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AF - 44098• CJ � Date: Owner• . . . . � City of Fridley, Minn. BUILDING PERMIT N� 6 4 5� - � 6 7�� ...�'_..�- �_�_..:- �..�___._.._.___._..____..._ � ._. � . . ....�� ...t. ... .___.. ._ _� Btuider _.. __..._. ... .._._ ............................_............._.....__...._...._.__.._._. Address....._.._..._...._.._..._..__.._..__._._..._..._._...___.........._..__.._...._.._......._.._ Addreas CATION�C��j�UILDiNG lvo. .:�.�.v.�.� � street ....__...._. ._.._. ,��► �ri��Fl.....__.C�.._��%�. P of Lot •-------..__....�----_.___ .____._. .. _._.� Lot _.__:...,;�..1-..�...._--..__ Block _._..._.........�.........�ddition or Sub-Division ..--•-• _-- 1L:�G�'�_..._._ � � � ._...._.. �. .___.__� Corner Lot ...__._...._..._._.... Inside Lot ...._-------...._..----•---------- Setback .,.j�..-�$.--.-•------_........... Sideyard ..._.__._.� ..._ ��2......_.._.__�__._.... Sewer Elevatian Foundation Elevation � DESCRIPTION OF BUILDING To Used . ___...._ Front _'�_,�....rt-- Depth �� Height .._�..�_.. Sq. F� ,l� _.,� ... ........_ . . _ _ t � .. Depth ..,,'�.�'_.�.. eight ....�/..�� .. Sq. Ft. ._ .��__ Type of truction _ ..•--.. _ ..... .. ... ............_.. Est. Cost��.... �To be Completed .... Cu. Ft � �� cu. F� _. ..l� d In consideration of the issuance to me of a permit to construct the building described above, I agree to do th� proposed work in accrordance with the description above set forth d in compliance with all pro�visio of ordinances of the city of Fridley. �'�------ r ej In co�sideration of the payment of a fee of $.��"'�......_.., permit is hereby granted to._.___._...._ ___.�_ .>.__,........_..�.._..._......_...._._..___.._.._ 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 in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding lceation, construction, altera.tion, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at ar�y� upon vio]ation of any of the provisions of said ordinances. e �1 / / Building Inspector NOTICE: ihk p�rmh dou not wwr � eonstrueKon, installation for wiefng. Plumbin0. gas heaNny, s�w�r or waf�r. M wn to sN th� BuiWing In�p�elor for s�pant� p�rmits fo� fha� ibms. „„ ��i�"'�� ' /� � �/�� APPLICATION FOR BUILDING PERMIT CI�'Y bF F'�tll�t.t'sY� MINNE34TA � �/ / ' / �� r � �'�' �� i .��«.l ..� �1 . � � ' �.��— � � � / i i � � � • iJ' :,r� , �� ,�,�s�L . � � . ., LOCATION OP $UILDiNG No. �� Street � %% � Part of Lot � — Lot � Block_� Addition or Subdivision Corner Lot Inside Lot �/ Setback _��ide-Yard SEWLR ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and propoaed build- ing location drawn on these Certificates. _ DESCRIPTION OF $UiLDING To be used as: ___�lU��/// Front '�"' l� Depth ,.i Height �� ' �%' Sq. Ft. Cu. Ft _ r FronC �� Depth � Height , �'t7 � Sq. Ft. Cu. Ft. Type o€ Construction Estimsted CosC ��i C;S O`� -- To be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City oi Fridley Ordinances and ruiings of the Department of Buildings, and hereby declares that all the facte and representations ed in this application are true and correct. DATE � SIGNATURE • (Schec�ule of Fee Costs can be found on the �verse Side). . . . � � . �> - ..