AF - 39037.:a_F�.�.� PERMIT NO.
City of Fridley ° 14'�'76
�
"TT"ET°`°""ETW'"S gUILDING PERMIT
' � ECEIPT NO.
� �
�..____ GOMMUNITV pEVELOPMENT DN. , C�{�'C'
r � ti PROTECTIVE INSPECTION SEC. /
� � .� L' ((�
1 �
` � �'°1 . GITY HALL FRIDLE� SSd32 HumBEN AEV carE caGE or nvaaovED B�
""-'� � •'� 6i2-560-3a50
910-Ft5 6/22/78 � �
lOB ADDRE55 511 Dover
t LEGAL LOT NO BLOCK TRACT OR ADDITION SEE ATTAGHED
oESCa 1, 2, 3, 4 K Riverview Heights sHeEr
2 PROPERTYOWNER MAILADDRE55 ZIP PHONE
Noxman Johnson 515 Dover St. N.E.
3 CONTRACTOR MAILADORESS Z�P PHONE LICENSENO.
Al Williams Construction 947-86th Ave. N.W. 784-4690
a ARCHITECTOFDESIGNER MHILADORESS 21P PHONE LICENSENO.
5 ENGINEER MAILADDRE55 ZIP PHONE LICENSENO
6 USE OF BUILDING
7 CLASSOF WORK '
�� NEW f: ADDITION ❑ A�TERATION � REPAIR ❑ MOVE I'�� REMOVE
8 OESCRIBE WORK
Construct house 41' X 46' Garage 22' X 22}` '
9 CHANGE OF USE FROM TO
STIPULATIONS 1. PmVide "COmbustion air" to fuTnaCe area W�N�NG
2. Provide verifying survey by 7/30/78.
Before di�inQ ca1� ioc� utilif�es
SEP�RAIE��RM�1�S �t�QUIRED3FOR�WIRlNG, 1E�E��pE�EIECTRiC-GASEtc.
HEA71N(i, PLUM8ING AND SIGNS.
REQUIRED BY LAW
TN4 C1TY O: �� OOES NOT GUARAIJTlE TNe
ACCUI�AGY OF tfiUN LOCAT�ONS AND ElE`;r;
30 DAT 1�07iCi: :•: � CIT`( ENG,
T�IS OAiA IS fOp ���"1`�N �^POScS O:.Lr -
aIV. REQUIRE�� FOR CURB ►erssor+s US1NG R SNOULD YERIFY TM� �0�'i� �
oN rne �rre
REMOVAL AND REi'LACENLENr
A7 DRiVEWAY OPENINGS,
SEPAPATE PERMRS APE REOUIRED POR ELECTRICAL. PLUMBING. HEATWG. TYPE OF CONST. OCCl1PANCY GHOl1P OCCUPANCV LOAD
Wood Frame
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BEGOMES NULL AND VOID IF WORK OR CONSTPUCTION ZONiNG SO.FT CU.FT
AUTHORRED IS NOT GOMMENCED WITMIN 60 DAVS. OR IF CONSTRUCTION
OR 1NORN IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAVS AT R. 1� SLO
ANV TIME AFTER WORK IS GOMMENCE�. NO. DWLG. UNITS OFFSTREET PARKING
i HEREBV CERTIFY THAT I HAVE fiEAD AND E%AMMED THI$ APPLICATION 1 STALLS GARAGES
AND KNOW TNE SAME TO BE TRUE AN�CORRECT. AlL PFOVISION$ OF LAWS yp�UATION SUPTAX
GND OADINANGES GOVEPNING THIS TVPE OF WORK WILL BE COMPLIED 34 045.00 1%.OZ
l"JITH WHETNER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR GANCEL THE PERMITPEE SAGGHARGE
PFOVISIONS OF ANY OTHER STATE OR LOCAL LAW FEGULATING CON- 91.1•� �IOO.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
� � � PLAN CHECK FEE iOTAL PEE
�� ,; -� �//[�C ��2 -•-�- �- :,7,1 /J 22.79 530.98
SiGVaiUREO�CCrv'aaC10A0a4uia0a¢EOnGEmT iO4TEi ���r.EN PROPERLY VALIDATED THI515 VOUR PERMIT
J �
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i:Gnn'�aec�ov.aEa�vovrnEaew.eEe. �on*E� w,-�5r �%(i'i r,o*p
CITY UI" ( fZIllLEY
� �'�. ' /SPI'LICh,�fl0il FOR RLSIllLf��TI�L PUILllliJ> PER11(TS
' `, '. (fd��•�, Il�_�r��znri����s, 11;�;�i1�io;;,, o,z R�i�niizs)
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Addr.ess: �/S� �c, E�/' � S / �L t
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P,UILUI>R: ����;'/l � //�/�>r C'u+✓1 % �i•� �-
Addres�: i��/ � r� � f.� f1 � i- b C� ,
`Pcl. IJo.:��/ C % l .
