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AF - 34950� � City of Fridley, Minn. BUII.DING PERMIT N° 3 8 2 9 �� : . . . . y . . � a . : . �-. � . . . . . . . Ow�r . .. . . ... .[ l.....�.��Z�� Builder ...... .............................. ... Addrees ...................................... Address ............................................. LOCATION OF BUILDING No. .V. .� ! . /. Street . . . . . . . . �� . . . Part o Lot . . . . . . . . . . . . . . . . . . . . . . j�,�j Lot . . . �l. . . . . . Biock . . .j�. . . . . . . . . . . Addition or Sub-Divisiom . .�!!T�O'� �Q ... • . C�oTner Lot ............ L�side Lot �........ Setbacic �� ........................... DESCRIPTIQN OF BUILDING ��U � . _� . . .. .. .. .. . . �ao-�a � �a. .� H�t,��o�� . �. �!�'� �: �. y��o .................... I+`rPtrt ........ DeP'th ........ Height . Sq. F't. ........ G�. Ft. ........ Tj►pe of Construction . .. . . .. . . . . .. . . . . . . At. Cast. . �.�.� � . To be Coznpleted . . . .. ,. . .. . . . . . . . . . In oonaideration of the issuance to me a! a permit to c�naEruct the building descibed above, I seree to do ti�e propaoed work in accordance with the descriptiam abrnre set forth and in canpHance wlth all provhia�e oi ordinances o! the dty of Fridley. . ,� . . �.-� :':�?'� . � . . . G.� . . . . . In conaideration of the payment of a fee �;. .��, Permit is hereby granted to ... .. .. .. .... .. .. .. . . . .. .. .. .. .. . . .. . .. .. .. . to conatruct the building or additiaai as described above. 1Lis pesmit is graated upea the expresa condition that the peraon to afia� it is �anted and i�is age�a� emplo3►ees and worlanen. in a11 wuric done in, around and upon said buiiding, or a�► part tt►ereof, shsll ca�form in all respecta to the ordinanoes of F�iddey, M3�►neaota regardit►g location, c�o�nattucl3am, alteratior►. mainterianoe, repair and moving ot buildin�s wlth- in the dty limits and this permit may be reva�ced at any ti�ne upon violation oi any of the provisio�s af said ordinances. i��;'►��'S„J• .r. . ��:� ._�.�%... . B� Inspeetor NOTICE: This pennit doa not oover tho oonstruaRion, imtallation o� alteration fo��H'fnp, plumbinp, pss h�atiny, �awe� or wa�s� Bs wro to sse the QWl�lil� Inspeotor fo� sspante psnrdb to� the�s ibsms, ��, �s N APPLICATION FOR BUILDING PF�IIT CITY OF FRIALEY, MINNFSOTA . � .'. . . Owners�'�Name�_�.x-�-�,,...��', �',G�-,..,� Bui.lder �� . _ ��-,��..) Address .5' 3 9 ..7 ��__-__,��-r�.� Addrese �L! `f . 3� �' ,�,��-`.�.,�'�' LOCATION OF BUILDING No. �3.,.�?.,:' $'Eres� �.:�� . Q�_�� Part of Lot , jP �- .. ._ G��%� Lot � Slcck ..� . Addition or 3ub. Mv. G�.w-..� -__ 7�%��_ . -y� , . Corner Lot _. I++gide Lot �._ Set Back . Applica� ��tacth to t�i.s farm Certifiaete oF Stiu�vey of Lot at�d p�ropesed buildiag Io�ztion. - - , � .� DE3CRIPTION OF BUIirDING To be used as �-�-�, p � : .: P�ront �_.`.°�.. Depth z�HeiBht Sq. Ft. ._aZ �.�— Cu. lNt PS�ont ._.,._._.._. Deptb ....� ight � • �i �" ., . . . . W • . r V � . �.iw..:..�.w.�r. . . - . . . . . . � �jtpe of Constructiou �. ��•__ � �••�•••--� Eet3�sted C�� 8 S' o To be oo�mpleted The wnderaigc►e� hereb�► mskee application tor a permi.t for the woock h�rein a�a�'iec}, agreeing to dc> e,].7. work in strict accordan�e with the City O�di�sances �and rulin8 of the Depart�nent ef Buildings�- and het�eby declarea that all the facts and representations atated ia this eppli�Cation are true and correct. Date Signature � , � ��-�"'�``-�_ (Ar.Schedule of Fee Costs can be found on the Reveree Side� � '_� � �� . BUILDING'PERMIT�FEE SCHEDUL� Sec+ion 2. The Inspector of Buildings sha11, before issuing any permit for the erection of axiy building or structure� or for any addition to any existir�g building or structure, or for any alterations_.or.repai�rs #.o � any exisiing building or stiru�ture, upon application therefor, require the payz�ent by tY�e applic�:nt for such permit of fees to the amourit ,. "� herein below :st forth and in the r�n:�er herein provided to-wit: 2,1 For ar_y �a.