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AF - 43729
�" t�'� a 4�` ,..: � � �. � �j� s � � � ?� �� �� �:; s � � -� � ,:. � �.sL Taa t�� �we rw��� � �-, r � � . � � L__e....»_, i.17i.tt�'JNITt n1�VF_�4t��s:tf:f47 fY�V. ` �� i ?�o�=r,r�,,� a �3cron!� t`7+"�• � a P"°y i Ci'1'Y 4v`�.l.L Pi?l�f.a:p �€+c3� �.-...�,.� °,.J ���'66G-3��� Jo� w`�d::i�-es.3 t,�;trret/ J �� C_".;3T1 t �`czC KlllE:.J O� Yitl�iif:l7il� �� , �� 7,��y, i.Jil?rt�.nt.1Gt1 �a t;: � 3 t, ;c I: . ' u ( ! ' I I i� �''" � � " I w � , � �- ; I ;� ; - � ---�. --;--- � --=- — i� � � w � , t , < a i \� � i �` 1 i' I" I j i � - - --- - - --- Ii 29Nb-�!i i _-i ,._.1 � ; �i�_.._��' "_. I__'__!_._. I__'_ I _ i •,.,���� i I _I. � i �a� � � � � ---- - ' -- ► •X�:i �_._;___�_i � I�V's�w _ I _ ' `---- �--- �� ���, � � i -; •.Mr�ival I � I . � m � � ---� --- -- �I SUISYrii � � ..I' i ,� F:��Y�I � I � 1 G. I� " �--- -- '-'-- �.-- i Ii cr:�vaal � � % � � � aoo�d I n(�--;- �' —; --� �— � :j iI5Fl3MOH$I I V � � � .0 a , > .� — �-- � _.- � � -- -- .-!) �se�ncs� � " �� xr�iaa � � i � � I' ---- � � ----- � - I--- a �,.•W;� ( � j �:Ii }�sv,r.) �) i i c, I ! i ,< j _.- -- -------- -- = -- 5 i Sl�,�s� I � ( . i:. �' � ---- -'— �� SNlSVEI I � I 1 f ' ___._.___'._I. _� � s��,�, ! � i I — i w:.vn i � i �____ i ._ .»._—.—_.. � __ _ _ I 51YN:&fl� � i_�_ � ' _.__.�___! __.__.-- ----� 51J5017 i. i .I._....` � —L'31Yf.^:� � . �.__� _� _ � ~1:__ � __� .. � �� � � � ,� I � � � � u1 f C"� ( ?° � ` �, ^- �', .__.____.__�.e.__..-_..... cl_.. � __. � LO .� � � �: 4� F �t � U I U I � i �,. ; G � U � �, i ✓ I C� �ft � .� ��y L � S-. q U L! �z„EGY ��E'�tiilt �iC1. � � ..,� -, -. f-'�L,�'`��� � �'� � 1'�R� � 7_( ,;'�,�-lPi_ i t`f� T i U;`� f:;�+i:)�.N��� �EV. ' q4'E �ASdE tk' _.`�1.(`-�:_�_�_'�._ ��. 0, � �15%7' _ 1 Z �, �j . L�. , Adcires 4 ] � � �/ / 1 �c � //�' _—,� � ��G �.5 8 ] J�. j il C �,E_�.� �'.:2�Y� 0�� . i,I��'�__._ �.�.�_.____ � ����� l.St1I11£t�r' OSt � �J i / 7 �� l: � �5 �/o�r -b�o Plumbi�FixturewRates ._ �,p,_ RAmE Tf!T'�� NuYnber Fi�;ti�res �, x $2.00 e?_L � ----� �'i�.___......�. F�u'�ure Fi�ttzzc�s �_ x $1.50 _T�,:� A�e�-� ri..xture-�J1d Ope�. �� :� $1.50 ��.M, Catch ��.s_�n x Y3.?=� �._.:. taate� k'��.r.er.-93, o�o r,Tt? ___�___ 2' $3 . a� 3• o� �_ Gxound �'.un Old Bldg, x $3.25 � �l_ec. W.�ter Heut�r _ x $2.00 Ga.s F'irr_zn�; Fe�s� � / i 1St :; i' IXtUY'HS e�l..rr. x�2 . �Ci ,,_�' � a I �`..dditz.onal Ii ixti.ires � y Y .75 �`�_ (JaS P�an�e-1�9,�C10 B'1'�J �______ x$S.U� .._.._ i __ � �)�ix'S �� �.! t�T2.t1G?"l.S � Se@ � ves�.x•ip�.iox1, � �o3e � ± ;a r e ...:�.�i Lz :� c t'�: a.� .____..�=?M `,_ ! z�a��.r� :�•�E � .1_Z�" ° I '1':�c: uilriersign�cl '.�ereby mat:E�:� applicatzon for c; PE?,�iTi:Ll': � � lor tl�c� r�ork }���;-c.��n spec�..fied, <a,;reei_-:.g tn dc� all c��a�k 4f :i.�� st:rir_t accor�:lac,ce witci ch�� Ci.ty �r,i:�nances ai1e1 ru � i.ngl I ai� the D�.��>artm�nt af Bui�.c7.iii�;�, anc� IZ!�k-eby deci,�r.e ti���,�t� . �i11 tile tact� �tnd ;repzeseiiL-��tior,s s�:aled in i:hi.0 u���.iC��t:"'�L)11 :f"E°t.'. �:?"il"u' raI'�ll l;OtlCaCt. � / �� �t.z2.C� �l.g y�.: � ,.? - .�C7 - ?� r_ L�_,.__�__..., �"_�_.—�____ ! .r.......t,�� 1_,_�_��_�_t_.�_..` .e___T_ .�._.,.l._._._ _____.___.��ji,1L.�, ~Y�__.___: sue�ecr P tT N O. City of Fridley � 3325 � AT THE TOP OF THE TWINS g U I L D i N G P E R M I T ; � R ra �' � ; L _.__ COMMUNITY DEVELOPMENT D1V. r � � PFOTECTIVE INSPECTION SEC. ,�,� / � � , l� �` � /"�1 � � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE Of APPROVEO BY ""-"�'� ,'� 612-560-3450 910-F15 12/5/75 � � JOB ADDRESS t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. 4 ARCHITECT OR DESIGNER MAIL ADDRESS 2�P PHONE LICENSE NO. 5 ENGINEER MAI�ADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING 7 CLASS OF WORK L�J NEW ❑ AODITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Constuct a house 44' x 24 & 26' and a garage 20' x 24' 9 CHANGE OP USE FROM TO STIPULATIONS . Provide a verification survey � Sewer (Approx. 15' deep) . Provide a hard surface drive� 80' E. of M.H. (E. Inv. 875.38) � � Wye Elevation 875.70 C�41 T� o Top of Footing - 878. 70 (mini.mum) l.9 ! Water "VtS's'1fd "aAFETY �G''�;��� T�AN�y• 10' East of Sewer Service „4 �;rj1' P4AN7 GR PLA���. TH?;d'� �N i hiFS �RFA �tit � ;;GUT A�- �ARMtHG ,r.;�.;;4Aii, UF '►ii� CIiY �7i ''Z4�'i�"(. Before di�ging cali loral uti{ities EPERATE PERMITS R�QU��� f�� ���`f° TELEPNONE - EIEC i R�C - G�S Etc. ,EATING, PLUNIBlNG A�� ����S• REQU{RED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PEfiMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, �„iood frame VENTILATING OR AIR CONDITIONING. TH1S PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 2S� 976 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 HEFEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GAFAGES 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �34r1SO 1.