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_ A.rc}siteet F'ridreY,- �'Liinn., ' f � ' � �.�;�_ -
Builder � � .,�F �, .a� �
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L�CAiIO1V �LJII.DIN� . _ . . .
No. � ��a � Btreet ��� Part of ?�o�
Lot Bloek Addition or Sutio-DivAsion - - - - --
� DEaCR.II'TI�i� -C}F' �lUTLDIN�
� ,` ° �roni � ;� � Depih �`� J Height� Storier� fi2a.naer "af Constrixciion � � :�
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� �
' Ta be usecl as - '�o be compiet� � ^ �� �3stimaied Co`st� ` "� �
4'�` � .�"�� �' �"' �
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i� �
Perxiai� is h�reby �ranfi,ecl to ��q -
the buildia� �. deaeribed �n the �i�v$ statem�nt. This pertnit is gra�tted =
.�` �' upou`the express co�dition tha� tk�.e��Tsersb�t tt� whom it, is,� b�anted, aad 'his agents, `�P�Yees attd 'vvorknnen, `in a'li _ ��
' the wo�k doa.� Po ffi`, g Part thereqf,,;_ shall �onform ; in a11 re s tb the ordi-
;- ia, a�r0und. and u_ n sa3d buildin or �n. speci
nauces of �'ridley, Mir�n•� regarditig ihe c�ctionk alteration, m�inteaauce, repair and moviag' of b�aildittga "
` witi�in t�.e c�Cy ]imits, anfl tt�ie pera�t maq be revok� at any �ime upon violati�n of any ot the provi�ione uF said ..
ordin�.nce.� � -
_. . ,
a or Qf BuiIding�g.
r _ ' - ` AGR,EEM]ENT Al� S�O� aTA�NT ; : , . .
In con�ide�.ti�a af ` �,he i�sue and delivery to : me i� tiie In. �_ `
y speetor of Bnilding� of �'ritlley of
` the aba�e permi�, I: -hereby agr�e to do the �propvsed _�ork ' i�. acec�rdan�e wit,h tb.� desc�iptacin '
_ above sei fi�rth and accQ�ding to the provisions bf the ordinanc� of l�idie�, and, being first `duly
;. sworn, I hereb�r :atate an.r1 sap fihat -f,he facts �tated b�` �� and contafYSed f� the`:a�ve.: pe�at a�re : .�_
-`� ,' i�ue as therein �.ated. - �
"`�� �,>��`�= �'�-� � � �� � � �'� �
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Subac and rsworn' to before me at I+'ridley, ,� a ��- �
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Caty of Fridley, Minn.
BUILDING PERIVIIT
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N° 6909
.� LO TIO� ��� ,�I� NG
xo. st�t
� -----,•-� .-e-� � : part
a��� �
Lot --��Slock � tlon or Suh-Divisdoa
Ca�ner IAt _ Inaide Lot Setback -,���_........ Sideyard � � s�._�_..
Sevver �levatta� Foimdattan Elevatt�
� � • . �
� i: a� /' J / .� �� ; /,�
� -::� ; :� �
- �:.� - ,�, � . _ �' - :., - �'� , - .� � ��« �
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! �s//_�..�-'S/.��_ � ��; 'J� .4��1 �
In canatderat[on of the i�uaacae to me of a permit to e above to do
the p�opo�d work 9n acoordance with the d�cription above set f ce th of
oR'�naac�es of the dty oY FY3dley. � , �
�S �
Ia cama�4deration of the payment of a fee oP $.�.d�..��peraitt is hereby grant¢�i to
%he expre� c�onditlaa► that �pe�on�to�wh��it� ���a�nd �his a�gen� � oe. Tl�iaea� wort��in a�II �k
done in, as+w;nd and up� said build9ng, or any thereo� shari conf�m in aII r�pects to the ordinances oE
Frldle�', Minnesota loc:atton� c�onstru� alteration, maintenanc� repatr and mwing of bt�il�g�
wI� dty ]imits��� pera�ft may be revoked at any� upon vlola�of aay of the Pl'ovtst�a�a of ea�d
�_�T^',. -_'.�T�
aonc�
1Y. � aos. net em�r W. w�, � te► r.Me�. R�. 6.. �. ,ar� er .at�r. 6. wn. te ,..
� � �* �* � P�tb � dun �t�ns.
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- _. APi�I.�GATI�N F08. BUILDiNG . PE�1IT _ , • . _
. � � " CXT'� . 08 ; FRInLE7I, MTNNES�
. . .r , , . _ Y.�)CA`L'�Ol�: OF BiJ�LDI1� �-7� ;
d°.;=....r�� �. :. :� ���� . �..�.,.., Street /� �iL�rrr�-��� ��,�.�art of Lot
Lo � �`Sl�k � Addit�,oa pi: �Snbd�tv3aton ,_��� �_.,__�
� _. _ _ . �
, � �
Ca�aes bat„_*aside Lot,� . SeCbacl� � �S3de-Farti
SE6dEB Ei.E9ATI0� • FOUNDATIOFt Ei�BVATION • -
Appl3cant atta+ct�, to tbis farn Two, CertiEicst� of Surv��r -of Lot sud grog�ed build-
�iag location draw�"oa these�Certif�cates, � .: , .
. . • .,:_ . -
E �as
DESCRIPTIO� OF BUILDiNG
� b. �ed as : . _
-=� � ont � � ���th ��,� Hei�ht
. Sq. �'t. . ,Cu. 'Ft.
� . ._ - ____�_, Front Dapt� - Height'
� � Sq. I�t-. . Gti . Ft . �
0
TppB of Con�structioa � ,� � � � ,`Eat3mat�d C�� ,� � _ ; ��
_ , .. ,.� .
. To be Ca�pltated' °
, .
The aadersi�aed hereby 'make� appiicatiom for, s, permi,t for �he wark herei�r. specified,
ag�ceein� to do all work ia strict ac�ordance witt� tt�e C�.tq of Fridley Ordinaaces and�
ruli�ge of the Departmeat of Buildiags, aad.he�reby; clsree��hae a11 the facte- aad
�;
sepreseatation,9-stated in tbis applicatioa'are_ �aac1 orzect..
� -f;: ,� � �
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/�p � �• � Pf
SZ� . �fF
YA/.L F' .
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�S+eYedule of Fee Coats caa be found an the �everae Side�.
'� `_ _�-�j° �" 1 � _ �. .ss.-
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a
80�DI1�G PE�+L:T FEE St�EDt�E
Sectioa 2. Th� Inspector of Buiidingg'shall, befose iesui� any perm�i.t for
the erection of eay building os et�uctuse, or for any addit3on to aay e:�iet-
ia� bu�tlding or atructure, or for aay altesaeians or repai;s to anp exiet�ag
buildin� or s�ructure, upoa application therefor, sequire the paqmeat by Che
applica�at for such perm3t of feea tQ the amo�mt herein below set forth a�d
ia tha maimer her��n provided to-wit:
. � � . _ _.... .. -_�y �. ..::- ... _.n... ._ .,.._ -
2� l�or any er�ch pera9.t for the er�c.�io� a� a�p #ire-pxdaf b�ildin�, other
t'han a,gar�ge� w�.rehc�use,- fectorq or gira�n �l�vator, or ;for th� ere�t�.an of
aay fire-proof additi�, for e3milar occupancy, ta anq esietin� building
ahall be at the rate of $1.40 for eacb one thousaod cubic feet, or fraction
thereof, in such cubical conCenCe. -
2.2. For any sti�ch,permit--fdr- Che =sre�tion of ang- ffre-proo�--garag�, wareho�se,.,.
factory or grain elevator, or for the eseckioa of any fire-proo� eddition, ,_ ,
for similar. occapaacy, to any ex��ti�' i�uild3.a�g sha11 be a� the rate- of $1:25
for each on� thousand cubic feet. claeaified a� t1firepsoof!' by Section SC2 Qf
the M9.nnsapo�.is Buildiug 6ode. � -
HOU38S � � __ _
___
2.3. For aay �uth permit for the ereceion of eny nan-fireproof buiTdin; orrer
thaa a garage, warehou��, factory or grain elevator, or aay non-fire��c«�
additioa, for similar occupancy, to eny euistiag builcli.n� - perm�t $1.40 for �
each one thoueaad cubic feet.
GABAGSS
i
2, 4_ l�or any such pet�mit for tbe er��i� � r�r�� r���-�' �. ���c�c+� gaxa,�e,
ware6ouse,' factory o� gr��u elev�tor, �_ {:�:�. r.:-:., ���:s•r_.€ca•�-car �raq t►cn-���.�praof
addiel.�, -#or--a�milar occup�ncy, to - -,. a<�:a a _•;.r_r.. ��:.'.. �.,�, :� ; oe� �or each s�.ch �
y_ ,---,buildis�g Qr ad+dition - ninety c�3�.^-_ r;s�:,�;�; d^:r a:-:��a o:e thcc�send c�a+e feet
or fsactioa tbereof, iD the cu����� c:e�ry� ;z��:.m c:;atir��i vrith a minimum of �4.Q0..-
�'os the purpose of cam�put�tg feea r"�-i ���� :�.�.in�; pgrr.�i �:s, tbe cubical cen�teate
of any buildiag os additioa to a un�tc� ce�?;�a�:t t�uset,L£;hout by �i.tipiyi.�g che .
ground area covered fraa a point six (6j i;ir�l�s bsZs�r t�e. �l,00Y ;1ia� of �the
basement or cellar to the average height o� c�� �=ra er sv�L-ace or to the ��
average height of tbe roof eurface of the meiu gavle of a pitched rooi: •
2.5. For repairs or aleesat3ona to an enisting structure, the fee shall be
a he rate af $3.00 per eaoh Five 8uadred.Dollate ($SO4.00� os fraction.
thereof ia the cost of ail proposed,work.
Z� In no case ahall tha fee�_cbargecl...for --aay permit. .a� set forth 3a
.Sectioa 2 be 1ess.�hea $4.D0. . _
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lo Report�ed by;
4. Name.of Viol�tora
H E A� T' H C D M F L A I N T
CITY OF FRIIILEY, MINN�SOTA
2. Adclress;
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11. Report o.f Action Takeno (Specify date o.f action) '
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sue.iecr PERMIT NO.
City of Fridley 4�
AT TME TOP OF THE TWIN8 g U I L D I N G P E R M I T '
Si.� RECEIPT NO
� ; L� COMMUNITY DEVELOPMENT DIY. 1
r � � PROTECTIVE INSPECTION SEC. U
�l • �'��1 � CITY HALL FRIDLEY $5432 ' NUMBER kEV. DATE PA�E OF - APPROVED BV
L•"'� � ,'� 612-580-3450
910-F15 4/9/76 � /
JOB ADORESS 6645 Anoka Street N.�.
1 LEOAI �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ��,-23 2 �8j{ (�OV� A�C�.'ijpII SHEET
2 PROPERTYOWPdER MAILADDRESS ZIP PHONE
�ara Pen� 6645 Anoka Street N.E.
3 CONTRACTOH , MAIL ADDRESS 21P PHONE UCEWSE NO.
Same
4 ARCHITECT OR DESIOIdER MAIL ADDRESS ZfP PHONE UCENSE NO.
5 EIdQINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDINO
�s�a��.�.
� cu►ss oF woarc
❑ NEW � ADDITION ❑ ALTERATIOPI C�, REPAIR ❑ MOVE ❑ REMOVE
X
8 DE8CRIBE WORK
Re-roof dwellin
9 CHANQE QF USE FROM TO •
STIPULATIONS
Rafters 12 inches on center.
SEPERATE PERMITS REQUfR�D Fip� �/IRIN�,
HEATING, PLUMBIIVG AND S!G(VS.
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBINO, HEATIN(i, �PE OF CONST. OCCUPANCY dROUP OCCUPANCY LOAD
VENTILATIN(i OR AIR CONDITIONINO. ASj�Il�.'t
THIS PERMIT BEGOMES NULL AND VOID IF WORK OR CONSTRUCTION zONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, pii IF CON3TRUCTION
OR WORK IS SUSPEPdDEO OR ABANDOPIED FOA A PERIOD OF 120 DAYS AT �j.
