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AF - 36524City of Fridley, Mi.nn. 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: —December 29 , 1972 ��; Richard Miller Homes B,,;laer _._..._. SAME Adaress �S.Q.Q R i c e C r e e k Ro a d Address ._..__ S�E �11940 � LOCATION OF BUILDING No 6165 S�.�t Briardale COUTt _ part of Lot - -._._.� Lot 4 Biock �..._. 3 ��__..._...._ Addition or Sub-Division ._ B T 1 S T' cl a 1 e i�^_�_ � ► � Corner Lot .__..........__..._ Inside Lot ____....._X_.--_-•--...__ Setback -•----._3.5...........---.•---_ Sideyard .._12 . 1rid. 13Y.YVy� J ,�Elevatian 908.75 �� __ 911.75 Minimum _.._..�._.___.._. -------.--------- .__._____ -W--ye Tnn of Footi ng DESCRIPTION OF BUILDING zo ue v�a �: Dw e 11 i n g .� Front �1 ' Depth _2S�'.._ xeight .... 2_�_'_._ Sq. Ft. ._9 6�.__ cu. Ft 19 �2 4 0 a a g� ._._._ Front ? 1_ l�. Depth 2 2�_ Height .---1 �- t-----• Sq. Ft. ._4 6 2--- cu. F� _ 4, 6 2 � Type of Construction �WO,Q,�.. FTallle __ Es� Cost �3 � i.0 �.� _..._.._.... To be Completed `JUrie 1_9 % 3 Y� STIPULATION : Provide a hard surface driveway. Provide a verifying survey before capping. Storm sewer escrow due of $315.00 when water meter is taken out. f WATER LOCATION: Stopbox 10' South of Sewer SEWER LOCATION: "Y" 114' S. of Manhole In consideration of the issuance to me oE a permit to construct the building described above, I agree ta do '�he Proposed work in accordance with the description above set forth and in compliance with all provisions oP Ordinances of the city of Fridley. � '- --��- ' ' - In consideration of the payment of a fee of $�.....�..Q_._...__., permit is hereby granted ta._R1..Crlax.c�-.11'L7.-l.l+� P Home s ••••._._..__._..._......__._.._.__ to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done m, around and upon said building, or any part thereof, shall conform in all respects •to the ordinances of i;iidley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings yyithin the city limits and this permit may be revoked a t any time upon violation of any of the provisions oi said ardfnances. ��✓L? �E' C X �� Building Inspector DARREL CLARK NOTICE: This psrmif does not cover the construction, insfallation fo� wiring, plumbing, gas heating, sewer or water. Be surs fo sw �hs Building Inspecfor for separate permifs for these items. ��,� � - . _....,_..-r�-- ----� - . . ..._ ,,,., ��r��r�%�iii �p„� ��,..Y,�y �i« ii��E�irii< ' . So�lti Te,t�n0 /� (/� ��`�• C�v�l Eng�ne�.�ng � Mu^'�'p°1 F„9�^rr"ny �' i]��I]BeT$ d�c Surveyore ee�s H�y►,wur Na. �s H. t Minneapo��ti , Minn. 55�3Z Trlephmne 7�e-6060 •rw Codt 612 Certificate of Survey for ,��.-,� a��'� ��h' _�Mc'-s �t �1 �' �� '" � ,1 �; <> � '�.. �� _ ' � _ = ii . - � F� _ .� `a1 , � C O � � , �} ' f S 1' �2:"—° �+ �3-. �; , � � ' {-..._y= _ . .�. ._._.�F,j,� �, I t� !J" � � ' � � � i �1 � �N R� A �O -- r - .�!- r �- �� i � :. , r: �w i � ' .� y _,�A�–_��– �'_ _ — C� i l yf. 2' -i% j` % � � t - 7 i 't � �. � � �—_ -� N OR-T N � �a. `v : ' . I� I I O � � � � � ` � K J �OT :�� C � �IA DALE f ` t ,�. `. ,/1; �,;IQr �f�Jfi fTlJfluf'(1111? i ��,1'10�0 Qun�Y 1 ` I l [ 1 .� --- - - --- �;Jf:�TOi ��V�sl�dt t �t�l�`V `Otirm:�1T 1 h�rrbr cart�iy tha� �h�► rs� o frue a�d cor�acl r�preaenlaf�on of o tiurrey ol the bov�da•ies of �M�e abo�� d�ticr�Urd la��d, ond ol �he loc�rion o1 0�) bvild�n +� eh�.eqn, pnd all vis�ble en�roothn+en��, �1 any, lrom w o� s�•d !ond. 4� •�rv�ysd by m• ll�if doy of_�i .•. �/� �A. D 1V_ �. Yi-' ' l � � , �nCF', e /� ?C 1 _ � _�.� _ - -- - 1 •--- SU�URdAN ENGINEERING, INC. fn��net►f � Surv�yOrf t: r.�..'�._�� `L�. � ('_� t'�_. - . Ma�c,-r-. ----- - -�..T.._._.�. . _ -_---_..,.� _ � � � � �� , , `/ '� ( � Gi � S 0 v �` �/ d /= /l�, /� � � � ' , �' ,,' � �°'� � !� !'/, �' � � �T S" � G�� U(� � G e� P o�� G.., „. .�� . ; := �. r.� � - ? � � r � � � ��- i �f v r 9' _ �- I' U� G (=- �� , �c � � Q� O � s" `''�' %{- �'7� J � /2, S�O�' l3 aX �� j�iU � r.� �� ;�r.v�-�� 0 0 � � �:� , .. , ; _ _ . ti APk�I,ICATIfJN �QR RE�IDENTfAi�. AI�TFR,ATIAN, QR,.ADAITION �UILDING PERMIT �ITY QF FRIAI.�Y� MiNN�soTA � :� � • , � + :�' � � ' � ►� a� . � .. � �DA�tESS: ADI�tES3:,j�aUO �ic� C��tc (�a,. ^,�°t% �Q3 ��n �!o S ST�E�7� ��21,��4�..� � 1' U►� 1 .. � ��/jq�1 �/�/�y 3 AAAITION t f3 K I.Q 12 �4L.� �4M1%�.�k� �I e � 1 �LV�/Ai !T CA�NER LO'� t �1� � LO'� :�CX , S ETBACR t 3 5� S I AEYARD :!Z � I�'-1- ��i�t�t �t�',ad� �p t�� „ia Certificates of Snsvea„r of Lat atid propp�ed 1�ai.lt�#ag �.+�tior� dr#�a ou t�es�e Cartificates. � ��SCRI�TION OF BUIi,i1ING 9�a �e if�s�d As : � � Fs�oat3 3 � ` �+th : 2SR ` AeiSht • 2� � squase Fe�a�:., 9�o z cubi,c Feet: . �,.5 z4-C� ,. �rcntts •zi' Depth, 22' Height: f0 � . �� Squa�s �eet;� �.G Z . Cubic Feet i 4-toZO ,,. . 1'Y{� of �oa�truc�io#�; �C1,� Esti�ated Cos�: $3C�CX7�' � �� r�areds �—( - 7� w �■ • • ^ i i '�het ttm�I�i$x�ed hereby aask�ea a�licativit for, a pe�ai.t for the waxk hsrein �ps��ied# 8��@E�!!� t� it0 all Noi'k in ett�ct accordance with the Ci.ty of �`�'l.d��r' Qx'd�i'�a�� d s�uli�s �f #�te Departnten� qf Bu�ldin�a, as�d hereby �lalaxe� � all �h� #acts a�d ��resenta�ione stated i� Xhia appl3,cation apCg �lue a�d ca�rect, . �i1T�i; �e c . 2fo 1 Z BIGNATURF: s �,� �.�!�El'� �*�-�c� � . � . ... (Btt R+�vssos B�de FoY pdd�ti,onetl Infox�atian. ) � ..v � � � / „ ✓ .r� '� . . i : r , � �` r' , ,�- � �3 ,� -�....,..,,..._._ 1 �� a BUII.DING P�RMIT F�� S�H�DUL,E S�F�T�p�1 2. The Inepect4� pf �ui.ldings sk�a11, before i.asuing permits for the �x��ion of any building ox structure, ox for any addition to any �xisting 1��i�di�g ox s�ru�ture, ox fo�r any alteration or re�aixs to any exi��ing �°.�a�.��.ng or stxtacture, upon �pp].i�ation therefore, require the payment by the �.r>��3��-Cai�t fP� such p�x�mit oi; �ees �o the amount herein below set ft�rth a�d in G�e mannex hexei� provided �o-wi�: Ulai��ORM BU�LDING CODE= Type 1�, 2& 4- $2.15 far each azte Zhousatrtd cubic fe��, p�' f7�action th�xea�s in s�t�ch cubical con�ents. Type 3& 5-$1.8,5 �or �:ac� ons �h�usand �v�b�.c �eeC„ � ��D�TIflNAL INFi3�tMATjON Fo� t�� puxgose of �ampu�ing fees for building pertaita, the cubical contents o� any building or addition, it1 determi�led by mul.tiplyin� the ground area s�ova�ed �7cQm a�oi�t� six (6) inc,hes below the f].00r 3.ine o� the basement p� tbe Cel].ax' �o the average heights of the upper surface or to the average� �i,�bt csf �he �oo� r�uxface o� �tte main gab�e oft a pitched xoo�, �`ax �aixs ox alt�xati,ons fio aa existin$ structure, t3�►e f�e shall be a� Ghe s'a�e o� $3.t10 ger e�+ch f�.ve h�udxed dollar� ($�00.�?4) otG fra�t#.on thereo� in �Pw CAA�.' �,�. +El�� i'Q�Mi�9EC� jVU}'�Lw I� �c+ case sha�.1 �he iss �sd fo�c auxy pez�it as set �o�c�� .�. Se�tian 2 be l�at t.}�an $5.1i4. � V�R��ATiQN �� Q�]NAATIGIN D141�� Pe�rm3ts �P� ("+r�IiSX��Pll wil�. be is�ued a tw�.ni.tmim o� �4 i�ours ��a�n the .