AF - 43223�
City of - Fridley, Minn.
BUILDING PERMIT No
..�__�
4558
Date: ... �.."..�...�.'..".":....-•�Gp.---�..._......__..._ ............._............._.
f� r
Owner: .���. .i . . .:.' -- •� --- •�..���..� .--- Builder ...........................:.... .:.........._........._.._......._.__.............W._._�...._..
�^" .
Address ..-��Q..----- ....�.._...--- ._ _ . �...�� Address •---�-- -.... ._...�+f.�srr.�_.�_......W_.:..�._._..�..;w_�.....,.�
/�%' ,
, LOCATION P BUILDING
rro. ..Ga. '.T..:�.....:. st.reet :::...... -- - . ..._...._:�„�„ �.�...,........ .. y'�......__ .............. parti i.ot ....._.......�..._......._. ____. _ .�. �.__....
` . .
Lot �'"�,r�°",�� Block ....._... !"� ....:.... .... ..:..:.. Additio� or Sub-Divisio� . .��'4�EZ..----� .� _.....__._..:.:.; ..
Corner Lot ................................. Inside Lot ......--`-�.--.:.......... Setback ....._�„�+�.�............_........ Sideyard ........�!!�..!'�_r�......_:..._.......-••--•---._.._..�..�___
SewerElevation .....................��---......---....---.....----.....--�----�-----•-----......_................---. Foundation Elevation ......:.:.---......._..._---........._._....._...........__.....�........_.._...._.
DES�RIPTION OF BUILDtNG -
To be Used as:
� ,/► f ,�"
,
. .. ... -. ���'.�_.�... ._�-•----. Frnnt ��1...:i.. Depth �!.9., _�..:--- Height �..... Sq. Ft �'".��� Cu. Ft, ����1���
.. a nt �.:V:...... Depth . ��. ...�! .. Height ..� _... Sq. FL ..:..�� �% Cu. li't. ...��!.�_�. `'� '
,,t.._. .:.��A�l.l.
� �.
1'y�e o Construction .-.«�!'�i��l�.::..._. Est. Cos"i,�l...�.��..�� .....:........ To be Co�npleted ....._........_..._..........._,..._._.
,�/� — --- _ __ _
�„�!r!"t''���+i�d''d�kl�` ��"�� '"7�?'���L�'...�.+Q' "...E-��+c ..�►"tr�� �'""�' �. . �
� � �
-�r�-a�.�� W��tr� � ,�` ��',,�'
�d� �,J�"1�
/�,.�� ���� �����'� THIS PERP�;IT C+:)�::,, �;� i AUTHO,Ri�,�'�lf:0,�p7-
���� �/ �,�c� ION OF A�;Y PFiIJA-f� �pNp COVENANTS ANQ :
� �.��,/.''/ BUILDING RESTRIGTIONS.
�.� � �'°' � . � n . .
In consideration of the issuance to me of a permit to construct the buiiding deseribed above, I agree ta c�
the propp�ed woa�k in accordance witli the description above set forth and in compliance with all provf�lat�1 0�
ordinances of the city of Fridley.
;
.:.� _......._...._......._..._._...__...._......_.._.__._...___.._...._.__.__._.._._._._._._...._..
In consideration of the payment of a fee of $,:�� --------......, permit is hereby granted to...._..._ ----..._. .._....�.....__
••-.--....._..--•--.._.....---__ .............•---••---..._--•--...... to construct the building or addition as described above. This permit ie gre�tte� upea
the express condition that the person to whom it is granted and his agents, employees and workmen, fn alt` wark
done in, around and upon said buildfng, or any part thereof, shall �caaifaa�m in all respects to the � oi
Fridley, Minnesota regaxding location, construction, alteration, maintenance, repair a� �t+avin$ o! �bH�dings
within the city limits and tlsis permit may be revoked at any time upon violati of any of ti� provisiau ot said •
ordinances. �
• ...����� ���"�.�- � �
NoricE:
This p�rmit do�a nof cow� Ih� eonsMUeKon, installation h� wiring. plumbin�,` gas 6�ai�a. s�w�e er rr�fp. N wn t� l�le
1h� Building InspeeMr for separaN psemits for tlwa iNms.
. ._ , � �4 �
� ,-:,..:.
++�
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
,
Owner s Name ���/� � rt/ � C �1'� i�t' � 1� Bu3l.der — .
Aaa�sas �/ s'' � G� P r c��'�'�^����aaxess __
—___—_ --�.--- ..
LOCATION OF BUILDING
No.___��� Stree� �� v��` r P�t of Lot .
' l�c��� 1`
iot ���� 9�3 �l3 l Block � Addition or Sub.Div. �� dcr v ��/N
._._..�... __._�., .�.._ S
Corner Lot Inside Lot� t Back Side-Yard
SE'WE'ti, ELEVATION FOUNDATION ELEVATION
Applica.nt attach to this form Certificate of Survey of Lot and proposed building
location. �
DESCRIPTIOI6 OF Bt�LDING X� ;'�
,�.�
`� �_ '� �`
To be used as:
� � ��,,� �
� Front �S �" Depth � �% Height
sq. Ft. T/ 3'9 G cu. �t. _ '
�����._ �/
� Front �Z �� Depth � �` Height
Sq. Ft. Cu. Ft.
�ype of Construction� ,\�� --��----'" Estimated Cost
/3, s''d d- a �
.�.. f
To be
�` c.
The undersigned hereby ma.kes application for a permit for the work herein specified�
agreeing to do all work in strict accordance with the City Ordinances and ruling of
the Department of Buildings� and hereby declaxes tha.t all the facts and repxesenta-
tions sta.ted in this application axe true and correct.
DATE �1 '� $ � d � SiGNATURE � �
(A Schedule of Fee costs can be found on the everse Side.)
_, . � � � , . � -
� �C��
City of Fridley U'"
Ap�icatian for Plumbing and Gas Fitting Perneit
- Dept. of Bldgs. Phone SU 4-7470
DESCRIPTION OF WORK '� s(`l ��..�,�.e•ti )
Number, Kind and Lxatian of Fixtures Locatioa
y1 � U�' WATER HTR.
r y� � N W ? � /
�y j� I. _� Z Y S y Z Z K Q Z U �Z! � S 1 (J u� Z
?i � a < 7 � Z � 4y °' Q S �� V m 6 3 (�'! ` C�9 c(`9 O F N GAS ELEC.
7 O h � 3 L- 0 1� N Y. �
Base !
�st / /
2nd
3rd
4th
` Futurs ConneCtion Openings
* New Fixfure, Old Openings
with
PARTIAL RATE SCHEDULE
Sewer �
Cesspool r'j
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Nuxnber F`ixtures ......................� x$1.50 $ G7 D
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening . . . . . . . . . . . . . . x 1.00 $
Catch Basin .... . ..................... x 3.25 $
Water Heater (Up to 200,000 BTin . . . . . . � x 2.00 $ �- � a
New Ground Run Old Bldg. . . . . . . . . . . : : x 3.25 $
GAS FITTING FEES: NO. AATE TOTAL
ist 3 Fixtures .......................... x $1.50 $
Additional Fixtures .... . .. ... .......... x .50 $
Gas Range to 200,000 BTiJ .............. x 2.00 �
REpl1IRS & ALTERATIONS—Refer to Code
. . ................... 0 G
Descript�on .............................
TOTAL FEE $-�.-=
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
Fridley, Minn. � � ly�`=o
� � A /
Owner � / �
Kind of Building —
Used as v�'�-'�'�=�-�-t
To be completed about
�_ oo ,
Estimated Cost, $ —
Old—New. Building Permit No.
� Permit No. / � �
Signe ��— '`��C'`_"c-�
ROUGH � U N 2 19 60
FINAL
a z 4M 7-s9
By
Business Phone
°ng�al , �
PERMIT for Power lants and Heating. Cool-
ing, Ventilation. Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No. of Heating Plants to be installed--eltered—repaired
Make �-�-�-a �-r/`U ( -�2LL�- • , Size °�� .�V r ;
Oil fcred ; Coal fired ; Gas fired ; Gas Authorization N
Remarks
Approved
Final Inspection
19_
i �
���,, , ,
Permit N� 4 5 2 9
Fee � c� �
�ice of the inspector of Buildings
City of Fridley
City of Fridley, Minn. , 19�
Owner �
Location �� � �`��l �__ Ce
Kind of Building Ca���.Q..� ,
How Occupied _
Work to be Commenced ,19_
To be Completed ,19_
Estimated Cost, $ /!�/ '
, Inspector I� Dld-New, Building Permit No.
Permission is hereby granted to ��� � �' to install—erect—use the material and devices described in th.e
above statement. T)cis permit is granted u n express condition that the person to wh it is granted, and his agents, employees and workmen, in all the work
one and materials used under this permit, and in the operaiion of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley
elating to or governing the work to be done and the operation of tlae devices herein named, and to the specifications set orth i the approved application for this
ermit on file in the ofj°ice of the Inspector of Buildings. ` , �
�, �,d.�� , ; nspector of Buildin�s
4Z sM i i-a� v
�
�
.4
0
L�
n
/�PPLtCAT10N FOk UIMHING At�D A9 . 17T(NG r�11
97-`�L�-8 '9�01 . .
