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PRE 2010 DOCSi; it i' li Village of Fridley, Minn. N° 22'g BUILDING PFR11" Office of INSPECTOR OF BUILDINGS �I it a owner Architect Fridley, Minn., Builder i LOCATION OF BUILDING 8 .57 No. street Part of Lot Lot i Block Addition or Sub -Division DESCRIPTION OF BUILDING ly'At Depth Height Stories Manner of Construction To be used as ` To be completed �I Estimated Cost � !� i .j Permit is hereby grated to io the building " described in the above statement. This permit is granted upon the express con4ition that the person to whom it is granted, and his agents, employees and workmen, in all the work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, Minn., regarding the construction, alteration, maintenance, repair and moving of buildings within the city limitt d this permit may be revoked at any time upon violation of any of the provisions of said ordinances.. i' Inspector of Buildings. AGREEMENT AND SWORN STATEMENT In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of the above permit,'', I hereby agree to do the proposed work in accordance with the description above set forth slid according to the provisions of the ordinances of Fridley, and, being first duly sworn, I hereby sfate and say that the facts stated by me and contained in the above: permit are true as therein stated. Ili Subscribed and worn to before me at Fridley, Minnesota, thi day o.D. -0. 18Wj — 9 0 i 0 City of Fridley, Minn. BUILDING PERMIT Date: November 17, 1969 a., /,-P !�(9 6 / 7 N° 10505 Owner: SamPa T++r-nPr Builder nalherg BiilderS Address —1685 -73rd ayPnuP N.F Address 1191 -80th A[,Tpn71P LOCATION OF BUILDING 11To. —1685 Street - 73rd Avenue N.E. — Part of Lot Lot 1_ _ Block Addition or Sub -Division _Auditor's -Sub, No. 108 Corner Lot X Inside Lot — Setback __ Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: AdditioA Front 12 1 Depth 24' Height 20' Sq. Ft. 288' Front Depth _ _ Height ._ . Sq. Ft. Type of Construction Frame Est. Cost —$ 5,200.00 --To be Completed _ Cu. Ft. 5760' Cu. Ft. 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 ant- in complian th all provisions of ordinances of the city of Fridley. ' (�� In consideration of the payment of a fee of $ permit is hereby granted to Dalbexg Builders 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 may be revoked at any time upon violation of any of the provisions of said ordinances. NOTICE: This permh does not cover the construction, installation for wiring, phnnhing, Sea heaft, sewer or water. Be sun to see the Building Inspector for separate permits for these items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME BUILDER` ADDRESS .��P�/ ADDRESS ZZ::� ),--mac.-i'%"� LOCATION OF BUILDING NO. LOT BLOCK ADDITION OR SUBDIVISION (X2.cD�C Jze.� • /�� • i o CORNER LOT INSIDE LOT SETBACK SIDEYARD SEWER ELEVATION TOP OF FOOTING 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: a-�'4ti-y Front ) a- Depth c9- VHeight 0 Square feet c2dVhCubic Feet S 9 66 Front Depth Height Square feet Cubic Feet Type of Construction )* gynl p Estimated Cost 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 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 .(Schedule of Fee Costs can be found on the Reverse Side.) NOTE: A Certified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before proceeding with the framing. fir._. Appllcaftn for Power Pkmft and Heats tgs Cooling. Ye n. ReMprafta and Air Con0loning S"ems -and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ...........................$10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ............. ... 6.00 $ Repairs & Alterations each add. $800.00 ............ . .. 3.00 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 Repairs & Alterations—up to $500.00 ................. 6.00 Repairs &Alterations ch add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam .... . $10.00 $ Furnace Shell & Line -to 640 sq. ft. IDR Hot Water .. 10.00 $ Each add. 200 sq. ft. EDR Steam .... ................: 3.00 $ Each add. 320 sq. ft. EDR Hot Water . . . ........ ... 3.00 $ OIL BURNER—to 3 gaL per hour ... .:... ...... ..... 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTW ..... ........ •.......'.. 8.00 $ over 199,000 BTU See. Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ..... ................ x$ 2.00 $ Additional Fixtures ...... I.......... x .75 $ Gas Range to 199,000 .......... is 800 $ AIR CONDITIONING FAN HEATING SYSTEM! VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH $ See Fee Schedule TOTAL FEE Dept. of Bldgs. Fbmw SW -3480 Locaaos i ;� �l ) , "'!5:— , City of Fridley: The undersigned hereby makes application for a permit for the work hereir 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, Kind of Building To be completed about EE UMated Cost, $ 44? ® ° Old -7 -New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No ��/, ) Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load Bind of Fuel BURNER — Trade Name Size Nck Capacity Sq. FL E.D.R BTU H.P. (REMARKS -OYER) Sign SUBURBAN AIR avlu IMM, Ca. MINN�4P�tus- wA_, 91DR By Business Phone Nn Oripnal • • PERMIT for PowerRants and Heating. Cool= ing, Ventilation. Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of 77eating Plants to be installed here epaired Make ,Size ; Oil fired �y , Coal fared ; fi Gas red ; Gas Authorization Nol/. Remarks dlto UA3-2 Approved Final Inspection Date , 19_ Inspector Permit - Fee 465'7 $ (� d Office of the Inspector of Buildings City of Fridley City of Fridley, Minn., d I`{ , 19_,17a Owner At+"6 e c, 9L&, Location / ea- 4� - 221d- 4� IV 6 - Kind of Building t✓ Aa-� -r4 How Occupied Auj,� -L L i rU co Work to be Commenced—, 19— To be Completed ,19_ Estimated Cost, $ A 0 ® • o o (aNew, ew, Building Permit N Permission is hereby granted to C-cQ L j5paAnC- [-0 . to install—erect—use the material and devices described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and has 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 named, and to the speci ns set forth in the approved application for this permit on file in the office of the Inspector of Buildings. �✓do►� e , Inspector of Buildings 4 z 2M t 1-67 v SUBJECT PE City of Fridley Rmn AT THE TOP OF THE TWINS BUILDING PERMIT i RE _ COMMUNITY DEVELOPMENT DIV. L PROTECTIVE INSPECTION SEC. p CITY HALL FRIDLEv 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 11/19/91 JOB ADDRESS 1685 - 73rd Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 Aud. Sub. #108 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James Turner 1685 - 73rd Avenue NE 784-7696 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Twin City Storm Sash Co 10825 Greenbrier Rd, Mtka 55343 546-8160 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION JJ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replacement sashes 9 CHANGEOFUSEFROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN BO DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 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 $3700.00 $1.85 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $63.00 Fire SC $3.70 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $68.55 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHE ROPER ID THIS IS YOUR PERMIT INSP SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) NEN [ .] Effective 1/1/91 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R -I AND R-2 Building Permit Application Construction Address: f �7 Legal Description: Owner Name A Address: Tel. # 7S `/ - 7 4 % (-- Contractor:re�� noes BASH nn. ntr Tel. # Address: 10825 GREENBRIER ROAD Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF BIPROXIOMN' T LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ ] Inside Lot [ ] Type of Construction: Approx. Completion Date: Ft. Yd Setback Side Yard Setbacks Estimated Cost: $ 6 X- .5." Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: % - / - APPLICANT: Tel. # -Y ' 6e ,CITY USE ONLY Permit Fee $ &,J.v0 Fie Schedule on Reverse Side Fire Surcharge $ 5- 7 a 001 of Permit Valuation (1/10th%) State Surcharge $ J 5.50/51,000 Valuation SAC Charge $ $650 per SAC Unit Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: RM3 SUBJECT PER City of Fridley 2140 AT THE TOP OF THE TWINS BUILDING PERMIT � RECEIPT NO. _ COMMUNITY DEVELOPMENT DIV. a. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910415 6/17/92 JOB ADDRESS 1685 73rd Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 Aud. Sub. #108 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jamey Turner 1685 73rd Avenue NE 784-7696 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. American Remodeling Inc 3700 Annapolis In, Plymouth.55447 553-0020 2406 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 8 DESCRIBE WORK Install soffit & fascia 9 CHANGEOFUSEFROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 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 $3, 800 $1.90 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $63.00 Fire SC $3.80 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE License SC $5.00 $73.70 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI HEN RO RLY VALIDA D THIS IS YOUR/PERMIT BLDG INSP ! DATE SIGNATURE OF OWNER I IF OWNER BUILDER( (DATEI NEW [ ] ADDN [ J ALTER [ ] Construction Address: _ Legal Description: _ Owner Name & Addre Contractor: Address -,_10.0 7jg4�� 0��j�� Effective 3/1/92 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Tel. # MN LICENSE Tel. # Attach to this application, a Certificate of S&Vdy of the Ica, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: Length Width Hgt/Ground A � OTHER: Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot j ] Inside Lot [ J Ft. Yd Setback Side Yard Setbacks Type of Construction: Estimated Cost: $�� Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x $ _ $ DATE: ' APPLICAN' Tel. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Park Fee Sewer Main Charge $ TOTAL $ ,� STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $700 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] SUBJECT PERMIT NO.. . City of Fridley 2 4 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPTNO. COMMUNITY DEVELOPMENT DIV. _ r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REVDATE PAGE OF APPROVED BY ' 612-571-3450 910415 3/11/94 JOB ADDRESS 1685 73 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 Auditor $ SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James Turner 1685 73 Avenue NE 784-7696 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 Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Remodel entry, add closet 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $2,500 $1.25 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PF1 NS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $54.00 Fire SC $2.50 S UCT N OR THE PERF E OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE 57.75 SIGNATURE OFC T RACTOR OR AUTHORIZED AGENT IDATEI y�WHEN PJPE Y VALIDATED THIS IS YOUR PERMIT . i�► lL DG INSP DATE SIGNATURE OF OWNER 0F OWNER BUILDERI IDATEI NEW (] Effective 1/1194 ADDN [ ] CITY OF FRIDLEY ALTER . [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 f - Building' Permit Application Construction Address: Z� b S 3 ke' 4 y2 y, Legal Description: 40 7 P< </ Aq 7 Owner Name & Address: SK / v 2 ov e 2 Tel. # L%— 76 Contractor: j MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: IO 111�fvdll SGL vl , a� \� C!&.-d: nlSti�A Corner Lot [ ] Inside Lot [ ] r Ft. Yd Setback Side Yard Setbacks Type of Construction: /l/Ooq r)? 4"t - Estimated Cost: $ Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: 6 Ft = Ft $ _ $ DATE: /% APPLICANT: Tel. # CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: S $ 5`7 Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $800 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 [ ] w_I 4 11IV/ CITY OF FRIDLEY INSPECTION DIV. Effective On March 1, 1996 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOBADDRESS RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $ representations stated in this application are true and correct. (Side Vent — Fill Out Back) t' ¢, &J ,1996 Gas Piping (Needed with new furnace) $ 10.00 $ OWNER )iv%. ( U,{ZNe� Gas Range $10.00 $ BUILDING USED AS �l.,i d(."T� C' Gas Dryer $10.00 $ ESTIMATED COST 11122q_ Gy PERMIT NO. X�,2 *Air Conditioning — All Sizes $ 25.00 $ a Ov DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. Commercial/Industrial BTU HP EDR 1.25% of Value of Appliance or Work $ Fuel Total Connected Load State Surcharge $!50 Burner Trade Name Size No. TOTAL FEE BTU HP EDR �� HEATING COMPANY Ee,�-�e�zd�e�( nV(�� [-�- S�Z CJ �. MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By Lc (1,CJM41a_ Tel No. PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved By Rough—In Date Final Date6) *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE FOR STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE -a CHE%INEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes () No ( ) 2. Is free from rust or deterioration Yes () No ( ) 3. Has no foreign objects lodged within Yes () No ( ) 4. Is securely