Loading...
AF - 43288�_ ___ _ ___ __ �, f � y 4 !�, y Q _`� ( ( /, /�� /�/� �% J ', � ����� I �u �4J�V . �/7�f� ��•Yrf' �", '�� y"' I, ��i' ��Fr �N 1 �� ��I, . i i +�.{ . � � �' I [I�. � � �I j �� , �, � ,� + �; 3 r' + ' � . '�� i , ��. �: t d� � , y� " � ir � � �i ` � i w„ „:y �* i � ,� {I I.0815 1�t �11M�i,I NO d? I�i.:a '. i i r� � r r eaed,Pla�i�{in ,� ` � < ��������ll� � 9 y �, , , � e� ,�ee�d';�34�v�Xi� `�;;, � i,�9 . � �l r�� l�f�X�j�l��� ����� M�,nneopol�f, M�' �e � • AAinn._ 5�9432 6 5011q T�p,R�e1�s �� •r• � '�- r P�',. � � �{' 4�^' �, , ,� � �' i 5� i `� Civ'41'�aqgi��e�sri� .,�� .,� ,,. � �;; , .i, ,, �,, . �:,�- � fele�hone�� f84,-80eE �. � I• Mpnit�pab•��pin�sriae . "�i'.�'Z,(��l1�eY"t9� ��t ,Sti�rvr�yars� n*C� Code 611 , � ^ a ,, � , � "� ��,� � � rr �� � . , , �j ��, .,� � , '' ���'rve t�:�-�&.'� . I t.t.C'-�� � tt�OM C-5 � Certiffcao�e of Su y,�or; �`��� _._.r. - _�- _:._ , , ,�' ,, , , "_`"'"';,."".� — ,. �` � �`.:..` , ,. ' u R ;'�� 4 r ''7' � , r � � a� ' � ' ` �•' � � � � � � ' , � � �', � , � 'f, � (� '" � g � < < ���� ' � � ii ���� f,;i� � �tk � 4 � r , , � � '+ i, ��'� � '. � � t� I .�.�Ji' + � i i „ � � � h, a�,� ,. e'T'i,ia; r, ' � 6 • 1 � 4 rf. fiy�� �I, �.�$` q' 1 � t ! a ' � � � {:.� � ' p 1. � ` ' � � } ,'�. . � �� � - I .Y _� � 1 , „�� �� r ' . � � � i � r r �� . �. ., � _ q � o . � • . 1 ��.�� � � � ��� � �, � y 1 G � .-�. i w � � ,.. � � �^. r� ��"NF"t �'��i��� � �� W . � . i -�. . ..t,' A�, � �_ ' 1 a� ' ' . I ,y , � I. �� Il` .'r ��.� � u�' i � � {", i . -w�`�♦L "�.� 'C� . �� `. '.� 1 ' I�'��, _ y �"`!� I fy `T 4` /� ��I� O 'r � ' ,IR.�,`� ar�r� ..�ia � I ',✓ , e�� �~ � , r ,�� �•i,+i�� ;� .,�.. a� � � "'" `i" ` d� ":� r ' . h' ' � . 6 �i I ' I'. . p , r �' t Y �� 1 ^ � `� , , ^ ,'' r �' ' �� (! , i�,;_ �� � � � � � _� � � � ' " -�r ,�1.f!� '�:�r 7 �.�,�'k'alta� $� � � i � , � q � � . .� tl � t �7�'� � � i � �� - + ` � � , '�', , ` . i )7 yi p a7 '� , ; i � �''i ' k3 .�1 � � , � �!' ,�� i'w �{ �j � � ,'. i . �i�„ ,$•� A �,, w.� �V � � N.,P 1 i��1 �i]Y� r�1� i�1„�1 IA�V � � �r.'4i �� ,��� 1r� ,� � . r'X � y i � p,.� ��i� 1 n 1 �a�l � I�� i �fiy;� ��r�, ,� �. . � I ..,y . . �� � , � �� 1 i I I I , . � ". � '�. � • �,'' t , ����}� " .' � � il:. � ^ �l � b � i � -. C M I � �? � � �: :! �,,�� �%� " � � � �M� � J ��.'. �,�s.�Ti.'1 � �� �' �� 4, Iv� �h.�1g � r � K i 4 n � i p��f ��,� ���'� ��' ��' �' . �:a ��� �� yk'.,p �� � � r °k,Yl�i`(u i f���fl'�-.i�rl �,� � �" � .�. n�� -''�{I ��i '' i d �♦ /��} k . � � �;� I t i '�i= 5 � a P`i H �, \ �'k'�: - , a '� �'�' /il.,d , � �i � .{.�„�� ,�i �t� �� � ��," �� � � ' �� � � . � � ' � '� �b � , h k' i' i...;. � � � �� � ,.: p t► +; ,�� 0 � � , .t � , , � � �. � �k , � [yh � � , ����� � d . . �� �, .��i , ,�,,��: , . w, � ., , , �� � i ��" � ' " � r ' « ,, �C, . ' ��� � ��� V, 4 J '(c �l , t, 4 y;�g' i � ��` I1 ,a , i � ` ��� A��� ��r,�.. '.•�� � �., t � � a � . ,� �. � i `s� ' 1' � i a,: � : �S. \Y_�i t� �..� i , ! \ ,p, i 11+� � � � 1 1. 1 /.�. I £ � �( 1 f 1 � I 1 M� -'r r ..,f.� � � � I ' .5 ' � F �. 4 . .� 1 � �� „� � i � n I � J., �' f . , ' •., , ! � � � i S �(� , ,� , , �;- + ' � • ' � � �, k ,�. � • �!� � , L � � ° � �.. � � � � � � � ' i , : ,� j � � � , ����� � �, � � � ����, s � � �� � 1 � _ ' � � � �-� �. .�:�,, :� � , . � � � � .i, � �� � ''� ( + '�i '' � - ' � � � . ' �t 'd� ,'' i .. ^�' . ��' a �� �.. � � � � � .���.1 �•�� � -���� "�t. � . n ,M � ' � � ' i .� ' i . : � � i N �., a; ��q`, it � r Hh° � , � � � � � � . �� � ; S -I � i�. r i I p �'• � 1 � � i ' '� t ,; � ,,� � ° � � �'� ' , , i � - � 1' � 1 � .� . - 1 �� td i"� � .J. �i ' �� ���� u L �' 'M� � � �N� � �yl i 1;� �h r, �f �( n��- � °v ; t a �' ay7 ti � a k 4 � � �� . � � � r -.�_ �, -' � �.�, � .�;1 i � �, � � i '�` i � i , �r , � . � rr. i• ir' �"� �� s , 4., t ;' ��� i , , �, � � � ���,� �� � V �' � � i�e� i��'�„ I,.i�� i ylt � ti � i'��1'�, � '��t'� hll dfpDi ��J ! '41�:�� � �� � ,y u' �.P � ! t� .�, i ''..i. i � i � � , . � � . �i:.r� j � , � � � !a ,�. , �{. e � � g�l° ., � f �' " , �. . :. � � R i ( 7 , i. �w, � I.i d M �� 14 �� �' � , I , a� � � �r�� � � , �� i n d, � n � � , , ._ � _.: d Ii, � ,_� ` � ,. x i � .� . i'� i � � 6; + 'i� � �. � � � � i.,,, p '' � � ' 1,; �; " ' �. �, (i���. ,�� � .. ,�� r�'.: � �! : �I N i1:� � r � �y" � r� r � >> /� Q j 1 � ' � I �•�� ��� � ,r� rR.r�...` � � yl H� ' ',� . �11�r' r.._ � � � ' a� r i rvI r�' AI �'� ■�� I ,ti�.F � � � � . , 1;'-�� . . . /� ,(�� /� f , , f ' � � .,. i �'. ��� � -- ' ', .. ,l�i��'W L�G�iTy '. .� IS n �,�� `�� ' 'i '� �� r , , � a , , , i � . i d��it.x��ti�e y�r�i��y, 1'�tlt��"1h�R ����e �r�ii���:�„��al .�`�►r��cN`��a�'rs�ig�►�a�t�_t� �$� � kwrr��' �Y,i�a� kra�a�+daa���a �� ''b�l�t� ��'�� �;�� �e�e.,b��►r^�r�►�, �;��,�1+�, fa.v�ri�,�� ��.�..ls,,,,�d�dq�i �,�e►n� �+r��t ����: ���I��r�i�r�K�+a�'.Ara��►r, ¢e a�*�eM fas�* k���, s�o a�A ;�4awl. A r '�'a�r+r�+`i d ' �r ,;��' !� �' da w i;- �K i ; , ,r'. �; y ,rqe ,� '"� dYY �; ` ' � 1.� � �� � i;, ' ° r ' � a � 1 � 1 � � �� ' � a � y . �. "'p'�"'�'" _ � " `G i ' -, n , ;�� �Y 7 �: �' r `i . � �,/� il in � ��. .q �!