�3� a� app�icatf.c�x�:, tv a��ow �ax Prage7� review of �he px�oposed a�ru�ture arid �,� �e t�rtx'uction ,si�e. ' ��'��,�i� Sul''V�y n� �be lttt, a3l�ing ti�s locat�n o� �he faundatia�, ox�e �� b�� r.�tists�t+�dw wiil ba sequired be€ore proc,eedin� w�.th �h� fr�i�g, , C�RT'TF � CA�'� Q� �C�i�PANCY Appl��atira€� �ax a Gex�i.�i.s:at� a� Occupancy ehal�. ba made tea t1Q) da�� pxi.ox to �ha ��e p� �4CGLlpaMj� �� ,any �tr�ckaxe for which a bui.l.din� permi� has bean iss�te�; �tc� �ai.d s�uc� #�hail, �ot be used ar occupied until a Ce�tifi.cate af p��ug��acy ha� bee� �.�sued. 0 0 560-3450 ,,,. � a�� %� /D ':, ^r ,� -� l�l�� O �Nl Gi L e -��-�'' � � �� . , :i ��_�,-� , ��„ -J' I,� ' 6431 UNIVERSITY AVENUE NE �� TO WIiOM IT MAY CONCERN : ANOKA COUN7Y December�9, 1972 fRiDLEY, MINNESOTA 55421 Whereas the City of Fridley has issued a building permit to construct a s truc ture a t G,/ �o�S .�z � cz i cE a C� � C��u-2�`, Whereas the permit is dated prior to January 1, 1973 and the City of Fridley did not collect or receive any "Service Availability Charge". Therefore if for any reason the Metropolitan Council and or the rletropolitan Sewer Board assess or bill the City af Fridley a Service Availability Charoe for this structure or sewer hook up, we the undersiQned aQree to and will pav the City �f Fridley for said charges. �� Witness % T tle �e►pplicatioe �''ow�r Ptan�s and HsaHng, Coding, Yentilation. R�ig�r�afion and Air Conditioning S�s curd Devic�s PARTIAL RATE SCHEDULE (�RAV*TY WARM AIA: �� T�u, lh�rnace Shell dc Durt Work . . . . . . . . . . . . . . =10.00 � Replacement oi P�rnace . . . . . . . 6.00 � Repairs & Alterations—up to =500.00 g.pp =___ _ .___ Repairs dc AlteraUons each add. =500.00 . 3.p� ___ ___ __._ 1[ECH. WJ1RIrt 11IR �trnace Shell & DuM Work to 1�0,�00 BTU . . . . . . . . a10.00 ;10. 00 each add. A0.000 BTU ............ .. .... 3.W i RePlacement of Ftirnace 6.00 � Repairs dc Alterations--up to ;500.00 g,pp ; R.epairs & Alterations each add. =500.00 3,pp ; STEAM or HOT WATEA SYSTEM Furnsce Shel} & Lines—to 400 sq. tt. F.DR Steam �20.00 s ______ F�rnace Shell & Line--to 640 sq. ft. EDR Hot Water I0.00 s- Each add. 200 sq. ft. EDR Steam g,O(1 �.. _____ Each add. 320 sq. ft. EDR Hot Water 3.00 5-- OIL BURNER—to 3 gal. per hour g,pp = __ over 3 gal. per hour—See Fee Schedule GAS BtJRNEA (up to 199,000 BTU) wer 199,000 B1't7 sse F« Seh�dul. GAS FITTING FEEB: lst 3 FSxtures _ Additional Fiatures _ Gas Range to 199.000 _ b.00 ;_. .00 Ii0 AATE TOTAL _ xE Z00 i�—��Q _ x .76 i - :i 6.0� _ — D.yt. of BWys. Phon. s60-3490 . . .: - . �� t' � City oi il�idley: The undersigned hereby makes application for a permit ior the work hereir specified, agreeing to do all work in strict accordance with the City Ordinance: and ruling of the Depai�tment oi Buildings, and hereby declares that sIl the facts and represerrtations stated in this application are true and correct. F1�idleY, 7K'snn_�lg.�� l9%� ... 1! — owner Richard Miller Homes Kind of Building .___. fY'�@ rlsed as __._ _ _res3de�1t�1 _---- To be completed about _____Q��Q�%�_ Estimated Cost, a..��.QO______._____ Old—New. Building Permit No. _ P�rmit No. �Q UV DESCAIPTIOIf OF WOM HEATING or POWEA Pi.AN15�4teatn, I%t Water, Warm Air—No 1 Trade Name WESTINGHOUSE Size No_ FG�7 Capacity 110.000 gq, �. E.D.R g� gp Tota1 connectea Loaa�•182 K{nd oi lh�et Gas BURNER — T�ade Nam� SA� AS ABOVE Siu No CaDacit3' 3q. �'t. E.DR BTU i�,p �p AIA COlEDI'l70IfI11G WEST i SIA-3 ( 3 ton-1200CFM) �,18 .00 ��N = John Borry F�►x r�►rixc sya�w s« F« seb.an�. COPY OF I�AT IASS ATTACHED. vEx�LArixc aYSr� � . 5o sURCH(� ALiER1►TI017S � REPAIAS ?OTAL FES = i 5. 50 Si�.i ; i, , �i � Hs � �-- ' —� � �, �, �.� , 'ROU(}H � Business No FR� VOGT ' - FINU l°� -� 9' 7`� FRED VOGT & U �'� �'+erham : ^ ` • �IEATIN6 & AIR CONDITIn^ �Lo�u Pa,R , (REMARKS—OVER) �Z60 Gorhnn Ar�, • q2y ., .�/{,)r22 � iatlN Park, Minn�so�a � _ r , 7 . � A _ �i / / : t .. � t •`... �`� f �... � � /� HEAT LOSS CALCULATIONS ,' . '; � � '' � � � �� `� �` % ,"� J'� �- � R �, ,� i � i � - ,.,,,., Weatherstrips �•S.H.V.�. Construction No. Insulation _ Guide _, Windows � Daors Reference Out. Wall Int. WaU Ceiling Roof Floor Kind How Applied Yes—I�to Yes—No 19_ -, ' FI. �.- Rc>om L.an�th Width `',�' Height `" F'1.� ;'` %:., Room Length ,:!_`% !'dlidth,�,__ H Windows and Doors--Cracka�e and Area Windows and Doors—Ceackagc and Aaea �Vldth HeSght Ao. ot Ltneal ft. Area �. Wldth Helght No. ot Llnoal ft. Area No. ot yane ot cg�e lights ot crack eq. tt. � No. of Dane of Dnne I1ghL � of cr¢ck �C. tt. r� -j .. � P"1 , r..-. . �t' l : - �f�'� :�•_ . COGf. Inhltration ,�� . Glass , �.. �. , £xp. wall � ' Ntt exp. wall �' ., ° - , Int. wall Ceiling , Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. L.eader area Fl.] �to�m! Lea�th � � Width %.� . Windows and Daors--�rackage and Area Width Hetg6t Iro. oL Llneal it. Area No. of Dane of pane lighta ot crack ap. tt. �r ..- ,E 1 �' �- _ �' Coef. ; lnfiltaation - ' ''. t' Glass � � �' Exp. wall i' r? � rv Net ezp. wall ' " �' InY. wall Ceiling �i <-' _ ,_. �- •x{- F1ooa � - - Total Btu. � Required sq. ft. E,D.R. or sq. ins. W.A. I,eader area �'°"' F7. ;; _:' Room L.ength j� Width i' I Winc�ows and Dooza—Cracicage and Area Wid[h Hafght No. of Llneal [t. Area { No. o! pane ot Dnne Ifghts ot crack ea. tt. � _.. �- ._- . ._.. � , - l.'Jl..._ //._ Btu :.. l' � / ;l ; �' ,f Heighc '-' Btu . �, . ;}:r ,; ;� _� . �� ` �.; i � � �� ,► . i Coef. Stu Infiltratimn �°� i ' .;i ; D � l�i ��53 � , �,. } . '.. FJ:p. W�B�� 1 ° f � , _ Met ea�p. waii � {�a. �". -?' �°- �� ,- Int. wall CeilinS . . ,', /;'i -, ;/ 4� f' IOOi - Total Btu. ,_; , � �.` �eguired sq. ft. E.D.R. or sq. ins. W.A. Leader area .% :' FI. - Room � Length Widch /_ He►ght :. Windows and Doors—Crackage and Area Wldth HelgA[ t:o. ot L1nea1 tt. Aree ?do. of pane ot pane Ilghtr ot crack ery. it. . �. _ i . � . --- ---' - . _ ,_ C�ef. - . Bit�'- 1n614sation - �a,_ / .;:� �-;' i C,tass i� - Exp. wall % �:M ' , �,; lolet exp. wall : % `-� i- " Int. wai9 Ceiling • ' � . � ` �" � . l F loor - _... Tota! �tu. - ° � �,.� a:, <�r . Required sq. ft. E.D.R. or aq. ins. W.A. Leader area � � Ca Infiltration � Glass ,�' �` Exp. wall , r�. , �.� ;� f- f^ Net exp. wall t � Int. �rall - Ce�iing ,� �^s . r r FlOOi ' Total Btu. Required sq. ft. E.D.R. or sq. ins. Q/.A. Leader area ":> Fi.l' . Room I I-ength Width `� Windows and D�ors—Cracka�e aad Area Wtdth Hetght No. of Llneal P[. Ares� No. of �ane of uane )fahto of crack sa. tt. i�ht -�: �iu ' �r /] ('�t, . : :� - ; f„ � � .. .._�-: � �,oet. tstu � Infiltration _ /; . ;. ,� ,� Glass � Exp. wall Net ezp. wall Int. wall Ceiling -i �% /�� i �r� ?%._`� �I Floor � Total Btu. ^ � `�' ��,%�.�: 4 Required aq. ft. E.D.R. or sq. ins. W.A. L.eader area ' FI.