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PRE 2010 PERMITSCity of Fridley, Minn. BUILDING PERMIT N? 3380 Date: .. .^.. /...... ...!!...... Owner"1, -!.�/Builder............................................. .,. Address.........Address3 .................................... L04CATIION OF BUILDING IO No. 1p.� Street !> ..V.1 :!='i!�...Y. � .�.......... Part of Lot ............................... Lot ............ Block .................. Addition or Sub -Division ....................................... Corner Lot ............ Inside Lot ............ Setback ............ Sideyard ........................... DESCRIPTION OF BUILDING To be Used as: .1..77/, AC.4 ... Front 1Y..L' Depth R.0 .7.IP Height .f. 0. _ OSq. Ft. 1�q. Rt Cu. Ft. .................... Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu,. Ft. ........ cle— Type of Construction ................... Nst. Cost... .0-0 ......... To be Completed ................... In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of !...�.... , permit is hereby granted to ......................... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ..... Building Inspector NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. SUBJECT,.0, City of Fridley 145 AT THE TOP OF THE TWINS BUILDING PER ITQ0 ECEIPT NO. Ir � • COMMUNITY DEVELOPMENT DIV. ' ------ '<: r PROTECTIVE INSPECTION SEC. ppp /7DO 3 � 1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 14 JOB ADDRESS 6823 East River Road 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 Ostman's 1st Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE William R_ Gardine_r 6823 East River Road Fridley, Mld 55432 574-1813 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. ame 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION? ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Pi -rep! are 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Franklin Fr 1 . 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 1 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 I&.50 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $7.50 PLAN CHECK FEE TOTALFEE .17 8.00 SIGNAT O Co AC OR AUikiORl ED AG ENT (DATE) VALID ED THIS IS YOUR PERMIT O WWPROPERLY /Cj-7p SI A EOF NERIIF OWNER BUILDER) (DATEI NSP DATE CITY 01= FRIDLEY APPLICATION FOR RESIDt=NTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER: Address: /f,,.3 IfZK. %SCJ% Address: Tel. No . I Street: LOT: CO BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS: Applicant attach 'to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING Front: Depth: Square Feet: Cubic Feet: Front: Depth: Height: Height: Square Feet: Cubic Feet: Type of Construction: Estimated Cost: $ ,���s //7/Wy To Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) 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. See reverse side for additional information. ' L DATE: �- �Q- �� _ SIGNATURE: Stipulations: .8 City of Fridley Su BJECT PE . o16259 AT THE TOP OF THE TWINS BUILDING PERMIT r � RE COMMUNITY DEVELOPMENT DIV. L r PROTECTIVE INSPECTION SEC. 3 7 70 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 6/2/481 JOB ADDRESS 6823 East River Road N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 OStman's lst Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE William Gardiner 6823 East River Road N.E. 574-1813 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 3311" x 12' Deck - 9 CHANGE OF USE FROM TO STIPULATIONS 'EPFRATF fy RHl�1G Eq r�� pFRM wA �+► ►oca► u�►►►�r�� Bret ON ELECTRIC . G4 Ett' t✓�, �0 iEIEP►� - LAW q y6 uIREp gY S'04 pap REQ 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 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 l 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 $2,000 $1. GO 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- $12.