�1(
��� M ?i q �!+ V � �-1
� .M+ .�• M H � p u Q „ roL u p; W
. u �7 C ,w� .0 +.� aJ N .0 ..�i 0.c � u
% � • C • � •u�ni .0 M u � � � � �n1 a p � I.A1
r U � a . q u� x G1 �, u� w � r� K x T
I . � . :.
.' �
.� ls�
' I 2�d . •
, ) •r t I •
! < c.h '
..(R) � iV tuse Connection Opcning { Connoctad With
(•) � 11ev Fixare, Old Opening I
U WACOK
� Ito4toY
� ��
�
� p ns •loc
Sowor
Water
�PARTIAL RATE SCHEDULE �
PLU�L9Y1�G FIXTURE RATES; N0� RATE
1.ti.5ex £lxGwcet ` • X S�.QO
fVture FL�cture Oponinq •, k $Z.00
Kcv fixcur��, Old Oponing . � x j2,00
Cstch 8aain• x 55,00
� Nstoz Heacer - to 99,000 HTt1 � x 55..00
� 100;G00 8TU Co 199,000 BTU x 510,00
Hater Sottener • ' x S7,p0
T�ev Grour.d� tain Old Sui�ding _�_ x 55,00
Eleccric W�Ger Neater � X 55,00
G,�S FITTI\'G FEES; � ,•
. ,
lst ] tixCUres
S.�dicio�nl Fixtura�
.G.i s Rang e to 199, 000 BTU
REP�IRS 6 ALTERATIONS
tirat 5100.00
e�c1� aCd. S100.00 or iraction
�
x $�,00
� x 51.00
x 510.00
State Surcharge
TOTkL FEE
55.00
5�.00
TOTAL
S
S
S
S
S
S
S
S
S
9
9
3
$
S .50
� �.Q,,�O
0
Job Addreee (�j�0 Dover ��,j�re�t _ __ -
�� Dapartment ot Uuildinge
' City o! Fridloy 1
Tol. N571-J450 �
, Tlio undaruigned hareby make� application tor.a pacmit for thc w rk
npecitied agraoing to do all work in atrict accordance with tha Clty
and r�linge o� the Dopartmont ot 9uildinge, nnd heraby dcclaro� thst
the tnot� and rapronnntati.onc etntad in thir npplication ara troe ar.�
' Fridlay, Mn, � l_0=1�-77 � 19,
OWNFR RaYmond Wafer ' _
KIND OF DU2LDING frame - ,
�
USED AS res.
10-11-77 � � •
TO BE COMPLETED A80UT � _„
ESTIMATED COST 20•OO
OLD — tJTW DUILOZNG FEFIMIT N0. �"�E(�r'lIT___HC�_._
.�� �
� Company .�qTN�EGA�C^
' MINN�GASCO
�, Signed Dy' �
� � Tol. No.
ROUGH ZNSP.
Date �
FINI}L INSP. � '� ' � (
Dato
APPROVAL COR PERMIT _�j�.� + .
. '
MIIJIMUM �FEE FOIt Js1Y PLUMBING PERMTT T9 37. SO
�. .
�7-ei�-�16o5i � � • . CITY OF FRIDLEY � � .
APPLICQTION FOR PLUMBING AND GAS �I�'T'ING P�RMIT
• �a � a [ � � �r � Water
-A�+ � y � c � H� L �n .�', H�gd f+ p, w � Heater
p � O .S i� N �C H�.�i � O S +� �N +� u� u� y �
L ,,.� w q r� . 1 n w o x .� ro�� ro ro
tA U �� C1 W 1A' .$ O f+� tA G� U W Q 3 (9 � O d3 1@C
i�r � r
2n3
3rd
a �ti
(R) � FUtuze Connection Opening Connected with Sewer
(•) � Nev Fixture, Old Openinq Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: N0.
tr,uaber Pixturea
ftiture fixture Openinq
New Pixture, Old Openinq •
Ca�ch Basin �
watez Heater - to 99,000 81V
100,000 eTU to 199,000 BT�J
NaGer Softener
Hew Ground �n Old Buildi�g
Electzic Water Hea ur
GAS FITTING FEES:
lst 3 iixtures
Additional Fixtures
Gas Range to 199,000 B1V
REPAIRS $ ALTERATIONS
8irst 5100.00 ,
, each add. ;100.00 or frackLosi
FtATE TOTAL
x S3.00
• x 52.00
Y 52.00 �
x 55.00
x S5.00
x S1o.00
x $7.00
x $5.00
x $5.00
x '$3.00
x $1.00
x Sio.00
3Cate S�rcharqe
. TOTAL FEE
REZNSPECTION FEE
(510.00)
S'
S
S
S
S
S
S
, w Q
Y
S
S
S
55.00 $
$2.00 S
$ .50
s 8.00 ,
Job Addrese 6l�0 �over Street NE � � � � � � � � �
Department oE Suildings + .
City of Fridley .
Tel. #571-3450
The undersiqned hereby makea epplication !or a pezmit !or Lhe vosk here�a
apeci£ied agreeing to do al]. wozk in strict eccordance with the City Cbdes
and rulings of the Department of Buildings, and hezeby declaren that all
the facts and representations stated in this application are true and corrxt
Fridley, Mn. 1n-2-7� , 19
owrr�R WA F'r�R �
RIND OF BUILDING frame �
USED AS res. �
J
TO HE COMPLETED ABOUT • lO "9 -7 S '
ESTIMATED COST �(��nO
OLD - NEW HUILDING PERMIT NO. PERMIT N0. /� !�
�, �
CbmpanY�./ a"�-�=�`c/� � �`�"°�`�'L.
Siqned ey MINNEGASC(�
Tel. No.
ROVGH 2NSP.
Date
1
FINAL INSP. f /' � �l `( �
� Date
APPROVAL FOR PERMIT _�
MINIMUM FEE FOR ANY PLVMBING PERMZT Z3 57.50 pLUS $.SO STATE 50�,
0
sue�ecr PER N .
City of Fridley ° 5
AT THE TOP OP THE TWINS g U I L D I N G P E R M( T •
r
; � RECEIP O.
� • COMMUNITY DEVELOPMENT DIV.
j �'' � PROTECTIVE INSPECTION SEC. 9 S� Q�7
� �
� � /'��1 � CITY HALL FHIDIEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
�----� • ••� 672-560-3450 910-F15 ��4��9 / /
JOB ADDRESS 640 Dover Street N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 2%-31 W Ri.vervie�r Heights SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Ray Wafer 640 Dover Street N. E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASSOF WORK
❑ NEW ❑ ADDITION C� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
S OESCRIBE WORK
Reroof Dtizelli.n
9 CHANGE QF USE FROM TO
STIPULATIONS
Raof can be second but not third xoof. Install ridged galvanzied
val leys..
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY IOAD
SEPARATE PERMITS AFE REQUIPED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATWG OR AiR CONDITIONING.
THIS PERMiT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS 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 $4.rJO �`. rjQ
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY 70 VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $7� r,Q
STFUCTION OR THE PERFOFMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
ySB. ��
� SIGNATUREOFCON a C( TQ�tORAUTHORZEDAGENT IDnTE1 WHEN PROPERLY V I ATED THIS IS YOUR PERMIT
� •t �� y ^ �- 7 l.,(����p ���� �
«/l�Ci(`il
iG UREO O ERtlFOWNERB LDERI IDATEI BLDG INSP �ATE
CITY OF FftIllLEY ,
' �1PPLIC/1TIO�d FOR RESIllf�NTI/iL BU�I_DING PEFtt�1ITS .
' ��VEIJ, IILTCR/1TIONS, ADDITIOtJS, OR REPAI(ZS)
�
OWtJ�R: ,l.� ����� SUILDLR: ' �-/Y1 � "' �
Address : � � D �/P' � N� Address : �
Tel. No. •
No.: Street:
�W ^ �
LOT: �' A" J� BLOCY.: ADDITION: _�1�.-��v /`/f(1L�• r-- �� , �
CO1tNER LOT: INSIDE IAT: S�;TBACY.: SIDEYARriS:
Applica"r.t attach to this fozm Ztao Certificates of Survey of Lot and proposed
building location drawn on these Certificates. .