� ��• �y, r ; II"� �i '.� � , �i � � � �- � 'W� ' n��� '�I ��•,�� " 1 , i -.�* n � ,; � I : ' � pi ��. .� ' � � � � •�f �� �� ��, �; � 5 susuee�►�I +��Ic��a����Ne�- r��'. ,, s. � � � ,1 ���' � ;n r, I�' ,i�,; s �e i �' '� �.K �EA�Rq�l�I�d 1 ', '�SYr�Yi@yore ���4 , ,s� : q �� c ��c�.`: /���1 �� q��� „ �.�, a �`+ +F � �/ � � � :t'•'3 � , � � � �`,�i'i � VC1W�T,� tKM� �. ������i ����Ii.�� n� "'�`�.b�lf�.. �„�k t� �^� �� " ' + � r��i �` 1 � �q�� - `� � �,I��'• ��,�-Y+�. '�� �'�.�.�. �' � ��. ' i T � ,��..� ie .� , . >. ,' ,� , � i. .�.� � , �� .. . .. , . . � r �� � r��i i . . . ,�, , . ;i , � i. , � ' � , � ° � ^,�� � � i r , rJQ\ ' � � � i � .tr�!i ' .:.: !.' . � } �. .. c � � �-. . m .. , .._- . . ....._ . . ' �^�� i� "�J .. � . . .. � i x , s� sus�ecr PE N . City of Fridley . 12650 , ` AT THE TOP OF THE TWINS g U I L D I N G P E R M i T CEIPT NO. r � ; L ______ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. C�� �� 1 ` , / �� /"'1 � CITY HALL FRIDLEV SS4$2 NUMBER REV. DATE PAGE OF APPROVED BY ""� � ,�� 612-560-3450 910-F15 7 25 ?4 � � JOB ADDRESS y580 Dana Court N.E. 1 LEGA� LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 2 Harris I�ake Estates SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Richard Miller Homes 1600 Ri.ce Creek Road N.E. 786-1600 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. $dIIl� 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE �ICENSE NO. 5 ENGINEER MAILADDRESS 21P PHONE LICENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WOflK �7 NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 42' x 26' Dwel].ing and a 20' x 26 & 33' Garage 9 CHANGE QF USE FROM TO STI PU LATION S Nlaintain required side yards at right angles to lot lines. Provide a hard surface driveway. Provide a verifying survey before capping. SEWER LOCATION: 173' East of Manhole (E. Inv. 879.78) Wye Elevation: 880.47 Top of Footing: 884.00 Mi.nimum WATER LOCATION: 10' N.E. of Sewer Service 54' 5.E. of Manhole � Location informa.tion received from Russ Johnson of Comstock & Davis SEPERAT'E PE�tMITS REQU1Rf.t� FQR WlRtNG, WEATIN�; PLUM�NG AND S�i.:GNS. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. WOOt� FiaIIl@ 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 R I. �.092 27, 560 Tota.l ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNIT5 OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ], STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $`Z8�%S�. ].LJ�.3$ DOES NpT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION� THE PERFORM CE O ONSTRUCTION. � .,S` 'rJ�.• OO 300.00 PLAN CHECK FEE TOTAL FEE �-��o - 7 $365.38 S,�NATUREOFCONTRACTORORAUTHORI2EDAGENT �DATEI i ', �- = WHEN PROPER LIDATED THIS IS YOUR PERMIT . � P SIGNATUREOFOWNERIIFOWNERBUILDERI IDATEI BLDG INSP fJAT �°� �z t- / 7 � � ��' �'�� �/ �� � �v�� Z�� � - ��o . �' � _....��v � � �% %� � � �' � o;,,�� — �r3 0 � ����',.��� , > f � �, � G�/� � � � % /�'� � �/� d � ���c,v �' r / C/ �y � �, � . � F �� /�, � ����✓�c �e , � �3 J 9" 2 � � �q � g ��a _y � � � �l/��Fo���T,��I ��C. 1��0� �liSS �vt�vvs�,�J ��= C�. � p. . � �. 1 � , v i i.::�;i ""•:��r���y :���������III�� OSIi H�c{i•r.t�Y ��n 65N f :u,�i: �..�v.y�n9 � j /•)j i 1' � - / 4••n�e�ujsql�•,� I �o�l�. ���:�rq �I�� (Yr� � I�/(�� �J �(i r M.rn 75�i? �� .1..E�hc>nc 7?�-b�6A t .,1 tnA�n�er,�p � M�n c i�u! Cng��err,�q FI1�11iE�E,'2'`i 11[ �112'Z"E.'VC)C!i - Arru Code b�� I, � v e f o r ��.,. N1� �� M( f...t.��'� �� ��[,- 5 � �e��tifi�c�a.ts of Su� y _ �� � C��� ° ' ^ .� _ � _ .��.. . ; �. ,�� ,U -_� f ����� t ��� : �', , ' �� a`�j�, f , �' � , �� G_�^�, � �,.,�� .._ `� � , - �, --- � , '��J / x\ � /„ � _ � �: 1_ � � r� � ..-� � �:, - • ' � �,� )', -% . 't�' � j' � �ti,t r; ; ., =1�'�� •� � ,�\'�,� } f �S � ` / i ; �`�`� / , Y`,_ .,.� *y,�' �rtJl�' / � O� ;. �� --1— i ��' '�f�k� � _ �. ���� � r �i�. . � �. . � � . .���� . . i . �:� ��Q,• i Aq,�''\.... ,, S,� \ � l � I � . \, . � � - � . r�'� . � � . 4f �v"' � ;� 1�;, . � 1 � �` �� � � / ► ; �, 7 � C `t � ~ • ,/ � .,�"_ � / �' � t f" /„� Y j ��.4;,.:. ' , ,�. - f... � � � �� �� I� ;� ;, �: �,,,; . ;' � r + �, • � � 5:...1�� i ''tt � �---�a�x-ti-----�a � � � �.�c r� j� � �� �t� C��`� CLti ` . �.4i" 9� ��.��� 21 r ; _ � �� �� ����� . • %�/JO.r'4�1 lOU�i�4 i f�rr!b� ce���+} ��+�+� t4��♦ i♦ a trur and corret! rrpr��entorion of o survny of �h« bvundo:•�r o� �he cr3c-<s detic•,aed lvnd�ando� t►�q {oco►iqn of oll k�u�ld�rty�p ��"�' .ron� und �,tl v�s�blr encroochme�*►, .� c�.. �•crr< .�-' so•d �a�d Aa �u�t�ryrd by mC ►1e�i'�__di,r o�.. l.C.'t ��..___..._A.�. :�'�> �.:' ��. : f��?i �'��is�'��v i s ��u �� i► ta � wr's��i'� � a � i� c! � i� c fny�r.aetl Sts: ♦rrur� _ _��� � vG��'� L7 �ti..i . . � � � �� . - . .�. . � ! . . � +�. �i�'..�'�lrc t� liT' 11' ��7:.ti�_`T eii � x'. ___._.___..- -�--- .. __.�..__.__....___ _. r ! APpLICATION FOR RESIDENTIAL, ALTERATION, OR AllDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER' S NAME : S PE L T Z BUILDER : R I G H'f} �� �l�t( I L L L� ADDRESS: I.fBC� p/1-N� CovJ�.