AF - 35243SUBJECT
City of Fridley PER �\
AT THE TOP OF THE TWINS gU ILDING PERMIT 20321
i �
' ` RE
COMMUNITY DEVELOPMENT OIV.
r � y � PROTECTIVE INSPECTION SEC.
, , � �, ��,
� i � �
� �'��1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROYED 8V
�•---� • ,•� 612-571-3450 910-F15 4/26/90 � �
J08 ADDRESS 6264 Bakex' ,��,venue N,E,
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. �. 12�].3 Z Mc�ore Talce Highlands SHEET
2 PROPERTV OWNER MAIL ADDRESS ZIP PHONE
D, Blase 6264 Baker ,A,��enue N.E s
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Kingswooc7. Builc�ex�s 6721 Oakland Avenue S�outti., Rich�i.eld, N�T 55423 722-1131
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
1ZL�SIC�.Fa1tl�
7 CLASS OF WORK
C� NEW � ADpITION ❑ ALTERATION O REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Construct a 24 �' x 20 �' Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
�'OV�J.C� �, �1d�C�. S"q.�',�°d�C2 C�'1S7�ida,�7`e
TYPE OP CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED fOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $7 142 $3'S7
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW fiEGULATING CON- �`�� a OO
TRUCTION OR THE PERFO CE OF CONSTRUCTION.
� PLAN CHECK FEE TOTAL FEE
��f"``' i�=�-_ -° $102.57
SiGN u OFCONTRACiOR THORIZEDAGENT (OATEI WHEN PROPERLY VAUDATED THIS IS YOUR PERMIT
� a-� -9D
SiGNATUREOFOWNERiIFOWNER8UIL0ERi iDATE� LDG INSP OF7E
«, �'
� � � Effective 1J1/90
� � � !�l AND R-2
�'� � � Building Permit Application
Construction Add.ress: � � � �/ ,�� k� r �jve /�' £ ,
-1
Legal Description:
_ e7. Jl7o�
Owt�r Name & Addr�ess: � �/ti��- ��16 % /�� ,���- ✓�� �l✓ � �, #
cbntractor: ,�� �� ��� o � ��, /�/ts-� T�1.. # �aa- `r�`
Address: � �� � as � ls�..� .� .� -
Attach to this application, a Certificate of Survey of the
lot, with the propa-,�ed construction drawn on it to scale.
D�SCRIP'1�I�T OF
LI�iII� AREA: Lerigth Width Height Sq. Ft.
C�iR�+GE AREA: 7 ength G' Width a�� Height �. Ft. y g- v
DDCR ARF�: Length Width Hgt/Gro��d Sq. Ft.
OTl�R•
Cornex' Lot [] Inside I,�t {� Ft. Yd Setback Side YaYd Setbacks
Zj�pe of Construction: ���G � Fstimated Cost: $ l oy?� -�/ �%a
Approx. Oaa�letion Date: �ti�cy /`/
Proposed Driveway Width If Ne�a Opening Is Desired; Ft, $ $
� Width + 6' See Back Page
n�: L/- �y_ � u �c�rrr: Z�ea.. # 7� a-�� �/
�t F� $ 9g��
State SurcharcJe $ c� - S�l
SAC C�an�e $
Driveway Escrow $
Park Fee $
Sewer Main Criarge $
. �.
. �,�
CITY QSE ONLY
Fee Schedule on Reverse Side
$.50/$1,000 Valuation
$600 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Det.erntined by IIZgineexin9
Aqreement Necessary [ ] Not Ne�.ssazy [ ]
$ >�a.��
� S. a t� C� � � �is �..