� `� Room I Length � Width % Hsi�ht �:;;';I Windows and Doors—Crackage and Area Width Heleht No. of Llnea) tt. Ares i No. of yane ot Dane Ilghts ot crack �Q. tt ;_} ,.. �.. .. ..� j i A .� �(. . .. '- ff; �� % .f, / Nrj ; � Ivy� � %��'` r.� ' . ✓`', 1� Y f tf _ Coef. Btu Infiltration �?' i � . � J . „y , . Ci�853 `' '=T� � �, �� '. Exp. wall /;; ` ,- �� Net exp. wall �� J �°, " Int. wall "� Ce'tiing _s` � Floor � �'=� � Total Btu. �-;, Required sq. ft. E.D.R. or sq. ins. WA. d.�eader area f' � � Fl•�, ' Room I Length ,� ; i Width ''�i. Height :� ." Windows and Doora—Cracka�e and Area • R'ldth Helght No. ot Llneal Pt. Area No. of yane ot pene Ilghts ot creck eo. tt. Coef. �t� In6ltration . , . _ . - /:, . , Glass - ` E�cp. wall ,,a � ` Net exp. wall .� �`_. � � :. Int. wali Cei�ing Floor ��,,- �s: • �' . Total Bia ,�;�- ,,� � Required sq. ft. E.D.R. or sq. ins. WA. Leader acra �� .. -._. _ -• ;. �._ � . � � HE�T iGSS CALCULATIONS ' Weather�rips A.S.H.V. . Con:tructioa No. Guide ' Wendoyrs Doora Reference Out. Wall Int. Wall Ceiling Roof F1oor Kind Yes—No I Yes—No 19_ j Fl.� -- Room Length f / Widch / ?, . Heighc ':�% / FI.� �. / j • (ioom 1�lindows and Doors—Crackagr and Area Windows and Doora—Cr �L'Idth Height No. ot Lineal ft. Area Wldth Helght No No. ot pane o[ Dane itghta of erack eQ. ft. No. ot pane ot pane Ifg =`r� ��' �� % � � � ��. ..� // /� �� c `-f t '-? �� - Coef. Btu Infiltration ' ,� < i �ass �-� `' �� 'n `r � Exp. wa11 � ° � x"` ,1 � Net exp. wall " % � • � , -; lnt. wall Ceiling Floor ` - � l ,� F�� Total Btu. ;� ;,, ,,� _ Required sq. ft. E.D.R. or sq. ins. W.A. Leader area •' Fl.� �' Room ( l,ength =% Width ;i ♦: Height .e Windows and Doors--Crackage and Area Wldth Helght IVO. ot Lfneal fL Ares No. o[ yane ot Dane itghu of cnck sq. ft. 1 � _ `' ` ,1� r-- l':: Coef. Btu Infiltration _ -%'F- �t %�f Glasa l9_,� _ � , • ;.�,� Exp. wall R' - , `<< - Net exp. wall � _ ,� � ;'; ' : � '�r Int. wall " Ceiling Floor , - ,- �otal Btu. � �� Required sq. ft. E.D.R. or sq. ins. W.A. Leader area � ,' FI. , ' , �, . , Room L.en�th : ' %� Width , -',: Height " Windows and Doars—Crac6cage and Area Width HefgCt ho. at Lineal tt. Area No. ot yane ot pane itghtt ot crack ea. [t. �„G�!'" � r � i � �J r �. � � � ,',�_ ' � _ x_ � ' :~% i�• � � ' Infiltration �853 Exp. wall � ,� ' Net exp. wall Int. �✓all Ce��ing Floor Totat Btu. r ��' u - � Insulation How Length .r, Width / ackagc and Area . ol Llneal ft. Area hts of crnck �Q. !t. / �� f � � �, !;��f� � ;equired sq. ft. E.D.R. or aq. ins. W.A. I.eader area , FI.I . �' `,---' Room ( Length ;�'- Widthj '�? _ Heig ��s Windows and Doora—Crackagc aad Area Wldth Helght No. o! Llneal [t. Area o. ot Dane ot Dane tlQht� of crac4 eQ. tt. ;� , �.,.. � -1 / �.�' (i � ;� �� - �; :a ��... � I ' In6ltration Glass Exp. wall ';' ^ � �Net exp. wall /� Int. wall Ceiling Floor � � /C� .i �' I �:�-��,,:. Tota! Btu. K-� �:� ' Required sq. ft. E.D.R. or sq. ias. W.A. L.eader area / ; -� F7.) ;' . - Room I Length �_ r�-� Width /' � Height s; '„�,: Windows and Doora—Crackage and Area ; 5 Wldth Hefght No. ot Lineal tt. Ares � -�� No. o[ yane ot Dane Ilghts ot crack eQ. tt. � , i � -., � a- � � Coef. �tu I I Infiltration ==:'- `-� ; �. � '" In6ltration Glass � ,-�+- �,� '� � � � �=" = � . Glasa Exp. walt .' ' ' �-� �'' Exp. wall _�? �' > ,.�',�. Net ezp. wall � _�'� �� !•� ;,-� -;" Net exp. wall �:' ; � Int. wall ' Int. wall Ceiling � �� `' `' ` f' Ceilin � := � S F loor - �y� ,�' `�., � . Floor TOidI BcU. Required sq. ft. E.D.R. or sq. ins. W.A. L.eader area � Fl• ' ' " Room ( Length ,!° __ Widsh ;`'" Windows and Loors--Crackage and Area R'Idth Helght No. of Llneal tt. Area No. of pene ot pnne Itghta o[ crack sQ. ft. � � i I �'� f _ , . � .! ;,:�� Total Bt�. ..� r) Required sq. ft. E.D.R. or sq. ins. W.A. t.eader area t>.` `.- I �,I Room I Length �-- Width Windows and Doors—Crackage and Area Wldth Helght No. of Lfneal [t. Aiea No. ot pane ot Dane I(ghts ot craek sp. tt. Coef. Beu Coe 1n61teation ,._; � " r % Infiltration Glasa i.,, �- .� ��. � � ` Glass fxp. wall � I' E�cp. wall Net e:p. wall /�'�% °`�� ,,� ,� �- Net exp. wall Int. wall Int. wall Ceiling i� r �%� ��:; �� Ceiling Floor �-•� �� Floor Total Btu. 'f 'J' Total Btu. Required sq. ft. E.D,R. or aq. ins. W.A. Leader area . Required s ft E D R q• •••. or sq. ms. WA. Leader arei Btu ,. :is�6t Btu � City of Fridley APP�ica�ion i�or Ph�nbing and Gas �q heed� Aept. of Bldq�. Phon� 380-3450 DESCRIPTION OF WOR1C L�� 'j �j�s� ��` AA n� �� . �� ` Numb�r, Kiad aad Localfoa oi Fixlures ��1 /"E/� 1/ N • � � Y� ° !;� � s� � � ;� o� � Base / / � � lrt � 2nd 3rd 4th • Fu:hu� Coaa�ctba Op�ni�s • N�w Fixtur�, Old Opatit►ys ..t ` Z I Z Z Q� y� _ • • WATEN MTR. �S a i3 '� � 3 �� V ��$ / M GAS ELEC. PARTIAL RAT� SCHEDULE 0 s....: ❑ Ccsspool j–j PC.IIMBING FIXTURE RAT£S: NO. R1►TE TOTAL Number Fixtures . . . . . . . . . . . . . . . . �� x a2.00 a :>� J C Future Fixture O��ening . . . . . . . . . . . x 31.50 j New Fixture Old Opening.. .... .. .. . x a1.50 ;_____ Catch Basin . . . . . . . . . . . . . . . . . . . . x a3.25 3 / , ` �- Water Heater 'Up to 99,000 BTU) .... __L_ x 53.00 ; - New Ground Run Old Bldg. . . . . . . . . x �3.25 $ Electric Watu ii�at�r . . . . . . . . . . . . . . s :2.00 = �AS FITTING FEE$: NO. R11'fE 'IOTAL lst 3 Fixtures . . . • . . . . • • . . . . . . . . _� x S2.00 •, , � i--`h — Additional PYxtures . . . . ..... . . . . . x ; .TS ;—__ Gae RanQe to 199.000 BTU . . .... . . . . .. x �5.00 � REPAIRS � ALTEAATIOMS--A�tsr to Cod� Deacription . . . . . . . . . . . . . . . . . ..... . . . .. . . . . ... . ... . � 1'OTAI.. FEE ; ''� �/ . '�� z; City of i�idley: The undersigned hereby makes application [or a permit tor the vsork herei specified, agreeing to do $ll work in strict accordance with the Cits Ordinance and ruling of the Department of Buildings, and hereby declares that alt the tacl and representations stated in ihis applicatio� are true and correct ^ Fridley, Minn,� T7 � � ^ � „ 18� Owner ��C/�l� � �'%%` �!4/ � Kind of Building .�,��%�K� Used � 2r��C� �� Y To be compieted about �.� 2 � oQ G� Estimated Cost, a , ' Ai�}--ATew. Building Permit No. Permit No. "��'� � Signed ' %O"!' ��1�/L"7 v QT' By �y' Business Phune No. ` SJ � ROUGH FINAL ��°/r�' %.S 53-8�-s-915.51 Ci� of fTidtey Applic�tioe /or'ivabi�q aad Gas Rtti�q hrt�t _.. . _ n�c- �e sd... n�..,. �eo�.a,so ncscarmo� or rro�ut �Y�[. K� �11i �4t�N � f:�:riP�i w �� t � ��s � I��I�� ?� 3 i� � » �s•;E�, �,��5� �t �� o� B�ac tit � ��i��l � ■�ra��i ' �� . 1 0 � �. • s / M GAS lltC. i..�r C��I PARTIAL R�ITE SCHEDULE ttA�ltll�C Fl=TVR6 MTL1: NC► MTt 70T>L Nmn6as llatutes . . . . . . . . . . . . . . . s Sl,QO i �1ri�e ltit�as (h,e�r�ie� . . . . . . . . . . . i :1.60 3.