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AF - 41657.. � . ��.�.� o ��h�' @ �� ,.d ��e . p �i�G66y��'R,`S �r �0�� !��►'�'Y��.S �DO W�ST ' "/2f� ��! STR�LCT . =BURNSVlLLE, MINNESOTA � C � � � 1 { i c � �� f �� r v� �r �'� �.��. � ��__._�p � ��r�r��rvr ��R�� ,.�� Q�� .�� o� r �.n �' � ' �► . ��°�7�� ' � : � �� . (e � 1 a � �► � i � «, � � z[o.� � � . ' Z S .'i 0 � �, ��t�1�. �l..��I�. W�l.�l_� i�,� ��, � �_ �• ---- ,.� cr ---- ��'� . �= � � � � ,��AL� 1'= �4�° . . . � IMDI�A�� BF�AiV �4i� 1�E�R t�� :�S��s.d� �� '� , �� . �Z- . . �$� � _�—� �� , r7�, a �' � �� . � � L,! � 6 1�.1 T"g' � 1� 1�.6�8 c�J A,.f�►� . � � ��'� �1l � {a!T ' - L��eqL- t��°��?�AT'df�Ae � L�'Jl" t 1 A, ��?�� Q�i�4 � �� '� ,��Zle°�� SG�� ,A.��E �''�'c�� r4hl�Kf�� t��f�f i �� 'iillt��:��'T� � I hereby �ertify thnt this sur�•ey, plan or report was ��repared by me or under my direct supervision and that I am a duiy �te�istered Land Surveyor under the lativs of the Szate of Miz► esc3ta. `? ' � ,�, -��` z` y�. .�. ,;,,e �-' - �t " � ' � Reg. No. �3 � _ � ` - P� .__..� .. .. 1 C �-a�-�� 53-8L� -s-915. 51 � �� Number Fixtures x $2.00 �_ Future Fixtures x $1.50 New Fixture-Old Open. x $1.50 Catch Bastn x $3.25 Water Heater-99,000 BTU x $3.00 Ground Run Old Bldg. x$3.25 Elec. Water Heater x $2.00 Gas Fitting Fees: lat 3 Fixtures x $2.00 Additional Fixtures x $ .75 Gas Range-199,000 BTU 1 x$5.00 5.00 Repairs & Alterationa See e `��' Description: Code �G�a�� State Surcharge ��aSS'�P� S .50 To� r�E $ 5 • 50 The undereigned hereby makea application for a permit for the work herein apecified� agreeing to do all work in atrict acco�dance w ith the City Ordiaances and rulin, of the Department of $uildinge,� and hereby declare that a11'the tacte and repxeeentations etated in thia application are true aad correct. �� o � c°'rd� o�G ., �:rsto �-ea.......s-.:..., � T�tn � � City of Fridley 4T TNE TOP 0' TIIE TN�INO . rL-------� cw+MuN�rr oev�w�+eNr mv. �{ � MOT�CTIVR /If�CTp� �K, i �� CITr MAI.L FAIOLRr iMi (l.� �.� M�-ss0-sN0 ob Address ��.. ��t� �T/� ( Contr ctor �� Gc �!s v.-� Rind of Building �. �cJ 4 G c � Comp etion Date �I m �. �I � � �� ip o �3 0 �0 u �O � !� n I� i� iA . � I W ti � 9-�L - 7s ��.`_1� :� ,', no � .� � � w .� f� � � � a� � � � < r.� (� I� �'. �� i i i � ! � II , �� i i��EGT PLUMBIiVf, PER�IIT APPLICATIt�i�d s Phone � r aaress Phone , � 3�y6 � � �2 � >�� y?�� se --1 — -_ -- --. - -- Plumbing Fixture Rates: N0. RATE TOTAL Number Fixtures � x $2.00 '��bJ Future Fixtures _�_ x $1.50 �� New Fixture-Old Open. x $1.50 Catch Bastn x $3.25 Water Heater-99, 000 B1'U ` x$3. 00 ��, �� —,—_ Ground Run Old Bldg. x$3.25 Elec. Water Heater x $2.00 Gas Fitting Fees: lat 3 Fixtuxes � x$2.00 ' a u J Additional Fixtures �� x $ .75 Gas Range-199,000 BTU x ,55.00 Repairs � Alterationa See Description: Code State Surchart�e � v .50 1 � To�at r�E $ �I .a �� !The undersigned hereby makes application for a permit for the wo�rk herein specified� agreeing to do all woxk in strict accordance w ith the City Ordinances and rulin; of the �epartment of �uildi.nga�, and hereby declare that a11�th� facts and repreaenCations atated in thie app,ic tion are e and correct. i �� a�� _'S ig at � e Da e . t � SUBJECT PER . 2445 City of Fridley ' 1 AT THE TOP OF THE TWINS g U I L D I N G P E R M i T ' � ; � RECEIPT NO. � ; .�_�_, COMMUNITY DEVELOPMENT DIV. '� �� L � PROTECTIVE INSPECTION SEC. 1 . � °'---'. � � /"'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �----� • •�� si z-seasaso 910-F15 3/4/74 � � JOB ADDRESS $041 Fairmont Circle N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oescR. 