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AF - 44515_ �/c�/� �s — • . � .� �''��/ � City of Fridley SUBJECT O 13544 . AT THE TOP OF THE TWINS g U I L D I N G P E R M I T • � � � ECEIPT NO. � ; L ��_�_ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. � . , :.+� `' � � /'�'1 � CITY HALL FRIDLEV 55432 NUMBEH REV. DATE PAGE OF APPROVED BY ""�' ,�� 612-5603450 910-F15 ' S 27 76 � � JOB ADDRESS 100 Alden Circle N.E. 1 LEGAL LOT y� BLOCK TRACT OR ADDITtON SEE ATTACHED DESCR. `, � 1 Henriksen Addition SHEET 2 PROPERTYOWNER MAILADORESS ZIP PHONE Leif Henriksen 6434 Riverview Terrace N.E., Fridley 560-4560 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. 5ame 4 ARCHITECT OR DESIGNER MAIL ADDFESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE I-�CENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 26' x 42' Dwellin and a 24' x 24' Gar.a e 9 CHANGE QF USE FROM TO STIPULATIONS Provide a hard surface driveway. Provide sod in the front and side yards. Provide a verifying survey before capping. Brace every 3rd rafter mid-span to the bearing wall and install purlins. THE CITY OF fRi�LgY DO�S NOT GUARANTEE 7yE �} W�RNIHG ��►�Y OF UT�l3t'f ECi4. t,QNS A�iD ELEVATiONS. THIS DATA IS FQ .�i+i.�,,, A� 1�. Ni : tJSES ONLY ANa Before digging caif (ocal utilities PERSONS Uv1NG IT SNGt,LD VENFY 1HE INfORAAAi{ON TECfPHONE • EIECIRi� - GAS Etc. Ow 1He s�tE R�C�UIRED BY .Lqyy —�MPORraNT-. � SEPERATE P�ERMI`CS REQ�lRED FOR WIREN�G, •NOTlFy THE ��p«Y FNGR, NEATING, PLU�4BING AND SIGN�r� ��visionr R��p�N� �U�B REN�OVAL AND REP�,qC�pqENT SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUP Y LOAD VENTILATING OR AIR CONDITIONING. WOOCZ F1'd1Re 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 ABANOONED FOR A PERIOD OF 120 DAYS AT �1 ZO92 + 576 22 � OOO + 5760 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE REAb AND EXAMINED THIS APPLICATION ]. STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORFECT. 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 $33 OSO �.C). S3 DOES NOT PRESUME TO GIVE AUTH TY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS F ANY OTH STAT R I.00AL LAW REGULATING CON- STRUCTIO T, PER A E, F CONST TION. L_ rj]..3(j 350.�0 �� PLAN CHECK FEE TOTAL FEE � f . ��2�' `"��.�(/ ��(m 17.8 . SIG UREOFCONTR TORORAUTHORIZEDAGENT (DATEI HEN R � VALIDA ED TH IS YOUR PER IT � 6r�,�� S�GNATUREOFOWNEFUFOWNERBUILDEAI IDATEI BLDG. WSP DA7E Al'I'LIC1lT'IUN 1�OR RLSTI)L;NTI/lL, /1LT}:i2/11'ION, OR /�ll!)ITION 13UILUING PL•Ri�1IT CITY OF FItIDL�Y, hIINNL•SOTA �. � . , � . � . . OtaNER' s . NAM� • ��; � T _�� » ,, ��. ,� ��U ILDrR : AbDTt�SS :' l� %;..�� LGt' �- ��. �:a � �P�ADDRESS : uo• �O� � s�:�T• � LD�/t� G6� G __._ T.OT : �BLOCK : l ADnITION : /�Y � 7� .�--�I � �.� �� CORNLr. LOT: INSIDT; LOT:�^ S�TBACK: SIDL'Y�1TD: Appli_cant attach to this form Zt�:o Certificatcs of Survey of Lot and proposed buildixig location dra�an on i:hese Certif-icat-es .� a UESCRIPTIUN OP BUILDING /6 � £r�nt : ,� ja Depth :J_ �� Height : ��..,..„,.. Scju�re Teet: G� � Cubic leet: p7��dQ � Fxont : ��_ Depth : � Lf Hei�ht ; _ l� / Square T� eet ;� Cu'�ic Teet :_ s��+ Q � '.C`,}�pe of vo3�.struction� �QoiJ ��L�•,.�.� ESt;.