AF - 407660
� City of Fridle�, Minn.
6431 University Ave. N. E., Minnea�lis, Minn. 55432
BUILDING PERMIT -
Date: ��.*��r�z, � 9] �
��: Viewcoa,, Enc . Builder �SaTM�
Address 5901 Brooklyn Blvd. Ad�$ Same
� 1659 �
5539 LOCATIOiV OF BUILDING
No. �____ Street — East Oberlia Circle p� of Loi
LOt .�._�_____ B1oCk �+ __._ Addition or Sub-Div3sioII .�.IIII1.��2r11C1L�D1Ct..h '�T+�
Corner Lot
Sewer IIevation
7nside Lot �. x Setback Sideyard ---�
----- ._ Foundation IIeva.tion .._--
DESCRIPTION OP BUILbING
To be Used as: 1240
Tawah o�.s e_� Front .—ZD'—_ Depth -3l! --- Height _,2$_'_._. Sq• Ft. 6 2 0 �, �,•�, 17 , 36 0
Garage Front 20' Depth 22' xeight 10� Sq. Ft �'� Cn. I't. 4,400
Type of Construction Wood Frame �� �� � 21,417 a80 To be Completed 1-15-73
Stipulationst
Owner and coatracter to be responsible for elevations and for drainage for a11
structure and the City shall be held blameless.
Construction must oomply witu i�. B. Cm 505 C1, C2 & C3. See attached sheeCs - use
figures 5, 9, or 10.
In conaideration of the issuance to me oP a permit to construci the building desesa'bed above, I agree to do
� praposed work in accordance with the description above and in compliance with rovisions oE
Ord�anc�ea of the city of Fridley. (���. f'' �� /
. �rrcnarge
In consideration of the payment of a fee of $�.�..2�—, permit is hereby granted to Viewcoa. xnc .
to construct the building or addition as described above. Thia permit is granted uPoa.
the express condition that the person to whom it is granted and his agents, employees and worl�en, 3n all work
done in, around and upon said building, or any part thereof, shall conform in all respects •to the or8in�nc:� oP
Fridley, Minnesota regarding location, construction, alteration, maintenance, , repair and movfng of buildfiig8
vyithin the city limits and this permit may be revoked at any tune upon violation oP any of tlae provisions of Said
o�diaances.
���5 L� � �,�c�S��S�. Bt�ldin8 Inspector
DA,RREL C,LA�itu
NOTICE:
Tl+is permh does not eover �he wnsfrue►ion, installetion for widn9. POu�'�8� 8� �eedo8. �►er or water. Be sure to me
tha Building laspeetor for aeperete permits for 4heae (tems.
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APPLICATION FOR RESIDENTIAL, ALTERATION,
OR AllDITION BUILDING P.�RMIT
CITY OF FRIDLEY, MINNESOTA
OWNER`S NAME: �jrareor, .1��re. BUiLDER: Sap.c
ADDRESS : sf4/ �tai.�'►a �oa/��rwr� ADDRESS : SA �+e�
NO:. SS39 STREET: E4d'� �6�r/is �ira/4
.,:
D LOT: / BLOCK: � ADDITION: �Z�`�
CORNER LOT: INSIDE LOT: i�' SETBACK: SIDEYARD:
�
Applicant attach to this form TYao Certificates of Survey of Lot and proposed
building location drawn on these Certificates. �
�ESCRIPTION OF BUILDING
To Be Used As:
�.�lievdt Front: ,ZO� Depth: a��� Iieight: 28�
/�90 .'
Square Feet: G,�p Cubic Feet: /%3�p � r
G ar��c Front: ZO' Depth: 22� Height: /C �
Square Feet ; 440 Cubic Feet : 4�40 O
Z�pe of Construction: �eOd Fra+••t Estimated Cost: $ �i/ ��7 8D
�
To Be Completed: /� /S-%�
The uadersigned hereby ma.kea applicativn for a permit for the work hexein
specified, agreeing to do all work in stfict accordance with the City of
Fridley Ordina.nces and xulings of the Department of Buildings, and hexeby
declares that all the facts and representations stated in this application
are true and correct.