I�'7,�7 " �,��.�
e�� ` s �
_���� • �. ::�:���4 �+�+` :;«:�5+�_11 �r
The Chief Building Official shall, before iF�?� ��+�+;'ts for the erec-�tion of any
building or structure, or for arYy a�dition to ariy existin9 building or s'truct�� °r
for ariy alteration or repair to any existing buildirig or structure, upon al�lication
ther�efore, requi.re the payment by the a�licant for surrh �m+i t of fees to the amount
herein belc�w set forth and in the manner herein provided to-wit:
7C�AL VAI�JE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
�a:
$15 (Misiimwm Fee is $15 plus surdzarge)
$15 for first $500 plus $2 for each acklitional $100 or
fraction thereof, to arid including $2,000
$45 for first $2,000 plus $9 for each additional $1,000
or fraction thereof, to and iricludirig $25, 000
$252 for first $25,000 plus $6.50 for each acklitional $1,000
or fraction thereof, to arid iricl� $50, 000
$414.50 for fi.rst $50,000 plus $4.50 for each additional
$1,000 or fraction thereof, to and iricludixig $100,000
$639.50 for first $100,000 plus $3.50 for each acklitional
$1,000 or fraction thereof, to arid including $500,000
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and ir�ludirig $1,000,000
$1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional
$1,000 or fraction ther�of
DRIVEWp,Y DEPRES3ION ESCROW
(Concrete Curb Stxeets On1Y)
Alternate nA�� : Removal a�xl replacement of curb and guttex only - Drivetiaay width plus
� 6 feet times $13.50.
Alternate "B": Remaval arid replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth -�iveway width plus 6 fe�t times $15.75.
OF �OUHIlATIO�T
Piermits for construction will be issued a miuzinnun of 24 hours froan the time of
application t.o allaw for proper review of the proposed structure and of the
constYUCtion site.
A Certificate of Suzvey of the lot, showing the location of the f�ation orx� it has
it has bee.n constructed will be required before proceeding with the framing.
b -.
INCSWOOD
su;taers, Inc.
Permit by—(�(,R(,./
Legal Description_
Lot
Blk
Add'n
Value
Type Const.
WORK ORDER
HOME PHONE:
NAME `� � BUS. PHONE:
JOB ADDRESS �� �'`a 7 � ��Y � (J� B�L�`'"
BLDG CODE ARE ^ f �-�
SALESMAN " CONTRACT DATEaI� SIZE �� � �>
SI,AB:
'�,�y Kingswood �
f7 �y Owner Approx. , _ ; � � _� ; .
; .._�_
❑ In
2-STARTING POINTS ONLY ��� p i
S.P.L. �'� . i :_ t i
:� � ,
___ . ,_
S.S.P.L. '
,.. . t :_
_.;.,
R.P.L. . .
Ailey � r .;.._
House O. a+V-� ����� s" E -:
, �
F. Street - x w+ 7--.
Other . �. � ��_F , . ._.., ._! .
�uare With
;d Rem�y`
B.U.
Grads Point
LJ Blocks: L.�y Owner OBy KW
❑Wtr.proof: �By Own. �By KW
❑Backfill: �By Own. OBy KW
'❑ Maintain 8' Total Wall Height
Including Blxks OR
❑ Maintain 8' Wall Height on
Top of Blocks
Block Size (Top course)
❑ 8" ❑ 6" O 4"
Wall Height other than 8' �
U Frame with full wall height
sold OR
O Cut studs as required for
OHD clearance
�O.H. DrOffset
�S.D. Location
f�Windows
� Att Gar Roof Tie•in
Drawn on attached pictures
Existing garage: No '
❑ Detached O Attached YeS�
Site of existing: x
Existing garage will be:
� Left as is
O Converted to L.S. • By owner
O Removed By: Owner ❑
Kingswaod 0
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Junk Must Be Rem ved By Owner ;. i
! _{
O Specify v I� ewoo ' �
Owner tr es b ta '''
O Show approx, dist. gar e to �+
house and all prop. lines �
Stakes visible - ❑ Yes No
_�.__
Survey evailable - OYes o -_��. �
O Special instructio�s fr m �._.�.
owner: ;. . !.
j.
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. PURCHASER'S II�17'
FOR OFFICE USE ONLY
. 1 .
Manufactured Trusses
ROOF: GABLE REVERSE GABLE HIP
� El
EAVE OVERHANG: �—
RAKE OVERHANG:
SEAL DOWN SHINGLES WITH PLYWOOD
Roof Sheathing
2" x 4" Double Top Plate
Manufactured trusses engineered to minimum
60# live load per sq. foot.
Seal Down Shingles
1) of approved by Minn. State Building Dept. as meeting Minn.
tate Code Requirements of 30# snow load.