DESCRI PTTOPd OF BUI LDI NG
� To Be Used As: ' �
. � T� vS�' Front: Depth: Height: . �
Square Feet: Cubic Feet:
0
Front: � Depth: � Height:
� Square Feet: Cubic Feet: '
^
7j►pe of Construction: ��/,U� L,2 � Estiunated Cost: $ �S �� ��
7.b Be Completed: Alt. A Alt. B
Proposed Drivecaay Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
The undersigned herek�y makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fx'idley Ordinances and rulings of the Department of �uildings, and hereby
declares that all thc facts and representations stated in this application
are true and correct. See reverse side for ditional information,
DATE: ^ SIGNATURE:
.�- ____�
5tipulatious: � , _� --1
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': EATING TEST RECORD SuBURB �'��C�t/`"
SE CITY r—
) z.� APT.�—FLOOR �—
���
. � ���� . �/ , ° OWNER � �
ADDRESS � � �L_ "�+�'�
OCCUPANT ( pAT� H • IN ITISTALI.ED BY �,,,,
,4 2
F{EAT LOSS �5 Line BY OTHER i
SOLD gY STEAM -----SPACE HTR. f
UNIT H�� �— ,
Electrical Work 8Y FA HW �_ CONVERStON
TYPE OF H�AT GA
�-- GAS DESIGN '"� �����L� MAKE OF BURNER
� ��, ,n i1„y L Q -'
.� ,--� � Mode�
MpKE '� 1 � , � � " Rating
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I�Aodel � E.. �� :�% MAKE OF FURNACE �
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INPUT + /� , �
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�ONTROLS Veot Size� SIZE—(:—�
(, �LINER ����°�
at Plug KyNp OF {2egularor
THERM�STAT � � ,� � �
Draft Hood Number
Valve Filters Size Outside
� ln da __.� �l-�''�- � �'
Limit Chimney Loeation • �� �'-
Limit Setting — ' "� �l ` Chimney �^stcuetion
Fon Settin9 ����(, y �� ��
Wiring � �d
Pilot TYPe smoke Bomb 7est Ta9
_�--�
pilot Make Draft Lighting Inst.
Pilot Model Door Pressura y� ��` �
Pilot Timing � .� �" .
�� � Z � r
L.W. Cut Off Date Tested ' ,
� percent CO2 �mpany Testing
-� �
Prossure :� ✓ percent 02 t, , � Name of 7ester
Input CFH � ' Percent CO --`—
N b �+~+
� C T O d tY > tl
Stack Semp• . _ v " t': A� w�� c i�' s,,,, ^�
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o ►• s o e+. a d
Form 23 0 � O7 3 �'o m O y�-+ 't7 E •+ ++ m m '� O� �
.. � d � .r m .r m 5
z r.. o m m v� a, o A o a A . u
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. � 52T207S .�qi rC n Q � � 0. � a
SUBJECT P '�CO.�� ��
City of Fridley 25 � 9 8�
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T :� ��
� � RECEIPT NO.
� ; y � COMMUNITY DEVELOPMENT DIV. �
r � � PiiOTECTIVE INSPECTION SEC. � 3�
� � �"�1 � CITV HALL FiiIOLEV SS432 NUMBER pEV OATE � PAGE OF APPROVED 8V
�'""�' �'' 612-571-3450 9�0-F15 10/16/97 / /
JOB ADDRESS 640 Dover Street NE
1 LEGAL �07 NO. BIOCK TRACT OR ADOITION SEE ATTACHED
DESCR. 28,29,30, 1 W Riverview Heights SHEET
2 PFOPERTY OWNER MAIL ADORESS ZIP PHONE
Michael LaFave 640 Dover Street NE 780-2366
3 CONTFAGTOR MAIL ADDRESS Z�P PHONE UCENSE NO
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE N0.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION ❑ ALTERATION �7 REPAIR p MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Garage (8 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCV GROUP OCCUPANCY LOAD
SEPARATE PERMITS AFE REOUIRED FOR ELECTRICAL, PIUMBING, HEATING,
VENTILATING OR Alq CONOITIONING,
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTqUCT10N ZpNING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANpONED FOR A PERIOD OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OfFSTREET PARKING
1 HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICA710N 1 STAL�S GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 8E COMPLIED @
WITH WHETHEii SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $667 �pSO
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CMARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- � 26 . SO Fire SC �. S 1
STRUC�ION OR THE PERFORMANCE OF CONSTRUCTION.
PI.AN CHECK FE TOTAL FEE
$27.51
S�GNATUREOPCON7RAC70FORA THO �ZEDAGENT �DA7E� HEN P L V�I TEO THIS IS V�R P� IT
! � (�� ' , Q "�' � ` � � �
S�GN4T E OF OWHEA ��F OWNEA BU�LDE i iDA7Ei ' B� �NSP �i�TE
N E�V
F.DDN
ALTER
[1
[I
L 1
ConstructionAddress
Legal Description:
' CITY OF FRIDLEI'
SiNGLC FANIILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT �PPL[CATION
(p`"� � �ov2� S� , �`� - �r� �lc
Cffective 1 / 1/97 ,�
h� �
� ^��
�Y �
Owner Name & Address: � � ���c � �� �a„� �� p (��U jr S-{ Tel. # � � � - �3 ��
Contractor: MN LICENSE # .
Address
LIVING AREA;
GARAGE AREA:
DECK AREA:
OTHER:
Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTIOi�i OF IMPROVE112E\TT
Length i�Jidth Height - Sq. Ft.
Length �� Width �_ Height Sq. Ft.
Length Width Hfft/Ground Sq. Ft_
� e�c7 0� �g Ci /�4 e� �`l� i � n� rP. S_��Ctr � N-}
�
�
�onstruction Type: Estimated Cost: $�� (p �
tFee Schedule on Back)
Driveway C�rb Ciit Width Needed: Ft. + 6 Ft = Ft x$ � _$
DATE: � O � � C�, �� ApPLICANT: TeL # ��� ���� �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
i?rosion Control
I'ark Fee
Sewer Main Charge
TO"I'A L
S't'tPUr.n"t�[ONS_
CITY USE ONLY
�$ ��� �� Fee Schedule on Reverse Side
� $ J � � -�p�� .001 of Permit Valuation (1/lOth%)
,, $ S��' ,� ' $.50/$1,000 Valuation
$ $950 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt_ "B" Above
$ $450_00 Conservation Plan Rei�iew
� Fee Determined by Engineerina
�. Agreement Necessary [ ] Not Necessar�� [ ]
� �'i S /
sue�ecT P NO.
City of Fridley 3 i 679
AT TME TOP OF TME TWINS g � f L D 1 N� P E R M I T
r
; ;, RECEIPT NO.
� • COMMUNITV OEVEIOPMENT OIV.
' •v' _"" , �j��
r � � PROTECTIVE INSPECTION SEC.
� � �"'1 � CI7Y HALI fR10LE� 55132 NUMBER nEV O�TE P�GE Of •PVqpvEO Br
�'""'�" �'' 612-571-3450 9�0-F15 3/15/O1 / /
J08 ADORESS 640 Dover Street NE
t LEGAL �OT NO. BIOCK TfiACT OR ADDITION SEE ATTACHED
oesca. 28-31 W Riverview Heights SHEET
2 PROPERTY OWNER MAIL AQORESS ZIP PMONE
JudylMike LaFave 640 Dover Street NE 763-780-2366
3 CON7RACTOR MAII ADORESS Z�P P►40NE LICENSE NO
Lifetime Siding & Remodeling 355 21 St, Newport, MN 55055 651-458-0844 1780
1 ARCHITECT OR OESIGNER MAIL ADDqESS ZtP PHONE LICENSE NO.
5 ENGINEER MAII ADDiiESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CIASS OF WORK
❑ NEW ❑ ADOITION O ALTERATION �7 REPAIR O MOVE O fiEMOVE
8 DESCRIBE WORK
Replace windows within existing openings
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and
flash all exterior openings.
TYPEOFCONST. OCCUPANCVGROUP OCCUPANCVLOAp
SEPARATE PERMITS ARE FiEQU1RE0 FOR ELECTNICAI., PLUMBING, MEATING,
VENTILATING OR AIR CONDITIONING
TMIS PERMIT BECOMES NULL ANO VOID IF WORK Oii CONSTRUCTION =ONING SO. fT CU fT.
AUTHOR12E0 IS NOT COMMENCEO V�1ITMIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO fOR A PERI00 OF 120 OAYS A7
ANV TIME AFTEN WORK IS COMMENCED. NO DW4G. UNITS OfFSTREET PARKING
� NEREBY CERTIfV THAT I HAVE REAO ANO EXAMINEO THI$ APPLICATION 1 STAI.LS GARAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS VA�UA710N SURTAX
ANO ORDINANCES GOVERNING THIS TYPE OF W�RK Wll� BE COMP�fE�
WITH WMETMER SPEC�FIED HEREIN Oa NOT. 7HE GRANTING OF A pERMIT �5,761 $2•HS
DOES NOT PRESUME TO GIVE AUTNOF;ITV TO VIOLATE OF CANCEL THE pERMITfEE SACCNAFIGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON• @�25.25 Fire SC �S.7C)
STR OR THE P ORMANCE OF CONSTFIUC710N W
j PLAN CHECK F TOiA� F
� 3"1� Q I Lice SC $5 .0 $1 .89
S�GNAtUAEOFCON'AACTOqOA�UTHOQ�2E00GENT iDATE� EN P V IOATEO T IS IS ii P 1T
���f ���"�°- �1
r—S�GN4TUAEO�OWNEp���OWNEQBUiIDEA� iO�tE� B�OG 'e5� � ��<<E
�
��+�+ t �
�� i l
A[.TER I )
Construction Address: _;
Legai Descxiptior�:
CA+un�r Name 8 Address:
ContracEor. � ,1����1 vYi 0
LNIWG AR�1:
oaw�G� Atx�a:
DECK AREA:
QTHER:
��ave �nr�oa�
cinr oF F�,a�.�r �rsa� a7a�sae arag ��a
SINGt.E FANNLY AND DUPLEXES R-�1 AND R-2
BC1tLDtPIG PERMIT APPLECATIpN
' I ' �: %, i C1f+ � . / �
� ./, ! / : I
. . �A �i►�l �i � �w . � •
Attach #o this application, a Cer�fica#e af Suroey of the
lot, with the propased canstn�ction drawn on it to scale.
