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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N? s 2 5 l Date: /' w 3a___'--6- 2-.- Om—&.Aoer:---- �_ Builder Address N _ DING F@# of Lot of Lot r___ Block � Addition or Sub -Division � -- -- -�` Corner Lot _ Inside Lot .— Setback - j — Sideyard J, Sewer Elevation ____ Foundation Elevation DESCRIPTION OF BUILDING To Used Front__ pepth Height 10 Sq. Ft. Ca. Ft. ate" Front Inz Depth Height Sq. Ft. Cu. Ft. Type of CLruction Est. Costwa""""_"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 with 21 provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $'iq�- , 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, constr%tilon, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon viola of any of the provisionsof said ordinance& .0-N ,IPA Building Inspector NOTICE: Ibis penult don not cover the condrucHoe, hoft9 ion for urin& phnobing, ass heatbkg, sewer or wafer. Be core to ae the Building Inspeefor for separate peeatis for thea hoom APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S ITAIM BUILDER Z -1t2 -C":' ADDRESS ADDRESS 3 2--7 I C4L�,--1 LOCATION OF BUILD No. / % ,= - _ - _ Street �--� G Part of Lot Lot / Block y Addition or Subdivision -e,_.� 2— Corner Lot Z--1 Inside Lot Setback 3 �`— Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: Front. Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction 1- Estimated Cost To be Completed 7-- /_ 6 3 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 4ad--,correct. DATE 0 /LI / 6 y StC:NATiTRE (Scbsdule of Fee Costs can be found on the Reverse Side). Application for Power Plants and Heating, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... 8.00 $ 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. 60,000 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 $ cr� GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $T� 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 SU 4-7470 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. _on Fridley, ll?inn Owner _ Kind of Used as To be co Estimated Cost, $ / Old—.Q. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Name—�� i`a�ilif Size No d O Capacity. Sq. Ft. E.D..R/ BTU H.P. Total Connected Load 3-1 Kind of Fue BURNER — Trade Nam r Size No Capacity Sq. Ft. E.D.R l/ BTU H.P. SUBURBAN HEATING & SHEET METAL 8419 CENTER D,,7Iy;_ N E Signe MINNEAPOLIS 21 By 2M Business Phone No '�✓'- (REMARKS-OVER) Compliments of North Central Public Service Co., HEAT LOSS CALCULATIONS DEPARTMENT OF BZEDINGS VILLAGE Weatherstrips A.SILV.E. Construction No. Insulation Guide Doors lop—NO I .�No � �� - I I W� I=Ceiling�I / I w ®Applied / FL ®a Room I Lenxtlyh !,0 Width / )t Height P/ 11 / Fl. Room Length /,_% Wiwi Ate/ Height Fl Windows add Doors—Crackage and Area, ol No. Width Height No. of of pane of pane lights Lineal 'Area of crack sq. ft. Area sq. ft. Width of panje Coef. Btu Tnflitratlon 0 L 7— _ O' 10 Exp. wall , ra Coef. Btu Infllti atiorx .;ar'd 74 Coef. Glans Exp. wall Ceiling Coef. Net exp. wall ff Floor Exp. wall Int. wall Total Btu. Btu Ceiling G O 0 Floor IL Glass Total Btu. ILP3 Required sq. E.D.R. or sq. ins. W.A. Leader area y F l TM mei All ` Pira( ' rn I ipnoth // 9 Whit lf% / Hpisrht GV1 Windowsand Doors—Crac ga a and Area. ol Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. I No. of lights Nl Area sq. ft. Width of panje Coef. Btu Tnflitratlon 0 Glace"" Exp. wall Net exp. Well i0 .;ar'd Int. Wall Coef. Btu Ceiling Coef. Btu Floor Exp. wall Total Btu. Btu Required sq. ft. E.D.R, or sq. ins. W.A. Leader area / M. m I Length /Z% Width? /O/Height-0/ Windows andDoors—Crackage and Area ol Weight Of No. of pane Bane I No. of lights Lineal ft. of crack Area sq. ft. Width