AF - 43731� usuRB�►N
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� � Civil, Municipal & Enuironmental Engineering
Land Surueying • Land Planning • Soil Testing
�
� Mr. Dave Harris
6279 University Avenue NE
Fridley, Minnesota 55432
Ro6vrl .'Nirtder. Reg. Eng.
Wm (i. Jrnnen. Req. Eng.
Re: Lot 4, Block 3
Harris Lake Estates
Dear Dave:
Main Office 5�1-6066
6875 Highway No. 6� N. E.
Minneapolis, Minnesota 55432
South Office 890-6510
1101 Cliff Road
8urnsville, Minnesota 55337
May 28, 1976 � '
��
1P��
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i'
On May 11 at the request of the excavator, Jerry Belair,
we examined the excavation on the above lot and found stable
material below the excavation bottom.
The Contractor then backfilled and compacted the excavation.
On May 12, we ran a density test below footing grade and found
91q of modified Proctor.
We recommended that two #4 reinforcement.bars be used
in all footings placed.
Based on the above it is our opinion that the foundation
fill is satisfactory to support a typical single family framed
dwelling.
PJM/jp
cc: Jerry Belair
City of Fridley (Darrel Clark)
E. A. ({athAun, Reg. Suru.
Wm. K. Meyer, Reg. Eng.
Sincerely,
SUBURBAN ENGINEERING, INC.
�, �
Pete J. Molinaro
Project Engineer
4Vm. E. Price, Reg. Eng.
H. Wil[iam Rogera, Reg. Suru.
Cary R. Harris, Reg. Suru.
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The �:nctersi?,z:e: hereby maxes ap,�licatio:� :o: a Derr.^it for L':e worJc .*.e: �.�
spcc�fied a�rc�c•.r,g tr� dc aEt �e�ork �n strict accordan:c with thc Ci:y O:C:r.z: t� '
and r!i�ir.g ot the Depa:t;n�nt of ii���ldir.pc, and hereby decln:es thst :A tbs f�
and rrNr���Pntdtiuris stalyd �n i}��s appLcaU<�n r�rr ttue a� CarreC� '
F`r�dley, :,2inn � � � -,..29�,.�.
l?�wr.er �iP/G�iC�I/F/� .�Jj�/G�'l% F.P.S� /�� : ,
Kind of Building �%4'��� fif'�?�'
Used a� . ��f%.J fy�� _
T� be coripietw; ab:ut �� �`�' �,� .
O?J . .
Es:imat�3 Cos� S ��6D �
O{d—New. Btu{ding Perm:t No. .--- •- — Ps:mit Ko. (L
i�r-C::i..=T:4:? Or^ tI G:i�
HE.�TTNG cr PO'�'i: �'",..A2�PFr--: tc :.•a, F•et �'n atrr, s.-z� � No..�,.�.___
T: ade h'ame �"Z�f'iP•OG��G�'c.°T.P/C' S�ze Na Lu /..ZU C'r.�6'
Capacity I�20s p�,8i�(Sq. i''S. i.D.R BTU H.P
TotaI Connected t.cti`d Afnd cf F�ct /�A�
BU::P3F.ii — Tr��r Name Sirr No
Cay�.cf ty � Sr�. F't. E.D � II'1'U �
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SUBJECT P .
City of Fridley ° 13504
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� � ECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV. ���/� 6
' � a: - -
r � � PROTECTIVE INSPECTION SEC. r�
'4 � ����1 � CITY HALL FRIDLEY SrJ4.32 NUMBER REV. DATE PAGE OF APPqOVED BV
""'� � ``� 612-560-3450 / /
910-F15 5 6 76
JOB ADDRESS c�melot Lane N.E.
1 LEGAL LOT NO. BIOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 4 3 Ha.rris Lake Estates SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
James Strande
3 CONTRACTOR MAIL AODRESS Z�P PHONE LICENSE NO.
Brickner Builders Inc. 6245 Ben More Drive N.E., Fridley 574-9871
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS 21P PHONE lICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
p NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBEWORK � `4•�\��J������
Construct a 30.5' x 40' Dwellin and a 20' x 32.5' Ga.rage
�. r>�r�t, �?! fC�i f1�1 !:;�'S
Te�EP�V,�;E- ���c�►?it;_ �{;.
