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AF - 46092�NERGY CONSERVATION SUPPLLMENT TO BUTLDING PERMIT APPLICATION pI,ANNING AND INSPECTION DEP71R`.PMENT CITY OF FRIDLEY, MINtVESOTA 'I'his supplement is provided to assist the applicant i_n computing EXTERIOR ENVELOPE AVERAG� "U" FACTOR INFOF2P�fATION. This information is required so the BUILDING OFb"ICIAL can determine that submitted plans c anply with the ENERGY CUNSERVATION DESIGN CRITERIA of the 5TATE }3UILDING CODE (Section 600G). It is the APPLICANT'S r.esponsibility to accurateZy compute the data; reflect the proper DESIGP7 CRITERIA in the plans; submit product specifications, if needed to support the "R" and "U" factors used; and to assure construction is per approved plans. JOB LOCAT I ON : �% � � � � �3 C L� � � � % 2 � OTr�N�Rf CONTRACTOR : (1.� � 5 T � �� a �.► S r�c ,� c T r �� ADDP.ESS : Z� 1 3 � o�() c R f s'r' � 2. PHONE: %�% -� 5% �',� A. Determine the Total Exposed Wall Area as follows: 1. Total w�ll window area 2. To tal door area 3. Total sliding glass door area 4. To tal fireplace wall area 5. Total wall framing area (average .10%) 6. Total net wall area above floor(average 90%) 7. Tc�tal rim joist area Subtotal: Total exposed wall area above fl.00r 8. Total faundation window area 9. Total net foundation area above grade Subto*al: Total exposed foundation area GR�TD TO^zAL EXPOSED WALL AREA �1��3 io �,� ��v pe�s� N� ..�+.� �%4 �3.3 I e� g 4 ro.� l zS, L� tzZ�f }3. Multiply the GRAND TOTAL EXPOSED WALL AFtEA X.17 = C. Determine th� Total Exposed Roof/Ceiling Area as follows: 10. Total skylight area 11. Total. roof/ceiling framing area (10 0) 12. Total net ir�ulated roof/ceiling area GI'�ND TOTAL EXPOSED ROOF/CEILING AREA �� io9, y- 9g1. � l D '�'f y D. r:ultiply the GRAND TOTAL EXPOSED ROOF/CEIL:LNG ARFA X.05 = �� 1 3 S� I�-em I �- � �.O 4 Item II S�T, �o E. Detern�ine the "U" value of each sec3ment (1-9) and multiply by the area as follows: 1. �j t, 3 , g„U�t . z-, � t� _ 2 a, �,� 3 2. � ?� c� X ��U�� , �-8 = �-, � R. ..._ 3 . �J R X "U" — _ � 4 . � � g �oU�� _ = o 5. �____ � �. � X.,U„ , � r9 - � �, �. ti� 6. Q�9 x��U„ �,s 9 = ¢G I � L• 7. 9 3, 3 X��U�� , aG►/ = S's,�q) 8. / D. `� X "LI" • �` P < = Sr, �ca "L 9. /sS,�i X ��U�� ,��`�^ = S�.4o�. ADD I- 9 I'OR TOTAL WALL SEGMENTS - ITEM S II � a� %, p! F. Determine the "U" value of each segment (10-12) and multiply by the area as follows: 10. �� X "U° 11. / n 9, '�'" g��U�� , D 3'S 12. 98 �. I X nU�� '� Z�r ADD 10-12 FOR TOTAL ROOF/C�TLING SEGMENTS = 3,Ld � Z- � r S # � ��rEr� rv 2 P'. � �% G. If Item III is the same as, or less than Stem I, you have met the intent ot S�ate Building Code 6006 (c) 2. H. If Item IV is the same as, or_ less than Item II, you have met the intent of State Building Coc3e 6006 (c) l. z. Aad z tem I � n�, o g J. Add Item TII 1� 1, v � q + zt� zz + Item IV 5 S� . L �-�' , r '1 = 2L 2.G � e 0�?, / F� K. Tf the sum of Items III and IV are less than Items I and II, you hav•� met �he intent of the Code for total envelope system. The undersigned, as applicant for a building purmit, hereby affirms the above infozmation has been �repared and >ubmitted by himself or under his direction, hereby acknowledg�s the information to be correct and a.ccurate; and hereby presPnts the information with r.equ5.red plans in support o� the builda_ng permit application. B . t� � 7 . °� c�/''° � � Y ' � G� .C.