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AF - 35394sua�ecr PER City of Fridley r° 13290 ,�� , ` AT THE TOP OF THE TWINS g U I L D I N G P E R M I T R�� `L ____�_ COMMUNITY DEVELOPMENT DIV. ��6� � r � � PROTECTIVE INSPECTION SEC. U � _ � ,` �"'1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BV L•"'� I ,'� 612'560-3450 910-F15 10/29/75 / / JOB ADDRESS 6190 Benjama.n Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION DESCR. SHEE7�ACHED 1 4 Rice Creek Estates 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Briar Homes, Inc. 8535 Central Avenue, M ls. 3 CONTRACTOR MAILADDRESS ZIP PHONE UCENSENO. 5ame 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. B USE OF BUILDING sidenti.al 7 CLASS OF WORK � NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK t � � � -- MP iA -- 9 CHANGE OF USE FROM TO ��VIStON REG�►ROtNG CURQ STIPULATIONS qT DRIVEYVAY OP�NiA1GS. Provide a hard surface driveway. Provide a verifying survey be o�e capping. Provifle sod in the front and side yards. Provide floor truss spec., it must indicate beaxing point for cantilever. SEWER LOCATION: (8' deep) 67' South of Manhole (Inv. 906.11) WYE ELEV: 906.38 TOP OF FOOTING: 909.38 Min�mum �a�� WATER LQCATION: s� North of Sewer service gefare digging rall lacal util�ties TELEPHO�IE - fLECTl�C • GAS Etc. SEPERATE PFRM��S REi�Uli��O ��ytf�ING, REQUIREa 8Y. l.�rlV r�EaT�NG, PLUM�ING pMD ��, SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. WOOCZ FY'3Ille 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 R 1 1125+566+54 18, 028+4336 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 THUE 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 GRANTING OF A PERMIT S3O�%OO �.�J.35 DOE�T PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE �ISI NS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTI N OR THE P RFO CE OF CONSTRUCTION. yS`4]..3% yS$Zr'J.00 PLAN CHECKFEE TOTALFEE � �� ' $381.72 " :g ATUREOFCONTRACTORORAUTHORIZEDAGENT (DAT 1J�IH PROP L AT THIS IS UR PERMIT ?+� S �� o. . SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI INSP �AT ,�� -'. ° • •APP'LICATION FOR RESI'AI::VTIAL., ALTL'RATION, ,� _ _, OR �lllllITION. BUILDING P�RI�IIT C�TY OF FRIDLEY, NIINNESO'TA • ; r . � ' Oi�IEIt' S NAl+1� � e �� $UILV�x: �,�� . - ADDRESS • �,�� . � �U� �,� ✓ ADDRESS :, . � . NO:. 'D I9Q=._ STREET• /u vv►� . F . � - � j,pT : � BLOCI:: � ADDITIOIv : i . � ' .._- `��9 t� ' COR1�,'ER LOT:� INSIDE LOT: SETBACK: SID�YA�.D: Agplicant �ttacY: �o this for� �lo Certifieates. �f Sur�re .•of Lbt and _pxoposed building location dra�an on these Certificates. � � � �HESCRIPTION OF BUILDING . 0 a e Used As : .. O � . � � . � �ron� : � � � Depth •. � �•°°�°" �S H�eight • � � � . - _ Square Feet: �1�ZS Cubic.Fest: ,� .�"?8' � • T� � ti�` Front : Z'�.1 Depth : � �3 Height : � . _S2 . �. . . � Squaxa Feet; �1.� Cubic Feet : � �. . . � . ,� � �. �jrpe� of �Construction: �� C�°t� �� Estimated Cost: '� l.- l 1� o, aoa To Be Completed: � � � � . • 3 , • ' . The undersigned hereby makes applicativn for a permi� for the work herein speci.iied, agreeing• to do all worlc in strict accordance with the City of Fridley Ordinances and rulings oi the Depaxtment of Buildings, and her�by declares thaC all the iacts and represent_ " ns stated in this applicata.on are true and correct. . • . • — ,� ' '� / f� • • � D�ATE: � � � SIGNATU2t�: � • (See �{everse Side For Additional Information.)' �� y �. �'l �1� t�a.,a� ��d� • . " / _� OIt�4'i'$ �,i , �'� � - L'S; 3 � � . , �� t�f � e�. — • . g'1.7 �' � . � �. . �3 � � . � 0 --�,� s 3 SP�r�. � ]`► I�os� , � . R1i�lt� � I�f�'' . �t+1�► �.4•�•�T�� [r� ; . . . , , , .� . . i3U1Lll1N� L�•L1cM11 rLL ��•��LL�Lc . --�_.� . s • • � • � • . � S�CTION 2. Tlie InspecCor oi Buildings shall, betore issuing permits for the exection of any building or structure, ox �for any addition to any exisCing building ox struc�ure, ox for any a1L-cration or rcpairs to any cxisting � builcling or struc.tuxe, upon application therefore, requixe the paymenC by the applicant for such pennit of fees to the air.oun� hexein below se� �oxth and i� the mannen c�rein pxovided to-wit: . � • . UIZIFORM BUILDTNG CODE: Type 1, 2& 4-$2.I5 for each one thousand cubic feet, or fraction thereof, in such cubical contents. Z`ype 3& S-$1.85 fox ' each one thousand cubic feet. . ' " • � ADDITIONAL INFORI�IATION Fox the purpose of computing fees fox building permits, the cubical content� af any building or addition, is determined by multiplying�the ground area . covexed from a point six (6) inches loelow the floor line of the basement • oz the cell.ar ta the average heights of the upper surface ox to the average� height of the•xoof surface of the main gable of a pitched roof. . . • For xepairs•or aZterations to•an existing structuxe, the fee shall be at the • ra�e of $3.00 per each five hundxed•dollaxs ($500.00) or fxaction 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. �. � � , � ' � °� VERIFICATION OF FOUNDATION . . � � � NpTE; Permits for construction will be issued.a minimum of 24 hours from the txme of application, to allo�a for proper review of the proposed structure and of the construction site. . � .. � A Cextified Survey of the lot, showing the location of the foundation, once it l�as been constructed, will be required befoxe proceeding with the framing. CERTIrICATE OF�OCCUPANCY ' Application for a Certiticate ot Occupancy shall be made ten (10) days pxior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall no� be used or occupied until a Certificate of Occup�ncy has been issued.. , . . e @ . • . • e • �; _ ; � . r _. i . . t =e f 1� f � i I. . .. - ----- -- - - - v� �Iqb '=�� t� i � _- �4 z3.3�t t�l. 3� S6G x�� .I�Z��,., �r. �, .'� x z�.3 ��s___---- Y� t y3► 3� �*.��l. � � �� Y �'i - 13Sea k-�SO = 'LS�4'% X S�p c a.'� �� r 22.t�u = zs•,u�„' 30 l.�'� an� � . �c .� _ .3� . � .� ;�� i x _ - .. . � — T , � � . �� D � �- -• ' � . , � ci��rri��eaY� o� S�RVEY � . . I . _ . � . �.uR _� Pine_.TreL Buidersi__Inc. _ ; ,� � � . � � �! �� I,� , .. ' � �►ISION SAFETY CONTROL ZON�'a � � , . _ - �1p NO7' PLARIT OR PLACE �f. ' � " . � �� 6'� 6ii�p M/b�1i0UT - �. �?AOV91. �E Yt�E 6�i�v► o� �r��. � �„ RD. . �� M. p � � \ R�P - '�� , Qy,`��p' $�z��$ , � ,�., - �, , ;� . � � p' QZ°\1a45 � �' �' d � r / � � 5 � • �-s _ � :: � \ \ �`s .\a�� \ x '.,�, i � � . ,' � � 6� o� ,. Ip� �- �' . � � ,� � �,�,,► � o � �wu� � I � p, d O ��d ' ��W r � ni � + � � `S°S � �--ar Z' � �1.:- Q � z I ? a � , ' �', 1, I �� .'"'ii . � �5 ' . �+" I - 120.00 - ; 2S ' , ;�,,,° � �i�POR��9V�-� � � � Deno-i-es Iron Monurr�ent �I�`�IPY iFl� FRIDI.� �NG� � 9efore digging caN local ufilifiies � � �IVI�ION REC�� Cu�� TELE�HONE - ELECTRiC - GAS Etc� ��' A�� ° ` Ai' �Rl��ipA� ��IF�(�. °. ' �t�C�UIRED �Y L/�►W � . D;��sc.�•i�?tion: I,o�t �., Block 4�, RTCE CREEK , � ' �STATESi Arioka County� Minn�sota..: : -� � " , , . � � . � a . y J . ' �. - ' ,, ' � . ' �,•.� i, -• • �{if��ehy a�rtify that this is a vue aric! cotract reEiiesentation of a survey af J��!