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AF - 36460• . • �+ � ��Ud� City of Fridley, Minn. BUILDING PERMIT Date: _...,... April 17,.V1969 , _� �. . , - _ � � �� Owner: __.Roger..Blohm .__..._..___.._._..______.._..._._.._ Builder _.. Rodne�BBillman._..�..._Inc..s...._. _._.__._...._� Address ...__.._.__..__......._.__..__._...__._.._..__._.._.........__...._._._..._..._._.._ Address _.151 Sil_v_�r,_Lake__Road___.__._..^.._._..._.._. New Brighton, Minnesota LOCATION OF BUILDING No. .._l6 05.--.-------- Stzeet ._.._...__$erne _Road._.._____._.___....._ ......................__.... Part of Lot _..._.__..._.._._.____.._.�_._... Lot .._.._.�.�....._......._---._ Block _._...._._._......__....1.._...----...._. Addition or Sub-nivision _...._.._._xnnsbruck_5th_Addn �.� Corner I,ot _.__.---•--_..._......_ Inside Lot ....._..•----X--•-•--_......------ Setback _-•---.5 �-� ••---...._..... Sideyard _....� 1 � e 6 rr �_�.__.....--� .962 .26 ----•---_966_, 2�i--_.... _.—_�_ Sewer Elevation ._._._...._._._. _._...._...._._..--•_._..._..._._...._......_._...___... Top of Footing DESCRIPTION OF BUILDtNG To be Used as: 756 _.$a.elling......_....__...__ Front _.._.._Z.9_� Depth ....._.28.�__ Height _...2Q�_._._ Sq. Ft. _.165.� Cu. Ft ±u�.��.g�....__......._..__.._.._ Front __.__......__ Depth _..___._.....__ Height ._.._......_.---_ Sq. Ft. _.._._.._...._.. Cu. F'� Type of Constxuction ....._.._Fxame.._.-----_...........---. Est. Cost _--•--..-��.s-QQQ_....._........ To be Coanpleted _.._.........._�...:.. SEWER LOCATION 145' East of Manhole WATER LOCATION - 155' East of Ma.nhole In consideration of the issuance to me of a permit to construct the building described above, I agree to do th� proposed work in accordance with the description above set and in compliance with all provisions of ordinances of the city of Fridley. /'� �i '- / i i �. �'�°�' 00. 00 Sewe� Con.nection Char In co�sideration of the payment of a fee of $._.__ 60.00 _� permit is hereby granted to_._.. Rod.n�v Bi].lman, Inc . .�.__,._...._.._._...._.....__.:..__.___.._.._ to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respect8 to the ordinanoes of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and. maving of buildings within the city limits and this permit may be revoked at any time upon violation of of the provisioas of said ordinancea � � arence Belisle � N0710E: 7hts p�emh doa not eowr th� wnstrueNoe. installNion for wirin�. Plumbiny. oas 6�atin�, swwr or wabr. 6� suer io sN th� BuiWiag insp�eeor for s�p�rah p�nnhs fo� fh�a it�ms. � 0 AF'.Pi,I�ATI01`d � OR. BUII,��N�` PIl�NIIT G�T� 0� FRIDLEY 9 MI_�INESOTA oti�,� �s ��o,� l��Cohn� ��B�JZI,:�k�t �Zoclne� ��.�L��arc, 9�c. ��RE�� .A��R�s� � SI _�.i,�e�c .Cake i�oad, New ��i,i,e�h,toh �C� A'I'�G�T Or BU:II,�1TP+�; ��` TJQ o l� ,. `"`S�REE:.�� j -�-�,'�-�.f �' _� �,02 � S �voc� I A.�DITIO� O�i SJEDIV��zo� 9�G� S-th Addn„ 6:�F.�� I�GT SEaGJ� ELE`e�A� .iC'Ti z�,��,�� ,o�r X sE�B� ;�. S01 sl��t� 10 � 6" T0� C�� ,0�:''�I�� Ap?�l��art �,��ach to this ;:o.L�. 'I'-�,�c ry��tiii�at�� c�° Su.�_aey oi ?,ot a.�u p:�og,ose� builn.l^.g lo��atio:�� ray.±?:� or�. ichE�•�� n�.�tiii��.+�� 7ES'>R.7�="I'.�%Ol�� CF BL?TL,DTPI� �o bP J��^c� A�: S�.�e �we�%�.r.vu�.�ro�+. T1��th H�ight /� .��'� � �q�uare �'e�t ' �,ubic F��t �� .�.��_ �°� Iae, th, Zi � �H�i.g°ht� Square a� .�� vabic Fee± T,ype o? Gorstructio.n�� i3�t�i.e%z Estlmated �,�� c� n---� . _ %� To Be Completed Thv u.�d��sigr�.ed hereby mak_r� applicatzon ior a permit for the �ork he� ��ln speciiic�.9 agY�ei�g to do alZ work in strict accor�dance �rith th� %'ity o.f F�°id�e.y Or�.inar�ce;s �.nd ru�ings o� thU D�pa��t��rt o; B:ziZding;�9 a.