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PRE 2010 DOCSSUBJECT ER City of Fridley 12768 AT THE TOP OF THE TWINS BUILDING PERMITf?" i • COMMUNITY DEVELOPMENT DIV. �y __•___, r � PROTECTIVE INSPECTION SEC. •//j � 1 I � CITY HALL FRIDLEY 55432 �•"' ,'J NUMBER REV. DATE PAGE OF APPROVED By 612-560-3450 91 0-F11 5 10/16/74 JOB ADDRESS 1367 - 76th. Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 19 3 Meadowmoor SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Dahlmeier Construction 8460 Cottagewood Terrace, M ls. 55432 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. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 441 x 261 Dwelling and a 22v x 261 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. Provide a verifying survey before capping. Nail composition board as per Code. SEWER LOCATION: 46' North of Manhole & 16' West (on property line) Wye Elev: 891.52 (at manhole) Top of Footing: 895.00 Minimum WATER LOCATION: 43' North of Manhole & 16' West (on property line) SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. SEPARAjffi PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. Wood Frame THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAB'S AT R-1 121 30,040Total ANftIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I 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 VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED, WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT$28,693 14-3 DOES NQT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROWS�ibNO OF ANY OZrESTATE OR LOCAL LAW REGULATING CON - TRU TIO OR P RFOR A OF CONSTRUCTION.S 110 PLAN CHECK FEE TOTAL FEE r SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DA ;:I H PROPERLY VALIDAT THI IS YOUR PE IT / BLDG )NSP DATE (� SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) 1 APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME:. r BUILDER: ADDRESS: �7�D®C ��/ ADDRESS NO:. 13 (P 2 STREET • LOT: BLOCK: ADDITION:T CORNER LOT: INSIDE LOT: _SETBACK:�/ SIDEYARD: S' 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: 4 TooS tC�WcQ Front: 1141 Depth • _2 4�0 Height • Square Feet: Cubic Feet: (-I ��ont : Depth: Height: Square Feet; Cubic Feet: Type of Construction:Estimated Cost: 0 40 To Be Completed: CP_' /_5 — 7 ' � V 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. A DATE: / ?Y SIGNATURE: —S4"� (See Reverse Side For Additional Information.) 4 ca , d:- yP f A f PARTIAL RATE SCHEDULE GRAVITY WAIN AM: ]RATE lrov I.. Furnace Shell & Duct Work ... ... .$10.00 Replacement of Furnace 6.00 $ Repairs & Alterations—up to $800.00 600 $ Repairs & Alterations each add. 4500.00 300 $ HZ(2L WARM AM Furnace Shell & Duct Work to 140,000 BTU ench add. 60,000 BTU . .. ...... Replacement of Furnace Repairs & Alterations—up to $500.00 Repairs & Alterations each add. $300.00 STEAM or HOT WATER SYG I EX ..$10.00 C? U_ 3.W ; 6.00 $ 6.00 $ 3.00 $ Furnace Shell & Lines—to 400 sq. ft. F.DR Steam $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 20.00 $, Each add 200 sq. ft. EDR Steam 3.0n $ 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 M,000 BTU) 6013 S-5-. C70 over 199,000 B'Y'tI See Fess Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x$ ZOO ; r O—D Additional Fixtures x ,75 Gas Range to 10AW s5 6.00 $ State Surcharge .50 AIR GO> MOMEG 8 FRF H=TMG BY23M Sees Foe schadMIG. T rrn.&Tma SYS ALTZRIATIOPM & EEPABiR1'il To-YaL 11m $ 1 2, ROMs IAL— Dept. AL II ptt. of 131d9z. Mmm MO -UM 76aC.. City of TvIdley: The undersigned hereby makes application for a permit for the work here&. specified, agreeing to do all work in strict accordance with the City Ordinmeef and ruling of the Department of Buildings, and hereby declares that -all the fad and representations stated in this application are true and correct. Fridley. Limn 20 Owner . -z m 0 .� �.