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PRE 2010 DOCS0 VMage ®f Frldey, . BUILDING Pli+.B]Wr ®ice of INSPECTOR OF BURMINGS Fridley, Mnn., /� / LOCATION OF BUILDING Street_ LP __,,-Part of Block 'J— Addition or Sub -Division Front_ Dip h ' Di3eight. Storied Manner of Construction To be used as To be completed ^'?. stimated Cost ` b r Permit is hereby gaated the building described in the above statement. This permit is upon the express condition that thep son to whom it is granted, and his agents, employees and workmen. the work done in, around and upon id building, or any part thereof, shall conform in all respects to th nances of Fridley, 1 lm., regarding the construction, alteration, maintenance, repair and moving of b within the city limi -A and this permit may be revoked at any time upon violation of any of the provisions ordinances. 1 a ,_'* inspector of Bu 1' AGREEMENT AND SWORN STATEMENT In consideration of the issue and delivery to rne by the Inspector of Buildings of l the above permit, I herebv agree to do the prof?oser1 work in accordance with the d above set forth d according to the provisions -of the ordinances of Fridley, and, beim sworn, I hereby tate and say that the facts stated by me and contained in the above I true as therein sated. Subscribed an1,! sworn to before ffie at Fridley, Mil�xles tom; thi day of a.- =; A.D. 19 ^"' .� II SUBJECT P City of Fridley 12769 AT THE TOP OF THE TWINS BUILDING PERMIT ECEIPT NO • COMMUNITY DEVELOPMENT DIV. INSPECTION '"7,3 rPROTECTIVE SEC. 1 � � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612 -NO -3450 910-F15 10/18/74 JOB ADDRESS 357 - 66th. Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 2 1 Rice Creek Terrace Plat 2 SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE Teresa Benner 357 - 66th Avenue N.E., Fridley 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Mr Siding Inc. 10800 Xavis Street N.W. Coon Rapids 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 9 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside Dwelling and attached garage 9 CHANGE OF USE FROM TO STIPULATIONS Caulk butt ends of siding -SEPERAITE 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. Aluminum 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 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. $2/720 1.36 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 PRS OF ANY OTH TE OR LOCAL LAW REGULATING CON- $18.00 NA ST UCTIO OR THE PER O N OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $19.36 SIGNATUREOF O TRACTOR ORAUTHORIZED AGENT (DATE) EN ROPERLY VALIDATEQ S I YOUR PERMIT i SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI BLDG )NSP DATE APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: j e `�'�5 E ��E —BUILDER: ADDRESS : 3 � _ � b � l�� l y►� ADDRESS: 15f Aj, k 7 U 'vim "1c. C 1 CS NO • . Z_'7 STREET: b P y AA . LOT: / ``j BLOCK: 12 ADDITION: �C_6 CSC!. 7� ez A /) % � CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey. of Lot and proposed building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING Front: Depth: Height: Square Feet: Cubic Feet: ro t: Depth: Height: Square Feet; � v Cubic Feet: Type of Construction. ''ll Typ rJ-/b_[,/j 1Altc III Estimated Coat: $ To Be Completed: Z 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. n DATE: Iry". C–� SIGNATURE: (See Reverse Side For Additional Information.) x.00 J SUBJECT PERMIT NO. City of Fridley 23671 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. Ir • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 8/25/95 JOB ADDRESS 357 66 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 2 Rice Creek SHEET Terrace Flat 2 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Scott Barrett 357 66 Avenue NE - 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 x 8 DESCRIBE WORK Construct a 16' x 15'3" Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARNiN�. Before digging call for all utility locations 454.0002 REQUIRED BY LAW, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING. 