�h �c;rr:�_t for '�he erect�_on of any fireproof building� other than a gart�.ge, w� ehou; e, �'a�tor3r or grSin elevator, Qr for the _,_. , erection of any �� r��roof �;.�d:�t? on, icr �,ir,�ilar occupancy, to any exist�r.g buil�i:�*�g �}��1'1 �e �?t �t�e' rat,e of �1.�.0 fo.:.. eack� _Qne ..thousand , cubic �'ce't; .c�r f�a c�'..�_on +.herao�, �.i1 �uc;h cubical cbntentse 2�2 I'or an,y su�� p�.�:�i�, f�r the er�c,i_on cf any fireproof garage, ware- ho�ase,' f�.ctor;� or' gia.in �l�vaz�..r, cr for ',;he erection of ariy ffxeproOP . - wddi�ion *�:�.e• ,.�r.��ar oc �,�:�.�c;;rr #� a.�y exi;t�n� building sY�Fill be, at•thQ ratt cf �l; 25 fer e��.^n or,e `•�1��!3«n�� c:icic f�F�, classified as "fireprooY" �y Sec-�ir�n 5J2 0�" �rr: �`�:�r�.�ea�.,��l�.s t3uilciin�;'.�bde�. - HOUSE� " � • ' - 2< 3�or �.ny �u �"� pe�:..it �`cr tiz� erec��ion of ar�y non-fireproof buildix� othzr th.��-a ��arage, wareh�usa�' -�artox�r or: �grain elevatox, or any_ _, non�firegr�of sdd�.tion, for simil�..r occu ncy,� to any existing building. F��.i� � �1.;� ior eac1� one thous�.nd at�b�ic�ee't. • . - . _. . ' . Cu;R.ACr.ES. . . .. . ,. < r : . • ' , . � � 2.�,. For an� such permi� for +he erec�ion of any non—fireproof gaxage� w^..rehous�, ¢� c; vory or �ai:� elevator, vr for the � erection of �y .nqn- ,, ,; fire�°o�f ad�itic�,r�, � for sinilar occupa.ncy, to any existif'ig building or f�� eac�i �c:�5.'�. �n�a��.i��ri� or i4:tldi �ionr � Ninety Cents . for_ eaah one ' �;h��as:ir�ci ��:iui�; ��t or �^action thereoP, in the cubical contents thereof w��;?� ��. ra��.�?z�.7u� cf �..;.:,�,?n . . • �'oY -Lr�� .s°7o: � ��' o�r-�,�t=.�nE z'ess for bui.lding .pexmits '�e cubfoal. � ' cor�t�n+� oi ��, �ui r'.�k z:: a�d � t�c�Z t-� a Z:zi:iform height throughout by n.al ��.�? �i. ^ t:� �r;,, ,.�. '_ r.._ � � e �uea <: d '"ron �. poynt six ' �6) inEhes = belcyw . the �1oc,r 1�_�; �;� ��' T fs< .'_ - 3^,F:,� ;, c�.„ ��_:��s to the average height of the .. uppei .7`LL��.�.. �'w C i'' � J � i"' trf>r'?.` !' ;;1 �?iT o�' ths roof surface` of the msin g�.tle o� a �:�� 'a�:a _ .:c_ ' _ :• �,.,.,. y _ �. .�- „„ +,,.- 2�.� Far „r }y� _. .. �_.., �.c:.� �o ari -�L_: �.��.� G �_.acture,t�; the fee sha11 �i":�. `G'. li �t,t'i i = '?.± ^ .. �� Sr_ � J'� '-.:i:.. _ i ... � � T.� _f n... ^.-•Q L�li�lc%i'rg � it',�r%W eVV,' � Q�� . � . . fr�:�ticr. t��:r<:��.� yn .`�,_ :�-.-., ; �' ._��.i ;•rc:��:�e,' k�c>:�k. 2�5 Ir, no c;�.st; �� a,4 : t"::,_ i c;� ;:c..<�r� :9. :t �M :tn}- �:��..�i-t as sat forth in ^ bc �ews ��i::�.� �,'�. n,�, , :. - , Sect,� 0.1 ._ . . . � `'- ^ �' , � . -y .. , � � City of Fridley, Minn. BUILDING PERMIT ��: �_ August 12,_1968 ___.__��__.w�, Owner: ___..__Wa�in.e Holmb_�_._._..._._.___.____ Builder _.____.._ Same pd� _._. 5397 Altura Road ________� �,d� � Same �3844 �� '7�� LOCATION OF BUILDING No. 5 3 9 7_.__.... Street .__._._ Al t ura . Road _._..._._........_.._........__.._._..... Part o! Lot _.._._._...___._.__..._.._._.�.�.� Carlson's Summit Manar North Lot ._..1 �....__._._..._ Block _.._._..._._._.._ �._..._.._............_ Addition or Sub-Divisi� ....._.._.._.___......__�_.._..._._._.._�_._.._.._..._ Corner I.ot ---_�...____ Inside Lot _..__.._..._.__...._._ Setback __.____.._.�_�_ Sideyard __. � Sewer Elevatfoa Foundatio�► IIevatian DESCRIPTION OF BUILDING To be veea as: � Di,nin� Room �t �_.12 � Depth _... 12 � Height ..14 �._..._.. Sq. F� 1�* _ Cu. F't _. 2016 � �.�...._ Front — Depth _.._...._.� Fieight _.___�__ Sq. F't. _� Cu. Ft 7�pe of Construction _.._.Frame ._...__.._---. Es� C�t �2500..00........_.._......_ To be Canpleted _.._..._.._._.._.._ In co�sideration o! the isauanoe to me of a permit to construct the building th� propoeed work in accordance with the description above set forth and in ca a�dinances o! the dty of Fridley. ,, ^� �( v�� - tP} l abave, I agree to do with all pmNiaions of In cansideration of the paymeat of a fee o! a _ 5. 