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PRE 2010 DOCSBUILDING PERMIT Village of Fridley, Minn. Date ���.fJ.....�?.�......................... Owner Address......................................... N° 2784 Builder ......................... Address......................................... LOCATION OF BUILDING No. lv404P......... Street U. f ................. Part of Lot ....................... Lot ... /I ......... Block .../.Q.......... Addition or Sub -Division /Kdmo**— Corner Lot ............ Inside Lot ........ Setback 34� Sideyard /tea 41ft ............... DESCRIPTION OF BUILDING To be Used as: A....! .... Front0... Deptlarfir height Asx .. Sq. Ft. ®. Cu. Ft. ........ .................... Front ........ Depth ........ Height ......... Sq. Ft......... Cu. Ft. ..... Type of Construction aG wo ... Est. Cost l#'T. Q,e .............. To be Completed In consideration of the issuance to me of a permit to construct, the building desqjWd above, I agree to do the proposed work in accordance with the description above set fortf and in co ante with all provisions of ordinances of the village of Fridley. In con iderg io of the payment of a fee of $.lf�.b. , permit is hereby granted to .%�,1 ....... 2=... to construct the building or addition as described above. This permit is 6franted 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 village limits and this permit may be revoked at any time upon violati oof any of the provisions of said ordinances. ��i�����'—. 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. City of Fridley, NUmn. BUILDING PERMIT N°5219 Date: Owner: 11 1eZ, 'zo Z -A �� Builder _.._.. ._..— ._......___...._..�__....�—_... Address I)M— Address - —_— _&C�,�N OF BUILDING No. 0 ' Street Lot __ Block Addition or Sub -Division Corner Lot -. _ __ _ _ Inside Lot ___ _ Setback®� Sideyard Sewer Elevation _ _ _ Foundation Elevation — DESCRIPTION OF BUILDING To z Front Depth Height Sq. Ft. - Cu. Ft.. Front Depth ht Sq. Ft. ____ Cu. Ft. Type of Construction _ k Est. Cost o 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. I In consideration of the payment of a fee of $-2L=—, 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 anyviolatiog of any of the provisions of said ordinances. a.• .. A r` Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building Impactor for separate permits for these liana. ,_,� 0oQjjj04 0 _..� APPLICATION FOR BUILDING P,NMIT CITY OF FRIDIEY, IOTA Owner's Name �� �� ��' ������ Builder _ ,67&4�ge Address 600 S�7�i, JOS', Al- Address SAIV, LOCATION OF BUILDING No. 0-0 Street z ��/�. /ll�. Part of Lot Lot Block Addition or Subdivision "Mjli,&—alyolc Corner Lot Inside Lot IO Setback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: DESCRIPTION OF BUILDING Front D Depth 2 c Height /D Sq. Ft. 01!x0 Cu. Ft. 44�0 Front Depth Height Sq. Ft. Gu. Ft. Type of Construction LA M -Z _ Estimated Cost AL.5 D6- ea 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. ,51 DATE_ / /i ` SIGNATURE (A Schedule of Fee Costs can be found on the Reverse ide.) �-A • • Date: Owner: Address City of Fridley, Minn. BUILDING PERMIT Builder Address N° .7440 �"�'O�TION OF BUILDING NO. � �� Street �6 Lam,, Part Lot Lot ._._�__ Block __... Addition or Sub -Di on .��z Corner Lot _ Inside Lot i' Setback Sideyard � Sewer Elevation _ __ _ _ Foundation Elevation DESCRIPTION OF BUILDING LT ° t ( _ Depth Height Sq. Ft. , Cu. Ft+' L Front Depth Height Sq. Ft. cu. Ft. Type of Construction �/_ Fst. C;�� `'� _ 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 incompliance with I provisions of ordinanoea of the city of Fridley. s''� /' 12 ­� 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 upo ordinaordinances.