2) , H'p roofs consist of 2" x 6" rafters, 2" x 6" cross ties 48" O.C.,
" x 8" hip rafters and no plywood gussets are used.
RAFTERS: Trusses 24" O.C.
STUDS: 2" x 4" 16" .C. 24" O.C.
WALL SHEATHING: ���`�����
SIDING: � GCCl�
OVERHEAD DOOR HEADER: Double�2'" or
Gluelam beam X
``
/0 !( /I �/ !'G %�Q h ��G�' ��C�����
Slab on grade construction approved per Minnesota State Code. Refer to State
Building Code Letter Number 11.
SLAB: 4" WITH MESH 6" x 6" #10 Gauge
-- --
45
�� " -
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_I'�"�1
Trim
t— Fascia
1 x6 Rabbited
Redwood
Soffit
3/4" cove
2" x 4" Studs
Siding
�/z" x 7" Anchor Bolt
� 2" x 4" Treated Bottom Plate
� Grade
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6����� HEATING HOUSE HEATING TEST RECORD
AIR CONDITIONING
AND E1.ECTRIC, lNC.
OCCUPAWT �_�y a,¢�,� ��� .��,. APT. —p� FLOOR �— CITY � StJBUFB� �a°�as�
OWN�R @���.&..c7 � 9 s�°' �
HEAT LOSS DATE HTG. INST. ��p�—�d O g
SOLD BY � � e' INSTALLED BY ��`f �.e�Q � . �-� �
ElecMcal Work By _ /� �' �..' � � ' °� �. t3ae Line By � D
TYPE OF HEAT GA FA [��F�1N STEAM_ SPACE HTR._ UNIT HTR._ OTHER
� GAS DESIGN
AflAKE ���`�gA
Model � � � � ° ��i�,
Seriai ,�' ��,� ,%� �J „� � ,a� ,�
INPUT ��,�, �6Y��''�
CONTROL3
THERMOSTAT Heat Plug
Valve � � �
Limit �',�- �62 �,,�
Limft Settfng /l � 2�
Fan Settfng ��1� i1� ��
Pllot Type � c�`�',� G��o" '' .� � � �
Pilot Make �� �s ��
Pilot Model ��' �
Pilot Ttming `�F� �i ��' °
L W. Cut Off s'—
Pressure � ,� Percent COQ �i � �
Input CFH �� E�Z� Percent O, ��
StackTemp. `�,;,$",� PereentCO �
Form 235
CONVERSION
MAKE OF BURNER
Modet
Max. BTU Rating
MAKE OF FURNACE
1Vlo�el _
Verrt Size � �
KIND OF LINER SIZE NONE
Draft Hood �-�� Regulator
Filters ' Slze // ���-� � 0 Number �
Chimney Locatlon Inside ,� Outslde
ChimneyConstruction � ��=„� �
Smoke Bomb - Wiring b' �= �
Draft o �� Test Tag � � 'a
Door Pressure Lighting Inst. ?y <" �
Date Tested
Company Test(ng
Name of Tester �� �`�
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CHIlVINEY AND STACK VERIFICATI�N
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefiilly examined Y� �) No i)
2. Is free from nist or deterioration Yes () No ()
3. Has no foreign objects lodged within Yes () No ()
4. Is securely supported Yes () No ()
5. Meets all current Code requirements for size
and total BTU's connected Yes i) No ()
6 Has totai heating B1'U's of
All other B1'U's
TOTAL BTU's
7. Has a liner been provided for water heater Yes () No ()
8. Has combustion air been provided for water heater Yes () No ()
Remarks:
List ALTERATIONS Bein� Done:
HEATING CO:
SI�IIP� Bj�:
Date:
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sue�ecT MIT NO.
c�ty of Fridley 2 � 12 �
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
� � EIPT NO.
� `y �_���_ COMMUNITY DEVELOPMENT DIV. ����
r � � PROTECTIVE INSPECTION SEC.
