AF - 47026SUBJECT PERMIT .
City of Fridley � 3046
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T •
t
; � RECEIPT N�O�
� ` ���� COMMUNITY DEVELOPMENT DIV. M
� L � PROTECTIVE INSPECTION SEC. � 0 '
r , ,
� . ,
�� � ��"�; �� CITY HALL. FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROV D BY
----�' '� 612-560-3450 g10-F15 6/24/75 / /
%
JOB ADDRESS 1(3]. CdIllelOt Lane N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 20 2 Harris Ld.�{@ �St3't@S SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Elmer Isrealson Jr. 8957 Pierce Street N.E.
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
SAME
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
residential
7 CLASSOF WORK
C� NEW � ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct 26' x 40' house with attached 2�' x 3r ; Garage
9 CHANGE OF USE FROM TO
STIPULATIONS SEWER: (Approx 8' deep
l. Minimum Basement Floor Elevation 886.00' 140' E. of M.H. (Inv. 878)
2. Need Truss design Wye Elevation 878.56
3. Sod front and side yard Top of footing 881.56 (minimum)
4. Provide a Hard surface drive WATER:
5. Provid� a verification survey 13' East of Sewer Service
� � ,�
`� ,�"ti�'� P'
� � � ,.. � .
��► �. RAT� PERMItS R�QUIRED FOR WIRINC, _
_,����,,,,�� � EATING, PLUM�#iN� ANfl SfG�l� ` . a ,,� - .
� . '�' , ,
��� �����
TYPE OF CONST. OCCUPANCY GR ` P OCCUPANCY LOAD
TE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
ILATING OR AIR CONDITIONINCa. WOOC� fYtlIR2
HIS 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 �-7H4 3O�ZSO
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY 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 COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $36�4SO IH.22
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. SE).OI 325.00
CK FEE TOTAL FEE
99.23
�i��oFCO iRACTORO AUTHOfiIZE GENr IDATEI WHEN PROPE lY LID T D IS IS YOUR PERMIT
_� v Q �a`_ �,.
SiGNATUREOFOWN RUFOWNERBUILDERI IDATEI BLDG.INSP DATE
�•
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A.�'��LICl��rra�a I'OR R1:SIllL':�TIAL., ALTk:�2��,TION,
QR .�.�}llI i ION. LUTLDTti'G PLR�IIT
CITY OF FRillLEY, NiINNESOTA
OT�TNER `S ri!��� e�L m e r� I�ta.e.I s o,� �f. �uzLV�r.: ��L ►� er� Js �4e �s a►1 ���
ADDR3:SS: $95l ���'fC� �� %�F�
ADDRESS :$95� �; e�c� ST, N,�;--
�;0: �� �3I STREET: C0.1Vl�I�� LAAE. �/I��•
i0T : a � BLOCh: � ADDITION ://4« � S lqXe ,�sJ�q�eS
CORNER LOT : INS IDE LOT : � SE'TBAC�:: SIDI;YAI:D :
App1.5.cant attacr �� this forn� Tc�o Certificates of Survev of Lot. an3 .pxopose '
building location drawn on these Cextificates. r �
DESCRIPTION OF BUILDING
Tr� Be Used As : •
, , �/ �' i
Front :�3,_,� Depth : • 7� � Height : % 8
.• Square Feet : 1� y� Cubic . Feet : Z,1 ��i�
� ,
Front : o` y Depth : 3 � Height :
I Square Feet; �yy Cubic Feet: ����
�
�pe of Constru.ction: Wood �Q�e Estima.ted Cost: � OOt� _
To Be Compieted: �L'C, � r 197 s � . . ��is� .
. �
. The undersigned hereby* mnkes applicatinn fox a�perniit fox the work herein
specified, abreein� to do all worlc in strict accordance with the City of
Fra.dlcy Ordi.nances and xulin�s of the Department of Buildings, and hexeby
declares that all the facts and representations stated in this application
� axe true and correct.
� I�TE : �l----� � .-=-- SIGNATIJR� : �
"(See I�evexse Side For Additional Infonnation.)
0 rn�;� aaaR MR.�s. F�,� ���c 88G.o�' .
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CITY of FRIDLE
6431 Uaivessity Ave. N. E., Mianeapolis 21, Mian.
PHONE• s�o -3�
STOP
WORK
REMARKS: PENALTy F-oR REmo ✓�u� T��s /A!c
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ADDR �ESS
ENSPECTOR
DA��£� �;
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SCHAFER'S SPECIALTIE� �.r'PLS.
. ' ' �rl� � �f'IC��@�/ • . . .
�. Applicugian far P)�mb�r�g c�nd Gt�s �'r�in� 3'e�it
Dep�t. •f $ld�. '2hono �` -•3.
� �. vgsc�rnrior� oF wo� � � �i,.o�Lo- /� 3i- -�
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• Kts�Lsr,•tCind at�d Loc�#ie�r a� Fixlut�f ,' . . • .�••,•• T--�•- -_ . .
` 4 '" wAT�t Nr�. City o1 Fridley: /
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.` ��`r z.n �� v1 � 6 0 �
. ! I_ I 1 � T. '^ ao:k re^e
� • �� ` � ' ° � � ; < � !' � � � I� � ' < 7 � � � � 7 � 7 <'x `� a " � EueG 'I'hr Lzdezsi�ncd hereby m��ces a��.tcation for a per.r,it fcr L.e
?< accc. ....�e •�
_ ��, � 3 js �� M:� � �o � I a i: o i� e �< 3�u 2 u.. �v �, . spcciiird, a;;rec:ng .o �o a:l �rcrk ia s:.:c: ��^- w:::� the C� Ni:.�-c
/ and n,Iing o1 ihe ^^_pa:::�cr.t cf iu::c�'n�, an� he: _�y de:l2rrs tiz:t a:l L':e f:�
Ea:r �! � . and rn�resentations sLa:c�i Lz w is z�r::ca�t.fl ::e :r�_ :..� eo::eci
%� � '_" :`ridIey, b�fnn . .�,.... - - - 19.�
_` � � _ .