�,�t�a c�s�: $ � ��v ��_._�__.. '.lo l�e Comp7_eted: t� _-% :.;� (; _ __ The unde:rsi�r_ed hereby mal:es applicatinn for a permit f_ox thc caork 1?erei.n - : peca.ficd, ��greeing to do all work in si:xict accordazlce �aith i:he City o� �'rzdley Ordinances and ruli.ngs of �he D�partment- of 33ttildi.ngs, and hereby decl�res i:h�t all tl�e facts and repxesentatzons staL-ed in this application r�re true and corxect. � • 11ATE : ,�_ _ SIGNATUFE : ' (See i��.verse Side �'ox Addition�l In�ormation. ) � �� ..... __ �� s �� _ ST/ i�►��- Mi'! 0 N S' { � � � � .. , � �> �. .. , , . , .� ... � � ., _ �� .. .. ...... � .. . . :- , _ SI�. ��i� � ^ . • � s-��,�� _ . . -�.�� . HUILllING 1'ERJ�iIT F�� SC1tL'l)ULL S�CTION 2. The Inspector of P.uildings shall, betorc issuing pci�nits fox the execL-ion of any buildin� ox structure, or for any addition to any exisL-in� buildin& or structurc, or for any alteration or repaiis to any existing buildi.n�; or sLrucLurc, upon aPplication thcrcf.ore, re�uire the payment by the applicant for such per►ait of fees to the amount hexein below set iorth and in the maniier herein provided to-wit: - UNIFO1Zri L'UILDING CODE : Z`ype 1, 2& 4-$2.15 for each one thousand cubic ieet, ox fraction L-liereo£, in such cubical contents. Type 3& 5-$1.85 for each one thousand cubic feet. ' ADDITIONAL INFORAIATION ;cr the purpose •�� computinb tecs for building pez;nits, t-he cubica3 conten�s oi any bui.lding or addition, is determined by multiplying the �xound area covexed from a point six (6) i.nches 'aelo�a the floor line of the basement o� tlie cellar to tlie average lieiohts of the upper surface or to the average.. height o� the roo� surface of the main gable o� a pitched roof. Fox xepaixs or altexations to an existing stxucture, the fee sl�all be at the rate o� $3:00 per each five hundred dollars ($500.00) or fraction L-hereof in the cosL- af all proposed �ao:-1c. _� T.zi no case s�iall the �ee chaxged i'or any permit as set foxth in Seci�ion 2 be Iess than $5.00. VERII'ICATION OF FOUNDATION NC)T�: 1'ermits for construction will be issued a minimum of 24 hours from the time of application, i:o allow for proper xevie�o of the proposed structure and O� t.�1C COI1�tXtlCi:lOI1 S1tC. , _ A CerL-ified Survey ot the lot, sho�ain� the Iocation of the foundation, once it has been construcLed, will be xequixed before proceedi.n� �aith the framing. CERI'IrICATE OP OCCUPANCY Applicati.on fox a Certificate of Occupancy shall be made ten (10) days pxior to the use or occupancy of any structure for which a building perniit has been issued; and said s�ructure sl�all not be used or occupi.ed unt-il a Certifi.c�te . of Occupancy has been issued. - , . . 0 0 .. � Q Y _ ___. __ � i , i � I ._r..�.:._ ...:.. ... ... .._. . ._. ': . .. .�. .. .. . , __ . _�. , �+ . .._... . __ . _.. .__ . .. .. _ .. . .... .. . ..... . � ��-«-_�-. i,.. .-:..... . °-. _... . _ _.... . . -.. . _ ..._ ... __ . _�.._�.._ _ ._ .� .�._--«. I � . , � . . ' � . . . �. 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ANOKA COUNTY 6431 UNIVERSITY AVENUE NE December 20, 1976 FRIJLEY, MINNESOTA 55432 Mr. Leif Henriksen 6434 Riverview Terrace N.E. Minneapolis, Mn. 55432 Re: Final Inspections at 80 Alden Circle N.E., 81 Alden Circle N.E. and • 100 Alden Circle N.E. . Dear Mr. Henriksen: Final inspections were made on December 20, 1976 of the above addresses and the following items were noted which must be completed before the structures can be finaled out; 80 Alden Circle N.E. 1. Provide door closer on garage door by January 10, 1977. 