of panje Height No. oP of pane lights Lineal ft. of crack Area sq. ft 16 Z Coef. Btu Infiltration ! Glass Coef. Btu p Exp. wall Coef. Btu Net exp. wan Net exp. wall 1/671 Int. wall �► Int. Wall Glass 4 .. Ceiling Exp. wall Fl.Room I Lengthy idth /Height / Windows Floor Net exp. wall Int. wall and A7&q. Total Btu. Ceiling Floor Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage a d Area and Area _ No. Width of panje Height No. oP of pane lights Lineal ft. of crack Area sq. ft 16 Z Coef. Btu Infiltration Q Coef. Btu Infiltration Net exp. wall 1/671 Int. wall �► 5 Glass 4 .. Total Btu. 1 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Exp. wall Fl.Room I Lengthy idth /Height / Windows and Net exp. wall Int. wall and A7&q. Ceiling Floor . 01 Width of pane Height of pane Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1./ Room I Length% / Width/1drHeightk0 Windows and Doors—Crackage and Area _ No. Width of pane Height of pane No. of lights Lineal ft. Area of ppck sq. ft.. �1 Coef. Btu Infiltration Q y. Glass Exp. wall Net exp. wall 1/671 Int. wall 17ZV Ceiling Floor 4 .. Total Btu. 1 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 722 Fl.Room I Lengthy idth /Height / Windows and Doors—Crackage and A7&q. No. Width of pane Height of pane No. of lights Lineal ft.ea of crack ft. Coef. Btu Infiltration 0 Glass 0- fZ1 Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1 �� Ci f Fridley tY o Application for Plumbing and Gas Fdring Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Dation �3 /C �'PZZ PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... .............. x $1.50 $ . Z U - Future Fixture Opening ................ x 1.20 $Z New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x Water Heater (Up to 200,000 BTU) ...... x New Ground Run Old Bldg. ............ x 3.25 $ 2.00 $ 0 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ `S Additional Fixtures .................... / x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description................................................$ TOTAL FEE % 4; ' 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 Owner L� Kind of Building Used as To be completed about Estimated Cost, $ Ol New ding Permit No Permit o. 6 AL3 Signed j BY-4iZ4 Business Phone No ROUGH FINAL d2 '2M pp�CUN' r N WATER HTR. GAS ELEc 0 999 0 F v7 Base 1st 2nd 3rd 4th • Future Connection Openings Connected with New Fixture, Old Openings I Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... .............. x $1.50 $ . Z U - Future Fixture Opening ................ x 1.20 $Z New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x Water Heater (Up to 200,000 BTU) ...... x New Ground Run Old Bldg. ............ x 3.25 $ 2.00 $ 0 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ `S Additional Fixtures .................... / x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description................................................$ TOTAL FEE % 4; ' 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 Owner L� Kind of Building Used as To be completed about Estimated Cost, $ Ol New ding Permit No Permit o. 6 AL3 Signed j BY-4iZ4 Business Phone No ROUGH FINAL d2 '2M City of Fridley, Minn. N° 8627 • BUILDING PERMIT Date: DECEMBER N 10, 1965 Owner: BLAINE CONSTRUCTION Builder SAME Address 10152 Butternut S t . N. W. Address Coon Rapids, Minnesota LOCATION OF BUILDING No. 936 Street 68th avenue N. E. pmt of Lot Lot 1 _ Block 2 Addition or Sub.Division . Meadowlands, 2nd Addition Corner Lot _ Inside Lot _ _ Setback —_ Sideyard Sewer Elevation _ — — Foundation Elevation • DESCRIPTION OF BUILDING To be Used as: HOUSE Front 42 Depth 24 Height 10 Sq, Ft. 1, 008 CtL Ft. 10, 080 GARAGE Front 14 Depth 22 Height 10 