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AF - 43751. � - 3 � - � � ��`�`�`� Number Fixtures �_ x $2.00 %_/� �� Future Fixtures �_ x $1.50 +�{ i� $ ( New Fixture-Old Open. x 1.50 Catch Basfn x $3.25 Water Heater-99,000 BT[I % x$3.00 3�G � Ground Run Old Bldg. x$3.25 Elec. Water Heater x $2.00 Gas Fitting Fees: 1st 3 Fixtures _� x $2 . 00 ' Additional Fixtures x $ .75 Gas Range-199,000 BTU x $5.00 � Repairs &-Alterations � See �I � Description; C�de 3�� v , State Surcharge .50 TOTAL FEE . $ (1� The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance w ith the City Ordinances and ruling of t Department of Buildinga, and hereby declare that all' h facts and r pr entations atated in thia app ic tion are t e d correct. � _ � %� 'S gna �ure te ; . 1 . sus�ecr PER . City of Fridley . 12539 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ' ' P-�-N O. � � � • COMMUNITY dEVELOPMENT DIV. �/��� ` r � v � PROTECTIVE INSPECTION SEC. �� L � ' 7 � � ` � � /"�1 � CITY HALL FRIDLEY SS432 NUMBER REV. DATE PAGE OF APPROVED BY �""�' ,'� 612-560-3450 910-F15 5/16/74 � � JOB ADDRESS 1620 Camelot Lane N.E. t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 34 2 Harris Lake Estates SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Ronald Barrows 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. The Rottland Company, Inc. 1581 Rice Creek Road N.E. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING . Residential 7 CLASS OF WORK � NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 26' & 27' x 40' Dwelling and a 28' x 22' Garage 9 CHANGEQFUSEFROM TO STIPULATIONS provide a hard surface drivewa Provide a verif y. ying survey before capping. Specials and sewer location are not available at this time. SEPERAi'� PERMITS REQUIRED FpR y�rRtNG= HEATtNG, PLUMBING AND StGNS, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. WOOC�i FY'dICle THIS PERMIT BECOMES NULL �9ND 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 �'�- 1066 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CER7IFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLtED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 524�486 12.24 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRU TION HE PER ORMA CE OF CONSTRUCTION. Sl.•OO OO OO �(�.! �p��` �r k� �, � ,� PLANCHECKFEE TOTALFEE �6 - 7 ¢_ $363 . 24 f � � ?� � � -.� - ! " SI'GNA�EOFCONTRACTOFORAUTHOR EDAGENT IDnTe� WHEN PROPERL LIDATED THIS IS YOUR PERMIT f � �C.�!YL L ^ � 1 SiGNATURE OF OWNER UF OWNER BUILDERI IDATEI BLDG INSP �AT APpLICATION FOR RESIDENTIAL, ALTERATION, OR �llDITION BUILDING PERTiIT CITY OF FRIDLEY, NIINNESOTA OWNER `S NAME :��/A L� � A� 70 w S BUILDER :-� �7�-� Lvu d �O .-T�l� ADDRESS : ADDRESS ; %,s fl/ /t r.P �rY�/� �„� z�o : . �;, v' S TREET : �� h-,� L � � �-A � � �� � � : LOT: 3� BLOCK: � ADDITION:__/�ili9 rr�S �fd,f'P Esr.�T-°S CORIvTER LOT; _ INSID� LOT:__L�^SETBACK: 3J � SIDEYARD: /d � o� S Applicant attach to this form �ao Certificates of SurveY of Lot and proposed building location drawn on these Certificates. ~ ,�.,_ . �ESCRIPTION OF BUILDING To Be Used As • S /��9��. F�1^� + ��' �c-� � �� '" � • ,� � }�o u S � Front: � (o � �Aepth: �Q � Height: ' �� � � � ,� /L�. Square Feet: �Z'�p Cubic Feet:. ��41 yh1�e � � � Front : � � � Depth : � a � Height : �- �/ �'� �� �� � � , Squaxe Feet; �5��, � Cubic T'eet: �� � ,. �pe of Construction: �►^�l ��. Estimated Cost• $ 3� 00�. d� ;; r To Be Completed: �(/ot/� ��� �f � ��� `� ! -��"� i ,��` T'he undersigned hereby makes app�icatin� for a permit for the work herein specified, agxeeing to do all work in st'rict 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 correct. ��i� /� U �`� L v.v �✓ � . .Z`ir�, . DAT�: S' �� - i� SIGNATURE:�Y 4��` ��YS. (See Reverse Side For Additional Information.) �,'�; _ .�� � � ' , � �" - _ � . , _ . � � �. ( . �� � t . . � ' . . . ..� . /,_ ' .. . . . ...., , , � � � _. . _..,. . .. ... ;' � . . � . ( � • . . . / , � . . � �, w�'� Yp} � � . ' ' � � . . ' . y� ±� . =g` r� • t' .. � . . _ ,¢ � /�y y/y,qy � 'V fY �p,� �Y � . �. �'' . 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'..:n . ,..a,� . � .. �-.xn=� . . .. ,. a�.,. � . ��'t�'Yl� � ��� � �� �� �°� e���� ���.��W � - "���, �������e��a ��������,�� � ��� �,���.m r� ���� �� ���� PART6�L R�T� SCi�E���.E aR�►d*mr v��� Ar�: rt�� �or�.. �re sr:�ti � nu�t wo,�� . . ;io.00 s Rrplacement of F�.irnace , g.pp � P,cpairc 8� A1!crations--up to =504.00 g pp �, Re�airs & Alterations each add. f500,OQ . 3 W ; i[LCii. W11.A� AIR S'�i7'719CC $tJ�l� ac D11C't WOI'jS t0 ZiQ�Q� $� each add. 60,000 BTU . .. . . . . . RepLcemeat oi Fl�rnace Repairs Ec Alterations--up to ;500.00 Rtpairs & Alterations each add. g50Q.00 ..�l400 ; I��� 3.W ; 6.00 ! 6.00 = s.00 a �TEAM or HOT WAT�R $YaT£�[ Ftimace Shetl Sc Lines—to 400 sq. ti. F.DR Steam �:O.