�a`� DATE : , , �, �`t F n� L d S S `,a � c v L r� �~- � a�..� S �} P��.. t . ��+-�f�,o,� A.�. � „ �. ��. SN��T �ocs�c 3: 3 � �, G. `�NsUs. . `• ��/32 �i'�� M T1.► �Nf� t f. /2 4=Y�rta�`ra��ei S�9�n3�, V . � X'�'. P• � _------- . - W ALL �i2i+ w, :..� p 1 , �+a'ti' . R � rt 2, ��L S V' E 6'T Q e L �C „ �, , 3 ',,. L ,. v� +�s E +s. �� 2S�'Rt. SNCr�YN��lt. s. '/,. �s � � ,�.,�, M��c��,r � �. . �,c -c' . i} � at R ..r.� To � y �r- I, �►aT. h�rL ?. 3 y INtul. F, C�. �' ' i �r �. v µ► �Fi E rt � �At �?►s•�A t� +}� �y 5�o�at,. µ 5 , �x T. P-� �. ---- -- ��..n��c Wrw�.LS �, i�'r. ��rt r� 1 , i�. i3�ntacti 3 , � x � , � � r�. � � u� e � ,"� � ��R�.�. �-� _ . �o g � � . 1 ►aT , {� � 2 , . y �.° 1. sl& S � , , �3.00 3� (o %1 � cL4,. ZNs.�� .o L ( 4' . �j y L v v.,.. �i 6� �'► " � � ' S, Eu� . ��c ,,„� � ,i li.o 3.c 5`� 1j CE ��. �.a t, ! �� ,�B i �. ►..�T. A,rc . �t �� 1� '?, � S/Q' S F� F t T tR s C.iC y.�►� �� - � ;i 3, � 4�" e� �� .r� =Ns„� �. . o {. ''. �` G(, C�tT � f1r�% i �i � .�1 � . � �► i , � L', I �.�i�i . �Iq ir ;------;-�.�...� � r i� 0 i . �; . � ` . . ! ` ►3.od ! �� ; � � 1. 8� � �` e I � ti ! .�5� �+ � I �� i w �, �v �� 'Ib.4►\ i,pte� t' i� f"'_'� ; ; �.4.� i ;} � :r � (.2� � :i � , i"� � �' � � ;� � i i � �; i ; ;: � 2.�s � .�b9 �: � i " f � w ` t ' ,` � ,, � � -� �, -, � . � � � . t� 1 . �� z �. S �. �{ � •V � 3a,� �.033 ----- .G( .s1 i$,oa .61 ____----�---- 34,1Q ,,# ozY f �_ � ;.� ;„�. ' �'" � � ��: �r �": GIiY �F FRIDLEY APPLICATIOV FOR PLUNiBING AND uAS FITTIiJG pERMI7 -�-^--+-----�-� q �, v, 'ro u • � v water y� m � � y�, c..[i N q ��u c�i, w � Heater y .0 .� tn F•.+ rt 1.� vf rtS k 11 .a c� ro e m x� c� ►+ .c e e m a • u 1r :J N G .0 •.-1 .1C ^ G C 3 O U••�1 O.0 U Q� o O •.-� y N q in •�+ � O O J.� Uf 11 tN Ul N UI F N U a � � ••i N N O .0 �-/ �0 �d ^f f6 rt7 y ro J'� as lec �n 3 0[�. tn t4 U al �2 3 C� k. C7 O , � iZ � � lst * � � /i� _ 2:�d 3rd C`-n (R) �£uGure Co:uzection Opening Cocinected with Sawer (*) = New FixL-ure, Cld Opening Water PARTIAL RATE SCHEDULE PLUA1BIhG FI\TURE RATES: N0. RATE t.�i„be.r Fixtures !� x S3.p0 F�4use F:�cture Opening � x $2.00 New Fixture, Old Opening x S2.00 Catch Basin x $5.00 water Fieater - to 99,000 BTp _� x $5.00 100,000 BTU Go 199,000 BTU x$10.00 hater Softener x $7.00 New Ground 13xn Old Building x $5.00 £lectric Water Heater x 55.00 GAS FITTIti'G FEES: lst 3 fixtures � x $3,00 Additiona2 Fix tures x 51.00 Gas Range to 199,000 BTU x$10.00 TOTAL Od $ ��_� $ i_ cyo� ---s� $ ,._.__._. S � . o ci $ $ $ S 8 �.�D S S REPAIRS �, ALTERATIONS First $100.00 SS.OQ $ eaeh add. $100.00 or fraction 52.00 S State Surcharge $ .50 ' TOTAL F�E $�J� � � li,x'.ZNSPECTZOI+t PEE �510.04� 3ob Address /C� �j- C- /7'�`� Depzrtment of BuildSnqs City uf I•ridley Tel. #571-3450 The undersi.gned hereby makes application £or a pezmit for the work hezP3n speoif.ied agreeing to do a22 work in strfct accnrdance with the City Codes and rulings of the Depaztr.ient of Buildings, and hereby declares that aIl tho facts a�1d represonCations stat.ed in thxs application are Lrue and crorroct Fri3ley, Mn. �, / �C� , 19 �Ci 0`rTNER ��/C�C�l� C.X/�=S%lii,/� KIND OF BUiLDING ____1 _I�G'� /�? USEB AS TO BE CONIPLETED ABOUT [1 C�. _ l}�'�1 �._.._ _ Esx=aza.xD cosT OLD - NEW BUT�.DTNCa PERMIT NO. Comoany PERi9IT 2J0. 