Floor 0 Ceiling XxxA11 OU Floor a 1 otal tutu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area FI.I Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eQ. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Tbtal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I Infiltration Glass Exp. wall Net exp. wall Int. wall FRIDLEY, MINN. Insulation How Applied Width,:; - 3 Height' and Area meal ft. Area crack sq. ft. e O Coef. Btu Ceiling Floor ,5 :z 2e) Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Height Windows and Doors--Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area F1.I Roofs I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal it. Area No. of pane of pane tights of crack eq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area SUBJECT P City of Fridley16 i 3 2 AT THE TOP OF THE TWINS BUILDING PERMIT r -------- COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. C� � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L J` 612-571-3450 910-F15 6/8/81 / / JOB ADDRESS 548 5311 Ave. N. E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 12 2 Temple Terrace 2nd Add. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Ledermann 548-531� Ave. N.E. Fridley 55432 560-5092 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW CX ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install a masonry chimney and free standing woodburning stove. 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Masonry 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 R-1 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 $400.00: $.50 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- $7.50 STRUCT$ N OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $8.00 SIGNATURE OF CONTRACTOR OhAUTHORIZED AGENT (DATEe WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER$ (DATE) CITY OF f=RIDLEY APPLICATION FOR RESIDbITIAL BUILDING PEPNITS (New, Alterations, Additions, or Repairs) 01-1I4ER:�j� ADDRESS. -5-3 TEL NO: 0 15 % �-- BUILDER: ADDRESS: TEL NO: ' Construction Location STREET NO: STREET: LOT: BLOCK: �^ ADDITIO14: Corner Lot: Inside Lot: Setback.: Sideyards: Apj,.5l,icant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION Front: Depth: Iieight: Square. Feet: Cubic Feet: Front: Square- Feet: Depth: Iieight: Cubic feet: Type of Construction.- To onstruction:To Be Completed: C Proposed Driveway Width If New Opening Is Desired: Estimated Cost:---�-_�- cp—o _" � Alt. A Alt. B SEE REVERSE SIDE OF SHEET 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 represen tlitions stated in this application are true and correct. DATE:9 I!:/- SIGNATURE Stipulations: �c)6 I 01 SUBJECT PERMI_ City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT L17513 RE Ir? ' ___ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. 1��n r PROTECTIVE 1 . � NUMBER REV, DATE PAGE OF APPROVED BY �'---t CITY HALL FRIDLEY 55432 ---- ilk, ".j 612-571-3450 910-F15 I 5/30/84 I JOB ADDRESS 548 - 53h Avenue N.E. 1 LEGAL . LOT NO. BLOCK 2 TRACT OR ADDITION SEE ATTACHED Temple Terrace 2nd Addition DESCR. SHEET 2 PROPERTY OWNER MAILADDRESSZIp PHONE 5/Z-9033 Robert Ledermann 548 - 53h Avenue N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK 5j NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK Construct a 10' x 16" Shed in Rear Xard 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRING HEATING. PLUMBING AND SIGNS. 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 $800 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $15.50 NA RE OF CO CTOR OFL4WORIZEDAGENT IDATEI WHEN PROPERLY (DATED T IS IS YOUR PERMIT BLDG INSP DATE IGNATURE OF 00VINICR (TF OA6NER BUILDER) IDATEI 01 CITY OF FItIDLCY Effective Aug. 1, 1981 ' APPLICATIM FOR RESIDENTIAL BUILDING PEWITS View, Alterations, Additions, or Repairs) OWNER: b�ew� L�r� 'e-t^Pw2'c`t ODUILDER: r� ADDRESS: 2-- �gp, ADDRESS: TEL K0: -1 -T - 7, -2- — 9 ® 3 3 TEL 110: Construction Location STAT NO: � STRFX..T: LOT: BLOCK: �^ ADDITION: 6 QPIC a.L' Corner Lot: Inside Lot: ._X_ Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTIOR OF CONSTRUCTION _ Front: 0 Depth: A Height:jV AV Square Feet: Ll Cubic Feet: Front: Depth: Height: Square Feet. Cubic Feet: Type of Construction: � ��XiJ r/ 7 dC Estimated Cost: S ` 'lb Be Ooripleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: S $ SEE pzvrRSS SIDE OF SHEET . 