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PRE 2010 DOCSSUBJECT„.,, �v• --.,y_ City of Fridley 1p ® 18714 AT THE TOP OF THE TWINS BUILDING P E R M I T RtDEIRI NO. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r PROTECTIVE L CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY •.-.�/'--,,� j, 612-571-3450 910-F15 10/20/86 10B ADDRESS 1358 - 66th Avenue N.E. 1 LEGAL LOT N�Out�lotA, CK TRACT OR ADDITION SEE ATTACHED DESCR. Pt. Dennis dition, W. 75' of L. 14, Rev. A.S. #10, SHEET 2 PROPERTY It DR S ZIP PHONE Beth Dahlmeir 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Brickner Builders Inc, 6199 Heather Place N.E. Fridley 574-9871 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 ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 51.51 x 29..331 Dwelling and a 22.33' x 22,51 Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide sod in the front and side yards. Provide City with copy of verifying survey before capping. Provide a hard surface driveway. Record R.L.S. prior to closing on house. SAC credit from House moved out of City. Paid $1500.00 park fee.. 1 Sewer and 1 Water Service available to Lot 14 -• Plus one wye only. SEWER LOCATION (1) 79' W. of Manhole (Inv. 875.85) Approx. 14' Deep in Street (:2) Wye Only - 311 West of Manhole WATER LOCATION (1) 68' West of Manhole Use Oldh� qa=,fpr West House -- East lot use new services Before digging call local ulili°iell TELEPHONE -ELECTRIC - GAS Etc, SEPARATE PERMITS REOOIR_�b MR REQUIRED BY LAW WIRING, HEATING; PLUFIVIONNG AND SIGN 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 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FORA 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 7S,4SO $39.23 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $ DOES NOT PRESU TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS Y OTHER STAT OR LOCAL LAW REGULATING CON- $340.00 Credit from Old Hou I STRUCT E PERFORMA OF C NSTRUCTION. ° PLAN CHECK FEE TOTALFEE �d ” 2 Z - $ 85.00 $464.23 -F Park Fee NATURE OF CO A R Au HOR12ED AGENT IDATEI WHEN PROPERLY V IDATED THIS IS YOUR PERMIT do 0 BLDG INSP SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI ATE NEW [ ADDI; . [ ] ALTER. [ ] Construction Address: Legal Description: Owner Name i Contractor City of Fridley �R-1 AND R-2 Building Permit Application r - Effective 4/1/8i Tel. Tel. 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 Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: �_ Side Yard Setback Corner Lot [ ] Inside Lot [] Ft. Yd. Setback Type of Construction: Estimated Cost: nt `� ADDrox. Completion Date: Alt. A Alt P Proposed Driveway Width If New Opening Is Desired: $ See Back Page for Explanation o _ ,y- �� . Com._ DATE: ,APPLIAPPLICANT:Tel . 2,t CITY USE ONLY Permit Fee S A0•� Fee Schedule on Reverse Side Plan Check s+� - 25% of Building Permit Fee State Surcharge $ " '• 'a3 $•50/$1,000 Valuation SAC Charge �►'f $475 per SAC Unit Park Fee d ' S� U oMFee Determined by Engineering Sewer Main Charge • �`�• Agreement Necessary [ ] Not Necessary [ J TOTAL STIPULATIONS: A a k _ W, . RONALD c LNIE1 ER LA_YD SLRVEYOR 1r.Ho 5unvMNO 'SUSCIVISIOH DtsiaH TcLcr►+onc 771-4586 i obs Jtiilt Sr. Sr. PAUL. MItVH. 