�'' _ : rt � � � , Application for Pawer P�ants and He�ating. Cooting, Ventilation, .Refrigerafiion dnd Air Canditianing Systems and Device�s PARTIAL RATE S�HEDULE GRAVITY WARM AIR: RATE TOTAL . Furnace Shell & Duct Work . . . . . . . . . . . . . . . . . . . . . . . . . . 8.00 $ Replacement of Furnace ............................. 5.00 � Repairs & Alterations—up to $50U.00 . . . . . . . . . . . . . . . . . . 5.00 $ Repairs & Alterations each add. �500.00 . . . . . . . . . . . . . . . 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 1?A,OOU BTU . . . . . . . . . . . . each add. 60,Q00 BTIJ ....a .................. Replacement of Furnace . . . .. . .. . . . . . . .. .. . . . .. . . .. . . Repairs & Alterations—up to $500.00 . . . � . . . . . . . . . . . . . Repairs & Alterations each add. $500.00 . . . . .. .: . . ... . 8.00 $ 2.00 � �_.___. �.00 $ 5.00 $ 2.50 $ 3TEAM or HOT WATER SYSTEM Furnace Shell & Lines--to 400 sq. ft. EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR fiot Water ... 8.00 $.�1L� Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . . 2.50 $ Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 $ OIL BURI6ER—to 3 gal, per hour . . . . . . . . . . . . . . . . . . . . . . . 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTiT) . . . . . . . . . . . . . . . . . . . . . . . 5.00 $ � G U GAS FITTING FEES: NO �tATE TOTAL lst 3 Fixtures . . . . . . . . . . . . . . . . . . . . . . x $1.50 $ � Sr � Additional F`ixtures ................. x .50 $ Gas Range to 200,000 BTiT . . . . . . . . . . . x 2.00 $ AIR CONDITIONING � FAN HEATING 3YSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS 8c REPAIR3 TOTAL Fi;E ��S...L� � ROUGH FINAL Depi. of Bldgs. Phoae SU 4-7470 � � �� City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to da all wark in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn. � �— , 19 � Owner �/ //� E:-l�-� — .— Kind of Buiiding �� -�"`�""� Used as ��Z-;�-�_---= To be completed about Estimated Cost, $ Old—New. B'iulding Permit No. Permit No. � �� DESCRIPTION OF WORK HEATING or POWER PI.ANTS—Steam Hot Water, Warm Air—No. ! i Trade Name � y� �- Size No. �f ��3 u Capacity Sq. �ft. � S u J BTU H P � Totai Connected Load�� — Kind of Fue� BUftNER — Trade Capacity. (REMARKS-OVER) ��0�.4 z va �-s9 Size No Sq. Ft. E.D.R. BTU H.P. Signe - sy Business Phone No �.s6 � 9 Sa 3�%— %x��-.� �i2, A��'Y �'� HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS N��S. MI1VN• Weatherstrips A.S.H.V. . Construction No. Iasulation �" " Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Roof F1oor Kind How. Applied Yes—No f Yes—No 19— Fl.� Room Len$th � Width Height Fl.� Room Length Width Height Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area �Vfdth HeiBht No. o[ Llneal ft. Area W►dth Height No. oi Lineaf it. Area No, ot yane of pane lighta of crack eq. ft. No. of pane ot pane llghte � of crack eq. 1t. 4— I k� (o .z .�� ir z z� 1s Coef.l Btu ! Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI.� Room � Length Width Height Windows and Doors—Crackage and Area � � Width Helght No. of Lineai tt. Area No. ot pane of pane 1Sghta of crack ery• tt. � ' rZ %,� / fI 1 r� �i% i � / �. !t r � n n � _ _ ;. ., _. �, _ Coef. Btu tnfiltration j„� ,,�j �, � Glasa �27,5 ,Sd /� ?S� Exp. wall Net exp. wall p (, Int. wall ' , �,7' Ceiling � f0 �S D� Floor /OS 0 St Tota! Btu. t' ;� / � Required sq, ft. E.D.R. or sq. ins. W.A. Leader area ;,� Fl. Room � Length Width Height Windows and Doors—Crackage and Area � Wfdth Height No. of Ltneal it. Area � No. ot pane of pane llghte o[ crack eq. ft. Coef. Btu Infiltration �— ��— Giaas Exp. wall Net exp. wall Int, wall Ceiling !