2be undersigned hereby makes applicaticn for a permit fcr the ::vrk herein specified, agreeing to do.all work in strict accordance with the City of Fridley Ordinances and rulings of the Delx-irtment. of Buildings, and hereby declares that all the facts and represenUttiens stated in this applicatiqA--pre true and correct. DATE: -22&s1whTUM.. Stipulations: Land Plau>rn9 KS #L Lad ^ ' 7r� Mnrnu�is)? j ENGINEERING, INC. tml & mwvw/ Sl�srl! x066 f� En ineers Surve ors — . 9 y certificate of survey for i . M. ,; j5•� �.� C �j C L,: s c�a^rajpCr< ��lV/fic�yJ Tib ` 0�'Y�/j. ,a 75 /llom* certifyAwb Alis me !�w and mrmcf nprrsen/of an'p scrrey e#x dm+s 4-s e!k &4,ff dsu bd !aid, and /a Amn ea f dald;js , ikmw. . and d/ rrsib/e avvahmen/s , i`ay. f im or an sad /and. As sa"neyed bJ Ihs - dfi/ Al e7 A SUBURBAN EMINEEEER/NG• INC. L 31(o 18 , Fit. ..yf _ z TE TE /llom* certifyAwb Alis me !�w and mrmcf nprrsen/of an'p scrrey e#x dm+s 4-s e!k &4,ff dsu bd !aid, and /a Amn ea f dald;js , ikmw. . and d/ rrsib/e avvahmen/s , i`ay. f im or an sad /and. As sa"neyed bJ Ihs - dfi/ Al e7 A SUBURBAN EMINEEEER/NG• INC. L 31(o 18 , Fit. ..yf _ 11 SUBJECT PERMIT NO. City of Fridley 19 8 8 3 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIP ' ` ' • _____ COMMUNITY DEVELOPMENT DIV. }� 3 ��- 1 � PROTECTIVE INSPECTION SEC. tl�r 1 1 = CITY HALL FRIDLEY 55432 %.J NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/8/89 JOB ADDRESS 548 - 53' Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 2 Temple Terrace 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Ledermann 54 8 - 5A Avenue N.E. 572-9033 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 install bow window 9 CHANGEOFUSEFROM TO STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1500 $.75 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- $35.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $35.75 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT yiz 'P BLDG INSP s6 t r)E SiGNATURE OF OWNER(IF OWNER BUILDERI (DATE) 11 NEW [ ] ADV [ ] ALTS [ ] Construction Address: R-1 AND R-2 Building Pe= Application ,P -J A y e- IV Effective iii legal Description: owner Name & Address: eu-4 Q/QVIM 6? 0 A Ciontractor* .�i4>a'/ Tel • # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. tEMCK OF IIVEMM LI`IM AREA: Length width Height Sq. Ft. GARAGE AREA: length Width Height Sq. Ft. DECK AMM: length width Hat Ground Sq. Ft. 07HER: -,/ ,h sa 130 lwt-� Corner Lot [ ] Inside Lot [ ] Type of Construction: Approx. Completion Date: Ft. Yd Setback Side Yard Setbacks Estimated Cost: Proposed Driveway Width If New opething Is Desired: Ft. $ $ Wi + 6' See Back Page DATE: APPLICAM Tel. # 7 /940 Permit Fee $ JS -- OO State Surcharge $ 7S-� SAC Charge $ Driveway Escrow Park Fee $ Sewer Main Charge $ $ 35 r%S STIPULATICNS : CITY USE CINLY Fee Schedule on Reverse Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] SUBJECT PERMI City of Fridley21334 AT THE TOP OF THE TWINS BUILDING PERMIT r _ COMMUNITY DEVELOPMENT DIV. rr PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/13/92 JOB ADDRESS 548 5A Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 2 Temple Terrace 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Ledermann 548 - 5A Avenue NE 572-9033 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. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Add twokitchen windows.r.new .siding? new service doorl close off two windows tn garage . 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. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN BO DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $3 r 000 $1,5Q WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $54, OQ Fire SC $3,00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $58.50 OF CON TR CTO OR AUTHORIZED AGENT IDATEI POO PER Y ALI ATED THIS IS YOUR PERMIT X,SATURE )WH � BLDG iNSP GATE SIGNATURE ID TEI WNEROF OWNER BUILDERI y NEW [ ] Effective 3/l/92 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: SM 53%Z of 41,6 FroJley i In& 5 S y 2/ Legal Description: `®t 12— 91 CSC K Z R AD, T fm PZ £ TEf rrca- 2 �^ Owner Name & Address: (?C)13,<kT S ZgW R✓Y7f /`�,-n Tel. # S iz 90 3 3 Contractor: Address: MN LICENSE # — Tel. # — 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: Z 9cfehen wP,?dgws lYyy s,Z)'n9 Ale -v seyyjcc c6or C -W iwo Corner Lot [ ] Inside Lot [� Type of Construction: Approx. Completion Date: fl? i Ft. Yd Setback Side Yard Setbacks Estimated Cost: $ 3, O o Z071% (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: APPLICANT: Tel. # 572 - ya L� CITY USE ONLY Permit Fee $ Gin Fee Schedule on Reverse Side Fire Surcharge $ .0() .001 of Permit Valuation (1/10th%) State Surcharge $ /, $.50/$1,000 Valuation SAC Charge $ $700 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1991 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric $ 7.00 Water Heater - Gas $10.00 Gas Range $10.00 Gas Dryer $10.00 Back Flow Preventer Required ( )Yes () No Type $5.00 &f RRel Pachon Fee $30 O ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance State Surcharge 1 .50 TOTAL FEE $ Z�� JOB ADDRESS 5�19 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 and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. 