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AF - 35658�1 n � Caty of Fridley, Mi.nn. BUILDING P�RMIT Date: _ APril 22, 1969 �� N° 10i94 p�r; Thomas R. Swanson B�d� White Oake Builders, Inc. Address 3425 Coolidge St . N. E. Ad��e 2198 Long Lake ltoad LOCATION OF BUILDING No. 5255 S�t - Capitol St . � Part oP Lot Lot 8 _ Block 8 Addition or Sub-Divisian �arl�on �� Avmmit N[anor South Cornex' Lot — 7nc�tde Lot x Setback 35 � Sideyard 10 � / 14 � Sewer IIevation 83 6. 43 83 9. 43 Tov o� Footin� DESCRIPTION OF BUILDING To be Used as: _Dwellin�;_ ��t 2�+� Depth �'� � Height 20 � gq, �, 1010 �� 19, 70U � Front � Depth �� I�eight � Scl• F't. �' Cu. F't. � Type of Constructfon F� Es� Cost _..__.�,,�'�� To be Completed �16 000 00 SEWER LOCATION' 86' East of Ma.nhole WATER LOCATIOIV 76' East of Maahole - 10' West of Sewer In consideral3on of the issuance to me of a permit to co et ding described above I agiee to do the proposed work fn accrordance with the description above f in compliance w3th all proviafona of ordinances oP the city of Fr3dley. — $100_00 Sewer Connection. Char�e In consfderation of the �yment of a fee of �. �,�� g�by g�}� to �omas R. Swan:son to construct the buflding or addition ea descrlbed above. This permit ia granted upon the exPresa condition that the person to whom it ia granted and h3a agent�, employees and workmen, in all work done in, around and u�n eaid build9ng, or any part thereof, shall conform fn all respects to the ordinaace� of FridleY, Mfnnesota reg lacation, construction, alteration, ma3ntenaace� repair and movfng of bufldinga within 'the dtY Ifmf'ts and�s permit may be revoked at any time upon violation of aay of the provisions of said ordinancea .1 s��'/�"�+°�'�°""'�°�°'"r �Build�IIg�InepeCtor Clarence Belisle NOTICE: Ti�s psrmtf d� not eeve� �6s eoaslrneHoe, Insta(Hdon to� whiee. P��+�e. 6+� b�oe, senrar or watsr. B� s�ra to sss f6a Bnildiae Insp�eta� for aparat� permiy fo� t6e�s ti�ms. �r. .i, r �`s APPLICATION FOR BUILDING YERMIT CITY OF FRZDLEY, MINNESOTA. owrr� ►s �r� �,�� s 5'��SG��, ,�B�z�� 1.��, ��: �,��%�,1�/E,��,.��, AUDRF�'SS c3��S � ��c� �7 �,� c ST /�C �`' ' ADDRESS � / �'l s'"�c�u� �iv �r �7d � � � � �_ LOCATION OF BTJILDING NO . ��,S��S STREET c._. � � � �v � '��e � s o�.�'�'� �.,...,.. 7� I,OT � B�,OCK � AUDITION OR SUBDIVISION �! �„v �,2 Q u7�'j,� Y %�� - �%OU�S C .SidG� CORNL�`R ZOT � INSIIaE LOT „� SE°I'BACK �S � SIDEY'ARD /O r:�iyRAGE $��r SL'WER EI,EV'ATTpN TOP OF FOOTING Applicat�,t attach to this ,fox°m Two Certificates of S�u�rvey� of Lot and propos�d bui.7.di�g l,ocation draw.n. on these Certificates. DE�CRIPTION OF BTTILDING �o �e TTsed As: �.,.� f�: ��.�.., /� f �� s ° �� _- � Frox�.� p�� ( Depth `7'� � Height � � � /� �'� ` �quare feet � Cubic Feet / �, `�OO — :•-- �.. i� F'�or��_ Depth � Height � � I Squaxe feet �._._. Cubic Feet � ..___.__. T e of Construction � �� O/ �� ' � YA �� Estimated Cost��° T ` To Be Completed � �of.�/ c�b,c Fe-�r�� 5-4�G The underai�n.ed hereby makea application for a perm�,t fo� the wor�k hereiz�. apec�ified, ag:�eeing to do all work in atrict accord.a:n.c� with tYi,e City of Fridley Ordi.nar�ces and rulings of the Depaxtmen,t of Buil,di�gs, and hereby dealarea that all the facts and repre tations stated in thia ap�la,catio�. are t�ue and correcta DATE j / � /� `�' SiGNgTIIRE —� ^ (SchedulQ af Fee Goata can be fou�id on the Reverse Side.� e � a ` r lr�._ ! � � <�� `� � � ,� �� , ' �,. �:� ��_-�� - - > � - _�� y � -r � �. � e P 6 .�i. . � � . -� , ' �"'�`�.� ,'_ —�-_--�-�---�--.'r �r '< �' s � . , , ... . , _ - , . . : . . , . � "' - . 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S : : : . . � �° � � � o 000g r� .R �, $. .A 0 � a�.a� � ;�� ° y �v � � � `� w p ,.��°� a, a �"�' � � � a� M �C omp�' � d°�� b o ��o � � pp�`C � � �.�p y p�t. �u � �. `� � ��' u ��y� p-ru ��N � � �O.�p C.y wO H A� `� �'�7 �.�� f�DH ;+w'�?� e+ eT lD �� G�o e� y�.. A � ro�� • D � i � � m H _ m C m P d � ��is Od � x � m � � � � �. 3 O � � O � � �� o �' �o o; � o' �` � � � �� h A � o. =o � � <� � � ��. , Oi D � � � � L7 � � a HEAT LOSS CALCULATIONS DEPART-NIENT QF BI�II.DINGS Weatherstrips A.S.H.V.E, Conatruction No. Inaulation Guide �I Windows � Doora Reference Out. WaU Int. Wall Ceiliag Roof Floor Kind How Appl Yes—No Yes—No 19_ j Fl.� Room� Length � Width � i�Ieight Fl.� � Room Leagtli � Width �'�C a Windows and Doora—Crackage and Area Wiadowa and Doora--Crackage and Area Width Helght No. ot Lloeal f. Ares Wldtd Hol`ht No. ot Linsal !L Area No. o[ D$ne ot Dane ilghte ot erack �q. ft. No. af yans ot pane IIEbb ot cnek sa. [Q �� 3 � ° i � � ,� Coef. Btn CoeE Infiltratioa �r, � In6ltraaoD �Q �� Glaas e � � � m Fap. wall o Nec exp. waA � � Int. wall Ceiling - - -- — -- - —_� _ Floor Total Btu. Required sq. h. E.D.R. or sq. ine. W.A. L,eader area �.I �m �p�s f w�a� �/ B Hei�ht � � Windowa and Doora—Crackage and Area Wldth Helg6t No. ot L1nea1 ft. Ares No. o[ pane o[ pane I!`hts ot craok �. tL � �— f� Coef. Bcn " In6ltracion , � Class � � � Exp. wal) �-a Nec ezp. waD Inc. waq Ceiling Floor Total Btu. Required aq. k. E.D.R. or aq, ina. W.A. Leadsr ana Ft• , m � Length Width Height Windowa aad Doora—Crackage and Area Wldeh Helght No. ot Lfneal tt. Area No. ot pans ot Dane Ilghte ot crack sq, it. � � � � � 1 �" � a Coef. Btu Eup. wall Net e:p, wall Int. wall Ceiling I� loor Tbtal Btu. Required aq. ft. E.D.R. or aq. ina. �/.A. L,eader ana i� � ■ � Glasc ac Fsp. wall Net e�. wall --- �t. �all--== Ceiliag .� � � :quired aq. k. E.D.R. or aq. ins. W.A. Leader area � Btu �.� - �m � �� w�a� Hei�ht Wiadows and Doors--Crackaget and Ana Wldth Hetsbt Na a! Lfneal [t. A�ea ot ysne ot yans II�hL ot enck �. tt 1 � � � . _ �° / �EL �' � P Btu iltration �' �g�• l6b � � a � � � p. wall ,� , t ezp. wall � � . Wau iling � � � wr ;al Btu. � �uued aq. k. E.D.R, or aq. ina. W.A. l,eader area 1•� ngth Rlidth Height 1�/indowa and Doo ackage aad Area Wldth Hel`IIt Na o! Llneal [t. Area CX ot ysna ot Dane Ilght� ot cnck �, tL. �j � � �� Coef. Bt� � s 0 �. wall ezp. wall wall ing �r �l Btw Nired �q., k. E.D.R. or sq, ina. WA. L.eader area aannrivN ovitiT y y�°p ��:�cCo A oa�a� m'b 3 � o � � i �y�� . < �C ��. ��.��. �b � ��C�a„ °,� �� " o fo �., �, �' A � o �. o,� � �� s� o �. � s� �� . ��:M ��'n, � � �� ~ fb0 vJ `ti' A cn �•�'� �"' O A' �� C_�•� ° ��r.� � �n � �.�'� � �• o � � � � o ' �� Q �� .�� , �. . �� q O „ y � ��,,, �. � c0 —.. �� a �• ti. � ��`�'. y Q � �n f0 �. b � o�� °b� r«o��' ��; � „ Q �. Q ��,� 0 c�o�O o�' ^�J� R'►�i, �' r. � b `�' � �i � � �� A��a�3��i ' � s� ti� � ��.�� y��. �� '„��p' y �c�+. 4j �n�`t c3" (0 � � � � � � b 0 cCo i�. e� � � � � , �m � I 1 . � � 0 � f0 s � ca � � O � � � 0 � y« 0 6" m � � � a�'� s � �o 0 �O a � � � � �' o �, s• � a e�t � q O to 0 � � y O Z Q ` � � • � � � � � � . � � � � a �: � � � o � � i 'o � � O , -�'i� 70 � � � �� \ � � � � � , � � � � � � �� 3= e� y � � �� 3 � 0 o� ■ � � ti, � � �' � A � � � 3 � � m A B � O � � '�'� C — � � � �� ro �B � _-� � r►' � ir, b � � � �i � �� , � oM� � W 1� TA: �'re� L��bl. i�a.pr,� - Ge��'�d l3�.