__ . l�e�r t[st�rt Old Oprnit�s . . . . . . . . . . r il.,W i Cste+e Haaia . . . . . . . . . . . . . . . . . . . . : �.� �, Rater Re�ter ,'Ilp ta M.OSb H'lU1. ... z fi.�00 t New Greund Rua ON Hld� . . . . . . . . • : �.1i !� fl�etate wat� N�err . . . . . . . . . . . . . : ttOp i cns ri�n�c r�a: .a �u►zc raru. 1aE � t�aves . . . . . . . . . . . . . . . . . . z �Z00 �_, �IfooN ll�eltieea .. . . . .. .... ... . s i 7i � Q�r R�ere to t!� Aoo 87'ti ..... ...... 1 : l6�M � 5. 00 State Surchargt • $ .SO �cr:1�s t �u.t�tit'to�ea-�a�t.r ,. cw. � ..................�..........._....�.� �.�o rorr�� 'f � 3 �s "A" Surcharge ,5a � • • � � • ' c�a �c n��ars_ The uadersi�ed hes� matrea �pp�ie�tion tor a oermit tor Me vor1� Aerd = Si1t��i�ld, �T!!{i1j LO d0 i� �Oft �D itl'�Gi a@!Of'�iON! M�i:l tb! Qd Q�'t ind Tulin j Ot LR! Dlpartft�L Oi BYl]dlnp� �m h!flb� d!'d�r!! LhaL a1� tllt iat! : . and t�epsYSentstloos stated 1a tAh appiiealia� are trut aud eorreet �! .a� 9-28-73 is . p,�� Richard Miller Homes _ Kind ot Hu�ldi� FramP< U� � Res. _ ro nc ��a .eont 10-5-73 ��m:,ka c�,. s 10.00 70t��ler►. IIuiId�n� P�rrtNt �r ' ��` �`�-' � O'� �►yi_ , - Sf�ed '— �a��: ��f ��% � Husi�e�s !'`�e � ADDRESS '�'�� _ OCCUPANT , HEAT LOSS SOLD BY '�� Eleetrical Work By TYPE OF HEAT GA HOUSE HEATING TEST RECORD ' �! ° APT FLOOR �' CITY SUBURB OWN E R '"'r� DATE HTG. INST. GAS C0. METER BADGE # � � INSTALLED BY Gas Line By � _ FA - HW STEAM SPACE HTR. UNIT HTR. OTHER ,., GAS DESIGN MAKE �`!�%", � ' MAKE OF BURNER — � Model r'`" ' �' f_, �� . ' Model Serial Max. BTU Rating — INPUT MAKE OF FURNACE . Model CONTROLS THERMOSTAT ''' ' Heat Plug Venf Size Valve � .�.r KIND OF LINER Limit ,� • ' `� '' � ` Droft Hood Limit SeNing •- Filters Size— Fan Setting Chimney Location Pilot Type " Chimney Construction Pilot Make .<� Pilot Model $moke Bomb Pilot Timing��*w"��° D�aft L.W. Cut Off Door Pressure � CONVERSION SIZE NONE Regularor ' Inside Outside Wiring Test Tag Lighting Inst. �= � L Pressure -� °^ Percent CO2 F4: ." Date Tested 1='1 ° y Input CFH f- 3� Percent 02 �' �' Company Testing -' , Stack Temp�: �'� ^• Percent CO {� -''4` Name of Tester Form 235 .—.,..-..,,r,,�-- _ �-�---,r--�-. �-- ,� �.-� �,::� sue�ECr PER lF�itlt1"-- City of Fridley ° f 128'71 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 � v � PROTECTIVE INSPECTION SEC. � � 1 � � � /'��1 � CITY HALL FRIDLEY SS432 NUMBER REV. DATE PAGE OF APPROVED BY ` ""� � ,�� 612-560-3450 910-F15 3/3/75 � � JOB ADDRESS 6165 Briardale Court N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. C� 3 Briardale Addition SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Dr. M. Pastones 6165 Briardale Court N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Panelcraft Incorporated 3615 East Lake Street 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUIIDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION C� ALTERATION ❑ REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Install steel beam - Rough in basement 9 CHANGE QF USE FROM TO STIPULATIONS <,��RAT� PE�ciJi1TS R�Q:)if?EG° t-C'' `�.�'��;;`'� : ,,_ �c.;`1��"tNG, �'l.�l��QIlVG ANL ��GN�. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED 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 COMPLIEO 2�000.00 Z.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE G.RANTING OF A PERMIT $ DOES NOT PRESUME TO GIVE AUTHOFITY TO V LATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER ATE OR LOCA LAW REGULATING CON- STRUCTION OR THP"PERFOR A CE OF CONS UCTION. $ZZ.00 � PLAN CHECKFEE TOTALFEE --� ` _''�-! �'�` $13.00 SIGNATUREOFCONTRACTOROR rHORi2E nGENr iDn7Ei '��WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT �• ' .,Ci.�;.._-� � �-�.CiJ��i .� �' 'i;i SIGNATUREOFOWNERUFOWNERBU�LDERi IDATEI BLDG WSP D E AP.pLICATION FOR RESIDENTIAL, ALTERATION, OR AllllITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA ! c OWNER' S NAME • , BUILDER : G�' ��i( ��' ADDRESS : �� ADDRESS : � � -- �� % r�-,�% //J ' . NO • �' �_ STREET • I� cGL�►^� �%l / � Ci�' / � � � ` LOT: BLOCK: ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form �ao Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As : HESCRIPTION OF BUILDING Front: Square Feet: Front: C,,� �, ^ �� Square '��'� � .�� J � � ��Z�pe of Construction: a��-- � s To Be Completed; � Depth• Height• Cubic Feet• Depth• Height• eet; Cubic Feet: �� - �`"'� Es�ed Cost: $ ��£��J, �� / The undersigned hereby makes applicativn for a permit for the work herein specified, agreeing to do all work in stiict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representati ated in this ication are true and correct. _ ( f'.- -- � (i'(/ � � ` L` ` � DATE :`��'L " 1 J S IGNAT[JRE : (See Reverse Side For Additional Info on.) � �v i �Z.o. � . ��' + �� c � ( / , 0 6 .-- � .. __ _ �'!�'^�' _ �BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing pextnits for the erection of any building or structure, or for any addition to any existing 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: UIJIFORM BUILDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic feet, or fraction thereof, in such cubical contents. �pe 3& 5-$1.85 for each one thousand cubic feet. ADDITIONAL INFORMATION For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average � height of the roof surface of the main 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. VERIFICATION OF FOUNDATION NOTE: 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 construction site. A Certified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before proceeding 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 pe�nit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. __._-- --,�._.___ _ ---_ �+�-, CITY �� FAIQLEY INSPECT{ON DIV, Effective On January 1, 1993 �s431 University Ave N� - �`� � �' Fridley, MN 55432 APPUCATION FOR POWER PLANTS AND HEATING� COOLtNG, VENTILATION, � �� 572-3604 REFRlGERATION AND AiR CQNQITIONiNG SYS'!'EMS AND DEVICES ,�" JOB ADDRESS I i. �r 1�r rG�`[ � W' i i {. i Residential Fumac hell and Duct Work, Burner — Als eplacement Furnace Gas Piping (Nesded with new furnace) Gas Range Gas Dryer *Afr Conditioning — All Sizes All Others/Repatrs 8� Afterations (LIST ON BACtn 19'0 of Value of Appliance or Work �: ;<; Commercial/tndustrial . �F ` 19'0 of Value of Appfiance or Work Rate $ 20.00 $ 10.00 $ 10.00 $ 10,00 The undersigned hereby makes application for a permit for the work herein TOTAL spec�ed agreeing to do all work in strict accordance with the City Codes and DO rulings of the Building Division, and hereby declares that all the iacts and $%D representations stated in this application are irue and corre �/ ' � � 198 T $ r OWNER �✓ N � $ $ $ 10.00 $ � $ State Surcharge TOTAL FEE BUILDING USED AS � 6v1�`/�N`7 ESTIMATED COST I 3 D D PERMIT NO. /9/�- /�' QE�SCRlPTION OF FURNA�E AND OR BURNER � No, ot Heating Units Circle One (Steam) {Hot Water) arm Air Trade Name Size No. BTU �0 0 HP EDR � Fuel Tota1 Connected Load_ �� $ ,50 Bumer Trade Name Size No. � BTU FiP EDR � � ROYAL7QN NEATING & COQLING / HEATING COMPANY ___ ��n _ R�TU AvFNI IF N_ _______ __1 � MINIMUM FEE FpR ANY HEATING/COOLlNGNENTILATION REFRIGERATION/AIR CONDITtONING PERMIT !S �15.00 �'I� Signed By PLUS THE 5.50 STATE SURCHARGE �/� � �� (, � � � � Approved B � �, v REINSPECTION FEE 530.00 *Air Canditioners can not be placed in a side yard without written permission from adJoining property owner. BROOKLYN PARK,, MN 55443 ��"IV!I�C ��t°ca�va� Rough—In Date Final Date � � I F1LL OUT BACK SIDE FOR STACK VER(FICATION ON REPLACEMENT FURNACE � CHIMNEY AND STACR'V$RIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined `Yes (� No O 2. Is free from rust or deterioration Yes (�No O 3. Has no foreign objects lodged within Yes () No (/f ��y�'� '`� 4. Is securely supported Yes (�No O 5. Meets all current Code requirements for size and total BTU's connected Yes (�No () 6. Has total heating . I3TU rs' of �t ,' ` All other BTU's � �� TOTAL B� � S � o a c� . � List Alterations Beinq Dones HEATING COMPANY �ti Signed By Date � S� 0 t '�. , ; � . , H.:y�, d,Y � .. .... � � er�: . .. . � , .. _,�� . � °p' _ k :: i:' ' . �+. 't . . . . .. � �'., +�^� ..( �^.+t. . � +} � }�� 'i .4'�:. :V�.:. 1 �pJ },_ 44�v`. ' . S ^f": �'Y ��.N M� � . � . 1 � r' � � �7 �l� L o-� HEAT LOSS CALCUL�►TIONS DEPARTMENT OF 1NS�ECTION Weathcrstrips Comtruction No. Guide MINNFAPOLLS. 11�II{�M. Inrmlation Windows I Doon Refereace Out. Waq Int. Wall Ceiling Roof Floor Kind How Applied Ye o es o 19_ Fl,� Room [.enech W;deh Heighc �I Fl.! Room l.eneth R/ideh Heighe Windowa and Doors—Craekage aad Area � `�'�ndow�,and Doorf-Crackage aad Area �—� �Vldth HN�At Ho. ot Llnwl tt An� � � j WIEtb H�1�4t Ne. o� Llewl tt Ary j � Ne. o[ Dan� of Dan� Ufht• ot crael[ �0. tt. ,Z No. o[ pan� of pan� 11[pt� o[ encic p. tt 1% i ___L_. 3' d ' ' ' ��o� /9� 3 1a� ��i �-v ? a'' l �'9. lo _._.___- // Z' F'' 6' �`�' DD%� 30• 7�SG � / �* tZ � I %3 .Y �, i�o �� : . i� � E�- ii � o -�-c- / / 9. � //, a Coef. Bcu _, Coef. Bcu Infiltration , Infiltntion cl0 k/�o D Glau � Glass J�� .f o�- OD Fsp. wall , j Fsp. wall � Flet e: p. wnU �I Plet e=Q. waii �% � Y" /D ��%�' I Int. wal! ,» i) Int. waU Ceiling ;I Ceiling f131- �v 8.33'0 Floor �� Floor � �ry T�� 3 �- .i — Total Btu. � ': � Total Btu� • 1�%(od Required sq. ft. E.D.R. or sq. ins. WA. Leader area Fl.� Room 'Windows and Doors--� Wldth He1�At N0. 0l pan� ot pan� i/ i i 3 � ��ii Z� >� In6laac;on Clau Fsp. wall - Net e:p. wall lnt. wall Ceiling Floor Total Btu. � w�a�h e and Area Lla�al tL Ar�� ot eneY p. tG ?�3 , D � , �i Coef. Btu � � � �O I / � yJ� � /�yp I . ; ) /Y /// 7 L I 3/ io 3/ �-v /�51 s �-U .�`�.�Oy I Required sq. ft. E.D.R. or sq. ins. W..4. L.eader area � Fl.' Room Windowe and Doors---� Wldth HN�et , Ne. ot oan� ot 9an� � In6ltration Glass F�p. wall Net e:p. wall Int. wali Ceiling Floor w�a� r- aad Area 'otal Btu. ;�quired sq. Et. ED.R. or w. ias. WA. Leader �rea Btu Require�,. sq. h. E.DR or sq. ins. W.A. Leader area Fl.I RAOm I Leagth Width Heiai�t Windows and Doon—Craekage and Area Wldeh HH�ht� No. o� Llu��l tt. A� No. ot D�e� et paeq � ll�et� ot enek p. [L 1n61tration Calau Eap. wall Net esp. wal! Iat. wall Ceiling Floor ro�.� s�. Required �4. k. ED.R. or �. ias. W.A. l.eader area Fl.� Itoom I I..engch Widtb Height Window� and Doon--Cracka�e and Area �WtAts Hd�Yt Na et Llawl tt An� Na o[ xe� et e�� Il�ets ot tr�et �O• _� Infilr. ation C.laa Eap. wall Net up. waU In� waU Ceiling Floor Total &a Rcquired iq. ft. ED.R or w. ia�. WA Leade� a�ea Bill ADDR ESS OCCUPANT HEAT LOSS SOLD BY EI•chieol Work' By TYPE OF HEAT GA MAKE. Mod�l S�riol _ INPUT THERMOSTAT Volvs Limit Limit S�tting _ Fon Setting — Pilot Type — Pilot Make — Pilot Model — Pilot Timing _ L.W. Cut Off _ Pressure Input CFH— Stack Tsmp. — Form 235 DATE HTG. INST HOUSE HEATING TEST RECORD APT. FLOOR _ OWNER INSTALLED BY — Gas Lin• Br ��,:�-.m -.-,_�..._-...�;-� CITY SUBURB _ FA HW STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION CONTROLS — Heet Plug P�rceM CO2 P�rc�nt O� Perc�nf CO MAKE OF BURNER Mod�l Max. BTU Ratioy MAKE OF FURNACE Mod�l V�nt Siz• KIND OF LINER SIZE NONE Draft Hood R�pulawr Fi It�rs Siz• �'1umb�r Chim��y Location Insid� Outsid� Chimn�y Construetion Smoks Bomb M�i►iny Draft T�st Tap Door Prsssure Liphtiny Inst. Date Tsstsd Company Tssting Name of T�st�r CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572— 3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Effedive On January 1, 1997 �,�-�-�-�-�i � i�o ��' � � (� rJ 0 I MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR � PLUMBING FIXTURE RATES New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater —Electric NO. RATE TOTAL Water Heater — Gas** � Gas Range** Gas Dryer** Back Flow Preventer Required ()Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ '1.00 $ 7.00 $ 7.00 $� o.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance �� n State Surcharge TOTAL FEE $ .50 $ D, b JOB ADDRESS /� /�D� ��/l �� /v � The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. r�� 7 , 1998 Owner ��L%'�'r�Cs f�%��`f'.��!`� 5�7/ - s Z y-2 G Building Used As ff ,/, o c� , ' � � '; - � Estimated Cost �d0 � PERMIT NO. 1-j �^ % PLUMBING COMPANY /�� Dr� d /� /`t/U�� C��f/� SIGNED BY � � TEL N0. �i�C� b��tD Approved By Rough—In Date Final Date MINIMUM FEE OR ANY PLUIMB�NG/GAS PERMIT IS 320.00 PLUS THE 3.50 STATE SURCNARGE **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 Sa INCHES. SUBJECT .�P •� City of Fridley 2 7 1 5 4 AT THE TOP OF THE TWINS g � I L D I N G P E R M I T r i � � � N � � • COMMUNITY DEVELOPMENT DIV. �/ i �V'�"" , r � � PROTECTIVE INSPECTION SEC. % � � � � � 1 ' �'�'1 � CITV NALL FRIDLE� 55t32 NUMBER REV DATE PAGE Of APPROVED 8� �"""� � �'' 612-571-3450 910-F15 8/12/98 / / JOB ADDRESS 6165 Briardale Court 1 LEGAL LOT NO. BLOCK TRAC? OR ADDITION SEE ATTACHED DESCR. 4 3 Briardale Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dion Pastones 571-5242 3 CONTRACTOR MAIL ADDRESS Z�P PHONE UCENSE NO An - 20 40630 4 ARCFiITECT OR DESIGNER MAIL ADDRESS 21P PMONE LICENSE NO. 5 ENGtNEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING 7 CIASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK ' h co letes within existin o enin . 9 CHANGE OF USE FROM TO STIPULATIONS Install smoke detectors to meet the State Building Code - in each sleeping room and on each level of home. TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD SEPARATE PERMITS ARE REOUIRED fOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONOITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHOfiIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOO OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLICATION STAL�S GARAGES AND KNOW THE SAME TO BE TRUE AND COiiRECT. ALl PROVISIONS OF LAWS yALUATION SUFiTAX AND ORDINANCES GOVERNING THIS TYPE Of WOFK WILL BE COMPLIED WITH WHETHEA SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 4458 2• 23 DOES NOT PRESUME TO GIVE AUTHORITV TO VIOIATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW fiEGULATING CON- STRUCTION OR THE PERfORMANCE OF CONSTRUCTION 99.75 Fire SC ��F.