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PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT is Date: — Nov. 24, 1967 0 Owner: S. E. Templ in Builder Address 6 L84 Stinson Blvd Address Same Same LOCATION OF BUILDING N° 9564 No. 33 _ Street — 66'x, Way N. E. ---- Part of Lot Lot 8 __ Block 3 __ Addition or Sub -Division -Edgewater Gardens Corner Lot _ ____ Inside Lot x Setback 35 _ Sideyard _ _ 12' Sewer Elevation ___ _ _ 837.00 _ 840.00 Top of Footing DESCRIPTION OF BUILDING To be Used as: Dwelling Front _.._ 24' Depth 38 ' Height _ 20' Sq. Ft. 912 Cu. Ft. 18340 Garage. -- Front 25'4"Depth 22' Height —1-01 Sq. Ft, ----550 Cu, Ft 5550 Type of Construction Frame Est. Cost _ $18,000 ___ To be Completed _ SEWER LOCATION - 10' East of Manhole WATER LOCATION - 1' West of Manhole In consideration of the issuance to me of a permit to construct the boding described above, I agree to do acid the proposed work in accordance with the description above set forth in compli with all provisions of ordinances of the city of Fridley._ J $100.00 Sewer Connection Charge In consideration of the payment of a fee of $ 36.00 , permit is hereby granted to S. E. Templin 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 F dley, Minnesota reghin the city limitsinances. 7� Building NOTICE: This permit does not cover the construction, iest %Mon for wiring, plumbing, gas heating, sewer or water. Be nn to no the Building Inspector for separate permits for then hems. 1 I APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME L G /� _ BUILDER ADDRESS ADDRESS C�jD '�/�� %1/`C , LOCATION OF BUILDING NO. STREET PART OF LOT LOT BLOCK ADDITION OR SUBDIVISION011, CORNER LOT INSIDE LOT74—SETBACK 3-V1 SIDE -YARD P/ / l SEWER ELEVATION _R 9 �. D d FOUNDATION ELEVATION S 7 Q sy Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be us s: / Front Depth Height � Sq. Ft.� Cu. Ft.` /93 7/O Front ZDepthfHeight / Sq. Ft. �.� Cu. Ft. .5'-50 Q Type of Construction — tz Estimated Cost To be completedr 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. �-� SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). 1oc) C G Application for Power Plants and Heating. Cooling, Ventilation. Refrigeraand Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... 5.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 80,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations --up to $500.00 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ................. 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL Dept. of Bldgs. Phone SII 4-7470 Location 33 - 66t Way N.E. City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn_ 19 6 Owner Templin Constr. coo. Kind of Building frame Used as d To be completed about Estimated Cost, $ 970.00 Old ew. Building Permit No. I �(p Permit No.� DESCRIPTION OF WORK HEATING or POWER PI ANTS team, Hot Water, Warm Air—NO 1 Trade Name A'F'C 0 Size No AFB —100—B Capacity Sq. Ft. E.D.R 100M BTU H.P. Total Connected Load 48 o 277 Kind of Fuel Nat . GaS BURNER — Trade Name A C 0 Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signed Mill City Heating Company 4 z Business Phone No 544-1501 Y 658 a a ` > L� 11�� /Vi HEAT LOSS CALCiJLATIONS DEP RTMENT OFINSPECTION Infiltration�+ Weatherstrips A.S.H.V.F.Construction Guide No. Infiltration Insulation s ( Glass Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied e o 04Z 11 0 19_ Net cap. wall J-011Net F1.� % / oom I Length /idth Height Fl. /8 Room I Length _�—Width X ;-_-freight Windows and rs—Crackage and Area Windows an ours -trackage and Area width Height N o Da of No. oL Ltneal tt. Area 116 a of crac sq. L Ceiling ✓ V 7-PCeiling WIdt6 Halg No of Llaeal ft. Aces No. of etae ota WN12t■ � et crack sa_ tt. NO Infiltration Glass Up. wall 4L� MU Infiltration�+ .13421 Infiltration Glass Glass a 00 Exp, wall -- N X 04Z 11 Exp. wall —ze Net cap. wall J-011Net exp. wall Int. wall Int. wall Ceiling ✓ V 7-PCeiling Floor Floor Total Btu. Tota tu. Required q ft. D.R. or sq. ins. W.A ader area Require . h. E. . or sq. ins. W.A. loader area Fl.1 m Length Width Height FI.I Ban m I Length Windows and Doors -- ge and Area No. Width Height No. of Lineal L Area I Windows and Doors—Crackage and Area Width Height No. of an of panp No. of Lineal ft. Area lights of cra 0 sq. _r 124L No. of p s of ae lights of a aq. t ^ 11071 .44! Btu Infiltration Infiltration Glass Glass Eap. wall Exp. wall Ox x Net exp. wall tzNet exp. wall Int. wall Ceiling f_ Int. wall Ceiling Floor To Dor Total Btu. Requ sq. t. r sq. ins. WALvider areaMOK RequireAeq. 