%" ADDRESS:��OC�O R�cc GR�EK ��D NO :. 1 S� d S TREET : A/�/tl /� G Q�e l� T LOT :_,��_BLOCK t � ADDTTION : I�i4-%L� I S L./4 K& �STi9�E iS' CORNER .LQT: INSIDE LOT:�_SETBACK: � �, SIDEYAR.D:�d/$ /Q � Applicant attach to this form Two Certificates of SurveY of Zot and proposed building location drawn on these Certificates. r HESCRIPTION OF BUILDING To Be Used As: ,�WELL• 1 �V G Front : � Z� Depth : � (� � Height : � � � Square Feet: �0 �%Z Cubic Feet; � J. � y'� (��-�4I2/4G F F'ront : � 0'' � Depth : � �� ''� a� Height ; �� � ,_ Square �'eet; ��� Cubic Feet: � 71 ��U �� � �_:' �� -! �pe of Construction: �R�/S((� Esti.ma.ted Cost: $ J�Q, OOO� To Be Completed : � C % � !� � �E � ` � , � � �1 � �.� %t � � �z /�-P ei s u � � � -�� �-P �' l�.< < �- y � The undersigned hereby ma.kes applicativn for a permit for �he work herein specified, agreeing to do all work in s::�ict accordance with the City of Fridley Ordina.nces and rulings of the Department of Buildings, and hereby declares that alI the facts and representations stated in this application are true and correct. DATE : 7' I oZ '�% � S IGNATURE : oCJ�-0�'v�G� �CL�t��� (See Reverse Side For Additional Informa.tion. ) "�' � `� ���<� ' `' " - � ' . �� �� � � � - � � , � � s y.;' �._ i �� �_ f ' �2 i.� � I � _ s � � t 0 BUILDING �PERMIT FEE SCHEDULE � SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building or structure, or for any addition to any existing buil.ding ox structure, or for any alteration or repairs to any existing building or structure, upon application therefore, requixe the payment by the applicant fox such permit of fees to the amount hexein below.set forth and in the manner he�ein provided to-wit: . - ; UNtFORM BUILDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic feet, or fraction thereof, in such cubical co�tents. Type 3& 5-$1.85 for each one thousand cubic feet. ADDITIONAL INFORMATION For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches belo�a the floor line of the basement or the cellar to the average heights of the upper surface or �o the averagef height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in - the cost of all proposed woxk. Tn no case shall the fee charged for any permit as set forth in Section 2 be less than $5.00. VERIFICATION OF FOUNDATION NOTE: Permits for construction will be issued a minimum of 24 hours from the t3ane of application, to allow for proper xeview•of the proposed structure and of the construction site. A Certified Survey of the lot, showing the location of the foundation, once it has been cons�ructed,�wil1 be required before proceeding w ith the framing. CERTIFICATE OP OCCUPANC'� Application for a.Certi,fi.cate_of Occupancy shall be made ten�(10) days pxior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. . , �. ., -- e Main Office 784-6066 � UBURBAN 6875 Highway No. 65 N. E. ,---- 1� �f���I NOINEERINGi Minneapolis, Minnesota 55432 .` 1=,_=' INC. South Office 890-6510 � ;! �; Civid, �Municipal & Environmental Engineering 1101 Cliff Road � Land Surveying � Land Planning • Soil Testing Burnsville, Minnesota 55337 �: ' '?; � i�__'i City of Fridley 6431 University Avenue N.E. Fridley, Minnesota 55432 Attention: Mr. Darrel Clark Dear Darrel: July 30, 1974 � ��. �z �� �'"� ,� �. �;�� � ;.:::_�' Re: Harris Lake Estates � � � c��� �—, �, r-�, We have observed the excavation and compaction of Lot 9, Block 2 of the above subject p.roject. The deleterious materials were removed and a compacted granular pad was constructed as per our letter April 26, 1974. Density tests were taken and a result of 92% of modified proctor density was obtained, 90� being minimum allowable. If you have any questions, please feel free to call. Sincerely, SUBURBAN ENGINEERING, INC. ��� � s v Peter J. Molinaro PJM/rp Robert Minder, Reg. Ereg. E. A. Rathbun, Reg. 3raru. Charlea L. Lenthe. Reg. Erzg. John F. Dwyer, Reg. Swu. Jejfrey J. Roos, Reg. Eng. Wm. E, densere, Reg, Erzg. Wm. K. Meyer, Reg. Eng. Wm. E. Price, Reg. Ereg. Donald E. W¢dleigh, Reg. Ert$. � � — — � o€� « � � � � � � �� � � � �� � � � � �� c?�� � 0 �� �m � s,:� . �� �� �� � � � � � � � � � � � � . � � � d � A � � ..� � � V � � � � � � .� ��� ,� a � � o � � � �NM �$u� . M��� M3,�� tN �' a+ a, � h � R � a N .�°.��� c� �u��w °�� uBUa� ��1�� Q y '� :� . �q.aa � `° � o .. .:: E3°� � ���� d � o . �i .C�R� � � N �mQ� ��� � "�� �' � a, ,�., .. � ��06 � � � �� �°'�� a ���w M y'O'Cf U hw� � .F+ � � � 8 � �O tG �6 M N : � � � � � � � � � � ���� �� � o � � � � � � ti � � M � � � � � �p� � � a� a` a �i � i � � x a � � � � � N � � U � � � N 4a m g � .� Ga 0 .�. � b -� � � b -� � �� � � 8 » � � � � � � :O tC m M � � � � $ , g � M � � 3 � g � � � � �+ � � ����� ������ ��"a� � � � � � � � � � �� ��� � `"I n � O I o s • t� O �O � � �� i � E � � � F w A�. z � a4 � � aa � d � v O , v► vi sis w R � � 8 O O e+.' c7 d�! ~ d W � �- .