3-d 1 I I Ovmer
,.� � � , � � � I{ind of
� =� ' ' Y Conaaet�d critlo�. . , ,h _ •
.:r.:.-• Co_.�:•.'.�- O?cW-.;c Sew.�R�' Used az � .
� X�w i i_-Yti:rs. O:d O",+o�:r.,rs Cetsp�ol �' ` . �
� - • � • To be completed about .,.��..�.- �- S �- �- 9 ,��,------ �°�'
. - . . � • • � / %�Ol�, �— . .
� PAR7tAL �ATE S�I�EDUI.E . 'Estima;�:d Cost, s ,
� s�a
� . ' . � hew. Buitding PPrm:t I�o. � ,_.;_._--p•rnit Hd. ^ �
� PLt7'MSING E'iXTtii�E R�►'t�3: NO. RRTE hTOTAL ' . . � �,�' • (� /p( .!'� "�;1�6f �'%
� . ,._.�� x S2.CA S°��` `�— . _ , Si�eci -
. ::uzr.ber F:xutcs.••��••••.����•
. � � . � .�-�-�
' i1it�'e Fxtu:e O;,cr.ir.g .... . .. . . ... ---- x 51.5� S _.. ' . � By - .�.r.. �)
. . . .___ x SI.SU S _ ' B�:�:a� :s P:.une 10 .
::ew Fix:u:z O:d Op�riir.g....... _ . . .
C.ilc'� Sas1n•••����������������• ���� X �N.�.J .S . . � � ' . . •
� C� � • • '
Y�a:c: iiea:cr'I.'p to �9.Oa0 BTV�•••• x...GO b RO'JG'si �
• ;:�ra Grcur.d Run OId B:dg. ..:..:: x 5�3.25 5.._...--. • ' . ,
�-
��c:r'.c :'l�:ns H�.:tor . . . . . : . . . . . . . . '..__� s 52.GJ S Fl:v�iL �'.t - ���� .
�e1lS �T`TitiG F�.SS • 2Z0. RisTE T07AL _ '
Ist3 FixtL'ICS•••���►������•��'L�• �...�'X 52.� y ,� �
. . � � . • .f��iv�.iG�al F:xtti:res. . � � � � �'�•� � � � �.� • ��� ii v .�rJ y - — . � . .
' ' ' x S�.CO ' E -- •
G:s °.:: se to 1S9.G� B:V . ..... . . . .: �---- , . . ' ' .
• . ' ,50 State ,Surcharge
1C�1�RS a� 1►L•TtRJ►T1�Ns—�4fstlo GaL • , . . . , .
• . Desta�'piion . . . . . : . . . . ... . . . . . . ... . . . ... : ... . ... . ... : � � �,, s�i • .
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/� T.:n?i,,.s;r�"��.. °. �3n�ti-„',w �`'-.-.,r,� -,,,.+3 Rfiy,..�., �r �, $?� �' ,n��^Se�+ .?,.5�...�,,.,n!,..,
. � F"�y �.O�y.o`.:r,v�it3 i�.�'d i��,rsr..'� � ��.;.�.cza :.:.':�S C"..�. .�.�+.�c�,;, 6�ww:�-a:c�.�' � .�'ii;L.�:.�.zc�+d's�. f �i.�.«�.�,.rut,i:s�a9e� �'��i.�
. . . k�4a �G1r..rT� �.. ��: � �^a�n�1�;�. . 'P /T�''ae i"','Rp''��s'j.n. .
G'"i.5 timrL��::atLV.�:. Yr r:�iu: WbLJ we•v$ iior�ak �,u�'•J .
i"/'\1'C[��P'1� +'it'�! � ��✓i"�i����
i.Ra1�tTT `itAn�d AIR:
F�^�e�c� S1:�11 � D�M Work
Rrp:scrme-it of �rnart
P,rpai-� & At:c:3;:ons-- up to S.`.00L00
Re�s.rs � Ait�rs:i�^s each add. 5544.C4
MZC.Ii. �tJ1ii3�t 1113t
�:rr.act S.*.ell Pt A:ct �'nrk to i]�,oGO BT'U
ta� add. 60,Q04 B'I'tT . .
Rcp?ste^iea: of Fsrnsce
Rrsairs & A;te-ations--uD ia SS00.00
�Rrs,ain 15e Alttrations each add. SS00.00
�..: �� ���z.
.. $10.00 S '
G.QO ��_
b 70 �
. 3 Uc1 i �
.��000 S ��;�
:i.W S
fi.OQ 4
6.OQ S
3.00 ;
STERM or HOY WAT�A SYSTE?�
F�rr:acr Shc?1 Sc Lires--to S00 sQ. i: ?.DR SLear.: t:4.M $.
itirnsce SheIl & L�ne---te 6�G �q ft. EDR Fioi Water I000 S.
EaM Add ?0�1 sQ. fl EnR Ste�m 3 tx� �
Each add. 320 sq. 1t EDR Hot Wa!er 3.00 S
02L SIIRhEF—LO 3 gai. per hour 6.04 S.
over 3 gaI. per hour--5ee 1�'ee 5chedule
GAS Bvx�cER (up :o L'S9.000 BTU) 8.e0 = 5 60
ovtr 2�'9.C�t?Q B'I`U Sea Fae 8c�:vduls
G� FITTI2iC £r^.i'.5: 3°€O RAi`�E T07AL
lst 3 Flxtures ' z$ 2p4 S�<r'%
Add�tio�a! F7ztures _ x .78 4__. • _..
Gas Rsr.gr t� L43,000 xb b.d� S
lll�[ C.�,ia,:ITLO1CIlr:4',
1►d..sE. �:Z.`&ti SYSY'-.�.�"
?�ii'II..�TI3�1G gT�:��
L,--�p �- r
� �r .���c�:a a r�k.�s
�ovax
i Y'`i�iSA � .