sq, Ft. 30 Cu Ft. 3,0 0 Type of Construction Frame Est. Cost _ _14000 To be Completed REBUILD ON PRESENT BASEMENT & FOOTINGS 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 with aft provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $13.00 , permit is hereby granted to BLAINES CONS'' urwox to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota location, construction, alteration, maintenance, repair and moving of buildings within the city limits permit may be revoked at any time upon violation of any of the provisions of sold ordinances. ALLEN G. JENSEN NOTICE TMs permit don no corer the eomlruadoe, hutaMen for vrWao, plumbing, gas hating, sower or water. Be an to as the Building hispoator for apmto pwmNa for tin" Nuns. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME ✓ i- v��BUILDER ADDRESS/Q %S - �o �TQrL� u �-(t, & *.jADDRESS_ I LOCATION OF BUILDING Street J„ 9- Part of Lot LOT, ADDITION OR SUBDIVISION Corner Lot V Inside LOT Setback Side -Yard SEWER ELEVATION .FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: ® n Y- 2 Front_ a ,? // . Height Sq. Ft. Ct Cl Cu. Ft._ 0/ 0 --��-�- Front_ Depth --2 -7-- Height Sq. Ft . '&4g- Cu. Ft._ , Q Type of Construction - Estimated Cost To be completed Az Is- / 1/4/, 4 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts. and representations stated in this application are true and correct. DAT$ Pea, / ®i SIGNATURE - (Schedule of Fee Costs can be found on the Reverse Side). �� 0 53-84-s-915.51 City of Fridley Appificatim for Pkmbbig and Gas nuc. d 21doL Phom SW -3400 PARTIAL RATE SCHEDULE N%VNMNCE rMum MAYM DESCRnmon or WOR t................:no Oar. Kind and Locaflas of Mft.e N" ... ill -le i a i $3!i 01! ; 1§9 1 Is 9 O 1.7 ® 11 ® s1 61c4 llcC. PARTIAL RATE SCHEDULE N%VNMNCE rMum MAYM we` M= Tarte. t................:no ....®...... SIM s—. N" ... SM S Ca .................... WSW Ra tsr'v® to "AM RM.... : am S 1Vew Cromtd mm ow HES ........ • r I&M & untorWaw .............. a SM S CAB mftam nm&. a&,= Tri. ISE 3 Fbt .................. : IM ............... z 75 S an Rmv M 10.0" m v ..........! : am a scare surcharge $ •so p . .... install Gas Light & Grill -8.00 29rAL M • 8.50 CIM W Surcharge .50d a�� 936 N. E. 68th Ave. City of r sueJEcr PERMIT NO. City of Fridley ®13062 AT THE TOP OF THE TWINS PERMIT S BUILDING RECEIPT NO. � `y ______ COMMUNITY DEVELOPMENT DIV. -1 r PROTECTIVE INSPECTION SEC. f) o CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 812-580-3450 910-F15 6130/75 JOB ADDRESS Leo Allender 936 68th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Meadowlands 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Leo Allender 936 68th A venue N.E. 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. 8 USE OF BUILDING storage shed 7 CLASS OF WORK ZA NEW! ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Wood Frame 12' x 10' storage shed 9 CHANGE OF USE FROM TO STIPULATIONS 1. Must have a permanent foundation �aEo TO S�PERp,1E p�tT� S,GO N�pj1NG• p��y�BING SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. frame THIS PERMIT BECOMES NULL AND VOID IFwoorl WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION 12O 960 OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 'HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAL ATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEDless than 500. .50 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- 5.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $5.50 GNATURE OF CONTRACTOR OR AUTHORIZED A NT IDATEI 000 1? PRO ERLY VA (DATED THIS IS YOUR PERMIT SIGNAT R F OWNER IIF OWNER BUILDER( IDATEI ;EN INSP ATE- + •APPLICATION FOR RESI'DENTIAL., ALTL'ItATION, OR ADDITION•BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNERS NAME: 4112 BUILDER: ADDRESS: �-,� O� C� ADDRESS NO:. STREET: LOT: BLOCK: ADDITION: • I CORNER LOT: INSIDE LOT: SETBACK: SIDE -YARD: Applicant attach to this form Ttao Certificates .