�JO S. Furnace Shell & Line—to 640 �q. ft. EDR Fiot Water I0.00 S. Eath add 2p� sp. tt. EnR Steam 3.(Nt ; Each add. 320 sq. ft. EDR Hot Water 3.00 5:.._.___._. _ OiL BIIRKER—to 3 gal. per hour 6.00 S_ � over 3 ga1. per hour--See P'ee Schedule GAS �IIRI(ER (uD tn 199,OD0 BTU) 6.00 s�� Q'� ov�r 199.OQ0 Ai'iT S�e Fw Schsdul• GAS FI'ITINC FZE3: MO RATE T07AL i� s r�Xtu� � xg 20o a a,Q'� Additional p5�ctures � x �g =__. _ Gas Range W 199.OU� ai 6.OP S 1LIR CO�SiTli028Y1�G FApQ H�ATT�(i SiSi�! YEAYtl.ATYIIG SY�Ti� xI.TiRATiOiil�! � REP1lI2ffi �� �� � �-- �� State Surcharge .50 i- a.. F« s�a�a�: T44�E. Y'°�6 i-�...LL]ZY �t. o� ����. ��,. �-�� �— O�� !� � �'�,�p � ctty or �at�.: . The �:ndersigned hereby makes application for a permit for the woric Aereir spec�Iied. agreeing to do ali w�orEc in strict accordance with the City Ordtszar.t�= and ruling of the Depa� tmcnt ot Buildines, ar�d herehy decl3r�s that aTl the fa� and repr�sa�ntatiuns statrd in this applicalion are true and Correet./ 0 (lwner _ 1 1 Kind ot Building . Use� �c .,____� To F�e completed about 2� � 4 Estimated Cus�, � � ' O[d ew. uilding Permit No. ---- _ Yermit No. � y� � • 037 OF �OIltg HF.ATTNG or POWE PL.A�team, Fiot Water, —No_ 1 . � �. Trade Name�� Siae No- I I I/-�I_Q___.__ Capacity--._- — 1�.. E.D.R�� BTU Hp TotaI Connected Lavd � Rind oi 1�Le BURNER — Trsde Nmmn Sizr No Capacity 3q. !'!. �.D.Yt �r g;� c..��.,��ai �I I �, F. ,.�, , ��,� l' . � , � �t� _ . � :[ --'- , F.. <. � �, -� ; M_�-: � � �.' � � � ;� � � a , r.a _ , . �, ��,.-.� �/6� �i � �o� o�� � . � 1 a o �le�`. �,..a�su�tcf¢ ->-�-�`" y.�� � i i �i HEAT C�SS CALCULATIONS H EATI NG. & AI R I:UN DI TION I NG CO. MINNEAPOL(S, MINN. Weatherstrips A.S.H.V.E. Constriiction No. Ins�lation Windows Doors Guide put. Wall Int. Wall Ceiliny Roof Floor Kind How Applied Reference Yes--No Yes—No � g _, F1�� j/���/�jr Room Length Width � Height FI. Room Length Width Heignt Wir�dows and Dpors—Crackage and Area Windows and Doors—Crackage and Area ��Width Height No. of Lmeal ft. Area No Widrh Height No. of Lineal ft. Area . �O� nf oane of oane liphts of crack _ sq, ft. of ane of Oane lights of crac� sq. tt. Infi 1ti ' ���`: � i � + �v,l -� . `',� �� I �Ld� etu Infitirafion � Glass ' , Exp. wai I : � Net exp. walf�`. ` � tnt walt. � ' C;eiiing "f toot " :T.o#al Btu. B tu �...�` �� R�ufrgt{�4:`,ft �:D:R. nr,sq.'ins..W:.A. Leader area Required s4.:tt. E.D.R, or sq; �ins._Nf.A.� Le�er at8�. �;. ,:jj/ �r,.;� Ropm ,. �l.engtb ' �` Width � �" Height Y � Ft �%�,£'.� Room °Length. _ 'rdth� �:.F�eight., . � , . } �f►}�dt��v's aod�:oor�=Cracka�e�and Are� : Wip�dows and Daors—CraGkage;;and�Area � � ° UYidth „'HeighY � No_r of "Linzat,tt. Atea - ' No: . WidfM Height No. of Lineal iY. Ar�'_ �a v<. �:,vf ane .of pa" li hts. .of crack g4• �t•' ,• + ; � oF pane of pane lights of.crack' sq• f�'� c' .. . � _ � ,a� <" p� ,. # �Ct3ef . B tu B;ci , , �#����� � - ��. „Irtfit#ration � � ��� �. (� Gfass �� . .. r :. . ... ; .., - "�x� �+pall - _ Exp.'wa!! �Q � � � � : ... ,� �:. � � � � �., Ne,t expz irtrall' � ` - ' � �� �� f Q � ..;� � �;�t�a. w�l t . ; : _ . : '- . ` � � � ' �, � �t�t �.i�r�tY �� � i nt. `wal L � • , � �t,;�; �� � c�; t �ng ��` 4! � S�C� �Ib�ST.> Floor v? _ � ' ` �� , � _ � � Total� Btu: � . , : Tot�ii ��3tc�. _ _ , :_ _ : , . - Reqceiied Sq., ff. E:D.R, or sq. ins. W.A. Leader area ' �' Required sy. ft. E.D.R. or sq., ins, W.A. Leader area ` �! C,� Room ,: Length � Width Height F(. ,x ,�� Room Length � Width f eight ' Window�'and Doors-Crackage and Area Windows and Doors—Crackage and Area No-� -.. � owpatr�re �of pane .No.hts ofnc ack qfefL � � . . rJO. of Pane of Pane � rligh�s ofnc a'ck Qre�t. . ' ::� , ... , . bL �' . .. �. • � 4 � - � - � � ��� ... . : Coef B tu � ' Coef B tu Infiltration Infiltration d% � G lass � Glass vj � Exp. wa! l� _�� Exp. wal t�'� � � 1Vet exp. w2tl 1 Net exp, waU � ��- Irrt. uralt Int. wall /� = Ceilitig , � � � � Ceiling `� � C/ �l` , £1+�' , . �: r` F Ioor -. ; ' � �ui�Fl �ar. �..� � '� ' � Tot�1� Biu. � °"�itr�d sq. �t. �.i�;�. C�'�q, ins.:1A+.A: Le�der area -. - Recp�ired sey. ft; E.D.R. or sq. ins. W`�.A. Leadec afea � . � � Y. . � .X.:. � ii.bk;:N $ �. t ������� .. i.m. . R .4'tirv'a, tr , ,,.6.s , x'�."4i. '��±^���`,��=7� v�'�. ,. .�_ , a: . . . -. �.,..�, r»,i .. 2+ �'-�#.-:.�trF, �s.�._ . , .� . . � - ., . .. �= . . . . �r?� t - e .�1`_ .. . _-. ... -- � . . _ . � . . � �� tl��E,��� �� .. � . . . /� � HEaT i_��ss G��cu�arioNS HEATING& AIR (;C;NDtT10NING CO. Weatherstrips A.S.H.V.E. Construction No. Windows Doors Guide Q�, Wall Int. Wall Ceiliny Roof Fipor Kind Reference Yes—No Yes—No �g � FI.