State Surcharge o .50
�oo F�s �cfi�t�.lo
roT�a. � �Q��
0
�.9?t. O��i'�t��1,. ?}SOCI+ �-�'�wJ
__..� l 6 � 1 ��
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City oY Frid:c7:
Thc< �:ndersiq.^.EC.' hereb!+ makes ap�licaUo:� fo:^ a Dcrr.iit :or the wcrk !:ereir
spectfied agr�.Y•.ng tu de aU w•ork ,n s,rict accordance with ihe Cify �dir..gr.:�
and r1��ing•of the De�a:tm�nt o4 FIutl3ir.a�, and he:eby decln:es 4`� aIl thQ f�c°.t
and re{,r�rcentatiuns statrd �n this appLcalion art true d carrect )
� ��
' fl ►dle , hiinn --- . 18 �
�+^Pf c�'" _ \
Kind o: Buildin2 � � _ ---
Used as
To be compie�eri about
Est;ma�c�3 Costi t
Otd—� Buildirig Perntit No. ------ __,_ P•rm:tNo._____f�-'?`�-
i�: ...��i�FTIQiT OF �3431i
iiEATING or POS7�R Fi.ANT'',r—Stcsir_, i'et i'i'atn. Warm A!r—No_
7�rade Name �'�'M ��d n� S�:.e Ha
CaPaciey--�----- -- SQ. Fe %.D.R �v J y�� o�� C3 g..�,
TotaI Connected i.cwd ..,� Riad cf �tsxi
BURNER — TYs�e Na*�+p S!x Na
Cay+aclly Sq. Pt E.DR Ii'i'iJ ` �
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. � �I �� .
$L,!':iTrt
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(tk,'MA�7�S--OYtRj '
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. .�0��.� ����� ���t•' '� �- ,�� �`' /�.3� �a�� �'4�
,._ ��j 0 v -�—�—_--�'°' � .,,;7 ,,,�s ..> /�
p.�6 , : ; • a z / � �a. /��!�7� �j T ��0 v � "` / /�J �/ V (ic.��- °�
� H�AT LOSS CALCULATIONS DEPAitT1iAE�1��F BUILDINGS FRIDLEY, MINN.
, Weatherstrips A.S.H.V.E. Construction No. Iasulation
Guide
Windows I Doors Reference Out. Wall Int. Wall Ceiling Roof F7oor Kind How Applied
Yes—No Yes—No 19_
�S Fl.� Room � Length Width Q,,$C-leight �j s FI.� oom gth Width z Height �
Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area
�Vidth Helght No. ot Lineal ft. Area Width Helght No. ot Llneal [t. Area
No. ot pane o[ pane lighta ot crack eq. ft. No. ot eane o[ Pane Ifghte ot crack p. tt.
Infiltration '~
Glass
ExP• wall 8 S�'/� ,S 8
Net exp. wall 3
Int. wall
Ceilin O ,� 3
Floor
Total Btu.
Required sq. fc. E.D.R. or aq. ins. W.A. Leader area
F7. Room � Length Width
Windows and Doora—Crackage and Area
Width Helght No. o[ Llneal tt. Area
No. of Dana o[ Dgne Ilthts ol crack �a. tt.
Bcu ! '
48o In6ltration
� 45o Glaaa
Fap. wall
�.2 30 Net eap. w
-i�-7va�}I�
� Ceiling
Floor
8 ��D Total Btu.
r
Coef. Btu
In6ltration �'j Q DD
�a� D 50 /.SO O
Exp. wall
Net exp. wa 1 p
Int. wall
Ceiling / r j
Floor
Total Btu.
Required sq. ft. E.D.R. or aq. ins. W.A. Leader area
S. Room � Length ,2� Width
Windows and Doora—Cracl�age and Area
Wldth Height No. o[ Llneal tt. Area
No. of Dane ot Dane Ilghts ot crack �Q. tt.
lnfiltration � �j q v
Glass s p
Exp. wal) � ¢
Net exp. wall o / o
Int. wall
Ceyling ��. f 3 O
Flmor
Tbtal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
Btu
2a
�o
�
�uired aq. ft. E.D.R. or aq. ins. W.A. Leader area
�•� /
Windows a 1
Wldth H
No. of Dana ot
In6ltration
Glaaa
Exp. wall
Net e:p. w
I�+�� �
Ceiling
Floor
Total Btu.
f/.�
Btu
i r
e and Area u, � ,-
Llneal It. Area � �+d0t'"S er7J.�
ot crack sa. tt.
Required aq. ft. E.D.R. or sq. uia. W.A. Leader area
Windowa and
Width 1
No. oL pane t
/ 1f
Infiltration �
Glaas
Exp. wail
Net exp. wall
+�a+• � N ;
Ceiling � ,
Floor ��
Total Btu.
�� w�a� H��gh�
and Area
ired sq. h. E.D.R. or aq. ins. WA. Leader arra
�
� I� /
['J �
� °
� i i
� :..
. , � ��. � ,L��� t� ��SP�,�� — .z,�; O s"S
t�,T toss c��cw►m�s -r� �"a. —
' oEPNtt1�vT oF euu.otNC.s
, ' WeriA�rs�r�ps • • Gsttrrcfas No.
Cwde �
w'"dow� I Door� Relersnce Ort. W�II lal. WaN Csilin� Roof Floor
Y�i—�le- e�— 19_
�. s a �� R«�, �M�ti w�ti � o, �ar�� 8 eFl.�
Wiedow� � n--Guka aed Area a�r�.bw� and
t\�W�� H��R�� �1�. �f e�N .6 Ah� 'T` �d�e
N� •f pe• �f �a�• btlll• �f er�e� �/t. Mw nf s�n• �
Iniltwtion
CJau
Eap. walla6ov� +ia,s
Net e:p. wall Q
. wall below O.S .S
¢ ulalla ar I
Floor
Total Btu.
Required sq. ft. E.D.R. or �q. ins. W.A. Leade� area
� Fl.� �` Room ( Len�th Width ,
Windows a� Drar�—Cracka�e and Aroa
M'IAII� llNf�t •. �t LI���1 tt. Ara
Ne. ef y�w• �t pan� Ilf�t� �f er�elt N. f1.
�II�I�i�ai1011
Clau
Esp. wall a 6ovc y
Net e:p. wa 11 a d o,rs y,a �..¢.,.
'wall I� ( [� /
Ce�lin` ---- ---.
Floor / Q
To�al Btu.
