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AF - 38664�` ,� Villa.ge of Fridley, Minn. � �''*� �_ BUII�DING PERMIT �� 0�7:-�' . Date: . ....................... Owner . . .`..�!��`�J�'�e�E-'/Suilder . . . . e . . . . . �� G��7/�_/ Address . . . !✓ �� . . . . .1.�! . . . . . . . . . . . Addre . . .`� . .�f . . . . . . . . . . . . . . . . . . . . . . ��c�f�%P.��. LO TION OF BUILDING No.��.r�./...... Street �-�� !"�'.f1�� ................. Part of Lot ...:. Lot ...�..... Blo ......`:..'... Addition or Sub-I?ivision �G��p� �� v / Corner Lot ........ Inside Lot ..�.. Setback �,l........ Sideyard�� s DESCRIPTtON OF' BUILDING / %�; , ,%i, ! / a ;^ � r r /y To be tised as: . . . . . . . . a . . . . Front .T• • : • • • Depth �`'. ! . '. !'�1 geight�'� .�. `�'/ Sq. Ft/�! �� Cu. F� . . . . . . . . . . . . . . . . ont 4�.�. �. . Depth �l../ . Height . .'.". . . . . Sq. Ft. .�� Cu. Ft . .. . . .. . //' � �_ ,�y� Type of nstruction . . � . . . Est. Co J. ��d� :-"� . . To be Completed . . .� e� �i� . � �� .� ,.��L � �a�, f, � '��,--� �� 1�8�' 1S'� �� In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description abov t forth and in compliance with all provisions of ordinances of the village of Fridley. '�� q� �� \/ -�.:�..... ,_,3::�...•.�...... �� R In consideration of the payment of a fee of $. ,/��permit is hereby granted to . . . . . . . . . . . � . . . . . . . ......................... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and worl�nnen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of P'ridley, Minnesota. regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. m NOTICE: P " � " Thia permit does not cover the construction, instatlation or alteration fo� wiring, plumbtng, s heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. �� ^ ^ � �� r � � � ,�� ,� � �` ��'� � � � �� - R � ,- � � S �`'° � �? � . _ � � �� --� : ��-� � � �ca�-� � � ., � : � � �� a � �a � .� ��. �� . .�.�. � ��° , . �. � � � K �J '7 '�° � �� a��' City of Fridley, Minn.. N° 835? BUILDING PER.MIT Da�: AIIGIIST 13, 1965 �: DICR MII,LER g�� SAME Adarea�a Address LOCATION OF BUILDING No. 6579 s�t Clover P1ace p� of Lot Lat _ Block Addition or Sub-Divlsian Coraer Lot — Inaide Lot Setback Sideyard Sewer Elevation Fo�mdation IIevation DESCRIPTION OF BUILDING To be Used as: Front Depth Height Sq. FL Cu. Ft Front Depth I�eight Sq. Ft Cu. Ft Type of Construction F�t. Cost _�2, 000_ 00 To be Completed REBUILD AETER STORM In consideration of the isauance to me oY a permit to construct the building desc�it�d abave I agree to do the ProPos�rl work in accordance with the d�script3on ab e set rth and in pliance with a'll provisioas of or�inances 0P the dty of Fridley. �� p Ia cam�deration of the payment of a fee of � 10• �� , permit fs her�by granted to DICR N�LLER to coaetruct the building or adaition as described above. This permit is granted upon the egpr2� c�ndition that the persoa to whom ft fa graated and his agents, employees and worl�nen, in all work doae in, around aad upon safd buflding, or any�rt thereof, shall conform in all respecta to the ordinanc� of Frldley, Minnesota regarding la:ation� construction, alteration, maintenaace, repair and moving of build3nga withiu the dty limits and thia permit may be revoked at aqy time upon violation of a�► of the provia�tons of said or3inances. ALLEN G. JENSEN B�� NOTICEs '11ds p��mtt doa ew eovn �6s eoesleueriee, 6uta0dlse ter vrGie�, plum4lee, ou 6.aNe8, s�nr or wane. B� s�n to � t6� Botldirte inqaeto� tor apar� � Por th�» ff��m. � � .