� � N � `� a w� W � �M M S � � � � � v� x °s��� W �a;��� `P' °� � a �, � � y N M N o� � � MO � VH !0 l9 �����. h W �o ,. � : r: �, �: �4' p � � � PR� i p N � I � � � � � � � � � � � -- O � � � � � �m �M � ��b �� � � � I �a� � �� � Mi � � �I E � x I � � V � F~ U F d � � w � � o " � � � _ �� � m ;, M � 3 y I � WO O x � D � a O � » � � � � I � � � � � ��� UOp" d[ Q P m .�� g �z � c°� � � > O Q G 9��� � !� z F- ,�z, � �ad Q �^ N � V/ o � F � . ' �; o� » as � � � � � o� d _�9 � i�t /t M � 7 � � V � � I � � ° � w 3 � � � � � w � � �. � � � ��.. � � � Q � M � •'.• " � o �c��M�r� � p y � � .. �. v 0 � V � � � � � � : •:��� r � ;. Y �y .: � r . fi � � �-i�� .- � � i � '� ` � Fl�USE HEATING TEST RECOB2D �`" �,� r_.�., ADDR ESS �" � E< �� ,� �.r.-�:. ; ,� � .^ . �,;, � ,� �, -� y *`' APT. FLOOR CIn SUBURB OCCUPANT- `r� -�"� �'`�' OWNER �4 � , . � `",r�� HF�!1T LOSS�—DATErHTG INST. GAS C0. METER BADGE R—,�. �—�=� SOLD BY � - " `�'�'��'�"` *='" ` '� �-�� . INSTALLED BY y�'" �t_ ' '` = '' �` �' �, � �� a� , �.. Eleetrical Work By Gas Line By �'�� °�,�' «' TYPE OF HEAT GA FA � HW STEAM SPACE HTR. UNIT HTR. OTHER �, GAS DESIGN CONVERSION MAKE �^�`�+`°�'�'�``�'�"�' MAKE OF BURNER Model � +� � � � "°' A'�' ,a'� Model - Serial Mox. �Tll Retina INPUT � � � �� MAKE OF FURNACE '' Model CONTROLS THERMOS,,�T T���°� -" Heat Plug Vent Size � y{ Valva �'+ �� `"� ', KIND OF LINER � `& ���'� �`� SIZF '' �` NONE Limit ��' �' ,� �°� �' �`� Draft Hood `-£��' f*"¢� , Regularor �� �~'`',`� Limit Sel4ing � �''�� Filters Size �Smber �+eo ` °° ° ;� �+ � Fan Setting � �" Chimney Loeation (ns�de � Outside Pilot Type ��' ` Chimney Construdion � �= �`='"J �'"` . Pilot Make �'�'��>'�'� �``;� Pilot Model "°�` Smoke Bomb � Wiring "�' �"y_; Pilot Timing �_';_�'`'�" Draft °�'� � Test Tae ?''���. +' L.W. Cut Off Door Pressure Lighting Inst. `�'� `� Prossure ��• �'� „ Percent CO2 � 3 � Date Tested �"� � '� �N � � Input CFH� �+ x Percent 02 i+�j�* � Company Testing �' r�%'� ,`'� �" �'� Stack Temp. � �'`�' �Percent CO �' - ��' Name of Taster �� ;s':�k' ., " Form 235 � � . - ........ . . _ <__ . , . . . , _ ..,. . ._ f �, � . . � � � � � . �,� ... � ` /. , ,.. � -_ � .�b � �,1, � � • �l i- I iv � � � ... � � . � ae';. -- . � .,�... .. H�AT I.�.9 CAI.CNA'f fONB �- �- A� .:.:� � .. _...,_.... . , _ . . .. _ r' ,' , e . ° � � : . ; � , .`^ �. . Weatherstrips ' '' Coaat ction No. Insulation Guide Windowa Doara Referettce Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Yes—No I ` Ye—� 19_ <' Fl.� ,. Room L.ength �'' , r Width ,�' Height -�`` � r Fl.� Room Leagth .' Width . Height . Windows and Doora—Crackage and Area Windows and Doors-�rackage and Area � \Vldth He18At. No. ot Llneal !t. Are� Wtdth HelBht. No. ot Llneal tt. � A�e� . ' No. ot Dana ot Dene� Il�hte, � ot crack �q. tt. � � No. ot Dgns ot pane Ught■ ot crack �a. tt• � -,(' � !.�- A� -°� G..ti ` � � � �e``.• ._.. .� / .� '�� .. . . - f� .� o �E�:;• t . . . - � � . . � . t„i' . . Coef. Bcu � Coef. Btu _ Inhltration � ?� _ � _ ,� - ; .�r'° Infiltration �;` .% � -� � ; � `�> ; Glaas. „'� � �: �; � � . , � ' GI s s Y '" � i � - : '� Exp. wall:.;, / Nec eap. wal) m � • '" lnt. wall Ceiling --�° <�, �, � _, . � Fl�or - Total Btu. , Required sq. ft. E.D.R. or sq. ia�. W.A. Leader area / Fl.� ,�'', s-i• ;^ Room � L.ength ;�' �; Width,.i �' H Vf/indows and Doort--Cracltage and Area � � Width � Hel�ht � � No. ot � Llneat tt. Are� No. o[ Dans ot D�n� � Iltht� of er►ck sa. tt. `�% ' � ; 7 %� 4 .s'1 �dv . . ,. �. '.. Coef. In6ltratioa ' ,� j�;,' Glaa, . f-,� � E:p. wall = : -, � st ,� Net e:p. wall �`� " i Int. wall Ceiling -r" : %� ;� ''�.. Floor � Total Btu. Required sq. ft. E.D.R. or eq. ins. W.A. Leader aroa .° Fl. • . E3QOm Length _: ' . ° Width "� �- Windows and Doors—Crackage and Area WIEth H�I�ht No. ot Llneal tt. Area. No. o} ytne ot Dane 116bt� ot crack eq. tt. : ,; � !✓�. " o' -� :1 / 3 1n61tration � r y •_ Glaas � t'° , Exp. wall '"" � - �E! !1[p. Wa�� (� Int. wall <: ; Cetling `� �. !� loor . Total Btu. Required aq. ft. E.D.R. or aq. in�. W.A. L.eader area Fl. ,�!_ i - Room �l.ength ��, Width fiVinc3ows and Doora—Craekage and Area Wldth Hel6ht No. ot Li�osl tt. Arep No. -etya+rs `of yana" i1tMr e[ enck �9. tt. .s L� ��1 .l � . . � � d � 4� ... . . :� t/' % - . - �� � ,. .,,_ Btu �� . �� ,, � , F:°� ��." �, �.:�... �� �� �7'"� � [eight : Btu 1':,� < _::� . � ' � �� � fw-�. � ' � ;`�",'f � ght ,�r - Btu as Exp. wall _ `:�' -; " Net eap. wall Int. •rall Ce„in g Floor • Tota! Btu. � r_ � � °!''' � SI !=. �" Required sq. f.t. E.D.R. or sq. ins. W.A. Leader area f' ✓ FI.I �'' ,� i� . '=�-,,, , Roam I Length ' . Width . �', `' Height � ' � � Windows and Doors—Cracltage and Area Width Helght No. qt Llneal tt. Aren � No. ot Dane of Dans 116ht� ot cracA eV. tt. � °, a � �` �' _ - � „ a;., .� d :;r' �!_ : � �.v .a: - .. . _ f. m 1n61tration � � � ` � - -5 ��--- .�... P .- Exp. wall r, ° - ✓ r� Net exp. wall Int, wall Ceiling Flooi Total Btu. ��� ��� ��� ��� ��� �. ft. ED.R. OI 6Q. ins. QI.A. I,.eader area � Fl.