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AF - 42082City of Fridley, Mi.n.n.. BUILDING PERMIT N° '7269 • Date: ..� �� `. �..�'..�...(r,(.,,��..�.... .__.._.._......� � �-,�-� f �,�,,I C Owner: �/�%�"�.1�� ,�•�_..._.. Builder .._. ... .._.._�,� �_`�-.�........... ........_.. __. ._a.....�� I \ J Address...__._.__:..._._..__.___._.._____...�_._._._.._..._...._...._._..._......._.._ Address �.,, LO TION OF BUILDING No. sx�.. �._� .... Street ....._. _ - ._ ....!..�a�:._.._..._......._.__... Part of t _............__ t / • Lot ..��'9�'.., .��..�Block ._._.__.__._......__...1!_ .............. Addition or Sub-Divisi � ...._.. . .1.._.��,�i.�� _L.... Corner Lot ...__....✓:.'... Inside Lot ....._..........._..._.._..._..... Setback ....��._........... deyard .........�� -_..�.!..._..._.._......__ Sewer Elevation _��..�..,�.,.� . . ..........._..._._ F�ion Elevation ....._..�-?�D � O �_...�_._..._..._ _._. _..._.._ --� • � � n F �nrs i H / r DESCRIPTION OF BUILDING To Used . ' .. _ Front _�.1.�..�. Depth �..�i._ Hefght .�Lf...._.. Sq. F't. �� Cu. FL /(Gt_,�JK✓ � � /� ..�,�L. _��.._.__ Depth _..�.�.� eight ...�.�%.___ Sq. Ft. ..�..'l.�Cu. F't. ��`_L' .._ ._ _w...._ Frnn Type of onstruction _. ...._ .. ._. . . ... Est. Cost ..��....�:.....-To be Completed _...____......__.__ ..............__._ In cansideration of the issuance to me of a pernut to construct the building described above, I agree to do th� proposed work in accordance with the description above set and in com liance with rovisions of ordinances of the city of Fridley. - �3._.— In co�sideration of the payment of a fee of �.��'�� percnit is hereby granted to___._._...._ � ...__,......___....__..----__..�..__..__. to construct the building or addition as described above. This pernut is granted upon the express condition that the person to whom it is granted and his agents, ernployees and workmen, in all work dane in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upoa violation of aay of the provisions of said --�-_----- NOTICE: • ?his p�rn�it dou not eov�r fh� eons�rueHon, insnllNion for wirin{�, plumbino, qas h�afin�, s�w�r � wabr. M sun to tN fh� Building Insp�eM� fer aparah p�rmks for th� ihms. ` � � R•� • �� u � .. i � I 11 � � �� (P v � � � 1 , r.. . ., . . ... , . .. «:, � � A.PPLTCATION FaR BUILDING FL:.I�1IT CITY OF FRIDLEY, MI�TNES�TA OWNER' S NAME - ��=-�� BUILDER � aDn�ss l/� � o��-� �n'�nxESS �� 4 �- �� c � � � LOCATION OF BUILDING 1 No. Street �%� Part of Lot �— ��1 �'�'�'`_� Lot 7��' y� Block �� Addition or Subdivision� Corner Lot_�Inside Lot Setback 3 S Side-Yard S'}' 1 d SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certi�3.cates of Surve.y of Lot and proposed bLild- ing Zo ation dra on these Certif3.cates. Q--.�,�._- � ��,- 7/ 7 3--'' DESCRIPTION 0� BUILDING To be used as: Front ��_.�h Height Sq. Ft. Cu. Ft, Front Depth Height Sq. Ft. Cu. Ft. Type of Construction�� Z-��, Estimated Cost _ . To be Complete �� , ! � � � ---� The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work ir► strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are e and correct. DATE � �� `� �' � SIGNATURE � �� (Schedule of Fee Costs can be found on the Reverse Side). � • � • • � � �� ai�y " Applica��o� f�� P1�a��g �aa i�as �",�lr�� P�r�it I?ejrt. of Bld4s. Phono 3f,U-3450 D£SCRIPTIOTd O,r^ VdOTt : ' "� " ' Numbar, Kind and Loce�en of Fi:ctures I'O��°" �� a � � N N . �� g ; - =z y � r k .� z u_ p o I; � S 2 � � �; � c � � g o �S � � � �c7i � _ _�.. Basr 1 rt 2nd 3rd �th • Futur• Connectioa Opaninys Conaactad t N�w Fixtutw, Old O�+ainqs u $ � • � � � w�T� � `U ► M WS FLfC. PARTIAl. RATE S�HEDULE 8�-�r�s � �� pLIIMBYNC FIXTURE AATES: NO. RATE TOTAL Number FYxtures . . . . . . . . . . . . x 32.00 a F1�ture Flxture O��cning . . . . . . . . . . . x 31.50 5--. New Fixture Old Opening.... .: .. .. . - x 51.50 E,-..-- Catch Basln . . . . . . . . . . . . . . . . . . . . x 53.25 E Water Fieater 'Up to 99,000 BTU1. ••• x$3.00 S New Cround Run Old Bldg. . ... .. x�3.25 $ El�ctric P�at�r H�at�t. . . . . . . . . . . . s $2.G0 S :sA3 FI?TING FEE$: NO. RATE 'f07RL I 1st3Fixtutes •••••••••••••••••• xS2.W i . Additional Fixtures . . . . . . . . . . . . . . x = .15 s ' i Gaa RanYe to 199,000 BTU ..... ...... . x 35.00 5 City a1 flidley: The undersigned hereby makes application for a permit tor th� vrork herei specificd, agree:ng to do all work in strict accordance with the Ci�j Qrd'uun:c and ruling of the Department of Build:ngs, and hereby declares tha4 all thc tact and representatlons sLated ia this application are true and correct � ��ey� �� , . I � 19? � Owner __._��;� �^� c- Kind of Building "�� t Used as To bc completed about �/ f ��` /� �� t � ��' Estimated Cost, ;_ � J ` — Old—New. Bui2ding Permit No. P�rmit No. `�'� � � /i,� � Signe B �^� � % `' ��C •in Phune No � � ROUGH FINAL ' REPAIRS i� ALTER7ITIONS—A.f•r :o Ccd• .50 State Surcharge .DescriDtfon .........................,.............. i . ro�r,U. � s � �.:. City of Fridley AT THE TOP OF THE TWINS ;, � � � ; y _..___ COMMUNITY OEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. � � � i•_--�; �"' �,� CITY HALL FRIOLE� 55432 i 612-571-3450 SUBJECT BU ILDING PERMIT NUMBER. REV. DATE PAGE OF 9�0-F15 5/10/85 / / JOB ADDRESS 2gg Ely Street N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION oESCR. 