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PRE 2010 DOCSBuilding BUILDING PermitNo.` I Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 763-502-4977 FAX EFFECTIVE 1-1-08 DATE YOUR E-MAIL ADDRESS 1F t f~ H.n (7 c e tfe r Cy he i mo d . e o M SITE ADDRESS 5-9 1/ f 5.1 W E F,r i d le- �, N'7 Al Y 412 THIS APPLICANT IS: Jd OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: Ta<(d + 94o Obi wm 4 oef co l t! , Z s TENANT ADDRESS: 5--f-73/ 3'-J V v k CITY E, .%re ,r STATE r iv zrP 53 432 UM PHONE: 763 -S -71-219i 4. 5,0 REMODELING SUBMIT: NAME: a ADDRESS: CITY STATE—ZIP— TATEZIPSUBMIT CONTRACTOR SUBMITA COPY OF PHONE FAX YOUR STATE LICENSE ❑ DETACHED GARAGE 3. List of structural members to be used STATE LICENSE # EXP DATE PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE Sewer Main Charge ❑ TWO FAMII.YJNEW CONSTRUCTION STORIES PERMff TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ADDITIONS_ & PORCHES SUBMIT: % BASEMENT FINISH [3 ROOF [3 DRAIN TELE ❑ DECK ❑ SIDING ❑ OTHER ❑ Fascia ❑ SW]MM]NG POOL and proposed project TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION 2. Two sets of construction plans ❑ MAINTEKANCFJREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 13o s r #" e n 4 f- 14 i s A l t! , Z s SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT UM ❑ HOUSE ONLY 4. 5,0 REMODELING SUBMIT: NNUMBER OF SQUARES ❑ HOUSE & GARAGE License Surcharge BASEMENT 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE $ 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: - Park Fee $ - Sewer Main Charge $ FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING 13 Vinyl VinylAlumi ❑Soffit ADDITIONS_ & PORCHES SUBMIT: ❑ wn ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project 2. Two sets of construction plans $'lXWWS 3. Energy Calculations IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 UBC FEE SCHEDULE) 70TAL JOB VALUATION S OCCUPANCY TYPE Permit Fee $ l t! , Z s Plan Review $ 72.3/ Fire Surcharge $ 4. 5,0 Surcharge $ 2.2sr License Surcharge $ - SAC Charge $ - Curb Cut Escrow $ Erosion Control $ - Park Fee $ - Sewer Main Charge $ - See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1825 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review T Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks savable to: Citv of Frkllev 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 on site; thatNFA will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURELICANT �'� PRINT NAMET -�� A/. 4 s E 4 DATEJ1JnL0bA APPROVED BY DATE PLEASE NOTE: SEP RMITS ARE REOUIRED FOR PLUMBING. ELECTRICAL AND MECHANICAL WORK I c;un►�.r�trc r v. - 0 I O t Zi°QED C I o A N i- 4 1� WIDE LN 1 -to b ---- -- ----=------ - ----- 11 %J r - — — — — — — — — — — — - I r --------------- T=-------T"l--r-°--rt----------7 I n I I T r——_—T----_-- I L --__—_J I r I, I I I I I I I I 12C. 12 BLK. I � I "" � " cc V i r,��= __�� A—i i \ % i i �� i p U 20 x8 FTG. 1* I 12c. 12 BLK. (DO O I ii ��\ ' i i a0 �� I_ -------- i i ,,'% O i _n ifl 20"X8" FTG. J W a i 4 I I op 1 j N l 'Q � I� I I tfl� `cit \� j R• . ATH \,,, /Ij'I I ��I �I- `_ ~ ® I I�. F— ` O WINDOW N Y I " 2x6 STUDS I �___� FUT. BEDRM. I WELL �f-z' 1 I 3 1 /2 CONC.SLAB 1 c. 6;"HALF HIGH I I -- _-� - 1 �k I el- " 16"A" FTG. 9,x:8," ,_B." i 12,_ - I o0 C� of - T " " ", 6 ice► I 13'-8" I �� _ NQS/ /'I 12-3 3 7 3-9 �` �-ION ------�-------- BF4M I (2)9 1/2" LVL �— �-�---------- ---------------DROPPED BEAM , ► 909.EFF. ifl POCKET I .I r1=, , , I ra�ll I I " SUMP ; I' o I w/MECH. IR 1 c. 8 BLK. D 6 I + I BAS d ` - ► . -+ _ "� I EXCHANGE 11 c. 12 "BLK. 1c. 6 "BLK. I 1 6 0 o `,WIIICDOW L: I . = 20 x8 FTG. 4c. 8 "BLK. I I WELL ) 2, 6 STUDS' I HDR. , - - -J 1 16"x8" FFG.N 1c. 6'"HHIGH 1 fi -^� : WATER HEATER I N .I I 16 x8" FTG. --- 0W/PO R VENT 4FIB.GLS. co ,I1LAUN.TUB zW�1 f - 2C o v, o W z I 1 " 1 c. 8BLK. L 1 I I II I