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PRE 2010 DOCSSUBJECT PER City of Fridley -117328 AT THE TOP OF THE TWINS BUILDING _ P E R M I T rp COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 11/9/83 JOB ADDRESS 241 - 57th Place N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 & Pt. 13 1 City View Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE K & H Builders 1425 Coon Rapids Boulevard N.W., Coon Rapids 55433 757-6400 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS SEPERATE PERWITSf P Q 5 ENGINEER MAIL ADDRESS HEAT-INGE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE x 8 DESCRIBE WORK WARIN�� Construct a 36' x 241 Dwellin nd a 22' x 25' Garage Before digging call localOHIO ONE - ELECTRIC - GAS Ett, 8 CHANGE OF USE FROM TO REQUIRED BY LAW STIPULATIONS Provide City with copy of verifying survey before capping. Provide sod in the front and side yards. Provide a hard surface driveway. SEWER LOCATION; No existing service. 81' VCP on center line of 57th Place WATER LOCATION: MUST BE TAPPED 6" CTP 101 S. of Centerline of 57th Place Park Fee $500.00 Paid. �#� /a -0'j 1-,/�/beef' DRIVEWAY DEPRESSION COST: scrow in 1984_ Provide u Wed sdr�e dovemye :t.! C-IfY OF FMDLEY DOES NOT GUAkANTEL 3 feet from the sideroe � � .1 JPAC'v OF UTILITY LOCATIONS AND ELEVADC P IS FOR INFORMAMN PURPOSES ONLY AND line, or closer with consent. DA 1,-., li f m nei3hhbo�VLM150N� USING r SHOULD VIM" TM 06*RMATION 'Its! as T149 Srrt SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood Frame 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 Z 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 $49, 200 $24.60 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $ 70.75 $803.35 SIGNATURE OFC TRACTOR OR AUTHORIZEDA ENr (DATE) k3'EN PROPERLY LIDATED THIS IS YOUR } �PERMaaIT �7/,1J 1 BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) OWNER: ADDRESS: TEL NO: CITY OF FRIDLEY APPLICNTIM FOR RESIDENTM BUILDIING PERMITS (Ncm. Alterations, Additions, or Repairs) Effective Aug. 1, 1981 BUILDER: 4- ADDiRESS: � `i 2 � � �� C �, s A/i TEL 110: Construction Location STJUET NO:,a 4 1 STREET: S --I LOT: D 2 BLOCK: f ADDITION: C M 13 Y1,4c-114� i L),a �" � ,f-7 0 Corner Lot: Inside Lot: i � Setback: -2� Sideyards: k Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTIOR OF CO'N'STRUCTION � / r t� Front: j� Depth: � Height: /� Square Feet: q G% Cubic Feet: Front: Depth: �l Height: l� Square Feet: Cubic feet: SVpe of Construction: �� ( �1—� kv - 1 Estimated Cost: '!b Be Cbripleted: Alt. A Al t. B Proposed Driveway Width If New Opening Is Desired!` - 7 s 9 W17,0 s SET; PEVf:JLL' SIDE OF SHEET . Zile undersigned hereby makes applicaticn for a permit fcr the %:vrk herein specified, agreeing to do.all work in strict accordance with the City of rridley Ordinances and rulings of the Del-.irlment. of Buildings, and hereby declares that all the facts and reprecenuttiens stated in this appl' ion are true and correct D.�TTi: �' slcaJnTvey� Stimulations: ly �® "4- (4, 24", 6% PO.i'L sou Det. W. d 014 00. %r 4= Cj ti Lor fA/-m EYING & ENGINEERING CO. 83434 JOB NUMBER STANDARD SYMBOLS 23 30 24 SEC/TWP/RN Jim McQuay CLIENT LEGAL DESCRIPTION: Lot 12, Block 1, CITY VIEW, and that part of Lot 13, Block 1, CITY VIEW, which lies west of a line 70 feet east as measured at right angles to and parallel with the West line of said Lot 12. 