supported Yes () No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes ( ) No ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: SUBJECT City of Fridley 255407- AT THE TOP OF THE TWINS BUILDING PERM11 r ` RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r 1 . � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 9/25/97 JOB ADDRESS 1685 73 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 I Auditor's Subdivision #108 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jim Turner 1685 73 Avenue NE 784-7696 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Whitetail Construction 7435 Oakley St NE. Fridley, MN 55432 783-9519 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Reroof House & Garage 25 SO Tear-off 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 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 $2,085 $1.04 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $74.75 Fir SC $2.09 STRUCTION OR THE PER RMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAA FEE Citn e $77.88 SIGNATURE OF ONTRACTOR OR AUTHORIZED AGENT IDATEI ENP OP ALIDAT HIS IS Y PEEIMIT BLD IN SP DATE SIGNATURE OF OWNER i iF OWNER BUILDER) IDATEI NEW [ ) Effective 1/ 1/97 ADDN [ ] CITY OF FRIDLEY ^ �� ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 "1 �h BUILDING PERMIT APPLICATION L 1 / � ConstructionAddress: 7-R Legal Description: Oal-- Owner Name & Address:_ (�rn 7—L) t,-/V(f Tel. # Contractor:wf'7 // ► / `7�ig`/ ,� iVS / MN LICENSE # Address: olg. v.S% j/` Tel. # Attach t(/this application, a Certificate of durvey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IMPROVEMENT Width Height Length Width Height r Sq. Ft.� Sq. Ft. A _ Sq. Ft. Construction Type: / n /(f- Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: APPLICANT:7/p ��J`i.g (,� Tel. # �� F-5?- CITY -5 CITY USE ONLY Permit Fee $ / S� ` Fee Schedule on Reverse Side Fire Surcharge $ 60 .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge ,- $ $950 per SAC Unit License Surcharg(e'r ` $ - —� $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ u50 00 Conservation Pl R Park Fee $ Sewer Main Charge $ TOTAL $ r% STIPULATIONS: an eV Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ) CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Effective On January 1, 1997 Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Water Bath Closet Urinal Tub I 1 ; Shower Wash Smk .: Tray Drink Fount Floor Drain Catch Basin Auto. j Gas Gas Washer fAppl. (Range Water Heater Gas Elec Stories Basement misc. Fixt.' i Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS _ / 6F,5- 7,3k D. New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. Rain Water Leader Sump/Receiving Tank $ 7.00 $ 7.00 �'�9 1997 Water Treating Appliance Water Heater —Electric _ $10.00 $ 7,00 Owner 7_(//, R)� Water Heater — Gas** Gas Range** Gas Dryer** Back Flow Preventer Required ()Yes () No $10.00 $10.00 $10.00 Building Used Asf,�%f��j�l �®� Estimated Cost �+ PERMIT NO. Type $15.00 PLUMBING COMPANY_ Reinspection Fee $42.00/Hr SIGNED BY + TEL N0._ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance ®a State Surcharge $ Approved By Rough—In Date Final Date 0 �f .50 A/z TOTAL FEE MINIMUM FEE FO ANY PLUMBING/GAS PERMIT IS $20.00 $k'�T PLUS THE $.50 STATE SURCHARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 Sa INCHES. SUBJECT City of Fridley T3711 4 7 g AT THE TOP OF THE TWINS BUILDING PERMIT r � RECEIPT NO. ______ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. -70 r PROTECTIVE 1 � i CITY HALL FRIDLEY 53432 NUMBER REV DATE PAGE OF APPROVED By 612-571-3450 910-F15 10/12/00 JOB ADDRESS 1685 73 Avenue NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 Auditor's Subdivision #108 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James Turner 1685 73 Avenue NE 784-7696 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Wellington Window & Door Co 3938 Meadowbrook Rd, St Louis Park, MN 55426 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 952-933-6300 City 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION J] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace windows 9 CHANGEOFUSEFROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Permit Inspection Cards W111 Be Mailed To Homeowner To Post SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 $3,683 $1.84 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEESA CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $97 25 re SC $3.68 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHEC EE OTALFEE City i ease $102.77 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT iDATEi HE Y VALIP6ftD THIS IS YOUR PERMIT _ S-GNATURE OF OWNEROF OWNER BUILDER, sOATEi BL NSR FjATE NEW [ ] Effective 1/1/2000 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT/APPLICATION b9 01LAI' Construction Address: Legal Description: Owner Name & Address: Con Add Tel. #-7FV i 1/ C% MN LICENSE # Tel. # 996,!' (� 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:/' /17 [.J rel ZatZT 4,_at Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 F0-- Ft x $ _ $ DATE: 10 9-6 APPLICANT: Tel. #-q- = CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee�S $ � �' Fee Schedule on Reverse Side Fire Surcharge $ 3 .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1100 per SAC Unit License Surcharge $ i z -$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 [ ] j MAN, TOTAL $ STIPULATIONS: i , 0".t vY.. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604 Stories Basement Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: Urinal APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Wash ti31 i``l'<I> Floor Auto. Shower T Drain ....... ..... ilil v I~:Ciuitt�l�.. '1��»:> Washer NO. RATE TOTAL JOB ADDR Effective On Jan i, 2002 Gas Gas I Elec New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all. the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 , Water Leader $ 7.00 '— , 20U,>_ zzRain Sump/Receiving Tank $ 7.00 -�/"- Water Treating Appliance $10.00 Owner 2s�� —E /,f' Water Heater -Electric $ 7.00 Water Heater - Gas** $10.00 Building Used As Gas Range*" $10.00 �J % Gas Dryer** $10.00 Estimated Cost;�7_ce PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMPANY Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge .50 TOTAL FEE $ SIGNED BY FAX # Approved By & A Rough -in Date TEL N0. �ll�r!�cr Final Date 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 �. MMONFNT VENT-QNNFCTOR ANn GOMR11STIM AIR VFRIFICATIM When ra In acing an existing ,ran _ , 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 manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The exeeting cnmNistinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to install a new _nmh usher air it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When jpctallenn a new venting ny_stem, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specfications. 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_ Appliance #2 Type _ Appliance #3 Type _ Total Appliances _ BTU Input _ BTU Input _ BTU Input Total Btu Input Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat 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 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 57L -56U4 YAIX: ( 705) ,71-1L5'1 ADDRESS : 1685 73 AVE NE PIN : 123024140014 LEGAL DESC : AUD SUB NO 108 : LOT 11 BLOCK PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMI�2004-016&5 DATE ISSUED: 09/23/2004 VALUATION : $ 0.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A INSTALL A GAS WATER HEATER. # ELEC WATER HEATERS 0 # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS 1 # GAS DRYERS 0 # GAS RANGES 0 # OF NEW FIXTURES 0 VALUE (FOR MINIMUM CALC) 400 # WATER TRMT APPLIANCES 0 APPLICANT PLBG PERMIT MINIMUM FEE PLBG FIXTURES (NEW OPENINGS) 0.00 0.00 NORBLOM PLUMBING CO 2905 GARFIELD AVE S PLBG FIXTURES (EXIST OPENINGS) 0.00 MINNEAPOLIS, MN 55408-2173 WATER TREATMENT APPLIANCE 0.00 (612) 827-4033 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 35.00 GAS RANGE FEE GAS DRYER FEE STATE SURCHARGE, PLBG FLAT 0.00 0.00 0.50 OWNER TURNER JAMES K & ALICE M 1685 73RD AVE NE TOTAL 35.50 FRIDLEY, MN 55432 PAID WITH CHECK # 29120 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 work 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 regula ' coqstr,uction or the performance of construction. SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. :ITY OF FRIDLEY INSPECTION DIV. 431 University Ave NE 'ridley,.MN 55432 763) 572-3604, FAX (763) 571-1287 Effective April 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT R_+ Q0 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR 'LUMBING FIXTURE RATES: NO. RATE :Iri:::::< <> Shower Uri al :>.