� loor Total Btu. Reqnired sq. ft. E.D.R. or sq. ins. W.A. Leader area � In6ltration Glasa Exp. wall Net eap. wall Int. wall Ceiling Floor s� Total Btu. Required sq. ft. E.D.R. or aq. ina. W.A. Leader area Ft.� Room ( Length Width Height Windows and Doora—Crackage and Area �Wtdth HeSght No. of Lineaf tt. Area No. of vane of Dane IfBhts oL crack na. ft. Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ieis. W.A. Leader a Fl.` Room I Length Width Windows and Doora--Crackage and Area Width Height No. of Lineal ft. Area No. ot pane of pane lighte of crack eQ. tt. I Coef. Btu In6ltration Glass Exp. wall Net exp. wal! Int. wafl Ceiling Floor Z'otal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area D•S6 ' 9 �� ✓6f �� ;2u'"�1Qzc'�'1. HEAT LOSS CALCULATIONS DEPAR'IMENT OF BUILDINGS Weatherstrips A.S.H. . . Conatroction No. Guide ' dows oors Reference Out. Wall Int. Wall Ceiling Root F7oor Kind es o I Yes No 19— � Fl.� �� Room Length ,S Width ,� Height FI.� •' Room 1 Windows and Doors—Crackage and Area Windowa an Doora—Cr+ �Vfdth Height No. ol Llneal t. Area WIdLL Heighi No, No, of pane of Dane lighta ot crack eq. ft. � No. of nane ot vane lia� Coef.l Btu Inhltration Glasa Fxp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ina. W.A. Leader area Fl.+ Room Length % Width ` Windows and Doora—Crackage and Area W(dth Hefght No. o[ Lineal it. Area No. of pane ot yane ]i�hta ot crack s�. tt. �� Height Coef. Btu Infiltration Glaaa Exp. wall � Net exp. wall Int. wall Ceiting .. Floor Total Btu. Required sq. ft. E.D.R. or aq. ina. W.A. Leader area �� Fl. Room � Length Width Height Windows and Doora—Crackage and Area Width Aeight No. of Lineai ft. Area No, ot yans ot pane lights ot crack sq. ft. Infiltration � "' . Glaaa Exp. wall Net exp. wal! S Int. wall Ceiling Floor Total Btu. Required aq. ft. E.D.R. or aq. ina. W.A. Leader area BtU ,, r ��. Insulation '`� � How. A�lied and Area oea�:c. e,w crack aa. ft. Infiltration Glasa Exp. wall /!� t /'7 +2S Net eap. wall Int. wall Ceiling Floor �s' � /(� }( � T'otal tu. Required aq. ft. E.D.R. or aq. ins. WA. l.eader areR "FI.I Room I L�� 1.5` Wi� Windowa and Doora--Crachagt and Atea Wldth Heisht No. oL L1nea1 tt. Are� No. ot vsne oi vans ifihb ot crsck ea. tt In&Itration Glaaa Fap. wall Net exp. wall Int. wall Ceiling Floor Z'otal Btu. Required aq. k. E.D.R. or �. ina. W.A. Leader are+� "Fl.� Room I Lenech /.S�' Width ) Windowa and Doors--Crackage and Width Hel�ht No. of Lineal ; No. of pane ot.pane ti`hts ot crac In6ltration � . Glass Eap. wall Net exp. wall Int. wall Ceiling Floor 'fotal Btu. Required aq. ft. E.D.R. or sq. ina. WA. Leader �u�ea 0 Biil � � � �i��«��L�G �;,(� �:�-CG�'L�1 � f� �� s � �� 9s�vo � . � � L . �� , r. � � . . �.+�.`�v:: 4. ,#• � . . ' .. �'�'7M' .. . , � �. �� y� � � � � . I>� _---� 1,�� __.. �._�� _. _______ __.._ _� _._._ � _ _ .___ Y..-...----- . .: .� . _ �.��,,.V._.:__.� ______:��---.