PRE 2010 DOCS0 City oFridley, Fiidley, Minn.n..
BUILDING PERMIT N° 4 4 31
Date:_
4...10 __...___..__...-------....................
Owner: .....-. Builder ....._ ........................---....._... - .... ........ ..... ....... ...... ......... _.._......
p.. .. ....._ .._... -.... _ -
Address .1T .. .._...._.. -...._ _.z. - Address
!i
LOCATION OF BUILDING
No..� .. Street ..... -.'�
....... . _...................................... Part of Lot ....._......_...................................... ..... __....
Lot .' ...<�............... Block .......... 14 ............................... Ad 'tion or Sub-Divisipn
Corner Lot ..... . ........... ....... _........ Inside Lot ....�.__...... Setback......��............ .............. Sideyard ../.. .....o.:
Sewer Elevation ..........
Y-3 f -------- -------------- _------------------•- ------.......... Foundation Elevation ... .. o
DESCRIPTION OF BUILDING
r/1�T,,,o, bbee�U as: , yy yy
----- _------._ .-......... t . --yy _.. Depth .!W Height .1... (�....... Sq. Ft.. ®s7 Cu: )F301 1.7�/00
................................. Front.st`-....... Depth 4._..Height . Sq. Ft. .��..... Cu. .....-.................
Type of Construction ........ Est. Cost./.... .........._.._.. To be Completed ..... . ...........................................
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance all provisions of
ordinances of the city of Fridley. X,('/ ��i(9—�/
In consideration of the payment of a fee of $.... ..---- permit is hereby granted to ..... ............. _............. _...................... ...
.... ___.......... ............................................ .... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation any of the provisions of said
ordinances. ll 17A s
Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
4
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
(763) 572-3604, FAX (763) 571-1287
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On Jan 1, 2003
PLUMBING FIXTURE RATES:
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`"
NO. RATE
Gas Range" _
Gas Dryer"' _
Back Flow Preventer Required ( )Yes () No
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
Type $15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
TOTAL JOB ADDRESS /'0
State Surcharge $ .50
TOTAL FEE $. '�_O. Sb
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.
�.� 200?
Owner (�v
Building Used As bu"o
Estimated Cost PERMIT NO.
PLUMBING COMPANY
SIGNED BY
Approved By Rough -In Date Final Date
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00
PLUS THE $.50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
WhentP^r" an xic ing f irk anne, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions, No
and is securely supported and firestopped where required. Yes () ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes () No ( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan Yes () No ( )
assisted and natural draft appliances.
The pxistipo�,„meoistinn air is sized and installed to meet the current codes
and manufacturer's specifications.
Yes No
() ( )
When required to 1n.ratall a new cnmblistinn air_it will be sized and installed
Yes No
to meet the current codes and manufacturers specifications. ()
When in arri a now ventinn system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace No
Venting Tables for fan assisted and natural draft appliances. Yes () ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented Yes( )No(
)
separately as per current codes.
Appliance #1 Type
BTU Input
BTU Input
_ Fan Assisted or Nat
Fan Assisted or Nat
Appliance #2 Type
Appliance #3 Type
BTU Input
Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height
Diameter inches
Appliance #1 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #2 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #3 Vent Connector Height
ft Length
ft Diameter in Type
HEATING CO:
Signed By: Date
Building
$ �,
BUILDING
Plan Review
Permit No.: c -k7- 0
Inspections
Fire Surcharge
RESIDENTIAL APPLICATION
Received By:
763-572=3604
$
CITY OF FRIDLEY
Da M'� -EP &: fO 6 7
3ATE 1 �4 a'1
YOUR E-MAIL ADDRESS
SAC Charge
>ITE ADDRESS
$1675 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
THIS APPLICANT IS:
❑ OWNER M&NTRACTOR
Erosion Control
PROPERTY OWNER/
NAME %
Park Fee
TENANT
ADDRESS: nia
CITY PN. d I { V STATE,&4IP_CT
$
PHONE: 't t. 3 16 S (a
Total Due (')C21
CONTRACTOR
NAME: S e SAJ
C,•'n v ate+
SUBMIT A COPY OF
STATE LICENSE # d tM I EXP DATE
YOUR STATE LICENSE
ADDRESS: l 2, %144 44 Z 301``
S 4. CITY—aAW4--STAT0*IP—Stft6 I
WITH APPLICATION
PHONE O FAX
PROPERTY TYPE
❑ SINGLE FAMILYNEW CONSTRUCTION
SIZE
W7`W0 FAMILYNEW CONSTRUCTION
STORIES
PERMIT TYPE
❑ ADDMON ❑ GARAGE/SHED
❑ WINDOWS
❑ BASEMENT FINISH RMOOF
❑ DRAIN TILE
❑ DECK ❑ SIDING
❑ OTHER
❑ SWARMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MANTENANCE/REPAIR GW&MODEL.ING
DESCRIBE WORK BEING DONE:_Qs. p
SIZE OF IMPROVEMENT LENGTH 1
WIDTH l HEIGHT Sq. Ft.
ROOFING
WrHOUSE ONLY
NUMBER OF SQU
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES -
❑ ATTACHED GARAGE
1. Existing Floor Plan
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1. Site Plan/Survey, showing the existing structures
❑ Other
❑ Fascia
and proposed project
WINDOWS
2. Two sets of construction plans
Yes No LOCATION OF WINDOWS
IN EXISTING OPENINGS ❑❑
3. Energy Calculations
OR FOR NEW OPENINGS-DESCRBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF•WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION S OCCUPANCY TYPE
Permit Fee
$ �,
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$ , ��
.001 times the total job valuation
Surcharge
$
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
SAC Charge
$
$1675 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow
$
ft + 6 ft = ft x $21 =$
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due (')C21
$
Make checks payable to: City of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work whick requires r viewd approval of plans. t J
SIGNATURE OF APPLICANT PRINT NAME 5C.0ti
Tl &t. i NC r DATE q) Z G I 1
48arting
the Standard
November 20, 2007
Attention: Allen Hoffer
Hoffers Homes
P.O. Box 32052, Fridley
Anoka, MN
55432
Dear Mr. Hoffer,
This letter will confirm that if IKO asphalt shingles are applied at the eave such that they
are flush with the edge of the outer drip edge, the IKO asphalt shingle limited warranty will
remain in full effect. Plea*e ensure that the shingles are applied according to the
remainder of IKO's recommended application instructions and local building code
requirements.
Please contact me if you require additional information.
Yours truly,
Debra Arscott
Technical Support Coordinator
IKO Industries Ltd.
IKO Industries Ltd. manufactures and sells waterproofinWwatersheddmg materials. IKO does not practice architecture or engineering. Therefore, the
design responsibility remains with the architect or consultant. We hope the information given here will be of some assistance_ It is based upon data
considered to be fire and accurate and is o" solely for the user's consideration, investigation and verification. Nothing contained herein is
representative of a warranty or guarantee fqr which IKO Industries can be held legally responsible. IKO does not assume any responsibility for any
misrepresentation or assumptions the readeF may formulate.