�� h��c:b,y �.�clares that alz t�!a :iacts a��p_~°c.:�ertation,� st�,t �d �n � �h�� ap�� icat�orE a.�e true �,.M�i �.o:�:rect o ,,�� ; �� ATE �-- �-- �' �ir,�rIATURE ,G-4 � ..�_._ �• (Schewule o�° ��ee Costs ca,r be �ourid on the R e� e:;ide� ) � ._ � : �� r4 , , ��-� � � �� . �+ ' a � r ' ...... � ,.,a" '�� : t, r . • .. // . '" ' t 4... °� �,� ...e i � S f � . BUI3,DIT�i� PEE�M�T "��EE SCI�DULE SECTIO�? 2o The Insp�ctor of Build'z.ng� shall, �a�iox^e is�uing per�it� for the �s�ection oi any building or st�°uctur�, or for any adc�ition to ar�y existing �tr°ueture or buii�i�g9 or ior any a,lte�ation or repair� to any existi.r.g buiir�ing or s �ru�tur� 9 upon a��c'�i:;a.t �on there:for�-j ��ec�uire the pa,yment by the applic�,nt �or such permi-t oi f�e� to th� amount h�rei.� belo�r �et forth a.n�. i.r� th� na:7.ner he.�ein �s�ovided tom�sit: Uniiox°m Build.ing Co�e� Type 19 2, & q. -$'�075 for each one thousand �ubie feet, or fraction thereof, in �uer cubical c:onter�tsa T,ype 3& 5�- $1050 for ea�h one thousa�d cubi� feeto For the purpo�� oi computi:ng iees ior bui�ding perm�its9 the cubical conte.nt� of an,y building or addition to a uniform height th�oughout by multipl,yi.ng the ground area covered from a poi*�t six (6� inches bel.ow the iloor line of the basement or the ceilar to the average height of the upper �urface or to the averag� height oi the �^ooi su�iace of the mai.n gable oi a pitched roofo Fo� repairs or alteratio.r.s to an �xisting structu�e, th� iee shall be at the �ate of $3000 per eacr f'ive hundred dollars ($500�00� or iz°action thereoi in the cost of a,ll p�oposed ��orko In no case shall thE �ee cha�ged. ior any p�rmit as set �"orth i� Section 2 be 1�s5 than �S�OOo I�TSSSD Co.nnection Char�ge� based o.� �o�ation - Area � or 20 0 • � . '• • N° 4935 �� Permit for PB.UMBING AND CAS Fi ING y7�� Permit N.B. When work covered by this permit is ready, the Plumbing Ordinance requires fihai request for ��,� �� inspection shall be phoned in to the plumbing Inapector, 560-3450 giving number of thia permit., DESCRIPTION OF WORg Number, Sind and Location of Fixtures Storie9 Basement lst 2nd 3rd 4th F j y � a _......._..: Z � = N Y �"' r N Z =�-. N..:. Y � Y Z Z 3 c"'i � m r'- m m 3� o° 1 � � i � / 2 Connected with Sewer-Cesspool � Z = Z 3 � �NATER HTR. City of Fridley /`�' `�'� / s/ � 1J� Z x GAS ELEC. O U- N U J + N IJi. p U m d' �J i LL G Q U' d' �� / � Owner Gas Piping for Openings Permission is hereby granted� °��-yJ �` to do the plumbing and gas fitting in the building described in the statement hereto a tached, upon the express condition that the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing or gas fitting of said building shall conform tin all respects to ordinances of the City of Fridley, and this permit may be reuoked at any time upon the violation of any of the provisions of said ordinances. By Order Of The Inspector Of Buildings Roughing in Inspection Inspector. Finallnspection Date Inspector. � a z 1 M-6•65-V �.G/� Location �� ' � /��L�-� �� Kind of Building Used as °`-' k`�" d To be Completed ��-�-� � , 19 � 9 Estimated Cost Old-New. Building Permit No._� i-rj'� � Inspector of Buildings. sue�ecr PERMIT N city of Fridley 13217 ' ` AT THE TOP OF THE TWINS g � I L D I N G P E R M I T �E►PT N. � � ; L____�_ COMMUNITY DEVELOPMENT DIV. CJ`f� r � � PROTECTIVE INSPECTION SEC. !� � �'�'1 � CITY HALL FRIOLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY .•---� • •�� si2-56o-3a5o 910-F15 9/2�/75 � � �06 AooRess Roger Blohm 1605 Berne Road 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO DESCR. ��J 1 Innsbruck 5th Addition SHEET 2 PROPERTYOWN�o9er 6]ohm MAIL�t,�[�j,ES�erne Road N.�. Z�P PMONE t�u5 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO. Wanless Construction 1046 Rice Street St. Paul, Mn 4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE UCENSENO, 6 USE OF BUILDING residential 7 CLASSOFWORK � NEW ❑ ADDITION ❑ ALTERATtON � REPAIR � MOVE ❑ REMOVE 8 OESCRIBE WORK Aluminum sidin and aintin 9 CHANGE QF USE FROM TO STIPULATIONS SERERA'i� �ER��"T:'� ��^' �;�ED FOR� �IItRIL�a, N�ATING, PLU�iSliv� ��v� SiGNS. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY IOAp VENTILATING OR AIR CONDITIONING. a�UITI�CIUI7I 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 !S SUSPENDED OA ABANOONED FOR A PERIOD OF 120 DAYS 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 ANO CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX WITH WHETHER SPECIF ED HEREINIOR NOTOTHE GRANTI�F�PERMIT 977 • 70 . 5O DOES MOT PRESUME 70 GIVE AUTFiORITY TO YIOLATE OR CANCEL THE pERMlT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- 6.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE e �-��.�,,-. �i �L-� �� 6 . 50 SIGNATURE OF CON7RACTOR OR AUTHORIZED AGENT IDATEI N PROPE LY VALI D TFiIS YOU IT y SIGNATUREOFOWNERIIFOWNERBUIl0ER1 IDATEI BLDG.WSP OATE �c APpLICATION FOR RESIDENTIAL, ALTERATION, OR AllllITlON BU.ILDING �PERNIIT CITY OF FRIDLEY, MINNESOTA OWN�K' S NAME :✓��ti� J��.� BUILDER: ��L2� �,� �� , �1DDRE S S : �l C' �,5� ' �--r=�-i.,t�� ADDRES S : � �' �� G� -c� L�'" '��Clr� NO:. STR�ET• ZOT: BLOCK: ADDITION: CORN)'sR LOT: INSIDE LOT:. SETBACK: SIDEYARD: Applica.nt attach to this foi-m �ao Certificates of Survey of Lot and pxopose�. building location drawn on these Certifi.cates. vESCRIPTION OF BUILDING ' Ta P,e Used As : . � � Front: Depth: Height: Square Fee�:i Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: �pe of Ganstruction: �=c:�� - � E�ted Cost: $ 17 �� ?� To Be Completed o %'o -/-� - 7s The undersigned hereby makes applicatinn fox a perinit for the work herein specif.ied, agreei.ng to do all work in st'xict accordance with the City of �ridl.ey Ordinances and rulings of the Department of Buildings, and fiereby declar.es that all the facts and'repxesentations stated in this application are true and correct. DATF : �'2�� r Z S SIGNATURF • /��-�ti��f� � /� (See Reversa Side For Additional Information.) . U/ . . ` �'' , . . . �`L,� �..:y v�c lu- i,`� _... . . - � �L1 � . �; 5 .� -. , BUILDING PERMIT FEE SCH&llULi: SECTION 2: The Inspector of Buildings shall, bef_ore issuing pennits for the . erection of any building or structure, or for any addition to any existing building or structure, or for any alLeration ox repairs to any existing building or structure, upon application therefore, require the payment by the applicant for such pexmit of fees to the amount herein below set forth and in ' the maiiner herein provided to-�ait : • � UNIF�O:�M BUI�DING CODE: Type l, 2& 4-$2.15 for each one thousand cubic feet, ox fraction thereof, i.n such cubi�al contents. Type 3& 5-$1.85 for each one thousand cubic �eet. ADDITIONAL INFORMATION Fox the purpose of com�uting fees for bui.lding permits, �he cubical contents of �.ny building or addition,_is determined by mu1_tiplying the ground area covered from'a point six (6) inches i>e'low the floor line of the basement ox the cel]_ar to the average heights of the uppex surface or to the average:< height o{ �he roof surface of the main gable of a pitched roof. �or rePairs or altexations to•an exiSting stxucture, the fee shall be at the rat� of $3.00 per