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AF - 35307: _ ; > . � a I O < � � � 1 � � � r ,-: � � � � � � � � � � � � �� Q �I � � � � z m � 0 � � � � � � � � � O � � � p ���� ����� � � � �.-.,�- � i � � � � �. _� .� � � :�� � rn ni � 2 is I � G��, �� � y � � °° �a�� � � W � ��� �� � s � � ,..��" o �� � �� � � m � � • � i . � «��� .� p�a�� MNi � - � I � �' C o w m � � � w � o � �� � � � � d � � '3 � �, � � W � � � � � , � � ' , �� � � � � � ���� o � , � �� � b � � a � 0 � a � °< � M I W� �� �� � � ? y C � "1 � UI ro eb� � � �. � � � � � � � �1 w g � I 0 � � �� 0 0 � �� {y � � O � � � � � � � � � � � a a � � 5C � o a eo "1 �� ��� ��� d � � ����� OA ,0 � �J � � � � �i � �. � � � x �' o� �� � � w:�oo s�sg ���� 1i1 I I I I , a O � y a � o � � o � � � A �+ �D � O. � m � I � A M � I � » �I o � � I � � i� 0 � 0 � � � � � � �� � � � � � � � �a� �� � � ��.�.� oo��� ���ga �' � Oi� a �► � � � ' C1 � � � � ���wo s'sa�s N �6► � � C � � �. � � i\ ` � �V. � I IA 0 � I �-"u N ; �� � � � ��'� �� R� R� � � � ��o�� ��"�� ���� � � � � 7 � O� � . � � . g $ . . 8 : : a w��o� sag's� � I Sp� � 'y7 � r I I $. o.� � b��� � A � �. � � m ~� � O A � � � d� � �'y � .°: .m, a�. a' r� � o � � � 5��� � a �o E � y ~�� � ���.� b.:�� ���� a' �'� A��p ��� �� A p� m �� �. a� � !�r r. ��� �2� � ��� � � � � �' i�..� ��� � � D '� r � T � z � c° � � M � i� 1 � � 4 �:, � � � �a � N �� � � � � D e � O � w �. _ City of Fridley, Minn.. � ��� � 6431 University Ave. N. E., Minneapolis, Minn. 55Q32..: � I�UII.DING PERMIT r � v .n Q%' /�'� te: December 9 s_]„�� . i, � �, 04vaer: �Sot?t T�n� RQ�1.�� Builder S me Address 1 o�ddress ---Same �a� � LOCAT10iV OF BUILDING No. _..._ G.�.,�$�.. Street $�n More 1�riyg ]�.E, . Part of Lot �� -------5.. Block _.__._.],....._..�_._,.______ Addition or Sub-Div3sion up �+-H o v u; 11 a e��, an Corae�r Lot _---.._._...__._.. Inside Lot — �L Setbaek 35' ,____. Sideyard _ 7 n� � 5' ,$�'gb�r/IIevation __919_59 7�'b1�d��l�i���i�dn- A92 SA Mi��IlIlIL1.�_,...�., o n noi-i g i DESCRIPTfON OF BUILbING - To be Used ea: �Dwalling ____ �ont �9 Depth 28 Height 20 Sq. Fi, 1462 �, g�, _33�$32 Total _Garage __ �nt 20' �p.� 26' Hei�ht _ 10' Sq. F� 520 �, �, 5, 200 Type of Construction Wood Frame ��t $27, 50Q TQ ��pleted Ma�* 197� 27 072 Stipulations: Provide a verifying survey before capping. Provide a hard surface driveway. WATER LOCATION: 10' South of Sewer Serv�ce SEWLR LOCATION: 103' Northeast of Ma.nhole (Inv. 920.00) In considera.i3on of the issuance to me of a permit to construci the building described above I agree tg do �he praposed work in accordance with the description above set/�ortlYlan� in yompliance with a�l provisiong pf Ordinances of the city of FridleY• // �,[ / 13.54 State Yn consideration of the payment of a fee of $�.3.._Q�,._,_permit is hereby granted try South Towne Realty to construct the building or addition as described above. This permii is granied ugpn, the express condition that the person to t�vhom it is granted and his agents, employees and worlunen, in, a11 Work done in, around and upon said building, or atty, part ttiereof, shall conform in al1 respects •to fihe orc�inanCes oi I+'ridley, Minnesota regarding location, construction, alteration, maintenance, , repair a,nd movIng of bwlldiIIgs ��� city ]imits and this permit may be revoked at upon v3;o1 n f any oE the prov3srlons of said Buil�ing Inspector RRFT� C RK NOTICE: Thls permit does not eove� the eonatruction, insTallatfon for wtrine. Plu�bin8. eaa heating� �trer or water. He sure to 1�9 t6s Building Inspeeto� fo� aepa�aie permhs for these items. , f .m= APLICATION FOR RESIDENTIAL, ALTERATION, OR AllDITiON BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER' S NAME : BUILDER s—� � -� / �i� �/ � ADDREa� S: ADDRES S: J ��f/ � i� /� �/� /�� ��.