%.OH DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 48.06 325.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PIAN CHECKFEE TOTALFEE $390.14 SIGNATUREOFCONTRACTORORAUTHORIZE�AGENT IDATEI WHEN PROPER�Y VALIOATED THIS I YOUR PERMIT _ 1� s �L �C 1 J% � �i�.._J(.�C/ �� � =%1, SiGNATUREOFOWNERIIFOWN R UIL ERI ID T 1 BLDG INSP nATE .r ' .d. Al'pLICATION rOR RL'SIDZN'1'IAL, AI,TL:RA'I'ION, OR AllllI1'ION BUILI)ING PERT4IT GITY OF FRIllLE1', htINNI:SUTA � OWNER ` S NAME :� J/.� � f-P/t �Y% �%� .� �'��1�/BUILDER : � i� SS � L� _ ADDRES S : � % � _,�SS �r� f�fi..� L>l ADDR�S S : _ ,L.�� O � D /�'i /) /�/1C°-- NO � 5 C� � STP.EET: ��'`✓'� F�� T �/-��U t LOT : /�`,''i" BLOCK:� ��DDITION :,�,Q,�,Pi_� ��/�� s T T�S CORY3ER LOT: INSID� LOT: SETBACK: SIDEYARD: Applicant attacli .to this for_m 7`wo Certi_fica.tes o.f Sur_vey oi= Lot and propos�d building locatior� dxat�.;� on these Cert.ifi.cates. llESC]ZIPTION QI� BUILDING To Ee Used As ; � � �OG � � -- - -- Front :i��Depth : � �_Hei.gl�.t : Square E� eet : / ��Cubic I'eet :� ��, fl-G � Front :_���_Depth :��� Height : Square Feet;� Cu'�ic FPer: Type of C�nstruction: �JD� c,l t-��c, /n t E�tirnated Cost: $���/D p _ To lie Complet�d: _ �flJ �_ i����_ _ 7�--rr 3 y, i, r, The undersigned hereby makes apPlicatinn for a permit fo� the work herein specii:ied, agieeing to do all waric in stz�ic� a.ccor.d �nce with the City ot Fridley Ordx.nan:,•es and rul.in;s of the i3e,�artmer�t of Bui.ldings, and hereby decla.res that all thc facts aiid re��eseztt��.tions sta�ed in this a�plication are trtae and co-rrect. DATE : � �, j� % / �.� S I GNAT[TRE .� , cx. ,� -r � r. � , i���� 2� `-�z��aG (See Re�*erse Side Far Additional 3:niormat�_oii. ) � �� ��. b6 � i�,o� ��, 325, oa 3 � a, i4 0 ; =r� . W � �AS�. a�P X�l �= ld S �6 /j()I x �= ;- , I 11 � �'�'� �-�i � s�i ,, � K ��t �. � i u� �' t Z� l 3� 2� C,�.�'r' �.5�-- o`�C' � oty �-- �-t � a 1G� CC,� • -� �8 D d �� C� � r ���g .� t3 ?z ,� Z�/1� � �j� '� � t Q a v ..� ��,o� �' � � � �c �. g� �- . � � z, �� 56 ,� �, �-c� z 4,,� �2, o0 � ��� X 22 . 6d = a�,�'s�, y o �b'� � �7. �o '' 3 ���� ao , ��l % � � � � °`� 3 �► / Sa x,� � �+? o � � , � �.- �8� 0 6 � ►�, 08 S � � Z ^► ��.. � .? 9[a, I �' . � ��- ,$��t • at '' �Bo�aets ` �`�����1���>>�,�11 � ls��A1� '11 i '���i��SUSSEL NEAR-BILT� HOMES A DIVISION OF THE SUSSEL CO. �larence Belisle 64�31 University N.E. Fridley, MN. Deax Mr. Belisle: n� v✓ � e� 'l April 6, 1976 In regards to the missing grade stamp on the rafters in the Walter Milbrandt residence, we use three suppliers, but all material is stamped WWP #2 or better Hem-Fir. The fiber stress is 1,150 psi and the modulus of elasticity is 1,4�00,000. If additional is required plese contact the Sussel Co. Sincerely, ..�=r� , � f`,��--__ �. �Gary/ Taft Head Draftsman cc: Walter Milbrandt � ��d ��0� 1850 COMO AVENUE, SAINT PAUL, MINNESOTA 55108, PHONE (612) 645-0331 , � �3-8t�-9915051. � , � � . ,' . � . � , . �i���r �� �'i�1�y . .. . . ' • . . . . ' � . +,� • . � ��`1�`�iG�:1cJi� �L?1' �3CE►�:c:i i.`"�' 4::.i<r.,�l �.^'�w u 6e"�;;ti� �'��:'•i: . . . ' _ .....,.,...�..�,.u�.�...�� 3�opt. of B.dp-s. I'hoz�o S�"J•3{� ... .. 37�5C�I�';IOIt E'r: V;t)l�i , i,o,;a.!'_na, � �,,,�(11 ('� roalnt,...j.��A ?iuLY9s:. ::�i.^..3 n..hd Lc�r3��� a! i!v!��':es. . ' . , � City of F7idlcyt. . M N � � " W Y o e wavca Hrx. �L `" � � ^ i" _k�'� cZluZ oJ1 �� � . ' ` � � '� �^ Z • $'�� � 7 W � H_ r,�s cuc. 'I`he und�rsi;ned hereb� rr.�,ces sp�.tcat�on for a yersnit Icr t`�e� Qo:Y hezei in i; � ' S � � '" !� � �` � � � � � �v � j � U � u �;� � specifie3, a.�ecing to do :,ll «•o:k in �:ric: �cco:�ar.cz wfth tre C:� Q�:r.:..ce —" "�"j�""� � 3r.d ruling csi the Depa::mcnt of F3ui:�.'n�, an� rere�y �ec:ares �'�at s:i t�'�e f:ct �3:t � � � •, ar,d r2pres�-�ta'.ia:�s stated in Lhis 2�p'.icai:oa €re true u',d eo:rect . 1:: I � � - 2 r l ��.� � 3:d 1'� —� Cc: ...t::� �iYz • �'c�.:o�-;.:•..',,.-� G�..: i^ =• 5c�o: ❑ t ?tav �::��:o. O:d �T',r�^•.i.^.L'z Ccs.:pcol [� _ ���. . P�P.Tlr�L RAT� S�HLDUL� r idley, biinn 19�. !�lalter Milbrant - ' Ow;.er � frame Kind of B:ulding Used as res. r' �'o bc co:npleied abaut �-5-76 Eslim.�ted C�s:, S �� �--?�'ew. Flui.ding Perr:iit I�o. __ F.:�'st 40. �� ; L^utii8I1�G F'I:CTi11?E RATES: it0. �iATE TOTAL C- .__.._.. � e� G�, g ' . ' Sigr,cd , ���..�T 'flXiLi25 • •�•••••••..•••• ,�..�..�..� X Y�. . . '__ F�:ure F>xture n;,cning . . . . . . . . . . . . x S1.FA S , _. ' By .. x S 1.50 S�._ _. Busia�K..s P'h� :r ho ::ew Fixture O;�i Oyerin�.....:.... . . • • . C,iiCti1 8�5111 • • • • • . • • • • • • • � � • • • ♦ • X y.,.2.5 S -- . tY.tet iieater 'Up to �.00�0 BTUs.• •• x�3 C0 S ��. •. . � ROUQ H �e�+ G:a�nd Run Old B:dg. ...:..•.. x;1.25 S—.—..---- E:►ctric Yla:�: Hw�tu . . . . . : . . . . . . . . s :3.CJ � FINAL � - l ' � � ' I i1S FI7TSIG FEE3: ' 2�'O. R:,:�' TOTAL . • lst3 Fix:llieS • •••���••�•••��♦•• ��� .Y 52.