0 5igr.ed Ey � � • �_ TeI. No. �U �" l!'� G� RQL'Gli SNSB. Date PT23AL INSP. ��r� Ddte ABPRdVAL FOR YERI,IT' t� D/C,) � NiZPiTD'iUM Y'EE YOi3 A1�3Y PL13D'iFSI33�+ PERMYT IS $7.50 PLi35 �5.50 $ie1'�'E SSUA..i3ARG£ 0 SUBJECT PE . City of Fridley � 5 6 9 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � r � COMMUNITY DEVELOPMENT DIV. REC� T NO � . � � L ------� f�/��• 1 � � PROTECTIVE INSPECTION SEC. i , � � � � � /'�'1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF A ROVED BV � ""�"� ,�' 612-571-3450 910-F15 5/1/80 � � JOB ADDRESS �562 Able Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. P't. 2 3 Shaffer's Subdivision #1 SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE Charles Westling 2523 Woodcrest Dri.ve 786-4445 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MA�L ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Res iden ti.al 7 CLASS Of WORK Q NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 42' x 26' Dwellin and a 22' x 24' Gara e 9 CHANGEQFUSEFROM TO STIPULATIONS provide a hard surface drivernray. Provide sod in the front and side yards. Provi.de City with_ copy of verifying survey before capping. Record lot split at County before applying for 2nd house permit. SEWER LOCATION: (Approx. 1Q' Deep In Street) 1Q0' S. of M.H. (Inv. 882.93) WYE ELEV: $81.86 �WYE ONLY� Top of Footing: 885.36 WATER LOCATION: 1KUST BE TAPPED 6" CIP 10' W, o� Sewer DRIVEWAY DEPRESSION COST: 16' + 6' x$15.75 =$346.50 �� B�fore �igding �N l�c�i �#i1i�i�s SEP�RATE PERMITS REQUIRED F{�R t�llRt(VG� TEl�PN+D�i�-�IEC�'t��ti�,S�t�. HEATlNG, PLU�ABING A�D. Sl4a�YS`i. REt�t„�t�Ep $Y �►V1f' TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY �OAD SEPARATE PERMITS ARE REQUIRED FOR EIECTRICAL, PLUMBING, HEATING, VENTILATING OR AIFi CONDITIONING. FYdYR@ 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 OH 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 THA7 I HAVE READ AND EXAMINED THIS APPLICATION ,]. S7ALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS Of LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OF NOT. THE GRANTING OF A PERMIT $45,30Q $Z2.6S DOES NOT PR UME TO GIVE AUTHORITY TO V10LATE OR CANCEL THE pERMIT FEE SAC CHAFiGE PROVISIONS ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTIO O THE PERFORMANCE CONSTRUCTION. y51QH.4S $425. QO � PLAN CHECKFEE TOTALFEE �^ � - � 0 $ 27.12 $583. 25 SIGNATUREOFCONTRACTORORAUTHORIZEDAGENT IDAiEI WHEN PROPERIY ALIDATED THIS IS YOUR PERMIT � � � _� � ' `� � SiGNATUFE OF OWNER 11f OWNER BUILDEPo IOATEI BLOG �NSP �/+TE CI7Y Of' t=(tIUL.EY Af'f'L�C11TI0'�� !�O(t f�f�Sl�rtvTIl1(_ C'>l1ILOlf��G ('ERP1TTS • � . ((de�-r, J1lterai:iane:, /'id�iii;;ons, or Rcpairs) OLltdCR: C ��-�2 L �� TL ► � C� �111LDER: �� c�r � � ,..i � �,�, sT ADURlSS: �;� t 3 Z.v��c� c,tr� r" �.,� IIDDRESS: Z�'� z�, l�ac� c�E-�r J72, TEL t�0 : ? ��, r �5� � �° 7EL (�d0: � �' � `I �l � .S� Construction Location STIti�T NO : � � � v S`.1'12LLT: �� ' i y i rJ � % Ag 1'� o r �• `! G. � . . . I�OT: _ , :L CPa,c�' o F � BLOCK : � 11DDITION : SI�/ a9 FFF i2 �5 �� i ✓i 1. _s � ,,.