� � � �G ly i � �� � � / ! � No.. ��a�� S�T: � � � , ^ �r.. � ] � LOT:_� BLOCK: / ADDITION:_ �1 � r¢ �l�-�� /;�e ��i CORNER LOT: INSIDE LOT:�gETBACK: r� SIDEYARD; � '�� -�.�� J S AppliCant attach to this form �ao Certificates of Survey of Lot and proposed building location drawn on these Certificates. BESCRT�TION OF BUILDING To Be Used As : �� S �� i�,�. ; ✓{- � � +� �� ��� � c ��AQA6�- t � � �� < < : �_, Front - ��P� =� `�° fq �v�e Height • ' r' � Square Feet• Cubic Feet: �,^ '� � `� • � y p ; �-, Front ; _�. r; Depth : � � r � ----= Height • � _..� �_. � Square Feet; '� _,y� Cubic Feet: ' � , Type of Construction: -� �✓� j� �� �� Estimated Cost:_,� � �'� � To Be Completed; ��� / ���'? � � � �}--- The uadersigned hereby makes applicativn for a permit for the work herein specified, agreeing to do all work in st�tict accordance with the City of Fridley Qrdiaances and ruli�gs of the Department of Buildings, and hereby daclares that all the facts and repxesentations stated in this application are true aad correct. , ,�� � r --_ __� �TE: SIGNATURE: / (See Reverse Side For Additioaal Information. ) � .�� � , C ���, ��� � �' �°`��`�'�� ,1��'� � � �_ f -� � ��-. .— � � s _- ;:� /�. � � � ^���� _ _ _�..�...�,� �� �� y ;- �� , s � -° C� e � 3 ' � BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permita for the erection of any building or structure, or for any addition to any existiag building or structure, or for any alteration or repairs 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: UNIFORM BUILDING CODE: 1�pe 1, 2& 4-$2.15 for each one thousand cubic feet, or fxaction thereof, in auch cubical contents. Type 3& 5-$1.85 for each oae thousan.d cubic feet. ADDITIONAL INFORMATION For the purpose of computing fees for building permita, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floox line of the basement or the cellar to the average heights of the upper surface or to the average.* height of the roof surface of the ma.in gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. In no case shall the fee charged for any permit as set forth in Section 2 be less than $5.00. V�RIFICATION OF FOUNDATION NOTE: Permits for construction will be issued a mini�m of 24 hours from the time of application, to allow for proper review of the proposed structure and of the construction site. A Certified Survey of the lot,.showing the location of the foundation, onc� it has beea constructed, will be required before �roceeding with the framing. CERTIFICATE.OF OCCUPANCY Application for a Certificate of Occupancy shall be made ten, (10) days prior to the use or occupancy of any structure for which a building pexmit has been issued; and said structure shall not be used or occup�ed until a Certificate of Occupaacy has been isaued. • S � S � �1 (s\ �11 � r�'� �' f��� � �*'���t���f � ttin�� �� � �,� t`&€,� �, �. � :� � �'"�'�� .:: #���^ � ��� r���1 � '"�- ��,� �z�� � n'� �' �:ysr ��6 � x : a'a� � �i- � t y"�c';�,r ��. �F � � o- .