> N�� , ��Ot('01 t-�" C ounfrc� chr l�ounclai ies uf th�� I�ove descril�ed land and af the loc�tioi7 of all kniildi��ys, 2�r.� : it any, tha:reun, and �Il visible enc�oachments, if any, frc�m �r un saici land. .-�/.�/°[�E�[�OS'� � [3�c,k - F'a_��' �' � �- As s�nvcyecl by� tlte this.___:.-��1'if1,-----_ day of -- .��"'.�-�.._------ . 1� �S. � I�du�l;,��r�i•yiny_• .,ib� Pl��nnini� , � �� '.,, . y � . � �. . � . r ,�, l,i:il Enqin�rr�ru�y �,p n �j/J ,��2-ui✓1�A__-_'�Y�_ !bG?,_ii' cGtil.i2' ---r .__.�._ - ,��.,cdlr — B,'-116 /Oth Av ��J ll 9a ,�t Brn�ne Q�.. N ! --- --- -- - --- -�-- . — • --- . f�t..�uElyn f'drk. M"J 55�128 _ n, �' ; �= 4��: �; Pl,�.�n� 533 7'340 ` ' Minn. Reg..No. _,.;.��___- ,� . � . i ,,. > �.�.,�• � - _ _�,....._....�m. - — — �, - - - � - _ .� _. � . - - -- - � _ _ . _ _ _; � � 3 - ,. � , � �—� �`2 '��, � t ��'� i� ��✓ a� �;; ��s�, � , � � � ��.�v. _ � la ��-� — � a � � �W� i; ��i 1 r�. : ,� 4 • �/�� / S , �� i I V +�t � � ��w 1 �� N h Ri. 1, Y � Y, �i � „ �� .� �� A \ I �� J , , � '�: a ��,L v�v v� �� , s l � ' �� , � � ,: ; ,c� �� •, �' � � C/�/i?�//�r �Jhi y Q . .�9.�;� .;��- � Av. '" h ^ � 6 � • o� : 0 1 �:`� � � Y � q '� NA � �. _ _ .� :M, ti ��._.,3 �b � �� .a �� ti� ' d ci � a A� F, � �,� `4 � f,� � �� ` � ;'. - � '�, . . ��/ � � dh � � � . � , � a 4, �� I, ' W � �ry �� a� l �i� � i � yt i� ;�� Y - �� , �� , � � � � i' ,' r ! 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C � '1 � � M A � � E H �a� A1 � � ry � � � � �� n � O .. � IA � �. ► t � i7! � M � "J � Q � 0 � O � � �� a yr n .: r. 3 � m � a � a � ~ �C n � o y �� 7 .Y O $ L�• .'_ "� A A '� � .� �, � r r � y � C1 �' �! a � ,�1 .'i: p ! � ``C' Iin � a � ~ 01 � . � � � � u �( �' M .� � q e b �o � w N o � � � � :p G.� :IJ O O � � � � d! i1 bl U � � � 7 � � � �. � � � 7, 0 0 p x 0 � �� ' � H � �� a � a y � �, � �9�� u�� T � � � N � a � � •� S � � �7 $ � � � W W Of G: O � � i � � eo �+, eo a en � � � � � �; x �� (i. � t N � N � � J ti � A y � � � b �• %y � � � �, � \ � d � i g l � �.� � � �� ¢ w �`� :� � ��,10 v �� ' �7 V T,1 � a e. m � � � z. � � ; � :,' � =� � � � � � � m_� � � . u � � • 7 � � � x 'p �, m O a � � �p O O � � M W P. Ol 4 � 2�' g � i�� oa r.+ � � d�u n � � Z% H 4 D. n a� � :l y"� 4 w � �' a. T � aca,a, o a 7�W � ' a°' � �� w � � 5r .� �. � � � °? 1 r � � �.< M r: � y �s � 07 x� y � .c-.�y c'�,Mv n 7 b C w � m �� p°'o� ,. �' d, o` ��"" a `a � � a•°,"f.� a��= �� ' A p� � �o � -� �� 'O ?Y7 .."+ � � � T C;.7 � � � o�a. t0 ) � � � � � _� L �� ii; � �� d;i �a �,� 4� # �. a� � 1 � Q.� r� �p`�� 4,� p�� . ":H �`.:3a �j �a «3a t) . i �; � t?� ; � �.� � �' � ; a�.� ti'�� C+ � �;� �9 H � �' i ��l�y p'�4� V tl Cv �� 'S : � da ^ •' a � �;i �� ., � � �� af !� � �-� � :, �aV � � � �� 3, � � � �37"� � i� � � ��.�� ,� I�IEAT LOSS CALCULATIOIe1S DEPARTOpAE1NT O� BUILDIIdi;S Weatheratrips (;uide Con�true�e No. tru Windowa Doora Refereaee Out. Waq Int. �lall Ce�7ing Roof �7oor Kind 1 Yes-1110 Yea— 0 19_ Fl.� �- Width Height F7.� Room � D Windows and Doora—Cracksge aad Ana D�9indoww� �ad p�n--�n �Vldth He16b� No. o[ Lleul t. Aru Wldlh I3d6pQ Na No. ot pane _ ot pane IIBha ot cne� _p. Pt. Na ot cse� et �ane tD<1 Coef. Ben In6ltration / �� `� � � �'alass �- �' ,�� '� j ,� Fsp. wal! � � Net e:p. wail �d� � ' � �' �. � � Ini. wall Ceiling �� J'� � Q �� Floor �� j� �� Tocal Bcu. � �� Required aq. k. E.D.R. or sc0. ins. W.A. Leader ana Fl•I � 5 �i�i Width Height Windowa and Doors—�rackage and APea wiatn Hei�At xo. o: �e� te. a� Na ot pane o[ pane 11aAU ot encic �a, ft. Coef. Btu In6ltradon o2 � � ! Glass • � .4� � � �' Fsp. wall �a � Net ezp. waU � � �� ' � � � do�. wau Ceiling Floor � � �� Total Btu. � � �'.�-� Required aq. k. E.D.R. or eq. iaa. W.A. Leader area Fl. Room ( Length Width Height Windows and Doors—Cracl�age and Area Wldth Helsbt No. ot Llneal tt. Ares No. ot �n� ot caes Ilrht� ot ceack �e_ tc_ Inbltration Glas� Eup. waU Net �p. waU 14t. wall Ceiling a loor Tbtal Btu. Require� fq. h. or �q. ins. �I.N. Leador area B�1t VILLAGE OF '' In�nlation � Q/idtb and Ares Bcn dn6ltPadon Cles� �p. waU Net ap. wall In� wall _ Ceiling Floor Z'otaD Btu. Required aq. ft. E.D.R. or �q. ins. 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RANGE ~ � � . L�� w G�IS � onEa�ucs ° � • � 0 z • � � � � > E � 4'3 � � �. �d � : s4 � ^ _ � � � � � _ � =�' � � � ��' �" p � O � o C 7C . �n' . o �. . � � G Q . � w� " �, o ,{ � A M � W � � • � a • o � . �� . � ► � � . � . . : • b ��„r' �' n w � � � . � �. � � j g �, . . � � ) t \\ � � � �� . y � � cs�,.� o � � `� � � o � �4 � • � � � � � � :7 A 7. �0 , .� � r (� � �� w �! ' .� , ° v � . : ; �� , � � � � 'o A aa� � n b �a� w � � �. N � �' � � �o� a' � ��x�N � �� , � N ��p,� ��oH d a•�n� e � �r � .r.a�. � � � o� � » o � � K: 'v; arocx � b � n m �a�b a �. � r.. � � � � w � N 0 . � Li' p � . a''�,o �� A � � t � � • � A .µ. � $"x~ ��ti ��R ��o . .. � �' � � m �4� .�► � � a�� • � � c� . � � � � � � �� .. � 4 � � � � a � �g �.� . �° �s n � 0 0 e r, � � 2S �, - � � � � ' ' .. � . � ��. 560-3450 e ��(�,, r% , ��y O 3'1GT[@'y ` U C/ � ANOKA CQUNTY . 6431 UNIVERSITY AVENUE NE March 25� 1976 Briar Homes Incorporated 10134 Central Avenue 1�T.E. Blain.e o Mn . 55434 FRIDLEY, MINNESOTA 55432 Re: Final Inspection at 6190 �enjaYnin Street l�i<E� .. Dear Sirss A fina]. inspection was made. at �he above address on Marc�i 23, �.976 and the following items must be completed before the structure aan be fina].ed out; � l. Complete fire�wal,l by gaxage cioo�o 2, Water meter must be sealed l�y Plumb�.ng �nspector. 3. Hot water heater vent missinq. 4. Tx°�er not nailed under step fo�rer. 5. PeCe Alarm not operating. 6. Post house numbers on structure. 7. Provide a ha�d surface drinewaye 8. Provide sod i,n the front and side yards. 9. Provide a door closer on door between house and garage.. 10. Provide handrail on outside front step. 11... Provide joi,st hanger on outside patio joist: We will expect items #l, #2, #3, #4, #5, #6, #9� �10 and�#11 to be comple�Ced by April 15, 1976 and it�s # 7 and #8 to be complete.d by J'une 1, 1976. If you cannot complete these items by the appointed dates please contact us. Reinspections will be conducted on or about the appo3,nted dates to deter�i�e compliance. � Since ly, DARREL G. CLARK Community Developmeat Aadm. . TO: FROM: DATE: Engineering Sewer Water P��kS Streets Maintenance MEMORANDUM I �� c � � �p I �i � %`� ` �'� � � Mark A. Winson, Asst. Public Works Director PW89-205 Ray Statler, Engineering Technician � July 27, 1989 SIIBJECT: Lot 1, Block 4, Rice Creek Estates This memorandum is in response to the Home Owner's request for lot corner locations along the west line. The southwest corner was found, and a nail was set at the approximate location of the northwest corner. I informed the Home Owner that the nail was an approximate location only. I suggested that before any fence was construction, they have a lot survey performed by a land surveying company. Rs/ts C G7YOF FRIDLEY sue�ecr PERMIT . City of Fridley 20274 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. r j L • � PROTECTIVE INSPECTION SEC. �° s� �� /'�'1 � CITY HALL FHIDLEY 55432 NUMBER REV. DATE � PAGE OF APPqOVED BY �"'""� � ,�� 612-571-3450 910-F15 3/30/�0 � � J08 ADDRESS 6190 Benjamin Street N,E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. �- 4 Rice Creek Estates SHEET 2 PROPERTYOWNER MAILADORESS ZIP PHONE Steve Mokita 6190 Benjamin �treet N,E. 572�18Q4 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. (Not licensed in Cityj 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENOINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING Residential 7 CLASS OF WORK � NEW ❑ ADDITION O ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct an 18' x 38 �` Above Ground SWimming Pool �21 F 24a ga,llons) 9 CHANGEOFUSEFROM TO STIPULATIONS See stipulations on letter dated Ma,rch.l5f 1940. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OFi 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 �- STALIS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROYISIONS OF LAWS VALUATION SURTAX AND ORDINANCES OOVERNING THIS TYPE OF WORK WILL BE COMPLIEb $3 � lOO yS`]. s S�J WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- 63 �OO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $ � � PLAN CHECKFEE TOTALFEE d I`'t.�z- � O� 1" 9(% $64 s 55 SIGNATUREOFCONTRACTORORAUTHORIZEDAGENT �DaTEi � WHEN� ROP R I A ED THIS IS YOUR PERMIT w SiGNATUFE OF OWNER iIF OWNER BUILDERI IDATEI � � � BLOG INSP � qq� � � � � Effective 1/1/90 ADIX�T [ � R-1 AND R-2 ALTII2 [ ] Huilding P�ermit Application C�.stnlctiar► Addres.s i � / � �E'i� � �°i�a o Po1 � e � 1� a �l�/,� �`� � Iega1 Der�ription: h �!%" / �3L a� � ��g� � ��t� � �f��$' owner Name & Address: �� rI1C) � i°'�� 6`'7a �i� � ��;� �� Tel. # S'j�.�,�� Contractor: � •,• - # I ,l� �, LE��s �. # �� s�� Attach to this application, a Certificate of Survey of the lot, with the proposecl construction drawn on it to scale. D�SCRIPTI@T OF LIVING AREA: 7ength Width Height Sq. Ft. Q�iRAGE ARF�: Iength Width Height Sq. Ft. DE7CK AR�: Length _ Wi th /G� Sq. Ft. O�Pi�RR: �� L° -�( /f� i d c�(� t40(�� t.ei�� a�� ?�LL�.tls Corner L�t [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks Zj�pe of Construction:�,�,�� r��• ��g� Estimlted Cost: $�/�� ' Approx. C.csmpletion Date: Praposed Driveway Width If New Openirig Is Desi.red: Ft. $ $ Width + 6' See Back Page DATE: �° `�{' �' 6 APPLICANI': � �el. # � _ Permit Fee $ ' State Surch�ge $ ` � o � r SAC C�arge $ ? Driveway Escrow $ Park Fee $ � `�' Sewer Main charge $ �� . �. srz�oNS: $ � '�� d �� v�� CIT7C USE �Y Fee Schedul.e on R,�verse Side $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" l�lbave Fee Determ�ned bY ��! Agreem�nt Necessary [ ] Not Nece.ssaty [ ] �. � �� / �.�� ' o ��b�� yS�oc� �� e�� :�� . . • �+•� � - �- _ �:�:�.�� Zhe Chief Building Official shall, before issuing ��;ts for the erection of any ba�ildirig or stnxcture, or for any addition to ar►y PYl �t-1 „Q �ilding or structure, or for ariy alteration or repair to ariy exi.sting ��i 1 dinq or structure, upon application therefore, rem> i� the payment by the applicant for such ��++; t of fees to the amount herein belcxa set forth and in the manner herein provided to-wit: ZnTAL VALIJE $1 to $500 S5oi to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 , $100,001 to $500,000 -� � $15 (1Kinitmnti Fee is $15 plus surcharge) $15 for first $500 plus $2 for each acklitional $100 or fraction thereof, to arid including $2,000 $45 for fiYSt $2,00o plus $9 for each additional $1,000 or fraction thereof, to ar�d including $25,000 $252 for fiYSt $25,000 plus $6.50 for each ac'�ditional. $1,000 or fraction thereof, t.o ar�d iuicludirig $50, 000 $414.50 for first $50,000 plus $4.50 for each additional $1,000 or fraction thereof, to and includitig $100,000 $639.50 for first $100,000 plus $3.50 for each ac�iitional $1,000 or fraction thereof, to and includirig $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�luding $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 thereof DRIVE�iY DEPRESSIdIJ E�,Q�OIW (Concrete Curb Streets On1Y) Alternate "A": Remwal arid replacement of curb arid gutter only - Driv�way width plus 6 feet times $13.50. Alternate "B": Removal arid replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. � �� ■ a• • �� li,i�.� N �;� Pennits for oon.stniction will be issued a minimiun of 24 haurs frcan the time of application to allaa for proper review of the proposed structure and of the oonstruction site. A Certificate of StiiYVey of the lot, shcxainq the location of the faa�ndation once it has it has been constructed will be required before proc-eedirig with the framing. s a . � �i � � -;-_ �: . CIIYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55433 •(612) 571-�450 • FAX (612) 571-I'87 March 15, 1990 Mr. Steve Mokita 6190 Benjamin Street N.E. Fridley, NIlJ 55432 Re: Swimming Pool Construction at 6190 Benjamin Street N.E. Dear Mr. Mokita: This letter is to make clear this department's requiremen�s for the swimming pool construction at the above address. 1. As indicated, one (1) skimmer approved by Foundation will be provided. 2. As indicated, one (1) inlet of approved repurified water will be provided. the National Sanitation design for fresh and/or 3. The filter and pump shall be approved by the N.S.F. and be of sufficient capacity to provide a minimum turnover of at least two (2) times in 24 hours. This department recommends a turnover rate of 6 - 8 hours. 4. A deck of at least three (3) feet wide, measured from the pool waters edge, shall be provided which extends completely around all private residential pools. Above ground private residential pools may be provided with decking of a minimum size of 4 feet by 4 feet at pool entry points and provided that such decking has the approval of the City. 5. Fencing or oth�r effective means including but not limited to walls or buildings, acceptable to the City, shall be provided to positively control all access to public and private residential swimming pools. Fencing shall meet the following criteria: a. The fencing shall prevent the entrance of children and be without hand or foot holds that would enable a person to climb over it. b. The fencing shall be at least 6 feet high and entrances shall be equipped with self-closing and self-latching gates capable of being locked. c. S�lf-closing and self-latching devices shall be placed at the top of the gate or otherwise inaccessible to small children. d. The opening between the bottom of the fence and the ground or other surface shall be not more than four inches. �.M._.,,.�.,�_..�.,w �...�.�„- � March 15, 1990 Mr. Steve Mokita Re: 6190 Benjamin Street N.E. Page 2 ✓ 6. An autoaat$c chlorfnato� �hould �� pr��ri�i�ri '��th � �►1i�t��r1� �� 12it. � 7. All electrical and plumbing installations shall be inspected and approved by the City Inspection Department. 