�, �$ty �n��ae i� �s �,ar��e�+� Bel.isl�, �u��.d�.+� �ap��or � ��: Ag�eil 2�, 1�)Z 8Ea i�� `sn�e �lsint �'�r+� fi�r, G��.��. 112 53r8 ��r�nu+� '�,�. �S�Q�-598�} I iaav� G�Zked t� i3r�►. C�rtdif� $� ��.� ��'d ��T� ��d�ag ��at si� c�'�1� � '�ug�y,� Fenc� a� �ar+a�g��g � .��Z�� pi�4� T�ere �S A+�� gra�i� 'here �s �t �trJ.ldren tia�re fi�� +��i�$ thes� g�ntt�s �a� tce�h � ��1�. �e+ Cauc�i��a &�+d �te�e�l ��t �� tt�, , a chsin li� f�� 1�ut h�d �+� die��i��d �� +w�teh the�s �_r. ' �a �� l�at� �d�.eatee � €his �et��e i� �e�bs��i�a�. a�d +�I.�1�i �.� Ci� c��a 1��.� S�+e�� i�f�i wit� 7�'�� itt�1 �► ��ea�u ��. �1s�, ie i6 $gg�4��e�ai 12 �.A�hP�� .IIBt�' �et �e �p��'tq �.i�Bw ��.ea�� r��u� p'h+�to ev Ias��os� ��s��nt. ._ G- � ._. _ _ _ � , �� .__ _ � a� t�.� B�.Y�I� _ �ld�g Iau�p�t� ��d� c�a �3ty �� SUBJECT PERMIT City of Fridley � 12996 ATTHETOPOFTHETWINS gUILDING PERMIT � RECEIPT NO. � � COMMUNITY DEVELOPMENT DIV. Q„�� ; /j� L PROTEC7IVE INSPECTION SEC. � �F � _ i � - r � ---- ; � .1 , � 1 /�"1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �----� • •,� 612-560-3450 910-F15 � � JOB ADDRESS 5255 Capitol Street N.E., Fridley, Min�esota 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. $ g Carlson's Surr�nit Manor, South Addn. SHEET 2 PROPERTYOWNER MAILADDRESS 21P PHONE David Eu ene Mattila, 5255 Capitol St. N.E., Fridley, Minnesota 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. MILES GARAGES 4500 L ndale Avenue North Minnea olis 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS Z�P PHONE LICENSENO. 6 USE OF BUILDING Detached Garage 7 CLASS OF WORK C], NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE A S DESCRIBE WORK - Construct Detached Gara e l2 x 22 x 10 9 CHANGE QF USE FHOM TO STIPULATIONS Garage cannot later be attached to house because of no frost footings. Also provide a hard surface driveway. i�I�RNING .. . � : ��►� ��r.�� 'r� �c�� - Before digging call local utilitie -� ` E�� TELEPIi01dE • Ei.EGTRIG - GAS '�tr,. ��!!� �1� S;�,��. 65�e:.i.� �-''i t..��yi� REC�IJ ' TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Frame THIS PERMIT BECOMES NUL� AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPEPlDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-� �L64 . Z,640 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 aRDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �� , 953. GO �• 98 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIDLATE OR CANCEL THE pERMIT FEE SAC CHARGE PFOVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �c.O� STRUCTION T E PERFORMANCE OF NSTRUCTION. � J PLAN CHECKFEE TOTALFEE �o � °S"°—�� $5.98 SGNA REOFCONTaACTOR RAU7 oRiZEDAG N7 iDATE� N PROPERLY VALID ED THIS IS YOUR PERMIT June 4, 197 SIGNATURE OF OWNEA IIF OWNER BUILDERI IDATEI BLDG. INSP DATE � - �., . ."� � � . v... . : . � . r. . , , .` -. � �� I ul / e � � s_. ��'� / � , / �, , �� ..� _- _ `, , � � � � � . � _ =��, � , �, �; _ . � ;r �,� �/ � �- �� / �� ,; ,�- � , , �_ , /� � /i > � � � � ,: , , . , � �i .� i: � �= / � �� ,,, , �l �_.��/r � � ..� �. i �,�'/� �� %�'� a ` _ .. ��'y! ��.( r- ` c` ' ' ti e ��►�'P`s�ICATION FOR RESID�NTIAL., ALTEItATI�DN, OR AllllITION.BUILDI•PJG PERMIT CITY OF � FRIDLEY, NiINNESOTA ' � � • �� / ��, , � �,� ,� ,s.�.� : : � �• lF t t � �� • � � � �, �1� ,t1� - • � � • NO:. STREET• � LOT: BLOCK• ADDITION: CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: � Applicant attact�. to this forsn Two Certificates o-f Survey.of Lot .an3.pxapose. building location drawn on these �ertificates. HESCRIPTION OF BUILDING To Be U d • e' � � Front : � � � Depth : �� Height : � • f . Square Feet: Cubic.Feet: � Fxont: Dapth: Height: '� �/ Square Feet; Cubic Feet: 7.'ype of�Construction: '� Estima�ed Cost:��;� To Be Crnnpleted: ,� " �� . �j f � �P �O � � The undersigned.hereby makes applicativn for a permii for the work herein specified, agreeing to do alI work in st�ict accordance with the City of Fxidley Ordinances and rulings of the Department of Buildings, and hereby daclares that all the facts and represantations stated i.n this application are true and correct. � UATEs G-��- 'S ��— SIGNA'. {See I�everse Side For Additional In: a4 G G ' �-�� P 9� � ��'– �2=� '� °�_'. �' � . , . 0 . � � � �BUILDING P.ERMIT FEE SCHEDULE � a A . , S�CTION 2. The Inspector of Buildings shall, before issuing permits far the erection of any building or structure, or for any addition to any existing building ox structure, or for any a�teration or repairs to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below seG forth�and in the manner herein provided to-wit; . �. 0 UIQIFORM BUILDING CODE: Type 1, 2& 4-$2.15 fox each one thousand cubic feet, or fraction thereof, i.n �uch cubical contents. Type 3& 5-$1.85 for each one thousand cubic feet. . ADDITIONAL INFORMATION Fox the purpose of computing fees for building permits, the cubical contents � of any building ox addition, is determined by multiplying�the ground area covered from a point si.x (6) inches below Che floor line of the basement ox the cellar to the average heights of the uppar surface or to the average� . height of the xoof surface of the main gable of a pitched roof. � 0 �or repairs or alterations to an existing structure, the fee sha11 be at the rate of $3.OD per each five hundred dollars ($500.00) or fraction thereof in " the cost of all proposed work. ' In ao case shall the fee charged for any permit as set forth in 5ection 2 be less than $5.00. . . VERIFICATI�ON OF FOUNDATION � NOTE: Permits for construction will be issued.a minimum of 24 hours fxom the ti.me of application, to allow for proper review of the proposed structure azid of the construction site. . • A Certified Survey of the lot, showing.the location of the �oundation, once it has been constxucted, will be raquired before proceeding_with the fxaming. CERTIFICATE OF OCCUPANCY Application for a Certifi.cate of Occupancy shall.be made ten (10) days prior to the use or occupancy of any structure for which a building permit has bee� issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. • . . , , � � . - . :: - i . - TN� 10HN !. �v�uv co. SCAI�i: 1 INCM '�� aE[T - 1595 SELBY AVENUE, ST: PAUL 5810A T�f,�10N� 646-isbi� � � �� OF PROPERTY OF ��.r'r,�1��' � t�.�7! !/!'� �!;'s^r�r�:,a ��r./ �.e'? ��c''�"r':''�'i',P".'! _�,�/.9_/j.�� r�C�• . _ . _ �, . -� � t� ' 1 • , ro -- . '� , - - n? �a..3 . -- - � 41 s�+.o - : - _ 0?'^ }' , Oa��ti' . _ =: � e - �� . � ' -` _ . � - CJ � _, _ , � � � � _ _ ias '"_' 29.3 �DO ! . . .. .. i T� � /- S. F. N. �1 � � Y_ � � N h .�'`3235 N f� � H �rf' ,z, i �j� • ' �o,� ' . - --- !Oi � I d' ' ' ♦^ i - C,� 7S C-i9P/ 7`OL �c �' /►/. �=- fvo � ' eS,.R.`.e'�.