AF - 43255sue�ecT R
City of Fridley 1837
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
' ' R
� �
� ` COMMUNITY DEVELOPMENT DIV. i
r � ti � PROTECTIVE INSPECTION SEC. �O 3� S
i �
1 • �
� ' /'��1 � CITY HALL FRIDLEv 55432 NUMBER REV. DATE� PAGE OF APPROVED BY
�""'��� ,�� 612-571-3450 910-Ft 5 4/15/86 � �
10B ADDRESS 1311 Creek Park Lane N. E.
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 4 1 Hidden 41�OC�S SHEET
2 PROPERTY OWNEF MAIL ADDRESS Z1P PHONE
Garjac Inc. 481 - 206th Avenue N.E., Cedar, NIl�T 55011 434-7096
3 CONTFACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNEH MAIL ADORESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
C� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ���REMOVE
8 DESCRIBE WORK
Qonstruct a 43' x 40' Dwelling and a 24' x 24' Garage gefore digg►n� cail local util� i��
Etc.
t
Y LA�N
9 CHANGE OF USE FROM TO
STIPULATIONS provide a hard surface driveway. Provide sod in the front and side
yards. Provide City with copy of verifying survey before capping.
SEWER LOCATION: "Y" 111' East of M.H. "Y" ELEV: 883.59 FOOTING TOP: 886.59 MIN.
WATER LOCATION: Water in same trench as sewer
Paid $1,500 Park Fee and $297.00 Driveway Escrow.
�'p� THE CITY OF FRIC! �"Y ��;� , ; ; .-
,Rr RA rF p ACCURACY OF UTiL! � 1�'�-', 1, : �
NG' � E A T R M� T S R AND P a ONS�US3 d� ; 3��: ��' ':� _ �.-
, ,
N p�V�p(I/RE � ...,...,.<<�� � ;,
G� vt�,�Y ir o�? r:a� ��:-i, .. ..'.:�
e/N� � FpR
A
SEPARATE PERMITS ARE REQUIRED FOR ELECTFICAL, PLU I�HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OFi CONSTqUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOF A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFF8TREET 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 WILI BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTtNG OF A PERMIT $69�OSO $34. S3
DOES NOT PRESUME TO GIVE AUTHOR�TY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUC N OR THE PERFORMANCE F CONSTRUCTION. $343.00 $475.00
PLAN CHECKFEE TOTALFEE
85.75 $938.28 +PF&DW
SIGNATUAEOF ON�RACTOROR ZEOAGENT IDATEI WHEN PROPERI VALIDATED THIS tS VOUR P RMIT
� -: _ „ is�' �
SiGNATUREOFOWNERiIFOWNERBUILDERi IDATEI BLDG WSP - OF7E
NE�,�' [� City of Fridley Effective 4/1/8u
A�Pt�. I l iR-1 AND R-2 j n - ��
pLTER. [� Building Permit Application f',('}� �
. �
���
� � ��
Construction Address: i � �`� C�� • �/� �A�e �
Legal Description: �� "%L `�( ��Q �- (� �/ C'� ��' � �'a 4
Owner Name & Address: Tel. #
Contractor: ���T1��- �� T�el. # ��31 �°��
Address: ���� 020�.� �►�/e /V� CeD�-2 /yl�v� SSa/( _
LIVING AREA:
GARAGE AREA:
DECR AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction draWn on it to scale.
DESCRIPTZOp OF IMPROVEMENT
Length � 3 Width `i� Height �
Length � `� Width �_ Height �_
Length Width Hgt/Ground _
Sq. Ft. la-fd
sq. Ft. .fi�6
Sq. Ft.
Corner Lot [] Inside Lot [�j Ft. Yd. Setback .�-� Side Yard Setback
�M �_ �
Type of Construction: _ �� Estimated Cost: � _�_ �
Approx. Completion Date:
� Un�e 3 � �D� ��J�+
I Alt. A v Alt B
Proposed Driverray Width If NeW Opening Is Desired: G2 S--�1�II!'� � ,.