[ � �°' �. vt + �' x . `",�. � �. � E� � � ,y ' ��� �� .` r : ,�F �w �+�h.,� y c� �: yab ���� � H } � ss � � � '� f ;'� . _ � . � .' � s.,� 4 1��� � ;�� �' r . t � ��� % ,�'„-` 3 .�+ �. � Y'q.. � � : Y :� � � � Y ' ry� � '� � .�' F �: `�; s h� ra4 .��'� � v. r� `� 4n? hr,g � �� � .,. m � i u{ � '� ''�i'-, �. � �"aY' ��i.Jgi � � � F " `+. ? � '�+� ` • ,� v� 3s� �'� -.. � ` y �:i �` � y,'` � r �` F' � �;, � r�, r� t y �_ -� �9,€�.-it � �t,�„ � �, � ^'� � ��f � � . � t• a � � �.��'e�Y+Y. ,q 4 y , 7f 3+x. +pyN �'1 1-� . :��,i �.j ��� '� � � �- S�' � d .� A '13,� '� :, d .` �j. � � �'' $'.�° ` +7.z ���r`� y' T y �� � r "�� � � } ,p.'z `y k '' � ��s„t�"�`"' �r' .r}, q��w „� . �_ : o ;; _ � ;� _ '_ # � :. 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I� i�"� 'p o � o O •� osi �a e �� a" C Buildin on Date ��_..y,.o ' � 11 � ; o I! � i O i I � I� I I w � eo 'a i� � i � � a� � � � I i � � . ���i� i��EGT - � PLUMB I ��r, PERf1 I T aPPL I CAT IO�� � plv. pATE ��iE OF I► OY er - 0 2 15 73 i �i soo � . �� se S P one S P one ��� x���_- 0 � � _ _/�'°v._- - -- Plumbing Fixture Rates: Np, gATE TOTAL Number Fixtures —. � X $2,00 $ �� oe Future Fixtures � X $1.50 � New Fixture-Old Open. x $1.50 —__ Catch B�,atn x $3.25 Water Heater-99,000 BTU _� X $3.00 � Ground Run Old Bldg. x 3.25 , -�.�._ $ E1ec. Water Heater Gas Fittin Fegs: lst 3 Fixtures x $2 . 00 � x $2.00 Additional Fixturea x $ .75 Gas Range-199,p00 BTI7 x $5.00 Repeirs � Alterationa See Deacription; Code State Surcharge _ 50 TOTAL FEE $ � The undersigned h�reby makea application for a permit for the work herein apecified' agreeing to do all wark . in strict accorda,nce wit�t �he City Qrdinances and ruling� of the Depaxtment of $uil,dinge� and hereby declare that � a1l�the tacta and repxeaentations atated in thia l applicati�/ are �ie and correct. '� �` %� Date . � -��'�� ��� � � Y IiOUSE HEATING TESY RECORD A�DRESS ���� si��s�oi�G� � APT. OOR Ci S RB OCCUPANT ONINE '� HEAT LOSS DATE HTG. INST. GAS CO. METER BAD SOl.D BY INSTALLED BY � -�� Elsetrieal Work By Gas Line By TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER G DE �'s i CONYERSION MAKE , MAKE OF BURNER Model �� � �,� � � [°. � � Model �ia� -��'� � � �" �.�� Max. BTU Rating ONPUT �`� �� MAKE OF FURNACE AAodel ��—�' CONTROLS ,�y THERMOSTA ___!�� p�ug Yent Size Yalve +� L KIND OF LINER SIZE NONE Limit ��_ - �� Droh Hood Regularor Limit Setting -��' Filters Size Number Fan Setting O� ��� Chimney Location (nside—L-- Outside Pilot Type Chimney Construction Pilot Make ` p� Pilot Model Smoke Bomb Wiring ��^ Pilot Timing �'� Draft �� Test Tag C� L.W. Cut Off Door Pressure Lightirtg Inst. Pressure �>� Per ent CO" ���� ���pte Tested °� ��� Input CFH ��/ P�� �� `�� "eompany Testing � � 2 Siaek Temp. -�-5� Percant CO �`� Name of Tester Form 235 � T � � I T � z � � � G 1 � N 0 � x t�" CM ,�b ►��+ H x x � �, r � o� �-yi H � O ,.�.. 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N .��oocuo c � �f c°'i � rrit � '"' v .� C W v -c = � � d � � � � � � � � N � r-� ►.r (,V cn o 0 0 0 � °o °o °o °o °o � � � � � � � � A� � a V , � � W � � � ��o �. c� �? c� o � z � � 2 c� O � �, 0. •p �p d ° �c m � ?. � N _ \ � .