ANY TIME AFTER WORK IS COMFAENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE REAO AND EXAMINEO THIS APPLICATION �. STALLS GARAGES
AND KNpW THE SAME TO BE TRUE AND CORRECT. ALL PROKISIONS OF LAWS yp�UATION SURTAX
AND ORDINANCES GOVERNINO THIS TYPE OF WOHK WILL BE COMPLIED. �], � OOO . rJO
WITH WHETHER SPECiFIEO HEREIN OR NOT. THE (iRANTING OF A PERMIT
DOES NOT PRESUME TO (31VE AUTHORITY TO VIOLATE OR CANCEL TH@ pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCRt LAW REtiULATING CON-
STRUCTION OR THE PfRFORMANCE OF CONSTRUCTION. $G.00
PLAN CHECK FEE TOTAL FEE
�,�.— $6. 50
,� SI6NA7UREOFCONTRACTQAORAUTMORIZEUAQE�T �DATEI WHEN PROPE LY VALIDATED THIS IS YpUR PERMIT
s /�,�
,� -y' ��,r,.�/ � d_ � � � �� Ic ,�_�_,�>�-
SIGNATUREOF OWNERUF OWNER BWLDERI IDATEI � BLDG. iNSP DATE "
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR AllllITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
orar�R � s r�r� :�,U�/�'!� �°� �/i'� BIIILDER : 5' ��`� �
Annx�ss : % � ,�- �P� ��i-- � 7` AnnxESS :
N0: � STREET:�� �°�'it� � � � %`
�. /�
LOT:�'�"'� 2� ^a"3°BLQCK: �"' ADDITION:�1� �.� %i���� _
CORNER LOT: INSZDE LOTa��SETBACK: SIDEYARD:
Applicant attach to this f�rm �rao Certificates r,f SurveY of Lot and proposed
builrling location drawn on these Ce�tifica�es, �
BESGRIPT�ON�OF BUILDING
To 3e Used Ass
��j " %� 4� � �' :�xon� s �� %�� Depth ° � o �eight •
� .
Square Feet: �� � Cubic �'eet:
Front: Depth: Height:
Squaxe Feet; Cubic �`eet:
�
Type of Cons�txuction: . Fsti.mate�. Cost: dC'1O
To Be Completed: l � � ��—
The undersigned hereby makes app�icativn tor a permi.t-�or �he work her.ein
specified, agreeing to do all wc�rk a.r stxict accordance with the City of
Fra.dley Ordinances, and x�alings of the Departimen� a£ Eua.lctings, � and hereby
declaxes �hat all the €acts and representations s�a�ed ix► this.application.
are true and corxect. �
DATE :. LE � cT "- t� � S IGNATURE t�/��
(S�e Reverse Side For Additional Information.)
_.��°`'�C/dvo = C�.o 0
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BUILDING PEItMIT F�E SCHEllU�LE
SECTION 2. The Inspector of Buildi.ngs sha11, before issuing permits for the
erection of any building or structure, or for any addition to any existing
building or strucCure, or for any alteration or repairs to any existing
building or structure, upon application therefore, requixe the payment by the
applicant for such permit of £ees to the amaun� herein below set forth and in
the manner herein provided to-wit: �
iTNIFORM BUILDING CODE: 1j►pe 1, 2 Fx 4-$2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. Type 3& 5-$1.85 for
each one thousand cubic feet.
ADDITIONAL INFO.RMATION
Fox the purpose of computing fees for building permits, the cubical contents
of any building or addition, is determined.by multiplying the ground area
� covered from a point six (6) inches below the floor line of the basement
2�ti� or the cellar to the average heights of the upper suxface or �o the average�
/b ��height of the roof surface of tlze ma.in gable of a pitched roof .
�
For xepairs or alterations to an existing structure, the fee shall be at the
� rate of $3.00 per each five hundred dollars ($500.00) or frac�tion thereof in
the cost of all proposed work. • .
In no case shall the fee chaxged for a.ny permit as set forth in Section 2 be
less than $5.00.
VERIFICATION OF FOUNDATION
NOTE: Permits for eonstruction w3.1T be issued a minimum of 24 hours from the
time of application, to allow for proper review of the proposed structure and
of the construction site.
A Certitied Survey of �e l.ot, showing the Iocatioii of the toundat�.an; once it
has been constructed, will be required before pxoceed3.n�.with the fxaming. .
CERTIFICATE OF OCCUP�NCY
Application for a Certificate oL• Occupancy shall be made ten (i0) days prior
to the use or occupancy of any structur� fox which a building p�rmit has been
issued; and said structure shall not be used or occupied until a Certificate
o Occupancy has been issu�d. � '
.. . . .
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sus�ECr PERM I
City of Fridley 16 0 7 6
' ` 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. � cs�
r j � PROTECTIVE INSPECTION SEC. '
1 1 �
(..-- A����`,� CITY HALL FRIDLEY SS432 NUMBER REV. DATE PAGE OF APPROVED BV
L , � 612-571-3450 910-F15 3/27/81 / /
JOB ADDRESS 6645 Anoka Stxeet N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oesca. 21, 22, 23 2 Oak Grove AddS.t:i.on SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Arv'ard Pentz 6645 Anoka Street N.E. 571-1266
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
.5�8
4 ARCHITECT OR DESI(iNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENOINEER MAIL ADDHESS ZIP PHONE LICENSE NO.
8 USE OF BUILDINO
A@S ].C�eA'tl.�.
7 CLASS OF WORK
X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Qonstruct a 26` x 3Q' Detaah� Gara e
9 CHANOE OF USE FROM TO
STIPULATIONS
Provide a hard surface drive�ra.y.
-�'aarE P � �� ���
�RMliS RE��r�FD � � u�
HF,qT��ll;, p1.1114�RiN� geforg d��CtR���t�.
4R ANf3 41�;�;� � �I�G, T,�{ONE
�UIREQ BY �'`W
R�
SEPARATE PERMITS ARE REDUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY (3ROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WOFK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION '780 %$OO
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE CiRANTING OF A PERMIT $6i87�- $3.43
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TH6 pEF;MITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $3�-•2O
PLAN CHECK FEE TOTAL FEE
$34. 63
SIGNATUREOFCONTRA RORnuTHORi2EDA ENr �DaTE� WHEN PROPERLY VALIDATED THIS IS YOUR PERM T
� 3 ��—�/`' � �
SIGNATURE OF OWNE tIF OWNER BUILD IDATE) BLDG iNSP fjA
. _._ . . _ . > .. . _.: �. __. �.� �. _ _. ,.�_ .r . _ . : � _ . ._.. _,... _. . . , . . , . .. . . ..� _ _ ..� r
� . CITY or FRIRLCY • ` � � �
� /�PPLIC/1TIad ��f; RESIUEi�ITllii_ QU1LI)Ii�G PGRtlTTS ' • '
� �tde►r, �1 ter��tivns, Itdditions�, or Repairsj . . ��
� OldtdER: f� /i� U ��1� � � ,� /j/T�
ADQR�SS: ,�o��l � ,�/Yo�/� 5%`
TCL h0: �? � � % �'"�
0
,. .
[3UILD'�R: - S' �� � • � .
11UURESS: • �
TEL ��d0: ' "
Construction Location '�
,
• STRL•�T NO : �I � �%l J� � STREET: ¢ N O � �
. �--
LOT: �" �" a � " a'� BLOQC : �^ ADnITION : O �k �' /� O � � . .
Corner Lot: � Insic3e Lot: �^ SetbacY.: Sideyards:
Ap�licant at�ach to this form tcva Certificates of S►trvcy o�E lot and
proposed�building location drawn on certificates to scale. � ,
� � DESCRIPTIOiJ OF COPaS7RUCTIOPd - � �
���/��,� � I�'ront: �� Depth: 3 O Heiqht: ��
square. k'eet: � 1�Q Ctiibic Fceti: %BDO ' .
� Fron�: Depth: � Heiglit:
. � Square• Feet: � Cubic I'eet:
Type of Construction : �/ � �' !� �%t� /�'� � � EstimaL-ed Cost: $ �'' �/ d o
t
xb $e abr,�pleted: _/i/� ,�� l � �`� , . . .
� ' . Alt. A Alt. B
Proposed Drive��ay Width rf New Opening Is Desired: $� $
� _ .. . S�E R�VERSE S7DE OF SHEET .
R9ie undersigned hereby ma}:e� applicatian �or a permit for the t:nrk� herein specified,
agzeeing to c� ,all work ir� 5trict accordance c�ith the .City of I'ridley Ordinances and
rulSuigs ot L-l1e Department of Buildings, and hereby declares that all the iac�s and
represen t.-�tions stated :n . this 7pplication are true and correct.
D.�T�: � " �- %•- �''(' SIGI�TATUI'.E:
SL•il�ulations : �
• � � j �3 .
� � ��.��
s -� � -
L� .. .
�, .
. . �au��r�i��1G I�c_r,t�t-r� r-r:�_� :>c�ir:r�u��� � �' . . . �
;l�i:'t'x01�� 2. �'3'I�Z 7n�.:pecL•c�r. of: )�ui.lc?i�uJ:: ::hri7:1, 1,�foi:c i.��:.ui.�ig pe»nit�:t for t:hC crr.cL•i.on •
uf• r�i�y 1�u:i.J.cl.i�r,�j ar :,i:ruct:urc, or. �c»: a►i�� ��c1cli.t:a��n �.:o ¢iny cr.i:�t�i.»c} Ltiildi.ncl. nr :stnic�uxe,
. i»' i:c>r zuiy til.t.c•r�t.i�m, ar, r.cj,aS.r.:; i:o •any c:►:i..�t.in�� �3•�tii.).di.�i�I oz sL�:uc:ture, uJwn a}���Zi.catS.on
'{;}���:uf.or.cs, r.cc,�uirc t]�� 1�tiymer�C }�y L'lie �tip�,�l.i.ca�zt: fc�r. such .per.ma.L• 01: fee, L•o. tlie a�n�unt
hrr�i.n Uea.oar .sc:L• �or.th �uiQ i.» t�hc mannez hcrcin ��i:ovxcic:cl L•�-�:a.t: • �
pJ},��1 CpN�;TJ?UC',CIOIJ: Singl.e 1'�ZiniJ.y Ilotnes anc� Gar.�zc{es: ,�4.00/J.,0�0 cuba.c fec:t:. �
)?7.�::d Clt3:�l;: 2J j�C:x'CCili: a�' bu�.lcii_i�cJ }'�e�-mii: fee. . '
U1tIl�]:��AY llL•'1'P1:SS20t•:.: (Cpncretc, �1i�b �L-rects Only) '
• . Al.tein.-�t:e A: lt�:inoval and re��laccment of concxete cuzU and �
yuLL•er only; l7riveway c•ridth p].us 6 feet• v. � i.3.,s�o
Alternate B: l2emoval and rep�.acemc;�t of concrete curb afld • �
,� guL•ter and inst�ll a 3 fooL- wic3e aPproach �aith ��y� ' .
• . � 6 a.nch depth; Driver�ay �•ridth �plus G feet x is��s:
. � � . AnDI �' I Ot�/�L � I f�%O�t1T I ort . � _ .
�'or the purl:a�se oi co�nputi.n� fees for_ building permits, L-he� cuvical conten�s of any
bua.IdS.nq or addition, 5.s dci:cr.mi.ncd hy rnuli:ip�.y3r�g L-he ground area coverecl fro:n a
p�a:nt sa.x (G) inches below the fJ.00r l.S.ne of i:he bascment or th� cellar to 'thc .
avc�acage hei.qhts of.- the •upper surface or to the average height o£ • fhe roof. surf:�.ce
of i:ii� raain cjabJ.e o� a pa.tched roof . •. �
k'or r_e�ai.rs or aZteratio:�s to an exist�.ng structure, the fee shal7� be at the rate
,. pf $3 .00 rcr. cacli f�ve hundred do].lars '� ($500.00) or fXac�ion thereof �i.n the cost .
at all groposed wor.Y.. . • .
xn •no case sha�.l the fee charged fax any pP�r►nit as set tozth i.n Secti.an 2 be less • .
than $7.50 �lus $.50 state swrcharge. � � � _
• � � VERTFIC�TiO�! OF FOUNn�1 IOfd
0
� NOTE: Permits : or construcL-ion will be isstted a minimum oi 24 hours �'rom tlae t3me
of ap�slication to a].l.o�v far pro}?er review of the pro,posed stzucture and of th� �
cor,struction si.te. • .
r � . ,
1r Ceri:ifa.cate � of Survey of the lot, sho�,*inq the location of the foundation once a.t
has been cons�nictcd ���ill be required bef.ore proceedinq �rith the frantinq.