See Back Page for Explanation
DATE: L� � _�. � �° APPLICAhT: Tel . � ���L��=7°��
CITY OSE ONLY .
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
SeWer Main Charge
�.W�t
3�TAL
STIPULATIONS:
� 3 �3. ou
$ S'. � �
S �
� �-1') �', ��
a 1 �bo,ac�
� ��
�
$
�%�S. 02�
Fee Schedule on Reverse Side
25x of Building Permit Fee
E.50/�1,000 Valuation
�425 per SAC Unit
Fee Determined by Engineerin�
Agreement Necessary [ ] Not Necessary [ ]
< . . „
BOII.DING PERMIT FEE SCHEDDLE
The Chief Building Official shall, before issuing permits for the erection of ar.y
building or structure, or for any addition 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 such permit cf tees to the amount
herein beloW set forth•and in the manner herein provided to-vit:
Total Valuation
=1.00 to ;500.00
�501.00 to a2,000.00
Feea
.
a10.00 (Minimum Fee is �15.00)
�10.00 for the first �500 plus $1.50 for each
additional �100 or fraction thereof, to and including
�2,000.
52,001.00 to $25�000.00 �32•50 for the first �2,000 plus �6.00 for each
additional �1,000 or fraction thereof, to and
including a25,000.
525,001.00 to �50,000.00
�170.50 for the first
additional �1,000 or
including �50,000.
E25,000 plus �4.50 for each
fraction thereof, to and
�50,001.00 to 3100,000.00 a283•00 for the first �50�000 plus �3.00 for each
additional �1,000 or fraction thereof, to and
including <100,000.
�100,001.00 and up
.
�433•00 for the first �100,000 plus �2.50 for each
additional �1,000 or fraction thereof.
DRIVEHA7 DEPRESSION ESCROi�I
(Concrete CurG Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Drive�ay width plus
6 feet times a13•50
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approacr xith 6 inch depth - Driveway Width plus 6 feet times a15.75
VERIFICATION OF FOUNDATION
Permits for construction xill be issued a minimum of 24 hours from the time of
aF�plication to alloW for proper revieu of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, sho�ing the location of the foundation once it
has been constructed �rill be required before proceeding with the framing.
, �
�,0� t ` ����� 2zx��� -- 3� �f�,b�
So, o�,�._. ' 3 x b = I�? � t3�;,�,-°
a g3 .� at ►3 x�lv a s:s1- Sg Z°
p`��3 � a.._.. .. - �.z�� - _ ..
;
�3 . . � ��a� Sx s�.Z� �� .�83.ou
x�.r
Gaz� ��t,.°�� = S'�c X ��,i�
,
�o��g�
�1,,�9�.Sz.-,
CITY OF FRIDLEY
APPLICATION FOR POHER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERAT(ON AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
!1ESIDEt�TIAL
Purnace Shell and Duct Work,
Burner (�leo repla�ceAent turnace)
Cae Piping
(piping naedsd with n�w lurnaca)
Gas Range
Gea Dryer
" Air Conditioninq (all sizee)
All Othere/Repair6 and Alterationa
10 of Yalue of Rpplixnce or idork
COMHERCIAL/IHDUSTRIAL
18 ot Value of Appliance or t3ork
W1TE
$ 2U.00
$ 10.00
$ 10.00
$ 10.00
$ 10.00
State Surcharqe.
'I°OTRL !'E�'
.Yninsp�ction Fee ($15.00)
Rough Insp.
Date
l�inel Tnap. �t —/�"��°
Date
Approv�l for Per�it �i �
HINIMUM FEE FOR ANY HEATING PERMIT IS $10.00
PLUS $.50 STATE SURCItARGE
�ro�r�L
$ �� �G�
—A.JG=
$�d�
$
$
$
$
F.ffcctive Auy. 1, 19H1
Job Addrese ���� L�.��� / l✓�� �--i�// ��—
De�artment oC Buildlnq s 6431 Univer9lty Ave. N.E., Frldley, MN 554]2
City of Fridley
Tel. N571-3G50
The undersiqned hereby melcell applicatlon for • pecwit for the work heratn
specifted aqreelnq to do all work !n atrict accordance wlth the Clty Codes
end rulinqs o[ the DeparUnent of Buildinqe, end hereDy decl�res thet ell [h•
fact9 and repreeentatton� atated !n thia spplicatlon are true and correct.