Strcet: �� G' l � /. /�'
J_.OT: ,� 3 �/ — liT.O^Y.: /�'___ ADliITIO?]: ��/ b /- ��� i�/ ��- � � / / � N % �
GU7tI7I.R L01': >� IIIJIDL LO'i': JI.'I'P�ACY.: _�_ SIUI:tAR;)J: S�' /C ' J(7
I:j?p]icart attach to thi<; fc�:a 'iS:o Cert��i::a,_•.,, og �:u�_•c�,_ of Lot an3 prc�p::scd
Lui.lding ].ccation dra;;n on thesc (_,�rti;_icc:t.os.
0
llESCRIPTI01d OP BUII_DII�G
To J3c Used T,s::
i -���.--- Front: ��� _ llepth: _�_6- Height: C �
- /O�
. Sqtiare Fee.t: 7�g-�- Cubic Fcet: �8, ,3 �� __,
�-
--(=✓ /� /��/-%_l F� Pron`.: _ �_ Ucpth: � Z=_ Height.: �'?--
Squa�'e reet: .��/C Cubic FeeL: yyOU_
� 3y o � `�'
!'y��� of Censtruction: � �� tJ � _ Esti:natec: Cost: $ � �J' .
'lb Fe Co:nnlet:e3: _�_��
Prciyu>sed Driae�any 4;i.citl�i If I;ew Openiny Is Desired
j � �lt. A �l.t. B
---- $ '— --
(SEH l:�l'iF::>l Sill:: Oi' SHEtiT)
;The ii�iders.i.nned hereLy mz'.;c� aprli.cation for a t�e.:riit foi thc wer): iierein
�� spe.cif icQ, aqreeinq t.o �o all cor}: ir. strict ac^ord<,:;ee �oi�.i� tl:e Ci.ty of
r
S'T:idlay Orcin:.nccs and ruli:in:; of th� Dc��urt:,icilt oi: ]�uilcling:;, ar.d ;:creby
dec).:rc: t}i�t, a'_'_ thc fnct� ar.i rcE�rc:c��i�.�tio:lr. sC:.tc3 �n 1:iiis a(�i;licr�:-io:i
���� are Lrue ,��d correcL. Sec :evorse side for a4dition�l i.nfonaation.
nr�'rL: � _I_t /_�_ szcr���rm;t:. �y� � :i til' ��,.---
stipuiatio:,_ :
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c/ Su.b�.�c. �� 33a.98
n�� - �%��fG).r✓y,s-� _ � �3� 9', =
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BUILD1f�G P[P,f+IIT FEt �CiIEDULE
S.T•:C7'IC� 2. The Insr�ector of Ltuildin9s stiall, befoze issu��g r�ermits for the erection
of any bui?.d:in9 or str�.ictnre, or for any ad�iit.ion to any existi.n9 buildiny or. stnictLrc,
or for any altcsatioc; or repai.rs to any existing buil3ing or structura, upon application
thcrefore, require tlie peryment by the ayplicanY. for such permit of_ fees to the an'�ount
her.ein beloo� set forth and in the manncr herein prnvideel to-wit:
NLW COI��'SIiUC7'ION: Single Family Homes and Garages: ;9.00/1,000 cu:�;_c feet.
PLlll7 CHL:Ct:: 25 perr.en� of buil.ding permit fee. �
DkNE47AY Ui:P12E5SI0N: (COncrete C�rb Streets Only)
Alternate A: P��moval and replacement of concrete curb and
gutter only; Lr.iveway width plus 6 feet x$14.50
Alternate H: Removal a:id repl�cement of concrete curb an3
� cutter and ir.stall � 3 foot wi_de approach with
6 inch depth; Driveway wiath plus 6 feet x S1?.20
���iJIONAL= ;�FORf�lATION
For ti,e �ur�;,ose of computinq iees for b�.ii.lding perr,its, the cubical contents o` any
huil3ing or addition, is determined by multiL�lyii:g t�zc ground axez covered frem a
point six (6) inches below the floor line of the basement or tne cellar to the
average hei9hts of t?ie upper surfiace or to the average hei9ht of. the roof surface
of the main gable of a pitcned roof.
Fo° renairs cr alterations to an existing structure, the fee shall be at the rate
of $3.00 per each five nundred dollars ($500.00) or fraction thereof in Yhe cost
of a].1 proposed work.
In no case shall the fee charqed for any permit as set forth in Section 2 be less
than S7.S0 plus $.50 state surcharge.
,/FRIFICATIOiV Or" f=OUNDATIOfJ
L70TE: Permii:s �or construction will be issued a minimum of 24 hours from the time
of apolicati.on to a11ow for proper review of the prowsed structure and of the
cons-"truction �ite.