� �—�--�---'� � . Add:tfcaai FZxtures ... . ........... +.— x S .75 S - ' . . Gu R:�.at to 2�3.00x� aTV ...... ..... 1--- X SS.CO $ �n . . �,,,:;?.�1::i8 ic J�L7E°.1TI�NS—P.�:er !o Cods • .50 St�te SuXGh :��0 � � .DC:CT�y:iOA . �• � . � � . • • � � . . . . : . • ... • • . s.• . . . •...«•. ... . .$ � - . . � . • . � . � �:� �:.1'+ 5��.�sL� • �. .. . . � � . . .. . � • � � , . . : � • • . • 560-3450 �ito r�dle � � ANOKA COUNTY 6431 UNiVERSITY AVENUE NE July 16, 1976 FRIDLEY, MINNESOTA 55432 Mr. Walter Milbrandt 1501 Camelot Lane N.E. Fridley, Mn. 55432 Re: Final Inspection at 1501 Camelot Lane N.E. Dear Mr. Milbrandt: A final inspection was made of your address on July 15, 1976. The following items were noted and must be completed before the construction can be finaled out;, . , l. No plumbing final - arrange with your pliunber and Plumbing Inspector. �i''fProvide a hard surface driveway. / �. � Provide handrails in.foyer area. �Reinspection of smoke detector required. 5. Black patio door or provide deck. We will expect all of the above items to be completed by August 14, 1976 when a reinspection will be made to determine compliance. If any problems arise that will prevent you from completing these items by that date, please contact us. Sincerely, RON HOLDEN Building Inspection Officer RH/mh 0 � _�o_�,_ .�o_��� �..� _ _:__ _ __ _ / � �a� --- _��,` l��rv : �;,L�/5' _e__� � � - _ _ -----�_ _f'i 1, , . ���_C/��%-5 F `� - -,��-� f �/ �� �_ __ _- -- ,� � � � e __ _ _ _ _ __ __ __�_�__ � _----_�? %�� � _ ���%�-�--- _ --� �_ _.�_3 �.__ _ - - --__ ___----__ ---- -----_--- — � � �zo ,�,� v" . � � �/ } , __-.. _ _ _ _ _ _. _ __ _ _ - _ _ __ _- - - -- ---- — -- ,- `'� ` , -- - - __ �� Y-�----- c� ��- �� �2 : ��C �e.- T ���� -� �- - - �!'?- �-�-�------- - - -�-�. �'l� '_ _ . ���.'`,J3 t ___ �L- __ _�� c� '�.-.__ __7�fi.-� -----� -�-�_ �- 5�.�-�'�'-�-�--- -- / , ------��- _ _c�c_5.�..__� s's_ Q c�_____�,�'�_---�� �.__ -- 7'-�_��-_ ���;_. _--_. / � ' �/ � � �l �-. - ____�-t1� �✓'-�_-�-�1`-' _____ .�.� -- _i_l�_ __���! � �--� —�-_�-- o� _ _ __ � �-: 1�-� � _ _� .�_ �� �_ _ �� �.�� _� � �` � - _ - � � -- __ _� � �m r� � -- - s_ �� __ ._ p_� �.s - o-- __ _ � _ _ _ � �� _�----�.--�- r --- -�.� �n1 � .� _ _ 3 3 l _--. _ �� � �? -� . _ _ __ _ _ _ -___ _ _ _ _ _ -- - ----- ---�--=--- c� ,�- � s �i.,- Q ✓ � � _----- -- - --_ (�?�.. __ __ _ _ _ _ . - - - �-,_ - c9 '��-- _ -�� �°- - _c� � ►�-'�-�"'t-�----- - - , -j----- � �-d�_ .�y �/_ s� ��� �;�- --��__�------ _ _ _ �..- ��.- _ _ c p_1,.� � . _ _ - - . � _ � �: .�- � _ � �-__� __�------ � _ _ ��� � . _ - __ � rh _ L � ___-c--����... cA'� ?�.� - �� - c� c�.-. _ ___ _ _�. . = �.-� �:__ - --�- --��__---�--�i -- , _----�� G� � -- Ji�,�.� - �,� �.__r� __ - - ---���� - - --�8 _ 1� �- -----�-`�-s---- -- , � �� � __ _ _ __ ._ __ _____ � _____ �_�. ____ ___- ___________ __________._ _ _ _ _ � _ _ __ _ __ __ _ _. :�-_ __ , _ __ _ __ __ _ _ _ _ __ _ _ _ _ _ ___� __ ___ _ _ _ __ _?�� - ___-�� � --, ---_ ___ . _ --_ _ __ -- - -__- _- ----_-_---- -- - -----_ _ __ ___ . - - , _ _ � , � . �.____ ----- -. _ ___ _ _ ___ _,_ __: _ _ ______...�i ____--- ___ ____ _ ____ _,; � � .�/h) - / �` _ _ _ _ . �` . . . �a o .,._....__.`..._ ,,._ _ '..._ ._.___'_'. 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Af'! l'ON, -� _i =i i =i � �;�; wnEr r�tVER1.E84 � � � MADt �IN`1iS�.A,e,; 1 : ,� �� i: p � dS. ..�,*d'� +``�' � N tt".(.?':. ,* �'' _ � '�_ ., .� �4, . . ust 18, 1976 . . ���� �� ������� 6431 UNIVERSITY AVENUE N.E., FRIDLfY, MINNESOTA 55432 TELEPHONE ( 612)5T1-3450 0 Mr. Wally Milbrandt ' 1501 Camelot Lane N.E. Fridley, Mn< 55432 Re: Final Inspection of 1501 Camelot Lane N.E. Dear Mr. Milbrandt: An inspection on August 18, 1976 noted your hard surface driveway, handrails in foyer, and smoke detector to be installed properly. Thank you for your compliance with these sections af the Code. During this inspection I noticed that you had begun your deck construction. I feel that you are procee3ing well toward completion and we will reinspect for the following i�ems on or about August 31, 1976; 1. Completion oi patio deck. 2. Plumbing final. 3. House numbers on structure. If you have any problems or questions, please call me at 571-3450. Sincerely, - / ' ^ ' f? ���13�- �2����, � ��c=k-Z� ROiQ HOLDEN Building Inspection Officer RH/mh ,' ��� �:: � d e 0 /lppRc�on 1�or'owir � and H�1i�, Cooling, Y�nh'totion. R�ig�ro�ios a�d A� Condieioning SYst�n�s a�d D�vie� PI�RTIAL RATE SCHEDULE ' (iltll�'!lE iIFFJIlilrt AIR: lU1TE TOTAI.. !'�usna�ce Sbrli dE Duct Woa�k . . . . . =IO.OQ � Rrptaeemen� oi Pltrnacti s.00 � Repairs ds Altcrations—up to f5Q0.00 6.00 E-- -_ __ Repairs dc AlteraUons each add. f500.OQ . 