55101 I hereby certify that this survey was prepared by me and that I am a duly Regis•areo Land Surveyor under the laws of the Stcta of Minnesota. i- Reg. No. 9051 Date: October 12, 1986 TN � yF r N EVVt 7 ; O1 M 7SnOFtw n p3S0d0=1d nl Jr%Pn n i s- �%QGr. If �A JI � L Scales 1"=40' o Indicates iron monument placed outlot A, Bennis Addition, Anoka County, Minnesota, excepting therefrom the East 337.5 feet and excepting therefrom the West 41?.5 feet. also The Wast 75 feet of Lot Fourteen, Revised Auditor's Subdivision No.'10. also That part of Lot Six, Revised Auditor's Subdivision No. 10, described as :ollowss Commencing at a point 467.5 feet East of the Southwest corner of said Lot Sixt thence North parallel with the West bounr:ary line of said Lo;; Six, 124.5 feet to the point of beginning= thence continuing North on last said course 15.75 feeti thence East parallel with the South boundary line 'of said Lot Six, 75 feet: thence South parallel with the West boundary line of .;a -id Lot Six, 15.75 fecti thence West parallel with the South boundary line of sold Lot Six to the point of beginning. - Also know- as Proposed Tract A, Registered Lend Survey No. • �;, w i -P � / A4rg7w yVgiZ-&aZ-(�- fio �ervl c I -e Z --O7- /7 . P0s Oaf (1)-2 9 ' W e)l-- /ly. h(_ /fox, C�&,kl 31 4�9 Ts — CI) If Int/, ®r_ p1w `1 r� I C. Ac.r icy-tc -13b �1 .w� FLAu'r UmF It1i�r�� S4y.1 O SX 1 �s.'be �► r SIS x l38� r� 8? Sr = 129 X ��,3? _ 57, Sq). $l 2'rn = %4 8,4)e 12.11 z 164911.6? wit 4 So, o' (i qLZ � . Uc,_ _ �� y�2.1 �• Ll p I _amu s . a� _ --- -- 117 Yzl� -47 la• = • O 91I -- Ll I } 6' r�. Y7 - g Ll EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION owN.EP, h D y --r% e - SITE ADDRESS '1�+�u �C� 0.Ve— LEE. -- CONTRACTOR D c.�ch Determine working square footage of each. 1. Total exposed wall area ft. x X17 = • 2. Total roof/ceiling area 13 7 sq. ft. x-r-O�_ S� 70 • Total exposed wall area above floor = a. Total wall window area ..............:........!.. • b. Tctal... - - 6 2 door" -area :......... . . ..................•... c. Total sliding glass door area................... 31'3 do. Tota,1> fireplade wall area .................. ......�,_ e.< Tot. al;.,wall, framing. area (average; 10%) .:......:... 1 f, Totalk unet: wall,.;area, -above -,f loon .:.............'. 1''�j�� I .g.'Total rim joist.area ............................ 17/ • Total exposes foundation area = flu it • ., �'"P� ... .*.. ,��...` • h. Total .�,,. W'.Z�.. �t 'll;:•j Vii_ ? % � _ • foundation window•area...............:'.... i. Total net foundation area above grade..*.. ....... . _ Determine "U•" value of each:.wall segment.' J a.- --I Vk 'q (o x -11U " b 35' = y, 3 !� • b." ..37.- 4c/ X OSU MI . �Ft' _ � � ,- C.1 � .,. •. . .__.._.X a0, 9.��. �. y X .,U„ • f. r i�J+y}j: X. flu it • h. X Stu of a*3k _ LO _.......� .............Total -2- IF iter #3 on previous page is the same as, o: less than -item #1,. Y ou have met the intent of SBC 6006(c)2. Total exposed roof/ceiling area-= -i3,71/ j• notal skylight - k. Total roof/ceiling framing area . • • � • • � ). c� (average 100 96) A. Total net insulated roof/ceiling area.....s,' 9 Determine "U" value for each roof/ceiling segment. ISU I$ _..e.. -k, X 11U B1 4..................................Total If total 0A-44 above is the 'same as or Tess 'than 42 _..-. . _. - m the intent of SBC 6006,(c) 1. You°have met. Alternate Buildin Envelope Design To ,utilize the total envelope system method, the 'value`s established by ,,the sum of items r,#3• and #4 shall not be greater'` than :`tie` sura of ,items #1 a;ld.-,#2. 1 f • -}.2 • +4. _ MY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE .USIDZ%TLAL RATE TOTAL Furnace Shell and Duct Mork, db Burner !Also replacement furnace) S 20.00 $ , Gas Piping $ 10.00 DO (piping needed with now furnace) Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ a Air Conditioning (all sizes) All Others/Repairs and Alterations 11 of Value of Appliance or Mork COMMERCIAL/INDUSTRIAL 11 of Value of Appliance or Mork S 10.00 $ State Surcharge TOTAL !EE Reinspection Fee (515.00) Rough Insp. Date Final Insp. Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS $10.00 PLUS $.50 STATE SURCRARGE S Attach stack verification [ors with replAcrurnt furnace permits •Air Conditioners can not toe placed in %ide yard without written pnrnission frau adtnininq net-11d■.r. ... .-,.VP ..Vy. .. `'1011 Job Address /35 O lW Department of Buildings, 6411 university Ave. N.B.. Fridley. NN 55432 City of Fridley Tel. 11571-34150 The undersigned hereby waked 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. El� Fridl y, Minn. 1 . 1904OWNER �m � � RIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED_ COST c�,2 jlDa, O 01A NEM BUILDING PERMIT NO. PERMIT NO. DESCRIPTION of FUPNACIVII(I 1ER HEATING or PON R PLANTS. Steam. Not Nater, Norm Air- No. Trade Name ®tae No. DC7 A V C);5 Jr 3 IWIZI Capacity OOC) Sq. Ft. CDR _�- BTU H► Total Connected Ioad Rind of Fuel — BURNER - Trade Name Size No. Capacity Sq. Ft. EDP Company Signed By Tel. No. �� L✓ CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT e m PLUMIBING FIXTURE RATES: NO. T w a e o u a K w m Old Opening, New Fixture Water g 1.50 Beer Dispenser S 4.00 Blow Off Basin -.c+ Mm 5.00 Catch Basin $ 5.00 � Heater 5.00 Hydraulic Valve $ 5,00 Susp or Receiving Tank WA $ 5.00 Water Treating Appliance � gup O� 4j to 4 u �_ d 5.00 Gas Range ra u 0 �$ i$ toa9 0" w° a U.u A g 3 • Reinspection Fes State Surcharge iy o s lec FEE 1st 4th (R) - Future Connection Opening Connected with Sewer (') - New Fixture, Old OpeningWater RATE SCHEDULE PLUMIBING FIXTURE RATES: NO. RATE New Fixtures $_5.00 Future Fi:tures $ 3.50 Old Opening, New Fixture g 1.50 Beer Dispenser S 4.00 Blow Off Basin $ 5.00 Catch Basin $ 5.00 Rain Water Leader S 5.00 Hydraulic Valve $ 5,00 Susp or Receiving Tank $ 5.00 Water Treating Appliance $ 7.00 Hot Water Heater �_ $ 5.00 Gas Range $ 10.00 Gas Dryer $ 10.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS It of Value of Fixture or Appliance • Reinspection Fes State Surcharge ($IS.00) TOTAL FEE Ettecttve Aug. 1, lybl Job Address � Department of Buildings City of Fridley Tel. 1571-3450 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, Nn. // -/g . 19� OWNER KIND OF BUILDING 7 / - USED AS -- 2uj TO BE COMPLETED ABOUT 1 -1 -5— - ESTIMATED -/J`— ESTIMATED ODST TOTAL OLD - NEW BUILDING PERMIT NO. PERMIT HD. s�b S 0 Company I '� S Signed By S S �� 8Jr Co Tel. No. S S $ ROUGH INSP. $ Date S �/ $ FINAL INSP. O `� -� 7 S _ 00 Date S $ APPROVAL FOR PERMIT S S C.50 S J /, L, b PLUS HTHEFEE SFOR ATE SURCHARGE PERMIT IS $10.00 Su9jECT PERWTWO _—` City of Fridley 129078 AT THE TOP OF THE TWINS BUILDING PERMIT REOY COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. /�PROTECTIVE NUMBERREV DATE PAGE OF APPROVED BY i ;'j CITY HALL FRIDLEY 55432 ---. L „ 612-571-3450 910415 3/25/99 JOB ADDRESS 1358 66 Avenue NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. See File I SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Beth Dahlmeier 1358 66 Avenue NE 572-2371 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Town & Country f 858-9365 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 20091282 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW 0 ADDITION O ALTERATION REPAIR 0 MOVE O REMOVE x0 8 DESCRIBE WORK Reroof House & Garage 31 S ear -off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. 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 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1.33 $2,656 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHA RGCTION PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- Fire $2.66 STRUCTION OR THE PERFORMANCE OF C NSTRU $74.75 PLAN CHECK FEE TOTAL F E �.5 Lic SC 5.0 83.74 S.GNATURE OF CONTRACTOR OR AUYHdR1ZEO AGENT ObATEi EN PR PE TE PERMIT YR I 4 S-GNATURE OF OWNERoF OWNER BURDM NSP OAT[ Mar -19-99 11:24A NF -.W [ ] P.12 Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION tA ConstructionAddress: f Jed �o x0C'__. k?