DESCRiPT1aN C1F tMPROVEMENT
Le�gth �tficiih Height,_._.,� SQ. Ft
Length Width Heighk 3q. FL
l.sngth Width HgU�round Sq. Ft
Construction Type: ' �..Q.li Estimated Cost �,�f �
briveway Curh Cut V111idth Ne�d�d: Ft. + 6 Ft = Ft x� _�
�
DATE: ,� - � "(),1, APPLiCANT: %1. #�I - �l��i'D�i�
X /aa(�
� � �
Perrrtit Fe�
Fire Surch�rge
State Surcharge
SAC Char�e
Lic�nse Surcharge
Driveway �scrow
Erosion GoR#rol
Park Fee
Sewer Nlsin �harge
ToTa�
STtPU1.AT10NS:
Z0.�Z0'd S96Z8StrtiS9
C.�11(763) 572-3504 far Perntit �ees if mailing in applEcadon
$� a��� Fee Schedule on R�verse Side
� �. ��i� .00� of Permit Valua#ion (9110#h°Jo)
�.,.,. � �� � $.50J$1,O�J0 V�luation
$ $1 � 50 per SAG tJnit
$� $5.00 (State ��censed Rssidential Cantractors)
$ Att. "A" or A(k "B" Above
$ $45Q.00 Conservation Ptan Review
$ Fee aetermined by Engineering
$ Agreement NecassarY I I Nat ntecessa�y E J
�1��:t�..�:L
Ql
� , ,
.l3'IQI21� �0 J41I� W0� SS:80 ti�-60-H3�
SuB�ECi
City of Fridley 3 3 2 4 9
AT THE TOP OF TME TWINS g � I L D{ N G P E R M I T
i�
� � ^ �.
� • COMMUNITY DE�ELOPMENT O�V. �/�
� ; V'�'.�� ' 1f/'�` ! /�
r � � PROTECTIVE INSPECTION SEC. �
' � :
� � �"'1 CITY MALL Ffi10LE� SSIJ2 NuMBEa pEV D�iE v�GE OF �vnqpvEO 8r
�'""�� ,'' 763-571-3450 910-F15 11 / 13 /02 / /
J08 ADDRESS 640 Dover Street NE
1 LEGAL LOT NO. BIOCK TRACT OR ADOITION SEE ATTACMEO
DESCR. 2,8 — 31 W Riverview Hei hts SMEET
2 PROPERTY OWNER MAIL ADORESS ZIV PHQNE
Mike/Judy �aFave 640 Dover Street NE 763-780-2366
3 CONTFACTOR MAIL AODRESS Z�P PHONE LICENSE NO
Creative Homes Realt 4616 5 St NE Coiumbia He� 612-978-7463
1 AFICHI7ECT OR DES�GNER MAIL ADORESS ZIP PHONE UCENSE NO
20205186
5 ENGINEER MAIL ADDiiESS 2�P PMONE IICENSE NO
6 USE OF BUILDING
Residentiai
7 CLASS OF WORK
O NEW ❑ AODITION O ALTERA710N � REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Replace windows within existing openings; reside house & garage
9 CHANGEOFUSEFROM TO
STIPULATIONS
Per Sect�on 1402, 1997 Uniform Building Code, requires tha� a weather resis�ive
barr�er be placed over exterior sheathing ta protect the �nterior wail coverrng.
Exceptioas for thas provision wou�d be i� sheathing �s an approved wea�he�proof
par,el or when the s�d�ng is an agproved weather barr�er. V�n�1 sidi.ng is not
a weatherproof coverir.g unless the ma�ufacturer states th�s ird their appiica�.�o:�
gu�delines. Cai�. for �nspection of wrap be�ore covering. Caulk and �iash a1�
exterior open�ngs.
Provide smake detectors i^ ail sieepiag rooms and on ail leveis or the �we:.��ng
per Section 310.9.1.2 of the 1997 U�iform Bui�ding Code. Cau�k and �lash a�.�
exterior oper��ngs.
TVPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD
SEPARA7E PERMITS ARE REOUIREO FOi± ELECTRICAI, PLUMBING. HEATING,
VENTII.ATING OR AIR CONOITIONING.
TMIS PERMIT BECOMES NULL AND VOID If WORK Oq CONS7RUCTION 20N�NG SO. fT CU F1
AUTHORIZED IS NOT COMMENCED WITHIN 60 OAVS. OR If CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOq A PER100 OF 120 OAVS A7
ANY TIME AF7ER WORK IS COMMENCED. NO DWLG. UNITS OFFSTFEEI PARKING
I HEREBY CERTIfV THAT I MAVE REAO ANO EXAMINEO THIS APPIICATION 1 STALIS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS VALUATION SURTAX
ANO OFiDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMP�IEO
WiTM WMETHEfi SPECIFIEO MEREIN Ofi NOT TME GRANTING OF A PERMIT �17�000 �H.SO
OOES NOT PRESUME TO GIVE AUTNORITV TO VIOLATE OR CANCEL THE pEqMITfEE SACCNARGE
PROVISIONS OF ANV OTHER STATE OR LOCA� �AW REGULATING CON-
`$T'RUCTION OR THE PERFORMANCE OF CONSTRUCTION $279.LS F�iT� SC �17.00
x ` PLAN CHECKFEE TOTALfEE
�� � l !�. � L� rrs SC $5.00 $309.75
S�GNATUA O CON'pnCr aORAUT�OQ�2E0eGEHT iD�TE� N PROPERL� VAUDA?ED TN�S IS �OU PEQMi
/1 l �
S�GHa7uFEO�Ow�vEA��FOwtrEQBU��OfR� �DAtE� G �HS� ����E
. �
NEW
ADDN
ALTER
[ j CITY OF FRIDLEY EffecGve 1/1/2002
[] 6431 University Ave NE, Fridley, MN 55d32 (763) 572�604 Bidg insp
( j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Cohstruction Address: ��( l7 1) � ��. �C s� � � , � �
Legal Description:
Owner Name 8 Address: _�l � k J J��fl� L..,� F� V� Tel. #�°7103 � 7�50 ~����
Contractor. C' �1�t�V�.. i-4c�eS 12e1��T`f ___ MNLICENSE# �� �b S_j �b
Address: LfL� l �, .��h St�'z. (�. � , i`a�. �'t.�. f�►� �_ SSya-1 ---TeL �(("ot �i Q ik-7 �l � 3
Attach to this application, a Certificate of Survey of the
lot, with the p�oposed constnlction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LNtNG AREA: Length Width Height Sq. Ft
GARAGE AREA: Length Wdth Height Sq. FG
DECK AREA: Length Width Hgt/Ground Sq. Ft
OTHER: ��i�C� 1=.�t�C�Ti�h UVtin���flw�-(�o�1SC R ��,4C �r�OI�IJC'� ��
Y
j�l O � S'L � C�.a� �Z �-e, '�
Construction Type: Estimated Cost: $ �� o ao
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: !f •^ APPLICANT: �� t l Yv��o��'f 1<: h-� f Z �`1 ���� Tel. ��f� 41 �= 7Y6 3
Call (T63) 572-3604 for PeRnit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will
calt you for card number.
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Mai� Charge
$�% .�
$ r �, �� d
$ � _ ; C;
$
$ `� _ C',`'[�
$
$
$
$
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 [ ]
TOTAL $ �� 1 � �� STIPULATIONS:
Building
Inspections
763-572-3604
DATE�� '
SITE ADDRESS �
THIS APPLICANT IS
PROPERTY OWNER/
TENANT
CONTRACTOR
BUILDING
RESIDENTIAL APPLICATION
❑ OWNER
SUBMIT A COPY OF STATE LIC
YOUR STATE LICENSE ADDRESS:
WITH APPLICATION pHONE �
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
•--
CITY OF FRIDLEY ,
YOUR E-MAIL ADDRESS
�L"L/���
❑ SINC�f:E FAMILY/NEVA CONJfR�CfION
❑ TWO FAMILY/NEW CONSTRUCTION
❑ ADDITION � GARAGElSHED
❑ BASEMENT FINISH ❑ ROOF
❑ DECK ❑ SIDING
❑ SWIMMING PO(
�NEW ❑ ADDITION
❑ MAINTENANCE/REPAIlt ❑ REMODELING
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
ROOFING
NUMBER OF SQUARES �
GARAGES
PROPOSED SIZE: l i'� � �i�-�
PROPOSED HEIGHT: �''�
SIDING
j� Vinyl
� Aluminum
❑ Other
VF'INDOWS
IN EXISTING OPENINGS ❑Yes �No
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED_
� �,'1/ i,�ENGTH '
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
I�DETACHED GAItAGE
GBSoffit
❑ Trim
� Fascia H
IACATIQN OF WINDOWS
—1�,r��,'P
NUMBER OF
CITY
Permit No.:
Received By:
Date Rec'd:
A
�� �
e' ll..l�/ � • �' ,I � �
i �- - "
SIZE
STORIES
❑ WINDOWS
❑ DRAIN TILE
❑ OTHER
�
�WIDTH /2 � HEIGHT
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
Ft.