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 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 $29033 $1.01 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- $74.75 Fire SC $2.02 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE $77.78 SIG T F O a T AUTHORIZED AG T IOATEI WHEN PROPERLY ALIDATED THIS IS YOTR PERMIT Zed_ Si ATURE OWNER0 WNER BU 6ERI IDATEI BLDG INSP V qa E NEW [ ] Effective 8/1/95 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 `} Building Permit Application ! J C Construction Address: 351 � AL)e- �� , _ Legal Description: Owner Name & Address: S Co� 1T Zp! v E /),-4: Tel. # 54a -&99l Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: 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 Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length y Width /51 3 , HgdGround & Sq. Ft. ,��?(g?_ Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $ 1300-00 T Approx. Completion Date: j - l - 91 ®°t �' (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: APPLICANT: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY M] Tel. # $ _ Fee Schedule on Reverse Side $ .001 of Permit Valuation (1/10th%) $ 0 $.50/$1,000 Valuation $ $850 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 [ ] �rict `� 3 1% W MIN 0 nry Wc� MENS WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring Sealing H 135437 County Name Well owner's mailing address 0 different than property owner's address indicated above. WELL AND BORING SEALING RECORD GEOLOGICAL MATERIAL I COLOR HARDNESS OF FROM TO FORMATION If not known. Indicate estimated formation log from nearby well or boring. METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS, OR CASING AND BORE HOLE: X. No Annular Space Exits ❑ Annular space grouted with tremfe pipe ❑ Casing Perforation/Removal In. from to ft. ❑ Perforated ❑ Removed In. from to fL ❑ Perforated ❑ Removed Type of perforator ❑ Other MinnesotaUnique No. Anoka Minnesota Statutes, Chapter 1031 or W -series No. (Leave blank it not known) Township Name Township No. Range No. Section No. Fraction (sm. i Ig.) Date Sealed Date Well or Boring Constructed Fridley 30 24 114 1 % % 14 5-13-98 Numerical Street Address or Fire Number and City off Well or Boring Location 89 ,3`57 66th Ave. NE, Fridley Depth Before Sealing ft. Original Depth ft. Show exact location of well or boring Sketch map of well or boring AQUIFER(S) STATIC WATER LEVEL in section grid with °X° location, showing property X] Single Aquifer ❑ Multiaquifer N livres, roads, and buildings. A, R] Measured ❑ Estimated WELUBORING W MIN In. from to ft. ❑ Yes ® No ❑ Yes ❑ No ❑ Unknown in. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown in. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown MENS Property owner's mailing address if different than well location address indicated above. Same NEEM OBSTRUCTIONS 4M RodstDrop Pipe ❑ Check Valve(s) ❑ Debris ❑ Fill ❑ No Obstruction Type of Obstructions (Describe) 1"At 3/413d . p . — 2 pipe jet Obstructions removed? ® Yes ❑ No Describe MEN Well owner's mailing address 0 different than property owner's address indicated above. ,'1 Water Supply Weil ❑ Monit. Well . w.�.. 37 ❑ Env. Bore Hole ❑ Other ft. [9 below ❑ above land surface EYu}.�,�..., CASINGTYPE(S) T+ ;K3 Steel ❑ Plastic ❑ Tile ❑ Other 16 mile x CASING Diameter Depth Set in oversize hole? Annualar space initially grouted? S J'85 I r rule I In. from to ft. ❑ Yes ® No ❑ Yes ❑ No ❑ Unknown in. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown in. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown PROPERTY OWNER'S NAME Annette Barrett Property owner's mailing address if different than well location address indicated above. Same SCREEWOPEN HOLE Screen from 85, to 89 ft. Open Hole from to ft. OBSTRUCTIONS 4M RodstDrop Pipe ❑ Check Valve(s) ❑ Debris ❑ Fill ❑ No Obstruction Type of Obstructions (Describe) 1"At 3/413d . p . — 2 pipe jet Obstructions removed? ® Yes ❑ No Describe WELL OWNER'S NAME Well owner's mailing address 0 different than property owner's address indicated above. PUMP Type Universal DW ,et A] Removed ❑ Not Present ❑ Other GEOLOGICAL MATERIAL I COLOR HARDNESS OF FROM TO FORMATION If not known. Indicate estimated formation log from nearby well or boring. METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS, OR CASING AND BORE HOLE: X. No Annular Space Exits ❑ Annular space grouted with tremfe pipe ❑ Casing Perforation/Removal In. from to ft. ❑ Perforated ❑ Removed In. from to fL ❑ Perforated ❑ Removed Type of perforator ❑ Other GROUTING MATERIAL(S)) Grouting Material Nt Cmt from 6 to 89 ft. yards 3 bags from to ft. yards bags from to fL yards bags from to ft. yards bags REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING OTHER WELLS AND BORINGS Other unsealed and unused well or boring on property? ❑ Yes X] No How many? LICENSED OR REGISTERED CONTRACTOR CERTIFICATION This well or boring was sealed in accordance with Minnesota Rules, Chapter 4725. The information contained In this report Is true to the best of my knowledge. —11=k Well Co. Inc. 02658 dor ne ND/R�� License or Registration No. o�� /� 5-14-98 Autharliak Representative Signature Date Ran Danielson LOCAL COPY JH; 135437 Name of Person Sealing Well or Boring HE -01434-M 2197 R A009-Cill`1 - 4EW [ j CITY OF FRIDLEY %DDN [ j 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp 4LTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: Legal Description: ��lf) Gf(-33(- /30 Owner Name & Address: /�^'S� fir¢ '��(<< Tel. # -7(o- ��f �3 �3 Contractor. 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 DECK AREA: Len Width Hgt/Ground Sq. Ft OTHER: � c �) e�� E��II Construction Type: �.��v� ��'"� Estimated Cost: $ W/1e C-) Driveway Curb Cut Width Needed: Ft + 6 - Ft x $ _ $ 6 DATE: l 0 S APPLICANT: Tel. # Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1450 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 [ ] TOTAL $ 13- 'i S✓ STIPULATIONS: e) I jj Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received $y:� 763-572-3604 CITY OF FRIDLEY Date Rec'd: Z, t� G DATE YOUR E-MAIL ADDRESS L� SITE ADDRESS S 7 THIS APPLICANT IS: ❑ OWNER ONTRACTOR PROPERTY OWNER/ NAME: qaALt0hAJ44 -) ADDRESSn CITY STAT�ZIP��3� TENANT f PHONE: ! b 3" .? 7 1" 7 3 73 CONTRACTOR NAME: STATE LICENSE # ,EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY TA` ZIP 55:014f WITH APPLICATION PHONE 6 l 6 FAX % 5 t`� Q PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORI S PERMITTYPE ❑ ADDITION ❑ GARAGEISHED OWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION YJ ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: LJ SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Ft. ROOFING ❑ HOUSE ONLY --Sq. NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES , ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used 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 IN EXISTING OPENINGS es ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS- SCRIBE 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: �" TOAL JOB VAL• UATION $INj '1j�1 G THE 1997 UQ .(fE 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) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work ich re . es eview d approval of plans. Q SIGNATURE OF APPLICANT PRINT NAMD� (, 8 So ATE_b P (�Q —O L From: 952 255 8292 Page: 1/9 Date: 6/11/2009 4:37:07 PM Building BUILDING (USING THE 1997 U.B.0 FEE SCHEDULE) lFPermitNo.