� _ Room I Windows and Doors—C Width Helaht N No. ot pnne � ot pane 11 / �:: �- <- _ =- �:� �,. << � � . ,-_ � I I Infiltration GIBSS Exp. wall � � � `• P Net exp. wall ,� � r �, i ' Widch . `� Height ° e and Area Wnaa tt. Aro� ot erack �O. tt. ° ... p.. � � �, -� t �: r � •� l r • � � . �,:� ,1�7 -�. y �4' Coef. Btu < ." � � � .J • / ,F, ��yf. ��.. ^': L �'X 1fl in�. wau � � -� Ceiling _. ._ ...:_:.-_ — _ ._ Floor .,,F,a " . Total Btu. . . / .� y� Required sq. ft. E.D.R. or sq. ins. WA. L.eader area j'� F7. r;,. _ Room I Length Width ^;/ �HeighRt ;`;� ' Windows and Doors--Cracicage and Area _ R!ldth- #fatgilE- Nu of Ltneai ¢t. Ate� No: oi dane ot D�oe 1l�bt� ot cr�ek' �Q: tt. _�� '�� /: i,l / G7 �, '. ' . �% Coef. Btu In6ltration � °.' � .� ;, F' �.- � . Infiltration '�' c � t- �� ,, C�Iaea ,�1,. ,�°'� r� , Glaas 2 . .�� p� .`,^ r .w G7[p. Wa�� ,''� � e ' �,� EXP. We�� � '�'; i . ,m�e"'. Net esp. waU ,� � C;, `� . �. Net exp. wall �� f` s �r int. wall Int. wall �a• f'�, -. ,' �.. .� .� Ceilin8 r° �' -? t�' �' Ceiling �loor E'loor ---0- °�'�-� � Total Btu. ° ;1 p Tota) Btu. ��, ;`� Required aq. ft. E.D.R or sq. ina. W.A. Leadsr aren Required sq. ft. E.D.R. or sq. ins. WA. Leader at+ta • �o � ��y � � � . H�AT LASS CALCUTAiiONS Weatheret�ipi < A Guide � �d��ction No. Windowa � Doare Refereate Out. Wall Int. Wall Ceiling Roof Floor Kind Yes— o es-- 0 19,_. �'1•f `-'!,, � , d �.-- .-� � Raom Length �° ,e Width �' j' , Height =' � -� ' Fl.� Room � 1 Windows and Doors—Crackage and Area Windows and Doora—Cr+ �� �Vldth HelgDt No. o[ Llneal ft. Arcs Wldth Halght No No. ot pane - ot Dane Ilshte ot cnck �p. tt. No. ot Dane ot Dane Ilg �� .n 6.. A , �. � P.o � . Coef. Btu lnfiltrahon � r'a •;''._ "-'P� r`�' Infiltration Glaas .�`'.�- � r �. fF, ;�� � Glaas . Exp. wall �' ;�. ' �:`-:, . ._, .r' � ' Eap. wall Net exp. wall �� � _ Net exp. wall Int. wall Ceiling Fl��or ��0� �_�_ Total Bcu. Required sq. ft. E.D.R. or sq. ina. W.A. Leader area '�, FI. ;;, ± f�: P Room � L.eegth e, Width ; ii` Windows and Doors--Crackage and Area Wldth H�I�bt Ho. ot Lineal tt. Are� No. ot DQ�e ot p�ns ll�ht� ot crack p. tt. d • ',� � e_% �I,,s>... • Coef. Btu lnbltration' ,�� r_;' �ar,� J e.°: Ad � % Heighc r:�% Glas. Eap. wall 5' ' � ;�;.�,_ t. Net e:p. wall ' Int. wal) �`,� �'a : - Ceiling . Floor -� � o__ Total Btu. ��� ��_ ���� Required sq. ft. E.D.R. or aq. ine. WA. Leadu area j,s,a F1, '� ., ;;, " Room Length; Widthi�P-+ � ,; Windows and Doors--Crackage aad Area Width el6At No. ot Lfneal tt. Area -� No. � ot D��e ot Dane II�At� - o4crack �p. 1t�. .,� ° ' � "' Li" �,. , .�,, . ', .�q �.. .�'�, 1 - .�A.f ._. �i � In6ltration J � (�lan E:p. wall ,�,f� ^ ` , ,�r Net e:p. waU Int. �aall �T„'y Fa Ceiling Floor . Tots) Btu. � ,_. •':8 Required sq. ft. E.D.R. or eq. ins. W.A. Lesder area F'I. ��; � ° Room � Length „2__ Width � " Windows and Doors—Craekage and Area Wldt� He1fAt No. ot Llno�l ft. Are4 No. � of psn• ot Dane Il��t� ot crack `�p. tt., � �LL -� .,,, � «_ � �.,.° � ,_ 7� ' � 1neulation How Applied Wideh end Area aeal tt. Area cr�elt �a. tt. — Int. •rall Ce��ing Floor . Total Btu. Required sq. ft. E.D.R. or aq. ins. W.A. Leader area FI.I Room I Length Width Windows and Doors—Crac�age and Area � R'Idth Hefght No. ot Llneal It. Area No. ot Dane ot Dane 116ht� ot crac4 �V. tt. Neighc Btu Infiltration Glasa Exp. wall � � Net exp. wall Int. wall Ceiling Floor Total Btu. Required aq. ft. E.D.R. or nq. ina. W.A. Leader aree FI.� Room I Length Width Height Windows and Doora—Cracicage and Area . Wldth Hel ht No ot Llnesl [t � Area • r u � No. of yane ot Dans U`ht� ot cr�ek p. tt. _, Btu Coef. Btu : ���'�_ In6ltration . � � ; Glas� • Exp. wall / � Net exp. wall ,f � Int. wall Ceiling � z�' � Floor �° Total Btu. Required sq_ft. E.D.R. or sq. ins. WA. Leader arra �t ;-'' Fl.� Room I Length Width . Height= Windowa and Doors—Cracicage and Area Wldth HeIQAt No. ot - Llneal ft. Aroa No. ot pane ot Dans U�ht• ot eraek sQ. tt. . ,>r� � Coef. Bcu Coef. Btu `�!' In6ltration ` � *% �; ^'; �� � �,� Infiltration r' „ 4 . _, Glaaa � � �-, Glass r�ap. WBII �� r2�o�.._r� . � T J C.i�%. W8II Net eup. wall `' f' %� :e Net exp. waU ;�;� , Int. wall �s' _ �� � s"; ,r �� �' Int. wall Ceiling Ceiling 'i, Floor "?� �' �,�'' Floor ' , �� Total Btu. / Total Btu. ` Required aq. ft. E.D.R. or sq. ina. QI.A. Leader area Required sq. ft. E.D.R. or sq. ins. W.A. Le�de� atra `�" ,.,-� ' '�\ rr� ,;� _ --- ----- � � � �� � �� � � � � .0 y w � � � ���� s�� 8 «$ � � ���� , A�� � W� o� .. �� a �� $ a' °'a , � � � `� � � .� 4 � �a�� �� $���� �� �� � � a� �m�� �, � � ` �� g ��o� , � � � � �O • y � M �, � ��� .� .� � � � � � � ;� i '� � � � . �� � � ,� ; � � ._ • . � S�JqIN3d0 SV9 � 51�9 Oe � � 0 � � � 9 �� A M � z '�ev sr9 HMSrM Oif11l SNISYY lUIY� �� �� � .� '71NIit0 s�vMi MSVM sw�is �►. � �.� ��► s� ,�.�M � � } ' �� F� � � : � �M _� � � o � � �m � � � � ���� o � m � � x � � � a � 'g c � ;� � y ,� � � o q a c� Go � �0 3 O � � t'�9 7'-. �.�.��� D F t:� ❑C �� ������ ����� : : ,�■■■ • . ����� : : �C��■ ' - �■��■ � _- \���� � � `O ` O � o�a h � � �� h ��� �� � W V) K i9 aR t9 N� M Y► °� g � w i� � � � °� 4i w `�$ W i! le % iC k i� N N k 11 � �i � W �'^� \ Z � . . . . � . . . � . . . . . � a : � : : � : : : : � � . . . . � . . . : : � ' m � . � � : � ' � W . .