each five hundred dollars ($500.00) or fraction thexeo� in the cos�. of a11 proposed work. ' In no case shall the fee charged for•any pexmit as set forth in Sec�ion 2 be �!.ess than $5.00. VERIFICATION OF FOUNDATION NOTE: Permits for construction will be issued a minimum of 24 hours�fr.orn the . titue oi application, to allow for pxoper review of the proposed structure and - cf the construction site. � - _ E1 Certiiied Survey of the lot, showing the location of the fourida�ion, once it has been constructed, will be xequired before �roceeding with the fxaming. CERTIFICATE OF OCCUPANCY Application for a Certificate of Occupancy shall be made ten (10) days prior 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 tzeen issued. � � � CITY OF FRIDLEY Effettive Date May 1. 1986 APPLtCATION FOR POWER PLANTS AND NEATiNG, COOLING, VENTILATION, REFRI6ERAT10N AND AIR CANDtTIONING SYSTEMS AND DEVICES RATE SCHEDUtE QESIDEFTUL . � Purnace Shell and Duct Work, Burner (A1so replaca�ent iurnace) Gae Piping (pipinq ne�ded vitlt nav furnace) Gas Range Gas Drysr RATE TOT11L Job 1►ddress (n b 4�_/�1 f' Y� /'�G �' �� ""' �= $ 2�.00 s 10.00 $ 10.00 S 20.QO S�� S S S • Air Conditioninq (all •izes) $ 10.00 S 1121 Othere/Repaira and ]�ltesations 1� of Value of Appliance or Nork S CONMERCII►L/INDUSTRIAL 1� of Value ot /►ppliance or iiork S State Surcharge TO?]1L !EE Reinap+ection Fee tS15.00) Rouqh Insp. Date Final Insp. �� ` � Date Approval ior Pernit -�� MINIMUN FEE FOR ANY HEATING PERMIT IS i15.00 PLUS $.50 STATE SUFfCflARGE •Air Conditione n can not be placed in side yard without vcitten pc nlasion fscs adjoining neiqhbor. Departmertt of HuildingS 6431 University Ave. N.E., Fridlay, lel 55�32 City of Fridley Tel. �571-3�50 The undersigned hereby makes application for a p�r�it fos ttal wck Mr�1n speciEied agreeinq to do all wrk in strict accordancs wit6 tM City Codes and rulings of the Department ot Buildinqa, and hereby declases that all th� facts and tepresentacions stated in thia application • ttut and ootrect. F idley, Minn. � � �" . 19 9� OWNER f KIND OF BUILDIIiG� _ _ _r/�� N'""�--- USED AS TO 8E CVlfPLETED 1180ti? � �� ESTIMATED C06T �/► / / (f ✓ — $ .50 OLD - Nh11 BUII�ING PERl1IT N0. PEAMI? N0. ��CJ(D S ��r� S DESCR2PTIal1 OF FURNACE/HUNI�Q HFJITING or POi/ER PIJ►NTS. Steaa, tTOt Mat�r. W=f llir Ib. /v `7 � IL I d U /� . Trade Na�e _ Sise !b. �U � Capacity Sq. Ft. E�R 8711 �,,,_,_ 1� 1bta1 Connected Ivad � 7� 3� Kind of luel ��_;� � BURNER - Trade Nase Sis� No.� Capacity Sq. Ft. EDR 81V NP Coopany .�. � siynea ay 4�R 2� - 85th �1Yet�uB N. Broukiyn ar f, Tel. No. Filt out back side for stack verification on replace�tnt furnates �z. r: ��'..P►�` i�..t��,''. �:;"��_�:1Ji..�'�'i�"�N5 ��[:z'� �t'�`��1:.NT � - ---_- . �. �4 �:H.'1T��. V ..�w.. r� lX�eathrn t °,�� aty.ft�� rifFY9lCi101i � t., v�swa � i.9a�,'s �a F'tefCrenCt C3u9 'rF'�li (nt��af' ��',etlmg. i. 4°�'�4 ��; �rY t�a i� --- �_ ._ �._..a _ � _.a..3 'i S'_.._ � f't.� � � f�rwue� L.ength . �PWidth ; .. NeighR t�� '�Ylindorvs nnd Doctirs--• �C:rackege and Atea , " aVl lth (!'.. 74elsht� N� of : Lln��l it A�ti � . .. r�n nf c a �e 4 of a�n• Ils�t• �� ot crack luy. tt. . . . � ' .._�._...�,.... � .a �� . .! ! ° J , � _' _ � �� _ t ' �'�� c Y� �� f,� � f� Coe�; B¢u _ " _�__ . ,_. .__... � � ��.,Ii�tratiom � � Glass . ____..._.__ __.. ----- � xp��all -_._.....M .. _i� .._......., __.u.......__•_.,.. . ._,. _,._...,�_a.. � t"ICt.C.�j"3. W.4�� . . .. . : . p �Int, w;�ll _ � �. � -,.,....._.e.,,.,.. .... ..�� _. .� } M� c�lmsz ... �..K.. - ..e �..�a __ ( C lc,,�r J . ! N�r otal Citu.� � .. ( _.._ _ . _ ...__...