Required �q. ft. E.G.R. or sQ. ins. W.A. Le�de� aroa
� F,u .� r � 00111 ( �.!l1��1 w 1�`I ~
Windows and Doorr—Cruk��e �wd An�
R'I.nn MN��t Ne. s[ ��al fl. Ar�l
Ne. wf ��w• Of C�w� Ilf��• �f cr�tll M. ft.
� Il�l�I/��Nll � �
W�/! !
F.so. w��{ L(, (O OtK r
nf tap. M�u ,.,�
M.�� e( o�a r
Cc�6n�
� Fl�er /�2 S (}
� T�tal Btu.
� R��n� q. ft. E.D.R. er sq. in.. w►.A. Lt�sr an�
.
�
� / r
InwbtiM
Kind ��"
em � L.seN j B�W��
-�r�ek�p a�d Are�
N• �f IM�1 f�. •/N
Ilr��• nf �r�t� _ M. ft
InFltation I �G "/ 1
Gl�a '
u
�p. w.�� z
[ret e:p. w
Int. wall
Cedm�
Floor_
Tota{ Btu.
Requi�ed w. R. E.D R. or �o. ie�. �.A. Leader
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April 15, 1977
� �- .•�
8431 UNIYERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
Hir. E1mer Israelson Jr.
1619 - ?3rd Avenue N.E.
Fridley, Mn. 55432
Re: 1631 Camelot Lane N.E.
Dear Mr. Israelson:
TELEPHONE ( 612)571-3450
We recently received a second call from Mr. Donald Palmer, present oRaner
and oacupant of the above referenced home. The reason for his call and
cancern is that his dining room floor is Ioose.
On April 14, 1977 we inspected his home and found 3/4 inch combination
subfloor underlayment not properly fastened to the framing members. We
also noted that the joist hangers under the foyer were not properly
installed as they are not helping support the joist.
As you are aware, Mr. Palmer is also experiencing some separation of the
kitchen counter top from the wall.
All these items must be corrected by May 1, 1977. Af ter you have made
the corrections, would you please contact us so that we can reinspect
and close your f ile.
Your prompt attention in this matter will be appreciated.
Sin ly,
DARREL G. CLA
Community Development Adm.
AGC/mh
CC: Mr. Donald Palmer
Main Office 784-6066
� U F� U R�A N 6875 Highway No. 65 N. E.
�11GIRlEEF�IIdG i Minneapolis, Minnesota 55432
--_- -------- INC_----- --
a South Office 890-6510
� Civil, Municipal & Environmental Engineering 1101 Cliff Road
� Land Surueying • Land Planning • Soil Testing Burnsville, Minnesota 55337
Mr. Dave Harris
6279 University Avenue NE
Fridley, Minnesota 55432
Re: Narris Lake Estates
Lot 20 Block 2
Dear Dave:
���y ii, 1975
Y /
I l, i t.. ��o�J � ��}►� � C: Ci ) 1.,I�:ti..
We recently inspected the basement excavation on the
above captioned lot at the request of the Owner, Mr. Elmer
Israelson. The material encountered below the excavation
was a mixture of organic soils and black sand and was quite
soft. We reconunend that this material be removed from the
house and garage areas and a compacted (90� modified)
granular pad be placed with 1:1 side slopes to a point two
feet outside the footings.
Please contact us if you have any questions.
TMH/jp
cc: Elmer Zsraelson
Darrel Clark, City of Fridley
Robtrt Minder, Reg. Eng. E. A. Rathbun, Reg. Suro. Charles L. Lenche, Reg. Eng.
Wm. E, Jensen. Reg. Eng. Wm. K. Meyer, Reg. Eng.
Sincerely,
SUBU BAN ENGINEERING, INC.
, ���
�
Thomas M. Hals,�.
Project Engineer
John F. Duryer, Reg. Suru. �sflnY J. Roos, Rss. Eng.
Wm. E. Price, Reg. Eng. Donald 8. Wadltish, Reg. Eng.
�
� uBURBaN
�� H�INEER1N�i _ --,---�_-_
1 NC.
Q� Civil, Municipal & Environmental Engineering
� Land Surveying • Land Planning • Soil Testing
����
�,�rnolo�i- l..a�ae..r
Mr. Darre1 Clark
City of Fridley
6431 University Avenue NE
Frid1ey, Minnesota 55432
Re: Lot 20 Block 2
Harris Lake Estates
Dear Darrel:
Main Office 784-6066
, 6875 Highway No. 65 N. E.
I Mmneapolis, Minnesota 55432
� i South Office 890-6510
� I 1101 Cliff Road
� � Burnsville, Minnesota 55337
July 25, 1975
We recently provided inspection and testing on the above
subject lot. Previously placed fill and organic t6psoil
lying beneath the building site were excavated and a com-
pacted granular pad was constructed per our letter dated
Apri1 26, 1974. Subsequent testing indicated densities of
93 and 95� of modified Proctor.
If you have any questions please contact us.
TMH/jp
cc: Dave Harris
Sincerely,
SUBURBAN ENGINEERING, INC.
�c<��,
Thomas M. Hals,
Project Engineering
Robert Minder, Reg. Eng. E. A. Rath6un, Reg. Suru. Charlea L. Lenthe, Reg. Eng. John F. Dwyer, Reg. Suru. Je/jrey J. Roos, Reg. Eng.
Wm. E, denaen, Reg, Eng. Wm. K, Meyer, Reg. Eng. Wm. E. Price, Reg. Eng. Donald E. Wadleigh, Reg. Eng.
P PRRts e �'� . H-963C 5 0.2271 1Q 68.40 550 441 99L ,i
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.irlon rvi1�.INOI MlGIII�tDrlw�ploi��anynw� i,ue pWh locwdi.��� wtill� I� mmiw<Isnp�! Meciry vhlcM �ne1 d rpvirW M p�<Illa qqllptlon. frvxw �Irll M�w�cNi in ��Iwi! �nI IM ��poNbili�y d IM Fobrie�la, who au�ww� Ie1111o011ir� �Mnfa. llew>�apwl� �i�slal�
,�a.l .n,n �. �. e' �o,�o .,.��io, .;,,o ,b,a, o. no• elona�r 9/77' Mod: 0.007' efw.���r, I.5' x,..+onr pa���o�. i+atioutic . r,,,�... mou w ti.ed.e rbA <an dwirp lobrlcalm. �hippiny anr nymJllllly d Ileblllfr la M�ipro eM y»cilleo�lm� Iumi�MG !y II WnuW b IwUr p.
