AF - 43319sue�ecr MIT NO.
City of Fridley o 1796
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
f
; � , RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
, ;� ----- . j �(�3
r � � PROTECTIVE INSPECTION SEC.
1 . i
� ' �"�1 � CITY HALL FRiDLE� BS432 NUMBER REV. DATE PAGE OF qPPROVEO BY
�'""� � ,�� 612-571-3450 9�0-F15 5/�/85 / /
JOB ADDFESS 1425 Creek Park Lane N.E.
t LEGAL LOT NO. BLOCK TRACT OF1 ADOITION SEE ATTACHED
DESCR. �.4 2 EPaCr].dc32 AC�C�1'kl.Ori SHEET
2 PROPERTY OWNER MAIL ADORESS ZIP PHONE
Brickner Builders inc. 6170 Heather Place, Fridley, MN 574-9871
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS Z�P PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CIASS OF WORK
�7 NEW ❑ ADDITION ❑ ALTEHATION ❑ REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 26' x 38' Dwelling and a 22' x 2' G E UIRED FOR
`�IT,;�,, �,�ATif�G, PLUMBWG AND .
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide a hard surface driveway. Pxovide sod,�in the front and side yards.
Provide City with copx of verifying survey before capping.
SEWER LOCATION: (Approx. 11' Deep In street) 20' W. of M.H. (Inv. 880.09)
WYE ELEV: 880.17 TOP OF FOOTIlVG: 883.67 Minimiun
WATER LOCATION: In same trench west of sewer service.
� ����� �
Paid Park Fee of $i, 500. oo g�{�re �igg;�g ca�l I��a� uti��ti�
THE CITY OF FRIDLEY DOES NOT GUARANTEE THE TEL€PHOIVE - E�.ECT#iiC' ��5 ��G�
ACCURACY OF UTILITY LOCATIONS AND ELEVATIONS. R�,����Ep �Y L��,y
7HIS DATA IS FOR INFORMATION PURPOSES ONLY,
AND PERSONS USING TWIS 1NFORM�AT�O{V �HOId1.D.
VERIFY IT �N TW6 �1��►
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOOC�i FY'3Ille
THIS PERMIT BECOMES NULL AND VOID IF WORK OF CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OFi IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WOFK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALIS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PFOVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE F WORK WILL BE COMPLIED lO% � OQO $53 . SO
WITH WHETHER SPECIFIED HEREIN OR T THE GRANTING OF A PERMIT $
DOES NOT PRESU E TO GIVE AUTH IT TO VIOIATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS A Y OTHER STAT OR OCAL LAW REGULATING CON-
TRUCTIO T E PERFORMAN C NST CTION. �4SO. SO $425. 00 CREDIT
� LAN CHECK FEE TOTAL FEE
,, r-- � � � - $112 . 63 $ 616 . �3
ruaE oF CoNTfiACTOR R A ORIZED AGENT IDATEI � WHEN PROPERLY ALIDATED THIS IS YOUR ERMIT
l � ���
SiGNATURE OF OWNERiIF OWNER BUI�DEA� IDATEI BLDG WSP a7E
�N�r I ]
ADDN. [ ]
AI,TER. [ ]
Construction Address:
Legal Description:_...
Owner Na�ne i Address :
Contraetor:
Addreaa • �� `� d
LIVIIiG AREA:
GARAGE AREA:
DECE AREA:
OTHER:
City of Fridley
�R-1 AHD R-2
Building Permit Applieation
Effective u/1/84
L����
Attach to this applieation, a Certificate of Survey of the
lot, With the proposed construction drar�n on it to seale.
DESCRIPTIOa OF IMPROYF•l�NT
Length ilidth Height Sq. Ft. ��ZU
Length Width Height Sq. Ft. �_
Length iiidth Hgt/Ground Sq. Ft.
?/
Corner Lot [] Inside Lot �] Ft. Yd. Setback � 1 Side Yard Setbaek ��
Type of Construetion: �--�- Estimated Cost: � i
��
Approx. Completion Date: r�f �
�p�� pGc/
Alt. A Alt B
proposed DriveWay itidth If NeW Opening Is Desired:�� a �
See Back Page for Explanation
l
DATE: '� � ` �� APPLICANT: ,:: � l-�'�'��`-� Tel . � 'r�y %�7%
Permit Fee
Plan Check
State Surcharge
SAC Cbarge
Park Fee
Se�+er Nain Charge
Tor�.
STIPULATIONS:
j ba o�.
,
CITY DSE O1�LY
� ��, �
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� �
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� � 500. dO
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M
cT�
Fee Schedule on Reverse Side , �
25i of Building Permit Fee � �
•�,
�.50/�1�000 Yaluation
;425 per SAC Unit �
Fee Determined by Engineering
Agreement Necessary [] No� Necessary [ l �
�
�vaa,�- 2�', 6�i �c' 38 = �t'� y� �
a
-� 2,G� �' 13'J� lo�l X4.42: �
0
I� 26x � � R88
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2��.sx���i°��
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�sa. 22,r a3 , s�, x ta, tg =
yV,'�'�,9�
Nb 038p
6� �h �
- �
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' I � I
S• `+��~ r EXTERIOR ENVELOPE AVEF2JIGE "U" COMPUTIITION �
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� OWNER ��/ C i� %V �IZ /'�J U/ G,() E,�S %/�C.
SITE ADDRESS /7 L S� `�CL"�' ���� �.ii'�� —
CONTRACTOR S�%� c p�.�� �' � ~�1 PHONE ��� � `4 �
, . , �
�. • Determine working square footage of each. .�
7 / �
1. Total exposed wall� area ...._ a G/3� sq. ft. x�'� � ��'
' � � � �� .1/
• 2. Total roof/ceiling area ....��� � sq. ft. x_'�_'� �
• ! � �
• Total exposed wall area above floor =
a. Tota1 wall winaow area....� ..........:........... a3S- 2g
. b. Tctal. door area ................................ 3i•6q � �
c. Total sliding glass door area ................... 33• 3 •
• d. Tota1 fireplace wall area.. v —
...................
, e. Total �wall � framing area (average 10/) . . . . . . . . .. . �
, f. Total net wall area above f loor . . . . . . . . . . . . . • • • • � 3 S• 9
� •g. Total rim joist�area ......................•••-•-
, • Total exposed foundation area = �JID _ �
� h. Total foundation window area . . . . . . . . . . . . . . . . . . . . �.�' �O � '
i. Total net foundation a�ea above grade...........��' 3
, . . .
'�H� Determine "U" value of each wall segment.
. : � O `
� a 2 3 .S", 2 g X ��v ,� • � � _ ' . � .
� . • 3�. 6g „ „ . S�� _ °�I• �b � � :
, b. X U _ . .
_ .. 3 3 �g _ ►�•6� . '
c . X ��U �� •
�
. .
� a . y Z x „U„ , °a- �- � _ , ti� � ;
�
� l ��/� � � X „�,, .� . a = 16 • 3 � - �
e. ;
� � f. �G ��.r• q� X „U„ � . a y� _ � S• ` 3 � ;
��,s� . ;
g �, � ! x ��U �� / �� _ . 1.
.
, (' �
� • h. � �J •�a�,' X ��U�� • �� = J �� �
� � i ,s'�.3 X „U„ - . �' �� �3,65�' i
- � .
3 .. ....... . ... ...Total � _ . �O i
. ... ... ....
. . , • . .,
,�
' �_ I � I
'' • -2- .
If item #3 on previous page is the same as, or less than item #1, .
you have met the intent of SBC 6006(c)2.
�� /a6
Total exposed roof/ceiling area = ,,._.
. � , .
j. Total skylight area .......................... •
k.. Total roof/ceiling framing area (average 1Q9�6)
- 1. Total net insulated roof/ceiling area........ �
� � 1 � _
•.. Determine "U" value for each roof/ceiling segment.
� jX ��U., _
.
k� X ��U �� _ � � �
.
' 1 � � X •��U�� . � '� = p���. .,/ •
.
' 4 ..................................Tota1 = ,
\ • '
' If total of #4 above is the same as, or less than #2, you have met
the intent of SHC 6006 (c) 1. • �
� ' Alternate Buildinq_Enveloae DesiQn ;
To u�ilize the total envelope system method, the values established
. by the sum of items #3 and #4 sball not be greater than the sum �
• of items #1 and #2. •- '
, � 1.� +2. _
3. +4. �
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� � ' �� SUB�ECT � .. � � " � � IT NO.
c�ty of F��a�ey l3 i�56
AT TME TOP OF TME 7WINS ��J � L D 1 N� P E R M I T
r
RE EIPT NO.
� � /,.
� • COMMUNITY OEVEIOP�ENT DIV. y�L_3�04 /��
VV������
r � � PROTECTIVE INSPECTION SEC. ��
� �
� � �"'1 � CITY MALL FRIDLE� SS1�2 NUMBER pEV O�TE v�GE O: �PVROvEO Bv
�'""�" ,'' 612-571-3450 910-F t 5 5/ 29 / O 1 / /
JOB AODRESS 1425 Creek Park Lane NE �
t LEGA� LOT NO. BLOCK TRACT OR ADOITION SEE ATTACHEO
oescR. 14 2 Creekridge Addition SHEET
2 PROPERTY OWNER MAIL ADORES$ Z�P PHONE
Lisa Archer 1425 Creek Park Lane NE 763-574-9210
3 CONTRACTOF MAIL ADDRESS ZIP PHONE LICENSE NO
M J Lodermeier Construction 8421 Center Dr, Minneapolis, MN 55432 763-717-2327
a ARCNITECT OR DESIGNER MAIL AODRESS ZIP PMONE UCENSE NO.
20112515
5 ENGINEER MAIL ADORESS ZIP PHONE UCENSE NO
6 USE OF BUILDING
Residential �
7 CLASS OF WORK
❑ NEW O AD�ITION � ALTERATION l� REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof House & Garage (26 Sq) Tear-off; partial reside of house
9 CHANGEOfUSEfROM TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires that a weather
resistive barrier be placed over exterior sheathing to protect the interior
wall covering. Exceptions for this provision would be if sheathing is an
approved weatherproof panel or when the siding is an approved weather
barrier. VinyZ siding is not a weatherproof coverir.g unless the mar.ufacturer
states this in their application guidelines. Call for inspection of wrap
before covering. Underlayment must comply with the State Building Code.
TYPE C/f CONST. OCCUPANCY GROUP OCCUPANCV IOAD
SEPARATE PERMITS ARE REOUIfiEO FOR ELECTRICAL. PLUMBING. HEATING.
VENTI�ATING OR AIR CONDITIONING. � � �
THIS PEHMIT BECOMES NULI AND VOID If WORK Oii CONSTRUCTION ZONING SO. fT CU FT
AUTMORIZEO IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONS7RUCTION
OR WORK IS SUSPENOED OR ABANDONEO fOA A PERI00 OF tY0 OAVS A7 '
ANV TIME AFTER WORK IS COMMENCED. ' NO DWLG. UNITS OFPSTREET PARKING
I HEREBY CERTIFV THAT I MAVE READ AND EXAMIN�O TMIS APPLICATION 1 STA��S GARAGES
ANO KNOW THE SAME TO BE TqUE AND GORRECT. ALL PAOVISIONS Of IAWS VAWATION SURTA%
AND OROINANCES GOVERNING THIS TVPE Of WORK WILL BE COMP�IED $6 � OOO �3.00
W�TM WHETMER SPECIFIED HE OR NOT. THE GRANTING OF A PERMIT
OOES NOT P ME AUTMORITY TO VIOLATE OF CANCEL THE pEqMIT fEE SAC CMARGE
PROViSlO Y OT STATE OR LOCAI LAW REGUTATING CON-
rau T N a u TION $125.25 Fire SC $6.00
P4AN CNECK FEE TOTA� FEE
License $5.00 $139.25
OTUQE O� CON'PACTOQ OQ oUTMOA�ZEO AGENT �D�iEi EN ROP UDA THIS IS Y UR PEFMIT
� -D
$�GNOTU�7E O� OWNEQ��� OwHEQ Bu�LOEQ� �OATE� ' � Bl � �NS� � � r���E
NEW ( ]
ADDN
ALTER
Effective 5/10/99
[ ] CITY OF FRIDLEY
[] SINGLE FAMILY A1�1D DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: � ��5 � � �� � �� � � �j � (/� / Yj'111� �.SL/� �
Legal Description: �
�� .
Owner Name & Address : Lr S C� �✓���� Tel. # 1�O3- 5-1 `� -�a/0
Contractor: ����' I�Y1 P.+ 'u' �',�C.�1 �-�[�-i �9f 1 MN LICENSE # aD I/ a.S75
Address: ��� I C�'�'A� �. �'1 L.h YI D.C� b'Li S YYNV 55�-f �1 Tel. #, lo ��(-1 ���
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
Length
Length
DESC:�IPTION O�' IMPROVEMENT
«
Width
Width
Width
Height
Height
Hgt/Ground
, , . „
Sq. Ft.
Sq. Ft.
Sq. Ft.
► �Y i �r<�-��
Construction Type: ��� ��P�j'1Q,1� Q���� Estimated Cost: $ ��d, (�Q
,
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$
_$
DATE: �--��� .� 1 APPLICAN'T: � � Tel. #
Permit Fee
Fire Surcharje
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS :
$ ��S��df
� - .<i�
$ ��UC�
$
$ - � C�
$
$
$
$
� �� 1��2.5`"
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Perm.it Valuation (1/1Qth%)
$.50/$1,000 Valuation
$ l O5Q 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 [ ]
,,.�,
��a. t�� . us�3
✓
sue�eCT PERMIT NO.
City of Fridley 32294
AT TME TOP Of THE TWINS g � � L D I N G P E R M I T
r
; � RECEIPT NO.
� �ti: ------
COMMUMITY OEVEIOPMENT pIV. /��
r � � PROTEC7IVE INSPECTION SEC.
i . ,
� � �"'1 � CITY HA�L FRIOIE� 55132 Nuk�BEA pEV D�TE P�GE OF �PPnOvEO 8r
�'""�" �'' b12-571-3450 910-F15 11/1/O1 / /
10B ADDRESS 1425 Creek Park Lane
1 IEGAL �OT NO. BLOCK TRACT OR AODtTION SEE ATTACHED
DESCR. 1/a. 2 Creekridge Addition SHEET
2 PiiOPERTY OWNER MAIL AOOR�SS 21P PMONE
Lisa Archer/John King, 1425 Creek Park Lane, Fridley, MN 55432 763-574-9210
3 CONTRACTOR MAIL ADDRESS ZIP PMONE LICENSE NO
SeanXXX Schimmelman Contractin , 6230 152nd Ave NW Ramse , MN 763-464-0616
a ARCHITECT OR DESIGNER MAtL AOORESS ZIP PHONE LICENSE NO.
20276402
5 ENGINEER MAII AODHESS ZiP PHONE UCENSE NO
6 USE Of BUIIDING
Dwelling
7 CIASS OF WORK
(g NEW O ADDITION ❑ ALTERATION ❑ REPAIii O MOVE O REMOVE
8 OESCRIBE WORK
Install new windows
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the dwelling
per Section 310.9.1.2 of the Uniform Building Code. Caulking and flashing for
all exterior openings.
TYP�OFCONST, OCCUPANCYGROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REOUIRED FpR ELECTRICAI. PLUMBING, NEATING.
VENTILATING OR Aiq CONOITIONING. �
THIS PERMIT BECOMES NULL AND VOID IF WOiiK Oii CONSTRUCTION ZONING SO. fT CU FT
AUTMORIZED IS NOT COMMENCED WITMIN 60 OAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANQONEO fOR A PERIOD OF 120 DAYS A7
ANV TIME AFTER WORK IS COMMENCED. ' NO DWIG. UNITS O�FSTREET PARKING
I NEREBY CERTIFV THAT 1 MAVE AEAD ANO EXAMIN�D TMIS APPLICATION STA��S GARAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PqQVISIONS OF �AWS yq�UAT10N SURTA%
AND ORDINANCES GOVERNING 7HIS TVPE OF WORK WILL BE CpMPUED $3 � 2OO . OO ' � 1. C)O
WITH WHETHER SPECIFIED HEREIN OH NOT. 7HE GRANTING OF A PERMIT
OOES NOT PR UME 10 GIVE AUTMORITY TO V�OLATE OR CANCEL THE pEpMIT FEE SAC CHARGE @
PROVISIONS ANY OTHER STATE Ofi LOCAI LAW REGUTATING CON- $97.25 Fire SC y�3.2O
STAUCTION TME PERFORMANCE Of CONSTRUCTION
PLAN CNECK FEE T iAL FEE
� � �� �� �o� License 5.00 $107 5
N4TU�7E O� CON"QACTOQOA oUTHOAIjED pGENT ip�rE� N PR ERLY LI ATED T I IS VOUR aERMir
/� "/��%
S�Gr�nTUAE O� OWNEA��F OwHEpBW�DEA� iD�iE� ' B�DG � �� � ��`�E
N�/ [ � Effective 1/1/2001
ADDN [ j . CITY OF FRIDLEY .(763) 572-3604 Bldg Insp
ALTER � SINGLE FAMiLY AND DUPLEXES R-1 AND R-2
BUII.DING PERMIT APPLICATION
Construction Address /y�� «�"� p�`-'�- � �
Legal Description:
Owner Name � Address: � s/� I�c�'��� n t�'''� l,��,•,- Tel. #�`/ -��� °
Contractor: ���^�' Sc�.-�r^^��.�� ��,.� a�+.�T,�� MN UCENSE # � d�
Address: .6 � � � � 5 a^r� .d��•2 � �.,r �2.�.-s� c���el. # yG �I ' � � � 4
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.
l.ength Width HgUGround Sq. Ft.
Construction Type: -� ^�4��� w�-^��-� S Estimated Cost: $ �a 0`�� u�
Driveway Curb Cut Width Needed: Ft. + 6 F= Ft x� _$
�
DATE: �l � � APPLtCANT: �- �"�--- Tel. # � �� `% � � � � � < <p
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Controi
Park Fee
Sewer Main Charge
TOTAL
STI PU LATI ONS:
Call (763) 572-3604 fo� Permit Fees if mailing in application
$ ��°� � Fee Schedule on Reverse Side
$ ���v .001 of Permit Valuation (1/10th%)
$ /, (00 $.50/$1,000 Valuation
$ $1150 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 [ ]
s� � 67• D-�
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sue�et* PERMIT NO.
City of Fridley 323� 1
AT THE TOP OF THE TWINS g u� L D I N G P E R M I T
r
� ` RECEIPT NO
.
COMMUNITY DEVELOP�ENT DIV. / �
r � � � PROTECTIVE INSPECTION SEC. ���'1
� � �/
i ,
l----�'��'�';'� CITY HALL FRIOLE� SSI,�Z NUMBEp pEV OAfE � PAGE Of AVP/iOVED 8�
L 612-571-3450 9i0-Ft5 11/28/O1 / /
JOB ADDRESS 1425 Creek Park Lane NE ,
t LEGAL ��T NO. BLOCK TRACT OF ADDITION SEE ATTACHED
oescA. 14 2 Creekridge Addition SHEET
2 PROPERTV OWNER MAII ADpRES$ Z�P PHONE
Lisa Archer/John King, 1425 Creek Park d�ane Fridle MN 55432 763-574-9210
3 CONTRACTOF MAIL ADORESS ZIP PHONE UCENSE NO
Sean Schimmelman, 18760 Periodot St NW Burns Townshi - 64-0 6
a ARCHITECT OR DESIGNER MAIL ADDRESS ZtP PNONE LICENSE NO.
20276402
5 ENGINEER MAIL AODRESS ZIP PHONE UCENSE NO
6 USE OF BUIl01NG
DW2111YLg
7 CIASS OF WORK
O NEW O ADDITION � ALTERATIQN ❑ REPAIR O MOVE O REMOVE
8 �ESCRIBE WORK
Finish basement
9 CHANGEOFUSEFROM TO
STIPULATIONS
See notations on building plans.
TYPEOFCONST. OCCUPANCVGROUP OCCUPANC`/IOAp
SEPARA7E PERMI7S ARE REOUIRED FOR ELECTRICAL. PLUMBING. HEATING,
VENTILATING OFt AIR CONDITIONtNG
TMIS PERMIT BECOMES NUII ANO VOIO IF WORK OR CONSTRUCTION ZpNING SO. fT CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR If CONS7RUCTION
Oli WORK IS SUSPENOED OR ABANDONED FOR A PER100 OF 1�0 DAYS A7
ANV TIME AFTER WORK IS COMMENCED. ' NO DWLG. UNITS OfFSTREET PARKING
I MEfiEBY CERTIFV TNAT I MAVE READ ANO EXAMINEO THIS APPLICA710N STALLS GARAGES
AND KNOW THE SAME TO BE TRUE ANO COPRECT. ALL PROVISIONS Of LAWS VALUATION SUfi7AX
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILI QE COMPUED � 1(} � OOO ' �7.00
WITM WHETHER SPECIFIED MEREIN OR NOT TME GRANTING OF A PERMIT
DOES NOT PR UME TO GIVE AUTMORITY TO VIOLATE OR CANCEI THE pERMITfEE SACCHARGE
PROVISIONS ANY OTHER STATE OR LOCAL lAW REGUTATING CON• $237.25 Fire SC �L�F.00
$TRUCTION ti TME PERfORMANCE OF CONSTRUCTION
P�AN CHECK FEE TOTA� FEE
L �--� L��e�se $5.0 $263.25
S�GN4TUFIE OF CON'AGCiOQ OA �UTMOQ�ZED AGENT iD�rE� HEN OPERLV VALIOATED TMIS i5 �OUR EFMi
S�GHntuAE O� OwaEQ ��t OwNEa Bui�OEp� iD�TE� . � OG%'�NSo � �� F
N�/ [ � Effective 1/1/2001
ADDN (] , CITY OF FRIDLEY .(763) 572-3, Bidg Insp
ALTER (�. SINGLE FAMILY AND DUPLEXES R-1 AND R-2 1
BUILDING PERMIT APPLICATION � �t,1 •
G;. �l a
Canstruction Address: `�a� c ��,�, ,� +Q � .-�
Legal Description:
Owner Name 8 Address: �<5�- /�'-��- b«� �w4 Tel. # 7�3 s`"Zy �'��°
Contractor. ��^J s� � �^•�..�� ,..�� ��^ � �-�-t-.^�c- MN UCENSE # o��' a- 7 � � o�
Address: l�'? �� %��►��- �r- �t� l���s ru-i" Tel. # 163 y�'-! e�� �
. S-s3 � 3
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length VVdth Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length VVdth HgUGround Sq. Ft.
OTHER:
L� c�G d RI�-�a.r-�"i--- �-cc �kCdYC� �N CQ��
Construction Type: � Estimated Cost: � /�'°° �
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x� _$--�
L%��
DATE: / 13 °� A��LICANT:
c� l----� Tel. #�� � O(c' � t°
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $ �. Fee Schedule on Reverse Side
Fire Surcharge $ C7 .001 of Permit Valuation (1/10th%)
State Surcharge $ �, � O $.5Q/$1,OOQ Valuation
SAC Charge $ $1150 per SAC Unit
License Surcharge $ ��� OD $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ A{t. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not Necessary []
TOTAL S oi �.J � ��
STIPULATIONS:
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PROJEGTSGOPE: BASEMENTFINI5H
NAME: LISa ARGHER & JOHN KIN6
ADDRE65 1425 GREEK PARK LANE
FRIDLEY
HOME #'163-5'f4•9Z10
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\' THIS DOGUMENT 15 THE PROPERT' OP
l¢EGAL BUILDERS 8 REMODELER5,ING
4NY DUPLIGATfON OR U5E 15 STRIGTLY
'ROHIBITED WITHOUT EXPRE55 WRITTEN
:ONSENT. NO REPRESENTATION OR
NARRANTY 15 MADE k5 TO THE DE51GN OI
DRAPTING. ALL DIMEN510N5 AND
3TRUGTURAL DETAILS MU5T BE VERIFIED
PRIOR TO 60NSTRUGTION.
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
763-572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On Jan 1, 2001
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
New Fixtures
Old Opening, New Fixture _
Beer Dispenser _
Blow Off Basin
Catch Basin
Rain Water Leader _
Sump/Receiving Tank _
Water Treating Appliance _
Water Heater -Electric
Water Heater - Gas*"' _
Gas Range*" _
Gas Dryer'"� _
Back Flow Preventer Required ()Yes () No
Tvpe
�
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
�/, D�
0
$ ���s�
JOB ADDRESS f � °'� �
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.
, 2oo°Z
Owner
Building Used As�Q,.G �—�,-�.. _r� , _
/ �.� r
Estimated Cost /�� � PERMIT NO. /-�� ��
c �,[
PLUMBING COMPANY°� � G� / /
SIGNED BY
Approved By
Rough-In Date
TEL N0: `02 ' � � ��
Finaf Date � � � 3 '� �'
COMBUSTION AIR SHALL BE 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 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENT{LATfON,
(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 �%a�2 ,'-� � �l �g--
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work
Commercial/Industrial
1.25aJo of Value of Appliance or Work
Rate TOTAL
$ 30.00 $ 3.�, tc��a
$10.00 $ !�d-�'�
$ 10.00 $
$ 10.00 $
$ 25.00 $
$
$
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATINGICOOLING/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
$ o, S-�
Effective On January 1, 2002
JOB ADDRESS �' �d �' �cu'�u� D,a�� L �
OW N E R �r S,6� r',1 Q�- r-/-�3:L-�
BUILDING USED AS /'�" ^^�.,
ESTIMATED COST
PERMIT NO.���
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units_� Circle One (Steam) (Hot Water) rm Air
Trade Name �a-��.. Size No. �o �� �-� `
BTU HP EDR
Fuel Total Connected Load
Burner Trade Name Size No._
BTU HP ED
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do alt 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 app{ication are true and correct.
DATE % o�� �iZ
HEATING CO �� �G��"L�J C���'�'�
Signed �- � � TEL #� Cp�' 4� ��% 6�0 1 C�
FAX # � 1O �'`� a"' 4f �' 1 f�
Approved By Rough•In Date
�J
�
Final Date Co "�J' • ��
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
s�i-36u4 r�ax:
: 1425 CREEK PARK LN NE
: 133024130083
: CREEKRIDGE
: LOT 14 BLOCK 2
: BUILDING
: RESIDENTIAL
: ADDITION/ALTERATION
s�i-iz��
--.
PERMIT O.: 2004-01171 '
DATE ISSUED: 07/28/2004
VALUATION : $ 36,576.00
NOTE: SEE NOTATIONS ON PLAN.
CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS.
PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE
2000 INTERNATIONAL RESIDENTIAL CODE. CONSTRUCT A 22' X 16' ADDITION AND REMODEL KITCHEN.
STATE LICENSED CONTRACTOR 1
APPLICANT
COX CONTRACTING LLC (20319491)
5925 POLAR BEAR LANE
WHITE BEAR TOWNSHIP, MN 55110-
OWNER
KING JOHN K& ARCHER LISA M
1425 CREEK �'ARK LN NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after wark is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of wor�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
re ulat' cons tion or the erformance of constructi n.
g P
Applicant Date
Bldg Insp
SEPARATE PERMITS
BUILDING PERMIT FEE
PLAN CHECK FEE
FIRE SURCHARGE
STATESURCHARGE,VALUE
LICENSE SURCHARGE
TOTAL
PAID WITH CHECK # 4968
, .
) FOR WORK OTHER THAN DESCRIBED ABOVE.
512.45
333.09
36.58
18.29
5.00
905.41
� ��°�l1'Z� ,���03�
NEVN [] CITY OF FRIDLEY ����� � Effective 4/1/2004
ADDN [] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bidg Insp
ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPUCATION
�q- aS^ c 2 r-_ r t� P,��.�c � r� , �� � o�. r s�q 3
Construction Address: y . ra'I �
Legal Description:
Owner Name & Address �0 4.+v d- L. t S,A �L� rv� —f��te(' Tel. # ZG 3� 5'�% �` ^�l ��v
Contractor. (' oC �'�rc�TQr�-c �' � �t1 G L �L- ,C' MN UCENSE # � ,� 4 � [ °j �-� I
Address:�Zj'as'� P� l�� (3 �� 2 �-rv t,.-f 11-. (�2. Lcc.. N��nl ��OTeI. # GS �- C s�3r?7�f�f-
Attach to this application, a Certificate of Survey of the
bt, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
< < S�� �Ss 7�,�
LIVINGAREA: Length �-� Width (G Neight��,_ Sq. Ft. 3 Y-�'
GARAGE AREA: , Length Width Height Sq. Ft.
DECK AREA: Len th--�— Width HgUGround Sq. Ft. �
OTHER: ��`� �i Ir`�e--� �� C! � 6
N G �✓ c4 Ycct ��n1
Construction Type: �� A I�(1-�k-r�� — R"�� < i�N Estimated Cost: $� � �� S�7�
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ ( _$ `�1�
DATE: ? "" Or�"� �APPLICANT: �oL Tel. # �S✓�"��'���'
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credi��i nd we will call
you for card number. � �Q�
CIN USE ONLY - v
�.
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ ���•'�%Sf
$ �� ��3 �G )
.P <� � � ,�C
� 1� ���
$
$ �. l.+0
$
$
$
$
$ _��RJ - I
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 per SAC Unit
$5.00 (State Licensed
Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [
STIPULATIONS:
— INSTALL NEW r — (3) AWNING
WDW UNIT � STYLE WDWS.
�k--- 5'-Z"----�-7 �- 5,_Z„_,_� 3�_ 1 ��
I I� _ i !
�4� 2,. X s,. � I � �%�� 'i\
WQ. POST � �--^-
EACH StDE � W �1- � � t'�t�C;� ? ('�' ! �
I �r I�
�� �� .
I �
I- ��
10" TGI PI�R. JSTS.
FLR.JST�.76" O.C.
�I
�
�,
UNE OF � � _FAMILY ROOM
EXISTINO �
STRUCTURE i
ABOVE � REMOVE EXIST.
� i CANT. SECTION
SEE SHEET � (4) 2" X 6"
1 of 5 FOR I� WD. POST
REMODELING � EACH SIDE
ON THE 1 ST
FLOOR ( � RE-INSTALL
REMOVE PATIO
DR. �NSTAIL
NEW WDW —
� EXIST. 5' PATlO DR. ;'�
� iI
___J
� 7x j�li�i.i Gf��:1K;Sfi�'–�''
I i
o,�--- �}�-o"--- �
<t
I
FACE OF EXIST. I
FOUNDATION �
I
— 16'-�"--�--- ---�'
1 ST FLOOR PLAN _
SGALE: 1 /4" =1'- 0"
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M
PATTISON & ASSOCIATES IDATE: 02/13104 j��HN 8� LISA KING—ARCHER
1425 CREEK PARK LANE
2711 VERA CRUZ AVE. S. iDWG NO: 4A OF 5 FRIDLEY, MN 55432 (763)574-9210
CRYSTAt, MN 55422 (�ss� a� �-s2ss _ _ _ _ __.-- — -- -
I
�
r
INSTALL NEW �r-- (3) AWNING
� WDW UNIT i STYLE WDWS.
�-__ 5,_Z„ 5�_2„_� 3,_ � „�.
� � _ � �I
'`,%/ ��
(4) 2�� X s�• %� I
EACHSIDE� I Y,,��-3� '��"?; ��
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►
- ,
10" TGt F4' R. JSTS.
FLR. JST$.16" G1.C.
i
I
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�,;
UNE OF � � FAMILY ROOM_
EXISTINO
STRUCTURE I i
ABO� REMOVE EXIST.
� CANT. SECTION
SEE SHEET ' � (4) 2" X 6"
1 of 5 FOR I� WD. POST
REMODELING EACH SIDE
T
ON THE 1 S
FLOOR
REMOVE PATIO
DR. INSTALL
NEW WDW —
�
RE-IN:
EXIST.
FACE OF EXIST.
FOUNDATION
N
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— 16._�„ --'�
1 ST FLOOR PLAN
SCALE: 1/4" =1'- 0"
PATTISON & ASSOCIATES �°ATE: ' JOHN 8� LISA KING-ARCHER
02113I04 1425 CREEK PARK LANE
2711 VERA CRUZ AVE. S. IDWG NO: 4AOF 5 FRIpLEY, MN 55432 (763)574-9210
CRYSTAL, MN 55422 (�ss) a�7-s23s �_ __ _� __ ---- - -- -
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FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
COVER SHEET
TO:
FROM: Inspection Division, City of Fridley, 763-572-3604
Ron Julkowski, Building Official
Dave Jensen, Building Inspector
Mary Hintz, Permit Technician
DATE:
Page 1
.
�_ �
CONTRACT INSPECTORS:
Bob Clauson, Electrical Tnspector
Kevin Hanson, Mechanical Inspector
Terry Overacker, Plumbing Inspector
NOTE: Please call if all pages have not been properly received.
RE5check Compliance Certificate
2000 IECC
REScheckSoftware Version 3.6 Release 1
Data filename: Untitled.rck
PROJECT TITLE: King/Archer Residence
CITY: Fridley
STATE: Minnesota
I-iDD: 7391
CONSTRUCTION T'YPE: Single Family
WINDOW / WALL RAT10: 0.16
DATE: 07/O1104
DATE OF PLANS: �'ebruary 13, 2004
PROJECT DESCRIPTION:
Addition kitchen
DESIGNER/CONTRACTOR
Deane Schwalenberg/Cox Contracting LLC
COMPLIANCE: Passes
Maarimum UA = 107
Your Home UA = 106
0.9% Better T'han Code (UA)
Ceiling 1: Flat Ceiling or Scissor Truss
Watl l: Wood Frame, 16" o.c.
Window 1: Vinyl Frame:Double Pane with Low-E
Floor l: All-Wood JoisdTruss:Over Uncondirioned Space
Craw12: Masonry Btock with Empty Cells
Wall height: 4.0'
Depth below grade: 3.6'
Insulation depth: 4.0'
Furnace 1: Forced Hot Air, 78 AFiTE
Air Conditioner 1: Electric Centra] Air, 10 SEER
Permit Number
Checked By/Date
Gross Glazing
Area ar Cavity Cont, or poor
erimeter R-Value R_Value U-Factoi �$
352 38.0 0.0
432 19.0 0.0
70
432 8.0 0.0
216 0.0 10.0
11
22
0.29(? 20
38
15
COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building pfans,
specifications, and other calcutations submitted with the permit application. The proposed building has been designed to
meet the 2000 I$CC requirements in RES checkVersion 3.6 Release 1(formerly MECehe�� and ttf comply with the
mandatory requirements listed in the RES checkInspection Checklist.
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1. CONJRACTOR IS RESPONSIBLE FOR'►xE YERIRCATiorv oF '
A(1 Dr�V1�NS/ON5 AND E?OSi1N�i CONDITIQNS Pi{iQR TD START
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PATT�SON &�SS+�G/ATES DA7F' � JUHN & I�i�SA KiNG-ARCHER
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ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
�631572-3604 FAX: (7631571-1287
: 1425 CREEK PARK LN NE
: 133024130083
: CREEKRIDGE
: LOT 14 BLOCK 2
: ELECTRICAL
: RESIDENTIAL
: ADDITION/ALTERATION
PERMIT NO.: 2004-01647 ��
DATE ISSUED: 09/22/2004
VALUATION .
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL 10 CIRCUITS IN
KITCHEN REMODEL AND ADDITION.
# 0-100 AMP CIRCUITS 10
APPLICANT
COUNTRYVIEW ELECTRIC
8414 165 AVE NE
FOREST LAKE, MN 55025
OWNER
KING JOHN K& ARCHER LISA M
1425 CREEK PARK LN NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of wor�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Applicant Date
Bldg Insp Date
ELEC CIRCUIT FEE (0-100 AMPS)
STATE SURCHARGE, ELEC FLAT
TOTAL
PAID WITH CHECK # 4142
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
60.00
0.50
60.50
CITY.OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fr;dley, MN 55432
(763) 572-3604, FAX (763) 571-1287
Effective April 1, 2004
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
���
.� �
�
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
'v'Vater Treating Appliance
Water Heater -Electric
NO. RATE TOTAL
Water Heater - Gas"'`
Gas Range""
Gas Dryer`"`
Back Flow Preventer Required ()Yes () No
Type
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
$35.00
$35.00
$35.00
$10.00
$10.00
J
$15.00 �� �
Reinspection Fee $50.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
$ .50
$ l-5 � v�`"�
�
JOB ADDR
���
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.
DATE: � � ��� , 20 � `�
OWNER
BUILDING USED AS `�— �S ��g�sz c'
ESTIMATED COST PER T NO. ��� l��I �/
�% / .
PLUMBING COMPB�,N 7�c</,A��' �.�/ c��J�iv� c:.¢- �_
SIGNED
Approved By
Rough-In Date
TEL NO.Z��-- �;� � ��,� �
Final Date
COMBUSTION AfR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. �*PROVIDE COMMON VENT INFO ON BACK SlDE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-36U4 1+'AX: (763) 571-1"Lif7
_ __y
PERMIT O.: 200401607
DATE ISSUED: 09/15/2004
ADDRESS : 1425 CREEK PARK LN NE
PIN : 133024130083
LEGAL DESC : CREEKRIDGE
: LOT 14 BLOCK 2
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION : $ 0.00
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL ONE SINK.
# ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE
# NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS
# GAS DRYERS 0 # GAS RANGES
# OF NEW FIXTURES 1 VALUE (FOR MINIMUM CALC)
# WATER TRMT APPLIANCES 0
APPLICANT
GATEWAY MECHANICAL INC
13950 RADNM ST NW S
RAMSEY, MN 55303-
(763)433-2662
OWNER
KING JOHN K& ARCHER LISA M
1425 CREEK PARK LN NE
FRIDLEY, MN 55432
PLBG PERMIT MINIMUM FEE
PLBG FIXTURES (NEW OPENINGS)
PLBG FIXTURES (EXIST OPENINGS)
WATER TREATMENT APPLIANCE
WATER HEATER - ELEC
WATER HEATER - GAS
GAS R4NGE FEE
GAS DRYER FEE
PLBG REPAIR/ALTERATIONS
STATE SURCHARGE, PLBG FLAT
TOTAL
PAID WITH CHECK # 9289
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if wark ar construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time a8er work is commenced.
I hereby certify that I have read and examined this
application and know 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
granting of a permit does not presume to give authority to
violate ar cancel the provisions of any other state or local law
regulaf� con ction or the performance of construction.
Annlicant \ Date /
Bldg Insp
c
)�
CFPARATF PFRMTTC RFfITTTRFII F(1R W(1RK C1TNF.R TAAN I�F.SCRTRF.17 ARnVF,
0
0
0
0
15.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.50
15.50
0
CITY Os,F FRIDLEY INSPECTION DIViSION
643T University Ave NE
F��idley, MN 55432 APPLiCATtON FOR POWER PLANTS AND HEAi'tNG, COOLING, VENTILATION,
(763) 572-3604 REFRIGERATION AND AIR CONDITIOMNG SYSTEMS AND DEVICES
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Afso 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% of Value of Appiiance or Work
Commercial/Industrial
1.25% of Vafue of Appliance or Work
Rate 70TAL
$ 30.00
$ 10.00
$ 10.00
$ 10.00
$ 25.00
State Surcharge
TOTALFEE
MINIMUM FEE FOR ANY HEATING/COOLING/VEtdTILATION
REFRIGERATION/AIR CONDITIONING PERMIT 1S 25.Q0
PLUS 7HE .50 STATE SURCHARGE
REINSPECTlON FEE $47.00/Hr
$
$
$
$
$
$ ,,_9�
J08 ADDR
OWNER �ii�.sc. ��
BUfLDING USED AS � `�%.��
Effective On January 1, 2002
,��
y�`'� R5��2
: � __` _ V � � �y�/�
ESTlMATED COST���(�'�_�r,J PERMlT N0. '
DESCRIP71uN OF FURNACE AND OR BURNER
No. of Heating Unit�/ Circle One (Steam) (Hot Water) (Warm Air)
irade Name �c�:-t� � � �•` Size No.��
BTU ��,,;.� MP EDR
Fuel � (�s Total Connected Load '
Burner 7rade 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
$ :50 rulings of the Building Division, and hereby declares that a(I the facts and
representations stated in this application are firue and correct.
$_�.�ti
DAT ��ld'/uy
A�iieQ rireside
H EAT I N G CO dba Fireside Hearth i Home �
' icanco $20090911
2700 N. Fairview Ave.
RoseviNe, MN 55113
Signed �5,�sa3-zss� TEL #
FAX # _�
,*Air Conditioners can not be placed in a side yard without Approved By� ��� �ough-In Date Fina!'Date
written permission from adjoining property owner.
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
57Z-36U4 r'AX:
: 1425 CREEK PARK LN NE
: 133024130083
: CREEKRIDGE
: LOT 14 BLOCK 2
: HEATING
: RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
571-1Zii7
�. _-�
':
PERMIT N� 2004-01942
DATE ISSUED: 10/21/2004
VALUATION .
NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM
ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A.
INSTALL GAS PIPING FOR FIREPLACE.
# A/C UNITS 0 VALUE OF APPL OR WORK 0
#FURNACES
# GAS RANGES
APPLICANT
FIRESIDE HEARTH & HOME
2700 N FAIRVIEW AVE
ROSEVILLE, MN 55113
OWNER
KING JOHN K& ARCHER LISA M
1425 CREEK PARK LN NE
FRIDLEY, MN 55432
0 # GAS DRYERS
0 VALUE (FOR MINIMUM CALC)
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of worh
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating�.onst�uction or the performance of construction.
Applicant `=-...4', Date
Bldg Insp � ,�,�'�/�__ . Dat�1��(
HEATING PERMIT MINIMUM FEE
FLJRNACE SHELL/DUCT WORK
GAS RANGE FEE
GAS DRYER FEE
AIR CONDITIONING FEE
HEATING REPAIRS/ALTERATIONS
STATE SURCHARGE, MECH FLAT
TOTAL
PAID WITH CHECK # 112940
0
1100
25.00
0.00
0.00
0.00
0.00
0.00
0.50
25.50