<E Legid Description: -7e--,v-.r c`EE I. '&- "/FC o -p Owner Name & Address: Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Da';) It'h Pa/ Lr` Tel. #,±Vb? " o2j-%/ MN LICENSE # c2bc) �—� Oa 4-0-1 c b N .lf /I Tel. # �Se' 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 Width Hgt/Ground Sq. Ft. Construction Type: 1?U G Estimated Cost: $, (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: 3JCJ APPLICANT: 61Tel. # 0 ..amb Permit Fee $ 7 Fire Surcharge $ , State Surcharge $ SAC Charge $ License Surcharge $ Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge S. TOTAL $ C�. STIPULATIONS: 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 [ ] Building Inspections 763-572-3604 DA 0 MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS SITE ADDRESS t ~19V THIS APPLICANT IS: ❑ OWNER Ar-ONTRACTOR Permit No.: Received By: !2 Date Rec'd: 01 , I PROPERTY NAME: I sh e' t r OWNER/ ADDRESS: 1 � Sys &(e CI5TATE/—"--1ZIP5W TENANT PHONE: -2&1-51-72-237) CONTRACTOR COMPANY NAME: SUBMIT A COPY OF CONTACT PERSON: M� • ( T .A.• YOUR STATE STATE LICENSE #_ E & DATE LICENSE WITH ADDRESS: 2700 N. CITY STATE ZIP APPLICATION PHONE 8511- FAX PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK 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 fixtures. (This should reflect only the cost of labor ) improvement, installation or replacement of a residential fixture, excluding the 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: UNDICATE TOTAL NUMBER OF EACH BELOW) MFG: io MODEL: �a,�dl SIZE/BTU 3 S + t� Equipmentlnstalled MFG: MODEL: SIZEBTU MFG: MODEL: SIZE/BTU FIREPLACE (GAS) $15.00 GAS RANGFJOVEN $10.00 A/C $25.00 TO AIR EXCHANGEER $15 IRE _FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00 UNIT HTR 510.00 _AIR BOILER _CHIMNEY LINER $10.00 _FURNACE $35.00 _GAS GAS DRYER $10.00 POOL HEATER $35.00 —VENTII.ATOR $15.00 DUCT WORK $10.00 ZGAS PIPING $1000 Ya ��1��.�C�.�. : ._ . ".a��;,i�.4. L8r�i�.pc!„vvrtm�Y'. �".??sn �ccnw aN.•.ea-z . ., :..,-.--..,R.,... _,_..._,__ Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ 50 Number of fixtures @ $15.00 1 x $15.00 = $ 1 "L . Q TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $50 Total = $gI - : CQ 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 wor which requires review and approval of plans./g �� SIGNATURE OF APPLICANT PRINT NAME IC �J r �r : t �jj r DATE ' City of Fridley Building Inspections Department . 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEWIEXISTING HOMES maw's e $* • **a* ewMit 1. Combustion Air (See note below) a. Oil or solid fuel TMC Chapter 7 with MNL. 9 b. Natural Gas or Propan&UGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting - 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 1MC 1346.0603.2 a. ACOA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations Building Inspections 763-572-3604 DATE__L' L -' Q SITE ADDRESS THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERNM TYPE TYPE OF WORK: MECHANICAL Permit No.:� RESIDENTIAL APPLICATION Received By: CITY OF FRIDLEY °'AU YOUR DD' • �� .lig `.. �t,�1� ❑ OWNER GeONTRACTOR CONTACT PERSON: STATE LICENSE # EXP DATE r�1t�Ififi�Lr'> [0] FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE ❑ NEW 0 -REPLACEMENT ❑ ALTERATION/REMODEL � • i � � r • • � • �i�1)�`_is!i!JI�`�l!��st'!