� ,� OWNER'S APFLICATION FOR BVtLDING PERI�IIT CITY OF FRIDLEY, MINNE30TA ADDRESS ADDRESS LOCATIO� OF BUILDIDTG� � N0. S1;REET �' � = i PART OF LOT LOT BLOCR AI�DZTION OR SUBDIVISION CORNER LOT INSIDE LO'� SETBACK SIDE-YARD SEWER LLEVATION FODNDATION ELEVATION Applicant attach to this form Two Certifiaatea of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTIUN DING To be used as; , P � � �� 6' / ��' ' �� ' h � Fro Depth Heig t Sq. Ft. Cu. Ft. Front Depth Aeight Sq. Ft. Cu. F Type of Conetruction Estimated Co ) �— To be completed The undersigned hereby makea application for a permit for the work herein specified, agreeing to do all work in strict accordaace with the City of Fridley Ordinances and rulings of the Depart�ment of Buildinga, and hereby declares that a11 the facts and representat3ona.'stated in this application are true and correct, , __ �.-� � �- `� �� S: (Schedule of Fee Costs. can be found on the Reverse S�ide). � ,_ � _ - �1 �--�►, ,� � �'. �IV � ' Y aF , � BUILDING PERMIT FEE SGBEDULE SEG°PION 2. The Inspector of Buildings shall, before issuing any permit for the erection of any building or structure:, or for any gddition to any esisting building or structure, or for any alterations or repairs �o any existing building or etructure, upon applicatian therefore, require Che payment by the applicant for such germit of fees to the amouaC herein below eet forth and ia the manner herein provided to-wit: � 2.1. For any auch permit for the erectian of any fire-proof building, other th a garage, warehouae, factorq or grain elevator, or for the erection of any f3.re-proof addition, for similar occupancy, to any es3eting building, �hall be at the rate of $1.40 for ec�,�h one thoueand cubic feet,�or fr�cCioa thereof, in auch cubical contents. 2.2 For any auch permit for the erection of any fire-proof garage, warehouse, factory or grain elevator, or for the erection of any fire»proo� addition, for similar occupancy, to any exietiag buildiag shall be.at the rate of $1.25 for each one thousand cubic feet, clasaified as "fireproof" by Section 502 of the M�tnneapolis Building Code, HOIISES 2.3. For any such permit for the erection of any non-firep;oof building, other than a garage, warehouse, factorq or�grain elevatox, or� any aon-fireproof addition, for similar occupancy, to any existing building - permit $1.00 for each one thousand cubic f�et. GARAGES _, 2.4. For auy auch permit for thes e�ection of any non-fireproof garage, warehouae, factory or grain elevatoz, or for the exectis�n of any non-fire-proof addition, £or similar occupancy, to any egisCing buildit� or for each such building�or addition�- ninety cents ($0.90) for each one thous.and cubic feet or fraction thereof, in the cubical contents fhereof with the minimum of $4.00. For the purpose of compnting fees..for building permite, the cubical contents of any building or addition to a unitorm height throughout by mult:iplying the grouad area covered from a goint ais (6) inchea below the floos 3.ine of the baeement or cellar to the average h2�ght of the upper aurf�;:a or to the average height of the roof surface of the mafn gab�e of a pitched roof. 2.5. For repairs or.alteratians Co an exiating atru��ure, the fee shall be at the rate of ,�3,00 per each Five Ii�a:.�iced� Doliars (,�`Si10.G�) or fraction thereof ia the cost o.