AF - 36469�
City of Fridley j �
Apptication for P'lumbing and Gas Pitting Permit
Dept. of Bldga. Phone 560-3450
DESCRIPTION OF WORK � :' /-�
Number, Kind and Lxation of Fixiures
Locetion Gr �� ( 1 S O�—+.v
f Z =� � �iZ 2} Z Z
W � ` N Y ~
3� � �� � v=-i 3� o�
Base
lst
2nd �
��
��
��
3rd �4th _ `
• Futurs Conaection Openings
* New Fixture, Old Openiags
u
p Z = � Z
3 Oa� �'� O� �a �< 7a
N LLo sm <3 �< �� �o
Z n ti
PARTIAL RATE SCHEDULE
WATER NTR.
• •
i N GAS ELEC.
Sewes �
Cesspool j-j
PLIIM$ING FIXTURE RATE3: NO. RATE TOTAi.
Number Fixtures . . . . . . . . . . . . . . . . . . . . . ____L� x $2.00 $ •?� d!G
Future Fixture Opening . . . . . . . . . . . . . . . . ��_ x $1.50 g 3�d b
New Fixture Old Opening . . . . . . . . . . . . . x $1.50 $
Catch Basin . . . . . x $3.25 $
Water Heater (Up to 99,000 BTiT) ...... x$3.00 $ 3• v U
New Ground Run Old Bldg. . . . . . . . . . . . .
Electric Water Hsater .
GAS FITTING FEES:
lst 3 Fixtures ..........................
Additional Fixtures ....................
Gas Range to 199,000 BTU . . . . . . . . .. . .. .
REPAIRS & ALTERATIONS—Rafer to Code
— x $3.25 $
_ _ $2.00 $
NO. RATE TOTAL
—x�2.00 $ 2.vU
_x$.75 $
— x $5.00 �
City of F`ridley:
The undersigned hereby makes application for a germit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct.
Fridley, Minn. � c8 , 19_
Owner �"L-�-
Kind of Building ,
i /
Used as
To be completed about - � -/ �"' 8
Estimated Cost, $
�
Old Tew. uilding Permit No. � Permit No. �
Signecl ��
By �
Business Phune No. � ���
ROUGH � - �O l � �
FINAL g'��� � a
Description ................................................$
TOTAL FEE $�, r.. 06 ea
•
•
�- -
City of Fridley, Minn.
BUILDING PERMIT
Date: __._._.� 1:'larch 15.z.. 1968 ____...._._._....____......._
_�_>
� � �// 3 ��
�� 9633
Owner: _..._._John Powers_-.---__._. _._..._...__._____ Builder _........_...�i.QS1,n.e,�t....Bi1].ma.n.,.....Inc.�......._.._.._......._._..
Address....._._._-•----._....__.__.._.._..._._._.,..._..._._.._...__---.--•---•-•._...._...._._.._ Address 3 000 36 th Ave . N. E.
LOCATION OF BUILDING
No. .----1613.-------- Street ._.._..-----Berne _Road._...___..._..___.---.--- .... Part of Lot .-----......_...___.___._______...._.
Lot _--•-••--13•--....._..._ Biock _._.._..._....---z•---.--••---•--.........._. Addition or Sub-Division ....--•----._._Innsb.,�u:c�--•,� t�.._.__......____
Corner Lot .----•----------••-•-•----- Inside Lot .._..---......---X----------........ Setback -----.._...__39 �._.....----.. Sideyard ---.._ 16 �..�-__ 15 �.._._._._.._._.�..
SewerElevation _..-.---.._.._...._962_.89._--------_....._...._......._..__..----- ---,-----._..2.�.�..�.$.9__.__�.._..__...___.�.
Top of Footing
DESCRIPTION OF BUILDING
To be Used as:
Dwe l 1 in..g.__...__..__ F�ont _... 4�. �.._ Depth ..._� .7.. � 8�� Height -------� 8• �--- Scl. F� ...��..�T9.._.. Cu. Ft _._..�........
_ _.Gara$e ........._... . Front ••���--••----- Depth _...__24�._.. Height .._1�-�----.__ Sq. Ft. 528 .._. Cu. F� .�.z$� �
Frame . Est. Cost .._......_�30a 000.. :,_.__ To be Completed _.__.�'.��... 1_,,_ 1 68
Type of Construction _..._...--•------.....__..._......_......_._.._. . .._. .�
SEWER LOCA.TION - 7' West of Manhole
WATER LOCSTION - Stop box 10.8' East of Sewer Service
Tn consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions og
ordinances of the city of Fridley. ,r'y,�,�
� � ���/
$100.00 S er Connection arge
Tn co¢isideration of the payment of a fee of �._..__57 .00 _���t yQ hereby granted to. Rodne� B_illman iin.c .
._._._,........_.._.._..._......._�.._......__.._.._ to construct the building or addition as described above. Thia pexmit 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 respects to the ordinances o�
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of bufIdinga
within the city limits and this permit may be revoked a t a�y�me upon, yiolatio of of the�rovisio�s of sa�d
ordinances. / I r/1
Official
NOTICE:
. This permN dou not eowr th� eonstruetion, insfa11N1on for wieinq, plumbtnp, �as I��aNn�, s�w�r or w�Mr. !� wn fo tN
th� Buildiag Insp�o� for s�parah p�rmin fo� fh� ibms.
0
�z � � �� 6 �
2,.� .� �
.�"� 2, �"�' 9 3 3�
-�33�'
a. � `� .� $UILDING PER►'►�CT FEE SCHEDULE � ` � __._....3 �,
�� �' �3 � %
� ��v
SECTION 2, The Inspectox of Buildings shall, before issuing permits for the
erection of any buildin� or structure, or for any addition to any existing 3� 0��
buildiag or structure, or for any alterations or reg�irs to any existing buildin 9' 0 0�
or structure, upon $ppiicati,on therefore, require the payment by the applicant
for such p�rmit of fees to the as�ounC herein below set forth and in the manner S% �✓F�
hereiA provided to-wit: • �
2_.1: For any such permit for the erection of�any fire -proof buildtng,
other than a garage, warehouse, factory or grain elevator, or for the erection
of any fire-proof addition, for similar occupanry, to any existin��builti,�ng,
shall.be at the rate.of $1.4� ior e�cl�+sqq� �h�uesnd cubic_feet, o� fr�ct�
thereof, ia such cubical conEenC$: � .: , .
2.2. Por any�such permit for the erection of any fire-proof garage, _
warehouse, faetory or grain elevator, or. for the,erecEion of any fire-proof� �
�dditi"on, `for eimilar occupancy, to any existing building eha11 b� at the rate
-of $1.25,for each one thousand cabic feet, classified as "fireproof" by 3ectfou
502 0£ the Minneapolfs Building Code. • .
HOUSES . .
__._._ .
2.,;3. For any auch permit.for the erection of any non-fireproof building,
other thaa a garage, warehouse, factoty or grain elevator, or any nari-fireproof
addition, for similar occupancy, to any existing building permit fee $1.00 for
each one thousand cubic feet.
GARAGES � .,.. _. _._. ., .
� 2.4:�" gor any auch�permit for.the_erection cf.any non-fireproo# gara�e,
warehouse, factory or �rain;elevator, or fox the earection of any non-fire�rt�af
additfoii, for-simtiar occupancy, to any �existing building or for each such
building or edditiqn - ninety cents;($4:90) for eact� one thousand cubic fet�t
or €ractian thereof, in the cubtcal`coa�enEs thereof with the miaimum of $4.00.
For the ptir�ose' of coanputing f��s for 8uildirig, peraiits, the c�b�:cal contents of
any building ar addition to a unifo�m height throughout by multiplying the:�roimci
area covered�frcm a point•�six-{6) tachea be1.Qw__the floor line of the hasement or
ceilar to the average height of the upper surface or to the average height of the
.` �. �oof surface of the a�a�n, gable of a pitched rooE.
.':; 2_ 5. For repairs or alteYations to �n' exist3ng structu�re, the fee stiall
be at the rate.of $3.00.per ea�Ye Five Aundred'Dollars ($500.00),or fra�tion.
thereof in the cost of aIl proposed raork. � ,�, ;
_2. a6....� In no case shall the fee charged for any ger�it aa see forth;iq
-SecCioa 2 be less than $4.00. ;... _ _ _
. . � �{' �� �� � ��i
_ �
. •
�.�y . .
� w ' �
0
Application to� Power Plants and Heating. Cooling. Ventilation, Refrigeration and
Air Conditioning Srstems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work . . . . . . . . . . . . . . . .. . . . . . . . . . . $10.00 �
Replacement of Furnace .. ... . .. . ....... ... . . .... . .. . 6.00 #
Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . . 6.00 $
Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . .. 3.00 $
MECH. WARM AIR
Furnace Shell & Duct Work to 12U,000 BT[J . . . . . . . . . . . . $10.00 $ � � `
each add. 60,000 BTIT . . ........ . .. .. . ... . . . . 3.00 ;
Replacement oP Fi�rnace . . . .. . . . . . . . . . . . . . . . . .. .. . . . . 6.00 $
Repairs & Alterations—up to $500.00 ..... . ... .... . .. . 6.00 $
Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . . 3.00 $
3TEAM or HOT WATER SYBTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam .... $10.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $
Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . 3.00 $
Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 3.00 $
OIL BURIvER—to 3 gal. per hour . . . . . . . . . . . . . . . . . . . . . . . 6.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 199,000 BTU) . . . . . . . . . . . . . . . . . . . . . . . b.00 $ � �
over 199,000 BTU See Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
lst 3 Fixtures ...................... x$ 20p $ Z�
Additional Fixtures ................. x .75 $
Gas R,ange to 199,000 . . . . . . . . . x$ 5.00 $
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL ' .
See Fee Schedule
TO AL FEE
��� �
Dept. of Bldqs. Phone 560-3450
t
Location +� ���..''1�+N 1r �� �2► C��•..ti
City of Fridley:
The undersigned hereby makes application for a permit for the work hereir:
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.
F�idley, Minn. , 19 _
Owner ��� 1► 4:��►.. M, pi�1.�
Kind of Building �t'_2�1YM�.
Used as ��V��==
To be completed about
Estimated Cost, $ �'k � �
Old—New. Building Permit No. 3 Permit No. '1` � 1` �/
DESCRIPTION OF WORK
HEATING or POWER PI.ANTS�team, Hot Water, Warm Air—No.
Trade Di amP ► ��.A►v t%�- Size No. ��� 3�"
Capacity Sq. Ft. E.D.R. 13 Om � BTU � N� u� H P
Total Connected Load �i�.�0� Kind of Eiiel ��� ��-A�
�
BURNER — Trade Name �N '� Size No�G"u �� �_
Capacity Sq. Ft. E.D.R BTU H.P.
�
$
g .O
�4E
� "
(REMARKS-OVER)
Signe /� �/� Orv+t7
By
Business Phone No. �c3 �'� � �
sua�ecr P E .
City of Fridley � 19 3 6 �
AT THE TOP OF THE TWINS B U I L D I N G P E R M I T
r
; � EIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
r � ~ � � PRO7ECTIVE INSPECTION SEC. a � �% ��
� � �
l.--.�; �'��;,� CITY HALL FRIDLE� 55432 NUMBER REV. � OATE PAGE OF APPROVED BY
i 612-571-3450 910-F15 3/31/88 � �
JOB ADDRESS �}3�x,ne �D3C� N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCF. 13 1 Innsbruck 5th Addition SHEET
2 PROPERTY OWNER MAIL AOORESS , ZIP PHONE
Dr. John Pawers 1613 Berne Road N E
3 CONTRACTOR MAIL ADORESS 21P PHONE LICENSE NO.
Rodne Billman Inc. 15I �ilver Lake Road New Bxi hton 633-0536
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO.
5 ENGINEER MAILADDRESS ZIP PNONE IICENSENO.
6 USE OF BUIIDING
Residential
7 CLASS OF WORK
❑ NEW �7 AD�ITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Constxuct a 10` x 14' Deck and an 18' x I4� Porch Addition
9 CHANGEQFUSEFROM TO
STIPULATIONS
See notations. on plan. 3 Sea�on Poxch can not be hea.ted unless structur
meets the State Energy Code. A wood stove would �e a,cceptable. Prwide smoke
detectoxs in existing house,
� ��-�
SEPARqTE PERMITS
����� ��" ,,.;�ti�es Wf R1NG. HEA T1NG, PL REQU�RED FpR
a:��$ �a11 R\G` r�'�5 �.�' U1Ul�l1�G ,qND S�
�et�Q��,.��-�c� �� ��� G1VS,
��� �����0
��
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY IOAD
VENTILATING Ofi AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOtD IF WORK OF CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTFEET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORqECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ,O{3DINANCES GOVERNING THtS TYPE OF WORK WILL BE COMPUED $6, 200 $3 . ZO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GHANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE
ROVISIONS OF ANY OTH STATE OR LOC LAW REGULATING CON-
RUCTION O E PE RMA OF �ON RUCTION. $62 . SO
LAN CHECKFEE TOTALFEE
c� % $15. 63 $81. 23
S�GNATUREOFCON7RACTOAORA RIZEDAGENT ID fi HEN PROPERIY V I TED 7HIS IS YOtJR PERMI7
SiGNA1UREOF OWNEA��F OWNER BUILDEAi IDATEI BIDG �NSP - � q E
N�y' L ]
AD�ri.
pLTER. �
�
City of Fridley
___._�
R-1 AND R-2 �
Building Permit Application
Effective 4/1/86
Construction Address: ����� �������1� 1���� ��Z / f, ��
Lega2 Description:
Owner Nante & Address : sJ�' Ja��-%�� 1��'w �lz-S Tel .#
Contractor • - Tel . # E' 9� ` �r� �
�
Address• �= L- � ^ '
.�l� � /Z l Gfoti T 4/�1 �/V%ii(//✓
Attach to this application, a Certificate of Survey of the a Si'Z
lot, with the proposed construetion drawn on it to scale.