9 CHANGE QF USE FROM TO R E� L! � ati �� Ls �/ ��l � A/
'1 YY
STIPULATIONS provide a hard surface driveway. Provide a verifying survey before
capping. Provide sod in the front and side yards. Provide truss design. Soil tests
may be required.
SEWER LOCATION: (Approx. 13' Deepj 86' West of Manhole (Inv. 876.43)
WYE ELEV: 876.09
TOP OF FOOTING: 879.59 Minimum
WATER LOCATION: 10' East of sewer service. '� ��^':' n''�'
;.�� .�, , i : -<, � -
� ^ � �;TE :
�� NOTlFY THE F c;i�L_Ey E�d�q.
� �L.L�y D��� N�T C�f,: QIVISION RE( /`,� �::�J C;�!;z�
Tt-tE CyTY �" , r�,. �C;C:,:$'.C�a;� Ar:J Ei�vATlO'r.S REMOVAI RND i�Ll'►fi� _s�<<c�JT
,. �
� �. cY 4,:��. r ,� :
�.��:..U':;r,vY n s�vy,�::aYq`�J,� PLi:=r���-S O�LY AT URfVEWAY OPE�i�ii�luS,
Tt,i�• Gr"•.��a t� �0^ TIiE 1PvF0��
P�n�O�yS US�t�C IT SflOULD V�i'��Y
ON SH� StT�.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TVPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OFi AIR CONDITIONING. WOOC� FYaiCle
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRCICTION ZONING SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 1236 +(SO 19,792 + 6500
ANY TIME AFTER WORK IS COMMENCED. NO. OWLCa. UNITS OFFSTREET PARKING
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPUCATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVEFiNING THIS TYPE OF WORK WILL BE COMPLIED.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF q PERMIT $3S, 540 y��.%. %%
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW FEGULATfNG CON-
STRUC� R THE PERFOR CE OF CONSTRUCTION. $4H.C4 $350.00
r. > � PLAN CHECK FEE TOTAL FEE
� ta�;�✓ .- ,�� /.�,�, J -%��/ �./,� $416.41
SIGNATUREOFCONiR ORORAUTHORIZEDAGENT •IDATEI ' � WHEN PR PERLY VALIDATED THIS IS YOUR PE.RMIT
' ��.'�.' � I �tk. ��.1 � ��C� _ l� .
SIG�NA URE OF OWNEpI�f OWNER BUILDERI IDATEI BLDG INSP nATE
APPLICA:fION 1�OR RLSIDL'NTIAL, ALTERATION,
OR ADllITION BUILllING P�RAtIT
CITY OF FRIDLEY, MINNESOTA
/J ,��% .
OWAiER' S NAME : ��1M,�:, . ,�t,�-Y BUILDER : � �'��f ,•�, l���"-� � '
ADDRESS : -�� ' ADDRESS : % �-Y.�� �1-�'.,�yf ���L+� �-'! '
� «�� �
NO • . �� STREET • O'Y!'l�e�'� !y�'��•-
. � � �
LOT :,� BLOCK s .�' ADDITION t/����-�� �,
. �`-
CORNER LOT: INSIDE LOT: � SETBACK: �� SIDEYARD: %P� ��� �
Applicant attach to this form Two Certificatcs of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OP BUILDING
To Be Used As : j��1,���� ��,,�.,� , .
,
, , ���
Front : �v � � Depth : %U Height :
Square Feet: �Z 3�o Cubic Feet: �%, ~%9 L�
Front • -� � � Depth • ..,3 Z. � ,� � Height • � Q
Square Feet; (� 9� Cubic Feet: G 3�~-C)
%�, �- /
7�ipe of Construction: ��/,�,rt�1,�!.�, Estimated Cost: $ .%i���.�
�--4��---
To Be Completed: _��� "/ �-� / � �,�i" �'.�/Q � �
. � J
The undersigned hereby makes applicatinn for a permit for the work herein�
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and coxxect. _
I° ^ ��
• DATE : � � " /� SIGNA.TURE : � �
(See Reverse Side For Additional Information.)
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Page o
� �
EXTERIOR ENVELOPE AV�F211GE "U" CODIYUTATION
. r..
' . , OWIIEK: ��,�- ' "�'����YI�.,.
� '������
SITE ADDI2E:SS: /��
CONTRACTOR: ���!��i�'�/�' �� —� .