11 2 Bourdeatta's Spring Brook Addition SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE ThE Rottlund Com an 4220 Central Avenue 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO. Same 4 ARCHITECTOROESIGNER MAILADDRESS 21P PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USEOFBUILDIN(i Residential 7 CLASS OF WORK � NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBEWORK �oustruct a 26' x 40 & 41' Dwelli.ng and a 26' x 24' Garage 9 CHANOE OF USE FROM TO STIPULATIONS provide a haxd surface driveway. Provide a verifying survey before capping. SEWER WYE: 97' West of Manhole Wye Elev: 848.83 Top of Eooting: �� 851.83 Minimum Maxihole ?.nv . Elev : 848 .47 WATER LOCATION: 87' West of Manhole SEPERATE PERMITS REQUIREI� FOR 1�lIRING, � �IEATING, PLUMBING AND StGNSw TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WiTHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 1066 + 624 �.O O3L'I'(L�FO ANY TIME AFTER WORK IS COMMENCED. NO. DWIG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 24 445 12•22 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIOF�S OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $rj1.00 300.00 STRUCTIG OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECKFEE TOTALFEE '� ° � ,— c%� . 22 a SIGNATUREO CONTRACTORORAUTHORIZE �� IDATEI H P OPERLY VALIDATE HI IS UR PERMiT � SIGNATURE OF OWNER IIF OWNER BUILDERI IDATE) OG INSP �ATE ,M �!a' .� . � ��a'. ,.�. . .Yo. -a:r�, .,i,:,i�'.iu, �,-'r. .�. ...-.,-s�� ,�v:... �r:P . i, ir�i: �, �«� „ ,.. , .,.-a-� .. , o . ,.r .. . � . �a . _ _-_ . . . � , . • b . � , a,�� .�� : �� m � � Ci��C�l6��R.'S �^� ��/-�6�� `i��YC��'; � , : ° O0 WLST �� .; /2�'t��i`.�..STR��.T..'�,. - �BURNSVILLE, MINNESOTA, � C � �' � j � d C C� �`G� � f SP� P' Y�.' �! �� "_ �;r 1/� � �2� � � �_,_,�,; ' .� . �� I �„.--FAIRMONT:C11��[��,;; . � ' .' � . . , - . � Q ' N� � � •, 1 � + �� . � N.�`1.�7.�VU � � . `F � . � s . . . �4;' ..,� � - � • . . � ;» �s �;, . � . � . S�ALE�_�.1_'= �� f . . . , ' . . � �! � �' , r � , � . � � ,$• -- , h � . , _o� :_7N01 CP+T,�S: _ � ROiV � ° � � , . . • : . ALL: _ �I�EAR1�l�S_ -�SS�f.P�i �D' � I7, �! , . . . . . . . � : . � ' ' /I 1 � � . � S � I f� i h . ' ', � '�' .—�— � C9� i R � , ' , � ' , , ` � �,�1��1��1.�. ��14}�, • �;,� ' ' . .' ' . � . a _ � �. � , ,: . . . � s G � � -- t , �r . + �'' , ; � . � � ��- � , ,; � � : , � . . , p� f ;�1 � ;. � � �� . . _ � . - . � . �. _ . :,. : � . . . . , : � �- � : I � :; _ , � . , ,� . . .. :;.....� . . --�- , . .. , � � -- ��.�.�� -..r-= s ' �; . - ��.s��. .�; ;, . , . �-r�� s.�.-r � D'�.�d��.�� . �.._ , ` . �as��►�cv� , -. . . , � �. � t.E, G A � � �D�S �R � i�Tt�� . ;< ; • � � I herebq �erdfy that .this sur�•ey, plaa or .. : � ' , ,, . -- '� rrport was;;�repared by me or under my dizcct ��;p�' :l� ,: ��.�� _..,_. . supervision;. a�td ihat I am a dvly �te�istexed �Qd'Ui R ��P►8.1 �'� ' .�P�'dl1��..� �F��'C .�.�1?1.�'��. � �.and SurveYat under the laws of the �*.ate �I �.. . . . _ �: �il.l V� �+ �/°1': � C!� �t N.T �9� � -7�°9I �'�id �,��'7°r'�� ,� . o� Mvn e.'Sdt�'. �`q��,r .. �',� df � �' � � . . . . . _ . ' , - ia'c..�,'� _ � � «�. ' � ,. " (e _ � 3 � o, � � �, � ;i: . . . D�t 3 � Re�. No � � , � �, � ' Q � . > w�(C _ �-7i U,��—E��=v� W !.= S � a (_ �'t �, ��b�, �� a(' �a aT r <!'� �:.n , �t, ��'�rl% �' St, �'� �I t, !�4 1 ti! V, �.° L t� V. �'{ L/ c�, N� �� oz �' � � vU't= s -� o r= �(�+. �` . 0 _7 - : , ;; �.., � _v�, , _ __ __ ____ �-- _ -, �. ;� � J d < .