��/ � Room Length f� Width Height Windows nd Doors—Crackage and Area N� Width He�ght No, of Lineal ft.. A�ea - of p of pa > lights of crack sq. tt. . � , � ... _ _ r --� �— i MINNEAPbLIS, MINN. Insulation �How Ap��l ied FI. Room � Length width Windows and boors—Crackage and Area ho, Widrh Height No. or Linea�l ft. Are3 of pane_ of pane lights�f crack sq. ft. - I Height Coef B tu Coef B tu , lnfiltration � � Infi►tration - '° .; . GJass `' �" � Giass _ ' - , . - ' Fatp; waU . ` . � '°'. r - Exp. wai l . '. , - 5 _ ; •.r ` ;•�Per�xp� w�tl' •' �_ - Net,ex�3, vv8{t _ - . _ _ „- . _ - _ : ,- . . _ _, , 13��t, viral l^ �_ . ; � . ' � -: ; _ , - �int.� wal l ' : ,�- � : �, . ,. �: , � �� _., ,.r .. �� � � � 1, , , �l Ceiling _;°• ' . . , �ei�i 9` . . _ n �� � .. . W � ,_ . � ��tc,�' -_ .. . :_ . � T - . F ioor=. v� iota�"�$tu.; Tatal:Bju. = � � �„ � , , ., ' t ..;` ` . , `. - ; � R�qnir�ed �q: fi. E.D.R. or sqr;rns. W.A Leadet area -, Requi�e�i SQ: ft. E.d.R or�sq, ins: W;A, teader�'ar�8 `-. �. - �i _ Rc�m , 1:.eng'th `: 4 Widtlt. e�9ht :" Fi. , � ;. Ropn �yffi $' Wtt�t�ti.. � <'#{ei�ttf , �,'! , ;. .. , .. { , ' � . . � ;; .'�indc�nncs and.DoQrs-Cr�ckage.at�c�, Ae�� .. r' n ;.� Windpws;arid Doors—E"rackage and ,4rea .;- ��. ` No. � ' � W�dth ;��� Heiyht � �.No�.b# LiirQai ft. ' � Ar�a � _ N�idih � �Heipht ' �No. of. ;�linQai .ft.- � ArsaSt RcY# an0 of pgr�e liphis oi ewack- sQ• ft•: No. ' of ane of pane li8hts of cr8ck s4- _ _ . " . ` `=3, ;�-" . . ... -; - � ,. - . _. , . ... - .. , . _ . . - ' �, . , ..- �. , � , ,.. , .. �.� . . . .. . . >. .. ,. _. , : , . , � .� . . ��' . . _ e- � ,. , , c - �. _ . _ . . � � : � . , � , ., . . �, . .. . , , r� � , , . � :.i �i . .- ,. .. . ,. . � � i .._ . . . a . . . . . .t� . a-. `. �x � .� � t� . r. , .�.. ... . .� ..�..... ,:.--y: . , ` " `.� Coef � ��, �� .B tu � ' . . oef _ B tu, � � . � . _ ,� � �. :; . - � - 1nfi�lttation � - � � �nfi iiracion '_ ` � _ Glt�ss , . : - -� > Glass - _ ; � . .. � . � �- � � - '€xp;: wa!! F � � � ��° . �� � . � � . . ' � � � Exp; wal I � � ' 'dk�et,:BxP. w�IE,:= � w u r ._ ` ' , _ Net exp. waii . ; � _dnt: �rqal.t � - � tnt.:.wafl � � - . , Ceiii`rtg � . -; _ � � �; _`� : :, � � ; � � ng - ., .. .:. Ceili _ � � � ., � , ,, , � F�oor ,. . Fioor': _`. ' " � ,. , . . , _. Totai $tu. >; : , . 7ota18Lu. ,, y, , y Requirecl sq. ft. E.D.R. or sq.'ins.,W.A. Leader area Required sq. ft. E.D.R. or sq. ins. W.A. teader area: FI. Room Lengtfi Width Hei�ht FI. Room Length Widtfi Height ' Windows and Doors—Crackege and Area . VVindows and Doors—Crackage and Area . ; No W��Th He�ght No. of .��Lineal 't_ Area " -- . . N�� Width Height No. of Lineal ft. � ATea � of pa�e of pane �iphts of crack� � Sq. �ft. - of pane of pane lights of crack �sq. fL � _ � Coef Btu Coef Btu Infiltration Infiltration - Glass _ � - Giass Exp. wail Net exp. watl int. wa�i _.__ Ceiting . __ :flbor 'TOtal 8t.u: ' ' �uifecf'sc�..ft. E.D.fi:,'or:ss,� js�, �NiA. #.earier area,: w�. . ��-...�. _ h,<�. � '�� .x �.- v,.a , . ~ Exp. waii ----- -- .—_.___._ ___--- . Net exp. waE! � __---_ __ __._ __�._ lnT. wall : . � Ceili�q .-'--- , Fioor � ` . : . , -: Totai 8tu. ' ' .. �'equir�d sc� ft. E;R,R. a� st;: �ns. W.A. Leat� area, - �• = , �- �;; '?_ .. y "�`_ � � � - *��� �. _ �� , r .�`_�� 560-3450 �it o rid�e � � ANOKA COUNTY 6431 UNIVERSITY AVENUE NE September 23, 1974 FRIDLEY, MINNESOTA 55421 Weatherly Electric Box 80 Elk River, Minnesota. 55330 Re: 1620 Camelot Lane N.E. Dear Sirs: Upon inspection at the above address, it was noted that the panel clo.sures were not installed and the panel was wide open. Please correct this matter as soon as possible. When it is corrected, please contact this office. Sincerely, �.� � �.-�a��Cju��c�'c. �c,�4�� �'L.L�.�.(���„� LEONARD EICHMILLER Electrical Inspector LE/mh U�FICE OF TNE CITY ��AidAGER CITY OF FRI�LEY MEMO N0. DS-225 Respond by: 6/12/75 r�lEt�OR�1i'�1�UM F�Of�1 THE i,IT`( !'�lAi��AGER �ont. to: TO: Pu�LIC 6dJRKS JIRECTOR UHTE: Ji;NE 5, 1975 . � �v � RE: ��iA7Ei� P�2UBLEih AT 1620 i,AMELQT LANE, ROP� oiZuW, HOME PHONE 751-6201 :�,iD i+IIKE t�lELTOi�, 372-3774 0 These two nomeowners are having wet basements and they have the feeling that the City has some responsibility for this problem. I i ndi eated to them that I feel the Ci ty has nn �� ah� �,,��--�-they mig�it nave a recourse a�»�-1 '" �,T� 3345'7 �ut that th "'� ��ork wi i B�,ildia��e Job Report unaerst� ADDRESS wnat we Thank yc'' I�i�1Q/ms June Il I have ! Dailey blem na homes n Wednesd Comstoc develop blem, w necessa. pumps t� iVe cont� City is Fridley point. Soil bor to a dep was grav RNS/jm OWNER � BUILDER � DATE '�""",,, ` r.�e�i+o� oTll1N1 th the� e see �entioned. �ut this also) �.�1 iM � G � !J m�j Z} rl.. fC� — l�-�� � � � -1- �-�-«-- c.