� Kind of Used as To be completed about, Estimated Cost; $ Old—New. Building Permit No. __ Permit No. &— HEATING or POWIvR PIANTS--Steam, Not Watrss, Warm Air—No �!y Trade Namewv� sin No la ti -3 Capacity____ ._ sq, FL E.D..R 0_rV BTU Hp - 71 rt Total Connected Load 4 ® Kind Ft=e BURNER — Trade Names size Nd Capmci Sq. Ftl. EM R- BM Z30-1 IAMAaES—OV01 SUBURBAM AIR CONDITIQNIN CO. �i 8419 CENTER DRIVE MIMNEAEOLIS, MINNESOTA 55432 NO -7's-2 City of Fridley Dept. of Bidga. Phone Sim -3490 rh DESCRIPTION OF WORK � _ '76o 14ve. Ali Number. Kind and Localion of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... ...... 7 x $2.00 `" $_ A Future Fixture Opening ............ x $1.50 $__1__ New Fixture Old Opening.....:.... N $__ Catch Basin ...........:........ x $3.25 $ N • N WATER MTA. GAS fLEC. Electric Water Heater............. . s $2.00 3 :AS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ............ • • • x $2.00 $ , Additional Fixtures ............... .. Cs3 $ Gas Range to 199,000 BTU ... ,.......... l7!< l�'l o� V U U 3ase lst / Ind _ 3rd 4th • Future Co Moctioa Openings Connoctoci with Sower New New Fixture, Old Openings Cccapool C] PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... ...... 7 x $2.00 `" $_ A Future Fixture Opening ............ x $1.50 $__1__ New Fixture Old Opening.....:.... x $1.50 $__ Catch Basin ...........:........ x $3.25 $ Water Heater ;Up to 99,000 BTU).... _L— x $3.00 $ 3 � New Ground Run Old Bldg. ....... x $3.25 $ Electric Water Heater............. . s $2.00 3 :AS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ............ • • • x $2.00 $ , Additional Fixtures ............... .. x $ ,75 $ Gas Range to 199,000 BTU ... ,.......... x $5.00 6 U REPAIRS & ALTERATIONS—Refer to Codo 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 ase true and correct' Fridley, Minn 19_ Owner Kind of Building ✓��® Frfe �' Used as 002 •., e Ah To be completed about Estimated Cost, $ /5,6 o Old—New. Building Permit No. Permit NO. Signed Business Phune No Ziff - S.Xs'rf ROUGH , .50 State Surcharge Description ............. a ....... ...... . . I.. . . ...... ..... .S TOTAL FEE UP 0 5 "d 560-3450 C'ay Odell ANOKA COUNTY 6431 UNIVERSITY AVENUE NE January 15, 1975 FRIDLEY, MINNESOTA 55432 Mr. Stanley Dahlmeier Dahlmeier Construction Co. 8460 Cottagewood Terrace Minneapolis, Minn. 55432 Re: Deficiencies Noted During Final. Inspection at 1367 -76th Avenue Dear Mr. Dahlmeier: This is to confirm our telephone conversation of January 15, 1975 wherein it was pointed out to your office that certain items need your attention at 1367-76.th Avenue. The followingis a list.of the deficiencies; 1. Install a products of combustion alarm, to be State approved, in the hallway leading to the bedrooms. This to be completed on or before January 27, 1975. 2. Install the street address number on the house to be completed on or before January 27, 1975. 3. Install a door closer on the door between the dwelling unit (Group I Occupancy) and the garage (Group J Occupancy) to be completed by February 3, 1975. 4. The floor joist cut off beneath the bathroom area must be headed off. This to be completed on or before February 3, 1975. Would you please call us when you have completed the four items listed above so that we can reinspect for Code compliance. Your cooperation in this matter will be appreciated, and if you have any questions please call us at 560-3450. Sincerely, CLARENCE.J. BELISU Building Inspector CJB/mh SUBJECT City of Fridley 948 CEN AT THE TOP OF THE TWINS BUILDING PERMIT O • COMMUNITY DEVELOPMENT DIV. f � � PROTECTIVE INSPECTION SEC. � _Tp �L I CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY j 612-571-3450 910-F15 6/12/89 JOB ADDRESS 1367 - 76th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 19 I 3 Meadowmoor I SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Marlyn Jeske 1367 -- 76th.Avenue N.E. w 3 CONTRACTOR MAIL ADDRESS ZIP PHONE SE NO. �6� Byers Construction 8695 Nashua Avenue, Elk River, MN 55330 441--�I 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 O NEW ❑ ADDITION ❑ ALTERATION I7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside. Dwelling; soffit & facia 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 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 $71000 $3.50WITH 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- $90.