,�F, T�. I F I CL�'E�� OCr�pA�CY � �
'?►gp�.ication tor a Ceztifa,cate ot Occupancy shall be mac�A fien (10) days priox to the
u�:e or accurancy of �n}► st�.-ucture fo�: tJ�11CI1 a��ui.lcling permi.t has been a.ssued; �nd
st�.icl strucfi:u�c : ha�l iiot be used o�: occu�,>ied LuiL-i.�. a Cezi:S.tic��e• of �Occuranc}� has
liC:Cll XS5UCC3.' .
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sue�ecr PERMIT NO
City of Fridley -�- �
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T �
�
� � COMMUNITY DEVELOPMENT DIV. RECEIPT NO.
� •
' ; L ��'��'�
r � � PROTECTIVE INSPECTIOId SEC.
1 �1 �
� 1 ���'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED B�
������ � �'' 612-5� �-3450 si aF� s
4/26/94 � �
JOB ADDRESS 6645 Anoka Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACNED
oesca. 21, 22, 23 2 Oak Grove Addition SHEET
2 PROPERTY OWNER MAIL ADDRES$ 21P PHONE
Robin Turner 6645 Anoka. Street NE 572-2412
3 CONTRACTOA MAIL ADDRESS ZIP PHONE LICENSE NO.
American Remodeling 3700 Annapolis Ln, Ste 145, Plpmouth 55447 553-0020 2406
4 ARCHITECT OR DESI(iNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENOINEER MAIL ADORESS ZIP PHONE LICENSE NO.
8 USE OF BUILDINfi
Residential
T CLASS OF WORK
0 NEW � ADDITION ❑ ALTERATION �J REPAIR 0 MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside Dwelling
9 CHANQEqFUSEFROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIREO FOR ELECTRICAL, PLUMBIN(i, HEATINd, �PE OF CON3T. OCCUPANCV dROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONINf3 SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCEO WITHIN 80 DAY3, Ofl IF CONSTRUCTION
OR WORK IS SUSPEIdDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCEO. � NO. OWLO. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPL�CATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUHTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE dRANTING OF A PERMIT �9 � 928 $4. 96
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEPMiT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATIN(i CON- @
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. W117.O0 Fire SC �9.9L
PLAN CHECK FEE TOTAL FEE
License SC $5.00 $136.88
SIGNATUREOFCONiRACTORORAUTNORIIEDAGENT IDATE� W N Y VA TED THIS IS VOUR PERMITQ
� �0 i
SiGNATUREOFOWNER�iiOWNERBUILDEHI �DATEi - 'BLDG�NSP Da7E
� � � � Effec�ive 1/1/93
ADDN [ ] � CITY OF FRIDLEY
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R 2 �S� r 1
Buiidiag Permit Applicabion ��` �7
Constiuction Adaress: l0 6 �1/S �nJC��' �-�� �.t� � � � �
Lega1 Descripti�: �
O�vner Name & Address:
���.«
� , � :,..
,
Tel. �.�_7't —��l l z
[CEAiSE # � 1.L 6 ,6
TeL � .SS.�-ooa.o
Attach to this application, a C,ertificate of Su�vey of the
lot, witfi the proposed coc�struction drawn on it to scale.
DESCRIPTI�UN UF IMPROVEMENT
LIYING AREA: Length Width Height
GARAGE AREA: i.ength � Widdi He�g�rt
DECK ARBA: I.ength � �dth y. Hgt/Ground
Sq. Ft
Sq. Ft
Sq. Ft � T
o�x� .
Corner Lot [] Inside Lot [] Ft Yd Setback Side Yard S�backs
� F.stianated Cost: $ ����'°—� .
�ype of Consb�uctiion: � I c� ► c� _
� �
Approx. Comple.tion Date: � - �� �� �/ . . .
(Cost on Baek)
. '
Drivearay Curb Cut Width Needad: Ft + 6 Ft = Ft x$ _$
�
DATE: L APPLICANT: Tel. #� �S; 3 G> �
�
_Y_ . � -�
Permit Fee $ 1 I 7 6 0 Fee Scheduie on Reverse Side
Finee Surchuge S q`l � .001 of Permit Valuation (1/lOth%)
State Surcharge S 4. �� $.SO/$1,�0 Valuation
SAC Charge $ $750 per SAC Unit
License Surcharge S � AD $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt "A" or Alt "B" A�ve .
Park Fee $ Pee Det,ermined by Engineexing
Sewer Main Charge $ Agreement Na�saiy [ l Not Necessary I]
TOTAL � $�� �• �
STIPULATIONS: ' �
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PURCHA�E ORDEE� oare DEPART nn� I
�- A:� ��� � �� . /�.r ��t�: /G9y�� � 3723�
PURCHASED BY , THIS NUMBER MUST APPEAR
� ON ALL SENTRTOP SNDENCE
THIS DOCUMENT GOOD FOR PURCHASES UNDER $1,000.00 ONLY
SUPPLIER )/ It t
rnonr�ss � � ',vr3 �L /S ' � 5'
. L - .S
C�TY OF
f RI D LEY PHpNE N0. L� i� -��-� -���
e�� uNiv. av�. w.e. �
PAYMEIdT VOUCiiER
BY SIGNIN6 THIS DOCUMENT BELOW I HERfDO AUTHORIZE
PAYMIENT AND THAT THE C�OODS AND SERVICES HAVE BEEN
RECEIVED OR RENDERED AND ALL CITY GUIDEL{NE5 HAVE
BEEN FOLLOYVEO IN THE PROCUREMENT OF THE BELOW
STATEO ITEMS.
�aa�r. �u sss�x�ea �ac� = onr� a�c� o
s�z-s��-�+so � -
PR/NTED ON RECYCLED PAPER. PAYb1ENT AUTNORIZED BY
t
�
�
�
�
:32Z-
•�yZ-
QTY. UNR PLEASE ENTER OUP
�_ '� - , � ... -
FOR.THE FOLLOWING UNIT PRICE AMOUNT "
( . i�-,�/hii '
� ��- • ��%
�.
,�SI �; — �,. C _
1�t: S-�.
�;� S�
� .� C.
� �� �'1:�. oc
� �� , -�
��
�; ,
� � ,•
��.-� I� ;
1 f' �
�/ 9 �
.� : C'C^
�.3 �-. �
•— l-� : CC�
TOTAL � ��/, ��'
THIS A(3ENCY HAS AGREED NOT TO DISCRIMINATE IN HIRINC3 PRACTICES ON THE BASIS OF RACE, SEX, COLOR, CREED, MARITAL STATUS, RELIGION,
OR NATIONAL ORIt31N AND HAS AGREED TO TAKE AFFlRMATIVE ACTION TO RECRUIT MINORITIES AND WOMEN INTO EMPLOYMENT. IT ENCOURAGES
FlRMS AND �THER AQENCIES WITH WHOM IT PURCHASES PRODUCTS OR SERVICES TO DO LIKEWISE.
YKHITE, VENDOR — YELLOW, PURCHASING — PINK, ACCOUNTING — GOLD�N ROD, DEPT. HD.
,
f
sue�ecr ERMIT NO.
c�ty of Fr�aiey 2 2 715
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T �---_
r
RECEIPT NO.
� � COMMUNITY DEVELOPMENT DIV. � � � �
� •
� bV ����.��
r � � PROTECTIVE INSPECTION SEC.
1 • �
i•--. ���'�';� CITY HALL FRIDLEY 55432 NUMBER REV OATE PAGE Of APPROVED BY
L �� 612-5��-3450 s�aF�s 7/13/94 � �
10B ADDRESS 6645 Anoka Street NE
1 LEGAL �OT NO. BLOCK TRACT OR ADOITION SEE ATTACHED
DESCR. Z j, 22, 23 2 Oak Grove Ad SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Robin Turner 6645 An.oka Street -
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 EN(iiNEER MAIL ADDRESS �P PNONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW 0 ADDITION 0 ALTERATION O� REPAIR O MOVE � REMOVE
8 DESCRIBE WOIiK
Replace exterior sheathin (Residin to be done b Contractor- e
requ re
9 CHANCiE OF USE FROM TO
STIPULATIONS
Residing permit to be applied for within two weeks of completion of
sheathing replacement.
TYPE OF CONST. OCCUPANCY t3ROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBINCi, HEATINO,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VpID IF WORK OR CONSTRUCTION ZONINd SQ. FT. CU. FT.
AUTHORIZEO IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLd. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO TMIS APPLICATION 1 STALLS (3ARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAW3 yALUATION SUfiTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO '
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �900 �.SO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEFMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REf3ULATINti CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �23.00 Fire SC �.90 .
PLAN CNECK FEE TOTAL FEE
24.40
SIGNATURE OF CONTRACTOR OR AUTHORIZED A6ENT IDATEI WH N PR Y V ATED THIS IS YOUR PEiiM1T
SiGNATURE OF OWNER UF OWNER BUILDER� 1DATEi LDG INS �/AT� �T
NEw [1
ADDIoI ( ) � CITY OF FRiDLEY �
ALTER [ � SINGLE FAN11Llf AND DUPLEXES R-t AND R-2
Buitding Permit Appiication
i � ��
ConstevctionAddress: ip��5 T10�R ST ��, =�6ZI��F_� Yi�
Legal Description:
Owner Name c�i Address:
eontractor:
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Effective 1 / i /94
Tel. # �`l a - ay 1 �
MN LICENSE #
� � � � � Tel. ,# . �
Attach #o this application, a Certificate of Susvey of the
lot, with the proposed construction drawn on it to ss�aale.
DESCRIPTION OF � IMPROVEMEN!'
Le�gth Width Height
Length Widtb Height
Length Width Hgt/Cnound
�ECJI�,N.�►n._-� � �`�-�4��0�1 �=1�-F
Sq: Ft. �
Sq. Ft. .
�Sq. Ft.
Comcr Lot {] inside Lot � Ft. Yd Setback Side Yazd Setbacks
Type of Constivction: Estimat�i Cost: $ �t`� . 00
Approx. Completion I)ate: � ' �� - �I
(Cvst on Backj
Driveway Curb Cut Width Ncedet�: Ft. + 6 Ft = Ft x.$ =$
DATE: �'1- 13 - 9 APPLICANT: �� �, ` � �.�.�(t` Tel. # S"1a - � � 1 �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
� ����
s ,�C�
$ ���
$
$
$
$
$
$
►, i �
��. �
Fee Schedule on Reverse Side
.QOI of Permit Valuation (1110th%)
$.50/�1,�0 Valuation
$8Q0 �r SAC Unit
�5.� (State Licensed Re.cidential Contractors)
Alt. "A" or Alt. "B" Above
$450.� Conservation Plan Review
Fee betermined by Engineering
Agreement Necessary [] Not Necs.ssary [ J
I3UiLUING !"EItMXT FEE SCHEDULE
'1'hc Chict� 13uildin� Uliicial stialt, t�efoce i.ssuing permits for ihc eroction of aay building or structure,
c�r !or any additicm to any cxisiin� building or structurc, or for any altcration or rcpair to any cxistin�;
building or struc(ure, u�n a{�plication therefoce, cequire the payment by the applicant for such �ermit
oi� fu:s to ttic aciiaunt herein t�cl<�tiv set fortli and in tlic nianner herein Prc�vidcxi to-wi1:
"['U"1'AL VALiJE:
$ ! to $500 . � -
$SO1 � �to $2,000
$2,001: to $25,000
$25;001 to $50,000 .
$50,001 to $100,000
,
$I00,001 to $500,000
$SOO,OOi io $I,000,000� .