� + � APPLI��TION FOR RL•SIllENTIAL, ALTERaTIi}�, OR �1i)ll1'I'I01�' �uILDING PEItMIT CI'!'�' OF 1-1:1DI.��', �11�tiN�SO'TA OTn11�T� � S NAME :-f�� o lce.�� BUILDER: S� �.� �n� ApDRE5S :!'/�� E.-r7�� a�i> e ADDRES S: Si.�h.� NO ; . �d� / STREET : �i��.Plyra.� 7� �� , T,O�; f� BLOCK: � ADDITION:�Qu.,�i��s s�s� .C�G��,,��/� CORNER LOT: INSIDE I.OT:�^SETBACK: c3.S � SIDEYARD; �/ �� Ag�alicanG attach to this Loxm �ao Certificates of Survey of Lot and proposed bt�i,ldiri$ location drawn on these Cextificates. � �ESGRIPTIUN OF BUILDING To Bs Used As: � �-� " .��.��/� � � Front : � �v Depth : L/�Height : /-��. --_ —�—^� �' �� ; Square Feet: �/ �—�_Cubic Feet: ''' -' � f �-� Gf /�,��tT � Front • `a � Depth : � c.�/ Height ; % L� Square Feet ; �'�� '( Cubic Feet : '��-�CQ -- ' � � � : ,--.� y a �' � b � Typ� of Constxuction: �ovo�lc� �i�.�a.� Estima.ted Cost: $,�� opU�, �a Be Comp�.e�ed: J, — 8/=�� `°��' �� ° � � ' The undexsigned hereby ma.kes applicativn for a permit for the work herei�a ap�cif�.ed, agxeeing to do all work in stiict accoxdance with the City of �'x':Cdley Ordinances and rulings o� thc� Depaxtment of Buildings, and hereby deelaxes that ,�11 the facts and representations stated in this application axe true and �urr��ct. DATE: � ��,_ �%7�i � IC;�ATURE: .� ,- ),�,, : , � (See Reverse Side For Additional Tnforma.tioa.) I__ --'_ � \ .-�� <<� �r`� � r 6 a ♦ . " ., BUILDING t'�;lt��Tl'I' 1��:F. 5Ctil:llUl_� S�CT�ON 2. The Inspect:�r �( B��i.1d?ngs shall, before issuing permits f.or the exeetion of any buiiding or strur��rc�, or Fo� any addition to any existing building oz structure, or far •.iny .+lterati.on or r�pairs to any c?:isting buil.din� or structure, upon app�icati,�n thereior�, r�quirc the payment by the �.QpliGant foX such permit of fec:s tc r.h�� amount herein below set fuxth and in the manner herei.n provided to-a�it: TJNI�ORM BUILDINC COAE: Type 1, 2& 4-$2.15 for each onc: thousand cubic feet, ox fraction the.r�of, in such cubical contents. T�•pe 3& 5-$1.85 for �aoh Qne �housand cubic feet. ��UI)ITIONAL I�PORI��ATION Fox the purpose of eomputing fees f�1- building permits, the cuhical coittents of any buildin� or .�ddition, is determined by multiplying �he ground area cAV�7Ced fx�m a point six (6) inches below the floox line of the basement 49C th� Cel.la� to tl�� average llei�lits ,>f the upper surface oz to the� average - ht�i�ltt �£ ths roof surface of the main gable of a pitched roof. �ox xepaixa ox al.texations to an existing structure, the fee sha1J. be at iche 7Cate o� $�.00 pex eack� five hundred dollars ($500.00) ax fraction thereaf in the �cos� of all pxoposed worlc. Tn ma case shall the fee charged for any permit as set forth in Sect3.on 2 be lesa than $S.Op, ' VERIFICATION OF FOUNDATION P10T�� P�i'�ni�s ior construction will be issued a minimum of 24 hours fram the tisne o� appl.ication, to allow for proper revieW of the proposed strueture and o$ �he co�nstruction site. A Certified Survey of the lot, showing the location of the foundation, once �.� has� been constructed, will be required before proceeding with the framing. �'�RTIFICATE 0}: OCCUPANCY Application for a CerCiiicate o� Uccupancy shall be made ten (10) days prior tp the use oz occ�ipancy of any structure for which a building permit hae been �.��tt�d; �nd s.�id structure shall not be used or occupied until a Certi�icate of Occupancy has been issued. . � � 1 � � � 1 1 V 1 � r �,� r- - a r �: � � � f � � jI `! ,. _ . :� � � .; ; ; `. ; 3i t ,s�� a�� W � � � M �� ✓ � � C r. V � �' � • � � �� 8 � rt � Q tD � : � � � � l � � � ��° � � � NA a O � !Y N EA � I �.il � � , �. C � I � � 0 o a � � o � 5' I � ' _ � _ I � � � V � � � � � G N � O r m d � � � ^s w � � �.R �� o , � o � c A � � 8 �' � � a � �a m � � � � � � 0 �.