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $93.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY ALIDATED THIS IS YOUR PERMIT i.a BLDG INSP f1ATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) i NW [ ] Effective 5/1/88 MW [ ] R-1 AND R-2 ALTER [ ] Building Permit Application Construction Address: /3Z 7 76- 77- N Legal Description: Owner Name & Address: M AA K457 Tel. Contractor: ��,� /', ��2u Tel. #_�-/W'�i�l� Address:�/L-- Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. laVIIG AREA: Length Width Height Sq. Ft. CWIM AMM: length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. Off: ilp - c , fic sL• . w c_..e u- . . Corner Lot [ ] Inside lot [ ] Type of Construction: Approx. Completion Date: Ft. Yd Setback Side Yard Setbacks Estimated Cost: Proposed Driveway Width If New Opening Is Desired: DATE: APPI TCS: Permit Fee $ State Surcharge $ �® SAC Charge . $ Driveway Escrow $ Park Fee ' $ Sewer Main Charge $ sTIP<.ti. MCM: Ft. Width + 6' CITY USE COY See Back Page _ Tel. # Fee Schedule on Reverse Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] '26 ®c) 01 SUBJECT City of Fridley 6 AT THE TOP OF THE TWINS BUILDING PERM f RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC r 1 CITY HALL FRIDLEY 55432 NUMBER r ATE PAGE OF APPROVED BY 612-571-3450 910-F15 T 5/15/97 / JOB ADDRESS 1367 76 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 19 3 Meadowmoor Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Marlyn Jeske 1367 76 Avenue NE 786-7129 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Jeff LaFrance Exteriors 12008 Ibis Circle NW, Coon Rapids MN 55448 755-9470 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 2001887 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ ❑ NEW ❑ ADDITION El ALTERATION % REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (25 Sq) 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 SQ. 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 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 $2,062 $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 PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $74.75 Fire SC $2.06 TRUCTION 05, THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE T TALFEE �zx 14�4— License SC - A .00 $82.84 SIG U CONTRACTOR OR AUTHORIZED AGENT IDATEIE RLY V ATED THIS IS YOUR PERMIT Y y ..� .. _ SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI DG INW FATE 01 NEW I ] Effective 1/1/97 ADDN [ ] CITY OF FRIDLEY ALTER ( ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 1:56-1 76714 AZ E . Legal Description: Owner Name &Address: �� /� ��% Tel. # ��6— / "_;Z 9 v Contractor: ��MN LICENSE # Address: e' QTel. #-ZSSS 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: OTHER: Construction Type: DESCRIPTION OF MIPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground So. Ft. Estimated Cost: $ �06c) �� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: �� APPLICANT: Tel. # 1 TOTAL STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ 4-63 $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $ (0 $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 STIPULATIONS: 11 CON o 5,00 �5� A jorU FtN,) Nk, cx I � 1. , i-- - -- - - F t SUBJECT PERMIT NO. City of Fridley 3 2079 AT THE TOP OF THE TWINS BUILDING PERMIT - ______ COMMUNITY DEVELOPMENT DIV. SEC. 672-3604�� REC IPT NO. r PROTECTIVE INSPECTION NUMBER REV DATEPAGE OF APPROVED BY CITY HALL FRIDLEY 55432 1 612-571-3450 910-F15 8/13/01 JOB ADDRESS 1367 76th Avenue 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 19 3 Meadowmoor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Juleen & Marlyn Jesko, 1367 76th Ave., Fridley, MN 55432 763-786-7129 