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $ 3.00 $16.00 SIGN AR;' 17RAACCTTORROO AUT HORI ED AGENT iDATEEii� / NHEN PROPERLY VALIDATED THIS IS YOUR PERMIT SiGNATURE OF 15WNER OF 0WNER BUILDERi IDATEI BLDG INSP r)ATE 1 CITY OF FRIDLEY APPLI(:A'fIO;J FOR RESIDEi`1TIlli_ BUILDINGPEfL'rI'fS (14cm, Al aerations, Additions, or Repairs) OWNER: iN�i��i � �j �CD`4*X BUILDER: - W"Ik/"il-ge ADDRESS: lo� jQl1� ADDRESS: TEL NO: TEL NO: Construction Location ' STRI,(fT NO: STREET: LOT: �j BLOCK: �^ ADDITION: Corner Lot: 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 - �CA— Front:%` t� Depth: l*�� Height: /d' q'( Square Feet_Cubic Feet: Front: Depth: Height: Square- Feet: Cubic feet: q 8 :. y t� - m 4f Type of Construction: Estimated Cost: $ xb Be Clompleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET . Ilie undersigned hereby makes application for a permit for the %:.,ork 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 co ect. DATE: � � IX.�" �� SIGNATURE: Stipulations: P. e '& O U Rx G� CAP i Q+c a►+t 'ihR CK.T ?CST 0 c< I" 0. C 9otU 515 y W D. 8k Tlr sT POST- foo�ac� RAckaZ` G � Poen„ P t FDOT,i�� �4R.ii�JD�t�+i' GF 5���3 c J d L C 0 s U 94, w n i 11 f 1 /i f 0 0 0 sueJECTMI City of Fridley 16 7'5 0 AT THE TOP OF THE TWINS BUILDING PERMIT _ r REC L COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. % g r 1 PROTECTIVE NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/2/82 JOB ADDRESS 6823 East River Road N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 Ostman's First Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE William Gardiner 6823 East River Road N.E. 574-1813 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 Reroof ENKXXX X Dwelling 9 CHANGEOFUSEFROM TO STIPULATIONS Roof can be the 2nd layer but not 3rd. Install ridged galvanized valleys. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Asphalt 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 $400 $.50 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- $15.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $15.50 SI ATUREOFCONT AC ORO Au HORIZEDAGENT IDAfE/i WHEN PROPERLY V IDATED THIS IS YOUR PERMIT SI NATURE OF OW NER OF OW NER BUILDERI IDATEI BLDG INSP DA 0 0 0 CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATION FOR RESIDENTIAL BUILDING PER14ITS (Herr, Alterations, Additions, or Repairs) OWER: (. c_X�JC� r� � ��[►2'��i2er ADDRESS:�,- 0 TEL NO: Construction STRIMT NO: �oz3 STREET: LOT: BLOCK: BUILDER: ADDRESS: T TEL NO: tion 1/ Corner Lot: 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 CONSTRUCTIO14 2� Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: Type of Construction:. 46= Estimated Cost: $ c7J Tb Be Completed: 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 %-.ork 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 trueand correct. DATE: � SIGNATUF2E: Stipulations: Ivo Sb sueJECT PE . City of Fridley 28372 AT THE TOP OF THE TWINS BUILDING PERMIT r ` RECEIPT NO. • _ COMMUNITY DEVELOPMENT DIV. ,.------ . 11063 r PROTECTIVE INSPECTION SEC. i NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIOIEY 55132 612-571-3450 910-F15 10/20/98 10B ADDRESS 6823 East River Road 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 Ostman's 1St SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Linda D. Gardiner 574-1813 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 1 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE N0. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION @x REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof garage (5 Sq) TEar-off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING. HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES 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 428 $.50 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 21.00 Fire/9C $.43 PLAN CHECK FEE TOTA E SSG RQR AUT FtiZED ,►,GENT iOATE,Ew4yy& S Y UR PERMIT �TUREON'A �GNa 7UAE F OwNE OWNE WLOEQ' iDATE� 9l DG ��arE NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �a �J ConstructionAddress: 0 (6 eS Legal Description.- Owner escription:Owner Name & Address: �1�1� ,�� - Tel. # �S %y a:� Contractor: MN LICENSE # Address: Tel. #,'��S/—/���_ Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: Length GARAGE AREA: Length DECK AREA: OTHER: Construction Type: Driveway Curb Cut Width Needed DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. _ Estimated Cost: $ (Fee Schedule on Back) Ft. + 6 Ft = Ft x $ _ $ DATE: /c9 APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control $ o C) $ 3 $ .D 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 $1000 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 [ ] . T -Y OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2002 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS RATE SCHEDULE OWNER .