A Certificate of Suivey of the lot, showing the location of the ioundation once it
has been constructed will be requir�d before proceed.iug with the framing.
i � i � ! � [� 7: \ �� � ) � Z Kd n » e C�'�
Applicati.on for a Certificate of Occupancy shall be made ten (10) days prior to the
use or uccupancy 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 Fas
been issued. �
1. Address 5�� ��'�' '��
2. Leyal /.� =-'� �
3. Zoning r " �
4. Lot Width
5. Building Width
6. Front Setback
7. Total Use I
8. $ Lot Coverage '
9. Eas�e�its
10. Variance . '
11. Soil
12. Contractor �
13. Phone ql
14. Architect j�
15. Drainuge �
16. Eneryy Ashrae
17. Utility Locations
18. Specials
19. Driveway opening
20. Truss Design
21. Combustion Air
22.
23. '
24.
25. ' -
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Cjflll+4-C � .tv x z = -
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CEEa"�""IE'IC.4'V"� OF' �UFaVEV
�u�3� �u�3v�ve�G, en��.
4002 JEFFERSON ST. N.E.
COLUh7HIA HEIGHTS 55421
7H8 9769
1 1(611tlY Cb1�T1�1/ TNI1T TH19 RV11V�N. PLAN, OR R6rORT WA] ►RR�ARCD DY MR OI� VNDlR MY DIR[CT W►lRVIt10N
AND TOtAT I AM A Ltl IKOIOTQRCD L/1MD lLFlY6YOA UM�EA 41fL LAW7 CT TM! OTAT[ OI MINNSEOTA.
( - �� DATE �'�� i %�
h11 RI N ESt��A
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30
'P'ION NO. 5332
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a= IRON MONUMENT
�M�=MEASUREb ��STn.f10E
W ARNI�� utiliVes
gefote d�f,Bing , Gpg Etc.
TELEPHONE-E�ECT���
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Y V
� DAY NOTICE TO CITf EI�G.
�� REQUIRED FOR CURB
�EEi1tOVAl AND R�PIACEMENT
.R:T DRIVEWAY OPENINGS.
���Z
�� /CITY OF FRIDLEY DOES NOT GUARAPlTff TM�
�� :Y OF UTILITY LOCATIONS AND F1FiATiOn_
, ,:aU51NG R�SHOUI.D�ERIFY RTHE INPONWMTICN
- SITf.
ii. . "� ;;-: .' . ., ..., '.,: !., .. .
as folloi�rs: Be9inning at th� Horthvtest cor�ner o;
Worth�rly line of said Lot 1, a dis�ance of 13 fc-
point of intersection with the 4!esterly line of �
Southerly of the �dorthaiest corner of said Lot 1;
line of Lot 1, to the �oint of beginning.
And
- , '.nunty, Minnesota described
thence Easterly along the
outherly along a line to its
--aid point being 45 feet
I erly along the 4lesterly
Lot 2, dlock K, P,iver View Heights, Anoka County, Minnesota except all that part of said
Lot 2 described as fo7lows: Comm�ncing at the Southeast corner of Lot 2, Block K; thence
Vlesterly alor.g the South line of said Lot ?_, a distance of 17 feet; thence �dortheasterly
to a point on the East line of said Lot 2 iocated 65 feet Fdorth of the Southeas't corner
of said Lot 2; thence Southerly along the East line of sairl Lot 2 to the Southeast corner
of said Lot 2 being the point of beginnin�, and there terminating.
Flnd
Lots 3 and 4, Glock K, Riverveiw Heights, Anoka County. Plinnesota
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='7.;. A3
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Page 'iwo
R-Value
�, Tnrr.;or air film 0.6Q
2. �/z„ G n�. Bo/a,2o , 45
3. 9"inches soft vood �J.��
a. �/z°.�ni� �,aS,� �. i4
5. .�!!/.lJu..J�7F SipiiJa •4s
G, Exterior air filn = 0.17
Total 7, ZQ
t/-%=,/3d a � : , iA
1. Interinr �i.r filre 0.68
2. �/: ,� /� �oAZO .45
3. ,3/z„GL�Jft$F,7 i�•i� iNS //.00
4. �/�,,,✓i!�'G �AS�_` /. /O
$. �aN/Tr S/�J/N6 -4S
G. P;:terio: air filri U.17
�rat�i �3.�9
G/- �j'. . o7i us� . 07
1. 7nterier air filn 0.G6
2. _3�Z"GL.PSS.ri/jF2(ifi.��) //.00
3. Z"Gi2 fTiMT0�1? /.8ri
5. �/.? "NAiG FjASF /. /�
5. M,Ofa.�/.>v S�pi..iG .S>7
6. Exterior air film 0.17
Total i5•3z
/./- %j�: . aGs u5/_ . oG5
1.
2.
3.
4.
5.
G.