8. All overhead electrical lines must be a minimum of 10 feet horizontally from the pool surface and 18 feet straight line distance from the waters edge. An alternative is to bury said lines. 9. The pool fill spout must be protected by a vacuum breaker or air- gapped. 10. Suitable safety equipment to include but not limited to a ring buoy and rope that is 1 1/2 times the pool diameter, and shepherds crook pole must be provided and maintained with the pool at all times. Furthermore, these and any other requirements must meet the provisions of the Fridley City Code, Section 115, Swimming pools. The building permit is approved contingent on final inspections and approval by the City. If any questions or problems arise from this letter, please feel free to contact me at 571-3450. Sincerely, D . CLARK Chief Building Official DGC/mh �J� -1�� f )t��"��. CERTIFICAT� O� SUR�E1( r-c,� ��',i• -c�.4� � Irc. �-� ' o P�E' � � �P� $� 2� � \ � \ �4-�0 8 : 3Z �b�5 / \ �/ � �\�'`p .\p`QZ'� \��' � �' y �� 6 � '�dj �XL 'S � ' � ua.i �c.�' .Y ° O � .�' p�-� � , C ` p ► d ',y�. �� J I• �-+' a �t, Y u�. Lf� � d � �� L::� L2�� Z —r— - ; RD. NI ' . '-i5.00, -�S F" � ,R,, •� � i � �-° � I �5 � 25 � � . I � ` � i�- C � O v I� d � 7"� tj7 I :� W r- I � � � � d I.-; �` b I a6 ��.J'� r �i. • 42.8 � 15 120.00 �� _ G ��i��f � t�L� ��e ��r � Deno+es Iron Monv ment Z � � W�./�I W : 2S � D_��crif�Lion: I.,o�t "_, ;�lock ��, RICE CREEK ESTATES, Anoka Count,y, l�:inn�.�ota. ` � ^�A��. S ��'. t��. �� ,� C/! � �=��:E..- �y� �� ara�RG C�ott��t � �ou�afrr� ctiu rc.�PC�or3 l dtnl 5�i�., y�ny •`�iir f'I,i�ui�ny l.�v�l t n��n�e•._•rit�y N�31i� /l)t!i !1, P,i 11 'J4 st B�u�n.� A�. P: Rru��i�lyn F'.arh_ PJM1: 5�•�.>H ��i�,��,� 4,:i�3 t3ao a �*��. �� 0� Revised 12-1-'1S To Show g�� e Fo�naa-ti-iot, It�- place 1 heieh.' a�ility tlr.it tli;s i� a ttu�' anil ce>ii�rct re�nr5�rntat��m ut ,i sutv��y ot tln• linur,cl.u�f�� ut Ihcr,�l�i�vf� de;Critx�ri Idrnl .�nti uf Ih�r lur..itiun ut ull huil:iinyi, �f dny, Ih��i��rni, dnc) .ill vi�,�til�r ��nc:io�ichnienh,, it a��V, hi,ni nr �n �.�irl I<ant1. Aa titiiv��yeni !,y i,,,� thii _ V9+h �i.av-�,t �pri1 - - - ..��;� � �. �a.,-a ^��n�i. Flr��. nlu. __ �O� --• ��5 .��,i, r�,� 205 .,�iiik --l� i,�N 8 -�9 �, :;�� 1" - 40' � SUBJECT P c�ty of Fridley 215 2 ' ' AT THE TOP OF THE TWINS B U i L D i N G P E R M I T E� r � � COMMUNITY DEVELOPMENT DIV. f 1�� r 1 • � ' LL ��'��, r � � PROTECTIVE INSPECTION SEC. �� "'1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY !"'""� � ,'� 612-571-3450 910-F15 S/28/92 / / JOB ADDRESS 6190 Benjami.n Street NE t LEGAL LOT NO. BLOCK TRACT OH ADOITION SEE ATTACHED DESCR. 1. 4 Rice Creek Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS IIP PHONE Steven Makita 6190 Benjamin Street NE 572-1804 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIIADDRESS ZiP PHONE LICENSENO. 8 USEOF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION ❑ ALTERATION C� REPAIR ❑ MOVE O REMOYE 8 DESCRIBE WORK Reroo� House (20 Sc�ua,xes� 2nd Laxex 9 CHANGEpFUSEFROM TO STIPULATIONS Roo.�i�n.g can be ths 2nd layex but not the 3rd, TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REOUIRED FOH ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONINCa. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK tS SUSPENDEO OR ABANDONED FOR A PERIOD OF 120 OAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTfNG OF A PERMIT S�-IOGO $.53 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $2'��OO Fire SC $I..OG STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $2 8, 59 S� N TUREOFCONiFACTO�ORIZEDAGENT IDATEI HE PR ERL V O D THIS IS YOUR PERMIT �P�- q � �� '2� p � Si NATURE WNERii OWNERBUILDERi IDATE� BLDG INSP �ATE NEW [ ] ADDN [ ] �-�R [ 1 CITY OF FRIDLEY 5INGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit AppliCation Constcvction Address: � � � � �e N � Legal Descriptioa: Effective 3/1192 9 Uwner Name & Address: �e � c. .� OY) ��/%F} J�F� e Tel. ��7,� -/�C� y Contractor: ��e c9r,ary�l�(z . NIN LICENSE # Address: �'�Yy�yj�e� Tel. # � Attach to this application, a Certific�te of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: `� DESCRIPTION OF IlVIPROVEMENT Length Width Length Width �n�n w�ar�, 0 0 Height Height HgtJGround S � � � .�,��n � Sq. Ft. Sq. Ft. Sq. Ft Corner Lot [] Inside Lot {] Ft. Yd Setback Side Yard Setl�acks Type of Construction: Estimated Cost: $/D� C� �= Approx. Completion Date: (cost on Backj Driveway Curb Cut Width Ne�ed: Ft. + b Ft = Ft x$ _$ , , DATE: � ��,� � � a- APPLICANT: � TeI. #��-� Permit F� $ � �. D � Fire Surcharge $ � /. v � State Surcharge $ � SAC Charge $ License Surcharge $ Driveway Esctow $ � Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: � $ �o . � �` C�,TY USE ONLY Fee Schedule on Reverse Side .�1 of Permit Valuation (1/lOCh%) $.50/$1,U00 Valuation $700 per SAC Unit $5.00 (State Licensed Residential Contractors� Alt. "A" or Alt. "B p Above Fee Deternnined by Engine�ring Agreement Necessary [] Not Necessary [ J .� . BUII.DING PERNIIT FEE SCHEDULE The Chief Building Officiai shail, before issuing permits for the erection of any building or structure, or for any addition to any existing boilding or structare, or for any alteration or repair to any existing building or structure, upon application therefore, require the paymem 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,� $2,�1 to $25,� $25,�1 to $50,000 $50,{�1 to $100,0� $10(},001 to $500,(1Q0 $500,001 to $1,000,� $I,OOQ,001 and up FEES $15 (Minimum Fee is $15 plus surcharge) $15 for first $500 pius $2 for each additional $100 or fracdon thereof, to and including $2,000 $45 for first $2,�0 plus $9 for each additional $1,000 or fraction thereof, to and including $25,(�0 $252 for first $25,(�10 plus $6.50 for each additional $1;0� or fraction thereof, to and including $50,000 $414.50 for first $50,� plus $4.50 for each additional $1,OQ0 or fraction thereof, to and including $100,000 $639.50 for first $1(�,WO plus $3.50 for each additionai $1,(IQO or fractian thereof, to ant� including $500,000 $2039.50 for the first $SOO,OOQ plus $3 for each additional $1,000 or fracbion thereof, to and iacluding $1,(�O,OQO $3539.50 for the fia'st $1,�,Otm plus $2 for each ad.ditional $1,OU0 or fracti.on �thereof DRIYEWAY DEPRESSION ESCRO�VV (Concrete Gurb Strests Only) Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 fcet times $13.50. Alternate "B" : Removal and replacement of curb and gutter and install a 3 f�t wide approach with 6 inch depth - Driveway width plus 6 f�t times $15.75. vERIFICATION OF FOUNDATION Permits for consnniction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed stiructure and of the construction site. A Certificate of Survey of the lot, showing the locadon of the foundation , once it has it has been constructed will be required before proceeding with the framing. d - �- sue�ecr - P M� c�ty of Fridley 215 7 8 , , AT THE TOP OF THE TWINS g U I L D I N G P E R M I T R O. r � � COMMUNITY DEVELOPMENT DIV. � � � � � � LL � �' r � � PROTECTIVE INSPECTION SEC. ii i � --_- A�'�',.� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE �OF APPROVEO BV i �� 612-571-3450 910-F15 9/29/92 / / JOB ADORESS 6190 Benj amin Street T�fE 1 LEGAL LOT NO. BIOCK TRACT OH ADDITION SEE ATTACHED DESCR. .1 4 R].CE Creek Estates SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Steve Mokita 6190 Henjamin Street NE 572,1804 3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO. DeMars Construction 8401 166th Cir NW Ra�►,sey MN 55303 441-7084 6614 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS Z�P PHONE LICENSENO. 8 USE OF BUILDING . Residential 7 CLASS OF WORK ❑ NEW C� ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 20' x 8' P,,dditiqn; Remov'e old deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations qn plan. Ins.tall smoke detectors in dv�elling unless already installed. � wA�� Beiare digging call for al1 ut�iity locations SE�'�RAt�'E P�RMITS RE 454•�042 liiltRlNC, HEA�'t�4G, PLU BtI�G q F� �EQUIRED BY LAW No st��s SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY (iROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPUCATION �- STALLS ,GI.IRAG�S AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX ' AND ORDINANCES GOVERNING THIS TYPE OF WORK WII.L BE COMPLIED $g�558 $4.28 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PEHMIT DOES NOT PRESUME TO IVE AUT RITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS ANY H R S A R LOCAL LAW REGULATING CON- $lOS.00 Fire SC $B.SFi STRUCTIO THE R A E F CONSTRUCTION. � �� PLAN CHECK FEE TOTAL FEE License SC $5.00 $125.84 SIGNATURE OF CON i RACTOR OR AUTHORIZED AGENT IDA i HEN OP Y V LI AT THIS IS YOUR PERMIT ^ : ° �Z�'-�� SiGNATURE OF OWNER �IF OWNEF BUILDERi IDATEI LDG INSP f7ATE NEW [ J �-. ADDN ALTER ] Construction Address: Legal Description: CITY OF FRILILEY S[NGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Owner Name & Address: Contractor: Address: Effective 3/i1�2 ��g � G'_r�= MN LICENSE # @J,I� � / � Tet. # � �� Attach to this application, a Certificate of Survey of the lot, with the propased consbruction drawn on it to scaie. ��`�, DESCRIPTION OF IMPROVEMENT vV"5�&S�� , � LIVING AREA: Length �° � Width �_ Height � GARAGE AREA: Length Width Height DECK AREA: Length Width�#� Hgt/Ground . OTHER: Corner Lot � Inside Lot {, ) Ft. Yd Setback _ Type of Consh�uction: � � �� Approx. Completion Date: Sq� F� � Sq. Ft Sq. Ft. Side Yard Sexbacks Estimat:ed Cost: � , � � �� (cost on Bacxj Driveway Curb Cut Width Needed: Ft. + 6 Ft — x$ _$ DATE: � APPLICANT: TeI. # � % / CITY USE ONLY Permit Fee $ ��:_.�� Fee Schedule on Reverse Side Fire Surcharge $ � P �.001 of Pemut Valuadon (lllOth%) State Surcharge S , � $.50/$1,000 Valuation SAC Charge $ -`� $7� per SAC Unit License Surcharge $ .Sr �' �$S.� {State Licensed Residential Contractors� Driveway Escrow $ - Alt. "A" or Alt. "B" Above Park Fee $ �•°-�`�'- Fee Determined by Engineering Sewer Main Charge $ _��'°"°'?" Agreement Necessary [ j Not 1Vecessary (] TOTAL $ �� ST[PULATIONS_ � e!d��-�l'`''� s " . BUILDIATG PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing pertnits for the erection of any building or structure, or for any addi6on to any existing bailding or structure, or for any aiteration or repair to any existing building or structure, upon application therefore, require the payment by the applicanE for such permit oi fees to the amount herein: below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $SOi to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $1Q0,000 $l0i},001 to $5�,(�;0 $500,001 to $1,000,000 $1,OIX?,001 and up FEES $15 (Minimum Fee is $15 plus surcharge) $15 far first $500 pius $2 for each additi.onal $100 or fraction thereof, to and including $2,000 $45 for first $2,000 plus $9 for each additional $1,000 or fraction thereof, to and including $25,Q00 $252 for first $25,000 plus $6.50 for each additional $1;000 or fia.ction thereof, to and including $50,000 $414.50 for first $50,� plus. $4.50 for each additional $1,000 or fraction ther+�f, to and includ.ing $100,000 $639.50 for first $i�,�0 plus $3.50 for each additional $1,(l00 or fraction thereof, to and including $50(i,000 $2039.50 for the first $500,000 plus $3 for each additional $1,(100 or fraction thereof, to aad iacluding $1,t�OQ,000 $3539.50 for the first $1,�,OQO plus $2 for each additional $1,000 or fraction �thereof DRIYEWAY DEPRESSION ESCROW ` (Concrete C�rb Streets Only) " Alternate "A": Removal and repla.cement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate °B": Removal and replacement of curb and gutxer aad install a 3 foot wide approach with 6 iach depth - Driveway width plus 6 feei times $15.75. 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 constraction site. A Certificate of Survey of the iot, showing the location of the foundation once it has it has been consbructed will be required before proceeding with the �raming. `� A I � \ � ��' �)t'�'��. � r�r' i 1 �� I A�f f' t CERTIFICATE OF Sl1RVEY � ; � � �- � �� .� �� , r t,�: _ ._.-- -- . t' � �� ,.� . I :� r. . � . �� ,�; RD. � F�o A�,� N� , . •, � ��Q. $3 2� - 5.00• -/S� � � � ,R, � � � _ t4"1 • .. � � o � �/i 'i8 � \ � � � . 3Z \b46 � ( �5 � 25 � c� 0,t... ' ' /� . � � ... �. � S .\A i � ' � . � t �' � ' i • � � i�. t .i �� X� .� �� I�C� z � � �`� � � I� G O I v � C � � � � �� c d O I�d v� .:,. � � �-TW r Q n1' I ' � � ° yl: ., y� i I = u � � � � � : d N �� & � 2 � 7 d �� _L n. F '��. . � �..: ,> .111 i : ' b � �6��1 5 Q�^'� �; ` � �s ' �. ai.e � � �Q. 120.00 0. -� �C��G� " �2SI' 'a� d� „r G ' � � � �' sc,�F Cl or�.�► �1 � a M`' � /'7iM�� ' � Deno+es Iron N1on�ment D:•;,•ci•if�;,ion: T..o�� '.� i�lock 1�, RICE CP,EEK ESTAiES, Anoku Coiarct;; � :�:inn��ota. N �oc�i'��►.-' i�l` . , Y'` .�'� ��' Revised 12-1-�5 To Show . j'5,3� Cc��, �p � V. Foundn.-��oc, In- lace ��(%i�'I1 t.T � n��%t f/'� 1 h��•��: �'�•tt�1y th�i Ili:y i� �i Utut .ln�t cu�irCt ir�u��.a.i�idh�nt nt .i ,�uiv�.y nf .1��1• PJ�i ( �li�• Iu�u�:�Li� n•� t:i �Ir�.JHn•e� cl�•.a itk�r! lo��l .aed u1 th.•:�n•..�t�un u: .iii Ihnl�hr��.. � 2�5 e-1��/'�►(�t/O/'.i 't .iny. Ili�nc�m, .in�l .iN v�•.�Id�� i!n�a��dCit�nenh., J dry. l;�.�n �>� r�n �.,ni ldntl. i� �dt��l.lni.��•i�i � ��t. I�t� .i�lr�{.-"'--- � ,,,•�,� n, ,��•ti��•�� t��, ��,. o��.. 19 +h ��.�v �� qpril �s) 75 i �:p. �.,.,� t ��,��„. � .•.� . � � e �'b� t ' ENERGY CONSERVATION SUPPLEMEN'P '1'O BUILDING PERMIT APPLICATION � pLANNING AND INSPECTION DEPARTMENT CITY OF FRIDLEY, MINNESOTA This supp lelnent is provided to assist the applicant i.n computing EXTERIOR ENVEL�PE p,�gpGE "U" FACTOR IIdFORMATION. This information iWi ��e�ERGY CONSERVATION pFFICIAL can determine that submitted plans coa�ply DESIGN CRITERIA of the STATE BUILDING CODE (Section 6000). It is the APPLICANT�S responsibility to accurately compute the data; reflect the proper DESIGN CRITERIA in the plans; submit product specifications, if needed to support the "R" and "U" factors used; and to assure construction is per approved plans. � �� ` JOB LOCATION: 4 i� �� .S� �' �' �`�. z� -� w` F !�•� � ��E.