� :all. �roposed wo:rfc. : . . . . ;: . . ,. 2.6. In no case sh�ll the fee�charged for any permit.�s set fortl� in Section 2 be less Chan $4.00. , 0 STORM REPAIR DAMAGE r]3�5; Residential; Eatim.a�ted Cost of work up to $50�..00 •$5.�0 Estimaced Cost of work over �5�n.4a� -$sU;00 Commercial; Estim.ated�„�Cost of work up to_,�;:��?�, 00 -$10—�`�0 -� �� Estimatec �st of work over $S�O.QO -$il 0 0. -_ ....� ATTEPITION OF: �-� CITY OF FRIDLEY r_ ______.______. _----------..�__.___..__ __ __ _______ ______-_., 6431 U ' ' N TO_____��C�.d _ ______ _��.__---___.__�-_`_-.—..____ ------ --______ --- ---� .. suB. n�versity . E. Minneapolis Minn. 55421 612-560-3450 e r J � �'�� • � r � (/ �� r/ U /� a'2c?; __ _-,---_---__ � ------ ---___ ____. _ _ _ __ _ __ _ _ . - -- - _ _ _ - � ' % U �- - �a �- -� ---- ----- -�. -�� _ ___ _ ___ _ _ � _ _ _ . _ ____ ___- � - ---. DATE �� _ Z� SIGNATURE �tEPL1�R'S COPY-ItEiAIiN FOR YOUR FILES �� ; �� .� � ... �� . � O ot e � � � >0 e�� N .�...� _� �� 0 � � � � � W � J H � � p�, � � a w � d � � a � �� o�� w�� 3b� � �sqy�+ w d •° �'� a, o�� '� �� ay�� .;a �i��' � ��o� �°°`� �� s�� Y�q � mQ � �do � a �"� � � ��o� mv � �� M �'O a � �� i � ; ! � � � �888� �O tG �O M � . � : 8 . . g � � � • � � � �� M � � �Q � 0 � � o � � � � � Q a � � � •� a � � � � � � � � �� ,� c�c a a d � a� .. � o � �Q� � 1 O � li l I �01 i I ' i � � I , ' m S � � � w � � ' � o " � � � � �° N M M s�gss � fJ t0 (O ErJ � a�a : : � e� . g � '" � � � � � � �° 75 � � °�' �'' �$ � o � � � ir i.� �� o�w ��"Qa � � � � � � a � �� a � � � � � s w � � � z : a° z � a m � � d z b 0 I � I I , � � � sg�8 O « OC+ a! � � � B � o � � � a ~ � � � S � � � ��x ��?�� x x � � � �' �' � d v g M °x�'�' � � � � � � � W c� � m O S O 0 z � � � S 0 � � � � 0 � � � s d � � w d M � o '" � � � a m � � m � M .. � ' 0 p ao a O z � � � g � O 0 F 4 v� � w �g�8 M M � O � � K k M "� � M � � w .� � ' w - � � � �� r�' � � s a "' w' o, � ~ � � � �� M � � �� 00 � v v � � t! � � � �� o � � o� � � � � � � & 0 � � � P� I � � � � � n � � � ? > 0 � M � � t � : --� � O Q � W y � 0 \ � � �� J � � 1 J > . . .� ) � � \ l� � I � �� o � � 1 SUBJECT c�ty of Fridley o 1975 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T f � � RECEIPT NO. � ; v ___��_ COMMUNITY DEVELOPMENT OIV. r � � PROTECTIVE INSPECTION SEC. �D 1 = � ' /"��1 � CITY HALL FRIDIEY 55432 NUMBER REV. DATE PAGE Of APPqOVED BY �""� � ,�� 61 Z-571-3450 9t 0-F15 11/15/88 � � JOB ADDRESS 6579 Clover Place N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 20 Clover Leaf Addition SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Venne 6579 Clover Place N.E, 571-3409 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D& D Home Inlprovement Incs 7401 Central Avenue N.E. 784-7543 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING Residenti al. 7 CLASS OF WORK O NEW ❑ ADDITION � ALTERATION C� REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroo� Dwell.ing. 9 CHANGEOFUSEFROM TO STIPULATIONS Roo.� can be 2nd lay`er but not 3rd. Install ridged galvanized valleys. 0� al) n�Vii 1'i�� r `t�ar�-o`��s 'antl ►��:�,�:�rerit��1`� r��'� State Code requir�s that � layers c; '�, Ib, felt, mopped tog�ther� b� i��lle� #o a��oint 24 inche5 up from exterior wa11 line, or tMe �se of ofher. approved underlayment membrane. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PIUMBING, HEATING, TYPE OF CONST. OCCUPANCY aROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOH A PERIOD OF 120 DAYS AT ANV 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 $1,950 $.9H DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- S7RUCTION OR THE PERFORMANCE OF CONSTRUCTION. $4'rJ.00 PLAN CHECKFEE TOTALFEE $45.98 SIGNATURE OF CON i RACTOR OR AUTHORIZED AGENT IDATEI � yy�N PROPERLY V IDATED THIS IS YOUR PERMIT SiGNATURE OF OWNER iIF OWNEA BUILDERi IDATEI �� BLOG iNSP pTE I�W [ ] A�N [ ] r�• City of Fridley R-1 AND.R-2 Bu.i.lding Penait Appl ication EEfective 5/ � . � � Qonstruction Address:_� � � `� �� U� � � ��r r�� Descriptian: �� i�a �� t_1 L��" f-f�14av OWr�er 1�Ia�ne & 1�dress : ��_ w� � � Tel. � � 7 � ` � ��'y abritractor : �- � � �+�,� �yt� �� U ��vl � �� C` � Tel. # �` -7,� Y� �r�: ��e� ( C��fiJ�( o4v�� Attach to this appl ication, a Certi.f icate o� S�uvey of the lat, witt� the prop�sved oonstruction drawn on it to scale. �' •• �. •, y:.' �_ i.• �� ;��:�� LIViNG ARF�i: Length width Heic�t SLZ. Ft. Q�,RAGE ARFA: Lerigth Width HeiC�1t St�. Ft. � o-.«; . ; �+. �14:i�; Length Width egt/Gro�d 9q. Lt. Gbrner Lot �1 Inside Lot ��]� F�. Yd Setback Side Yard Setbacks Type of Qonstruction: �£51�►Y�� c�lc�vn P S��-�� 9 rl��t5� Fstimateol Cost: S��`� .�� ,�'� 1 Cy �Y\i �e � ApprOx. C�omFletiOn E�at�: /�-��` `� � V J Alt� A Alt.� B Proposed Driveway Width If New Opening Is Desired: $ S Width + 6' See Back Page IaATE : — — � � APPL IC�11� : ��-�� L��C`�'� � � CQY DSE �Y Pe�it F�ee State Surcharge SAC Qlarge Driveway F.�scrvw Park I�ee Sewe� Main �iarge Torru. �STIPtJI,A�I01�S: � �•C�� S P � � S S $ �/S -�,q T�.. � ��y��-y � l�ee Scheclule on Reverse Side 5.50/51,000 Valuation $550 per SAC U�t �iYt. '�,' ar Al.t. "B" Above Et�e Determired by �gir�eering Agree�nerit Nea�essary [ I No� Neaessary [> I ,� , . :•��1 �. �, ' �;�v�4 ;�� :i�!� i� T�ie Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any �7dition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for suah permit of fees to the amount herein belvw set forth and i.n the manner herein pravided to�rit: � TOTAL VALDE Sl to $500 5501 to $2,000 S2, 001 to 525, 000 �25,001 to �50,000 $50,001 to 5100,000 5100,001 to $500,000 FEES S15 (Nlin�mtm► Fee is S15 plus surcharge ) $15 for first $500 plus S2 for each additional 5100 or fraction thereof, to and including 52,000 5�15 for f irst �2, 000 plus S� tor each additional S1, 000 or fractio� thereof, to and including 525,000 5252 for first 525,000 plus �6.50 for each additiana]. 51,000 or fraction thereof, to anol including �50,000 S414.50 for first 550,000 plus $4.50 for each ac�itianal �1, 000 or fraction thereof, tQ ancl incl�ing 5100,000 5639.50 for first �100,000 plus 53.50 for each additiona]. �1,000 or fraction thereaf, to ancl including 5500,000 5500,001 to 51,000,000 52039.50 for tlie first 5500,000 plus �3 for each additional Sl, 000 or f raction thereof, to and includir�g Sl, 000, 000 51,000,001 a�d �� 53539.50 for the first 51,000,000 plus $2 for each additional $1,000 or fraction thereof (Concrete Curb Streets Only) Alternate °A": Removal �d replaaement a� curb and gutter only - Drivew� width plus 6 feet times 513.50. Alternate "B": Renwal and replaoement af curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. ��±; � � �l � � • ' �•.�J� !