� /Nr�,/� �'�{-r�bn1 ;. . Residential Rate TOTAL '. Furnace Shell and Duct Work, Burner- BUILDING USED AS�� Also Replacement Furnace $ 30.00 $ �! (Side Vent'- Fill Out Back) ; ESTIMATED COST (C1��`X�'� PERMIT NO. Gas Piping (Needed with new furnace, $ 10.00 $ /�• but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of Heating Units_ Circle One (Steam) (Hot Water) EWar=mAir Gas Dryer $ 10.00 $ Trade Name Size No. UG' e 4017 *Air Conditioning - All Sizes $ 25.00 $�EaQ BTU_ '7 oQa HP EDR Fuel Mit A _ Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR Commercial/Industrial 1.25% of Value of Appliance or Work $ 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 an State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and lL representations stated in this application are true and correct. TOTAL FEE DATE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION :.; THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED COMMON VENT, VENT CONNECTOR AND COMRl1STION AIR VIFIRIFICATION When _ra I� a ring an existing furance, 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 -LAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing comhustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new comhiistion air it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When ins ailing 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 -LAMA 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 Common Vent Type Appliance #1 Vent Connector Height Appliance #2 Vent Connector Height Appliance #3 Vent Connector Height _ BTU Input _ BTU Input —BTU Input Total Btu Input Vent Height Fan Assisted or Nat Fan Assisted or Nat Fan Assisted or Nat Diameter ft Length ft Diameter ft Length ft Diameter ft Length ft Diameter inches in Type in Type in Type ®/L 71 6AS�✓ r� Rice' %Ae c��, PCYUXv V —'-w t 514), U r—L2 - rd Y_ G� -L ECSC w1 Y65' -At- ot-,4b H A5 © J A -+---Y C 9 1 eu nr z5 -f HEATING CO: ;r1.1PI R CONTRAC�tOF6 INC. Signed By: Date : 1E3�'6 0 2 3uilding BUILDING Permit No.: =nspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 0111 )ATE IG L YOUR E-MAIL ADDRESS ;ITE ADDRESS (A 2 �J C (Z-\ V rc 2 (Z4) - 7 HIS APPLICANT IS: ❑ OWNER 4ICONTRACTOR PROPERTY OWNER/ NAME: L i/�D�o— (JG r ,tib ADDRESS: $Z ✓cT 120k ' CITY / STATE(ZIP TENANT PHONE: CONTRACTOR NAME: E2 (C/� °S bi✓ST CCN �7- STATE LICENSE # 20 I -"7 1) 0 S EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: 'lg�i z hw' I t 0 - S l (0 ` 1 CITY STATE ftZIP S3 b WITH APPLICATION PHONE 2 63. 2?c(- SO ``7 0 FAX 7 6 3 r 4, 3 3- L 7 0C> PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILYINEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH I�,ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 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 I . 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,0 S $ OCCUPANCY TYPE Permit Fee $ 3 3 .2'See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ ,S2 .001 times the total job valuation Surcharge $ l .Girl .0005 x Permit Valuation Minimum $.50 License Surcharge $ S . C170 $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ Make checks payable to: City of Fridley Attach Stipulations 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 requir review and approval of plans. SIGNATURE OF APPLICANT/--�---v _ PRINT NAME IM^ff-4c- V ET9­011 L DATE ez,' z 10':� From: City of Fridley To: 7632411445 Page: 4/4 Date: 11/1f2007 1:4`5 22 PM City of Fridley 2 00 7 6431 University Ave NE Fridley MN 55432 (763) 572-3604 or Fax (763) 502-4977 Water and Sewer Permit Application ❑ New Connection INUtility Line Repair/Relocation ❑ Existing ❑Water and Sewer Connection Date: 6 Job Address: 6 -re 9 3 15 9 4 J Name of Applicant (Plumber): DAy YhGc:) 6. Name of Property Owner: A" ti J/-1 6 N14� d N r vz Existing Structure Permit # Permit Type: Sewer Fee: i Water Fee: Meter Fee: Repair Fee: iY Relocation: State Surcharge: SAC Charge: Special Assessment Fee: Total: S Applicant Signature: Inspector approval: Water Meter Repair - Weekend & Holidays $125/hour Water Connections Permit $54 Sewer Connections Permit Inspection Fee for Water/Sewer Line Repair $40 Special Assessments See Cost of Water Meter See Utility Billie SAC Charge $1675 State Surcharge $ .50 Water Tap See Engineering