PRE 2010 DOCSPAR74
!ALIL� f Fm ,a ,ateH,: 4A (�
M,MA AM: yg TOTAL
Ukumace Shell & Dud ?%h ... .... 410.00 �
Replacement of Pomace .. 6.60
Repairs & alterations—ug to X350.00 6,00 $--- • -.- —
RejmiTs Alterations each add. $500.00
c0'MCIL WA= AM
- J
J-vrmce Shell & Dust Wor°h to 1,0®6 B°lU ... .. ..�IlO.�
-L�
Mach add. 601M 9M ............... .... 3.GDi9
Replacement of lgarnace &00 it
Repairs A Alterations—up to SMM &00 3
Repairs & Alterations each add. $M.00 3.00
` 1 or HOT WATER STSTEX
°�urnace Shell &s Lines --to 400 sq. ft. LDR Steam $10.00 $
Furnace Shell &a Line—to 640 sq. it. EDR Hot Water 10.00 $-
Each add. 200 sq. ft. ZDR Steam 3.00 $... _ _ - Each add. 320 sq. ft. EDR Hot Water 3.00 $__
OIL IDURiM—to 3 gal. per hour 6.60 $ —
over 3 gal. per bourse Fee Schedule
GAS B cup to 11,660 BTU) .. Lai)
i -o
over 199,000 BTU see !ce mcbsdule
GAS rrrrING FEE9. NO RATE T AI.
Ist 3 Fixtures x$ 200 $
Additional Pixtur+es x ,75 $
Gas Range to 199, 0 =$ 4100 $
AIR COlIDITIONINA
!AN H>MTING B?sTEA[
YENTILATMQ XTSTZM
AILTERATION9 & BEPAIM
ROUGH
17NIiI. /® - 2. - 7,5_
Flee !w �
TOTAL ru
Wit. of zdva� nano M' -MM
City of Fridley: . v
The undersigned hereby makes applicafon fos m -permit fw Fay work hereig
specified, affreeing to do all work in strict-aEcordsibee with the City
md reeling of the Department of Buildings, and harfby decImies tbos an the Sri °a
and representations stated in this application are trw.zad gera-vet.
Kind of Building
Used as _ _. A
To be completed about
Estimated Cost, :..—....®�
Okl—New. Building Permit No. -permit No. .
or WOM
HM77NG or Hot Water, 6arm No__ Z�
Trade Name- A� Sin Nem J00 __?f0e_
Total Connected Load - 01 6 Kind of
BURNER — Trade N,a+e Size No
Capacity Sq. !t zMit BTU
(A�A�IIf—OYtRI
1
ormBD5 Asak
M lr�r� ` gg�
��A�tT�E `
e4a I-'%
f r
HEAT LOSS CALCULATIONS
Exp. wall 1.
ti
BUILDHf6
i T i
�
a MINN.
Weatherstrips
A.S.H.u.E.
Net exp. wall
Int, wall
Construction No.f'
Floor _
Ceil.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Insulation
Floor
Ceil.
Floor
Ceil.
Total Btu.
Required sq. ft.
FI. I OM
4 FI. I &- _ 10.9 4111oom I Lenlzth 0 Width 1 "'A
_
_Windows
DoorsGuide
Reference
Out. Wall
Int. Wall Ceiling Roof Floor
. Kind
How Applied
Yes—No
Yes—No
19—
9
Fl.
FI. J Room Length
Width
Height
FL
Room I Length
Width Height
Windows and Doors--Cracka a and Area
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft.
Area I
Width
Height No. of
Lineal ft. Area
No. of pane of pane lights of crack
aq. ft.
No. of pane
of pane lights
of crack sq. ft.
Coef.I Btu
Infltration I Z
Glass
Exp. wall
L1011Infiltration
Width Height No. of Lineal ft� Area
No. of pane of pane l lights of crack sq. ft.
_
Glass
Exp. wall 1.
ti
Net exp. wall
Btu
Infiltration
Glass
Net exp. wall
Int. wall
Net exp. wall
Int, wall
Int. wall
Floor _
Ceil.
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Floor
Ceil.
Floor
Ceil.
Total Btu.
Required sq. ft.
FI. I OM
4 FI. I &- _ 10.9 4111oom I Lenlzth 0 Width 1 "'A
Height
Windows and Doors—Crackage and Area
Width Height No. of Lineal ft� Area
No. of pane of pane l lights of crack sq. ft.