00 ��t is hereby granted to___. wayne Solmberg to c:�struct the building or addition as described above. This permit is Branted uPan the exprees candition that theperson to whom it is granted and 1us agents, emPloyees and workmen, in all work do�e in, aroand and up� said buildin8, or any part thereof, shall conform in all respects to the ordinancee o� Fridley, Minaesota re8�►B location, constructi�, alteratiar, maintenance, repair aad mavin8 of bt�il�ings within the dty limits and this permit m�► be revoked at any time upos� violation of any o! the P�visiana oi sa�d ordinaao�. n Breher Official` Builaing �$6� ^ I NOTICE: lUis p�e.it de.s ew �owr fiw eoe�ueNos. is�talhNa� fee vrkiso, pMeb6�a aa. 6..N.s, sw.. o. wa1�.. �. an. re a.. tM ivildi�g InpKler for Hpwa» P�rwi1+ for fhw h�. J APP�ICATIO� FOR BUILDINC PERMIT ��TY OF FRIDLE`Y, MINNESOTA OWNER 'S NAME BUIL•DER ADDRESS �.3 -/ e% L�� if.G�-CL ADDRESS � LOGATION OF BJII;D � rloe 3q s�x�r 2� �_,,�. —•��-�-.2 �� LOZ J fl BLOCK 7 ADDITION OR SUBD'IVISION �-�Z/!:�'�'1 ., COF�'ER LOT I�ISIDE I,OT #� SETBA�:K SI�JEYARD SEWF� ELE`TATI01`� TOP OF �'OCTI.�.�G Applicant attach to this iorm. T��o !��rtiii�at�� o�' Suxvey of Lat a�?� proposEd buildi.r.$ locatio:� dra�n o�a thEe� Cestiiicates� �ESCR.TF"I'.�OI� OF BLTII,DII�TG To Be Us�� As: �v '1 Fr�ont � D�pth Height � �quare ieet �'ubic FEr-_t '�t� �� F�oo�,� Fxont r Z Depth ��- Height r`i� ,+� '� � , Square feet ��`f �ubi� Feet 2 p! L Type of Construction Estimated Cost To Be Completed � Th� undersig.ned hereby mak�s application for a permit for the work herEin specifi�d, agreeing to do all work in strict accordancF� with the �ity of Fridley Ordinances and rulings of the D�partment o:�' Buildings, and hereby declares that alI the facts and repr�se.r�tations statE�d in this application are true and correcto DATE �` % '— �j g SiGNA`�[TRE (Schedule of Fee Costs can be fourid on the Reverse Side�� `� j�'S U U ,fJ � �-�t/`.� ( J ..� 'f ,��3�/ ^. _ � � ,; BIIILDING PERMIT FEE SCHEDIILE SECTION 2. The Inspector of Buildin�s shall, �aefore issuing pernits for the erection of any building or structure, or for any addition to any � existing structure or building, or for any alteration or repa,irs to any existin� building or structure, upon applYCation thereforE, requixe the payment by the applicant for euch permit of fees to the amount herein below set forth and in the ma.�ner herei.n provided to�-wit: Uniform Buildin� Codes Type 1, 2, & 4-�1.75 for each one thousand cubic feet, or fraction thereof, in such cubical cantentse Type 3& 5- � �1.50 for each one thousand cubic feet. For the purpose of computi.ng fees for building permits, the cubical contenta of any building or addition to a uniform height throu$hout by multiplyixig the ground area covered from a point six (6) inches below the floor line of the basement or the cellax to the average height of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. For repa.ira or alterations to an existing structure, the fee shall be at the rate of �3.00 per each five hundred dollaxa (�500.00) or fraction thereof in the cost of all proposed work. In no case shall the fee charged for any permit as aet forth i.n Sectio:n 2 be leas tha.n �5a00. NSSSD Connection Chaxgea based on location - Area 1 or 2. /�� S� � � � � � � � � �� _ . -w � r .� ,r A � Oct. 17, 1968 Wayne Holmberg � 5397 Altura BQad Frbdley, Mi�►�esoCa Deaz 3ir: The fallw�ing is due to the City of Fridley for aa electrical Permit: 1-18-Outleta $3.00 1-10 Sociuts 2.00 Afiida�iat .75 $5 . 