�. � n d n � � O � > > � � fD n � (/) p (n N fl- (n f�D m r N' c, o amZ� r^� �ar. �..... �O � O' � c�.... � i " � 1 � D m � � � D --� rn � c� � N � �' � rs � m � � � Z O � �� !?�� C � O W � � � Z � G� � C � N � � � � n � � I� � Q � � 'v .-� -ry Ol n W� W-�C � c1i `_� C � v � rv��•�, WZcp � 0��,0 �A � �c m W < � N tn Z Z N rn � m � � O Z � C � a � '� Z � r -�rn'!-Di � O G� Z m �, �o D � -i O � Z � Z� v ab � Z O N' Z y v_z �v o= zm z -Di � Z � � � n m� 0 N Z a z� vm vZ < '� n r a N � 0 z m � n < c� O _ � � � � d `G N 0 0 N THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPUCATION WILL BE RETURNED C'nMMnN VF�T l�Fti�T _nf�l`F(`T(�R A��D (`C)Il�F3l ISTIC)I` AIR VFRIFI �4TI(�I` WI1@t1 r� In a_in� an pYistin� furanc-P, the undersigned hereby verifies that the . venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required, Yes (�Q No () The venting system is plasticlPVC and meets all current codes and manufacturer specifications inciuding sizing, length, number of elbows and termination. Yes () No (`� The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAAAA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. i1 The ex,�e �omh��t�on air is sized and installed to meet the current codes and manufacture�s specifications. When required to ir,�ta�� A nP��� _-omh��Q±�en ��r�,itwill be sized and installed to meet the cuRent codes and manufacturers specifications. Wher1 insialling a new ��Pntir��yc Pm, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturers specifications. This does inGude AGA-GAMA Category l Central Fumace Venting Tables for fan assisted and natural draft appliances. Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes � No ( ) Yes ( ) No (Xj Yes � No ( ) Yes (� No ( ) Yes (� No ( ) � • • . • ' • ' . � • ' • /� �� • � ' � . � • ' � • � � " M • � • ■1� . • � Appliance #1 Type v�.N+�� BTU Input ��o Fan Assisted or Nat ��4� Appliance #2 Type _ t�a�re� I E�-r� BTU Input �� Fan Assisted or Nat�.l� Appliance #3 Type �TU Input Fan Assisted or Nat - - — fibfa�App-iiances-- -1'otaT�tu input m � �� -- --- -- - - _ _ Common Vent Type �L�-�5 � Vent Height �S � Diameter�_ inches Appliance #1 Vent Connector Height �O ft Length � ft Diameter � in Type Appliance #2 Vent Connector Height f� ft Length -7 ft Diameter �in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type • :: 1�► .- ..- HEATING Signed By: �'C�� �ss��z Date : 7—lt -03 Building Inspections 763-572-3604 DATE SITE ADDRESS G 7'HIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE �E oF wo�: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY E-MAII. ��!�1��.�ws�s.s���� r. • ■ • s • i . /� PHONE: %��—��� i{��d STATE LICENSE # � DATE ADDRESS: CITY PHONE SINGLE FAIVIII,Y/Nf ❑ TWO FAMII.Y/NEW FAX 0 ADDTTI4N ❑ GARAGFdSHED ❑ WWDOWS � BASEMENT FINISH �ROOF 0 DRATN TILE ❑ DECK ❑ SmING ❑ OTHER u ❑ ADDTPION ❑ REMODELING Pernut No.: �� ' Received By: Date Rec'd: ����J-- ATE ZIP DESCRIBE WORK BEING DONE: ,jZ� � P l��,�% �,P�� ����� 4�8�� �/��'�� ���� SIZE OF RO�FING NUMBER OF SQUARES � GARAGES PROPOSED SIZE: PROPOSED HEIGHT: S(( � SIDING "'� �3 ❑ Vinyl ❑ Aluminum ❑ Other LENGTH BJIDTH HEIGHT ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE �Soffrt O Trim ❑ Fascia WINDOR'S IN EXISTING OPENINGS OYes ONo LOCATION OF WINDOWS OR FOR NEW OPEMNGS-DESCRIBE STZE OF OPENING CHANGES & Ft. BASEMENT REMODELING SUBMIT: I. Existing Flaor Plan 2. Proposed floor plan 3. List of strucinral members to be used FOR A1EW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUBARTI': 1. Site Plan/Survey showing the existing siructures and proposed project. 