� �'it/�°.'�e9 .'y G.S/ce'S O. �2 � .T f-G�JS /• O EAVES F.PDir! ,GG 7�' Z �� . - � . _ . ` CERTIFICATE OF IACATLON OF BUILDI1�iG CERTIF'IGATL Ol�' BU��EY I hereby certify that on �`�'�� 19 7'¢ I hereby certify that an 19 this survey, plan, or report was prepared by me or under ._. �- this survey� plan, or report was prepared by me or under my direct supervision and that I am a duly Registered I,and my direct supervision and that I am a duly Registerec! L�nd Sur�•eyor under the laws of the State of Minnesota,--� ` Surveyor under the laws of the State of Minnesota. .�./ / i ' �; �%' �' -�a � ,s ,,•--` _ - �-. '-�•___..-�.----�+ .. ._ . . . _ . _.-.- . _�- -� x�- '-�- SUBJEGT PE . City of Fridley ° 15 7 3 9 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � r ; � RECE . � ; v ______ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. g9��'� � � a i � � /°'1 � CITY HALL FRIDLEY 55432 NUMBER � REV. DATE PAGE OF APPROVED BY �""-"� � �� 612-571-3450 910-F15 5/23/80 � � JOB ADDRESS 5255 Capitol Street NeEe 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oescR. g g Carlson's Summit Manor South Addition SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE David Matti].a 5255 Ca ital Street N.E. 56Q-8693 3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO. 5ussel Com an 1850 aqno Avenu P - 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING 7 CLASS OF WORK 0 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK � � 8 CHANGE QF USE FROM TO STIPULATIONS Provide combustion air and fire a]:axm. S�pERq V�I�RNING l�j�� , TF p Before diggin� call local utiliti�s ��1C�'+ �� 'l��PS TEL�PHONE - ELECTRlC - GAS Etc. '��r�►� � Fp�,��,o �E�UiRED BY !AW �� S��r �°R �i � R,� SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, �PE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. WOOC�. Fi�G THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION . OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT 322 3220 ANY TIME AFTER WORK IS COMMENCEO. NO. 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 ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH THER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �.O OOO rJ.QO DOES T PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROV IONS OF ANY OTHEii STATE OR LOCAL LAW REGULATING CON- STR ' TION OR THE PE FORMANCE OF CONSTRUCTION. � � ��+ �� PLAN CHECK FEE TOTAL FEE i NArUaEO ONTR ROA THORIZEDAGENT (DATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT �"L�' �'�' � !�_ �� " � SIGNATUREOFOWNERIIFOWNERBUILDERI IDATEi - BLDG WSP DATE � CITY OF FRID! �Y - ARPLICATION FdR RESIDENTI�L BUILDIPdG PERMITS (P�ew, A1terations, Additions, or . ' OWfJER: � . ADDRES S : �L�� ' /� �' TGL �IO: �C�� °� �� g � BUILOER: ADpRESS: TEL N0: � a -: Construction Location . STitEET NO � ' � STREET: t �t.�/� _ � ° LOT: L'LOCK: � Gr �• � ; , . . , � / • w r�, 1/ •�� '. Gorner Lot: � � Tnsicle Lot: Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed buildi.ng location draFm on certificates to scale. DESCRIPTIOId OF CONSTRUCTION - I� �� 9--1��I j I 0� Front: � Depth: � ,_,_, Height: -- t--'-' Squa�e.Fee�: � � � Cubic Feet: Front: Depth: H eight: Square• Feet: Cubic Feet: . .. � �d � Type of Construction: Zb Be Cbmpl.eted; � L d � Ov Estimated Cost: � � � Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $� $ ,,, , SEE REVERS� SIDE OF SI3EET , The undersigned hereby ma.kes application 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, d hereby dealares that all �e f acts and representations stated in this �pplicat' are true and cor ct. . � � DATEs ��1 3 ° � � SIGNAT[JRE : . Stipulations : � �✓ — �� 322 X 3 !. 01- = °�i9�,. �l y �,., ,c,: � �v . P�rl.•�'� r ��. Ols • ' _ 0. � �, °v �� a Q .'v � ti � IIOi `A�q� ,�i ��ar f'T�� r I/t I� Il L I,/s�' , 0 a � . .�� .c ...� ., ' _�. �_.�. �. . :._ ..:. n.... , ..._�..,.: ..� .:; .... ... ....... ..... . :..-.��:_:Y.. �'k�.� .�>, -5�:�...e]C.av�^_�C?e.. .. r:&' �+�9Fi�1 • BUILDIIJG PERI�9IT FC� SCHCDUI_E� . S�C'PIUI� 2. �'he 7nc;��ectox of 13uilclirig� :;ha].�., beforr. a.ssu�.ng pea.�niL-s tor the erecL•ion oi' any buiJ.ding or sL•ruct.ure, or. ioi any addi.tiS.on to any exisLing building or s�rucLure, . or £or. any alL•eration or xepairs to •any cr.i.�ting bui�ldi�ig or sLx�ucture, up�n aPplic:ation �Lher.ciorc, require the Paymenti by t]ie a�p].icanL• for. such pexmiL- of i'ces L-o_ t•he amoun� hcrcin be].ow set �ori:h and 9.n the manncn c�:rei.n provided L-o-wiL-: � Nr4? C'U1�::TRUCTION : Single �amily IIomes and Garayes : $�k . 00/]., 000 cttt�ic te•et. PLI�N �:I11:CY.: 25 percent of bu�.lding pezmit fee. • . DRIVLP7AY D�PRI:5SYOI1: (Concrete, Curb Streei�s Only) � • A1L-ernaL-e A: Remava.l and replac�ment of concrete curb and gutter only; Driv�way width plus 6�eet x Y�,�o?5 Alternate B: Removal. and replacemenL- of concrete curb and . ' gutter and i,nstal7. a 3 fooi: wide approach with �' ' 6 3.nch depth� Diive�•�ay width plus 6 feet r. $17.85 AD�I T I Q�!/�L. I NFOR�'�A.T I 4N Fo� the purpose of computing fees for building permits, the cubical contents ot any building or addition, is detez�nined by muli:iplya_ng i-he ground area covered from a . pa�nL- six (6) inches below ihe floor line of the basement or th� cellar to the average.heiqhts of the upper surface oz to the aver_age heighi. of the roaf suriace o£ the main gable of a pitched roof. For xe�airs or alterations to an existing structure, the fee shall be at the rate of $3.00 Per each five hundred dollars�($500.00) or fraction ihereof in the cost o� all proposed work. . . � Tn•na case shal.l the fee charqed for any pexmit as set forth in Section 2 be less� than $7.50 plus $.50 state surchargee ' • � f � � ► 1 '��1� ' NOTE: Permits �or construci:ion coill be issued a minimum of 24 hours from the tirne of application to allow for proper review of the proposed structure and of the construction si�e. A Certificate of Suxvey af the lot, showing the location of the foundation once i� has been construcLed will be required before proceeding with the framing. C : � ' 1 Applicai:ion for a Certifica�e o� Oceupancy shall be made ten (10) days prior �o th� use or occupancy of any si.ructure for wiiich a bu�.lding permit has been issued; and said structure shall not be used or occupied until a Certificate oE Occugancy ha5 been issued. • 0 . i .. V - . . r �r . . . , � � � , //� . a � ' � � � �1 . � . �'• . . � , . . . . , �� f ' �e .�1� `� �f. � a°-14°'): "' ',�/ ,r�l i ��i''°' �"�° � `r TkE J�F:l� ,9. �v�..��°. C�. . Tcn.�raO�g, e�e•A.e• �CALR� f Ity'CN'_ EHT t698 SELSY AVi<NU�, $l'. PAUL 65104 � � � . � rN �� . ' au OF PROP�Ri'1f t3F.__!'�'��-�t°�'�' ,. e� iP-��>'� ��%�� ... A / �L ��`�/ L�CA71o11_� ��.��s ��% ° d i�f r�,�� / 1"iC.#��/��,,,Cf.��° � i a��caieea� as w�sow � �-� °�� ? -i.��%?� �,��L�.� .�� "�� s�'� � , � , � . :, � � . � .' � h, ia.3 � snaa . _ .. ,` � _-..._-.. • � � � o�� e�f?1__ , �� . v. �. _ ��° ..