DATE : �'" � 2- 7 Z S IGNATURE : �. .si�,aG,,.i
(See ReversE Side For Additiona.l Information.) �
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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 any exis�ing
building or structure, or for any al�e�ation or repairs to any exi�tin�
building or structure, upon application therefor�� req�ir� ��� p����� �� �he
applicant for such permit of fees to the aano��g ��ge�� b���� ��� ����h ��� ��
the manner herein provided to-wit:
UNIFORM BUILDING CODE: Zj�pe 1, 2& 4-$2.15 fog each ox�e thousa.r�d cutsic
feet, or fraction thereo£e in such cubical confcentso 1�pe 3& 5�$1e�5 for
e�,ch one thous�d �ub�Lc fe�tm
ADDITIONAL INFORMATION
For the purpose of computing fees for building permits, the cubical content�
of any building or addition, is determined by multiplying the �round area
covered from a point six (6) inches below the floor lin� of the basement
o� ttae cellar to the �v�g�g� hei�hts of th� upper suxface or to the avera�ge
h�i�ht of �the romf su�f��e of the anain gable of ��itched roof.
For repairs or alterati�ns to an exisging staucture, �the �ee shall be at the
rate of $3.00 per each five hund�ed 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.
VERIFICATION OF FOUNDAI'ION
NOTE: Permits for construction will be issued a minimum of 24 hours from the
time of application, to allow for proper review of the proposeii structure and
of the construction site.
A Certifiad 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 stnacture shall not tse used or cccupied unti.l a Certificate
of Occupancy has been issued.
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City of Fridley
4T TME TOP 0� TII� TwIN�
L-------� GOMMUNITr DEV[60�MENT OiV,
i rR0'T�CTIVq //f/�CT�Qtj Ot/T,
�'-' i pT1� MA�,L IIIIOL�: /M�
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53-8l�-s-915.51
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PLUMBIiVG PER�IIT APPLICATI+�iJ
ob Address -- —
5539 Fast Oberlin Circle
wner
?�a,rrell A . Farr Develoepment
Contractor
Kind of Building
tion
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a3� AAAkQUEYTE AVENUE
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Res.
stimate ost
, 10.00
Plumbing Fixture Rates: N0. RATE TOTAL
Number F�tures x $2.00 �_
Future Fixtures x $1.50
New Fixture-Old Open. x $1.50
Catch Basfn x $3.25
Water Heater-99,000 BTU x $3.00
—�.r
Ground Run Old Bldg. x$3.25
Elec. Water Heater x $2.00
Gas Fitting Fees:
lst 3 Fixtures x $2.00
Additional Fixtures x $ .75
Gas Range-199,000 BT[T 1 x$5.00 5•�
Repairs � Alterations
See
Deacription: Code
State Surchar�e .50
� Class �'A° �urcharge .50�
iToTar, �E $ 5 • 50
!The under�igned hereby makes application for a pernnit
for �he work herein specified� agreeing to do all work
ia atrict accorda,nce with the Citp Ordinancea and rulin
of the Department of Bui9.dinge, and hereby declare that
a1l�the facts and represeatationa atated in thia
application are true and correct.
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'Signature� Date
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SuBJECT
City of Fridley
AT THE TOP OF THE TWINS g U i L D i N G P E R M I T
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i �• COMMUNITY DEVELOPMENT DIV.
� ��: ------�
r � � PROTECTIVE INSPECTION SEC.
i . �
� i �"'1 � CITY HALL FHIDLEV 55432 Nu�tBER pE�
�'---� � �'� 612-571-3450 9t0-F15
JOB ADDRESS 5539 East Oberlin Circle NE
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION
DESCR. 1 4 Innsbruck North 2nd
2 PROPERTYOWNER MAILADDRESS
DATE PAGE OF
7/13/94 � �
3 CONTRACTOH MAIL ADDRESS "'
Dicks Fire & Storm 864 19 Ave SE, Minneapolis, MN 55414
4 ARCHITECT OR OESIGNER MAIL ADDRESS Z�P
5 ENGINEER
MAIL ADDRESS
�ERMIT NO. -
22691
RECEIPT NO.
��7��-
APVROVED BV
SEE ATTACHED
SHEET
PHONE
PHONE UCENSENO,
781-6170 2481
PHONE LICENSE NO.