�'' e g, �,� �� : ,��:,�� +� '��y _e �� a � � OWNEFZ/CONTRACTOR : � `'�1`` � ° ��n`'`�� a``�� a �* " PHONE : � "�,Y�� `� �'� �°`� ADDRESS : � � �� , p ;;1 "�' . A. Determine the Total Exposed 6Ja11 Area as follows: 1, Total wall window area 2, Total door area 3, Total sliding glass door area 4, Zb tal f ireplace wall area 5, Total wall framing area (average 10�) 6, Total net wall area above floor(average 90�s) 7;y Total rim joist area Subtotal: Total exPosed wall area above floor g, Total foundation window area 9, Zrotal net foundation area above grade Subtotal: Total exposed founda.tion area GRAND TOTAL EXPOSED WALL AREA ��:� .�- _� � � �e � � �.� � � � B. Multiply the GRAND TOTAL EXPOSED WALL AREA X.17 = C. Determine the Total Exposed Roof/Ceiling Area as follows:. 10. Total skylight area � 11. Total roof/ceiling framinq area (10�a) 12. Total net insulated roof/ceiling area �� GRAND TOTAL EXPOSED ROOF/CEILING P,REA ��°°� D. Multiply the GRAND TOTAL EXPOSED ROOF/CEILING AREA X.05 = Y�-� ��. � \ �: r� �. -. Item I Item II .° E. Determine the "U" value bf each segment (1-9) and multiply by the area as . � fol lows : l. � � g ��U�� _ � 2. � � X II{7t1 ��A� � �, 3. X ��U�� _ 4. X njJn ' _ 5. � �s g ��U�� _ Te, j � i� 6. �e � �, g ��U�� « % - 7. X ��U�� _ 8. X ojJn — 9. X nUn = ADD 1-9 FOR TOTAL WALL SEGMENTS = ITEM III F. Determine the "U" value of each segment (10-12) and multiply by the area as follows: T0. X ��U�� _ . 11. g ��U�� _ 12. � � X ��U�� _ ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS = ITEM IV G. Ifti,Item III is the same as, or less than Item I, you have met the intent of State Building Code 6006 (c) 2. � H. If Item IV is the same as, or less than Item II, you have met the intent of State Building Code 6006 (c) 1. I. Add Item I + Item II = J. Add Item III + Item IV - K. If the sum of Items III and IV are less than Items I and II, you have met the intent of the Code for total envelope system. The undersigned, as applicant for a building permit, hereby affirms the above inforniation has been prepared and submitted by himself or under his direction, hereby acknowledges the information to be correct and accurate; and hereby presents the info tion w' required plans in support of the building pexmit ° application. BY: � � DATE: � � � (��r�� (��-, � f� . - � � �..._.. �. . ..-.-_.a.�... �" .�..' � S .�� .�'��,�..1_ c; 8 � _ N � �� 3 _ �. �i � r.�► � ��W� � � � � N �'Nmv_ ti,Pw� o`°°-' � � a c m3n� W a 1 � O � 7 � �� Z �? �b 1 � � D m� N G � � j �eZf� z �..r � �.\ / r"°° - - - � � �. G' � �, C'' r.,�, �� N� � :� :1 �� .„ : ►� � � � - ;;� .✓1� f � ± !Y1 .�. � f • [� � i�� +t�� 1 • y` A £ � :...,.__.o..., � �� 1 � N• �� N� r'�� - _ 5 � w � � � '� 1 f � �- � ° � 9� '`� , , cF _ � �� i �q . _� � � �/ � 8 �--� � �- � �` '"� j r �* J� { a � � �� s ( ;+ ;,k___.____T __._ t •( � . � �. . � �: � `r-"� ; :� � � / � �y � �1 .T � T� � �� f �.""""' � t�Q "_""i '� � � � ��' o � � �� i /�- � ! . A � ' `- � u�� ., .��, ,. -� � �- 5 � � G'�� .,P �y � 3 �- � �' � �ZZ,'�� -� � ; � � � � �� . �� I: .� g • - w;_. � � � �� `'� � :�� 1 .�� . �� :� � �� R � �� - � . ,V � � ��, a �,� z e � . C3 5� --� � �. �� .� ,,� � �� - � :� °� ` • �. � �s �� . _� �.��`� ,. , �, i� . ��i �� '. �f� ' �. � , � ; �_ �� °� � ��.. . :� �A?�� . � �� f-. � � � � � � .,.a � � 6_!l f�'4°' ,� � ,'. � . � � � � !r'a , , te�` �� '�'' � �� 1 J � � � _ �.. i` - � r T � � � r=.. � f ..�. � �% �� ,__(� � � �.� ,' � �� e ' J �.�� i �"H�.. � � � ! ; i�j y;.. _ f"� � �,.l� f . � `� _ � �� .� L �+"0 ) ! a �' � � ��t�� 'p � d '_: �"..d� � � �. 1 ! „'. : '.a . --. �.. � �, 1 .4> • � ..: } . , � � "� �i .� � � . d: � � � �y�,P�y � + $\ V � ,: ne�-:.: ._- ;... . . - v'""a� . ,ti � �,, a . -.�,�, „�'' � * � "�� FOR CERTIFICATE OF SURVEY �.ri�r �' om�.�- , Inc � p P`E' , ��PR $3 2��g � � � _ \4"Io d�S � b � � , 32 � \ \ �s O,L - , � .\A' � � � �� r � b � �,X3ei,IGS � � i.�r w ao � � o � + o, . � � O �_d � � o � I �.� � LL � La 2 . . 4 z. � � , � � j � is a!� ` � I �i� dh _ »n nn T— - ,�; RD. Ni •� _, �-15.00, -/S � �. � I � Deno+es Iron Monurnent � ,R,, •� � � , a t. I l5 � 25 �, I L ::. � � � � � I� d p � I�W r Q I � v �, I 7 d z h..; � � IS � � ' ' ZS Dcscription: Lot 1_, Bloek 4, RICE CREEK ESTATES, Anoka County, Ninnesota. �ou�n �' �'oun trc� c�urc.�ec�or3 Lai�d Survcyiny • Site Plannlny Civil Enyir.�eering 8816 70th Av. N U 94 at Boune Av N i Br<�oklyn Pa�k, Mfd 55428 Phone 533 7340 a . <: t r � Revised 12-1-`IS To Show Founaa-F�ioti �F�- lace I t�ereby certify that this is a true and correct representation of a survey of JoU N��, the bounda� ies of the above described land and of the location of all buildings, 205 if any, thereon, and ail visible encroachments, if any, from or on sai�1 land. Book - P�jge As s�irveyed by me this ___ _�_'t�l____ day of ___A�r11 , 19?5, 8 -�9 --- -- --- _ -- . _ -�-�-�%✓�,c-�-a -� _ _�, -�1�-3�-- Minn. Reg. No. �0�� 5c:aie I" = 40' SUBJECT City of Fridley AT THE TOP OF THE TWINS g � I L D I N C� P E R M I T i � � � � ` ___�_�_ COMMUNITY DEVELOPMENT OIV. r � L � PROTECTIVE INSPECTION SEC. � '� �""1 � CITY HALL FRIDLEV 55432 NUMBER AEV. �""� � �'� 612-571-3450 910-F15 JOB ADDRESS 6190 Benjazr�in Street NE t LEGAL LOT NO. BLOCK TRACT OH ADDITION DESCR. 1 4 Rice Creek Estates 2 PROPERTY OWNER MAIL ADDRESS Steve Mokita 6190 Benjamin Street NE 3 CONTRACTOR MAILADDRESS Mike DeMax� Construction 8401 lb6 Circle NW. P 4 ARCHITECT OR DESIGNER MAIL ADDRESS 5 ENGINEER MAILADDHESS DATE 9/29/93 ZIP PAGE OF � � PHONE aai..• .�_"._... "—' _ 2214� RECEIPT NO. � ( � ` APPPOVED BV SEE ATTACHED SHEET LICENSE NO. UCENSE NO- PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW � ADDITION O ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct a 12� x 22�.Li.vinq �f,ddition and a 12' x 22t Garaqe Additiarl 9 CHANGEOFUSEFROM TO STIPULATIONS See npta,tions on plan, Variance #�3--04 approued 5/4/93 to reduce sideyard from 17.5� to 15F, �� efore digging call for all utility locations REQUIRED �By � AW TYPE OF CONST. OCCUPP SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OH AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTEfi WORK IS COMMENCED. N0. DWLG. UNITS I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UATION ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $14� 784 WITH WHETHER SPEC�D HEREIN OR NO . THE GRANTING OF A PERMIT DOES NOT PRESUME � GIVE AUT TO VIOLATE OR CANCEL THE pEpM1T FEE PROVISIONS OF ANl6' OTHER STA R OCAL LAW REGULATING coN- $162,QO SjRU��T�qqQ R TH PERFO MA F CONSTRUCTION. . /�� f� �/ / �� PLAN CHECK FEE %\ �( j s Licens�e SC $5. QQ CONTRACTOR OR AUTNOR12ED AGENT 1 `r' GROUP CU. FT. f PARKING GARAGES �7e3� AC CHARGE Fire SC $14.78 DTAL FEE $189. 17 THIS IS YOUR PERMIT , � �� qaTE ivEw ADDN AL1'ER Cl � tl conSavction Aadres.c: � ��o�: Owner Name & A Co�t�rador: '� � Ad�ress: CITY OF FRIDLEY SINGLE FAMII.Y AND �DUPi.EXES R-1 AND R-2 Building Permit Application �D �� ,��« Effective 5J26J93 �. C�-��-t� s lr�ss: � �i�. v�- � � �� i � �. Tel. # S� 2-� / �� / � M cc�S.S � o d��C� �Gfi �,.