75 LBOl1AitD SICNlIILLBS Electrical In.pector LE/bks sua�ecr ERMIT N . City of Fridley � 4� 96 AT THE TOP OF THE TWINS g U I L D I N G P E R M I�' i� � � RECEIPT NO. � `y _ COMMUNITY DEVELOPMENT DIV. �� r � � PROTECTIVE INSPECTION SEC. 1 . � L---. A��'��;•, CITY HALL FRIDLEv �f4$Y NUMBER REV OATE PAGE Oi APPROVED B� i' �� 612-571-3450 9t0-Ft5 8/26/96 / / 10B ADORESS 5397 Altura Road NE 1 LEGAL �OT NO. BLOCK THACT OFi ADDITION SEE ATTACHED DESCR. ],O 7 Carlson's Summit Ma.nor North SHEET 2 PROPEHTYOWNER MAILADDRE5$ ZIP PHONE Judith/Darrel Roo man 5397 Altura Road NE 574-7282 3 CONTqACTOR MAIL AODRESS ZIP PHONE LICENSE NO Same d ARCHITECT OR DESIGNER MAIL ADDRESS 21P PNONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADOITION O ALTERATION p REPAIR O MOVE O REMOVE X 8 DESCRIBE WORK Reroof House & Gara e 21 S 2nd La er 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. SEPARATE PERMITS ARE REOUIREU FOR ELECTRICA�, PLUMBING, HEATING, �PE 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 AUTHORIZEO IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF /20 OAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OfFSTREET PARKING I HEREBY CEHTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GAHAGES ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUHTAX AND OHDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING Of A PERMIT �1�3OL �.bS DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUETION. $4S.7S Fire SC �1.30 PLAN CHECK FEE AL FEE $47.70 SIGNAT EOFCONiRACTORORAUTMORiZEDAGENT (DATEI pq Y VALI D THIS IS Y R PERM17 ! � � • NATUFEOFOWNEP�iF WNERBUIL � IDATE� G�NS paTE NEW ADDN ALTER i] [l [l ConstructionAddress: , Legal Description: _ CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R 2 Building Permit Application Effective 3/1/96 � � Owner Name & Address: �,�) , � �� a�,�! � � ef /�o, � ,,, ,,,,, � �. Tel. # �- 7 y - 7 2 � Z. �° Contractor: MN LICENSE # Address: LIVING AREA: GARAGE AREA: DECB AREA: OTHER: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTIUN OF IlVIPROVEMENT Length Width Height Length Width Height Length _ Width HgtlGrowad ��yF s��.��'� a- L � • Sq. Ft. Sq. Ft. Sq. Ft. �ou5� 9� ��.�� v . - � - - �- r Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks Typ�e of Construction: Estimated Cost: $ r�, � a, o� Approx. Completion Date: � � � (Cost on Back) � � �t� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: S� -,� 6 - `� �' APPLICANT: Tel. # S � `� - � Z � Z CITY USE ONLY - Permit Fee Fire Surcharge State Siucharge SAC Charge License Surcharge Driveway Escrow Erosion Control Pazk Fee Sewer Main Charge TOTAL STIPULATIONS: � 5. $ �1 0 3 b � . �� $ $ $ $ $ $ � `�` , I� Fee Schedule on Reverse Side .(�1 of Permit Valuation (1/lOth%) $.50/$i,� Valuation � $900 per SAC Unit $5.(m (State Licensed Residenrial Contractors) Alt. "A" or Alt. "B ° Above $450.� Conservadon Plan Review Fee Determined by Engineering Agreement Ne,cessary [ ] Not Necessary [ ] �� - - BUII.DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $5(� $501 to $2,0� $2,�1 to $25,000 $25,001 to $50,(�0 $50,001 to $1(�,(m0 $100,(�1 to $5�,� $5�,001 �o $1,0�,000 $1,�0,(�1 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $5� plus $2.75 for each additional $1(� or fraction thereof, to and including $2,�0 $62.25 for first $2,� plus $12.50 for each additional$1,0� or fraction thereof, to and including $25,� $349.75 for first $25,� plus $9.00 for each additional $1,� or fraction thereof, to and including $50,000 $574.75 for first $50,�0 plus $6.25 for each additional $1,� or fraction thereof, to and including $1�,0� $8$7.25 for first $1�,000 plus $5.00 for each additionat $1,� or fraction thereof, to and inclnding $5�,0� $2887.25 for the first $500,� plus $4.25 for each additional $1,� or fraction thereof, to and including $1,OQ0,0� $5012.25 for the first $1,�,�0 plus $2.75 for each add.itional $1,� or fraction thereof � DRIVEWAY DEPRESSiON ESCROW (Concrete C�,irb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B" : Removal and replacemem of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus b feet times $15 .75 . VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of applica.tion to allow for proger review of the pro�sed structure and of the construction site. A Certificate of Survey of the lot, showing the l�ation of the foundation once it has it has be�n constructed will be required before proceeding with the framing. . , _ ., CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, NIN 