-- � _ City of Fridley Application for P'lumbing and Gas Fitting Perm�t Dept. of Bldgs. Phone SU 4-7470 DESCRIPTION OF WORK � 2 3 O ,� U C/� �4 �S/ •4. ,��/ S T �/.� , Number, Kind and Location of Fixtures Localion (�'J WA7ER HTR. G' I� 6� � Z VI W W Z � � W� � x,� �� x} ZZ � Qz Uz Ox � c� Z < �.J � ~°� � Z �� y p = j� �' `� j 7<6°, 7 <Z 7 a F N GAS EIEC. 3 U � �� m VI 3 F- � LL N LL � S LO �� C� ` U� R' U� O Base � � � � � � lst � � � � 2nd 3rd 4th _ ' Future Connection OPe�in9s * New Fixlure, Old Opeaiags PARTIAL RATE SCHEDULE 3ewer � Cesspool n PLIIMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ........... ..........,L_ x $1.50 $ 3sa Future Fixture Opening . . . . . . . . . . . . . . . . x 1.20 $-- New Fixture Old Opening . . . . . . . . . . . . . . x 1.00 $ Catch Basin ... ............. x 3.25 $ Water Heater (Up ta 200,000 BTi7) ..... .�_ x 2.00 $ Z W , New Ground Run Old Bldg . . . . . . . . . . . . . x 3.25 $ � GAS FITTING FEES: NO. I� lst 3 Fixtures Additional Fixtures . . . .. ..... ... ..... .. Gas Range to 200,000 BTLT .............. RATE TOTAL X $1.50 $ r,s"G x .5Q $ X z.00 � REPAIRS & ALTERATIONS—Refer to Code Description ................................................ TOTAL FEE � 6� �� ' City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the facl and representations stated in this application are true and correct. Fridley, Minn. �UN � �� , 19— Owner —�' � L C / T � /3 G 'D � Kind of Building ��" Used as � � � To be completed about �4 " �' � Estimated Cost, $ Old—r3Qev�T. Building Permit No. �� Permit No. v� �/ �� O v LONDON PLU�d{BIN� C0. Signe By ��c'. E � Business Phune No. ROUGH � ` I � — e —3 FINAL az 4M 0 5z-st�-�9i5.51 , City of Fridley Applica�ion for P'�umbing ond Gas Fitting Pennit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK 5230 N E�uchanan S'� Number, Kind and Location of Fixtures Locatioa <�I � l�s�l ��? f � oiloe OI ; Ij ac�4 �I�`I<al� ZI�?I R I N�G STER HTEC. 3 7 VI � 1- Q LL N LL � U < 3 c� < c� � c� O I Base ist I � as : 2nd 3rd 4th _ • Futu:e Coaasct€on Openiags * New Fixlure, Old Openings PARTIAL RATE SCHEDULE PLUMBING FI]LTURE RATES: Number F`ixtures ...... .. . Future Fixture Opening ............. New Fixture Old Opening , . . . . . . . . . . Catch Basin .... . .................. Water Heater (Up to 99,000 BTLT) ... New Ground ftun Old Bldg. . . . . . . . . . Electric Water Heatsr GAS FITTING FEES: lst 3 Fixtures ....................... Additional Fixtures ................. Gas Range to 199,000 BTU . . . . . . . . . . . Gas Drye r Sewer � Cesspool rj NO. RATE TOTAL x $2.00 $ X �i.5o � x $1.50 $ x $325 $ x $3.00 $ x $3.25 $ a $2.00 $ NO. RATE TOTAL . x $2.00 $ x$.75 � . x $5.00 � 1 5.00 iL�YAlli3 OC AL 1 Li[A 1 L V i\ r1�8eIB3' t V Waa Description ................................................$ TOT,e,L F'EE • 00 City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridiey, Minn 1a22-68 , 19_ owner R.obt paquin Kind of Building fra.me Used as Z'CS _ To be completed about �'�'��7^68 Estimated Cost, $ � �•n� Old—ATew. Building Permit No. Permit � . ( Z. Sign By MINNEAP Business Phune No. ROUGH FINAL J� – � – % � az SUBJECT P O. C�ty of Fridley 18880 AT THE TOP OF THE TWINS g � I L D! N G P E R M I T f ; � REC . � • COMMUNITY DEVELOPMENT DIV. ' i �%' � y� r � � PROTECTIVE INSPECTION SEC. � � � , � � A� /'�'1 � CITY HALL FRIDLEV 55432 NUMBER REV. OATE PAGE OP APPROVED BV `.