2. Provide sod in the front and side yards by June 15,1977. 81 Alden Circle N.E. 1. Provide door closer on garage door by January 10, 1977. 2. Provide solid block or joist hanger on foyer floor joist by January 10, 1977. 3. Provide handrail on stairway from basement to garage by • Ja.nuary I0, 1977. 4. Provide sod in the front and side yards by June 15, 1977. 100 Alden Circle N.E. Provide door closer on garage door by January 10, 1977. We will expect the above items to be completed by the appointed dates when reinspections will be made to determine compliance. If you have any questions on these items, please feel free to contact me at 571-3450. Since ly, . DARREL G. LARK Community Development Adm. DGC/mh CITY QF FRIDLEY � APPLICATION FOR PW MBIN6 AND GAS FITTING PERMIT � • " �� .l ,� .��'/ �'�r� .> N y 'b � . x v Water Job Address / L f N. ! • J ttl N � tma �� Gl N�� LL G. � HC1'�eY (� . . � �L � � � y N F � ,�, �, �, � � a � :r',' � �. � llepartmerit of ITuildings s, �c; ;n c .c •=+ .c c c a o 0 o � o •� ++ N � �•'� � o o "`� " N N `� N '[ City of Fridley i, Cn .a s� rs ro •�+ ro�+ o.c .-� ro ro a m �a •-� '� ". as • lec 3 p�, � li, v�.� g c; � � o Tel. #571-3450 t!} U 7 CA P� VI � � 'st � � � 2nd 3rd 4 ttl I . (3:) _�ture Connection Oper.ing Connected with Sewer (*) _ :1ew Fir.ture, Old Opening Water � � PARTIAL RATE SCHEDULE PLUti1BING FIX'PURE RATES: N0. RATE hu=�er Fi.xtures %� x S3. QO �ture Fixture Opening x $2.00 t3ew r^ixture, Old Opening x $2.00 Catch Basin x $5.00 Water �?eater - to 99, O�JO B?'U �_ x $5.00 100,000 BTU to 199,000 BTU x$10.00 Water Sof�ener x $7.00 I.ew Grour.d Fain Old Building x 55.00 Electric Water Heater x $5.00 GAS FITTI\G FEES: lst 3 fixtures � x $3.00 Additional Fixtures x 51.00 Gas Rar.ge to 199, 000 BTU x $7:0. 00 REt'AIRS $ ALTERATIONS First $100.00 $5.00 each add. $100.00 or fraction $2.00 State Surcharge TOTAL FEE REINSPECTZON e,^•.E . (Si0.00) TOTAL $� �'). U � $ $ $ S J`�,UL� S S S S s o3�� S S The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance aith the City Co3es and rulings of ttie Department of Buildi�i9::, aiid hcroby 3oclares th�t sll the facts and repzesentations stated in tnis applicatioa are trse a.^.d corr�t 1 I'ri.dlcy, M:i. �-�Ut� •.� a1( , 19� � OWNER �L - �%� / �n .t,err� er KIND OF BUILDING �/ � JSED AS � LO - TO BE COMPLETED ABOUT ESTIMATED COST �,��, . � 6' . � OLD NEW UILDING PERI�:IT NO. PER�2IT NO. ll:' C�i' /i'� Compar.y C� , �2 �/ , ✓ Signed By Tel. No. ��(r �- 2 0 4� ROIIGH INSP. Date FINAL INSP. � "' [ � � / Date APPROVAL L'OR P�I'.MIT � i � S $ MINIMIJM FEE FOR ANY PLUMBING PER�fIT ZS $7.50 $ .50 s �t--�' _� SZ? �-fs!_r, � , ,,..w�_.__v_ /s . � �� e � �._ ........__�. . ''��...._�'�� ,' �f r �� '�` .�. � ��` ` '� �, � ;�"` September 9. I976 � :f f; r�, Corcoran Pl�nbing 3040 Sumter Avenue Crystal, Nin. 55437 � t �' ? '�' 6431 UNIVERStTY AVENUE N.E., FRIDLEY, MINNESOTA 55432 iELEPHONE ( 612)5T1-3450 Re: Plumbing Permit for 100 Alden Circle N.E. Dear Sirs: An error was made on your applic..