47 , 48 11 Spring B�i Brook Park PERMIT NO. I° 17965 RECEIPT NO. /'6 �° 7 APPROVED BV SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADORESS ZIP PHONE Gary Michurski 298 Ely Street N.E. 780-1443 3 CONTRACTOR MAII ADORESS Z�P PHONE LICENSE NO. Western Construction Co. 5353 Wayzata. Blvd., Mpls. 55416 546-3388 4 ARCHITECT OR DESIGNEF MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL AODRESS ZIP PHONE LICENSE NO. 6 USE OF BUIIDING Garage 7 CLASS OF WORK � NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Construct a 22' x 24' Detached Garaae ��" 9 CHANGE QF USE FROM ro STIPULATIONS provide a hard surface driveway. Money to be paid for curb cut. Garage must be set back 37 feet from th.e curb, with 8 feet froan rear of garage to east property line. Special Use Permit for Second Gaxage approved 7/2/84 by City Council TYPE OF CONST. OCCtJPANC SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PIUMBING, HEATING, VENTILATING OR AIR CONDITIONING. WOOCZ FYd.I[lE THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT 576 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION ]_ S7ALLS AND KNOW THE SAME TO BE TRUE AND CORRECT. aLL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 8E COMPUED $ 7� 021, 44 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE O CANCEL THE pERM1T FEE RO ISIONS OF ANY OTHER ST TE OR �OCAL LAW RE LATING CON- �`(H. SO S CTION OR T E PERFORM CE OF NSTRUC ON. PLAN CHECK FEE � NATU E OP CON'RAC R OA AU OAIZED AGENT IDATEI EN P �E V LIC SiGNATUAE OF OWNEF7 Uf OWNEA BUILOERI - �D�� BLDG WSP UP OCCUPANCVIOAD CU. FT. 5760 FSTREET PARKING IGARAGES RTAX $3.51 C CHAFGE TAL FEE �`�2,�1 fHIS IS YOUR PERMIT � ~ na7E �MOUS*wu� �Jf hEfS c��• ao+s `Go'v:.N�e.. � r�o� •.v � �, � `. � t 1, o �� #':.. _ "�t �. ^� }�, v:� � . T�. =`j-.f . �. C.. E. COULTER LAND SURVEYOR RE3,STERf:% U'vC�ER LA�hS O� ST��E OF M'.NNESGT� . L�C[hi[D �� O�G�b�hC[S Ot C�Tr O� �•NNE�►OI�L 3300 IVNOALE A�'E SO MINNEAPOLIS 8 MINN TAVLOR 4-0370 iburbepor'g Crrtificatt �l�Tl•N6 ��N tVA:f�i uetsHOwt �'JC-.C��11 ' ;�-�'' =- =- ��'T' - � �'�''� . f,Q-c ��-.C�� _----- 60.0-- -- —i�- � ' 30.0 30,0 � � 1 ° � W r � � � --J- I N T � / Y - - � � 5�=.:�'�:-- 11'� -- �•'� � "�� , � ,a/ , ��. �sY 0 � � Z �- . _� t�;'_ � � , � J � � �� - w, � �0,� 3C,^ � ` - - �,.,.0 _ - �. 1n�,L�� t , � � 1-5-F N =Z64 � -�,0 � �^�wf.R P �LE 0►'� �J� r.r��iC-�� I l;ereb�- cer ti`}� that t7ie a�aove i� a true and correct plat of a sur��e•: of : Lots 47 and 48, °.lock 11, Spring Brook Park, Anoka Count��, Minnesota. As surveyed by me this 20tYi day of August 1964 A.D. �;' � !', ..:..-.: � S igned____^� �'- =.� 1�:, t �.� j.-� _.� �.. Minnesota�Reaistration No. 25Fi4 __ ��.._.._. __ ___� _ ......._.._ , . _. ._ _.. _ — `j Q, I ��!y.? . . ,... . .� •..�, � . . . ... :...,. ..,, __., ..� ._ .. -._ . _ r. _,,.: . •._ . • ..� 1� NE�1 �- ADDN. [ ] 11I,TER. [ ] Construction Address: '�( O Legal Description: � Owner Name � Addres : � �� Contra�tor: �Y" Addresa • �� /vl � City of Fridley �R-t AIfD R-2 Building Permit Applieation �y � � � � Effective 4/1/84 rei:�# 0- 1�y3 Tel . # ` - 3 �J Attach to �i1,�s application, a Certificate of Survey of the lot, rrith/�he proposed construction draWn on it to scale. DESCRIPTI01� OF INPROQEMENT LIVZI�IG AREA: Length Width Height Sq. Ft. GARAGE AREA: Length .� Width � Height � Sq. Ft. __�ps� DEC� AREA: Length iiidth Hgt/Ground Sq. Ft. OTHER: Corner Lot (,� Inside Lot [] Ft. Yd. Setback Side Yard Setbaek Type of Construction: u✓LG� ��? Approx. Completion Date: Estimated Cost: � `� `7, d��. �'� � Alt. A Alt B �� U �� Proposed Driveway Width If e� p Is Aesired: � a See Back Page for Explanation � / % _� , � � � � L � Tel. # � DATE: � � � APPLICANT• �L� u . CITY Permit Fee �Og�s� �� Plan Cheek $ State Surcharg�'� � �� SAC Charge a Park Fee a IISE ONLY Fee Schedule on Reverse Side 25x of Building Permit Fee �•50/�1,000 Valuation ;425 per SAC Unit Fee Determined bq Engineering Se�wer Hain Charge # r�� a.Dl a Agreement Necessary [] Not Necessary [] �' �G�� U� � STIPULATIONS: I �� /lQs-.- V � G�z' f ` � (.�--VL � n �.� �---- -" � ' � �.�' � C�� : � f �� . . r . . . 5353 Wayazata Boulevard Mianeapolis, Minnesota 55416 �,. � (y 5 � 546-3385 � ___ _'' �o�c ^iz� v0'„�.:;x, � � , r� J ��w ► �'� � �`° CITY ; `�°'? c� lc��, ADDRESS �� _'l;r :� .- �;. �' NAME ,�r'�j :''';- ;h� r-�,ti i::i rrias^��-i �ELEPHONE '?��-1�1Y'� W�.g�� 5��•_7=� a1 P�RMIT OBTAINED BY :�t��. r�t SALESMAN '�'�� '�• �t�4�:.;�°t CEMENT MAN OI.D GARAGE REMOVED BY OLD CEMENT REMOVED BY �a a ,�a �� DATE a/��rs�;_, GARAGE SIZE �tz X �2_X APRON DRIVEWAY SIZE �'�"�� .�' lac�,top • �' ��WIRE MESH '/Z"=RODS CONDUIT PIPE OVERHEAD DOOR SIZE 26h� OFFSET �y'-lE� SERVICE DOOR LOCATION �°uth �'ast Ccrn�� r BLOCK SIZE & LOCATION �' � � ��e� WATERPROOF BACKFI LL EXCAVATION BY GRADE FLAT DROP OFF 12 " `, .; . , _ ; . � �� /l�� - `> T v � ,r� �- � 11.� � � � � � � l � +• � i�-!� ��/ �- 5 T p � � �- J 1 � � � v 1 l� � 1\ l �E�1 [) City of Fridleq Effective 4/1/8� - ADDN . [ j R-1 uD R-2 �� AI,TER. [ ] Building Permit Application Construction Adidress: �q� �.