�s , did 9n_viol ion of any of the provisions of said NOTICE: This penult does sof corer the coestrucdon, hnstaliatioe for v rhM plumbing, gas heating, son or water. Be sore to sae the Building hopector for separate permits for these lteam APPLICATION FOR BUILDING PErXET r CITY OF FRIDLEY, MINNESOTA r OWNER'S NAME BUILDER ADDRESS ADDRESS LOCATION OF BUILDING No. Street Part of Lot Lot Block 16 Addition or Subdivision Cornet Lot Inside Lot 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. DB`SCRIFTION OF BUILDING To be used as: Front�� rapth Sq. Ft. Cu. Ft. Front Depth Height Height Sq. Ft. Cu. Ft. Type of Construction 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 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 S_SIGNATURE �- J Schedule of Fee Costs can be found on the Reverse Side). 53-64-S-915.51 `� wweaw wR. Umm= mmm M, WE PARTIAL RATE SCHEDULE MCC rUKTUM RAM: M. REM TOTAL Numbw /P aitwu m .............. ♦ -mum l.... '....... v *jw & Beat CM .......... it SM Cote% .............. ...... 3L Ra(er Rester !alp to WAW B'TVf ... • a a" g New Gramd Run Old oft ........ • _w$925 & cwctdvw&%wKm r .............. a an 8 CAB FhTMG rcm- m RA= TOTAL lot i Mtum .................. 1 = un .. . . ........ ► 1 . _ 75 0n now to M.00�- State Surdiasge $ .SO >0�►>1� i� iL?Qi?10gi— bdw b Crit vuVWUM.ins .0.0�.....g 3.00 TorAL M 6 5 _ KO m cid of Kind of Buiidtin Frame . a Umd w Res. To W caeweted ,Imut 7/3of73 FMimated Cast., S 10.00 Building >}..rA *e R.®ttyG'1t� e Class "A17 Surcharge .50¢ a suBdEcr PERMIT.•hl"C� City of Fridley c 19363 AT THE TOP OF THE TWINS BUILDING PERMIT R 1 '161✓'______ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 9 7%34 CITY HALL FRIDLEY 55432 NUMBER REV. DATEPAGE OF APPROVED BY L 612-571-3450 910-F15 3/30/88 JOB ADDRESS 600 - 57th Avenue N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 10 Donnay"s Lakeview Manor SHEET 2 PROPERTY OWNER MAIL ADDRESSZIP PHONE Ellis/Donna Wojciehowski 600 - 57th Avenue N.E. 571-3665 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Panelcraft of. MN. , Inc. 3118 Snelling Avenue South, Mpls 721-6628 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 �E7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install siding/soffit/fascia 8 CHANGE OF USE FROM 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 $5,300 $2.65 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- $56.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTA4FEE $59.15 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI% WHEN PROPERLY BLDG WSP V LIDATED THIS IS YOUR PERMIT )ATE SIGNATURE OF OWNER OF OWNER BUILDERI (DATE( NEW [ I ADDN [ ] ALTER ODnstructior, Legal Descr' Owner Name Oontractor : Address: City R-1 AND R-2 Building Permit Application Effective 5/1/88 Address: /fir i/ L..►� L /./ ow . , �Address: / � � � rte[m.<, ehaxsfi .-��i�. 1A. Tel. #.M Tel* 2) 452 Attach to this application, a Certificate of Survey of the lot, with the proposoed construction drawn on it to scale. DESCRIPTION OF I ,, T.T`ING A— • Length Width Height 9q. Ft. GARAGE AREA: Length Width Height Stg. Ft. DECK AREA: Length Width Hgt/Ground Stg. Ft. MHE@t ODrner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction:. <,L46 91 1n_, Estimate st : $ 3Dt7.in MF Approx. Completion Date: V. Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ Width + 6' See Back Page DATE :OZ APPLICANT : Tel.# 7-21V,&9S' QTY USE ONLY Permit Epee State Surcharge SAC Charge Driveway Escrow Park Fee Sewer Main Charge TOTAL Fee Schedule on Reverse Side $.50/$1,000 Valuation $550 per SAC Unit Alt. "A" or Alt. "B" Above Flee Determined by Engineering Agreement Necessary [ ] Not Necessary [ l �►,'®®c,— Via, � � e CITY OF FRIDLEY INSPECTION DIV, Effective On March 1, 1996 6431 University Ave NE Fridley, MN 55432 APPLICATION! FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE JOB ADDRESS COO— !9,7 vim. 4J6 - The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner - rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30,00 $ representations stated in this application are true a d correct, (Side Vent - FIII Out Back) l / - Gas Piping (Needed with new furnace) $ 10.00 $1996 Gas Range $ 10,00 $ OWNER l� G' �� .S71 - C 4 4 7 BUILDING USED AS Gas