DESCRIPTION OF IMPROYEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft. �_
DECR AREA: Length '�I2�� Width _� Hgt/Ground �'%9 Sq. Ft. ��l/ "
.:�:�,z � � Z- � �
1�o�c��a �g�8.g� � �� z�sa��.� -� Ca����
Corner Lot [ l Inside Lot [q] Ft.�Yd. Setback Side Yard Setbaek
Type of Construction: �-��/f��J'r� Estimated Cost:
Approx. Completion Date: �� �
Alt. A Alt 8
Proposed Driveway Width If New Opening Is Desired: $ �
See Baek Page for Explanation
DATE: �—�1-- ��
Perr�,it Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer riain Charge
TOTAL
,�i <°�' ; /�%/� � ..�s�
APPLICANT : Tel . �� �— �-��
CITY OSE ONLY
$ ��� Fee Schedule on Reverse Side
$ %�.�e3 25� of Building Permit Fee
$ 3 �1C� �.50/$1,000 Valuation
$ $ ��Q per SAC Unit
� Fee Determined by Engineering
�
$ �,, �.-� Agreement Necessary [] Not Necessary I 7
r-y-`-'---_--
.
.
.' . �• � L � � � , ♦ � � �, `I�1
, � - �
�...; �j� i ... • • :,.�
�.� .i , �`�� `' �
f� ' � � � ±
.. .
�d�� �.50
a�G�-
��6 3�`
�� $U
�
BUILDING PERMIT FEE SCHEDULE
The Ch�ef building Officiul shall, before issuing permits for the erection of any
rt�ilding or structure, or for any addition to any existing building or strueture, or
fcr any alteration or repair to any existing building or structure, upon applicatio n
tY.erefore, 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:
Tota�.Valuation
.vI.00 to $500.00
W501.00 to $2,000.00
Fees
$10.00 (Minimum Fee is $15.00) �
$10.00 for the first $500 plus $1.50 for each
additional $100 or fraction thereof, to and including
$2,000.
�2,001.00 to $25,000.00 $32•50 for the first $2,000 plus $6.00 for eaeh
additional a1�000 or fraction thereof, to and
including $25,000.
W25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for eaeh
additional �1,000 or fraction thereof, to and
including $50,000.
W50,001.00 to $100,000.00
��100,001.00 and up
$283.00 for the first $50,000 plus $3.00 for eaeh
additional $1,000 or fraction thereof, to and
including $100,000.
$433.00 for the first $100,000 plus $2.50 for eaeh
additional $1,000 or fraction thereof.
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
klternate "A": Removal and replacement of curb and gutter only - Driveway width plus
6 feet times $13•50
l�Ztern2te "B": Reraoval and replacement of curb and gutter and install a 3 foot wide
approaeh with 6 inch depth - Driveway width plus 6 feet times $15.75
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of
application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation onee it
has been constructed will be required before proceeding with the framing.
�� ,
J�
7 Z -
/ `
_ Z 3� � —
__ _ __
. , , r., . � ; �, ' � : � . � - � - - , ,
. � �-;:.� - , _
. . ;� . _ _ .
�
' .! .� . � . a ' ��
: (,�itir wws�1�
c�s�,�y
- _ _ . � :-:
- . �..
r, . . . . - � .. .
�
... �� . .
tt���'�q+ `�s �.
�Syr.
; � �'��S'� ENGINEERIN�G� tNC. �°"°
; C"rv�; tr �.-,pd . �h,t1 ��7i66
��� --- En ineers � Surve or�s�---- .
9 . y . .
cert�i�scate o� �usve �.: R.aA. . � -
- � � � ��- � .
� ��'"�� �,�A � 4TF- �M,�, �`. roQ
r - - , `131 3 N�Y, .�a ,
9 � �'9
L p : c�
. i -- •T ; . � ' �: .
—_�_—�� r.
� p���.GO. P/P[ �.1N[-- CAiW�i'�5�...,..+... � �
— � � -- �� .��. �.�. �� ,,,r,,.. � �
' `�t' f �` �
�
7 r
rv , � � �y � g '3.'�/–isiS �3 tik `�
� �� ti
�6 ` x ��" � '
, o
i. �
. P\
/ � � 3 . 4.�
BERNE CIRCLE �EAST
,
,.,-.- y
� . . `,�� `°
/ .
� '.
�
,
�oT �3, E3toCK �, IN�S6AUGK rj�H AOO1T10�t
_ � _ °��;orfs rtae�; ' ANOKA t�uMTy
..°. ,.- -- —..._ DE!.�or�9 pQI►;N�G6 �t+Ja vsf�►rY �Ai�l�£N'rS
��
�!�F'+�4+�r''� �� �'�'� n � �s sd - . -. - : �
� �.�, y arr�cf ��ot�on �('o � f'�t �i�ts �l'ilk �ae �str+ibd �rad,rnd
. "i n.�'�'' ��'N "s'�dr er+�eorA�rs�lf ; �'�y. �nrr► .r � s�ai � As ""'�'ce�+d /�/'rk /J�a . �/
�. . , _ . .
..�., -b sua vae�vv fN�,NEERavG , avc.
� � �~� �`-'� • .. ��, . , , �
a- s�-
� � x�:�,���',�,� .,a.>_� � - s ! 1�j f;. { + . .
� `
.. -� . ..
� � _. .
; --`
_ �.-
sue�ecT PE .
City of Fridley �.� � �� _
AT THE TOP OF THE TWINS g U I L D I N G P E R M i T � �
f
; � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
�
r � V '� PROTECTIVE INSPECTION SEC 3Q
1 , �
' � /'��1 � CITY HALL fRIDIEV 55432 NUMBER AEV DATE PAGE OF APPROVE� BY
� ----�.' `.1
b12-571-3450 910-F15 10/13/95 / /
JOB ADDRESS 1613 Berne Circle East NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO
oESCR. 13 1 Innsbruck 5th Addition SHEET
2 PFOPERTY OWNER MAIL ADDRESS ZIP PHONE
Catherine Powers 1613 Berne Circle East NE
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO
Lifespace Construction Inc 10020 Hi hview Ct Cham lin NIN 55316 427-0157 4197
4 ARCHITECT OR DESIGNER MAIL AODRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS Z�P PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION [�. ALTERATION ❑ REPAIR O MOVE O REMOVE
X
8 DESCRIBE WORK
Interior alterations to 6 rooms
9 CHANGEOFUSEFROM TO
STIPUTATIONS
See spec sheet and plan for stipulations.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. fT. CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OF 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 CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �35 000 �17.SO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STA7E OR LOCAL LAW REGULATING corv- �439.75 Fire SC �3S.00
RUCTION OR THE PERFORMANCE Of CONSTRUCTION
��� _ PLAN CHECK FEE TOTAL FEE
o � License SC $5.00 $497.25
SIGNATUAE OF CONTRACTOA OR AI/TMOAIZED AGENT iDAT � WHEN PqOPERIY UDATED THIS IS YOUR PERMIT
r '^� i _ /D � I � 7 V
SiGNATUAEOFOWNEAUFOWNEABU�LDERi iDATE� BIOG iNSP ��FTE
NEW
ADDN
ALTER
[l
Il
il
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Effecdve 8/1/95
�
�
ConstructionAddress: /� f 3 / -2 ,.�c �.'� 2�c � �As7- �.�.�-� v ��" 55yZ �
Lega1 Description: _
Owner Name & Address: / T� -,�,�.,�:, �o�.ti,� �2.� Tel. #
Contractor: � � �c-S �.r� � � ��, ,U :sr l�u ��r-� c� �v ��� � MN LICENSE # �/ y 7
Address:� � i� rf J� �r„� �: T Cf-/� r'�� �v rrt� 5s � it� Tel. # �27-t�r s`7
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this applicadon, a Certificate of Survey of the
lot, with the proposed construction dra.wn on it to scale.
Length
Length
Length
DESCRIPTION OF IMPROVEMENT
G �;�.,�5
Width Height
Width Height
Width Hgt/Ground
i
Sq. Ft. �Oo
Sq. Ft.
Sq. Ft.
Comer Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks .•
Type of Construction: Gl��1µ �c � tit��s ,%�� f7�,.Estimated Cost: $-�°'� -�5 euC,
Approx. Completion Date: �z�5 �/�,s
(Cost on Backj
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � o �,, s�,r- APPLICANT: �"% � '' ''
_ y.�.�� r�,�.G�., Tel. #�Z 7-v•s 7
Fermit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
�� �s
� .�S . c�c�
$ 1�.so
$
$ � - C?C�
$
$
$
$
$ � '� ���'
SITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1 / 1()th %)
$.50/$1,000 Valuation
$850 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ )
STIPULATIONS: _ . .
BUILDING PERMIT FEE SCHEDULE
T'he 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 provideci to-wit: �
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,OQ1 to $25,000
$25,001 to $50,000
$50,001 to $100,Q00
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $Z,OOO plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $SO,Q00 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for each additionai
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Altemate "B" : Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for pmper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
v... \:�..�ai��:.�;�`��:rt v. �.,':�;
. n•�.�\�•:•���' .'::�'.}t•y'�::':Y.:: ..'.•..;.•i�.., :
•.�.�. . ' �.n;Ch:.:r.-: �;.:•.,^•,k...•,v�.. '�`• :•.i.. ...
.. . . .. o.\� .. \.�. �
' � ��.�:.. .;•+. .... ``i;v-: ,
... �� �.c`.•:i�\M1i.���,{.�{.4�" Y•Yi•�'ti'i•�\':
`. .;y\. •.. . W}' •.'�•'.. \' • ... • \"' .{`.
.;`y. i� �. . . .��.�.::�nv�`�,v.y.'.
i �>>� �A�i�"`_ r �� • ' � '%� �^C�'
.�.�a2.�C. .:�cY ,4` �V�������...,...w.ti.4:�1fi^_
}`Ki'�1+�7."4. s. `. : . .
q <. r. .: �h'\5::::i��u� . �<�` 4'`• ' .:....... �:�lti:i.
+-:C\�"•\;•�. ..:... , {,� �: a.\`A4�• {\yl•�� ]... �� �.. ....-��: :.�.. .... :: � .
+:,: . t�.�\:<.i.�'t�;Ew\ . ' '' �'
...\r\r�t�i�+•k�sc .p v.� �:t� cw••x:�:�::`f�:J:.4;;'.
��Y��v�.�4�vyi'v.'�{t �i�i���i{:(-0j<l2CA�.�`24'.'.:va�44v'-.-•••S:}:�.:M1..�....
�.� ''' i'r.> �:.�C���.�.`�'.��`..�:�
,.,:. �:.�2:'v.``� :,+++e""'°°•. �\ C: .:;�1�A'ecewr.t. .. . .
. ' - �
REMODELING
OCTOBER 9, 1995
Kitty Powers � ,
1613 Berne Circle East S'�?�,�i%.�� �'L <--l' ��'�''c / L�-��'j��� �y
r ��, . 1
Fridley, MN 55421 `�L�- �; , r,, . ;, � ,��=( ;' ( t �i<c- -�'% ��
l
FIRST FLOOR
1 Remove existing vinyl flooring and underlayment in the
kitchen, family room, nook and back hall and install new
2 1/4" select red oak, sand stain and apply 3 coats of polyurethane
2 Open up fam. room doorway to kitchen (re-case/drywall as needed)
(no new header figured)
3 Remove entry door to family room (repair jambs as needed)
4 Install new Oak 6 panel doors in existing jambs (w/ new Schlage flair style
hardware T.M.E. front door) bi-folds hardware allowance S5 per pull
a. 2'8" door to basement stair
b. 2'0" to half bath
c. 5'0" bi-folds front entry closet
(all doors stained, sealed and varnished T.M.E.i
5 Install new ceramic backsplash ,pe� H/O tile selection
6 Add lights in glass cabinets switched in backsplash below
7 Add wood lip to existing cabinet for microwave
8 Move microwave receptacle as needed ( to upper left corner)
9 Add paneling to right o# wall oven to match existing
10 Change switching and fixture at walk out door and garage service door
1 1 (as per discussion)
Replace garage service door w/ steel 6 panel exterior door
12 (paint as needed)
(woodgrain painter : D J Weinand Tell. # 493 4284 Not included)
Replace existing kitchen countertops w/ plastic laminate
13 Provide 2 solid surface hot pads (not cut into countertop)
Re-install existing sink, valve, and disposal in new countertop
Install built in cabinets on both sides of fireplace in family room
14 (as per S C Cabinets) with new 2" cove mldg. at ceiling of room
Remove shelf and repair staining on family room paneling (as neededl
15 Weather strip front door and porch door (as needed)
16 Sun protection on front storm door,l fitm provided by H/0)
17 Install motion light at bsmt walkout door (fixture by H/O)
18 Remove ceiling texture and skim coat in kitchen, nook, 1/2 bath, and family rm,.
and paint new ceilings with flat ceiling white
19 No plumbing changes in the powder room / 1/2 bath
10020 Highview Court Champlin, Minnesota 55316 Phone and Fax (612) 427 - 0157
� CABLE TV
•� ,
1 Family room: add two outlets
2 Basement: add one outlet
3 Master bedroom: add two outlets
4 Porch: add one outlet
MISCELLANEOUS
1 Repair chimney cap and mortar as needed
2 Install new overhead garage door (insulated steel raised panel)
(re-hook existing opener)
SECOND F1.00R
A. MAIN BATH -
(Tear out and re-build existing bath as per plans and specs.)
1 Install new ceramic floor and tub surround same as existing
(repair drywall as needed, Durarock used in shower area)
2 InstaN 2 new cultured marble countertops with backsplashs on existing vanities
3 Install new tub and shower valve, (existing tub stays in place)
4 H/O to supply and install new lav faucets and new toilet
5 Remove existing and replace 2 vanity mirrors from countertop to ceiling
(Re-install 1 mirror in new master walk in closet)
6 Install 3 new recessed can lights, (2 in large vanity area and 1 in tub room
over vanity)
7 S�rape texture and smooth tape ceilings
8 Paint wa!!s and ceilings as needed
9 Open wall into existing bedroom closet and frame linen closet
from bathroom side, install new shelving as needed
10 Install new 4' face frame and doors - stain to match existing
(5 2.00 per pull allowance on faceframe doors)
B. MASTER BATH
(complete tearout and re-build bath area as per plans and specs.)
1 Remove and replace ceramic tile floor and walls, (continue ceramic backsplash
off whirlpool surround under window and behind toilet , ending at side of vanity)
2 Install new doubie bowl cultured marble countertop w/ backsplash (approx.. 5' 6")
3 Install all new plumbing fixtures as described below
a. 5' whirlpool tub and filler with over flow
b. toilet and seat
c. 2 lav. faucets and drains
d. 2 shower faucets
e. shower stall Iper H/0 selection standard pricing allowance)
f. all rough in water lines and waste lines as needed
4 install new 5' 4" x 36" tall vanity and tub front access pane! to match existing
cabinet style (52.00 per pull allowance)
5 Install 5 new recessed light Cans as per plan
(Re-wire new 110 cfm bath fan /lights and switching as per H/O)
(install new circuit for whirlpool tub)
6 Install 5' 6" mirror from countertop to ceiling
7 Install new 2'4"flush oak pocket door as per plan
9 Open wall into new walk-in closet area
10020 Highview Court Champlin, Minnesota 55316 Phone and Fax (612) 427 - 0157 2
� 10 Provide and install new wood bay window ove� whiripool as per plan
'• (repair roofing and siding as required)
�� Re-insulate and sheetrock as needed tape sand and paint (smooth ceilings)
1 1 Install new bi-pass shower door (chrome with clear glass)
note: save face frame for re-use in walk-in closet -�
C. WALK IN CLOSET
7 Wall up door from hall and window to back yard, (Repair surfaces as required /
paint as needed)
2 Wall up closet to bathroom and drywall/paint as needed
3 Install 5 recessed can lights as per plan
4 Install built in ironing board with flat painted door
5 Scrape ceiling texture and smooth tape/paint as needed
6 Shelving as per plan with clothes poles, shelves/ built in drawer unit and re-used
face frame from master bath as per plan
7 Re-install mirrors from main bath, ( H/0 to select location)
8 Install 1 telephone jack
9 Change electrical for outside light to downstairs
10 Remove sewing desk and add 3 legs to be re-located to new sewing room
D. MASTER BEDROOM
1 Wall up closet door ,drywall / paint / install base as needed
2 Remove paneling on north wall and repair drywall as needed
3 Install ceifing fan / light wiring (fan / light fixture allowance S 250.00 )
4 Install 2 cable T V outlets
5 Scrape texture and smooth tape ceilings
6 Paint walls and ceilings
7 Refinish hardwood floor
E. PLUM ROOM
1 Open wall into old master bedroom closet
Z Re-install existing 2' 4" flat oak door from master bedroom closet
3 Paint walls where repairs were made as needed
F. DOORS @ 2ND FLOOR
(install new Schlage hardware on 7 existing doors)
1 Install 1 new 2' 4" flush oak door in pocket door frame with pocket hdwe.
10020 Highview Court Champlin, Minnesota 553i 6 Phone and Fax (67 2) 427 - 09 57 3
a
�
S s
_3
�i
_ �
e
---�:.
�
3
'�_
♦
�
;
0
�
�
.X
� � �. � . � � �n
���
" r � � �
S .,
�,� ,�) S3 � ��, � � � � o
�O � iJ r �
i ►i
. �c � � `� .
� �.
:r ,�� � . `�--
`�; ' �L � c, ''�
�� , ��
u
r �� - y
� ��� �..__... �-
� . � .
1�
• t � ...::�;
��
C___�.1 Q �
r ,
- N o^- - �x �, �, ;�,
C�- �j
� �� ��'�.
Y /1 � i
e ��
1
h
1 ' -
N �a^ - �Y :� y� � 1
. i � ►
u i /�i
9! � _ � M r Y [a]
��/
� -
nt N_ � a - v► � v� .,� �L
y:,
.... . _ .. . _ _ h
� ��
� y � /
� t
��
� J
N
:o� —
N.
� �s �
_� �
,�
�
��. ,
t
�-
.c�
S �
. b
�
4
0
rc
Xi�h
n � � �
`1'i
n� �. .
i �
� 4'�.
tF
����„r„ v � �i�� :s �? �W
� '3.
` �, a1'rr� � c� ��
�, _
-�
� {
g ' �J
ti �
Q �-
S�JC ~ j� :..1
b p L''f q,
. � � �r �
N �
�
� VQ
N '_'�
_� �
Q
� -
�
��
,'`
W
4
�;.
�
�
r�
..�
�. � I N M V . �, ,1 . ' ����.�
� . I � � �r,�e � � ; �T t'
_ l �� �J� � � � � �,
_��� ��, � __ �
�` i
. i r z�.n �� ", I �
Jl � � ; � � � �. J '� {q• ;
• _ " . t d' � — °`� � \ � ,i' I1 f
� ' . • . � � � t"' 'ti, i 1
� '� �` ,s , f c
Q � � � � �-� Q ,•� � '
` ' � � �� ' � r� _,� i
� --= ��� � x . . �
� : � � � w .�:�
� . . � � � � -. .. ._ . .
;�_ _ . �� � ' � � _
. ..
. .
.. .� . . ,
.
. ,� _ , . . . .
: .
rK� :- . `. � �`� � : : . _ ... � � .� �
, ' ' . . . . • � � ' -.. r .�� r � f .
j,/i • . . � . . . . . 0. • � � � .� •
'� . : t.?l'i . ' .. . ' � ' .
'`''!�� . ••L..Q : _ LI7 Ol � 8 ��� , • -�.9 ' .�,-°� ' I ' O�� ' .
.� �. � �:"�. �.. . ' � .4` , 1 ` . ., . F �
v �. � ( . • . -, , . 1 � a . • � � � .'"' _ 1, . � 1 . ,.
,� , ' ; �— � � , ,� �
�, - r. �� J ✓ ,/ � � � J � ,:ri�� ! r�' ��{jI .
' h i l' ;::9s� . .. •. , � . �r� � • . �^ �� , �..� � � I I�
_M � � 1....�_ '�� !� � �� .- � i: ( � �,,. .1 r �
. � � � •s , - '
�, � f. 'a.. .' :, ,'J , , . ��'j � S . . � � y � . �� � � ,:
_ _ ;,i¢ C js d = � ; Iw � i
t .. . *.a.r � J', } � -� -� . \�I�.. � �,� � �+h
.1- . { - . a dd J: . '� W ' , , s 1 ��
i ' `�'�� , 3e�� Q '��+u � � �� �4•, ',�� ° � � �.l ; ^.
's 1 , �- r j�iy '" . m� �� r " :.r ` � , --'
f - � � .� . � z . � . • ,9 - ,�•� r _ ,� 3 • -Y I .
,'�� f � 1L Vf � � d ? ? i r F' � � �t`�� � � .f , � � �
t ''' �n � .� �` J � ~ . '` 1'� � • � ? � M � J 1 a � � ' �i � �
� ' �o �1` , . :o,,�'; 3�1! . � �,r: J1 i �
�'.� ' � � h µ S- � � ' z S � . '.. .6
I � �t�• `•Q ' :�'a� . : � ds `��� �. . � ��� � �� T • �
� -,�r , � • � .� a. 4:, a... _ 2 � �• - ,: . ,- �... �i Y ,�, t.
� L1 � �rl :;t ' � �► J x r - �.. �` ` � � a O j"i a � �.
� i • .�. �.1, I d. • �e�.. :i � "� Z e� � � .
� � �.�'~'�� � �A r. �Sy y t � 4 di �.
-�t � _ : �,�t.?[ :� � d . ` w. K s +� s,�r-`� ' : �.
.e .►� - -� a6Y!». ,� i�"�;i. _ . . ''' � � V �yte �� �c�i Y f , �., ,r � .. �#'n � . �
'� ,. � � . r . �• 't. � � � � t , I . . � ' 'Q � ' :' V
, �. a �` + � � • �� .�; + ��` �� • .� �
� � �+. ��� '� .J.'� ��. [�,. .... .. ..s, �� `L.. . y,s f .,. � -� Ci
7. �� h -�� ' y"� � _ \.�� -� - - �
� �_ �f ,' 1 Q 1". `.- . . {: '. , •� d�.r _:;' . . � I �
�.S M ' �r. Z v'd � �h� `� �i C.` t t � s + �
. +a� + �� � .� + ��� �� � � �r / j �^.y� .' � 1 _) � '�'
T . �n.,',s � . I ({
S ,� `; /t �•, � k � •.� . y = , , • i
. :` � . , • } '� � J �"
� 1-'. t' • } f � ' �� ' ., t . . ", ' �I
i Z '; I .. s;�, : . ��:.��i ' . � � ; a °
I t J L • 2 {/�' ,�, ' � ,,, + w ' T • • ' � � 1
a ' � J , � �� �. � , l l �4 1
j . � . u1 �.. . . , �� �r ¢; •� "'� r� ` ( � �
It , `�'� � =.� �,� .. � p., ¢: ` f
� � ` ���=� . 'e '�r;. R - 3 . Z °
.. � � —:� a'
; �
.f' � _.� i•�•� • � �.� ."y� �•� . ' . , . . . . � I
.�. � iL :�i �, ,.; . • - � � � ,�
: � •� ��• ;��.:n� � - �.; . , .
x-' �';; '� z3 � � . c � Y k � ' _ ,.,..
� �� � Jt�' +f ` ''iy�+ � "� �• Z't ' tj � ' i
� .� i' � �.., ..��.. �...�,� � �� kr j � +r� . , . ' � � , o -Z ' }. � '
�� � �.�, f ���: ��.;�,�'+'''��' `r'�� � �t _� � .� ' � � ' � ' j
:r.. ,p '' 'Fi`� � � ,�F. w p,, .r _,� , • L � � , �
��� .,•� � �. � f � !��'.'r .( '. �� -{ � 4 � � i
•` G :l"' � � �, c . t � . . , \,�s � �
�� • {.�� � � � � '' t' .. , �� � � �, �• � �
. . "'; � ' , ' � �
� --- �s nJ � I
� '' � � � ' � •�; . . ' � � .. � ,il _ � ;
.. 1 0 � • •' „ � � � ; �
�:; s:.�: a �lv1 .- .. 1.L � i
� � �, `� � �� r. - � r . � ' � � ; ,
.� . � � o - � ;
.� � � ,
.�,�, �do � � ! i �
���l',r .� �
i�- � _ : ; d u- �U'I . � . . i ; . . .
. .�I , i'� `i ' ��- � • � ' .
. '� � � Z `� 5 a�Z,qxTe�t , � � D,a�vTi wmoL �
� , , �
�i-.'.
( y .. . '�` a � -�i '�.6 .. 91- O I k'j, ''�/e ., a.+ • 0 �k 2 � .
. :'�► ��i`. . � i ,.! 69 . . .
� � � � 7 '�..191tQ 1 Sl p(\ -Zl�r�, ,1 pf� •
�I — � � l �! � � ` •- ._ � j{`,f .
' +`\ =' ' �'�e . � �� � � � I r ' o ' � � `i
--M �) !- '.t,^f�- Ik�7. — - •,y'�i�8� rcz -
��. , r. •p -, L. ;
-. �' � p - ! �_�� . O � / ,
���- � -.��-- .�,�, .
� � �"_' , a - gZ, . ` ,....-. �
.r,..,�....
'�: !7: r = " 4 � �- •� 1 j ' � ._._.._ .__ . .
14` ;y....5'. . . ' .j . I • I .
`' . . . , . . —.`, . . .. . . �' �ft � . �
• ` � I • ' � ', .,. . _ _ _ T j i � .
. � I - � ' , . � ' � 1 � .
r I I � ' Jot.S"r 'OvEi� ��01sT OvER�-- . '�• �
,t , • l _ --
( , ! b �i o/ _'�^"' I � IG :.'�Ct�i- 1 a ' °/� � � e
� � .� . .z.[ IO- „� ` � . .� ' _
' ! 1 . tn =
j i, � ` . I �, t i t�� Z Q ; ��
! ,� . I I�' r : • -' � � �
� i: �; o.. � c ? = — m - �
I t . p = ij � ' � :' � �' • y r-' �
1 ( 'f ° �� + 1 . I ,r. � 1, � ` ,
1 ' r '�--' :. • • ; �, :a ` �
� i � i � .. d ! � . � .
� ' , y ( '' : i
�y � y f Y
i � ; . �r'_ � t G 7� o� y.
N �" : �,� � f` Y �
, � ' �7. � � , r � .r � . � � , M N� � �
i L ,, -.� ,�\� a o �
� �
4 � �, ,�, � � � � � ; . ,. � � � l ( .
; i �+' �'� ``; � � ° Q ' . a -- � � . 1
` ,� � ,'c c� . - . � i
j � ; •1 � • � �, � ` . �, ' , C'�gT S ""~ �
� �� ;� r � . . ; � ► i
' h � " . , f . : � �
� � , � ���. ... � �o �� �
� � 1 a o ,� i+� �
� � � � � � ` � d • ' � � , ' �� � I.9•, h T � .� � � . F ' 1 i`� � .
' �f� . . �' � � � •1 .j e, , iiF � ' -�` � /'� �
{ O �� � � � � , �n Z ?,; j �.4 r � o ' i � S � 1
� . r �i -�.O ' • " i � � ' "* � l p �
i l � ✓ _ °-�.6 � ; ` _. __ ' � i - � [`�? . �,, � -i j y - �• � 1
`�,�„ �n ��• �, `d' +� ` � i f
� .� .� �sa�. ..� � . S� .�� � � . � j : , , � :
� l � ., s� a��� . r�e �i� . . . .,,�' `� ,
, _.
,.ti. rn ^ ' � � .
� ' � ."" ' 1 � �. ��yt,C�.es , ;,.. . • . .
� 1 . � � � ., 's���tti. �. �t �-- ' ' �, ,
� � �- `4tt'C S --r
a �� 1 �.•1� 6� I j $°x�ia�i�FoW j�r y ' r. . j t.
� ,! ?fra- �. � . l°wcqi, e.�rinP��t� ` �r a
! ��; � C t. � S, � n � j.
� - � �,.. � , L �� O j .j te .� , �
� +Y r
.� �� j�2. E�,� fr .. �`'. �a ?� � � 1
��, °- '� -- " � ,r "�„ . M ':c i
� ,I� � .� �. � • " . ,�� � „_; . . � r, .� �- �
.�1 . � i . � . ,A `a; J ` � " �° w 't'� ��} - �� � ? `f ,� i. ' 1
`M L
� � �: � M � �ti. * p y�
• �i! o �1:. - i i' • ' ��• a: S •�i � E LI 0 .' � . = i � ' � � ', /i �' � �
� '� . � � �;` , � �(+. � ` c � O_
� -''• l ' .... . . .�.--. r�"/� � .
� � ��.�� . j � ,`;�.ti �r ..�. , zD � •, . � r ��_ r��� �' �" .y . � .
�,,.. . , � . '.'� f � �� T �1 ���� � '' S �^` i �� ' � . . �' '
� � ' ....5 D i� � a: 3� �, � � � . � -- ° � '_ . . • . -. ' ' . � . . . . r J � ..
�* 'f` �f (�' ��;y: :.;{ ' r r :i � �� � 'o ' ,. .. ( r . . -
� '•: � `��0�___.b,.�K r � �� n�a e�r,i ; 1• �'� .r � .. +�-k6a �. �
� ' - .. o
� � o y �.* �, �,:a �,. c S�Fo�
, _ _ ;-
. . � wi ��� � ....i � N � �y:i ..
�. ' f� M �� �, •. •. . f �1. '�'�% . S. � _ ; � '1i ... � fia.�. � ';j.r.��� S ' • -' S �
R � 7 r�, . ; .� c te �
r �' ' �. '� ��,� :.� - �' � ' �` .. � �. s�
.� ,� .a � .,9-�' {�. s � E � .��' �or�si+. , _�
'a};` � � Q � � -� . �`x� �•�(� r .� � � i� . M�3? i
�1.f� � "` � � ` � /�i S • � n _ � n � � f'�
J� � T � � '';�• � ` r• r- P �� � > � " w ,,. : - '�* f� � �
,, ' O� ��; a r F A� t � . �
'' �'_ � � -. � , . • � � °,� f` � �c ' ... 1 ♦ �
o � � l� � `� .; . _. �. �" F " `� . : r w �
� i -` �' : ' K �' � _ � �, . - , � � c � _ o
► � � . � �,�? � ,�"
, � . 4 "...,."�` . .i �° � 0
1 .�„- , . ..x,r. � ��� � . �.
. } .-.. _ _ ,.. . �.
� ' " � .. ,�'; C e^n• ��
• J `. ` . \ -
., . ,
�[ ` , _
' �,_ � •,. � , _ c�ly . ` Z ,,
� , �?. , ,.. ?� , � � � 3 - ,, 5
tii•�tr'w r; } �; •. ....�_ �� . � , !` � . :' � . s' �� � .. � .
�l _ �, �r �� "'1' Z 7
.�t:��'�! ��; �. . - . ( �� wZ4'-� / , . � �
�. , , , � eQ�� �� r•� , � ��
.` , . i � J j� � v� _ � ' c� �-:... �
. � � K �o I ,.e lR � C+ t "�. . t ,
i - . `
. ' ' � ,�,�, i m ( � • t ° ^ � � �
i � l , r � � Q � , .
• a� ,� _ ;�` r r S l �-4�.. i
r , n
� (' � �, � D � �(,`f � ri !
� � r �� h�` l^ ;
., 4 ' � � r � ^+� � � �" i f
l ' _ y „ � �� �`� �. r `�-� ; 1
'� u { �
. � � : � � i � C i �'''_'.. {, � , � ,, `' ,
.� i -•w.. ` � ; i
� , �.- � .�,,,. � r . \
, . � ,, 4 � � — ,� _ . .,_ _, r � p � � �
I L i . C ..� � Q 1 : '
. S i 1 � 1 a "� � ,�.,,,. �� ..•. r.: `� / -1 p �, �.'�l � � t
� � ,jy' (� � .n t
�.-. = j> -,,"�
� ,� � 1 � � ( � �- ° � f � -�
� ` �) � � �` -- '� � � � 1� i
!� �
1 S ' ' 1 ; f� l � .� �{'j ;
;--
. �3 �, �` � . t . .
' _ r � • . . .� � � .-• �� .d,�,�.. . ,:� �
S ' ;.` � . ,
;., '�.j *
! "; . �. . .
� R
: ' . s;!� � �
-, � `
. , . � _�--'
� ; _
., ��� �r L � �
� r .
.J ` �, '' I
� , � �.
l � � _,... _
� , ��J V , .
�. -., � , , � . .
� � - _.
t` � '� � � �' _ ._ _
. � � . - � � , , t. �� . •
.. . �- �
. • . •• .y'. ' � � . '
� . . ' ' iA�, � , . � - '
, � r . �•n' �•��.'' ' . . . .
. . . . . . . . / .
� . � ��Y f. . ' 1 � . . . . ,.
: r,,:. , • ' oO�$„I
ww�
. . - � �
, � . ,. 6 � • • , 9-, L 1 ..._._.. , � �
. a; Ir2 . ; . � ,
•-..r.. �.., � '...
�
l
� � ,,, tiS Q� * • ;��� �` � - ... �� � i � �f
� ; o� e� Z � � � � w . �,, �.� . � { t
� `p '� ; `� .e J 1!� J'o'1�' ti -� , _ _.._ ,o'•.'L' w�j'r'Z; �! : ..\ j � � �
� ' ' ' � � . ���'�t� � � O �` . i � ;
� � � .
f : , �0. � .h'�.r4y ��Q h , � . �1
3 r �s�� 1��.. . ��3'�� xrb �. . j 1
� ;
; } J �, 1 . _ � � , � � . .. . V � i
1 j � � r ,: Y''� _ ; / �' S - � �' � r
:
�.: f � �� - � � i � 8 ' . � a � �
�� ,� � `
� � � � � � � > �� � t i
( - ', ,�;�c�_-. � , � \ r� i- v ` g' < � ' ; �'
;, l ' � �
,r��,' , � • d. r� ti ' �
� 9 � � r . �.r. ; • �;.. . . �,.' M � �
� _ 4 _I a� � v �i}u• k _,�+ � � ��� 1
• ��:
- • `•::
. , '�'
t , ,
tc' e �� A_ Q ...�:�....:.:_�- C•`."'"'r'�t . �_3.—,"""'�'" -- 'i! i"
, � j _ � _ _.__ ... •. . �
�t �. . _ ,� p, ' ".� • - .'j � ' �
� � � s � 3 '!"'� � uJ. . `,;�•�. . � T` ^ � � � j � � N `� � -� ' �
� ° 9 . 3 � �` :1, � � 5 EI � �
°'� , � . :; :� � � � ► , � � ' �
� i . � w b ..z :�.. ; .� : ,._.,._ r
_ � 'r r ' r � , � � � � ' �
� 9 . �sf . � ` � �� ,� ; �
- ( �� � �a�'�'a��x b 9, , � � � ..-�• ;
a � ° ��.:._ � � ; : , .
_ � l � `�� ''.� � ) j � �
,�� , �; ^ .. . � � � � ,.� � ;,� �'3 .
�i � ° •� � � �. �. �
, ' , ;-� �'s�ae�k__ '��� . , � a �� ��� ,r '; . '
( � � � '� �� ' �i o 1 , .
j � i . o � �" F . ...' �� ^ _ � � ~ °3'/, ti '� ! g � L, '�' N ' � " ,
< �r. �
� � �
� � u. r � � ° � . � ,� �P j� � ,
�, t �'� �.':�►� r/ � � a � j� o •' ' ►
`v � � � ` '. '� '' .." " � b Ic� `4' � � � � j
i �i,. • � .t'' v "� � � �'
' ..' ,� , � W + .r ; , = i
� t : � - E� ':,...�„�:? °� �� . - � 7: . � � 'z:.:. ��' ' ' ' � .; .
� , `" � ` z `` ; _ '
1 �:J•v� J , � w;�J
Y , t •r, r N � � ', 1 '� t �`���. ,
� . . t. � . . . . . ; Y-, � . � � � ' ^.�„_,,,,,; + � .
. � �� p �. .. . : �1 ^' . ��.� - 'w''�
- , .�� � � +?� .�Oh . orL'� 3 � , i � r .
� r �' :� � ; , i •� �c�°' , . � �`S_;x _ � , ��,' _ .,_�f . E � � ..
M1 � f . i , ,. ; ;; � ' %'__( � 8 8 , i • ---� s . #.,. ' i
' ') � •z �. ' `�� '� .{'' `" �i `�i �� �, � f F
�� ••:• " �, 3 � ••� �� '� '� �
7��h'..:{. ''' o _ .� . + C� � � .
:Y-. ' '�.. . . � _ � •w . '.C�, ( � �r Q O � � �^ j i .
. � ;� �.1 - . Y�'. Y o � � � � � � . . � � i � � .
' l's � �`, �I I ./ s � k �'%'_�..
. , 4;� � O r L� t�" �' � i � ,
� ` � : ��� ,� � '� � ---.���-�.-1• � � ' � .;s � I .
` ` ' S' � � O � � r I
`'� � A � f
.. �..�..i'� R . � �,�. y( . t'' �� 4 � • •K . � . • .
s'�. a'-� r'•�^"na�,�it;��S,''••: :� vi � t a 1 ° qr .♦ ' . I , �l',.
I a . �' � ,, �„'�+""�i+N:PfJF'!1�kZ .a j+� ' ��. . 3 • " "'%�cs.. °1t-`'S-1 "' • a:
A l iI �' 1.
4 i 'r"'S� CS 31n(` i �. �. .8i,�.a-Si�;�"'�•.Y . t ��
� � `� .. � ! y. -�e• i ,� � �
�, , � t � . �.�, �j� ; I �
i . �• 2 - J ,•e� �Z �:���.__*_..�:_.X.._
•, o � g � . � .m � �• =, o ► >� _.. �
•�-,01 ,9;� .�-:. ' �, � ,cl `�
==�= - . -- - , . .f-• + .. ' ^.t �`= ��•�•:'..'' :..r. �
�I I 7 Vr FHIULEY INSN��Ii��v ulV.
6431 University Ave NE
Fridley, MN 55432
572— 3604
t�iecUVe vii ��tllUafy i, lyyJ
APPLICATION FOR PLUMBING AND GAS FITTING PERM17
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH �LOOfl
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Aain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater —Electric
Water Heater — Gas
NO. RATE
� $ �.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
Gas Range
Gas Dryer
Back Flow Preventer Required ()Yes () No
Type
$10.00
$ 7.00
$10.00
$10.00
$10.00
$5.00
Reinspection Fee $30.00
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
19'0 of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
TOTAL
��..UC�
$ .50
$ •��-S�
� ,,
JOB ADDRESS ��, I '�� _,��? " 1 ;%ix' I,a i � � �G � -
The undersigned hereby makes arplio�tion for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
/'
��-'�-�--1--' 199�
Owner
�
Building Used As � ,[�
Estimated Cost �+.��� •� PERMIT NO. i� /�%� �
PLUMBING COMPANY � � ; �� � -' ",� � '�' � � °
,
��� � � �� ` .
SIGNED BYjr�� � � � �` TEL N0. ���%t�-�-� ���j �.
J
Approved B Rough—In Date Final Date _Q��C%Ti"— %��`��
��
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
sue�ecT PERI�11-r°iV'O"�'—
City of Fridley 'r30966
AT TNE TOP OF THE TWINS g � I L D I N G P E R M I T
', � EIPI.-[a9.' .
� .
COMMUNITV DEVELOPMENT DIV. ��D /
� j V ����� , .
/ � � PROTEC7IVE INSPECTION SEC.
� . ,
i-_-_�; �'�' �-� CITY HALL FRIOLE� SS�32 NuMBER t1EV O�iE v�GE O: �PVROvEO 8r
i 612-571-3450 9t0-Fi5 5/23/00 / /
lOB ADORESS 1613 Berne Circle East NE
1 IEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACHED
oesca. 13 1 Innsbruck 5th Addition SNEET
2 PROPERTY OWNEii MAIL ADDRESS ZIP PHONE
Catherine Powers 1613 Berne Circle East NE 571-3645
3 CONTRACTOR MAIL AODRESS 21P PHONE IICENSE NO
North Central Builders Inc 7401 42 Ave N, New Hope, MN 55427 533-6168 3763
4 ARCHITECT OR OESIGNER MAIL AObFESS ZIP PHONE LICENSE NO
5 ENGINEER MAII ADDRESS IIP PHONE IICENSE NO
6 USE OF BUILDING
Residential _,
7 CLASS OF WORK
O NEW O ADDITION O ALTERATION �] REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reside House & Garage; Trim & Gutters
9 CHANGE Of USE FROM TO
STIPUlAT10NS
Per Section 1402, 1997 Uniform Building Code, requires that a weather
resistive barrier be placed over exterior sheathing to protect the interior
wall covering. Exceptions for this provision would be if sheathing is an
approved weatherproof panel or when the siding is an approved weather
barrier. Vinyl siding is not a weatherproof covering unless the manufacturer
states this in their application guidelines. Call for inspection of wrap
before covering.
Perr�it tnspection Gards
I��il �e l�ail�d
To ����e�����.��� To Po
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAO
SEPARATE PEfiMITS ARE REOUIRED FOR ELECTR�CAL, PLUMBING, NEATING.
VEN7ILATING Oii AIR CONDITIONING
THIS PERMIT BECOMES NULI AND VOIO IF WORK OR CONSTRUCTION 20NING SO. fT CU fT
AUTHORIZEO IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WOFK IS COMMENCED. NO DWLG. UN17S OfFS7REET PARKING
I HEREBV CERTIFV THAT I MAVE REAO AND EXAMINEO THIS APPLICA710N STA�LS GARAGES
ANO KNOW TME SAME TO BE 7RUE AND CORRECT. ALL PROVISIONS OF LAWS VA�UATION SURTA%
AND ORDINANCES GOVERNING TMIS TVPE OF WORK WILL BE COMPLIED
WITH WMETHEA SPECIfIEO MEREIN Op NOT TME GRANTiNG OF A PERMIT �LO�827 �S.�F2.
OOES NOT PRESUME TO GtVE AUTMORITV TO VIOLATE OR CANCEL TME pEqMIT FEE SAC CHARGE
PROVISIONS OF ANY pTHER STATE OR LOCAI �AW REGULATING CON• @ i9S . ZS FlY' SC � LO. H3
STqUCTION OF THE PERFORMANCE OF CONSTFIUCTION �
PLAN CMECK FEE TOTA FEE
Licen S $5.00 16.50
S�GNI1iUpEO�CON"FA(;TOAOQAU�NOA�ZEDIGENT iO�rE� EN ROP VA�IOA THIS IS VOUR PERMIT
J,
4
S�GN4TUAEO�OWNEQ���OwHEpBU�LDERi iD��Ei BL �NSD f��,}E
•
N� Il
ADDN [ )
ALTER [ ]
Construction Address: � 3
Legal Description:
CITY OF FRIDLEY
SINGLE FAMIIY AND DUPLEXES R-1 AND R-2
BUiLDING PERMIT APPLICATION
E
Owner Name & Address: � � If �/�
Contractor: /�/D2% ' % %�� L
pddress: `7 �f D/ �,� tirQ AUC
LI�/ING AREA:
C�
Effective 1/1/2000
612-572-3604 Bldg insp
��
, oq ��
� �,�
uJC�S Te�. # � 7l -- �(� ��S
_� S� -L/V� MN LICENSE # ,� 7ro 3
��u� 9�✓z�P�, %�') l� Tel. # � 3�-- �v 1��
- ���`o� �
Attach to this application, a Certificate of Survey of the
totr with the proposed constnaction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length � , Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
D�CK AREA:
OTHER:
Length . Width Hgt/Ground Sq. Ft.
���iQ� .r�/��EE� ��A���- , i ��� � ��TT�2�'
Construction Type: Estimated Cost: $ ��' ,��� /, d�
- :}.
Driveway Curb Cut Width Needed: Ft. + 6 Ft - Ft x$ _$.
_ ,�
DATE: � O�J APPLICANT: � -t.[ ��,iJ ���i" Tel. # � ��,�'(a �1��
CITY USE ONLY -'�all (612) 572-3604 for Permit Fees if mailing In application
Permit �ee $ ��/ J� � S Fee Schedule on Reverse Side
Fire Surcharge $ ��� �� .001 of permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge � � $ � � � • $1100 per SAC Unit
License Surcharge $ �� C'� $5.00 (State Licensed Residen "al Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B'' Above
Erosion Control $ $450.00 Conservation Plan eview
Park Fee $ Fee Determined by Engineering j
Sev�rer Main Charge $ Agreement Necessary [ j Not Necessary []
TOTAL $ . s�
STIPULA710NS: ��
,�� ��� 5%/� �
� �
��
BUILDING PERMIT FEE 5CHEDULE
mhe Chief Building Official sha11, before issuing permits for the erection of any building or structure, or for any
�ddition to any existing building or strucfure, or for any alteration or repair to any existing building or structure,
upon application therefore, require the payment by the applicant for such permit of fees to the amount herein
beloW set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up.
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fr�ction thereof, to and including $2,000
$69.25 for first $2,000 plus $1.4.00 for each additional $1,000
or fraction thereof, to and including $'25,000
,
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 fvr each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCttOW
(Concrete Curb Streets Only)
Alternate "A" : Removal and �replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Alternate "B": Removal and replacemeht of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VEttIFICATION O�' FOUle1DATION
Permits for construction will be issued � minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will
be required before proceeding with the framing. New Houses Onlv
..
� �r J�� �
/�/�3 �"�r� �
/
�
ctnroF
FRtDLEY
FRIDLEY MUNICIPAL CENT'ER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
November 27, 2001
Subject: Obstructions in the Public Rights-of-Way
Dear Resident
P'WO 1-067
During our preparations for the upcoming snow plowing season, our maintenance personnel inspect each
of their routes to mark certain trouble areas such as curving roads and obswctions in the right-of-way.
During this inspection it was noted that your property has a constructed obstruction that may pose a
hazard to snow plow operations including both equipment and/or the operators.
Please note that obstructions built within the right-of-way are a violation of City Code. These obstructions
may be retaining walls, fences, planters, or mailbox structures other than a standard box on a standard
wood, metal or plastic post.
While our personnel make every effort to avoid standard mailboxes and other objects, damage can occur
if the object is not visible due to piled snow or other sight obstnactions. It is the property owner's
responsibility to mark such objects so as to allow the plow operator to determine its location from within
their vehicles during plowing operations. This marking may consist of a long rod or similar marker
attached to the object or in the ground immediately adjacent to the object. The City will not be
responsible for damage to any such object in the right-of-way in violation of City Code. No exceptions will
be made for existing structures.
In the event a standard mailbox or standard mailbox post is damaged by a direct hit by a City plow, our
Street Operations Supervisor shall inspect the damage and make a determination as to the extend of the
damage and a recommendation for compensation. Compensation shall be limited to the cost to replace
a standard mailbox and/or a standard wood, metal, or plastic mailbox post.
If you have questions, please contact the Street Maintenance department at 763-572-3566.
Sincerely
i
Jon H Haukaas
Director of Public Works
�
� �_,
,. �1��� � _
�,ti-
Y" . Y i
+l
.w..., . ���
d
. iiM"; . � ., .
� -� �
h �
I �4» � ... .. �
.:�4r
���
fii►1 ■�1 � >
�' � � � sp�rr
!� ti_ v� � ���� .
I�
�
^i �` .' � ' . .
r ` �;:.. r . .-...
�
� •4�
. �� , , rM�. �I"..-I '
l` �
' V � ._i
.K. ~ �
.� . •�`�r�'-
♦�• * P
�.�� ��1M • _ __
..,�'
r
GTY OF FR}DlEY INSF'ECTttJN D;YiS10N Bffective .ianuary 1, 2003
6431 University Ave NE
Fridiey, tVlN 554,32 APPRfCATt�N fOR F�OYYER pLA�MTS AND HEATIl�. COOLING, YENi`ltATiON,
t763) 572•3604 REFRIGERATIQN ANQ AiR CONDITtONiNS 5Y
FA}[ (763) 571-1287
�:L�i��?, _ •
Rtsidential
Furnace Sheli ana Duct Work, Surner -
Also Replecernent Furnace
{Side Vent � Fili Qut Beck)
G�s Piping (N�ded with new iumace.
but not replacernent)
G85 R8t1gB
Gas Oryer
*Air Conditionir�g • AI� Sires
A!I Ott�ers/ReAairs 8 Rlteratians {LtST ON BACK)
2q� ofValue af Appiiance or Work
Commercia l/Indusiria l
1.25gb of Value ai Appiiance or Work
Rate
$ 30.t�1
$ 10.00
� 10.U0
� l �.�
$ 25.00
State Surcharge
Tf3TAL FEE
„ , u �: _.. .-; �t_ •• .tu_. : ,•,
: i. � _ ...i.. �i.l . �._ : � 11. �I .� .l . ► _ � t I 1: t
i. � a I �4 R a�
REINSPEC7JON FE.E $47.Op1Hr
'Al� Cunditioners can twt be placed in a side yard wi#hout
rvritten permissivn f�om adjoining property owner.
i'OiAt.
$.�.._..
$
$
E
��c a
�
�
� .50
$5��5�
STEMS AND DEV'10ES
10B aDDRESS � " -CZ� - � •CZC.� L � -
OW+NER__ �:� r �, c �-�..� t �� ` �-�.�c' �5
BUiIDING USE� AS N a�E
c c� r
ESi'IAllAiED CASt _ �� C PEi�MIT N0. /� v�
' � 'l_•i �. :.: _►� �; :,':
Na. of Heating Units � CirGlB Ot18 (Steam} (Hot water) (Warm Ai�'
'irade ntame ► --�= �• -�e r�. Size No.
9TU 1 i c� , o c c� yp EDR
���( ��T •- �. �- 5 Total Cor�nected Load
Burner Trade Name g��;� �}�,
8� Hp FDR
.�4 -L �t=�.''�' ti NSZ(�-62�-► 2 i �� 1� 5 E c-2
The undersigned hereby makes appiication tor a permit tor the wvrk here:
specilied agreeing ta do all work in strict accordance ruith the City Codes
rulirigs of tMe Building Divisian. ana hereby declares that al► the facts and
representations stated in this appiication are true and correct.
DATE _ '—► ' I �-I — os 3
HEATING GD ��EN'i� p•� ) -- �� �"c, ,� ,�
5igned ._._-�S��r—TEl # 6 c�-� 2� I$ qq
FaX #_ 6 � Z- iZ.'-f 'ZO i�
_ ��
Approved By � Rough-In aate' Fina! pate � G��
�
FIL.L �UT BAGK �`IDE FOR S7A K VGRlF!(`,AT�nN 11A�► o`e� Al���iew��r FURN.��`F
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNiNG APPUANCES OR THE
APPUCATtON WILL BE RETURNED
cnnnnnnN Nr� ��ti�t�n,F�, .��ti� � �g��sT�1�;, I�R�R�I[`ATInR
When r� la _ina an eYiatin0 fiiranra� �e undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, abstructions, �
and is securely supported and firestopped where required. Yes (,�' No ()
The venting system is plastic/PVC and meets all current codes and manufacturer ,/
specifications including sizing, length, number of elbows anci termination. Yes (`� No ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current c4des and manufacturer's specifications. This does
indude AGA-GAMA �ategory I Centrat Fumace Venting Tabtes for fan
assisted and natura) draft appliances. , Yes (.�No ()
The E+Yietir�0 c_omh �st�en 9ir is sized and installed to meet the current codes '
and manufacturer's specifications. Yes (v�No ( )
Whe11 �equil'ed to inc�ll a n_w _em6 ��tien air�,it will be sized and installed
to meet the current codes and manufacturer's specifications.
When josta�lliop a new �entinp,y�, �e undersigned hereby verifies that
it is a listed �ssembly and meets the current codes and manufacturer's
speaficatians. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appiiances.
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the cammon vent and vented
separately as per current codes.
Yes(�( )
YesF�o( }
Yes(�o( )
��.. .. .- ... .����.. -� ..� -� .��- . � ..��. .�
Appliance #1 Type �L� �� BTU Input � i 0, v ov Fan Assisted o Nat
Appliance #2 Type �- t BTU Input o � a Fan Assisted or Nat
Appfiance #3 Type BTU (nput Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type __
� r : � •► .- �.-
HEATING CO: __(Z
Signed By:
��
E�r, �, G �c /-� �2
Date : _ � �- 1 � � Q �
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
�631572-3604 FAX: (7631571-1287
PERMIT N�.: 2004-01300� �
DATE ISSUED: 08/10/2004
ADDRESS : 1613 E BERNE CIR NE
PIN : 253024110038
LEGAL DESC : INNSBRUCK STH ADD
: LOT 13 BLOCK 1
PERMIT TYPE : BUILDING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DECK
VALUATION : $ 3,990.00
NOTE: SEE NOTATIONS ON PLAN.
CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CONSTRUCT AN 18' X 16' DECK AND A 7' X 7'
DECK.
APPLICANT
POWERS CATHERINE L
1613 BERNE RD NE
FRIDLEY, MN 55421
OWNER
POWERS CATHERINE L
1613 BERNE RD NE
FRIDLEY, MN 55421
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of work
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the prov' ions of any other state or local law
regulati�tru� q�e performance of const�ucti�n.�
An �'�ti-Lv� Date�� �'� G
Bldg Ins�,,������ Dat , l. ��
BUILDING PERMIT FEE
PLAN CHECK FEE
FIRE SURCHARGE
STATE SURCHARGE, VALUE
TOTAL
PAID WITH CHECK # 19054
SEPARATE PERMITS REQUIRED FOR WORK OTH�R THAN DESCRIBED ABOVE.
97.25
63.21
3.99
1.99
166.44
NEW
ADDN
ALTER
�3��
[] CITY OF FRIDLEY Effective 4/1/2004
[] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bidg Insp
[] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPUCATION �D�c� , D) �Q�
[
ConstructionAddress: %G i3 �eP`�G ���'��e�� � �!���y ��
Legal Description: �
Owner Name & Address: C� f� er +� � L., �oi�v�v�S (�,q�-.�� ) Tel. # I�3-.� �i -3l ys
Contractor:
Address:
LIVING AREA:
MN LICENSE #
Tel. #
Attach to this application, a Certificate of Survey of the
bt, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
� � � ��i
�
�; i �' ,:� �L`
�+ �
�.
�-� f (�
GARAGE AREA: , Length Width Height Sq. Ft.
DECK AREA: Length �_ Width �_ Hgt/Grounda?/��iS �Sq. Ft. 3/d °�
,z y, �� � x � l� _ �"l�t
OTHER: � � � � - °2 - <i
�
Construction Type: /�-�4V"�� �✓Nx _ Estimated Cost: $ � G�� b� c� G'
�
�,
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
wo�l� �G 3 ��3 - oo y �
DATE: d �G 'G�/ APPLICANT: ��� 4➢ Tel. # �J � � ���" l � `% �
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
CITY USE ONLY -
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ C���F ��
� ��. a�
$ ��i�
$ � .G01
$
$ ;
$
$
$
$
$ L� �
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 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 [ ]
0
STIPULATIONS:
BtJILDING 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 lielow set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
CURB CUT ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined
rate
Pernuts for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
VERIFICATION OF FOUNDATION
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
0
The Home Depot # 2802
5650 MAIN ST, NE, FRIDLEY, MN 55432
(763) 571-9600 �
Mon Aug 02 16:56:42 2004
The materials for this project will cost $1744.31
CATHERINE POWERS ( � ��,L � {
TREX DECK
147780 �1 X, v l'- P" f''`i/
Deck Dimensions for Deck 1 ����% �J3��� ��� �`f�
� , f) � / n � - � � �, p na1'�
�
- , ���„ � � r � ,��-��,.,,� �j , P ,
� s �-¢� � ��'�
„ ;- � � -� h � �
� , r, ; t, :, j ,� � �. C� I _
; � A�y��- �aK��r aX�� �.� �� I
, � �
� � 7�exPi�m�;��,.� , . , , ;
, l ���,�/ ���� o�� d' ' �
�; �s
% G`o�s �" S�-�� i K� lC �> � . �
�z� �v J .�, � � ,
� � � ,� �C /a /.7..z « ri.
�� �r�c� : `c �'�ffs
� � ����j � � !
; ��C� � ��� ��ti � �
/ i --� � / �� ;
��� �,� ��� l� � � ��' � ��� �
��! � -� (�.c c ��
� sr-,� �,;, , �
� � � �,�.� ;�
��
d
��._
� —
IN�
�
Dec
—3'
���, �
� �,
—
' � _ c.i�
��r'��•�
�_ � �...x � � a,� . � �4,_ o � �..�:. � �:
_
�
�l _X—,
i�■���
i�������
-15' 8"
�8.
5'
/h�k C.�ti
Joist Spacing = 16 in. o.c.
�� x ��� ��e
�o .; �/� � x'�"
�3��U w, G�� y�
� _
vi �
�.
�,� �,
;� �,,., l7�-� I
���
COOE
� �re� ��
�����
�,
?�� � �
- r��
U�/V`;�
t,�. � f.:)
G� 6 rG %rr,
Sl I
vW�
�
�61��V�,
����
�
ir a
r� o�v
�;
� �i „
C,��ak l�
, � ��
��a�
:^�
"� - 6� �'(/.J k
X 3 4��� -��
a
t
1,,
�
,`
. . • �\
�� •
\ '
04/02/2004 FRI 13:21 FAX ��� ELDER JONES
�001/001
��o S. - � /o4�b � � : . � '. . ._ :. � - -. ..-- ::
N� [ l CIiY OF FRIDLEY Effective 4/1/2004
ADDN [] 6431 Universiry Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [] SINGL.E FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BU{�DING PERMIT APPLI ION
� � L�,,���, �
Construction Address: _ �(0 � 3 �-�. Y n.�. �(�`�_
Legal Description.
Owner Name 8� Address: _ Y.: ��i C�,�.�2.�CS Tel. #�(a 3. S�- I• 3104�
Contractor. _ PELLA WINDOWS & DOORS MN LICENS�#
Address: 15300 - 25TH AVE. N. STE. #100 Tel. #
PLYMOUTH, MN 55447
763-745-1400 a Certificate of Survey of the
LICENSE # 20165884 ;truction drawn on it to scafe,
D�SCRIPTION OF IMPROV�MEN7
LNING AREA: Length Width Height Sq, Ft.
GARAGE AREA: LengEh Wdth Height Sq. Ft _
DECK AREA: Length �dth HgUGround Sq. Ft. _
OTHER: �� Q i� (' 0�� t► � t� �/71 1 1C, f►(1 • n � n nC :�
Construction Type: Estimated Cost: $� 3 ���- S S 3
/•
prNeway Curb Cut Wdth Needed: Ft + 6 Ft = Ft x$ _$
DATE: � APPLICANT: Tel. # QSo� � 3�{S• (pQ�( �
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-7287 if using credit card and we will call
you for card number.
Permit Fee
Plan Review
Fire Surcharge
Staie Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TO7AL
CITY USE ONLY -
$_ �i-�- aS Fee Schedule on Reverse Side
� 65% of Permit Fee
$� 3• 4$ .001 of Permit Valuation (1/10th%)
$ j j . �y $.50/$1,000 valuation �
$ $1350 per SAC Unit
S � .00 $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 [ ]
y�
$ ` STIPULATIpN�:
Building
Inspections
763-572-3604
DATE � � ~ � !
SITE ADDRESS �
THIS APPLICANT I3:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
1�� �� . �
❑ OWNER ❑CONTRACTOR
PROPERTY OWNER/ Np�
�
TENANT �p�ss: % � / _'3 /. � c-'s2�v � ��GCITY.
PHONE: (�/sZ (� la ? '" � l0 %
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
N,�: d I ^ �
o-
STATE LICENSE # EXP DATE
ADDRESS:
fi:Zi]ilJ
F
Q'SINGLE FAMILY/NEW CONSTRUCTION
O TWO FAMILY/NEW CONSTRUCTION
❑ ADDITION ❑ GARAGE/SHED
❑ BASEMENT FINISH GYROOF
❑ DECK ❑ SIDING
❑ SWIMMING POOL
NEW ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:�
SIZE OF IMPROVEMENT��.�S GU
ROOFING
NUMBER OF SQUARES
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
O Aluminum
❑ Other
�b'INDOWS
IN EXISTING OPENINGS ❑Yes ❑No
OR FOR NEW OPENINGS-DESCRIBE S�ZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED
LENGTH
� HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
� �0 %/
❑Soffit
❑ Trim
� Fascia
LOCATION OF WINDOWS
NUMBER OF
Permit No.:
Received By:
Date Rec'd:
c � �,.p �/ STATE����/
CITY STATE_ZIP
SIZE
STORIES �
❑ WIN OWS
❑ DRAIN TILE
❑ OTHER
lC�G-� �oG
WIDTH HEIGHT S . Ft.
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS. & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing structures
and proposed project.
2. Two sets of construction plans
3. Energy Calculations
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ �_ OCCUPANCY TYPE _
Permit Fee
Plan Review
Surcharge
Fire Surchazge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ `�,/ oCS-
$
$
$
$
$
$
$
$
$
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 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 aclmowledge 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-� � requ' s r ie nd approval of plans.
SIGNATURE OF APPL� PRINT NAME w DATE �G ^� /^� S
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 15t $500 plus $3.05 for each additional $100 or fraction, to and
includin $2,000
$2,001 to $25,000 $69.25 for 15S $2,000 plus $14 for each additional $1,000 or fraction, to and
including $$25,000
$25,OO1 to $50,000 $391.25 for 15` $25,000 plus $10.10 for each additional $1,000 or fraction,
to and includin $50,000
$50,001 to $100,000 $643.75 for 1�` $50,000 plus $7 for each additional $1,000 or fraction to and
includin $100,000
$100,001 to $500,000 $993.75 for 15S $100,000 plus $5.60 for each additional $1,000 or fraction to
and includin $500,000
$500,001 to $1,000,000 $3,233.75 for the 15t $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 additional $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 Oniv
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
Building
Inspections
763-572-3604
763-50�-4977 FAX
DATE d O �
SITE ADDRESS %C,pl'
THIS APPLICANT IS:
BUILDING
RESIDENTIAL APPLICATION
❑ OWNER
PROPERTY OWNER/ NAME:
TENANT . ���.
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
INSURANCE
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
lJ�ui�71
CITY OF FRIDLEY
EFFECTIVE 1-1-09
YOUR E-MAIL ADDi�ESS �
�,rCl� � atv�
ONTRACTOR
L�a�/12� � /�7 ���/ GJ
� �+�62� �✓. � CITY_
- .s 7 / _3c° ��
• �5,�-c� �'orts 1-/1c
STATE LICENSE # � % % EXP DATE
ADDRESS: /,�/ S/lvG.� L, ,� C.f Zc� [j CfTY�
PHC�IE G�� �`.�' 3! c( O� FAX ��l
SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑�_ �D IN TILE
❑ DECK ❑ SIDING �OTHE
❑ SW[MMMG POOL �G � �`[Ga�
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR �1.R�IVIODELING
DESCR[BE WORK BEING DONE:
SIZE OF IMPROVEMENT
ROOFING
NUMBER OF SQUARES
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
O Vinyl
❑ Aluminum
❑ Other
� D[�
��.C> (.t/.
r�►�
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
HEIGHT
Permit No.: ���bq �
Received By:
Date � �
�
STA
3-�I� ��
�_STATE�'1'�LILIP /� 2
c �
-do �t�sc ��c�{ �,o�r t�vort�
�j .a.�'1.r�'�-/ s�.c-tS L
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTiON INCLUDING DECKS,
�Soffit ADDITIONS. & PORCHES SUBMIT:
❑ Trim 1. Site Plan/Survey showing the existing structures
❑ Fascia and proposed project.
2. Two sets of construction plans
WINDOWS 3. Energy Calculations
IN EXISTING OPENINGS ❑Yes � LOCATION OF WINDQW r( °_/ (i
OR FOR NEW OPENINGS-DESCRIBE SIZE OF f� �l�J�GLr ,C �Z rf(�j�
OPENING CHANGES & / ,��
TYPE OF. WINDOW TO BE INSTALLED `IL C��� NUMBER OF WINDOWS /
ALL FEES ARE BASED ON VALUATION, [NCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ � 2�OV OCCUPANCY TYPE
Permit Fee $ See Back Page for Fee Schedule
Plan Review $ � 65% of Building Permit Fee
Fire Surcharge $ �.001 times the total job valuation
Surcharge $ .0005 x Permit Valuation Minimum $.50
License Surcharge $ , $5.00 (State Licensed Residential Contractors)
SAC Charge $ $2000 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft+ 6 ft = ft x$22 =$
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary O Non Necessary O
Total Due $ Y 1 �' Make checks aavable to: Citv of Fridley Attach Stipulations
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 I 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 with the
approved plan in the case of all wo hich r u' es review and approval of plans.
S[GNATURE OF APPL[CANT /'d�"`� �z���» PRIN�NAME �� ��s`� � DATE ��3�/�9
/J� // l _ /� _ > L_ - S /�
AND MECHANICAL WORK
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 I S` $500 plus $3.05 for each additional $100 or fraction, to and
including $2,000
$2,001 to $25,000 $69.25 for 15t $2,000 plus $14 for each additional $1,000 or fraction, to and
includin $$25,000
$25,001 to $50,000 $391.25 for 1 S` $25,000 plus $ I 0. ] 0 for each additiona] $1,000 or fraction,
to and includin $50,000
$50,001 to $100,000 $643.75 for ls` $50,000 plus $7 for each additional $1,000 or fraction to and
including $100,000
$100,001 to $500,000 $993.75 for is` $100,000 plus $5.60 for each additional $1,000 or fraction to
and including $500,000
$500,001 to $1,000,000 $3,233.75 for the ls` $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 15t $1,000,000 plus $3.15 for each additional $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
,
7'-3 3/4" �
�
±R.O. 6'-5"
PELLA WDWS
� � � PP� Nut
' MICRO � INK
� .�
U
P
P
E 5
R T
s o
N
E
REF
FRZ
�
� � KITCHEN
L D� 36" GAS
v
COOKTOP W/ —
DOWNDRAFT
4'-0" �
0
N
���
J
2" _� -
PROJECTION
O
v
I
E
WD. ThREShOLD
DECK
,� _____--�-
. ��.�.�.-
�„/r"°-- Q 6 I
EXIST.� �R.O. '-10
STACK \ P
�
LUPPE
ftAISEO
COUNTERTOP
� FEATYIER
4 IN NEW —
WD. FtR
4 �
e,
8�_4�� — — — — . I'-6 ,
W/O
2,_�„
5'- I
��� ��
� �
FULL f1T. �
, PANTRY
I � 3
I, 5,_0,�
5
i �� N (• . ,,� .._ . ,, .
2_ C..��\ ,r�:�r�V(,� �
N t
�
��� ��k-�p w�� � ��
DINING
� ��� �� � ��
3
4 �
I
� BAR
U.C. REF.
5'-O"
a �� 5
VERIFY DUCT WORK - `...---- " � C�
ADJUST OPENIN� �� i
NECESSAF',Y. MAXIMIZE
OPENING /�`N
1 I
,��� 2 I
GROMMET CFIASE S �.0 �L � �f�S
� COORDINATE I I
1 l� TION W/ N LIVING RM. �'"`� � ��� TRY
v �
6 �; I S _ ;� _ _
TV
LINE OF WAL BEIIIND
�\ TV (FLUSh P EU
'!. . \ LWF OF CA . BELOW
MAIN LEVEL PLAN
SCALE: 1 /4" = 1'-0"
NORTH
I�
UP
�
��
� ��
��
�
� //�
�
�4�_ � ��
'tiG
LINE OF WD.
Sh1ELVE5 ABOVE
/�
WD. ��
TH
�
(6) Y100KS
LIPS FOR VACUUM
• ACCESSORIES,
BROOMS ETC.
HALL coNSU�r w/ own�e�
NEW FIRE RATED WD
DOOR
EW CASED OPENING
, �
�
�� �
� �
��
FAMILY RM.
W
�� �,�
r"�
�
s
R106.3.1
BEAM SCh1EDULE:
� (2) I 2" MICROLAMS
� (2) 2 x I O
QC (2) 14" MICROLAMS
� (2) I 2" MICROLAMS
�
� (`2'� ��lMti'�'� � Q V t7��, `
� � �
_ ���,� �
�' I�I uw� •
` , ' l W
.
�` �` J iN ��J/
�.J � � �^ , { �V � Q �V �.��.,_ f �
_ �' l �r� .
���. I���� --
�
�� � � `- �° �"�- � `�" V �� � � .�..
GARAGE � w
�� �=
— — — — — — — — — — — — — — — — — —
�
--� �� �(�.N �
� ��� �
�
_...�._.-- ----- ---- _
. _ _- _ -------�
�
i
o POWERS
—�' � REMODELING
� � � 1613 Berne Circle East
�, `" � F Fridley, MN 55421
� x
Su
�
-N-� o 0
; o � Quigley Architects
/ a o° International Market Square
��C7 � Z 275 M a r k e t S t r e e t S u i t e 4 4 3
� ] � Minneapolis, MN 55405
O a o phone: 612-692-8850 fax: 612-692-8851
April I O, 2009
QI REVISION MAY 5, 2009
1
�.
U
_
H—
� .
� W .
�
�
�
�
00
Q � .
o�
z
� �
�w
U �p
I
I � II I� II
I II II �
� I II II �
�� � �� �� ��
I I I I I I V I I
ii � � �� �� „
N
�
w
�
g
�
�
W
�-
�
J
�
1�
�1..�
�
�L W
� �
�
W �
O �
�lo!�=� I.�
� ��
u •
a� .
.
�
� ,.
. �o �
. �� ,�
11 ► �■ �
z
Q
�
�
J
�
�
�
� �
�
�U
� �Z n-
� N U
�
U I
�/ J
W z
� Q
� Q
�
Z �/
_Q
��
�
�o
�W �
O z
W
>U
w�
� W
C� �
O�
� �
O
\�
\ o 0 0 0
�'�� ��.. . .'.'.�.�.�.��,..� .........:.:.:.....:.:.:.: �.:. ; '�:�.'.�.
�. .
0
��� ::: :::::.....
........
,o
0
o� o�
��
0
�
/ o
o��......:::
O ::... ..::
o� i' : \
�
� I.
I
I
-------J
L__
_
Q
J
�
�
w U
�m
I I�
O
�
� W
Q W �
~ � O �
=O �O
��OQ cf�U
w
Q U z
��z
Q�z
w
z +�-
O ct�
��
� w
� Z
O�Z
J W
W
� _ �
� W
U � m
� ~ �
�
L O �L
�Q � �
OC � Q
F-- � U�
Z
W
�
W
� N �
� _ �
� � �
!� � W
J �
1 ���
�,0�
� � � �
� w��
W W
W �zz
O Op�
Z J
W W
� � �
�m
��O
z p �
�>m
o°�
o��
��o
r
�
0
Z
C�
Z
�
O
O
J
�
C�
Z
Z
0
\
W
_
V
H
Y
T
0
T
II
CV
T
J
Q
U
U)
�
�
W
�
0
!�
-�+
v j3�j N
z��'
��
l--�
u
�
�,
�
..,
U Z
w�,�
Q �
.
O � �
��
� m '�
��w
�
� �
�N W
V �
v
�
+�+ ~ � °
� �
• r-1 CI' G! � N
� � � � �
u ,� � z X
� � v��
.o
������
m a+ o o�p
i
�.1/ � R � �
����,
N
�� � � �
�� � N y
�
� �
�.
'SMtl1.LH�RUdOJ'ItlN3aHd d0 NOLltl'IOiA
NI 9�JNIMtlNQ 3S3H1 i0 35f143ZRIOH1f1tlNf1.(f�ttl
600Z S.LJ�.LIH�?IF� JC�'I�Ifl� O
L.�
U ) O
Z �/
O �'
�—
> � W
llJ (r] Z
�,W�O
O��
w��
�
z�Q
_�
���
��►z
..m�
o�W
z�o
N
m
o°
N
�i�i
m �.
� Q
� �
z
00
_�
Q�
a
�
_�
�
��
��
� O
� �
_�
o�
� w
U m
0
m
�
d '�
�
�
�
w
0
>
0
�
�
w
z
Q
�
�
�
�
�
�o
��
0
J �
� �z �
Q N U
U �
' J
� z
� 0
�Q
I
I � II I� II
I II II �
� � !� �� �
�� � �� �� ��
II I II I V II
�� I \ II 'Il ii
� ` '��
�=
� I�
.
.
1
� ��
I I■
� �
0
�i' ��
��� �
�
�_ _� �
I .►
�`" 1 �
��I �
� �
� � �, :
- � I� � :
i I
�
� w �
�
0
0
o �;
w �
z �-
�
w
�
g
�
0
w
�
�
J
�
l�
w
>
�w
U =
� N
W �
� Q
0
Q
w
m
W
z �-
OJ
�W
o�z
J w
W
L
� I— w
U�m
W��
� �
�
=o�
� J �
���
z
W
�
� N �
� Z �
Q � �
J ? �
1 ���
�oQ
��
� m��
� w��
w �zz
0 00�
�
�
O
Z
C�
Z
Y
O
O
J
�
V
Z
Z
G
,
W
_
r
Y
0
_�
T
��
N
�
T
W
J
U
�
F-�
W
�
�
I�
�
C.7 W �
� �(')
H U �
��,,,7 U �
a�
.
�� v
�m �
�� w
�
� �
� �
V 00
a� � m �
� ��o�
'r� c°n~ 61 u�'� �
�1 � � � �
U,x�"Z
�����
���.�°
'�G v 0.00
����
� `�� ��
N
�� � � �
• � � N i.
� �
�,
'SMV'11HJIN,tdOJ 1V1f30Hd d0 NOLLV'IOIA
NI SI S`JNIM VNtl 353H1 d035f143ZR10H1(1tlNf1 ANtl
600Z S.L��.LIH�2Id JC�'I�Iflb OO
�
V / O,�/
z L.L
Q w
- �-
Q � L.�
�}-W
J p7 Z
w p �
�w0
O��
O
w � �
�w�
z � �!
_ � �L
� v' �
Q W z
lLj � �
OQW
z�o
t'J
6�
0
N
�ri
m�
� Q
� �
z
00
_�
L
�w
Q OL
a
�
�
-TOE KICK
BASE BD.-�
PLUG MOLD
STO N E
COU NTERTOP
PULL OUT _
CUTTING BOARD
ADJ. BOOK-
Sf1ELVES
ADJ. SPICE
S1IELVES -
ISLAND - LOOKING EAST
1 SCALE: 1 /2" = 1'-0"
�N �:A , � . : :. . .
C_ .
� : ' . : : ' ' : :
36" COOKTOP W/_
DOWNDRAFT UNIT
CUSTOM WD.
BUTCt1ER BLOCK TO
GOVER COOKTOP
� �� ���� �
��
'��
� p� �p ��� ��� ��� p� �� �
� I
�� • • � ��
�
-TOE KICK
BASE BD.-�
0 0 \ /
ISLAND - LOOKING SOUTH
CURVED WD. SKIRT W/ METAL
TUBE SUPPORT BE111ND
STO N E
COUNTERTOP
BASE BD.
ISLAND - LOOKING EAST
3 SCALE: 1 /2" = 1'-0"
SCALE: 1/2" = 1'-0"
KNE PACE . :.: :..: . :.:� .: : ..::.:..:: . :.
LOOKING NORTH
SCALE: 1/2" = 1'-0"
NOTE: ALL I T
TURNED
N ERIOR ELEVATIONS
WOODEN MAY BE SUPERCEDED BY INTERIOR
LEG DESIGNER AND O
/ R OWNER
0
a
N �
�
H Z
W � 3
�g
ti~-1 � T
�+_� x �
r-
�i O O
�_�
� ��
���
0
azs
_
�o
o as
April 10, 2009
QI REVISION MAY 5, 2009
�
BLOCK CROWN
FORWARC
CAB I N ET
LVD. INFIL
OF CABI�
FRAME �
RAISED P,
W/ EASEC
LIGh1T RE�
ELECTRIC
2Ya° FRAM
APPLIANC
TOP hING
BACKSPV
COUNTER
EASED EC
FRAME � I
DRAWER-
FRAME � PANEL
RAISED PANEL D
W/ EASED EDGE
EUROPEAI
FRAMELE`
CABINET E
TOE KICK
CABINET DETAIL - TYPICAL
� SCALE: 1 1 /2" = 1'-0"
WD. Sh1
WD. TO
ADJ
St1 ELVES
CLOSET - LOOKING WEST
2 SCALE: 1 /2" = 1'-0"
�RAWERS
SCRIBE TO ALLOW
DRAWERS TO
OPEN W/ COATS
11ANGIN6 ON
ADJACENT WALL
qSTER
FLUSh PANEL
3 PANTRY - LOOKING WEST
SCALE: 1/2" = 1'-0"
NOTE: ALL INTERIOR ELEVATIONS
MAY BE SUPERCEDED BY INTERIOR
DESIGNER AND/OR OWNER
a�
0
oN
cn h
E� �
UZ
F� o `
�]
ry fy F•
xj x U
U t"
Q o0
�
ao�
0
� Z
�o
a=;
�o
� a>
April 10, 2009
QREVISION MAY 5, 2009
5
TV CABINET - N.I.C.
SCALE: 1 /2" = 1'-0"
-LUS11 PANEL W/ TV
�IOUNTING ARM
lVD. TOP
STORAGE W/ ADJ.
Sh1ELVES
n
0❑
FIXED PANEL
FRZ
KITCHEN - LOOKING EAST
��
o I o
o I o
BLIND CORNER UNIT
(hAFELE)
�— TOE KICK
OBIQUE VIEW OF
COR ER CA NET
��
i�
�n►i� `J�
� ��
I
� �
� _
�
�
�
APPLIANCE
GARAGE WITt1 TOP
f11NGING DOOR
TILE BACKSPLA511
STONE COUNTERTO
PULL OUT CUTTING I
BOARD
SCALE: 1/2" = 1'-0"
°` 1'V W �K;
N � REMODEL�
��
� � � 1613 Berne Cir�
� ? � Fridley, MN
xo�
�_<
NOTE: ALL INTERIOR ELEVATIONS w°o Ul le� ArC
a o w Int� ational Marke
MAY BE SUPERCEDED BY INTERIOR �? � Z 275 Market Street S
� z` � Minneapolis, MN
DESIGNER AND/OR OWNER o+} s
� Q o phone: 612-692-8850 fax:
April 10, 2009
QREVISION MAY 5, 2009
�
�
CROWN
C3:7'
.
STOI
COU
OUT
>RAGI
-TLE `.
L OU-
JFUG
)ID C
'LUM
,
BAR - LOOKING WEST
� SCALE: 1 /2" = 1'-0"
BAR/ KITCHEN- LOOKING SOUTH
NOTE: ALL INTERIOR ELEVATIONS
MAY BE SUPERCEDED BY INTERIOR
DESIGNER AND/OR OWNER
vJ
SCALE: 1 /2" = 1'-0"
�
0
0
N �
�N
H �
W � 3
ti~-1 � T
w Su
�
��/1oo
�1 � J
W � �
� s "
�
�¢o
aZ�
_
ro
o�>
April 10, 2009
QI REVISION MAY 5, 2009
7
NOTES:
• ALL OUTLET PLUG MOLDS TO BE
h11DDEN WIThIN UPPER CABINET ChASE
• CONSULT W/ OWNER ON M N
SWITCt1 ON DECK.
( AB ( FOit
� �nnicRO) _ UCP ¢
I
.
;
, _ r .
P '
, —_._ _f 4
I P �
(I CP
�
�
�F.)
\ �\\\
� �\ `
c1EC:ai
TO EXIST.
SCONCE
�z�z�i
LIVING RM.
MAIN FLOOR ELECTRICAL PLAN
TO EX�
FIXTUf2E -
SwITCti TO
fZE M AI�I �
�� ENTRY (�
I � — _ _ � � __ _. _.
iI
, �� ----
� I _ R3 ( W IXTURE,
�.� i� _�� `' EXISTI
� UGti-IN TO
I
3 I �? RE AIM
0
PLUC MOLD
� -- ---- ----. .
3-_ € ......_ _...----
> i
' € tCI
CL,� \
HALL
��
/�
��
/�
��
BA7H
FAMELY RM.
NOTE: CHANGE OUT TRIMS S Y10USINGS
OF EXISTING RECESSED CAN LI6tiT5 TO
MATCh NEW 4" RECESSED CANS IN
KITCHEN/LIVING RM.
SCALE: 1/4" = 1'-0"
NORTH
ELECTRICAL KEY:
¢R RECESSED CAN } SWITCti
� DIRECTIONAL LIGt1T �,3 3-WAY SWITCH
R AIM AS SI10WN
#4 4-WAY SWITCti
�I WALL SCONCE
w VERIFY YIEIGYIT � DIMMING SWITCH
� FLOOD LIGIIT • DUPLEX OUTLET
FL VERIFY 11EIGYIT �
DUPLEX OUTLET ABOVE
♦� CEILING MOUNTED tAe
SURPACE LIGt1T j SWITCIIED OUTLET
♦P PORCELAIN SOCKET � FLOOR OUTLET
�UCP UNDER CABINET PUCK LIGIIT � FLOOR OUTLET SWITCYIED
�ICP IN CABINET PUCK LIGtiT � QUADRAPLEX OUTLET
�CP CEILING PENDANT LIGYIT Q TELEPIIONE JACK
¢M MONOPOINT LIGIIT � COMPUTEWDATA
VERIFY REQUIREMENTS
� UNDER CAB. STRIP LIGhTS CABLE TV JACK
H STV
UCP� UNDER CAB. PUCK LIGYITS
�� FLUORESCENT LIGtiT C LING MOUNTED FAN
o CF
F FAN
�FL FAN LIGhT
GD GARAGE DOOR OPENER
� SECURITY SYSTEM
� STEREO SPEAKER
� SMOKE DETECTOR
O° DISPOSAL
� POST LIGt1T
CONSULT WITFi OWNER CONCERNING OUTLET
AND OTHER LIGt1T REQUIREMENTS, EXTERIOR OUTLETS,
SMOKE DETECTOR LOCATIONS, ETC.
CONSULT WITI1 OWNER ON SECURITY SYSTEM,
TELEPYIONE, CABLE, STEREO SYSTEM
AND 0TI1ER COMMUNICATION SYSTEMS
1- ! o POWERS
; ` °�
, ------ — H z REMODELING
�� 3 1613 Berne Circle East
W
, �, o �
I x x � Fridley, MN 55421
i ��
oo
� ; � � Quigley Architects
� � ° International Market Square
� 5 Z 275 Market Street Suite 443
� Z � Minneapolis, MN 55405
�
O a°s phone: 612-692-8850 fau: 612-692-8851
April 10, 2009
QREVISION MAY 5, 2009
•
G)� CJCi� �'
Building PLUMBING Permit No.:
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY vate xec'd:�� �
763-502-4977 FAX EFFECTIVE 2-19-09
DATE �'' [ 7" o( YOUR E-MAIL ADDRESS
SITE ADDRESS r� C3 �� R N£ CI�L� L
THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR
PROPERTY NAME: OL(J��
OWNER/ ADDRESS: CITY STATE ZIP
TENANT
PHONE:
CONTRACTOR NAME: L. SO N �L C3 G- lUC -
SUBMIT A COPY OF
YOUR STATE STATE LICENSE # p2 7 S�� 'Y►'� EXP DATE
LICENSE, BOND AND STATE BOND # EXP DATE
CERTIFICATE OF ADDRESS: � �� 02 �/�V ��I �-C[TY CO� r%�%�S STATE rn� ZIP �sya/
INSURANCE
PHONE ZCn s � � `�Y �6�(�( FAX
PERMIT TYPE ��NGLE FAM[LY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: � NE�' �EPLACEMENT
DETAILED DESCRIPTION OF WORK
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE
$35.50.
d BATH SINK/LAV FLOOR DRAINS � SHOWER WATER PIPING
BATHTUB GAS PIPING (NEED CITY LIC) SWIMMING POOL WATER SOFTNER ($3
CLOTHES WASHER i KITCHEN SINK ! WATER CLOSET BACKFLOW PREV. $1 )
� DISHWASHER � LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION
WATER METER OTHER
Number af fixtuxes @ $10.{�4 ' x $10.00 = �� ' ' ; ,
Nwnberoffixtures��@�$l�.fl��"� � x$15.00—$ �
�Itir�ainber of fixtures @� $35.pQ : � x $35.00 = $ �
i �ta�� S��rcl�arge �� � � $ � �0
,
�I ' ` � ,
�I � �t�i��33�iV'[[JM $35.50 �� Tc�ta3 = $ �i Gi .° �"`�
i;__
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an applicati or a permit a work is not to start without a permit on site; that the work will be in accordance
with the approved plan in the ca o all c requires review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME O�'V f 0 /�' Q L Sa � DATE �"� 7� O�
� �
�:�_ ���� �����'���'' � �§ ��+��.��III�`T_�"�r; �L`��'`� ',�.. �, � '�:
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 �
FAX: 763-502-4977
Building
Inspections
763-572-3604
763-502-4977 FAX
MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTIVE 2-19-09
Permit No.:
Received By:
Dat��13: I
DATE - `� � �! :% � / YOUR E-MAI L ADDRESS Z- O yvi e n, /�. �� hn 3� �.� I� wl E: �/; a�:' r'� /•'- � t
SITE ADDRESS � I., i'=� Ih C i �nl � � ��.i '� C
THIS APPLICANT IS
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
❑ OWNER �C6}JTRACTOR
NAME: �/� 7 li E�' /N E: ��N E��
ADDRESS: •:.�,q,�t t- CITY STATE ZIP
PHONE:
COMPANY NAME: L� ,,�i. I G, M� G
CONTACT PERSON: -1` �,vl C 1� l_) v
N � .
STATE LICENSE # EXP DATE
ADDRESS: ��� I S�J N FI �/-{ �/� /�'E G i�, CITY �' A� S� �! STATE�ZIP S S�=�
PHONE _ �' v� _ � Z 3 - �� � � s FAX ��: ; - 5 �� " °J ,/ � ' �
7
PERMIT TYPE �� SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: � NEW ❑ REPLACEMENT ��ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK �� - ;z,, �e ��; � f� �; � ,�� ;'• �,,� c �i,,� C s 7"� ,b� � E�Z
�" �'����.� t� '��i,��r-P I �' � N � �" � L�z�T r �
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NLIMBER OF EACH BELOW)
Equipment Installed MFG: MODEL: SIZE/BTU
MFG:
MODEL:
SIZE/BTU
MFG: MODEL: SIZE/BTU
A/C $25.00 FIREPLACE (GAS) $15.00 � GAS RANGE/OVEN $10.00
AIR TO AIR EXCHANGEER $IS FIREPLACE (WOOD) $35.00 NEW GAS GRILL SI0.00
BOILER $35.00 FURNACE $35.00 GAS UNIT HTR $10.00
CHIMNEY LINER $10.00 �GAS DRYER $10.00 POOL HEATER $35.00
� DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
� �lun�ber- of f�xtures�@ $10.0(i`� : � x��$ � Q00 �_ $ �= � . <.' . �
Nucnber of fi�tures ,�7ct $15.40 " x$ t S.00 =$
Number of fi}ctures �� $25.t3t1 x $25.00 = �
Nurn��;�- c;�� fixtures � $35.00 x $35.00 - � .
State Surc}large = � .50
,�
(MINT11!I.UM FEE �35.50) '�'r�tal = � ` �.:> z`�', '� �`
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and 1 acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an applicatio�for a permit a�yd work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of all work which'requires review and approval of plans.
' `I �
SIGNATURE OF APPLICANT ', �-�./-- PRINT NAME � F� v M A� E�i i J�.M DATE� Z I '��'
L__ r —�
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3 . V enting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction IMC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make-up air calculations.
Building MECHANICAL pe�it No.: j. �`'`'� -� I�o�
Inspections RESIDENTIAL APPLICATION Receivedl�By:�� _ .
763-572-3604 CITY OF FRIDLEY nate��C�..�.1
763-502-4977 FAX EFFECTIVE2-19-09
DATE 0 S YOUR E-MAIL ADDRESS
SITE ADDRESS �Q I 3 1.>C �%�'e �+ r
THIS APPLICANT IS: ❑ OWNER �CONTRACTOR
PROPERTY NAME: K� e w� �
OWNER/ ADDRESS: �G ( (�e f� � C� r CITY /r 1��� � STATEM�I ZIP�/
TENANT pHONE: 7�l3 -.S 7 I- 3�• y S
CONTRACTOR COMPANY NAME: HeSRh � H�� T �
CONTACT PERSON� • g a� 9A�S12O8O
SUBMIT A COPY OF ��
YOUR STATE STATE LICENSE # 2700 N. Fairvisw Ava. EXP DATE
LICENSE WITH ADDRESS: gFt/833-2561 CITY STATE ZIP
APPLICATION
PHONE FAX
PERMIT TYPE �SINGLE FAMILY � TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: �NEW ❑ REPLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF W ORK t nc � �+ \ � (a�. S F: r t P�u �� �-+� L� R S (��e
FEES ARE BASED ON 510.00 PER FIXTURE, EXC�PT WHERE NOTED. FIXTURES: ( DICATE TOTAL NUMBER OF EACH BELOW)
Equipment Installed MFG: �•l �G� F^ V I o MODEL: �� -� N SIZE/BTU �t��
MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZEBTU
A/C $25.00 �FIREPLACE (GAS) $I5.00 GAS RANGE/OVEN $10.00
AIR TO A[R EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GR]LL $10.00
BOILER $35.00 FURNACE 535.00 GAS UNIT HTR $10.00
CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00
DUCT WORK $10.00 �GAS PIPING $10.00 VENTILATOR $15.00
F=-- -------- ---_�___._
r �
�uznberoffixtuxes�{a�$l0.tl� x�;�(�.i�i}��'�=� �'�:�'
i
� Nur�3ber of fixtures 'r{�� $IS.00 ;�_ x $15.00 = � , ��'
Nunlber of fixtures {a� $25.(�(? x �25.OQ = �
Nun�ber of fixtures rr $35.40 x$35.0(J' _�
State Surcharge = $ .50 `
� �
MINIMUM FEE� $35.54 Tota1= �$ �` 1 � °�� - � � � � � � � � � ��
THIS IS AN APPLICATION FOR A PERMIT-NOT VAL1D 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 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 approval of plans.
�� /— (� � C}
SIGNATURE OF APPLICANT ���— PRINT NAME�� V i � !- r' � S v� e DATE S U/
APPROVAL INSPECTORS SIGNATURE DATE
��; � y�. �
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
� NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR
.�M ,tHi{,u! :..<�,,. , .. . . . , i; :
^nTt�y ��' +1!ii.rrt':,�)irs�ri-i ,,:�t.
t?BGSr�C: c,2n���i�
.`qVi� 1'rfli�'TlR� ,� Q'���
REQUIRED FOR NEW/EXISTING HOMES .-. ..� :�u y�;�y,� :;��
.. : ��!�i•..
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
4. Heat loss & cooling load per room
a. Required on new construction IMC l 346.0312
5. Ventilation
a. Per MN Rule Chapter 1322
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make-up air calculations.
Building MECHANICAL Permit No.: _ 1- �
Inspections RESIDENTIAL APPLICATION Received By: �
763-572-3604 CITY OF FRIDLEY nate�: AUG 20 9
763-502-4977 FAX EFFECTIVE 2-19-09
DATE � YOUR E-MAIL ADDRESS
SITE ADDRESS � L��_l� C r n i t G; r F
THIS APPLICANT IS: ❑ OWNER f�CONTRACTOR
PROPERTY NAME: r'" Po ... r-
OWNER/ pDDRESS: /�i �� v G rr1 i e C: �� CITY /� l � �� STATE '��1ZIP s.�y�(
TENANT pHONE: '�� � s? /— d3 G S/ S
CONTRACTOR COMPANY NAME: HeBRh 8� HOrt18 T �
SUBMIT A COPY OF CONTACT PERSON: d a r 12080
YOUR STATE STATE L[CENSE # 2700 N' F��n�� w� EXP DATE
LICENSE WITH pDDRESS: 851I�'ZSd� CfTY STATE ZIP '
APPLICATION
PHONE FAX
PERMIT TYPE �SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: � NEW ❑ REPLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK jn � q(� l� a g F�t_,p�� w� Lv n S �` r. e-
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
PROVIDE I-IEAT LOSS CALC'S PER MANUAL J 2006 SH[tAE HANDBOOK.
Equipment Installed MFG: p MODEL: �, - T�t SIZE/BTU �
MFG: MODEL: SIZEBTU
MFG: MODEL: SIZEBTU
A/C $25.00 FIREPLACE (GAS) $I5.00 GAS RANGE/OVEN $10.00
AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00
BOILER $35.00 FURNACE $35.00 GAS UN1T HTR $]0.00
CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
Number of fi�tures @$1 t3.00 x$10.00 =$
I
'Number of fiYtures � $ I �.gt�` x $15.Q0 = $�-- '; ,
,
�� `I�3umber oi fi?�tures @ $25.{3(} ` x $25.Of? >= $
�^vt�mber of fixtur�s �7 $35.00 a $35.04 '– $
� � - —
�
State Surcharge – $ .�0
� �. °� � ., ��
{MINIMtJM FEE �35.50 Tota1= $ - , _� � ^
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 wil] 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 quires review and approval of plans.
SIGNATURE OF APPLICANT � PRINT NAME ��,[_ ✓�� �/� r�_�I�fE � O
APPROVAL INSPECTORS SIGNATURE DATE
- x; - �
�b
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS � EXISTING HOME ❑ MAKE-UP AIR
:in; .'riG ;';I,,i?;:.7�, , E;:t: iy �; r!*ti;;;. ;
A^]CF� ,� •'t;li,iiPi dp!?'G+lii 6dl)
OciO�t:?OS t�,n,��g�� l
.:�kA woiYniai �+! 001�� _
REQUIRED FOR NEW/EXISTING HOMES +�+ ��r ►�M ,9rr;��.r�,x;
►�s-�sa� � z�
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments MN Rule 1346 Sec. 501
__ 3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments .
b. Fuel other than gas IMC Chapter 8 with MN Amendments
4. Heat loss & cooling load per room
a. MN Rule 1322, Sec. N1104.4.13
5. Ventilation
a. Per MN Rule Chapter 1322. Sec. 1104
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make-up air calculations.
- , r
�
� � ..
r . �
0
K
� F.'- �.
� OlYltri�' �7
APPLICATIO�I FOR BUILDING PBRMIT
CI3"Y OF FRIDLEY, MIN;�IESOTA
``„'"Z, � '
ifl ♦
�
ADDRESS � ADDRESS��� , ��� f��: �� �
..� _..._.. ,.,.r...`
LOCATION OF BUILDING
N0. 1a����� STREET��.L�,� , � PART OF LOT ,
LOT �Li3 BLOCK � ADDITION OR SUBDIVISIONC�dG���' `/�y'�����
CORNER LOT INSIDE LOT ,� SETBACK ��� SIbE-YARD� , f�p �„r �
SEWER BLEVATION FOUNDATION ELEVATION� -
Appiicant attach to this fosm Two CertificaCes oi Survey of Lot and proposed
building lacation drawn on these Certificates.
DESCRIP'TION OF� BUILDING
Ta Be Osed A�:
e� �____ Front � ?� Depth Z � � � � Height � S��%��1 , � 8 �
-�------
Sq. Ft. �?_:�_ /�i�o�% Cu. Ft.
i. i rw�
��rz� Froat �-� Depth � Height��_
� r � a---��... �
G/ `>
Sq. Ft. ��� A Cu. Ft. ��Z S� D
T e of Construct3.on �, f`��, �i �,�„"_ � s`� -�O ��p
yp � Estimated Cost ti �
To Be Completed
The undersigned hereby makes application for a permiC for the work herein speci£ied,
agreeing to do all work in strict accordance with the City of Fridley Ordinances
and rulings of the Department of Buildings, and hereby declases that alI the facts
and representetions stated in this application are true and correct. �)�—
�,-//� .� --.�---
�`
- - ��� _ _ O /_ i� / � -- -- - ----�i� �/1 � �
(Schedule of Fee Costs can b� found on the�verse Side).
��oo S� C. C.
�5� � • �,�'`�l
� �°� �� •
l5� �
�
w� l��- �
. .-,.