3 pp ;_ _ ___ lftC!!. 1lirltltM Allt Furnace SheI} de Ihict Wark to I]I►,000 BTU eaeh add. A0,000 S'P[I . . . . . . . . Itepiacetstent of Furnace u Repaira di Alterations—up to =500.00 Repairs dc Alterations each add. =500.00 S10 0� __,�� -�`> 3.W t 6.00 1 6.00 �_ 3.OU =_ __ _ STEA�[ or HOT WATER SYSTEH itirnace Shell di Lines—to 400 sq. !t. F.DR Steam �10.�J0 �.___ __ __ xe �rnace Shet} ���.—to 640 �q. ft. EDR iiot Water 20.00 S- __ _._—______ Each add. 200 aq. tt. EPR Steem R.OfI =_ ___ __ � Each add. 320 sq. ft. EDR Hot Water 3.00 ;__ _____ _ OIL BIIRMER—to 3 gal. per hour 8.00 S---- -- over 3 ga1. per hour—�ee !'ee Schedule c� avn�a �UD ca �,oao sTV� ower 199.00Q S'1't1 SK F�e seludul� GA8 FITTINC FEEB: ist 3 i�xtures _ Addrtionai Fi� _ Gas Range t,o 19�,060 — �!E CO�T�I�IEI/Q p'Al� H�Ti1� dT�'tEt! ������ � u.naa.rr�a�aa t �rx� a � , �-�a: t�s� 9-�2-?� b.00 = °`,', d, �, 110 RATE TOTAL _ x= 200 i —._ �.- �'�' _ x .76 i--. -- - :i 6.0o s _ � � F�s k�b O'T .�-- c- �y ' � � t./ ibiu. rs� ' � .s �� n.�. � e�as.. rs.a... seo.�eo Loe�liod.� f'� C. s� i�:r= .c t� �%�C,'.-°- 1� � � �f � ,. �� --;� T �:� � �, city or Frtd�ey: The undersigned hereby makes application for a permlt for the work herei� speciiied, agreeing to do all work in striet accordance witli the City Ordinaneef and ruling ot the Depat tm�nt of Buildings, and hereby decLres that aI1 the fact€ and representatiuns stated in this application are true and coerect. FTidle�y, Minn_--- - — -----�.1� � C�wner __._-�_�_.sr L"_�=-- �� — Kind of Building _ _ �� ' Use�3 as _ _ �1��.v� �� =- -- -- To 1�e completed about _ _ __ __.._ _____ _ ��.� Estima?ed Cost, a �� '� . ` '—' / y _ `" _ - - -- --...- --- -- e�widing Permit No. ___ P�rmit No. �- ��� DE'�CAIPT[OI( OF VIOIIE HF.A7`ING or FOWLR PI.ANPg—�gt+eam, Aot Water, _cwa�rm_.vy-No�. 1Yade 1Vame-s�%� � ' 31u N�'/`�"it'>}' ���= - � Capacity--_-- -- 84. �'t. E.D.A=�"`,�' %�� BT'tJ H.P Total Connected i.oad ��� � h�/,c'�'� /���" �fnd o! �Le� ,-t-"�- ; HURNER — Trade Name_ ��l' �''r giu tas GD�tY $9. !t ED=R B1V $� (MMARRf-01IlR) s� . y � ' / % � , � ��� - . � = .«=�-- s� . _ . �: y. , .. _. � � . � 'i � �,`� � '� � ' � n � � i � ' �����" ' �° �� � .. �'�, �� ` � n _ ` , � �i � 1 �t�- , ' � ��'�'" ��'� c{� �� ` �� '�C"�"' F�AT LOSS CALCULATIOiVS HEATING& AIR CONDITIONIIVG CO. ��N(�aPOIlS, MINN. Weatherstrips A.S.H.V.E. Consrruct=�re A�. Insulation � Nfindows Doors '��de Out. Watl Int. Wali C,ei2s"ng Roof floor Kind How Applied Refere�ce Yes—No Yes—No 19 F�l i' �' l �j-'Room ; �er�gth Width `� - ,e�ght YJindaws and Doors—Crackage and Area � ny� W�d*h He�ght �,�pf �meal ft. Area ot ane of ane tighis of crack sq. f; -�- � z .��t-�.�-� � . infiltratlon �G tass Exp. wail Net exp, wafl ;�,c. Wei� Ceiling � Ftoo� - Tota I Btu Required sq. ft. E.D.R. or sq. ins. W.A. Lea area ��i. �� ��Room Length �% Width / Windows and Doors—Crackage and Area No. µ'�dth Height No. of Lineal ft. Area of pane of pane li�hts of crack sa, ft : tnfiltr8tion Glass '' Exp. wall J I � Net exp. wal l - f ni, wat 1 Gei I ing Floor , Tota l Btu Btu ight B tu Required sq. ft. E.D.R. or sq. ins. W.A. Leade area F(. Room Length Width Height V'Jindows and Doors—Crackage and Area . No W�drn Heignt No. of �ineal ft. Area _. ot pane 1 of pane Ilphts of crack so. ft. BiU In�i ttratio+� G lass Ezp, wall Net exp, wall Int. wall Ce' I � ng G' . F loor Jatat Btu � ired sq. tt. E,O.R, or sq. ins. W.A, leader area F�f�,`��,°��:_ Room ' Lengt� G} � Widih Windows and Doors—Crackage and Area N� Widrh HeiAht Nu. of Lmeal ft. Area o( oaoe ot oana t�ohts nf crac�c sa, ft. Infiltration � G lass u� Exp. wall � i Net exp. wall ���' i�c. Waii Ce i I i ng f� Floor • � Total Btu. Required sq. ft. E.D.R, or sq. ins. W,A. Leader area F�. f=v�%` Aoan length �� Width Windows and Doors—Crackage and Area No. W�dTh Heipht No. of Lmea� ft. Area of oane of oa fiehrc ni �.ar� sa_ fr_ Infiltration G lass Exp. wa I f Net exp. wal I � Int. wall Ceiling � Floor Totai Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leade area FI �' Room Length Width � Windows and Doors—Crackage and Area No W�Arh He�ght No. of Li�eal ft. Area Of panC Of D�nB I�ahtS nf rrark SO. ft Infiltr�tion Glass f Exp. wal Net exp. wall ' Int. wall Ceiling /a � ,� Floor f Totat Btu. Required sq. ft. E.D.R. or sq. ins. W.A. �eader area ight B tu �� � / Height B tu f "Height � Btu � ,�5 �� � . i • • * M, � ; ", t . , e ` � ' ��A���� . HEAT LOSS CALCULATIOi�S HEATING 8 A1A CQNDITIONING CO. MINNEAPOLIS, MINN. : YYeathe�st�ips A,S.H.v.E. Cortstruction No. Insulatian Windows Doors ��'�de Out.