2. Two sets of construction plans 3. Energy Calculations TYPE OF WINDOW TO BE INSTALLED NUMBER OF WII�IDOWS I ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (U5ING TI-i� 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee Plan Review Surcharge Fire Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ $ $ $ $ $ $ $ $ $ _ See Back Page for Fee Schedule 65% of Building Permit Fee (.0005) times the total job valuation — Minimum $.50 .001 x Permit Valuation (1/10%) $5.00 (State Licensed Residential Contractors) $1450 per SAC Unit (Plans to MWCC for determination) $+6ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMTf-NOT VALID UAITIL PROCESSED I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work w� rey�ires r�� approval of plans. SIGNATURE OF APPLICANT O� i PRINT N.4NIE ����iN` �! ���/��<;J�71`E / � D� Page 2- Building Residential Application BUILDING PERNIIT FEE SCHEDULE The Chief Building Official sha11, before issui.ng permits for the erection of any building or stxucture, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: VERIFICATION OF FOUNDATION Pernuts for constru.ction will be issued a minimum of 24 hours from the time of application to allow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Onlv City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 City of Fridley Building Inspectians Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 Mechanical Permit # o Dl�s -�`�v Residential Application City of Fridley See Back Side For Required Information Date %l b� �, Site Address: - r°e- is: (cirlce one) Owner L Co Property Owner. G ��r°e� Address: C�y: State: Zip: Phone: ��' - .��d �fd �� Cell: __ Fax: Contractor Information Campany Name: p� a� T� Contact Person: � � � � Address: g� N, R� �. City: State: ZA� �rpi�► Wli�i�f� Phone: Cell: Fax: e�N�SSt Finail• MN Bond# & Exp Date Type of Work (circle one}: �New� Replacement AlteratioNRemodel Detailed Description af work: uipment f �� � MFG: Model: Size/BTU: MFG: Model: Size/BTU: Please check all that apply: ,�Fireplac� (gas) $15.00 New Gas Grill $10.00 A/C $25.00 Fireptace (wood) $35.00 _Gas Unit HTR $10.00 _Air to Air exchanger $15.00 Fumace $35.00 _Pool Heater $35.00 Boiler $35.00 Gas Dryer $10.00 _Ventilator $15.00 Chimney Liner $10.00 ,�Gas Piping $10.00 � n��r_t wrirk �10.0o Gas Ranae/Oven $90.00 Pennit Fee � (Total frorn above-Minimum fee $35.00) Surcharge �. �� 0.50 Total Due $.�,� " Make check payable to City of Fridley This is an application for a permit- not valid until processed I hereby apply ior a mechanical permit and I acknowledge that the informa�on above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Consiructlon Codes; that I understand this is not a permtt but only an applicaUon for a permit and work is not to staK without a permi� that the work will be in accordance with the approved plan in case of a(I woric which requires review and approval of plans. Signature of Applicant: Date: f%� Approval Inspector Signature: Date: Please Note: Separate permits are required for Buiiding, Plumbing, and Electrical work