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� 1�1�rvLAt��i,.m ef_Inu L6aW1�' Ix�� �.�n. na e..� a..p�.e w�.��..iro rM �ap c1w�a ��oue OE<i�µ Siar:�J�QS ca.do� +Ith �M erylfcobl� yrov6fon d rly 'W1fmd 0�4pn lpslll• eM qcilicarloro <o�o�n b fa4.icaa'� plan�. Any Alwrpmcin �Awld M ImmWla�ly MwpM'
.+�.�. .�. ,�.�� ��•.r, u�' ' �" � eai�om' eH 'l.dM M��al Plal� Conrr<tsd Woa! irwwi (/rw ilo�� MaIi�VMI. In w`lel�p, le IM Liur+er'� artmllon b�lo�� /eArlealim la �acauary nvl�lom eeeaplaM� le Mr
� , �ryin��r a�d/a arthlNC� coric��ned. '
)ES1GN FOR TRUSS 26'- 0" OVERALL SPAN
; ' �SPACED 2'- 0" ON CENTER
' OVER 3 SUPPORTS
11NInUtI"LUMBER SPECIFICATION FQR 1-t/2" LUMBER FT FB FC
IOP �HORD 2X4 N0. 1 DOUGLAS FIR-LARCH 1Q50 175Q 1250
i01TOti CHQRO 2X4 NQ. 1 DOUGIAS FIR-LRRCH IOSQ 175Q 125Q
�EB nEMBER 2X4 NQ. 3 DOU�;LAS FIR-LRRCH EXCEPT AS NOTED
l5 Y. INCREASE TRKEN, ON F9
IESiGN LOADING
rOP CHORD LIVE 4R.0 PSF
IOP CHORD DERD 1Q.Q PSF .
i0110f1 CHORD DERD 10.0 PSF
f01RC. OESIGN LQFD 80.Q PSF
lOTEs 1b.0 Y. UNIT STRESS INCREASE NEBS = 16 BFT.
iQP CO.= 19
N01E: ALL PLATCS TO BE 20 GA. 600-CL, iQTH��= 66
IINLESS OTI�RWISE SNOWN. �.
N01'E: pLL DIMENSIONS 1C1 SE VERIFIED BY
ARCHITECT OR BUILDINC CONTRACTOR
BEFORB FASRICATION.
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CHECKED BY �__�__._
I hereby certity [ha[ [his �la�,
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�CpIPT�ON C�/ � � ��.�.Q_.�� •��t
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DESCRIPTION ��
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sue�ecr PERMILBLO.
City of Fridley "�
AT THE TOP OF THE TWINS / �����
� , BU ILDING PERMIT
� �
� RECEI��
� • COMMUNITV DEVELOPMENT DIV.
r � V � � PROTECTIVE INSPECTION SEC. �
� �
� � �"�1 � CITY HALL FRIDLEY 55432 NUMBER REV. OASE PAGE OF APPROVED BY
�----� • •'' 612-571-3450 910-Ft5 6/29/92 / /
JOB ADDRESS 1631 Camelot Lane NE
t IEGAL LOT NO. BLOCK TRACT OA ADDIT{ON SEE ATTACHED
oesca. 20 2 Harris: Lake Estates SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Don Palmer 1631 Caznelot Lane NE 571-6145
3 CONTRACTOR MAIL ADDRESS ZIP PNONE UCENSE NO.
D& D Home Imparovement Tnc. 7401 Central P;ve NE Fridle 55432 -
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MA1L A�DRESS Z1P PHONE LICENSE NO.
6 USE OF BUILDING
Res i den ti al
7 CIASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION O REPAIR ❑ MOVE O REMOVE
8 OESCRIBE WORK
Reroof House & Garage (19 Squares� 2nd Layer
9 CHANGE OF USE FROM TO
STIPULATIONS
Roa�i,ng can be 2nd layer but not 3rd.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCY�OAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICA�, PLUMBING, HEATING.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING S�. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
Ofi WORK IS SUSPENDED OR ABANDONED FOR A PERIOD Of 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. N0. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND OROINANCES GOVERNING THIS TYPE OF WOFK WI�L BE COMPLIED $1�00% $.5O
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NO7 PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMtT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAI lAW REGULATING CON- ���� $2'�� OO Fire SC $1. OZ
STRUCTI R THE PERFO ANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
License SC $5.00 $33.51
SIGN URE OF CON'RACTOR OR AUTMORIZED AGENT IDATEI WH P ERLY VA ATED THiS IS YOUR PERMIT
� ` �-z9-��
SiGNATUREOF OWNEAi�F OWNEA BUILDEA� IDATE� BLDG �aSP ��°TE
NEW � [ ) Effective 3/ 1/92
ADDN [ ) CTfY OF FRIDLEY
ALTER [] SINGLE. FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address:
Legal Description:
Ownet Name & Address: ���/l/ ��/ll�,� Tel. #�'j/ :�/�/.S
Coetractor: D� D Home Improvement, Inc. MN LICENSE i� 4840
Address: 7401 Central Avenue N.E., Frldley, MN 55432 Tel. # 784-7543
Attach to this application, a Certificate of Survey of the
lot, widt the proposed c.�nstYUCtiai drawn on it to scale.
r
I.IVING AREA:
GARA(�8 AREA:
DECK AREA:
OTHER:
DESCRIPT'ION OF IMPROVEMBNT
Length � Width Height
I�ec►gth Width Height
L�agth Width HgVGr�md
Sq. Pt.
S9• I�t.
Sq. Ft.
