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SCALE 11'=100' w-MIu45 aA5E0 om ASSUMED vATUM _ Nclz>=P_,Y 41M'f1FY TAAT _THIS 15 A '92118.. A -w colzf_Et.'( 2rP.B6c2F_mTAT1oA off.. A _ 1 ZURVE-( Of •THE 50UNDAMIES of L-DV7 _ B-43, 56oc-K 1, of IA& AI.Ic,E WA -,.L AGPIT IOW, HAWAF-PIM CODN- , M IIJIItE'ioT/l, { AS SUIEVE`(F-0 W ME •jHIS 9•.b DAA( ` -(o -2gow MPRov&m5�I'j1416. S 2_ r W4rZoAROT r_K - oR7 MEtlj�,, IF ANY• j • 28.64 _ ���Ne9•ss'sa•Ir N * .. 0 O O 0 - 12aa wl _ 8 «I I 8 '0 21..0 •' 1.0 Nes 5s 3s • HARRY S. JOHNSON C0MPANIEINC_;:. 1 O 1 12 O .d w 2 L!* ' �'INO9839'33•w j 401 WEST 79TN•STREET h In, 13 .. _ in w I:o.a 21J BLOOMINGTON. MINNESOTA 55420. �� to -: PHONE 16121 BBb•3]bl 1!°.01 • CERTIFICATE OF SURVEY N �: FOR WALL ' CO2 -P_ N C; '+ 8 ' ,C= •.-� _ . - ! �r31�1.. hr•' j - a •• • . :.tea--• �. T��- . ' 3: w L =0.a1 • o 0 o 9 -' 474,19 Mf9.5f'33•rA r 29.94. e 80.00 -4-73-00- _.79.00_-- __ 75.00- 190.01 /70.00_ e , i 1 120.01 • • • 1 ''- 1 1100 1 11 n•39'sslr e W w �I� I r1 1 01 Nclz>=P_,Y 41M'f1FY TAAT _THIS 15 A '92118.. A -w colzf_Et.'( 2rP.B6c2F_mTAT1oA off.. A _ 1 ZURVE-( Of •THE 50UNDAMIES of L-DV7 _ B-43, 56oc-K 1, of IA& AI.Ic,E WA -,.L AGPIT IOW, HAWAF-PIM CODN- , M IIJIItE'ioT/l, { AS SUIEVE`(F-0 W ME •jHIS 9•.b DAA( ` -(o -2gow MPRov&m5�I'j1416. S 2_ r W4rZoAROT r_K - oR7 MEtlj�,, IF ANY• j • 28.64 _ ���Ne9•ss'sa•Ir N * .. 0 O O 0 - 12aa wl _ 8 «I I 8 '0 21..0 •' 1.0 Nes 5s 3s • ,..1 1 In 01 / •. n H 41 o AAXZy . H14509 (ZE[a. No, 1501x9 5 LANs SuR�E`(oR. ' • • 1 O 1 12 O .d w 2 L!* ' �'INO9839'33•w O • e L Lei w• h In, 13 .. _ in w I:o.a •f ! o '1 13.21 Itl' °o h In, 13 .. _ in w 21J . 'Pzr / JI i ' 1189.59.33-• -: 120.01 • M M f9.3f'fs•� �: N • •.-� 0 � 4 - DDD ; - 1 ! 001 _ hr•' j - a •• • . :.tea--• �. T��- . ' 3: w L =0.a1 ..� 474,19 Mf9.5f'33•rA r 1 6 80.00 -4-73-00- _.79.00_-- __ 75.00- 190.01 /70.00_ e , y • •f ! o '1 13.21 . 'Pzr 15 - � � M f9.3f'fs•� �: ---- • •.-� - DDD ; - 1 ! 001 _ �"• . _ - :.tea--• �. T��- . ' ;'-r---'�'*'-- .. 474,19 Mf9.5f'33•rA r 1 6 80.00 -4-73-00- _.79.00_-- __ 75.00- 91 9 /70.00_ e , y • • 1 ''- 1 1 11 n•39'sslr w w �I� I r1 1 01 o fl 1 1 OOI - T 8 23 /�" 21 s�20 1«w� I' »u 19 .� 0 Ici «"22 •dw _ = • ' T a i ���43 e 1 w1 1 ;yl 1 0 � L■11g`oo - � so tt ■ w� /!•31.20 sli• 1 8 '75.00 73.00 ►9 � 75.00 1 98.52 13.00 3 ANfO'16'f;'- 9874 sots \ 664.53 - N89059 ► =-. :'- ` -'�� - 53 HI). _ , - AVE. City of Fridley SUBJECT P 17 0 4 5 AT THE TOP OF THE TWINS BUILDING P E R M I T CEIPT COMMUNITY DEVELOPMENT DIV. Lu -------- 08 r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV, DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/14/83 JOB ADDRESS 475 - 63rd Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 18 1 Alice Wall Addition SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Rodney Billman Inc. 151 Silver Lake Road, New Brighton 633-0536 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. SEPERATE PERMITS REQUIRED FOR WIN 6 USE OF BUILDING HEATING, PLUME NG, AND SIGNS. Residential 7 CLASS OF WORK NEW ❑ ADDITION ALTERATION REPAIR ❑ MOVE REMOVE ❑ El X 8 DESCRIBE WORK Construct a 54'.x 28' Dwelling and a 21' x 26' Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide City with copy of verifying survey before napping. Provide sod in the front and side yards. Provide a hard surface driveway. Minimum basement floor elevation is 846.5 - Minimum walkout elevation equals 851.0. Provide drain tile and sump pump. SEWER LOCATION: 191' W. of M.H. (Inv. 841.77) 40' N. of Sewer Main(CL63rd Ave) WYE ELEV: 841.96 top of footing: 844.96 Minimum WATER LOCATION: 10' W. of Sewer Service, 201' W. of M.H. DRIVEWAY DEPRESSION ESCROW: N/A WARNIWG 1t.1 CITY OP FMIJ DOU NOT GUAM, Tft Before digging A,CCUPAC" O► UTILITY LOCAMA AND GLGVATIOI`s- call local utilities THIS OAIA, IS FOR WORMATION