55432 57Z-36U4 FAX: ADDRESS : 5397 ALTURA RD NE PIN : 233024330095 LEGAL DESC : CARLSONS SUNIlVIIT MAN NO ADD : LOT 10 BLOCK 7 PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE : ELECTRICAL : RESIDENTIAL : ADDITION/ALTERATION 571-1287 PERNIIT NO.: 2004-01441 DATE ISSUED: 09/Ol/2004 VALUATION . NOTE: ELECTRICAL PERNIIT BECOMES VOID 12 MONT�IS AFTER PERMIT ISSUE DATE. INSTALL SAVERS SWITCH. # INSPECTIONS 1 APPLICANT HUNT ELECTRIC CORPORATION 2300 TERRITORIAL RD ST PAUL, MN 55114- OWNER WALD LARRY JR & JENNIFER 5397 ALTiJRA RD NE FRIDLEY, MN 55421 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinaaces governing this type of wor� will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date ELEC PERMIT FEE - MII�T (RESn STATE SURCHARGE, ELEC FLAT TOTAL PAID WITH CHECK # 117431 .�L:a cu�iL: ri:ntvui u��u11�L rvA W Vl(11 V 1ri�iC 1riA1V L�Al;iC1ISL'L AtSV VL". 20.00 0.50 20.50 .' � ��_ / �_� FRIDLEY MUNICIPAL CENTER • 6431 UIVIVERSITY AVE. N.E. FRIDI.EY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 BUILDING PERMIT APPLICANT: PROPERTY �OWNER I, �r, �n ��' . understand that the State of Minnesota requires that all residential building contractors, remodelers and roofers obtain a state license unless they qualify for a s ecific exemption fr m the li sing requirements. As the owner of the property at �� 7 � � F�idley� I am exempt from the state licensing requirement only if I am not b ilding or improving this property for purposes of resale. By signing this document, I attest to the fact that I am improving this house for my own use and do not intend to sell it. I hereby claim to be exempt from the state licensing requirements because I am not in the business of building or remodeling on speculation or for resale and that the house for which I am applying for this permit, isl the first residential structure I have built or improved in the past 24 months. I also acknowledge that because I do not have a state license� I forfe� any rr�echanic's lien rights to which I may otherwise have been entitled under Minn. Stat. 514.01. Furthermore, I acknowledge that i may be hiring independent contractors to perform certain aspects of the construction or improvement of this house and I understand that some of these contractors may be required to be licensed by the State of Minnesota. I understand that unlicensed residential contracting, remodeling, and/or roofing activity is a misdemeanor under Minnesota law, and that I woutd forfeit my rights to reimbursement from the Contractor's Recovery Fund in the event that any cor�trac�ors I hire are unlicensed. I have also been informed and acknowledge that by listing myself as the contractor for this project, I alone will be responsible to the City of Fridley for compliance with all applicable building codes and city ordinances in connection with the work being performed on this property. Name oate� l'.�- o � REScheck Complianee Certificate 2000 Minnesota Energ,y Code ItEScheckSoftware Version 3.S Release 1 Uata filename: C:�P,rogram FileslCheck�RESchec�CVankowski.rck COUNTY: Hennepin STATE: Minnc�sota ZONE: 2 CONSTRUCTION TYPE: Single Family DATE: 0$/22/06 DATE OF PLANS: August 18,2006 PROJECT INFORMATIOId: Jankowslci Re�madeling 539'i Alhua S`t. Fridley, MN �i 2 � 3��1� �> ��3 COMPLIANCE: Pass� Maximum UA = 54 Ywtr H�ne UA � 45 16.7% Hett�' Than Code (UA) Permit Numl� ch«�ea sy� Grr�s Glazing Ar� c� Cavity Cont. or poor Perime�ter R� ue R Va1ue U_Facta� UA Ceiling 1: Cathedral Ceiling (no attic) 470 3$.0 0.6 13 Wall 1: Wood Frame, 16" o.c. 38� 19.0 2.0 19 Windaw 1: Abova-(3rade:Wood Frame:Dauble Pane with La�v-E 39 0.330 13 Furnace 1: Forced Hot Air, ?8 AFUE Proposed �nd Ma�tetnm U-F�ctor Aver� Above-Grade Windows and Glass Doors Includes Foundatia� Windows > S.6 ft2 Proposed Avaage U Fa�ta� 0.330 Maximum Allow� U Fac�or 0.370 C�MPLIANCE STATEMENT: The proposed building design descn'bed here is ca�sist�t with the lxtildin� Plans, sp�iffc��s, and aRhe,z c�lculari�s sub�itted with the pe�mit �plit�tio�. The prc�os�d lwilding has been d+�igned to me� �e 20� Minn�ta Energy Cods requir�n� in REScheckVersia� 3.S Release 1(form�ly MECchec� and to c�mply with the mandataay require�nea�is listed in the ScheckIn ' Checklist. Builder ign D� � �� `� � ) � l i � .ir.