�..._ .. _ "`"� ` �4 � i e uircd s. .�E. �ar w. iai . e aren � { q ��t D.R. � . W A: l.ead r , _.__.._._.___.__.__.�._.....__.. _�__�_._____. ___._......:_____ i i�l �- Knom B i:engt i Wiclah �.. f c ��ht - ... � 'Windcsws s��ra Caoo�s�-�(:rae�age aazd /4rea ..��~ . W1Atp... �� it¢Rght �No�. of 41naal�Xi. A.�«a.r . � . >� oC D� �a�� Wns � 1tBRt� o! cr�ck �p. ii, . I ~ � M1 � � 1 ,�, 1'} � � � ' .- � �_ _�.._. _ . ,__ ` / �r � � � � . . _ . � �-.�,.. K.�. . °�'� � t.,�? C.ocf,l .___..�iu Yn!"iltratian ��. � %, �,f, �.� a��r� ._.._.._... ..... .� .. _ ....,_� r� � ..,.�. __ .e.`. ._ .,.,. .d...•>.�_,....,_ , . . ...�..�,.-...�.,v. ...,. ,..�._._..., � X l wAli / 3 � ',;:. :, .�.. _�.._,.,,.........� ,____ � _.. i�s� e5tp, wr.,.�._,w._. .._�_ .,r_� /i i�yt Ji __ �t ..,__. __�C t. WB�� _ __'__._,�... �{�eiiing _ . _ __ - 4/�/� / y _. �I s�r `_ _._.�_._;._._ -.w. _ �v t:* J" - l j�e'; ~'7oRa� $t�a. � '� p� Requirec� sy. ft, �:.D.�"d. oe iq. ins. W.A. Leader asea : f�l�l� Room (Lcngth Width Nei�ht y' Windows and Daors—�CracicaQe and Area w�e�n tt.iine No, oc I.�a�a� t�. wn� � `.Nc. o(�pYna � alDan• �Il�htr `. �:�.etd�aek .�q. tt. � . GoeE. Btu �nfiltrxtion � Gta:� .._..T �4p. w�U _._ _ ..�... . Net exp, wall , - � TnE w�ll I, Cciiing �`i� •F loe�r _ . rotal Btu. ��.� Req;�ired �q. ft. E.D.R. or iq. iat. WA. �n� ... � sk' ii�;,,F'I:t::°�'10� t��f�!'1N�AFt3I.T�.:it+1�i � �} � >Tr�i�Istid�y �+ �' � � RGcii t'1+slit � Kt6�i �._.�. iidSWT A ie � �:____ ; :�.. . _ � . - ~ �i 7-� • 'Rttatlo �;i..rtr�th ? Y�X1icYtY. , , f Rcs,.}.t �----- =- - Windoti+s �nci,�oorlt=--Cracka�c a�scl Ar ;� { _.. ,, .—,.- ,r WIdU� Nrl�l�t !{o. of t4n�al tt 'ciieua' . , N tpan� �f.n+�ne ffst�li �.Cr • A �� tA . . r ,..,..�,...s..�.,... ,v � � _� ..,.�_.�. .. _�_. j_.� ��; � �:ari. _ t� � �. _ _� _.._ � _ ; _ _. .� __�_ _ _ . _ - _._ _ In��ltration ��,..L. -- -' �___. . __...____ _... t;l�x. .! .._.__ _ ._ i� Lx� evaCl�. �Y _ � m_ _._._ _.,, f, Y � = - f'fCt fX�.7. Wb�i' . . �n� w �h _ . ^ _ ., � 0. ^ Q� 'i�rt�, .�,.e. - f ►� c� r �.. ,.,.. e � � _.. .._,..� � . . . Tc�4��1$t�, , : T� {�.r.,�utrt� tc;. ft. �:D.R. Fr .��. �r�a. i� .1. �xa�r.,=dacea� - - _.__ _�..._ _..�_.� �__. _ .. _ _ ___. �F�i.y � � � €�ot�na�� er.�+tii`� � i�f�t�tlx. �� F-�tig: y _ ._ ._ .. ._�_ ....:..__. �.�._._... ..,�. �_ . '.�nd:.:,,s a�id Uaor�- :.r�ckdge'a;a� �1�rt;� r. � ...� vld4r HxIRhC � l�e 4[ *! neal t Ar � . t�� of rr�, �.ftini l�,.nt ��. r r�:rti tt t � . . , a _._. . . _�_ � . _ ; , . _.._.�... _ _ . �.. ' . � _ � ... �.. �� . . . 1. . ._ ,�. � ....,_. _ ._� �, � ��'xter �x� _ _ _...._.._ _.._.. ._ _ _ ..,_ .__..... ��:f�r�t�c�r� ` :' � _ � LF�� YM6lI� �' .._......�..�... M .... �'� ..r..� � 1Vet c:ap. €�a�li ._v .,,. v. - - --.;a. .�Y9&..�Mtir�.y�. . . ..._ . (..:iien�; - E tacyr ;_.__�... a,.. ,_. ._ .. .. ._.__ _ � �._ _ " Tatal �3tea. h�ec��ered rq. fe. ED.R. ctr;aq. �ni.'1�1.A.:l..�uder a;rcz+ Ft� Roorri �;k.ength'. Wrdtl� t itiglre � Wiadowt �nd- Daorr--Crackage aad Aeea� � - � WIAIb � �.�Hdibt . -,..�la- Llnwl� tt. .� ° r�a � ^ ''� � . Na o! p�h� ' ot p�a� I' U�IfN et cnek '-�V. tt. �t�. �Sf°i : Infiit-atioa . Glaa - �xp, walt • -- - _- ____ ._,._...-_�.,.�._ �_ __.__ ..... �.._ Net txp. w�U Int. w�i1 - � � Floar Tot�) Btu. Re4uired so. �h. L o� � •q. in�. WA. l..cadet a�ea` ...... . __ _ { . .� ,.... :� _ . _ . .�, .. v __ . _ .� ,�. _ � �- . .. : . , . . � . ..._ � HdUSE HEATING TEST RECORD ADDRESS ,l��-� �� "h � aG � ,�" '£' APT. FLOOR CIiY SUBURB �' �'e � OCCUPANT �'(t.