� ��-- n. � � r /J ����INSPECTOFi OWNER - REP. --��- _�� 1 - CITY 0� FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES PARTI�L �TE SCHEDULE GRAVITY WARDI AIR: Furnace Snell & Duct Work Replacement of Furnace Repairs & Alterations-up to $500.00 Repairs & Alterations each add. $500.00 �IECHANIC;aL WAR'�1 AIR: Ftirnace Shell & Duct Work to 100,000 BTU each add. SO,Q00 BTU Replacement of Furnace Repairs & Alterations-up to SS00.00 Repairs & Alteratiuns each add. $500.00 STE�+:'�i OR Hi)T IVATER SYSTE:41: Boi2er & Lines up to 100,000 BTJ each addn. 50,000 BTL' Boiler only up to 100,000 BTU each addn. 50,000 BTU OI"L BUR;VF.R- to 3 gal. per hour each add. 3 gal. per hour GAS BUR�F.r- from 100,00C BTU to 199,999 BTU (over 199,999 BTU see Fee Schedule) G1S FITTING FLES: 1st 3 Pixtures __ Additional Fixtures Gas R,ange to 199,000 BTU __ AIR CO�DITIONING -,� FA\ HEATIVG S15TE�1S �_ See Fee schedule 'VENTILATING SYSTE�:S t ALTERATIONS F, REPAIRS � R:�TE TOTAL S12.00 $ 7.00 $ 7.00 $ 4.00 $ $12.00 4.00 7.00 7.00 4.G0 $12.00 4.00 7.00 6.00 $lO.OG 10.00 $10.00 x $ 3 . ��� x $ 1.JU X $10.00 State Surciiarge TOTF�L FEE Job Address 162� CSIt1@I.Ot Ln. NE Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein $�� specified agreeing to do a11 worY, in strict accordance with the City Codes ` $ and rulings of the Department of Buildings, and hereby declares that all the $ facts and representations stated in this application are t=ue and correct. $ $ Frid�ey, Minn. %-29—%6 , 19_ OWNER Ri c�haYrl Mi 1 1 px Nnmcaa $ KIND OF BUIZDING frame $ residence $ USED AS $ TO BE CONiPLETED ABOUT 8� 1 rJ �% 6 $ ESTIMATED COST ����(J �— $/Q,� OLD - NEW BUILDING PERMIT NO. PERMIT NO. ��),� 9 $ . $� DESCRIPTION OF FURNAC�/BURNER $ $ HEATING or POWER PLANTS, Stean, Iiot Water, Warm Air- No. $�� �� -Lei��ixr'ame ° WeSt. Size No. FC�TT�-110E $ H►S9`�i11��p�4i�S 11QM Sq. Ft. EDR BTU iiP $ .5o Total connected r,oad 53.�2� xind of Fuel �aS $--��� s ame BURNER - Trade Name Size No. ' ROUGH INSF. REIIQSPECTION FEE Date ($10.00) FINAL INSP. � - Z 7 � � � Date #4040 John V. Borry APPROVAL FOR PER*1IT f ¢D M,Tit•:UM FEE FOR ANY HEATZNG PEkMI^t ZS $7.50 Capacity Sq. Ft. EDR BTU HP �R�ED VO�'sT & CO. Comuany �A31NG �i AIR CONDI710NINV yigned Bg�� � �60 Gorliam Aw. 929-6767 E(4 Nouis Park, M���esoh 55426 . Tel. No. _ � . �,��, CJ '' `�' � ` � �� p r � / F, . �� . 9 r... r � ../' 2.�f!.,. �o!""� 1 �..!/'i�.f"". �� � :�;.... ^� �;_....�%," . ... �-w r , � . ,�, ... ... . ,. ,..w -..,....... . , �" Cda �.. ,� 4.. ..i/C^'�^"..F .YE•--"( !.' ....1 . . . .:.: ;;.. .. _. . _ __.... ___ . '. . ... ._. . ... . .. ,..,__. _. ..,,__... � ___... . N�AT LOS3 CALCt)t1►TtON3 � '? `' � � l� Weathentrips A' '' Conitruction No. In�ulation Guide '' Window� Doors Referente Out. Wall Int. Wall Ceilin� Roof Floor Kind How Appiied : Yea--No f Ye� —�0 19., .z� . ' Fl, ;��... �; ��� Room Len�tA ,Z. Width . . Height �?.. FL� ,,�,,��t,.E' Room Length �--�Vidth / Heisht Windowa and Doors—Crackage and Area Windows and Doors�—Cracicage and Area tv�tlth Ne��1�t No. ot Wn��l tt. Are4 � � Wltltb Hel��t No. o[ Lln��l ft. Ar�� s� No. o! Dane o[ P�ne Il�ht� ot crick �V. tt. .. � No, ot Dan• of Pan• Ili�t• ot cnck �0. tt. �: �,���� .� � , � � �t�� � �� ��.� Coef. Bcu Coef. Btu Infiltration � ( '" �" � 1n61tration E',la�e / - �„� • -- Fap. wall .�' � i': ', Net ezp. wali~ - � �- Int. wall '-$ � ,'.�_..._..�.._. _ • �' � ' c° r 's Ceiling �'� '�'' � t' v Fl�or • `'� Total Btu. ,2 Required sq. ft. E.D.R. or sq. ina. W.A. Leader area ` fl.� �. � µ,-.i , Room � Length,,�' ", Wideh �,�,.._. He;ghc 'a'' 4'�-• Windows and Doon--�Crackage and Area � Wldth H�I�AI No. ot Llnea! !t. A�e• No. at D��e ot D��• �1fhb of crack �C. tt. .. � � � _ ... . .. _� � � �.>- sf" �i Coef. Bcu Infiltration ,'s ,� "'� 1, Glaaa !." A " �'y f t; �,,. ,� , F�p. waU s � � Net exp. wall � �>- C.�+ .� ,' �' ���. Wau - x �. � Ceiling :.+G /�`" .t-•:7 • Floor 7'otat 8tu. Required sq. ft. E.D.R. or �q. ins. W.A. Leader arca Fl. ... f ' Room Length ,,,� ,i' WidtA Wiodows and Doors--Crackage aad Area wie�n Hurn� rro. oe Ltnul tt. Area No. ot pan• e! Dans If�At• ot cr�ck �a. Ic. Lr— ..1 T� /,_ r-s / `� �"i ,L %t' ,�'�.. Coef. Btu In6ltration $� '�� � Glas� .'7. „�' '� � G F.�cp. wall ' ,A ;�... Net exp. wal! � 7 `i' ' ;.' lnt. wall Ceiling �i 3,,. ` ,,�f°P ��, t F1oor 7ota! Btu. `'; '"�' ,,-"' ' Requircd sq. ft. E.D.R. or sq. in�. W.A. Leadcr aru ,% FI. ��:.:'t'' ' Room' Length r�..� W;dth Height ��" �� � Windows and Doors--Crackage and Area I wiein"—a•i�ne rro. oe iin.ai a: wr�� � No. o[ pan• ot D�n• Nsht� o[ crack �a. tt. ', � r C i-� � � � �= . L.e � .S"-'"_. ,F i "� ,i.._- � i� � '�, , �� ;� ..,i", .�t` _. � � ,e:_ "R�,�:` , Coef. Btu Infiltration a "" �r -''c`" � � Glaas '' ` .., Eup. wal) -", '' • ��,i =;�' � Net exp. wall �'r-� .'- c,,.. :;,•' � 1 Int. wal) Cti�ing �; `�, /` „> ' -^' ! �loor Totat Btu. :� � �"`� Reauired �a. ft. E.D.R. or sa. ins. W.A. Leader arei % Gla�s E�cp. wall � Net exp. wall Int. •rall Ce�ung Floor Total Btu. Required sq. ft. 6.D.R. or sq. ins. W.A. Leadet area /�'1' FI.I ;?r�•.,, ,,,.