7 G_I+liE
Interior air filn 0.G8
/P " Ca.� c. /�i4K G'%1.0✓, ,4 GG
Exterior air fil:.i 0.17
Total �'
G!= %,y_ �% u s= �-
=G z � i =
S:=F /.i7T• l�'/,�T •
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NO:E:
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• /(/
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l[f /Ir ` /!/ = lrr = �
Tndicate tyue, "?2" v;,lue, denth and
placenent o_° insul�tio�.
��' 121d. ��CT/o.�/ TL�f�lf �^qf��OGE 6r//�LG Paae �n�o
� _ ��ALL Si:rTIONS � . .
N07'E; Usc� ��. of �paque wall area for %��A� �9-
^ frame construction Construction R-Valuc
"?'7G_ 43 j''
. � U • ` Y-
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I c r�
. � `
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r -/
1. Snter.ior azr film 0.�8 �-
2. '/s„ GY� ��OXD. . 45
3. 4"inches soft �•ood 4.3'J'r
4. 91" GY6 f{o,O�FO, . 5(e -
5. o. G E
G. = �
Total(�,7Z
�=�R: ��.•%L'./%8 �f/SE ./S)
�
1. Interior air Pilm p,[�$BrGE�
2 . // a • �
3. // ^ � � � -// . o0
4. '_�rl. f�o.�vKR . �'G
5. �ti,�a�.v,'a FzM o. `s
�>. -- -�- �
'iotal /3.37
l!= ��,q= �i3.37 = • 0�4 �v3E .07'��
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3. �t �"' iiS i,a Toi'ss /. ad
4. S/� �' G rP. �.v�v. . 56
s . /,JTt+�,C.ti�.t .OiR Fi[M. o. C►d
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To::al �,� �O
1.
2.
3.
4.
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G.
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FIG. !14
�' �i{ = �y�. �o =
Interior air filn
* �' �
oy7 (uSE . oG7 %
r3
£xt-erior air :i]:.i 0.17
TOtal
�= • �li
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n . �
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// / �
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indicate t��pe, "°" value, depth and
placenent o` inscl:,tion.
1 �
�i�
. �
�I,TOW-�.�Y�SON, IP'�'C.
CONSTRUCTION
M A T E Fi 1 A L S
a s� 2/s�s-t zi s
1221 North 2nd Avenue � Mlnneapoli�, Minnesota 65405
COST ANALYSIS *1ASONRY WAI,L INSIILATIOti
Type of Wa11 No Insulation Korfil Zonolite B-D Fil
8" }WCB 41C/unit
Block cost per SF .45 .45 ,45 .45
Insulation cost per SF ,00 .37 .18 .11
'Lotal material cost per Si� .45 ,82 .63 .56
U Factor .S1 .23 36 r34
8" Ik7CR S1C unit
Block cost per SF ,56 S6 .56 .56
Insulation cost per SF .00 .37 .18 .11
Total material cost per SF .56 ,93 .74 .67
li Factor .33 .15 .16 .15
12" HWCB SSp/unit
Dlock cost per SF .60 .60 .60 .60
Insulation cost per SF .QO ,48 .44 .26
Total material coet per SF ,GO 1.08 1.04 .86
i1 PacL-or .47 .24 .22
12" iS�JCB 70C unit
I3locic cosL- per SF ,]� .�� �� ��
Insulal-ion cost per SF .00 .48 .44 .26
Total material cost per SF ,77 1.25 1.21 1.03
U Factor .29 ,14 .12 .10
Figures based on the following contractor costs:
7.onolite 4 cu, ft, bag $2.90
B-D Pil 6 cu, ft. bag $2.(0
Korfil & Block based on Freidheim figures
Add for labor for filiing Ulock cores
ROOF/CB I LI ;:G
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R-V., ] t:e
1� Znterior air filn 0.61
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Total
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City of F'ridley 31 17 5
ATTHETOPOF,�E,W�NS gUILDING PERMIT
%
� RECEIPT N0.
� '
�
COMMUNITV DEVEIOPMENT pIV
� � � PppTECTIVE INSVECTION SEC ��C�
i
i
� J
i'°\ � GTY MA�I FRIDLE� lS�Ji NuMBfA AEV D�iE o�Gf O� ♦ovnpvEU pr
L""�'� ,'� 612-571-3450 gt0-Ft5 7/13/00 � �
�oe nooaess
511 Dover St. NL
1 LEGAI LOiNO BLOCK TRACTORI.DDITION SEE�TT�CHED
oesca 1,2,3,4 K Riverview Hei hts SNEET
2 PHOPERTVOWNER MAILAOOpE55 21P GMONE
Don Hanson 511 Dover St. NIi 784-8870
J CONTRAGTOR MAIL ADORE55 ZIP VHpNE LICENSE NO
Advance Aluminum Su 1 Inc. 7701 hfain St. NE Fridle �.� 55432 612-571-3440 7983
� •ACHRECTORDESIGNER MAILADDRESS ZIP VMONE ULENSENO
5 ENGINEER MAILAODRE55 21P PHONE LICENSENO
6 USEOFBWIOMG
Residential
7 C1A550F WOFK
CJ NEW ❑ ADDITION O ALTEFATION �1 REPAIR ❑ MOVE O REMOVE
B OESCRIBE WORK
Reroof F, Tear Off House and Garage 23 sq
9 CMANGEOFUSEfROM TO
S7IPULA710NS
lJnderlayment must comply with the State Building Code.