PURPOSES ONLY AND TELEPHONE - ELECTRIC - GAS Etc. PERf,CsNs USNrG r SHOULD VW" TNG INFORMAfitON REQUIRED BY LAW '`N THC Ali SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST, OCCUPANCY GROUP OCCUPANCYLOAD OR AIR CONDITIONING. Frame 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $72,100 $36.05 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE P VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- ST TION OR THE PERFORMANCE OF CONSTRUCTION. $322.00 $425.00 �r�f PLAN CHECK FEE TOTAL FEE 80.50 $863.55 IGNATURE OF CO i ACT Ro AUTHORIZED AGENT (DATE) ` HEN PROPERL VALIDATED THIS IS YOUR PERMIT O0 BLDG INSP j DAT iG T F OWNER 11F OWNER ILDERI IDATEI ri CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDENTIAL BUILDIING PEiL'fITS (New, Alterations, Additions, or Repairs) OWNER: BUILDER: rd�����1it�i� ADDRESS: ADDRESS: TEL NO: TEL N0: Construction Location STREET NO: LO �/ �STREET: LOT: ---rte BLOCK: J ADDITION: Corner Lot: Inside Lot: ✓ Setback: J Sideyards: /y /o Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION C ,,,/, f _� Front: ��� Depth: -2_6 V_ 2 d Height: Square Feet_ a Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: _ /Q 1 Type of Construction: 4b Be Completed: ,,U� / Estimated Cost: $ O Alt. A Alt. S Proposed Driveway Width If New Opening Is Desired: $ $ SEE p.EVERSE SIDE OF SHEET 19ie undersigned hereby makes application for a permit for the %:,ork 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: � z ' � SICNATUIE : Stimulations: At Ll i/��9i✓12u� mac. ,, u ri► i W*kA oar +. ° t aur 0 pqtou'o's sump P00 - ', " ''. , , - - , . . � I .......... I -!-. .:-,.' ,,w- .:...,--PT?Y'-L-- t, -�,� . ". . N", - � � �,, --i'. j - ; . Y� - ;.-.:i' ... - , � . .., . -, , "' , - Zl�f- , - e.� �- - . .. . �. ......."11111, �-iz.J,r, ., .;." . 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T � 4,"i 1�•� ti_ > � L� fn ♦� 1+�f� S ♦+ 4>i�lyf �t,'7r-:'�� r� ^� v- � hY�' - �/r� ��•at 't&n y j. .•i r i i 6I T r tVs 41 0 �D "�Li" �' `. �° ��� kI �t9i :a � •: tea n`�wiq�txd ��yy//.� yy g�1.aa�a$ax 1 ��yf f ? f1�{ra41t1l, I F I qe k r R s s i. 7 r w Y �•P r` tr4 / +Yr f • t F r�� �'t k� '�' ` e>q, � RZa 14y $:.R i d� d"tf � P a t rt, PJ x 4 W a � r a ,,, � p� �ij { '�1 Z �° 3 +a j•k q 2 Q �n S:^wLy4 �wr r I yg wf 2 R'M.� Y'3d f �. /,•iM 2.! " oo 77,; rtx tii ltt e . i 7 ,�'. '}�'tr+i� � ��4 Y.as'a Y+'ti t �'�k'!' t� � � • a F r N' toy r * � f s $ " rJ�'�ra � k'�`, !-� � f . �yy `t n Y-3 ��w P t iy k's 71 s •.'4 te„t< i+ Y£ h s ;.£ t f t i -� - f �yF `' >5. O CInOF FRIDLEY CIVIC CENTER • 6431 UNIVERSITY AVE. N.E.. FRIDLEY. MINNESOTA 55432 • PHONE (612) 571-3450 February 11, 1985 Mr. John Bogucki Rodney Billman, Inc. 151 Silver Lake Road New Brighton, MN 55112 Re: Verifying Surveys for New House Construction Dear Mr. Bogucki: In checking our files it was doted that we have not received verifying surveys for 445 - 63rd Avenue N.E.,✓475 - 63rd Avenue N.E., and 1472 - 66th Avenue N.E. We would appreciate your getting copies of these surveys into our office as soon as possible. If you have any questions on this matter, please feel free to contact me at 571-3450. Sincerely, DARREL G. CLARK Chief Building Official DGC/mh .4 - w SUBJECT P O• City of Fridley 2 7389 AT THE TOP OF THE TWINS BUILDING PERMIT r I COMMUNITY DEVELOPMENT DIV. r ~ PROTECTIVE INSPECTION SEC. i�%� 1 I l/ / ` NUMBER REV DATE PAGE OF APPROVED BY = I CITY HALL FRIDLEY 55432 ,.j 612-571-3450 910415 8 S JOB ADDRESS IkRix22mi 475 63rd Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 18 1 1 Alice Wall Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Bocucki572-4994 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Century Roofing 6336 L ndal869-5133 90093168 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 O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 