Caner Lot [) L�side Lot [] Ft. :Yd SeH�ack Sick Yacd Sexbacks -
'i`ype of consaucd+�n: ,Q�—slli�i�E' uSe �y,¢� Esti .� la0'7 °O
Apptox. Cotnptexion Date: � tG�U� I S� /l�Z /�L'A� fB/Z- �q
(Cost on Back)
Dtive�way Curb Cut Wichh Needed: Ft. + 6 Ft = Ft x$ = S
�
bATE: APPLICANT: � Tel. i� %$i��-r�
' � C1TY USE ONLY
' penn{t Fee � �'), 4� Fee Schedule on Reverse Side
Fire Surcharge S /, d/ .001 of Permit Valuation (1 / l Oth %)
; State Surcharge S ,� C� $.50/$1,000 Valuadon
SAC Charge $ S'!00 per SAC Unit
License Surcharge $ �:� O �5.00 (State Licen.sed Residential Conh�actors)
� Drivevway Escrow � Alt. "A" or Alt. "B" Above
� park Fee S Fee Determined by Engineering� ,
� Sewer Main Charge S Agreement Necessary [ l Not NecessarY [ l
�TOTAL
;
� STIPULATION5:
� �� • s l
�. . • r
_
_
CIIYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
August 28, 2003
Mr. Tom Strand
1631. Camelot Lane NE
Fridley, MN 55432
Re: Three Season Porch & Deck at 1631 Camelot Lane NE
Dear Mr. Strand:
Per your request, we checked our files to see when the porch/deck was added onto
your house. After checking our files we noted that a permit was not issued for this
construction nor were any inspections conducted to check the construction of this
porch/deck. The City Assessing Department has noted the porch/deck was
constructed in 1982 or 1983.
Replacing the deck and porch will require plans to be submitted for a plan review.
The plans will have to include frost footings to meet the Sta.te Building Code.
Please conta.ct me at 763-572-3603 if you have any further questions.
Building Inspector
DJ/mh
_
_
CIZYOF
FR[DLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
August 28, 2003
_� �_�a
���
Mr. Don almer
16 amelot Lane NE
..--
ridley, NiN 55432 .
Re: Three Season Porch & Deck at 1631 Camelot Lane NE
Dear Mr.�rfi r:
Per your request, we checked our files to see when the porch/deck was added onto
your house. After checking our files we noted that a permit was not issued for this
construction nor were any inspections conducted to check the construction of this
porch/deck. The City Assessing Department has noted the porch/deck was
constructed in 1982 or 1983.
Replacing the deck and porch will require plans to be submitted for a plan review.
The plans will have to include frost footings to meet the State Building Code.
Please contact me at 763-572-3603 if you have any further questions.
Sincerely,
DAVE JENSEN
Building Inspector
DJ/mh
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C[IYOF
FRtDLE,Y
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
December 2, 2003
Mr. Tom Nadeau
5314 Stevens Ave S
Minneapolis, MN 55419
Re: Structure at Rear of House Located at 1631 Camelot Lane NE, Fridley
Dear Mr. Nadeau:
This letter is in response to your request to complete an inspection of a structure located at your new
home.
On November 21, 2003 an inspection was conducted for the existing sunroom and deck. This
structure, per our records, did not have a building permit or required inspections as required per City
Ordinance and the Uniform Building Code.
The following is a list of corrections noted at the time of inspection;
1) Structure is built on a concrete slab — frost footings and concrete block required.
2) No flashing at deck/house connections. Flashing required.
3) No headers for deck floor load. Proper size headers required.
4) Windows located within 24 inches of a door not tempered glass. Code requires tempered
glass.
5) Missing joist hangers on deck floor joist. Joist hangers and joist hanger nails required.
6) Existing house foundation at northeast corner appears that the fill has been removed. Verify
minimum frost depth of 42 inches to bottom of footing.
The existing structure does not meet the minimum State Building Code requirements. The structure
must be removed or a building permit must be obtained and the structure brought into compliance
with the current State Building Code Standards per 1300.0140 State Building Code.
If you have any questions, please feel free to call me at 763-572-3602.
SincerE
�
RON J
Buildin�
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
PERMIT N 2004-00582
� ._.
DATE ISSUED: OS/OS/2004
(763) 572-3604 FAX: (763) 571-1287
ADDRESS : 1631 CAMELOT LN NE
PIN : 133024410028
LEGAL DESC : HARRIS LAKE ESTATES
: LOT 20 BLOCK 2
PERMIT TYPE : BUILDING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DECK
VALUATION : $ 1,639.44
NOTE: SEE NOTATIONS ON PLAN.
CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CONSTRUCT A 14' X 12' DECK
APPLICANT BUILDING PERMIT FEE 60.10
STRAND, TOM PLAN CHECK FEE 39.07
1631 CAMELOT LN NE FIRE SURCHARGE 1.64
FRIDLEY, MN 55432 STATE SURCHARGE, VALUE 0.82
TOTAL 101.63
OWNER
STRAND, TOM
1631 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 conect. All
provisions of laws and ordinances governing this type 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 rovisi f any o r state or local law
regulating co ion or perfo e of constr�,uti
Applicant Date
Bldg Insp Dat
__
QFPAR ATF PFRMiTQ RRC1T TTRFII F(1R W(1RK (1THFR TNAN 1�F.S('.RTRF.Ii AR(�VF,_
NEW []
ADDN []
ALTER [ ]
,� � s��
CITY OF FRIDLEY Effective 4/1/2004
6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 BI g Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fa
BUILDING PERMIT APPLICATION ,
r `� (+ .r . �� f , . "°` +, �
Construction Address: ��0 ?' � C K�W1 � LoT �- ti N� SS �i 'z, Z
Legal Description:
Owner Name & Address:�f�/1 �I1K. F�'� ��03 � ��WI �t �o � Te1. #�D IZB� 2 31 Z O
Contractor: �L T MN LICENSE#
Address: Tel. #
LNING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Cert�cate of Survey of the
bt, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft �� ��� J��
Length �_ Width /� Hgt/Ground�,_�Q_ Sq. Ft.
la.�Y
Construction Type: 1✓�K Estimated Cost: $ �
3 r'�
Driveway Curb_ Cut Width Needed: Ft. + 6 Ft = Ft x� _$
Z �l N " ' �"'� �� '"�'Iv � Tel. # ! �� �
�ATE: 3 'i ArrLICA T: j/
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
CITY USE ONLY -
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
� 0• ��
$ 07
$ �
$ . ��
$
$ — O._'
$
�
$
$
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 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 [ ]
TOTAL $ ��� lo� STIPULATIONS:
vva�y�i �r: 70v��
_ . _
Post-It° Fax Note
� � � Take this sh6 �°'°�p�r
Yaa havs seleated a 12' x i4' { FaK� �/� �33 �
Press�ure �'re�ted �ramin af
�Dia onai Ri • � � �� -
�-� !� ht Decki ng .