•.tion for the plumbing permit for the above address. Three fixtures were omitted which results in a shortage of $9.00 (see copy of apglication). We would appreciate it if you would send in the $9.00 before September 17, 1976 so we can process the application. If we do not receive the shortage, we w�_11 be forced to put a"stop work" on the job. If you have any questions on this matter, please feel free to contact me. Sincerely, WILLIAM H. SANDIN Plbg. & Htg. Inspector WHS�mh ENC: 1 ��,p�.UTlp,�, e� m Q � U m ¢ y 2 ��b �a /l��,��6 CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE GIL�VITY WAR�1 �'1IR: Furnace Shell � Duct Work Replacement of Furnace Repairs & Alterations-up to $500.00 Repairs & Altcratiotis eacii add. $500.00 nl�cria�vlcaL �vax:�i taik: Furnace Shell & Duct Work to 100,000 BTU each add. 50,000 B:U Re�lacement of Furnace Repairs & Alterations-up to $500.00 Repairs & Alterations each add. $500.00 STEr'4tit OR �iOT W�1TER SYSTE�I: Boiler &;.ir.es up to 100, 000 BTU each addn. 50,000 BTU Boiler only up to 100,000 BTU each addn. 50,000 BTU OIL BUI2NER- to 3 gal. per hour each add. 3 gal. per hour GAS BURNER- from 100,000 BTU to 199,999 BTU (over 199,999 BTU see Fee Schedule) izn7�r: $12.00 7.00 7.00 4.00 S12.00 4.00 7. 00 7.00 4.00 $12.00 4.00 7.00 6.00 $10.00 10.00 $10.00 GAS FITTI�G FEES: lst 3 Fixtures x$ 3.00 Additional Fixtures x $ 1.00 Gas Range to 199,000 BTU x$10.00 AIR CONDITIONING � FaN HEaTING S1STE�1S � see Fee schedule VENTILATING SYSTEMS � � ALTE�2e�TI0NS $ REPAI RS State Surcharge TOTAL FEE ROUGH INSP. Date FINAL INSP. /�' 7�� Date APPROVAL FOR PERMIT�� REIIQSPECTION FEE (.$10.00) MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 ToTnL S $----- $ $ S 1'�, c'o $ CG $ $ $ S $ S $ $ S $ EC� $ s 3.�� S $ s �0, c o S S 9 $ .50 $ ,SO Job Address Department of Buildings City of Fridley Tel. #571-3450 tJ � rV �(L 1� !< 5� iv � �; V�� n1 Co,;,� `� The undersiyned 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, Minn. i. o � , , 19� {v OWNER ��Q�'� �`\ � ti 2� \L1j cthi \` C raj'1' KIND OF BUILDING \��, �r � iISED AS �.Q` c�.a ,J� � �(? `— TO BE COMPLETED ABOUT �'� {� �� 1� ESTIMATED COST �� ('�TC� � 'r�C OLD -�NEW ILDING PERMIT N0. PERMIT NO, l� 6S�_ DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. A Trade Name �p`L� M1ARN'Q�✓ c12.1L Size No.� ��C. �� . � C 5��, Capacity i��(�CC (3T � Sq. Ft. EDR STU � Total Connected Load Kind of Fuel �t4S �Vi�l, BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP �/� / (�r.;� �\Z. Y`nC- � �-1 � `\ �e� 13�'`�- (-T C Company l� � t� � n, c � t�\ �� ,� NC „ n _ Signed By Tel. No. S� 7' 3 � 3) SUBJECT � . • c�ty of Fridley 218 2 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T i � RECEIPT NO. � � � ' COMMUNITY DEVELOPMENT DIV. ' `� --"' 1 � 7 3 r � � PROTECTIVE INSPECTION SEC. � � � � �"'1 � CITY HALL FRIDLE� 55432 NuMBER REV UnrE PAGE oF avcpOVEO Bv �""'�� ,'� 612-571-3450 910-F15 5/4/93 / / JOB ADDRESS 100 ALDEN CTRCLE t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 1 HENRI.KSEN ADD e SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE ART H.OFF 100 ALDEN CIRCLE k'RTDLE�' MN 55432 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. RICHARD HASTINGS 6338 RTVERVIEV�I TERRP,CE 574^9366 4051 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE O� $UILDING � �szD�rTZZ�L 7 CLASS OF WORK ❑ NEW ❑ ADDtTION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE � 8 DESCRIBE WOFK FtER00F 9 CHANGE QF USE FROM TO STIPULATIONS SEE NQTAT�QNS QN PLAN� TYPE OF CONST. OCCUPANCV GROUP OCCUPANCY LOAD SEPAFiATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTI�ATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZEDIS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK tS SUSPENDED OFi ABANDONED FOR A PERI00 OF 120 OAYS 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 GAfiAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 8E COMPLIED 13.