�Wali Int. Wali Ce�ling Roof Floor Kind HowApplied - Ref�ence Yes--Na Yes—No �g F!. � �L' oom length ��S � idthJ Neight %FI• l��1••17 Room Length � Width Heighi YJindows and Doors—Crackage and Area � Windows and Doors—Crackage and Area � ryo. W�drh He�ght No. ef Lineal fL Area W�dfh ke�qht No, af L�neal ft. Area ,_ of�ane of pane hghts of crack sq. tt, NO• of �ane �t oane iian�s ot crack sq. ft. Btu Infi�tratior, G lass Exp. wal! �� � Net exp. wa 1 I' fttt. wali Gaiting Floor total Btu Requireci sq. ft. E.D.R, or sq. ins. W.A, Leader area I� FI. Room Length Width Height Windows and Ooors—Crackage and Area Np, Width Height No, of Linea! ft. Area � of oane of Dane lipbfs � of crack sq. ft. ..,._ L Infi(tration Gfess Exp. wall Net exp. wal! Int. wail . Geiling Ffoor Total Btu. B tU Required sq. ft. E.D.R. or sq. ins. W.A. Leader area � F1. Ropm Leng2h Width Height MJindows and Doors—Crackage and Area N�, Witlrh Meight NO. ot Lmeal ft. Area of pane , of pane liphts of crack sq. fc. � lnfiltration G1855 Exp. wali 14et exp. wal I !lnt. wall .�Ceii�ng �Floor Totai 9tu. Required sq. ft. E.D.R. or Sq. ins. W.A. Leader area Btu Coet B tu Infiitration !7 � S � Glass � C/ g: ,�=� Exp. wal� � Net exp. wal I � Int. wali Ceiling Q Q DS F loor ' Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI. Room �ength Width Height Windows and Doors—Crackage and Area No, W��ih Helght No. of �1�eal ft. Area of oane of oane liohts of crack sq. it. Coef Btu I nf i 1 trati on Glass Exp. wall -_ 6� Net exp, wall lnt, wall Ceiling F I oor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. leader area Fi. Room Length Width Height NJindows and Doors—Crackage and Area No. W�tlfh He�ght No, of L�neal ft. Area of oane of pane liahts of crack sa. ft. Infi Itratipn � G lass Exp, waf t Net exp. wail int. wali Ceiling Floor � ToLal Btu. Required sp. ft. E.D.R, or sq. ins. W.A. Leader erea Btu GEO. SEDGWICK HTG. & AIR COND. CU. D���.3'�,(� H SE HEATING TEST RECORD ADDRESS �/ CITY . OCCUPAMT OWNER ' HEAT LOSS DATE HTG. INST. SOLD BY INSTALLED BY Electrical Work By Gas Line By % r TYPE OF HEAT GA_ FA HW_ STEAM SPACE HTR. UNIT HTR GAS DESIGN MAKE , �„R�11✓ MAKE OF BURNER Model FT f-f % C? `.� ,�t�`" —� Model Seria! Max. BTU Rating — INPUT �� 5-/%?3� MAKE OF FURNACE Model TH E R MOSTg� Valve � Limit ` � Limit Setting _ Fan Setting— Pilot Type Pilot Make — j,/ �� OTHER_ CONVERSION CONTROLS �� � �� � �' _: Heat Plug Vent Size KIND OF LIN� �� SIZE NONE Draft Hood ...1! %�' � �� /�� Regulator ���'jf-'�'�d '� � Filters Size%�C� � 1� � L� I�lumber •- /�S Chimney Location Inside ��� Outside Chimney Construction �. Pilot Model Smoke Bomb Wiring Pilot Timing �`' Draft Test Tag L.W. Cut Off r poor Pressure Lighting Inst. Pressure �� Percent CO2 ��`� � �b �� �ate Tested � � � Input CFH ��� �� Percent O � 1e O,k' 4�% Company Testing � StackTemp. ��5� Percent CO2 �•� �� �� Name of Tester Form 235 � sue�ecT PER City of Fridley 214 0 8 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ; � REC . � � • COMMUNITY DEVELOPMENT DIV. ; �� ----- . �.�3 y� r � � PROTECTIVE INSPECTION SEC. � � i---- �,��"';,� CITY HALL FRIOLE� 55432 NUMBER REV. DATE VAGE OF APPROVED BV L '� � 612-571-3450 910-F15 6/18/92 � / J08 ADDRESS 1501 Camelot Lane NE t LEGAL LOT NO. BLOCK TRACT OR AODITiON SEE ATTACHED DESCR. ZS 4 Harris Lake Estates SHEET 2 PFOPERTY OWNER MAIL ADORESS 21P PHONE Dennis Dewing 1501 Camelot Lane NE 572-1314 3 CONTRACTOR MAII ADDRESS Z�F PHONE LICENSE NO. Same 4 AFiCHITECT OR DESIGNEFi MAI� AD�RESS ZIP PHONE LICENSE NO. 5 ENGtNEER MAIL ADDRESS ZIP PHONE IICENSE NO. 6 USE OF BUILDING Residential 7 CIASS OF WORK ❑ NEW �l ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WOFiK Construct a 24' x 16' Garage Addition 9 CHANGE QF USE FROM TO STIPULATIONS S:ee notations on plan. Pxavide a hard surface driveway. s� WAR���� � �4�,q� Befor� :dlggrng caN for �il Ufility ib�a�tior�� �,r� ���`� � � �., .:; �lS, 454�OQd!Z '� ��e �REa �, R�QUI�2�D �Y L/�W 1,�� AN�OS ��NS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS AFE REOUIRED FOR ELECTRICAL, PLUM8ING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD Of 120 DAYS AT ANY TIME AFTEF WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS GAFAGES AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VA�UATION SUATAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMPLIEO $6, 044 $3. O2 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 REGUTATING CON- $90.00 Fire SC �G.O4 STRUCTION OR THE PERFORMANCE OF CONSTtiUCT10N. PLAN CHECKFEE TOTAIFEE $9�.06 S�GNATURE OF CONTRAC70A OA AUTN0:�12ED AGENT IDATEI HE P ERl V ID ED THIS IS YOUR PERMIT 6 -/�� � z SiGNATURE OF ON/NEA i�F OWNER BU�LDEA� iDATEI BLDG �NSP ��FTE � � �' d J � i ' � ���. . ;6; �F i �;��� 4 t `.� 0 r T �, �."a�`7 �..' r r:.i'S2 �#� � t�. r �, tr� � , `� � ... - ^�, �� 4,'Ve�j�'� � ,�"�'� , � N����� �.. � ,)� � _ , � ��� ���' ' a ,,�� . . �a ;�i�'kt. • .- (� r` `)��,�.,�C! 1J �[� 0 NEW [ ] ADDN [ ) ALTER ( ] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: ! � Ei�'ective 3/ l Ig2 �,� B�c.