Permit Inspection Cards
Will Be Mailed
To Homeowner To Post
TvPEOFCONST OCCUPANCVGAOUP OCGUPANC�L04O
SEPARATE CERMITS l RE REOUiRED FOR ELECTRIGAL PLUMBING. MEATING.
VENTi�ATING OA AIR CONDIiIONING
iH15 vEAMiT BECOMES NULL ♦NO VOID IF WORK Ofi CONSTRUCTION zpNING 50 FT �U FT
AUTNpqi2ED iS NOT COMMENCED WITNIN 60 DA�S. OA iF �ONSTRUCTION
OA WORK i5 SUSPEHDEO OA AB4NDONEO �OA A PERIOD OF 12p OAY$ Ai
ANV iiME nFiER WORR IS COMMENCED NO �WLG UNITS OFi$TREET GIRNING
I MEAEBY GEFTIFV THAT I HAVE READ AND E%AMINED TMIS AGPL�CAiIpN 1 $T��LS GARAGES
ANDMNOWTMESlMEiOBETRUEANOGORRECT ♦LIPROV1510N5OF�AW$ yq�UATION SUFT�%
aN� ORDiNANCES GOVERNING THIS iYPE OF WORrt Wi�� BE GOMPLIEp �^Z n1O,nn �l.nl
WrtH WHETMEA SvECi:iED HEREiN OA NOi TME GRnNTiNG OF � PERMIT �
DOES NOT PaESUME TO GrvE nUTNOAiTV TO ViOInTE OA CeNCEL TNt vERMitFEE SAC CN�RGE pO
FROViSiON$ OF 4NY OTHEA ST�iE OA LOCAL LAW AEGULATING LON� �^83.z5 Fire SC yG.�l
STAUCriON OA ir.E �ERCOAMANCE OF CONSTRUGTION
v�AN CHECM GEE *O«� F
License 5.00 $9 .27
S�G�+��uaE��CO�+"A�CIOepp�V��OaQE��GEY� �C�IE� N � OEAl1' / /TED 51$ PE MIT
y �
SGrve���cEO�OwMFA-�OnrvFaBw�OEa� �D�iE� ��Bt L So !
07/13/2006 14:17 7033932897
NEW [j
ADDN j]
ALTER [ ]
Construction Address: . �` 1 1
AASI
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMITAPPLICATION
PAGE 01
Ettec6ve 1/72000
612�72J604 Bldg Insp
i
n��1����� ..
Legal Description: �I
Owner Name 8 Address: ��i(1��V'1_,���� I/�y�. -�C_Tel. #%�Y ��g.�_
Contrador. l� QVAtiLL /� L U�'lLNV/►i 3 vPpLx'�.tC.MN LICENSE# %�.8'�
Address: 770/ /h9/�' ST NE Tel-�k ��l''.�7�' 3Y'��
I.MNG AREA:
GARAOEAREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed constructfon drawn on It to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length
Length
.lnCA1
Wldth
Helght _
HgVGround
Sq. Ft
Sq. Ft.
'i � �� ■f� � u • �i�1%'I
�
Driveway Curb Cut Width Needed: Ft. + 6 Ft =____Ft x S = S
DATE:_�Z��� APPUCANT: .s., �L.i+---- _ Tel.# /�1�;7_lI'3���
v
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Call (612) 572-3604 for Permit Feea if mAlling In appllcatlon
$ �?3 �S Fee Schedule on Reverae Side
$ �. (� / .001 of Permit Valuation (1/10th%)
$ /. � / �.50%$1,000 Valuation
$ �1100 per SAC Unit
$ �S - 1�C7 $5.00 (State Licensed Residential Contractors)
$ Att. "A" or Alt. "B" Above
3450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not Necessary [ J
TOTAL
STIPULATIONS'
s�%
�L�.2-2 l,� (:l�l �2. � W c�.Q � Q,tk �/1.eG�� t G'C�tc� .
l,J
� City of Fridley
AT TME TOP OF TNE TWIN$
i♦
r ♦
' COMMUNITV DEVEIOPMENT O�V
� � � PROTECTrvE1N5PECTION $EC
�
i
� � "'1 � CIiY MI.LL FRIDIE� SS�R
�"""'���' �� 763-571-3450
SvBiEC+
BUILDING PERMIT
NUMBEA
910-F15
JOB /.DORESS 511 Dover Street NE
1 LEGAL LOT N0. BLOCK TRAC70F ADOITION
oesca. 1,2,3,4 K Riverview He
1 PROPERTVOWNER MAI�ADDRESS
Don Hanson 511 Dover Street NE
] CONTRAGTOR MAIL ADDRES$
RMA Home Services Inc 3200 Cobb Galleria
� AFCHITECTOROESIGNER MAI�AODRE55
ENGINEER
MAIL �
4/29/03 � /
334?9
'.� 1��L.