Dryer $ 10.00 $ cs� rr ) "5 ' PERMIT N0. /• 9 *Air Conditioning -All Sizes $ 25.00 $ ESTIMATED COST DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Ap liance or,Work $ No. of Heating Units Circle One (Steam) (Hot WateC(—Wa�rmA:IrD Trade Name �LcP Size No, CommeJraI/l ndu trial BTU HP EDR 1.25% lue of Appliance or Work $ Fuel Total Connected Load State Surcharge 50 Burner Trade Name Size No, TOTAL FEE BTU HP EDR MINIMUM FEE FOR ANY HEFTING/CQOL_I!Q /ENTIL.ATION REFRIGERATIONJAIR CONDITIONIIVG PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr "Air Conditioners can not be placed in a side yard without written permission from adjoining property owner, HEATING COMP NY Signed By _ Tel No, 7,573' 03CZ Approved By Rough -In Date Final Date0 -Q4Z FILL OUT BACK SIDE R STACK VERIFICATION ON REPLACEMENT FURNACE CHEWNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes (v� No ( ) 2. Is free from rust or deterioration Yes (v�No ( ) 3. Has no foreign objects lodged within Yes 0/1o ( ) 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 TOTAL BTU's —3 - 000 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes( ) No ( ) Remarks: Viod -g�Jq WCA , List ALTERATIONS Beim HEATING CO: Signed By: Date: SUBJECT City of Fridley 2 8 04 8 AT THE TOP OF THE TWINS BUILDING PERMIT r? ' EIPT N `y _____O. COMMUNITY DEVELOPMENT DIV. ! INSPECTION SEC. j r � PROTECTIVE NUMBEROATE PAGE OF APPROVED BY i CITY HALL FRIOLEY 53132 612-571-3450 910415 f7l 9/30/98 10B ADDRESS 600 57th Avenue NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DescR. 11 1 10 1 Donnays Lakeview Manny SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Richard E. Ellison571-6667 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner jbium )S 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 0 NEW 0 ADDITION 0 ALTERATION Jc REPAIR 0 MOVE 0 REMOVE 8 DESCRIBE WORK Reroof house and garage 32 SO 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 REOUIRED FOR ELECTRICAL. PLUMBING. HEATING. VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ' NO DWLG. UNITS OFFSTREET PARKING 1 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 2740 $1.37 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 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $74.75 Fire SC $2.74 PLAN CHECK FEE TAL FEE �GNATURE OF CON'RACT OR AUTMQRIjEO AGENT (DATE. 78.86 HE P LY VA D ED THIS IS YOUR PER NSP'v S,GNATURE OF OWNERoF OWNER BUILDER, iD t NEW [ ] Effective 1/1/98 ADDN [ J CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: t Ol' 57" ' 4,e Legal Description: Owner Name & Address: Rt C -k -A /445) P )E L� i g ne Tel. # S7/ Contract, 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 GARAGE AREA: Length Width Height DECK AREA: Length Width HpjQ OTHER: Zhu .,� , -:? 2 ENSE # Sq. Ft. Sq. Ft. Construction Type: R E 0 1 Estimated Cost: $� — (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ ��. DATE: 2 3v APPLICANT: Tel. # 5-71–&'6,02 STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ % .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: 0- V_ to as 4 Building MECHANICAL Permit No-,•Ooiroo5cb Inspections RESIDENTIAL APPLICATION Received By 763-572-3604 CITY OF FRIDLEY Dat : DATE a I O$ YOUR E-MAIL ADDRESS SITE ADDRESS U60 ,e_ vvt- THIS APPLICANT IS: ❑ OWNER f CONTRACTOR PROPERTY NAME: G- a rrnYV%o OWNER/ n� _ ADDRESS: - d e N CITY STATES ZIP 5sy3%, TENANT 0-1-42;? CONTRACTOR COMPANY NAME: CENTERPOINT ENERGY SUBMIT A COPY OF CONTACT PERSON: JOANN 7 INKEN YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: 9320 EVERGREEN BLVD STE BITY ` "COON "RAP.IDS STATEMN ZIP5 5 4 3 3 APPLICATION PHONE 763 — 757 -- 6202 FAX 763"757--6701 PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑NEW )REPLACEMENT [3ALTERATION/REMODEL DETAIkED DESCRIPTION OF WORK `�rS� u.