�_�'� �2 Legal Description: � - / S l3 /a c � y - �idd . �c � r � �s � a k�e � s � ,� �p s Owner Name & Address: ��NNis �� cv� � S /,; 'ai �a rv� � �� � � �/ Tel. #...i-'7a i 3 �y Contractor. %�,�N,v�s .t�,� w � ti s �S� ��- v� �v �- MN LICENSE # Address:is"D i c• n� e�e � L�I- Tet. #.S'�a - i 3 � y Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DBCK AREA: OTHER: DESCRIPTION OF IMPROVEMENT Length � Width Height Length -�-� Width � Height �_ Length Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Comer Lot [�CJ Inside Lot [] Ft. Yd Setback � Side Yard Setbacks a Type of Construction: 1,�� o d� Estimated Cost: $�� d��i, Approx. Completion Date: /� � 9 u s� 1 S'` y' 2 (Cost on Back) Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x$ = 5 DATE: G z APPLICANT: �,����o �,�,��v� Tel. #��'7a -� 3 � y CITY USE ONLY Permit Fee $ �,l�z dO Fee Schedule on Reverse Side Fire Surcharge $_____�;�� .001 of Permit Valuation (1/lOth%) State Surcharge $ ,,3, � � $.50/$1,000 Valuation SAC Charge $ `�"�`'' $700 per SAC Unit License Surcharge $ ��-"" $5.00 (State Licensed Residendal Contractors� Driveway Escrow $ "�� "`` Alt. "A" or Alt. "B" Above Park Fee $ �'""""T� ' Fee Determined by Engineering Sewer Main Charge $ "�� '" Agreement Necessary [ J Not Necessary [] TOTAL STIPULATIONS: $ ��' � � - ,: 4? F R�=:�P�1 �E H��ATE h;F'�1 HE AD C�PS PR�E .�� 1 �� _`��� TECNNi]L[7GY� INC. FAX ND. ���� �d7.rt�_H&R71t�__MdiYdt#BC�uFirii7 divi���►n_ _ 6i2-E�44-7�?i6 DATE: J��NE 17, 1.992 � U. �I�Yi}E E. WILEY �UILDTNf�'.�, iMSFECTION °�€t�P� : DEt+iN I� UEW I NG - NRMb7R �#JF3J : F��RM i'f" CHANGE g`���� ch�r�ge the c►verali size +�f th� additior� #or the g�r"eege � F �- "� • ` A+� �;�=�►�i tted �i � e was 16 ' X 2B '. 1+�GW � ' _ _: ; c. ` X 24 ' . s F- ; c�r tF�e ch�nge wa� the 2F3 ` c�bstructed tt►e backyard v� arv. �,���ar d�W � . �� / :_ < iy <-.�-,r,� i f �r'E�'i[Y1 �" ��iVI�`It� ' ��-� � Cam�l at La. � 1-r. tr�dley, Mn. 51�-1314 Hame 844-7?2? Wctrk DENNIS DEWING 15�1 GAMELOT LA FRIDLEY, MN. ADDITION - GARAGE c^ X 6 WALLS TREATED PLATES 25/3� B�ILT-RITE SIDING SAME AS HOUSE - 4 X 9 SHEETS TkUSSES - BUILT TO MATCH PRESENT GARAGE - 24" ON CENTER ROOF - it2" CDK FLY -"H" CLIPS - WEATHER WATCH - SEAL DQWN PAPER - 15# FELT PAF'ER - SHINGLES TO MATCH PFtESEhIT GARAGE I}OQf� HEADER - 2 X 1 Q ❑VEFtHANG TO MATCH PFtESENT GARAGE tond vlo�ni�g lp�id Survey�ng Soil� iat�ing Civil [ngmeeriny Munit'rpvl Engineurrng Mortgage � � _ � --� � � �f�l-"�! I�/l1l ea�s N�way /ro. 6S N. E. ' • • ( Minneopol�t, ,,,�,,,�����rl�y, .1�t�. M,��. ss.s2 Telephon• 784-6066 Engineers 8t CJtll'VQ OTS Arso Code 61] �LTEf� NI/ C BRA N1�T Loan Survey for _ � Provide a ha��d surf�ce driveway, 3 feet from the side property line, or cioser with consent from neighbor, 79.98 `� ___--�' ►o r — — � � i��- � � �.� i � . I � � �,, 1� �.�- _ t�-1l � 2 .� 26. 21 ' ' m o i O �Q�l. N � � 2 /. 0 .. 10- � � M E�is� iNC , � N I�OtIS E � ? .9= � q�� \� 2 0' �a� o 9 � ;,\� o ---� � �U� �0.71 �� �1 / _____— � _� 2a � .._.- � �� s � C���oi LAnE N.E, 0 15 � LO T , BLOC K , �'IAXZ/Z15 �pKE ESTATES �,��o �'«•,�1y fhit �s o f.ue ond conec� rep.e�en�a��on of a wrvey o� rhe boundone� of Ihe la�d obove d�scnbed o�d o1 tM loeur�on o( otl build�nya� �f ony� rheraon, ond all v�tiible �nc.00<hmentf� �1 unr� from or o� �oid lond f1�is su•vey ii madr o�lr �n connecl�oM w�fh o mor�qoq.• loo.+ now !»i�y ploced o.. �V�• propertr ond eo Lobiliry ii ossvm�d e.cept ro�he hotder ol such morfpng� or unr othvr in�rre�� ucqu��rd by �he .euson ol wcl+ mort9a9Q• �� �s unde.HOOd and agroed np monvmen� ha��{ r bero ced !o� �he purpotie e1 establisl��ny lof hneti or boundory co�n�r� Du��d tA�s 22�ur of M�QCH A O. 19�� � SUtURBAN ENGINEERING, INC, p Sco�¢ � I 4 ' � tngineyy , j ,p e , o --- r�►� es d►�, E ���1�� �►�,►�nfs j "a`�` i b"r�i.�_�� —tL�-_!'`� ��' � f _ ��� ; � � 22 I � 2 Car Garage Master Bedroom Bath —d Closetl Closet Bedroom I Bedroom 22 .� � Dec \ ' � � Kitchen Dining Room � 't"'-j- Living Room DN UP 6 2 • 16 4 9 .-� � i � � � `' J� � �,J\ � . `/ r� ' � � �- Z � � Z �; � � 0 L , � T S � L� A(l 2 �. � � � ��� � � �> � 3 � �; �- o � � �� , � e _ �- �, �,� '� � � ay o u � �.� c G .{..� � ` C � �j �i �d C� Z � L. i_� p j �' R, �1.. ` . X �'; ,` �_ �A � r � _ �� ��� G c�} , C , � C 1.�� ; . , � � � � �`: O �_ � � :+._ � � N � � � � � F t -ti. ro !� �� I _ m t O T � � ^ � � ""-W � � O � .�, �i � ` � � � O T tZ � � r� ' n O � ( � O � � O � � � '� _, �- . ` � N .-h N � � � � � � ro � � � � �� a � �p c � � � � � � � � � -i � � m �c; ._ `v �� �� Z m � -��' c �' � �� � m � c� < � m � v m� �� i ��� z �' m � � t 2� � � f � _� ; \ d � �. 3. �� � G 7� �- f0o 7�/nyo - ?''Durr� �N 5 c,� �k T`P d , /� �� __� �o � �� � ��-� o � •- o'? /j���^, c %C �, `� M / � O o 'T'i n�� S �, A� r �.� 2�� F c fa L o r E� ��e u N- A� F��4- c.¢ ��c� � %'o �J - f�P M � v� o�d' ii/�F.. F ri � �, r iv� w e, li� v Q� i� n� r-c� �= Ye s� w 1` o� r �✓r ;.v . O w aJ e �- �'� /a ,� �o c�/ — � '' �- 6 �� � � � ,: �( � l.tJ l�)Cn_ �i. � � ;,f • � � p2 ,� / j/ ' U G_ /�^ - � i� � / ; � �/ __ _ _ _ J � � „ , �� _� � * � i \ __ . __. _ . ..._..