�!4 x b
�� Pressure rea��d Deak Boards
3�6 !�o Post Sp�ndie RailiRg
2�lx2, x42 Pressure Trea�ed Spindles, Beveled 1 E�
2 x6 Pressare Treated Nand Ra�1
Concret� and a Post Footings �
Premium Gold Sq�are Driv� Screws`�?n''�" °'�- ;
Galvanized framing Fastener� , = �--'��R- �°T .
2" x 8" Jaists
� ,,
11 " P �,k , S f
2 x 8 Beams ��° 3 x' �° p
,
�
4a PSf D�ck liwe Load �.. _ :��� � . _ �.�M ' °
$�
Il�ast�
�The posts shown ie f�is �iaiure
ursss� I—
J���--- ��-�- � (� ,� s
_i�t—��'"1'`��,G �% '�iS'�'�""
....�
'f�ir Widths : nane ����T�'�/.�/1�--__�''� `�-s-,'
or BqEtding Maferial's aqe only :14416gpg4pp,p�pqp600aSO402000iSp200QpOQQf
�� ��� V Q�
� ����n� :f�t� 9��
---' r yau� deck.
.�i..ST/ti/clr—�
��•�---
you seleeted!
J
�1 ��---�
� �1,% ,�`uL L-
d� � r��
'odaY;s cost for materials estimated in fhis desi n wifh '•
e�ae�mayt�r�ae: �a�sFa�kl�►at O�iO�lS. $��i�•��
oad, horrianlal de�krnp, �6 pt�ssun i��rd �k bo�tds, D� �bd trammg m�i ro �
. 35" �c4 r�l��g, Pross�ra �ted r�ilin6 po�s� a�d 9alwrtiaed bo,� naib. * • � �`
rBASE br�e�l� �!►�� �t�
rif-1'�. �� :_JV"r 1`i•..�
.
" �<
i t-
i ii J i ii ii .� .. _ _� i `.� . _.-.� i , ._. .
,�
9' 1 � �i
a
�
v � S�
�
�. car�titever i�-'
�_ �`�
� ����
Size of deck: 12'x 14'
.' Q,
s�
V
�JOS'�
f
� .. _ p r/ j �
,,_ LIc�' ". �_:�..."Li -I-/= � � /
,�!�"�=.,�.��.�=7T�-- �� ,�71>u.%
S
� �-�,�x� i ��/��r
�� �,� -
� � �'
�
v
6' ^
0'8" �
. , $�
I 72
6' � _ ,
cantilevar 3U"
. ost L.. _ � �r/ /y1 �.�
► � � ��" '�
�� .
�� � C- — 8, r� v
Footings: AII foe�tings are 42'' betow ��de witf� 8" of conerete and backfilled.
Poats labeled "a" are carner pc�sts supportinb a cantilevered load with l 1" dia�neter
footin�s, Pos�s labetcd "b" are interrnediate posis suppartin� a cantilevered load with 16"
ditsmctcr foo[ings. "__-�
Posts: 4x6. ranging from 6 to 8.5 feet above gradc, spa�ced 5 to 6 feEt apart.
� �
Lurnber: Pr�ssure treated, mininwm ��rade: punde��n �_ "Zh �� � %C � 'v `
I3eams: Z�x8 `s nailed to�ether witl� 2 ruvvs of 16tt �nails ri, 1 G" O.C.
Joists: ?x8's spaced 16" O.L'.
Deck boards: 5/4"x6" /
' r --=> � �/�� ,�ii/Lr�;i�Z'.�
'�i/�"o ��- ' G,�cc" �- .�--,r.� � �
J � � ` /
.,,� _. � -�J_ , _ /i��r i'��-;��'(��"il�%
/�.��/'� �'�'� •�
�-��� _. � _"/��_ �-�ui''1 ��-7��
�'�`� _
TOTAL P.03
� � � ,i . . s, . .
� �� _
� � ' � . . ' . � � � ` ♦ .
' , , � • �� � ' ' / ,`• � • . .� • • ' � �
. � ; � ` � ; �
� .�s �� . . • •
J. .
� w.� .� �� �� ��� .� r �. �. � ' • . + •
, �i ' ' . , .
J�� f y 1+l./� � ' • . ' , .
, . �. . ~ . 66' -, . - . . . . -,
, � . r .. �
. � �, . • ��-y' . . • ' . .
� � `.6'' '�'� , � ',�� • • �2�. . � . - .
,� �-,--�-y� T . _ ��. . � .
� � � . � ,��, ��° ,.: �� - ��-`' � . . � . . . ..
' _ r--- �0, p �.. -., • � J�A � C'�► • ,• ' . .
. � f • �r .� , _ •
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. . � , ��uN��T��� oNtY :� � � � . • .- . - � � .
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. . ,. , . .
, �' � •f.�r.� %�4 .�•'rt ;� � ii_$±' � � ,` , . .
• . �0.0 2�►.4 - . .. � . .
. . �� � ; . . .
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• . �, , . . • _ �
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.. . . . . . .., . .
. � � � ����.�.� '�� � � ��.. � � � . . � � � � - � � � � � ��.