Dl�TE "' � _ � �
PHONE : �� � / Q ��
Detexmine worki.ng square footage of each
� / �Y8:k3
1. To�al exposed wall area...... _� b sq. ft. x .17 =
2. Toal roof/ceiling area . . . . . . � � � � sq• ft. x .05 - �'
Total exposed wall area above floor =� l�• �J/
a. Tatal wall window area ................................. ��� � '
b. Total door.area ...................................... � ?. �'
c. Total sliding glass door area .........................
d. Total f.ireplace wall area ........................ ....
e. Total wall framing area (average l00) ..................
f. To�al rim joist area ..................................
q, _ wall area above floor ..........................
h, wall area above floor ..........................
i, wall area above f].00r ..........................
j, wall area above iloor... .... ................
Total exposed foundation area =
.
k. Total foundation window area............•.•••••••-••••• ���'
1, Tota1 net foundation area above grade ................. � 1
Determine "U" value of each wall segment
(e.g. window, door, each separate wall section)
.
��/a_�a X „U„ ,s� � _ '/��3
a. , —
b. �7. 6g x „U�� . �$ _ °d1 •��o
3 q . � ,� X „U„ . �� _ � ! � q 1
C. .
a. b� . a � x „U„ � '�-'L = 13, �L
� ��.�.37 X .,U„ •i� ^ ��S'`
�.
� £. �y�` X „U„ . �,� � g . �
Il L .o �o.�.
y , ��- X .,U„ � _
y-
h.
i.
X ����� _
X "U" `
7- '
X "U" -
k. X ��U�� �
►% 33 . 3�
' 1. � > X „U., • y7 =
' Total � _ �`��
3 . .................... ........
✓
f
i'� � , �
1
\ k
i �� � �
F� F . �... � i,.
i� \F
�:
�
�.'
If item #� is t:hr. �ame �s,
oz' less thai� itcm #1, .you
have me� tha intent c�f
SBC GOOG (r) 2•
,i�:xterior Envelope Average "U" Computation Page 2 of 4
..
• ,•
; , � _ . Total exposed roof/ceiling area = � � �a D
m. Zbtal skylight area ............................ .
n. Total roof/ceiling framing area (average 100)...
o. Total net insulated roof/ceiling area........... ���
Determine "U" value for eaeh roof/ceiling segment
m. X ��U�� _
�
V i. �• '� . � 5/ _ �^
i//� '�"� �j 5 l� X �.�„ � .
� L !� T ° - � �`� x „U„ , p = � � ,�
4 ........................... �tal = S •
If total of #4 is the same as, or less than ##2, you have met the intent of
SBC 6:?06 .(c) 1.
Alternate Building Envelope Design
To utilize the total envelope syster,i method, the values established by the sum of
items #3 and #4 shall not be greater than the sum of items #1 and #2.
1. + 2. _ .
3. + 4. _
�
0
• ' WALL SECTIONS
NO'PF� Use 10`� of opaque wall area for
� frame construction
�FSG. #�3 •
,tJ,�.� r' . 1
�._ , , � }- _ ' - i � � ' , '
. . ` ' • . ; �.
� .,
r• : . . � , . ,±; '
Construction
Page3of4
R--Va lue
1. Interior air film ' 0.68
2• ' L'' S N�tT (ZocK o•��__ �_____I S
3. 3��." sr�a - _ y. 3s
4. �i, ., ,NAt� 13A5�. --. ►, i
5. �/�., ��SoNr r�t., 0. 'i
` 6. Exterior air f i.1m ' 0.17
Total
; 7. y�
1, Interior aa.r fiZm p,68
a. '�t" SH�cr L���� �0-�5" .
3- 3 i,�� Fl�P.dP��a��S� l�1/SJ1. 1
�._______
� - ��.�� %d ��.a� 5.�. _.,.... ____ _._ -._t._. ��i
5. �i,� yl��o N l r't �.�
6. �cterior air fa.lm p,l�
Total/f `�t,/
� /
1, Interior air f ilm 0. 68
a. 3lti., FiQeeCt,4s� �Nsvi . l.f
3 . � '%,., r� m � i �'9
4 . �%. �� NA, L � p s � , : � y
5. �,/�" �psor�rr�. o.��
, 6. Exterior air film �(j,l�
Tota
; , s,�s
1. Interior air film 0.68
; 2.