___.___. _.� t \ � J: �\� � � ry �N `�L�; 0 sue�ecr MIT NO. City of Fridley 2 5 4 7 6 AT THE TOP OF THE TWINS g � I L D I N G P E R M I T f � ` RECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. � ; L��'��� ' . �/� r � � PqOTECTIVE INSPECTION SEC. L.-_- w,�/'��;'� CITY HALL FRIDLEV 55432 NUMBER REV DATE OAGE OF APPROVED BV L' ��� 612-571-3450 9�0-F15 9/8/97 � � JOB ADDRESS 1501 Camelot Lane NE 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO DESCR. 15 [} Harris Lake Estates SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE Dennis Dewin I501 Camelo Lane NE 2-1314 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO DeMar 441-7084 6614 4 AFCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGtNEER MAII AODRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CIASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof House & Garage (26 Sq) 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV IOAD SEPARATE PERMITS ARE REOUIRED FOR EIECTRICAL, PLUMBING, H�ATING, VENTILATING OR AIR CONDITIONING. THIS PEFMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING Sd. fT. CU. fT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WOFK IS SUSPENDED OR ABANOONED FOR A PERIOD OF 120 OAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALIS GAHAGES . AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAIUATION SURTAX ANO OFDINANCES GOVEFiNING 7HIS TYPE OF WORK WILL BE COMPLIED � 1, 629 �. H I. WITH WHETHER SPECIfIED EREIN OR T. THE GRANTING OF A PERMIT DOES NOT PRESUME TO IVE AUT Y TO VIOLATE OR CANCEL THE pEfiMIT FEE SAC CHAfiGE PROVI�SIONS OF ANY O E AT LOCAL LAW REGULATI G CON- STRUCTION F HE P f0 A C ONSTRUCTION �54.�� Fire SC �1.63 � i� /+� PLAN CHECK FEE TOTAI FEE `% License SC $5.00 $61.44 S�GNATUREO CON7FACT PAUTNOAIZEDAGENT � nrEi WHEN PROPER�V V DATED THIS IS VOUR PERMIT . r S�GNATUREOFOWNEAiiiOWNEABWLDEAi IDATQ� -�� �psp ppTE NE« ADDN ALTER [1 [ 1 i�4J ' CITY OE FRIDLEY S[NGLE FAiYIILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLiCATION ConstructionAddress: � � Legal Description: Owner Name & Address: r� n�� 5 Contractor: y _ _ e.�{' S � Address: �s' �-lb (— /� �� `' � 1�,,,, LNING AREA: GARAGE AREA: DECK AREA: OTHER: Effecti��e 1 / 1 /97 ��// � C� �7 % Tei. #�_ „S7� % / �( MN LICENSE #_% � �y �Tel. # yl��. � ��`% Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scate. DESCRIPTION OF IMFROVEME\rI' Length � A-'idth Height Length Width Hei�ht Length Width HgtlGround Sq_ Ft. Sq. Ft. Sq. Ft. �� 5��� � Construction Type: � ' � � � Estimated Cost: $ ( � ��p �' _� (Fee Schedule on Backi Driveway C�rb C�t Width Needed: Ft. + 6 Ft� = Ft x$ � —$ DATE: � APPLICANT: �1 � 7 . ���. # Y� 1:� o �Y Permit Fee �ire Surcharge State Surcharge SAC Charge I,icense Surcharge �riveway Escrow .�rosion Control f'ark I'ee Sewer 1Vlain Charge �ro�r�� =�t,�l�ur_n�l��o��s _ CITY USE ONLY $�.. . � C� Fee Schedule on Reverse Side � �. � .001 of Permit Valuation (1 J l Oth %) $ g � $.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 [ ) � ��.� �. . , r CITY OF FRIDLEY INSPECTI�N DIV. 6431 Universiry Ave NE Fridley, MN 55432 , 572-3604 RATE SCHEDULE Effective On January 1, 19y7 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES � Residential Furnace Sheil and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with ne fu�ace �-�� U � Gas Range ti � Gas Dryer *Air Conditioning - All Sizes � - Rate $ 30.00 $10.00 $ i 0.00 $ 10.00 $ 25.00 � . � JOB ADDRESS SG� � � .�.: � p � � C���� � The unde�signed hereby makes application for a permit for the work herein TOTAL specified agreeing to do all wo�C in strict accordance with the City Codes and rulings of the Building Division, and hereby deciares that ail the facts and $ representations stated in this appiication are true and correct. $ � $ $ $ All Others/Aepairs & Anerations (LIST ON BACK), �� 1�a of Value of Appliance or Work --% ��'�-�� $��' - -�-v�� Commercial/Industrial 1, 25% of'Value of Appliance or Work State Surcharge TOTAL FEE $ $ .50 ��S , MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRiGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. 1997 OWNER � ' , �,�L L (�C %7 �; JL. Z < < �� %Z- 13 I y , BUILDING tJSED AS � �����,Z� � � � / D2% ESTIMATED COST � �C�� � PERMIT N0. � ���(`; � DESCRIPTION OF FURNACE AND OR BUaNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Tota! Connectad Load 8umer Trade Name Size No. BTU - - HP EDR HE4TING CAMRANY ' �_ D--�-L�� �— Signed By G� �L� c Tel No.. "7� �%- �`��/ Approved By Rough-In Date Final Date FILL OUT BACK SIDE F R STACK VERIFICATION ON REPLACEMENT FURNACE Building. Inspections 7. 63-572-3604 DATE / � SITE ADDRESS � T}iIS APPLICANT LS: PROPERTY OWNER/ TENANT corrrx�cTOR SZJBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMlT TYPE TYPE OF WORK: t- MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS (� OWNHR GiCONTRACTOR IVA1ru.