-if Survey -of -Lot and .proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: 5. j"17f2,�E Front : l 2, Depth : I ® Height Square Feet: 2 U Cubic.Feet: 9% 0 C —eft Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: Fevs'w & (20-jha^ Estimated Cost:_ $ (ff_cS MQi dt7 To Be Completed: 3 AVAJT 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. DATE: SIGNATURE. - (See Reverse Side For Additional Information.)' S" o i< F Land PIOWiny 075,ql�hWy -ACS A(E. lwdSurveyiy Mimiw#ks 21, Soils Teshhq ENGINEERING, INC. miafw5olu Civil &- Municipal I SlIflot 440" En�irreerin9 Enylneers Surve yors certificate of survey for. JLK3 — INC. LOT I, --,BLOCK -2 except 71*e West &,;eef Meyev? Noper" ZVE4DOWLAND5 2 NO A TION I Anoka ,S c 0 1 ---- -. I ". 30' 41S.A AVE. IVE — A z - D E 'i s �'- Y n P_ n T. /?&V&j Uriffy #W *0 is & hW and WfMCI MPM5W10167 Ora 5w-vey elk bftvmw4es 4r#w 46dar dmay&d 4,4, &d /mAn of4711 b#ld#ys, fianefl, &-daff "Sible mavorhmmIr , if 'my. fn or *7 swof la7d As mrm!rd h d1w re A? --v Q A.D rl&O. SUBURBAN ENGINEERING, INC. ln5;fleers 5ur 5 Ail sueiECTRMIT NO. City of Fridley 2 929 6 AT THE TOP OF THE TWINS BUILDING PERMIT r R NO. �v ____�_ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. 30 r PROTECTIVE f•? CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BV l 612-571-3450 910-F15 4/26/99 JOB ADDRESS 936 68 Avenue NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 Meadowlands 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Garen/Tammy Nitzschke 936 68 Avenue NE 571-0898 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Castle Building & Remodeling Inc 3323 Arthur St NE, Mpls, MN 55418 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 789-8509 5657 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK 0 NEW 0 ADDITION 0 ALTERATION] REPAIR O MOVE 0 REMOVE 8 . DESCRIBE WORK Reroof House & Garage (21 Sq) Tear -off 9 CHANGE OF USE FROM 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 SQ. 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 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 $19799 $.90 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANT# G OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VI L OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF NY OTHER STATE OR LOC REGULATING CON - Fire SC $1 .80 RUCTION RUCTION O E PERFORM E OF CTION PLAN CHECK FEE TOTAL FEE ¢Z5-qaj License SC $5.00 $64.45 GNATURE OF N' FfAC= EDAGENT IDATEI WHEN AL ATED THIS IS YOUR PE..RMIT ePROPERL S-GNATUAE OF OWNER09 OWNER BUILOER, IOATEi Bl0 INSo GATE NEW [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 p BUILDING PERMIT APPLICATION41 '-q oZ ConstructionAddress: Legal Description: Owner Name & Address: 6,,?zF T�r' lW-r,-sch/%S� As gel: # 1" g7/- 08 9'� Contractor: /� �� /��r� .��r//Dr���/r✓C�,. /�L' MN LICENSE # 5-6S 7 Address: & r C/ -r Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height Length Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. -Et. OTHER: Construction Type: Estimated Cost: $ / l (Fee Schedule on Back) .Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ S4 "?S— iii CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1 / 10th %) $.50/$1,000 Valuation $1050 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 [ ] SUBJECT PERMIT NO. City of Fridley 29298 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 i CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 4/26/99 JOB ADDRESS 936 68 Avenue NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 1 Meadowlands 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Garen/Tammy Nitzschke 936 68 Avenue NE 571-0898 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Game 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 B DESCRIBE WORK Construct a 10' x 5' Deck 9 CHANGE OF USE FROM TO STIPULATIONS 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 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 $461 $ .50 DOES NOT PRESUME TO GIVE AUTHORITY T VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE R L AL LAW REGULATING CON- $21.00 Fire SC $.46 CT STRUIO R THE PERFORMAN OF NSTRUCTION PLAN CHECK FEE TOTAL FEE !�• $21.96 SIGN RE FL O suTHORiZEOAGENT iDATEP WHEN PROPERLY AMID TED THIS IS YOU PERMIT ah 9 y814ZINSP fjAiE SIGNATURE OF OVVNEAoF OWNER BUILDER) iDATE, NEW [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �� BUILDING PERMIT APPLICATION ConstructionAddress: -r�4 Legal Description: Owner Name & Address: 7r,-441 NIY A_JZ .S cTel. #�� /Z) ,5- 7/- ©8 9£� Contractor: MN LICENSE # Address: Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF BIPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length /® Width S Hgt/Ground J`' Sq. Ft. ZZ Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: Tel. #,zi eZZL- c89,9 CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ �. °� .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ �i STIPULATIONS: Is su9JEcr P #IT NO: ' ---� City of Fridley 3 5 4 6 AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. w_ r - PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 L J\ 763-571-3450 910-F15 5/22/03 JOB ADDRESS 936 68 Avenue NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. j 2 1 Meadowlands 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tommy Nitzschke 936 68 Avenue NE 763-571-0898 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Wright Construction Inc 27453 Polk St NE Isanti MN 55006 612-867-5407 d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20093310 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK Q ❑ NEW X ADDITION O ALTERATION ❑ REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 20' x 20' Living Area Addition 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARFINMOON SEPARATE PERMITS Before digging call for REQUIRED FOR: allutility5locations WIRING HEATING X54.0002 PLUNIRINd AND SIGNS 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 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 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 $8.61 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $17,212 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- $293.25 Fire SC $17.21 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE ce SC $5.00 $324.07 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI EN PROPERLY VALIDATED THIS IS Y UR PER IT 5 L4 D INSp IIA _ SIGNATURE OF OW NERiiF OWNER BUILDERS IDATEI Is NEW [ ] CITY OF FRIDLEY ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Effective 1/1/2003 (763) 572-3604 Bldg Irtsp (763) 571-12 Fax Legal. Description: Owner Name & ddress: I_ CP'1711nu S C Tel. # Contractor. �' L'� �� MN LICENSE W C -.c-? 00 Address:S SL', c .� 7�r �Y/r� - 5J �J Tel. # 4,1 3 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 22 Width_ Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: -% Construction Type: LL Y-) � /0/ �� Estimated Cost: $ 1 U� o a') Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT: �� Tel. Call (763) 572-3604 for Permit Fees if ailing in application. Fax to 763-5714287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1275 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 $ 3Q4-07 STIPULATIONS_ Land Panni �Q� Mrnniavp�s 2/, SoibTestnl ENGINEERING, INC. Minn�esn/a �CivilbMcnripnl � S!