_
Btu
Infiltration
Glass
jCoef,
Exp. wall 9
Net exp. wall
Int, wall
r
Floor
Ceil.
Total Btu.
Required sq. ft. ED.R o ins. WA. Leader area
Fl. 1 - b m Length Width
windowws nd Doors—Crackage and Area
Width Height No. of Lineal ft. Area
No. of an of pane lights of crack sq. ft.
C
Infiltration
Glass f
Exp. wall_
Net exp. wall
Int. wall
_Floor
Ceil. 1117
Total Btu.
Req lu red
ft. E.D.R. or sq. ins. W.A. Leader area
Height
Btu
I
Total Btu.
Required sq. ft. ED.R. or sq. ins. WA. Leader area
/ FI. _I �J , Room I Length / POW dth f , Height
Coef.I Btu
ins. W.A. Leader area
'Length / "ok, Width
Windows and Doors—Crackage and Area
Width Height No, of Lineal ft. Area
No. of pane of pane lights of crack sq. %
Coef. Btu
Infiltration
Glass
Exp. wall
Net exp. wall
CO
Int. wall
Floor
Ceil.
_0 Infiltration
_ Glass
_ Exp. wall
Net exp. wall t
Int. wall
Floor
ro OR Ceil.
Total Btu.
Required sq. ft. O.R. or sq..ins. W.A. Leader area
ft.
Btu
DESCMIMON of WORK
if r. Kind mad Location ef f'laturse
Ila
1111, 111 IIt 11111
53-84-879.01
City of Fridley
and cm ramb
DWt. od Bldg. Fib" . sla4m
7 151 N. E. 79th. Way
stew wa. CRY of rAd3e7:
cwg ruc. The undersigned hergbg makes appiieaum for a permit for the wwk heod
specified, agreeing to do aU .vote in strkt weardammm arab the City MAwmwv
and nWng of the Departnwd of Buildigm and herdW dedares that mA the feel:
and regresentatloas stated to this mmOu dion am Uw and correct
Ff idley. 9-13-73
it—
M. Broiher
PARTIAL RATE SCHEDULE
PLVNMtxG rUCTUM ItATM. N®► BS!`g't Tar"
Number Slabtres ................ ®aan e -
ie
Now wEntore old op"tift .......... 81.00 S®
CatA Haslet .............
Rabat Reuter Mp to Oi AW HTV ... • _am= S
New Grand Run oid BW ........ • r S&M S
z6vb,ie•wl&twvas6er.............. s I=
LEi MUM .................. —XIM $
AdN/omml IM -- , ............... = 6.75
Qat Ranke to M.M mm ........... :8800 8
State Surdtasge $ .SO
S►l� t L.TF�i?iO0 a-ia[ar to Clio
...... Replace Ranke �.— 3.00
TorAL M 6 3.50
Kind of guDdift Frame
Used as Res.
To be comMleted about 9-20-73
Estimated Cost. S 10.00
uildimg Porndt Mtn PWND t Nei OX
. gy ®t1�GA
Budimmom
Phio w we
C�fSft-A®Surcharge .StJe
f
63 -ah -1,16051
CITY OF FRIDLEY
• APPLICATION FOR PLUMBING' AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLU.M3ING FIXTURE RATES: r0. RATE
N der Fixtures
r^ature F:Lx—,ure Opening
New Fixture, Old Opening
Catch Basin
:Fater -:eater - to 99,000 BTU
!-'0,000 B:J to 199,000 BTU
Fater Softener
New Ground PI—in—Old Building
-Electric Slater Heater
GAS FITTIXG FEES:
1st 3 fixtures
A14ditional Fixtures
Gas F.ange to 199,000 BTU
REPAIRS & ALTERATIONS
First $100.00
each ade. $100.00 or fraction
x
$3.00
x
$2.00
x
$2.00
x
$5.00
x
$5.00
x
$10.00
x
X
w
$5.00
Water
e
m
m
a
to
w
tr cw
C -A
W
G
•+
++
ri
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.+
tp
Heater
w
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it
I,st
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ry(
r
} 2 =3
rd
(
t
(R) a Future Connection opening
Connected with Sewer
(•) - New Fixture, Old Opening
Water
PARTIAL RATE SCHEDULE
PLU.M3ING FIXTURE RATES: r0. RATE
N der Fixtures
r^ature F:Lx—,ure Opening
New Fixture, Old Opening
Catch Basin
:Fater -:eater - to 99,000 BTU
!-'0,000 B:J to 199,000 BTU
Fater Softener
New Ground PI—in—Old Building
-Electric Slater Heater
GAS FITTIXG FEES:
1st 3 fixtures
A14ditional Fixtures
Gas F.ange to 199,000 BTU
REPAIRS & ALTERATIONS
First $100.00
each ade. $100.00 or fraction
x
$3.00
x
$2.00
x
$2.00
x
$5.00
x
$5.00
x
$10.00
x
$7.00
x
$5.00
x
$5.00
x $3.00
x $1.00
x $10.00
State Surcharge
TOTAL FEE
REINSPECTION FEE
(SIO. on)
$5.00
$2.00
TOTAL
S
Job Address 151 79 Way NE
Department of Buildings
City of Fridley
Tel. #571-3450
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 Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correct
Fridley, Mn. 2-10-81 , 19
OWNER HUNT
RIND OF BUILDING frame
USED AS res.