�0 . I Cor_ner Lot: Ins:ide Lat: X Set}�ack: ��'� Sideyards: Applicant attach to tlii.s iorm t�ao Cerfiiticates of Survey of lot and proposed }:�uilding location dra�an on cer.ii.ficates to scdle. DESCRIPTIO(�! OF CCNSTRUCTIO� • / , �`.' � r �_��_i.�._.__�__._ I'ront: �ii'f 7-�-�X� Deptlz: y fo xeight: Squa�.�e i eet: / 0 l'Y - Cubic Feet: �'�,�FC,� - �,o�= ' Front : Y Y ' nepth : 'Z � � Square I'eet: �y�_ Cubic Feet: _ � I3eight: i . . � •� 7�Tpe of Consiruction : �s3 L�iC i-�e �� li Estimated Cost� $ �b Be Cbmpleted: '�;i> (e � / �! �U . y� � Alt. 1� 1�.7.t. B Pro�.;ec3 Dz:iveway 6�i.dt11 If. New Opening Is Desired. _%(s .$ „�� SE� 12EVT'RSE SIDE OF SH�'r'.T �iie under_s�.gt�ed �icreby makes aYplication �or a pennit �or the F�rk heiein specified, ac�rc�ei_n; to do al.l �•�ork in stri.r_t� accorc?arice �,%ith t:�e City oi' I'ridley Ordir�-uzces and r.uliiags ot th� D�p:lrLnient o� }3u_��_din,s, ana ]icrcby dcclares tl�at all ii7e iacts ai�d re��resen�.ata_oi�s statecl in i:his ap}�li.cat.ion are tr.ue and correct. L�11TE : �- � �" � S Y�,N71'1'U I'�r:' : _a �/�)1�� ------- SLa.pulat.ions : P�a�►� � io�. �ts 42 xz �: P.4 2�. IZ Z-4 �GtL � -r�,t z2. eS � SAc 4':.�, o 0 t)a.+�.� ; 3.� ,so � � �qa � �r .�._..- �o�qZ x zo Z SZ$ x Ib�=. � - 21.8y0 = .�. ��.3c S'2 � ��?- 1o8.`f �t %z� %�3 to92y3/.G L � x��r/ ; ; �%�' 32d', � � � � �S',3sso.� � e*� �� a b �.� � � 4`t�,' � �' �.� � � �' � <; 3�1 Nt�U WttCl� rkYE..:,S. �� , � �., �'1f� � � � +BOI.Q�J YJ1ll�l!. IWItNM, �F �t,l1,i, ^ MINN. RE�. Nif. 474t ��1 ��Y$�� - d� ^ � ' � �� , �4� �.. .<. -� i� iTlf6� LAw6 dr i�'!s O! � � r, . :` �(,y� - .� . _ � � . � � . � .. . . �'^ f!l�7� ' �. ' �r• '. 1 Y- • � ' . . "" �1i11i %� �� . ' . , •,� q/� ` , . . � . � � .. . �r . � , . �� ..� � � � �." " ir,RUSTeuu -- �u��Ci�� ` GOMMfRCiAL — 70P0{3RAPNIGU, �. Minraao�te6i��E t ',I�I�# � �c ` � `�i�. . c�Tr �oTS — eu►TT�r�� "�i � ,:� � o�r�: � ,aa. �:. , EX�PLAR {: _ �t � _ _. 9� Q� - - - �. : z ; � ; , �... ,� .....�... , -r . ,� ,, - �� y .��. 1 : p , -'j . � � ' �. ' � � � �, r � i � � ,� � + 3 3 I __�� ' ��• 0 � � i; : r ,Q� F 'N � O � �� i� Q � � �:;� � � �� f � � � � ( 1 Y — — — — — — � ; �'^� � � G ` �,.,,' � � j � ,_ �� ;� I f � _ `�- � n s� _ _ 3�,, p -- _ _ `_ ---- 93. B8 —__--__ --- ' 35. "? �- S-�" itjo . 7550 � (_, �Q j �1 That paxrt c�#' Lot 2, Block 3� S1�affer's Subdiviaion No. 1 lying ��asL c�f the west 90 feet thereof. � Swb ject ta e�9ement� of record, if ar�y. � !��C;� � ��S � � : : ,',,,_ , � �' Q�- � � . . � � � 4 . � . W� h�r.by weli{y M�t tA;s w t trw ��o�Ntt i�rp�walatioa j ,. of � wewy of 1As baw�#Mi�f a� 'llpt �w ' _ (� N�i � � ' 11+ IocN{op ef aN � �i ��I�i114 ��relroMi�sk � : !f Myb � � �ro�► a e� r�id i�ui. � � � Swvyr.d by w tRk ��..�d1��Yf. ��'eCt��BI' !� �� L�i��` � <<. .� . . . . . . . . . � . � . . . � � � � � . . ., . . .. �. �� 4... ._ .:.. _. _... _ -._. k y �+"+ .. . . . . ' _ _ . ' . -y.�.a'� ��' _ � � �, � � : �. �. . y a 7Y��t {".. 