/nselQ-6066 Engineers Sur veyors certificate of su*ve fo:._ RCO INC. T . LO LOCK 2 Pxeppt the we j 20 Leet thereof N CRY H AWL ANDS 2,v° _9 -,P-1Z-l.2A A n e h G, TOO Vt I M Seale: V. 30' .V; ' VL —T U I `l PraposeUi 11 " e ` � 42 J N I w 15.o A ( rn ti 3 I � lJtil�ty 4 prainac�e Ef4semen' -� V } = li Ili rxby `.al�f #bis a ahra and &wtd reprtsado&7 c�'a SWVey qr* dew� q(& adw Asri+'►6ad load aid a, �///''fff1Y�.��'++(a!wlai��Er+►ldy�s,�av,ndd/ris�b/t airroorhinarfs,��'a�,!ra�n ora►�savd �(w�d. As surre�ed GtJ� 1b5 day e tC�ruC1'u A.04". SUBURBAN ENG/NEERING, JNC. En�ine+ers fr .fw• s hy PXUAVJ - 1 tc—CA N N tA) 54- i �xu� ypp6Rti I,o�IER 00op c. I Poop -1 s A>:-PEIz`.{slDk 1�.�-�1lr�.JeLAH• _ L H(S JOB COPY SHALL i TAVAILABLE E JO ON THE - O - _.......... . .._., i SITE FOR THE Fi: V� S�f�50►� Po(ZGI -AND FINAL INSPECTIC i o horizon be a pro e n anffit. 1/'s' to be in roof ar i OAVA j j I (2-) !Q1j$_ (Zr1 ENGINEERED TRUSS DESIGNS AND LAYOUTS SHALL RE MADE - — — 4VAILAOLE ON THE J00 SITE i rOR THE FRAMING INSPECTION zo _ o• - —_--_�__--------.----- H(S JOB COPY SHALL i TAVAILABLE E JO ON THE - O - _.......... . .._., i SITE FOR THE Fi: V� S�f�50►� Po(ZGI -AND FINAL INSPECTIC i o horizon be a pro e n anffit. 1/'s' to be in roof ar i OAVA i , NNNN N. AV I /0 s WA 57 VPV Y 'II• ,,ss 4 oped Afrpevr %rsoIW14yl/ &4waw MIN / PLAN APPROVED • rr-•J' d 1 $U�?FCT T,6 FIELD mak" t Number MECcheck Compliance Report ked By/Date 2000 Minnesota Energy Code MECcheck Software Version 3.3 Release lc Data filename: Untitled TITLE: 4 -season pourch COUNTY: Anoka STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: Single Family DATE: 05/19/03 DATE OF PLANS: 5/15/03 PROJECT INFORMATION: 936 68th. ave. , fridly COMPANY INFORMATION: JOHN WRIGHT CONST. COMPLIANCE: Passes Maximum UA = 108 Your Home = 107 0.9% Better Than Code Value Ceiling 1: Raised or Energy Truss Wall 1: Wood Frame, 16" o.c. Permi Chec Gross Glazing Area or Cavity Cont. or Door Perimeter R -Value R- U -Factor UA 400 38.0 0.0 10 660 19.0 0.0 Proposed and Maximum U -Factor Averages Above -Grade Windows and Glass Doors Includes Foundation Windows > 5.6 ft2 Proposed Maximum Average U -Factor Allowed U -Factor 0.320 0.370 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 2000 Minnesota Energy Code requirements in MECcheck Version 3.3 Release lc and to comply with the mandatory requirements listed in the MECcheck Inspection Checklist. 74� 3 -? I I/ -- 3.,-- G,; Date �/ f(/O 3 Ll a 32 Window 1: Above Grade, Metal Frame with Thermal Break, Double Pane with Low -E 80 0.310 25 Door 1: Glass 40 0.340 14 Crawl 1: Masonry Block with Empty Cells, 6.0' ht/4.0' bg/6.0' insul 360 0.0 10.0 26 Proposed and Maximum U -Factor Averages Above -Grade Windows and Glass Doors Includes Foundation Windows > 5.6 ft2 Proposed Maximum Average U -Factor Allowed U -Factor 0.320 0.370 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 2000 Minnesota Energy Code requirements in MECcheck Version 3.3 Release lc and to comply with the mandatory requirements listed in the MECcheck Inspection Checklist. 74� 3 -? I I/ -- 3.,-- G,; Date �/ f(/O 3 Ll a 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`* Gas Range" NO. RATE TOTAL JOB ADDRESS ` 66%A A L/6 - Gas / - 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 State Surcharge TOTAL FEE l yor9 ' The undersigned hereby makes application for a permit for the work herein i 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. 7— , 20_93 Owner Building Used As Rc-S j � Estimated Cost _52PERMIT NQ �f r T�� PLUMBING CO ANY SIGNED BY l/ ti TEL N0. 