21 S 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 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 BO 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 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 $1751 .87 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 F CONSTRUCTION. $56.75 Fire SC 1.75 PLAN CHECK FEE TOTAL E Lice S 5.0 .37 SIGNATURE OF ONTRACTOR OR AUTHORIZED AGENT IDA I N OP BLjrG INSP Y,4fALIDATfDffHIS IS Y R PERMIT )ATE �� SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) NEW ~ [ ] ` Effective 1/l/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATIONS a6 ConstructionAddress: Legal Description: Owner Name & Address:ArJA L 14 7S Tel. # Sj 2, e Contractor: MN LICENSE # �� � 65 Address: Tel. # ttach 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�—;T' I WidthHgt/Ground Sq. Ft. OTHER: / �% / e �✓�s Construction Type:. o , + Estimated Cost: $ 1'7S-1 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: &01MAPPLICA9wa Tel. # EA1.1133 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: S CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 [ ] FRIDOF CEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287 May 17, 1999 John Bogucki 475 63ro Ave. NE Fridley, MN 55432 Re: Final inspection at 475 63 d Ave. NE Contractor: Marsh Heating & Air Conditioning Dear Mr. Bogucki: A mechanical permit was issued on May 29, 1998 for the property located at 475 63'd Ave. NE for a new furnace and air conditioner. According to Section 305(a) of the 1991 Uniform Mechanical Code a final inspection shall be performed on the mechanical permit. As of this date no inspection has been called for. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, we will expire the permit and any inspections on this installation will require a new permit. Any questions can be addressed to myself at (612) 572-3603. Sincerely, `tom. Bary esch Building Inspector CITY OF FRIDLEY INSPECTION DIVISION 6431 University Ave NE Fridley, MN 55432 APPUCA71ON FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Effective On January 1, 1998 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved By _/ Vim/ Rough—In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE 4 %-5- JOB ADDRESS RATE SCHEDULE 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 $30-00 representations stated in this application are true and correct. (Side Vent — Fill Out Back) '� f Z q ,1998 Gas Piping (Needed with new furnace) $10.00 $ `o . a OWNER 4- C ARis o ii a c1<—'-' Gas Range $10.00 $ BUILDING USED AS Gas Dryer $10.00 $ a � ESTIMATED COST # gdlot) . 0(3 PERMIT NO. % <�? *Air Conditioning — All Sizes $ 25.00 $ Z5<o-4 DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK 1% of Value of Appliance or Work $25,00 No. of Heating Units Circle One (Steam) (Hot Water) arm Trade Name -PW& Size No._-TUY0 V3 rO Commercial/Industrial BTU 80, 00 HP EDR 1.25°/a of Value of Appliance or Work $ FuelTotal Connected Load 4 z, ®®j 6rzf State Surcharge $$50 Burner Trade Name Size No. BTU HP EDR TOTAL FEE d SO HEATING COMPANY�� MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed ByRTei No. or_)&la7 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved By _/ Vim/ Rough—In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE CHDINEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes (%) No ( ) 2. Is free from rust or deterioration 3. Has no foreign objects lodged within 4. Is securely supported 5. Meets all current Code requirements for size and total BTU's connected 6 f Has total heating BTU's of Yes (x) No ( ) Yes(*) No ( ) Yes (X) No ( ) Yes (as) No ( ) All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No (x) 8. Has combustion air been provided for water heater Yes () No ( ) Remarks:a,4a �J.odoiC J� T bdd F Al-eew s° Plc &,-/ List ALTERATIONS Being Done: 5T#11 JD -4 A HEATING CO: Signed By: Date: FA a% a A { HOUSE HEATIUC TL::'1' WLLUKU 2, r ADDRESS L 3 405 N 1* APT. FLOOR CITYFA 104blums OCCUPANT_ �Tot4,.