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PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT N° :5:6DI Date: "Woo, Owner: Builder <f— Address Address ,�//��' C ION Uz UILDING No. LS.z! Street I _ __— P r Lot _ _._ ]Block __ _ __ Addition or Sub -Division -Ot Corner Lot __ Inside Lot Setback .r Sideyard -- Sewer Elevation ___ — Foundation Elevation DESCRIPTION OF BUILDING To Used IrA� Z49 1, �.. �+t Front Depth ght �� Sq. Ft..do Cu. Ft.. f ro -6 t Sq. Ft. Cu. Ft.O ype of Construction Est, __ 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 aft provisions of ordinances of the city of Fridley. In consideration of the payment of a -fee of $,1 _._._._., permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of • : Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings Within the city limits and this permit maybe revoked at anytime upon '� viola of the provisions of said 'ordinances. ��� C'= 7yr;.K NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these Renu. It APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name... Builder, .. ..._. Address -e Address LOCATION OF BUILDING NO. - Street -0. Part of Lot Lot Block Z Addition or Subdivision d� Corner Lot Inside LotSetbackZL_Side-Y&� SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: Frontes 4 Depth ��3eight sq. Ft. /® „ - cu. r<t. - Front 2 o„Depth Z jHeight Sq. Ft. C; " --- Cu. Ft. Type of Construction�� Estimated Cost/4 CI To be Completed 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 ruling of the Department of Build- ings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley Application for Plumbing and Gas Fitting Perndt Dept. of Bldgs. Phone SU 4„7 DESCRIPTION OF WORK Number. Kind and Location of Fixtures �j 3 f7 m VI 3 F p 0 LL Q� w a w Z O • • WATER HTR. Base 1st 2nd _ 3rd — 4th 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. Owner Kind of • Future Connection, Oponings . wrua� wu+a Sewer New Fixture. Old openings Cesspool O Used as PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heata-(Up to 200,000 BTU) ...... x 2.00 New Ground Run Old Bldg . ............ x 3.25 $ 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 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE To be completed about Estimated Cost, $ ,f -op ® Q Old ew. ' ding Permit No Z Permit No. FINAL az 2M 7-59 e r Appfication 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. IDR 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 TOT 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 $ F'OUGH FINAL Dept. of Bldgs. Phone SU 4-7470 . 7. i�.n — ' /'n -Ad 1.2 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. 4g P su�1� C Fr'� , )Fridley, 19inn — Owner .Z7� J CQ22 Kind of Building Used as To be completed about 5-1962 Estimated Cost, $ � "6 .f� wilding Permit No. '5-0114 Permit No. C DESCRIPTION OF WORK HEATING eat vt r , Warm Air—No� Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P, Total Connected Load Kind of Fuel BURNER — Trade Nam Size No �'�a Capacity Sq. Ft. E D. GCO. SEDC IC HG. & AIR-COND. CO 1001 Xenia Av. S. !Minneapolis 16, Minn. ed 1611 By ,w 42 2M 7-59 Business Phone (REMARKS—OVER) Db rv � 8-M L 47 6.Ae4 � rAFNnVF7W 3v HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS, MINN. Weatherstrips A.S.H.V'.E, Guide Construction No. Coef. Btu Btu Insulation \YiBjlo ors I Reference Out. Wall Int. Wall Ceiling Roof Floor Glass Kind How. Applied Le. No es No 19.__,_ -2-11 1419 Exp. wall /40 1 Fl.I oom 1 Length Width Height F1.I oom I Length Width Height Windows and Doors—Crackage and Area I Width Height No. of Lineal f . Area No. of pane of pane lights of crack sq. ft. �® BI j, q 20 �-�fall ! R t Coef.1 Btu Infiltration Coef. Btu Infiltration Glass Exp. wall -3 Net exp. --wall - y Int. wall Ceiling 14 Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI.I 1 Dilikoom I Lenffth� iiidth 4 Windows and Doors—Crackage and Area I Width Height No. of Lineal ft. Area No. of pane of pane llghta of crack sq. ft. Width Height I No. ofLineal ft. Area No. of pane of pane lights of crack sq. ft. -7- 8, l �-�fall ! R t Coef.1 Btu Infiltration Coef. Btu