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS. & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing struchves
and proposed project.
2. Two sets of construction plans
3. Energy Calculations
ALL FEF�S ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
�a�< J� (USING TFIE 1997 U.B.0 FEE SCHEDULE)
OTAL JOB VALUATION S �,Z. �G,' `0O OCCUPANCY TYPE
_ _ _ -- _ - - ---
Permit Fee $
Plan Review �j�, � � $
Surcharge
Fire Surcharge
License Surcharge
SAC Charge
Cwb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due �
$ I Lv . a7
$ 3a :5�i
$ �c DO
$
$
$
$
j ,�� $ -
See Back Page for Fee Schedule
65% of Building Permit Fee
(.0005) times the total job valuation — Minimum $.50
.001 x Permit Valuation (1/10%)
$5.00 (State Licensed Residential Contractors)
$1450 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks navable to: Citv of Fridlev Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclrnowledge 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 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 requ�r s review an pproval of plans.
SIGNATURE OF APPLICANT �� ����� ��( PRINT NAME / !„ ,��,��L1� � DATE �'^/i � �
�.c:� .�.�9 � PZ Y��a-S � "--�i21I � �_'.�> %��i
� �. �g
-�. 5�i
� �� %
GENERALSTRUCTURALNOTES
SCOPE OF WORK
SCOPE INCLUDES THE DESIGN AND DETAILING OF THE FOUNDATION
FOR THE PROPOSED GARAGE LOCATED IN THE FLOOD PLAIN. THE
FOUNDATION IS TO BE FLOOD-PROOFED IN ACCORDANCE WITH THE MN
BUILDING CODE REQUIREMENTS FOR A TYPE FP3 SPACE.
CONSTRUCTION IS TO BE PERFORMED IN ACCORDANCE WITH THESE
DOCUMENTS AND STAND,ARD INDUSTRY PRACTICE.
FLOOD-PROOFING PROVISIONS WILL BE PROVIDED IN ACCORDANCE
WITH THE CODE:
WATERPROOFING: TYPE C
STRUCTURAL LOADS: CLASS 3
CLOSURE OF OPENINGS: TYPE 4
WALLS, CEILINGS, & CONTENTS: CLASS 4
FLOOD PROOFING CLASSIFICATION W4 (FLOODED WITH FLOOD
WATER)
THE PLACARD, AS FURNISHED BY THE BUILDING OFFICIAL, IS TO BE
INSTALLED BY THE OWNER IN A VISIBLE PLACE ABOVE THE RFD.
THE RFD AT THIS ADRESS IS 823.2 FEET.
DESIGN DATA
�
STRESSES
F'c = 3000 PSI - COMPRESSIVE STRENGTH AT 28 DAYS FOR ALL OTHER
CAST-IN-PLACE �CONCRETE
Fy = 6Q KSI - REINFORCING STEEL - ASTM A615 - GRADE 60
F'M = 1500 PSI - HOLLOW CONCRETE MASONRY BLOCK - GRADE -
ASTM C90
MORTAR = TYPE S- ASTM C270
STEFFENS RESIDENCE
640 DOVER STREET
FRIDLEY, MN
engineers
5201 East River Road Suile 308
Minneapolis. Minnesota 55421
Phone� 763.5712500 Fax: 763.571.1768
Bismarck - De�mit Lakes - Fargo � AAinneapoiis - Sioux Falls
Web: www.ulteig.com
Drawn By. Selh Chm�iik
Checked By: Seth Chme�k�^ ,
Approved By� Dan Sargeanl
JOHN STEFFENS
200 L�BERTY STREET
FRIDLEY, MN
I hereby cerlity that Ihis plan, specilication or report Revision Date Descr
was prepared by me or un0er my direct supervision
and �hat I am a duly Licensed Prolessional Engineer
under ihe laws of the Slate ot Minnesota.
Print Nam � Ddfll �8f (li
Projecl Number 20 958
Signed: Dale: Auous118.2005
Date�.08/18/05 LicenseNumber PBSi% Sheets: 7 0l 4
S-1
LOADlNGS
SNOW LOAD =
FLOOR LOAD =
WIND LOAD =
GENERAL NOTES CONTINUED
35 PSF
50 PSF
PER AS�E 7-98
FLOOD-PROOFING LOADS:
HYDROSTATIC LOAD PRESSURE = 62.5 PCF/FT
HYDRODYNAMIC LOAD VELOCITY = 10 FT/SECOND BASED ON SECTION 602.3.1
UPLIFT AS CALCULATED
{MPACT LOADS =1000 LBS TRAVELING AT 10 FT/SECOND ON 1 SQUARE FOOT.
OTHER LOADS ARE CALCULATED IN ACCORDANCE WITH CHAPTER 6 OF THE
FLOOD-PROOFING REGULATIONS.
SOIL BEARING
ALLOWABLE SOIL PRESSURE = 2000 PSF ASSUMED
CODES
BUILDING CODE - STATE OF MINNESOTA AND IBC 2000
FILL PLACEMENT
REMOVE AND REPLACE ALL UNSUITABLE ORGANIC MATERIAL BELOW ALL
SLABS ON GRADE AND FOOTINGS, INCLUDiNG OVERSIZING, AS REQUfRED.
ALL FILL TO BE ENGINEERED GRANULAR OR OTHER NON FROST SUSEPTIBLE
MATERIAL COMPACTED TO A MfNMUM OF 95% STANDARD PROCTER DENSiTY
(ASTM D698). FILL TO BE PLACED IN LIFTS NOT TO EXCEED ONE FOOT.
MECHANICAL AND PLUMBING
DRAINS AND SUMPS, AS REQUIRED, ARE TO BE DESIGNED AND SIZED PER
SECTION 1302 BY A LISCENSED PLUMBER. ALL HEATING, COOLING, AND
VENTING SYSTEMS INSTALLED BELOW THE RFD WILL HAVE AN AUTOMATIC
OR FLOAT TYPE SHUT OFF AND BE SUBMERSIBLE PER SECTION 1301.
ELECTEICAL
ALL CIRCUITS WILL BE DE-ENERGIGIZED AUTOMATICALLY PER SECTION 1204.
ALL WIRING FIXTURES BELOW THE RFD SHALL BE SUBMERSIBLE.
STEFFENS RESiDENCE
640 DOVER STREET
FRIDLEY, MN
7
� �� '
�„ ' .
���`;�r � , -,�, f
�
5201 East River Hoad Suite 30B
Minneapolis, Mimiesota 55421
Phone: 763.5712500 Far: 763.571.1168
Bisma�ck - DeVal lakes - Fa�go � Minneapolis � Sioux Fafls
Web� www.ulleig.com
UrawnBy' SelhChmelfk
Checked By: Selh Chmehk
Approved By. Dan Sargeani
JOHN STEFFENS
200 LIBERTY STREET
FRIDLEY, MN
1 hereby certily that t6is Plao. specificalion 0� repoq
was prepared 6y me or under my direq sUpervision
and ihal I am a duly Licensed Pro�eSSlonal Engineer
unde� the laws of ihe State of Minnesota.
Pnn� Nain . 8� B8f1
Signed
Date� Q8/18(OS License Numb : 26817
Project Number� 205.0958 � ^ _ ^
Dale�. Auaust 18. 2005 � L
Sheets 2 0l 4
GEN�RALSTRUCTURALNOTES
SCOPE OF WORK
SCOPE INCLUDES THE DESIGN AND DETAILING OF THE FOUNDATION
FOR THE PROPOSED GARAGE LOCATED IN THE FLOOD PLAIN. THE
FOUNDATION IS TO BE FLOOD-PROOFED IN ACCORDANCE WITH THE MN
BUILDING CODE REQUIREMENTS FOR A TYPE FP3 SPACE.
CONSTRUCTION IS TO BE PERFORMED IN ACCORDANCE WITH THESE
DOCUMENTS AND STANDARD INDUSTRY PRACTICE.
FLOOD-PROOFING PROVISIONS WILL BE PROVIDED IN ACCORDANCE
WITH THE CODE:
WATERPROOFING: TYPE C
STRUCTURAL LOADS: CLASS 3
CLOSURE OF OPENINGS: TYPE 4
WALLS, CEILINGS, & CONTENTS: CLASS 4
FLOOD PROOFING CLASSIFICATION W4 (FLOODED WITH FLOOD
WATER)
THE PLACARD, AS FURNISHED BY THE BUILDING OFFICIAL, IS TO BE
INSTALLED BY THE OWNER IN A VISIBLE PLACE ABOVE THE RFD.
THE RFD AT THIS ADRESS IS 823.2 FEET.