�45 PLAN CHECK FEE TOTAL FEE License SC 5.00 111.43 SIGNATU�7EOFCON'RACT0�70FlAUTHOA�2EDAGENT IDA7E� WHEN PqOPERLV VALIDATED THIS IS VOUA PERMIT SiGNATURE OF OWNEA i�F OWNER BUiLDER� iDATE� BLDG �NSP ��7E NEW ADDN ALTER [l [] �� ConstructionAddress: Legal Description: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 0 Effective 1/1/98 i v� % ,�� ; _ � � Owner Name & Address: ��,,�,�/� p�/ �o l('o� �,�(Cf.,1l� �o ('� . Tel. # �`% / - �c�L(o� , Contractor: � MN LICENSE # �'�Q�{Q(�� Address: 3� � %3�� Tel. # 5(�-L(�"� -1 Attach to this application, a C ificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: D�SCR�'ii�N OF iII1�Yi'Ri� v'E�fEN�' Length W idth Height Length Width Height Length Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. ' �--2��z� . � - , _ � Construction Type: Estimated Cost: $ L( ,��_ � -� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: � 3( �t � APPLICANT: Tel. ## �%S�-� a�".�� Permit Fee Fire Surcnarge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ C� �°�� Fee Schedule on Reverse Side $ �( < <-(� .001 of Permit Valuation (1/10th%) $ �-�3 $.50/$1,000 Valuation $ $1000 per SAC Unit $ °> . vv $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 [ ] $ ��i.�3 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 $501 to $2,000 $2,001 to $25,OQ0 $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 $62.2s for f.zst $2,000 p:�s $12.50 for ea�r. aduitional a1,000 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 $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof URYVFWAY DEPRESSIQN ESCROW (Concrete Curb Streets Only) Alternate "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 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 been constructed will be required before proceeding with the framing. SuB�ECi City of Fridley AT THE TOP OF TME TWINS g U I L D I N G P E R M I T r � . � � � ; y__�_�� COMMUNITY OEVELOPMENT DIV. r � � PROTECTtVE INSPECTION SEC. i_--_�; �"' �•� CITY MAIL FRIOLE� SS�32 NUMBEA pEV D�TE L 612-571-3450 9�0-Ft5 5/4/99 J08 AODRESS 6165 Briardale Court NE 1 IEGAL �OT NO. BLOCK TRACT OR ADDITION DESCfi. L} 3 Briardale Addition 2 PROPERTY OWNER MAIL ADORESS IIP Kathy Pastones 6165 Briardale Court NE 3 CONTRACTOR MAIL ADDRESS Z�P Rite Way Waterproofing 448 Lilac St, Lino Lakes, MN 55014 / ARCHITECT OR DESIGNER MAIL ADDRESS Z�P 5 ENGINEER 6 USE OF BUILDING Residential 7 CIASS Of WORK O NEW MAII AODFESS PAGE O� / / f�RF11T NO. � 29386 � RECEIPT NO. a5q / APPROVEO BY SEE ATTACMEO SHEET PMONE 571-5242 PHONE IICENSE NO 786-0550 PHONE UCENSENO PHONE LICENSE NO O ADDITION O ALTERATION �] REPAIR O MOVE O REMOVE 8 DESCRIBE WOHK Install basement drain tile system 9 CHANGE OF USE FROM TO STIPUTATIONS Electrical extension cords can not be used as part of the ��x power source to the pump. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. TVPE OF CONST. SEPARATE PERMITS ARE REOUIRED FOR EIECTRICAI, PLUMBING. HEATING, VENTILATING OR AIR CONDITIONING TMIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION 20NING AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAVS. OR IF CONSTFUCTION OR WORK IS SUSPENDED Oii ABANDONED FOF A PERIOD Of 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS 1 HEREBY CERTIFV THAT I HAVE REAO AND EXAMINED TMIS APP�ICATION 1 AND KNOW TME SAME TO BE TRUE ANO CORRECi. ALL PFOVISIONS Of LAWS VA�UATION AND Oi:DINANCES GOVERNING TMIS TVPE Of WORK WI�� BE COMPLIED WiTH WNETMER SPECIFIEO HEf7EIN OR NOT THE GRANTING OF A PERMIT �1 , 699 DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEI THE pEqMIT fEE PFiOVIS10NS OF ANV OTHER STATE OR �OCAL LAW REGULATING CON• STRUCTION OR TME PEiifORMANCE OF CONSTRUCTION �S�+.00 PLAN CHECK fEE OCCUPANCYGROUP �OCCUPANCVLOAD FT STALIS Licen C $N/ S�GNGTUpE O� CON"AACiQR OA oUiMOQ�ZED AGENT ID�TE� ' ME PR9 . r VA� S�GNGTU�7E O� OwtiEF �ia OWNEA BU�IDER� iDATE� CU FT OFFSTREET PARKING GARAGES SUfiTAX $.85 SAC CHARGE Fi SC $1.70 TOT FEE $56.55 f THIS IS V UR PERM w ��` NEW ADDN ALTER L) [) � ConstructionAddress: � Legal Description: � Owner Name & Address: Contractor: - � Address: � �-/ SC I ,� �. , LIVING AREA: GARAGE AREA: DECK AREA: OTHER: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PE2MIT APPLICATION Effective 1/1/97 D� C r� �� ',l- U Tel."# i o I a- 5�% �` s��ioZ MN LICENSE # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT �ng� Width Height �n� Width Height �ng� Width Hgt/Ground Tel. # f 2S /- %� �r - C�SSZ� Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: � r Estimated Cost: $ i�4�j �, QO (Fee Schedule on Back) Driveway C`urb Cut Width Needed: Ft. + 6 Ft = Ft •x $ _$:, •. DATE: _U— oZ S-C�G� ApPLICANT`" �� Tel. # � ,Y� � —dS�C�� CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TO`I'AL ST[PI.ILn'1'IONS $ Fee Schedule on Reverse Side $ v .001 of Permit Valuation (1/lOth%) $ . $� $.50/$1,000 Valuation $ $950 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 [ ] S . ��P � � S. �� !��,ss� �- (3U[L�DING PERM[T FEE SCE�EDUI,I; "l�he Chicf I3uilding Official shall, before issuing permits for the erection ot� any building or structure, or i�c�r any addition to any existing buiiding or structure, or for any a(teration or repair to any existing buildit��T or s�iucture, upon application t(ierefore, require the payment by the applicant fnr such permit of fees to the amoi�nt herein below set foRh and in the manner herei� provided to-wit: TOTAL VALUE $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 $500,001 to $1,000,000 �1,000,001 and up FEFS $21 (Minimum Fee is $21 plus surcharge) $21 for iirst $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,t)00 $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 $b.25 for each additional $1,000 or fraction thereaf, to and including $1Q0,000 $887.25 for first $100,000 plus $5.00 for each additional $1, 000 � or fraction thereof, � to and including $500,000 $2887.25 fot the first $SOO,U00 pTus $4,25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,000 plus $2_75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete C�.irb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Drivetivay ividth plus 6 feet tin-►es $13.>0. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approacti with 6 inch depth - Driveway width plus 6 feet tirnes $15.7�. VERIFICATIOi�i OF FOUNDATION 1'crmits for construction wi(1 be issued a minimum of 24 hours from the timc of application to allow ��or pmr�r re��ietiv <�f the proposed sTtucture ai�d of the construction site. -� t�ertii-icate of Survey ��f thc lot, showing the location of the 1�ounda[ion ��nce it has it h.�s heen ci�nstruc��_��i -.��!': I,: r�c��iiirccl hcf�<�r�c (�r�,c:�c�lin�� iil�� thc framin<<. � �' CITY`0��`DLEY INSP� N D��ION �a I�� 6431 University Ave N E �� S' �� Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1°�0 of Value of Appliance or Work Commercial/Industrial 1.25°�0 of Value of Appliance or Work Rate TOTAL $ 30.00 $ $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/V�NTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25 00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ $ •' OWN : �ll� Effective On January 1, 2002 ESTIMATED COST �� (�( ) PERMIT NO DESCRIPTION OF FURNACE AND OR BURNER /��C�� ;' No. of Heating Units_ Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name Size No. $L�/ � BTU HP EDR �� • Fuel Total Connected Load $ Burner Trade Name Size No. BTU HP ___ ED $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. $ � _ / DATE __ � �( l�� HEATING CO � �/'/.��L�(J`G�� 1/Y(/�Y'Z� �i 1/� Signed FAX #I� Approved By 0 � ✓/ Rough-In Date T /' -�1 - TEL #( 7� �J �� / �.J � Final Date � c�� THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED •uu�► ► ► •►► •: e►� •��: �► :: : � •► When r�- -inp an existin4 f iran __, the undersigned hereby venfies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. The venting system is plastidPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The Pxi� i� comh ,� ion air is sized and installed to meet the current codes and manufacturer's specifications. When required to install a n w_omb ,s+�on air�it will be sized and installed to meet the current codes and manufacturers specifications. When inc alling a ne_w v�ntip� cyc m, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I 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 ( ) Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) Yes( )No( ) ARnliance Tyne and Si7P/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ►�1i��-7ti�iT�. � - . . - HEATING CO: Signed By: Date : , Building PLUMBING PermitNo.: ��`� ' _ ��` j Inspections R�SIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FR�DLEY Date Rec'd: `��- ��' <'�= D.ATE YOUR E-MAIL ADDRESS SITE ADDRESS � � (''�� b" � 'I'HIS APPLIC.ANT I5: ❑ OWNER �CONTRACTOR PROPERTY N�: �(�� : S t c� A S�tT�'►e-S OWNER/ a.D�xESS: �n /�� C3i�c.i�Y'�C2 �Y`f"• CITY t�� STATEf�'�r�IP� Z TENANT pHONE: —�'� � �Z Lf Z CONTRACTOR N,�,g: �� STATE LICENSE # Z{C�7 LtI G EXP DATE � � SUBMIT A COPY OF �/�/+ � YUUR STATE ADDRESS: ��l � r L(�' „� �C 1� CTfY � STAT��–�`LIP �3�> LICENSE WITH pHONE �.3 g 7�°�f`'/ F� ` APPLICATION ^ PERl!'IIT TYPE �GLE FAIvffLY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: � ��''r �pLACEMENT DETAILED DESCRIPTION OF WORK '' PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to 5500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtwes. (This should reflect only the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTLTRES: (INDICATE TOTAL NiJMBER OF EACH BELO� BATH SINKILAV _FLOOR DR.AINS SHOWER WATER PIPING BATHTUB GAS PIPING �x� cmucFr+s�j SWIMMING POOL � WATER SOFTNER ($35) CLOTHES WASHER KITCHEN SINK WATER CLOSET _BACKFLOW PREV. ($IS) DISHWASHER LAUNDRY TR.AY WATER HEATER ($35) FOR IRRIGATION — WATER ME'I'ER _ OTHER � - � r.�«�,� �b �� "��crs„FO�U�E�$soo �° � . �..�.,��>�...,.��;��. _. r � 9aFG �. ��.�..r . E:F?Y�it°�R��'+ b'�i��3�.:: Permit Fee $ Number of fixtures @$10.00 x$10.00 =$ Surchar e .50 Number of fixtures @$15.00 x$15.00 =$ TOTAL DUE $ Number of fixtures @$35.00 x$35.00 =$ State Surchazge = $ .SO Tota1= $ THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNI'IL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accwate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Constivction 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 wor which requires review and approval of plans. SIGNATURE OF APPLICANT � PRINT NAME �� l DATE � �k ��,��.��'��,��'��. .. , ,. ��,��,��.r��±�, , � .� �`�� ; City of Fridley Building Inspections Department 6431 Ur.iversity Avenue NE, Fridley, MN 5543Z 763-572-3604 FAX: 763-502-4977 33 13uilding 7�. �, ° Inspections 763-572-3604 �� SI1'E ADDRESS _ TEIIS APPLICANT IS PROPERTY OWNER/ TENANI' CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE TYPE OF WORK: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-M;� ADDRESS 0. � 'L C'_ � . Ni_.. 0 OWNER �OCUNTRACTOR Permit Received By: AnDx�ss: 6/ 6 S—.f.� �`�c,le./� e.F. � ci� �'rdd&-� sTa��r SS�/SZ PHONE: / C 3- 5? �- Sz yz �� STATE LICENSE # Z��'iY ZI Y� EXP DATE �-3 r'� O� ADDRESS:_� 0� �49 iC �Pla/�C /�,�. CTfY f7�'�%b�+til��J✓ STA�� ZIP S�� !-_�f3?'^ /7Go Fnx LS�� y�g- ❑ TWO FAMII,Y/NEW 0 BASEMENT FINISH ❑ DECK u N�w ❑ MAIP DESCRIBE WORK BE1NG SIZE OF IMPROVEMENT NUMBER OF SQUARES _ GARAGES PROPOSED SIZE: PROPOSED HEIGHT: �OOF O DRAIN TILE IDING ❑ OTI�R SWIMMING POOL LJ Allll11lUN ❑ REMODELING ❑ HOUSE ONLY ❑ HOUSE 8c GARAGE 0 ATTACHED GARAGE ❑ DETACHED GARAGE HEIGHT BASEMENT REMODELING SUBMIT: 1. Fxisting Floor Plan 2. Proposed floor plan 3. List of st�uducal membecs to be used Ft. S � FOR NEW CONSTRUCTION INCLUDING DECKS, Vi�l ,e95offit ADDITIONS. & PORCHFS SUBMIT: � Aluminum ❑ Trim 1. Site Plan/Survey showing the existing sttuctutes ❑ Other �Fascia and proposed pcoject WINDOWS 2. Two sets of wnstn�ction plans IN E}CISTING OPENINGS OYes ❑No LOCAITON OF WINDOWS 3. Energy Calculations OR FOR NEW OPENRVGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATF.RiAi �: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 7Qt�. —°O OCCUPANCY TYPE Permit Fee $ ��/, ,�,� See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ �J. �1 Q .001 times the total job valuation Surchazge $ ,c��5 .0005 x Permit Valuarion Minimum $.50 License Swcharge $ -� . U� $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Gtixrb G�it Escrow $ ft+ 6 ft= ft x$21 =$ Erosion Control $ $450 Conservation Plan Review Pazk Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary (} Non Necessary O _Tota! Due $�[�7. �i Make checks pa able to: Ci of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTII, PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conforma.nce with the ordinances and codes of the City of Fridley and with the Minnesota Constniction 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' ' s�view and approval of plans. SIGNATURE OF APPLICANT ��-- PRINT NAME ��^�— ��(/� DATE /�J CJ ! ��uilding �ZSpections i 63-572-3604 �aTE `� ',� � � �iTE ADDRESS i HIS APPLICANT IS: �'Rt7t ERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE � BUILDING Permit No.:.�, �c. � - RESIDENTIAL APPLICATION Received By: �� CITY OF FRIDLEY Dat�� YOUR E-MAIL ADD �SS ( O�-( ��J Ll� E[-� .� � J,O I�-C S. C �/' J '�n�(1 �,C Cf' iv r- ■ • �I C C�eflNTRACTOR Na�: K �rtn � o Q� f�, �D�ss: (, r c. S Frr, r c/� PxorrE: � l, 3 5? 1- 5� 4 R o ��.� N��— The Home Depot A.H.S. Inc. sTATE Lic 3200 Cobb Galleria Pkwy. a.DDxESS: Atlanta, GA 30339 PHONE �63-542-8826 CZS�GLE License #20268257 ❑ TWO FA QADDITION ❑ GAR.AGE/SHED ❑ BASEMENT FINISH ❑ ROOF ❑ DECK ❑ SIDING ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ��p (. µ � ADDITION C3�MAINTEI�TANCE/REPAIIt ❑ REMODELING �ESCRIBE WORK BEING DONE: � la t il LioL►S f't�� Ci G/�. ?IZE OF IMPROVEMENT :OOFING :UMBER OF SQUARES i �1RAGES ROPOSED SIZE: 'ROP05ED HEIGHT: :LDING 7 Vinyl 7 Aluminum ] Other t'INDOWS 'J EXISTING OPENINGS C�'�'es �No iR FOR NEW OP�TIINGS-DESCRIBE SIZE OF :'PENING CHANGES & `YPE OF WINDOW TO BE INSTALLED (levb ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GAR.AGE ❑ DETACHED GARAGE �Soffit ❑ Trim ❑ Fascia LOCATION OF WINDOWS K �CI%l.�i ('4Sa/'n[n i�MBEROF WINDOWS � CITY �%'� [� �l �! STATH "ZIP 554 3� o [i � !D E�(Cit � 0�[ 5 �t�a (3YS�L o�F7 CITY STATE ZIP �E ❑ DRAIN TILE ❑ OTHER x �.s-�n WIDTH HEIGHT BASEMENT REMODELING SUBMIT: 1. Exisiing Floor Plan 2. Proposed floor plan 3. List of structural members to be used Ft. FOR NEW CONSTRUCTION 1NCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project 2. Two seu of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING TIiE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ �� 3� OCCUPANCY TYPE 'ermit Fee 'lan Review urcharge ire Surcharge icense Surcharge AC Charge =urb Cut Escrow ,rosion Control ark Fee ewer Main Charge 'otal Due $ i.�.(v $ $ • $ �.(.Y $ S.Ou $ $ $ $ $ $ G 7 •'� � 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) ft+6ft= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridlev Atfach lations THIS IS AN APPLICATION FOR A PERMIT-NOT VALID LTNTIL PROCESSED hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; that the work will be in �nformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a ermit but only an application for a permit an work is not to start without a permit; that the work will be in accordance with the approved tan in the case of all work which requires rev nd approval of plans. JNATiJRE OF APPLICANT� � PRINT NAME ►! f' 1 .% �/� t IL l�. DATE � l J( �� . Page 2- Building Residential Application BUILDING 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 �ny zlt�ration or repair to an3� existing building or structure, upon application therefore, require t�'�e payment by tr�e applicant for such permit of fees to the amount herein belo� set forth and in the maiuler herein provided to-wit: TOTAL VALUE FEES $1 to $500 $23.50 (Minimum Fee is $23.5.0 pl°�s surchargej- $501 to $2,000 $23,50 for 151$500 plus $3.05 for each additional $?00 or fraction, to and including $2,000 $2,001 to $25,000 $69.25 for 1S` $2,000 plus $14 for each additional $1,000 or fraction, to and includin $$25,000 $25,001 to $50,000 $391.25 for 15` $25,000 plus $10.10 for each additional $1,000 or fraction, to and includin $50,000 $50,001 to $100,000 $643.75 for 151$50,000 plus $7 for each additional $1,000 or fraction to and including $100,000 $100,001 to $500,000 $993.75 for 1s1$100,000 plus $5.60 for each additional $1,000 or fraction to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the 15t $500,000 plus $4.75 for each additional $1,000 or fraction to and including $1,000,000 $1,000,001 and up $5,608.75 for the 15t $1,000,000 plus $3.15 for each additional $1,000 or fraction VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to a11ow 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 Only City of Fridley Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 r f $1111(�lIl� ��,1�� permit Na_: 1 U Inspections �SYTI�N�TYAY. ApPY.YCATYt�N� Received By_ ��3-s�2-��04 C��'Y O�' �'RYDLEY (�� 76�-J��2'-4�}77 �Q� EFFECTIVEI•1•201(! DATE ,� f��'�n) t} YOUR �-MAII.ADDRESS %Y��Ct Sa'r^dcdt G Cr't/L .�ar✓) SITEA.DDRESS �+�G..� �rta,-d4�� r� Ii�� THIS ApF'uCANT IS: 4 OWNECZ �ONTRACTOR PROPERTY OWNER/ NAME� � a TENANT ADDR�S$; 4i11.� i3re..f�n�L�. t7 A.1� CITY fi� � STAi'� fl z[P 5��,�_ PHONE: 7f�,�� 3G0 �/�I'ty CONTRACTUR NAME: r � L.i � SUBMIT �A COPY OF STAT� LICENSE N 2 at9 G Q N 7 EXP DATE 3'� � i O YOUR STATE LICENSE -� � ANLI CERTIPICAT� 0� rwQRESS: ry� ,g-o 6(� „�iq � 2 � c�� t STA'1'� P�'N�21P .5�72,� INSURANCE pyONE 5�$ �� 3 FAX /- PR01'ETtT'Y 7'Yi'E d SINGLE FAMILY/NEW CONSTC2UCTION S12� O TWO FAMILY/NEW CONSTRUCTfON STORIPS PERMIT TYPE ❑ Avut�'ipN ❑ CARAGE/SNED tNDOWS ❑[iASEMBNT FINISH ❑ i2�OF fJ 17RACN TIL� ❑ DECK ❑ SIDING ❑ OTNER [] SWIMMING POOL TYPE OF WORK: ❑ NGW HOME CONSTR[lCTION ❑ ADDITIQN ❑ MAIIV'CENANCPJREPAIR �2EMODELJNC� D$SCRIAG WORK BEING DONE: C titi SIZE OF IMPROVEMEN'1' LENCTH WI�TH HEIGHT SQ FT ROOFINC. O FiOUSE ONLY HACF.MRNT R�MbY)��.1NG Sl1gMf1'� NUMBER OF SQUARES O NOUSE 8c GARACE 1, �xisting �loar pinn (:ARn[; RR ❑ AT"fACHED GARAGE 2. Proposcd floot plan PROPOSED SI2E: ❑ DETACH�D GARAGE 3, i.ist of structural mem6ers lo be used PROPOSED HEIGHT: siDlNC FOR NEW CONSTituC7'ION INCLUDING I7ECrCS, o v��yi ❑So�;, �C]J,TIn�IS. �g. PnRCNF.S �URMiT� ❑ Aluminum ❑ Trim 1. Sitc Plun/Survey showing thc oxisling structuros � Q�Me� D�'ascia end proposed ptojcct. 2. Two sets of construclion pluns WINdOWS ��/ 3. Enorgy Catculations IN BXISTING O�'ENINGS �1'ts ONO C.00ATTOI� OF WINbOWS FOR WINDOWS — PROVIDE U-VALUE AND OR PpR NEW QP�NINGS�4CSCRIBE SIZ� O� MANUFACTUR� SfICKBR ON WINDOW. OPENINCy CHANGES & TYPE pF WkNDOW 'rQ i�fi INSTpI,�,�l) NUM��ft O� WINUOWS � AL.L F��S A1Z� $ASE� ON VALTJATTOIrC. TNCLiIDING THE COST (}F I;.ABOR AND MATERIAI S: 'OTAT.,,IOB VALU Permit Fee Plan Review Fire Surcharge Surcharge License $urcharge SAC Charge Cur6 Cut Fscrow Erosion Control Park Fee Sewer Main Charge 'Total Due (CJSING TH� 1997 U.B,C FEE SCHEDULE) � ��O �1� See Back page for Fee Schedule $ � 65% of Building Perrnit Fee $ �� .001 times the total job valuation $ .0065 x Permit Valuadon Minimum $.SQ $ $5.00 (State Licensed Residential Contractors) $ $2100 per SAC Unit (Plans [o MWCC for determinstion) $ fc+bfc- f'tx$22=$ $ $450 Conservation Plan Rev�ew $ �ee 17etermined by Engineering $ Agreement necessary ( ) IV�on Necessary ( } S F..�1 � Make checks navable ta: �itv of �ridlev Attach THIS lS AN APPiICAT10M F0�2 A PERM(T-NOT VA1JD UNT[L PROCPSSBD I hereby apply for a building permit and Y acknowledge chat the information above is complete and aeeurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the MinnesoCa 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 on site; that the wotk will be in accordance with the approved plan in the case of all work whic r quires rev w and approval of plans. SIGNATUCtEOFAppLICANT ��pCt1NTNAME �/I►�[x. ;��►^� DA"f� ��S�2b�, NaTE: 'SLpARA�' Wd 9S 8b Z OLOZ/8!£ �a��4 R Z/Z :a6�d unnou�un :wa� AIVD MECHANICAL