____--, -- 106 V 2�.i /00'� /- s r. �r. C � N �1 ,a�.sas-�a' � � s� ,Z. �� - ¢a.� • - - --- !D!� J,O' , � 0 , �„� 75 . C-A�'/ T4� �57," /i/ � �vo �.�' � . •.�'r�r',e�''1..� .�,v�'.� t� .� c�.vE.x !�. �' se a°. ;�c�ls s. o e��+v�s F.��.�✓ L� i 2 '�. � w . , � C�ATIFI�A'i'� OF LOC�.TIOAt t!P' ��II.UIYdCi C�°i'�'ZCA`i� OP' BU�V�Y I hereby rertif� lh�t on .� `�'t'�� 19 � I hereby cer�ify eh�t on 19 cl�is survey, plan, or repor6 �vas prepared by me or under .•- this c��rvey, plan. ar te�port wa.c prepared by me or under � my dirpct �u�a�rvi:;iun a�id thar. I am a duly Fiegistered �nd � my�dir��ci s'�pervisian and that 1 ain a duly Hegistered [.and -,..�ursc�y�ar tiqtf�r i he ia�}�s of the State of h2innesoW, � Surveyor undee the latvs of th� Stssie of biinnesota. �.-'`? . ''.�=:t t �- . �;b 3r-��. �,..�- �• " - �'�� JOl�N J. RYAN. R�G13YEfd�D �URdEYOR. Pdo.�B� � � raA�i. � .-r,ee..s- r. ....�+�..:i..�.� -...r..,.>.,...e .,,_ .. . .<,-e i . e � �t�;tt FXfFRIOR FNVELdP� AV�RAGF "U" C�MPUi'ATTON i SITE� ADDRF�SS _ SZS$ Capi-�-a�� , /J„�. �yt 5 54a. CON7'R� CTOit T v� e� 5�� I�� . DATE 5' I Z-�iU • PHONE �- O�� ,,._...'... �� DETERMINE WORKING SQUARE FOOTAHE OF EACH �.• `rOi:81 expos�ed W1811 �Ye$ •.��. J�'��v7 SQ• I''t• X •185 Q (V��A �.� 2 �o�al roof / ceiling area ....... �� Sq. Ft. x .04 ffi ° 1Z,�,� _.______. di o b. c. d. e. f. 8• h. i. TOTAL EXPOSED WALL AREA ABOVE FLOOR � L�3Z DETERMZNE "U" VALUE OF EACH WALL SEGMENT � g nUu , Tc�tal wail WlL1dOW area • e o � � � � � � � � � � � • qo X .'�� Z.i o 7 TC�tSl dOOi area •��o��••��• . �;�.. X.......... �......... Tatal �rliding glass door area .... .... � 3� � X' '� m� ' zo. SZ, Tc�tal fizepl.sce wall area — X '�¢ ............ a .,,,,,s Tutal w.Qbl frArning area (average 10%) 3,Z' X_� �IOS °� Tc�tal n�et wa�li area above floor . . , . . . �o ;a"�'�'� X � ' • , p�'�,� " � • ��L Tatal rim joist area ................ ••• • "��"°""� 4g,�� X'_ ,05$ ° ,..._�.� TOTAL EXPOSED FOUNDATION AREA =' '(,� 7, Q�3 . Total foundation window area .....,.., s— X e. _ Total n�t foundation area above grade (o-], g� g � • • • •,•�•.� • • � • • • •o•t �� } .........................TOTAI, �0��`� � o � a o • • � � � � e � � � � � � � � a e � a � � � � � � � � � � e�• s s e � � � � � � � � � � e [f item �3 ie the aame �s, or less th�n item �1, you have met the intent of � �BC 600�i (C) 2. TOTAL EXPOSED ROOF J CEILING AREA = �� AETERMINE "U" VALUE FOR EACH ROOF / CEILING SEGMENT. � nU�� - j. Total skylight are� .......................... X o. � ''�� k. Total roof%cealin framin area (avera e 10% `—'�"° ""'"""' �•"°'�" g g S � �Z:� X...�.� ..� 1. Total net ineul�ted roof/ceiling area ........ �Z g� X•�•�p� ffi• � + ..............o..e........................................................TOTAL �Z�� S� f totel of �4 ia the same as, or leas than ��2, you have met the intent of � sBC 60�6 (C) l. ALTERNATE BUILDING ENVELOPE DESING :o utiYize the tot$1 en��elope system method, the values established by the sum �f iteas �3 and �`4 ahall not be greater than the sum of items �1 and �2. I• ` � ��e"�(� + 2, 'Z. �� ( 1 �, (04 �..4.�.� �.-�..�� 3• �� + 4. �Z�7�J� ' _ �i�, Z� Y I _o L i3_a" I .. FanST��ty � � 1 —T, No�+�E �:�.. �:�. Catj7n.fvvCq � �__.__._.' _ ! RonF LiFI6 �__ 1� �-;- ; - ----- � . � -_ - ,, . . �� -;� -- -` ;� ; --A �I � i �� ; � / 11 I � , i � � ' �`� -�'-� i� � n � ; �;6 ' �� c: i K .� �L o'�� i ; I y `➢i m ' ; j �" i� -��I4 =� � Q m -� _ )( i21 L D I� � �+a �"DW� � � I^� y � I F � � �,. ItP / N � � �% ' i I � �' , �' ' L� * ro� '��-�; i i ! 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C] rn �n * � aa�� y r-w N W � � � w � � � r e+ m m �n � � rr�� M � H > w a � � -o '�v' � � m cf —i � m � � e�.i � � .� � r �o � a c�i� � rn � o tn u� o = o° rn o � o � -rn �A '�l �l N y O O O O L1y 0 0 0 0 in �ifl in �L/t H 9 Hf]G 'J 'G N tS �� Vtl-a'M o� � w r W W 0 C A��+ a m N N� �� 0 l` � � � r f7 n � 0 z � O � 0 � m � � �� Z c") --�I O tn b � --1 ZG O i z m -- a � � z � � -c � � � o 0 N r- b � m m .-�. '_Z1 n ar m � � �--! 0 2 � is1 �'1 � G7 m � m �-�1 O z a Z C T') � -c a � -� � r 1-k � • � sue�etT - � RMIT NO. ` c�ty of F��a�,�� 3 2 4 � 1� AT TME TOP OF THE 7W�NS �, � 1 L D i I� � P E R M I T � REC� � ,. � � - /� . � • CQMMUNITY DEVELOP�IIENT OIV. � LV ��.�� . r � � PROTECTIVE INSPECTION SEC. � � , � _ �"'1 � CITY NALL FRIOLE� '•i.i' �32 NuMBEIi NEV D�TE PAGE OF APVnOVEO Br �.---� • •,, 612-571-3450 910-F15 1/29/02 / / J08 AODRESS 5255 Capitol St NE � 1 LEGAL ��T NO. BLpCK TfiACT OR ADDItION SEE ATTACNEO oescR. 8 8 Carlson's Summit Ma.nor South SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PMONE David Mattila, 5255 Capitol St NE, Fridley, MN 55421 763-574-1214 3 CONTRACTOR MAIL AODRESS Z�P PHONE LICENSE NO RMA Home Serv Inc, 3200 Cobb Galleria Pkwy, Ste 200, AtZanta, GA 30339 763-542-8826 4 ARCHITECT OR OESIGNER MAIL AOORESS ` ZIP PNONE UCENSE NO. BC 20268257 5 ENGINEER MAtI ADDiiE$S Z�P PHONE LICENSE NO 8 USE OF BUILOING Dwelling 7 CLASS OF WORK �] NEW ❑ ADDITION 0 ALTERATION O REPAIR O MOVE � O REMOVE 8 DESCRIBE WORK Rep�.ace 4 windows wi�thin existing openin.gs 9 CHANGEOfUSEFROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on a11 levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulking and flashing for all exterior openings. Permit Inspec�ion Card� . Wil1 �e Nlaile� To Homeowncr To Post SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATINCa, TYP� dF CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTILATING OR AIR CONOITIONING. THIS PERMIT BECOMES NULL AND VOID IF WQRK QR COf�STRUCTION IONING SO. FT CU fT AUTHORI2ED IS NOT COMMENCED V�IITMIN 80 OAYS. Ofi tF CONSTpUCTION ; OR WORK IS SUSPENOED Oq ABANQON�O FOR A PERIQO OF 120 DAY$ A7 ' ANV TIME AfTER WORK IS COMMENCED. ' NO. OWLG. UNITS OfFSTREET PARKING I HEREBY CERTIFV TNAT I HAYE READ ANO EXAMIN�O TNIS APPLICA710N S7ALLS GARAGES AND KNOW TME SAME TO BE TAUE AND CORRECT. AI.L PROVISIQN$ l7F LAW$ yq�UAT10N SURTAX AND ORDINANCES GOVERNING THIS TYPE Of WpRK WILL, Q� C(JMPUED WITN WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �G, 340.00 �3. Z% DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL TME pEqMIT iEE SAC CMARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $139.25 $6 • 4 Fire SC P(,AN CNECK FE TO AL FEE $5.00 i ens $153.76 SiGNATUpEO�CON7RACTOAOpAUTMOA�2EDaGENT iOpTE� EN RO V VAU T THIS IS YOUfi PERMIT � ��► + S�GNATUAE O� OWNEA i�� OWNEp BUILDEA� ��rEi � ' BLO ��NS� ' � � pRiE L � ; � �, . [l [] EffectiVe 5/10/99 CITY OF F'RIDLEY SINGLE FAMII.Y AND DUPLEXES R i AND R 2 BUII.DING PERMIT ApPLICATION �o�ctaon Address: � ��''� Ca.p � �'D 1 � �- . . . . I.cgal Description: - � Owner Nanae � Address: �v ;d. �iiri I q Tel. #�'(0 3• S�y • I�I y COIIti�dCtO�a; RMA HOME SERVICES INC. ��ENSE #� Home Depot Installed Sales Address: 3200 Cobb Galleria Pkwy., ste. #20o Tel. # Atlanta, GA 30339 A 763-542-8826 urvey. of t�e 1cBC-20268257 �_ _� .,. ,�n..it to scale. • - r--r---- -_ - ..