TO BE COMPLETED ABOUT 2-17-81
ESTIMATED COST 50.00
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company
Signed By
Tel. No.
ROUGH INSP.
Date
FINAL INSP. ri a 1 S 5
Date
APPROVAL FOR PERMIT iA
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 pLUs $.50 STATE SURC%pZE
SUBJECT
RMIT
City of Fridley
16 6 so
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
�
REC
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
d
jp
GO
I ` �
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
j 612-571-3450
910-F15
17/15/82
JOB ADDRESS 151 - 79th Way N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
9,10
4
Spring Brook Park Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Mat Hunt 151 - 79th Way N.E. 784-0649
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Western Construction Co. 5353 Wayzata Boulevard, Mpls. 55416 546-3385
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
RajK=m1= Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 22' x 24' Garage
9 CHANGE OF USE FROM TO
STIPULATIONS provide a hard surface driveway.
WARMING
,�
)?EQUI
Before digging till 16"1 WOO
A.SIG b F01 TELEPHONE - ELECTRIC - GAS EtL
>
�t REQUIRED By LAW,
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST,
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Wood F'Rame
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
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
$5,438
$2.72
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
TRUCTION OR THE PERF05MANCE OF CONSTRUCTION.
$56.50
PLAN CHECK FEE
TOTALFEE
tel_
$59.22
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATE)
WHEN PROPERL VALIDATED THIS IS YOUR PERMIT
�Y A,
SIGNATURE OF OWNER I IF OWNER BUILDERI IDATEI
BLDG INSP DAIE
CITY OF FRIDLEY Effective Aug. 1, 1981
APPLICATIOJ FOR RESIDENTIAL BUILDING PERMITS
(New, Alterations, Additions, or Repairs)
MIER: 01-7al'_ T�`�s BUILDER:
ADDRESS: ADDRESS:
TEL 110: 7 TEL NO:
Construction Location
• STItITT NO: .._..�--� STREET: -2 4? -:59� " -"
LOT: 9- /0 BLOCK:
4
4<1
ADDITION: ri r! ?��LuC��' i7G�L�r
Corner Lot: g4 Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
Front: �' Depth: 02_ Height: /<2)
Square.Feet: Cubic Feet:
Front:
Depth: Height:
Square -Feet: Cubic Feet:
Type of Construction: 4,,V
To Be Cbmpleted:
Estimated Cost: $
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE REVERSE SIDE OF SHEET .
Mie undersigned hereby makes application for a permit for the herein specified,
agreeing to do•all work in strict accordance with the City of Fridley Ordinances and
rulings of the Delwirtment of Buildings, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE:
Stipulations:
SIGNATURE: %S "lez
B. H. BRADLEY P
amm lton�wm AND suwmvore
am-wm AVENUE SOUTH
. MU�N6APOLIBe MaW OTA o Ave Ala.
Baa-atm
gra �
C
k
SUBJECT
City of Fridley
312 9 7
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
v -------COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r PROTECTIVE
I
1 "'1 CITY HALL FRIDLEY 55432
NUMBERREv
DATE
PAGE Or
A0PROVEO BY
612-571-3450
910-F15
8/11/00
JOB ADDRESS 151 - 79th Way NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
9,10
4
1 Spring Brook Park Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Janet Chisholm 151 - 79th Way NE
780-1126
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Steven R. Lee 9465 Irving Ave N Brooklyn Park, MN 55444
424-1198 5758
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 XJ REPAIR
O MOVE ❑ REMOVE
B DESCRIBE WORK
Tear Off and Reroof House and Garage 21 sq.