$1,OOU,001 and up
rr�;s
$15 (Miitimum Fee is $15 plus surcharge)
$15 �or fiist .$Spp pjus $2 for each additional $ lOQ oc
frac�ion d�ereof, to and including $2,000 �
.,.$45 for fiust $2,ppp plus- $9 for each additioual. $1;000
or �fractiori thereof, � to - and iiacluding $25,000 �
$252 for fitst' $25,OOp p{c�s $fi.50 for each additional $1;004
or fradion thcxeof, �o. and including $SO,ODO -.
$414 SO for 6rst $SO,OOQ pius $4S0 for each additional
.$1,U00 or fraction t�eof, to aad including $100,000
$63950 for f�rst '$100,000 plus �$3_50 for each adclitional. .
$1,000 or fradion thereof, to aad including $�0,000
$2039.50 for dce S�rst $�0,000 plus $3 for each additiocia.t
$1,000 or fradidn t�eof, to and including $1,000,000
$3539_SO for the 5rst $1,Opp,p00 plus $Z for each additioaal
$1,000 or fractioa tt�ereof -
DRIYE�VAY DEPRESSiON ESCROW
{Concrete (�urb Streets Onty)
Alternate "A"= Removal and replacem�t of curb and gutter oaiy - Driveway widtii plus 6 feet times
$13_50_
Alternate "Q°= Removal and rep[acement of curb and gutte� and install a 3 foot wide
approach with 6 inch depth - Dniveway width plus 6 feet tirxzes $15_75.
VERIFICATION OF FOUNDAT[ON
i'crmils for constzuction will bc issued a minimum of 24 hoars from the time of a{�plication to al(ow
for proper review of the proposcxf Stnucture and of the cocastruction site_
A CerLificdte of Survey of the lot, st�owing the iocation of die founciation c>nce it h�c ii has heen
cv�►sUuciui witl be re;yuire:ci bc;fi�re proce�eding with lhe Ccaming.
,w_ ,..-_.
SUBJECT
City of Fridley ' 2 2 716
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
� � RECEIPT NO.
� � COMMUNITY DEVEIOPMENT DIV. � ^ �
r � L w� PROTECTIVE INSPECTION SEC. ��
1 � �
i-___ w�'��;•� CITY NALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY
� ''� 612—s��-3aso s�aF�s 7/14/94 � �
JOB ADDRESS 6645 Anoka. Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACNEO
DESCR. 2j — 23 2 Oak Grove Addi i SHEET
2 PROPERTY OWNER MAIL ADDRES$ 21P PHONE
Cameron Turner 6645 Anoka Stree -
3 CONTRACTOR MAIL ADORESS ZIP PHONE LICENSE NO.
First Choice Exteriors 2405 Anna olis Ln N 4�24 -
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PNONE LICENSE NO.
5 ENGINEER MAIL ADORE33 ZIP PHONE LICENSE PIO.
8 USE OF BUILDINO
Residential
7 CLASS OF WORK
� NEW 0 ADDITION � ALTERATION � REPAIR ❑ MOVE O REMOVE
B DESCRIBE WORK
Reside Dwelling; Install vinyl windows - e ress windows for bedr o s
9 CHANdEOFUSEFROM TO
STIPULATIONS
Bedroom windows must meet State Building Code for egress.
TYPE OF CONST. OCCUPANCY (3ROUP QCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBIN(i, HEATINd,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONIN(i SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN BO DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. • NO. DWLt3. UNlTS OFFSTREET PARKING
i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION I. STALLS GARAGES
ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS ypLUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO
WITH WHETHER SPECIFIEO HEREIN OR NOT. THE ORANTING Of A PERMIT �9s9OO �►.9S
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OF1 CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTH R STATE OR LOCAL LAW RECiULATIN(3 CON-
STRUCTION TH PER ANCE OF CONSTRUCTION. �117.00 Fire SC
///��/�� PLAN CHECK FEE TOTAL FEE
� ��� License SC $5.00 $136.85
51GNATUiiEOFCONTRACT ORAUTNOt712EDAGENT IDATEI W LY IDATED THIS IS YOUR PERMIT
� �� ��
SiGNATUREOFOWNER�IFOWNERBUILDERI IDATE� � BIDG INSP �AlE
NEW j] Effective i/ 3/94
ADDN � . [ ] � CtTY OF FRIDLEY � � �
ALTER � SINGLE FAMILY AND DUPLEXES R-1 AND R-Z
Buiiding Permit Application � �, �
�
Construction Address: ����,� � v� p �c� �
Legal Description:
Owner Name 8i Address: [' � ���� � � � J � � .r r Tel. # g � �? – c�µ / °�
Contra�tor: �i ✓'a%L � �i c.,P � �_..�c� � MN LIEENSE # �f �d (.� �
Address:�,�1�H ���o � L.. ��•� vd j � a�lr� /" l:Y - �'J �.SYY�� Tel..� s",�� �-/S /1�
LIVIN(� AREA:
GARAGE AREA:
Attach to dus application, a Certif�cat�e of Swvey of the
lot, with the proposed conshvction drawn on it to scale.
� � DESCRIPTiON OF IMFROVEIVIENT �
X.ength � � Width Height �
Length Width Heigiat
DECK AREA: . I.ength
OTHER:
Width
' d /V� w � /G �
�a,P /t 1°�s' G�r JV /J!J/�-� S
Sq. Ft.
Sq. F�
Sq. Ft.
�1 fS �J ,P� ao21- S
Corner I.ot [] inside Lot [] Ft. Yd Setbacl� Side Yazd Seteacks
Type of Conslruction: F..stimated Cost: $ ��'�
Approx. Completion I�ate: �=` — � �
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ =$
DATE: �_��� APPLICANT: Tel. #�'J`3 °�f S► C
Permit Fee
Fire Surcharge
sr�c� s��n�ge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
� �1. � ��- -
$ //% O� Fee Schedule on Reverse Side
$ � �� .QOl of Permit Valuation (1/lt�th�)
� �. 9s s.soi�i,�o v��aon
$ $800 per SAC Unit
$ S�CfU $S.IX? {State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
� $450.� Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Ne�essary [ ]. Not Ne��s�ry [ ]
$ t.��, s'
STIPULATIONS:
�
i�: • �
I3U[LUCNG PERMIT FEE SCNEDULE � �
"1'hc Ci�ict� i3uiiding Ufficia! st�all, t�cfore i,ssuing permits for thc ercction of any l�uilding or structurc,
or tor any additi<m ic1 any cxisliag i�u�idin£, t�r structurc, c�r for any altcrdtion or rcpair io any cxistin�;
bui(di�ig or sinucture, u�rc�n a�plication thcrcfoce, requice the payment by lhc applicant for sucti �ermit
<�f fcc:s to ttxc amount hcrcin t�clbw sci fortl� and in thc manncn c�rcin I�rovi�lcxi tt�-wit:
"I'O"I'AL VALU[:
� t to $500
$SOk to $2,000
$2,001 to $25,000
$25;001 to $50,000
$50,001 to $100,000
r�rr�s
$IS {Minimum Fce is $15 plus surcharge)
�15 for Cust $S00 plus $2 for each addilional �$i00 or
fraction thereof, to and inciuding $2,OOQ �
..$45 for Cust $Z,ppp plus $9 for each additional $1;000 �
or fraction diereof, to and incluiii�g $25,000 � .
$252 �for first'$25;ppp pl�s $6.50 far each addirional $1;000
or fraction thereaf, �o. and including $50,000 -.
$41450 for first $50,000 plus $4S0 for each additional
�1,000 or fradion t�te�eof, �o and including $i00,00Q
$i00,001 to $500,000 . � $63950 for €�st '$100,OQ0 pins� $3_SO for each addifional. �
$i,000 or frac.�ion thereo� t,o and inciuding $SOp,QQO .
$500,001 tA $1,Ot}0,000� .
$1,000,001 and up
$1039.50 for dte fiist $SOO,ppp plus $3 for each additional
�1,000 ar fractioa thereof, to and iaciuding $1,000,000
$3539_50 foc the 5rst $I,OOp,ppp plus $Z for eacf� addition,ai
$1,000 or fradiou �ti�eof -
DRIYEWAY DEPRESSION ESCRO'G(r
(Concrete (�rb Streets puiy)
Alternate "A": Removal and replac�etnent of curb and gutter �y _ Driveway width plus 6 feet times
$13.50,
Alternate "B": Retnovai and replacemeni of curb and guttec and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15_75.
VLRIF[CATfON OF FOUNDAT[ON
Pcrmits for consiruction wil! be issuc� a ininimum of 24 hours from the time of appiicaiion to allow
For pcoper rcvicw of t�ie proposeci siructare and of the construction site_
�1 CertiGcate ot- Sucvey of the lot, showiag the iocation of the founclation oncc it has it has hccn
co�ist.ruciui wili bc rc;yuirc:ci (x:fc�rc prc�cc;ecliag with thc fian�ing_
1�
�
_
_
CITYOF
F'RlDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(61') 571-3450 • FAX (61?) 571-1287
September 8, 1994 Y
Robin Phinney
6645 Anoka Street N.E. '
Fridley, MN 55432 .
RE: Property at b645 Anoka Street N.E.
Dear Property Owner:
Recently, it has come to my attention that you have constructed a
small retaining wall along-your driveway adjacent to the curb on
Anoka Street. While such improvements are not prohibited on city
boulevards, they could well be damaged by City snowplows and other
maintenance equipment. Therefore, should you choose to keep this
retaining wall at this present location, please be advised that the
City will not be held responsible for damages to this retaining
wall resulting from .the operation of City street maintenance
equipment.
Feel free to call me at 572-3595 if you have questions or wish to
discuss this further.
Sincerely,'
Steven Barg
Code Enforcement Officer
CE-94-444
SuB�ECT P
c��y of Fr�a�ey 29011
�
AT THE TOP OF TME TWINS g U I L D I N G P E R M I T
„
� �
� • COMMUNITY DEVELOPMENT OIV.
� LL �����•�
f � � PROTECTIVE INSPECTION SEC.
1 i i
� �•"� � CITY NALL FRIOLEY 55432 NUMBER pBv
ti.__.� � `•� b12-5��-3aso 9�aF�s
108 ADDRESS 6645 Anoka. Street NE
t LEGAL LOT NO. BLOCK TRACt OR AODITION
oesca. 21, 22, 23 2 Oak Grove Addition
2 PROPERTY OWNER MAIL ADDRES$
James/Becky Zondlo 6645 An.oka Street NE
3 CONTRACTOR MAIL ADDRESS
Sam.e
4 ARCMITECT OR OESIGNER MAIL AODRE88
S ENtiIN
OATB
3/15/99
ZIP
RECE
/�� �
\VP110VED BY
I /
SEE ATTACMED
ShIEET
PHONE
502-0807
PMONE LICENSE NO
PMONE LICENSE NO.
PMONE LICENSE NO
Residential
7 CLASS OF WORK
� NEW O ADDITION ❑ ALTERATION L� REPAIR p MOVE O REMOVE
e oescRise woAK
Repair one foundation wa11
8 CHANdE OF USE FROM
STIPULATIONS
TO
Foundation shall comply with State Building Code - core fill 6' on center
with rebar.
TYPE Of COI
SEPARATE PERMITS ARE RECUIRED FOR ELECTiiICAI, PLUMBING. MEATINd.
VENTILATING OR AIR CONOITIONINO
TMIS PERMIT BECOMES NULL AND VOIO IF WORK ON CONSTRUCTION ZpNING
AUTHORIZEO IS NOT COMMENCEO WITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONEO FOR A PERIOO OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCEO. NO. OWLG.