�_u ��./ Legal Deacription: ( �A,2�i - �t��-/�.v � ,%%li GNG�.PS� > Owner lia�e t 1►ddress : � � '`�'l , y8 � ��- �/, -�,��"�� 2�.t' �i9�� ?el . � Contractor: ?el. # Addreaa• Attach to this application, a Certificate of Survey of the lot� with Lhe proposed construction draWn on it to acale. LIVIIiG AREA: Length DESCRIPTIO� OF IMPaOYBl�NT Yidth Height Sq. Ft. GARAGE AREA: Length Yidth Height Sq. Ft. DECL AREA: Length � Width Hgt/Ground Sq. FL. OTHER: Corner Lot [] Inside Lot [] Ft. 7d. Setback Side Yard Setback Type of Construction: Estimated Cost: _ Approx. Completion Date: � 2f ��,� 6� �u-��/ ��?� � r Alt. A Alt B Proposed Driver�ay i�idth If Ne�+ Opening Is Desired: �`� f!o ,, �'�/flSSG� � See Back Page for Explanation DATE: J� 0�� APPLICANT: ( i� L �IL'�"�t;L/2S'�/ Tel .� �c°� -/5�� Permit Fee Plan Check State Surcharge 3AC Charge Park Fee Sever !lain Charge !a'T�I. STIPULATIONS: � _ _ _ _ _ _ CIT7 DSE 01�1.7 Fee Schedule on Reverse Side 25x of Building Permit Fee =.50/=1,000 Valuation =425 per SAC Unit Fee Determined by Engineering 1lgreement Necessary [ ] lioy Necessary [ ] r i►--- � �� =-=�� z �� o -- / ¢ �-3 a 2 � .f � ;. 3 ° x �� -� � � G�� l � / U Dace Received: CIT7 �F FRIDLE7 BUILDING PERMIT STAFF REVIEW NINNESOTA File No./Addreas: . . JIM f PAIL IiH�E � MARE ; Q7DE �( ) Has Plans E0H t. Planni - � 2. CoCe Entorcement 3. Er►6lneering ; Y. ,Fire TI!! 1 JIN DARRFI, JOHN ' 5. Police , 6. Code Enforcement l 7. PuDlic Horka Director � Cive Back to Plar.nir.g DAiE: DATE: Buildi Permit Review Mt . 2nd Mt Y/Ae ue�ter Re . � DATE FILE REQUIRED INFO[tMATION: � RW?INC � APPROVED = LOCATION COMMEt�TS � � _ � Site Plan ! JIM ' � � Design Plan � DAAREL ! � ! Construction Plan ! DARRII. ' ! ; � R.C.W.D. Approval (if nec.)� DAHRII, 6� ` ; , MARK , � ; aih a � � ; Bonds Needed ; SID ; ; _ Easements: Bike/Walkxay i CLYDE � � S � � � Road � R.YDE � � ' � � � � Drainage � CLYDE i � � � � � � UC111ty � CLYDE � � i � � � � Drair.age Plan i MARK � � � � � � _ � � � Landscape Plan � JIM � � j , i , , saw � HARK ; � � � � . � . . FIRE DEPAA'fMENT = BOB � � ' � POLICE DEPARTMENT ! JIM H. { � � OSHEA, LIST: t i i { i � � � � � � -- � DATE � INITIAL ; COMPLETED ; STIPULATIONS � � . 3/ 0/ 8/ 5/ sue�ecT PERMIT NO. City of Fridley o 18478 AT THE TOP OF THE TWINS g � I L D I N G P E R M I T r � � , � RECEIPT NO. � • COMMUNITV DEVEIOPMENT DIV. q ' �y � / r ' � � PROTECTIVE INSPECTION SEC. � ��, 1 � � ' � �� CITY HALL FRIDLE� SS43Z NUMBER AEV. DATE PAGE OF APPROVED BV �.---� • •�� 612-571-3450 910-F15 6/6/86 � � JOB ADDRES�98 Ely Street N.E. 1 LEGAL ��T NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. t�%,48 11 5pring Brook Addition SHEET 2 PROPERTY OWNEF . MAIL ADDRESS ZIP PHONE Cheryl Michurski 298 EIy Street N.E. 780-1443 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE IICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE IICENSE NO. 8 USE OF BUIIDING Residential 7 CLASS OF WORK ❑ NEW � ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 13.6' x 10' Deck 9 CHANC,E OF USE FROM TO STIPULATIONS Use treated wood. SEPARATE PERMI7S ARE FEQUIRED FQR ELECTRICAL, PLUMBIfVG, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTflUCTION ZpNING SO. fT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORFECT. 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 $8SO y�. SO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE p�RMITFEE SACCHARGE PROVISIONS OF ANY pTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $I.C.00 LAN CHECK FEE TOTAL FEE $ 4.0o Saa.Sa /� / Si nru oFCON�RACTO AUTHORIZEDAGENT IDATEI WHEN PROPERLY V I D THIS IS YOUF QER IT / `' / � , � p ^O �- i �p -SiGNATUREOF NERi OWNERBU4DEf:l �DATEI BIDG iNSP �� TEG NgW [] City of Fridley Effeetive 4/1/86 ADDN. [ ] � R-1 AND R-2 � pLTER. [ ] Building Permit Application Construction Address: �f �a ��i St NC> Legal Description: ��S �7 S' �/�, i�/UG� /�� r'�r� ,�L�j� �"t��77D� Owner Name & Address: "l_!�C�G � � � �� ' ` � `""`' ��G T�1• $ �d��`��'� Contraetor• Tel. � Address• LIVING AREA: GARAGE AREA: DECR AREA: OTHER: Attach to this applieation, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length DESCRIPTION OF IMPROYEMENT Width Height Sq. Ft. Length Width Height Sq. Ft. Length �3 �� Width �l ! Hgt/Ground .3 � Sq. Ft. ��_ �� x C�,3cJ �- gS�. XU Corner Lot �] Inside Lot [ 7 Ft. Yd. Setback Side Yard Setback �� Type of Construction: Estimated Cost: $ __ Approx. Completion Date: �.C1Q Q� 5u��? ��' � S�� Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: �"� �� APPLICANT: �/`�� -k-�a��- Tel . � ��' /��J� Permit Fee Plan Cheek State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: C�- � �.�.�._---- CITY IISE ONLY $ � V $ ��U� $ i� $ $ �� $ .V" Fee Schedule on Reverse Side 25� of Building Permit Fee $.50/$1,000 Valuation $�175 per SAC Unit Fee Determined by Engineering A&reement Necessary [ � Not Necessary [ � �v" ��0 C.� �U,U� � � I .