10/10/83 DATE SURVEYED 10/12/83 DATE DRAFTED 30 SCALE IN FEET PER INCH PROPOSED ELEVATIONS: FIRST FLOOR 849.5 TOP OF FOUNDATION 849.12 GARAGE FLOOR 846.45 LOWEST FLOOR SANITARY SEWER 846.09 BENCHMARK ELEVATION BENCHMARK DESCRIPTION: Top of curb opposite southwest lot corner as shown. 5300 HIGHWAY 101 SOUTH MINNETONKA. MINNESOTA 55343 Denotes 1/2" ID pipe with plastic plug bearing State Registration No. 9235, set. "0" Denotes iron monument found. "+" Denotes cross chiseled in concrete surface. "982x5" Denotes existing spot elevation measured at the point marked by "x", in this case, 982.5 feet above mean sea level. "982x5" Denotes proposed spot elevation at the point marked by "x". it >" Denotes proposed direction of storm water runoff. 5 Ll I hereby certify that this plan, survey, report or specification was prepared by me and that I am.a duly Registered Land Surveyor and Profes- sional Engineer under the Lawg of the State ov Minnesota. ` 1 ! / H. Parker, Minn. Reg. No. 9235 6E�5b� so 9.78 w La W �dA� W 60 9V9 I It h �o �0'LI 411 Qj o w °, o•LI 0 N l ool V9 r, t til r o•LI �td1�`I�MQ N 91�L'b8 � sodO'dd�� Q gs o 6" 00r'fOS 1 6 o r 89'98 . Z/ _ Effective Aug. 1, 1961 CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE tESIDBbTIAL RATE TO'PAL Job Address Furnace Shell and Duct Work, Burner (Also replacseent furnace) $ 20.00 $ ab, 0 0 Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Gas Piping $ 10.00 $ Tel. 1571-34SO (piping needed with new furnace) Gas Range $ 10.00 $ 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 Gas Dryer $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. • Air Conditioning (all sizes) $ 10.00 $ Fridley, Minn. ��,(1®�`. 19 All Others/Repairs and Alterations OWNER JYYI 'Q ,G , It of Value of Appliance or Work $ KIND OF BUILDING COMNERCIAL/INDUSTRIAL USED AS It of Value of Appliance or Work $ To BE COMPLETED ABOUT - ESTIMATED COST _ C36' ne.) State Surcharge $ .50 OLD - NEW BUILDING PERMIT NO. PERMIT NO. TOTAL FEE $� Reinspection Fee ($15.00) $ DESCRIPTION OF FURNACE/BURNER Rough Insp. Date Final Insp. -17-59— Date Approval for Permit 4Z k"S MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 PLUS $.50 STATE SURCHARGE Attach stack verification foe with replacement furnace permits *Air conditioners can not be placed in aide yard without w1itten permission from adjoining neighbor. u- HEATING or POWER PLANTS. Stec, Not Water, lfacm Alr- No. Trade Name Cn AJA a also No. Capacity + Sq. Ft. CDR sTU HP Total Connected Load �t�,.� -7 xind of Puel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Company Signed By Tel. No. 11 A0 . ' HEAT LOSS CALCULATION ® TEMP. DIFF* d..N. T c � C Typo Construetiat City Windows Storm Seth Dealer Name . Walls. Ina. Street __ Cliff" Ina. City Floor 11_2 mia 1'k WirMh *M Win0ows and Doors—Crackage and Area Doors—Cradugeand Area wo wrsre Il.r�n• No. of LMMI II. AIN n• .M O/ .M Lahti; of - on. N. Ns W.M., II.r'n/ No. of LWaW n. Ans ft. of Para Of n. L b of !MEL. I � f 1 a LH Coef. Btu Inf Iltration (v3 jeciet.1 Btu Glass DSD t Appo Exp, wall, // Glass Net exp. wall s" D Int. wall Ar D Ceiling Nei exp. wall Floor A3 X 3;Z 5" Total Btu. e• _ / ..._r. o�� 1 • �&. : Ways, --],A Y-t.i. Windows Doors—Cradugeand Area Windows and Doors—Crackaga and Ane Ns W.M., II.r'n/ No. of LWaW n. Ans ft. of Para Of n. L b of !MEL. 0— d I An 1 a LH jeciet.1 Btu Infiltration O Glass qq 60 7,Z,00 Exp. wall Ar D Floor Nei exp. wall Int. wall Ceiling 17 V F loor � r Total Btu. f 1.1 f n'f%f 1 G UdD01111 16111"W" I O.Rnn 7W •a .s v Windows and Doors—Crackaga