� ,
1 i �
� �"'1 � CITY HALL FRIDLE� 55432 NUMBER REV DATE PAGE Of APPROVED BY
�----� • •'' 612-571-3460 9t0-Ft5 8/12/98 / /
JOB ADDRESS
6264 Baker Ave NE
1 IEGAL �OT NO. BLOCK TFiACT OR ADDITION
SEEATTACHED
oesca. pt 12 .13 2 Moore Lake Hi hlands SHEET
2 PROPERTY OWNER MAIL ADDRES$ 21P PHONE
Dou Blase 571-6567
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
1 erican R o -6 76 5160
4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PMONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILOING
e 1
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
f hou e an 1 Te r-off
9 CHAN(iE OP USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING. HEATING, �PE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAO
VENTII.ATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. fT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED Oii ABANDONED FOR A PERIOO OF 120 DAYS AT
ANY TIME AFTER WOFK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT i HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS yALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEiiEIN OR NOT. THE GRANTING OF A PERMIT � 71
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OF CANCEL THE pERM1T FEE SAC CMARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION F�YO SC 1.�FL
• ° PLAN CHECK FEE TOT FEE
� l6� �'l�°9$'
IG TUREOFCONTRACTORORAUTHORIZEDAGENT IDATEI EN ROP VA�ID T THIS IS UR P M�
_ /.. l ar i
V
S�GNATUAE OF OWNER iiF OWNER BU�LDER� IDATEi 8L iNSP fiq7E
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION �°
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ConstructionAddress: ���Q-( � q, � � � j'v �
Legal Description:
Owner Name & Address: p a ��, C� la s e Tel. #_ �� (-- � S�%
Contractor: � l,c_ A w�e rc lt� v� e-o �, �� � e .,,( e � i�_ MN LICENSE # 5 L fGG �
Address: �{ I t a. ��t`� r,._, �y �� , Tel. # � �(� � (� �74�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
DESCRIPTION OF IMPROVEMENT
Length
Length
Length
�ea�-
Driveway Curb Cut Width Needed:
_ Width Height Sq. Ft.
_ Width Height Sq. Ft.
_ Width Hgt/Ground Sq. Ft.
�`e r0 n �' %�% % :/ / �/ J �
Estimated Cost: $ .� CSpC� . oU
(Fee Schedule on Back)
Ft. + 6 Ft = Ft x$ _$
�-i2- ° .
DATE: q � APPLICANT: Tel. # � � � - �G i �
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ i `'�
� 1
$
$.
$ '�,�
$
$
$
$
� ����
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1000 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
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 $500
$SO1 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,0{?0
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,0OO,OUO
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Altemate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
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 $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minunum of 24 hours from the tnne of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
�, - g
RECD APR 17 2007
�
APPLICATION # 07-��
CITY OF FRIDLEY
2007 LOAD LIlVIIT MODIFICATION PERMIT
/ _ , -
JOB ADDRESS: '� v- ��� DATE: /«-/ Z G�7
MATERIAL TO BE HAULED: ' �������.�
BEING HAULED BY:
PERMIT REQUESTED BY:
�:.
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DATES OF DELIVERY: � " < � ° � � (LTp To 3 Days)
THIS PERMIT IS ISSUED TO ALLOW AN ]NCREASE OF AXLE WEIGHT FROM FOUR (4) TONS PER
AXLE TO FIVE (5) TONS PER..�IXLE OVER'TI-� FOLLOWIl�TG DESIGNATED ROUTE:
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NOTICE: This permit is valid only for vehicles enroute to construction address during the hours of 8:00 am to
5:00 pm.
See Resolution # 01-2004 and Sta.te Statute Section 169.87
� / �
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PERMIT FEE: $25.00
RECEIPT # 4��
ISSUED BY: �
Copies Given To Police [)& Engineering []
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Signa e of Applicant
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FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSTTY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
BUILDING PERMIT APPLICANT: PROPERTY OWNER
I, � understand that the State of Minnesota
requires that residential buiiding contractors, remodelers and roofers obtain a state
license unles they qualify for a specific exemption from the licensing requirements. As
the owner of the property at ��e�� �� , Fridley, I
am exempt from the state licensing requirement only if I am not building 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 forfeit
any mechanic'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 af 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 would forFeit my rights to
reimbursement from the Contractor's Recovery Fund in the event that any contractors 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
pecFormed on this property.
Name
Date T" / � � �