� 1� �e ,� J i. , h.0. a- -e an Ct o�A:�r_.,e,l\-Q-,'­ 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) // =I Equipment Installed MFG: �N LODEL: �oR l- o� SIZEIBTU MFG: MODEL: IJ► ' I�J�-- 0 30 SIZE/BTU t Y1 S�1 �� MFG: MODEL: SIZE/BTU _I_A/C $25.00 FIREPLACE (GAS) $15.00 _GAS RANGWOVEN $10.00 _AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _BOILER $35.00 ,FURNACE $35.00 _GAS UNIT HTR $10.00 _CHR NEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 .. , -Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 6 x $25.00 = $ A5,00 Number of fixtures @ $35.00 _ jx $35.00 = $ 3S. 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 all work which requires review and approval of plans. o SIGNATURE OF APPLICANT �• NAME ROGER H7OFFHE IN DATE z d City of Fridley Building Inspections=Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 9 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC 0 NEW HOMES/ADDITIONS�ZXISTING HOME 0 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/1FGC 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. �� From: unknown �� Chi S1Ii10111 �UPage���te:5/21/20084:06:58PM j jjl� 'lets Review $ ns tions RESIDENTYAL APPLICATION rise Surcharge Re�ezved By: _ ►63-572-3604 ci,,,E� C3�+ + �iIDI�F+ TIS .�_ iurchmV Date Reed: 'ATE ��— YOUR E-MAIL ADDRESS �" l�Q C)'1enq r('a)-Fin r a E=j-4- {1 -pr ITE ADDRESS .�� $5.00 (State Licensed Residential Contractors) HIS APP=ANT is; 0 OWNER CTOR _ ?ROPE RTX OVWNQ:IR/- ,wb Cut Escrow $ TENANT ,a1�DRFSS: '� CiTY STAT6�IP $450 Cpnservation Plan Review 'ark Fee $ CONTRACPOT. AfAA !1b► tS�i l ] nC , $ , STATE LICENSE# _75 W BATE _. .. .. rY1� �— SUBMIT A COPY (OF YOUR STATE UCEI USE .ODDRM: 19:1 a 1-kts�G � !?1� STATl�"ZIP VIM APMCATtc94 ?jjq 1>z k4—bl q'%kA 1gUIL n FAX L..q&A 2 = PRC)PERTY TY7 "•L 3 SINGLE FAMILYINEW CONSTRUCTION SIM w TWO EAMILYMEWCONSTRUCTION STORK— .. ww. _3 PERM T I'li'la$ IADDITION OGAUGEISHIM O WINDOWS _ 13 BASEMENT FINISH ROOF 0 DRAIN TILE C) DECK ❑ SIDING M OTHER D 5'0VI]aIl�IDVQ POOL TYPE OF WORI(s Mw o ADDITION _ --------.-.---___ —,� C].MAQJTEi•1�A1R d REMODELING )ESCRIEE WORK EIEWO DONE: � tIZE OF IIVBROYSIIEN T LEN© WIDTH HEIGITT . Ft. E3 HOUSE OF SQUARES. «�+` CI HOUSE ONLY BASEMENT REMODELINO-SUBMCT, AGES O ATTAMMD GARAGE 1. 2 Exiigft Fioor Pt= Pmpawl taw 1hn 'ROFOSM SIZE: 0 DBMACHED GARAGE -ROPOSED tMGT-'�' ---- 3. List of sdrtcmral members m be and ID1KG FOR NEW CONSTRUCTION INCLUDING DW3. 3 Vinyl I35ofht APDUMM & PORCHM SUBMIT: 3 Akuainam O Trim I . Site Plamsurm showing the emirs 3b=tM a 30&& Q Fagala mid proposed project. Z. Two eras of carte pians EOPM Y. G OPENING 5 M es 13N0 LOCATION OF WINDOWS 3, Eetxgy Calculations )R FOR NEW OMaN(Ii-DESC1LIBE ME OF )PSNMG CHANGES & TPE OF WINDOW TO EE INSTryI.LED NIJUBER OF WINDOWS ALL FEES.,612F, BASED ON VALUATION. INCLUDING THE COST OR LABOR AND MATERLU S: (USING THE 1997 UJLC FEE SCHEDULE) %ns e -:3 -2!�k t-® f%ef'iTDA Vd- 'ermit See Sack Page for Fee Schau-Iie 'lets Review $ 65% of Building permit Fee rise Surcharge $ , �,�.--_.-- — .001 tines the tDial job valuation iurchmV . SL i� 1 _ 14', .0005 x PMMirt Valuation Minimum S.50 °icellse surelw9e $ 00 $5.00 (State Licensed Residential Contractors) IAC Charge '— $1550 per SAC Unit (Plans to MWCC far detetx *anon) ,wb Cut Escrow $ ft +6 R = _ R x $21= $ Irosion Control $ $450 Cpnservation Plan Review 'ark Fee $ Fee Determined by Engineering ]ewer Maki Charge $ Agreement necessary ( ) Non Necessary ( } rotal Ane S It Make checks payable to: City of Ffldley Attach St3 Mations TATS TS AN APPLICATION FOR A PERMITNOT VALID UNTIL PROCESSED hmby apply for it buldhig permit anal I acknowledge that the information above is complete and accurate; that the work will be in :onformance with th s cT i races and codes of the City of Fridley and with the M'nmesota Construction Codes; that I understmd, this is not a mrmit but only an a;pliaidou for a permit and work is cot to start without a permit; that the work will be in acx ordwee with the approved )Ian in the cue of al won t wbicb requires review and approval of pians. cIGNArM OF APPI.II'Wf Sh 11�+{ . - MM NAME- U061 8U