Frldley, Hlnn. �'7 �O . 14�
06iNER ��/ S„��(" � --
KIND OF
USED AS
$ 'PO BE ODl9PLETEO ABOUT �Ui�� ,J -
��n C �
ESTIHATED COST ""
S .50 c
�� �j� OLD - NEN BUILDING PERlIIT ld0. PERMIT NO. o.� �
`'�.. '�
$ -
Attach st�ck verlflcation fon wlth re{�lacement turnace E>e�nits
•Atr Condltioncrs cen no[ ba placed in �:idr yard witJwu�
arlttan {N•rnisyion fro� adjoining rx}1yl�bor.
DESCRIPTION OF FUAPJACE/BU�R
HEhTTNG or PO4lER PI1�NT'S, Steeea, Hot Flaterr anq Air- ...
8
Trade Name �L`e�/2�1� . Sis� t1o. ���`
Capacity / 7 Sq• Ft. EDR g� HQ
'Ibtal Connected Wad � Kind of Cuml (-�5
I1UWtER - Trade Name Size No. iF�ai�
Capecity Sy. Ft. EDR B'� p NP � y
C �:'.6..5lY✓:ti4'� . Z1�. i ... . jl`L^..k� �':ila
CG�>�i:.� .._.`•i1 :..' " " .. _
Company
— , „ . " .� _:_�-„-� ...�c
Slqned By —
Tcl. No.
�v�— ��
CITY Of FRIDLEY
APP�.ICATION FOR PWMBING AND �AS FITTIN6 Pfi�1IT
q a tr e i° � .i .� d, water
m L .-pl p E�.[i d w{,� � � a+ � pR,� k. ABi1tP,Y �
.�1 O �0 C .�� �j ai f M 1."' G�� R U � O
� v 5 0� a� ai 3� o� � g cai a� � a� 3 � c� O lec
C�� ��� r C� � r �
lst � � ( �
2nd
3rd
4th
(R) = F1�ture Connection Opening Connected with Seaer
(+) s New Fixture. O1d Opening`; Water
RATE SCHEDULE
PLUMBING FIXTURE RATES:
New Fixtures
Future Fiatnzes
Old Openinq, NeM Fizture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Nater Leader
Hydraulic Valve
5ump or Receivinq Tank
Meter Treatinq Appliance
Hot Nater Heater
Gaa Ranqe
Gas Dryer ,
N0.
'r
�
_�
RATE
s s. 06
g 3.50
S 1.50
S 4.00
$ 5.00
g 5.00
S 5.00
S 5.00
S 5.00
g 7.00
$ 5.00
g 10.00
g 10.00
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
ls of value of Fixture or Appliance
State Surcharqe
Reinspection Fee $
(S15.00)
TOTAL FE8
TOTAL
00
s3��
S /D 'S D
S
S
S
S
S
S
S
S
S .S ° o
S
S
S
$ .50
S `�/�D_D
Job Addresa ���/
Oepartment of &�ildinqs
City of Fridley
Tel. �k571-3450
The undersigned hereby makes application for a permit for the work herein
specified aqreeinq to do all work in atrict accordance with the City Codes
and rulings of the Departsent of Buildings, and hereby declares that all
the facts and representations stated in thia application are true and correct
� Fridley. Mn. ��UC 9 . 29 G��l
• r • �. / _!�
KIND OP BUII�II�
USID AS
TO BE COI�LETED ABOUT
ESTIMATED C06T
OLD - NEf� BUILDING PERMIT NO. PERMIT MO. V,��
NE
croa�pBnY C:c%��E��z�.��./�,.d' /�-P�iCLs�
Siqned By G^a----�
Tei. No. /pE^ ^%/��
ROUQi INSP.
Date
FINAL IHSP. � -! L' ` 0 �
Date
APPRO'VAL FOR PERNIT ��
l92NIHU9! FEE FOR A13Y PLUMBING PERMIT IS $10.00
PLUS THE $.50 ST?�TE SURCHARGE
,
;_
CITYOF
FRIDLEY
C1VIC CENTER • 6431 UNNERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
June 18, 1986
Mr. Gary D' Aiqle
Garjac, Inc.
481 - 206th Avenue N.E.
Cedar, 1�IN 55011
Re: Final Inspection at 1311 Creek Park Lane N.E., Fridley
Dear Mr. D'Aigle:
A final inspection was cor�3ucted on June 13, 1986 of the above address and
the following itesns were noted which must be completed before the stzucture
can be finaled:
1. Provide City with copy of verifying suYVey by July 31, 1986.
2. Provide sod in the front and side yards by July 31, 1986.
3. The egress window in the lower level northwest bedroom must be lowered
tr� 48 inches maximum sill height about the floor or place same peananent
piece of furniture under it to be used as a step to get out of the
window. This should be completed before occupancy of the structure.
4. F:�ctend the fireplace chimney above the chase by July 31, 1986.
5. Fill in (block) opening in garage for service door by July 31, 1986.
6. Remove old single car garage by July 7, 1986.
We w ill expect the above it�ns to be completed by the scheduled dates when
reinspections will be corxiucted to detennine compliance. If you have any
ques tions on these items, please feel free to contact me at 571-3450.
Sincerely,
. CLARK
Chief Building Official
DGC/mh
SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
f
1 1
� �
' • COMMUNITY DEVELOPMENT DIV.
r � ~ � PROTECTIVE INSPECTION SEC.
� ;
i � �
i
� �"'1 � CITY HALL FRIDLEV 55432 NUMBER AEv
` ""'� � ,�� 612-571-3450 910-F15
JOB ADDRESS 1311 Creek Park Lane N. E.
1 LEGAL LOT NO. BIOCK TRACT OR ADDITION
DESCR. L� 1 Hidden Woods
2 PfiOPERTY OWNER MAIL ADDRESS
Leonard Harff 1311 Creek Park Iane N,E.
3 CONTRACTOR MAILADDRESS
Same
4 ARCHITECT OR DESIGNER MAI� ADDRESS
5 ENGtNEER MAIL ADDRESS
6 USE OF BUILDING
Residential
DATE
4/28/88
ZI
ZIP
ZIP
PAGE Of
/ /
PER
� 19425
RECEIPT NO.
APPROVED BV
� �" �-�l �I
SEE ATTACHED
SHEET
PHONE
571-9028
PHONE LICENSE NO.
PHONE LICENSE NO.
PHONE LICENSE NO.
FIRE DEPARTMENT MEMO ���
_._
��. ��---- " ,___.-�....--�'`,
TO BUILDING INSPECTION ,__ � ---�--°-�`"�`
�_. . . _...--.----"...,_
ASSESSING
SUBJECT: FIRE DAMAGED STRUCTURE DATE: Feb. l, 1988
FIRE HAS OCCURRED AT
1311 Creek Park Lane _
DDRESS
January 31, 1988
E F R
� . ,.,,,�f � /Y �G�,-,,;�,,,,�
�
FD-7
S�riVV��v�DF�TFIE��rCI'TVIfM�R'I�VC��V��vvt�OtnVViTlT�. � - � -
( PLAN CHECK FEE
$3.75
/ S�G TUAEOFCON�RAC OROR�A�ZE� IDATEI WHEN PROPE LY
� SIGNATURE OF OWNER UF OW ER BU4DERi iDATE� t'��
RI DG �NSP
)TAL FEE
$19.25
TFjIS IS YOUF P�RM
�
y
NEW [ ]
ADDN. [ ]
pLT ER . t J
J
City of Fridley
� R-1 AND R-2 (
Building Permit Application
Construetion Address: % 3 �
Legal Deseription: �C)� y l
Owner Name & Address:
Contraetor
Address
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER•
� �
�O�d �'t9 P•�e� d c��
l3/l C�o� ,�d,
Attaeh to this application, a Certificate of Survey of the
lot, with the proposed construetion drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height
Length Width Height
,
Length �+ Width � Hgt/Ground
Effeetive 4/1/86
Tel . � .�%� � �D � �4
. �
Sq. Ft.
Sq. Ft.
Sq. Ft. 11.L
l I 2 � � �t'1./ � '� 7
Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setback
r e a x� o�.o--
Type of Construction: � Estimated Cost: $ �
Approx. Completion Date: . ♦J�
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE:
"1 �� 9 r o� APPL ICANT : Tel .�
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAI.
STIPULATIONS•
CITY IISE ONL.Y
� r Fee Schedule on Reverse Side
$ 25� of Building Permit Fee
$ � �� $.50/$1,000 Valuation
$ � �,�Q per SAC Unit
$ � � ` Fee Determined by Engineering
�.�
i
� ``�
� —
(� � \ Agreement Necessary [ J Not Necessary ( J
� �
�
,
Sa v— �G
� � �.�
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sue�ecr ERMIT NO. �
City of Fridley 2719 2
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
i •
� � •
� ` __._��. COMMUNITY DEVELOPMENT DIV. �r
r � V � PROTECTIVE INSPECTION SEC. Ja �O
, ,
i_---�; �'��;'� CITY HALI FRIOLE� 55032 NUMBE1i REV DATE PAGE OF APPROVEO 8Y
i 612-571-3450 9t0-F15 8/14/98 � �
J08 ADDRESS
1311 Creek Park Lane NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. (F 1 Hidden Woods s"EET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Leonard Harff 571-9028
3 CONTRAC70R MAIL ADDRESS Z�P PHONE LICENSE NO.
Affordable Custom Homes Inc 680 63 Ave NE Fridle 55432 574-0729
4 ARCM�7EC7 OR DESIGNER MAIL AODRESS 21P PMONE LICENSE NO.
20055319
5 ENGINEER MAIL AODRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION � REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Reroof house and ara e 24 S Tear-off• sidin •windows
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
Call for building wrap inspection before covering.
Install smoke detectors to meet the State Building Code - in each sleeping
room and on each level of home.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE REOUIRED fOF ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CON�ITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. 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
ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UN17S OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS VAIUATION SURTAX
AND OROINANCES GOVEFNING THIS TYPE OF WORK WILI BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING Of A PERMIT Q
DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTIp R TI-lE PERFO CE OF CONSTRUCTION. F1Y'e SC 17 . HO
PLAN CHECK FEE TOTA FEE
� `Y �l� '
S�GNATU�7E ON' ACTOROAAUTM0�7�2EDAGENT IDMTEI EN ROP ALIDA TF�IS IS R P T �
• � /
S�GNnTUAEOFOWNEAi�%OWNER'BU�LDERi iDATE� BL iNSP ��titE
r�w �
ADDN
ALTER
[]
[�
�
Co nstructionAddress :
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUI� ING PE IT APPLICATION
C;�'��e�2 ��
r'�l L ,� '� /�✓
Effective 1/1/98
�� `b
. �\ �
r,�
Legal Description:
Owner Name & Address: vt�,� � � Tel. #���� �'! d��
Contractor: /���/'„1�.��� ��'�.�r i i���� _P �1 � , MN LICENSE # ��SS`.�l �
Address: �������j't ,�f �E . Tel. # ��%�'�%�
,
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Length
I,ength
Length
DESCRIPTION OF IMPROVEMENT
Width
Width
Width
Height
Height
Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
�UO / %���
� �-� �s, � G
YP !�i> -S��ih ' r a� ��u�
Construction T e: W t.���-� �.S Estimated Cost: �
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � � APPLICANT: Tel. # �%�"l� 7�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
5TIPULATIONS:
$ �(C�.o2.��
$ ��. cjv
$ ��- cl'L�'
$
$ .��'�?
$
$
$
$
CITY USE ONLY
Fee Schedule on Reverse 5ide
.001 of Permit Valuation (1 / l Oth %)
$.50/$1,000 Valuation
$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 [ ]
$ � �3 . 9��
sue�ecT P .
City of Fridley
�
AT THE TOP OF TNE TWINS g U I L D I N G P E R M I T 3' S� 4
„
,� .
� • COMMUNITV OEVELOPMENT DIV.
r � L � PROTEC7IVE INSPECTION SEC. �J ys
� � .
� � �"'1 � CITY NALL FRIOLE� 55�32 NUMBEN NEV O�iE P�GE OF APPROVED BY
�"'"�"� ,'' 612-571-3450 9t0-F15 12/12/00 / �
10B ADORESS 1311 Creek Park Lane NE
t LEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACHED
oescA. 4 1 Hidden Woods SHEET
2 PROPEfiTY OWNEFi MAIL AODRESS 21P PMONE
Tim/Debra Kidder 1311 Creek Park Lane NE 991-7952
3 CONTRACTOR MAI� ADDRESS ZIP PHONE LICENSE NO
Advance Companies Inc 6400 Central Ave NE, Fridley, MN 55432 572-2000 4423
4 AqCHITECT OR DESIGNER MAIL ADDRESS 21P PMONE IICENSE NO.
5 ENGINEER MAIL ADDiiESS ZIP PHONE IICENSE NO
6 USE OF BUILDING
Residential
7 CIASS QF WpRK
O NEW O AD�ITION O ALTERATION C� REPAIR O MOVE O REMOVE
8 DESCRIBE WOHK
Fire repairs to garage and house
9 CHANGEOFUSEFROM TO
STIPU�ATIONS See notations on plan. Provide 5/8" Type X sheetrock on garage/house
common wall. Retest gas Zines/waste and vent.
Provide smoke detectors in ali sleeping rooms ar.d on ali levels of the
dwelling per Section 310.9.Z.2 of the 1997 Uniiorm Build�ng Code. Hardwire with
battery back-up.
SEPARATE PERMRS
REQUIRED FOR:
PLUMB�III�G' AND SI6�IS
TVPEOFCONST. OCCUPANCVGROUP OCCUPANCVLOAO
SEPARATE VERMITS ARE REOUIREO fOF ELECTRICAL, PLUMBING. MEATING.
VENTILATING OR AIR CONDITIONING
TMIS PERMI� BECOMES NULL AND V010 IF WORK OR CONSTRUCTION 20NING SO. FT CU FT.
AUTMORIZEO IS NOT COMMENCED WITHIN 60 DAYS. OR If CONS7RUC710N
OR WORK IS SUSPENDED OR ABANOONED fOR A PERIOD OF 12p DAYS AT
ANV TIME AFTER WORK IS COMMENCEO. NO DWLG. UNITS OFFSTREE7 PARKING
I HEREBY CERTIFY TMAT 1 MAVE FiEAD AND EXAMINED THIS APP�IGATION 1 STALLS GAFAGES
ANO KNOW TME SAME TO BE TRUE ANO COFiREC�. ALl PROYISIONS Of IAWS VA�UATION � SURTAX
AND OROINANCES GOVEFNING THIS TVPE Of WORK WILL BE COMPl1ED @
WITM WMETHER SPECIfIEO MEREIN OR NOT. THE GRANTING Of A PERMIT �SO�OOO � y�ZS.00
DOES NOT pRESUME TO GIVE AUTMORITY TO VIOLATE OF CANCEL THE pEqMIT FEE SAC CMARGE
PROV1510 OF ANY OTHER TATE OR LOCAL LAW REGULATING coN- �643 . 7S F� re SC �SO.00
STRUCTI N OR TME PERfOR NCE UCTION
�. P�AN CHECK E T AL FEE
�' G� Licen e C $5. $723.75
S�GNatuAE 0� CO "Qn T OQ � EO �G •TE ME PROP VAUOAT THIS IS VOUp PERMIT
� �z-�� -o�
S�GN�TUQE O� OWNEA��� OwNEABw�DEA� � iD�iE� Bl0 �v5� - ����E
�:
N � [ ] Effective 1 /1 /2000
ADDN [} CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [] SINGLE FAMILY AND DUPLEXE5 R-1 AND R-2
BUtLDING PERMIT APPLICATION
Construction Address: � 3�l C���`z �A� �iy
Legal Description:
Owner Name & Address: I rti t l�.73i2A %GAOa'K- Tel. #�¢ 99/ -'7gs'Z
Contractor: au�1�N�C� Q�X*�i4�Ui �� ��tTC� MN LICENSE # y�(Z.3
Address: ��/GD CtuiKtQC., ��c� Tel. # 5�% 2- ZC'-�
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Construction Type: f,(�' �/9'!/Z- Estimated Cost: $ ,�O�C�D
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: /2 /� APPLICANT: L.._A� �1 � � Tel. # S � 2 " �-'C(/�
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $��!�,Z��ee Schedule on Reverse Side
Fire Surcharge $ �`Q. GSb .001 of Permit Valuation (1/10th%)
State Surcharge $ c��Gib $.50/$1,000 Valuation
SAC Charge $ $1100 per SAC Unit
License Surcharge $,.� �'drC> $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above ,
.
Erosion Control
Park Fee
$
$
$450.00 Conservation Plan Review �
Fee Determined by Engineering '� t
,, � �
� a P� ,�
�
Sewer Main Charge $ Agreement Necessary [] Not Necessary [ j U� V�
� P
TOTAL $ •3� v � ��
STIPULATIONS-��dv �' �� c�����v i_���—�.- � f� G L
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Dy� E �72-2000
OMPANIES, INC. 24 HOUR RESPONSE
FULL SERVICE RECONSTRUCTION CONTRACTOR
6400 CENTRAL AVENUE N.E., FRIDLEY 55432 - ' MN Contractors License *4423
NAME JOB # DATE
LOCATION � � CONTACT
PHONE
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6400 CENTRAL AVENUE N.E., FRIDLEY 55432 - ' MN Contractors License #4423
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OMPANIES, INC.
6400 CENTRAL AVENUE N.E., FRIDLEY 55432
�7Z�Z��O
2 4 H O U R R E S P O N S E
FULL SERVICE RECONSTRUCTION CONTRACTOR
� ° MN Contractors License #4423
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DVAN E
COMPA.NIES, INC.
6400 CENTRAL AVENUE N.E., FRIDLEY 55432
�72-2000
2 4 H O U R R E S P O N S E
FULL SERVICE RECONSTRUCTION CONTRACTOR
' � MN Contractors License #4423
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CITY OF FRIDLEY INSPECTION DIViSiON
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
(763) 572•3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning • All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1�'/0 of Value of Appliance or Work
Commercial/Industrial
1.25°jo of Value of Appliance or Work
Rate TOTAL
$ 30.00 $ �a�e �
$ 10.00 $
$ 10.00 $
$ 10.00 $
$ 25.00 $
$
$
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
$ .50
� �v, s�
JOB ADDRESS ���� C���-k- P�
OWNE
Effective On January 1, 2000
L n�
.��,�C,J � (.'� �1 �o
BUILDING USED AS
ESTIMATED COST , ow��� PERMIT N0. ��l L�� �
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units�_ Circle One (Steam) (Hot Wate Warm A'
Trade Name Rr,�.. w� Size No.�O `�
BTU (o�y or�O HP EDR
Fuel N� C� . Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes an
rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
DATE � � � � ° 1
HEATING CO �'` � Q P( b�� d� �i �-9 S^� L
Signed �.�- �.�i�--�-*-h TEL # ��3 " y9 ? — 2° � �
Approved By Rough-In Date Final Date �"�� "��
COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacina an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ()
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications 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 existinp combustion air is sized and installed to meet the cuRent codes
and manufacturer's specifications.
When required to install a new combustion air it will be sized and installed
To meet the cunent codes and manufacturer's specifications.
Yes( ) No( )
Yes( ) No( )
Yes ( ) No ( )
When installing a new ventin� system, the undersigned hereby verifies that
it 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. Yes ( No ()
Is the common vent and vent connectors sized and installed coRectly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes () No ()
Apptiance Tvae and Size/Common Vent and Vent Connector lnfonnation
Appliance #1 Type �+,�h� �� BTU Input vo� Fan Assisted or Nat iil�`�
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type Vent Height Diameter inches
Appliance #1 Vent Connector Height �(�ft Length Z ft Diameter �_in Type �_
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Conne�tor Height ft Length ft Diameter in Type
ALTERATIONS: (Describel
HEATING CO:_ /�� Y� AI%o � ��y
Signed By: �-�. ���-�, Date : �— OS " a�
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS F{TTING PERMfT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On Jan 1, 2000
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Bfow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heate� -Electric
Water Heater - Gas"
Gas Range""
NO. RATE
Gas Dryer"* _
Back Flow Preventer Required ()Yes () No
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ �.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
TOTAL JOB ADDRESS �� I J ,�re �I.c.- tPAr'�- L/J
Type $15.00
Reinspection Fee $47.00/Hr �� � �� �L-�� (-�� � ��
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
�
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
�"�� ,ZO Or
Owner
Suilding Used As �( o rw--
Estimated Cost �`t g �� o'� PERMIT NO. /����,�
PLUMBING COMPANY ___� � D P�{�� d� i��7 .ZN �
SIGNED BY -�--� � TEL N0. 7� '� '`�`h- 2° 3)
Approved By Rough-In Date Final Date ��!�� �� �
m�n�mum r�� rvr� AIY i rL�J1111O11Y17/17A.7 rCRllfll l �a
TOTAL FEE $�� •� PLUS THE 5.50 STATE SURCHARGE
COMBUSTfON AIR SHALL 8E PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
CITY OF FRIDLEY INSPECTION DIViSION
6431 University Ave NE
Fridley, MN 55432
763•572-3604
RATE SCHEDULE
Residential
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
G—u�- f : �c� ���+--
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Rate TOTAL
$ 30.00 $
$ 10.00 $
$ 10.00
$ 10.00
$ 25.00
State Surcharge
TOTALFEE
Effective On January 1, 2001
JOB ADDRESS �„3/� C�i'�-J� ���j L-�
OWN E R / i`r„_ f%`�fe,. t'
BU{LDING USED AS /�GS.`d�7�.�
ESTIMATED COST ����- � PERMIT N0. � �l
DESCRtPTION OF FURNACE AND OR BURNER
$
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
$ Trade Name }�e�G/v Size No.
�-�% BTU � HP EDR
$ Fuel Total Connected Load
$
$
$ .50
� �. ��
MI(�IMUM FEE FOR ANY HEATING/COOLING/VENTILATION I
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 I
PWS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner. �►y�.�Tv �
��es,'�L° � oi-n e r
�S co, i��� �/
Os.sm, rh� SS�3��i
Burner Trade Name Size No.
BTU HP ED
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes an
rulings of the Building Division, and hereby declares that all the tacts and
representations stated in this application are true and correct.
DATE >- � ��
HEATING CO /�"! ` � � /�`�`�-si d�c.
Signed ,�� ��% �%� TEL # G S/ - G� --3s � /
�� a�
Approved By�� Rough-In Date Final Date 1���'��
BACK SIDE MUS BE FILLED IN ON VENT SIZE, VENT CONNECTORS
AND COMBUSTION AIR VERIFICATION