�v ,. � � . . � �6, U � sue�ecr PE . City of Fridley 19549 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 � ti • � PROTECTIVE INSPECTION SEC. aC1 �j f � � � � � ' /"'1 � CITY HALL FRIDLEV 55432 NUMBER REV. DRTE PAGE OF APPROVED BY �'"""�� ,'' 612-571-3450 9t0-F15 6/20/88 / / 10B ADDRESS 2 gg �y Street N. E, t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4%,48 11 Spring Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE Ga y Michurski 298 Ely Street N. E. 780-1443 3 CONTRACTOR MAIL ADDRESS Z�P PHONE UCENSE NO. First Choice Exteriors Ihc, 6587 Birkshire Lane N., Maple Grove 553-19Z8 4 ARCHITECT OR DESIGNEF MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE IICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ApDITION �7 ALTERATION ❑ REPAIR O MOVE O REMOVE S DESCRIBE WORK Install a kitchen b�a� windaw and a bedroan escape window 9 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTFICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AU7HORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUC710N OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WOfiK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STAILS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WOfiK WILL BE COMPLIED $3 � OOO $l. SO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHAPGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- $54.00 TRUCTION O HE PERfORMAN E OP CONSTRUCTION, ` /� LAN CHECK FEE TOTAL FEE � E� -�O -g $55,50 SiGN CONTRA ORORAUTHORIZED GENT IDATEI WHEN PROPERL V LIDATED THIS IS YO�P RMIT SiGNATURE OF OWNER iIF OWNEA BU�LOER� IDATEI BLDG �NSP pATE I�V [ l s �:�.� �I ALZER [ ] City of FYidley R-1 AI�ID R-2 Building Permit Ap�pl ication EEfective 5/L88 �nstructian Address: _ c�i � �' G Y S �' , �'� ,�'� � � rc Y Legal Description: � o-� 5 -+ 3�_ r �� ,.� k �,E Owner NaQne & Address :��' Y n�t �� , r S k i � r4�►'� �-_ Tel. �? 8 0��yy3 Cbmractor :_� �'S f- C�, a � c�• � X� �e r � � S' ,-,rC Tel. � S��-� -i9�1 AddieSS : — �c �� ri �/' �[ S�� ^ C C •:! /� tivl .�F�e -�' l`tYJ'� Attach to this appl ication, a Certif i�cate o� Siuvey of the lak, with the proposoed oonstruction drawn on it to scale. I�SQtIPPIOlJ OF I�!�'ROVII�TP �5� , . �� .c.� �: �. � LIVING ARFA: Length Width Height Sl�. Ft. C�RAGE AREA: Length Width Heic�t St�. Ft. ' nDC[c AREA: Length width Hgt/Grota�a SY�. Ft. �.. _ 6C��cJ �3oc,-.� �� ,.��%��...J .� �Q �.-��,.� c�a�. Gbrner Lot [ l Inside Lot [ I Ft. Yd Setback Side Yard Setbacks Zj�pe of Construction: Estimatea Cost: S .3 � Q' �� Approx. G'ompl etion Date : "7 - �/ -`a � Prop�sed Driveway Width If New Opening Is Desired: Width + 6' DATE : � ` .��` �S APPLI � �S QTY OSE �Y ��t � State Surcharge SAC Ci�arge Driveway Eecrow Park I�ee Sewer Main C2�arge � �I�iS: $ �U� � $ �J � S S $ S �S, � v S Alt. A Alt. B $ See Back Page Tel. # �� -<5'f� F�ee Scfiedule en Reverse Sicle 5.50/51,00� Valuation 5550 per SAC Uni� Alt. '�," or Alt. "8" Above F�e Determired by �gineering Agreenent Neoessary C] Nat Neoessary [ l y. . � t �' ° � � � -Z� G p�� a ! �� d� CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572- 3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On March 1, 1996 PLUMBING FIXTURE RATES New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range** NO. RATE TOTAL r Gas Dryer** Back Flow Preventer Required ()Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIUNS 1.5% of Value of Fixture or Appiiance State Surcharge TOTAL FEE ia -oo $ .50 / \ JOB ADDRESS �� The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Buiiding Division, and hereby declares that all the facts and representations stated in this application r and correct. I�-- ,,996 i't i �1'ri�lF _�R; i � �+�Fi• _ �'a�-' �1_'�i `:'�T�=,F�T I''�[IF�1'HEA��T Owner - �r � r,t r! + c.c - � i"' E v��.. i� .1J'�:�c H ; �C_�-144�ti �i� � � � � 7 3 Building Used As Estimated Cost _ � PERMIT NO. //2�� PLUMBING SIGNED BY Approved By f�� Rough-In Date TEL N0. � ? Final Date MINIMUM FEE`�OR ANY PLiJMBING/GAS PERMIT iS $20 00 $�� PLUS THE $.50 STATE SURCHARGE **COMBUS110N AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SGl INCHES. � G . CITY,t'�F FRIDLEY INSPECTION DIV. Effective On January 1, 1991 64s1 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Sheli and Duct Work, Burner - Also Replacement Fumace Gas Piping (Needed with new furnace) Gas Range Gas Dryer "Air Conditioning - All Sizes Rate TOTAL $ 20.00 $ �0, Q d $ 1 Q.00 $ D. O d JOE3 ADDRESS � g � ��i �� The undersigned hereby makes application far a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and ruling of the Building Division, and hereby declares that all the facts and representations stated in t's application are true and correct. � ,19� OWN $ 10.00 $ ' �, �` / BUILDING USED AS /� Ps i�4� �'i g L I76 m� $ 10.00 $ � Q� � , ESl"IMATED COST �,��Z d PERMIT NO. %%� �� $ 10.00 $ Atl Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/tndustrial 1�/o of Value of Appliance or Work State Surcharge TOTAL FEE DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units� Circle One (Steam) (Hot Wat Warm Air), Tracie Name �rrno;r� ��[/y96�d Size No. !o0 4�' BTU L�D, DOO HP EDR �.� `% $ Fuel /I�c� t C'ras Total Connected Load S�/,; � G/ $ .50_ M I N I M U M F E E F O R A N Y H E A T I N G/ C O O L I N G N E� N T I L A T I O N REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 "Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. `t . � Burner Trade Name Size No. BTU HP EDR HEATING COMPANY-��6 ///iu JLipa%n�s 9�- �i � ("e., c�i��'on.�r�ry D / Signed B Z � Tel No. G� 3 o y�� ,f✓ Approved By�_ Rough-in Dats�� Final Date - �- la.-�3 FILL OUT BACK SIDE FOR STACK VERIFICATION ON REF�LACEMENT FURNACE .