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building
Code.
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 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
$1,835.00
$.92
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$66.20
$1.8
PLAN CHECK FEETOTAL
E
F$7
Licens C $5.00
.96
SIGN A TUBE OF CON"RACTOR OR AUTHORIZED AGENT IDATEI
EN gOPE ALIDAT
BIL INSP
I IS Y R PERMI
l/ J
rIATE
S-GNATURE OF OWNER,IF OWNER BUILDER, IDATEI
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 vl
Construction Address:10,
Legal Description:
Owner Name & Address: c� �.� f� C- s a % Tel. #
Contractor: MN LICENSE#
Address: fo -5— /1/- Tel. #
c/ y 1, 10� l J 1/7 y S° S°
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. FL
GARAGE AREA: Length Width Height Sq. FL
DECK AREA: Length Width Hgt/Ground Sq. Ft
S -7s P
OTHER:
Construction Type: 4- Estimated Cost: $ 5 1&3s
AQ ""e- j �-
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: O l% o 'J APPLICANT: �/ -e�0 +�. L =it,Tel. # �4� >f )/ 91-0
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Call (766/3) 572-3604 for Permit Fees if mailing in application
$ Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$ 9.2 $.50/$1,000 Valuation
$ $1100 per SAC Unit
$-CSD $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
TOTAL
STIPULATIONS:
L v
SUBJECT
P
City of Fridley
3 i b 1
AT THE TOP OF THE TWINS
BUILDING
PERMIT
`
RECEIPT NO.
DIV.
COMMUNITY DEVELOPMENINSPECTION
r � � PROTECTIVE INSPECTION SEC.
o
� 2- 36®4
tl
1 �
NUMBER
REV
OATS
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
l 612-571-3450
910-F/5
5/30/01
JOB ADDRESS 151 79 Way NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DEscR.
9110
4
Spring Brook Park Addition SHEET
2 PROPERTY OWNER MAIL ADORES$
ZIP PHONE
Janet Chisholm 151 79 Way NE
763-780-1126
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 O ADDITION] ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Install 5 basement replacement windows;
finish 1 basement bedroom
9 CHANGE OF USE FROM
TO
STIPULATIONS
See notations on plan.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. "
NO DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1 ISTALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$61000
$3.00
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-
STRUCTION O THE PERFORMANCE OF CONSTRUCTION
$125.25
Fire SC $6.00
PLAN CHECK FEE
TOTAL FEE
34.25
ACTMAUTNOWED AGENT �D�iEi
$1 NAh;;Oh
EN OPE LIDATE THIS IS YOU ERMIT
YhI
�
Bl0 iN$P DATE
$,GNA UREOFOWNE ,1; WN RBWLDER� DATE,
L v
(
NEW [ ] Effective 1/1/2001
ADDN [ ] CITY OF FRIDLEY (7 ) 572-3604 Bldg Insp �D
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 5 W E Yyi&ra i�jZ
Legal Description:
Owner Name & Address: Q/YI P� 40tov SA�IYl�7 Tel #763 •7`� � C 2�
Contractor. d'UI'iti�(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/Grround Sq. Ft.
OTHER: '45 a mU' 'WU" hp'j -
Construction Type: %Dl �( Estimated Cost: $ 4 L�', DD D. Do
Driveway Curb Cut Width Needed:Ft.
6 Ft = Ft x $ _ $
DATE: 1"d ®( APPLICANT-
�Vl�fi� Tel. # I%q o •
CITY USE ONLY -
Call (763) 672-3604 for Permit Fees if mailing in application
Permit Fee
$ ��, o7J� Fee Schedule on Reverse Side
Fire Surcharge
$ —��®Ci
.001 of Permit Valuation (1/10th%)
State Surcharge
$ nQ $.50/$1,000 Valuation
SAC Charge
$
$1150 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ 1 Q-1"5—
STIPULATIONS:
i � ..... ... . - .r -- - �., .._ .�. r.., . ., .... . r ,s. - ..•...., ... -r �..-...e .. .r,..y_.,.—«,...,....a_ u.-.-.,..-.,�..�.a.��.;-.w�s:�k.+ara..•+�s��-_—.-.•..�...