�rO.QO +68 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- 33, QO FTRE `SC� � 1. 3S STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECKFEE TOTALFEE �,�_ •�_ � License SC 5,00 40.Q3 S�GNATUREOFCONSRACTOAORAU71 aiZEOnGENr IDATEi HEN PRO lY VA IDAT D THIS IS YOUF1 PEAMIT ` ��_� -y.� SiGNaTURE OF OWNER �,iF OWNEP BUiLDERi iDATEi �DG WSP qp7E NEW [ ] Effective 1/1/93 ADDN [ ] CITY OF FRIDLEY ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: Legdl Description: Owner Name & Address: Contractor: ii� Address: � 2.3 � � � ,�ba ,d L 1J��v c � � � C � 7- � ''; / c C. � r�4 kt l-�a F� /�iA S 7ci �C s � �1.1 %lz�, � MN LI �_ Attach to this application, a Cerh ic o y o the lot, with the proposed construcdon drawn on it to scale. LIVING AREA: Length GARA.GE AREA: Length DECI� AREA: Length OTHER: DESCRTPTION OF I1t2PROVEMENT Width Width Width Corner Lot [] Inside Lot (] Ft. Yd Setback _ Type of Construction: � � ,� ofl �- Approx. Comgletion Date: Driveway Curb Cut Width Needed: Ft. + 6 Ft = Height Height Hgt/Ground et. # ,� # S � Y - 9�6,� Sq. Ft. Sq. Ft. Sq. Ft. Side Yard Setbacks Estimated Cost: $ � 3 � � �.s S�, (Cost on Back) Ft x $ _ $ DATE: S 3 �t APPLICANT: C�ti�� /'��..� Tel. # S% S� "' 9 i�',�' CITY USE ONLY Permit Fee $ 3�5�, �� Fee Schedule on Reverse Side Fire Surcharge $ �, 3 S� _001 of Permit Valuation (lllOth%a) State Surcharge $ , cli d$.50/$1,000 Valuation SAC Charge $ `-�- $750 per SAC Unit License Surcharge $ v, �O $5.00 {State Licensed Residendal Contractors) Driveway Escrow $ -�' Alt_ "A" or Alt. "B" Above . Park Fee $ `�— F� Determined by Engineering Sewer Main Charge $ �- Agreement Necessary [] Not Necessary [ j TOTAL s yo, °3 STIPULATIONS: _> CHIIVINEY AND STACB VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefiilly examined Yes (r� No 2. Is free from n�st or deterioration Yes (/n, No _3. 4. 5. 6 Has no foreign objects lodged within Is securely supported Meets all current Code requirements for size and total B'TU's connected Has total heating BTU's of ��,�� All other BTU's TOTAL BTU's �� Yes (+�f No Yes ( � No Yes ( j'j No �'��f �"1��75 ` HOUSE HEATING TEST RECORD y��--r%�, ADDRESS �� APT. F�OOR CITY �� B OCNPANT OWNER � HEAT LOSS ATE TG. INST� �'"',�� c SOLD BY _ '� �!� — � INSTALLED BY C ` ` e %�� . El�ehicol Work By �- Gos Lin� Br TYPE OF HEAT GA FA �HW STEAAA �___SPACE HTR. UNIT MTR. 'OTHER GAS DESIGN CONVERSION MAKE �"� �� Al/1KE OF BURNER Mod�l '' ""� _. Mod�l ._ 5�►iol _— Mo�c. BTU Raiinq INPUT � —� MAKE OF FURNACE Mod�l =_'�NTROLS / ^f'tl � � THERMOSTAT H�ot PI`� V•nt S�:• Volv _—� � ��'� .._._ KIND OF LIN� SIZE NONE�. Limit "r��•-Z Drah Hood — R�qulawr Limit S�Miny � ��-C -- Filtses Sis� �1-�x'�"' Numb�r Fan $�ttiny � � �'� : C?iim��y Loeation Insid� Outs' • �-�-- Pilot Typ� — _L�1�! C�itnnry COnfhY�flOff Q�a�� Pilor Mab _ �L�� d��'� /' Pilot Model �"��' � _ Smok� Bomb _ e Wiriny // Pilot Timiny -- `T(L ZYC;�s ' D�aft 7�st To0 L�'� L.M�. Cut Off — "^'�� Door Pn�sur• Liyhtiny Insf. �� %/ Pr�ssur• _�� p�resn� COZ —� Dat� T•sad _ "` S� Input CFH _ 7� ._ P�re�nt 02 Co�o�r T.s�i�, C�� '/� ��-'I� �•` Srock Temp. ' PNC�nt CO Nan» ef T�s��r �°��"�'�"'� .