DESIGN DATA
STRESSES
F'c = 3000 PSI — COMPRESSIVE STRENGTH AT 28 DAYS FOR ALL OTHER
CAST-IN-PLACE CONCRETE
Fy = 60 KSI — REINFORCING STEEL — ASTM A615 — GRADE 60
F'M = 1500 PSI — HOLLOW CONCRETE MASONRY BLOCK — GRADE -
ASTM C90
MORTAR = TYPE S— ASTM C270
STEFFENS RESIDENCE
640 DOVER STREET
FRIDLEY, MN
engineers
5201 East River Road Suite 308
Minneapolis, Minnesota 55421
Phone: 763.5712500 Faz: 763.571.1168
Bismarck � Delroil Lakes - Fargo � Minneapolis - Sioux falls
Wetr. www.ulteig.com
Urawn By�. Se�h Chmelik
Ghecked By�. Seth Chmelik
Approved By� Dan Sarqeant
JOHN STEFFENS
200 LIBERTY STREET
FRIDLEY, MN
I hereby cerlily iha� Ihis plan, specilication or repoq Revision Dale Descr
was prepared by me or under my direct supervision
and that I am a dury Licensed Professional Engineer
under the laws ol ihe State ol Minnesoia.
Print Nam � �d I df fl�
Pmjecl Number 205.0 5
Signed_ Date-. Auous118.2005
Ua�e 08/18/OS License Number 26817 Shee�s 1 0l a
S'1
LOADINGS
SNOW LOAD =
FLOOR LOAD =
WIND LOAD =
GENERAL NOTES CONTINUED
35 PSF
50 PSF
PER ASCE 7-98
FLOOD-PROOFING LOADS:
HYDROSTATIC LOAD PRESSURE = 62.5 PCF/FT
HYDRODYNAMIC LOAD VELOCtTY =10 FT/SECOND BASED ON SECTION 602.3.1
UPLIFT AS CALCULATED
IMPACT LOADS = 1000 LBS TRAVELING AT 10 FT/SECOND ON 1 SQUARE FOOT.
OTHER LOADS ARE CALCULATED IN ACCORDANCE WITH CHAPTER 6 OF THE
FLOOD-PROOFING REGULATIONS.
SOIL BEARING �•.
ALLOWABLE SOIL PRESSURE = 2000 PSF ASSUMED
CODES
BUILDING CODE — STATE OF MINNESOTA AND IBC 2000
FiLL PLACEMENT
REMOVE AND REPLACE ALL UNSUITABLE ORGANIC MATERIAL BELOW ALL
SLABS ON GRADE AND FOOTINGS, INCLUDING OVERSIZING, AS REQUIRED.
ALL FILL TO BE ENGINEERED GRANULAR OR OTHER NON FROST SUSEPTIBLE
MATERIAL COMPACTED TO A MINMUM OF 95°/a STANDARD PROCTER DENSITY
(ASTM D698). FILL TO BE PLACED IN LIFTS NOT TO EXCEED ONE FOOT.
MECHANICAL AND PLUMBING
DRAINS AND SUMPS, AS REQUIRED, ARE TO BE DESIGNED AND SIZED PER
SECTION 1302 BY A LISCENSED PLUMBER. ALL HEATING, COOLING, AND
VENTING SYSTEMS INSTALLED BELOW THE RFD WlLL HAVE AN AUTOMATIC
OR FLOAT TYPE SHUT OFF AND BE SUBMERSIBLE PER SECTION 1301.
ELECTEICAL
ALL CIRCUITS WILL BE DE-ENERGIGIZED AUTOMATICALLY PER SECTION 1204.
ALL WIRING FIXTURES BELOW THE RFD SHALL BE SUBMERSIBLE.
STEFFENS RESIDENCE
640 DOVER STREET
FRIDLEY, MN
engineers
5201 Eas� River Hoad Suile 308
Minneapolis, Minnesota 55421
Phone� 763.5712500 fax: 763.571.1168
Bismarck � De1�ai Lakes - Farqo - Minneapolis � Sioux Falls
Web� www.ulteig.com
Drawn By: Seth Chmelik
Checked By. SFth ChmehV:
Approved By� Dan Sargeanl
JOHN STEFFENS
200 L�BERTY STREET
FRIDLEY, MN
I hereby cerply �hat lhis plan, specillca�ion o� repoh Revision Date Descr
was prepareA by me or untler my tlirect supervision
and that I arn a duty licensed Pmfessional Engineer
under the laws ol the Stale ol Minnesota.
Pnni Nam . 811 � eant
Slgned- Projec� Numbec 205.0958
Date: Auaust 18. 2005
Da�e� 08/18/05 License Numb � 2BS�% Sheets�. 2 0l 4
S-2
LOADINGS
SNOW LOAD =
FLOOR LOAD =
WIND LOAD =
GENERAL NOTES CONTINUED
35 PSF
50 PSF
PER ASCE 7-98
FLOOD-PROOFING LOADS:
HYDROSTATIC LOAD PRESSURE = 62.5 PCF/FT
HYDRODYNAMIC LOAD VELOCITY = 10 FT/SECOND BASED ON SECTION 602.3.1
UPLIFT AS CALCULATED
IMPACT LOADS = 1000 LBS TRAVELING AT 10 FT/SECOND ON 1 SQUARE FOOT.
OTHER LOADS ARE CALCULATED IN ACCORDANCE WfTH CHAPTER 6 OF THE
FLOOD-PROOFING REGULATIONS.
SOIL BEARING
ALLOWABLE SOIL PRESSURE = 2000 PSF ASSUMED
CODES
BUILDING CODE - STATE OF MINNESOTA AND IBC 2000
FILL PLACEMENT
REMOVE AND REPLACE ALL UNSUITABLE ORGANIC MATERIAL BELOW ALL
SLABS ON GRADE AND FOOTINGS, INCLUDING OVERSIZING, AS REQUIRED.
ALL FILL TO BE ENGINEERED GRANULAR OR OTHER NON FROST SUSEPTIBLE
MATERIAL COMPACTED TO A MINMUM OF 95% STANDARD PROCTER DENSITY
(ASTM D698). FILL TO BE PLACED iN LiFTS NOT TO EXCEED ONE FOOT.
MECHANICAL AND PLUMBING
DRAINS AND SUMPS, AS REQUIRED, ARE TO BE DESIGNED AND SIZED PER
SECTION 1302 BY A LISCENSED PLUMBER. ALL HEATING, COOLING, AND
VENTING SYSTEMS INSTALLED BELOW THE RFD WtLL HAVE AN AUTOMATIC
OR FLOAT TYPE SHUT OFF AND BE SUBMERSIBLE PER SECTION 1301.
ELECTEICAL
ALL CIRCUITS WILL BE DE-ENERGIGIZED AUTOMATICALLY PER SECTION 1204.
ALL WIRING FIXTURES BELOW THE RFD SHALL BE SUBMERSIBLE.
STEFFENS RESIDENCE
640 DQVER STREET
FRIDLEY. MN
engineers
5201 Easl River Road Suite 308
Minneapolis, Minnesota SS721
Phone' 763.5112500 Fax� 763.571.U68
Bismarck � Delroit Lakes - Fa�qo - Minneapolis � Sioux Falls
Web: www.ulteig.com
Drawn By: Seth Chmelik
Checked By: Selh Chme6k
Appro�ed By� Dan Sargeant
JOHN STEFFENS
200 l{BERTY STREET
FRIDLEY, MN
I hereby certily Ihat Ihis plan, specification or report qevision Dale Descri
was prepared by me or untler my direcl supervision
and that I am a duty Llcensed 7rolessional Engineer
under 1he laws of fhe State ol Minnesota.
Prini Narn . dfl dfl
Siqned: Projec� Numbec 205.0958
Date�. Auausl t8. 2005
oate 08/18/05 �icense Numb 26817 Sheets 2 0l 4
S-2
Minnesota Kule 1335.2200
Minnesota Rules, 'I�able of Chapters
7'able ol�conlents f��r C'hapler 133_5
1335.2200 FLOODPROOFING REGULATIONS, SECTION 802.1.
FPR section 802.1 is amended to read as follows:
Applicability: Spaces to be intentionally flooded with
flood water (W4) shall be provided with the necessary equipment,
devices, piping, controls, etc. necessary for automatic flooding
during the flood event and drainage system(s) shall utilize
approved piping materials and have sufficient"capacity for
raising or lowering the internal water level at a rate
comparable to the anticipated rate of rise and fall of a flood
that would reach the RFD. These pipe systems shall be directly
connected to the external flood waters to maintain a balanced
internal and external water pressure condition. Provisions
shall be made for filling the lower portions of the structure
first and for interconnections through or around all floors and
partitions to prevent unbalanced filling of chambers or parts
within the structures. All spaces below the RFD shall be
provided with air vents extending to at least three feet above
the elevation of the RFD to prevent the trapping of air by the
rising water surface. All openings to the filling and drainage
systems shall be protected by screens or grilles to prevent the
entry or nesting of rodents or birds in the systems.