` � � .� � �Q � � � � � '� '� ti � C' G. CL A A p N 0! � � � G. 0.� In O i�`i Q� � qp � w �t Y 7' � ry �+ $ �. '� '� � 9 � cr � � o �. � � � A R° �° � � � � � R° t+� � � � r.•�• � � r � � p �� C7 "J � w � x � s s � 7� � � � s � x � � °" � ° g a � � g �5 A o, � .. m g � � � � � � � � � $ � � o N � » � � � . . : . � � a� do op wq a► oo� wC op 8 � O O O S O C G M 41 �M tA � . M � � i =� � �: r, � ' .. � �\ � �m! F � � �. x 0 s � x 0 . � : 3 a. � � 0 O 9 � � � � � J � �. � A r�y � Ia � � � � ba� � � n � � Ro R° � A Y ,. � � 9 � p y "1 � � � � � �� 3 � � � � �, � o ,n�• � o � � P $ � �$�� 1 m y �� aa� � ��ti� � �aa �� o�� d`,�� y �?r.� y d� a � '° ��.- � - �� °� � �� oo� N p��+ � �r•� �� . n��b ��A n � � LR � �O � ��,0 M ro`0pm �� . �.��» �n� ► �� A � � O � � � � � � � � � > Y'° � � � � � � � � � � � �� A � 6'b7 � �� e � � � � �� s � � � � I -� --- � � . � � .� � � � � � � � � -� � ." � � � t� e �� °� � �1 � . - ��►�,� � ° ��-.�� y�� °�� d, �� / t-1,FAT LG'�S CALCULATIONS H EATI NG & AI R CON DI TI ON I NG CO. MINNEAPOLIS, MINN. Weatherstrips A.S.H.V.E. Construction No. Insulation Windows Doors Guide Out. Wall Int. Wall Ceiling Roof Floor Kind How Applied Reference Yes—No Yes—No �g �FI. �e � Room Length � Width�� Height FI�� Room Length � Width ` Height Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area No. W�dth Height No. of Lineal ft. Area No. Width Height No. of Lineal ft. Area of pane of pane lights of 'c/rack sq. ft. of pane of pane lights of crack SQ• o�L � � `t � � � nL. � `� � aC � ` Infiltration Glass Exp.� Net exp. wall Int. wall Ceiling� � d Floor Total Btu. �--�� ■�_� i �m� f —�-��; — -�mG� —_-_ � ��'� �� --� � r �� Required sq. ft. E.D.R. or sq. ins. W.A. Leader area � I. � � �� Room Length I Width Height Windows and Doors—Crackage and Area No. Width Height No. of Lineal ft. Area of pa e of pa ligh s of crack sq. ft. � � Z �� 2� � s� z ? / �� i �� Infiltration G I ass Exp. wa I I f Net.exp. wall Fnt. wall Ceili�g � Floor Total Btu. IiII Btu Required Sq. ft. E.D.R, or sq. ins. W.A. Leader area � / FI � - - �eom- ��gth f 4N+dth Height Windows and Doors—Crackage and Area No. W�dth Height No. of Lineal ft. Area of pane of pane lights of crack sq. ft. / / �� !`7 /ff Z Infiltration Glass Exp. wal I '7 Net exp. wall Int. wall. Ceiling �/ Floor Total Btu. Required Sq. ft. E.D.R. or sq. ins. W.A. Leader area Btu Infiltration � Glass /�� p � Exp. wall x %i� Net exp. wal I f� �/ O'd Int. wall Ceiling � � � �Q O Floor d�° Q �` � Total Btu. Required Sq. ft. E.D.R. or sq. ins. W.A. Leader area FI. �� Room Length � Width Height Windows and Doors—Crackage and Area No. Width Height No. of Lineal ft. Area of ane of pane lights of crack sq. ft. Coef B tu Infiltration �� Glass � (� Exp. wall � / � Net exp. wall %� Q ��i Int. wall. Ceiling ��/Q �jr 1e� Floor � / Total Btu. 3 Required sq. ft. E.D.R. or sq. ins. W.A. Lea r area Fl.