ZIP PMONE LICENSE NO.
8 USE OP BUILDING
Residential
7 CLASSOFWORK � NEW p ADDITION ❑ ALTERATION C� REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof flouse & Garage (Tear-off); gutters _
8 CHANGEQFUSEFROM
TO
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.
SEPARATE PERMITS ARE FiEQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORI2ED IS NOT COMMENCED WITHIN 80 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
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 WIIL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OFi NOT. THE GRANTING OF A PERMIT � Zs218
DOES NOT PRESUME TO GIVE AUTHORITV TO VIO�ATE OR CANCEL THE pEqMIT FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �S�F.00
_. .., ...,rnv eec
OCCUPANCY GROUP OCCUPANCYLOAD
SQ. FT. CU. FT.
OFFSTREET PARKIIdG
STALLS IGARAGES
License SC $5.0
SIGNATURE OF CON i RACTOR OR AUTNORIZED AGENT IDATEI yy�{E►�ypA'OpEi�iLY �
TOTALFEE
$62.33
D THIS IS YOUR PERM
IDATEI __ I..- BLDG iNS� ' ��
N�=� � I Effec:tive 1/ iJ94
ADDN [ j CITY OF FRIDLEY
At,TER (� SINGLE FAMIi..I' AND DUPLEXES R-1 AND 1�-2
Building Permit Apptication � ��
E, � ;c� -��
ConsYruCtiot�Address: __5_,5.��'= East Oberlin Circle, Fridley, Mn.
i.egdl I�escription:
Owner Name c�i Address:
Tel. #
COntCdCtOP: R.J. Williams General Contractor MNLICENSE# 2481
Addtess: 864 - 19th AVe. S.E., Mpls., Mn. 55414 Tel. # 781-6170
LIVING AIPEA:
GARAGE AREA:
DECK AREA: .
OTHER:
Attach to this appiication, a Certificate of Survey of the
lot, with the proposed consiruction drawn on it to scale.
Length
Length
Length
DESCRIPTION OF IMPROVEMfiNT
Width
Width
Width
Height Sq. Ft.
Height Sq. Ft.
Hgt/Grou�d . Sq. Ft.
Corner Lot [] Tnside Lot [] Ft. Yd Setback Side Yard Setbacks
TypE Of C01IStrUCdOt1: h o u s e & g a z a g e r o o f s. ��t� ��= $ 2, 218 . 0 0
Approx. Compledon Date: g u t t e r s
(Cost on Backj
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ =$
DATE: 7�13/94 APPLICANT: __R.J. Wi.1li.ams Gen. Cantracotr Tel. # 781-6170
Permit Fee
Fire Surcharge
State Surcharge
.SAC Charge
License Surcharge
I3riveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATION�:
CITY USE ONLY
$ �. 0� Fee Schedule on Reverse Side
$ �• 02�- .U01 of Permit Valuation (1I1(hh%)
$ � / / $.50/$1,�0 Waluation
$ $8W per SAC Unit
$ � C? D$5.00 {Siate Licensed Residendal Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary ( ] Not Necessary [ ]
$ ��-�.���'�
+, s
13UILll[NG PL'sRMI'f FEE SCHEDULE
�11ic Cliict 13uilding 0lticial st�a(I, (�cfore issuing permits for thc ercction of any building or stn�cture,
c�r i��r any adciilion to any cxisiinf; i�uildin�; or structurc, or for any altcration or rc��air to any cxistin�;
(�uildiiig <�r slructure, u�n a��lication tlierefore, �c�uire the payment by ihe a��licant for such �ermit
c�f� ices Ic� ttie aciiount - i�erein fx;low tiet i�xtir and in t1�e manner I�erein r�rt�vided tc�-�vit:
"['U"1'AL V�1,LUl:
$1 lo $500
$501 to $2,000
$2,001 to $25,OQ0
$25;001 to $50,000 •
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,OOO,Q00� -
$1, Ot)0,001 and up
rr � ��
$15 (Miniei�um Fee is $15 plus surcharge)
$15 for first �$SOp p(us $2 for each additional $100 or
fraction thereof, to and including $2,000 �
.$45 for fiist $Z,pQp plus $9 for each additioaai $1;0�0
or fraction thereof, to and including $25,000 �
$252 for first $25,ppp pl�s $6_SO far each addirional $1,000
or fractiou tfie,�-eof, to. and inclading $50,000 -.