STAT AUTH: MS s 104.05 '
Cvrrent as of 05/01/97 �
,:. ,
http://www.revisor.leg.state.mn.us/arule/1335/2200.htrnl
Page 1 of 1
8/18/2005
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1, DRA1N TILE AND 1NSULATI�N, AS WELL
AS THE1R 1NSTALLATIDN, ARE TO BE IN
ACCORDANCE WITH THE CODE,
2. MEAN ANNUAL FLQOD LEVEL 1S AT ELEVATION
823,2 FEET. TaP ❑F C�NCRETE FOUNDATION
WALL TO BE A M1NiMUM OF 10" ABOVE THIS
ELEVATION,
�/z "� x 10" LONG S
ANCHOR BOLTS w/
(1) NUT & HEAVY
DUTY WASHER
(7" MIN, EMBED)
OR SIMPS�N MAB15
@ 72" O,C, OR
APPROVED EQUAL
ELEV. = 824,0' —
DRIVE WAY �
SLOPE GRADE
AWAY FROM
FOUNDATION
�
STEFFENS RESIDENCE
640 DOVER STREET �./
FRIDLEY, MN �/
engineers
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GARAGE WALL
520� Easl Fiiver Noad Suile JD8
Minneapolis. Minnesola 5542�
Plwne�. 7635712500 Fax�. 769.571.�168
Oismarck � Del�dl LaNeS � Fargo - Minneapulis Siou< Falls
lVeb' www Ulleig com
DraWnBy� SelhGnnnlik
�:bncY.nd Oy� ;cih r:lun��6q
A�qrrovprf HV� U:m �arqnnnl
WOOD FRAME WALL
BY ❑THERS
8" CONCRETE MASONRY BLOCK
WALL w/ a�F VERTICAL BARS
@ 32" O,C, CENTERED IN WALL
. 24�� �
a4 x 5'-0' Ht]�KS
@ 32" O,C. TYP.
36"
4" PVC OPENING w! SCREENS
AT EACH END @ 36" O.C,
SEAL AROUND PVC AS REQ'D
—6" CfJNCRETE SLAB ON GRADE w/
C4" SLAB MIN WITH OUT 1NFL�OR
HEATING PLUMBING>
IN�'LOOR HEAT BY OTH�RS
ELEV. = 820,0'
"""—'�`''• ' �2" CLEAR TYP
12" RECYCLED CONCRETE
I„I I 1=
I- THICKENED EDGE C1F SLAB TO
13" w/ (2> � 4 BARS CONT.
�-3" RIDGID D�W STYROF�AM
HIGHLOAD 40 INSULATION
R MIN. = 13,0
:CTI�N
JOHN STEFFENS
200 LIBERTY STAEET
FRIDLEY, MN
1 hnreby r.?rlily lhal lids plan. syecilicalion or reppd
was prrparnd by me or umlar my dlrecf supervislon
and Ihnt I nm a duly I.icensed Prolessional Engii�eer
und�r Iho laws ol Ihn Stale ryol Mlnnr.sota.
Piinl Nanv 811 E �a►�e'�! _
n
ti�qn�wJ� � �
Uale��,{}(,�(�Lir,cosnNunAmr �G4�%
Projed Numbrtr 205.0958' /`'�
(lnle�. ' ��xws110.2005 J��
Sheetx. 1 0l 4 �
.. ' i
.�
�a�
1, DRAIN TILE AND INSULATI❑N, AS WELL
AS THEIR INSTALLATIDN, ARE TO BE IN
ACCORDANCE WITH THE CODE,
2, MEAN ANNUAL FLDOD LEVEL IS AT ELEVATIDN
823.2 FEET. TOP ❑F C�NCRETE OUNDATIDN
WALL TD BE A MINIMUM OF 10" A VE THIS
ELEVATION, � \ �
� t�N
�U'
�� ��� �
1
S4
�/z"� x 10" LONG-
ANCHDR BQLTS w/
Cl> NUT & HEAVY
DUTY WASHER
C7" MIN, EMBED>
❑R SIMPSDN MAB15
@ 72" D,C, ❑R
APPROVED EQUAL
W�OD FRAME WALL
BY OTHERS
REWARD ICF FLAT FORM w/6"
CONCRETE WALL PDRTION w/ �4
VERTICAL BARS @ 32" O.C.
CENTERED IN WALL
ELEV. = 824.0'
Cl> �4 HORiZ. BAR TDP & BOTT,
24" �
. ".. � @432" D.C„ TYP KS 36 �
,
DRIVE WAY—
SLOPE GRADE
AWAY FR�M
FOUNDATI�N
STEFFENS RESIDENCE
640 DOVER STREET
FRIDLEY. MN
engineers
. �
I
:
-!:
v
.'i 3" PVC OPENING w/ SCREENS
AT EACH END @ 48" D,C.
SEAL ARDUND PVC AS REQ'D
6" C�NCRETE SLAB �N GRADE w/
C4" SLAB MIN WITH ❑UT INFLOOR
HEATING PLUMBING>
INFLDOR HEAT BY OTHERS
, .o ,. ELEV. = 820.0'
�-2" CLEAR TYP
, :. �.
—111=111—I f=
113'-0" MIN I 1'-
GARAGE WALL
5201 East River Road Suita 308
Minneapolis, Minnesota 55421
Phone: 763.5712500 Fax: 763.571.1168
Bismarck - Detroit Lakas - Fargo - Minneapolis - Sioux Falls
Web: www.ulteig.com
Drawn By: Seth Chmelik
Checked By: Seth Chmelik
Approved By: Dan Sargeant
12" RECYCLED C�NCRETE
� I I�-THICKENED EDGE OF SLAB TD
III- 13" w/ C2) �4 BARS CONT.
— 3" RIDGID D�W STYROFOAM
HIGHLOAD 40 INSULATIDN
R MIN. = 13,0
SECTIDN
JOHN STEFFENS
200 LIBERTY STREET
FRIDLEY, MN
I hereby certify that this plan, specification or report
was preparetl by me or under my tlirect supervision
and that I am a duly Licensed Professional Engineer
under ihe laws oF the State oF Minnesota.
Print Name' fl
Signed:
Date: 09/08/05 License Number: 26817
Project Number: 205.0958 �^_ A A
Date: Seotember8.2005 � c}H
SheetS: 4 of 4
SEP-08-2005 09�02 CITY OF FRIDLEY
City of �ridley 6uilding Inspectians Dep�
6431 Unive�sity Ave NE
Fridi�y MN 55432
Date y,/�/v �
The appficant is:
Property Owner:,
Address:[vyo �
City: Fir� dl c� u
Phone: �
Contractor inforn
Company NamE:
Contact Person:l
. ,. ,
Ph: 763-572-3604 FAX: 763-571-1287
IVlechanical �e,m;t# o�OoS - D��l
Residential Application
City of Fridley
See Back Side For #�equired lnforma�ion
site address:I�51 � v�" �4-. FY-_ ,��a�� m�1
one Qwner ontracto
. �i- g errPP 9 r�a
Ciry_/�,Z\2...�1 o�r�.
Phone:`�-(n 3 -�a �-Co�j?,
�mai(:
Type of Woric (cirde one):
Detailed �escription of work;
�n lact �,rena.ce 4
Equipment Instatled: MFG:
Cell: �Lo3- 9lfec/ -
� �
►
State�LlsrV Zp:�i5���
Ceil: Fax:��-�-
MN Bond# & Exp Da
l� placem Alteratian/Remodei
ca
' 21 ZS 9�i �I
�f ` Ge o Ne� �
', MFG: ,.��e odei: W Size/BTU: � O
MFG: o-��-ae Mod�l: fW� a O SizeBTU: R'0� oac`�
Please ch�ck all that apply: __Firepface {gas) $15.00 ,�New Gas Grili $10.00
�i A/C $25_00 Fireplace (wood) $35.0� �Gas Ur�it HTR $10.00
Air to A�r exchanger $16.00 �Furnace $35.00 Poo( Heaier $35.00
_Boiler $36_00 �Gas Dryer $10.00 Ventifator $15.00
Chimr►ey Liner $10.0� _Gas Piping $10_00
�Z( Duct Work $10.00 Gas R�n e/�ven $10.00
�e��t ��: $ /� 'J`� • �f� (Total from above-Minimum fee $35A0)
Surcharge � 0.50
7otal Due � D� •�� � Make check payable ta City af Fridley
Th�s �s an application for a permit� �ot vaiid until processed
I hereby apply for a machanical permit and t acknowladge that the ir►formation above is complete and
accurate: that the work will be in conformance with ihe ordnances and codes ot the City oi Fridley and
wich the Minne .ota Construction Codes; that I undersiand this is not a permit but only � spp;ication
for a permit and work is not to star# wjthout q penrli� that the wark wiEl be in acGOrdance with the
appro �ed plan in case of at� wnrk whl�� �equires review 2nd approvaf of pfans,
Signature of Apptica
Appraval Inspectar :
Date:'"r � �
Date: c�
09J15/2005 09:08
8655913532
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CPI
Pa�E eiie2
Radiant Heating Design Summary
Praject Number. 2005-1942 AL KU
Project Name: GARAGE
Date: September 16, 2005
Project Summary Prepared By:
Location; MN
Fioorplans: Lacey Fleming
� CPI
Area: 98� fi� 135 Fox Rd Suite A
Totai Manifolds: �
Total Circuits; 5
Totai Length by Tube Type: 1152 ft p�x ��2��
Notes: A7TN: 763-7B6-3436 FOR qL K�1
Floorplan
Area: 98� ft�
Manifiolds: �
Circuits: 5
Length by Tube 1152 ft
Total Circuit Length: 1152 ft
PEX 1/2"
Manifold (5 circuits 235 ft. lonaest 2�� �t �h.,�,�f�
Knoxvilie, TN 37922
Phone: 8�0�89�8274 x221
F2uc: 800�323�034
Laoey�durapex. com
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640 Dover St.