�� y •J�I Permits for construction will be issued a minimtua of 24 hours f�om the time of appl icatia�► to allav for proper review af the proposed struckure and of the wnstruction site. A Certif icate of S�uvey of the lat, showing the locatian of the foundation once it has been aonstructed will be required before prooeeding with the fraaninq, _ ., � ,� r� ' rns ��. T � � � c tQ � C � a� > U � w Z � � Z w a �� Z U Ow 0 v°� z cn t!i � _ �. . 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'� s 'o � � o � C � U � � � O = N o� � E c a U � Q � 6 n � �: , �° � � `� � k� � _ .. _ _ _ _ _ _ —. — ..: �„' V c - . i� ��L,�+, c:7 _ i w" : � PR sa E)oN()sa� ()oN()�� (�)o�t(?�� ( ) o� ( } sa� {}oH()sa,L ()oN()�.i ��s :02�Q : �Cg p�u�i5 �O� JNI..L\r'�fH :-�-�i, � ;�� .I: i.`iiFCi `-t: �C�f i/1'�� I :s�utag .ia�eaq xa�en�► �03 PaPino.td aaaq .u� uoqsnqcuo� s�H • g aa�r.�� .Ta��enn io3 �aPino.�i u�q aauij � s�H � � s�tLLg 'IdZO.L S�il.LB sa� Ild �o S�fl Lg $�� I� ��H . tya��co� s��1.Lg I�io� puE azis io� sauawannt� apo� �uaun� �� sraaY� pa�oddns �Ciam�as s� un{�in� pa�poj s�afqo uScaso3 ou seH uor��oua�ap ao lsn.� wo,�3 aa.� sl 9 'S .,� '£ 'Z (} a�I () sa� � pautcu�xa �f[In�a.na uaaq seH - j :x��s so �(aawiqa �u�snra ay� �etp saguan �Cqalai{ pau3is3apun ac�,i, 3 �'.1. I •a�su.zn� �uan apzs s$uisn uaur� pa.zinbai g�� q�no.zu� i�� ZON .� � � RESIDENTIAL LOAD CALCULATION Purchaser ��-� �7 V� `'�`'L t Sales Rep � Date %� �� Addres s � S�? `( �- t o wy P �c�.�c �. �ir`�,Q.�; Running walls below grade: �� x �(Ft wall Ht)= � Running walls above grade: �� x (lst Floor) Running walls above grade: �� x (2nd Floor) �`■ _ � lu�b� Sq Ft gross wall �elow qrade 3q Ft windows and wall below ,� Sq Ft gross wall ' ( Ft wall Ht )_ �� above arade ( lst f r Sq Ft gross wall (Ft wall Ht)= above rade 2nd f Sq Ft gross wall + � �� Total gross Sq Ft _ ��F� ahc�vP nrac3P Sq Ft windows and - � �l �t doors above rade Net wall above = l ( 4 �-j c3rade Windows & Doors � Sq Ft x t �U HTM = 1;�BTUH Inf .(w&d x 1. 3) 2SS Sq Ft x O HTM = t�� BTUH Net wall below � q � � grade 1�� S Ft x HTM = �[ c� BTUH Net wall above grade �� Sq Ft x� HTM =� 0 BTUH Exposed Ceiling fo?� Sq Ft x I `� I HTM =��r: S�TUH T Exposed Floor [�'�'S Sq Ft x� HTM = � p BTUH _ ,��(o�' BTU TOTAL Windows & Doors � �i � � I � II � Ceilings & Floors °., b J � �� '�� ., •.. , , _ -. ,�. .. . , 410 W. LAKE ST. MINNEAPOLIS, MN 55408-2998 612/824-2656 HEATING AND AIR CONDITIONING CO sServina T6e Twin Citiea Siace 1930' ORS T TEST RECORD .r ADDRESS � 5�� V�° � � / ��/ CITY_ OCCUPANT ��Z � � _ __ __ __ _ n �OWNER DATE HTG. INST/D-,�/� � INSTALLED BY GAS LINE TYPE OF BY � HEAT: GA FA�HW STEAM SPACE HTR. UNIT HTR. 1072 PAYNE AVE. ST. PAU L, M N 55101-3892 612/772�449 r �c OTHER ` GAS DESIGN CONVERSION MAKE MAKE 0 NER MODEL (� f/fi%��Q �Q,/ ��5��/ MODEL SERIAL '�'Gf�` � ' � MAX. BTU RATING ---�_ INPUT MAKE OF ACE CONTROLS MODEL THERMOSTAT `� HEAT PLUG..� /� VENT SIZE � VALVE ��, --� KIND OF LINER ``� SIZE�_NONE LIMIT � / �'�! � DRAFT HOOD °-"� RE�ULATOR LIMIT SETTING ��%� CHIMNEY CONSTRUCTION �� FAN SETTING � ��° � DRAFT c TCST TAG PILOT TYPE �(�,� ,� LIGH ING TNST. ° f P I LDT MAKE '-°- PILOT MODEL PILOT TIMING �2..�--- PRESSURE � 5 PERCENT CO2 �/ ,� DATE I NPUT CFH �` PERCENT 02 ,� �� STACK TEMP.J�PERCENT CO p� NAME i TESTED � �� /'f `��'' rr� � OF TESTE� ,� �'`` � sue�ecT MIT NO. City of Fridley 2 6 91 , ` AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ECEIPT NO � � 1 y__�� COMMUNITY DEVELOPMENT DIV. _/� � J_ � � PROTECTIVE INSPECTION SEC. T y�J I � , � _ /'�'1 � CITY NALL FRIDLEr SS132 NUMBER REV OATE PAGE OF APPROVED BY ��"� � �'' 612-57�-3a60 siaF�s 7/30/98 / / J08 ADDRESS 6579 Clover P1 t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACFIED DESCR. 