. . 3. /`��� dG/� %•�0
4. �
5.
� 6. Exterior air f.ilm � 0.17
- . To ta� . � 3
. . '� . .• � . 6 • `
� r' • � � 6
.. �3.r.,,,(j�.?lr=� r ' � • �9 � r\ . • � i
__-- -- � .. � ! 1 �__-__ . • � - ` �
/!( ~- , ,' ; • � . .
..--- ,
.
� y „ �.
�..^ � � 6 • . ' i ►1! —
::: ^ - . �—
(lt .. •` . • - . � .__. / 11
� � ' ' - � !i/ '
FIG . 4� �} ""_ � . ` . ' � ,_: / r(
: /!t � • . � �, ,_._
" ' �� // ! ��
. . ... f
, ,,.--
• ' • (C( I! ( �`- l� -X !/� �:.. rt �
NaTr'.: Inclicate tyne, "n�" 'value, depi:h and
��
Y
� • .
.,�
ROOF/CEILING
` ���� 1....{ ] ) 1.-{ j j _ • •
� �✓
t�ented �Ieat flo�
F uP _ ..
FIG. �5 .
.. . �?�7.�e!N�t�_'�.1 _1�-'^�.L:�Y�•S�e,f,�'��y'✓'nl-.Gi--.TiKe�1 ,
_ - - = :�
� . `� � `�J `�.`�'.J � ' � i
: • i
�
?:eat floc•� up � . , ••vented �
. . � . • • .: I
_. . ;
: F�r,. �k6 ..... . � . _ i
_. . � i
• . - --- -------- - � .-, -- =---- I
- --� � : .-.� ; '
. � . ' 2
� _ . .. : (r`�9 �'.S; �rF'--�� � �..
.�a1 L: � �,.. �'� �
- F�sk:3t�`..-� =� , .•.
�,���a,�yi:�:=,':?:.: .•, ' .• •'� �
. �.�. '�' y' •�.►= _�-°'�'i�-�'�'. • � ' ....�-"'°t
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;;
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f/� : .
,...!-=-� 1 • � , .
• NOt.--�'.T�...D . � .
. ' '. , .
. � . . � � Heat � . , .
' , : � � fl�w ug� � � • ' � . ,
. � F'.T,r,. �7 : � . .
Page 4 of 4
Construction R-Value
l. Interior air film 0.61
a. %,,'' sH��rltnc.K o-y�
3. �p" �jg�.tGt-���5 ZN�,�� ��-
T
4. Exterior air f ilm (still) � 0.61
. � To al � ` . LI�
O /
1. Interior air film � U.61
a. `/ti " S N�� �Co c.k .
3. 6,� F r LQ c� ss A � s
4. Exterior air film (still) 0.61
To al A � , �,
��
� d,.
l. Inside air film
3.
4.
5. Outside air film
0.61
0,17
Total
Note: Use additional sheets if more space is
needed for details and calculations
.
.
CITY UF FR1p1,.EY INSPEC7�ON DIV.
6431 University Ave NE
Fr�ctley, MN 55432
572 —3604
Effective On August 1, 1995
APPUCATIDN i�OR PLUMBtNG AND GAS FiTTtWG PEHMIT
AAARK NUMBER (�F FtXTURES TO 8E INSTALLED ON EACH �1.00R
0
PLUM6ING FIXTURE RA7ES:
NO. RATE TOTAL JOB ADDRESS /,5.� B �. A dr�� �(-o T"" �%� ��
New Fixtures
�id Opening, IVew Fixture :
Beer Dispenser
Blow Oif Basin
Catch 6asin
Rain Water t.eader �
Sump/Receiving Tank
Water 7reating Appliance �
Water Heater —�lectric �
Water Heater — Gas*� °��'�'��;,"� �._
Gas Range** R
Gas Dryer**
Back Fiow Preventer Required ( jYes () No
Type
:$ 7.00
$ 4.00
$ 5.00
� 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10;00
$14.00
$t0.00
$15,00
The undersigned hereby makes application for a permit for the work herein
specified agreeing to da ali wc�rk tn strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all ttte facts
and representations stated in this application are true and correct.