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Grayhawk Builders, 3020 Centerville Rd, Little Canada, MN 55117 651-486-9888 d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20174611 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK C}X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Windows 9 CHANGE OF USE FROM 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. Caulking & flashing for all exterior openings. SEPARATE PERMITS ARE REOUIREO 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 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 $3,661.00 $1.83 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- $ 97.25 Fire SC $3.66 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTALFEE $102.74 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE- .- PROPERLY VALIDATED 7-40-. BLDG --NSP THIS IS YOUR ERMIT TATE S,GNATURE OF OWNER,IF OWNER BUILDERI IDATEI HUG -06-2001 11:41 FROM C I TY OF FP I ULEr' TO E514eGeG32 P. 01: NEW [ ] Effective 9/i/2o1 ADbN [) CITY OF FRIDLEY (763) 572-3644 Bldg Insp ALTER (I SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: ill-}- --O" Legal Description: Owner Name & Address:`�� Contractor: - , MN LICENSE Address•amn- Tet. C06l SS/7 Attach to this application, a Cerdfica f too Survey of ffie lot, with the proposed construction drawn on it to scale, DESCRIPTION OF IMPROVEMENT UVING AREA: Length Width Height Sq. Ft GARAGE AREA: Length Width height Sq_ Ft. DECK AREA. Length Width Hgt(Ground Sq. Ft OTHER: Construction Type _ 1 I Estimated Cost': $ � i e� �' Driveway Curb Out Width Needed: _Ft + 6 Ft - _Ft x s = $ DATE: APPLICANT: I Tet, CITY USE ONLY- Call (763) 372-3664 for Permit Fees if malting in application Permit Fee Fee Schedule on Reverse Side Fire Surcharge $� . L_G .001 of Permit Valuation (1/10th%) State Surcharge $_ 1. M $.50/$1,000 Valuation SAC Charge $--.$1150 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ A(t "A°` or Alt. 116" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary i ] Not Necessary ] TOTAL $ 16 . % STIPULATIONS: /�a !/ l ��7 3. C . C4�ie/-��.¢/•�'�- 0,4r ALL SUBJECT City of Fridley 73347069 AT THE TOP OF THE TWINS BUILDING PERMIT r COMMUNITY DEVELOPMENT DIV. RE�i r � � PROTECTIVE INSPECTION SEC. 1 � � NUMBER REV OAT E PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 763-571-3450 910-F15 4/7/03 JOB ADDRESS 1367 76 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 19 3 Meadowmoor SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Marlyn Jeske 1367 76 Avenue NE 763-786-7129 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same a 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 O REMOVE �O B DESCRIBE WORK Construct a 17' x 14' Addition to Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. ::- kw 04 N mu Baf®re digging :all for all utility locations SEPARATE PERMITS X5"002 REQUIRED FOR: RFOUIRFO BY LAW UBIADIGPINING�NSG Vq SEPARATE PERMITS ARE REOUIRED 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 $17,293 $8.65 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- Fire SC. $17.29 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $293.25 PLAN CHECK FEE T TAL FEE zi $319.19 SIGNATURE OF CON 7RACTO OR AU D AGENT IDATE, NEN�PROYLIDA D THIS IS LIR E IT Y2?� BlD INSo 1 TIME SIGNATURE OF NERI.F OWN BUI DER. IDATEI da 0 4Voy Permit Number MECcheck Compliance Report Checked By/Date 2000 Minnesota Energy Code MECcheck Software Version 3.3 Release lc Data filename: Untitled TITLE: addition COUNTY: Anoka STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: Single Family DATE: 03/25/03 DATE OF PLANS: 3/25/03 PROJECT INFORMATION: 1367-76th.ave. COMPANY INFORMATION: MARLYN JESKE COMPLIANCE: Passes Maximum UA = 65 Your Home= 60 7.7% Better Than Code Gross Glazing Area or Cavity Cont. or Door - Perimeter R -Value R -Value U -Factor UA Ceiling 1: Raised or Energy Trus 238 38.0 0.0 6 o.c. 406 19.0 0.0 21 Window 1: Above Grade, Metal Frame with Thermal Break, Double Pane with Low -E 49 0.340 17 Basement Wall 1: Masonry Block with Empty Cells, 4.8' ht/4.0' bg/4.8' insul 213 10.0 0.0 16 Proposed and Maximum U -Factor Averages Proposed Maximum Average U -Factor Allowed U -Factor Above -Grade Windows and Glass Doors 0.340 0.370 Includes Foundation Windows > 5.6 ft2 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. n ZC 7-3�-�a MECcheck Inspection Checklist 2000 Minnesota Energy Code MECcheck Software Version 3.3 Release lc DATE: 03/25/03 TrME: addition PLAN REVIEW AND INSPECTION ISSUES This list of items may be helpful for Plan Reviewers and Building Inspectors to use as a guide for enforcing the Minnesota Energy Code. The items apply to Group R, Division 3 Occupancies, one- and two-family residential dwellings. The items marked with * apply only to detached one- and two-family residential dwellings. PLAN REVIEW ISSUES FOUNDATION INSPECTION [ ] foundation wall insulation R-5 minimum [ ] foundation insulation extends from top of wall down to top of the footing [ ] exterior foundation insulation is covered by a protective coating finish CONCRETE SLAB OR UNDER -SLAB INSPECTION [ ] slab on grade perimeter insulation R-5 minimum [ ] slab insulation extends from top of slab to design frost line or top of footing [ ] floors over unheated space R-30 minimum WINDOWS / DOORS / SKYLIGHTS [ ] average U -value is 0.37 maximum for windows and glass doors (excludes foundation windows) [ ] window U -values consistent with building plan and MECcheck Report [ ] window and door areas consistent with building plan and MECcheck Report MECHANICAL VENTILATION ISSUES [ ] residential mechanical ventilation system provides adequate ventilation per code requirements* [ ] furnace efficiency is consistent with MECcheck Report or building plan [ ] protection against excessive depressurization is installed per code requirements* ENVELOPE INSULATION FOR PLAN REVIEW [ ] interior basement insulation R-5 minimum (if no exterior insulation) [ ] ceilings with attics R-38 minimum or consistent with building plan and MECcheck Report [ ] wall framing and insulation level is consistent with building design and MECcheck Report INSPECTION ISSUES CONCEALED INSULATION s ►' e + Framing and Sheathing [ ] wind wash barrier installed at attic edge [ ] exterior wall comers framed so that insulation can be installed after exterior sheathing is installed [ ] intersections of interior partition walls and exterior walls framed so that insulation can be installed between the partition and exterior sheathing after exterior sheathing is installed [ ] gaps between framing less than one-half inch are eliminated by securing framing together, or are insulated at the time of assembly * [ ] all penetrations between conditioned and unconditioned spaces made prior to framing inspection are sealed * Interior Air Barrier [ ] all fire stops are air sealed [ ] pipes, ducts, wires, equipment and flues and chimneys through the interior air barrier are sealed [ ] a sealed continuous interior air barrier is installed on the warm side of the building envelope at ceilings, walls, and floor rim joist areas * [ ] air barrier behind tub and shower is sealed and protected [ ] recessed light fixtures are sealed Envelope Insulation [ ] basement insulation R-5 minimum [ ] wind wash barrier on wall separating house and garage is sealed [ ] loose fill insulation is prevented from entering the eaves [ ] insulation on skylight shafts and walls exposed in attics is supported on the unconditioned side Attic Insulation [ ] attic access panel insulated to R-38 for ceiling panel and R-19 for wall panel [ ] attic card attached to framing near access opening [ ] notification of attic R -value and date of installation posted near building permit inspection card This is a summary only. Other requirements may apply. See the Minnesota Energy Code. Questions? Call the Department of Public Service Information Center at 651-296-5175 or 1-800-657-3710. Uil .. i.�,i i,:."I . , . : I __1 l k11... 1 )Iil -...>I i'1 � ('all � � �00 ; 17G i Irell_( cam. , THIS'JOS COPY SHALL DE CID. LUILABLE ON TjGq0R9+ SITE FOR THE FRAMING AME) FIN*t---INSPEe:f I e*4 - fi– — — — ��- �P�r s �fQ�r��io' �vR — -t- zio Ili evch (/n�/oes- 1,0,e 4/ 11*0 �,�oW dteC G�LN Nd opt. ex 4 lerar-1 4 49 ENGINEERED TRUSS DESIGNS .AND LAYOUTS SHALL BE MADE A,IL,ABLE ON THE JOB S14E , E FRAMING INSPECTtoR---,,,,, S, f, 1.3 0001. • do, e lexie c r", E; i` ��r� � �- r��r�,� �/ `ice' �/�UsS�S' f OTT T--, SL 4zy- 3 w sufZY5-K f6f ro of ....................... CLAN POVED M10 Fifto J,3 �Ci ITL b v, ✓ , -Sig NEW [ ] CITY OF FRIDLEY ADDN [J 6431 University Ave NE, Fridley, MN 55432 ALTER [ ] SINGLE FAMILY AND DUPLEXES R4 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Effective 1/1/2003 (763) 572-3604 Bldg Insp (763) 571-1287 Fax Legal Description: 4o "t- I `� aottt A d c 6,C,4 Ma R %,,O?P Ce-, Owner Name & Address: 42.6 al v&- 1'— Contractor: =Contractor: MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length < Width / Height ' ( Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 6 Construction Type: 401-490) FLAB Estimated Cost: $ /?o,;? 9 310� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 9 APPLICANT: Tel. #;7463 Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - $_q.3�o�J`� 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. 'W or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ -319-19 STIPULATIONS- 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 NI IMRFR r)F FIXTI IRFS TO BE INSTALLED ON EACH FLOOR Effective Un Jan 1, 2003 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures �_ $ 7.00 100 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric $ 7.00 Water Heater - Gas'' $10.00 Gas Range" $10.00 Gas Dryer"' $10.00 Back Flow Preventer Required ( )Yes () No 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 $ '50 JOB ADDRESS 136 X ", xve 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. 5—z/ q ,20 Owner Building Used As Estimated Cost'`" PLUMBING COMPANY SIGNED BY s Approved B&� Roug PERMIT NO. 6229 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 r'QMMQN VFNT, VFNT CQNNFCTQR ANn COMBUSTION AIR VIFIRIFICATION When rolea in_a an Pxirdong furan _ _, 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 pxi Ing -omh nntinn air is sized and installed to meet the current codes and manufacturers specifications. Yes () No ( ) When required to install a new cembustinn airs it will be sized and installed to meet the current codes and manufacturers specifications. Yes () No ( ) When in4allinn a new vantina nye m, the undersigned hereby verifies that it 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 ( ) 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 : %11 T Y OF FRIDLEY INSPECTION DIViS10N Effective On January 2, 2= i43* University Ave NE =ridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOUN% VENTILATION, 763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES ' ,;OB ADDRESS RATE SCHEDULE ' OWNER VC��1`C )i -tt-c) )U tesidential Rate TOTAL Furnace Shell and Duct Work, Bunter - BUILDING USED AS -- .. Also Replacement Furnace Also $ 30.00r ) �2 �� (Side Vent - Fill Out Back) ESTIMATED COST _ PERMIT NO.____L�(�.�, Gas Piping (Needed wig new furnace, $ MOO but riot replacement) f�ESCIPT�d�NACE fly OR BIdR R Gas Range $ 1C.0(} _.�.�._ No. of Heating Urits__I___ Circle One (Steam) ('dot Water (Vdarrri Air) Gas Dryer 10.00 . Trade Narne_Le.�`�1. ) Size No.--- o.____HP HP "Air Conditioning - All Sizes $ 25.00 Fuel -.•Y_._.-__ ,_ _....___-_ . -.Total Connected All Others/Repairs & AlteraWns (LIST ON BACK) Bumer Trade Name_ _. Size No. %® of Value of Appliance or Wore �- ..__. BTU---. - HP.-- _ EDS . :orngnersial/lndustriia( 4.25% of Value of Applianco or Work �__� The undersigned hereby makes application for a, hermit for the work herein specified agreeing to do all work in strict accordance with the City Codes an State Surcharge ___... _ 0 rulings of the Buildiog Division, and hereby declares shag an the facts and representations storied in this application are trua and correct. TOTAL FEE $5-15SD 7A.;. 