�•'' Room I Length � Width�'. Windows and Doors—C�ackage and Area R'Idth HdtAt No. ot Llneal Ct. Are• No. o[ D►ne ot D�n• ll�hb ot c ack � tt. ,� �- W _ ;�`�,,�`�i ,� . � � �,.:�` ._� �' � �' � I 1n61tration Glass fxp. wall „�. ' Net exp. wall Int. wall Ceiling ... /; *' Floor / ' �° �~ �1,�- � � � 'fotal Btu. ' Required aq. ft. E.D.R. or sq. iria. W.A. l.esdec ues � ,Fl.� ..:�.. },� �.; _�.,'Room l l.ength "? Width Height Windows and Doorr—Cracicage and Area Wldth Hel�ht No. oL Ll�a�t ft. Ares ��. � No. ot y�na o[ D��� 1l�ht• o! craek W. tt. / � � � !` , .� .�2.-•- �t? � � � d! �• �} f ! o ^W' F� � �` Coef. Bcn ; 1n61ttation �' �,._. od / / /,(�'� � j Gla�s Exp. wa11 =, �,;; � :'�-�.�� k, %Iet exp. wa11 �/'d lnt. wall :f�' -�,� Cei�ing Floor Total Btu. Required sQ. ft. E.D.R. or sq. in:. WA. Leader area ,� F7.� � ; ; .:: -� .� �, Room I Length ._ Width Windowe and Doors---Crackage and Area Wldth Hels�t No. of Llne�t [t. � Aro� No. of y�ne ot paM Il�ht• ot cnck p. (t. ✓' � � ,� _ . � _ i..=" 6 � / .�' .� �-;-t.y' s.o�nr� . r`: • x , i�� � �� % �::,�, Neight . '�,�. . Coef.l Btu 1n61ttation ', ,~, Glase �' Exp. wall � i�' -� / ' ,�'i� Net exp. walt , ;,�,� � �,,�, Int. wal! Ceiling Floor ¢., f';? Total $tu. r Required sq. ft. E.D.R, or sq. ins. WA. L.eader are� �° _ _ T ti . � � � � MEAT LOS3 CALCUI.ATIONS �' A. . �' Weathcntrips Guide �n�truction No. _ • Y Insu1►tan e Window� Doon Reference Out. WaA Int. Wal! Ceilins Roof Floor Kind How APP���d � Yea—No � Ye— �—�0 19____ # F1, "_� � Room Length /'' Width/ Heiqht 4'�''�' Fl.� Room Length Width Height ` , Windows and Doors—Crackage and Area Windows and Door�--�Crackage and Area � Wldlh Nel�ht No. ot Lln��l tt. Ar�► � . � lVtQth HNi�s No- ot Lln��l tt. Are• . � , ho. ot D�ne of pant IItBt� ot crack �Q. tt. No. of Dan• ol Dan• Ui1�U ot craek W. tt. . . .. � � .� � ' . . . *� , .- �, d> ' � : Coef. Btu Coef. Btu �- ` In6ltration . In6ltration -Glase � Exp. wall ,'„�'_. � * �".��,.. _ _,... . " ] � �: Net ezp: wall � lnt. wall � r�... • : � Ceiling : Fl �or ' t� �'^' x' Total Btu. Required sq. ft. E.D.R. or sq. in�. W.A. Leader area � Fl.� �,e � Room � L.ength �, Width Height �`:f rt- Windows snd Doorf--Crackage and Area � Wldth HeI�At No. ot l.lneal tt. Are� . � No. o[ pane oC pana tliht• ot cr�ck rp. it. �� K °� *`► % �/' � . In6ltration Glau F�cp. wail ,,,7-,,�� � Net e:p. wall �_. COtf. � B:U Int. wa(I (�: ; ' ,";a'^° � Ceiling F(oor C., Total $tu. —.—_ _ _ _ Required sq. ft. E.D.R. or tq. ini. W.A. i.eader area Q'i Fl. � , ,�,',. .:,�'1Room L.ength , � ': _ Width .,,�l4� Windowi and Doorr--Cracicage and Area w�a�n H•�sne uo. ot Lmw re. wrea .. No. of p�n• ot Dans If�ht� ot craek �p. [t. � � � Infiltration Gla�� , E�cp. wall �,�;� / Net e:p. wall lnt. wall C niie g � Coef.� Btu --- _ _ Floor .�+• Total Bro. �°" -� r ReQuired sy. ft. E.D.R. Qr sq. in�. W.A. Leader area ,,/ FI. Room � Length � Width Height Windows and Doora--Crackage and Area WIAth Hd��t No. ot Lln�al tt. Ary � No. ot Oan• ot Dan� ll�hts o! cr�ek �p. !t. . Coef.l Btu lnfiltration I Glaa ` Eup. wall Net exp. watl I�t. wall u'���� �eiling � � Eloor Total Btu. Reauired w. Et. E.D.R. or �c. ins. W.A. L.eader area �.`�, ^', � . ' ' -;.., _ Glass ' Exp. wall Net exp. wall • Int. •+all Ce��ing � � � Floor • Total Btu. Required aq. ft. E.D.R. or sq. ins. W.A. Leader arta F�.� Room I L.ength Width ei� t Windows and Doon--Cracicage snd Area : W'Iqth Hef�ht No. ot Llnerl tt. � Aro� � � No. ot D��e o� D��� 11[ht• ot crack p. tt. �. In6ltration Glass Exp. wa11 Net exp. wal) lnt. wall Ceiling Floor Total Btu. 'x Required sq. ft. ED.R. or :q. iris. W.A. l.eader area Fl.� Room 1 l.ength Width Height Windows and Doors�—Cracicage and Area Wldth Hel�ht No. ot LIM�1 It. Area . . No. ot p�ua ot D►M I�ihU ot Crack �C� tt• � � .� . . . . � . . ���� • Coef. $tu ;� , Infiltration Glass Exp. wall �, Net exp. wall ` 1nt. wall ' Ceiling Floor Total Btu. ' Required sq. ft. E.D.R. or sq. ins. WA. Leader arca " �1.� Room I Length Width Height �` � Windows and Doors—Crackage and Area �.: Wldth Hal�hl No. of Llne�l It. A�e• . .. . . -g No. of pana ot Dan• II[hb o[ cr�ck p. tt. .. . � � .. '$ Coef. &n (nfiltration Glass :� Exp. wall � Net e:p. waD b� �; Int. wall Ceiling b# Floor s': €? Total Btu. '' �, Required :q. ft. E.D.R. or :q. ins. WA. Leadet ana � a. F` -�--,--. � , � , � . ;, . _ ���� HOUSE HEATING TEST RECORD D--21155 ADDRE55 1620 Ca►xelot Lane APT. FLOOR CITY SUBURB ��d1eY OCCUPANT R,�n�lc3 P� Barr�wa OWNER Ronald P. B�,rrowis HEAT LOSS DATE HTG. INST. GAS CO. METER BADGE � SOLD BY INSTALLED BY Sedgwick Ht�. Electrical Work By Gas Line By �t It TYPE OF HEAT GA FA _�LHW STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE Wiilia�on MAKE OF BURNER Model 1117-10�5 Model s��a� T4`�ZOL3 Max. BTU Rating INPUT lOOs000 �t41 . MAKE OF FURNACE Model CONTROLS THERMOSTAT C'� �g� Heat Plu Val�e M�H. V�OOC Limit RObBh�l,w' RFL 750ri Limit Set4ing �DO f Fan Setting 90 f& 120 f Pilot Type C011pl� Pilot Make Vent Size `5„ KIND OF LINER �1��• SIZE 6� NONE Draft Hood V�x'tiCal Re9ularor Mesi trol 3Z5-3 Filters $ize 16 g�`5 Number 1 Chimney Location Inside Y� Outside Chimney Consfrudion Metalbestoe Pilot Model Smoke Bomb Wiring Y� Pilot Timing 43 Sec�lla8 Draft Test Tag L.W. Cut Off Door Pressure Lighting (nst. Ye� Pressure 4■3��,C• perceniCO2 ?