�' �` , ��
Owner �A rr1€ S S 7ri2A- ti'._t)E S'7� "� 5t g
10 �^ B�iiding Used As
� �
�stimated Cost .5od • p�Fi�y}T Np, ,��� ,� j �
Reinspection Fee $42,00/Hr
AlL OTHERS ANO/OR REPaiRS ANO ALTERATtONS �
i.5% of Value of Fixture ar i�lppliance a� .
State SurGharge
T�QTAL FEE
.50
PLUMBtNG CO ANY � A. ..I n l`I l.i � a� �c. S� I�
as �pes�s�u r Sr �3�y ��KS �ia
SIGNED B � d �w TE� No p � 3- �� ��
�
Approved By
Rough—In Date Final Date
$ o�e . 50 PLUS THE 5.50 STATE SURCHAR�E
**COMBUSTION AIR SHALL BE PFtOi/iDED PER UMC SECTtON 504(A) ftND TABLE 6—A. MINIMUM StZE 9 SQ INCHES.
SUBJECT PERNFiT�N'i5:"'->`•
City of Fridley �'� 2 5 4 6 3
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T �
! ` -RE£ffP .
� • COMMUNITY DEVEIOPMENT DIV. J '� +�
r � V � PROTECTIVE INSPECTION SEC. �� V
� �
� � /"'1 � CITY HALL fRIDLE� 55�32 NUMBER REV DATE PAGE OF AGPROVED BY
�.---�•' �'' 612-571-3450 910-F15 9/4/97 / /
JOB ADDRESS 1520 Camelot Lane NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCF. �1 3 Harris Lake Estates SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Ginger Strande 1520 Camelot Lane NE 571-6518
3 CONTRACTOR MAII ADDRESS ZIP PHONE UCENSE NO.
DeMars Construction 8401 166 Cir NW, Ramsey 55303 441-7084 6614
d ARCHITECT OR DESIGNER MAIL ADDiiESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS 21P PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WOHK
O NEW ❑ ADDITION O ALTERATION � REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WOfiK
Reroof House & Garage (22 Sq) 2nd Layer
9 CHANGE OF USE FROM TO
STIPULATIONS Roofing can be the 2nd layer but not the 3rd.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRtCAL, 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 DAVS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED fOR A PERIOD Of 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV TNAT I HAVE REAO AN� EXAMINED THIS APPLICATION 1 STA��S GARAGES
AND KNOW THE SAME TO BE TRUE AND COFRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
WI H WHETHER SPECIF ED EREINIORVOTOTHE GRANTING OF AOPERMIDT �1�37H �.69
DOES NOT PRESUME TO E A Y TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OT ER T T O CAL LAW fiEGULATING CON- @
TRUCTION THE P FOR NC O NSTRUCTION. W45.75 Fire SC �1.38
PLAN CHECK fEE TOTAL FEE
License SC $5.00 $52.82
S�GNATUAEOFCON'R CT�RO�: TMOR�2EDAGENT IDATEI WHEN PFOPER VALIO TED THIS IS YOIfR PERMIT
S�GNATUFlEOFOWNEAiiFOWNEABUILDEA� �DATEi ���� BlD iNS� � D�TE
NEW
ADDN
ALTER
[)
�)
�"�
� C[TY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: l�� � �'� � I� ��,,,..� �;
Effective 1/1/97
��� 25�6�
����
Legal Description:
Owner Name & Address: dC �/� S Z� G� v�.e � d'�' "1' ie # S% f .� S�' g
Contractor: � MN LICENSE # b,� � �/
Address: � � l'_ �� � p'1/ %���^-tSc Tel. # 7 y� %li�t/
Attach to this application, a Cercificate of Survey o tti ��
lot, with the proposed construction drawn on it to scale.