11HIMUMME F�ANY BELTING/COOLlh!WVFtJT TON HhATIN I MRM UMT- OWAIR C6NDI?l®NING PENITIS SAM 'Lo In UO STM SLMM ARGE Signe _ TI -L ) 014SPECTION FEE $47.00/Hr ` Air Conditioners can not be placed in a side yard withoutApproved By Rougi�-Yn ®ate _ Final DaLe mitten permission from adjoining property owner. M Z0'd -IUM1 gOg- TO — cQMt3tiSTf0M A lR VER[FtCATiON When remI cine an ex! �&—rance, the undersigned hereby verifies that the venting has been examined and Is free from rust, deterioration, obstructions. and is securely supported attd firestoPped where required. Yes WNo ( ) The venting system is plastiu/PVC and meets all current codes and mankifacturer specifications Including siting, length, number of elbows and tetminatior-,. Yes No The undersigned also verifies that the replacement unit Is a fisted assambly and meets the current modes and manufacturees specifications: This do, -?4 AOA-GAMA Category a Central Furnace Venting 'fables for fan assisted and natural draft appliances. Yes No ( ) The exis ' Lep t�ustio air is sized and Installed to meet the current nodes and manufacturer's spec,Mc&Iions. Yes (4 No( ) When required to Install vv cornta soon a rit will be sized and installed To meet the current codes and manufacturer's specifications. Yes (L -Y No( ) When Installing a new vent' not A Stern, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturers sPecificatlons. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes (,,-YNo ( ) Is the common vent and verst connectors sized and installed correctly ager an appliance has beery removed from the common vent and vented separately as per current codes. Yes ('Y�o ( ) A0otiance T R,q and Size/Common Vent and Vent t:onngetof Information Appliance #1 Type 4 — STU Input �.��an Assisted or Nat Appliance #2 Type r STU input Fen Assisted Appliance #3 Type__.__ or Nates STC Input - -._. Fars Assisted Total Appliances Total Btu Input or Nat Common Vent Type _ , _ Vent Height __. _ Diameter _ inches Appliance #1 Vent Connector height- ft Length it Diameter - Appliance 02 Vent Connector Height ft Length tt Diameter irs Type Type _ Appliance #3 Vent Connector Height _ ft Length ft Diameter., in Type ALTERATIONS.' Moscrmbe) w __ HEATING CO: � _ Signed ®y: Date: � 2C ZO/Z0 ' d S0986M 01 1,3-10 1 Sri d0 1.1 i"' WOMB 8s : Z S 0802-t Z-AON Building BUILDING 3A19 Permit No.: ' ` Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604CITY OF FRIDLEY Date Rec'd: 4 DATE o YOUR E-MAIL ADDRESS SITE ADDRESSU - THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY OWNER/ NAME: ADDRESS: , S �J 7�-� A(�� /V CITY �fL ,tl� J_ V STATEM4IP TENANT PHONE:03 CONTRACTOR NAME: J ,-— _e STATE LICENSE 4 e-)-8 2._ &S'Z Z % EXP DATE 3 3 73 D SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 0 P S -C +L- A() E rJ , 6.2 CITY fPWV\SCy STATEm,IP 530 WITH APPLICATION PHONE ' Z. — D 0 FAX PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ O FAMILYINEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ ARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH kROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: R -C 20c>� SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING O MOUSE ONLY NUMBER OF SQUARES INHOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES l3 ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ (Q V S A) 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) $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 savable to: Citv of Fridlev Attac 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 re us review and approval of plans. / '1 SIGNATURE OF APPLICANT NAME riy G1/I DATE & , t — 01 $ 3A19 $ 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 savable to: Citv of Fridlev Attac 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 re us review and approval of plans. / '1 SIGNATURE OF APPLICANT NAME riy G1/I DATE & , t — 01