• " — _ ADDRESS: / "-� U � C ii �� - —CITY PHONE: � / -� _ � 7 ;�. _ i 3 � `F COMPANY NAME: CONTACT PERSON: STATE LICENSE # E}� DATE CITY ADDRESS: PHONE FAX '�STNGLE FAMIL1' O TWO FAMILY � TOV+RJI-10USE ❑ J�W � REPLACEMENT ❑ AL7ERA770N/REMODEL DETAILED DESCRIPTION OF WORK PermitNo.: - <� Received By' Da���:SE 17 20 ,.�C,:,��. lu. �r��T ATE�I�IP STA'TE ZIP PER MS 16B.665 the permit fee is a minimum of S15.a1 fixtureo x luding the fixtwes� (Ths Ohou d reflect only thercostrof labor ) improvement, uLStallation or replacement of a res�denta , x.05= I,aboT� under $300 = SI5.00. Labor cost between $300 to $5� = cost of labor �_ I�.� �pTAL FOR PROJECTS �RE LABOR EXCEEDS S500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT �� N�T�S]ZF.�BTi�' � NUMBER OF EACH BELOV� �G. �fG�ZK_ MODEL: ________— Sti�g.N Equipment Installad . . � MODEL: MF(''' —'_ MODEL: sIZE/BTU _� MFG: GAS RANGE/OVEN 510.00 A/C $25.00 _FIREPLACE (GAS) 515.00 _J.�W G,qS Ggn,L 510.00 FIREpLACE (WOOD) $35.00 G� �T � g10.00 —,AIR TO AIR EXCHANGEER $15 F�pCE $35.00 —pppL �,p� $35.00 BOILER $35.00 � "�G,e,g DRYER 510.00 _�Mp�'pR 515.00 _CHIMNEY LMER $10.00 _GAS PIPING 510.00 DUCTWORKS1000 . _ . _ ' a , � � ��1\ � �Y� �' ��,��{��, �� i ' (i b,.' ., � . . ... . . - . � � q ..f 'k � � ?' ..... . ,...�. . . ._ � ...... �_ . ""'. . ..I[. � ....:.... ��.,.1?'� . .. ^ . � .. ... .. �-.. .� . .,.,,. ,.�� ����!'�'��.�'.,�. _ ��� .. � . ° ' � Number of fixtures @ $10.00 x $10.00 $ Permit Fee $ riumber of fixtures @$15.00 x$15.00 =$ Surcharge $ .50 TOTAL DLJE $ Number of fixtures @$25.00 x$25.00 =$ Number of fixtures @$35.00 � x$35.00 =$� State 5urcharge = $�_ Tota] _ $ �vJ � J� THIS I5 AN APPLICATION FOR A PERMIT-NOT VALID UNTII- PROCESSED that the work will be in I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; �at I understand this is conformance with the ordinance�l � fo �a e ermit and� workFs�not o startlwithout a Perm�t; � t� �'�'O k W al be in accordance with the n o t a p e r m i t b u t o n l y a n a p p l i c a P approved plan in the case of �work which requires review and approva l o f p lan s. • � P R i N T N A M E �� N% i t J !S � t t�t DATE 9�/� � �� SIGNATURE OF APPLICANT � • � _ __.... _ _ _-, .�,.a,��;-«:,-�r�'�"'���"ti.`�ra`i�Ft`'i�'�iG�"�.����.3� � City of Fridley Building Inspections Department . 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building Inspections 763-572-3604 763-502-4977 FAX BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 1-1-2010 Permit No.: Received By:_ Da�' cl� � DATE �J �/���v YOUR E-MAIL ADDRESS Gf'�� M4< <'oS @ L�'V G. GA�^'+ SITE ADDRESS I� i �r.� `IO f" L H T'I-IIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF INSURANCE PROPERTY TYPE PERMIT TYPE TYPE OF WORK: DESCRIBE WORK BEING SIZE OF IlvfPROVEMENT_ ❑ OWNER �CONTRACTOR ADDRESS: PHONE: � ve-F � %��N ST;ATE ZIP STATE LICENSE �! .�r �.a � 3 �oy Y l EXP DATE Ma6•�GG1 �/� �.O �� ADDRESS: � �O � � � � I� � ►/1 '+� CITY �"we �-Q^ STATE M n ZIP SS � O 3 PHONE L� 12 -�.2 Lp - SD`a � FAx 7!w 3- 5/ S- 3.C" 7/ �d SINGLE FAMILY/NEW CONSTRUCTION SIZE O TWO FAMILY/NEW CONSTRUCTION STOF ❑ ADDITION ❑ BASEMENT FINISH ❑ DECK ❑ NEW HOME CONSTRUCTION ❑ MAINTENANCF./REPAIR ROOFING NUMBER OF SQUARES �_ GARAGES PROPOSED SIZE: PROP03ED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Oti�er WINDOWS 1N EXISTING OPENINGS ❑Yes ❑No OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED _ '�. ROOP ❑ SIDiNG ❑ SWIMMRJG POOL ❑ ADDITION ❑ HOUSE ONLY � HOUSE & GARAGE ❑ ATTACHED GARAGE O DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia LOCATION OF W1NDpWS NUMBER OF ❑ WINDOWS ❑ DRAIN TTLE � OTHER BASEMENT REMODELING SUBMIT: I. ExistingFioor Plan 2. Proposed floor plan 3. List of swctural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations FOR WINDOWS - PROVIDE U-VALUE AND MANUFACTURE STICKER ON WINDOW. ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING�'HE 1997 U.B.0 FEE SCHEDULE) COTAL JOB VALUATION $ JD ►�� OCCUPANCY TYPE Permit Fee Plan Review F'ue Swcharge Surchazge License Surcharge SAC Chazge Curb Cut Escrow Erosion Control Park Fee Sewer Main Chazge Total Due $ Q'1,2`J $ $ 35 $ �'l � $ 5oU $ $ $ $ $ $ 0 ,5 SI See Back Page for Fee Schedule 65% of $uilding Permit Fee .00I times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (Staxe Licensed Residential Contractors) $2100 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$24=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks aavable to: Citv of Fridlev Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I aclmowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and wo ' not to start without a permit on site; that the work will be in accordance with the approved plan in the case of ail wo require iew and approval of plans. SIGNATURE OF APPLICANT _PRINT NAME C�.{� iNI.G�Ir'� S DATE '�' Q� T