I HEREBY CEpTIfV TFIAT I HAVE REAO ANO E%AMINEO THIS APPLICATION 1
ANO KNOW TNE SAME TO BE TRUE ANO CORREC7. ALL PROVISIONS OF LAWB yq�UAT10N
ANO ORDINANCES GOVERNING TMiS TYPE OF WORK WILL BE COMPLIED
WITM WMETMER SPECIfIEO MEiiE1N OR NOT. TME (iRANTING OF A PERMIT �2s5OO
DOES NOT PRESUME TO GIVE AUTMORtTY TO VIOLATE OR CANCEL TME pERMIT FEE
PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGUTATIN(i CON-
STqUCTION OR TME PERFORMANCE OF CONSTNUCTION �7�F.7S
CONCR TOpQgAUTMOpi2BDeGENT �OATE�
�OATE�
OCCUPANCY GROUP OCCUPANCYLOAp
SG. fT CU iT.
OFFSTqEET PAqKING
STAILS GARAGES
SURTAX
$1.25
SAC ARGE
F e SC $2.50
T A FEE
8.50
� �HiS iS.�i�E !I %
�
�AR-12-99 11:36 From:
AA C] � Cl'1'it' o�' F�DL�Y
AI.1'�� [] S Il� I G L E F A M I L Y A N D D U� R- 1 A N l' f R• Z
BUILDINC� PFR�BT APPLICATION
T-T88 P.02/02 Job-749
t�.tie�ave i�ii7�
���
�� � � �
Con�uaionAddt�� 1 y'�r �n � I�c� •�7� ,/l� �- - - -
_ ��«,..�
Le$al �sczipUou: �
Oamer N�ase dc A�d�ress: �c�nes �ti. � ,7r, ,//_•� _'�el. �1� �a-SO� -o�,r�%_
Cona�acwr: � � � � �n��o MN L�iCENSE �
A�a: �el s�i •,.zQ � s f,�y/ � - Tel. �,(�►�� - o- r�,1�n7
LNING ATt�A:
GARAGE A�EA►:
D� AR�As
07'�R:
AttaGh �o this applir.�on� a Cerdf�cate of Sutvey of tbe
lot, with the pra�pased co�ction dxawn c�n it m scal�e.
pESCRTPTION OF 3'�RO`�►�.�N�1� T
� Width , Heigbt _____�
I,�gth Width ��� �
� 'Width �_ H,gtlGrw�d �
Sq, i�t.
Sq. Pt. �
Sq. Fc. ��
Coash�i�tction Ty,pe:� -tnun• �( � �� � � � � � - �D
. ' lFee Schedu.Ie on BaCk)
Driveway Carb Cut {'�Vidth Needed: � . + 6 �t = F� x $ = $ . .
DATE: ���9
Permit Fee
Pire SuY�e
State S�u+cb�atge
SAC Chargs
Lia�e Surcbarrge
Driv�ray F�row
P�ra�ion Ca�col
Park �
Sewcr Maia Charge:
s .��
$ o�• �D
$ • �✓��.
$
$ �''�
$
���
$
$ -- �
TOTAL : $ � ��
w . '!" �1��
Fee scl�dutc on Reversc side
.ti41 of Petmit Valuation (1/lOth�b)
$.50!$1,000 Valuadon
Tel. �+//o? :��,?_C:���
$1050 pet SAC Uait ,
$5.00 (9ta�ee Li�oe�ed Rrsids�ial Co�,�o�c)
AIL °A" OT Alt, "B" AbOYe
$450.00 Con�etvatioa Plau Review
�� Dttermi�iad by Engi�neeri�g
Agreem�ent NeceSSary [ ] Not Necessa�y � ]
�TlPULATrONS: ' �� �����"/a�f �/,/�LL G�� �°� /
��.42�� "�u�� ,��/� C'd��':° �oT�� ��-
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�: � .� .
Energy Code Follow-up
I. Informarion on the code and interpretarions that answer quesrions we have
received.
II. Listing of software and forms you may see as submittals and find useful.
III. Comparison chart for Category 1(7670) and 7672, produced by the
Department of Commerce, Energy Division.
I. . Information and interpretations:
Q. If a home is to be built under the Category 1 provisions of the statute, can one of the Chapter
7672 Paths be used for the mechanical system?
A. Yes, Paths from 7672 may be used provided it is a path with direct vent, power vent or
sealed combustion appliances in compliance with the statute. Note: This question concems the
statute. The Departments do not provide legal advice on statutory intent. This answer should not
be construed as an interpretation, but rather as the department's analysis of one possible meaning
of the language. .
Q. How are alterations and additions handled under the new code?
A. The current energy code, Laws of Minn. 2000, chapter 407, allows alterations and additions
to comply with either Minnesota Rules chapter 7670 (the energy code adopted in 1994) or with
Minnesota Rules chapter 7672�(the energy code adopted in 1998) See the accompanying
comparison chart, page 4, for more detail.
Q. Does combustion air need to be added if an existing home is tightened?
A. As noted in the previous answer, this work could be performed under 7672 or 7670. If the
work is permitted under 7670 combustion air would not be required.
Q. How is multi-family construction covered by the new code?
A. Under the current energy code, La.ws of Minn. 2000, chapter 407, ttiree or more attached .
dwelling units, three stories or less in height, must comply either with Minnesota Rules chapter
,..
Building Codes and Standazds Division, 408 Metro Square Building.1217th Place East, St Paul, MN 55101-2181
Voice: 651.296.4639; Fax: 651.297.1973; •TfY 1.8QA.6273529 and ask for 296.9929
7670 (the previous code) or with Minnesota Rules chapter 7674 (the provisions are almost
identical to 7670).
Q. What aze sealed combustion appliances?
A. Several alternate prescriptive paths are available to meet the requirements for protection
against excessive depressurization in the 2000 Minnesota energy code. Path "0" is the least
restrictive path, but also requires that all vented combustion appliances be "sealed combustion."
Not all direct vent furnaces and water heaters may meet the definition of sealed combustion. The
code defines "sealed combustion appliance" at Minnesota Rules Part 7672.0900, Subpart 8, item
A (definitions), subitem (9) as: o
"Sealed combustion appliance" means a listed appliance that acquires all air for
combustion through a dedicated sealed passa?e &om the outside, to a sealed combustion
chamber, and all combustion products are vented to the outside through a separate dedicated
sealed vent. The appliance must be able to function and draft properly at a negative pressure
of 50 Pascals. (Note that a Standard for a sealed combustion appliance does not exist at the
time of adoption of this chapter. Until a Standard is available, equipment may be approved
under chapter 1346 of the state building code when a manufacturer certifies that the
equipment meets the requirements of this definition when installed according to the
manufacturer's instrucdons.)
The Department of Commerce Energy Division and BCSD have received several letters from
manufacturers in response to this definition. These letters have been posted on the Commerce
web site and can be read or downloaded. It is strongly recommend that readers egamine each
letter closely and determine for themselves whether the definition is met The Departments
make no warranty or endorsement, expressed or implied, and assnmes no legal liability or
responsibility for the accuracy, completeness, or usefulness of these letters.
II. Software and forms you may see as submittals
The forms enclosed with this mailing �vere developed by Joe �ierchak with the city of Inver
Grove Heights. Inver Grove is willing to share these forms. For builders without software, these
forms aze a�ood method for them to work with and show compliance.
Reliant Energy/1�Iinnegasco is mailing out soflware to builders and building officials, free of
charge. This soflwaze addresses mechanical systems under 7672. It contains a spreadsheet
analysis of paths that buitders will probably find useful. The outputs look good. Watch for this
soflwaze in the mail; it will prove valuable.
Computerized tools aze also available from the Department of Commerce to assist in determining
compliance with the code. Mncheck is a PC program for egterior envelope energ,y
calculations. Copies of Mncheck were handed out at our recent energy code seminars. A1so
available is a Residential Veatilation and Protection Against Depressurization Spreadsheet to
assist with mechanical reqnirements of 7672.
The Department of Comrnerce web site, www.comnierce.state.mn.us, has aU portians of the
Minnesota Energy Code that can be downloaded from the Energy Code page. This web site also
contains all the interpretations &om the joint Commerce/Building Codes & Stds committee. You
can also download Request for Interpretation forms. This information is also available from the
Depaztment of Commerce Energy Information Center at 651-296-5175 or 1-800-657-3710.
�
Job Site address:
"C=�ATEGORY 1" ALTERNATE -FOR
�NE & TWO FAMIL� DWELLINGS
v F E�' _�
ia ':�•-`<i;.
i
_'.
Inspection Division
763-572-3604
IYSTRUCTIOYS: This alternative may be used for oae- and two-famlly dweWngs built to meet the Category 1 requiremeats of
�Iinn�ota Rules, Ch3pter 7670. Complete Parts A. B, and C. Clearly mark plans with: insuiation R-� alues; window and skylight C-
values; size and rype of equipment; _ equipment coa�ols: and location of vapoc retarder and a�indwash bazriers. �Iore detailed
informarion can be found in the :titinnesota Energy Code summar}+ sheets available fi�ora the �finnesota Depar�nent of Commerce.
Part A. BUILDING ENVELUP
Check pro�sed envelope joint sealing opricn � Q�-Presc�cippve (caulking. gas'kets, etc. j� .� --p Performance (test per 76?0.0�70 subp. 7.C.)
Check thermal energ}+ calculation opuon used � Q'•Cookbook" (complete worksheet below) p L[nCheck method (attach report) `•
� ❑ Perfozmance (attach L:-value catculations)- ❑ Systems �nalysis method (attach analysis) j
"Cookbook" Worksheet
L�e�cnoxs
Check item(s) that design meets on Mininwm Reqrefre�ne�ets list
to the righ� Must meet ali items to use "Cookbook" option.
Indicate pioposed wall t}rFe on table below.
tndicate Window U-value and source.
Verify total window (including area of all foundation windows)
and door area is equal or less than allowable percentage.
� IV�'INNESOTA ENER+GY CODE - WH/CH RUL.ES MAY l USE ?
Part B. DEPRESSURIZATION PROTECTION ' `
Check opdon used: � Fuel buraing equipment (complete schedules below)
INSTRUCT[ONS
Step 1. Complete the Combustian Equipment Schedule beloR . Only equipment
with a Y(Yes) may be selected under the "Category 1" aIternate.
Step ?. Complete Exhaust/.1�lake-up Air Schedule on the right if direct or power
vented or solid fuel atmospheric vent space he�ating equipment is selected
O No fuel burniag equipmeat
Part Ci. VENTILATION
VENTiLATION QUANTITY _
_. .
(Mechanical ventilation must be provided per the larger quantity calcnlated below) "
� cabic feet a O.OQ583/minate = C cfm (�-g 15 cfm/bedroom) + 15 cfm ='. � cfni
_�.. . . _ - - z , .
� : .
volume af habitable raoms _ . . , ndnmber of bedrooms �; � , _ _ - � - �
VENTIIfATION FAN SCHEDULE _'_
� �
Check method(s) proposed � 0 Exhaust only � Balanced (heat recovery ventilator, air exchanger, etc.) _�
Fan description or location � TOTAIS �.: ;:=
V'E1V'TII.ATION Iatake cfm cfm cfin cfm cfin :
AS DESIGNED
„�
Statement of Compl�ance: The proposed building design represeated in these .documents is consistent with the building plans,
specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the
requirements of the Minnesota Energy Code.
Applicant (print nazne) Signature Date Telephone number
Part C2. VENTILATION (Snbmit Part C2 npon completion of system verification�)
� ----------------------------------------------------------------------
Job Site Address: � P� N�
i.or 1a
a;: . ,. ..
a
Compliance Statemen� Installed veatilation system is in compliance vsrith MN Energy Code and is sized to provide the design air tloa►•
` ,
Applicant (print name) Signat�ue Date T�l�phone number
_ . �� , -
. , �- ` !ob Site Address: ��
E�TERGY CODE WORI�SHEET FOR
,=` ��sP�ti�� o�s1e� ONE & TWO F.�MILY D`VELLINGS
�~ 763-572-3604
Y IYSTRCCTIOYS: ,Complete Parts I, II and III. Clearly cnark plans with: insulation R-values: window and skyti,ht U-vaiues; size and
rype of equipment; equipment controls; and location of intecior air barrier, vapor retarder and windwash barriers. �fore detailed
informacion can be found in the .Llinnesota Ener�• Code Sum�narn Sheets availabte_ 6rom_ the �Iinnesoca Departmeat of Public Service.