5-13 ,199?-' Building Used As f6sr__ Estimated Cost 19350 — PERMIT NO. PLUMBING SIGNED BY TEL N0. 74 �_ 3 -S'l�6-" Approved By_a, Rough -In Date Final Date 5- - iq �2 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1993 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Urinal Shower er Tray a::r tC1.:.:.;.. ... DrainStories . Auto. Washer NX eFlooWash Gas Water a e r ;{ Range Gas Elec ....... ............. Basement $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4:00 specified agreeing to do all work in strict accordance With the city codes Floor 1 $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Floor 2 CT (1 $ 7.00 Rain Water Leader $ 7.00 tom, /��' �I l 7 , 1993 Floor r 3 $ 7.00 4�- Water Treating Appliance $10.00 Owner Floor 4 $ 7.00 Water Heater — Gas $10.00 Building Used As zr7 S �� y )7' PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS �l New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4:00 specified agreeing to do all work in strict accordance With the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 tom, /��' �I l 7 , 1993 Sump/Receiving Tank $ 7.00 4�- Water Treating Appliance $10.00 Owner Water Heater —Electric $ 7.00 Water Heater — Gas $10.00 Building Used As zr7 Gas Range $10.00 Gas Dryer $10.00 Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes O No Type •$5.00 PLUMBING COMPANY Reinspection Fee $30.00 SIGNED BY �o(��_rh,•,d�,,..� TEL N0. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance Approved ey� Rough—In Date Final Date t 2.,- State Surcharge .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 TOTAL FEE $ �S.SC� PLUS THE $.50 STATE SURCHARGE SUBJECT P NO. City of Fridley AT THEO-HA964 BUILDING PERMIT 28128 ----- COMMUNITY DEVELOPMENT DIV. ` r PROTECTIVE INSPECTION SEC. I = � ICITY HALL FRIDLEY 55432 %.4 612-571-3450 a e K/e✓, !� NUMBER 910-F15 REV DATE 10/7/98 PAGE OF APPROVED BY JOB ADDRESS 548 53 112 AvenueKE 1 LEGAL DESCR. LOT NO. 12 BLOCK 2 TRACTOR ADDITION Temple Terrace SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Robert Ledermann572-9033 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Northern Crest Inc. - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION IRx REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 26 S Tar -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 OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION ZONING SQ. FT CU FT 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED VALUATION SURTAX WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 2228 1.11 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 PERFORMANC OF CONSTRUCTION 7 /„ )— 7-qr $74.75 Fire $2.23 PLAN CHECK FEE TOTALrF/ Licens C 5.00 8 SIGNATURE OF CON'RACTOR OR AUTHOR -LEO AGENT -DATE, P PERL ID&T IS IS YOUR PERM S,GNATUAE OF OWNER,IF OWNER BUILDER, -DATE, V IX BLDG SP r) A TE NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 5 4 8- 53 1/2 Ave. NE Legal Description: Owner Name & Address: Robert Ledermann Tel. # 572-9033 Contractor: Northern Crest, Inc. MN LICENSE #2 0 0 9 8 415 Address: 8245 Polk St. NE Spring Lake Park, MN 55432 Tel. # 792-9364 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: Tear off and re -shingle house and garage $ Construction Type: 26 square shingles Driveway Curb Cut Width Needed: DATE: 10-7098 Ft. + 6 Ft = Estimated Cost: $ C�"26 (Fee Schedule on Back) _Ft x $ = $ APPLICANT: 6a.4aW Tel. # 792-9364 TOTAL STIPULATIONS: CITY USE ONLY Permit Fee $ S Fee Schedule on Reverse Side Fire Surcharge $ 073 .001 of Permit Valuation (1/10th%) State Surcharge $ /, / / $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ S. Q(J $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: Building PLUMBING Permit No.- Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: RECD J U L DATE YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑ ?)VER ❑CONTRACTOR PROPERTY NAME: OWNER/ ADDRESS: S S 3 ,t �i,�CITY h E ST ZIP Z/ TENANT 3 2 A ^ PHONE: �r 7 0 CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS: CITY STATE ZIP LICENSE WITH PHONE FAX APPLICATION PERMIT TYPE ❑ SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW ❑ REPLACEMENT 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 DRAINS SHOWER _ WATER PIPING _ _FLOOR _ GAS PIPING (NEED cirrlrcFm) SWIMMING POOL _ WATER SOFTNER ($35) —BATHTUB _ _ CLOTHES WASHER SINK —WATER CLOSET _ BACKFLOW PRY.($�15) _ —KITCHEN _ DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGAa �E �.( _ WATER METER �C OTHER JA w V J ;,.•. €'3J .'�A Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 -� x $15.00 = $ Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ 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 applica ' n 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 c f rk whic review and approval o/fpl yrequ'es cans. 10 rli 3 v/ d p QF r Le �e h/yBn SIGNATURE OF APPLICANT PRINT NAND DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building MECHANICAL Permit No. U0i-40 o Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date 'd: 763-502-4977 FAX EFFECTIVE 1-1-08 DATE YOUR E-MAIL ADDRESS SITE ADDRESS THIS APPLICANT IS: KQWNER ®,CONTRACTOR PROPERTY NAME:��°` I -V9 101—.S Uf) ADDRESS: -� �� a7 CZL/� . - CITY STAT ZIP�� OWNER/ TENANT ,% K;' 3 — 7 aZ — 9 U 3 PHONE: CONTRACTOR COMPANY NAME: NOTE: SEPARATE CITY CONTACT PERSON: LICENSES ARE STATE LICENSE # EXP DATE REQUIRED FOR GAS AND HVAC. ADDRESS: CITY STATE ZIP SUBMIT COPY OF BOND PHONE FAX ANDINSURANCE PERMIT TYPE SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: EW 0 REPLACEMENT 0 ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK PER MS 16B.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 ) OR 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) Equipment Installed MFG: MODEL: SIZEBTU MFG: MODEL: SIZEBTU MFG: MODEL: SIZEBTU A/C $25.00 (GAS) $15.00 _GAS RANGE/OVEN $10.00 _FIREPLACE TO AIR EXCHANGEER $15 (WOOD) $35.00 _NEW GAS GRILL $10.00 _AIR _FIREPLACE $35.00 FURNACE $35.00 GAS UNIT HTR $10.00 _BOILER LINER $10.00 ASDRYER $10.00 POOL HEATER $35.00 _CHIMNEY DUCT WORK $10.00 2 -GAS PIPING 10.00 VENTILATOR $15.00 ON WIWZIRS`� iR Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ 50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ OR Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 MINIMUM $15.50 MINIMUM $15.50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a mechanical 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 s. 14 start without a permit; th • ork will cco ance wi the appro d plan in the case of all work which re � 're/s review and approval :0P" SIGNATURE OF APPLIC T PRINT NAME d 6 L' S DATE APPROVED BY JA��DAT '. City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 0k 3 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations. Building BUILDING Permit No.:n InspectionsRESIDENTIAL APPLICATION Rec ' y 763-572-3604 CITY OF FRIDLEY Date'Wd: 763-502-4977 FAX EFFECTIVE 1-I-09 DATE i' �¢ / /�YOUR E-MAIL ADDRESS SITE ADDRES �� LG/L�P c ' '5' THIS APPLICANT IS: OWNER ❑CONTRACTOR PR�PFB1 V OWNERI NAM , �nh� moi- /n C 14-4,'t TENANT NT J ADDRESS: .S .T oZ CITY �' ~ Cy �' STAT �f ZIP -S PHONE: 3 ._ 3 3 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 FAMILYINEW CONSTRUCTION SIZE ❑ TWO FAMILYINEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED KWINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK 1I❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: 1 ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 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, 13 Vinyl �, i ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim l . Site Plan/Survey showing the existing structures �l Other �✓1,� � ❑Fascia 2. and proposed project. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENING Yes []No LOCATI N OF WINDOWS OR FOR NEW OPENING D SCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO J IP BE INSTALLED :1� UMBER OF WINDOWS ALL FEES ARE HASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: ME5HE 1997 U.B.0 FEE SCHEDULE) COTAL 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 Make checks vavable to: Citv of Fridlev THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED Attach 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 al ork wh'ch equ�ir �s review and approval of plans. { x SIGNATURE OF APPLICANT ice` r�(p/1��'.;v ur PRINTNAMEDSD-/ ,, 1.-edfV'Xf'VftDATE q� 1J 09