$414_SO for first $SO,OQO pius $4_Sp for each additional
.$1,Q00 or frac�iton thereof, to and including $100,000
$639.50 for f�ust -$100,000 plus �$3_SO for each additional
$1,000 or fraction .mereof, to aad including -$500,000
$2039.50 for die first $Spp,ppp pius $3 for each additional
�1,�00 or fractioa thereof, to and including $1,000,000
$3539_SO for the fust $�,pOp,ppp plus $2 for each addifional
$1,OQ0 or fractioa thereof -
DRIYEWAY DEPRESSION ESCROV�
(Concrete G�u� Streets Only)
Alternate "t�": Rennoval 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 pius G feet times $15_75_
VERIF[CATCON OF FOU�tDAT[ON
Permits for cor�s(zuclion wil! be issuod a cninimum of 24 hours from the time of a�plication to allow
For proper review of tiie propt�sui structure and of the construction site_
A Cert,ific;�tte of Sucvcy of die lot, showing the loc�tiion of tlie foundation c�nce it has it has heen
cont(ruclul will hc Yc;yuirul ix:torc proccccii�g with lhc framin�-
-' _�
sue�ecr IT NO.
City of Fridley 310 4
AT TNE TOP OF TNE TWINS g � I L D I N G P E R M I
r
� ` PT NO.
� `y ������� COMMUNITY OEVEIOPMENT DIV. ����
r � � PROTECTIVE INSPECTION SEC.
1 ; i
� �"'1 � CITY MALL FRIOLEV 'S,i�J2 NUM6Ep aEV DATB PAGE O� APVIWVED 6r
�""�'� �'' 612-571-3450 e�0-F15 6/8/QO � � �
109 ADDRESS S$1],,15,19,23,27,31,35,39 OBERLIN CIRCLE
1 LECiAL �OT NO. BLOCK TRACT OA AODITION SEE ATTACt1E0
DESCR. 1-8 4 Innsbruck . North 2nd SNEET
2 PROPERTY OWNER MAIL AODRES$ ZiP PMONE
Innsbruck Townhome Association � 651-224-5482
� CONTRACTOR MAII ADONESS " ZIP PMONE IICENSE NO
Garlock-French Roofi.ng Corp. 2301 E: 25th St., Mpls., NIN 55406 612-722-.7129
� AiiCMITECT OR OESIGNER MAIL ADOqESS ZIP PMONE LICENSE NO.
00001423
S ENGINEER MAIL AODRESS ZIP PMONE LICENSE NO
8 USE OF BUILDING
Residential
7. CLASS OF WORK
p NEW O ADOITION O ALTERATION X] REPAIR O MOVE O REMOVE
8 ESCRIB WOR((
�eroo Building
9 CHANGE OR USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
* ��rrnit 9nspec4ion C�rds
Will �� �al9�d`
. . :. - % Homeown��'��� �osi
,-,
SEPARATE PERMI7S ARE RECUIREO FOF1 ELECTRICAL. PLUMBING, MEATING, TYPE OF CONST. OCCUPANCY dROUP OCCUPANCY LOAD
VENTILATING OR AIR CONGITIONIN(i.