� CHIMNEY AND STACR '�ERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully exami�►ed Yes �) No O 2. Is free from rust or deterioration Yes �) No () 3. Has no foreign objects lodged within Yes�(.,) No O 4. Is securely supported Yes�(.,J) No () 5. Meets all current Code requirements for size and total BTU's connected Yes�(�) No () 6. Has total heating BTU's of� _ �//, fob/ All other BTU's " TOTAL BTU' s 7�, G!v I Remarks HEATING COMPAN' Signed By Date �i:�'� _ s .� '� n�� `'' I,,,W� V!7►ffr ~ • ��M s:. 1 �. ��.� �''�"°-r► --�`� �'iadc��j .,w crraC' �'L'�; Door� �-A -- ��a _ _ �� s•� 4;l;nr S,B - � �'{ — ------ . - -- • — . � iloors — � -----:�� ! �Ks r �, t . .. �o ?6 's � �9 �� CMAt7 1 �a..� c� �� =- =�? *�* +�ws � � � a'' » �� °�' "s +.t:,,,�;,, �„� -M s.�:r� x c tt - ��.s _ - � � -f� � M .�s ��4� -�M l�ZaidttY � �L..a 1i1. _! . -.y`'•'O�►i�i � k.D•.�j ��Tiia! Aii"�t,ps� j�it�ip • , � � , Rw�. �i ..l3 aYyr G4. A� � • � �i �! �ir'� !�i'�` A �f +ii��n► 4 C M -� 1Z C o ► Q---e__ C� �l-�O � O �°'�`�° .� ��o.. /� ��u ..,��Gr �--�C �--s ) � r-�r cS� ��— ( �'�-.�=--�.-- � SuB�ECt City of Fridley AT THE TOP OF THE TWINS g� I L D I N G P E R M I T r � � � � � COMMUNITY DEVELOPMENT OIV. � ♦V'�"'�', r � � PROTECTIVE INSPECTION SEC. � � i . � � � i""1 � CITY HALL fRIDIE� 55432 NUMBER aEv �'""'�� ,�� 612-571-3450 910-F15 J08 ADDRESS 29g Ely Street NE t LEGAL LOT NO. BIOCK TRACT OR ADDITION DESCR. �{],48 11 Spring Brook Park 2 PROPERTY OWNER MAIL AODRESS Gary Michurski 298 Ely Street NE 3 CONTRACTOR MAIL ADDRESS Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS 5 ENGINEEA MAIL ADDRESS 6 USE OF BUILDING Residential 7 CLASS OF WORK � NEW ❑ ADDITION CJ ALTERATION 8 DESCRIBE WOFK Construct a 13' x 13' Detached Deck 9 CHANGEOFUSEFROM TO STIPULA710NS See notations on plan. DATE 5/27/97 ZIP ZIP PAGE UF / / i i� ��9 �l�a� AVPNOVEO B� SEE ATTACHED SHEET PHONE 780-1443 PHONE UCENSENO PHONE �ICENSE NO. PHONE LICENSE NO. ❑ REPAIR ❑ MOVE ❑ REMOVE --- -- TYPE OF CONST. SEPARATE PERMITS ARE REOUIRED FOR ELECTFICAL, PLUMBING, HEATING, VENTI�ATING OR AIF CONDITIONING. THIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSTRUCTION ZONING AUTHORIZED IS NOT COMMENCED WITH�N 60 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. UN17S 1 HEREBY CERTIFV THAT I HAVE READ AND EXAMINEO 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 1 499 WITH WHETHEF SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT � � DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �(FS.SO STRUCTION OR THE PERFOFMANCE OF CONSTRUCTION. PLAN CHECK FEE _ SIGyPT,�RE OF CON'RAC70R OR AU f\.�/ !1 — • Ow D 0 IDATE� V '��— iDATEi OCCUPANCYGROUP OCCUPANCVLOAD STALLS CU. FT. OFFSTREET PARKING IGARAGES SURTAX �.�.5 SAC CHARGE �re SC $1.50 TO' AL FEE $50.75 D THIS IS VOUR PERMIT NEW ADDN ALTER [l �� ConstructionAddress: Legal Description: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXFS R-1 AND R-2 BUILDING PERMIT APPLiCATION �Tg' � lu S�, a1 � Effective 1/1/97 , �� " � � Owner Name & Address: (�d r � /� /'Vj 1 C�I u 12�51C � Tel. # 7�0 - j��/ 3 Contractor: s � .F' � ,� ; ( �- MN LICENSE # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IlVIPROVEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height `/ � Sq. Ft. DECK AREA: Length / 3� Width �,� � Hgt/Groun�� Sq. Ft. %(p� T oT�R: � �- �� i �1�t1� � �i2r�,�� -��r�s � Construction Type: -�,^�a �c.d �L � k �e Driveway Cti.irb Cut Width Needed: Ft. + 6 Ft = Fstimated Cost: $_ �� , (Fee Schedule on Back) Ft x $ _ $ DA1'E: S-2 3 � `� % APPLICANT: � ' , Tel. # 7�D - / i��3 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ Z�� , � C.' � J. S r $ � � e- � $ $ $ $ $ $ � ��'•>� CITY USE ONLY Fee Schedule on Reverse Side 001 of Pemut Valuation (1/lOth%) $.50/$1,000 Valuation $950 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 0 = �rous+��.i •�s ti[s• c�*• �o�a •:a � � �::. ,� '� t, e � = N� ' a. � '�. ;, :; ": 1v: � t-,� .'� C. E. COULTER -�••�y� LAND SURVEYOR r�w~ s`•�•�•� . l�M[iNOA( REJ�S�ERE: ��tiC�ER L�tiS Cr 5��►+E OF u ntiE50T� � .vc c-.•: � I�CENSED �� pwG�ti�tiC[S Of C��r Ot �.ti.,E�►OL�i 3300 LYNDALE A�:E 50 MINNEAPOLIS 8 MINN TAYLOR 4-0370 �+urbepor'g �ertificatc -�� ^ -T �� • ��-c ��A .C,2� v=�-� _ �Y " `_ J ` , ------ 6�.0-- -- _ ��— �. ` �o.o � 30,0 � � y ; � � ; �. , ca - W r [Y � - j- N T - � - , - . - . J, / V , � - , v/ � !� �— '. SG'.'�.— �� _��,'� � � 1-5-F � � �� N - �6�'t G" C'l � � � � �. - -J li 0 � � E � E N2'^� " � � J �' .-, -�_� � 4. � � �� J �J.^i��1. . _. _ _ . ��-�,C _. .._ - �. �V� +�� I ' �♦ , �; > -�.0 � �"�vi E.R P ;'�=_ Gl_ � �.. r.-•+ i�� rJ `. •��V I l;ereL}� ce::_ir,• tr,at tiie abo�e i� a true and correct plat o` a �ur�.�e•.- of: Lot� 47 �r,d 4�3, �'�ioc)c 11, Sprin� Broo;� Park, Anc�:{a Count�•, Minnesota. As surveyed b}• me this 2Uth da� of Augus � 1964 A.D. l � "� �^ S i g ne d .�� _.� ; � { .,.� : .1 �" � , M1I1ri�sota� Reci� �ration No. 2�84 _ . . „_ ,:. ,. _ _ ! x ,..� ? ;,ign Works (R), Knox Lumber, # 220, Phone # 754-3550 � ue iVIay 20 13:01:59 1997 Pl`an ID: CQ5735 Deck Dimensions for Deck 1 �- I � � �x` �� `% d,�,y,�, a� h�1k�� °S} C ��" �' � s QG 1 a� 5 �,�c�" I � .. --- - -..... Z� See the Specification Sheet for More Details 0 �.� �$�� L_ �� ' � . �t nb�� ,� fi s.�,,.'�' ��' .._.