� . 'p � g � F � � � . � � � ; a � 4 " p '� . a ct � ' � d a « „ � ; � r� • •.� �� � ;; � � G � W � 3 w � � � „ ,g W � � � � � � x � � w � � � ~ d w ° d � � � � i� � z� z �� zq �� a� o� � � � a ca m � � � �. : � � , . � « � : • o� : � : �� � �, � a �� � �a a : , o�.`�.. ' ; � �ba - L �'' �v � � ..��r � . v �c: ~..'' E • �� w A . • � �� {/ • �•3v� . ' c� u a, � u . ' � H M � � Y • � �,,. p � �1 � • . C u � p ( . p � b � �. - :,1 - ea A � ���ti - � `n' a � A � `0 a � N p � � x x p �i .�.�j V. . � . � � °�� � . � . ;, : `'' - � p a � � °i i u `� ��J b I � � w � r. .. � , �-o�,ti• � U � a ;,; �� o E�� � � S� ¢. �e�no r • N ��� • � � � +- v - � � "� � b �� � F tr B3 . � ej�a � 6a � - F � � d: o w � '� --- a � r � a ��� � � �, j p � � a 'C7 �D C) • Q �' V v�i A� .�`�t � - • . Lll. � • ' � � � - J^` '�� i � � ' ._ � . � � I � � :. � y � t N , I Ci 3 {� Yy - r. . : .- - e•� ---- «^' o . ti� U s�H�r+u�o '� s.o �� ' � � • r,� ° ��r• ' N _ � � �7 % .z,1„ ' �: �- tvo � � . Q p 1t.'MYiA :- q ou:r • � 4 - . �,� �� Su�'M p �- y�avl • .. � w.wo • • • � trp01 • r1 o �, o,.t�a., ,� -s�.�.�s -� n:.� •L�+o� q. � N. � • n�� W �r� � 4I uw t 1 �� Q 7 MSYM � 11 M . � n���s � 7 . _ x v.�tv+ . N1Ma . • �nrw�rn • - .- : i � . I _`,, . �� 7: � 0 n . � 0. . . o • � . V � [• 1 . � O� � � i r- , %� � c � w � � � � � O � � � P"� .'�t (� . . � .., D � �� � �Q a � A H � .' . v � � H y 'C � d .ri .� a U , u °.� ►•, p `� u. .n � b �� � � b - � JG a E" w O . . • . . ' �. ' • . � _ � ' .. _ � • � , n . �� • . - c� , � " � � x a �' - d � r o � � u c. � ' . � • � .• N � . • . • • 07 . . • • � . • ' . • . . • a1 � � N � � "'� I � � ° s H I 1-� • R� o f t H. L7 C7 � (. ` y p N �'► • . �. . W h h M N H � � . �� . � a �3 ° � � � 3 .�c� 3 ti � � : � � • �. y, .n .�. � .., �. .n vs oy :� + !t �t x K �t !t M )l K x � • � W �. ' . ;� . .� o x • � � x , . � • . W • U � � . • � :i� � . . . . . . . .. . : . � �, . . . : '. •. . • • ` •• • . • . . . . .. • . • e . � . . . • . . • ' � � � . � " � . • : • '• • - . . : . . • • • • • C7 . � , � � . • • • • • • � � o . � . . • • • ai .• .� � i • M • . . .• . . • . . . . y • • • : . ri ' �•° '�°o.� ;�:.� °' ' . UI . G � • � • ' ' . �� �' , � W = �C � . O � �j • r� � ' � . F u • � ' ''' • _� b d � « � .� • �� ; 7 ; � 3: H . � . x x . •• �- W M ;; � • ` a w » o .� �. A-d ' � c^: x ti u • ., v� on � � -� o: � �i O • •J �j x M « V 7 � � M � � f• �i 0 � � � M.� K r � �. 5" y,� �t 0 � J 11 � t� . � 4. � �- w p � � 1"' V � � �Y� � � � � ' ' 3 r ~ f � � � ., � � r f� V � �+ ,. Y � — s � � iG � ! U i 'l. �,,�• � : { V p� � f 1 �ttlTi �p r ..._.. '� °• � � � • � � ��x� . . � N�o'SI ^I t� .�r'1 '+ �i 1 • y � � . � t'1 • • D• . W SuBJECT City of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � . � � � • COMMUNITY DEVELOPMENT OIV ' ��: _"'�', r � � PROTECTIVE INSPECTION SEC i � � � � � ��"1 � CITY HALL FRIDLE� 55a32 NUMBER aev onre PAGE oF �----'�'• •'' 612-571-3450 910-F15 6/24/96 / / JOB ADDRESS 1580 Dana Court NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION DESCR. 9 2 Harris Lake Estates 2 PROPERTV OWNER MAIL ADDRESS ZIP Sally Young 1580 Dana Court NE 3 CONTRACTOR MAIL ADDRESS ZIP Don's Weather-0ut 2808 W 72 St, Richfield, MN 55423 4 ARCHITECT OR DESIGNER MAIL ADORESS Z�P 5 ENGINEER 6 USE OF BUILDING Reroof House & Gar 7 CLASS OF WOHK O NEW MAIL ADDRESS ge (23 Sq) Tear-off ❑ ADDITION ❑ ALTERATION ZIP � REPAIR B DESCRIBE WORK Reroof House & Garage (23 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must meet the State Building Code. ��'�'30 � �� � APPROVEO BY SEE ATTACHED SHEET PHONE 571-7227 PHONE LICENSE NO. 869-3746 7155 PNONE LICENSE NO. PHONE LICENSE NO. ❑ MOVE ❑ REMOVE TYPE OFCONST. OCCUPANCV GROUP OCCUPANCVLOAD SEPARATE PERMITS ARE REOUIRED FOR EIECTRICAL, PLUMBING, HEATING, VENTILATING OF AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT CU. FT AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOH A PEHIOD OF 120 DAYS AT ANV TIME AFTEFi WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV 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 WOIiK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. TNE GRANTING OF A PERMIT � 1 s 897 �. 95 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OF CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- @ STRUCTION OR THE PERFORMANCE OF CONS CTION. �p.59..rJ0 IF $59. 50 Fire .SCi � 1. 9� � � �� PLAN CHECK FEE TAL FEE /`G'. Li s SC .00 ' $126.85 SiGNA UFE OF CON'RA TOA OA d.UTHOA�2ED AGENT 1DATEi pq LY V ATED THIS I�UR PERM�T � ' S�GNnTUAE OF OWNEA uF OWNER BuILDEfii iDATE� _ _ �DG �p o qq7E NEW ADDN ALTER tl �� �] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Effective 3/1/96 ConstructionAddress: _ � �-' �;'o � ��,�. �" � Legal Description: �,S �'G� °° � ��,r,a �' �°, Owner Name & Address: �',,,_ �/.� Gs�, ,,�, / �°��► �,,�,,�� G' �'" Tel. # ,�` j- '� � r--- Contractor: ��� ,� s �,r;pl�, �` _ �, � MN LICENSE # �/S � Address: C�t✓ �io2 ��, ������� Tel. # ��' % -� % i�.� ��� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GAItAGE AREA: DECB AREA: OTHER: DESCRIPTION OF IlVIPROVEMENT �ng� Width Height Length Width Height Length Width HgtJGround � � Corner Lot [ ] Inside Lot [ ] Type of Construction: Approx. Completion Date: � �'i /�Pc �lo� /'�-�-�;Z'_,.� �7 �t? Sq. Ft. Sq. Ft. Sq. Ft. ,� `��-'�' e�?3��. Ft. Yd Setback Side Yard Setbacks Estimated Cost: $ ��> �' , .S-� (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ —$ DA�: l� - a y �(�� APPLICANT: _ �F �� ,% �� �- Tel. # � �i�-��� �> � ��.:.� i Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: �� �g � � ��.SU �_ i�• �D � �s' $ $ .� � U $ $ $ $ � /�� . �� CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1110th%) $.so/$1,000 valuation $900 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 [ ] BUII.DING PERNIIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any e�sting 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,Q01 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $5(�,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.(?0 for each additional$1,000 or fraction thereof, to and including $50,0(� $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $1�,Oi?0 plus $S.l� for each additional $1,�000 or fraction thereof, to and including $500,�0 $2887.25 for the first $5�,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,0(� plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete C�rb Streets Only) Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alte�nate "B" : Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the l�ation of the foundation once it has it has been constructed will be required before proceeding with the framing. � rn rn rn � 0 � � m � W L � a � Z � � Q C Z a Z m a� a � O � z 0 a C� J a a a 0 � Ili � � � Z O U W Z Z m � Q c�i O � � � m Z u-���� O > >; cfl F- �"� 'o N ���� � O LL Z � W J � � Z w m O � w � � � � � � w m � � z Y 2 .- � � 3 , Q �I �I � m O � Q O F- W � c _ � .� i� � m 3 � � � �' `° � °��� � � � � `. � y� N 3 � �� `�c a°i ��-�� `o � � m � � d c � �p t `� t�i � � � c ' �a � � a ' W � � � NY�y� � ?� �Z C E - � � �., � c �? N � � y t `� m c -o c � o � �d � R � � p C •y � N N -�p � C Q � •� 2 � � a�i -v v � � � o � � � � `�.` � � � � � � ,.0 � d N � � � m' � �: � �' � '�, � �' c �� � c ,' � � � � m o u -� M c � � � � � � u�i a Z � ' � U, F- � '° � (a, � W C� � N z a � i � _ � J �, a � ` � z � Q � Q LL � � W o U �, LL .p Z m � � � m W � � E � � a �, w a cn ¢ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 r.; �� ti ti� ti c� o 0 o ui t� tA tA �A � tA �A �� H H� � z° I�IIIII�I�II I 0 Z v ayi } .-. v � W � � '� � � � w � � � � � � i� ... � � � � � a � � � = Z� c c0 c� W , > d • d � d C C•(�p C ` �+� .� w�' d Z �.0 V�! t� .� t�0 �� d d C�� O g i+-��O=�i a~ �p�- o. � 3 a`� 3 .� c � :: � � � N � >. 'o o R co ca F- a zOmmU�c�n���C�C�m I � � � � � Z 0 � w J Q 0 � Qc co � a Qa `- W `o o � � �p � a� Z O � ¢ � C � �p O � n� o ��� � Q � w w LL J � � l0 � O � � � � � � W _ U Z CJ � rn w N � 2 � z ¢ c� W J m H � z ¢ Q 0 � z 0 � U W � U � � � w a 0 W � Q � a w m _.1 Q 2 � � Q z O � � m O U s � � � O � � � S N � � d > v � W z 0 J W V � � �t W Z � Q Z U c/� C3 � Z � t�] � S � � Z � z Q � 1'�" ~ � Z a O U � � W —. O4 � o.. Z a O � O Q � � W U � a � 4 a Z O U a Z ` t1 � Z �� Q � m � y N � ¢ a � �� � d Z O ,� � � � � � � rn' �C ?C1/TG1',.� � 0 °a m O -� c � a�i N � _ � °z H � � W a � �J � � O U � ¢ � w i� � � � Z � � N Q � N W � o .o s �v ,..� J � � � � � � � a c`� o = ;a � � C7 � � � � �� � c � e E � A = m w�� � �G �= m l�i � � 4 O �Q Z Lu N a x m E � � � � m' m a� �'O ,�, V � � � U �p .�C � +� t � " 3 � � � W � '� � � i � � 'Y� �o � � N = o s y 3 p i� � o � � � � m bo y c r a`i� � lC y � C � � v N W a � � r �c � a�� �c . � c U • C9 z � 2 � � o � � �° � � � � � � � � � °o, °o, �b o 0 � � � � � ti °� N � � J i i � � m �' x � � o � r � c � 0 LL �o � C � � � � � � = U N C N R� d � � � � � � � ° � C Li sa TOU.QI.CJ. � N ai U m a�i �i � C !L � N Z n0 a � C9 b�0 G � y C�J ni C � C7 � a i eo G .O Cp U # 0 0 m �� o c �� v y x o � m � O � 0 3 ° �° o i+ ` N��� 03 �,s� � N � � � '� � o � O O � LA U La� 3 •� ,� �.r a���� N > > � � � E O a�� � U � m � O � � c Y � O � � °' o � v U �� a� ¢ O O M 7 � > � O � N c e�l � � c`o � � tl7 � � N O N � � n u'1 n 1 C+1 �O n � � `,,s� � � � I� M � W u. Q O F- � � x g ° � W � Z 0 V W � z W � U O n 8 � c > 0 a 0 f�. G C � 0 i 0 � 'u. i ❑ � � �° .Q ; �' �.��n r�� an �, i r � wn�-� b� : i t treez-zz-�dd C� ' d �t1101 FILL IN COMPLETELX FOR REPLACEMEN7 FUEL BURNING APPLIANCE PERMITS COMMON VENT VENT CONNECTOR AND COMBUSTIt�N AIR VERIFiCATION When repiacin� an existinq fumace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructi�ns, and is securely supported and firestopped where.required. Yes (� No () The venting system is plastic/PVC and meets al{ cu�rent codes and manufacturer specifications induding sizing, length, number of elbaws and termination. Yes (� The undersigned also ver�es that the replacement unit is a listed assembly and meets the curreni codes and manufacturer's specificaiions. This do�s include AGA-GAMA Category I Central Fumace Venting Tables fior fan assistecl and natural draft applianc�s. Yes (� . . ...a:,... ,.: . «. �� n .,1 • a+ +4.t,. ..