LIVING AItEA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
n �� S o��Q..c-� � � ` '1
Construction Type: �� Cp�� Estimated Cost: $ ;� �
�� a�� (Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
' DATE: � � � � A,PPLICANT: � ( / Tel. # �y � � v� l
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
S'CIPUL/\TIONS:
� �� , ��
$ J, ?o
� � ��� �
$
$ �-� ��'c�
$
$
$
$
$ ��� ��
CITY USE ONLY
Fee Schedule on Reverse Side
.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 [ ]
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
�631572-3604 FAX: (763) 571-1287
1520 CAMELOT LN NE
133024410049
HARRIS LAKE ESTATES
LOT 4 BLOCK 3
BUILDING
RESIDENTIAL
RESIDING
PERMIT NO.: 2005-02005
DATE ISSUED: 09/26/2005
C��
VALUATION : $ 9,708.00
NOTE: PER R703, 2000 INTERNATIONAL RESIDENTIAL CODE, REQUIRES THAT A WEATHER RESI5TIVE BARRIER BE
PLACED OVER EXTERIOR SHEATHING TO PROTECT THE INTERIOR WALL COVERING. BXCEPTIONS FOR THIS
PROVISION WOULD BE IF SHEATHING IS AN APPROVED WEATHERPROOF PANEL OR WHEN THE SIDING IS AN
APPROVED WEATHER BARRIER. VINYL SIDING IS NOT A WEATHERPROOF COVERING UNLESS THE
MANUFACTURER STATES THIS IN THEIR APPLICATION GUIDELINES. CALL FOR INSPECTION OF WRAP BEFORE
COVERING OR TAKE PICTURES. RESIDE HOUSE & GARAGE
APPLICANT
HALLIBURTON HANDYMAN SERVICES
2138 PROSPERITY ROAD
MAPLEWOOD, MN 55109
(651)303-1597
OWIYER
STRANDE JAMES E& V J
l 520 CAMELOT LN NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this rype of work
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to ,
violate or cancel the provisions of any other state or local law
regulating construct►Qn or the performance of construction.
,, _.c;; �„:�., 11 Date 1 � .
BUILDING PERMIT FEE
FIRE SURCHARGE
STATE SURCHARGE, VALUE
TOTAL
Bldg Insp Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
181.25
9.71
4.85
195.81
Building
Inspections
763-572-3604
DATE
SITE ADDRESS r' ' � �
THIS APPLICANT IS:
PRO�t ERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH A.PPLICATION
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
BUILI)�NG
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR
� OWNER
aDD�ss:/S�D �E �'r�vtieCo!
PHONE:
STATE LIC
ADDRESS:
L7 SINGLE FAMILY/NE
❑ TWO FAMILY/NEW
❑ BASEMENT FINISH
L7 DECK
U
DESCRIBE WORK BEING
SIZB OF IMPROVEMENT
NUMBER OF SQUARES _
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
�Vinyl
❑ Aluminum
D Other
EXP DATE
❑ GAR.AGE/SHED
❑ OOF
IDING
❑ SWIMMING PO(
❑ ADDTTION
❑ REMODELING
0
Permit No.:
Received By:
Date Rec'd:
CTTY STATE_ZIP,
❑ WINDOWS
❑ DRAIN TILE
� OTHER
LENGTH WIDTH HEIGHT
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
� DETACHED GARAGE
❑Soffit
❑ Trim
❑ Fa�cia
WINDOWS
IN EXISTING OPENINGS ❑Yes ONo LOCATION OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
�
Ft.
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS. & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing sWcwres
and proposed projec.t.
2. Two sets of construction plans
3. Bnergy Calculations
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS I
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USIN THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ �% D�"' OCCUPANCY � TYPE
Permit Fee
Plan Review
Surcharge
Fire Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ 1 �I�?S
$
$ I
$
$
$
$
$
$
$
$ -> ,�
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�able to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID LINTIL PROCESSED
I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinance codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an applicatio or a ermit 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 hic e,�iires irevievy��d.�ppi�a� -f`�gl'ans.
SIGNATURE OF APPLICANT i:�`t �� ���A�� PRINT NAME DATE
� �I ...... . ... �'�� '�,� ���5 .�
Building ���� � � 1V11+�(:HAl�ll(:AL ` � ..