2O Clover Leaf Addition SNEET 2 PROPERTY OWNER MAIL ADORES$ 21P PNONE LeRo Venne 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Halek Roofin 62 8 Ea e L 535-8835 5010 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PNONE LICENSE NO. 5 ENGINEER MAIL ADORESS ZIP PMONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITI�ON O ALTERATION $] REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK ' Reroof (25 S ) Tear-off 9 CHANOE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. SEPARATE PERMITS ARE RE�UIRED FOR ELECTHICAL, PLUMBINO, MEATIN(i, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OF AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WOFK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT ANY TIME AFTEii WOfiK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV TNAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUiiTAX AND ORDINANCES GOVERNING THIS TYPE OF WOiiK WILL BE COMPLIEO WITH WH Efi SPECIFIED HEREIN OF NOT. THE GRANTING Of A PERMIT DO OT P ESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL TNE pERMIT FEE SAC CHARGE P VISIONS F ANY OTHER STATE OR LOCAL LAW REGULATING CON- TRUCTION !i THE RFORMANCE OF CONSTRUCTION. �� LAN CFIECK FEE TOTAL FEE SIGNATURE OF CON7RACT OR AUTMOii12ED AGENT IOATEi N OPE Y LIDATED T IS VOUR PERMIT r� � � - ( S�GNATUAE OF OWNEA ii� OWNER BUILDENI IDATEI Bl �NSp ryATE . NEVV ADDN ALTER Il �l �] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUII.DING PERNIIT APPLICATION ConstructionAddress: � � o v.� Effective 1/1/98 �� I.egal Description: Owner Name & Address: v�.2� Tel. # Contractor: J��o� ' -MN LICENSE � � (� Address: s � Tel. #_ S�$ ��5.� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IlVIPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: - Length Width Height Sq. Ft. DECB AREA: Length Width ; , Hgt/Ground Sq. Ft. OTI�R: 0 ---. o,.� Construction Type: ated Cost: $ j�f 7� S.'�— � . �� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ � DATE: � 3 v -�� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Fscrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: , � �7 y 7� $ � �� $ /� � �f $ � $ SP� dv $ $ $ $ $ ��7 CITY USE ONLY Te�. � ..535'' � �3 S Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuadon $1000 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 [ ] .� . � - � c BUII,DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any..alteratio� or re�ir to any existing building or structure, upon application therefore, require the payment by the applicant fqr such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 _ $50,001 to $100,000 $100,001 to $500,0� $5(�,001 to $1,000,000 $1,000,(}O1 and up FEES - • . . ° , ... . $21 �1Vlinimum Fee is $21, plus' surcharge) - � . $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 � $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and inc�uding $100,000 , '� � ' , $887.25 for first $100,000 plus $5.00 for eac$ additional $1,Q00 or fraction thereof, to and including $500,000 $2887.25 for the first $SOO,Q00 plus $4.25 for each additional $1,000 or fraction tt�ereof, to a�d including $1,OU0,000 �' $5012.25 for the first $1,�0,000 plus $2.75 for each additional $1, 000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A°: Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding witti the framing. SuB�ECT City of Fridley �' 2 9 3 0 2� AT THE TOP OF TNE TWINS g � I L D I N G P E R M�T r � � R NO. � �v �_�� COMMUNITY DEVEIOPMENT DIV. � �� r � � PROTECTIVE INSPECTION SEC. � _ � t �"'1 � CITY NALL FFIDLE� SS13$ NUMBER REV OATE PAGE Oi AVVROVEO BY �----�' �•' 612-571-3460 910-F15 4/26/99 / / lOB ADDRESS 6579 Clover Place NE 1 IEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACNEO OESCR. 