and Ane Ne. WrAw•h Nvrggt No. of Leo""'Ar� .' •M nl M L h .f Omit W. I. R& ALL o LH C00. Btu Infiltration 3Z. Gym Exp. wall eL Z Not exp. wall m Int. will Ceibftg }a S Floor _pan Room I Length it Width Windows atd Doors—Crim*m aed Area Infiltration Glass Exp. wall b�(Q Not exp. call Int. wall Ceiling j (2 Floor Total Btu. FI s Room Windows and Door No. 13H IL Width and Area Btu Total Btu. 3 II Total Btu. xt/(6, �. m / 17 V � r ® n 1"131�. _ JIM _- Total Btu. 3 II Total Btu. xt/(6, Effective Aug. 1, 1981 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: New Fixtures Future Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Hydraulic Valve Sump or Receiving Tank Water Treating Appliance Hot Water Heater Gas Range Gas Dryer NO. 3 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance RATE $ 5.00 $ 3.50 $ 1.50 S 4.00 $ 5.00 $ 5.00 S 5.00 S 5.00 S 5.00 $ 7.00 $ 5.00 $ 10.00 $ 10.00 Reinspection Fee $ State Surcharge ($15.00) TOTAL FEE S $ .50 Job Address Department of Buildings City of Fridley Tel. $571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. 4 19 OWNER O��i�l �i�y� ✓ KIND OF BUILDING USED AS TO BE COMPLETED ABOUT e ESTIMATED COST OLD - HU LDING PERMIT NO. PERMIT NO. Company G Signed By Tel. No. !f 'C7 ROUGH INSP. Date FINAL INSP. /-//, - Date APPROVAL FOR PERMIT _jjjrj!jk09 MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE >, m �p u 1�C m Water e .c� .0w w a Heater MO m y N .0 +RI O �O U m -•ag5m�l g o u on 3 lec F3rd 4th (R) - Future Connection Opening Connected with Sewer (�) a New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: New Fixtures Future Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Hydraulic Valve Sump or Receiving Tank Water Treating Appliance Hot Water Heater Gas Range Gas Dryer NO. 3 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance RATE $ 5.00 $ 3.50 $ 1.50 S 4.00 $ 5.00 $ 5.00 S 5.00 S 5.00 S 5.00 $ 7.00 $ 5.00 $ 10.00 $ 10.00 Reinspection Fee $ State Surcharge ($15.00) TOTAL FEE S $ .50 Job Address Department of Buildings City of Fridley Tel. $571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. 4 19 OWNER O��i�l �i�y� ✓ KIND OF BUILDING USED AS TO BE COMPLETED ABOUT e ESTIMATED COST OLD - HU LDING PERMIT NO. PERMIT NO. Company G Signed By Tel. No. !f 'C7 ROUGH INSP. Date FINAL INSP. /-//, - Date APPROVAL FOR PERMIT _jjjrj!jk09 MINIMUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE CITY OF FRIDLEY APPLICATION FOR PWMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: New Fixtures Future Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Hydraulic Valve Sump or Receiving Tank Water -Treating Appliance Hot Water Heater Gas Range Gas Dryer NO. RATE $ 5.00 $ 3.50 $ 1.50 S 4.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 7.00 $ 5.00 $ 10.00 $ 10.00 TOTAL S ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance $ State Surcharge $ .50 Reinspection Fee S /�, .001 TOTAL FEE $ /0.60 Effective Aug. 1, 19131 t Job Address C;�'// - �] ( 9 Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. �e - �b , 19 - Al OWNER KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. `% /% / Company f Signed By Tel. No. ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT HINIHUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE yq >, W bb u x w Water E r.7 4 Mr. u a w Heater ai+ m m U 0 y m uJ Q W 0 W U p O S leC N 1st 2nd 3rd 4th TTi (R) ® Future Connection Opening Connected with Sewer (*) - New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: New Fixtures Future Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Hydraulic Valve Sump or Receiving Tank Water -Treating Appliance Hot Water Heater Gas Range Gas Dryer NO. RATE $ 5.00 $ 3.50 $ 1.50 S 4.