Infiltration SO VZYQ -:N19 O. Glass Net exp. wall '-2,S' S`V 7 O Exp. wall /40 Ceiling a-ILI 3 Net exp. wall Net exp. wall 11/40 Int. wall /7 1151 Int. wall Ceiling /7—)(/j / P-/ J� Floor >0 '- 16 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Height I Fs.l MRoom 1 Length 1,t- Width 1/ Heiaht Windows and Doors—Crackage and Area I Width Height No. of Lineal ft. Area No. of pane of pane llghta of crack sq. ft. p -7- 8, l �-�fall ! R t Coef.1 Btu Infiltration (® 31 Glass SO VZYQ Exp. wall O. Infiltration Net exp. wall t Int. wall Floor /40 Ceiling a-ILI 3 Floor Total Btu. I- Required sq. ft. E.D.R. or sq. ins. W.A. Leader area -1 12Moom I ength Width Height Windows and Doors—Crackage and Area %/ Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of,pane llghts of crack sq. ft Coef.1 Btu Infiltration 371 667 Glass Exp. wall 14 Coef. Net exp. wall — - 3 Infiltration Int. wall Ceiling (� . Floor /40 � Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I -' Windows and Doors—Crackage and Area �D Room I Length / J) Width Height No. of Lineal ft. Area No of pane of pane lights of crack sq. ft. %/ Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of,pane llghts of crack sq. ft v 1 f Coef. Btu Infiltration Coef. U Infiltration Glass 1 -my 24 .S70 /40 Exp. wall S7)( 2-100 Net exp. wall Net exp. wall /7 1151 Int. wall Int. wall Ceiling '- 16 2 - moi../ 12 - Floor Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1r Fl.j �D Room I Length / J) Width %/ Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of,pane llghts of crack sq. ft v 1 f Coef. Btu Infiltration 1 -my Glass MI Exp. wall Net exp. wall Int. wall Ceiling / Floor Total tu. Required sq. ft. E.D.R. or sq. ins. WA. Leader area Original• PERMIT for Power lants and Heating, Cool- ing, Ventilation, Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of Heating Plants `�Z-�-� L , to be insta ltered—repaired �/1 _ G -r% Make -�� ,Size ; Oil fired—,- Coal fired ; Gas, fsred_7,,,_; Gas Authorization No. Remarks W Approved by Final Inspection Date , 19_ Inspector p 4�"2 SaZ Permit N° 4547 Fee Office of the Inspector of Buildings City of Fridley City of Fridley, Minn.- Owner inn. Owner a - 44=j Location a 1 y Kind of Building How Occupied �v Work to be Commenced / - —,31,19-61 To be Completed t 15, ,19 Estimated Cost, $ / 9 '5-' � Old -New, Building Permit No. Permission is hereby granted to - 4 to install—erect—use the material and devices described in the above statement. This permit is granted upon We express condition that the persor0to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein na d, and to the specific ns set forth in the approved application for this permit on file in the office of the Inspector of Buildings. Inspector of Buildings az 2M11 -67V SUBJECT City of Fridley 4 AT THE TOP OF THE TWINS BUILDING PERMIT( r COMMUNITY DEVELOPMENT DIV ~ PROTECTIVE INSPECTION SEC r � , �'�'1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OFJAPPROV613 By �""� 612-571-3450 910-F15 6/9/97 JOB ADDRESS 210 69 Avenue NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 2 Rice Creek Plaza North Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Nelson 210 69 Avenue NE 571-3476 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. B & B Roofing 6760 Madison St NE, Fridley, MN 55432 571-0248 9042 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 j1 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD 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 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 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED @ $2,062 $1.03 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 PROVISIO19S OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $74.75 Fire S�'i $2.06 STRU=CT PERFORM CE OF ONSTRUCTION. PLAN CHECK FEE TOTAL FEE C License SC $5.00 $82.84 ` $IGNATUREOFCONTRA TOR OR AUTMORIZEDAGENT (DATE) WHEN PROPERLY IDATED i BLDG SP THIS IS YOUR PERMIT DATE SIGNATURE OF OWNERoF OWNER BUILDERI (DATE) SPIA ADDN [ J CITY OF FRIDLEY ALTER [ l SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDDING PERMIT APPLICATION