VATS er 1 rn N HDR 10 11 c. 12 "BLK. ---- I CORE FILL V I I I I FE:® 20"X8' FTG. 130 x30 x12" CONC. FTG. ----------- 1 - - - - --II CORE .FILL - - - - C� -30"x30 x2" L--sL�� �� l�L-, r- ---- -� I CONC.FTG. _L ��_��_1J' I 6"BLK. 6"BLK " �� 1 c. 6 BLK. " - 20 CANT. 1 I 4c. 12"BLK. I I o 4c. 120 1 o ABOVE i I 20 x8" FTG. 20 x8" FTG. cfl 1 L -- ---------J L-16'3 9- Q-_ ----- ----------J I r I _. —, T'`---- —------------------------ eF 1 - I� Building MECHANICAL Permit N c�7- Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date ReC'd: 763-502-4977 FAX EFFECTIVE 1.1-08 DATE YOUR E-MAIL ADDRESS SITE ADDRESS `A 3 3 ` a� S� IYt� ro l Jli i , roy THIS APPLICANT IS: A OWNER OCONTRACTOR PROPERTY NAME: T.,dd oL /I./, i&m 4 a c f c v ADDRESS: 37'9J/ :rt'/ 3'f Wgf CITY Frl�l<y STATE�ZIP SSr/il' OWNER/ TENANT PHONE: 76 _�-- S 7/ - 201 CONTRACTOR COMPANY NAME: NOTE: SEPARATE CITY CONTACT PERSON: STATE LICENSE # EXP DATE LICENSES ARE REQUIRED FOR GAS AND HVAC. ADDRESS: CITY STATE ZIP SUBMIT COPY OF BOND PHONE FAX AND INSURANCE PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: NEW ❑ REPLACEMENT O ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK degfl4!r Vsa91 in C+Ilsf!•n4 d1s.4 c✓®rk irv1- ilsssrAV" 0of F1n�s•4 PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to 5500.00, 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) Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEIBTU A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGEIOVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 $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 XTVENTILATOR $15.00 PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ Number of fixtures @ $10.00 2 It x $10.00 = $ 2 Surcharge $ - .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ OR Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 MINIMUM $15.50 MINIMUM $15.50 Total = $ QM11ze 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 in conformance with the ordinances and odes of the Ci 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; work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APP CANT Bi( PRINT NAME %.%� OIh vn L, o %� DATE Ze1 00 APPROVED BY tl DATE C� PLEASE NOTE: SEPANATEMERMTS ARE REQUIRED FOR BUILDING, ELECTRICAL AND MECHANICAL W RK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-5024977 W cc lvq Building PLUMBING PermitATo{. —� Inspections RESIDENTIAL APPLICATION Received By. 763-572-3604 CITY OF FRIDLEY Date Recd: 763-502-4977 FAX EFFECTIVE 1_I -M P r DATE YOUR E-MAIL ADDRESS fc 164 ou 4 o (ter SITE ADDRESS 5-G)31 314 5-1 A/ AF F I'i/ a j, nl jV ;-f of z THIS APPLICANT IS: OWNER OCONTRACTOR PROPERTY NAME: / ., J L Kole ADDRESS: .5-93/ >t' $7 All- CITYFeWe �f STATE WAIZIP F OWNER/ TENANT PHONE: tell. (o . * ,1ir2V CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY D TOWNHOUSE TYPE OF WORK: *NEW 0 REPLACEMENT DETAILED DESCRIPTION OF WORK 89 toy a c ,„ F©r 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 ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $15.50. X BATH SINK/LAV FLOOR DRAINS SHOWER _ WATER PIPING —BATHTUB _ GAS PIPING (NEED CITY LIC) _ SW1M?vIING POOL _ WATER SOFTNER ($35) WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($15) —CLOTHES _ _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION —DISHWASHER WATER METER OTHER PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ Number of fixtures @ $10.00 *-f x $10.00 = $ Vy 3e Surchar a .50 Number of fixtures @ $15.00 x $15.00 = $ OR Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ 70 0 State Surcharge = $_ 55 $15.50 MINIMUM $15.50 Total = $ ZOM A THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 on site; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF CANT PRINT NAME %�,� /IIaw,4a--I�/ DATE '1 APPROVED BY DATE PLEASE NO—TE—,Q�ALRATE PERNUTS, 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 JAL'