=>><->I Urinal �::: b.::::::..... .::.:::. Wash Tra Y (#£>:::::::::<:: :l":.I..::::::::. Floorff#:::::<:::: Drain Auto.::>::::::::>: =< W Washer � -*I Gas Range »»:::[Za ter Heater Stone s<.>:>I �;:.;:: >>`s Elec Basemen $10.00 and represe TURNER, JAMES and correct. ',atch Basin $10.00 1685 73RD AVENUE NORTHEAST U FRIDLEY, MN 55432 5' lain Water Leader $10.00 I I 1 F oor $10.00 , (763) 784-7696 Nater Treating Appliance $35.00 OWNER Nater Heater -Electric �_ $35.00 g'eWm as 0 2 Floor $35.00 BUILDING USED AS Sas Range*` $10.00 I� Do -` o®• OC� r� � Jas Dryer* $10.00 ESTIMATED COST PERMIT NO. Floor 3 Type $15.00 PLUMBING COMPANY hI I? I GAA PI I WRING. -CO. 612 827-4033 Floor 4 SIGY TL�[V0. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS ' VV 1.25% of Value of Fixture or Appliance MINNEAPOLIS, MN 55408 COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "PROVIDE COMMON VENT INFO ON BACK SIDE 'LUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 196t OW dew Fixtures $10.00 The undersigned hereby makes application for a permit for the work herein )Id Opening, New Fixture $10.00 specified agreeing to do all work in strict accordance with the city codes leer Dispenser $10.00 and rulings of the Building Division, and hereby declares that all the facts Now Off Basin $10.00 and represe TURNER, JAMES and correct. ',atch Basin $10.00 1685 73RD AVENUE NORTHEAST U FRIDLEY, MN 55432 5' lain Water Leader $10.00 2D I >ump/Receiving Tank $10.00 , (763) 784-7696 Nater Treating Appliance $35.00 OWNER Nater Heater -Electric �_ $35.00 g'eWm as Nater Heater - Gas** $35.00 BUILDING USED AS Sas Range*` $10.00 I� Do -` o®• OC� r� � Jas Dryer* $10.00 ESTIMATED COST PERMIT NO. 3ack Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMPANY hI I? I GAA PI I WRING. -CO. 612 827-4033 reinspection Fee $50.00/Hr SIGY TL�[V0. ALL OTHERS AND/OR REPAIRS AND ALTERATIONS ' VV 1.25% of Value of Fixture or Appliance MINNEAPOLIS, MN 55408 Approved By J Rough -In Date Final Date State Surcharge $ F�QANY 35 MINIMUM FEE PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST TOTAL FEE $ OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. 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 termination. 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'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 Type and Size/Common Vent and Vent Connector Information 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 c inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter to T e Appliance #3 Vent Connector Height ft Length ft Diameter in T;e ALTERATIONS: (Describe) HEATING CO: Signed By: Date : Building ;V�72-q& ol BUILDING Permit No. `( f Inspections RESIDENTIAL APPLICATION Received By: it{ 763-572-3604 CITY OF FRIDLEY Datef * is ;* T ' DATE YOUR E-MAIL ADDRESS SITE ADDRESS � —73 �'%'JIi�Q /V L YrTIRT47 771V THIS APPLICANT IS: ❑ OWNER JACONTRACTOR PROPERTY OWNER/ NAME: ' !/ TENANT ADDRESS: Z&f2 — %3kz- e AlE CITY i'1� %i6 STA*ZIP PHONE: 7& a 7,OLI CONTRACTOR NAME: SUBMIT A COPY OF STATE LICEJ.'NSE # —('f��T� EXP DATE - YOUR STATE LICENSE �2 ADDRESS: �'AP CITY A�� r�a/`7 STA& WITH APPLICATION PHONE Z / :�, �D FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORI _ PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED PWINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ j` EW ❑ ADDITION ANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: & /'/ % F—W.Lj 4i11k-' 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 PROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING ❑ Vinyl ❑Soffit FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Aluminum ❑ Trim ADDITIONS. 1. & PORCHES SUBMIT: Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATIQQN CQSF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF K / T/,9r�,P/'I OPENING CHANGES & ' TYPE OF WINDOW TO BE INSTALLED 'P NUMBER OF WINDOWS % tmuJu rZJU-O AKr. JL$P-5 L vlv VAl.UATI N, 1NCLUll1NG THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOT. Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due VALUATION, a 9 ---1, Q OCCUPANCY TYPE $11')s 1 -AS See Back Page for Fee Schedule $ 65% of Building Permit Fee $ .001 times the total job valuation $ fo 5 .0005 x Permit Valuation Minimum $.50 $�� ,!1%' $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 ( ) �. 1`'j Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans.9] y SIGNATURE OF APPLICANT /I ; f% � � PRINT NAME 1p % —J&Z 6tV'7 DATE ' �� C!`z