ConstructionAddress z�� 4- � P Effective 1/1/97 Legal Description: L� j / A w 1 j— Owner Name & Address: ��/� /1/L`.Z S��I Tel. # -5-7 Z 7z� Contractor: MN LICENSE # Address: _%z �'� ��� 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: /oma y� o? S S CP v/l L S Construction Type: Driveway Curb Cut Width Needed: Ft. + 6 Ft = Estimated Cost: $ (Fee Schedule on Back) Ft x $ = $ C'?o 6 —), M r DATE: % ✓� �I g �j" APPLICANT: ��j AUT i� (� Tel. # _� 71— 7/-/ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ 11S Fee Schedule on Reverse Side $ o C) .001 of Permit Valuation (1 / 10th %) $ A &_J $.50/$1,000 Valuation $ _ $950 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 [ ] ✓a %W3 Building BUILDING Permit No.:-�007 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 DT6R J0 L - 2007 CITY OF FRIDLEY DATE V" -k vi YOUR E-MAIL ADDRESS Lex C • C.onI SITE ADDRESS , THIS APPLICANT IS: ❑ OWNER PROPERTY OWNER/ c^ ,,CONTRACTOR NAME: -C, E: 1 TENANT ADDRESS: I CITY STATE_ZIP PHONE: 1 +4-I -Co �?7 NAME: Renewal By Andersen CONTRACTOR SUBMIT A COPY OF STATE LICENSE # 1920 County Road "C" West YOUR STATE LICENSE ADDRESS: Roseville, MN 55113 t TATEZIPWITH WITHAPPLICATION PHONE [3 SINGLE SINGLE FAMILY/NLicense #20130983 —STATE—ZIP— PROPERTY TYPE ❑ TWO FAMILY/NEW G 651-264-4777 ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS PERMIT TYPE ❑ BASEMENT FINISH ❑ ROOF 13 DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW 13ADDITION C3MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: �ei1 j �s' i5• ' SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT t. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGE ❑ ATTACHED GARAGE 1. Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING ❑ Vinyl FOR NEW CONSTRUCTION INCLUDING DECKS, ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Other ❑ Trim 1. Site Plan/Survey showing the existing structure ❑ Fascia andP*oPo sed ro'ect. P J WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION O WINDOW OR FOR NEW OPENINGS -DESCRIBE SIZE OF 1\ LA h �! OWE r ®Cr( 3. Energy Calculations OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL r LES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) AL - Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge ATION S See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of 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 iI conformance with the ordina s and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not. permit but only an applicati' for a permit d work is not to start without a permit; that the work will be in accordance with the approves plan in the case of all work vbich requires iew and approval of plans. SIGNATURE OF APPLICANT INT NAME ta_(nLkjDSC>JN DATE Q%:SUt,-0 6 / Building BUILDING Permit No. Inspections RESIDENTIAL APPLICATION Received By., 763-572-3604 CITY OF FRIDLEY D.W',EC ®1 2008 763-502-4977 FAX EFFECTIVE 1-1-08 DATE l d dd — of YOUR E-MAIL ADDRESS /7 a'�� 9/� A G o,y7 SITE ADDRESS fd �% /9!/ L iL) E THIS APPLICANT IS: ❑ OWNER 'CONTRACTOR PROPERTY OWNER/ NAME: SclS, ,J 4, £GS 01 J ADDRESS: �.'o ""q4 'A4 /J L CITY STATE_ 14/ZIP TENANT PHONE: ���_,721— 3 2l NAME: d e- C a'J V-4 ADDRESS: 7YO% ✓U S'.ve z-C'✓6 .4-L� CITY 47- STATE OVLIP 2F16 CONTRACTOR SUBMIT A COPY OF PHONE ::L- / - /_-ZL 7/G / FAX '.f1- �y6 ' ysU5 YOUR STATE LICENSE STATE LICENSE # EXP DATE oz�DP PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILYINEW 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 19 MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE:% Pg.- e t 1Vc - ew SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES JB HOUSE & GARAGE 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: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS, & PORCHES SUBMIT: 13 Vinyl ❑Soffit 1. Site Plan/Survey showing the existing structures ❑ Aluminum ❑ Trim and proposed project. ❑ Other ❑ Fascia 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: (USING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ ?6-7�.tri ?