1h EW or sq. itis. W.A. Leader area Fl gth •�dth Height �Length Windows and ®Dors—Crackage and Area WHans /dth Height No. of Lineal It. Area I Win ws and Doors—Crackage and Area No. �f of oaaoe Width Mel.ht M.- .r NO Infiltration Glass Up. wall 4L� MU • Dig . ae®os .,( R/ ��(f ~ �,//� ®�/9� &-e HEAT LOSS CA=I.ATIO DEPARTMENT OF INSPECTION MI Weatherstrips A Construction No. k Insplation _ Guide Windows and Doors—Crackage and Area 1 sReference Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied LojCfYe No 19— Fl. r IMoom I Length „Width Height Room Lengtheight Win ows and Doors—Crackage and Area xjIFI.1 Windows and Doors—Crackage a d Area �Vldth Hctlght No. a of No. of Lineal ft. Area I�hte of crack eq. ft. Width Height No. of Lineal it. Area No. M.. of nane Ila6te � of emelt sa. tt. Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor To Btu. Windows and wldth No. ot_naneF Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor / Total Btu. Require . ft. E Fl. A Windows and I Width I H No. of -Da" of Infiltration Glass Exp. wail 4f Net exp. waU Int. wall Ceiling Floor or sq. ins. W.A. ad im I Length —Crackage and Area or sq. ins. W.A. 1pad Im I Length �dld —Crackeae and Area area area Total Btu. Required sq. ft. E.D.R. w sq. ins. W.A. Leader area Infiltration Glass 01 i Exp. wall �� oo Net exp. wall Int. wall Ceiling For 11 Total Btu. Required sq. ft. E.M. or sq. ins. W.A. der area oom I Length 49L Width Windows and Doors—Crackage and Area Width Height No. of Llneai tt. Area No. ofnane o1 Daae 11 his of oraclr, Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor s Total Btu. . k Required sq. ft. E.D.R. or sq. iris. W.A. Leader area F1.1 Room I Length Width ight Windows and Doors—Crackage and Area Width Height No. of Lineal it. Area No. of cane of Dane Ilehte e[ crack sa. tt Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area Btu City of Fridley Application for Plumbing and Gas Ruing Permit Dept. of Bldgs. Phone 560-3450 + DESCRIPTION OF WORK r i , Number, Kind and Location of Fixtures Location �1 1, PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $2.00 (/� Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ............................ x $3.25 $ a9 C O P N WATER HTR. GAS ELEG Base 1 $ GAS FITTING FEES: J 1st 3 Fixtures ...... ................... 1 $ .L Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ 1st f 2nd 3rd 4th _ • Future Connection Openings New Fixture, Old Openings I Connected with Sewer � Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $2.00 $—/X Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ............................ x $3.25 $ Water Heater (Up to 99,000 BTU) ...... x $3.00 $. New Ground Run Old Bldg. ............ x $3.25 $ Electric Water Heater a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ...... ................... x $2.00 $ .L Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ...............................................$ TOTAL FEE $ 1 U, City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn V 19 � Owner Kind of Building) Used as To be completed about Estimated Cost, $ Old—New. Building Permit No Permit No. Signe r By �. Bss Phone No :2`f �%� i 2 17 ROUGH Z-191-6 FINAL 42 City of Fridley, Minn.. BUILDING PERMIT Date: August 25, 1970 Owner: _ JohniMayer Builder _same Address 33 _663 - Way N . E . Address Gam' LOCATION OF BUILDING No. 33 Street _ 6 i Way N.E. . , — Part of Lot Lot _____8 --- Block 3 Addition or Sub -Division _ Edgewater GardPrG Corner Lot ---- Inside Lot.— X Setback —_ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING N 0803 To be Used as: Screen Porch Front _ _12Depth 16 Height 20' Sq. Ft 192' Cu, Ft, 3840' Front Depth _ _ Height Sq. Ft. Cu. Ft. Type of Construction Slab &Screen Est. Cost _ 2,000,00 _ To be Completed Aug. 1. 1971 Provide 3'6" Frost Footings , fig" Z� qS'(o �/ In consideration of the issuance to me of a gc::..nit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $---Q,-00 , permit is hereby granted to John Mayer, to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair andmoving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinanoes. a Inspector IM CLARENCE BELISLE NOTICE: This permh don not cover the couftction, huWWon hr wiring, phnnbieg, on heating, sewer or water. Be cure to see the Building Inspector for separate pernilts for these Itemm e 0 s APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME:_' �✓1 %�b�<Vc'l� BUILDER: �� e ADDRESS:�� ADDRESS: NO: STREET: 6 .