� � � �, � 1 , 3� :,, , r` �� i }� tl � � � � i � 3 3� .: � � � � �� ` � 2� � 7�_� �I � _ B� �tL � ► �� G��, �� /�i � �"/��% � �� 1,� ^ � �� S� �� C �` r� i ! i _ � t � � �°��`� ,2 � �. , � �,� �� 2 � o � 5 �y � � � �� -�., � � �� i � S��a� -�.-�------- .� �� -��? � a �� b u� ; � .:=J � �;�s � �� "�� .._._..._. .,_. __ _ �. ___ _�_�. _-- �tti 2, � ' -� �.Y�'�C.L 16r�, T �1�� iJ _-� -- � �-- �� :��,�.� '� _ , i r m coNC. r�t �+ �,� B�. �e eonoM ro i s� re �� xru. �xs �en. .r��T��.�. . � �� ',-� �� BOSi'G. 12' f�dC. BIK. FOUNDA'f10N WALL �y �° L � � 6X6 TRTD. P09T 12' 0 CONG PIER PIAR� BiM. 20' 0 a-anoian.mc 8'-I I° i.� �y�� Z�� O � � — . O� � ..�� I C-9�" BASEMENT TILfD. 2X 10 LEDGER 6D. lAG BOLT 70 RIM J9T. i 8� m c�i'.. et� PIARE BiM. 70 24° 0 6'X6 TRTD. P09T a-anonau. me. T-IQ�° � � iRTD. 2X8 tPDGER BD. � lAG BOLTTO RIM.�T. � o � � � CRAWLSPACE FOUNDATION LEVEL - I/4"= I'-0u ��,;�. �� - � Q3« �� 6" � s� ��''�- E _,�4-�.�, � �r CAM'..JST3. � I `F �emm..�srs. �� 6X6 TRTD.P057 I 2° 0 CONC. R2R BOTfOM TO I 6° 0 �.---_... f ��}�.^7��.0 �..�J � fG�C �mCL- ' •�ii t � � , +,� p�ctos t`I ��o gLOti: S ` � e.. �� .r� � � I °��,vo� 0 �� N � � 1 � � � � � e � � � N � � �S � °2`� �C uv� 7"'s''Z!� tbS � �F' v iQ i. �,-� �-�° �z NOTE: NEIh/ tMNDOVd NUMBERS SHOWN ANDHL9�1 CIAD UNR9 � W�� UPPER LEVEL - I/4p= I'-0° �� 8 Z�� . w � o r ,l � � uv � IW�1�� O � � G � O z � �� v°�� - �rn � �� 0 � � �. � � O N m � �� + r � N .■ � � � �� - �� / % � 1 � � �.� �� U =�,�v+ � �. a � N n e« sy :�' a• ' N � � � �, \ �-s o ra w � _ "$ =v o.°_ � mm � a �7� y � � � rn � � O z � w � �' O 3 � �. w °��oo Z�� ( � � � � N � � � � N � N �L � _ -�-I rn � � O z II O 3 � � � � � O Z i � � II O � � � � N �g � � 0 �� m � �I � � � � � � �N � � � �� D� � «� � �� A�� i� �� °� � � �a�� . � I � � � � � � �. K� l`�= � � O � : ( Qr � � � a � l � � � % � � z' � � � °� � , � � �' G � �. n � �� " � Z� � - r ' N a��3 � 2 �[ �. � �� J� � �� . t ��s � � �► u ; � ��: . � .� � � �� ti� . � �� Building Inspecti�ns 2 763-5�2=3604 -.. . SITE ADDRESS � THLS APPLICANT IS: BUILDING �� RESIDENTIAL APPLICAT ON CITY OF FRIDLEY Permit N Received. By: Date Rec'd: YOUR E-MAIL ADDRESS �r�,K �� I/T�l�B_ Go � . .-, _A.. , _ . �� ; : �71� To�� PROPERTY OWNER/ N,�yg; ��'i ' TEN�►1�TT annx�ss: S'�9 7 �4/f� �, /t � crrY RE PHONE: �Z ��5� S�3 CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION NAN�: STATE LICENSE �l �� .�?�i� ss z/ ADDRESS: CITY STATE ZIP T'YPE �u�c.T� rp,nnu.YiNt O TWO FAMILY/NEW PERMIT TYPE TYPE OF ❑ BASEMENT FINISH � ROOF �DECK ❑ SIDING � SAVIIVAR DESCRIBE WORK BEING SIZE OF U' DRAIN TILE ❑ OTHER WIDTH HEIGHT Ft � ...,....... _ NUNBER OF SQUARES O HOUSE 8c GARAGE BASENIENT REMODEI,ING SUBIrIIT• GARAGES O ATfACHED GARAGE ?: �� fl� P�� PROPOSED SIZE: � DETACHED GARAGE 3. List of struchual members to be u�1 PROPOSED HEIGHT: `� 1 �`V � FOR NEW CONSTRUCTION INCLUDING DECKS, p�g� A�DITIONS 8c PORC�-TES SUBMTC• �� Trim �� I�l �'! i�t 1. Site Plan/Survey showing the existing shucroures ❑ p�� ❑ Fascia � ProP�� P�.1�- 2. Tvwo sets of construction plans WINDOWS 3. Energy Calculation4 Ild EiQSTMG OPENINGS DYes �IVo WCATION OF WINIX?WS OR FOR NEW OPEMNGS-DESCRIBE SIZE OF OPENING CHANGES 8c TYPE OF WIl�iDOW TO BE INSTALLED NUMBER OF WIN�WS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $�� C�� T�E Pezmit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Dne $ E� $ $ $ $ $ ., .. 