� ;;�_:. _ , _ :;��: ` GlTY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 APPLICA710N FOR POWER PLANTS AND HEATING, COOLING, VENTILA710N, 572-3604 REFRIGERATION AND AIR CONDITIONING-SYSTEMS AND DEVICES RATE SCHEDULE Residential �urnace Shell and Duct Work, Burner — Also Replacement Furnace (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning — All Sizes All Others/Repairs & Afterations (LIST ON BACI� 1°/a of Value of Appliance or Work Commercial/I ndustrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.00 $_�� $ 10,00 $ 1�� $10.00 $---- _ $ 10.00 $ $ 25.00 $�_� State Surcharge TOTAL FEE �� Effective On January 1, 1997 ��;,`�' �� _ �'- JOB ADDRESS %� l'�"�L.�L� L�� 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 an correct. ' ,1997 OWNER �'1�i7�'� �� ,� 7% � � S l `i BUILDING USED AS � ' , L � � ESTIMATED COST PERMIT N0. �.-.,�A -` ,°j;; � DESCRIPTION OF FURNACE AND OR BURNER $ No, of Heating Units_L Circle One (Steam) (Hot Water) arm Air Trade Name L�/1�i'� Size No. B� 7-a�`� HP y� EDR $ Fuel �� Totai Connected Load_�';�;,�j $ , 50 � �� ' -��,�'j�°-9� MINIMUM FEE FOR ANY HEATING/COOLINCiNENTILATION `AEFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLI�S THE $.50 S�ATE SURCHARGE REIN��:GTION FEE $42.00/Hr ��i�' *Air Cond�`i�rlers can not be piaced in a side yar� without written permission from adjoining prop�rty owner. Burner Trade Name Size No, BTU HP EDA HEATING COMPANY � � Signed By Tel No. _ ��--f ' ' Approved By Rough—In Date Final Date FILL OUT BACK SIDE F R STACK VERIFICATION ON REPLACEMENT FURNACE \ �^,/ r�Q.t� 1�� 1s�L �c��cw�. � � ��i � . . . a�e�c�� . City of Fridley AT THE TOP OF THE TWINS g � f L D I N G P E R M I i � � � � ; � _____ COMMUNITV OE�ELOPMENT OIV. f � � PROTECTIVE INSPECTION SEC. � . � l_-_•��"' �'� CITY HALL FfiIOLE� 55132 NUMBEA i 612-571-3450 9t0-F15 �oe nooaess 100 A1 den Ci rcl e NE � LEGAL LOT NO. BLOCK TRACT OF AOOITION DESCR. ] 1 Henri ksen Ad 2 PROPEiiTY OWNEF MAIL AODRES$ Arthur Noff 3 CONTRACTOR MAIL ADORESS Owner � ARCHITECT OR OESIGNER MAIL AO�RESS 5 ENG�NEER MAIL AODFESS 6 USE OF BUILDING Residential 7 CLASS OF WORK REV O�TE P�GE O: 6/25/99 / / :J/ 1�LJ. ZIP PHONE ZIP PMONE 21P PHONE ,_.._... ..... 29765 CEIPT NO. �( T� PPROVED B� SEE ATTAGHED SHEET LICENSE NO UCENSENO. LICENSE NO O NEW ❑ ADDITION � ALTERATION XX REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK 9 CHANGE OF USE FROM STIPULATIONS TO Underlayment must comply with the State Bui1ding Code. TrPE OP CONSr SEPAqATE PERMITS ARE REOUIRED FOR EIECTRICAL, PLUMBING. MEATING. VENTILATING OR AIR CONOITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OFi CONSTRUCTION ZONING AUTHORIZEO IS NOT COMMENCED WITHIN 60 OAYS. Ofi IF CONSTRUCTION OR WORK IS SUSPENOED OR ABANDONED fOR A PERI00 OF 120 OAYS A7 ANY TIME AFTER WOFiK IS COMMENCED. NO DWLG. UN I HEAEBV CERTIFV THAT I HAVE READ ANO EXAMINEO THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECi. ALL PROVISIONS Of LAWS VA�UATION ANO ORDINANCES GOVERNING THIS TYPE OF WpRK WIIL BE COMP�IEO ��Ono WITM WHETMER SPECIFIEO HEREIN Oii NOT THE GRANTING OF A PERMIT �O DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL THE pEqM1T FEE PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFOfiMANCE Of CONSTRUCTION $83.25 S�GNATUQE O� CON"�7AC AOA AUTHORi2ED sGENi IDATE� � � � � �� GN tUAEO� NEQ��FOWNEQB DEAi --�� OATE� �' OCCUPANCV SO. fT STA��$ OCCUPANCVLOAD CU FT GAiiAGES 1.05 AC CNAfiGE i re C OiAL EE 8 .40 HIS IS V� , ,- r� c t NEW [ ] ADDN ALTER Effective 5l10i99 [ ] CITY OF FRIDLEY [] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUII.,DING PERNIIT APPLICATION Construction Address: _ l (..