Part I. BUILDING ENVELOPE
Check option used: ❑"Cookbook" btechod (complece «orkshezc below) ❑�inCheck method (aaach reporc)
❑ Building Componant method fattsch calculations) ❑ Systems �lnalysis method (actach analysis)
"Cookbook" Worl�sheet MI�'i�.'i �Q`��r�•�s . :
for "Cookbook" O tioa
O Heatin svstem efficiencv: Minimum 90% AFUE
I*tStRUCTiONS 0 En Doon: 1'/." solid wood, or ma�cimum G-value of �.40
Step 1. Chzck icem(s) that desigrt meets on �linimunr Requirer,renrs O Skv1i ts: None itted
. tist to the righ� Ntust meet all items to use Cookbookoption. ❑ Ceilia lnsulation: �Iinimum R-38 �
Step 2. Indicate pmposed waIl type on table below. � Rim Joist Insulation: Niinimum R-10
Step 3. Indicate Window U-value and source. � Floors over unconditioned ces: Minimum R 30
Step �. Verify toal window (including azea of all foundation win- O Foundation windov�: '/•_" insulated glass in wood or vinyl
do�vs) & door area is equal or tess than atlowable percentage frame or marimum U-value of 0.� 1
TABLE FOR DETERMINllYG 1riAX11�1U�1 WL•�iDOW AND DOOR �iREA
Maximum Altowa6le?otal Window and.Door }-;��
0 0 0 0 0 0 0 ' o , o o'-
Area as a Percea e of osed_ Wall � 10 !0 12 /0 1� /0 16 /0 18 /o . ZO /0 22 /0 24 /0 6/o ZB..lo,:
wall T e R S_ to R 10 Foandation Insul. : Maximum Avera�e Windowt�value ex t foundatian windows a 5.6 sf): `o :�;=�
rJ 2x�, R-l3 ' sulation. < R-5 sheathins 0.�7 0.36 0.30 0�6 0.�3 020 0.13 0.16 • 0.15 0.14 �
�..� 3x�i. R-13 insulacion. �r R-5 sheathin� ( 037 0�7 037 0.37 0.35 03I 0?8 025 4.�..�' 022t
rJ" 3x�l. R-I� insulacion, b R-7 sheachins 0.37 0.3 _. .37 0.3? 0.37 O.i� 0.31 0?8 026 �024=
3:c6. R-19 insula�ion. < R-� sheathins 0.37 .�� -0.37_ 0.34 0.31 0.28 0?5 023 031 ':
"'°°� 3x6. R-19 insulation. � R-� sheathins Q31 37 0.37 Oa'7 0.37 0.37 033 Oa0 0?8 0.26
�?x6. R-31 insulation. <.R-5 sheathins 0.37 Oa7 0.37 Oa7 0.37 0.33 0.30 0.27 0?� 023
O 2r6. R-31 insulation, a R-5 sheathins 0.37 0.37 Oa'7 Oa7 Q37 0.37 035 0.31 0.29 O.Z7�_
Wali.T wit6 R-10 Foundatioa Insulation : Maximetm Avera e Windo�v U-value ex t foundation windows p 5.6 s�:. ;`-:�.�*%.
O 2xa. R-13 insulatioa < R-5 sheathins 0.37 03? 0.33 028 a25 0.22 �020 �� 0.18 - t3.17 �Q�S_�
0?x4. R-13 insulation. b R-5 sheathin 0.37 0.37 037 0.�7 . 037 0.33 030 0.27 0?S .��0.�3�
❑ 2x4, R-13 insulation. a R-7 sheathine 037 037 -� 037 037 - 0.37 0.36 � 433 ���030 027� �=
0 2x6. R-19 insulation, <R-5 sheathin Oa"7 � 0.37 0.37 037 9.37 � 0.32 0.29 �' � 027� 024 :.0�"
0 2r6, R 19 iasulation, a R 5 sheathin 037 . 037 �037 ' 037 '� 03? 037 '� 035 '= � 032 =: �� t3.Z9 =�- -
O 2x6, R-21 insulation, < R-5 sheathin 037 � 0.37 ". �037 � � ��03? : �037 035 � 031 `r' � 029 � -'�Z6 ` •.. -
Q 2x6. R 21 insulation, b R 5 sheathin 037 -: 0.37 037 � 037 ';:Q37 0.37 .,a36 �- -� 033 '� ��: 030 �°�� .
WaII T witti Rd:l9-Fouadatiou�bisutadion : Max�um Av -. Wiadow I�Value ex � fo�dabion viim�ow's: G?.;�:K s�.'. _-�`".�-- .
0 2x4, R-13 insulation, < R-5 sheathin 0.37�: � � � 037 . _�`,�34 . 429_� :�!:OZ6.. � :�023 :�c ''A�21. � . =0.19:� � r01��; '�
O 2x4, R 13 insularion, a R 5 sheathin 03T � ..037• �- } �037 . ± '037 :� '='rE{3T - : �-0.34 �: � �.`0:3�1 � : 0.28 :' . � 0�6'•=
0 2ac4. R-13 insulation, b R 7 she 037 ::� - =037. '- _ D3? � �= "037.. � :; ' =�037.-:� '�' 43? `' : 4� i�4:° � :��031 �: -�01� =° . " .
0 2ac6, R 19 insulation, <R-5 sheathin �037 � �-�037: � _'037 �� �,03? '� ,b�f37�.' :�::034 -_ �0�0�: �428' �'��'O:ZS
O 2x6,R-19insulation, b�RSsheathin 0.37 037 �•, �0.37 037..� :s032 �,�037 �� �036'� .so-33; �.�;0,3�.�4_~
❑ 2x6, R 21 insulation. < R-5 sheathin 037 . 0.37 : 0.37 0.37 ._ 0.37 0.36 0.32 �- -'029 ? 0.27 °:� .,
0 2x6. R-21 insularion, 4 R 5 shea ' 037 T'� 0.37 ._ :037 037 :, 037 :� 0.3? ' 0.37 -�� 0.34_ :� 031 �`
.- �: ,_Windoar U-"valne: � 3 �;,- Souree: = C C� Code Default Table see Part 7670.07d4 -
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t ,�:: ' '� ' �'� :_:M � ' " " �-:�:�..*.F �'�; �-:,.,.�' .
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r• �,`�.' .�.�-��-',n ! . � . .,� , ° � r � ' _ � <.
�.��_ 1vi►iridoyv�;;�t daoi� � � ' ._ � exposed�wa�I_area �' ..;I7 YGN ���fl"`� ; :�'.���LI,OR� LE •`� e'.
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Part II. DEPRESSUI�IZATION PROTECTION � °
Check option used: ❑ Ag�regate (complete aggregate worlcsheet on nect page) ❑ Prescripdve (coiaplete worksheet belaw)
❑ Performance (submit test report prior to fiaal mspection) ❑ No fuel buraiag equipment
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' PRESCRIPTIVE PATH WORKSHEET \
Ivs�UCr[o`s
Step l. Complete the Comburrion
Equipment Schedule on the right.
. Step 3. Choose a �61ake-up dir Path with a
Y jYes) for all selected equipment.
Step 3. Complete the t�blz below for the
,Ltake-up dir Path chosen, indicating
flows in cfm for e:chaust aad make-
up air methods proposed Oaly the
capacity of targest e:chaust appliance
in each category need be considered
Step 4. Fill out the Passive �tilake-up Air
Opening Schedule oa the ne�ct page.
❑ Path 0— Prescriptive Make-up Air Nlethod
Cloihes dryer: Passive in5luatiian for up to 175 cfms
Passive opemn�s for cfms over 175
Kitchen exhaust: Passive infiltcatioa for up w 250 cfm .•
Passive openings for cfins over 250 _ �
Powered to match flow for cfims over 500 ��
Other exhaust: j� Passive opeamgs for up to 1�0 c�n
Powe=ed m match flow for cfms over 140 .
e
t Need not include central vacuum exhaust m Path 0. TO'TAIS
0 Path 1— Prescriptive i�Iake-up Air Method
Clothes dryer.+ Passive infiltration for up W 175 cfm .
Passive openings for c&ns over 17S -
Kitchen exhausG Passive openiags for up to 250 cfm =: �.�
- ::� Powered to mafch�flow for c5ns over 250 .� �. :T
C?ther exhausx$ -,` Passive openmgs forup to 140 cfm'�-'�• .-_ :::i�"�F _
"• -. Powered to match flow for cfin� over 140 :���.=..
- ',y''1 � 4 .. ' �':���
#', If CIOSP,� COIIf]'O� CO�US�lOII SO211�{lICI b1II�lIIg �QIIBIICC �ti
' exflausts LO aut�de must be pmvtded with tnake-up aa bY Pa�t�'e �ope
Q Path 2- Prescriptive Make-up Air Method �
Sii+ehea� exhaos� �' �oov"ered fo�match�low ' _ ,� _� � '�
�her`-eiihaus� �:`..� Poweredta.matcli:flow -1 _ '�
___-.T�
� ••,� t� y . _ ' . . ... - �}[�l
� ..l - . . . ��.� v `'ll
❑ Path 3— Prescriptive Make-up Air Method
�
�.�. E�thaust Passive -. • nPassive = Powece� :�l
L�filhation . � Openmg Make=up
�1iA .
Exhaust .: Passive . Passive Powered
InSlttation Opening$ Make=up
N1A
N/A
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N/A
l�i/A
N/A
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AGGREGATE MAI{E-UP .AIR WORKSHEET
INSTRL'CTIONS
Step 1: Camplete Exhaust Schedule on the right indicating cfm of largest device in each category.
Step 2. Complete the Co�nbustion Equipment Schedule on preceding page.
Step 3. Choose a path with a Y(Yes) for all selecud eqiupment
Step �._ Camplete Aggregate A�fake-up �ir table below for chosen path. Usmg tfie total cfm from the
Exhaust Schedule, indicate flocv in cfm for proposed method(s) of providing make-up air.
Step 5. Fill out the Passive ;tifake-up �lir Opening Schedule above. �
�,;; �:. -
Part TIIa. VENTILATION ' �
�. _�
I�YSTRUCI'IONS
Step 1. Complete the Ventilation Quantity worksheet below. ' .
Step 2. Check the Make-up Air Path (from Part In on the Ventitation �tilethods table below.
Step 3. Choose permitted method(s) for Feople and Supplemental VenNation from the Ventilation Methods table.
Step �. Complete the Venti[ation Fan Schedule.
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AS DESIGNEU
Statement of Compliance: The proposed building design represented in these documents is consistent with the_ building plans,
spec�cations, and other calculations submitted with ihe permit application. The proposed building has been designed to meet the
requirements of the Minnesota Energy Code.
Applicaat (print name) Signature Date Telephone number
Pa,� 111�J. �NT�ATIVN (Submit Part IIIb upon completion of system verificatian)
� -----=---------------------------------------------------------_-------
Job Site Address• Pecmit Number
��.. dsew�ntie�n nr 1nr�fittn : _ : ` .-�c, °,�..�::";vTOTAL-S :_�
CompBance Statement: Installed ventilation system is in compliance with MN Energy Code and is sized to provide the design air flow.
Applicant (print name) Signatiue t, �• Date Telephone number
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JUN-21-2001 08�54 SHAW LUMBER 651 488 9?79 P.05
���- �� � rc� or �.ra•• x n.o-- �.y� ��cronan� �v� ,
.�
Tj�m1�"'� v8.66 SertalNum6s:7C017�7 �,.�„� �JRy.
BFAiAIJSAr 1111 9119109 x38:66 PM
f� 1 m�1 � Bi�CO� 748
THIS PRODUCT MELTS OR EXCE60.S'�IE �ET DESIt3N CQNiTROLS FOR ?HE APPLICATiON qND LOAa'8 LI�TED
IYlombe� Siopa: 0 Rooi Siopa: 8H2
�
�
�
an a�nen�o� � t�isonml.
l�� n
�e
1�.
� aor 9eam nAemroer � sMOw A��on. Tr�umry Lo� widd,: '2'
L�ps�: 40 Li'ra at 11b°� dtuet� �7 �ed; a�
�+oauat o�a�, r� co�epn�a�.