O� �>vAOVEO Sv
/
SEE�TTACHED
SHEET
763-784-8870
Zi� VMONE LICENSE NO
STE 200, Atlanta, GA 30339
ZI7 VMONE UCENSE NO
763-542-8826 20268257
ZIG GHONE UCENSE NO
fi USEOFBWLDING
Resideetial
I CLASSOF WORIc
❑ NEW ❑ ADDITION ❑ ALTERATION
B OESCRiBE WORIc
Replace two wndows within exis[ir.� openings
9 CHANGE OF USE FROM
STIPULATIONS
ro
� REPAIR ❑ MOVE ❑ REMOVE
Provide smoke detectors in a11 sleeping rooms and on z1i leve's of the dweliing
per Section 310.9.1.2 oi the 1997 Uni.`orm Bui�dir.g Code. Caulk aad flash all
exterior openings.
PF.B'�S"t�$ �n�.�.,,,?o�ia� ?�s���.i
�►i�r �� Maited
T� f�� ���i��n�r ia Pa�t
SE�qR<iE PEAMIi54RE AEOUiRED fOA EIECTFiCA�. P�UMBINQ HEATING.
VENTI�AiING OR AIR CONDITIONING
in15 PEAMIT BECOMES NULL ♦NO VOID IF WORK OA CONSTPUCTION ZONING
/UTnpqiZEO I$ NOT �pMMENCED WITHiN 60 �A�$ OA IF CONSTRUGTION
OA WORN IS SUSPENDED OR ABANDONED FOR A GER100 OF 120 DRVS AT
ANY TIME AFTER WORR 1$ COMMENCE� NO DWLG
I MEPEBY GEFTIFV iMAT I H�VE AEAD AND EXRMiNEO TMIS APPLICAiIQN 1
nNORNOWTHE$<METOBETaUEANOCORRECT /.IL�RpVI$IONSOfLnWS yq��p1�ON
nN0 OADINANCES GOVERNING THIS TYPE OF WpRR WILI 8E COMGLIE�
WttN wHETNER SPEGFiEO MEAEIN OA NOT THE GRANTiNG OF a PERMrt �3,943
DOES NOt CRESUME TO GIVE AUTNOAITV TO VIOLAiE OA C>NCEL iNE pEAMITLEE
�ROVi5�ON5 O� 4NV piHER S�ATE OA LOCAI L<W REGUUiihG CON�
S�AUCiipN OA THE PEAFOAMPNCE OF CONSTFUCTiON 59�.25
$'GN�iUaE 0� CON"a�C1O4Oa ���wQa�$EO
•i.Gh� eaE 0� O�u.�Fe .[ ONmE° Bb�i0E4
�o•,E, t
�O��E• B.
OCCVPANCYGROU� �OCCUPRNC'/LOSO
ISTA��S
IFEE
� SC $5.00
EN �ROGEFLr yp
GU iT
)iFSTREET ��ANING
IG�RAGES
$UAT4%
$1.97
S�CLH�RGE
?�re SC $3.94
�Oi�� cEE
$108.:6
] THiS i5 vOl1R GEAMiT
RPR-30-2003 08�99 �P.OM CITY OF FRIDLE'� - -� � ��^��2
M A2`; .
�'[ l �,vc�.os� P�2 Yw2
ADDN [ ] CI7'Y OF FRII
ALTER [ J SINGLE FAMII,X ANA DUP] �Q��T ,
BLTIL.AING PERMtI' A - SS(-N.ILO /�PI�1 �rlUn/
�ons�uctionAddress: S11 �Ou.e,Y� S�'IV,�C . �- 5..�-1E-�i� �=o(t APOIrttWAL.
#� S . "a
Legal Description: � ���� � s- T� rr` S C�-►Erv IL
Owner Name & Address: ��ip(� �Ui�O � � 1
Con�actor: �� HOME SERVICES iNC
' Home Depcc Insralled Sales
AddICSS: 3200 Cobb Galleria Pkwy.. Sre. fi20U
Atlanta, GA 30339
A 763-542•8326
j� BG20268257 . �n� it to sc&le.
. r"'r'"'_'..'___"".....�.»..�
DFSCRII�LON OFi il�fi>RO�;ME�V'I'
LIVING AiiEA: Lengih
G�ARAGE A.REA: Length
DEC� AREA: Length
OTF�R: '�c, S�
Cons�ucrion Type:
Wi�th Height Sq. Ft.