�....». LNING �A: G.AR.AGE AAI�A: DECK A1tEAe 01�R: � . �� . � � e � � �• e � � r;� Length Wislth Height Sq. Ft. I.ength Width Height Sq. Ft: Length ' Widtli �� Hgt/Ground Sq. Ft. o � �ii r�.�� (..�i��. .' ..._ � r,c. : c ..(.s ,�. c.� nr�, Construction TYP�= Estimated Cost: $_ tQ t�� _ i Driveway G�arb C�it Width Needed: Ft. + 6 Ft = Ft ic $ _$ DATE: oi 3•�o�U • 0� APPLICANT: �I�_ Tel. #_�' ��5. (� y� PerYnit Fee Fire Surcliarge � State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Cbarge $ l�q �s $ (� 34 $ � l� $ $ S;. $ $ $ $ CITY USE ONLY IFee Schedule on Reverse Side .�1 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (�tate L�c�ns�d Residential.C.ontractors) Alt. "A" or Alt. "B" Above $450.OQ Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] TUTAL � 1 ��✓ sr�ui.��oNS: l �� 1�� - 8`� ��'� G�/�. � G%��/��.�� --��vz ��.�� > ��'•.3�D >.,! / � �%��.��-/��- �lG sue.i�ti PE . �. c�ty of Fxidley 3 2 4� 8 A T T M E T O P O F TH E T W�NS g� J � L D 1 N G P E R M I T ! � REC . � • COMMUlaI1TY DEVELORMENT OIV. r � � � PROTECTIVE INSPECTION SEC. �� 1 � i � � /'�'1 � CITY HALL fR10LE� SS�3Z NUMBEA pEV DATE PAGE OR APPROVEO �°�"�" �'' 612-57�-345p 9�aFis 3/29IO2 / / JOB ADDRESS 5255 Capitol Street NE t LEGAL LOT N0. 9LOCK TiiACT Oii ADOITION SEE ATTACHED DESCR. $ 8 Carlson's Summit Manor South SHEET 2 PROPERTY OWNER MAIL AOOR�S$ ZIP PHONE David Mattila 5255 Capitol Street NE 763-574-1214 3 CONTRACTOR MAIL AODRESS Z�P PHONE LICENSE NO RMA Home Services Inc 3200 Cobb Galleria Pkwy STE 200, Atlanta GA 30339 4 ARCHITECT OR DESiGNER MAIL ADDRESS iIP PNONE LICENSE NO. 763-542-8826 20268257 5 ENGINEER qIA1L ADORE$S � ZIP PHONE UCENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK � NEW ❑°ADDITION O ALTERATION f� REPAfR O MOVE � O REMOVE B DESCRIBE WORK Replace 5 windows within existing openir�gs 9 CHANCiE Of USE FROM TO STIPULATIONS � Provide smoke detectors in all sieeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997.Uniform Building Code. permit �n�p��ion Cards �Ii�I �e Mailed To No�.eO�nerTo Po�� SEPARATE PERMITS ARE REOU�RED FOR ELECTRICAL. PLUMBING, HEATINO, TYP� OF CONST. OCCUPANCY GROUP OCCUPANCV LOAO VENTILATING OR AIR CONDITIONING. ' TMIS PERMIT BECOMES NULL AND VOID IF WQRK OR CONSTRUCTIOM 20NING SQ. FT CU FT. AUTHOR12ED IS NOT COMMENCED VjIITHIN 80 DAYS. Oii If CON$TRUCTION OR WORK IS SUSPENDED OR ABANQONEO FOR A PERIOD OF 120 DAY$ AT " ANV TIME AFTEFi WORK IS COMMENCED. ` NO DWLG. UNITS OFFSTFEET PARKING I HEREBY CER7IFV 7MAT 1 MA4E READ ANO EXAMIN�O TMIS APP�,ICATION I. S7ALLS GARAGES AND KNOW TME SAME TO BE TF1UE AND CO�IRECT. ALl PROVISIONS OF LAW$ VALUATION SUR7AX AND ORDINANCES GOVERNING THIS TYPE OF WpRK WI�L QE CpMPUEO 3 82O WITM WHETHER SPECIFIED MEREIN OR NOT. TME GRANTING OF A PERMIT � � �1.91 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CAMCEL THE pEqMIT FEE SAC CHAiiGE PROVISIONS OF ANV OTMER STATE OR LOCAL LAW REGUTATING CON• $97.25 Fire SC �3.SZ STRUCTION OF THE PERFOfiMANCE OF CONSTRUC710N PLAN CNECK FEE TOTAL FEE License SC $5.00 $107.98 S�GNOTUAE O� CON'RACTOA Op AUTMOp�ZED AGENT iDATEt MEN PROPERLV VALIDATED THIS IS VOUF PERMiT Z.� � � S�GN4TUREO�OWNEQ��FpyVNEpBU4DEAi � �OATE� � ' � g� ip ' q�tE � M :, � �� , [1 [l . Effective 5/10/99 CITY OF �RIDLEY SINGLE FANIILY AND Di� F�� R i AND R 2 BUILDING PERMT'T APpLICATION Construction t�ddress: ' � � � � �.p ��, S� : � . . . . . � - . Legal Des�ption: ' Owner l�affi� � Address:�10�,U� C�. Y�0.�i �. � Tel, #�'la3 •�{ • 1'aj�i COIIti'dCtOI'.; ' RMA HOME SERVICES INC. j� jJj�IN�E #� Home Depot Installed Sales Address: 3200 Cobb Galleria Pkwy., Ste. #200 Atlanta, GA 30339 Tel. # A 763-542-8826 uivey. of t$e ' 1cBC-2026825 r--r---_ -�Y.___.��....�..,. ,m..it to scale. . DESCi��;i.�fiT OF �?.f��.��NT. �. . � ' LIVIl�TG ARE�i: GARAGE �EEA: DECB A.�A, OTI�R: Length Wirith Height � Sq. Ft. Length Width Height Sq. Ft: �� Wic�tli � � Hgt/Ground Sq. Ft. � ., r, � �. ., a � , . _ ._ ,� „ ..�. , _ . . � � - - - . _. _ _ 1. � _ _ co��ao� �°�: ��a co�c: �_3 $a0�% Driveway �b �iit Width Needed: Ft. + b Ft = Ft ic $ -$ . DATE:�YY�,p,�•0� A,PPLICANT: �. o Tel. ,#_�� j�jj�'•(OO�� Permit Fee Fire Surcliazge � state Surcharge SAC Charge License S�zrcbarge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPLJLATIONS: $ ��-•aS � � •� � $ 1�� 1 a $ $�� $ $ $ � � b �•�' �S CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOtb.%) $.50/$1,0� Valua.tion $1050 per SAC Unit • $5.(� (State L�cens,ed Residential.C.ontractors) . Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not N�;essary [ ] ��,� - ds Building Inspections 763-572-3604 763-542-4977 FAX DATE STTE ADDRESS = THIS APPLICANT 1S: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND CERTIFICATE OF 11VSURANCE PERMTT 'TYPE TYPE OF WORK: - PI�iJ1V�ITdTG ��IDE�'I'IAL� AP]PI1I�A'�I�1`T CI'TY OF FRIDLE� ADDRESS �� / �r _ PHONE: � .� - � �-�/ - �aS � STATE LICENSE S7'A7'E BOND ft _ Permit Na.: �� °�s � � Received By: � Date I EXP DATE EXP DATE Zl 3TA7F��ZIP S� Z� ADDRESS: CITY STATE ZIP PHONE �SINGLE FAMILY ❑ NEW O TWO FAMiLY �tEPLACENIEN'f FAX O TOWNHOUSE DETAILEDLDESCRIPTION OF WORK ' � Ar"' `( �� ` "� �` ' IOV/ (�.�/ PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% af the total cost up to $500.00, whichever is greater, for fhe � improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of ]atior ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = plus .50 surcharge FOR PRQJECTS WFiERE LABOR EXCEEDS $500, FEES ARE BASED ON $] 000 PER FIXTURE, EXCEPT WHERE NOTED. :(INDICATE TOiAL WF ER NUMBER OF EACH BELOt�. MINIM(JM FEL $I5.50. WATER PIPTNG - 11�/Ue- BATH SINK/LAV FLAOR DRAIATS ,_ SHOWER _. —g,��g _ GAS PIPING (NEED CTTY LJC) _SWIMMING POOL _ WATER SOFTNER {$35) CI,pTHES WASHER KITCHEN SINK WATER CLOSE7' _$ACKFLOW PREV. ($15) DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION — — WATER METER _ OTHER _ . .. . _..__.._ _ _ Permit Fee $ ' Number of fixtures @$10.00 x$10.00 = Surchar e .50 Nnmber of fixtures @$15.00 x$15.00 =$ TOTAL DUE $ OR Number of fixtures @$35.00 x$35.00 =$ Sta.te Su�charge = $ .50 (MINIMUM $15.50 (MINIMUM $15.54) Tota1= $ TWiS 1S AN APPLiCATION FOR A PERMI'I'-NO'f VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge ihat the information above is complete and accuraxe; that the work will be iri 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 on site; that the work will be in accordance with the approved plan in the case f all work which require rert.+iew and approval of plans. SIGNATURE OF AP?LICANT _ -1i�e �� PRINTNAMF,��eii� � - J' ��e �� I�iDATE / � O� - Z� DATE APPROVED BY City of �ridley �uilding Inspections Departnaent 6431 University Avenue NE, Fzidley, MN 55432 763-572-3604 FAX: 763-502-4977 Buil�ditlg BUILDING PermitNo.:Z�I�� nspe�tions RESIDENTIAI.. APPLI�ATION Received By• 763-572-3604 CITY OF FRIDLEY vate Rec'd� m L� 763-502-4977 FAX �c°rrvE,_i-aoio DATE � !