� MN LICENSE # �� - �. (� L� ~ � c' c.�,,� � W �� l� Tel. # �l y! � � � �f �--- Attach to tY�is application, a Ce�ttificate of Smvey of the lot, with the proposed cons�nucticKt drawn on it to scale. � �0 �� DESC:RIPTION OF II1�R0�'�?11�ENT LIVING AREA: Leng I 2. Width �-. Height Sq. F� � GARAGE AREA: Length I� Width ,� �.- Heaght �. Ft. �, c, DECK AREA: i.angth - R�dt�t. HgtlCround Sq. Ft. ; OTHER: Corner Lot � Inside L� j Ft_ Yd Setback Side Yard Setbacks Type of Consbruction: ° ''� Estimated �a►st: $ Apprax. con�leaon Date_ > - q `� %¢, 7 ��, �' ��"- (Cos� � Back) Driveway Gurb (�tct �V'xlth Ne�ded: F�. + 6 Ft = Ft x$ _$ / DATE: � � APPLICANT: � S Tel. # e{ I�%�� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewe,r Maia Charge TUTAL � I ��<t�C_� � / '`-/- %� � 7,�� $ --° � � , �;��, $ $ $ $ -- �� >, ±�. .�1. _ . ' ! .i_ �1 / !� ��Z ��-��"� �� .��, sT i� Fee Schalule on Reverse Side �' ��i�d�� .U01 of Permit Valuation (I/101h�) $.50!$i,000 Valuation $750 pex SAC Unit $5.00 (Staie Licensed Residential Contra�) Alt. "A" or Alt. "B" Above Cons�vation Plaa Review $450.� Fee Determined by Eagineeriug Agreemeat Necessary [ l Not Necessary [] STIPULATIOPTS: - , � a � ....�c �-�l�-9� 1 �� 0 ; � � i c � :�� ;i � :�• .r� � The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for azry addition to any existing bnilding or strucdue, or for any alt�ration or repair to any existing building or shuc�ure, upon application the,refore, require the payjm� by the applicant for such permit of fees to the amount herein below set forth and in the mann� herein provided to-wit: TOTAL VALUE $1 to $500 - $501 �o �$2,000 $2,001 to $25,000 � � $25;001 to $50,000 � $50,001 to $100,000 $10(?,001 io $500,000 $500,001 Co $1,0OO,OQQ $I,U00,001 and up �� $i5 (Minimum Fee is $15 plus svrcharge) $15 for first $5U0 plus $2 for each additional $100 or fraction thereof, to and including $2,OOU � $45 for fust $2,000 plus $9 for �e�ach additional $i;000 . or fraction th�eof, to and including $25,Q00 � .$252 for fust� $25,000 ples $6.50 for each additional $1;OOQ � or fr�tion t�eof, to. and including $50,000 - $414:50 for first $50,000 plus $4.50 for each additional $1,000 or fraction thereof, to . aad inclading $100,000 $639.50 for fnst $100,0U0 plus $3.50 for each additional � $1,000 or fraction tft�eof, to and including �$500,000 $2039.50 for the first $500,000 pins $3 for each additional $1,0� or fraction thereof, to and iacluding $1,000,000 $3539.50 for the fiist $1,000,000 plus $2 for each additional $1,OU0 or frdction �thereof • DRIVEWAY DEPRESSION �SCROW (Concrete Curb Sire�s On1Y) � 0 Altemate "A" : Removal and replacemem of curb and gutter only - Driveway width plus b feet times $13.50. Alternate "B": Removal and replacement of curb and gut#e� aad install a 3 foot wide. .� approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERiFICATION OF FOUNDATION Permits for conshuctioa 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 construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has t�en constructed will be required t�fore proceeding with the firaming. ' ` ...� ' .�, � 0o a � ^ x' �- d � 0 _ � � �- � � � �e � � � O � � � .. -�v� _� �� \ � �h � A� �� G�`�. t '1,a � �} � ��.u�ss.��t :v,. � �t`�,. �� , � �� r � c°, '' � `" ��` . �� :, rr, ,1 .� _ � 6 ,�.�� 'j `f`� �,� � � u : �` � , , ��_ � , � � �., � fi s :t; r `;.< "� �, � � � � �' `'��" � �� n �' ,� X ?` _ .� � .3 � � ; �1 v A � ��- �—r�` � . 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I ". � ' - _' .�\ l . _ . . _ V ` r � __ �� - � `� "�_�__._....�.__ " . . , :� �. „� , ! . r /�. /�(a ��t'�' 1 r�f��l i n� J 1�f l' i a CERTIFI�AT� O� �UR�E� :��; � �� ° !'�� +�.� ��'1. r c,Ft _ _--- _._ . L� ' ', ,.�` , 1:' C.. ' � V ` / � �( � - ` � z Pd �x . �---� � - . �� „ R D. /J �O P N' - ' ' � -15.60 • -ts �- I � / ��` $� 2��8 � 'R° �! (!� / ' � � � ' �4o6qS � I .� o � ` � . ,� � � I �5 � , 25 �� pti"- '�' ''.. . s .�°�• . � ' '• � � . � �� •�+- � - �" �r� �.. c • ' ie i! � lr�!' � � r � � Q) � � . I�� y'I �• � �� . � O �� d' V�� ' 7 � �''� W(" QI n1 I ��. o-X; •� i d I— v ►'7� � � : a N Z�'' �" � I + d' - 'L �� •.. Z4 7 d Z) , , F..: �.1.� I »'�� 1 �` e i /6�-�I 5 �^ "^. • a2.6 � IS (�; 120.00 2s ,' �,�r+�e�� `' 9, G � f f / � �..� _ _ � sc�F cLos.�,� ,�� rG; G,r , � ' � Deno+es Iron Mohurnent f - I . � � ,' . ,, . i='�'^i'i,� Lior� : r,o �_, ��locx� 1�, RICE CFEEK ESTATES , Anok�. Coi�r� t:; ,:�: i:nn�•�ota . � j / � ,�.Oci�'i'lra�' C�� ' � � ��.'.� '. Revised 12-\-15 V r � To Show ; �, .S3 �; C�F••• ;'..p G ,r�-6� , Founda�l-ior� In- Icue �.�0!('I2 Z7' (.Ol�/2tP[� I hei�•li: i:�•itity th.it ir::, i; d tru�t .in�l cu��•ct ��•�n...��nt.U��u� ut .i �,u�v,.y c�t �� tl��• iu�ur,�l.0 u•< c.i:r�nr.il:.�e•� t.1r.C� itn•r1 I��.il .uui �� th.• i.��•.i:inn ��: :�ii l�u:hhnt�•,, r' [liL'(��Oi.f '� ��ny. tli.•i�rn�i, .u�J .4i vr.ililc e:nci��u:l�nicnt•,, �t .�ny. h��n� r�� n �.�nl !enel. I.��.�f J��.. �••a� •'i.r, NI ir.�ii•iy .'>> ♦u�•��y��il lr, �IU lii�. �/'�'4"1 �I.�V ut /�pril IY) 7�J, t.�:,l E iu�i��•. r i•.� . � .. - ► ,�C� / � � .1� �f � PJ" Z�S :,��„k ��,:�.� F7 ' �.a� C�TY OF FRIDLEY ,a 6431 UNIVERSITY AVENUE NE � - " FRIDLEY, MN 55432 (7631572-3604 FAX: (7631571-dB87 ADDRESS : 6190 BENJAMIN ST NE pIN : 133024440075 LEGAL DESC : RICE CREEK ESTATES : LOT 1 BLOCK 4 PERMIT NO.: 2004-02152 DATE IS5UED: 11/22/2004 PERMIT TYPE : HEATING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION . NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. # A/C UNITS 0 VALUE OF APPL OR WORK 0 # FURNACES # GAS RANGES APPLICANT CENTERPOINT ENERGY/MINNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304- OWNER MOKITA STEVEN J& LYNN M 6190 BENJAMIN ST NE � FRIDLEY, MN 55432 1 0 AGREEMENT A1vD SWORN 5TATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wor� will be complied with whether specified herein or not. The granting of a permit does not presucne to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Bldg Da� # GAS DRYERS VALUE (FOR MINIMUM CALC) HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 6253 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 2600 0.00 35.00 0.00 0.00 0.00 0.00 0.50 35.50 - " d' S N d�' v > m w a � W CWj � ? �r' W Z � � Q U cn C� � Z W r �� .L 0 � Q � I'y_ O � Z d � � � � W Q O G o.. Z, ¢ O � O � Q �. U a � ¢ Wa --i- V .� W d � � �. V � C ¢ O � w N � _ io' � � W a � � O U L�t,l a � W L � � �o � Z � N Q 3 � w o � S � ,.,, J E � ��! � v O C a��at`3 o .�t s � a� C�o }O U � � O � � L c � C � � � � s aZi � � � d �t�mt�s Z Lu N a x Q� � Z � � H � m m �� O „' .1 V � C �� a� � U �p i � � v � .'.�� " c , � • � � � U � . � a�i''�c '�a',°,c�`c�a Q � C � � H @S = � � � L c �a E� . y `� �� . c c N o ; Y W � 3 � �za � — � H ' � 'O .� � C: � tD0 m � .��, ��!" .� � '.�"'+. U � � ��ea i � N O , N � � n u� n I � � n � d �- n � c;�� 1 � � � � c Q � � •� � 2 �' r � � o. c �" u`� :�0 '� V� �0 fti i LA LL � � 0 o �� J � � � � � � � ,� � � °o, °o, g o 0 m � � � � � O � U a � � ti � � � w c Q � _ �. 