�1� �" OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1825 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 Davable to: Citv of Fridlev Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED lations 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 des; 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 accord with th proved plan in the case of all work which requires review and approval of plans. �� SIGNATURE OF APPLICANT PRINT NAME 41(e- *NO end °� DATE AWOVA' APPROVED BY DATE Building MECHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY arc - 4 007 DATE /,;2 3 -o-7 YOUR E-MAIL ADDRESS � SITE ADDRESS ,-21 � V e- /v �_-' THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAME: Sv.'i OWNETENANT ADDRESS-,-,2)C2 &2� A v N -'V F CITY_r i' 1e_ STATF/�ZII' PHONE-%7& e3--S7/-.34f 7L- CONTRACTOR COMPANY NAME: S 4 e r yn S 74e rs SUBMIT A COPY OF CONTACT PERSON r► (a r - '0? //.' YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRE/SS.� ` 9 c enema ea; 4L.ri e/ C1TY�yt4b .S'-. L'?q ,c I sTATIII) ZIPJeSJU'/ APPLICATION _ PHONE(GX5/-7sVe z�f Z) 7 FAX (!1� J-� �7� &P %-' PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK- (ATEW O REPLACEMENT ❑ ALTERATiON/REMODEL DETAILED DESCRIPTION OF WORK n S> ! 0 ,:,as 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 the improvement, installation or replacement of 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) EquijHWm Installed MFG: / 6CL V S M0DEL0 V i-_:7,�S,e + SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 FILER $35.00 $35.00 GAS UNIT HTR $10.00 —FURNACE CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 _VENTILATOR $15.00 PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ Number of fixtures @ $10.00 1 x $10.00 = $ 4b-,v v 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 o all work which re review and approval of plans. / SIGNATURE OF APPLIC PRINT NAME �Q. / IM f-�► DATE 42 3 -0 PLEAS 'NOTE: SEPA:DATEPERMITS ARE RE UIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 Building ❑}VEW HOME CONSTRUCTION ❑ ADDMON BUILDING Inspections DESCRIBE WORK BEING DONE; _ RESIDENTIAL APPLICATION. 763-572-3604 13 HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE CITY OF FRIDLEY 763-502-4977 FAX PROPOSED SIZE: ❑ DETACHED GARAGE PROPOSED HEIGHT: EFFECTIVE 1-1-08 DATE • // • 1/6 YOUR &MAL DRESS SITE ADDRESS �% % . `A THIS APPLICANT IS: ❑ OWNER *P&NTRACTOR PROPERTY OWNER/ NA1V1E: TENANT ADDRESS:i;_% CITY PHONE: 1748557I—Z CONTRACTOR NAME: ADDRESS -1 SUBMIT A COPY OF YOUR STATE LICENSE pHOL� FAX �o st 1 STATE LICENSE # EXP DATE PROPERTY TYPE &SINGLE FAMILY N SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE(SHEDWS ❑ BASEMENT FINISH ❑ ROOF DRAW TILE ❑ DECK O SIDING ❑ OTHER TYPE OF WORK: ❑}VEW HOME CONSTRUCTION ❑ ADDMON A?A>IVTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE; _ SIZE OF IMPROVEMENT LENGTH WIDTH 13 HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE GARAGES ❑ ATTACHED GARAGE PROPOSED SIZE: ❑ DETACHED GARAGE PROPOSED HEIGHT: SIDING 13 Vinyl OSoffit E3Aluminum ❑Trim ❑ Other ❑ Fascia WINDOWS IN EXISTING OPENINGS ❑Yes Flo LOCATION OWS OR FOR NEW OPENINGS.DESCRIBE SMS OF OPENING CHANGES & TYPE OF. WINDOW TO BE IN3TAT r Fm) t rrnrtnvo AD asn.,.r....., ALL FEES ARE BASED ON TOTAL JOB VALi Perm it Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge 1aL.LYYI Ulfl:IT'IS.5URLDUL � 1 I N PermitNo.• Received By:e1 ��_ Ri ODEUNG SUBMTr; 1. Existing Floor Plan .2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. &PORCHES SUBMIT, I. Site Plan/Survey showing the existing structures and proposed prgJwL 2. Two sets of construction plans 3. Energy Calculations OF LABOR AND See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minim= $.50 $5.00 (State Licensed Residential Conttactors) $1825 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 uayableto: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate, that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I d this is not a permit but only an app 'on for a permit and work is not to start without a permit on site; that the work will be in acco with the p the terse of all work which ' rm and of plans. SIGNATURE OF APP/LIC PRINT NAME DATI • I• I • I• I APPROVED BYI /,/.ems —. Z /, .