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 aavable to: City of Fridley Attac THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclaiowledge 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 wiffi the Minnesota Construction Codes; that I understand this is not a permit but only an application fo 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 w'c uires review and approval of plans. �` �, b SIGNATURE OF APPLICANT PRINT NAME �/,'� V 4�i�ji��I � DATE v~ � Page 2- Building Residential Applica.tion � BiJILDING PERNIIT FEE SCHEDULE ' '� The Chief Building Official shall, t�fore issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of proposai structure and of the construction site. A Certificate of Survey of the lot, showing the loca.tion of the existing foundation will be required before proceeding with the framing. New Houses Onlv City of Fridley Building Inspections Deparlment 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 � IWSPECTION REPORT � (,,. , � � CITY OF FRIDLEY MINNESOTA� ,�} � (763) 572-3604 ADDRESS OWNER BUILDER if no corrections are listed above, approval hereby given to proceed. You wilt be in violation of the ordinance if you do not call for the proper inspections and make correctlons as called br. Building Inspections 763-572-3604 DATE `D" /9' D SI'I'E qDDRESS J TMS APPLICANT IS: PROPERTY OWNER/ TENANT r� MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY 0 OWNER NAME:� nDDxESS: 5 39' vzaro�• IA�oZ" . YOUR E-MAIL ADDRESS 1�ONTRAC7'OR _ .- . . � C1TY Perrr.it N Received By: Date Rec'd: CONTRACTOR �o��.,Y N�: Anderson Heating and Air-Condinoning SUBTUT A COPY OF C��A� PERSON: �"��f� — YOUR STATE STATE LICENSE � N�A' 4341 Central Ave N.�, � LJCENSE WITH ADDRESS: .��,�� CAI. HtS, iYll, SS4Z1 ��,�. ,4PPLICATION PHONE �Lo�"��- �'�// I�.SMGLE FAMILY � TWO FAMILY PERNIIT TYPE � TYPE OF WORK: � �w ��PLACEMENT DETAILED DESCRIPTION OF WORK __�. a � O TOWNHOUSE ❑ ALTERATION/REMODEL A' _STATE Zip PER MS 16B.665 the permit fee is a minimum of S15.a1 fixtwe� xcluding the fixtu �so ��O.Ohouldlreflect onl�y the costrof labor ) improvement, installation or replacement of a res�den � x.05= Labor cost under $300 =$15.00. Labor cost between $300 to $S00 = cost of labor __________ FOR PROJECTS �'I�RE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EaCEPT WHERE NOTEDS �TURES: (IN�I�ATE TOTAL NUMBER OF EACH BELOV� �,G' `_ MODEL: ,�—. Equipment Instaped MODEL: ��. 5�� —` �G' ---'— MODEL: _______— SIZElBTU _____ MFG: ,___ GAS RANGFJOVEN 510.00 ,�AIC 525.00 FIREPLACE (GAS) $I5.00 _' -�w Gp, G�,L $10.00 TFIREPLACE (WOOD) $35.00 G� �T }�R $10.00 _AIR TO AIR EXCHANGEER $15 . �F�ACE $35.00 —pppL �p7'gR 535.00 _,BOILER $35.00 _GAS DRYER $10.00 CHIMNEY LINER $10.00 GAS PIPING $10.00 _�NTILATOR S15 00 —nuC7' woRK 510.00 — .;�r;•�;.�,� `'�""�'' 7`S O:'?�R$SO ��' . - _ - .. _._ ._ ,: ro -• � . �� ia.r: a' .,,. . ,: u. ..., e .- .�: �., ;. :.. .: - (I�,�'�EE:�R(��` $ �_ DD . Number of fixtures @ $10.00 x $10.00 = __ Permit Fee 50 Number of fixtures @$15.00 x$15.00 =$ Surcharge $ Number of fixtures @$25.00 x•$25.00 =� TOTAL DUE $ ''� Number of fixtures @$35.00 x$35.00 =$ State Surcharge = $,�50 Total = $,__ • THIS IS AN APPLICA7']ON FOR A PERMIT-NOT VALID UNTIL PROCESSED I hPreby apply for a building permit and I acknowledge that the information above is complete and accwate; that the work will be in conformance with the ordinances and codes of the CiworkFs�not o startlw thou a permrt; that thec�'�'or C�'a� be�n acco dancend itht the not a permit but only an application for a perm�t and approved plan in the case of all work which requires review az�ri approval of�an;.�L' �� DATE �� J 9 D�_ C�I.WI Sc�� • PWM NAME G(i�/ � SIGNANRE OF APPLICANT _ �..,j„�....;-:,,.,....:�..,.,rn �-r��nrnuu "` _ _ ,:.s.: City of Fri�ley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 BL111Cllrig �C�C�, Permit No.;�3'?-- o0 Inspections RESIDENTIAL APPLICATION R�i�� By: 763-572-3604 CITY OF FRIDLEY Date Rec'd:� o DATE Z��'� YOUR E-MAIL ADDRESS SITE ADDRESS � � � �� 4'''�1 . TI-IIS APPLICANT IS: OWNER OCONTRACTOR PROPERTY NpME; OWNER! ADDRESS:��7 % �I�L�i CITY STATE ZIP� TENANT PHONE: ��Z ^ 3gt% �� CONTRACTOR CoNtpANY NAME: SUBMIT A COPY OF �NTACf PERSON: � YOUR STATE STATE LICENSE # EXP DATE LICENSE WTfH ,r�D�g. CITY STATE ZIP APPLICATION pHONE FAX PERMIT TYPE � SINGLE FAMII.Y ❑ TWO FANIILY O TOWNHOUSE TYPE OF WORK• ��w D x�r.ACE�rr ❑ ar.