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 5.00 $ 7.00 $ 5.00 $ 10.00 $ 10.00 TOTAL S ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance $ State Surcharge $ .50 Reinspection Fee S /�, .001 TOTAL FEE $ /0.60 Effective Aug. 1, 19131 t Job Address C;�'// - �] ( 9 Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. �e - �b , 19 - Al OWNER KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. `% /% / Company f Signed By Tel. No. ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT HINIHUM FEE FOR ANY PLUMBING PERMIT IS $10.00 PLUS THE $.50 STATE SURCHARGE 0/ SUBJECT - PE City of Fridley 32543 5 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. 116 ► COMMUNITY DEVELOPMENT DIV. ._ v __��_ f 1 PROTECTIVE INSPECTION SEC. ' WEE9 w NUMBER REV DATE PAGE OF APPROVED Br CITY HALL FRIOLEV 554$2 L 612-571-3450 910415 4/26/02 10B ADDRESS 241 57 Place NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 12, Pt 13 1 City View Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bret Anderson 241 57 Place NE 763-571-3753 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 O ALTERATION Ek REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Remove existing 8' x 10' Deck; Construct a 14' x 16' Deck (for future 3 season porc 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. 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 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 $2,576 $1.29 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTALFEE $87.12 ATURE OF CONTE+ CTO R A AUTHORIZED AGENT iDATEi N P PERL LIDAT IS ERMIT �[S�R �' SGNATU OF OWNEROF OWNER BUILDER, iDATE, BLDG SP 00,DALE 0/ NEW [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address:o��l -y%/� /Ke! . \ Legal Description: Owner Name & Address: Contractor. Tel. # 76-?- Fee 6j- MN LICENSE # Address: 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 _ 10 DECK AREA: Length '/ Width - - Hgt/Grou d Sq. Ft OTHER: du e ('_>_y/S.1 49-X 16 c,�' Construction Type: 4�®lj zni� Estimated Cost: $ ASreCi- Gb o�, 7� r Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: "7 -��' �°Z APPLICANT: 24t f�� Tel. # Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: The Home Der ---t #2802, 5650 MAIN ST, NE, FRIDLEY, MN 55432, (763 Tue Apr 16 1-':13:52 2002 The materia -3 in this deck will cost $1442.01 File saved -:: f:\dn\decks\41408C76.DER 3D �idiv �ef? �xtl�U�E � c 1 0'4 .Jl i.-4 The Home Derot #2802, 5650 MAIN ST, NE, FRIDLEY, MN 55432, (763 Tue Apr 16 17:13:52 2002 File saved E_s: f:\dn\decks\41408C76.DER Post Layout nor Deck 1 /bJ 15 p; Ow 4' 9" 1'k L___y______ 1 3" ------------- HiQ JOlS�Q�,02iJ The Home Dept #2802, 5650 MAIN ST, NE, FRIDLEY, MN 55432, (763 Tue Apr 16 17:13:52 2002 File saved as: f:\dn\decks\41408C76.DEK Deck Layout —M/.0 ?oo1�i� dc�/�✓j Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By. 74 763-572-3604 CITY OF FRIDLEY Date Rec'd. b 3 zDL DATE 3 YOUR E-MAIL ADDRESS SITE ADDRESS AIE ° THIS APPLICANT IS: ❑ OWNER P60NTRACTOR PROPERTY NAME: -7-63'j'- r -0 o n ADDRESS:_�� (� 1" L CITY STATF�'iIP� TENANT PHONE::Zna CONTRACTOR NAME: S <~ e e STATE LICENSE # °t%�� CO C_ EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS: 73 % g - � 4 %rLaP r1V W CSTATE 0(rJ ZIP_M__ j LICENSE WITH PHONE FAX APPLICATION PERMIT TYPE INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE M1519PLACEMENT TYPE OF WORK: o NEW DETAILED DESCRIPTION OF WORK : S -J, CL WAYeA 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) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR:PROMM WHERE LABOR EXCEEDS—S500,—FEES ARE BASED ON $10.00 PER FDn URE, EXCEPTWHERENOTED:F1XT-UMs_.