��S Date Tested jl;''7�'�4 Input CFH 100 Percent 0 R-7� Company Testing 2 � Sfack Temp. 5`�O�f Percent CO , 0��� Name of Tester Form 235 CITY OF FRIDLEY Effective Date May 1, 198g APPLICATION F0� POY.�ER PLANTS AND HEATIN6, COOLING, VENTILATION, REFRI�ERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE 4ESIDErTIAL ` Furnace Shell and Duct Work, Burner (1►lso replacement furnace) Gas Piping (piping needed with nc�r furnace) Gas Range Gas Dryer RATE TOTAL $ 20. 00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ * Aiz Conditioning (all sizesl $ 10.00 All Others/Repairs and Alterations 18 0� Value of Applianc� or Work �-o� V�.�-, �,.�-�--f,� �� �-QSi Z.�'� MMERCIAL INDUSTAIAL � �0��� �Z � 18 of Value of Appliance or Work State Surcharye T�TAI. FEE Reinspection Fee ($15.00) Rouqh Insp. Date Final Insp. � � � � Date Approval for Permit __�/1� MINIMUM FEE FOR ANY HEATING PERMIT IS $15.00� PLUS $.50 STATE SURCHARGE *Air Conditionezs can not be placed in side yard without written pezmission frao adjoining reighbor. S S S $ �.S so $ S Job Address / (!/ �� ��-�(� ���� /� � p � . � f Department of Buildings. 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Tel. #1571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeinq to do all work in strict accordance with the City Codes and rulinqs of the Department of Suildings,•and hereby declares that all the facts and representations stated in this application are true and correct. �.a Fridley, Minn. � - �'- , 19�� OWNER KZND OF B[IILDING USED AS TO BE O4.-.�........., .,....... 0�--�----- ESTIMATED COST � � �G� ��' , O�r NEW BUILDING PERMIT NO. � PERMIT NO. %��.i�� ,�-z_.tt�,�,-L.r, � ` DESCRIPTSON O FURNACE_BURNER �z � �--,�.�� L� H er, No. Trade Name �tit�/ � �'�1�-x-� Size No. Capacity Sq, Ft. EDR ° BTU HP Rbtal Connected Load Kind of Fuel � BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP CampanY � � -�--�% ��� �'�/.���%�� Sigeeed By � �� Tcal. No. � � � �"(�7 / � Fill out back side for stack vearification on replacement furnaces sue�ecr PERMIL.. City of Fridley AT THE TOP OF THE TWINS gU ILDING PERMIT 22580 i ` RECEIPT 1�. . COMMUNITY DEVELOPMENT DIV. r � y � PROTECTIVE INSPECTION SEC. aQ� � � 1 � �"'1 � CITY HA�L FRIDLEY 55432 NUMBER HEV. OATE PAGE Of APVROVEO BV �'""� � ,'' 612-571-3450 9�0-F15 6/2/94 � � JOB ADDRESS 1620 Camelot Lane NE 1 IEGAL �OT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3�F 2 Harris Lake Estates SHEET 2 PROPERTY OWNER MAIL ADORESS ZIP PHONE Stan Aukema 1620 Camelot Lane NE 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. D& D Home Improvement 7401 Central Ave NE Fridle - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW � ADDITION ❑ ALTERATION I� REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof House (19 Squares) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE Of CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIF CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONS7RUCTION ZONING SO. F7. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENOED OR ABANDONEO FOR A PERI00 OF 120 DAVS AT ANY TIME AFTER WOFK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. A�L PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED � 1 425 �.%2 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT � OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW FiEGULATING CON- $3S.00 Fire SC �1.1F3 STRUCT R THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE � L License SC $5.00 $42.15 �GNATURE OF CONTRACTOR OR AUTHOQ12ED AGENi IDATE� � V�I EN OPE Y V ATED THIS IS YOUnR PERMIT - 6� � SiGNATURE OF OWNEA i�F OWNER BUIIDERI �DATE� BLOG �NSP �1iTE 1vEVV ADDN AL1'ER [] Il [J Construction Address: CITY OF FRIDLBY SIN(iLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application 0 Effective 5�26/93 �aos� Legal Description: Owner Name dt Addre�: �/l� %�/�e!!?� Tel. ��7/-53.3�' Conaa+ctor: D& D Home Im�royQmen�,,, In _ MN LICENSE A� 4840 pddress: 7401 Central Avenue N.E., Fridley, MN 55432 Tel. � 784-7543 At�ch to this a�plication, a Certificate of Swvey of the lot, with the proposed oon.savction drtwn on it to scale. DSSCRIPTIdN OF IMPROVEMENT LNIN(3 ARSA: Lsngth Width Hcight Sq. Ft. tiARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width HgilGround Sq. Ft. OTHER: Cosner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks 'Ij+pe of Conshvction: /,�°��6=e�ZT Estimated Cost: $ '`�.� S��`� Approx. Completion Date: �.