�xa�rtow�ODEt. DETAILED DESCRIPTION OF WORK 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 = FOR PROJECTS Wi�RE LABOR EXCEEDS $500, FEES ARE BASED ON $10.� PER FIXTURE, EXCEPT WF�RE NOTED. FlXTLTRES: (IIJDICATE TOTAL NUMBER OF EACH BELOVi� Equipment Instelled MFG: MODEL: SIZF/BTU MFG: MODEL: SIZEBI'U MFG: MODEL: SIZFJB'I'U A/C $25.00 FIItEPLACE (GAS) $15.00 GAS RANGElOVEN $10.00 AIIt TO AIIt IXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRII,L $10.00 BOII ER $35.00 FURNACE $35.00 �GAS UNIT HTR $10.00 CIIIIVINEY LAJER $10.� GAS DRYER $10.Q0 �POOL HEATER $35.00 DUCT WORK $10.00 GAS PII'IiV(3 $10.00 �T �►TOR $15.00 — �� s �:�: � F;:, Permit Fee $ :$ � Number of fixtiues @ $10.00 x $10.00 = $ Surchazge $ .50 Number of fixhues @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @$25.00 x$25.� _$ Nwnber of fixtures @ $35.00 x $35.00 = $ State Surchazge = $ .50 Tota1= $a s < <' THIS IS AN APPLICATION FOR A PERIvIIT NOT VALID UNTIL PROCESSED I hereby apply for,a building permit and I aclrnowledge that the information above is complete and accw�ate; that the work will be in conformance wich 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 appli or a permit and work is not to start without a pern►it; that the work will be in accordance with the approved plan in the case of . which requires review and approval of plans. . SIGNATURE OF APPLICANT PRAVT NAMR J sn arn �A�loa„yr,�ui �DATE A` �"O � . , - .:, i .. �..A . i. -. - c:ity oY r'riatey 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 PERNIIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS 0 E�ISTING HOME 0 MAI{E-UP AIR REOUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Cha.pter 7 with MN Amendments b. Natural Gas or Propane/IFGC Cha.pter 3 with MN Amendments 2. Make-up Air (See note below) a IMC Cha.pter 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 REOUIRED 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 IlVIC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energ,y Mechanical Code Guidelines software may be used for combustion and make-up air calculations. Building Inspections 763-572-3604 DATE � �t `�'0 � SITE ADDRESS,� THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATTON PERNIIT TYPE TYPE OF WORK: PLUMBING RESIDENTIAL APPLICATION CITY OF FRIDLEY • ��• � � _. � � • ■ • •� ��:�1�`�� ♦ -�..._..._._.�� " ; ..�• � STATE LICENSE # EXP DATE Permit N Received Date F/t d I e�STATE ZII'�Z� ADDRESS: CITY STATE ZIP, PHONE °�GLE FAMILY �� ❑ NEW TON OF WORK FAX _ ❑ TWO FAMII.Y ❑ REPLACEMENT � TOWNHOUSE PER MS 16B.665 the permit fee is a minimum of 515.00 or 5% of the total cost up to $500.00, whichever is geater, for the improvement, installation or replacemexrt of a residential fixture, excluding the fixtutes. (T'his should reflect only the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECTS WF�RE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT W[3ERE NOTED. FIXTURES: (IIVDICATE TOTAL ER OF EACH BEIAV� BATH SINKILAV _FLAOR DRAINS _ SHOWER _ WATER PIPING gA�'('ZJg GAS PIPING (N�oC1TYtrCF�) SWIMMIlVG POOL _ WATER SOFCNER ($35) �.�5 y�� —�TC� g�{ � WATER CLOSET _ BACKFLOW PREV. ($IS) — D�� —' I,p�Ry �py WATER HEATER ($35) FOR IRRIGATION — — WATER METER _ QTE�R Permit Fee TOTAL DUE w $ Number of fixtures @$10.00 x 10. _ .50 Number of fixtures @ $15.00 x $15.00 = $ $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $,_,_?0 Tota1= THIS IS AN APPLICATION FOR A PERMIT NOT VALID UN'fIL PROCESSED I hereby apply for a building permit and I aclrnowledge 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 pemait but only an applic 'on 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 which requires review and approval of plan SIGNATURE OF APPLIC PRINT NAME �� °� �'°V DATE Z`' �� 7 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 ?63-572-3604 FAX: 763-502-4977 '