--� � � SUBJECT � P . c;ty of Fr�aley 3 0 8 7 0 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � • � � • � ; v _ COMMUNITV DEVEIOPMENT DIV. / r � � PROTEC7IVE INSPECTION SEC. Q�5 3 � ' /"'1 � CITY NALL FRIOIE� 55�32 NUMBER REV DATE PAGE OF AOPROVEO B� �----�; ,.� 612-571-3450 9�0-F15 4/27/�� / / JOB ADDRESS 2gg Ely Street NE 1 LEGAL �OT NO. BLOCK TRACT OF AODITION SEE ATTACHEO oesca. 47,48 11 Spring Brook Park SMEET 2 PROPERTV OWNER MAIL ADORESS 21P PHONE Gary Michurski 298 Ely Street NE 3 CON7RACTOR MAIL ApDRESS ZIP PHONE IICENSE NO Sears Home Improvement 8823 Zealand Ave, Brooklyn Park, NIN 55445 1-800-903-4176 � ARCHITECT OR OESIGNER MAIL AODRESS Z�P PNONE UCENSE NO. 20090017 5 ENGINEER MAII A�DRESS ZIP PMONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS Of WORK ❑ NEW O ADDITION O ALTERATION f�7 REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reside House & Garage 9 CHANGEOfUSEFROM TO STIPULATIONS Call for building wrap inspection before covering. TYPEOFCONST OCCUPANCVGROUP OCCUPANCvIOAD SEPARATE PERMITS ARE REOUIRED FOR EIECTRICAL, PLUMBING, NEATING. VENTILATING OR AIR CONDITIONING TMIS PEfiMIT BECOMES NULL ANO VOIO IF WOiiK OF CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCEO V�1ITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OF ABANDONED FOR A PERIOD Of 120 OAYS AT ANV TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HERE9Y CERTIFV THAT I HAVE READ ANO EXAMINEO THIS APPLICATION 1 STA�IS GARAGES ANO KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PfiOVIS10N5 OF LAWS yp�UpTION SURTA% AND ORDINANCES GOVERNING THIS TVPE OF WORK WI�� BE COMP�IED WiTH WHETMER SPEGFIED HEREIN Ofi NOL THE GRAN7ING OF A PERMIT �4,753 ` $2.37 DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL THE pEqM1T FEE SAC CNA GE PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON• TR CTION OR T ERFORMAN Of CONSTRUCTION �111.2.5 F1Z' SC ��F.JS PLAN GMECKFEE TOi FEE Licens C $5.00 123.37 5 •fUAEO�CON" ♦(; ROpAU� 2ED�GEtit IOATEi MEN ROPE LipA HIS IS VOU RMIT f/" I C {/ � S�GtiaiuAE O� OwrvEQ ��c OWtiEQ BWIDEp� iD�iE� �hg� r�crE r�e NEW [ ] Effective 1/1/2000 ADDN [] CITY OF FRIDLEY (763) 572-3604 Bidg insp ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDtNG PERMITAPPLiCATION �� % 1 � i� . 0� � Constructior� Address: __��g � ''� 5 � � � �' Legal Description: Owner Name & Address �� r'1 i C�H ��S�-t Tel. # �i Contractor: � r S �� `^1 q80 �% `l— I '^'� �C�� 15. � MN LICENSE # � t Address: � ?J c...�o-�i� c��j �3 l c.. �:.,� Tel. # i'�c�v '`1 � � "`'� ) 7� LIVING AREA: GARAGE AREA; DECK AREA: O7HER: 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 Length Width �s�� Height Sq. Ft. _ Hgt/Ground Sq. Ft. � ��s � Construction Type: � ��, Estimated Cost: $ i,�5 3 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �'I - � � `�%� APPLICANT; o�^'► Tel. # CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application $ �//, �S� Fee Schedule on Reverse Side $ '� 7S .001 of Permit Valuation (1/10th%) $ ��% $.50/$1,000 Valuation $ $1100 per SAC Unit $ � bU $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $ $ $ 1�3. � $450.00 Conservation Plan Review .Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] i;; , ; ;fr �-�-z,�� IivSt'tCTION DIV. 6431 University Ave NE Fridiey, MN 55432 (763) 572-3604, FAX (763) 571-1287 Stories Basement Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: New Fi�ures Old Opening, tVew Fixture BeerDispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas"" Gas Range'" Urinal APPLiCATION FOR PLUMBJNG AND GAS FlTTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Wash n#'1t�4�. Floor C�t�h Auto. ;:::: . :: ;;;:., > <:;:::;: Shower �i�k. . ; Tray Four�� ;., Drain �as�n ,,. Washer NO. RATE � Gas Dryer'* Back Flow Preventer Required ()Yes () No $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ �.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 Type $15.00 Reinspectian Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE TOTAL $ .5� ��--.� JOB ADDRESS titecUvc un Jan 1, LUU:i Gas Water Heater Ranqe �. :. Gas Elec The undersigned hereby makes application 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. , 20S]� n � �1fh0� Owner Building Used As_l�P `�!�G�_�° rC .� Estimated Cost PERMIT NO. 1 y� PLUMBING COMPANY �p�ill�l`E'�)' � T SIGNED BY _ TEL NO.��{3 � Rou h-In Date Final Date �"u 'C1-� Approved By g / MINIMUM FEE FOR ANY PLUMBINGIGAS PERMIT IS $20.00 PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 s�z-36u4 r�aa�: : 298 ELY ST NE : 033024310106 : SPRING BROOK PARK : LOT 47 BLOCK 11 : ELECTRICAL : RESIDENTIAL : ADDITION/ALTERATION s�i-iz�� PERMIT NO.: 2004-00077 DATE ISSUED: Ol/22/2004 VALUATION . NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL XCEL ENERGY SAVERS SWITCH # INSPECTIONS APPLICANT HUNT ELECTRIC CORP 2300 TERRITORIAL RD ST PAUL, MN 55114-1614 (651) 646-2911 OWNER SAMMON, DAWN M 298 ELY ST NE FRIDLEY, MN 55432 1 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 provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp ELEC PERMIT FEE - MIN (RESI) STATE SURCHARGE, ELEC FLAT TOTAL PAID WITH CHECK # 113375 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 20.00 0.50 20.50 04/02/2004 FRI 1a:21 FA% NEw Il ADDN [j ALTER [ ] Construction Address: Q Legaf Descrfption: Owner Narne � Address: -�-�i ELDER JONE9 �� - (� f �l �S � �iooiiaoi - �- � -� -- -� CITY OF FR►DLEY Effeetive 4/1/2004 �6431 UniversityAve NE, Fridley, MN 55432 (763) 572v'SQ4 Bldg Insp SINGL�E FAM►LYAND DUPLE?CES R-'( ANQ R 2 763) 571-7287 Fax BUILDlNG PERMITAPPLICATION ' �� ^ � ! � I�. � , _ �� ,��( Contractor. _ The Home Depot A.H.S. Inc. Address: 3200 Cobb Galleria Pkwy. Atlanta, GA 30339 763-542-8826 License #20268257 LMNG AREA: GARAGE AREA: bECK AREA: o-rHeR: �+- �� MN LlCENSE # Tel_ # � Certificate of Survey of the truction drawn on it to sca(e. D�SCRiPT10N OF IMPROV�MEN7 Length �� d� � Height � Sq, Ft. LengEi� _,__ �/�;d� __ Height Sq. Fi Construction Type: Estimated Cost: 1�'►��11'�L►'fiiT►r!3��_� / • - . priveway Curb Cut Wdth IVeeded: Ft, Ft = F� -� DATE: USqpPL1eA�; Tel. # U 1, O Call (763) 572-3604 fer Permit Fees if mailing in applicaiion. Fax to 763-571-'f287 if using credi! card and we will call you for card numbe�. Permit Fee Plan Review Fire Surcharge Stafe Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer M�in Charge ; T07AL CI'IY USE ONLY- $_ l�• S Fee Schedufe on Reverse Side � 65°/a of Permit Fee $ .007 of Permit Valuation (1/90fh%) $ $.50/$1,000 Valuation � $ $1350 per SAC Unit $ � 6 C..� $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 [ ] $ v I STIPULATIpNS� �^(p�° �C, l ,� %��• COS� C I TY � FR I DLEY ,��ding .spectio�s ;3-57�-3644 'E ADD1'tF�S _-2 aS APPUCAM' l5: T�NAN'I' SUBMTT A CQ� OF rOVR STATE �.�C�NSE yViTH AP�'LICAiTQN PROP�tTY 'CX�'� �r V �.Ti��r' �ESYDENTiAL A►�'�"�ICA.'�IUl�T C�'X O� FR��"S� YOUR E-MAFL AA�RESS ■ • • �• ��{iq �ennit No.: Receivea sy: � � n� ��?a.:��'?,b TaA�E: Sl'A7L•?� p.D��ss: GITY rxoa�: �3 ' 6 , � SiATE LICENSE � ❑ �r� ��G � � n swnvnv� ��.,_ �. ; � �� . . - • � �� * • la. 'I"YPE O�' �1►ORK: u�'�,`'" A.3lg — -- ODELI�IG ►�SCR3B� YJ4RK BEING DOI�- -� Q r v� ai � G� Ye � v o . ---. ucrrx�rr Sa. F't. � ��.�.+��-- :t►„CtA,,, 6ES �RQPflSED S��— RO� ��: �IDIIVG 3 v3�ny1 7 Alumi�zan ] 0�' „�_�_ i�Y1VbOQi'S N F.KIS'T�G OP'FNII�GS OYes C.INo JR �!QR NEW OP$NxidQS-T?ESGRI�E SiZE OF G C�C�NCsES � L�:NGTH ❑ HOUSE 8c GARAC� ❑ ATTACHEA GA1tAG£ O DEXRC�p GARAGE vs� O Trim y�� Li Fascis J 'St �"' LUCATIUI3 OF WINDOWS $A�T n�, n�r, stlsMrl': t. fi�dstiu�p, �1oor k1a° 2 P�a�osed �oor Pt�► 3. List vR soruceual members to bo e�d FORTiEW GCiNS"R'�tL3CTi02d II1Ci.LJDING ��CK3, �DiTION�. � onRr:�s tt1�M1T: 1. Srte Pia�eS' sh°Mnag thc � struet�s aod prop�o�d p�o1�.. 2. 'Itivo sets of a0� P� 3, Eae�gy (:ais�tiavoAs TYPfi q� WQ�(DO'W T4 SE MSTAi.LED NIJ1vIBER OF �� r�. ��s ��ns�� art v�u,u,��xorr, rnrcz,v�a�c � cos�e oF r�ao� �,.rro rr�'�'E�.�s {USIIVG '�"Q� � 947 U.B.0 FEE SCI�b�EJLE) 'Z'OTAI. J08 VALUA'�Ol+j $ ��? ' I , � UCCUPANCX �'� Permit Pee S_ See Back Page for �'ee Schedule Pla�tlt �eviow . $ 65% of Building FenoRiR �F�e Surcharge $ �(.0005) tiu�s the total job vahiation _�mum $.50 $ .001 x petmit Valnffiioa (1/10%) Fire Sur�harge Licensed �sidential Co��) License 5�,� $ - C`3r�— $5.00 (55� S�� e � $1450 per SAC Utnt (Plans to M'�� fO� ��"�ion) C�u'b Cut Esc,�ow $ �R + 6 S = �� 20 = � Erosio�a Gont;nt S $450 Canservatia�n Pla�a R,eview Fark lFe� $ �'ee Detarmined b3' �8�'�1e�� Sewer Mai,n Charge $ Agreement n�cessary' () Non NecessarY () ._. . . ..__ � "i'" � C - Make �b�ecks payabte bo: City of �+'��Y A�" �� 1 TtiI5 YS AN APPLICATiO'� FOR A PERT4iT NOT VAi.ID UN7B. FROCESSbSJ I hcreb3' �P�Y �'or a tn�ldiong p�rmit aud x a,ckaowledge t�at che infonouation above is complete and accflratG> that the work will be in conforma.�ce with the ord'unaaces an.d cvdes of the CitY 4f Fridley amd with the M�m�nesota Consizuc� on Codes; that I waderstaad �is is not a perz�;t t�ut oniy a�n applicaaon foz a permit aud wvrk is not to ssa�t without a Qermit; that e work will be in accor�nc� w� �ie �oved ptan in t1�e caso af all work w�ic� requires r�'ew� approvai of p�s- � �/�� .......,. c�� ii SIGNATUit� OF A.PPL.IL'ANT Building a MECHANICAL Permit No.: Inspections (,'�� + SIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DatR�e�d• � DATE �Q " O� S' U� YOUR E-MAIL ADDRESS S�-��D�ss aq$ �u s . 1�E THIS APPLICANT IS: O OWNER �7CONTRACTOR PROPERTY NAME: 1r1'tU OWNER/ ADD�SS: a9 � E( u S i� N� cr� r,' -e� sTA�m�IP SSU�i TENANT pHONE: %Io�j- S-IU - 1 a y"3 � CONTRACTOR COMPANY NAME: CENTERPOINT ENERGY SUBMIT A COPY OF CONTACT PERSON: JOANN � INREN YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH �D�ss: 9320 EVERGREEN BI,VD STE HtTY ''COl'711i ""RAPIDS s-ra,�MN ziP�5433 APPLICATION PxoNE 763 — 757 — 6202 FAX 763--757�-6701 PERMIT TYPE �GLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: � �W ��PLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK �r �.1 Cz �,e i � n < < e+'' PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $SOQ FEES ARE BASED ON $] 0.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) J- Equipment Installed MFG: �1A MODEL: �� NL' � oZu SIZEBTU a� ' 7'� 1'� MFG: MODEL: SIZEBN MFG: MODBL: � SIZEBTU A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _NEW GAS GRII,L $10.00 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 — � �. �. . � _w� — — , ,, �.�� { : �.. �' .