Geo Layout
PPER
IDWEST
ADIANT
Upper Midwest Radiant
Geothermal Heating and Cooling
Since 1997
Location:
Fridley,
MN
Drawing By:
David Henrich
Date: n ' � � � O C
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Steffen's Pp� Upper Midwest Radiant
640 Dover St. IDWEST Geothermal Heating and Cooling
Geo La.yout ADIANT Since 199?
Location:
Fridley,
MN
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09/16/2005 09:08 8656913632 CPI PAGE 02/02
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Scale: 1:20
Steffen's
640 Dover St.
Geo Layout
PPER
IDWEST
ADIANT
Upper Midwest Radiant
Geothermal Heating and Cooling
Since 1997
Location: � � Drawing By:
Fridley,.
MN
Date:
Residence o£
David Henrich
9- 12-05
05-U- 1374
Building
Inspections
763-572-3604
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
Permit No.:
Received By:
Date Rec'd:
DATE
!� C�G� OS YOUR E-MAIL ADDRESS t�' �� ��'� �►k+�' W'�1STTzU<=ti c� - Co�
SITE ADDRESS �'t v �d+�`� � NE
THIS APPLICANT IS: ❑ OWNER i�CONTR.ACTOR
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
�
��
ADDRESS: C2`�� �� � �� CITY��
PHONE: � Co �-�CD�I — Z z CP
NAME: � cr'��vC1uFR-aL 'C�NSi�L.vC.;fTJJ � ^�< <
STATE LICENSE �i ►J� '�3�? ZS7 S �XP DATE
ADDRESS: �� W_ �[ni� S(-� CITY ��c.Lw�fl,—'iC STAT�NLIP S���Z
PHONE Co �j 1— Z`� $— � Z-1 FAX �F ji �" � J I— Og(o I
�'SINGLE FAM]LY/NEW CONSTRUCTION S1ZE _ � __
TWO FAMILY/NEW
❑ ADDITION ❑ GARAGE/SHED
❑ BASEMENT FINISH ❑ ROOF
❑ DECK O SIDING
❑ SWIIv1MING POi
❑ NEW � AbDITION
AIIt
❑ DRA1N TILE
❑ OTi�R
DESCRIBE WORK BEING DONE: � Ni�"i�Rl,o fZ t-�uoV �t"tv�-CY -
SIZE OF IMPROVEMENT LENGTH � WIDTH ZZ' HEIGHT Sq. Ft.
NUMBER OF SQUARES _
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
❑ Aluminum
❑ Other
VVINDOWS
IN EXISTING OPENINGS �Yes ONo
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE IN3TALLED
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
❑Soffit
❑ Trim
❑ Fascia
LOCATION OF WINDOWS
ALL FEES ARE BASED ON VAL
Permit Fee
TOTAL JOB VALUATION
•; ( J
Plan Review � �'"�
Surcharge
Fire Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
BASEMENT REMODELING SUBMIT:
1. Existing Floor Pian
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS. & 1'ORCHES SUBMIT:
1. Site Plan/Survey showing the existing sWctures
and proposed project.
2. Two sets of construction plans
3. Energy Calculations
OF WINDOWS I
UDING THE COST OF LABOR AND MATERIALS:
�.B.0 FEE SCHEDULE)
OCCUPANCY TYPE
�s $ �/�.�-,���� See Back Page for Fee Schedule
��$ 3._��� 65% of Building Permit Fee
$ (� , Q (.0005) times the total job valuarion - Minimum $.50
$ �}� , - .001 x Permit Valuation (1/10%)
$ -� , �„ $5.00 (State Licensed Residential Contractors)
$ $1450 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= 8x$20=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ . Make checks aavable to: City of Fridle_y Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclrnowledge 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 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 ap ro al of plans.
SIGNATURE OF APPLICANT �'� PR1NT NAME ��—'r'"' � DATE �� d�-� O�_
�
Building
Inspections
763-572-3604
DATE
SITE ADDRESS
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERMIT TYPE
PLUMBING
RESIDENTYAL APPLICATION
CITY OF FR�DLEY
YOUR E-MAIL ADDRESS
❑ OWNER l6eONTRACTOR
�
Permit No.:
Received By:
Date Rec'd:
STATE�IP SS y32
STATE LICENSE # �1+ � �� �TE � � � � V °
ADDRESS:' "t� d � �/�% CITY��_p,, a.� STATE�LIP� '
PHONE ' ' r O F�?� ' ����'� � �S3y �
TYPE OF WORK: I �W
FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
�REPLACEMENT
DET�D,DESCRIPTION OF WORK �K �e��t. � �' ��' { � � Ce✓►-�ev� � � �' l.a.�.p i�+� c�
� ��c��,
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, 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 PTtOJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
MBER OF EACH BELOVt�
BATH SINK/LAV FLOOR DRAINS � SHOV✓ER r WATER PIPING
BATHTUB GAS PIPING �e� c»ruc�s� SWIMMING POOL _ WATER SOFTNER ($35)
i CLOTHES WASHER �KITCHEN SINK 2 WATEIi CLOSET _ BACKFLAW PREV. (�'15)
DISHWASHER LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION
WATER METER _ OTHER
Permit Fee
TOTAL DUE
.., � �,., � . _�, � . . .. _�__. _ __ .
$ / / O ,� Number of fixtures @ $10.00 x $10.00 = $ . �
.50 Number of fixtures @ $15.00 x $15.00 = $
$ l/ �_.� 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 permit and I acla�owledge 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 work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of a o k which re ' es review and approval of plans. ,j
SIGNATURE OF APPLICANT PR1N'f NAMEY,Jrt✓`"� �ov�ha � v' DATE ��'1 �
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
��
1. DRAIN TILE AND 1NSULATI❑N, AS WELL
AS THEiR 1NSTALLATI❑N, ARE T❑ BE IN
ACC�RDANCE WITH THE C❑DE,
2, MEAN ANNUAL FL��D LEVEL IS AT ELEVATIDN
823,2 FEET. TOP ❑F C�NCRETE FOUNDATION
WALL T❑ BE A MINIMUM ❑F 10" ABDVE TH1S
ELEVATION,
� �/2"� x 10" L❑NG�
ANCHOR B❑LTS w/
Ci> NUT & HEAVY
DUTY WASHER
<7" MIN, EMBED)
OR SIMPSON MAB15
@ 72" ❑,C. OR
APPROVED EQUAL
ELEV. = 824.0' —
DRIVE WAY �
SLOPE GRADE
AWAY FR❑M
F[]UNDATI❑N
1
STEFFENS RESIDENCE
640 DOVER STREET /
FRIDLEY, MN _/'
engineers
. ■�
I
:
-!-
WO❑D FRAME WALL
BY ❑THERS
8" C�NCRETE MASONRY BLOCK
WALL w/ �4 VERTICAL BARS
@ 32" ❑,C, CENTERED IN WALL
z4" ��4 x 5'-0" HOOKS
@ 32" ❑,C. TYP. 36"
4" PVC OPENING w/ SCREENS
AT EACH END @ 36" O,C.
SEAL AROUND PVC AS REQ'D
6" C❑NCRETE SLAB ON GRADE w/
- C4" SLAB MIN WITH DUT INFLqOR
HEATING PLUMBING>
IN�'LD�R HEAT BY ❑THERS
..o o. ELEV. = 820,0'
�-2" CLEAR TYP
. • �•
12" RECYCLED C�NCRETE
— — — — II�THICKENED EDGE OF SLRB T❑
-0" MIN 1' -0" -I I I- 13" w/ (2> �4 BARS CONT.
I�T� —_— 3" RIDGID D❑W STYROF�AM
HIGHLDAD 40 INSULATION
R MIN. = 13,0
GARAGE WALL SECT
5201 East River Road Suile 308
Minneapolis, Minnesota 55421
Phone� 763.5712500 Fax� 763.571.1168
Bismarck � Delroit Lakes - fargo � Minneapolis - Sioux Falls
web: www.ulle�gcom
Drawn By- Sa_�h Chmefk
Checked By: Selh Chmelik
Approved By� Dan Sargeanl
JOHN STEFFENS
200 LIBERTY STREET
FRIDLEY, MN
I hereby certify that this plan, speci�ication or report
was preparetl by me or under my direct supervision
and Ihat I am a dury Licensed Prolessional Engineer
under ihe laws ol the State of Minnesola.
Prin1 Nam an e.S8 e nt
Signed.
Date�08/18/05 �icenseNumber 26817
Projecl Number: 205.0 ' /`'�'
Date�. � Auaust 18. 2005 J �
Sheets: 4 0l 4 �
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