(INDIC-ATE TOTAL NUMBER OF EACH BELOW) SINK/IAV DRAINS _ SHOWERWATER PIPING —BATH _FLOOR GAS PIPING (vFED cnrucaw) _ SWIMMING POOL T WATER SOFTNER ($35) —BATHTUB _ CLOTHES WASHER KITCHEN SINK CLOSET _ BACKFLOW PREV. ($15) _ _ —WATER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION —DISHWASHER _ WATER METER —OTHER 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 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 w k whic quires review and approval of plans. r / �J DATE,�� SIGNATURE OF APPLICANT PRINT NAME �� I d � m1 � [ � � �� 7a '&.1 w ado City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building BUILDING PermitNo.: (1�t1U inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 Date R A CITY OF FRIDLEY ATE Lq I S d YOUR E-MAIL ADDRESS t%" s to 41 d/ r"M da . e D m iTE ADDRESS K l S Z n U NM e V— HIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: 6/)l I i li 1-r Son TENANT ADDRESS: Y 1 ci 7 I; 1' l t. '' CITY XPi d It t/ STATE ZIP Sk 3� — PHONE: Z V 3 3 -7 (' 3 CONTRACTOR NAME:_ fHD At- Home Services, Inc. Jo d t ® Vdt r J b n 4 5 STATE LIt 2690 Cumberland Pkwy, Ste 300 q �S A 3 q5 - (. o t47 SUBMIT A COPY OF Cumberland Office Park YOUR STATE LICENSE ADDRESS CITY STATE— ZIP-WITH APPLICATION PHONE Atlanta, GA 30339-3913 ❑ SINGLE Lic# 20268257 Ph. 763/542-8826 =E PROPERTY TYPE ❑ TWO FA .ORMS PERMIT TYPE Er ADDITION ❑ GARAGE/SHED WS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ANCE✓REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: (y wm6w r/P[ cis /al .[ ke 141 n4 bArJ)/104 c >IZE OF ]MPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. :OOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES 'ROPOSED ATTACHED GARAGE 1. Existing Floor Plan 2• Proposed floor plan SIZE: 'ROPOSED HEIGHT: ❑ DETACHED GARAGE 3. List of structural members to be used ;IDING FOR NEW CONSTRUCTION INCLUDING DECKS, 7 vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: 7 Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures 7 Other ❑ Fascia and proposed project VINDOWS 2. Two sets of construction plans 14 EXISTING OPENINGS Yes ❑No LOCATION OF W�✓S ?R FOR NEW OPENINGS -DESCRIBE SIZE OF J I V, A! j , bA bl el., did) 3. Ener Calculations � >PENING CHANGES & 'YPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS t' ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ / D . 4 LI8 OCCUPANCY TYPE 'ermit Fee 'Ian Review surcharge 'ire Surcharge Jcense Surcharge AC Charge ,urb Cut Escrow .rosion Control ark Fee ewer Main Charge Iotal Due $ •Y $ lo,Q $ 5.bo V See Back Page for Fee Schedule 65% of Building Permit Fee (.0005) times the total job valuation — Minimum $.50 .001 x Permit Valuation (1/10%) $5.00 (State Licensed Residential Contractors) $1450 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in mformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a en -nit but only an application for a permit and pork is not to start without a permit; that the work will be in accordance with the approved Ian in the case of all work which requires rel-A,approval of plans. 'GNATURE OF APPLIC PRINT NAME t l I rL J C I DATE 7 I/