Inspections RESIDENTIAL APPLICATION Receivea By: �._,1__�
763-572-3604 Date Rec'd: `� � �'�'�'�
CITY OF FRIDLEY
DATE �1 '�- l G� YOUR E-MA1L ADDRESS
sr� a,�DxESS l� oL O �rn �to � c�.r, �
THIS APPLICANT 1S
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOURSTATE
LICENSE WITH
r'+.PPLiCATION
PERNIIT TYPE
0 owr�R �corrrx.ACSOx
�v���
PHONE: � ln � - � � � ' � � I �
COMPANY NAME: •,.... _...-- ---- -
CONTACT PERSON: 3OA� ZI�TIREN
STATE LICENSE #
EXP DATE
�r i � �� STATE, l��'LIP_C��
�,DDRESS: 13562 CENTRAL AVE NE CITY ANORA s'rATE MNZIP 55304
PHONE 763-757-6202 p,�; 763-757-6701
TYPE OF WORK: I o rrEw
DET
FAMILY ❑ TWO FAMILY
�REPLACEMENT
OF WORK �
O TOWNHOUSE
❑ ALTERATION/REMODEL
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (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. FTXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOV�
Equipment Installed , MFG: r r � ef MODEL: ilri-� � Ola b SIZE/BTU ���
1v�G: r �� �t MODEL: L����U30 SIZFJBTU ►'i
�G; MODEL: SIZE/BTU
�A/C $25.00 _FIREPLACE (GAS) $15.00 GAS RANGE/OVEN 510.00
AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _NEW GAS GRII.L 510.00
BOILER $35.00 �FURNACE $35.00 _GAS TJNIT HTR SI0.00
CHIMNEY LINER $]0.00 GAS DRYER $10.00 _POOL HEATER 535.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR 515.00
��� � �a.�-�.�.�•� ,� ��
',;±,� .#�u�r���?+.����. �. _�.r-,�+�i.e-..o.. „-:- , -� _._ .. _ _,.. _. _
Permit Fee $ Number of fixtures @$10.00 x$10.00 =$
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ Number of fixtures @$25.00 � x$25.00 =$ o�Ob
Number of fixtures @$35.b0 t x$35.04 =$�
State Surcharge = $ .50
Tota1= $ � .�i
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building perrait and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota-Construction Codes; that I understand this is
not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLIC,�„�'�.� �. ���`��—PRINT NAME ROGER HOFFHEIN DATE `�' a�_��
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
REQUIRED lNFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITlONS �EXISTih�G HOME ❑ MAKE-UP AIR
REQUIRED FOR NEWlEXISTING HOMES
1. Combustion Air (See note below) .
a,. Qil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. TMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IF�'rC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load pe�• room �
a. Required on new coustruction IMC 1346.0312
5. Ventilation .
a. per M1LT E�ergy rode 75?0 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make up air calculations
Building PLUMBING nerrnit rio.: 007 -c 3 0
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY D��'�� "
DATE ��"' �" d� YOUR E-MA(L ADDRESS
SITE ADDRESS ��Z O �/� /'� e� O j G� �"JL�
THIS APPLICANT IS: ❑ OWNER iSjCONTRACTOR
PROPERTY NAME:_�� ,•'� S'TPL � ;"s� -�
OWNER/ ADDRESS: �� L O �}r�c t- a r C� CITY /� R� ✓J <<�, STATE /h^� ZIP -�S'�!Z /
TENANT pHONE: '(� j—,S 7/" CP 5 I 8
CONTRACTOR NAME: �`t C (I � L J
SUBMIT A COPY OF STATE LICENSE # L/ Z�'r/' EXP DATE � 2— U%
YOUR STATE ADDRESS: S� i d/ G^ �/�°'C- /t/� CITY /—%� I� �S STATL�^f ZIP -�S�lZ /
LICENSE WITH pHONE %6 3"' � Z- Z� S(� FAX
APPLICATION
PERMIT TYPE �S[NGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: �NEW � REPLACEMENT
DETAILED DESCRIPTION OF WORK �s� Si 6i- ll �o � S Li �c.. /—�2 /�i`�' ��
/��v/� -�P .�r � s'i,�K i�isP. /��w
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor � 8 � x.OS =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDiCATE TOTAL
NUMBER OF EACH BELOW)
BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING
_ BATHTUB �GAS PIPING �EE�Ci7vuCC�vsE) SWIMMING POOL WATER SOFTNER ($35)
CLOTHES WASHER �KITCHEN SINK WATER CLOSET � BACKFLOW PREV. ($15)
lC DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION
7� WATER METER OTHER
�, , ; ,.
. _.
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 Surcharge = $ .50
Total = $ �.
THIS [S AN APPLICATION FOR A PERMIT-NOT VALID UNTIL 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
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 applic ' n for a per ' and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case all w r hi requir s review and approval of plans.
SIGNATURE OF APPLICANT '�-.� PRINT NAME /� ��''� G I C Ld � L DATE ��"'L1 `U 7
,��`�- � �; .�:
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977