3.. : 4 3 ta+�` qr >. � ' . . �, �. a ta — _ _..+rr �t `T�'�'°�.�^d�d � � ��j�y� � � ,..5 k�,� � h ' � . �� > � ��. f ,sli. A;• �w,� �.y` � �i4v, x .a'< �'CF: �,"'e . Y 4a 4' . . a a .{ Y ..�.y � � �� . . k� � � 5 . . .,'�4 ::.$ ��Y� � � .. ¢ i� �� h n. ' ��2 �--�':. ___-- � ' � .�� ST.� ��T� ��' �� _.__ ,� _ __ � � � .i�� C .�i� U . �o� S', ._ ��J, �� L.�Y� �G� �� N� � ��y� �: 1� �� ✓� ,:��-�� ,- �� / _ _ �� r � /� �� S F��, y3� ,�'_ _ - ��3 3 � /_ � ° �' / `c� � '� � � �� ' �'� � l= , � �w�r ,� ��, �3 �_� � � �� -� � � /� �-SS/��v � s j . G� �/Z � 5 � � �� i� � � 3S�'�� d . „� SUB�EGT c�ty of Fridley AT TME TOP OF THE TWINS g U I L D 1 N G P E R M I T r � . � � i LV �� COMMUNITV OEVELOP.MENT O�V. j � � PROTECTIVE INSPECTION SEC. � , i-_--�; �"' �'� CITY NALL FFIOLE� 55132 NUMBEN REV O�TE P�GE O: i 612-571-3450 9t0-Ft5 g/30199 � % JOB AD�RESS 7562 Able Street lOT NO. BLOCK t LEGA� OESCR. 2 PROPERT s�ot � CONTRA( Rene � ARCHITE� 5 ENGINEEI 6 USE OF B Resi 7 CIASS OF B DESCRIBE Rep 1 open 9 CHANGEI �� STIPULATI Prov SEPARA7E PEi vENT1LAT�NG TMIS PERMIT AUTMORIZED I OR WORK IS 5 ANY TIME AfT I HEREBY CER ANO KNOW THI AND ORDINAN WITH WHETHEi DOES NOT PR PROVISIONS 0 STRUCTION OF S�GN4T�JR S�GN�TUAE. � ' � / TfiACT Oii AODITION CITY OF FRIDLEY PUBLIC WORKS DEPARTMENT .��g�� s a 0142 ��J �� — APPROVED BY ___ SEE ATTACMEO SNEET — LICENSE NO ��c.uf l7. �� '9R3 UCENSE NO. Date TAPPING APPLICATION AND PERNIIT FOR INSTALLATION OF WATER & SEWER SERVICE I) This form to be completed before a tap is made to any eaisting water or sewer line. Lot�lock �.�' Addition Srl A r r � �Z `S �.� � . � / Address �SC�oi i`i11 L� .�T,Q�.�.f` l� � c� Owner �)�-S I C-[ ��C-� �1)�v 1 Plumber /�'1 <t�t,�f�STf�.�C1 �%�J�'�%s�C,�L CHARGES TO BE PAID BEFORE TAP IS MADE — WHERE ASSESSMENT HAS NOT BEEN LEVIED AGAINST PROPERTY II) Water & sewer connection permit must be registered before this Tapping Permit can be issued. City supplies all material and labor for 1" or under water tap. Con- tractor supplies all material and labor for water tap over 1", and all sewer taps. WATER TAP: Materials Used: $ /�?S U U Street Patch: �x�: $ 1��' � � /�a� �'� .U��SsA2� - ��,�xx�xxx�xxx�xxx �,,,.r 4>, �. i, � < <,c, C�t ; �-�C �, SEWER TAP: Street Patch: x . III) If this property has not paid a full Lateral Charge for its share of the water and sewer system, additional charges will be placed against it. This will be in addition to the normal connection and tapping permits, meter deposits, etc. ,, ; ` TOTAL s �a� . ao ,<< Water ASSESSMENTS TO BE LEVIED: Lateral: $ "+ Sewer Lateral: $ TOTAL ASSESSMENT: $ �`— �.._ . Clerks Signature 1 � J Supt. of Public Works �'�'` x� �-. �'Yh-� M/P 3/76 White P.W. Canary Finance Pink Prop. Owner Goldenrod Plumber IICENSE NO ❑ REMOVE dwelling n Cards led To Post )CCUPANCV LpAO �U FT PARKING ARAGES $3.70 DUR PEF iT / �.�' fi r�ntE _�rg�� N� 5 8 4 0° � CITY OF FRIDLEY .��,.��, �i7, w�o Date PUBLIC WORKS DEPARTMENT TAPPING APPLICATION AND PERNIIT FOR INSTALLATION OF WATER & SEWER SERVICE I) This form to be completed before a tap is made to any esisting water ot sewer line. Lot�Block J' Addition Stf A FF�,2 `S 5�.� z3 .