�_�.e..,CL'�j,/1^t OWNER HEAT LOSS DATE HTG. INST. SOLD BY INSTALLED BY Eleetrical Work' By Gos Lin� By TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER _ GAS DESIGN CONYERSION MAKE 1�`� �"�:%: T/� r^ MAKE OP BUI�NER Model � y�L�� .,3Q _i,�. () 3� Model , Sxivt ��'�� Max. BTU Rating INPUT � ,Ur�QU MAKE OF FURNACE Modsl � � � CONTROLS � �" ` THERMOSTAT '�1'�' Hect Plug �' �— Vent Size •� Volve ��,1�� H� KIND OF LINER SIZE NONE Limit <=' �fJl'S7%� T Drah Hood Reyulator Limit Setting ��^� C Fitters Sizs '2S� ( umbsr Fan Setting Chimnsy Location Insids Outsid� Pilot Type ��P`— Chimney Coestruction Pilot Make Pilot Model $moke Bomb Wiring Pitot Timing Droft - �� Test Tay l.W. Cut Off Door Prossur� ` Lightirt9 Inst. Prossure �� -� - -Psrcent CO2 7' � Date Tested �"� °`��% �� input GFH `��% Pereent OZ �� Company Testing '� �-� Stack Tsmp. ��J�� Percent CO � Nome of Tester • � Form 235 - ' CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 6431 Universiry Ave NE Fridley� MN 55432 APPLICATION FOR POWER PLANTS AND HEATING� COOLING� VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residenfial Furnace Shell and Duct Wo�k, Burner - Atso Replacement Furnace Gas Piping (Needed with new furnace) Gas Range Rate TOTAL $ 20.00 $ $10.00 $ $10.00 $ Gas Dryer $ 10.00 � *Air Conditioning - All Sizes S 1A.00 $� All Others/Repai�s & Alterations (LIST ON BACK�°' 1% of Value of Appliance or Work $ 2''�� Commercialilndustrial 19�0 of Value of ApplianCe or Work State Surcharae $ $ .50 TOTAL FEE /��'' $ %�� v JOB ADDRESS ' � a`� �7 �2Nf� �� " � The undersigned hereby makes application for a permit for the work herein speci�ed agreeing to do ali work in strict accordance with the city codes and ruling of the Building Division, and hereby declares that all the facts and representations stated in this a lication are true and correct. �ua°e /'% ,199y- OWNER ��i� �� /'� � BUILOING USED AS l�-�°S/ c� �^- i i� � ESTIMATED COST��vdO• � PERMIT NO. �%�'�'� DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR HEA71� MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 Signed PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 Approved By �.l`�; Rough-In Date Final Date `� -�1 *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CBIMNEY AND STACK VSRIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes O No O 2. Is free from rust or deterioration Yes O No O 3. Has no foreign objects lodged within Yes () No () 4. Is securely supported Yes () No () 5. Meets all current Code requirements for size and total BTU's connected Yes () No () 6. Has total heating BTU's of All other BTU's TOTAL BTU's Remarks List Alterations Beinq Done: �..t�' r.1 /. ( /�l��c: � HEATING COMPANY Signed By Date SUBJECT � P ' City of Fridley 21019 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T i • HECEIPT NO. � �• COMMUNITY DEVELOPMENT DIV. .__-._" � � L � r � � PROTECTIVE INSPECTION SEC. / y� �- � � /'��1 � CITY HALL FRIDLE� 55432 NUMBER pEV. DATE PAGE OF APPROVED BV �.---�: ,.� 612-571-3450 910-F15 8/21/91 / / JOB ADDRESS 1605 Berne Road NE t LEGAL �OT NO. BLOCK TRACT OFi ADDITION SEE ATTACHED DESCR. ZS 1 Tnnsbruck 5th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roger Blohm 1605 Berne Road NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Al-Ko xome Improvements 8090 - 4th Ave, Lino Lakes, MN 55014 788-5850 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PMONE LICENSE NO. 6 USE OF BUILDING Res identia,l 7 CIASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION � REPAIR O MOVE O REMOVE 8 DESCRIBE WOAK Reroof Dwelling (;28 Squares) 2nd Layer 9 CHANGE pF USE FROM TO STIPULATIONS Roo�ing can be_ 2nd layer but not 3rd. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOFI ELEC7RICAL, PLUMBING, HEATING, VENTILATING OR AIFi CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S�. FT. CU. FT. AUTHORIZED IS NOT COMMEtJCED WI7HtN 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 1' STAL�S GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VA�UAT�ON SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPIIED WITH WHETHER SPEGFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1 �456 $. %3 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMiT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE CONSTRUCTION. $3S.O.O k'ire SC 1.46 PLAN CHECK FEE T AL FEE �t�' � t �' .� ~� 3 7.19 - � �G A E F �� tOA A A�ZEDAGENT tOATE� - WHEN PFOP iiL T D HIS IS YOUR PER IT � � �. S�GNATUAEOFOWNERiiFOWNEpBU�LDERI �DATEI OLDG iNSP �1ptE � [] �'►� I 7 �'i'� [ ] �or�tn�c'tian 14��: 1�1 AND i�2 Buildinq PeZmit Applic�tian � �'( �-,. ,. �� /�� : �__c i` �S` owrwx r�a�e � Aaar�ss : ;. ;►rr ., .J�'� .: • • +__ i , � l . /n � :z ; EffeCtive ],/1/91 � '� �� - �. � �'" /--. ��7 '11e1. # Attadi to this applic�tian, a Oertificate of S1uv�y of the lcrt, with the pt�cpo�d oo�structian drawn an it to scale. DBBCRIPI'ICN G� II�ADVffi��T � 1 ��.l�' _J • r v r- v:,� - . � JM� '1�' J • � �� Width W1,dth Heic�t Sq. F't. �{.. �• �• O�rner Lat [] Inside [� Ft . Yd Setback Side Yard Setbacks Zype of Ooc�stnx.-ticri: � c- Estimated Qost: $ �� ,�. ��-� j`�� _ o0 � Approx. CY�letiac� Date: Pi�oposed D�iveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See ffick �ac�e � � DP,Z�: i� ,' 6-- �� APPLIC�INT: 'I�e1. #_�� > ' C QTY �E Q�II,Y Petmit Fee $ �� , � O Fire S1�zcisai�ge $ / • y� State Surc2��arge $ r% � SAC Q3arge S D�iveway Escxvw $ Park Fee $ Se�aer Main Q�arge $ �L 5�� ~l� � siz�,TTCrs : '� � -, .___ _ ____ ._ . . ,��. �� L Fee Schec�.ile rn �aeverse Side .001 x Pezmit Valuatian (1/lOth $) $.50/$1,000 Valuatian $650 per SAC Unit Alt. "A" C� Alt. "B" Abvve � r�to,�,�; � bY E�ineeritn4 Aqz�ea�t Neo�salY [ J � �azY [ ] ..- - �. �1�� l/, t r.�.y�y1 � a. _•:Ir� 11 _ Zt�e Qiief Building Official shall, befc�+e issu,inq permits for the e�ian of any h,; � ding or Btn�e, a� fa� any edditian to any existin� buildirr� a� struc4u�e, or for any alteratian cr repair to any existiriq buildin4 0� �vc�e. � aPPlicatioaz therefore, re�quire the PaYme�t bY the appliaar►t fa� sudi pezmit of fees tfl the mmxxmt herein belvw e�t fa�th and in the ma�n�er herein p�wi,3ed ta-wit: RI�TAL VAIIJE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 _,�� S15 fMinfm� F1�e 3s $15 Plus �r�arge) $15 fcar first $500 plus $2 far ead� additict�al $100 or fi^actiGCt ti�reof, to ard il�cludit�q $2, 000 $45 fa�r fi=st $2, 000 plus $9 for each additiot�al $1, 000 o�' fra�ctian thereof, to at�d fncludit�g $25, 000 $252 fC� iirst $25,000 plus $6.50 far eaCh additiacsal $1,000 O� fra�.tiaR t2�e�aecf, to anl filCludirg $50, 000 $414.50 fos first $50,000 plus $4.50 for eacii additicnal $1, 000 0�' fractian ti�f, to ar�d itycludir�g $100, 000 $639.50 for first $100,000 plus $3.50 fas each additional $1,000 or fZactian therecf, to at�d including $500,000 $500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additio¢�al $1, 000 G� fraCtian thereof, to ar�d i,rrcludir�g $l, 000, 000 $1, 000, 001 ar�d � $3539. 50 for tiie fizst $1, 000, 000 plus $2 for each a�3ditianal $1,000 0� fractirn t2�.reof DRIVE�Y �Pl�BIaN EBG3i01W (Ooc�ct+ete � Stte�e�ts Qn1Y) AlternatQ "A" : Removal arxi replao�ent of aab arid gutter anly - Drive�ray wicith plus 6 feet tim� $13.50. Alternate "B" : i�ral ar�d replao�nt of a� ani gutter ani f nstall a 3 foat wide approadi with 6 frrh dep�th -�ivewdy width plus 6 feet times 515.75. _.