Width Height Sq. Ft.
Widtb HgUGround � Sq. Ft.
. �-.r.1r. �-�C l.�s�'��n�,. �... . e rL: ��
EsamateaCosc: $ �,�u3c�
i �
Driveway C�rb Cl.it Width Needed: _Ft. + 6 Ft =_____Ft x$_ _$
DATE: 4• 30 . 0'S APPLICANT: ` S J`—' � Tei. �t Qsz �85� •2.g54
C�'X US� ONJ.X ��
Pernut Fee
Fira Surchazge
State Surcharge
SAC Charge
License Slzrcharge
Driveway Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
$ 9� �
$ 3�1 -
$��
$ _
$ S, Gli
$ _
�
$
$
TO��. $ I � ---
STIPLTLATIONS
Pee Schedule onlReverse Side
.001 of Permit'Valuation iI/1Cth%}
$.50/$1,000 Valuarion
$1050 per SAC Unit
$5.00 (State Licensed Residendal Con�actors)
Alt. "A" or Alc. "B" Above
$450.OU Conservation Plan Review
Fee Determined by Bz�,vineering
Agzeement Necessary ( ] Not Necessary [ ]
/vf�.��
roTA� P.ea
�o : m ^�Y
� Building
, Inspections
763-572-3b04
763-502-4977 FAX
DATE.__L� .� OC
SRE ADDRESS _ �i
TH[S APPLICANT IS
PLUMBING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
❑ OWNtii
' NAh7E�. ,YiYl
OWNER/ qDDtiESS._ S�
TENANT
PHONE �Zb3^
YOUR @-MAIL ADDREti9
c
Permit No.� �'�-`"I U �' ��
Received By: �( r � t'
oa�a�E�:N o U 0 5?
�,v:�inna.avn �AME� - i�Vf"I Uv`�%lC.e-E.�/i� pi�1"� �C,
SUBMIT-A COPY OF -� --c�---�
YOURSTATE STATEL[CENSGp (pl�Y°/SPlN _ L-XPDA:E
LICEV SE, BONU AND 57'ATE BOND a EXP DA'IE _
CER?IFICATF.OF qpDRF.SS. SC�.�S � p�L'(lr� S}- CRY � STATF.�YI�ZIPS O
INSIJRAN<'F: �b3 ~ Sr]e� '� 2� 2�(� FAX 1.lo�a ^�SZ.�" - f� ��j C�_�.�
PHONE_
PERMIT TYPE
TYPE OF WORK: I� Htw
FAMILY 0 TWO FAMILY ❑ TOKTiHOUSF.
DETAILED DESCRIPTION OF H'ORK
FEESARL-BASEDONEIO.00PERFIX"IIiRE,EXCEPTWFLRENOTHD. FIXTURES: (INDICA'PFTOTALNUMBEROFEACHBELOW) MINIMI.MfEE
S35S0. ,
__BATHSR:K/LAV FLOORDRAINS SHOWER WATERPIPING
_BA711'Il�B GASPIPING(NEEDCITY�1Cj SWIMM[NGPOOL WATERSOFTNER(S35J
_:LOTHF.SWASHGR KITCHF.NSIFK WATERCI,OSET BACKFIAWPREV.(S�i)
_D[SFfR'ASHb'H _LAUNDRYTRAY _WA7'ERHE.4TER(f33) FOKIRRLGATION
_ WA'IF.R METER ,�CpTHEFt
�Tu�(biroFfl�c�rrs � S76 #�,Y„� xiT6.80°,3,,��,_
# � F :.
C � '
rwao�nre�a�,�.�aas.uti�xars.oa=s `� � , , `, � � �
rr�r.ati�� �.s5.s:oo ,�, xs�s.Ao� s :� ��; � ,
�' '.�t r ,' y � �t
` �� ` � ,
.,` �� -.�,
5tme StYe7strgo + ��p�5� �.��' _ � r ��
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fFkIN�'Mi.?11�13C13.S'R�r�'�' 3'otaC=S �v�.S� ��% `' r,�: Sy , `
7HIS IS qN qPPLICATION FOR A P6RMR-NOT VAL70 UNT1L PROCESSGD
I hereby apply for a plumbiog permit end I ecknowledge that the information above is compleh and accurate; thaz the woric will be in
conformence with the ordinences and codes of the City of Fridley and with the Minnesola Construction Codes; tha[ 1 underspnd this is
not a permit but only an application for a ertml and work is not to start without a pertnit on site; tha[ [he wmlc will be in nccordance
with the epprovtd plan in the case of al rk which requires revmw and approvalI of plans/.
tiIGUATL'RE OF AP �/1CA�n�I� � �1 _ PR14T VA�1L ✓CGyI L�LY �{�( DATE � 3 U
__.—... �� / C-f � 1— �
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, !vIN 55432
763-572-3604
FAX: 763-502-4977
..... .__.._...._ ... ...__.__ ..___ __ __..