20 Clover Leaf Addition SHEET 2 PqOPERTY OWNER MAIL ADORES$ 21P PHONE LeRoy Venne 6579 Clover Place NE 571-3409 3 CONTRACTOR MAIL ADORESS 21P PHONE IICENSE NO Twin City Exteriors Co 9060 Zachary Ln N��'108, Maple Grove, MN 55369 2595 4 ARCNITECT OR OESIGNEfi MAIL ADORESS ZIP PMONE LICENSE NO. 425-4737 5 ENGiNEER MAII ADORESS tIP PMONE LICENSE NO 8 USE OF BUILOING Residential 7 CIASS OF WORK O NEW ❑ ADDITION O ALTERATION � REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reside House 9 CHANGE OF USE FROM TO STIPULATIONS Call for building wrap inspection before covering. SEPARATE PERMITS AqE IiE�UIREO FOR EIECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAO VENTILATING OA AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTMORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WOiiK IS SUSPENDEO OR ABANOONEO FOR A PER100 OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO OWLG. UNITS OPfSTREET PARKtNG I HEREBY CERTIFY TMAT I HAVE REAO AN� EXAMINEO THIS APPLICATION 1 STA��S GARAGES AND KNOW TME SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS VALUATION SUR7AX AND ORDINANCES GOVERNING TNIS TYPE OF WOiiK WILI BE COMPLIED WITM WHETHER SPECIfIED NEREIN OA NOT. TME GRANTING OF A PEFiMIT �C �OOO �3.00 DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL TH� pEqMIT fEE SAC CMARGE PROVISIONS OF ANY OTHER STATE OR LOCAI LAW REGUTATING CON- @ STqUCT10N OR THE PERFOfIMANCE OF CONSTRUCTION �LZL.ZS Fire C y�6.00 PLAN GNECK FEE TOTAL EE Li $5 $126.25 S�GN4TUAEOFCON'�7ACTOpOpAUTNOA�2E0AGENT IOATEi NE P LIOAi IS IS YOU PERMIT � +� S�GNOTUFEO�OWNEp�iipWNEpBU0.DEiii �D�rE� OG �NS� qpt( NEW ADDN ALTER [l [] �l ConstructionAddress: � L'egal Description: Owner Name & Address: Contractor: Address: gi/7� � � LIVING AREA: � GARAGE AREA: DECK AREA: OTHER: CITY OF FRIDLEY SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/97 3�� U � Tel. # ��- ��1� � NIN LICENSE # p?� �� 1�_Tel. # ��a7 �i? �y7 :� i r-_-.- Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IlVIPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Construction Type• �� Estimated Cost: $ � � (Fee ScheduZe on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �� APPLICANT: Tel. # �aS- �'%� � CITY USE nNi,Y Pernut Fee Fire Surcharge State Surchazge SAC Charge License Surcharge Driveway Fscrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $,� ,� Fee Schedule on Reverse Side $ � , p� � .001 of Permit Valuation (1/lOth%) $___ �, L� $.SO/$1,000 Valuation $ $950 per SAC Unit $ � $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B ° Above $ � $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] c�e . . $ �� -�.� ° �y a s = .��. �� ,,' � � � �%,/ / ^,�`� /�� f l�/,,,1 �� J �� i� �� ADDRESS PIN LEGAL DESC PERNIIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 iTNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 l+'AX: : 6579 CLOVER PL NE : 143024140054 : CLOVER LEAF ADD : LOT 20 BLOCK : HEATING : RESIDENTIAL : ADDITION/ALTERATION 571-1Z87 PERMIT NO.: 2004-02110 DATE �SSUED: 11/18/2004 VALUATION . NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERNIISSION FROM ADJOIIVING PROPERTY OWNER COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. # A/C UNITS 1 VALUE OF APPL OR WORK 0 # FURNACES 0 # GAS DRYERS 0 # GAS RANGES 0 VALUE (FOR MINIMUM CALC) 300 APPLICANT STANDARD HEATING & AIR COND CO 410 WEST LAKE ST MINNEAPOLIS, MN 55408-2998 (612)824-2656 OWNER VENNE LEROY L& KATHI,EEN L 6579 CLOVER PL 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 construcrion 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 l�ow the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The gra.nting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating ns crion or the performance of construction. Applicant Date / / —�-� :,,�,�7�7�._ �./y��i HEATING PERNIIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE AIR CONDITIONII�TG FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT TOTAL SEPARATE PERNIITS REQUIRED FOR WORK OTI�R THAN DESCRIBED ABOVE. 0.00 0.00 0.00 0.00 25.00 0.00 0.50 25.50 ,. ' � O � a 0 7 7 04 '0 0 � � 0 � m 8 � 0 C� � � m z � � n � O Z m m � � O 0 � x 0 � � O � v r � � C m 3. w rn � � � ' , � � V ''� , ; � .� 1 � A � 0 m � � m � � !� j N 3 � c ° 3 °� '11 � � c N � "M v o� o � � o -, � � w � � 3 �N,� fl. rN+ � N N �v � � c � 0 � � � a m c�u � c _+i � � �a °' m � � � o��m� � tD N � a Wo� -'a�D °-� o � � � � � � � Uf, � N 7 7 � �, �► - _ �� Q � � � �� °.� Q� �� v � ,� N s r: � � � o °: m � n� n m � � o � Q � � (� � � � � v � � � `°3�� rn -n m m ' � � � D ? F�.► .� V� ci cn -o 0 � �g�� N � 0'3 � o � m � � � �' � °� o o � cn oWi o v M r-} °, � � W m 1 � o� a m Z v � _ � N m � o � � � N � v a � O � � O4 � � � � ,c�i� o 0 0 0 0 � � � � � �W�� m �c a °+ m = z� � °; mo'a C � � C�i n � � �= o �� a � 0 v = a o rn � � � � \1 o `� � �6� � � � N o�i � m � N � �o, 9 OR z � c � 31 m -� � � fD � o� � � o � �n ,� � � � � � 3 � �p 01 � � � � �. c ° �� o � o� � � R� � A x v � r 0 0 ,c�"�s� '� 0 0 o fm 0 0 0 � �► � � � 3 '�1 m v O � 1 -� m � � _� z 0 a c � a � � n w a _c � w Z � O � ,�,, n � -� N�°r � Z� � rn � � C � �=- �' v � z � � � � m " O Z �O 3� m 'v � r �a � -�� zo n� vo n� � m � � 0° O � ° � Z � � � 0 D Z �zv U� � _ '� � � y 1 � Z p� � � e��r i(� � � ,� '''�` a o �� z o ,� p r � v� � � < � m m � � � m �� O � � � � 0 � FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION � When realacinsa an existina furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, dete�oration, obstructions, and is securely supported and firestopped where required. Yes () No () The venting system is plastic/PVC and meets all current codes and manufacturer spec�cations including sizing, length, number of elbows and termination. Yes () No () The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The existin�t combustion air is sized and installed to meet the current codes and manufacturer's specifications. When required to install a new combustion air, it will be sized and installed to meet the curren� codes and manufacturer's specifications. Yes ( ) No ( ) Yes ( � - � t ) Yes ( ) No ( ) When irfsta#lit�a a t�w ventin�a svstem, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's spe�ifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () Aapliance Tvpe and Size/Cori�mon Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Tdal Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter �in Type Appliance #3 Vent Connector Height ft Length ft Diameter :in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date : No ( ) No ( ) ��