TFIIS PEFMIT BECOMES NULL ANO VOIO If WORK OR CONSTRUCTION 20NING SO. FT CU. fT,
AUTMORIZEO IS NOT COMMENCED WITHIN 80 OAYS. OR li CONSTRUCTION '
OR WORK IS SU3PENDED OR ABANDONED FOfi A PERIOD OF 120 DAYS AT
ANtl TIME AFTEN WOFK IS COMMENCEO. N0. D�11LG. UNITS OffSTREE? PARKING
1 MEREBV CERTIFY TMAT I NAVE REAO AND EXAMINEO TMIS APPLICATION S STAILS GARAGES
ANO KNOW TME SAME TO BE TRUE AND CORRECf. AlL PF;OVISIONS Of �AW$ yp�VATION SURTAX
ANC ORDINANGES GOVERNING TMIS TVPE OF WORK WILL BE COMPLIED
WITM WMETMEii SPECIfIEC MEREIN OR NOT. TME GRAN7ING OF A PERMIT ��.6�ZZ2. HS .�H. �.1
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL THE pEpMIT FEE SAC CMARGE
PROVISIONS OF ANY OTNER STATE Op �OCA� LAW REGULATIN(i CON-
STqUGT10N OR TME PERFOqMANGE OF CONSTRUCTION �2%9.ZrJ Fire SC $16.�2
PLAN CMECK FEE T TA� FEE
303.58
S�GN�TUpEOFCON'11ACTOp0�1AUTMOp�2ED�GENT �D�rE� WME PRO LV� D THIS IS OUR PE;�M�T�
� �
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pape;sui pue pazls aq puw �i ��e uo�snqwo� �n�u e ��e;sui o� pa�mba� uay/�ry
' �suoqe��ads s�am�e�nuew pue
sapo� �ua�r� at�;aa� o� pa�ie�sui pue paz�s si ��e uoasnqwo� u4scxa a�
°sa�uei�dde }}e�p �eJn�eu pue pals�sse
ue� �o� sa�qe16uuuan a7ewn� �e�ua� �/GoBa�e� ywy�-�y apn�u�
saop sn�,1 •suoqe��}aads s�a�n�e�nuew pue sapo� 3ua�n� at� s�aaw pue
�(�qwasse pa}si� e si �iun �uawa�e�daJ ay� }ey� saguan os�e pau5islapun a�
() oN � sa� •uoneuu,wal pue snr►oq�a �o �aqwnu 'y�6ua� '6ums buipn{�ui suo�e�gs�ads
�am}�e�nuew pue sapo� �ua�n� ��e s�aaw pue �nd��3se�d s� wa�sl�s 6u�uan a�
(} oN �sa� -pa�mha� aJaynn paddo3sa��} pue pa�oddns �(ja�n�as si pue
°suot�ru3sqo 'u�r�e�ouajap `�sru wo� aa� si pue paurwexa uaaq sey 6uauan
a� �ey� sa�uan /�qaray pau5islapun at� `a�u�n� uqs�xa ue u�ae� a� uay/N
NOLLt/�l�R{3A 2llt/ NOI1Sf18W0� ON�d 2l01�3NN0� 1N3A 1N3A NOWWO� .,
' HEATING
AIR CONDITIONING
AND ELECTRIC� INC.
ADDRESS� � 1 ,r�a��" E�A�PL(� 01 C �� �� w Ie Y
OCCUPANT
HEAT LOSS DATE HTG. INST. �
SOLD BY
ElecVica� Work Bv ' 1��. . �
TYPE OF HEAT GA FA� HW STEAM SPACE HTR:
CaA8 DE31GN
MAKE �A��'-
AAodel � � ���d�l�d � J �
Serial S�L ���� /3 %
INPUT �OO, �D
CONTROLS
THERMOSTAT �� Heat Plug
Velue �
Limi
Umit Settf °
Fan Setdn
Pilot Type
Pilot Make
Pilot Model �� 7
PilotTiming �� S@i:�
L.W. Cut Off
Pressure �. 5 �'� Percent COZ
Input CFH k@ @.� �� Peraent OZ �
Stack Temp. �%�� Peroent CO
HOUSE HEATING TEST RECORD
APT. FLOOR CITY SUBURB �
OWNER�����1 0�+@-�.
INSTALLED BY � I�� I'Je. � t�T� �
Gas Lirte By 'p%�- , i�ir -
UNIT HTR. OTHER
CONVERSION
Vent Size
KINDOFLINER, SIZE �I� NONE
Draft Hood Regulator
Fliters Size � �� Number I
Chimney Locadon Inside Outside
Chimney Construction
Smoke Bomb Wiring �
Draft Test Tag i�
Door Presaure Lightlng Inst.
Date Tested — CJ
Company Tesdng � � �
Nema of Tester Ce
Pressure , • �,��i% ls��.. PercenYCO2 / ��
Input CFH � �� � Percent OZ ���
Stack Temp. Percent CO % ���9
�� - SUB�ECT c ' ��
City of Fridley � 3 217 8
AT THE TOP Of TME TW�NS g � I L D I N G P E R M I T
; ` � � ��� ��� RECEIPT NO.
� ` ��� COMMUNITY DEVELOPMENT DIV. ���iA
v'
� �' � � PROTECTIVE INSPECTION SEC.
r , ,
, � ,
� /'�'1 � CITY MALI FRIOLEr SS132 NUMBEN REV DATE PAGE Of AdvROVEO BY
�-•-�� � �'' 612-57�-3450 9�aF�s 9/19/01 / /
JOB ADpRESS 5511, 5515, 5519, 5523, 5527,� 5531, 5535, 5539 East Oberlin Circle NE
1 IEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACNED
DESCFi. 1_ g 4 Innsbruck North 2nd Addition SNEET
2 PIiOPERTY OWNER
MAIL ADORES$ 21P PNONE
Various
3 CONTRACTOR MAIL ADORESS 21P PMONE LICENSE NO
Columbus Exteriors 2131 111 Lane, Coon Ra ids, NIN 55433 763-757-7530
� ARCFIITECT OR OESIGNER MAII ADORESS 21P PMONE LICENSE N0.
5 ENGINEER MAIL ADDRESS ZIF PMONE LICENSE NO
B USE OF BUILOING
8 Unit Townhouse
7 CLASS OF WORK
O NEW O A�DITION O ALTERATION � REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reside Building•Soffit Fas
9 CHANOE OF USE FtiOM TO
STIPULATIONS
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. Vinyi siding is not a weatherproof covering unless the manufacturer
states this in their application guidelines. Call for inspection of wrap
before covering.
SEPARATE PEFiMITS ARE REOUIRED FOR EIECTRICAI, PLUMBING, MEATINa, TYPE Of CONST. OCCUPANCY GROUP OCCUPANCY lOAO
VENTILATING OR AIR CONOITIONING
TMIS PERMIT BECOMES NULL AND VOID If WORK Oii CONSTRUCTION ZpNING SO. FT CU FT.
AUTHOFIZED IS NOT COMMENCED WITNIN 80 DAYS. Oq IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONEO FOii A PERIOD OF 120 DAYS AT
ANY TIME AFTEIi WORK IS COMMENCED. NO DWLG. UNITS OFFSTiiEET PARKING
I NEREBY CERTIfY THAT 1 HAVE READ ANO EXAMINED TNIS APPLICATION 8 STA�LS GARAGES
AND KNOW TME SAME TO BE TNUE ANO CORRECT. ALL PROVISIONS Of LAWS yp�UpT10N SURTAX
ANO ORDINANCES GOVEiiNING TMIS TYPE OF WOIiK WI�� BE COMP�IED r
WITH WNETMER SPECIFIEO MENEIN OR NOT.•TME GRANTING Of A PERMIT $59,637 �29.82
OOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pEqMIT f EE SAC CMAiiGE
PROVISIONS OF ANY OTMER.S7ATE OR LOCAL LAW qEGUTATING CON-
STRUCTION OR TME PERFOFiMANCE OF CONSTRUCTION �%13.7rJ Fire SC $59.6�1
. PLAN CMECK FEE TOTAL FEE
�l� %��d� � 3.z�
S�GNATUpEOFCON:A�CTOpOpAUTMOp�2E0AGEN� iO�TEi ROPE l A�IDATED ,MIS IS YOUR PERMIT
. 9'/9 •v/
S�GNOTUAEO�OWNEp���OWNEpBU�IDEp� �O�rE� � BL �NSO � f���f
/
sue�eeT - � ' • P MIT NO.
City of Fridley 3 2� 91
AT TME TOP OF TME TWINS � u I L D I N� P E R M I T
f
; � RECEIPT NO.