0 00 J � _ � q� m � � � c� � u� � co W � � � � 0 ¢ m � c �'(3 � :� t�n a � � v^ �' co co °' � �' � > Z n? ai � � � � � � _ � � � � � v � �a � � � �' a � � � �°n r C) rn �� r� Cr ti i3 �-� �GiTGt •..I TGIJ.QJ.CJ. � � U co . v Lr:. � c ti � a� z nu � � C4 bo � w z c � � ni � ¢ � n� c 0 G a � 0 b � � °m ''' w� � � ° � ,� c �`a ca � � i �,`�� t0 �S m �v !� a> m � o � C �/�i c o � � � � '� �. G i. 'Y ` ti �.Ji L � +4+ '" � 03� � c °� o � � U U O tA t0 m O � � � d H •a � 0 ° ca.� `-' � o � �,QtH � — a�� a=�� '�>� .. �o E.� m o � °'>>> E 5 ° � � � � �° � °' �y � Q ci � � C� e-I � �.a�n t a�-� an �, i t � wna�-� W� t � c O ? f- ' � z � � O � i $ s O � c � � w � � � z � o � U " s z � � 3 b� : T T bE �U � i � �. � j � C � 3 � i� i � � � 'o L : �' � a� � � o � � � . i � � �� , . 'c � i 'o f � � c � o � f0Z-LZ-i � � w .�u 0 � .� no � � .� N 0 �' > G L � C � L � ] � C [ 5 � � � � � �dti 2� ' d �d101 FILL IN COMPLETELV FOR REPLACEMEN7 FUEL BURNING APPLIANCE PERMIITS " COMMON VENT VENT CONNECI'OR AND COMBUSTI�JN AIR VERiFiCATION When replacin� an ezistinq fumace, the under�igned hereby verifies tftat the venting has been examined and is free from n.ist, d�terioration, obstructi�ns, Yes (� and is securely supported and firestopped where required. The venting system is plasticJPVC and meets al{ current c�odes and manufacturer specifications including sizing, length, number of elbows and termination. Yes (� The undersigned also verifies that the replacemenf unit is a listed assembly and meets fihe cucrent codes and manufacturer's specifications. This do�s include AGA-GAMA Category I Central Fumace Veniing Tables for fan assisted and naturaf draft app(ianc�s. The existin combustion air is sized and insta(led to meet the current codes and manufacturer's spec'�'ications. When required to install a new cembustion air,_it will be sizeti and installed to meet the current codes and manufacturer's specificaiions. Yes ( � Yes ( � Yes �, ) When installinca a new ventinq svstem, the undersigned hereby verifi�s that it is a listed assembly and meets the current c�des and manufacturer's specifications. This does include AGA-GAMA Category I Cer�tral Furnac� Venting Tables for fan assisted and natural draft appliances. Yes (� Is the common vent and vent connectors sized and installed correctly a�ter an appliance has been removed from the c�ommon vent and vented separately as per current codes. No ( ) No ( ) No ( ) No ( ) No ( ) No ( ) Yes � ) No ( ) Appliance Tvpe and SizelCommon Vent and Vent Cunnector Information Appliance #1 Type �� B'TU lnPu# �l .t� Fan �lssisted or Nat � Appfiance #�2 Type � BTU Input _"?d�,�o Fan Assisted or Nat �, Appliance #3 Type BTU Input Fan Assisted or Nat Tota1 Appliances Total 8tu lnput r Common Vent Type �1��Vent Height �� Diarneter� inches Appliance #1 Vent Connector Height �ft Length 4- ft Diameter � in Type or Hei ht ft Len h ft Diameter �_in Type � Applianc� #2 Vent Connect g s3 9t _�. Appliance #3 Verrt Cannector Height ft Length ft Diameter in Type ALTERATIONS• (Describe) CENTERPOINT ENERGY MINNEGASCO HEATING CO: 13562 CENTRAL AVE NE BLAINE, MN 55304 SignedBy: Date: �� -d7 �R/�R' �I SAJ.9I.SL Dl J+3�Q 12�.� �D Jll 1� WO�J-� S?. : T t bHOZ-LZ-�1dEi • Buildin�� Inspections 763-572=3604 DA'CE � I S'�O SITE ADDRESS i � THIS APPLICAAiT IS: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY _ t : �, ��. 1�fowiv�x YOUR EA- ADDRESS 9 9 � ❑CONTRACTOR PROPERTY OWNER/ N,�: Se�rn i11�j q.t� n a-� --- TENANT pDDRESS: �o /5 b��?. j 4�►, �..� S� CITY �� PHONE: � l�` g 7 g� l b.3 � CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WTTH APPLICATION STATE LICENSE # EXP DATE Permit No.:� Received By: ^. I Date Rec'd:�D f�ve!'2, cU.^� Annx�ss: crrsr sTa,� z�, PROPERTY TYPE � SINGLE FAN ❑ TWO FAMII.' PERMIT TYPE �rE oF woRx: ❑ BASEMENT FWISH ❑ ROOF ❑ DECK �f SID1NG ❑ SWIMMIlVG � DESCRIBE WORK BEING SIZE OF NUNBER OF SQUARES GARAGES PROPOS�D SIZE: PROPOSED HEIGHT: C C D 9'�'l ❑ HOUSE 8c GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑ DRAIN TILE �OTHER � � �� ;.�� L/h �u.✓1�r5 Lst HEIGHT Z Ft. BASEMENT REMODELdNG SUBMIT: 1. Existing Floor Plan 2. � Proposed fl�r plen 3. List of structuial members to be used SIDIIVG FOR NEW CONSTRUCTION INCLUDWG DECKS, ❑ Vinyl OSoffit ADDITIONS. & PORCHES SUBMIT: ❑��n J ❑ Trim 1. Site Plan/Survey showing the eacisting structures �pther �r ic.�- "� �✓' �y a � o ❑ Fascia and proposed project WIl�iDOWS Z. Two sets of const�uction plans TN EXISTING OPENIIQGS �Yes ONo 1'ION OF WINDOW$ 3. Energy Calculations OR FOR NEW OPENINGS-DESCRIBE SIZE OF �cN ��a� [y n. t r v'�f b��D� �'C, OPENIl�iG CHANGES & TYPE OF WAiDOW TO BE INSTALLED NUMBER OF �✓INDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB YALUATION $ '�'OOII� _�r OCCUPANCY TYPE Permit Fee Plan Review Fire Surchazge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Dne $ ///• ai � $ �;� � I $ ,�i.G� $ �• �?� $ $ $ $ $ $ See Back Page for Fee Schedule 65% of Building Pemvt Fee .001 rimes the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1675 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMTf-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclaiowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but anly 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 ch requir •eview and approval of plans: SIGNATURE OF APPLICANT �� L�'�/' �`' ` PRINT NAME �eln �1 I'(� �iM N6G1 � DATE �'! 5�� Page 2- Building Residential Applica.tion ,� - , BUII.,DING PERMIT FEE SCHEDULE The Chi�f Building O�cia1 shall, before issuing permits for the erection of any building or siructure, or for any ad.dition to any e�s#ing building or stru.cture, or for any alteraxion or repair to any� existing building or structure, upon applica.tion therefore, require the �ayment by the applicaut for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: VERIFICATION OF FOUNDATION Permits for construction will be issued a minunum of 24 hours from the time of application to allow for proper review of proposed structure and of the construction site. A Certifica.te of Survey of t�ie lot, showing the location of the exi.sting founda.tion will be required before proceeding with the framing. New Houses Onlv City of Fridley Buildi.ng Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 � 05/09/07 fiED 16: 51 FA% 651 429 8869 T�E L�PS STURE f� 002 \; ... . . . .�� . .. ' - _ ' -+... . �'i � ` . . ... , _ _ _.. .. ... ��`� _.�`\ . - • i i : .. .... � \ . .. . . . ... . � 6 .. .. . . �a �.. ��.. .. ti� ��.�....�� !� _� ..:.. ___. ' � 91 �._:_. _.. .. � : � . __. . .� . , . .. .. .. .. _... . . �S� � � f' `M � .' ...,. . ._. .. .._. . ' "' ' �':, . . .. � �.. . � . . . .. � % � i. , ...._..i �, . . . .... �..� .. ! __ '� � ...�... ._ __i�`�/ a'�. , . � � l� �_ ._. � �� _._.... . _...__._ -�- - f . - � � '� - _�.. a-��i� - � . ... _ _... '.. .._.. _ �. _._._._._ �� . 4�_. .. .. . ' . . ._... , , , . .�� : ; . ,� _..._�. . .�_.._...._. . 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