�/ Address �S� A� �-�- .�7 �,�7^ Il� � Owner ��TL.r� e.o�ST Plumber /Yl r!Jl�JfSTf�IV /��SiCAL CHARGES TO BE PAID BEFORE TAP IS MADE — WHERE ASSESSMENT HA5 NOT BEEN LEVIED AGAINST PROPERTY II) Water & sewer connection permit must be registered before this Tapping �' � Permit can be issued. City supplies all material and labor for 1" or under water tap. Con- tractor supplies all material and labor for water tap over 1", and all sewer taps. WATER TAP: Materials Used: $��S G Q Street Patch: �: $ 1�Q' 0 D lhAy &� ,U�c�SS�2Y - �m�x�xxx�xxxxxxxx sr c.v, � L�� c,� (�a r�e �, SEWER TAP: Street Patch: x . III) If this property has not paid a full Lateral Charge for its share of the water and sewer system, additional charges will be placed against it. This will be in addition to the normal connection and tapping permits, meter deposits, etc. � TOTAL s �as. o0 Water ASSESSMENTS TO BE LEVIED: Lateral: $ °�� Sewer Lateral: $ TOTAL ASSESSMENT: $ �'— �. . Clerks Signature 1 � J Supt. of Public Works M!P 3176 Wfiite P.W. Canary Finance Pink Prop. Owner Goldenrod Plumber SUBJEGT � P�, c�ty of Fridley 0142 AT THE TOP OF THE TWINS g � I L D I N G P E R M I T r ' ' NO. � � � `y�� _ COMMUNITY DEVELOP,MENT DIV. �� ^ f � � PROTEC7IVE INSPECTION SEC. ��W � . , � � �"'1 � CITY HALL FRIOLE� 55132 NUMBER pEV O�TE P�GE Of AVOROVED 8r �'""�� `�� 612-571-3450 9�0-F15 8/30/99 � � JOB ADDRESS 7562 Able Street NE t IEGA� LOT NO. BLOCK TRACT OR ADOITION SEE ATTACNEO DESCR. Pt. of 2 3 Shaffer's Subdivision #1 SHEET 2 PROPEii7Y OWNER MAIL ADDRESS 21� PHONE Scott F� Nanc Albrecht 78 -1 2 3 CONTRACTOR MAIL ADORESS ZIP PMONE LICENSE NO Renewal b Andersen 350 7 r A e - � ARCHITECT OR DESIGNER MAIL A�DRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDFESS ZIP pMONE IICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION O ALTERATION � REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Replace 2� window inserts and 1 full frame window in home within existing openings. 9 CHANGEOFUSEFRpM TO STIPUlAT10NS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling Permit Inspection Cards Will Be Mailed To Homeowner To Post TYPEOFCONST, OCCUPANCVGROUP OCCUPANCVIOAD SEPARATE PERMITS ARE REOUIREO fOFi EIECTRICAL, P�UMBING. HEATING, VENTILATING OR Alii COND1110NING THIS PERMIT BECOMES NULL ANO VOIO IF WORK OR CONS7RUCTION ZONING SO. FT CU fT. AUTHOR12ED IS NOT COMMENCEO WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOR A PER100 OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. NO DWIG. UNITS OfFSTREET PARKING I HEREBY CEi;TIFV THAT 1 HAVE REAO AND EXAMINED 7HIS APPLICA710N STA�LS GARAGES AND KNOW THE SAME TO BE TRUE AN� CORRECi. ALL PROVISIONS OF LAWS VAIUATION SURTAIt AND ORDINANCES GOVERNING 7HIS TVPE OF WORK WILL BE COMPLIED WITH WHETMER SPECIFIEO MEREIN OR NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE AU7MORITV TO VIOLATE OA CANCEL TME pERM1T FEE SAC CHARGE PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGUTATING CON• STRUCTION OR TME PERFOfiMANCE OF CONSTRUCTION 9%, 2S Flr SC 3. %O PLAN CNECK FE TOi FEE Lice S 5. 