� HEAT LOSS_ DATE I1TC . INST. SOLA BYE /71 /—) INSTALLED BY YI) 1-4 ------------- ciCcLrlca.L Work IIy ajQ/-)R Cas Linc By. Pn s-1-1 TYPE OF HEAT: CA Fit x 11W STEAM ShCE IITR. UNIT IITR.• OTNER CAS DESIGN CONVERSION r-J;KE TP/a :-� MAKE OF BURNER �r o 3 o r_,0C) )j o Model _ Serial AJ 11 4 'Al P Max. BTU Rating INPUT ( Opp r o 0 I-!AKE OF FURNACE model CONTROLS Tit ERHO [cat Plug Vent Size v� Valva W KIND OF LINER SIZE NONE Limit Draft Hood Rcl;ulator Limit Setting 0- Filters; Size -,,?o x,2 > Number I _ o • Fan Setting �"c� - /mac;' Chimney Location: 'Inside h Outside Pilot Type HZ>Z'-" 5 F_rK_Q_ Chimney Construction PyG, • Pilot Make Pilot Model Smoke Bomb Wiring Yllot Timing ;?- S -- Draft Test Tal, L.ii.• Cut Off' Door Pressure LightinE Inst. Prcasurc/-Co -3.5'Pcrccnt CO2 7 Date Tested (.P110f79 _ Input CF}l Z00,yo✓Percent 0, Company Tcntinr Stack Temp. cl 7 Percent CO 0 Name of Tester w -A CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: .- - NO. RATE TOTAL - New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 TOTAL FEE $20.-50 JOB ADDRESS _'?$XIE I -s duir.3 r✓ 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 BOGUCKI, JOHN/J� 200-0 475 63RD AVENUE NORTHEAST FRIDLEY, MN 55432 (763)572-9554 Building Used Asi��1�% c� Estimated Cost PERMIT NO. PLUMBING COMPANY Or= Z,UI'✓lly�i �� SIGNED BY TEL N0. ,7" O '�'- W - - Approved B Rough -In Date Final Date 43 `Q�) COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE rl Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: -3604 763-572q,00-05- CITY OF FRIDLEY Date Rec'd: L/ DATE , 0 0 - O 5- YOUR E-MAIL ADDRESS I�F•�� crcC� ([��(1 � �i1'S - CCJYYI I _ SITE ADDRESS CO3 �t�a _ ASZ • I HIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: TENANT ADDRESS: CITY STATE ZIP PHONE.1 U 3 •��a • r.� S� — CONTRACTOR NAME:— The Home Depot A.H.S. Inc. SUBMIT A COPY OF STATE LIC 3200 Cobb Galleria Pkwy. YOUR STATE LICENSE ADDRESS: Atlanta, GA 30339 CITY STATE ZIP WITH APPLICATION PHONE 763-542-8826 0 SINGLE License #20268257 PROPERTY TYPE _ . oRZEs PERMIT TYPE ❑'ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMM[ING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MA ITENANCEMEPAIR ❑ REMODELING DESCRIBE WORK BEING DO 3IZE OF IMPROVEMENT LENGTH WIDTH HEIG S . 200FING ❑ HOUSE ONLY JUMBER OF SQUARES 0 HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 3ARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 'ROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan 'ROPOSED HEIGHT: 3. List of structural members to be used '>IDING FOR NEW CONSTRUCTION INCLUDING DECKS, 7 Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: 3 Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures 3 Other ❑ Fascia and proposed project, V114DOWS 2. Two sets of construction plans N EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations >R FOR NEW OPENINGS -DESCRIBE SIZE OF >PENING CHANGES & 'YPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION INCLUDING THE COST OF LABOR AND MATERIALS• TOTAL JOB 'ermit Fee 'Ian Review surcharge 'ire Surcharge .icense Surcharge AC Charge :urb Cut Escrow :rosion Control ark Fee ewer Main Charge btal Due (USING THE 1997 U.B.0 FEE SCHEDULE) .TION $ 1 B 1 S+ a ® OCCUPANCY TYPE 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 ( ) $ CX Make checks vavable to: Citv of FridIev 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 )nformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a :rmit but only an appli on for ape t and work is not to start vtiithout a permit; that the work will be in accordance with the approved .an in the case of all wo which req it s review and. approval of plans. 1/ GNATURE OF