�4�p l-T���, �� 5�3���-S (Cost an Back) Driveway Curb Cut Widt6 Neoded: Ft. + 6 Ft = Ft a$ = S DATE: APPLICANT: Tel. #_����� Pamit Fee Fire Surcharge State Surcharge SAC Charge License 5urcharge nr;veway Escro�► F.rosion Coalrol Park Fee Sewtr Main Charge s � c � C; S �,�/� S %� $ S �-��: S S S S r ' � +- Fee Scheduie on Reverse Side .00 l of Permic valuatioa ( i/ l Oth 96 ) �.50/�1,000 Valuation $750 per SAC Unit SS.00 (State Liceased Residential Contractas) A�t. ~A" � /�i�. ~B� i��'V�'i Conservation Plan Review 5450.00 Fee D�mined by Engineering Agreement Nece.sssry [ j Not Necessary [] T4TAL S ` �� �`� ,�,�..�+. STIPULATiONS: CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE ' Fridley, MN 55432 572-3604 Effective On January 1, 1993 � r APPUCATION FOR PLUMBING AND GAS FITTING PERMIT �hJ �"���� . /V'!� ��(� ..��' MARK Nl1M8ER OF FIXTl7RES TO BE 1NSTALLED ON EACH FLOOR P�UMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas Gas Range NO. RATE TOTAL JOB ADDRESS �b ao CaY'''e�°�' Lh . N� 0 Gas Dryer _ Back Flow Preventer Required ()Yes () No Type _ $ 7.0o The undersigned hereby makes application for a permit for the work herein $ 4:00 specified agreeing to do all work in strict accordance with the city codes $ 5.00 � and rulings of the Building Division, and hereby declares that all the facts $ 7.00 and representations stated in this application are true and correct. $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS t°� of Value of Fixture or Appliance m State Surcharge TOTAL FEE , .. $ .50 .ks''S„ � �d� l q I �1 �� , 1993 owner ��`Gtn �� U. kf mc�- . Building Used As �CS� d e�n� a� S � Estimated Cost f��� �ba PERMIT NO. i� ��Z- � PLUMBING COMPANY �,m 5 C`�v,Qi i� Plc�w�b � nq .�nc� � � SIGNED BY ��J�C ���Q/3'"" TEL N0. S�� - OLf-S� Approved By Rough-In Date Final Date ��� MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS 515.00 PLUS TNE $.50 STATE SURCHARGE sue�ecr PERM � c�ty of Fridley �.�� �2 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T f — � � , � RECEIPT NO. � COMMUNITY DEVELOPMENT OIV. f � L � PROTECTIVE INSPECTION SEC. Z� i i _ ' � �'��1 � CITY HALL FfiIDLE� 55432 NUMBER AEV DATE PAGE OF APPRO�EO BV � '---�'� `.! 612-571-3450 910-F15 6/12/95 � � IOB ADDRESS 1620 CAMELOT LANE NE t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oESCR. 34 2 Harris Lake Estates SHEET 2 PROPERTV OWNER MAIL ADDRESS ZIP PHONE Stan/Terry Aukema 1620 Camelot Lane NE 3 CONTRACTOR MAIL ADDRESS Z�P PHONE UCENSE NO Archadeck of River Valley 5608 0'Brien Ave N, Stillwater MN 439-1370 20016435 a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OP BUILDING Residential 7 CIASS OF WORK ❑ NEW �7 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 16' x 12' & 18` x 12' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. TYPE OP CONST. OCCUPANCY GROUP OCCUPANCV �OAD SEPARATE PERMiTS ARE fiEQUIFED FOR ELECTF�CAL, PLUMBING, HEATING, VENT�LATING 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 CONSTHUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WOFK IS COMMENCED. NO. DWLG. UNITS OFFSTHEET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO 8E TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND Oii01NANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHEii SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �3�32� �1.66 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVI OP ANY OTHER STATE OR LOCAL LAW REGULATING CON- STR TION THE PERFOAMA OF CONSTRU r�oN $63.00 Fire Si �3.33 PLAN CHECK FEE TOTAL FEE ' � �1 �1 �� C,� License SC $5.00 $72.99 � SIGNATU�7EOFCON7RACT0 ORAUTHOA�ZEDAGENT IDATE� WHEN PROPE VALIDATEO THIS IS VOUR PERMIT r N� SiGNATUREO�OWNEAiIFOWNERBUI�DEA� �DATEI BL � �NSP f�RiE NEW [ ] Effective 1 / 1 /95 ~ . .ADDN - _ . [: ] _ : .. : : CITY. OF FRIDLEY , . . . . .. ... . . : . .. .. .._ . .. . . . . _ . ALTER [] SINGLE FAMILY AND DUPLEXES R-I AND R-2 Building Permit Application �ZZ�, j ��� rn L �'� ConstructionAddress: � �� � � 1 � r ��7 [ � j= � , 1--� Lega1 Description: Owner Name & Address: Contractor: B 1 �1C�f i � Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: � �- 1 �� ._ r1 ..- � 0' � r� � �r.� � i��=-. Tel. � �j� I�' V�`� 1VIN LICENSE # ��'� �g�I�.�J � ' ) Tel. # ���� � � �r%(� Attach to this application, � 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 Sq. F#. Sq. Ft. Sq. Ft. �'q = ��1 Corner Lot [] Inside Lot [] Ft. Yd Setback c�� Side Yard Setbacks �� � p Z i� �Type of Construction: � Estimated Cost: $ C� ' Approx. Completion Date: ��L�. � � � . �(�� j.x ��,/f = �� 325, ZJ � (Cost on Back) Driveway Curb Cut�idth Needed: F.+ 6 Ft = Ft x$ _$ DATE: Cy ° v � ! � APPLICANT: � Tel. # � � / � � � D Permit Fee Fire Surcharge Sta.te Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: ITY USE ONLY � � cr'� � $ �> Fee Schedule on Reverse Side $ �, �� .001 of Permit Valuation (1/10th%) $ , . $.50/$1,000 Valuation $ $850 per SAC Unit $ 3, � $5.00 {State Licensed Residential Contractors) $ Alt. "A" or Ait. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary ( ] Not Necessary [ ] $ 2 . - --- . _—__ _ _ _ . __ (�3/a 0 , tand Plonnen4 stl("t/tf�'f.li1 6875 Niqhwoy No.63 N.l. laad EvrveY�"9 � � Minn�opeiis� san� �es�ing r'J��l"i"!PPlLjI.lf� ��11�'. M���. ss�3s Civil En�pinesri�9 j� i�i�phon• 7i4-006b Munit+pol 4n9iaeorin`� Engineers �t St�TV@�OTS Araa Code 612. ` Mortgag�e Loan Survey for ��'TT'�,.Oi�l� ���/��iY � C��.ot Lp,N� N.�. �;2�5.� �3195 Q.6.21 .� a a _....-- -- ,� - - � . ,h �9% ` na� .R.RR..� � e BIOCK 6.3z M c�_' �N PouNOaji� ��.Y �3 u s• - C �...� I ll� � �74`-�I l,.�1- 3� 75.00 � 0 : ; .�: :;. �OT � �LOC�� r , �..._} . �. . �_, r::.. � � ' �t 4, A LM . �����'� ������ � •���.7 � I �:��'.. � ... . °� r t � � 4' y4 �'.'. . . . . ' . � :`S% .. � �' � �� . � � �. '�.,. �. � .:� � � /� . '. � + .� AF `� . 4 :, c�. il�i�,is �'yru� �ad sq�r�s� nrg�rllMroti«+of w wr.hr �f tl�• 1�wAdoriti ai'!hr teed�� M�sri`ed:�wd�f MNk, 5� � a; �� '{ l 1 c e� i M e f o l) b u i l d i w�� t i awr� f f►�r�aw�.gw di l l v i� s�� fncr�achrw�nh� if aty� f r om br�i soid hs�. TYi+i svrvyri� r ��• +i:. 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SEGTI�N � 1994 U. 5. 5trua}uras, Inc. 2X6 S015T . . � � �- �-- 3/8" GARRIAGE 601.T (4) Ibd NAILS 5/4X6 SPAGER 4X4 P05T ► ,� �� �� \ ) 2X8 BEAMS EI.EVA�TiON T�'PIG�� TR E �1.�5 SGAI.E: I"=I'O" �T i /T2 1000 xEV vsa � . . .+. .-, - . _ . � � .._ . __. .. _ . . 1- 2 3 4. 5 6 7 8 9 10 11 T2 'la '14 15 '16 17 18 19 20� 21 22 23 24 25 26 27 28 29 . 30 31,� 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 • --- —. ._ A 50 51 52 53 54 55 56 57 58 g . .1� . : C . . . . . . . . . . . . . . . . . . . . . . �-: � ;/..� I ✓ � l I `I. . � �,�,%� � � '� . � �. �,,_.��. • (� iQ S L I �C1 � � /� G�' �/LL DATE � � J� . . . . . � _ �� . . . . . . . . . . . ;y�(� D . �i� ) S T I � G- • . . . . . . . :� � . . . . . . . . .�� � �Jo�I �(/.� • Z 7C �C� -- . . �' j.J Z �'_`_ A� OFFICE ���� U� LC �' � . . 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""._...�_ _�� . _... . ._, ..�...' "' � : .. _ A'.�.`. . '_.,: . . . . . . � �� � :'- _ i�r•..� . .. . . . . . ..-�. . .. ----^+ �.�_. . � � � '. -.. ' . . . . � .. . . . . . , .. . . .,_ . . _ _ . . . . � _'- . .. .. . , . . . . . . . :., . . - � - � _. . . . . . � _ .. � � � . • . . . � . _ . , . . . . ..��.. ..�. �� .-�� _r.V..___ . . .. . . . . . � . . . . �� _ .. .. . .. . - . . . � . ... . . ' . . . . .. .. . .. . • . . . . . ... . ... . " . . . - . -., . � . _ . . .. . . t>.. h��` . . � . i Building BUILDING Permit Na � I Inspections R,ESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY nate �� +' '� 763�5�2-4977 FAX EFFECTIVE 1-1-08 S�1TE ADD� \�''L(� C D�YYVL�VT �, �/�Q,UR �M� IL ADDRESS G THIS APPLICANT IS: ❑ OWNER �1CONTRACTOR PROPERTY OWNER/ NAME: U �. (% TENANT ADDRESS: ���,� C(�� �(Y�.Q �o � 1�Q. ITY �� 1.C,� STATE�ZIP 5Gt-F'�2 PHONE�1.1�� '- -f ji'j � - p�J�jQ NAME: r CONTRACTOR ADDRESS: �� 1�p �'}(� � CITY Lt�l I I'�'"e i�QC� STATFYY1nZIP� SUBMIT A COPY OF pHONE (�� 1-') (� 2' q Z� 5 FAX �D cJ I"��P Z� �( �j�I 5 YOUR STATE LICENSE STATE LICENSE # ��`� ��,15 � g EXP DATE PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMTT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH �ROOF ❑ DRAIN TILE 0 DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ADDITION ❑ MAINTENANCE/REPAIR �REMODELING � �e- r� � F DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S FT ROOFING ��I SE ONLY NUMBER OF SQUARES �-� [3'HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPEIVINGS �Yes �No LOCATION OF WINDOWS OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CfIANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL N'r;i+.J AKr: 13A�1Ell U1V VALUA'1'lU1V, 11V(:LUll�1V(i'1'HL�' (:U.�"1' UN LAl3Ul( A1VL 1VlA l EKlAL.�: ,� SING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ c�- OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ __ 65% of Building Permit Fee Fire Surcharge $ L .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensetl Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft+ 6 ft= ft x$21 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary O Non Necessary O Total Due $ � L . Make checks payable to: City of Fridley Attach THIS IS 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 Co cti 6i}es; that I understand this is not a permit but only an application for a permit and work is not to staR without a permit on site; that the work will be in accozd p Gved plan in the case of all work which requires review and approval of plans. SIGNAT[JRE OF APPLICANT ' PRINT NAME ��' �� PG �Q cS o� DATE / Z� APPROVED BY �� PLEASE NOTE: SEPARATE PERMITS ARE REOUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK