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AF - 40760City of Fridley, inn 6431 Univeraity Ave. N. E., Mmneapolis, Minn. 55432 BUILDlNG PERMIT .1: _ _ . �,,:��.��. �� Viewcon, Iac. Builder Same ,A,d�resa _ 5901 Brooklyn Boulevard ,p,d�s Same ��i � , .e LOCATIOW OF BUILDING No 55� Street _ East Q}�er],in C:irc_�_ PaTt of LOt Lot T� Slock - �i Addil3on or Sub-Division - �*+,�.��,.�.�.}�e�.}� �� Coraer Lo� Inside Loi Setback Sideyard 9ewer IIevai:Yan Foundatlon IIevation DESCRIPTION OF BUILDING To be Used as: 1496 T�wnh oi s e Front � Depfih �� Height _ 2.�� Sq. Ft. � Cu. Ft � 2�2 Garage Front 20 � Depth 22 � Hei�ht 10' �. � 440 �� 4,400 q•y� �p �� Wood Frame �� 25 , 416 . 96 To be Completed 1-15 -73 Stipulations: Owner and contractor to be respoasib�e for elevatious and for drainage for a11 structures and the City shall be held blameless, Construcgion muse comply with U.B.Ce 505 Cl, C2 & C3. See Attached sheets - use figures 5, 9,XlB� or 10. In consideral3oa of the issuance to me oE a permit to construcE 'the building described above, I agree to do � proposed work ia accordance with the deseciption abov�� P� and in compliance with �11 provisionst oE Ord�ancxa of the dty of Fridley. � l o ..y In consisieral3on of tbe paymeat of a fee of � � �• 5� , permit is hereby granted to V iewc oa, Xnc . to construct the building or addition as descrlbed above. This permit is granted upoa. the express condition that the person to whom it is granted and his agents, employees and worlunen, in a11 work done in, around and upon said building, or any part thereof, shall conform in all respects •to the ordinances oi T+'ridley, M3nnesota. regarding location, construction, alteration, maintenattce, repair and moving of builcling� �1�� dty ]imits and this permit may be revoked a t any time upon violation of any of the provisions of seid �� y � Buildin8 Iaspector D�iRREL CLARK NOTICE: ffiia permit does not eover the eonstrucHon, installation for wiring, plumbing, 8es heaHng, sewer or water. Be sure to eas� t6s Building lespeetor for aeparate permits for these ifems. � �, r .- � APpLICATION FOR RESIDENTIAL, ALTERATION, OR AllDITION BUILDING P.£RMIT CITY OF FRIDLEY, MINNESOTA OWNER' S NAME : �//twti.. ..�ht. BUILDER: S4a�, � ADDRESS :__�590/ �Qi�io�/�s� �ou�ivqra/ ADDRESS : �O� t NO:. S.T.Zi STREET: L�Al� 0.6<s��%� C�%`c�C d. C LOT : "� BL�K : '� ADDITION : ,I/�rs�/�•rt� �.��!� .��' � CORNER LOT: INSIDE LOT: � SETBACK: SIDEYARD: � Applicant attach to this form Ztao Certificates of Survey of Lot and proposed building location drawn on these Certificatea. � DESCRIPTION UF BUILDING To Be Used As: '7s� /J►o•�Jt Front: .Z'Q� Depth: 3�� Height: �8� /4'9G . ' Square Feet : 74d Cubic Feet : a�� 8$L �—�- ..-•.- �►ad�e'G Front: 20' Dep'th: 22' Height: /O� Square Feet; '9�0 Cubic Feet: '9�00 1�rpe of Construction: ivOOd f�'Q�b.t Estimated Cost:_ $,ZS4/le.qCo P To Be Completed: /" �+r� 7.� The uadersigned hereby makes applicativn for a permit for the work hexein specified, agreeing t� do all work in stfict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hexeby declares that all the facts and representations stated in this application are true and correct. DATE : 8�2 t— 7 Z SIGNATURE :�� -w- � ��irr✓ (See Reverse Side For Additioual Information.) � Ha,OD S. i: ot3 -�Z' P'C' --�'''��o � ;� �3. � r s .� BUILDING PERMIT FE� SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building or structure, or for any addition to a,ny existing building or structurea or for any alteration or repairs to any eaci��i�� building or structure, upon application therefore� r�q�ir� �� p�� he applicant for such permit of fees to the �mo�� gei� b�� the manner herein provided to-wit: UNtFORM BUILDING CODE t 1�pe 1, 2& 4-$2.15 for each one ittaosasa�d cutsic feet, or fraction �hereofe in such cubical conitentsa �rpe �& 5-$le�� for g�ch one thou��d ��ab �ic £e�t. ADDITIONAL INFORMATION For the puxpoae of computing fees for building permits, the cubical conte�ts of any building or addition, is determined by �ltiplying the ground �rea covered from a point six (6) inches below th� floor lin� of the basement o� the cellar to the �v�r�� kaeights of th� upper sux£ace or to tlae avera�e h�i�ht of the �oof �ugface� of ttae aa�in gable of ,� �itched rouf. For repairs or alterat��ns to an e�:i�ging sta°ucture, �he fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. In no case shall the fee charged for any permit as set forth in Section 2 be less than $5.00. VBRIFICATION OF FOUNDATION NOTE: Permits for constructi�n will be issued a minimmim of 24 hours from the time of application, to allow for proper review of the proposed structure and of the construction site. � A Certified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before proceeding with the framing. CERTIFICATE OF OCCUPANCY Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or eccupied until a Certificate of Occupancy has been iseued. . 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Ai�� v � � °"� �roR� � « a y ��7A Li . ��, �+ 'N ��' � a �'GA�'90� � ^�°0y �� o �� « c 'o -cs U hW� � T � �� 4iJ : S� � � � d� � � � � y W � V � � � � . � � q ��.�� a � � r. . � � .�.. d � � d � N � � � � � ^ � ��W�. a � � a a x � l � .. � � � � • � _ �I c � � �; o � �3 .� � O x � ee� ca �s e5+ � � � � � o :h cg � eo � � . � ,e � ' � � � � � � r1 .x � a � �� `y � o � °�' ��.�a a � � � � � � q � � � � � � � � aQ .O O. 0 F � � � � � w � .� a 0 � � � � :� W 3 � z � O �l � � 0 ��'i � i 1 M Q9 6�$ 6H �� R � � � � 0 o c�: co �o � H �� '� O � M � a A W ; �� J H � � � �w � �,��`-, °a�, oo� e+, p �*s �G v`i :� � � � � i � � A �, .�, w w �:=�� ' � � � $ �' Q+ � N M N � � U; 'O 'q o � � W � �� 0 � � � � � � 0 Gy � � � O � � � d � � � � u 0� � 4 � � ,, O � � O H '� x� .� �� M � O � a Q� a 0 � � � 0 � � � ��v� I � � � I�J � ' � � � � v � � A I kl � • . _ (� � I . QPI 6 - 69 Q7i � w• � �=�� N � � � � �„� � � � �� U � � I � �• � � Go � � � � � . cn ...�,..�.. � ' � � �� . � � � � t' � � .$ � a, � X io E9 � p� ' � a a�Q �� M � •OC � �r. � .. '� C5 � � � � � � ��e:a &y �� ' c� � �>; � (:t +�'� �� F.,t ~`� � pK�� a � F* �aa� � �;a r5 F � �� . � � .� � � � � � � � � � Su8JEC7 c�ty of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � COMMUNITY DEVELOPMENT DIV. �' PROTECTIVE INSPECTION SEC. i ` _ � _'_'- r � ; � � ��"1 � CITY HALL FRIDLEY 55432 NUMBER REV. �"'"'�'� �'� 612-571-3450 910-F15 JOB ADDRESS 5527 East Oberlin Circle NE t LEGAL LOT NO. BLOCK TRACT Of; ADDITION DESCR. �F 4 Innsbruck North 2nd 2 PROPERTY QWNER MAIL ADDRES$ DATE 7/13/94 3 CONTRACTOR MAIL ADDRESS ZIP Dicks Fire & Storm 864 19 Ave SE, Minneapolis, MN 55414 4 ARCHITECT OR DESIGNER MAIL ADDRESS Z�P 5 ENGINEER MAILADDRESS Z�P 8 USE OF BUILDING Residential 7 CLASS OF WORK � NEw ❑ ADDITION ❑ ALTERATION C� REPAIR 8 DESCRIBE WOHK Reroof House & Garage (Tear-off); gutters 9 CHAN(iE OF USE FROM TO � PERMIT NO. 22694 RECEIPT NO. �� OF APPROVED BV � SEE ATTACHED SHEET PHONE LICENSE NO. 781-6170 2481 PHONE LICENSE NO. PHONE LICENSE NO. ❑ MOVE ❑ REMOVE STIPULATIONS Underlayment must comply with the State Building Code. Inform owners to install smoke detectors as per State Building Code, adjacent to all sleeping areas and in basement. TYPE OF CONST. SEPARATE PERMITS ARE RE�UIRED POR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTHUCTION ZONING AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAVS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED ' WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT � 2 ZLH DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE PROVISIONS OF ANY OTHER STATE OR LOCAL I.AW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �S�F.00 PLAN CHECK FEE License SC SIGNATURE OF CON i RACTOR OR AUTHORIZED AGENT IDATE� W�E�{�PR�S l OCCUPANCY GROUP OCCUPANCYLOAD SQ. FT. CU. FT. OFPSTFiEET PARKING STALLS IGAFAGES Fire SC $2.22 TOTALFEE .00 $62.33 ' ALIDATED TH1S IS YOUR PERMIT � � � + naTE NEW ( � ADDN [ � CITY OF FR[DLEY ALTER [ J SINGLE F1�IVIILY AND DUPLEXES R-1 AND �-2 Building Permit Application ConstructionAddr�s: 5527 - East Oberlin Circle, Fridley Legal Description: Owner Nanne & Address: Tel. # ContraCtOT: R.J. Williams General Contractor MNLICENSE# Address: 864 - 19th AVe. S.E., Mp1s., Mn. 55414 Tel. # LIVING AREA: GARAGE AREA: DECK AREA:� OTHER: At#ach to this appGcation, a Cerbifica�e of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height Length Width � Hgt/Ground Effec;tive 1 / i /9� �� 2481 781-6170 Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks Type Of COIIStniCtioII: h o u s e&� a r a g e r o o f s, F,stimated COSt: $ 2� 218 . 0 0 Approx. Completion Date: g u t t e r s (Cost on Back) Driveway Curb Cut Width Naded: Ft. + 6 Ft — Ft x$. DATE: APPLICANT: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ $ $ $ $. $ $ $ $ $ ��M! .'f_ � = $ Tel. # � F� Schaiule on Reverse Side .001 of Permit Valuation (1 / l Oth %) 5.50/$1,000 daluation $800 �r SAC Unit $5.00 {State Licensed Residential Contractors) Alt. "A" or A1t. "B" Above $450.00 Conservation Plan Review Fee Determin� by Engineering Agreement Necessary [ ] Not Necessary [ ] I3UiLDiIYG PERMIT FEE SCHEDULE 1-hc Chiei liui(ding Utticial shall, t�efore i,ssuing �ec-Cnits for the erc:etion of any bui(ding or stnicture, c�r ti�r any aciciitic�n to any cxititi�g building or structurc, or for any alteration or rcpair to any cxistinz; (�uilding or seruclurc, u�n aJ�plication tt�crefore, rcquire the payment by the applicant for such �ermit ��f lccs t�� thc <tc►ioun[ f�crcin t�cib�v tct fort�� and in fhc ziianncn c�rei� providc�i to-�vit. 'ro�rn� v�r_tJc $1 [o $500 $SO1 to $Z,IX}0 $2,001 to $25,000 $25;001 to $50,000 ` $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,00p� . $1,000,0p1 and up F�i;[:S $15 (Minimum Fee is $i5 plus surcharge) - $15 for first $SOp p(us $2 for each additionai $100 or frac�ion thereof, to and including $2,000 � $45 for fust $Z,pQp p(us $9 for each additional $1;0�0 or fraction thereof, to and including $25,000 � $252 for f�.cst� $25,ppp pl�s $6_50 for each additional $1;OQQ or fraction thereof, to. and including $50,000 $414_SO for first $SO,OOQ plus $q..Sp for each additional .$1,000 or fractioQ thereof, to and including $100,000 $53950 for f�rst -$100,OQ0 plus �$3.50 for each additioaal � $1,(�0 or fraction thereo� to and including -$SOp,000 $2039_SO for die 5rst $SOO,pQp plvs $3 for each additionai $1,000 or fraclion thereof, to and including $1,000,000 $3539_50 for the 5rst $I,OOQ,000 plus $2 for each additional $1,Ot)0 or fraction thereof - DRIYEWAY DEPRESSION ESCROW (Concrete Ctirb Sireets Oaly) Aiternate "A": Removal and replacement of curb and gutter only - Driveway width plus b feet times $13_50_ Alternate "E3": Removal and replacement o� curb and gutter and instalI a 3 foot wide approach with 6 inch depth - Driveway width plus G feet times $15_75_ VER[FiCAT[ON OF FOUIYDAT[ON Permits for CU[1SlIZiCLIOii will be issuod a minimum of 24 hours from the time of a��lication to allow for pro�cr review o! tiie Exo��osuJ siructure and of the construcLion site_ A Ccrtificaic oi- Sucv�y of die tol, st�owing the tocation of thc foundation once it has it has hccn construciui will i�c requ+rcd f�etore prc�ceedin�; with lt�e fr�tm�nfi- SuBJECT - . � c�ty of Fr�aley �� ,2� AT THE TOP OF THE TWINS B U I L D I N G P E R M I T � .,. — - ; � RECEIPT NO. � � _____ COMMUNITY DEVELOPMENT DIV. p I � � v � PROTECTIVE INSPECTION SEC. �-i�� 1 �'�'1 � CITY HALL FRIDIE� 55432 NUMBER REV OATE aAGE Oi nPaROVED Br �--"�' �'' 612-571-3450 910-F15 9/24/96 / / JOB ADDRESS 5527 East Oberlin Circle NE 1 LEGAL LOT NO. BLOCK THACT Oii ADDITION SEE ATTACHED DESCR. /{ 4 Innsbruck North 2nd SHEET 2 PROPEHTV OWNER MAIL ADDRESS ZIP PHONE W. Carlson 5527 East Oberlin Circle NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE UCENSE NO Coronado Enter rises 8282 Arthur St, S rin Lake Park MN 55432 786-2341 7950 4 ARCHITECT OR DESIGNER MAIL ADDHESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CIASS OF WORK ❑ NEW ❑ ADDITION ❑� ALTERATION ❑ REPAIFi O MOVE O REMOVE 8 DESCRIBE WORK Install Heat N Glo (S632) gas fireplace 9 CHANGE OF USE FROM TO STIPULATIONS Install per manufacturer's specifications. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PEFMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIH CONDITIONING THiS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOii A PERIOD OF 120 DAYS AT ANY TIME AFTEF WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GAFAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �900 �.SO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- @32.00 Fire SC �.90 STRUCTIO OR 7HE PERFORMANCE OF CONSTRUCTION. W ' PLAN CHECK FEE T07AL FEE .Zy License SC $5.00 $38.40 SIGNATUfi CON' TOAOAAUTNOA�2EDAGENT � ATE� WHEN PfiOPERI � ALIOATED THIS IS VOUR PERMIT �� 'v. �,;� i a�-9� SiGNATURE Of OWNERdF OWNER BU�IDERi IDATE� �-BL 3NSP qFTE NEW ADDN ALTER [l �] [] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Buiiding Permit Application ConstructionAddress: _ SS � 7 ��l S T o/3 ,� �•' �v f R Legal Description: Owner Name & Address: w. C� �� s eN Tel. # Effective 3/1/96 �- ��? � Contractor: Co4 `,�A � o E.v re�s oR, s.� MN LICENSE # o o c 7 9 s o Address: g� g�. ,q� y.y�,R s r, s��t.,vd GAK� �•o a� ��- Tel. # 7�p6 -� 3 y/ Attach to this application, a Certificate of Survey of the lot, with the pro�sed construction drawn on it to scale. LNING AREA: GARAGE ARE�: DECK AREA: DESCRIP'rIOIiT OF IlVIPROVEMENT Length Width • Height Sq. Ft. Length Width Height Sq. Ft. Length Width HgtJGround Sq. Ft. OTHER: S t'�' l�ra�r ,,N_ 6 Go � c Z ra s �..v.T � Corner Lot �] Inside Lot [] . Ft. Yd Setback Side Yazd Setbacks Type of Construction: _ Estimaxed Cost: $ 9 00, � Approx. Complerio� Date: . (Cost on Back) Driveway C�rb C�t Width 1Veeded: Ft. + 6 Ft = Ft x$ =$ DAT�: � APPLICANT: � �„u� ��- . Tel. # �gG - � 3 y/ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow �rosion Control Park Fee Sewer Main Charge TOTAL $ ��. �`%� $ � ��l� $ � $ $ �- �� C_' $ $ $ $ � �� `lC� CITY USE ONLY Fee Scheduie on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,0� Valuarion $900 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: , . . _ 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 $1 to $500 $SO1 to $2,000 $2,001 to $25,000 $25,0C11 to $50,000 $50,001 to $100,00Q $100,�1. to $500,000 $SOO,�Y to $1,000,000 $1,000,001 and up . FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,OQ0 $349.75 for �'ust $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $�0,000 plus $6.25 for �ch additional $1,000 or fraction thereof, to and including $100;(?(10 �887.25 for first $100,000 plus $5.00 for ea.ch additianal $1,000 or fraction thereof, .to and including $500,000 ' $2887.25 for �he first $5(?0,000 plus $4.25 for each additional $1,(i00 or fraction.thereof, to and including $1,0(}O,OQO $5�1�.25 for the first $1,OOO,t�?0 plus $2.75 for each additional $1,000 or fraction thereof � . DRNEWAY DEPRESSION ESCROW (Concrete C�rb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "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 constnsction 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 once it has it has been constructed will be required before proceeding with the framing. � rn L � c� � C � > U � lLl � L .� s � Z � � � F- Z � W > �� Z U � O W �i 0 U � �. � � � Z �, � W FW- g _ } m p � O �� z �z z° �o dz W U 3� oa a. o oQ �Z � O O Q U � a °L �� Z 0 H U W � w � Z � � � N } Q M W � � � � � � a� Z �. � _ � o O� �r�Di � I U � ti �i � W U � W Q � � � c � � � 'd � � - c � a � Y U Y O V ? .i'�' � � U a> � m � " r � � V � � � N : � � `o , 3 r �T d! U � = v Q C m �f tG � � m a� i U ` 0 o m •- •- o � m O t3 � � t�C U � � V � � O Q. N '� � Q. 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Q � � Z � ('�'� 9 � �� q F W � � � � � � g � g � C7 O li� Ef3 � I � � � r. � � �m�� o� ou�� '� _ � ; � �o��, v Q � �2�tL ��a � O � f+E3 � � Q G ��-•.;..,a �C � � � ,,��,. ._ � � O � � � � � �� Zu�,1� �.-. � � � m � o v v a. ° � � s �� h �� 0 z°�� Z � � a _ � � � � }- �� mm 1L9 �"1 � � v � � �. � �� ` � a �� m .� � � � �� z � ► ,� ►� ` �� N � W H � � �� V � � t� O V � 3 a � i� � �. �, a� C � . � � � . ` o r � � � r � : � � � � � o o �C .� Q � � � �, e � , � � �� -� o � � � � � U� � ��,J L1.. CC � � '� � ��A O � �V � � O � ' �. c� ` � c � 8 � � W N � � F � � � � v� � � � � O � �� W � � � F�- � c�� . i� Z U a �w a � � ° �HIlVI1dTEY A1VD STACK VE IFICATION � T�e undersigned hereby verif�s that the existing chimney or stack: 1. Has b�en carefully examined Yes (�) No () 2. Is f�� from rust or deterioration Yes (�� Na {) � 3. Has;;-no foreign object� Iodged within Yes (� No O 4. Is sec�irely supported Ycs (� No () 5. � '1. � IV�ts a�l ctarrent C�cle requirements t�rsize and total BTU's conne�ted - Has total heating I�TU"s of _��; � -� All o�ier BTU's — T4'�AL �TU's 75;� Iias a liner been pravid�d f�r water heater �ias combustion air been pr�svided for water heater Remarks: Y�s (v} No ( ) Yest)No() Yes { j No ( ) � s •- - L' �1',1 i a��►�NG co: s�� By: Date: :j �,+ �� ; o �� Add�ess� �r� ��t �IA� '' Otl�r � �at�o ; ; I \ � HW � _, _- i; T i' �RSAT Test Report 0 Sp�.ce �ieater ______ c R / 1 city i- � .. � .,..,._._ .--.-.---... � � �� '��c�� `-� � ...._.....�. -- �.�.�,. -..,,�.____�.-__._._ `�� ---�------r-- Unit Heater ______. n� ed � r/� � �° � Dat� 1°e�tcd ��, � �� ry� ��.�� _ _� ,,,r� 3. s� __ coa � � � _ . c� .__,�� __ O2 .� � �- .� � Te� �� co � � _____.� � ....�....._._..._._. _.. :.�� :� �. �? AMERICART HEATiNG & AIR SUPPLY �p i..,.�.�.. Na�ae o�`:: ester � �, ;i ,. , .� '� �; ;j ,. � �i ', . ;:; � � :, ;: .I � �i ; ; ,� ,� , ; I; � � ; , j, ; ,. �� ; � ' f i � � WALTER �SUFKA �� - AMERICAN HEATING & AIR SUPPLY, INC. 8347 UNIVERSITY AVE. N.E. SPRING LAKE PARK, MN 55432 (612� 750-3800 � 0 . . ave�c�� City of Fridley AT THE TOP OF TNE TWINS � � I L D 1 N G P E R M I T ;. � � � �y ��_ COMMUNITY DEVEIOPMENT DIV. r � � PAOTECTIVE INSPECTION SEC. � � _ . � �"'1 � CITY HALL FRIOLE� lkS132 NUwBEa nEV O�TE �----�� •' 612-57�-3a50 s�aF�S 12/28/99 lOB ADDRESS 5527 East Oberlin Circle NE LOT NO BLOCK TRACT Oq AbDIT10N PAGE Oi / / 3060� � RECEIPT NO. %9'�� 1PPROVED BY 1 LEGAL ' SEE ATTACMED DESCF. !} 4 Innsbruck North 2nd Addition SMEET 2 PiiOPERTY OWNER MAIL ADDRES$ 21P PHONE William Carlson 5527 East Oberlin Circle NE 574-1181 3 CONTHACTOR MAII ADORESS 21P PHONE LICENSE NO Window Lite Home Improvements 8400 89 Ave N, Brooklyn Park, MN 55445 20039258 4 ARCHITECT OR DESIGNER MAII AODRESS ZIP PMONE �ICENSE NO. 425-2227 5 ENGINEER MAII ADORESS . ZIP PNONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WOFK ❑ NEW O ADDITION O ALTERATION [� REPAIR D MOVE O REMOVE 8 DESCRIBE WOFK Replace garden window 9 CHAN(3E OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Pe�mit In�pec��n Gar�s �lill �e �aiie� To Homeo�ner To� Post SEPARA7E PEFMITS ARE REOUIRED FOR ELECTRICAI, PLUMBING, NEATIN(3, � rrc vr t,a�n,�. VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CQNSTFUCTION 20NING AUTMORIZED IS NOT COMMENCED Y�!ITHIN 80 OAYS. OR IF CONSTpUCTION OR WORK IS SUSPENDEO OR ABANDONED FOii A PERI00 OF 120 DAYS AT ANY TIME AF7ER WORK IS COMMENCED NO DWLG. UNITS I HEREBY CERTIFV TNAT I NAVE READ AND �XAMINEO TMIS APPLICATION 1 ANO KNOW TME SAME TO BE TRUE AND COFiRECT. ALL PROVISIONS Of LAWS VA�UATION ANO ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIEO WITH WHETMER SPECIFIED HEREIN Ofi NOT. TME GRANTING OF A PERMIT �1�945 DOES N07 PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL TN6 pERMl7 FEE PROVISIONS OF ANV OTHER STATE OF LOCAI LAW REGULATING CON- STRUCTION OF TME PERFORMANCE OF CONSTFUCTION $69.. ZS PLAN CMECK f EE Licen S�GNATUAE OF CON'aACTOA Oa vUTMOpIjEO AGENT IDAfE� ..,�.. ... �iF OWNEii BWLDERi iD�iE� IPANCYGROUP OCCUPANCVLOAD T CU fT. OFFSTREET PARKING STAI�S GARAGES ' $.97 SAC CHARGE Fi SC $1.95 TO AL FEE $77.17 1 IT rrEw � � EwDN Il ALTER [ ] Construction Address: I.egal Description: Owner Name & Address: � i� � o Contract Address: Effective 5/10/99 CITY OF FRIDLEY Sl1i TGLE FA1�Y A1�1D DUPLEXES R-1 AND R-2 �'� �o /� �� BUII.,DING PERMIT APPLICATION LIVING AREA: GARAGE AREA: DECK AREA: OTI�R: Acracn to [tus app�icat�on, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DE.SCRIPTION OF Il1�IPRO�EII�IENT �ei. # cf `%i�- l/�/ :ErrsE a �1 D4.39��'"� Tel. # ''�a�c5 = ��_r'f �n� Width Height Sq. Ft. �nb'� Width Height Sq. Ft. �n� Width Hgt/Ground Sq. Ft. Construcdon Type: � /� °� Estimated Cost: $ ,� `7'c� � �� Driveway C�rb Cut Width Needed: Ft. + 6 Ft = DATE: Permit Fee Fire Surcharge State Surcharg� SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee �Sewer Main Charge Ft x $ - $ . $ 1.�5' � r $ , �7 $ $ v�' Ov $ $ $ $ CITY USE ONLY Tel. � J � � Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) �.SO/$I,C�t�i) Vai�tion $1050 per SAC Unit $5.00 (State Licensed Residendal Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] � � � �p�� TOTAL $ � �•I� /� S1'Il=ULA oNS: ��-��(J/� �ir�.a�C �7'��'� l-� u L�� q.Jo �.� ��L ��.� �'.�/� �r.r�� '2 �,�c .- �3/O. 9. /.. � /� j�7 � /,�;-��-� ' BUII.DING PERA�IIT 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 $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 $S00 plus $3 .OS 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.OU for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each addidonal $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 DRIVEWAY DEPRESSION ESCROW (Concrete �b 5�reets Ur1y) � Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "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 $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper r�view of the proposed shvcture and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. � sue�cct IT NO. City of Fridley 310 4 ' s ` � AT TME TOP OF TNE TWINS g U I L D I N G P E R M I �pT NO. � ; � ��.� COMMUNIri OEVELOPMENT DIV. �� r � � PROTECTIVE INSPECTION SEC. 1 . . � � �"'1 � CItY MALI fRIOLEV SS�J2 NuMBEp 11EV O�TE PAGE oi AvoaOV80 Br �.�.� • �.� 612-571-34b0 e�aF�s 6/8/00 / / � �oe �ooRess 5511,15,19, 23, 2T, 31, 35, 39 OBERLIN CIRCLE 1 LEGAL �OT NO. BLOCK TRACT OR AOOITION SEE ATTACMEO OESCF. ', 1-8 4 Innsbruck . North 2nd SMEET � Z PROPERTY OWNEii , MAIL ADORES$ ZIp PMONE Innsbruck Townhome Association � � 651-224-5482 3 CONTAACTOR MAIL ADORESS ' ZIP PMONE UCENSE NO Garlock-French Roofing Corp. 2301 E: 25th St., Mpls., NW 55406 612-722-.7129 � ARCMITECT OR OESIGNER MAIL AOORESS ZIP PMONE LICENSE NO. 00001423 S ENGINEER MAIL AODRESS ZIP PNONE LICENSE NO 6 USE OF BUILDING r �Residential 7, CLAS80F WORK - O NEW O A�DITION O ALTERATION X] REPAIR O MOVE O REMOVE . 8 - ESCRIB WOR(( l�eroo� Building 9 CMANOE OF USE fROM TO STIPULATIONS Underlayment must comply with the State Building Code. ti �er�nit Bnsp�ction C�rds l�1i9� �� at9�d� '�'o Hom�own��`°'�� osi ,-. SEPARATE PERMITS ARE REOUIREO FOR ELECTiiICAL. PLUMBING, MEATINd, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY �OAO VENTILATING OR AIR CONOITIONING. THIS PERMIT BECOMES NULL ANO VOIO IF WORK OR CONSTRUCTION ZONIN(3 SO. FT CU iT. AUTMOR12EC IS'NOT COMQAENCED WITHIN 80 OAYS. Ofi IF CONSTRUCTION ' OR WORK IS SUSPENOED OR ABANOONED fOR A PERI00 OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED.. NO D�11LG. UNITS OfFSTAEET PARKING I ME�iEBY CERTIfY ?MAT I MAVE REAO ANO EXAMINEO TFIIS APPLICA710N H STALLS GARAGES ANO KNOW TME SAME TO BE TRUE AND CORRECf. ALL PqOVIS10NS Of �AW$ yp�UpTION SURTAX ANO OROINANCES GOVENNING TNIS TYPE Of WORK WI�L BE COMPLIED WITH WMETMEti SPECIFIED MEREIN Oii NOT. THE GflANTING OF A PERMIT ��.C)�ZZZ. HS .�8. �.�. OOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL TME pEFM1T iEE SAC GMARGE PROVISIONS OF ANY OTNER STATE OR LOCAI LAW REGULATING CON- STRUCTION OR TME PEIiFORMANCE OF CONSTqUCT10N �2%9. ZrJ Fire SC $16.22 PLAN GMEGK FEE T TAL FEE 303.58 S�GN�TUpEO�CON•f1ACTOpOf1�UiNOp�1ED�GENT �O�rE� yyM PRO Y� D THIS IS VpUp PE;M�T� I � S�GN�TUAE O� OWNEp�� OWNEpBU�IOEp� �OAf BL �hSO ryatt City of Fridley AT THE TOP OF TME TININS g U I L D i N G P E R M I T r i • � � � `v _____ COMMUNITY DEVELOPMENT OIV. r � � Pf10TECTIVE INSPECTION SEG. 1 . � i._-.�� '�' �'� CITY HALL FRIOLEr SSI$2 NUMBER pEV DATE vAGE OF t 612-571-3450 gt0-F15 10/12/00 / / JOB ADORESS 5527 East Oberlin Circle NE t LEGAL �OT NO. BLOCK TFACT OR ADOITION DESCR. !} 4 Innsbruck North 2nd Addition 2 PROPERTY OWNER MAIL ADDRE$$ ZIP PNOI� 3 i �76 to�1 � AOVED Br SEE ATTACHED SHEET Dorothy Carlson 5527 East Oberlin Circle NE 763-574-1181 3 CONTfiACTOR MAIL ADORESS ZIP PHONE LICENSE NO Wellington Window & Door 3938 Meadowbroolc Rd, St Louis Park, MN 55426 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PMONE UCENSE NO. 952-953-6300 City 5 ENGINEER MAIL AODRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CIASS OF WORK O NEW O ADDITION ❑ ALTERATION � REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Replace windows 9 CNANdE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. �ermit I�r�?��tio� Cards lN�� Iled To Nom�� o Po�� TYPE OF CONST SEPARATE PERMITS ARE FiEOUIRED FOR ELECTRICAL, P�UMBING, MEATING, VENTILATING Oq AIR CONOITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING AUTHOFi12ED IS NOT COMMENCED V�1ITHIN 80 OAYS. OR IF CONSTRUCTION Ofl WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT ANV TIME AF7Eq WORK IS COMMENCED. NO DWLG. UN I HEREBY CERTIFV THAT I MAVE REAO ANO �XAMINED THIS APPLICA710N 1 AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UATION ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL 8E COMPLIEO WITH WHE7HER SPECIFIED HEREIN OF NOT. THE GRANTING OF A PERMIT �Z,099 DOES N07 PRESUME TO GIVE AUTMOAITY TO VIOlA7E OR CANCEI TMB pERMl7 FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON- STqUCTION OR THE PERFOfiMANCE OF CONSTRUCTION $83.25 $�GN4TUAE OF CON'i7ACTOp ON AUTHOA�ZED OGENT IOATEi �1 A,�� iD�iE� �� SQ. FT OiFSTRE STALLS SURTAX ` $1.05 CU FT f PARKIN( GAFAGES CV LOAD �e SC $2.10 a� aEE 86.40 ns��a aEa�i�� < � r��it NE1N [ ) ADDN [ j ALTER [ ] Construction Address: Legal Description: _ Owner Name 8 Addre: Contractor: "��4� c LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Cc� CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION � � �. C � ('c �P, Effective 1/1/2000 (763) 572-3604 Bidg Insp � ,�,�,a-� .� �P - Tel.# �63— �1�'�� MN LICENSE #_ ��' �`►�/f-� Tel.# /, ��" ��dd Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. � Length Width Height Sq. Ft Length Width Hgt/Ground Sq. Ft. Construction Type: � � w ��imated Cost: $ r� � � � Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �� APPUCANT: /� Tel. # J r �� CITY USE ONLY - Permit Fee __ _ Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULAT�ONS: Call (763) 572-3604 for Permit Fees if mailing in application • ,� �rj $ . ,�a _ , Fee Schedule on R�rs��ide _ -- $_ � v .001 of Permit Valuation (1/10th%) $ �.(�� $.50/$1,000 Valuation $ � �" $1100 per SAC Unit $ � � % $5:00-(vtate-Lice�sed-F�esidential Contractors) $ Alt. "A" or Alt. "B" Above $ } $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ � °� . �b � iup sasnoH nnaN •�u�.r� aq� �im �uu�paa�o�d a.zo3aq pannbaz aq �iAA ��1L1�SQ0� II22a SE[� �i SSLL[ �i 2'JIIO IIOijL�IIl10� 2Lj� �0 IIOi�L'�0j 2L� �LIIMOiiS `�oi a� 30 �fanms 3o a��a� d •a�[s uoq�tuxs�o� aq� �o pu� a.m��n�qs pasodo.zd aq; 3o nnatna� ladoid io� nso� o� uop�tiddE �o au� aq� Luo� smoq �,Z 3o umm�u� � panss� aq fins uop�npsao� io� �tuuad l�IOI,L�'QL�If103 301�i0I,L��I3I?I�A ' SZ' £Z$ ��1 �aa3 9 �Id �pjM ��manuQ - q�dap q�ut g q�inn ��oidd� apins �003 £��sai puu� ia�n� p� q.�n� 30 �uaLUa��idai pu� �noiva2i �� H�� a��a�Po' 'OS'Si$ �� 3 9 �id y�pTM ��ManuQ - �luo .za�n� pu� qm� 30 �uatua��idai ptte �nouzag :,,y„ a��ua�� (�CiuO s�aa�S Q� �;ai�uo�) . AAO�I�S"3 I�IOISS�d�Q X�AA�AI?IQ �oa.�a� uop��.� ao ppp'j$ i��?�IPP� u�� io3 Si'£$ �Id 000`000`i$ �sn,� a� io3 SL'809`S$ 000`000` i$ $cnpni�uT pu� o� `3oaia� uor�� io ppp` j$ I��nIPP� ��a �TO� SL't�$ �Id 000`OOS$ �sn3 aq� .�03 SL'££Z`£$ , , �0`OOS$ $�Pni�ut pu� o� `3oa.�aq� uot��E.r� .�o ppp`i$ I�aor�ipp� q��a io3 09'S$ Snld 000`OOi$ �s� �03 SL'£66$ 000`OOI$ $utpni�ut pu� o� `3oaia� uop��.r� io pp{�`I$ i�o�IPP� u��a io3 00'L$ �Id 000`OS$ �s.n,� .�03 SL'£1�9$ 000`OS$ $�Pnj�ut pu� o� `3oaiaqx uor��.r� �o 000`i$ i�ot�ipp� q��a so3 Oi'OI$ Sni� 000`SZ$ ls.n� .�03 SZ'T6£$ � 000`SZ$ $�pni�ut pue o� `3oa�a� uor��.r� ao 000`i$ I�o�3iPP� u�� Io3 00'�I$ �id 000`Z$ ls� io3 SZ'69$ 000`Z$ $uipni�uT pu� 01 `3oaia� uor��.r� io ppi$ �aopTpp� q��a .ro3 SO'£$ sn�d pps$ �s.n3 T�3 OS'£Z$ OS' £Z$ 5��3 dn P� I00`000` t $ OQO`000`i$ �� i00`OOS$ 000`OOS$ °� i00`OOi$ 000`OOI$ °� IOObS$ 000`OS$ o� I00`SZ$ 000`SZ$ �� i(}0`Z$ 000`Z$ �� IOS$ QOS$ °� t$ �n�n �ioi ,, :atnn-o� papTno.�d maiaq iauu�tu aq� ur pu� q�o� �as nc�oiaq utaaa� �unoi� a� o� saa� �o �tuuad q�ns io3 �u�tidd� aq� �q �uau��d aq� annbai `a.�o3a�aq� uoi��tidd� uodn `a.m��nx�s io �utp�nq �ur�spca �u� o� .n�dai io uop�ial� �u� io3 io �am��na�s io �uTp�nq �ur�snca �u� o� uonipp� �Cue .zo3 io 'aml�na�s io �utp�nq �us �o uor��aia aq� �o� �tuuad �umsst aio3aq `�s �t�t�p �uTp�ng �aiq� a� �rnQ��s �� ,i.�x�a ��ua�ng � SuB�EC► � •� City of Fridley 32178 AT TME TOP OF TME TW�NS g � I L D I N G P E R M I T i � r�a tfif� ;'"� % R� / � � �� _ COMMUNITY OEVEIOPMENT DIY. � � ��*.�m°�„�.,�� y ' V �'�� '; �� r � � PpOTECTIVE INSPECTION SEC. i = � � /'�'1 � CITY HALL FRIDIE� SS��2 NUM6ER R8V DATE PAGE Of AVPROV80 B� �""� � �'� 612-571-3450 9t0-Ft5 9/19/O1 / / J08ADDRESS 5511, 5515, 5519, 5523, 5527, 5531, 5535, 5539 East Oberlin Circle NE t LEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACNEO OESCR. j_ g 4 Innsbruck North 2nd Addition SMEET 2 PROPERTY OWNER MAII ADDRES$ 21P PMONE Various J CONTRACTOti MAIL ADORESS Z�P PMONE LICENSE NO Columbus Exteriors 2131 111 Lane, Coon Ra ids MN 55433 763-757-7530 a ARCNITECT OR OESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO. S ENGINEER MIAII ADDFiESS ZIP VMONE LICENSE NO 8 USE OF BUIIDING 8 Unit Townhouse 7 CLA3S OF WORK O NEW ❑ ADDITION O ALTERATION � REPAIR ❑ MOVE O FiEMOVE 8 DESCRIBE WORK Reside Building•Soffit F c e CHANGEOFUSEfROM TO STIPULATIONS Per Section 1402, 1997 Uniform Build3ng 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. Vinyi siding is not a weatherproof covering unless the manufacturer states this in their application guidelines. Call for inspection of wrap before covering. TYPE OFCONST. OCCUPANCY(iROUP OCGUPANCY�OA� SEPARATE PERMITS ARE REOUIRED FOii ELECTRICAL. PLUM8ING. MEATING. VEN7ILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSTRUCTION 20NING SO. fT CU FT AUTHOR12ED IS NOT COMMENCEO WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENOED OR ABANOONED fOR A PER100 OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OfFSTREET PARNING I MEREBY CERTIfV TMAT 1 NAVE READ ANO EXAMINED TMIS APPLICATION 8 STALLS GAFAGES ANO KNOW TME SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAW$ yp�VAT10N SUqTAX AND ORDINANCES GOVERNING TNIS TVPE OF WORK WILI BE COMP�IED r WITH WMETHER SPECIFIE� HEREIN Oii NOT.•THE GRANTING OP A PERMIT �59,637 �L9.HL DOES NOT PRESUME 70 GIVE AUTHORITY TO VIOIATE OR CANCEL TME pEqMIT FEE SAC CMARGE PROVISIONS Of ANY OTMER..STATE Oii IOCAL LAW REGUTATING CON- STRUCTION OR TME PERFORMANCE OF CONSTRUCTION �713.7.� Fire SC �S9.C)�F /� . /� PLAN CNECK FEE TOTA� FEE ��"\ 7 l� C9/ $ 3. 21 S�GN1TUpEO�COM•AACTOpOp�UfMOp�ZEDAGENT iO�iE� qOPE l A�IpATED ,HIS IS VOUp PEpM17 , , ��/9�0� $�GNeTUpE O� OWNEp�� OWNEpBU�lOEp� �OAtE� BL �MSp � f�6Tt Building Inspections 763-572-3604 DATE SITE ADDRESS _ T'HIS APPLICANT IS: OWNER/ TENANT CONTRACTOR � PLUMBING itESIDEN'I'IAL A.PPLICATION ❑ OWNER CITY OF FRIDLEY E-MAIL ADDRESS CrrY Permit No.: Received By: Da�e�'c� � A STATE LICENSE # � i.` � �S �� ' EX�Pp DATE SUBMIT A COPY OF —i— C� / . YfOUR STATE ADDRESS �!� I : �'G��L,� i C✓r � c>u1� CITY y�i�`�'.�'1L �� iL�� STATFy�ZII' LICENSE WITH PHONE S' �'k- ;�E=i_S =�%��%G FAX APPLICATION ' ` PERMIT TYPE TYPE OF WORK: I � ��'+' FAIvFILY O TWO FAMILY � TOWNHOUSE DETAILED DESCRIPTION OF �VORK PER MS 16B.665 the permit fee is a minimum of $15.OQ or 5% of the total wst up to $500.00, whichever is greater, for the improvement, installation or repla.cement,of a residential fixture, excluding the fixtures. ('T.his shouldreflect only the cost of labor ) Labor cost under $300 =$15.04. Labor cost between $300 to $500 = cost of labor x.OS = � FOR�ROJECTS WHERE LABOR EXCEEDS°$SUO;TEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT Wi�RE�'1�D<.FI�CTiI1t�ES;-.(D�DICATE TOTAL MTMBER OF EACH BELOV� BATH SIlVK/LAV FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING (n��cmuc�vsE) SWIMMING POOL T WATER SOFlNER ($35) CLOTHES WASHER KTfCHEN SINK WATER CLOSET � BACKFLOW PREV. ($15) _ DISHWASHER _ LAUI�IDRY TRAY WATER HEATER ($35) FOR IFtR1GAT[ON _ WATER METER _ OTHER Fee TOTAL $ .50 $ Number of fixiures @ $10.00 Number of fixtures @ $15.00 Number of fixtures @ $35.00 THIS IS AN APPLICATION FOR A PERMTf-NOT VALID UNTIL PROCESSED x $10.00 = $ x $15.00 = $ x$35.00=$ State Surcharge = $ .50 Tota1= $ 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 perttut 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 w wh,fich equir � eview approval of pl SIGNATURE OF APPLICANT PRINT NAME�� DATE -�% `� - ��f--�� City of Fridley Building Inspections l)epartment 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Land Planning s�,C�u��)�n 6875 Highway No.65 N.E. Land Surveytng � • � Minneopolis� sou. rebr��9 ��'G�l'-1�2Pe�lZ?'G�j �/'�C• Minn. 35432 Civtl Englneering Telephona 784-6066 Municipal Enginaering Engineers & Surveyors Area Code 612 Certificate oi Sarvey for 1�A�1ZEL �Al2R 'OEVELOpEMENT CO'�p %�1 � S�nIP. i�„�I�=1b ��ft I�rcperiy L'ine- . \' ,\ ' ��pu,hed�lme �iuie: �� Par1y Wqll ._�,��; ° �efltlley�irnnmumm�enl J � �� u � �l � _ "_.. �� ,I , o � . . _. 1J. J � u � : v . I OO i I i ' � � � -- _— � �� ,°L - --.,,�---� 9�.0 — —`j �; •:� ; � . � � �I d u�isco •' : : :� .: :.•;•� i r ,' n ..4G.�e£ : � � 4RJMSE:1 /� % . . / � /.°+ / '��UNWiW+E�, i %. . 4i ' / , / , � / �- : /.1t�� 1\ __ .1�._'__ ��i`.JNC: � a '____.7'_'_ _ Ibf. '.�nw�.cE _ / ' . ' i , % / Pac� :,sco '.' �' . � / , � � Tc,vrow,usE j�. � .�. '/' 31•. � � _'_� �_ __ ' _ _'"_____._... ..._., e � _ � - ��_:.-:. ' . ll ; YWIHhCq � ' : � e� ' � cvw.rn, , Tmvw�wsE • . , •i11K4iF �'� _' ' �� ' _" - 11.... — '� _—_' i' i�' • � Y7!':�ft: Grur�,ii.; � .; , i oG1U�fi1 �. ,,_�.; ; I-'�.•u . <t o '�,�4'n:.L � .' 12 . /,' :` f:"� _.�' . :_'. � ' �eorrostu , Tcwwu�u:E ,%� _--=.p �__- � - _. '�31, : . 1'NO('OSCq . . 'TUwNN0u5E % / �� .si.' — ,- -� _�,-�, --- .... �. � ' ' uuciw:EU i TUwl1HOUSE - , ' �' . _ __ � 1�3�, �, _ e_� ' _''u_ " ' �oTS 1 Tuaou�N �, ' � � n �, 1� '� f��,•,�� . k�LOCIC �; � " i�'Gtot,�i _ Torrwio�r..s,' � I �rv �t.AF2P�E . - --- , -/- TNN��Urk NO�� a � � «�" �� - -=3,�=: -- :,, - � i �- ------ _:.--:;; TOWNIaOU��E'> � ;� � ►��1-<<> ��,�..:«: �' ; � y o � Cfpl�GF. � •TW4NHOuSE 2"° A��.��TION � ' '%i,, � ; � � C�ro�oeed� '° _ _'`_. 14�---- --�v 1 �----•--- - - iao ---� ANOKe,� CWNTY I hereby eerllLy that thie ie a lrue and corsece repraeentetion oY a eurvey of the boundariee oP the above deecribed len8, aud oP tAe location oE all buildiraJe, tAereon, en8 all vieible encroaclwente, if a�y, fsom or on eaid ]end. Ae eurveyed by me thie day oP ��, ; • L A.D. 19 7"L . 1 9 O e O A H A 9 E 9 Q I d 6 8 R I B 6� I Ii C. Et�glneere eurieyOie nr �' . // :K� •�-.�,f i •: ,.