� YOUR E-NIAIL ADDRESS N�� SITE ADDRESS � � THIS Ai'PLICANT IS: ❑ OIVNER OCONTRACTOR PROPERTY OWNER/ N�: e �s �N� ADDRESS: �/J/'� � St�Q� CITY STATE al'�2� �orrE: � �-63 °�% 1 — 23 ?� CONTRACTOR N�: �}.¢ /C� bvDa-w f t% SL3BMIT A COPIr OF STATE LICENSE #�O� �� EXP DATE O� ,� "L D I Z YOUR STATE LICENSE AND CERTTFICATE OF Annr.ES • I� Sb C l2,. I-�a , crrx p�� (�962 y sTw��% � g3 �2e! nJSUxarrcE �orrE SZ - �'3 cf�� ' F� �- S� I s�l i s� PROPERTY TYPE SINGLE FA1�ID.Y/NEN CONSTRUCIION SIZE O T6V0 FANIII,Y/NEW CONSTRUCIION STORIES pEgNIIT TypE O ADDITION ❑ GARAGFJSHED O WINDOWS �BASEI��NT FII�ISH ❑ ROOF O DRAIN TII.E DECK O SIDING 0 OTHEIi � SWIl4IlVIING PaOL TYPE OF �VORK: ❑ 1dEV� HOME COAiSTRUCfION O ADDITION ❑ MAINTENANGEJRII'AII2 ❑ REMODELING DESCiusE WO� sEn.rG po�:� 4rs ��45�' �' fi� cqoe..S O�wt ,,•� N T�,.� S�S �-°� ,�na�e . SIZE OF IMPROVEMENT LENGTH WIDTH HIIGHT S F1' � S�% ROOFING O HOIISE OATLY g�gpy�� ggMODET.ING SUBMIT: NLJMBER OF SQUARES O HOUSE & GARAGE 1 ��g �� P� GARAGES O ATTAQ�D GARAGE 2. Propoaed floar plan PROPOSED SIZE: ❑ DETAQiED GARAGE 3. List of atract�al membeis to be used PROPOSED HEIGHT: ��G FOR AIEW CONS1YiUC1ION INCLUDING DECKS, ❑ Vinyl OSoffit ADDTITONS. & PORCf�S SUBMIT: ❑ Alummnm O Trim 1. Site Plan(Smvey ahowing the existmg structures ❑ Other ❑ Fascis ffid pf1D�� °��' 2. Two sets of coffitruc�ion plans WINDOWS � � 3. En�gy Calwlations IN EXISTIhIG OPENIN �No LOCATION OF WIlVDOWS FOR WIAIDOWS —PROVIDE U VAI,UE AND OR FOR NEW OPENII�TG - ESCRIBE SIZE OF MANUFACTURE STICKER ON RrINDOW. OPENING CEIANGES � TYPE OF R�INDO�V TO BE IATSTALLED N[JMBER OF WIIVDO WS ALL �EES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MA7'r-RiAi 4: SING THE 1�7 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION ��a ��•� OCCiJPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erasian Control Park F� Sewer Ma.in Charge Total Due $ �' �, al � S� Back Page for Fe,e Sch�ule $ 65% of Building Petmit F� $ �'j .001 times the total job valuaYion $ j d(� .�OS x Permit Valuation Minimum $5.� $ $5.00 (State Licensed Re.sidential Contractors) $ �2100 per SAC Unit (Plans to MWCC for determmation) $ ft+6ft= ftx$24=$ $ $450 Conservatian Plan Review $ Fce Debeimin� bY Engineering $ Agreement necessary ( ) Non N�essary ( ) $ �� .� Make checks Davable to: Citv af I�Yidlev Attach THIS IS AN APPLICATIOAi FOR A PERMIT NOT VALID UNfiL PROCFSSID I hereby apply for a bttilding permit and I aclmowledge that tl�e information above is complete and accivaate; that the work will be in conformance with the ordinances a.�l codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a pez�nit but only an applicatio or a ermit and work is not to start without a peimit on site; that tl� work will be in accordance with the approved plan in the case of i c/requires review a� apgroval of p [) SIG23ATURE OF APPLICANT PRINC NAME ��0�.1 � 7��L� DATE ��/� 1�l � APPROVAL INSPECTOR SIG �— PLEASE NOTE: S ARA ERMITS ARE REQUIItED FOR PLUMBING, II,ECTRICAL AND MECHANICAL WORK � �� . c� � r� �� q� � C�) � � - 3�� : "'��p�•. M-� �,�s�" AUTHORIZED ACCEPTANCE I ; � , ,, , �^ � _ � � �� _ , , t' , "��d �'L ¢i � � � < . ; � , , I ` _ , _ , . e � �r i . � 4 :�. .. .� '��',. . . �p .t� ,x• � . , �. ; , . , ; , , , , �►` , � , : ; .�•�--�-- . ,_ � �G 4tl�± ; .� � �'+ � O � � � ' _ �- Q. o . ' � �c� � .�% � �� '. � � � � � � �,�; � �� H:..�� ti ��i"' �� ct�` � �t; _ , _ p,� p,1.; L? �'�J� � a � •.� �r",' � � �` � � ; ;�5��. �,� -�L .. � ,, ,'��' 1!,�'�� ,; ;�, _. ; s�.`�` , _ _ , ; � . , i � �, _ , , , �`'y �� . � �� ; . : f •. .� � , � .:. t � i . f �. ,y � I ' ....... : .. � . . ., �� ..... .... .... � .. . . . � 3 S y ' < e f k � , �; , 3 + � ' .' , j� / � __ , *F ,< v,�,4,;� z. , �_ ;.. ;.. . �. � = r J� f � � — . . ; ,, , �� , . , � _ �. _ , . . �; ;, `,�. � � ._ _ ��' ' ' �' P� � _ ; �� : A� � ; - , �. ,. � i . ; _ . ��-oa � ��. � _ ; ' ' > ' � _ � APPROVED PLANS .L°/�v1 �� _ Rti� PER EC R106.3. ' . I (� hLV � Ik . . � �/ � ' . v. r � ' ` � � � � , ; �I : � `��I g�� : � ; t f� � _ E q f � _ �" ` , �f ' _ ; � . � , � 3 � _. �� ,�J ; ; `� _ � /'� i \' ^ q . ;.. .. a v� � _ _� �� l _ _ � ... , , ; � , ��. �` �. N�.�•I , dr�� - � __ _ _ _ . r , , , , . , � �� .� � �� t , �; _ _ , 3 � �� : �a° _ ,� � � � P ` , . , . __ _ __ _ _ , . _._. _ . �� - ! � �� , 4 _ ; + : .�x��+��' �� ;��^�' w� �=- t SCALE� 1/4 � 1 foot 1/4 = 2 feet Measurement and scale are only ap roxi ations. �Cl/�. .�V �. �-.�, � e ��. �, DVI� �� "� � � - r— :�{��_ = - _ - � _-- � - --_ - �4_ . �� ,—_ —�� - -, c� �� .�- �� _��..-. .� � � ��:� ��- �-� � � � �.� �- ' ., TECHNICAL BULLETIN #2 Study Objective To validate the theory that no vapor retarder shauld be used with the Basement Finishing System. This would be accomplished by obtaining point moisture condition and combined system moisture transport data for various vapor retarder configurations with the system. Of key interest is the locations in ihe basement system where moisture levels are high; the interior humidity and temperature conditions under which such high levels are achieved; as well as the interior temperature and humidity conditions required for complete moisture removal (wetting/drying curves) The study was conducted at the University of Minnesota Foundation Test Facility and began in November of 1998. The Owens Corning Basement Finishing System ( R11) was installed with three vapor retarder configurations: � A polyethylene vapor retarder placed between the insulation and the foundation wall "Exterior Side Vapor Retarder" � A polyethylene vapor retarder placed on the interior surface (between the insulation and interior air.) "Interior Side Vapor Retarder" :- "No Vapor Retarder" on 2 of the module quadrants (opposing corners) From 12/98 through 2/00, measurements were taken of: interior air temperature, humidity ratio, and barometric pressure, ambient exterior temperature and humidity ratio, and humidity ratio measurements at 40 locations within the insulation (10 per quadrant). Additional data was collected (or: amount of dehumidifier condensate (water) removed, mass of 8 removable sq. ft. sections, electrical energy consumption Discussion The environmental conditions were established to be representative of "typical" MN basement conditions. Testing began with the basement module under ideal indoor conditians — 65°F and low relative humidity (40% RH). Conditions were later modified to represent a"worst case scenario" — an unconditioned basement at 56F and 70% RH. Following is a brief discussion of each quadrant performance. I ; ; University of Minnesota — Foundation T �est Facility: t Evaluation of zhe Rll Basement Finishing Sys�em Exterior Side Vapor Retarde, During the winter months, cori� on the insulation side of the v2 amounl of condensate was er� the vapor retarder onto the flo� transitioned into spring and s' droplets accumulated on the the vapor retarder. In both th cooling seasons, this vapor r configuration was clearly una q� Inierior Side Vapor RetardeJ, When the vapor retarder was interior surface, condensation on the insulation side of the v� Additionally, the insulation pa� moisture gain during the sprin that exceeded the drying pote heating season. This cycle w insufation becoming progress [ime. Thus, the interior vapor configuration was unacceptat No vapor retarder: The two quadrants with no va showed a "stable wetting/dryi. a heated basement." As expi significant moisture gain was panels during the "unconditio� study with no dehumidificatioi data also showed the ability c effectively "dry out" once corn This can be extrapolated to c vapor retarder configuration t wettingldrying annual cycle ir unheated basement as well." Conclusion When installing the Owens R11 Basement Finishing S; retarder should NOT be us� single vapor retarder, regardl provided a condensation plar water formed and remained t system. Additional information rega be obtained by contacting i 1-800-GET-PINK. �ensation formed por retarder. The ough run down �r. As the climate mmer, water xterior wall side of ; heating and �laced on the also accumulated �por retarder. �els showed 3/summer at levels �tial during the �uld result in the vely "wetter" over retarder e. �or retarder clearly g annual cycle in �ted, a more �bserved in the ed" phaSe of the , However, the the system to itions changed. nclude "the zero �s a stable an approximately tem, a vapor �. The use of a >s of the location, where liquid pped in the this report can s Coming at . .� � INNOYATIONS FQR LIYING' BASEMENT FINISHING SYSTEM �SUBMITTAL SHEET fNTERIOR WALL PANEL DESCRIPTION The Owens Corning'" Basemeni Finishing System is comprised of IightweiqM fiber glass panels, PVC lineals (which repla�e conventional ii,3ming) and (oamed PVC trim moldings (whith replzie tnm lumber).The trim moldings snap into the lineals, holding the �anels in place. Moldin�s and �n�all panek are easily removed (or r-emoving or adding wiring. Because traditional wood and paper-bas�d building materials are replaced with tiber glass and PVC materials, U�e Basement Finishing Sysiem oKers inhereni resistance to moisture, mold and mildew'. The s��stem is covered by a lifetime limited tiansferable wa��-anty`"' fi•om Owens Commg. USES The rJwens Coining'" Basement Finishing System is an innovative system designed to finish basement walts in a(ew simple steps �.vhile providing acoustical treatment The interior wall panel provides a Class A (lame spread rating, meeting the requirements far the IBC for single and multi-family residences.The intei-ior panels can be installed over interior partition walls and sWiiwelis built with erther wood or metal members. Panels may be used on wood frarned walkout walls that are in;ulated and n�eet lotal vapor ba�rier code requu-ements. AVAILABILITY 4�1" :< -IR" a 151I6" Paneis Lineals Trim MoidinQ: Cove Molding Ve��tical Battens �,s� rioid��,� Outside Co�ner Casing �amb E�.�tender Chair Rail Color Choices: Paneis: "Linen Mist" woven tabric Gim: All trim avail<�ble in White ur Woodgrain, In addition. vertical trim available in fabric look lin�sh o�' fabric wiapped lo match panels. ' Whde ihe n�;itenals and design of ller. Ov,r_ns Comu��+`. N+semm�t Finislwig tiystem mvst mold and mildew, the 5�,stem can not prevent or allewate nx�ld d tF�e �ond�tions �iecessb . fa� n�d mrnvth oi)�wns� ehs� ni vtxn basemern. ..SPe �:cn::7! aJrr�;ntp ;o: ,:7@rOds. 6mrtC;UO;)� a��•i:PStnR:vrY; �� < � - ; t f s - ;: _.:.`� ` ,"� , . ; IOIR . . - . -. PHYSICAL PROPERTIES Property For Feber Glass Boord: WaterVapor Sorption Compressive Strength cr I 0% deforrnation "La�25% defo�-mation Noi�nal Density For Finished PaneL• Noise Reduction Coefticient Sw-face Burning Characrteristics -Meets Class A Burn R,avng Interi�rTextile Pinish Fire Classifitation Mold Resistance � k � r, �- I :: � ! _ 1 ; a i I #.: �_ 1 � � :", i- �'� �_ ��;` 5!� Test Method Value ASTM C I109 ASTM C 165 ASTM C 303 ASTM C 923 Type A Mount ASTM E 89+ NFPA-286 ASTM C 1338 ASTM G 21 <2% by wt. � I 20NF, 95% RH min. 25 psf 90 psf 5.0 PCF 0.75 Class A Flame Spread _< 25 $moke Developed <_ 450 Meets Acceptante Criteria Pass Pass +The ;wiaie•bumm� chaiaceAr�scics of the firnshed composrte panel were determmed i�ccordance wtth ASTM E 84.Th, ,[andard measures and desaibes the prooerties ot materials, products or assemblies in i sponse te heat and flame unde�� controlied laboratorv cond'¢�on>. Data'from ASTf9 E R-} testing canncrt be used to deur' ca- assess the fu�e hazard or fiib �r;k of materialc., �roducts or assemUli=r. when cons�derin� all of the faaors pei�inent to Sn assessmeM of the fir< h�ard ol + part�cular end u>e Vaiues are re�rted to the nearest 5 r.�ting. , .� -� . � ,. . ` BOCA Internatianal Evaivatian Report evaluation scope Compliance N�iCh the fallowing codes: BOCA Natinnal Builtlrn� Code/1999 ■ Section 803.2 Classificatian ■ Section 803.6 Carpet and carpei-like wall coverings ■ 5ection 1(K.4 Altemative nlaterials and equipment ■ Section 2G03.71nterior tzim ■ Section 1301.1 Scope (Energy conservation) ] 99S Inte�Tiational O�re- c��ad Ti��- Fnmi1�� Divellinr Goc�e ■ Section 314.7 Wall and ceiling (flame spread index.} ■ Section �18.2 Smoke-de�eloped index ■ Section 318.3 Testing description OWENS CORNING Basement Wall Finishin� SystemT�' is an alternative to conventional wall fi-�ming and gy�sum �+�allboard. The Basement Wall Finishing SystemT"' consists of PVC suppc�rt lineals, hase, batten, and cove mold- ings, and ri�id preiinished iiber��lass panels. Panels ar� pretinishcd �vith a labric cover. Basement Wall Finishin� Syst�ni��^� is primar- ilv intrndcd for instaUation in residential applicationti. Ref'er to Fi�*urc I at U�c cnd of tltis report for illusu•atians of Ihe Basemeni Wall Finishin4 Sys�em��"�. The Basement Wall Fiiiislling System �'`� shall he installed in accur�ance with the manufac- tui•er's installatioii instructions an�l lhis report. lnstallation typically consists of either me- chanical fasteners or adhesive fastenin� or a con�bination of botfi to the suppoi�ting sub- strate. Thennal resistance (R-value) far the fiber�lass panels is I I. Basement Wall Finishin� SystemT"� panels meet the reyuirements fc>r classification as a Gass I interior finish as testec� in accordanre with AST1�4 Eti� and also ha� demonsu�ated that it �vill not spread tire to the ed�e of thc specimen or cause Ilashover in the test r�om in accordance ��ith lhe testin�� requirements speci}ied in Sectie�n 50;.6(�) 01� Ihe BOCA Na�innc+l Ruil�ting Cud�/1999. condition of use This re�ort is liniited �o applications and products as stated