��J\•/ �� . . 612-571-3450 910-F15 4/16/87 � � 108 ADDRESS 5230 Buchanan Street N.E. 1 IEGAL L07 NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2[� 1 MaY'1dI1 Hl1.IS. SHEET 2 PROPERTY OWNEFi MAIL ADDRESS ZIP PHONE Gary Cirks 5230 Buchanan Street N.E. 571�-4381 3 CONTRACTOR MAIL ADDRESS ZIP PHONE IICENSE NO. Pro--Exteriors Inc. 3012 Kentuck North. C sta.l 546--8329 4 ARCHITECT OR DESIGNER MAIL AODRESS 21P PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Res iden ti al 7 CIASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE ❑ REMOVE X 8 DESCRIBE WORK Reside Draellin 9 CHANGE pF USE FROM TO STIPULATIONS SEPARATE PEFMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NU�L AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, Ofi IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK {S COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEiiEBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORfiECT. 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 $S�r'JOO $2.%S DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CON RU/CT�ION. $S6. SO /,vCS ��t.�� PIANCHECKFEE TOTALFEE �� $59 25 ' � /G ��r 9 • sicrva aEOFCON�RACTOROAAUTHORIZED ENr —� ' iDnrEi WHEN PROPERLY IDATED THIS IS YOUR P RMIT � .. SiGNATUqE Of OWNER �If OWNEP BUILDERI IDATEI BIDG INSP ��T ♦ r : NEw [ J ADDN. [ ] ALTER. [ ] Construction Addre Legal Description: Owner Name & Address: �'�t"'�i C�r 5 Contractorer. %�� ' �x �� r �' i �rs-� � �''�� - Address: ��'D / Z �'r.�-� �� f� � /�D , C City of Fridley Effective 4/1/86 �R-1 AHD R-� Building Permit Application LIVING AREA: GARAGE AREA: DECR AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height _ Length Width Height _ Length Width Hgt/Ground Tel. # e.5�"7/, L/3�'j Tel . � '� - S 3 Z, Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setback Type of Construction: !C � S�� C Estimated Cost: � ��.� � U Approx. Completion Date: .5�� 5� �g,�— Alt. A Alt B Proposed Driveway Width If NeW Opening Is Desired: $ � See Back Page for Explanation r�.--,..:;_.,. D�TE: � � � APPLICANT: r �° �r� Tel . # -S� �T � � Z � P�,`'�°``-�� - - CITY IISE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: � ,5"� . S� $ $ � • 2-�' � � � Fee Schedule on Reverse Side 25� of Building Permit Fee $.50/$1,000 Valuation � 525 per SAC Unit Fee Determined by Engineering . Agreement Necessary [ ] Not Necessary [ � �� -�.� .�S �r � � _ n � �S� s � CERTIFICATE OF INSURANCE BIOOMINGTON, ILLiNO1S This is to certify that the Company indiCated above s the following insurance in force: /�0 MORTGAGEE POLICY � / CiE IRATION p,�� LOAN NUMBER NUMBER DATE �./tJ iti/Y • (IF /1PPLICABLE) NAME AND ADDRESS OF PARTY TO WHOM NAME AND ADDRESS OF CERTIFICATE IS ISSUED OTHER INTERESTED PARTY _ r . c$�-c� � r-- � /i1,v � ' �� -� � h- • L� (%I�-✓`- 5`��z.7 J I_ J �� LOCATION OF UNIT IIF DIFFERENT THAN SHOWN ABOVEI NAME OF INSURED _ (ASSOCIATION) ADDRESS LOCATION OF PREMISES: (IF DIFFERENT THAN SHOWN ABOVE) No. 1 No. 2 . No. 3 No. 4 Premises described above and with respect to those coverages and kinds of property for which a specific limk liability is shown below are subject to all of the terms of