• Inspection$ RESIDENTIAL APPLICATION Received By: 763-572-3604 3 ,a See Back Page for Fee Schedule Plan Review $ �qfol 65% of Building Permit Fee Fire Surcharge — $ CITY OF FRIDLEY Date Rec'd: 763-502-49FAX S $ , .0005 Y Permit Valuation Minimum S.50 License Surcharge — $ ,r $5.00 (State Licensed Residential Contractors) SAC Charge $ EFFECTIVE L1 -o9 Curb Cut Escrow $ y77 DATE l YOUR E-MAIL ADDRESS &L AL SITE ADDRESS Y �� Park Fee THIS APPLICANT IS. O OWNER CONTRACTOR $ PROPERTY OWNER/ NAME: • �, (p Make checks savable to: Citv of Fridlev Attach StinnlatinnV TENANT ADDRESS: STATE ZIP PHONE: CONTRACTOR NAME: D 11 Wxma:z, SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRES5:_A%�CX Ia%g� ' �J ` ff Ml^ CITY W4%Wd STATEA6&�IP INSURANCE, PIIONE t FAX PROPERTY TYPE 1EAMII CONSTRUCTION SIZE D TWO FAMIL r/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH O ROOF D DRAIN 11LE ❑ DECK O SIDING O OTHER O SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCEIREPAIR GbfiEMODELING DESCRIBE WORK BEING DONE: + AxIdInIA I� SIZE OF tMPROVEMENT LENGTH " WIDTH t HEIGHT el1 S FT 6 ROOFING NUMBER OF SQUARES O HOUSE ONLY D HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES .. ❑ ATTACHED GARAGE 2. Propose floor plan PROPOSED SIZE:'' O DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: _ SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl CISoft ADDITIONS. & PORCHES SUBMIT: ❑ Alumioum O Trym 1. Site PIWSurvey showing the eyristing structures ❑ Other _h_ O Fascia and ofd 2, sets prDjczL conrciion plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ONo LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF f ALSOV W;40jV pot p441 OPENING CHANGES & I TYPE OF WINDOW TO BE INSTALLED I NUMBER OF WINDOWS ALL r Gr -a ARE BAIL' U ON VALUATiOIN2 INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATIONS & - Ov OCCUPANCY TYPE Permit Fee 3 ,a See Back Page for Fee Schedule Plan Review $ �qfol 65% of Building Permit Fee Fire Surcharge — $ 001 times the total job valuation Surcharge _ $ S $ , .0005 Y Permit Valuation Minimum S.50 License Surcharge — $ ,r $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 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 — $ �, (p Make checks savable to: Citv of Fridlev Attach StinnlatinnV THIS IS AN APPLICATION FORA PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building Ilermit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordin d codes of the City of Fridley and with the Minnesota Construction Codes; that 1 understand this is not a permit but only an applicat' n a permit and work is not to start without a permit on site; that the work will be in accordance with the approved pian in the case o 11 rk which requires review and approval of plans. _ SIGNATURE OF APPLICANT PRINT NAMEIV DATL• I From: 952 255 8292 a- 4. 4 LV 06 a:z,gs:5 Page: 7/9 Date: 6111/2009 4:37:09 PM �Iu-_ 7R�V_C� 71-411 t - ar_-_ IZAIIIIIIIII1�4 I eC 2640 rr 2-9.6'M dropped 11I vinyl flooring 1. C) 6 7/16, 12"A2" poured in place concrete pier footing 2468 CM LO existing wall J�; vinyl flooring M w3f4!'subfloor 00 (0 n 1/4' underlayment _7 Co BATH 6 x 5 • CL CL , 7: - ly existing wall= -7---' 7- e .77— xisting wa 7. CD co, . -existing hardwood'.. . dust wall, no access otectfloor existinwall existing wall g PROPOSED RENOVATION. W912009 -_ FLOOR PLAN 1/411=11-011 H U From: g52255 8292 Page: 8/9 Date: OU1C200S4:3710PM � � -— -- � — --� '---' ------ ----- ------- -----' ----'— ----' ------ —— | ~ , _—'-- '---- existing jog in foundation From: 952 255 8292 Page: 9/9 Date: 6/1112009 4:37:10 PM nmvilborabove ...7 -BEARING LINE IN BASEMENT existing Insulation In attic H a mar, nachartges r iffiN UM i. 2x header over window, please note '-...thiswl3 bearnorooficad Marvin inteo*.y casement Whdow"b _.exhaust fan and ligh' . combo --new2x4vallconvenflonalfirishes Miec tub, sprox exact same rough in toication, will move laterally sprox 4" . inches 14N pWy vapor barrier app ied to inside face of exposed exterior well surfaces (44 w.r.b. applied to all exposed exterior wall shewhina new 2x6 wwall shids; IWOA Jemove suolboras needed and replace vAh now I r3.14 t & gaps rated subf oor '11•irwlated ft and floor cavity complete • ..318-grvain Mtedplywood covering fidaid!o?rn under exposed floor V ridgicifoam under exposed floor —4car wtv 6 '.0 7 - cast in place con c. pier footing *42" AM 61912009 Building PLUMBING Permit No.: X39 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY ateu%:ITC��l 763-502-4977 FAX PVFPCrrvp,_,9_na SITE ADDRESS W1W �,/7'y y i THIS APPLICANT IS: ❑ OWNER lYCONTRAC OWNER/ TENANT SUBMIT A COPY OF STATE LICENSE YOUR STATE LICENSE, BOND AND STATE BOND _� CERTIFICATE OF �k ADDRESS: INSURANCE -s?