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►d ca.sacr ..pr��en►e�io• a� a sv�v�y oF ��•e bou�d.�.•af � a�.. i.�d ob�o�• d+��s:b+d �..a• �.b�
Building �����
Inspections
763-572-3604
MECHANICAL
RESIDENTIAL APPLICATIQN
CITY OF FRIDLEY
DATE v-(� �� YOUR E-MAIL ADDRESS
S.ITE ADDRESS � �n'3 1 - �`'n �
THIS APPLICANT IS: O OWNER �CONTRACTOR
PROPERTY NpME:_A�` Q� e O1- r �.1-e
OWNER/ ,4DDRESS• �� 3 � a�Yl � b-f' I-
TENANT pHONE:
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERNIIT TYPE
Permit No.: �
Received By:�
Date Rec'd: �' � �
ATE,�ZIP,
COMPANY NAN�• a•r''• "•"` •• i••' '••••.•__.. _
CONTACT PERSON: JOAI$I�I ZINKEN
STATE LICENSE # EXP DATE
a,nDxESS: 13562 GENTRAT, AVE NE CIT�' ANURA S'rATE MNZ�P 55304
PHONE 763-757-6202 F,s,7; 763-757-6701
FAMTLY ❑ TWO FAMILY
TYPE OF WORK: I � �W �pLACEMENT
DETAILED DESCRIPTION OF WORK
❑ TOWNHOUSE
❑ ALTERATION/REMODEL
�
PER MS 16B.665 the permit fee is a minimum of $IS.00 or 5% of the total cost up to 5500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the 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 PROJEC7'S Wi�RE LABOR EXCEEDS 5500, FEES ARE BASED ON S 10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTU1tES: (IIdDICATE TOTAL
NUMBER OF EACH BELOV� a r r i e� MODEL: �;��-�p �Q�� SIZE/BTU 0 00 v
Equipment Installed . MfiG� �����--� , y. .�{ O'3� SIZFJB'N 3 ►�►
�G. ,r � r MODEL:
MFG: MODEL: SIZE/BTU
FIREPLACE (GAS} 515.00 GAS RANGE/OVEN 510.00
�„A/C $25.00 ,NEW GAS GRILL S10.00
AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 `Gp� �T HTR 510.00
BOILER $35.00 1FURNACE $35.00
CHIMNEY LINER 510.00 GAS DRYER $10.00 POOL HEATER 535.00
DUCT WORK S10.00 GAS PIPING S10.00 _VEN7'ILATOR 515.00
_ _._ _ _
-- r sir.�s
` �...��. ,�' .�` �� . ;. _. ;�...:.'4Y.z!D�N,4'y,.�..�aw.asri ' :. wv �x. s«cs ... �'!xrz .o.�.,s..�:...� .. ,., a� ,,P.-«.__....�„ . ..._...__. .. _ . .
Permit Fee $ Number of fixtures @$10.00 x$10.00 =$
Surcharge $ .50 Number of fixtures @ $I5.00 �c 515.00 = $
TOTAL DUE $ Number of fixtures (a3 $25.00 ,� x$25.00 =$ 025 O�
Number of fixtures @$35.00 � x$35.00 =$ 3��
State Surcharge = $ .50
Tota1= $ (oo , S�d
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTII- PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that.the work will be in
conformance with the ordinances and codes of the City of FridIey 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. �6
SIGNATURE OFAPPLIC�,�� �° � � PRINT NAME ROGER HOFFHEIN DATE �� I�-
�� — . .
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
���_���_��n4
�.
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT �
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMESfADDiT{ONS �EXiSTING HOME ❑ MAKE-UP AtR
REQUIRED FOR NEW/EXISTiNG HOMES
1. Combustion Air (See note below) .
�. �il or solid fuel IMC Chapter 7 with MN Amendments
b. Natw-al Gas or PropaneJIFGC Chapter 3 with MN Amendments -
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC 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 per room �
a. Required on new consiruction IMC 1346.0312
5. Ventilation .
a. per MI�T Energy Code 767Q or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be u$ed for
comb:ustion and make up air calculations
3uilding BUILDING Pe�it N°.: r���
�
nspections � RESIDENTIAL APPLICATION Received By: t
�63-5�2-3604 CITY OF FRIDLEY Date Rec'd: io :
1ATE_____��[7`s"'
ITE ADDRESS _
'HIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
YOUR E-MAIL
� OWNER
i.G��i
STATE LICENSE
E}� DATE
A-7llfv= �����
ADDRESS: CITY STATE ZIP
PHONE FAX
TypE I � SINGLE FAMILY/NE
❑ TWO FAMILY/NEW
�9i'�I�
PERMTT TYPE ��DITION ❑ GARAGEJSHED U WINDUwS
❑ BASEMENT FMISH 0 ROOF ❑ DRAM TILE
0 DECK ❑ SIDtNG ❑ OTHER
❑ SWIIvIlvIWG POOL _
TYPE OF WORK: � �
_� O
DESCRIBE WORK BEING
SIZE OF IMPROVEMENT
pF SQUARES
GARAG
PROPOSED SIZE:
PROPOSED HEIGHT:
0 HOUSE ONLY
❑ HOUSE & GARAGE
O ATTACHED GARAGE
❑ DETACHED GARAGE
WIDTH `� HEIGHT
Ft.
BASEMENT REMODELING SUBNIIT:
l. Existing Fioor Plan
2. Proposed floor pien
3. List of sWctural membcis to be used
SIDIIV FORNEW CONSTRUCTION MCLUDING DECKS,
❑ V�y� OSoffit ADDITIONS & PORCi�S SUBMIT:
0 Aluminum ❑ Trim 1. Site Plan/Survey showing tt►e cxisting structures
❑ p�a ❑ Fascia �d P�P� Prol�
2. Two sds of construction plans
WINDOWS 3. Energy Calculations
IN EXISTING OPENiNGS OYes ONo IACATiON OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBE STZE OF
OPENIIdG CHANGES 8c
TYPE OF WWDOW TO BE INSTALLED NtJ1vIBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDTNG THE COST OF LABOR AND MATERIALS:
(USING TTiE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ �QJ OCCUPANCY TYPE _
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ �. �
$ :, I 9_ a
$- O
$ •S
$
S
$
$
$
$
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks�a�able to: City of Fridley Attach S
7'HIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; that thc work will be in
conformance with the ordinances and codes of the City of Fridiey and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a pe it 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 whicl� re��iew and approval of plans.
SIGNATURE OF APPLICANT N�%/i_ ���K/% PR1NT NAME DATE
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