the orignal policy available at the Office of the Association or Named Insured including forms and endorsements made a part thereof: UMIT OF LIABILITY COINSURANCE COVERAGE �oo. No. ew No. Loc. No Bld . No. Loc. No. BW . No. Loa No. �: No. P�RCENTAGE � APPLICABLE A. Buildingls) S $ S S SECTION B. Personal property $ $ $ $ Addl. Cov. (Specify by Namel 1 PROPERTY S S $ S OOVERAGE $ $ $ $ S S S S ' g S S S . COVERAGE LIMIT OF LIABILITY SECTION C. Bodily and Personal Injury and Property Damage Liability $ each occurance S � aggregate �� D. Premises Medica� Paymems $ each person g each acciderrt LIABILITY COVERAGE TH1S CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE AFFORDED BY THE POLICY DESCRIBED HEREIN. .. � � -. Signature of Authorized presentative Title Date Ffr855.2 � sus�ecT PERM City of Fridley o 20209 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � RECEIPT NO. � ; L_�_��_ COMMUNITY DEVELOPMENT DIV. �� r � � PROTECTIVE INSPECTION SEC. � � � � � � /"'1 � CITY HALI. FRIDLEV 55432 NUMBER REV. bATE PAGE Of APPROVEO BV �.__..!`.• ••� 612-571-3450 910-F15 11/28/89 � � JOB ADDRESS 5230 Buchanan Street N. E. LOT NO. BLOCK TRACT OR ADDITION t IEGAL 24 1 Marian Hl�S SHEETTACHEO DESCR. 2 PROPERTY OWNER MAIL ADDFESS ZIP PHONE Gary Cirks 5230 Buchanan Street N.E. 571-0301 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Pro Exteriors 3012 Kentucky Avenue North., Crystal, MN 55427 546-832g' 4 ARCHITECT OR DES4GNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDFESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION ❑ ALTERATION �7 REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof Dwelling (_20 Squares� 2nd layer 9 CHANGEOFUSEFROM TO STIPULATIONS Roof can be 2nd layer but not 3xd* Install ridge.d galvanized valleys. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIF 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. UN�TS OfFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALIS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $]. �O;OO $. SO 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- $2 rj � OO STRUCTION OR THE PERFORMANCE F CO TRUCTION. PLAN CHECKFEE TOTALFEE �� . _ $25, 50 . SIGNATU EOFCONiRACTOROFlAUTHOA�ZEDAGE tDn7Ei HEN PROPERLY VALI ED 7HIS IS YOUR PERMIT `L SiGNATUREOFOWNERUFOWNERBUIlDER1 IDATEI BLOG �NSP TE � [ ] �r L � AL'1'II2 [ ] R 1 AND R-2 Building P�eYmit Application Effective 5/1/88 Construction Address : J o� ,3 � �t/ . � , � u c Li P .� � ,U s' �" � � �' �- � �_ � l� � ` /-I,' i�s 1 Descri ion: Ld /�a }� �� o� N� & Aaare�: � � � � C � � �S �ma.. # .�7 / 0 3 o / Contxactor: _ / 1P �-� k�- j° v� �^a r' S Tel .# 5��- � 3 z g AddresS: _� �/.2 !�C' t� .v T� vG K �i /�` v�P /UO . Cv'�lS T'ca � �� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. . - �«• . . � � �• •.. �, ��, LNING AREAs Length Width Height Sq. Ft. GAR�E AREA: I.�ength Width Height Sq. Ft. DDCR AREA: L�7gth Width Hgt/Ground Sq. Ft. OTHER: (r�e !� a o r�- 02 G� -��/ ,� �. c� � a� c�^ Corner Int [] Inside Lpt [] Ft. Yd Setback Side Yard Setbacxs 'I� of Construction: Estimated Cost: $ /�-� APProx. Campletion Date: _ _ _ _ � %Z�dd Proposed Driveway Width If New Opening Is Desired: Ft. $ $ / idth + 6' See BacJt Page OATE: //�� l g9 APPT TCADFr: Tel . # .5'�G - �3? � Permit Fee $ � S.- o G State Surchan�e $ .:z7j SAC Charge $ Driveway E.scraw $ Park Fee $ S�wer Main charge $ 'I�p�, $ 01 S . S � �� •711r V J.Y']11V1v5 : �o � �-?� CITY IISE ONLY Fee Schedule on Reverse Side $.5oj$1,0oo valuation $575 per SAC Unit Alt. "A" or Alt. "B" AUove Fee Detexmined bY EncJineering Agreement Necessazy [ ] Not Necessary [ ] � 0 0 CITY OF �RIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Stories Closet ' Basement ' Fiaor 1 Floor 2 Floor 3 Fioor 4 Effective On January 1, 1995 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT � n � a'1 L � ,-�, MARK NUMBER OF FIXTURES TO BE 1NSTAtLED ON EACH FLOOR Bath ; Wash Dnnk;i ' Floor C�tch ` Auto. Gas .. Gas Urinal Tub Shower Sink . Tra Fount, -�' Drain Basin : Washer App{ ; Ran PLUMBING FIX7URE RATES: NO. RATE TOTAL New Fixtures $ �,pp Old Opening, New Fixture $ 4,pp Beer Dispenser $ 5.00 Blow Off Basin $ �.pp Catch Basin __ $ �,pp Fiain Water Leader $ 7.00 Sump/Receiving Tank � 7,00 Water Treating Appliance $10.00 Water Heater —E{ectric $ 7,pp Water Heater — Gas _� $10,pp Gas Range � $10.00 Gas Dryer $10.00 Back Flow Preventer Required ()Yes () No TYpe $5.00 JOB ADDRESS Water Heater Gas Elec � The undersigned hereby makes application for a permit for the work herein specified agreeing to do al4 work in strict acco�dance 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. � 1� ' J C/ , 199 � Owner � Building Used As �GCJ�Q , ` /! t / .., ,. �) Estimated Cost PLUMBING COMPANY Reinspection Fee $30.00 SIGNED ALL OTHERS AND/OR REPAIRS AND ALTERATIONS ,•, , d 0 1°/a of Value of Fixture or Appliance �__ State Surcharge TOTAL FEE .50 (/'t�--�-� Approved By � /- a�� z 7 / / -� � �i � . . � . Rough—In Date Final Date MINlMUM FEE FOR ANY PLUMBINGIGAS PERMIT IS $15 00 PLUS THE 5.50 STATE SURCHARGE (�c- �� (��ro,� ,J� � �,�s� � SuB�ECi c�ty of Fridley AT THE TOP OF TME TWINS g � I L D I N G P E R M I T r � � � • COMMUNITV OEVELOPMENT DIV. � ; V �"�� ' r � � PROTECTIVE INSPECTION SEC. � � �"'1 � CITY HAII FRIOIE� 55132 NuMBER pE� �"'"�� ,�� 763-571-3450 9�0-Ft5 JOB ADDRESS 5230 Buchanar. Street NE 1 IEGAL �OT NO. BLOCK TRACT OR ADOITION DESCR. 2!} 1 M�.rizn Hi11s 2 PROPERTY OWNER MAIL ADOfiESS Mark P2rriott 5230 Buchanas. Street NE 3 CON7AAC70Fi MAII. ADDRESS Wir.dows America 559 Shoreview Park Rd, Shorev� � ARCMITECT OR DESIGNER MAII ADDRESS 5 ENGINEER MAII AODFiESS 6 USE Of BUIIDING Residential 7 CIASS OF WORK ❑ NEW O ADDITION O ALTERATION 8 DESCRIBE WORK Repiace 10 wir.dows within e�:ist�n� over.::n�s 9 CHANGE OF USE FFiOM TO OATE 5/20/03 ZIP ZIP q_ REPAIR x vAGE OF � � �3534 IPT N . �� AVPROVED 8� SEE ATTACMED SHEET PMONE 763-571-1788 PHONE LICENSE NO 651-203-0149 PHONE LICENSE NO PMONE LICENSE NO O MOVE O REMOVE STIPU�ATIONS Provide smoke detectors in aii s3eepin.g rooms and on aIl ieve�s of the dweil.�ng per Sectior. 