`1 PHONE PERMIT TYPE SINGLE FAMILY TYPE OF WORK: I ❑ NEW DETAILED DESCRIPTION OF WORK O TWO FANMY XREPLACEMENT EXP DATE-� EXP DATE S CITY STA _ FAX 0 TOWNHOUSE FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT W HERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MNIMUhl FEE $35.50. BATH SINK/LAV DRAINS WATER PIPING BATHTUB _FLOOR GAS PIPING (NEED CITY LIC) —SHOWER SWIMMING POOL WATER SOFTNER ($35) CLOTHES WASHER _ KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($15) DISHWASHER _ LAUNDRY TRAY ATER HEATER ($35) FOR IRRIGATION WATER METER _ OTHER THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 1 wor wh' h requires review and approval of plans. _ f% SIGNATURE OF APPLICANT PRINT NAM -5# rM # 14 010 DATE 6 4J�/� 1 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-5022-4977 -. ^_ .. ,, ......_ .--- -- .. — INd 17V9Z6 600Z/ZZ/9:91e0� �6%4 it'd LbZLSLZOZ£ out Building MECHANICAL Permit N°•= Inspections RESIDENTIAL, APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Dat & JU 763-502-4977 FAX EFFECTIVE 2-19-09 {{ DATE �/ / . i YOUR E-MAIL ADDRESS -JJ%9 CPA SITE ADDRESS –a;) % eGy `'" ..ylZ'� ► I MODEL: SIZE/BTU MFG; THIS APPLICANT IS: ❑ OWNER ACONTRACTOR MODEL: SIZEBTU _A/C $25.00 PROPERTY NA]M& GY $ _FIREPLACE (WOOD) $35.00 `NEW GAS GRILL $10.00 BOILER $35.00 OWNERI ADDRESS: +7 H(MNEY LINER $10.00 -X 1 DUCT WORK 910.00 CITY _GAS POOL HEATER $35.00 ZVENTILATOR $15.00 STA'' TENANT PHONE: CONTRACTOR COMPANY NAME; SUBMIT A COPY OF CONTACT PERSON: Q i YOUR STATE STATE LICENSE q f73—/M EXP DATE d LICENSE WITH ADDRESS:.;n9a I WS- d. CITY SQL STA APPLICATION % " A-7 PHONE' L� y.�i (�� I AX e0_2rA PERMIT TYPE SINGLE FAMILY O TWO FAMILY ❑ TOWNHOUSE O NEW ❑ REPLACEMENT ALTERATION/REMODEL TYPE OF WORK: DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZE/BTU MFG; MODEL: SIZE/BTU MFG: MODEL: SIZEBTU _A/C $25.00 ,_„_FIREPLACE (GAS) $15.00 —GAS RANGFJOVEN $10.00 —AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 `NEW GAS GRILL $10.00 BOILER $35.00 $35.00 UNIT HTR $10.00 H(MNEY LINER $10.00 -X 1 DUCT WORK 910.00 _FURNACE GAS DRYER $10.00 GAS PIPING $10.00 _GAS POOL HEATER $35.00 ZVENTILATOR $15.00 THIS 1S AN APPLICATION FOR A PBRMrr-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 ofork lch ui review and approval of plans. J SIGNATURE OF APPLICANT:5!rZk A PRINT NAME .r�"a1 �J� DATE2/�! ) tO� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3644 FAX: 763-502-4977 UVd M:6Z:9 60OZ/Z/L :elea £!6 GBBd � LVZLSLi:OZ£ :wo�� 0 From: 3202751247 �.. Pa1/1 _ .Date: 7/1/2009 2:23:15 PM ` , Building ECHANICAL Pem"trle" M Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604Date Rec` d: 1 763-502-4977 FAX CITX OF FRIDLEX RRRRC'rrV'R 7_19_M SITE ADDRESS — THIS APPLICANT IS PROPERTY OWNER/ TENANT SUBMIT A COPY OF YOURSTATE LICENSE WITH APPLICATION YOUR &MAIL ADDRESS i ,v,.O, E3 OWNER ADDRESS: '/ Gsl��ro /` �d/i CITY PHONE: COMPANYNAME: CONTACT PERSON: STATELICENSE# r%✓'- BXPDATE_ PHONE FAX PERMIT TYPE KSINIGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE. TYPE OF WORK: 0 NEW ❑ REPLACEMENT 4LTERATIONIREMODEL DETAILED DESCRIPTION OF WORK r,� A& FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL DUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZE13TU MFG: MODEL: SIZFJ3TU MFG: MODEL: SIzEfsTU A1C $25.00 FIREPLACE (GAS) $15.00 OAS RANGE10VEN $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 CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00 -7nr it wnit a tin nn GAS PIPING $10.00 _ _ VENTILATOR $15.00 r - - THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I wknowledge that the information above is complete and accurate; that the work 'hill 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 a] ork ich quit review and approval of plans- IfDA1E SIGNATLR£ OF APPLICA PRINT NAME City of Fridley Building Inspections Department 6431 University Avenue NE, Fridtey, MN 55432 763-572-3604 FAX: 763-502-4977