�p � Rc�om Leng�h - Width +feight Win ows and Doors—Crackage and Area No. W�dth Height No. of Lineal ft. Area of e of pa lights of crack sq. ft. / 3 � > 9 � - � - - - B tu �oe Infiltration 2 �Q � Glass Exp. wall � ��Q Net exp. wal I � Int. wall '� � Ceiling aj � F loor � � � Total Btu. Required Sq. ft. E.D.R. or sq. ins. W.A. Leader area 4 Btu � . � HOUSE HEATING TEST RECORD D��10�3 ADDRESS 8041 Fair�ont Circle APT. FLOOR CITY suBURB �r��ep , OCCUPANT Sh@1dOII L. 018ori OWNER Y� HEAT LOSS DATE HTG. INST. GAS C0. METER BADGE SOLD BY INSTALLED BY edgwiak Htg, Elechical Work By Gas Line By n n TYPE OF HEAT GA FA X HW STEAM SPACE HTR. GAS DESIGN MAKE �'illiam�on AAAKE OF BURNER _ Model 1117-10-b ntodel 74120�5 Serial Max. BTU Rating — INPUT 100�000 B'�dli � MAKE OF FURNACE UNIT HTR. OTHER CONVERSION Model CONTROLS THERMOSTAT C'��0 Heat Plug Vent Size � � Yalve M•g• �8v0Q KIND OF LINER A1nm_. SIZE 8� NONE Limit Robehe,w R�''L 750t1 Draft Haod ��'t�a�l Re9ularor �3t,x'ol 325•�3 Limit Setting �� Filters Siza �-as2S ►�►umber �- Fbn Setting 90 ��: 120�' Chimney Loeation Inside y� Outside Pilot Type CQn�11e Chimney Construction �etalb@8'�OS Pilot Make Pilot Model Smoke Bomb Pilot Timing �7 S�OII(38 pra{t Og L.W. Cut Off Door Pressure_T._ _ _ Pressure `��4��C' • pereent CO ��►�'`"� Date Tested �'�Y/ �674 I�ut CFH 99 Pareant 02 �• Company Testing C'pmb ti011 S Q1A�'t9.e8 2 Staek Temp. ��f Percent CO �'� � Name of Toster Wiring Test Tag Y� - � :-�.•:-- i_�. �@8 Form 235 r � (.1 G t9 � a � m �o a°� � � � a � ° g � _ � �' � 7 r C Y . a w a a n r ii � c� � pR `� ��111 � w y � c� K r.°� X�n N� L : O � � O � ~ p � � � a p � � � � o r � � � a np o n r ti�Rc �`c �n N O � � MJ K � A A� M � � F� ii °o° � � � a � K � K � � O o s H �e r p • C�D O � �� N Z r�+ O ap Rf ttf , M •O °0 • ' � C � f�0 ; r ?p � . N y � ►��+ � 0 7� � li7 � O � � p 0o O �O y � � o� � . , ''3!c' � 177 . . y _ _m t� • z c •° m • D� i� 1� g Wa o r w O O O O O m � �� 0 i._ �� C) �� ' ro � � 3 M lC O � �C � � Q � � N _� 0 v .� 0 K K fi f� le K K ii. 9t m n► ni �n r w v► �n a► a► � IA W J O W W N w1 W O O O O O O O O O � a� tu � �n �e � �n �n �w H h v� y � 9 r a gy r � � H � � � ,. M !y M � ro � c � M� � . � p ~ � r � � � � � . � A � N �r Storic4 : �o �x w a n „ `" ,. ca � � Clossets C � • . � �' 'Orinals m � � . eath Zvbs �t - s 3 Dasins O p p�, ; ' Sinks O � �Q W8511 TtBys r � Drinkinq- � m . . Fountains �,., Showesa Floor Drai � 3 �tr�� Basins 0 Autamatie d Washer w Gas Appl. �- HiSC. Fio[t � � �iBS R�1gB a m � � other • � P ea► � :°i � 0 d 1I O �+1 � , � � I � o � � c � �►�+� y p O 2 � � � w0 M �. O O � O � � i r ' 2 C7 '� � C1 � a c :: `p � • R ° o r�' o � t y � O R' o S %+ � q � ... � � ^ d G h � � O �Q'. ' • � O 4� O F� M� C {!'� M� q Q �� aw ��n� m 1b �q O � M R m 'V ►� a�O m m a O�. O � � O. o K r �n r r� M U] ~ m '�j � Y�. x � �-1 Q �r ��r m a r r �y m R m � D . � � b ° " � . n �raaa o 0 O � �t o ''� ��a e w � : R '' � '� • ,`a C�D '�' �h�� • � r •o � • m ww� � � . �C raa d - H � 7 M M . n � .� �o r o � O o � M C�i pg�K � ��' � �o b . � �o � o�O� � r?M � • „ � � o , . 4 �l:1►O N � 7 f� � 7� � V F� tL M ;�+� OCT-16-19Q7 �8�48 �'�, � � � � � � � � ^ ��1 � �� . � �� 1 /� � � �� a � Mv � , `I � C �� '� � � � � � r -� � � � �� r G � i rn I� � �A �m i� � � 3� �, � � � � � � I�� .� � �' � � � � ' CITY 0� FRIDLEY N �' � 3 o � � w Qw �' � � -� _ � � � � o � � `° m � � •a ��. � �Q � � � � � � � . . s. �i �. � N ( � � � � o� � �� z � +tfl aa �n d Q �� z � _ � � � � � : j � . �� R•� � '� o � I � � � � O.� �� 0 . z ca �� - �. zz _ �.+ � 4 � � � � mr � ` � �.� b � � � � � ��p � Q. � � � �•� a � z� . � G � � � � �� 0 � � m � � � � �i �. � � � � � er, !� �5 I � 1 N � � � W � � � � � � � � � Q � � . .. 612 571 12�7 P.03iO4 �' �� ,,� ' � � t0 ,� � � �� ] v �. i � p� , 8 � � � et� bq � � � �� 5.��. � � � � � � � w � Q � �•v8�,� � � ��.� 'O � , � � � � � � � � � � � m �d �� $' � �, � A �, � � � o. • �� O ��7�' :� � � � � y � � � � Q � � � � � �� a W 'C 3 O �� zz m� � 4 �� a 0 � � •� � . � � � � �� z� � �v � �z � �� O C .��- � � � � �� ` � � � � g � � � �� !D D 5 � � a w V � , ��,� y. . - . •-., �s+,?°"`r�-".ti+'�^*s:�.s.-;,.'w{t.-w. .: r_. � . � i'�-.'... _ P!.. -..,oc .c--r� .. . � ... � . . �TC.;+�^-�r2: vs•r��.r..:.._"`�i-Z`��r."�-o . ,,., r`* ..:�:,.- r-,�, . � �_:.. �_..eer.Nmiw.K.�+nnr:�.+� �_ � ,:.��w. . -+,..,ara-ifwc�w ��,�x:aRaJtiw�i. N'd;i�x:tY�-�a�a.�,n,.� _ e«.s,�..3:.i-.;,�� F.f__ v:�•:+rn::..wv.a:��r.wnw,r�ir��.Y'.•�.:.;.�, .�.�,. _ .,�airt..y,-,.�cre,.a.e+� ro'�waa�s,�;n::.-awd. .- _.-a.. ..:�.'1°'.m�t'�. � . .f .. . « .... L. .. �. .v�-OCT-16-1997 �:.48 �� _�iCITY OF�FRIDLEY . . . 612 571 1�7 P.0M04 ; . °_ � �. CHIA�IlITEY AND STA� 'V��RI�TCA►TiON Tl�e w�dersigned �iereby veriE�es mat tiYe exis�m� c;�iaamey or �: . 1. Has been carefitllp ex,amined Yes (�� l�o {) � _.:. 2. Is free from zvst or deteriotation Yes �c )�10 () 9. Has na foreign obje�ts lodged �vithffi Y�s �t' ) No () 4. Is seCUrely � support�cd Yes �t )�l'o {} 5. 1VY�ts alt curnent Code �requirements �ox size and wtal �'Y`U's connected Yes (�i No () �� 6 T�as toral ]�tir�g BTU's af • All other BTL1's TOTAL BT'U's �'� , ?. Has a li�uer been p�t�ovided for wat�n c�ater Yes () No �� S. Has combustion air be�n pravidai �fax water heatesr 'Y'es () No (� , Re�arks: . I�EATING �CO: S;gned By: Date: TOTAL P.04 sue�ECT City of Fridley AT TNE TOP �F TNE TW�NS g U i L D I N G P E R M I T i� � � � ; v _�� COMMUNITY DEVELOPMENT DIV. r � � PiiOTECTIVE INSPECTION SEC 1 = . � �"'1 � CITY MALL FRIOLEY SS132 NUMBEN REV OATE PA �'""'� � �'' 612-571-3450 910-F15 5/25/99 / �oe nooRess g041 Fairmont Circle NE t LEGAL LOT NO. 6LOCK TfiACT OR ADOITION oesca. 11 2 Bourdeaux's Spring Brook Addition 2 PROPERTY OWNER MAIL AODRES$ Z�P Jeff Potter 8041 Fairmont Circle NE 3 CONTRACTOR MAIL ADDRESS Z�P Same 4 ARCNITECT OR DESIGNER MAI� ADDRESS 5 MAIL ZIP ZIP O: / ERMIT NO. 29556 �/� 7 �aOVEO Br SEE ATTACMED SMEET PMONE 784-3235 PNONE LICENSE NO PMONE LICENSE NO PNONE LICENSE NO 8 USE OF BUILOING Residential 7 CLASS OF WORK C� NEW ❑ ADDITION O ALTERATION ❑ REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Construct a 30' x 12' & 16' Deck 9 CHANOE OF USE fROM STIPULATIONS See notations on plan. Q•� CONSTRUCTION WORR HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. �pR�� e#ore digging cali for all atiiity location� ��QU1R�D �BY L�q W TYPE OF CONST. SEPARATE PERMITS ARE REOUIRED FOR EIECTRICAL. PLUMBING. HEATIN(i, VENTILATING Ofl Alii CONDITIONING THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION 20NING AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAVS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO fOR A PERIOD OF 120 OAYS AT ANV TIME AFTER WORK IS COMMENCEO. NO. DWLG. UNITS I HEREBY CERTIFY TNAT I MAVE REAO ANO EXAMINEO THIS APPIICATION 1 ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALl PROVISIONS OF LAWS yALUATION AND ORDINANCES GOVERNING TH�S TYPE OF WOFK WILL BE COMPLIED WITH WMETMER SPECIFIEO MEREIN OR NOT. TNE GRANTING OF A PERMIT �3 � 7C O OOES NOT PRESUME TO GIVE AUTMOFITY TO VIOLATE Oq CANCEL THE pEqMIT FEE PROVISIONS OF ANY 07NER STATE OR LOCAL LAW REGUTATING CON- STqUCTION OR TME PERFONMANCE Of CONSTRUCTION �97. ZS $�GN4 FEO CON:AACypROpOUTMOA�IEDeGENT ID��E� %% � � � � i�GNOi � tpWNEA��fOWNEpBU�LDEti� �� - DATE� C ° � _ OCCUPANCV GROUP IOCCUPANCVLOAO SO. fT CU fT. OFFSTREET PARKING STALLS GAiiAGES SUR7AX $1.88 SAC CMARGE Fire SC $3.76 TOT FEE 102.89 VALID THIS IS VOUFI��r / /'� 4J q`T6 �w [ ] ADDN AL1'ER � CITY OF FRIDLEY [] SINGLE FAMII.Y AND DUPLEXES R-1 R 2 BUII,DING PERMIT APPLICATION 10/99 / � �� , � � �G�`.1 ��P Construction Address: ��/,� � � �,� � �J� �° � ,��,� Lega1 Description: � �`�'� 1 / j�'� �� ' ��' �- ��°.