WV94�ES�Ll600ZlSlLl�ale4 ��� a6ed unnou�un:wa�
9
�U11C�ll1�
nspections
63-�72-3604
„E-_ 5 s �r ^o
::'-.4D'JRESS 'J I
: [IS ?.PF'LICNiT1S:
;:01�ERTY O�i'NERI
TF.NANT
CON'TRACTOR
;�UBt.117.A CGI'Y OF
uUR STATE LICENSE
.i'ITH :�}'PLICA"1'ION
;'ROPERTY' TYPE
PERMIT TYPE
YPE OF Vl'ORK:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOCi2 ti-hL41L ADDRESS �
l.l� N�
❑ OWNER 9COMRACTOR
E
N,�� CI ID At- I lomc Scn-iccs. Inc.
sTn7e u� �G90 Cumbcrl.m�l Pk�vy. St� ;00
.aDDxfass Cumberlund Ol�ficc Park
PHO�:e Allanta. G/� �0;;9-;91 i
as�c�e Licr'� 30_'65257 Ph. 763ri 33-3536
❑TWOF?.
❑ B.4SE.'vIENT FIV SH ❑ ROOF
❑ DECK ❑ SIDI1dG
❑ SWIMh'
CRIB� R'OKK BEI!�G DONE:
Z°_ OF IMPROV E!�gNT
i•^BER OF SQliARES
RAGES
'OSED SIZE�
��.�:'OSED 1-C 1GHT,
�G
nyl
!uminum
ner
IE11:��
❑ HOUSE ONLY
❑ HOUSE & G.4RAGE
❑ .4TCACHED G.AR.4GE
❑ PETACHED G?,RAGE
❑Seffi[
❑ Trim
❑ Fascia
� D0�4'S
-tiIST1NG OPENINGS�Yes ONo LO .4TIGN Or C' NLGV✓S
�'OR NEV�' OP6KII:GS-DESCRIBE SIZE OF ��V� /1 �. �� dro � m• D �n i�
'<I?JG CtL+�.NG55 &
al cf�
Pennit I�'o.:
Received By:
Jod� m F(d�r Jo
95� � 345- (. 047
❑ DR4RJ TILE
❑ OTHcA
HEIGHT
r
3"S 43 �
TE_ZIP
BASEMEN'L REMODELING SUBNfl7�
l. Ezisting Floor Plan
2. Pmposed floor plan
3. Lis[ of structural membcrs [o be used
Ft.
FOR \�E�� COI�STRliCiION QJCLUDiNG DECKS,
ADDITIONS. d PORCH �S SOBA4IT�
L Si[e Plan/Survey showing the exis[ing sWCNres
and propo�ed project
2. Two sets of conswction elans
3. Energy Calculations
:c OF \4'INDO W TO BE INSTALLED O H S NC�7BER OF l4IhD0�4'S 'S �
ALL FEES ARE 13ASED 01�' V.ALUATION, 7NCLUDING THE COST OF LABOR AND R7ATERIALS:
(USI1�G TI�E 1997 U.B.0 FEE SCHEDULE)
TOTALJOB VALL'ATIOV $ 3 Q L/ OCCUP.4NCY TYPE
: mi[ Fze $ �' �. �{ See Back Page for Fee Schedule
.�i Review S 6�% of Buildin� Pzrmit Fee
���.har�e $ /, 9 3 (.0005) tunes the total job valuation — Mininmm ,£.50
� Surchar�e $ j g V .001 x Permit Valuation (1/]0°�a)
�e�se Surcharge $ 5. b o $5.00 (State Licensed Reside�tial Contractors)
C Charge $ $1450 per SAC U�it (Plans to MWCC for detcm�ination)
b Cut Escro�v $ ft+ 6 ft= ft x$ZO =$
��ion Control $ $450 Conservation Plan Review
-I: Fee $ Fee Determined by Engineering
�: er Main Charge $ Agreement �ecessary O Non Ne�cessary O
�.al Due $ / D 6, ey D1ake checl:s payable to: City of Fridlev Attach
THIS IS At4 APPL]CATION FOR A PERViI"I-NOT VALID UlvTll, PAOCBSSED
�::reby apply for a building permii and I aclaiowledge that the information above is complete and accurate; that the work •,vill be in
��ormance with the ordinances und codes of the City of Fridley and wi[h Ihe Minnesota Construction Codes; that I understand this is �o[ a
�.:iit bu[ only an application for a permit and work is not to start without a permit; that thz work will be in accordznce with the approved
n in the case of all work which �reJquir�s revi d approval of plans.
�.:ATUREOF.4PPLICAIJTY�l� � PRIIJTN.II�4E�//"� �(h•nk p.4TE S! �`�J