07.80 $�GN4TUAE OF CON"aA(;TQA Op AUTHOp�ZEO eGENT IO�TE� EN R VALI A THIS I R PER IT 4 S�GN4TUAE O� OWNEp�� OwNEpBUi�OERi �D�TEi B G iN$� �1�TE � . � NEW [ ] ADDN ALTER Effecrive 5/10/99 [ l CTI'Y OF FRIDLEY [�C1 SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Constn:ction Address: �- �l.p o� �ip��f Legal Description: 0 �� 1 �� Owner Name & Address: S�� '(1.��_ ��O��.Ca1�' Tel. # (Q�a •�'�y. /ya�- Contractor: RENEWAL BY ANDERSEN MN LICENSE # 350-73RD AVE. NE Address: FRIDLEY, MN 55432 Tel. # (612) 502-4777. LICENSE #20130983 5urvey-ofthe ..,�, ...�_ ..__ r__r __ _ on it to scale. .LNING AREA: GAI�AGE AREA: DECK AREA: OTHER: Construction Type: DESCRIP'TION O� IlVIPROVEMENT Length WidLh Height Sq. Ft. Length Width Neight Sq. Ft. I.ength Width Hgt/Ground Sq. Ft. �� • w �'��N�� l.J?�i �rlj v v Estimated Cost: $ Driveway C�rb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: g • 0��0 • � � APPLICANT: ��O.COI ��E't�J i S Tel. # (p l c� • �/ • or2�L/ ��' Permit Fee Fue Surcharge State Surcharge SAC Charge License �urcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge $ �� .�s � $ -3.��'�C)� $ /. ��5� $ $ � �� . G� C� $ $ $ $ CITY USE ONLY Fee Schedule on Reverse Side .�1 af Permit Val�.ation (1/lOth%) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (State Licensed Residentia� Gontractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] TOTAL $ �� r STIPULATIONS: �. �j f// ��' ��'�/r�./ CT .�--/5'.�/ � / '�(T. G%��"— 'l �� /�1 /�G� �� `�'�/EG� O �' 7'"i�� c�ty of Fridley AT THE TOP OF THE TWINS � � . � � COMMUNITY OEVELOPMENT OIV. . � ; V �� ' � � � PROTECTIVE INSPECTION SEC. � � � �"'1 � C�TY HALI FRIOLE� 55132 �"""�� ,�� 763-571-3450 sue�ecT ERMIT NO. BUILDING PERMIT 33836 RECEIPT NO. � NUMBER NEV OATE PAGE O� AGPROVEO BY� 910-F15 8/27/03 � � �oe nooaess 7562 Able Street NE 1 LEGAL �OT NO. BIOCK TRACT OR ADDITION oesca. Pt 2 3 Shaffer's Subdivision ��1 2 PROPERTY OWNER MAIL ADDRESS Z�P Scott Albrecht 7562 Able Street NE 3 CONTRACTOR MAIL ADORESS Z�P Renewal By Andersen 1920 Co Rd C W, Roseville, MN 55113 � ARCHITECT OR DESIGNER MAIL ADDRESS Z�P 5 ENGINEER 6 USE OF BUILDING Residential 7 CIASS OF WORK 8 OESCRIBE WORK Replace five 9 CHANGE OF USE FROM MAIL AODRESS O NEW O ADDITION p ALTERATION TO ZIP � REPAIR SEE ATTACMEO SNEET 763-786-1427 PMONE LICENSE NO 651-264-4777 PHONE UCENSE NO. 20130983 PMONE LICENSE NO O MOVE O REMOVE STIPUTATIONS 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. Caulk and flash all exterior openings. ��K�� n �ar�� I1 �e �asled T� ��ec��r °�o Post TYPE OF CONST. SEPARATE PERMITS AqE REOUIRED FOR ELECTRICAL. PLUMBING. MEATING, VENTI�ATING Ofi AIR CONDITIONING. THIS PEiiM1T BECOMES NULL ANO VOID If WORK OFl CONSTRUCTION 20N�NG AUTMORIZEO IS NOT COMMENCEO WI�HIN 6U OAYS. OR IF CONSTRUCTiON OR WORK IS SUSPENOED OR ABANDONED FOFi A PERI00 OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED NO OWIG. UNITS I HEREBY CERTIFV THAT I MAVE READ ANO EXAMINEO TNIS APPLICATION 1 AND KNOW TME SAME TO 8E TRUE ANO CORRECi. ALL PROVISIONS OF IAWS VA�UATION AND ORDINANCES GOVERNING TMIS TVPE OF WORK WI�L BE COMPLIEO WITH WHETHER SPECIFIED MEREIN Oii NOT. TME GRANTING OF A PERMIT �S �OOO DOES NOT PRESUME TO GIVE AUTMOAITV TO VIOLATE OR CANCEI THE pEqMIT FEE PROVISIONS Of ANY OTHEA STATE OR LOCAI LAW REGUTATING CON- STqUCTION OA ?HE PERfORMANCE OF CONSTiiUCT10N $111.25 S�GNaTUQE OF CON"anCTOp OR vUTr+OA�ZEO eGENt B�i�DEQi iO�TEi iO�iEi ense m SO.FT STA�LS $5.00 OCCUPANCVLOAD CU fT. ' PARKING GARAGES SURTAX �2.5� SAC CMARGE Fire SC $5.00 10iAL FEE $123.