� ��.� � �' � � � f � �� , ��, � �.�� r�� Owner Name & Address: ��_ , � ', , � �- , Tel. � ° _ ��?�� _�',�� .�-� �,� � � Contractor: �,�� MN LICENSE # Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length � Width Height Sq. Ft. �� r � Length Width Height Sq. Ft. '��"�� y 1 Length �T, ' Width = � Hgt/Ground �'�q. Ft. � � �� "_ � �tl � FSL1IIlaLP� COSt: � ✓� ��,� ` � � Driveway Curb Cut Rlidth Needed: Ft. + 6 Ft = Ft x$ _$ � DA1'E: � �✓0 �°�' APPLICANT: ,�� _� ..; � Tel. # 7�� .�� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL �TIPULATIONS: $ q� � $ : i $�� $ $ $ $ $ $ $ (/ r CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1050 per SAC Unit $5.� (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] 1�Tot Necessary [ ] � ;, ..- s BUII.DING PERMIT FEE SCHEDULE The Cluef Building Official sha11, before issuing permits for the erection of any building or structure, or for any addition to any existing building or stcucture, or for any alteration or repair to any existing building or st�c�ure, upon application therefore, require the payment by the applicant for such permit of fees to the affiount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $23.50 $23 .50 for first $500 plus $3 .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,OOa or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $1�,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1, 000 or fraction thereof, to and including $1, 000, 000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1, 000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "B": Removal and 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 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 b�en �o�� wa�i be required before proceeding with the framing. � 1 ^ �� v L �. � � � _2 '� � � �\1 �. �� ;; • sT � � � � , `� � � . `� � . v � � �, .��C? y.b � � '� __.._ �� "� . �,L � S' ` � . � n � � . S _ 2 � ; � � �, � � '� � � � ' � � $ ; � L � � � �` � �i v. f v � .` � v O � � � b � � � � d `' � � 1 `� � - �-, �. . _` � �� . � � . - . st � � � � m �3 � X � ,+ � - � • � � ( � �� . 9 � �- `��' v � � ! �C � ��- : � � • � � , � � �1 ,� � � � r �- . � � � , _ .3'°� � v � � , c� � �a' \.kj �.� � ; ,� � �. � ► � � � � . � � �. c�„�,,, ' 1 � -� C i •-+� � � � . ^r) � c� � . � f � � � ��• � �� A � � 2 � � � � � �J � � � �� ,i:� �1� � � � �� d � a � �- � � � �.: � � � �► . °-� � � ,,� � � �� ,� . , �� - � �Z � : �. 5 � � � '� � � � � �\ � �� , � � �Q� �. �, ' � - � ' -. ,v _ � D a � ; �, + � . i � I � _9� . . I ' �.-^ � , � � . .. 0 0 , � . � i V ��, v , ,� � � � ti" �al l� �, `� � .- � � �� . � � � ,�' �, �� , �,�� ; �� . .�� M��.�� .;: _ t� � � . F`l� �/ �` -_ . � � ( r"/' y�dN � .,,., . �S�, C�% ��=� 137� � ,� �,, , <F � A �� . � v .__` / Building Inspections 763-572-3604 DATE SITE ADD S �� THIS APPLICANT IS: PROPERTY Np� OWNER/ ADDR TENANT PHON CONTRACTOR NAna� SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERNIIT TYPE TYPE OF WORK: ��''Z� � PLUMBING RESIDEN'TIAL APPLICATION CITY OF FRIDLEY I�[�1:il�l�l7 � STATE LICENSE # ?O i ADDRESS: PHONE �- B'�INGLE FAMILY ❑ r�w DETAILED DESCRIPTION OF BJORK . .� -,.� . ' � • • • • I' �i�� J �� /.