7�S'��`Y- 412� Approved By Rough -In Date Final Date $ .50 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 When repla _inn an existing furancn, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) 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 manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The axictin cnmB ,stinn air is sized and installed to meet the current codes and manufacturers specifications. Yes () No ( ) When required to install a new rnmhunfinn airy it will be sized and installed to meet the current codes and manufacturers specifications. Yes () No ( ) When ong ailing new venting nye m, 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 Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( )No( ) Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat 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 : CITY OF FRIDLEY INSPECTION DIV.—�� Effective April 1, 2004 6431 University Ave NE ��� 5 Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT a .n (763) 572-3604, FAX (763) 571-1287 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADD New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas" Gas Range" Gas Dryer"" Back Flow Preventer Required ( )Yes () No Type — G&-(�A,1,jE_ $10.00 The undersigned hereby makes application for a permit for the work herein $10.00 specified agreeing to do all work in strict accordance with the city codes $10.00 and rulings of the Building Division, and hereby declares that all the facts $10.00 and representations stated in this application are true and correct. $10.00 / $10.00 DATE: L c , 206S $10.00 r� $35.00 OWNER $35.00 $35.00 BUILDING USED AS ee S $10.00 $10.00 ESTIMATED COST PERMIT NO. $15.00 PLUMBING COMPANY(?&A l C_� c4� Reinspection Fee $50.00/Hr SIGNED BY ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance Approved By TEL N0. 7� Rough -In Date Final Date State Surcharge $ .50 MINIMUM FEE FO NY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST TOTAL FEE / OF THE IMPROVEMENT WHICHEVER IS GREATER ON WORK LESS THAN $300 COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "*PROVIDE COMMON VENT INFO ON BACK SIDE FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and terminatidn. 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 assisted and natural draft appliances. Yes () No( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer'sr sgecifications. This does include AGA-GAMA Category I Central Fumoce Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) 16 the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type Appliance #2 Type Appliance #3 Type Total Appliances _ BTU Input _ BTU Input _ BTU Input Total Btu Input Common Vent Type Vent Height Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat 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 ALTERATIONS: (Describe) HEATING CO: Signed By: Date : From: 7635020227 Page: 1/2 Date: 2/23/2009 3:53:29 PM Building BUILDING F'e=it Ivo.: Inspections RESIDENTIAL APPLICATION Recei 7'63-572-3904 Plan Review Fire Surcharge $ $ 65% of T3uilding Permit Fee .001 times the total job vaitmOon CI'T'Y OF FRIDLEY Date 1I• rtbz 763-502-4977 FAX License Surcharge �ff5 _ $ .0005 x Permit Valuation Minintum $.50 EFFECTIVE 1-1-09 DATE. YOUR E-MAIL ADDRESS rr!6 yf SITE ADDRESS l THiS APPLICANT IS: © OWNER OCONTRACTOR PROPERTY OWNER/ NAME; TENANT nnnRES$: — �? cam. STA ZiP• T'rosion Control _ PHONE: -h-1-4 CONTRACTOR NAME: Gip p SUBMIT A COPY OF YOUR STATE LICENSE RTATE LiCT; SE N ERP DATE D AND CERTIFICATE OF ADDRESS;_ INSURANCE 'fCtTY STA .S^ PHONE FAX T o C% PROPERTY TYPE ❑ SiNGLE FAMILY/NEW CONSTRUCTION SiZE ❑ TWO FAMTLYlNEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGWSHED ❑WINDOWS ❑ RASEMENT FiNISH ❑ ROOF d DRAiN TiLE ❑ DECK 0 SIDING ❑ OTHER O SWIMMING POOL TYPE OF WORK: ❑ EW HOME CONSTRUCTION ❑ ADDITION MAINTC:NANCE/REPAIR ❑ REMQDTI.