TYPE CU6S5 LI1/E DFJ� LOCATION APPUCA1iON COMMENT
Pc�fbs.) Sncw(1.1� 2870 18?r4 2' 10" /ld��
��R�' WPUT 8EARING REAC110IdS(lbs.j
� �� WIDTH LENOTI�1 LNFJDEIIDROT. PLY OEPTH D�Ti41L OTNER
1�c4 P� 3.b0" S,b° 1682 / 964 / 2816 1 9.5° DefaA R1 8B $t�ear BbGCh'�
2?� Ple� 3.50" 3.5" 186Z / 85a /?.�95 1 �.�' �il R9 SB Shear 61odc�ig
- See TJ SPECIFIER'S / BUILDER'S CC�tU1DES. fOt detail(8): R1.
�
� =�14�;. • �.1 - •
MAXIMUM OEStC3N
Sh�) 2594 2475
I�It-�) 84&t 64�64
LWe Defl.(in) 0.081
T�i D�1.{in) 0.�
CONIROL CONTROL LOG4TION
i�6 Pa�ed(3496) Lt end S�+ 1 under Sr�v Roof lo��
93841 P�(48%) MID Spa�n 1 under Snow R�P k�
0.2A7 P�as�ai(U899+) NIIO Span 1 Wldet Snsw RvoP aadbtg
Q358 Paassd{[l799) NpO Span 1 under 6rtaw R�f load�
- De�n Cr�srl� STAN�ARO(LL: U2d0. TL:V180�
- Brad�g(Lu): AR c�rfPr�sion edges (toP end bottom) en�t be braoed at 2' 8" dc u� � olf�ervv�se. Proper attadu�e�t and
�s�rtb�g vf �ai bracin� Es �red to ac�feMe m�nber �b�ty.
- Des�n �es �equ�ate �r�hwaus �tet�el �t�port of �e oompr�ston edge.
. .,u�•�..., _ _. •
- GM�ORTANT! Tl�a � pres6nted,b oUlput fr�n 8oflwene �veloped by Tn� .� ('TJI. TJ wBRetds �e �dr� 01` ib pindtlCte by th�
soii�+e w� De a�omp�t�d t� �cord�noe w�h TJ prod� d�gn e�ris ard aode a�ep6ed �sf9n vat�es. 't�s e�c �Cd+�t
�� d�agn lo�ds, emd � d�nner� F�s be�n prov�i by!!� �M►are �. Th� aAput t�es r� beea� �e�d by
�TJ�.
=1�t el! prcd�ts eue �Ay a�raRable. cr�c with �ur supp8er � TJ t�mha) r� f� pr�� a�bii�yr.
.-rr�s a�u►�vs�s Foa ntus �o�sr aROOUCrs o�n.�n �onucr sues�rrunoN voros rMS aue��s.
- AB�rable S`t�ss D�n m�dology wa� used t� Code 116C anay�rg the TJ R�el product 6�t,ed al�e.
- No�9: See TJ SPECIFlER�s i Bun.o�s outnES �r mu�e �r �n.
Ee�rl Mad�on
J'nn 8 Beeicy Zor�Jlo Addi�a�
Heatier Aborre V11dw► in ihe aeoor�l i�r
�P6R4T�R�IMRbRMAT10N:
3�E�a►art L�nber Comp+�ny
1LRRY TNOMPSON
Z17 Cano Ave.
StPeid, MN b5103
P�e: BCi1 � 94�
Fsx 631488 9778
Gap�la O�0D oy'lfim Jmat, a 1Aie�np� &a�yas. TJ-8eamti+ (e a v� alTlub J� .
lddahan� le e � �q�lqrk oT7nre ,io�t .
� 6� ��,�4����9 s%r
JUN-21-2001 08�54 SHAW LIAhHER 651 488 9779 P.Ob
' j l�C� Oi 7./�" X 77.i�/S" 7.Jt iwlCrOlid[� LYL
� �A� ILw� 1� �J �M
r.i�17� 1.�.� � �1itl1�. %� ��% /+ir/
�18A h911 8r�10� r,5t;�aee �
� 1 t� 1� 8ti� Code: UIB
THIS PRODUCT MEETS OR EXCEEDS THE SET DE81C,1N CONi`ROLS EOR THE APPUCA710N AND WAG9 LI�TEp
�� �
S ' �� I
������
� �
Ar�ty&� 4�ar BaAm AAember Sttpportln9 FlA�R � RES. A�on. Tt�ary L�d Wi�C 6'
I�ads(psij; 401.ira et 1�6, d�dor� 12 D@�; 0 P�lcn; at�
T1(PE CLASS WE DEAD LOCATION APPLICATION COMMENT
Pa6�t(8�5.) SnorY(1.167 4Z8 21g � 3" Ad� iD
a�o�.) sr�w(�.�� aze 2�g tr � aeds �
SUPPORT�• INPUT BEAR1Nt3 R6AC770NS{�s-i
WIDTH LFS{OTH LNEdDEAOITOT.
1?x4 5� W�9 3_5�' 22� 2197 /�T / 30�
2 Z�a4 Sbud Wa� 3.fi0` 2.26' 2319 / 980 1 3278
PLY OEPTH D$TAIt.. OTHER .
1 11.9° Dsi�l A3 1.Z6' L�SL Rint
1 11.9" DefaA A3 1.2�' LSL Rfm
- See T.1 SPECIFlER'S / eUiIAER'S GUICES tor def�N(s): A3.
DESiIQW CONTROLS•
MAXtMUM
st�eeKro1 �
11�men�(ft-B�) 12278
IJMe Defl.fhj
7o�ad Defl:ifi)
DESIt;N CONTROL COMROL I.00ATION
2312 'I 1845 P�sed(2G9(+) I.t. end SRa�t 1� Floor i�tg
113ai 28T12 PesseCl(a2°l6) A�0 Spaa� 1 lu�er �OOr i�dtng
G.378 0.� Passed(!l868) MID Sp� 1 under Snow R� l�dhg
0.515 C.88:i Pe�sed(L1404) AAID S�n 1 In'�der Snow Rc�f f�
- Oefl��ion C�eria: STIWDARO(LL:1J38Q, TL:LJ7rd0).
- er�ng(u,k aa coma� � f� ��f m�t t� I�ea at Y 8" dc untess d�gad oth�. P�per a�unenc snd
positbrdng of leo�al � is �qtilred to s,�eva mentber slab�t_
A�tR�NAL NOT6S:
-�ORTANT! itre ar�gnsis pre.ae�0 is a.�ua from scft� de�ed by Trus Jo�t (T.n. TJ w�rtar� 4he s� of � produa� bY ti,�
saf�ra�e w1u be acoomp�shsd In aaoordarroe �h TJ �d d�lgn aime� aad oode �ooep09d d�gn valuea The op�fic ptad�
sPpA,�, input daeig� I�ds. and ed�ed dtmer+� I�rave be� p�vlded by tha � us8ir.• llds a� f�as not been reviewed by
a TJ A�.
- I�! aA aroduds xe r�y sv�ble. Chedc wi�h yau su�ppNer or TJ tiecFudcal � f� �od�t ava�ly.
-1HIS ANAI.YSIS F�R TRUS J015T' PRODUCTS ONI.YI PRODUGT SUBS'TT1U710N VOIDS THIS ANAL1fS1S.
- AQa�rable �ress Design methodabgr vras �ed for Code U8C ar� tha TJ Rs�derdial produa �ed abov�e.
- No�e: See TJ SPECIR�R'S / SUILDF.R'S DUIDES br m�tp0a ply com�dioti;
P��C�,T INRARMA�ON
Eari N�d�on
JNn & Bedcy Zcrdl� Adaf�ton
B�m beiwean r�ew kM�Ct+en 8 e�s'tlt� ha�e
OF+ERaT�,R �IFQR�AIKIN:
St�S6�war! L�nb� Comp�ar91
TERRY T1iON1�SON
Z17 Como�Ave.
�.Peul. MM b5103
Pt�r�: 861 �Q514�
Fax @51 489 9T79
ca�soz000 ey sn►.,id�, a M+�.�..�r ew�.. j,�.p�o"' �a r.�aedn+r.�eaaae��s ot�rda .
etl� �s � rop�4asa v�a�m.t ot 7tie�s .�sc .,
, �,,
4
JUN-21-2001 08:55 SHAW LUMBER 651 4B8 9779 P.04
��'�� 2 N� Ot 7.75�� x 7��� 7.� M�crollant�3► LVL
TJ�Beihlti' Y�6 8etial Num�; 7001944�7 � ��
BPJ111u3h 7111 q►1AG07 29B;4S P1A
�J�s �0�1 • Bu�Code� 1f8
TFUS PRODUGT NIEBTS CR BXCEBD� T'F116 36T DB�I�N CONT'ROL9I�OR TN8 APPLICJ►T{ON AND LOADS L.IS7ED
Imrobar �bp�: 0 Raat 9�lope: 8M2
Ali �tns�iat7e ats Iro�ll.
�
Ar�Is fi� Beam 1�antber Suppc�fng SiNOW App� Tr�u�ry �d Wldth: T
l�(pslj: 40 ilve at 11b% dura�wr,li De�td
Prod� Qis�tam 19 C�ep1u�l.
S►UPPDiB• WPUT BFAR�ING �AC710NS(tl�.)
WIDTH LENGT'H t.NE/DEAOrfOT: Pt.Y OEP1'H OETAiL OTHER
1 Zx4 P�te 3.6� 3fi" 2870 / 18Z4 � 4494 1 18.0" �Itl R1 S8 Sh�P B�CIl�
Z 2a4 Plat� 3.b0" 3.b° 2870 / 18�4 /449�4 1 18.0' De� R1 SB Shegr 8�(cing
- 5ee TJ �ECIFIER'S! BUILDEI�3 GU�ES fior de�s): R1.
�a ��
MA)qMUAA �ESICiN CONTROL CONTROL LOCA►T101d
sn�artm) 44a1 37e� ��3e P�d(3�5b� Lt. �! s�n � under srww Roar �
Maner�(ft lb) 22281 2?291 38789 Pass�d�8296) MIO Sp�n ��r Snaw R�f �g
Liv9 DeA.(�f) 0.490 9.� PBS�d(LJ494) lil� Span 1�Ide1' Snow � la�ading
Total Dslt.(in) 0.787 1.344 Psssec�lJ315j AAIO Span 1 t�+der �ow Rpof l�dhg
- �ort Critsria: STANDARD(Ll,: L1�4D. TL-U180).
� er�{�-u� A9 comPre� �(tpP �nd bo�D�n) Mu� be breoad at 2 8" ak urde� d�d a�hen�a. Proper e�merrt and
poe�on6� af �isral ��g is raq� �o s�ve member �bi4ty-
- D�(gn aaswnes �qt�e � b�al s�port of d� �np� ed�.
�NAL NOTE6:
- u�oRraKr� �,a arcads� ar�a � o�t �o,�, ecea�re dava�iee �r Tru� .�t �r.�. TJ q►amnt� �te s�1p +�i' �s p�odl�ffi by �a
' soii�rare v+� be sooam�ed 4n e+poade►roe v� TJ produddes� cr�ria � oo� �oepb9d des�n �. 'fhe spe�ic prodt�t
�p�+� b� de�gn �ds� �d �,ed �ner�iorea havs been prvvkied by the sofhaane �r. Tf� ou�►ut ha.a r�t been revie� by
e TJ A�a.
- Nct aA R�� ��f► sva�able. Clledt w�t► y�ur st�AUer � TJ ied�rd�oal reptesent6�fiive if�ot product ava�ab�r.
- THIS AId�1LYb`IS FOR TRUS JOlST PRODUCTS ON�YI PRODUCT SUBST1T�t'110N VOID6 iHIS ANAl.YS15,
- A�e S� pe�n me�odaloyy 1n�s �sed tor Co� U8C sn� the TJ lie�der�l produ� �d abore.
- No� See TJ SPEC�IER'S / BUIL,DER'S C�UlDE8 ibr m�te py mt�n�ed�n.
Pl�CJECT IMPORMA7TON OPERA'fOR iN1�ORMA'�N•
� Ad8��C11 ShAtAliS681�tt LlReb�f CDfll�llY
Jim 8 Sedcy Zandlo Add�on 7ERRY 7HOMPSON
�9A � 217 Cano Ave.