310.9.1.2 of the 1997 Ur�iform Bu��ding Code. Cauik and ��ash a�i exter�or openings. P�rr�it lnspection Cards Wiil Be Mailed To Homeowner To Post TYPE OF CONST. SEPARATE PERMITS ARE REOUIqED FOR ELECTRICAL. PIUMBING, HEATING, VENTI�ATING OR AIR CONDITIONING TMIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTFUCTION ZONING AUTHORIZED IS NOT COMMENCED WITMIN 60 DAVS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO fOA A PEN100 OF 120 OAYS A7 ANY TIME AFTER WORK IS COMMENCEO. NO DWIG. UNI I HEAEBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLICATION 1 AND KNOW TME SAME TO 8E TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VALUATION AND OROINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITN WHETMER SPECIFIED HEREIN OR NOT. TNE GRANTING OF A PERMIT ��F�OOO DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEI THE pEqMIT FEE PROViSIONS OF ANY OTHEA S7ATE OR LOCAL LAW REGULATING CON- STRUCTiON OR TME PERFORMANCE OP CONSTRUCTiON �97 . LS OCCUPANCVGROUP OCCUPANCVLOAp SO. fT CU fT OfFSTREET PARKING STA��S IGARAGE$ - Tic nse SC $5.00 SIGN4TUAE OF CON"AACTOQ OR 1UTNOA�ZED OGENT IOATE� � WHEN PROPEQLV V �2.�� SAC CHARGE Fire SC $4.00 TOTALFEE $108.25 S�GHS7uaEO�OwNEa��cOwrvERBu�LOEQ� iD�TE, .. ip, ti � r�cr NEW ( ] CITY OF FRIDLEY ADDN [] 6431 University Ave NE, Fridley, MN 55432 ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1 /1 /2003 (763) 572-3604 Bldg Insp (763) 571-1287 Fax _ Construction Address: J�o%3� ��a�i�� , Legai Description: Owner Name & Address: °�%%�� zo� - Tel. # 7l 3—.5�7/— /78�' Contractor: GvL/IG� �,C�.o�I1�� R MN LICENSE # aDa4��o?� Address�5'�� •��lJl.� �a�2 �o�--c�i�Y��, f'�1/�•�S/aZ/ Tel. # �l -a�3 -�� 9 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROV�MENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. . o0 Construction Type: l0 �lJC/lQ`OZ�..�i',Q',��%Yh�e/�Estimated Cost: $'� �� Driveway Cur6 Cut Width Need"ed: Ft. + 6 Ft = Ft x$ _$ : �� _. , - _ , .. -o/�y DATE: � �-� APPLICANT: :TeL #��._ Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ � 7� �� Fee Schedu{e on Reverse Side �� $ ,�`Q .001 of Psrmit Val�aation (1/10th°1o) � $ �.� D('j $.50/$1,000 Valuation $ $1275 per SAC Unit $ 5� Db $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] _ TOTAL . . ._. .._. ... $ �U O i � � ._ _ �TIPULATIONS� .. .... ._ ... . .... .... .. ... . .. _ . _ . . CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 Urinal Floor 1 Floor 2 Floor 3 Floor 4 ��(��-(�%(}� � Effective April 1, 2004 APPLiCATfON FOR PLUMBING AND GAS FfTTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR ::: Wash :;��::�::.:;.:«<::>':>::' Floor :��1�::::::>:;:` Auto. :� ,��t!�1�.;::>::»>:. �i�Ct�`::;:::;:<`' Was her � :::>::: < :;: : <::::::> �:::;.;: ::<:::; Shower : a[i��::s::::::::�:> TraY :�cii�rit-<'�:�_�>:: Drain ..................... PLUMBING FIXTURE RATES: NO. RATE TOTAL 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 Water Heater - Gas`* Gas Range"* Gas Dryer"'` Back Flow Preventer Required ()Yes () No Type $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $35.00 $35.00 $35.00 $10.00 $10.00 $15.00 Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge TOTAL FEE 7� ....� Gas JOB ADDRESS ;��/ ^ t c�� e G� �1�v�1 � l t Heater Elec 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 c rrect. 1 DATE: �� . 2�� OWNER BUILDING USED AS ('�-� `�(�t/�--° _ � ESTIMATED COST � PERMIT NO. PLUMBING COMPANYy � f , � C�2��P_/� � SIGNED BY TEL NO.IU��^ �� T Approved By Rough-4n Date Final Date $ .50 �i�� MINlMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST OF THE IMPROVEMENT WHICHEVER IS GREATER ON WORK LESS THAN $300 COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE