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AF - 43231r.. BUILDING PERMIT village of Fridley, Min.n. N° 250� Date ......., r��"+�.ir'�":'. �.•'.�....��''.'�.�.vdJ.'I�.. �'�'�'�r' .. . �".�� Er ' * Builder �+��,�r� . . . . . �. .��'?�'�' � ;,.- Owner . . . ��;�C,.�:�r.� . . . . . . . . . . . . . . . . . .�� Address . . .le. �+,��,:+,��, .7 . .�. � .. '. ..-. !� .� Address . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . LOCATION OF BUILDING No. . . . �.�� . . . Street . . .��r3:i�� . . . . . . . . . . . . . . . . . . . . . . . Part of Lot . . . . . . . . . . . . . . . . . . . . . . . Lot................ Block .....e.......... Addition or Sub-Division ....................................... Corner Lot . . . . . . . . . . . . Inside Lot . . . . . �. Setback . . . . . . . . . . . . Sideyard . . . � � . .�. .'�. .� . • DES�CRIPTION OF BUILDING To be sed as: ,�� . . . :�:': . . !'� Front . � .'��. Depth . ��. Height . . . . . . . . . Sq. Ft. � Cu. Ft. . . . . . . . . � .................... Front ........ Depth ........ Height ......... Sq. Ft. ........ Cu. Ft. ........ Type of Construction .��:?'''��'Est Cost ...:.`...,�.��... To be Compieted .�.+�f��':�!�� ,�� .Z�% "�t�� .��:.�� t'.�.' � � a. � ��t�� e In consideration of the issuanee to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the village of Fridley. ,/ t � � r . �". x:',��'::.'`tdn ��:>� . . �r""��a:•:.�*.4�...... . s (�� I,n�, �c,onsid 'hao payment of a fee of $.'�.'. .� pernut is hereby granted to .��rScs'��.. ... ....�r�'" "*'. .��:'��".��. C��o construct the building or ad dition as described above. This permit i5 granted upon the express condition that Y.he person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, sha11 conform in all respects to the ordinances of �ridley, 1Vlinnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limiYs and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ,� ,, �.z.�.�:.. NOTICE: �'' This permit does not cover the construction, installation or alferation for wiring, plumbing, gas hea4ing, sewer o� water. Be sura to see the Building Inspector for separate permits for these Ytems. ,•��, � �' --�ir� � r^, City of Fridley, Minn. BUILDING PERMIT Date: �Y 12, 1965 �y � �� N° 8174 Ovvner: VTNG".L1�1T MARTIDTILLE Builder �• R. ANDERBERG COMQANY ,� 115 Crown. Road N. E. Ad� 2923 Oaklan.d Qven.ue Fridlev 21 Minnesota Minneapolis+ Mianesc�ta LOCATION OF BUILDING No. ris s,�t �owN Roan �v.E. Part of Lot Lot Sl�k Coraer Lot Inside Lot Sewer IIevation Addition or 3ub-Div9sion Setback � Sideyard � Founda.tion IIevation To be Used as: Front Front 1�►pe of Construction DESCRIPTION OP BUILDING Depth Height Sq. Fk Depth FTeight Sq. Ft. ��, ��C 6 000 _ QO To be Completed Cu. FL Cu. Ft STORM REPATR DAMAGE In ca�slderation of the issuancae to me of a permft to construct the building described above I agnee to do the proposed wark fn accordance with the d�script3on above set forth and in cbmpliance with a'11 provlaions of orclinanoea of the dty oP FricIIey. ., ,� .O_ , Ia cam�deration of the �yment of a fee oP $ 10• �� , permft fa herebY graated to 0� R. ANDERBERG CO., INC. to conatruct the building or additfon as described above. This permit ia gra�rted nPon the eapress condition that the peraon to whom it ia granted and hfs agents, employees and workmen, 9n all work done 1n. around end upon eaid buildir►g, or any part thereof, shall conform fn all respecta to the ordinancee of Fri�IIey� Minnesota regardiag lacation, conatruction, alteration, mafntenance, repair and � of buildin�s within the dty ]imits and thia permit m&Y be r�voked at any t�me upan violatfon oY aay of the Provisiona Bsid ordinanc�s. ALLIIV G. JENSEN g��g �r NOTIC& Tld� parm@ doa ew eewr ths eoestroerioe, hulaQ�loe Mr wlrtns. P�ti+9. Ya 6e�, a�ru or wdsr. B� surs to a� flu Bu�di� f�eto� fer apn� �m�s fer fk�a �. , ,. _ _, ,. __ . __ � ... . .,. ,..__ 9 APFLICATION FOR BVII.DIIQG PERMCT '' CITY OF FRIDLEY, NitNNESOTA oWNER's NAi� Vincent Mar.t3,nille , BU�DER 0• �• ��e�berg Co. ADDRESS 115 Crota� Road ADDRESS 2923 Oakland �vet � LOCATIOAT OF BOILDING N0 � 115 STREET Crown �oad PART OF LOT __ _ LOT BLOCK ADDITION OR SIIBDIVISION GORNER LOT INSID� LOT SETBACR SIDE-YARD SEWER ELEVATION FOUNDATION ELEVATIQN Applicant attach to this form Two Certificatea of Survey of Lot and propoaed building location drawn on these Certificates. To be used as; DESCRIPTION OF BUILDING Front Depth Heigl� , . � gq, gt. Cu. Ft. . Froat Dept � Height Sq. Ft. Cu. Ft. Type of Constructionst�� epai�' Dama�;e Eetimated Cost 6,000.00 To be completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ord3nances and ruZings of the Depa.rtment of Buildinga, and hereby declares that all the facta and representations stated in this applicatian are true and correct. � DATE 7-7-65 (Schedule of Fee Coste can be found on the Reverse Side � n . , �� n • -�� I � . .. - •,. � .. :., . , . '.- , `i. :. •; � BUII.D]NG PERM�T FLE SCHED�LB SEGTION 2. The Inspector of Builc�ings shal�l, before isau3ng aay permit for the� ere ioa of any building or atructuxe, or for any addition to any esisting building or atructure, ar for any alterations or repaira to any existing buildiug or eCructure, upon application therefore, requ%re the payment by the appliceant for &uch permit �f fees Co the amount.hereia`below aet forth and in the manner herein provided to-wi�; � . 2r,;1. For aay such permit for the erection of anq fire-proof building, othei than a garage, warehouge, factorq ot grain elevator, or for the erection of any fira-proof additiau, for similar occupancy, to any e$isting buflding, shall be at.the rate o£ $1.44 for ea�h on� thoueand cubic feet, or fraction thereof, ia such cubical contents. 2�.2 For any such permit for the er�ction of any fire-proof garage, warehouse, factory or grain elevator, or fox the erection of •any�fire�proof additi�nn, for aimilar occupancy, to any esieting building shall be at the rate of $1.25 for each one thousand cubic feet, c],gssified as "fireproof01 by Section 502 of .the Minaeapolis Building Code; HO_ 2s3_ For any such permit for the erc�ctioa of any aon-fireproof building, other than a garage, warehouso, factox�► or �rain elevator, or any non-fireproof addition, for similar occupaacq, to any exi�ting building - permutt $1.00 for each one thoueand cubic feet. GARAGES -2_ 4. For enq auch permit for the erection of aay non-fireproof garage, warehauae, factory or grain elevator, or for the ex�ctivn of anq non-fire-proof addition, for aimilar occupancy, to any egisting buildiag or for each such - buildiag or add3tion - ninety cents ($0.90) for each one thousaad cubic feet or fraction thereof, in the cubica� contenta thereof with the minimum of $4.00. For the purpoae of Eoanputing fees for building permite., the cubical c.ontents of any building or.addition to a uniform he3ghC throughout by multiplying th� grouad area covered from a point sis (6� inches below the floor line of the basemeat or cellar to the average he�ght of tha upger surface or-to ehe average height of the roof aurface of the main gable of a pitcbed raof. ; 2,5. For repaixs or alterations Co an existing atructure, the fee ehall be at the rate of $3.00`per each Five Hundred Dollars ($SOO.Op) or fraction thereof in the cost of all proposed work. 2_ 6. In no case ehali th� fee charged tor any permit as set forth in Sectioa 2 be less than $4,00. ST� IK RLPAIR DAMAGE FEBS ; Residentisl; .,Commercial; Eatimated Coet of woxk up to $500.00 -$5.00 Estimated Coat of work over $500.00 -$10.00 Estimate�ost of work up to $50Q.00 -$1Q�0 Estim�atec. oet of work_ over $500.Q0 -$2t,_,0 .. t ,'-,. SUBJECT P City of Fridley o 19145 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � � � � �L _ _ COMMUNITY DEVELOPMENT DIV. �r � � r � � PROTECTIVE INSPECTION SEC. �� i1 = i .--_ A �/"',,� CITY HALL FRIDLE� 55432 NUMBER REV DATE PAGE OF APPqOVED BV L J\ 612-571-3450 9�0-F15 9�2�8� / / JOB ADDRESS ZI.S CiC7V�7I1 RCk3C1 N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. SHEET 2 PROPEHTY OWNER MAIL ADDRESS ZIP PHONE Everett Little same 572-0306 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS Z�P PHONE LICENSENO. 8 USE OF BUILDING 7 CLASS OF WORK ❑ NEW 0 ADDITION � ALTERATION ❑ REPAIR ❑ MOVE � REMOVE 8 DESCRIBE WORK 5tep - 4' x 4' roof. 9 CHANOE OF USE FROM TO STIPULATIONS Prav:i.de f ront footing for new step . SEPARATE PERMITS ARE REDUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY (3ROUP OCCUPANCY LOAD VENTILATING OH 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 FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT 1 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 $ZOO.QO �.SO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. y�LS.00 PLAN CHECKFEE TOTALFEE 15 s 50 S N REOFCON7RACTOROR U O IZEDAGENT IDAT 1/�H ROPER Y V ID T IS IS UR PERMIT / � E iiF E BU �DATEi DG INSP qaTE - r ' _ BREEZEWAY YARD IMPROVEMENTS YEAR BUILT CLASS DRIVEWAY -/� S / • T � i FOUNDATION FIOOR EXTERiOR ' ' ROOP � � INTERIOR i � DIMENSIONS . ��; . 3a x�y= '� �v'�� c x.3�= cc x = � g.' � X a= i� �4.-. X = X = � ;. x = � � y x = u,x:� _ � � x = �, X �. c = y �i � . x = •. x = x = x = x = x = x = x = x = x = x = NO. 19 19 19 � 19 �, �� -� � � BUIIT INS � RANGE-OVEN � � � HOOD-FAN � , O �� DISHWASHER / o GARBAGE DISP.� - � k � `�' fIREPlACES 3- fIXTURE BATH! a �O v 5 e 2 - FIXTURE BATH CERAMIC TILE ' 2 VANITY `� a C (ARPET - YARDS ' 2 -"'�— , ��_. . INTER(OM C� AIR CONDITIONER '.YALKOUT • /2O -�= � N� [] City of Fridley Effeetive �/1/86 ADDN. [ ] �R-1 AND R-2 pLTER. [ ] Building Permit Application Construetion Address: �� `�v �� Legal Description — Owner Name & Address: Tel. � �� —0,30� Contractor• Tel. � - Address• Attach to this application, a Certificate of Survey of the lot, with the proposed construetion drawn on it to scale. DESCRIPTION OF IMPROYEMENT LIVING AREA: Length Width Height 5q. Ft. GARAGE AREA: Length �_ Width _� Height Sq. Ft. _________- DECK AREA: Length 6didth __ Hgt/Ground Sq. Ft. OTHER : � 1�-Q �r� � :� �' 'Ll � � r ` � � `� � � c.eS � Corner Lot [] Inside Lot [� Ft. Yd. Setback Side Yard Setback _ Type of Construction: Estimated Cost: $ � �a �i Approx. Completion Date: SL �� Alt. A Alt B Proposed Dr3veway Width If New Opening Is Desired: See Back Page for Explanation , DATE: � � l - �� APPLICANT : Tel . � 5�/'Z ' �'� � � Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL CITY IISE ONLY $ J�,4o $ $ �� $ � - � 6 l� . s`� Fee Schedule on Reverse Side 25� of Building Permit Fee $.50/$1,000 Valuation $ 525 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] • � ' i� r � �:'�� i j ` ` v � � � � �� r- , , ,: i ��, � �; ,..a BIIII.DING PERMIT FEE SCHEDIILE 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 alteration or repair to any existing building or strueture, upon applicatio n therefore,�require the payment by the applicant for sueh permit of fees to the amount herein below set forth and'-in the manner herein provided to-wit: Total Valuation $1.00 to $500.00 Fee$ $10.00 (Minimum Fee is $15.00) $501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for eaeh additional $100 or fraetion thereof, to and including $2,000. $2,001.00 to �25,000.00 $32.50 for the first $2,000 plus $6.00 for each additional $1,000 or fraetion thereof, to and ineluding $25,000. $25,001.00 to $50,000.00 "�170.50 for the first additional $1,000 or including $50,000. $25,000 plus $4.50 for eaeh fraction thereof, to and $50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each additional $1,000 or fraction thereof, to and ineluding $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. DRIVEWAY DEPRESSION ESCROW (Conerete 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 approaeh with 6 ineh depth - Driveway width plus 6 feet times $15.75 VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed strueture and of the construction site. A Certificate of Survey oF the lot, showing the location of the foundation onee it has been constructed will be required before proeeeding with the framing. - � - . � sue�etr < City of Fridley 2 8 � 2 4� AT THE TOP OF TNE TWINS g u I L D i N G P E R M I T r ; � RECEIPT NO. � `v __�� COMMUMITV DEVEIOPMENT OIV. f � � PROTECTIVE INSPECTION SEC l�� 1 � /�"1 � CtTY HALI FRIDLEv SS132 NUMBHN pEV DATfi PAGE O� APPROVED 8Y �'""�� ,'' 612-571-34b0 9t0•F15 1z/�/9s / / JOB ADDRESS t LEGAL �OT NO. 9LOCK TpACT OR AOOITION SEE ATTACHED DESCR. � SNEET 2 PNOPERTY OWNER MAIL AOpR�S$ 21P PMONE 3 CONTRACTOFi MAIL ADDRESS Z�P PMONE �ICENSE NO 4 ARCHITECT OR OESIGNER MAIL AD FiESS ZIP PMONE LICENSE NO 5 ENGINEER MAIL ADDRESS 21P PHONE IICENSE NO 8 USE OF BUILDING 7 CIASS OF WORK O NEW ❑ ADDITION ❑ ALTERATIAN � REPAIR O MOVE • O REMOVE 8 OESCRIBE WORK us 12 S 2nd 9 CHANGE OF USE fROM TO STIPULATIONS Roofing can be 2nd layer but not 3rd. SEPARATE PERMITS ARE fiEOUIRED FOR ELECTAICAL, PLUMBING, HEATING, �P� �F CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTI�ATING OR AIR CONDITIONING TNIS PERMIT BECOMES NULL AND VOID IF WORK OR CpNSTRUGTION ZONING S�. FT CU FT. AUTHORIZED IS NOT COMMENCED V�1ITHIN 80 DAYS. OR If CONSTRUCTION OR WORK IS SUSPENDEO OR ABANQONEO fON A PERIOD OF 120 DAYS AT � ANY TIME AfTER WORK IS COMMENCED. ' NO DWLG. UNITS OfFSTpEET PARKiNG I HEREBY CERTIFV TMAT I MAVE READ ANO EXAMIN�D TMIS APPLICATION STA�LS GARAGES AND KNOW TNE SAME TO BE TF1UE AND CORRECT. ALl PROVISIONS Of LAW$ VAIUATION SURTAX ANO ORDINANCES GOVERNING THIS TVPE OF WQRK WILL QE COMPLIEO WITH WHETMER SPECIFIED MEREIN Oii NOT. TNE GRANTING OF A PERMIT ]]2 . $.SO DOES NOT PRESUME TO GIVE AUTHOfiITY TO VIOIATE OR CAMCEL TNE pEpM1T fEE SAC CHA PROVISIONS OF ANY 07MER STATE O LOCAL LAW REGULATING CON- STRUCTION OR TME RERFOfiMANCE O NSTRUCTION 2,2,5 Fire C y�.%% PLAN CMECK FEE TOTA FEE, ��'�� ' -� �. /� -7—I� 5. 0 3 .�2 !' S�GNATU:�E OF CON'AAC Op OA AUTMOA4ED AGENT iO�iE� yy N P OP Y ALI AT T IS VOUR PERMIT � �� S�GN4TUaE O� OWNEp�� OWNEa Bu4DEp� iO�TE� ' B�DG �a5� � r��rE N L�v � I ADDN ' `� [ � ALTL-'R ( J ' CITY OF FRIDLEI' • SINGLL; FAM[Ly pND DUPLE3►FS R-1 AND R-2 BU[LD[NG PERMIT APPLICATIOI�T Cffec[ive 1 / 1/97 �� ConstcuctionAddress: 115 Crawn, Road � . . �o �� Legal Description: Owner Name & Address: Brian Little (same) Tel. /{ 572-0306 COntractor: Milton Johnson Company 1V1N LICENSE� 2083 Addtess: 525 Lowrv Avenue N.E. , Mpls. 55418 Tel.l� 781-9548 Atiach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEAZENT LIVING AREA: � Length __ Width _ Height � Sq. Ft. _ GARAGE AREA: L,ength Width ' Height _ Sq. Ft. _ � DECK AREA: Length __ Width _ Hgt/Ground Sq. Ft. OTHER: . �7�.� COnStiuCtiOII Type: Re-roof ,house �� ,�� .�,�)�a� CoSt: �•�� l � .(Fe� Schedule on Back) Driveway Cbrb C�t .Width Needed; Ft + 6 Ft = � Ft x $ • .. � _ � . � . , . . . _.. . !� . � . . . . . DATE: /� � . � � . APPLICANT: �-- � „�� el. � 7 � 1 � 9 5 4 8 . � Permit Fee �ire Surchacge Stace Surcharge SAC Charge License Surcharge' �riveway Escrow lrosion Control 'ark Fee �ewer Main Chargc TOTAL �r�i�ui.n�c��s: �i9_,�5 $�P $ m `� 7 $ • �� $ $ �� d � $ $ $ $ ,. CiTY USE ONLY Fee Schedule on Reverse Side � :001 of Permit Vaivation (1/lOth%) � $.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 . Agreem,ent Necessary [ ] Not Necessary [ ) ' .- . . ;. . . � . '. ° �w�c.��,�c: ��.�i�irr rr�,c sc�{�u��.��: , .. 'l'I�� ChieC i3uilding Ofticial sl�all, bcfor� issuing pemiits for tl�e erection al' any building or c[ructure, or 1i�r any addition to any cxiscing building or stnuturc, or for any alteration ar re�i� to any cxisting buildin� or st�ticture, upon application d�erefore, re�uire the payment by the applicant for such permit of fees to the amount lierein below set forth and in the, manner hec�ein provided to-�vit: ' � TOTAL VALUE $1 to $500 $501 to $2,000 $?,001 to $25,000 $25,001 to $50,000 $50,001'to $100,000 . FEES �21 (Miaimum F� is $21 plus surcliarge) $21 for fust $S00 plus $2.75 for each additional $100 or fraction thereof, to and including $2,Q00 S62.25 for first 52,0� plus $12.50 for each additional $1,000. or fracdon thereof, to and including $25,000 $349.75 for first $25,0� plus $9.00 for each additional �1,000 or fracdon thereof, to and including $�0,000 � $574.75 for �first $509000 plus $6.25 for each additionai S1.Q00 or fraction thereof, to and including $100,OQ0 � •'� �$100,001 to $500.000 � .$887:25�for fust $100,000 plus $5:00. for each additional � . • . � $1,000 or fcaction � thereof, . to and �including $500,000 • . .. . . , . . $.SOO,�l .to $1,000,000 • � $?.887.25 �for �d�e fnst �$500,000 pius $4:25� for eacli .addi6onal . .. . . � . $1,Q00 or fiaction thereof, w and iacluding $1,000,000 ' � � . ' $1,000,001"and •uP $5012.?S for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY �DEPRESSION ESCRO�'V ., (Concrete (�rb S�reets On1Y) 1lternate "A"•: Removal and replacement flf wrb and gutter only'-�Driveway width plus 6�feet times $13:50. 1[ernate "B": Removal and replacemeat of curb and gutter and install a 3 foot wide approach with 6 inch depth�- Driveway�width plus 6 feet times $15.75. VERIF[CATION OF FOUNDATION . . •;• �rn�its for construction will be issued a minimum of 24 hours from the time of appli�:atio� to atlo�u for proper :view ot' the pr�iposecl stivcture and of the eflnstcuction site. . i.:cnilicatc UI' tiurvey of the lot, showin, the location �f the foundation ��nce ii hac it ha,n c�en c�n�tr�ucic�! •'�;i !*_ r��uir��t l�ct��rr t�r��::�:�din:: ��itii �h� fnmin�. . ' � � SUBJECT .� ' , . City of Fridley 2 510 AT TME TOP OF TME TIMINS � � I L D I N� P E R M I T r ; � � RECEIPT NO. ' ' COMMUNITY QEVELpPNtENT DIV. � ��: ------� `�� f � � PROTECTIVE INSPECTION SEC. i �1 • i---. = ��,•� C1TY NALI FRIDLE� SS�'i NUMBER pEV DATE VAGE OF APPROVED BY i 1� 612-571-34Ep 910-F15 4/16/02 / / J08 AODRESS 115 Crown Road NE � t LEGAL �OT NO. BLOCK TRACT OF AODITION SEE ATTACNED DESCR. ] 3 Carlson's Summit Manor North Addition SNEET 2 PROPERTY OWNER MAIL ADOR�S,� Z�P PMONE Brian Little 115 Crown Road NE 763-572-0306 3 CONTRACTOF MAIL ADORESS ZIP PMONE LICENSE NO Tollefson Bros. Exteriors 10808 Toledo Circle, Bloomin ton, MN 55437 20200882 4 ARCMITECT OR DESIGNER MAIL ADDRESS 21P PMONE LICENSE NO. 952-881-2218 5 ENGINEER MAIL ADDRESS ZIP PNONE LICENSE NO 8 USE OF BUILDING Residentia3. 7 CLA3S OF WOfiK O NEW O ADDITION � ALTERATIpN � REPAIR O MOVE O REMOVE B DESCRIBE WOiiK , Reside House; Replace windows within existing openings 9 CHANGEOFUSEfROM TO STIPUTATIONS Provide smoke detectors in alI sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. 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 �his provision would be if sheathing is an approved weatherproof panel or when the siding is a.n a.pproved weather barrier. Vinyl siding is not a weatherproof covering uniess the manufacturer states �his in their application guidelines. Call for inspection of wrap before covering. Caulk and flash all exterior openings. " TYPE dFCONST. OCCUPANCY GROUP OCCUPANCVLOAD SEPARATE PERMITS AiiE REOUIRED FOR ELECTFICAL. PLUMBING, HEATING. VENTI�ATING OR Alii CONDITIONING TMIS PERMIT BECOMES NULL AND VOID IF WORK Oii CpMSTRUCTION 20NlNG S�. FT CU FT. AUTMORIZED IS NOT COMMENCED V�!ITHIN 60 DAYS. OR IF CONSTRUCTION ; OR WORK IS SUSPENOED OR ABANQON�O FOfi A PERIOD OF 12Q DAYS A7 ' ANY TIME AFTER WOfiK IS COMMENCED. ' NO DWLG. UNITS OFFSTREET PARKING I MEAEBY CERTIFV 7NAT I NAVE REAO ANO EXAMINEO TMIS APPLICA710N 1 STA��S GARAGES ANO KNOW TME SAME TO BE TFlUE ANO CORRECT. ALl PROVISIONS OF LAWS yp�UATION SUfiTAX AND ORDINANCES GOVERNING TNIS TYPE OF WORK WIL� d� COMPUED 13,500 $6.%S WITH WHETMER SPECIFIED MEREIN OR NOT. TME GRANTING Of A PERMIT � DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE O:i CANCEL TNE pEqM1T fEE SAC CMARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $Z37,25 Fire SC �13.SO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION ��?%e� � PI,AN GMECK FEE TOTAL F E / ''-�r�r j $2 . 50 S�GN41UpEOfCON"NACIOAONAUTr10A4E00GENT iD�TEi N P OPE � AUOAT HIS IS YO PERMIT �� $�GNAIUAE O� OWNEA��F OWNEpBU�LDE�1� �DATE� ' BLD �NS� � ��`TE s. � WEW [] CITY OF FRIDLEY Effective 1/1/2002 ADDN [] 6431 University Ave NE, Fridley, MN 55432 (763) 572�604 Bldg insp EILTER [ J SINGLE FAMqLY AND DUPLEXES R-1 AND R 2 BUILDING PERMIT APPLICATION Construction Address: � �� G'%�G �`'''� �2 � . Legal Description: OwnerName�Address: _ ��Iq� C iT/G� ��"G � Tel.# ��3 S�2 -G3e� � Contractor. �_� o"� �i�G -�- MN UCENSE # Z� ZGO �� z Address: %D �� oL�� G�'2 a Tel.#C°��Z� �by� �2Zl� LNING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed constn�ctian 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: �/ � �/ 1. S � L1 � �- � � � �' o �r�stimated Cost: $ �� S� � �— Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$ DATE: �/ ��/� Z- APPLICANT: `�` �'� � Tel. # G� 2.3Z S" - z Z� 7 �� Call (763) 572-3604 for PeRnit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we wiil call you tor card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ �� S� $ $ �i $ $ -I�C� $ CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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: � BUILDING PERMIT FEE SCHEDULE The Chief Building O�cial 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 alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below 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 $500,000 $500,001 to $1,000,000 $1,000,(?Ol and up �� $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional$1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,�0 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,0�,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter only - Driveway width plus 6 feef times $17.�. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the rime 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 with the framing. New Houses Onlv :� .,.. BuilditZg MECHANICAL Pe�t No.:��-�� Inspections RLi SIDENTIAL APPLICATION Received By � 763-572-3604 , �� CITY OF FRIDLEY Date Rec'd: /—//--�� DATE 1-�'�� YOUR E-MA1L ADDRESS SITE ADDRESS � � S � C�`'�l �� 1 v� - TFIIS APPLICANT IS: ❑ OWNER �CONTRACTOR PROPERTY N,e,�: � r� o� �—.' �-�- �^ OWNER/ ADDRESS: �\� V'�vJ r'� ��_CITY t` r' � STATEYi1N ZIP �s 4a� TENANT PHONE: ��3— S-1'� • ��Olo CONTRACTOR CoIvIPANY N,�: �OINT ENERGY SUBMIT A COPY OF CONTACT PERSON: JOAPTi�T Z�i YOUR STATE $TATE LICENSE � EXP DATE LICENSE WTTH ,r�DRESS: 13562 CL�NTRAL- AVE �iE CITY ANOKA STATE i�zlP 55304 APPLICATION pH�� 63-7g7-b202 F,�3; 763-757-6701 9 PERNIIT TYPE � SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: O NEW �tEPLACEMENf ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK 1.m�� c�.�� v r.� Ci UCP', � k— C��O ��' r+n �e �e— PER MS 16B.665..the permit fee is a minfmum of $15.00 or 5% of t6e total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (T'his should reflect only the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (Il�iDICATE TOTAL NUMBER OF EACH BELOVi� EquipmentInstalled MFG: �vVG� MODEL: V�oCl� —(�o SIZE/BTU CoC�a�O � MFG: MODEL: S1ZElBTU MFG: MODII,: S1ZE/BTU A/C $25.00 FIREPLACE (GAS) $15.00 _GAS RANGF/OVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW CiAS (3RI1.L $10.00 BOILER $35.00 ,�URNACE $35.00 GAS UNIT FiTR $10.� CHIMNEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPIN(3 $10.00 VEIVTILATOR $15.00 — _. . . .. . . .. _ . � . >., .... �. ' � ' : : . ' .' ., . , .- - .,. R '. ....� l.�. td.. � . . .., � . : . .. . � - -. �..� - . -- �-. - . .. . . , . Permit Fee $ 5.,� Number of fixtures @$10.00 x$10.00 —$ Surcharge $ .50 Number of fixtures @ $I5.00 x $15.00 = $ TOTAL DiJE $ �. �Q Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge � $ .50 Tota1= $ THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a building germit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the lviinnesota •Construction Codes; that T understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLIC �„ �. � � PRINT NAME ROG�R HdFItHEI�T DATE %`�� D�' Y - ��' c�• �,� :� .r�', C;ity of r'ridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 T I �7. '7I �1 C /1'1 � !1'7^7 �.. REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS �,EXISTII�G HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) . a. �il or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propanel�GC Chapt�r 3 with MN Amendm.ents 9 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Ga,s appliances IFGC Cha.pter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room � a., Required on new conshvction IMC 1346.0312 5. Ventilation . � a Per MN Energy Co�8.7670 or 7672 6. Duct Design Per IMC 1346.0603.2 .a. ACCA Manua]. D N01'E: Centerpoint Energy Mechanical Code Guidelines software may be used for . , combt�stion and make up air calculations CITY OF FRIDLEY � 6431 UNIVERSITY AVENUE NE � FRIDLEY, MN 55432 (763) 572-3604 FAX: (763) 571-1287 ADDRESS , PIN , LEGAL DESC . PERMIT TYPE . PROPERTY TYPE . CONSTRUCTION TYPE . REPRINTED ON 1/12/2006 115 CROWN RD NE 233024330020 CARLSONS SUMMIT MAN NO ADD LOT 7 BLOCK 3 HEATING RESIDENTIAL X ALTERATION NOTE: INSTALL RWD UGRK-06 60,000 BTU FURNACE #FURNACES 1 APPLICANT CENTERPOINT ENERGY MINNEGASCO 13562 CENTRAL AVE NE ANOKA, MN 55304 (763) 757-6202 CA01796 OWNER LITTLE EVERETT L& LEOLA M 115 CROWN RD NE FRIDLEY, MN 55421 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and conect. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. T'he 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 Bidg Insp Date PERMIT NO.: 200C}00083 DATE ISSUED: OU1U2006 --� � ,% FURNACE SHELL/DUCT WORK STATE SURCHARGE, MECH FLAT TOTAL PAID WITH CHECK # 7580 � O( _ � l� �� SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 35.00 0.50 35.50 Building PL�JMBING PermitNo.• � °�rL� Inspections RESII)EIOTTIAL� APPLICATIOI�T Received By� 763-572-3604 CITY OF FRIDLEX r��G 20 8 763-502-4977 FAX EFFECTIi'E 1-1-08 DATE Y' �' O� YOUR E-MAIL ADDRESS • � • i e. �lU' �, �,� srrE �Dx�ss i t -�, � �!'o �, ,.•. �� . THIS APPLICANT 1S: ❑ OWNER �CONTRACTOR � PROPERTY N�: �� ADDRESS: CiTY STATE ZTP TENANT ' PHONE: CONTRACTOR NAME: �� . � '1 SUBMIT A COPY OF STATE LICENSE # J�Z� e. U I T�.K.� EXP DATE YOUR STATE - LICENSE, BOND AND STATE BOND # c� � rr� �� EXP DATE CERTIFICATE OF ,r�DRESS: CITY STATE ZIP INSURANCE . PHONE F� PERNIIT TYPE MGLE FAMILY ❑ TWO FAMiLY ❑ TOWAIHOUSE TYPE OF WORK: � �w �°t�pt.,aCEr�rrr � a DETAILED DESCRIl'TION OF WORK �,c ��+Z �- �'w �-i -e/ S � io b �!� /� ilrzl � �^'��'e` �'`�.�`�<� PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, insta.11ation or replacement of a residential fixture, excluding the fixtures. (This should reflect onty the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NtJMBER OF EACH BELOV�. MINIMLJM FE� $I5.50. / WATER PIPiNG BATH SINK/LAV _FLOOR DRAINS SHOWER _ BATHTUB GAS PIPING (NEED CITY LIC) SWIMMING POOL WATER SOFTNER ($35) CIATHES WASHER KITCHEN SINK WATER CLOSE7 _ BACKFLOW PREV. ($IS) DISHWASHER LAUNDRY TRAY �WATER HEATER ($35) FOR IRRIGATIOAI — _ WATER METER _ OTHER � � ;� «:: , hr °„�� ,,,� •, ;. � . �`_:' �g�`-' .�,:'�z.:.:^°, -�S«:«� �w,.. . �:i Permit Fee T$ � � Number of fixtures @$10.00 x$10.00 =$ Surchar e .50 Number of fixtures @$15.00 x$ l 5.00 =$ TOTAL DUE $ .� OR Number of fixtures @$35.00 x$35.OQ =$ State Su�charge = $ .50 (MINIMLJM $15.50 (MINIMUM $ I 5.50) Tota1= $ THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and k is not to start without a permit on site; that the work will be in accordance with the approved plan in the case o� 'c quires review and approv of plan� - SIGNATURE OF APPLiC PRINT NAME�� `� e [ DV� � S DATE �� /�� O APPROVED BY ��%�/ DATE � 7 � , . _ n � T c City of Fridley ]Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977