herein. BOCA-ES intends that this report be used by the code official to detern�ine that the report suhjtct coroplies wid� tlie code requirements specifically addressed, provided that this praduct is installed in accor- dance wiU� the following conditions: ■ OWENS CORNING Basement Wall Finish- ing S��s[emT�' is intended for finishin� walls in basement applications. Other applications are outside. the scope of this repon. ■ The maximum permicted area of the PVC moldings shall not exceed 10 percent of tl�e aggregat� wall and ceilin� v�ea of the room. ■ lns[allation of tlie Basement Wall Finisliing SvstemT"' shall be in accordance with this repon ancl the manufacturer's installation manual. ■ Base►nent Wall Finishin� System'''TM� shall be insialled aver cast-in-place concrete or concrete masonry unit walls, or wood or metal StUC� �1"1111t11�. SUp�O!'Lltlg structural systems shall confonning to code require- ments for that systzm and are outside scope of this repo►-t. ■ The electrical �viring in the chase at the bottom of the Basement Wall Finish Svs- tem'T' shall conform to the requirements of U�e code and is outside the scape of this repoi�t. items requiring verificatian The iollowino items are related to the use of the repoi�t subject, but are not within the scope of this ev��luation. Ho�vevcr, these items are related to the d�termination of cod� compliance. ✓ Concealed electrical, mechanical, or plumb- ing compoiien�s shall be inspected prior to the installatian of the Basement Wall Fin- ishing System'�'�� panels to verify compli- ance with related code requirements. Evalu- ation of these components is outside scope Ol 1�115 1'�pQl'C. ✓ Fra�ning supporting thz Basement Wall Finishin� Systeni'�r''shall be inspected prior to the installation of the panels to veiify compliance �uith related cocle requiren�ents. Evaluation of this framin�� is outsicle scope of �liis re�on. � .� �` o ��. � � �� i/ ; q � ., _II �11:1�- Research Report ', 21 �24 I MANUFACTURER: i O�IVENS CORNING O�VE OWENS CORNING PKWY TOLEDO, OHIO 43659 i. i DIVISION 7 —THERMAL AND ; MOISTURE PROTECTION Section 07200 — Insulation DIYISION 9 — FINISHES � S�ction 09540 — Special Wall � Suriaces ; EVALUATION SUBJECT: BASEMENT WALL FINISH � SYSTEMT"" i PRINTED AUGUST, 2000 Page 1 of 2 Copyright0 2000, BOCA Evaluation Services, Inc. ; A Participating Member of the NES, Inc. Page 2 of 2 ' ' Research Report No. 2'1-24 information subrr�itted product identification ' ■ IntegrexT� Testing Systems, Report No. 73143, dated Apri117, AIl OWENS CORNING Baseme�at Wall Finishing Systems7M � 2000, containing results of physical testing. manufactured in accordance with this research report shall bear ■ IntegrexTM Testing Systems, Report No. C423-99065, dated the following identification: August 19, 1999, containing results of physical testing. • Omega Point Laboratories, Repon No. ] 3060-l03216a, dated May 14, 1999, concaining results for fire �esting in accordance with ASTM E84 for rigid fiberglass wall panels used in Basement Wall Finishing SystemTM. ■ Omega Poinc Laboratories, Report No. 1621�-106644, dated April 13, 200Q, containing results for �re testing in accordance with ASTM E84 for moldings used in Basement Wall Finish- ing SystemT"�. ■ Omega Point Laboratories, Repon No. 13060-1 Q3213a, dated June 7, 1998, and Report No. 1 3060-1 0447Qa, dated March 24, 1949, containing results for fire testing for full-scale room corner testing in accordance with requirements contained in Section �03.6 (2) of the BOCA National Bacildiiig Code/1999. ■ OWENS CORNING Prvduct Literature, dated May 1998. ■ OWENS CORNING Submzttal Slieet for• Baseme��r Wnll Finishii�g Systen: (BWFS), dated Apri12000. ■ OWENS CORNING BasemeJZ� Wall Finishing System Insrallar.ion Ma�ival, dated January 2d00. appiication for permit To aid in the deteiTnination of compliance with this report, the following represents die minimum level of informa�ion to accompany the application for pernut: ■ The language "See BOCA Evaluation Services, Inc. Research Report No. 21-24" or a copy of this report. ■ Plans indicating the aggregate area of the room and the area of the PVC moldings being used. • Plans and specifications of any electrical, mechanical, or plum;bing items installed within the wall system. ■ Details and specifications of the supporeing construction to which the system is to be applied. "See BOCA Evaluation Services, Inc. Research Report No. 21-2�." � �B�e All Molding Snaps into PVC Support ��'•. Grid 2.5" Glass `': Fiber Board ': Panel with Facing I . PVC Support Lineal — {top, bottom, vertically every 48") PVC Molding Vertical Batten Existing Foundation Wa(I or Interior Partition �1 PVC Cove Molding PVC Molding Base � i Figure '� * Sketch of Basement Wall Finish SystemT"" Showing Typical Cwmponents 'THIS DRAWING IS FOR ILLUSTRATIC}N PURPOSES ONLY. IT IS NOT INTENDED FOR USE AS A CONSTR CTION DOCUMENT FOR THE PURPOSE OF DESIGN, FABRICATIO� OR ERECTION. NOTICE TO F�EPORT USERS This report is subject to annual certification. Reports that are not certified shall not be used or referred to. To determine the status of certification of this report, contact BOCA Evaluation Services, Inc., or consult the latest edition of d7e BOCA IntenTntional ProductEt�alucz�ion Listin.g published periodic111y in the BOCA ma�azine. This report is subject to the conditions listed herein and to the specific product, dat� and test reports submitted by the applicant requesting this report. Independent cest were not performed by BOCA Evaluation Services, Inc. and BOCA-ES specifically does not make �ny warranty, ei[her expressed or implied, as to any �ndinss or other matter in this report or as to any product covered by this repon. Evaluacion neports are not to be construed as representing aesthetics or any other amibutes not specifically addressed nor as an endorsement or recommendation fo� the use of the report subject. This disclaimer includes, but is not limited to, merchantability. Please contact BOCA Evaluation Services, lnc., with any questions you may have regarding this report» Ad have any information on We performance of the product described herein which is contrary to this reporL 4Q51 West Flossmoor Road • Country Club Hills, IL 6047� telephone (708) 799-2305 • fax (708) 799-0310 e-mail: baca-es@bocai.org • http: //www.bocai.org please contact us if you ,� � � �� ,��, C �' R �s�`, : , - _ � .. � ,{ _ . ,� 1� � . � �/ r-- 1 ' j � i � , � �Y . M ,�• ' �� !�' � ;` � � • .f' { �..1'�.� � r'� � 1 .. � ;�- jt� � �' / . �.; +' , ; .,j� � '� ' .�.�.� `, � �� . � �c� � � ! � __ � �, � , , . - _ t rt,. � �- ._ � � s�� , �-�� ~ -� ' �` � k�y • . . . � �( Y T'� ' . � > k,,,n�+•:N � 4..� ' i[ I.. '•M/ . . �e' ^�� 1 . � �.-h.;.:.f-� . � '> i { . 1 � ¢T...4 � ` �t• . . ��.��a ` z� �� . � ': �- �� .. � 1, '� ' . ,% r :,:.. �,,.. �Gt �<t�'��