�5 { D THIS IS V UR PEF11 r�w � � ADDN ALTER Effective 5/10/99 [ l CITY OF �RIDLEY [� SINGLE FAMII.Y AND DUPLEXES R-i .AND R-2 BLTII.DING PERMI'T APPLICATION Construction Address: �1�J� a �kj�� `^� . Legal Description: _ Owner Name & Address:�(� �{- �� C�l� Tel. #1(9�-�.9 - �� o�� Contractor: . �.e,��a� '�u A.nd.ex .e,tL MN LTCENSE # 0"101?j0� � � Address:_}�i ap C.O�n� 't Oo�c� C. W�,S�: �Sc.v�lk.� rc1t� S�S ll� Tel. #(c51 • a�4 •y�'�' Attach� to this appl�cation, a Certificat� of Survey of--the lot, with th� progoseci �c�nstniction drawu on it to scale. DESC�i.UN C1F �'�iD�ElV��T'� _ ' LIVING AREA: GARAGE AREA: DECK AREA: � � � Construction Type: Length _ Length _ Length _ ,sz�� c� Wi�th Height Sq. Ft. Width Height Sq. Ft. Widtli Hgt/Ground Sq. Ft. . ,� --�- � Estimated Cost: $_ �j � 000. CSo Driveway C�rb C�t Width Needed: Ft. + ti Ft = Ft x$ _$ DATE: ` ��A,PPLICANT: � Pemut Fee $ I �• a� F�re Surcliarge $ �j- , Q� State Surcharge $ Z . S � SAC Charge $ -rj , p(� Lic�nse Surcharg Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: � �a � CITY USE ONLY Tel. # Sa •3�15•is�ON�- �� —� Fee Schedule on Reverse Side �� .001 of Permit Valuation (1/lOth%) � $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or AIt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] r Building PLUMBING Permit Ivo.: � Inspections RESIDENTIAL APPLICATION Receivect By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: �(�= (a -2� DATE � / � � � YOUR E-MAIL ADDRESS SITE ADDRESS 7 �� - /% �%C= S'�'� THIS APPLICANT IS: C�WNER OCONTRACTOR PROPERTY NpME: °`�,> h. :+.J �l I� i2 'c h✓ TN�,T ADDRESS: �%S � � /� ��E ST • � �' ' CITY % ^i� / �✓ �Y°�/ STATFi�?� ZIP Sf y�J- PHONE: `7 Ci � , %�'G - �� CONTRACTOR NAME: SUBMTT A COPY OF STATE LICENSE # EXP DATE YOUR STATE ADDRESS: CITY STATE ZIP LICENSE WITH pHONE FAX APPLICATION PERMIT TYPE � SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: � �W � �PLACEMENT DETAILED DESCRIPTION OF WORK �.'� 7` �' ll ��„cG%'- o`'� L c.{ (� �� ✓ f-�/ ° Yl �' 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.OS = - FORPROJECTS WHERE LABOR EXCEEDS'$500;�'EES ARE BASED ON $10.00 PER FIXTURE, £XCEPT:�V3-IERE NQ'I�D. FT�CT:i1R-E�:-.(ITFDICATE TOTAL NUMBER OF EACH BELOV+� BATH SINK/LAV FLOOR DR.AINS SHOWER WATER PIPING ^ BATHTUB GAS PIPING p✓ee� c�rrucEn�se) SWIMMING POOL J WA'i'ER SOFTNER ($35) CLOTI-IES WASHER KITCHEN SINK WATER CLOSET � BACKFLOW PREV. ($15) DISHWASHER LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION _ WATER METER _ OTHER Permit Fee $ Number of fixtures @$10.00 x$10.00 =$ Surchar e .50 Number of fixtures @$15.00 x$15.00 =$ TOTAL DUE $ Number of fixtures @$35.00 x$35.00 =$ State Surcharge = $ .50 Tota1= $ 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 w rk which re � review and approval of plans. SIGNATURE OF APPL-Lt;A1VT PRINT NAME .� C) � /� �� j� � �r � �DATE /G /� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977