-��, . Permit Fee $ Number of fixtures @$10.00 x$10.00 =$ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @$25.00 _� x$25.00 =$ o? S,CA Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Tota1= $ o?S� SO 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; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT L �� ' � ��irrT NAME ROGER HOFFHEIN DATE � i7�6 % ':�°��?I�,�A�.f ` � 9 ' '`,�� x� � ; Gity of Fridiey 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 PERNIIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS XISTING 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 PropanelIFGC 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 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 Inspections 7. 63-572-3604 DATE / �- 07-�7 _ O"t SITE ADDRESS a g d TH1S APPLICANT IS: PROPERTY � OWNER/ TENANT 1VIECI-�NICAL RESII)ENTIAL A�']PLICATI�N CITY OF FR.�LEY _ YOUR E-MAIL ADDRESS � N � FIQ/AI� 0 OWNER �dCONTRACTOR Permit No.: Received By: Dat�d: . N,a�„tE: iJaw J A � o � ADDRESS: a q 8 r� �F • N C CITY�R. t � 1�.� STATE,�_ZIP� S U 3 a- PHONE: "Z�3 • S � `� • i a �F � CONTRACTOR � COMPANY � «f SUBMIT A COPY OF CONTACT PERSON: � � YOUR STATE STATE L]CENSE # EXP DATE LICENSEWITH ,a�nxESS: Ra9� !-'�G��'► S�• �� CITYFiQ.�ol� STATDMy ZIP,$�Sy3� APPLICATION PHONE � 6 3` 7 S 4� a� 4 4 FAX PERNIIT TYPE TYPE OF WORK: BiSINGLE FA1vIII_Y ❑ TWO FAMILY ❑ �W �REPLACEMENT ❑ TOWNfiOUSE ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK L�► s�- A l I �� I c�. c c H� h� �u. a',' ^ �� __ PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to 5500.00, whichever is greater, for the improvement, installation or replacement of a residenrial ftxture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor � x.OS = FOR PROJECTS Wi�RE LABOR EXCE£DS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCFPT WHERE N�TED. fIXT'[JRES' (�`1�IGATE TOTAL NUNBER OF EACH BELOV� V p MODEL: Il P,Ph. b? �� SIZFJBTU .� d u,--�-- EquipmentInstalled , MFG� �U MODEL: SIZEJBTU MFG: SIZFJBTU �C,: MODEL: A/C $25.00 _FIREPLACE (GAS) $15.00 . GAS RANGFJOVEN �10.00 'AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) 335.00 NEW GAS GRILL S10.00 BOILER $35.00 x FURNACE $35.00 _GAS UN1T H1R 510.00 _CHIMNEY LINER $10.00 �GAS DRYER 510.00 POOL HFA7'ER $35.00 DUGT WORK 510.00 GAS PIPING $]0.00 _VENTIL�►TOR S15.00 . . x�.ww�.,...,�r„��.?�nr,.,.rnyrazv�Dxr �.c.., 1�i�.Cd'i,�r..�Gli\N/7i1.:i�an.? r v�.a_a±��asrsu.sr... �...,,.•. �. M.�;}�... ...... , ...� ........... ......... ... ... .. .. .. Permit Fee $ 3 J , o o Number of fixtures Q, $10.00 x$10.00 =$ Surcharge $ .50 Number of fixtures (a3 $15.00 x $15.00 = $ TOTAL DUE $ 3, •�d Number of fixtures @$25.00 x$25.00 =$ Number of fixtures @$35.00 �_ x$35.00 =$ S• u a State Surcharge = $�?� Tota1= $ 3 S . � ° THIS IS AN APPLICATION FOR A PERM�T-NOT VALID UMIL PROCESSED I hereby apply for a br�ilding 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 appro��al of plans. , n �. P�6l,p PRIN'f NAME V� � l S �. �^IO P DATE 1 a` • a1'7 -�� SIGNA'fURE OF APPLICANT l� �..t.� o City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 F.A�: ?63-502-4977 REQUIRED lNFORMATION NEEDED TO PROCESS PERMIT RESiDENTlAL PERMIT APPLICATI�N HVAC � ❑ NEW HOMES/ADDI�(ONS � EXiSTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEWlEXISTING HOMES 1. Combustion Air (See note below) . a. Oil or solid fuel ]MC Chapter 7 with MN Amendments b. Nattu'al Gas or PropaneJlFGC Chapter 3 with MN Amen.dments � 2. Make-up A.ir (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 REQUIRED FOR NEW HOMES 4. Heat loss & cooling loa.d. per room a. Required on new conshv.ction IMC 1346.0312 5. Ventilation . � a. per MTT Energy Code 7670 or 7572 6. Duct Desiga Per IMC 1346:0603.2 a. ACCA Manual D NQ1'JE: Centerpoint Energ� Mechanical Code Guidelines software may be used for comb:ustion and make up air calculations Building �nspections 763-572-3604 763-�02-4977 FAX DATE 2 � U' SfTL ADDRLSS THIS APPLICANT IS PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STAT� LICENSE, BOND AND CERTIFICATE OF INSURANCE ��a �S��Il�'�'�� .�P�,��'�'I�l`� C��'Y ��+' ��+ � EFFECTIVL- 2-19-09 YOUR �-MA1L ADDRESS ❑ OWNER ADDRESS: � I S ( L�� CITY�� PHONC: �UIZ— � ✓ � I�2� STATELICENSE# ' STATE BOND # ADDRESS: Z' I PHONE U � - �5�� PERMIT TYPE �?INGLE FAM[LY I TYPE OF WORK: � N�' DETAILED DESCRIPTION OF WORK ❑ TWO FAMILY �REPLACEMENT � CITYJ FAX ❑ TOWNHOUSE Permit No.: � (,��>�'� Received By: N �i`'� �� :� � � L� ATE �c!,ivZIP ��%3 Z EXP DATE EXP DATE � STATE�ZIP S� Z 3—� � �Zo� FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOVI�. MINIMITM FEE $35.50. BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING (NEED CITY LIC) SWIMMING POOL WATER SOFINER ($35) CLOTHES WASHER KITCHEN SINK WATERCLOSET BACKFLOW PREV. ($IS) _ DISHWASHER _ LAUNDRY TRAY �WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER THIS IS AN APPLICATION POR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a plu�nbing 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 Conshuction 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 worlc will be in accordance with the approved plan in tl�e case of all worlc which requires review and approval of plans. SIGNATUIZLOPAPPLICANT Li�`�'� ��y(% PRINTNAME Ci"�%�S �Y31`�� DATE 2��LV YL�,AS� NV l.'h;' �•� Cltj' O� �'1"3(�1�3' �ualding Inspee�ions �e�a�-�Yraent 6431 University Avenue NE, Fridley, MN »432 763-�7?-360� FAX: 763-�02-4977 ... .... .. ...._ ,. �