(� Z—CORLOT: 6� BLOCK: ADDITION:- LIZ— CORNER NER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front:_ /.Z Depth: /6 Height: '20 Square Feet: r`�2 Cubic Feet: � J_ _'Z(_1 Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: Estimated Cost: _$ To Be Completed: / /I '7� The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stitict 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: SIGNATURE: _4 S C (See Reverse Side For Additional Informatitdn.) d 01 City of Fridley Application for Plumbing and G= i=nking Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number. Kind and Location of Fixtures 67 I C li Y z c� C Z 88 u.c Z �_ S Ci 5kx Z3 9.1 w o �o� ? z �U' O • F • N WATER HTR. GAS ELEC. Base 1st 2nd 3rd 4th • Future Connection Openings I * New Fixture. Old Openings I II Connected with Sewer ❑ Cesspool ❑ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin .... . .................... Water Heater (Up to 99,000 BTU) ...... New Ground Run Old Bldg . ............ Electric Water Heater GAS FITTING FEES: 1st 3 Fixtures ...... .................. x $2.00 $ x $1.50 $ x $1.50 $ x $3.25 $ x $3.00 $ x $3.25 $ a $2.00 $ NO. RATE TOTAL 1 x $2.00 $-2.00 Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ install (1) gas grill 3.00 REPAIRS & ALTERATIONS—Refer to Code 53-84-5915.51 Location John J. Mayer 33 NE. 661�5 Way City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn Sept. 30, 1970 19— Owner John F. Mayer° Kind of Building frame Used as residence To be completed about Oct. 5, 1970 Estimated Cost, $ 10.00 Older New. Building Pe No Perm �02/ o By ." Business Phone No ROUGH FINAL --L Description .......... .....................................$ TOTAL FEE $ 5.00 az SUBJECT City of Fridley 32498 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIP t �: -'--- _ COMMUNITY DEVELOPMENT DIV. j I � PROTECTIVE INSPECTION SEC. /8 i NUMBER REV DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55432 612-571-3450 910-F15 4/11/02 JOB ADDRESS 33 66 1/2 Way NE I LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 8 3 Edgewater Gardens SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dave Allen 33 66 1/2 Way NE 763-754-7433 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Standard Water Control 5337 Lakeland Ave N, Crystal, MN 55429 763-537-4849 1522 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 Ck ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install drain tile 9 CHANGE OF USE FROM TO STIPULATIONS We `r e dor T® rod �omoowoor 7.0 p®�r 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 1 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 @ $2,900 $1.45 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- $83.25 Fire SC $2.90 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOT L FEE Licen Sc $5.0 92.60 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHE PROpqL/VALIDAjqb THIS IS YOU PERMI/TT B G INSP - QATE V S-GNATURE OF OWNER .6 OWNER BUILOER� IDATEI FROM : FAX NO. : 7635371BB2 Apr. 10 2002 12:28PM P2 NEW (] CITY OF FRIDLEY Effective 1/1/2002 ADDN (j 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER (i SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address:. Tel. Contractor: �r2/Zn MN LICENSE # �. Address 11PAd 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: Length Width Hgt/Ground Sq. Ft OTHER: Construction Type:%�G�'�!2 �, �/p Estimated Cost: Driveway Curb Cut Width Needed: Ft. + 5 Ft Ft x $ = S DATE: / /� OcAPPLICAIVT: Tel. #�o �rPy,9 Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-671-1287 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 CITY USE ONLY - $ e'3.�S Fee Schedule on Reverse Side $ , 16 .001 of Permit Valuation (1/10th%) $.---�$.50/$1,000 Valuation $ $1200 per SAC Unit $ • �" $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. T" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ j Not Necessary [ TOTAL S F.7.49 0 STIPULATIONS: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 ►63) 572-3604 FAX: (763) 571-1287 ADDRESS 33 66 1/2 WAY NE PIN 153024140010 LEGAL DESC EDGEWATER GARDENS LOT 8 BLOCK 3 PERMIT TYPE BUILDING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION VALUATION : $ 1,075.00 PERMIT NO.: 2004-02026 DATE ISSUED: 11/03/2004 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. EXPAND DINING ROOM. APPLICANT BUILDING PERMIT FEE 41.80 TIM JUNKERT PLAN CHECK FEE 27.17 33 66 1/2 WAY NE FIRE SURCHARGE 1.08 FRIDLEY, MN 55432 STATE SURCHARGE, OTHER 0.53 TOTAL 70.58 PAID WITH CHECK # 2002 OWNER TIM JUNKERT 33 66 1/2 WAY NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law construction or the performance of construction. Applicant I Date V Bldg SEPARATE PERMITS REOUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. fl NEW [) CITY OF FRIDLEN ,9, Effective 4/1/2004 ADDN (] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bid g In ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1?87 F x �i BUILDING PERMIT APPLICATION 85770 Construction