44V// 1A
aimFCs�ni
Thls Plan Must
Be Maintained And
Accessible On The
Construction Site
Every; sleeping room; shall have at least one
+WDAOW with a Sill height'of not more than 1'
4" bove the ;floor; and ;shall, provide not
less thanvsq. rt. ;of openable area with
a min. height of 24" and` a min. ,;': of 20"
P
de-R&?�-v
PLAN APPROVED'
SUBJECT TO FIELD
INSPECTION
�4
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Building
BUILDING �� `�
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By
763-572-3604
CITY OF FRIDLEY
Date Rec'd:.I�` o�n
DATE
YOUR E-MAIL ADDRESS
SITE ADDRESS
THIS APPLICANT IS:
❑ OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME: (h < h n I rJ1
ADDRESS: 1,5� / 7 g t A kvecy NE CITY r h i'd
ICY STATEMZIP_�TL(,3Z
TENANT
PHONE: 76.3 — 7 U — I I A
CONTRACTOR
NAME: PI = KKt-n Pv J O v i /,1&-�
STATE LICENSE # 17 % 7 EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: 4 a I Easf 7 e fh &-t CITY STATF/4j[ZIP �'S 4o2d
WITH APPLICATION
PHONE FAX
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED JOLWINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING I9 OTHER %: Fc�r IvanFl--a4,,'ns For
13 SWIMMING POOL
It f moi. t�
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCE/REPAIR RrREMODELING
DESCRIBE WORK BEING DONE: k,' 4- C rmdy" i I - hew
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1. Existing Floor Plan
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS, & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
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 dYes
❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF , k e Y1
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 $ I Y l o v c, 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
$ J73 . a
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 Davable to: Citv of Fridlev Attach
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for 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 pproval of plans. y
SIGNATURE OF APPLICANT � PRINT NAME D CL r F y / SPO �' �� DATE 10 — 0
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Building
MECHANICAL
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604CITY
OF FRIDLEY
Date Rec'd:10 (r'
DATE '-� ®(,e YOUR E-MAIL ADDRESS
SITE ADDRESS I 22 L Lnj er
THIS APPLICANT IS: ❑ OWNER WOOFiACTOR
PROPERTY
NAME:
ADDRESS: CITY STATE ZIP
OWNER/
TENANT
PHONE:
CONTRACTOR
COMPANY NAME:
SUBMIT A COPY OF
CONTACT PERSON:
�5
YOUR STATE
LICENSE WITH
STATE LICENSE # EXP DATE
ADDRESS: 17 2-2 $ AM AyCITY STATE /'O"1P j12
APPLICATION
PHONE C 3 - `6��' 5 -el 8$ FAX —�� -- 9S1. 3221
PERMIT TYPE
GLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TERATION/REMODEL
TYPE OF WORK:
❑ NEW ❑ REPLACEMENT
DETAILED DESCRIPTION OF WORK Q SLta I
PER MS 1613.665 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 a 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)
Equipment Installed MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZEBTU
MFG: MODEL: SIZEBTU
$25.00 FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00
_A/C
TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
_AIR
$35.00 FURNACE $35.00 _GAS UNIT HTR $10.00
_BOILER
CHIMNEY LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.00
_
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
..
Number of fixtures @ $10.00 x $10.00 = $
Permit Fee $
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 = $ M
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 ordinance and codes of th ity of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an applicati n for a permit work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of all w which u' s review and approval of plans. (` 1 , /'j
`� -5ta
PRINT NAME 1 O` DATE / V - J
SIGNATURE OF APPLICANT
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME 0 MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction IMC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make-up air calculations.
Building
PLUMBING
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd: z O.�
DATE a-1- 90 YOUR E-MAIL ADDRESS W I Q.I Oae- l: �GDrY11 n . ni
SITE ADDRESS 51 / q WA -I
THIS APPLICANT IS: ❑ OWNER CONTRACTOR
PROPERTY
NAME: M
ADDRESS: S , q VVa!!4 CITY 5'1riGile�1 STATE
OWNER/
TENANT
—�
PHONE:
CONTRACTOR
N,1Iv1E:
SU13MIT A COPY OF
STATE LICENSE - S707 PIW E� D ATE / oZ � l �b 201 4TH AVE eW, SUITE 3 •
YOUR STATE
ADDRESS: CITY NEW PRA( UAW_ V SaN/ 1
LICENSE WITH
PHONE/ 59 7_54 -6V161 FAX 1 5aZ 7 6-V ' 5 .)