• r � • .r i. �ii�'; � � � Permits far ��tirn wi11 be issued a mfnim� of 24 i�aus frcm the time of applicatien to allew far p�op�r revie�a of the p��oposed � arr3 of the oar��tn�ctian site. A Oertificate of �vey of the lot, showiriq the lxatian of tiye faa�datian acre it has it has be�n will be required before p�ooeedir�g with the fraanirg. � , �f Building Inspections 763-572-3604 763-502-4977 FAX DATE " i'—� L-- a V SITE ADDRESS O THIS APPLICANT IS: Q OWNER BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 1-1-08 PROPERTY OWNER/ NAME:� TEIVANT ,qpDRESS: PHONE: CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE PROPERTY TYPE PERMIT TYPE TYPE OF WORK: PHONE vI Z l ��L ADDRESS G-� PIl CITY CiTY_ FAX �E� 5 •- STATE LICENSE # 2-C)� ��G �� EXP DATE --r �SINGLE FAM[LYMEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCT(ON STOR[ES � Q ADD[TION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH �ROOF ❑ DRAIN TILE ❑ DECK (�SIDING ❑ OTHER 0 SWIMMING POOL ❑ NEW HOME CONSTRUCTION ❑ ADDITfON ❑ MA(NTENANCE/REPAIR ❑ REMODELiNG DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT Permit No. G�'' Received By: Date Rec'd � STATE ZIP �__ _ Cl(�P STATE� Z, `a _ ., /� W IDTH HEIGHT s33 �� ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES � ❑ HOUSE & GARAGE BASEMENT REMODELING SUBM[T: l . Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, S ING �o ADDiTIONS & PORCHES SUBMIT: inyl �()�Q � ❑Soffit �, Si[e Plan/Survey showing the existing structures � Aluminum ❑ Trim ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations I IN EXISTiNG OPENINGS ❑Yes ❑No LOCATION OF WiNDOWS OR FOR N$W OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NU1�ER OF WINDOWS ALL FEES ARE B�„SED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: TOTAL JOB VAL ATION $ �(t (p�U�IN�G T�iE 1997 UBC FEE SCHE OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ �s r7• al S $ $ $ $ �� $ $ $ $ $ $_- � See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1825 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engiaeering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that 1 understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance w� e approved ' e case of all work which requires iew and proval o lans. .� /�,�+ SIGNATURE OF APPLIC � ��' RINT NAME ��f �� Y �.J�'r DATE_�� i i APPROVED BY /` ��i,��%`—�-�- DA Page 2- Building Residential Application BUILDING PERMIT 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 existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE FEES $1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for IS` $500 plus $3.05 for each additional $100 or fraction, to and including $2,000 $2,001 to $25,000 $69.25 for 1S` $2,000 plus $14 for each additional $1,000 or fraction, to and includin $$25,000 $25,001 to $50,000 $391.25 for 15` $25,000 plus $10.10 for each additional $1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for is` $50,000 plus $7 for each additional $1,000 or fraction to and includin $100,000 $100,001 to $500,000 $993.75 for 15` $100,000 plus $5.60 for each additional $1,Q00 or fraction to and including $500,000 $500,001 to $1,000,000 $3,233.75 for the 1s1$500,000 plus $4.75 for each additional $1,000 or ' fraction to and includin $1,000,000 $1,000,001 and up $5,608.75 for the 15` $1,000,000 plus $3.15 for each additiona( $1,000 or fraction 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 proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Onlv City of Fridley Building Inspections Department 6431 UniversiTy Avenue NE Fridley, MN 55432 � 763-572-3604 Fax: 763-502-4977