� . — Q.QFi7i�zrorr oair-�.-r .�Z£C�-�� If�&�x-cv n �� : .� �.. ..��fl�Flt &- ---- -- and manufacturers specifications. Yes (1� When required to install a new combustion airLit will be sized and installed to meet the current �des and manufa�ture�'s spec�cations. Yes �) When installina a new venting svstem, the undersigned hereby verifi�:s fihat it is a listed assembly and meets the current crodes and manufacturer's specfications. This does include AGA-GAMA Category I Central Fumar,� Venting Tables for fan assisted and natural draft appliancES. Yes (� Is the common vent and vent connectors sized and inst�lled carrectly after an appliance has been removed from the common vent and vented separately as per current codes. No ( ) No ( ) No ( ) No ( ) No ( ) Yes � ) No ( ) A liance T e and Size/Common V�nt and Vent Cunnector Information Appliance #1 Type ��� B'R1 � nP� _E�..�� Fan Assisted or Nat -�.Y• Appliance #2 Type BTU Input Fan �issisted or Nat Appliance #3 Type BTU Input Fan flssisted or Nat Total Appliances Tatal Btu Input _ Common Vent Type ��� � Vent Height � Diameter � inches Appliance #1 Vent Connector Height 5� ft Length ,,,�e�ft Diameter �_in Type � Appliance #2 Vent Connector Height ft Length ft Diameter �in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATI�NS• Describe} - � CENTERPOINT ENERGY HEATING CO: 13562 CENTRAL AVE NE BLAINE, MN 55304 Signed By: ����� � � � A Date - �S ,, �A/�R' �I SRJ,9I.SL Ol J,31Q 1�� �0 J.l 1� WO?J-I �� : i T b002-LZ-�IdEi. � Building Inspections 763-572-3604 D.ATE `� "c.- � SI'i t ADDRFSS � THIS APPLICANT I5: PROPERTY OWNER/ TENANT CONTRACTOR SUBNIIT A COPY OF YOUR STATE LICENSE WITH .APPLICATION PERMIT TYPE TYPE OF VVORK: � MECI-�A.NICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAJL ADDRESS � r � ❑ OWNER �ONJ'RACTOR � a S: CITY '1(_ � _r*�I _ '7�► l'1� Permit No Received By: � . �� - .� i1 �o��'Y N"',�: Anderson Heating and Air-Conditi�ning CONTACT PER50N: �� J STATE LICENSE � 4347 Central Ave N.E. ADDRES$: � PHONE ,� f�'� p��- ��s�� Col. Hts, Mn SS421 � �INGLE FAMILY ❑ TWO FAMILY p �.I�W �REPLACEMENT n GETAILED DESCRIPTION OF WORK ❑ TOWNHOUSE p pLTERA7'ION/REMODEL _STATE ZIP PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the totat cost up to 5500.00, whichever is greater, for the i m provement, installation or replacement of a residential fixture, excluding the fixtures. (This 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 �'I�RE LABOR EXGEEDS 5500, FEES ARE BASED ON $]0.00 PER FIXTURE, EXCEPT WH£RE NOTED. FiXTURES: (INDICATE TOTAL NUNIBER OF EACH BELO� �"��' '4���= MODEL: SIZE/BTU o7 0, <� Equipment Installed I''�G' MODEL: S��T� ��' SIZE/BTU �G: MODEL: �A/C 525.00 _FIREPLACE (GAS) 515.00 _GAS RANGF/OVEN $]0.00 P1R TO AIR EXCHANGEER S15 FIREPLACE (WOOD) $35.00 _NEW GAS GRII.L $10.00 BOILER $35.00 _FURNACE $35.00 _GAS UNIT HTR $10.00 CHIMNEY LINER $10.00 _GAS DRyER 510.00 POOL HFATER $35.00 _GAS PIPING 510.00 _VENTII-ATOR $15.00 DUCT WORK $10.00 _ _ .._� .. .........:....e....,pr...n.a.m,:.�.���.�- .,,.�.�r,�.--�:�:- rc�::t*::cx,�,r_r:s��.nxhcriuccn 1,1.�2'��iL'�;i1CtJJGV1�Jr:L'iVd��.ti?.L�a✓ua4::�vrv.v. c�. �,•".•=n : � .,:,,.,.,� ...-.,- .. ... : .:... .. .„__ . _ _ . Permit Fee $��• G� ' Number of fixtures @$10.00 x$10.00 =$ Surcharge $ .50 Number af fixtures @ $15.00 x $15.00 = $ TOTAL DUE $��•� Number of fixtures @$25.00 x$25 UO =$ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Tota] _ $ � THIS 15 AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the inf�rmation above is complete and accwate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota �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. S IGNA'rURE OF APPLICANT L`�� Sc(i''V • PRINT NAMEC � Gv�'I ��T e/J 4� iC � �j di/� DATE e;ry of Fr;aley ' Suilding Inspections Depariment 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAx� 763-502-4977 1� 0 i \`C t- 0 � 0 suo�Ejn�Y�� �n� dn ax�ui pu� uopsnquzo� ao� pasn aq ��m aaEa�os sauriapm� apo.� IE�iu���ay� �iau� �utod�a�ua� :�,Y,p� Q i�� d���1 � — — — �_ __ _ -- --- � €��'9#t�-�u�FI-��� u��s�-��t�� '9 � ZL9L I� OL9L aPa� �ia�3 I�I �ad � � ' uor.�eTquaA 'S ZZ£0�917�I �LVI II01'��'[LL�SL[O� M2II IIO �2[L1U2�j �e taoos iad p�eoj ��ooa � ssoj xeaH '� S3WOH M3N 2�0� a�?�Ifli'�32� s�uamPIIa�' l�Ui�I qXUe 8�a�dE� �J�II �� ��za�o jan,� •q s�uaurpaazay 1�U�I �?�'� S ia�d�I� �J� sa�ue�ddE se� -e �u�Ba� "£ s�t[a�aPIIa� l�t �?m S Ia�c�e� �L�II `� (motaq a�oct aaS) rr� dn-a�ey� 'Z -� - s��aacap�a� l�i �� £ Ia��� �J3flaaEdoia io serJ T��N 'q ��mP��d 1�U�I �?� L���� �NII tan� Pt�os io i?O `� �. (n�ojaq a�ou aaS) ny II°psnq�°� � i � S3WOH JNIISIX3/N1�N 2i0� a32i1f1��2! 2�1y d(1-3}idW ❑ 3WOH JhII1SIX3 ❑ SNOIlIOaH/S�WOH M3N ❑ �`dAH NOIl`d�I�ddH lIW2i3d �t/11N3aIS321 llW�l�d SS3�02�d Ol a3a33N NQilt/W2iO�N1 a3211f1i��?� . .�.