� 8tPatd, pA�AN 89103
�� • � VV� iIW 1�
Fax �1488 9779
� f5 t�n��4a��atc� �'�'�' t�as INa arawra�i� a'1Y4..rala� .
rn-roi p ��
sue�tti - � . , PER .
c�ty of Fr�a��y 3192 .
�
AT THE TOP OF TME TWINS �� J� L D I�l � P E R M I T
! �` _� COMMUdITY QEVELQPNIENT DIY. ���o���� RECEIPT NO.
r � L '� PROTECTIVE INSPECTION SEC. ��/
� . ,
i----� ��"' �', CITY NALL FRIOLE� '�'N32 NuMBBR pEV DATH PAGE O� �VVAOVED B�
L 612-571-34b0 9/0•Fi5 6/22/O1 / /
lOB AODRESS 6645 Anoka. Street NE -�
1 LEGAL �OT N0. 9LOCK � TRACT OR ADOITION SEE ATTACMEO
oesca. 21,22,23 2 Oak Grove Addition SMEET
2 PROPEfiTY OWNER MA1L AOQR�$$ ZIP PMONE
Jim/Becky Zandlo 6645 Anoka Street NE 763-502-0807
3 CONTRACTOR MAII AODRE88 Z�P PNONE LICENSE NO
Same
a AFCHITECT OR OESIdNER MAIL ADORES$ ' 21P PNONE LICENSE N0.
S ENGINEER MAIL ADORESS , Z�P PMONE UCENSE NO
B USE OF BUILDINCi �
Residential .
7 CLASS OF WORK
O NEW C� ADDITION � ALTERATION 0 REPAIR O MOVE � � REMOVE
8 DESCRIBE WORK
Construct a 10' x 22' Addition; change flat roof to peaked roof
9 CHANOE OF USE fROM Tb
STIPULATIONS
See notations on plan.
Provide smoke detectors in a11 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.
WARtVING
�efore di�gi�g ��� for
�il utility �oc�tions
SEPARATE PERMIiS as4000z
REaUIRED FOR: � �Ep �Y LA,V1�
�LUMB��NG �ND�S9G�IS
° TYp Ci� Cl7NST. pCCUPANCY GROUP OCCUPANCY LOAO
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING. NEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL ANO VOIQ IF WQRI� OR CQ�STRUCTIQN jONINCi SO. FT CU FT.
AUTHORIZEO IS NOT COMMENCED VjIITMIN 80 DAYS, OA IF CONSI'RUGtiT�ON �
OR WORK IS SUSPENDEO OR ABANQpNQO FOii A PERIQO OF 1�Q DAYS A7
ANY TIME AFTER WORK IS COMMENCEO. ' NO. OWLG. UNITS OFFSTREET PARKING
I MEREBY CERTIFY TFIAT t HAVE REAO ANp QXAM�NEO TMIS APPUCATIQN 1 STALLS GARAGES
AND KNOW TME SAME TO BE Tf�UE AND CO�iRECT. ALI. PAOVISIQNS �iR LAWS VAWATION SURTAX
ANO ORDINANCES GOVERNING THIS TYPE OF WQAK WIL4 �� CpMP41ED
WITH WMETMER SPECIFtED MEREIN OR NOT. TME GRANTING OF A PERMIT �16�328 �S. ZS
OOES NOT PqESUME TO GIVE A�JTMORITY TO VIOLATE OR CAMCEI. TME pERMIT f EE SAC CMARC�E
PROV�SIONS OF ANY OTHER STATE OR LOCAL LAW REGULATIN(i CON-
STRUCTION OR TME PERFORMANCE OF CONSTRUCTION �2,%9.25 Fire cJ�'. �16..33
P{,AN CH�CK FEE TAl FEE
i
'$30 73
S�GNATUpEOFCO � TOpON UTMOp�ZEOA NT IOATE� j�R PERlV � 7ED �S YO PERMI
° � : �-��
�GN4�UAE O Ep�� Ow' aB � • E� . �� g�p�,� go • � � ' qatE
NEW [ �,
ADDN �1rf
��R Il
Effective 1/1/2001
CITY OF FRIDLEY (763) 572-3604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R 2
BUILDING PERMIT APPUCATION
Construction Address: 6 by 5 AN� I�C� 57� 1V. �
Legal Description:
Owner Name � Address: �� +�� eky ����o Tei. #%�3° 5�,��D�07
Contractor. ��� eJ � I° MN LICENSE #
Address: Tel. # _
LMNG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
i �
Length �� Width � Height Sq. Ft �
Length Wdth Height Sq. Ft
Length Width Hgt/Ground Sq. Ft
ea��� -�e�� ��� � �� � �� �
Construction Type: i�10�� Estimated Cost: $ IU�. � Ss�Y
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$
, /� !
DATE: �° I i� `�I APPLICANT: .��AM� � ZoU�I� Tel. #���° �� � o����
CIIY USE OIdLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
Call (763) 572-3604 for Permit Fees if mailing in application �,� H
��
$�°� g. v2�Fee Schedule on Reverse Side
$ / �. �� .001 of PermitValuation (1/10th%)
$ g , /S $.50/$1,000 Valuation
$ $1150 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 [ ]
TOTAL $ � �.• J
STIPULATIONS: � bQ�`- �
� �
� ��
, s �-'�'�� P_____-_�,
� . �
BUII.DING PERNIIT FEE SCHEDULE
The Cluef Building Official shall, before issuing germits 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 $500
$501 to $2,000
$2,001 to $25,000
$25,�1 to $50,0(�
$50,�1 to $1�,000
$100,001 to $500,000
$500,001 to $1,000,�0
$1,000,�1 and up
FEES
$23.50
$23.50 for first $5(� plus $3.05 for each additional $1� or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,0�
$391.25 for first $25,000 plus $10.10 for each additional $1,(m0
or fraction thereof, to and including $50,0�
$643.75 for first $50,� plus $7.00 for each additional
$1,Q00 or fracdon thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 fior the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,�,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
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 the proposed structure and of the consiruction site. '
A Certificate of Survey of the lot, showing the locadon of the foundadon once it has it has been constructed will
be required before proceeding with the framing. New Houses Onlv
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�HIMNEY AND �TACK VERIFI ATION
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examuied Yes �() No ()
2. Is free from nist or deterioration Yes (� No (}
3. . Has no foreign ob� laiged .within .. . Yes %) . No j).. .
4. Is securely supported ' . � � y� ( � No � � : :
'"� 5. Meets all cutrent Code requirements for size �� � � �
and total BTU's connected Yes (X) No i)
6 Has total heating BTU's of %�,�� �
:.--
� All other BTU's 3� oo�
. . TOTAL BTU's /,�� �
� - . ' . .. �' , .
7. � Has a liner been provided for water heater Yes () No (�
8. Has combustion air l�en provided for water heater Yes (� ) No ()
Remarks:
List ALTERATIONS Bein Done:
L ��� L,�� � �-e , � � ����
HEATING CO:
Signed By:
Date:
L �_ l i,_ _ � _�. � � .i.- -� -
ADDRESS: �D�'`�S � /� �/I9 APT: FLOOR: CITY: ��' G�e DATE: � l b I� q
OCCUPANT: 10 Jr., OWNER:
HEAT LOSS: M��S - HEATIN6 INSTALLED BY: �A'��
ELECTRICAL WORK BY: 5�7�IQ�C GAS LINE BY:
TYPE OF HEAT: �3A FA ROOFTOP SPACE HTR UNIT HTR OTHER
GAS DESIGN
MANUFACTURER• L.ev�v�
MODEL: �.� � - Ca� 3 � L�
SERIAL: `�JS��9 ���'I�
INPUT: /� �C9�
CONTROLS
THERMOSTAT: � g�� VENT SIZE: e✓ ��
VALVE: (�1.2 . IL KIND OF LINER: S�� �9 s� NONE
LIMIT: �eX�S � h.s DRAFT HOOD: REGULATOR:
UMIT SETTING: �` �� � ��� FILTERS - S1ZE: 11� ZS �� NUAABER:
FAN SETTING: � CHIMNEY - INSIDE OUTSIDE
PILOT TYPE: S f%�* K� �s. CHIMNEY CONSTRUCTION: ��
PILOT MAKE: h��g brot�.►^
PILOT MODEL: 'SMOKE BOMB: WIRING: � p-iC
PILOT TIMING: 2. �C _ DRAFT: TEST TAG:1�'►�
L.W. CUT OFF: DOOR PRESSURE: LIGHTING INST:
PRESSURE: � . � /w . � °k COz � • �olo DATE TESTED: � - � - �.�
IMPUT CFH: 14�i �� % Oz �,`3 °�o COMPANY TESTING: /91> P4 �� �
STACK TEMP: � 3�� �% CO NAME OF TESTER: L �'`-
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FRIDL.EY
FRIDLEY MUNICIPAL CENTER • 6431 U1�TIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
March 12, 2001
James Zondlo Jr
6645 Anoka Street NE
Fridley, MN 55432
Re: Final Inspection at 6645 Anoka Street NE
Contractor: Marsh Heating & Air Cond
Dear Mr. Zondlo:
A mechanical permit was issued on July 12, 1999 for the installation of a fumace and air
conditioner at your address. According to Section 305(a) of the 1991 Uniform
Mechanical Code, a final inspection shall be performed on the mechanical permit. As of
this date no inspection has been called for.
The permit fee that was paid covers the inspector's time to check to make sure the
appliances were installed correctly. We also need to check for the installation of
combustion air, vent and connector sizing.
You will be given thirty (30) days from receipt of this notice to respond. If we do not
hear from you, your permit will expire and any inspections on this installation will require
a new permit.
Any questions can be addressed to myself at (763) 572-3603.
Sincerely,
Inspector
.,.,
DJ/mh
07/26/2001 13:13 FAg Bbl 487 2837 DOODY/UNiTED
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�,, _0,7/�?5/2001 1a:16 FA% 651 437 26a7 DOODY/UNITED
COMMON VENT. VENT CONNECTOR AND CpMBUSTION AIR VERIFICA710N
� oo�ioo�
� �--` :R
Wh�n replacing an esestins� furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions.
and is securely supported and flrestopped where required. Yes (}. No (}
' ; . , , .
� The ventirig system is plastic/PVC and meets al( current codes and manufacturer
specficatians including sizing, lengt�, number of efbows and termination. ; Yes () No (),;
The undersigned aiso verifies that the replacement unit is a listed assembly
and meets the current codes and manuf�cturers spectflcat[ans. This does
inctude AGA-GAMA Category I Central Fumaoe Venting Tables for fan
assisted and natural draft app{iances.
The existins� combustian air is sized and fnstalted to meet the current codes
and manufacture�s specifications.
W�ten tequir�d� nst�tt a n� ' n ai� it wiiE be sizQd and
to meet the current codes and manufacturers specifications.
When installin� a new venting s, s�em, the undersigned hereby v rifies #hat
it is a lIsted assembly and meets the cu�rent �odes and manufac rer's
specifications. 'This does include AGA-GAMA Category I Cen Fumace
Ven6ng Tabfes for fan assisted and natural draft apptiances
Is the common v�nt and vent connectors sized and in tled correctty after
an appliance has been removed from the common v t and vented
separately as �� current codes, •
Yes ( ) I�( }
/
Xfes ( ) Na { )
Yes ( ) No ( )
Yes()No{)
Yes( }No{ )
Appliance #1 Type U tnput Fan Assisted or Nat
fippliance #2 Type �TU tnput Fan Assisted or N�t �
Appliance #3 Type BTU Input Fan Assisted or Nat �
Total Appliances otal Btu Input �
Common Vent Type
Vent Height Oiameter inches
�ptie�,ce #'!-�#--G�nng�or 'ght - ft Length ft Diameter in Type
Appliance #2 Verrt Connecto Height ft l�ength ft �iameter in Type �
Appliance #'� Vent Conne r Height ft Length ft Diameter in Type
_
HEATING CC?: ' ' '
Signed 8y: Date :
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