� `� �_���_ COMMUNITY OEVEIOP�ENT DIV.
r � � PROTECTIVE INSPECTION SEC. ��,�i''
�
� ` �
� �'��1 � CITY MALL FRIDLE� SS1,$ NUMBER pEV DAT� VAGE OF AVPROVEO B�
��"'� � �'' 612-57�-34b0 s�aFis 6/13/02 / /
JOB ADDRESS 5539 E. Oberlin Circle �
1 LEGAL �OT NO. BLOCK TfiACT OR ADDITION SEE ATTACMED
oescR. 1 4 Innsbruck North 2nd Additiott SHEET
2 PROPERTY OWNER MAIL ADOR�S$ ZIP PHONE
Jerry Tienter, 5539 E. Oberlin Circle, Fridley, MN 55432 763-586-0887
3 CONTRACTOR MAIL ADORESS Z�P PMONE LICENSE NO
Pella Windows & Doors, 15300 25th Ave N, ��'100, P1 outh MN 55447 20165884
4 ARCNITECT OR DESIGNER MAIL AODFiESS ZIP PMONE LICENSE NO.
763-745-1400
S ENGINEER MIAII AODRESS Z�P PMONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
� NEW ❑ ADDITION 0 ALTERATION ❑ REPAIR � MOVE - O REMOVE
8 DESCRIBE WORK
Replace windows & patio doors within existing openings.
��C.■9�� ��V . . � ti
9 CHANOE OF USE FROM TO ��" �� �
STIPULATIONS ���r �o PQ��
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.
Caulking and flashing for all exterior openings.
�EPA�� � � ����� � � � .
� � �� ����
�EPARA P RN�IT�� REaUI FORo �efore di 9i g���I fo�
REQUI �ORo PI.UM �� A D�t��� �II �til' ocatior�s
��u�i���� �t��� �EQ� E� °��
� � �i��� ���
" ' TYPE OF CONST. OCCUPANCV GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTFICAL, PLUMBING, HEATIN(i,
VENTILATING OR AIR CONDITIONING
THIS PEF;MIT BECOMES NULL AND VOID IF WQRK OR CONSTRUCTIOM yONING SO. fT CU FT.
AUTMORIZED IS NOT COMMENCED VyITNIN 80 DAVS, OR IF CONSTRUCTION
OR WOFK IS SUSPENDED OFi ABANQONED FOR A PERIOO OF 120 DAYS A7 "
ANV TIME AFTEii WORK IS COMMENCED. ' N0. OWLG. UNITS OPfSTREET PARKING
I HEREBY CERTIfY THAT I HAYE READ AND EXAMINEQ THIS APPLICATIQN STALLS GARAGES
AND KNOW THE SAME TO BE TAUE AND CORRECT. ALL PROVISIONS OF LAW$ yp�VAT10N SURTAX
ANO OROINANCES GOVERNING THIS TVPE OF WORK WILL �E CpMP4�E0 �1(,444.00 �S.LL
WITM WMETHER SPECIFIED NEREIN OF NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CAMCEL TME pEqM1T FEE SAC CMARGE
PqOVIS10NS OF ANY OTMER STATE OR LOCAL LAW REGULATING CON• $2](�.25 Fire SC �LC).4�F
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
Pt,AN CNECK FEE TOTAL FEE
Licen 5.00 $3 .91
S�GNATUAEOFCON'AACTOpOp4UTMOp�ZEDOGENT IOATE� HE PROP VALIOATE HIS IS Y9U� RMI�
C� ' �
S�GNOTUNE O� OWNEA��� ON�NEA BULLDEp� ���TE� ' B G� �NSo � ����E
�[ ]
ADDN
AL1'ER
Effective 5/10/99
[ ] CITY OF �+'RIDI.EY �
[] SINGLE FAMII.Y AND DUPLEXES R 1 AND R 2
� BUII.DING PERMIT APPLICATION
Construction Address: � S_�_� `L . blr�e.x1: � �:�Cc�1�Z:.� .. .
I.egal Description: '
Owner Nam� � Address: �� Cy �;.�r�� R� � Tel. #� l0 3. SB'�o • O�S� �
Contractor:. � PELLA WINDOWS & DOORS MN LICENSE #�
� 15300-25TH AVE. AT. STE. #100
Address: PLYMOiTTH, Ntrt ss44� � Tel. #
A� 763-745-1400 ey:'Of t�1C'
LICENSE #20165884
lot, v
LIVING AREA:
GARAGE AREA:
DECK AREA: -
OTHER:
- ------- —_.. ...: to scale.
. DESC�.�fiT QF ���?�� _ �
Length Width Height � Sq. Ft.
Length Width Height Sq. Ft:
I.ength � Widtl� �� Hgt/Ground Sq. Ft.
� . _ _ _ � . �, ,. _� � �t _.. � .. -�,._.� .. . =.��. ' -- - a nc :
-- . a� �i�: �j .
con�mmx�ion Ty�: �a�r�a co�c: $ 1[0, yy`( / -- Cl
Driveway C�rb C�t Width Needed: Ft. + 6 Ft = Ft R$ � _$ -
DATE: .' .O� APPLICANT: ��(' Tel. � gsa•�•�Q�`��
Permit Fee
Fire Surcliarge
s�� s,��ge
SAC Charge
Lic�nse S�rchazge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPLJLATIOIVS:
$ a�� .as
� t(o. y�-I
� $.aa
$
$ � �. ��
$
$
$
$
� �0� 9 I
CIT� USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
�.soi$i,000 v��on
$1050 per SAC Unit
$5.00 (State Licensed Residential Contractorc)
Alt. °A° or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ l Not N�essazy []
�`3dL
City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287
6431 Universit�r Ave NE
Fridley MN 55432
Mechanicai Permit# .�����`L����'�
Residential Application
City of Fridley
See Back Side For Required Informa#ion
Datef/—Od''-+�Y Site Address: S
The applicant is: (cirlce one) Owner
Property Owner.� T/G�/t'-�
C'rty:
Contractor Information
Company Name:
Contact Person:
State: /YI � Zip:s"SL/3 '�
Cell:
River Citv Sheet fVle�l, Inc.
C'tty: r���T�6� �:?ans�
Phone: Cell: F��
Finail• MN Bond# & Exp Date
Type of Work (circle one): New
Detailed Descriptior�.,of work:
Equipment Installed: MFG:,��D� 9!�-- _ nnoae�p �e.rc� ���a � ��
�pjtbi��- MFG: Mode1: Size/BTU:
MFG: Model: Size/BTU: .
Piease check all that apply: ✓P�ireplace (gas) $15,00 New Gas Grill $10.00
_A/C $25.00 Fireplace (wood) $35.00 ,_Gas Unit HTR $10.00
Air to Air exchanger $15.00 Fumace $35.00 Pool Heater $35.00
Boiler $35.00 Gas Dryer $10.00 _Ventilator $15.00
_Chimney Liner $10.00 _Gas Piwng $10.00
Duct Work $10.00 _Gas Range/Oven $10.00
PeRnit Fee $ � 5�•� U (Total from above-Minimum fee $35.00)
Surcharge � 0.50
Total Due $ 3��5?> Make check payable to City of Fridley
This is an application for a permit- not valid untii processed
I hereby apply for a mechanical permft and I acknowladga that the informa�on 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 Construcdon Codes; that I understand this is not a permit but only an application
for a permit and work is not to start without a permiG that the work will be in accordanca with the
approved plan in case of all work which requires review and approval of plans.
Signature of Applicant: ('� ,�o �D�1! l� Date: �'����
Approval Inspector Signature: Date:
Please Note: Separate permits are required for Building, Plumbing, and Electrical work
Revised 6/14/2005
Land Planning s�,C����l�� 6875 Highway No.65 N.E.
Land Surveying [ • • � MinnecpoUa�
soab Testing �%'�!�'-1/I2P6�lZ?2f�j �2C� Minn. SS432
Civil Engineeri�g Talephene 784-6066
Municipal Enginaering Engineers & Surveyors Area Code 672
Certificate oi Survey ior DA�12EL �A1212 DEVELOpEMENT CO'Rp
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INN �B�UCU N0� � 1-� � f— - — _—__— "'i i1- �a - , =_- ��===--_ - -
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I hereby certlYy that thie Se a true and eorrect repreeenkaLlon oY a eurvey of the bou�daziea of the above deecribed
InnB, aod oP the locakioq of all buildimJe, thereon, apd all nieible encroachmente, iP airy, fs� or on eaid la¢d. Ae
avrveyed by me thie dey oE ,Q i, ;;, �� A_n, 19_7'.. .
i
9 9 B O R B A N 8 9 � I B E B R I 9 O� I N C.
Eagineere eurveyare
mr �� . l' dl • -.E�: ,.