APPLICATION
PERMIT TYPE
ASINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
OF WORK:
11
❑ NEW ,q REPLACEMENT
TYPE
DET DES TIO41 OF WORK d �• !
PER MS 1613.665 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 a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
AM
Labor coda under $300 = $15.00. Labor cost between $300 to $500 = cost of laborx .OS =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FLY'PIJRE, EXCEPT WHERE NOTED. FE{T IRES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
BATH SINK LAV FLOOR DRAINS SHOWER _ WATER PIPING
_
BATHTUB GAS PIPING am-DcrrrarcAm3g) SWMIMING POOL WATER SOFTNER ($35)
_
CLOTHES WASHER KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREY. ($15)
3 DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION
WATER METER L OTHER
PERMIT FEE PROJECTS FOR 13NDER $500
PERMU FEE FOR PROJECTS OVER $500
Permit Fee $
Number of fixtures (r-) $10.00 x$10.00=$
,Surcharge .50
Number of fixtures 6a7 $15.00 x $15.00 = $
Number of fixtures i $35.00 x $35.00 = $
TOTAL DUE $
State Surcharge = $ .50
Total = $ O
THIS IS AN APPLICATION FOR .A PERMIT -NOT VALID t1NTIL 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 p t work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of all hi and approval of plans.
SIGNATURE OF VelzDATE
.APPLICANT
PLEASE NOTE: SEPARATE PERMT9 ARE REQUIRED FOR BUILDINGS ELECTRICAL AND MECHANICAL WORK
City of Fridley
Building Inspections Department
6431 University- Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
r
Building MECHANICAL Permit No.: Zook -60
Inspections P RESIDENTIAL APPLICATION Received By. ,
763-572-3604 CITY OF FRIDLEY D M',41 11 69 200
763-502-4977 FAX
EFFECTIVE 1-1-08
DATE ^ � - YOUR E RAIL ADDRESS e S LO �56 n h c:a-�' . Com
SITE ADDRESS 1 1 "1 WNrl— FA t 01@x, IM .Aj 6L13 2—
THIS APPLICANT IS: ❑ OWNER CONTRACTOR
PROPERTY
NAME: P. net,111 L M
OWNER/
p
ADDRESS: 15 I -1 �A V\-e-V\-e-` W . CITY FC STATF�7
ZIP 5432
TENANT
PHONE: % (O 3 -% F0 — Z4
CONTRACTOR
COMPANYNAME: We-y e_A�v zQ -
NOTE:
SEPARATE CITY
CONTACT PERSON: C�aQ
LICENSES ARE
STATE LICENSE # EXP DATE
REQUIRED GAS
ADDRESS:A2_12--.3 �S 12_12-3 2-o-y" 'A\e. CrfY�f �C-e_A6 (1 STATEMzIPSS311
HFOR
AND H
SUBMIT COPY OF BOND
PHONE Co'b -3"- 1 F*& FAX-763 - 3,? 9 - 128
AND INSURANCE
PERMIT TYPE
)(SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
o NEW 0 REPLACEMENT 'X ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK 54\rZ BALL �rfi("�� A'�Q, Cp,t\� &NCr_ `^
e� 51 �5 � . �\w-r �' 1Rl c.
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 a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
OR
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) Y1n p S�1 �i D 0 Z`{ K
Equipment Installed MFG: ' ' `MF MODEL: i SIZF/BTU 2- TG
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
BOILER $35.00 FURNACE $35.00 GAS UNIT HTR $10.00
CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00
_DUCT WORK $10.00 _GAS PIPING $10.00 _VENT LATOR $15.00
PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500
Permit Fee $ 2-S .00 Number of fixtures @ $10.00 x $10.00 = $
Surcharge SO Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ .6c) OR Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
MINIMUM $15.50 MINIMUM $1550 Total = $
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a mechanical permit and I acknowledge that the information above is complete and accurate, that the work will be m 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 ' ccordance with the approved plan in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLICANT 9141,� PRINT NAME 4rV44 DATE �%'8 ' *
APPROVED BY DATE
PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR BUILDING ELECTRICAL AND MECHANICAL WORK
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977