Address: � _ LA I A PL Legal Description: 'Ci6�l Til. # %(�.3-71-�i2-� Z Owner Name & Address: 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: GARAGE AREA: DECK AREA: OTHER: Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width o, Hgt/GQ�round Sq. Ft I.AA &V..c ' ,fiv IV' N.r 1P1PeJ- iA Construction Type: Estimated Cost: $ PQ/ ,,50 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 3 O 0 APPLICANT. Tel. #-5 7t -1? Zj Z— 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 $ _ F7 Fire Surcharge $ State Surcharge $_ a �53 SAC Charge $ License Surcharge $ Curb Cut Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $.m M STIPULATIONS: Fee Schedule on Reverse Side l 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 per SAC Unit $5. )0 (State Licensed Residential Contractors) 5 Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: Building $ BUILDING Permit No.: d W7 - 6087S- 0875Inspections Inspections $ RESIDENTIAL APPLICATION Received By: 763-572=3604 $ CITY OF FRIDLEY Dattfeq)d l DATE' – YOUR E-MAIL ADDRESS t STIE ADDRESS 33- & V NG $ THIS APPLICANT IS: -OWNER ❑CONTRACTOR Sewer Main Charge PROPERTY OWNER/ NAME: t{+►�l ldt�lKQ��' $ TENANT ADDRESS: 35-0-0,12- wcty {v L CITY eN STATIC ,5SY,3L — PHONE: '763o -5-7(-919 Z CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: CITY STATE ZIP WTTH APPLICATION PHONE FAX PROPERTY TYPEJS-SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: c t iia 4.1-5 SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ 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 I. Site Plan/Survey showing the existing structures ❑ Other . ❑ Fascia and proposed project VV94DOWS 2. Two sets of construction plans IN EXISTING OPENINGS AYes ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF Wes' ' 50,-44N OPENING CHANGES & e 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 $ 5, aG— _ CZ7 OCCUPANCY TYPE Permit Fee $ Plan Review $ Fire Surcharge $ Surcharge $_ 1 . U0 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) $1675 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 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 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 chre ' e revie d approval of plans. SIGNATURE OF APPLICANT 104 PRINT NAME (dtil .J(.t✓tKQ%� DATE6–/– -:� S- (047 ( Building BUILDING Permit Fee Permit No.*, -U( 3 Inspections Plan Review RESIDENTIAL APPLICATION 65% of Building Permit Fee Received By: 763-572-3604 .001 times the total job valuation CITY OF FRIDLEY $ Date Rec'd: 763-502-4977 FAX $ " p $5.00 (State Licensed Residential Contractors) SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination) EFFECTIVE 8-19-099j $ ft + 6 ft = ft x $22 = $ DATE- 0 �y YOUR E-MAIL ADDRESS oo � Q'i2 SITE ADDRESS 33 , (06 ,va lax 5 Fee Determined by Engineering THIS APPLICANT IS: ❑ OWNER )(CONTRACTOR Agreement necessary ( ) Non Necessary ( ) PROPERTY OWNER/ NAME: Alf. JIu+, k -e r } Make checks payable to: City of Fridlev Attach Stipulations TENANT ADDRESS:S!¢ML` CITY STATE ZIP' PHONE43 57t/ 9.21.2 CONTRACTOR NAME: Mfvwesi 960A S' % ,/ Ctf/ Ot,.rs SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE #J20010,2 i? EXP DATE 0 AND CERTIFICATE OF ADDRESS: (p%$ Cg,r,,P..a C,� . fU CITY �%td�6 Cave STATEM/V ZIP 536 q INSURANCE PHONE ,27 ('o FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH XROOF ❑ DRAIN TILE ❑ DECK SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION XMAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: ""W 110u. SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ,� L/ �' �� HOUSE & GARAGE BASEMENT 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: IDING FOR NEW CONSTRUCTION INCLUDING DECKS, )KVinyI 4s-' ❑Soffit ADDITIONS. & PORCHES SUBMIT• ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other -1 ❑ Fascia s and proposed project. 2. Two WINDOWS I sets of construction plans 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U -VALUE AND OR FOR NEW OPENINGS -DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. 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) I v It AJU JUD V AJ.UA I WIN a OCCUPANCY TYPE Permit Fee $ 157,�, .25- See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ -7. 6 .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ " p $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 $22 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ .-J/+ Make checks payable to: City of Fridlev 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 on site; that the work will be in accordance with the approved plan in the case of al,14qrk which requires review and approval of plans. / Q SIGNATURE OF APPLICANT �[ PRINT NAME�%`�/�C� L. �Qot DATE 0