�L��)_��lI.T1��1�� PER MS 16131.665 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) v/ Equipment Installed MFG: e/Z 0 MODEL: SIZEBTU JM MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU _A/C $25.00 _AIR TO AIR EXCHANGEER $15 _BOILER $35.00 _CHIMNEY LINER $10.00 DUCT WORK $10.00 FIREPLACE (GAS) $15.00 _FIREPLACE (WOOD) $35.00 tl !URNACE $35.00 _GAS DRYER $10.00 GAS PIPING $10.00 _GAS RANGE/OVEN $10.00 NEW GAS GRILL $10.00 _GAS UNIT HTR $10.00 _POOL HEATER $35.00 VENTILATOR $15.00 PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ afl=� c 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 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ 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 ofalI work whic4jequires review and approval oMp ans. �} 111j��.��./ AJ lnA A AI 6b C� �_r\1 SIGNATURE OF APPLICANT A PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR BUILDING, ELEC'UMAL AND MECHANICAL WORK J City of Fridley Nli Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Permit No.: OY_u `7 PLUMBINGReceived 7uildiing tions By:2 RESIDENTIAL APPLICATION 220 63-72-3604 CITY OF FRIDLEY kTE/I / l `� y YOUR E-MAIL ADDRESS TE ADDRESS 1354 � -11S APPLICANT IS: ❑ OWNER �CICONTRACTOR PROPERTY NAME: 9✓ S c H u L T/fir-JzlP F/� �'� Les/ STATE OWNER/ ADDRESS: i 3 S d ` iQCITY TENANT PHONE: `� 3 % .3 7 / CONTRACTOR NAME: Terry Overacker Plumbing, Inc STATE LICENSE # 502 E Main St zIP SUBMIT A COPY OF Anoka, MN 55303 YOUR STATE ADDRESS: LICENSE WITH PHONE F APPLICATION 0 SINGLE FAMILY � TWO FAMILY ❑ TOWNHOUSE :pERAUT TYPE EW TYPE OF WORK: DETAILED DESCRIPTION OF WORK 0, whichever is eater, tor Me PER MS 16B.665 the permit fee is a minimum of aresidential fixture excluding the fixture00 or 5% of the total cost up s (Thiisshould reflect only the cost of labor) improvement, installation or replacement Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor __ x .05 = ___ EXCEPTWHERE NOTEDFIXTURES: (INDICATE TOTAL FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.0o PER FIXTURE, . NUMBER OF EACH BELOW) SHOWER — WATER PIPING BATH SINKILAV FLOOR DRAINS — SWIMMING POOL _ WATER SOFTNER ^_BATHTUB _GAS PIPING MW �'UC�`'�) —' WATER CLOSET _BACKFLOW PREV. ( ($1$15) CLOTHES WASHER ,_KITCHEN SINK _WATER HEATER ($35) FOR IRRIGATION —DISHWASHER _LAUNDRY TRAY _ WATER METER _OTHER x $10.00 10.00 Permit Fee $ Number of fixtures @ $ Permit 50 Number of fixtures @ $15.00 x $15.00 = $ TOTSurcAL DUE $ Number of fixtures @ $35.00Sta� Su$ ge _ $=50 Total = $ 3 5��0 THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED that the work will be in I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; conformance with the ordinances and codes of the City of Fridley to startlwithouth the ta permit; that the worConstructionk Codes; be in accordance dance withlthe not a permit but only an application for a permit and work Is approved plan in the case of all work which .requires review and approval of plans SIGNATURE OF APPLICANT y KY 1� �� DATE �/�� PRINT NAME City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 i Btfilding BUILDING Permit N'0, Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Dat 200Q 763-502-4977 FAXd=(l1N EFFECTIVE 1-1-09 �-24 — d Q DATE YOUR E-MAIL ADDRESS SITEADDRESS I3S,? G6d'" Nyt- 't/7 THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME:_( � yy'/�- TENANT ADDRESS: (3 Sf iW ^ .duc CITY FrrJ�� STATE ZIP �43Z PHONE: - S%z" 2-3-2 / CONTRACTOR �-74 �3 NAME: ,(wk,(,r,- Canty-l-,"wx SUBMIT A COPY OF STATE LICENSE # ),04, 3 2171v ? EXP DATE 3 3��9=010 YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS: /58'0D i►7 Sa Nw CITY,4rJov---,— STATE J-WZIPS•S-Vel INSURANCE PHONE GIS. 7417 ?M FAX PROPERTY TYPE 0 SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILYNEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: NGL,J OedC� r SIZE OF IMPROVEMENT 2 LENGTH WIDTH HEIGHT S ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES 13HOUSE & GARAGE BAS)~MENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 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 I . Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE 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: TOTAL JOB VALUATION $ Rr � Ham® U.B.0 FEE SCHEDULE)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 $ q 7, a a-- — See Back Page for Fee Schedule $ /K, ar 65% of Building Permit Fee $ 3,3 .001 times the total job valuation $ .0005 x Permit Valuation Minimum $.50 $ Sr $5.00 (State Licensed Residential Contractors) $ $2000 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$22=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ Make checks savable to: Citv of Fridlev 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 on site; that the work will be in accordance with the approved plan in the case of all + k whic view d approval of plans. q ,�, SIGNATURE OFAPPLICAN %' PRINT NAME d��a l � "°iJ,t./�� DATE -� r I I A 5 s�G vA— A -J7 91 g— --.1, al"S ro 0 z> L Corn OAR qN. 9 w z> L Corn OAR "' RONALD F. MEYER ---� LAND SURVEYOR LAND SURVEYING SUBDIVISION DESIGN TELEPHONE 771.4686 983 Jessie ST. ST. PAUL. MINN. 36101 I hereby certify that this survey was prepared by me and that 1 am a duly Regis red Land Surveyor under the laws of the State of Minnesota. Reg. No. 9051 Date: October 12, 1986 -Fev. /1-3-86 //o. Loc. Co � rW % t .1 -S O Ove/o � 1 T Pr►•� rs .4�/� 1 1 1 � ------- IT 'k(Jv Q10.0kr 4j Scale: 1"J+0' mn o Indicates iron monument placed AN � L .� IG� I Outlot A, Dennis Addition„ Anoka County, Minnesota, excepting therefrom the East 337.5 feet and excepting therefrom the West 417.5 feet. also The West 75 feet of Lot Fourteen, Revised Auditor's Subdivision No. 10. also That part of Lot Six, Revised Auditor's Subdivision No. 10, described as follows: Commencing at a point 467.5 feet East of the Southwest corner of said Lot Six; thence North parallel with the West boundary line of said Lot Six, 124.5 feet to the point of beginning{ thence continuing North on last said course 15.75 feet; thence East parallel with the South boundary line of said Lot Six, 75 feet; thence South parallel with the West boundary line of said Lot Six, 15.75 feet; thence West parallel with the South boundary line of said Lot Six to the point of beginning. Also known as Proposed Tract A, Registered Land Survey No. RONALD F. MEYER`-= LAND SURVEYOR LAND SURVEYING SUBDIVISION DESIGN TELEPMON[ 771.4386 083 JESSIE ST. ST. PAUL. MINN. 55101 I hereby certify that this survey was prepared by me and that I am a duly Regis red Land Surveyor under the laws of the State of Minnesota. Reg. No. 9051 C Date: October 12, 1986 .rev, //-3-86 /%• LOG. 10q 1 ; 1t. ' q0ll�l 0 /7.8 Q 24,2 IN p N I — 10 I o Indicates iron monument placed Outlot A, Dennis Addition, Anoka County, Minnesota, excepting therefrom the East 337.5 feet and excepting therefrom the West 417.5 feet. also The West 75 feet of Lot Fourteen, Revised Auditor's Subdivision No. 10. also That part of Lot Six, Revised Auditor's Subdivision No. 10, described as follows: Commencing at a point 467.5 feet East of the Southwest corner of said Lot Six{ thence North parallel with the West boundary line of said Lot Six, 124.5 feet to the point of beginnings thence continuing North on last said course 15.75 feet; thence East parallel with the South boundary line of said Lot Six, 75 feet; thence South parallel with the West boundary line of said Lot Six, 15.75 feet; thence West parallel with the South boundary line of said Lot Six to the point of beginning. Also known as Proposed Tract A. Registered Land Survey No.