� � Legal Description: Owner Name & A Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: OTI�R: Construction Type: : . 'l� �' � l � � �� `�� ' 1 � � �-�- �.�' �--��e�. # j �-�,�t MN LICENSE # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length Driveway C�rb Cut Width Needed: DESCRIPTION OF IMPROVEMENT Width _ Width Wid �°� 4 Ft. + 6 Ft = Height � Height Hgt/Ground Estimated Cost: $ Ft x $ Tel. # �$ Sq. Ft. _ Sq. Ft. _ Sq. Ft. _ ��'�j%�< , � % DATE: ��S APPLICANT: - � �_' Tel. # d�l ' � S� � _— 1� Pernut Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ �- °� `� Fee Schedule on Reverse Side $ �. � � .001 of Pernut Valuation (1/lOth%) $ /� vS V $.50/$1,000 Valuation $ $1050 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Detemuned by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ �7� � Building BUILDING Permit No Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 763-502-4977 FAX CITY OF FRIDLEY Date Rec'a: C EFFECTIVE 1-1-08 DATE �? `� v� YQURE-MAILADDRESS �q-ClL P[l'J'�NCVt.S(Ur,� CK%�'►�t.tCscZS rC.C7/v1 sITE a��RESS I(�,� NC �-I tJE�1J C� I t2C: C� �[ h�i.`-r-► �-'1 i1J _�z_.� U�� L THIS APPLICANT IS: ❑ OWNER �CONTRACTOR PROPERTY OWNER/ NAME: /� /l%N I'�� F�'" TENANT ADDRESS: �(.jCi {�jc ��ncl� �.i��" CITY �" I,IJL�% STATF,�ZIP SSy 3L PHONE: l(� I�-��'I O- �� Z� NAME: ' 2, CONTRACTOR ADDRESS: I Z�Z I'I �� T� �� 3(J'U CITY N"��Mi..�KE STATF��1 ZIP S (, � SUBMIT' A COPY OF pHONE (p I Z' �'FG i�)'° 3�Z-y FAX 7� �"�I 3�� SZ`� YOUR STATE LICENSE STATE LICENSE # ZU �-� ��"i 3 EXP DATE S� 3�-U� PROPERTY TYPE $I SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH $ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING O OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION MAINTENANCE/REPAIR � REMODELING DESCRIBE WORK BEING DONE: ��]hJ /�p �_,�l.t�vS 31ZE OF IMPROVEMENT LENGTH � � WIDTH � r� HEIGHT � SQ FT ZSl ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES � �'HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES j(1 ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCI.UDING 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 OPEN[NG CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL P'L�'r:S Al�: BASL�'ll UN VALUA'1'lU1V, 1N(:LUll1N(:'1'H� (:UJ'1' UN' LAIiUIt A1Vll MAlElilALa: (USING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ 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 $ �'I � ��i $ �� $ $ l �g $ �� $ $ $ $ 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 Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks uavable to: Citv of Fridley 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 cvork will be in conformance with the ordinances and codes of the City of Fridley and with the Minn on o es; that I understand this is not a permit but only an application for a permit and �vork is not to start without a permit on site; that the work w' be in ac rdan proved plan in the case of all work which requires review and approval of plans. SIGNATU�-O.�PL�ANT �� PRINT NAME �UL 1-'AI�Sci? DATE j(�' 30'� APPROVED BY c�/ �i.�lJ'� DATE ARATE PERMITS ARB REOUIRED FOR PLUMBING, ELECTRTCAL AND