-ING Dt SCPJDE WORK BEING DddONE:� ,%IL—^^' P Ort jyy� 11 o?t i&eLim �— SIZE OF IMPROVEMENT V•�� T EL NQTH WIDTH HFrI(iHT SQ PT EaG NUUMMROF SQUARES 13 HOUSE ONLY © HOUSE & CiARAOE BASEMENT RtRVj).DFLT 5U8MIT: O ATTACHED GARAGE PROPOSED SIZE: O DETACHED GARAGE I. Existing Floor Plan 2. Propmed floor plan PROPOSED HEIGHT; 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECK& 0 Vinyl ❑Soffit ADQJ.UQN8. & POR i`C C twlvrrT. U Aluminum Q Trim 1. Site Plan/Survey showing & existing structures M Other ❑ Fascia andro osed P P Pn4cm WXN.IDQM 2. Two seta of construetion plmts I NI N EG OPENINGS OYcs 17No3. LOCATION OF WINDOWS Energy Calculations OR FOR NEW OFENiNCS-DTSCR1i3E SIZE OF OPENING CHANCr,$ & 'rYPE OF WINDOW TO BE INSTALLED NIJMBIiR OF WINDOWS ALL FEES ARE BASED ON vAT TrA iVf4r UDIING THE COST OF LABOR AND MATERIALS: SiNG THE 1997 U -B -C FEE SCHEDULE) TOTAL JOB VALUATTON $ -� OCCUPANCY TYPE Permit Fee $ . Z- See Back Page for Fee Schedule Plan Review Fire Surcharge $ $ 65% of T3uilding Permit Fee .001 times the total job vaitmOon Surcharge $ License Surcharge �ff5 _ $ .0005 x Permit Valuation Minintum $.50 $5.00 (State Licensed Residential Contractors) SAC Charge $ .. $2000 per SAC Unit (Plaits to MWCC for determination) Curb Cut Escrow $ ft + d ft = ft x $21= $ T'rosion Control S $450 Conservation Plan Review ;,ark Fee $ Fee Determined by Engineering ewer' Main Charge $ Agreement necessary ( ) Non Noccssary { ) g'otal Ane $ 15 Make checks payable to: City of Fridlev Arr...k THiS IS AN APPi,ICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and T acknowledge that the information above is complete and aoeumte; that the work will be in conformance with the ordinanecs 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 Iproved plan in the casae :99=2=PRrNTNAMC—&-4--��/!Cr�.,DATB f approval of plans, GNATURE OF APPLICANT %� DAT6 022 — 23 —D Building PLUMBING Permit No. Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY webwa 2010 DATE 4-77-1 YOUR E-MAIL ADDRESS SITE ADDRESS ! g q� o THIS APPLICANT IS: ❑ OWNER IRCONTRACTOR PROPERTY OWNER/ NAME: T&m to I 5 3%+ ADDRESS: SG AQ o CITY STATE_WZIP TENANT PRONE: CONTRACTOR NAME STATE LICENSE # 65'51-365-1340 EXP DATE 3670 Dodd Rd. CITY STATE ZIP SUBMIT A COPY OF YOUR STATE ADDRESS: LICENSE WrIH PHONE Eagan' MN AX APPLICATION PERMIT TYPE gD3INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW --r REPLACEMENT DETAILED DESCRIPTION OF WORK PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for th improvement, installation or replacement of a residen al 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 5500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDIC TE TOTAL NUMBER OF EACH BELOW) WATER PIPING BATH SINK/LAV FLOOR DRAINS _ SHOWER — WATER SO ($35) _ —BATHTUB _ GAS PIPING (AMM MTLXnw) _ SWIMMING POOL — BACKFLOW PRE V. ($15) WASHER SINK WATER CLOSET _CLOTHES _KITCHEN DISHWASHER LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATIO WATER METER _OTHER _ PERMIT FEE PROJECTS FOR UNDER $500 PERNIIT FEE FOR PROJECTS OVER $500 Peralit Fee - $ 00 Number of ft"nes @ $10.00 x $10.00 = Surcharge .50 Number of fixtures @ $15.00 x $15.00 = TOTAL DUE $ 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; tbat the woz r will be in this is conformance with the ordinances and codes of the City of Fridley and with the Minnesota COUSM ction Codes; that Iunderstand the 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 accordm ice with approved plan in the case of all wo hic 'ew and approval of p .� TE SIGNATURE OF APPLICANT e PRINT NAME ,.. PmArrS ARE UIRED FOR BUILDING, E • E I'RICAL AND MECHANICAL WORK PLEASE NOTE: sEPARm City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 , q 66 763-572-3604 �( V A v. MCI CAP) en77