�r-�. �. �� l �� .' �� J �. � . � ��'�1 lr� ■ � ii ■ • � � � �� /� C 5 i ��L�, i _ , _ p� Permit No.: ` � �� Received By: Date Rec'd: / ATE ZIP . ,. (r� I PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost np 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 WI�RE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEP7' WI�RE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOVi� BATH SINK/LAV _FLOOR DRAINS SHOWER WATER PIPING — gpTHTUg GAS PIPING � ctn'uc�s� SWIIvIlvIlNG POOL � WATER SOFTNER ($35) CLOTI�S WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15) DISHWASHER LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION — — WATER MEfER _ OTF�R Permit Fee TOTAL DUE ............_o _. $ - Number of fixtures @ $10.00 . x $10.00 = .50 Number of fixtures @ $15.00 x $15.00 = $ $ Number of fixtures @ $35.00 x $35.00 = $� State Surchazge = $ .50 Tota1= $ THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSID I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; that the work will be in conformance with the ordinanees 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 o rk w ch requires review and approval of plans. SIGNATURE OF APPLICA �s�� PRINT NAME DATE � �� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Building WATER OR SEWER Permit No.:` `� Inspections pERMIT APPLICATION xe�i� 763-572-3604 CITY OF FRIDLEY va�!'-�'e�'d�-. �� g 763-502-4977 fax �c� i-i-os APPLICATION DATE: YOUR E-MAiL ADDRESS: THIS APPLICANT IS: f�[CONTRACTOR ❑ OWNER JOB ADDRESS: r � c� e� � �� a ss /�'% (y- rt� -� � t� �C C� � � /L� /s T <``�` � � Y `-( NEW CONSTRUCTION PERMIT # (IF APPLICABLE): PROPERTY NAME �j /� X i� vti` �-j OWNER/ ADDRESS: ��e `!/ �� ; �s'�er��- CITY: �'; � !-e STATE:l�� ZII': TENANT PHONE: �'� � - � � S° - `,�'Pc � `% CONTRACTOR NAME:� �7 �c'`� �-1 ��-- T N ��-L �`� � ° SUBMTF A COPY OF ADDRESS: �� s c� �•��+ �- rt�L -� �� /F� _CITY: /U =J 7`k � r+- STATE• I�- ZIp,7 S 3�1 YOUR STATE LICENSE PHONE: l� ' Y y/— �� G= CELL PHONE: /^ 7S'�° u�' � d' 7 AND BOND STATE LIC: ��' t Y ��? STATE BOND: e��:.%1 �� EXP: PERMIT TYPE ❑ SEWER CONNECTION PERMIT $50 0 WATER CONNECTION PERMIT $50 0�VATER/ �VVER L1NE REPAIR PERNIIT $40 _ U•� ❑ ADD STATE SURCHARGE $.50 . � ❑ SAC CHARGE @ $1825 TOTAL � U. OTHER CHARGES (IF APPLICABLE) PAY TO UTILITY BILLING NEW WATER METER COST SEE UTILITY BII.,LING SPECIAL ASSESSMENTS s� Fu�rArtcE WATER TAP SEE INGINEERIlVG NOTE: WATER METER REPAIR, INSP OR SHUT-OFF / w�xnvns & xoLmAYS $125 / HOUR-BILLED THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a water or sewer (new connection or repair) 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. I understand this is not a permit but only an application for a permit work��not to start withou ,a permit SIGNATURE OF APPLICANT: `� f��% PRINT NAME �� '; °� S`t� �, l f DATE fY> —�� APPROVED BY: DATE COPY GIVEN TO: ❑ UTII.,ITY BILLING City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 EFFECTIVE: January 1, 2007 City of Fridley 6431 University Avenue N.E. Fridley, MN 55432 (?63) 572-3604 WATER AND SEWER LINE INSTALLATION REQUIREMENTS WATER SERVICE LINES: TYPE K COPPER PLASTIC PIPE WITH TRACER WIRE 6D Polyethylene D2239, D2737 6E Acrylonitrile D2282 6F Polyvinyl D2241, D1785 6G Polybutylene D2662, D2666 1. Flaze fitting in yard are�. or silver (brazed) fittings underground, within building or yard area 2. Approved AWWA compression fittings permitted on existing lines. 3. Valves at meter to be gate or other full-way valve 4. Curb stop with rod must be used. 5. 7 foot minimum bury (only dense foam insulation allowed if needed). 6. 1 foot minimum separation of sewer and water. SEWER SERVICE LINES: Cast iron with ma.tching fittings Plastic ABS Schedule 40, D2661 Foam Core, F628 Thin Wall, D2751 Plastic PVC Schedule 40, D2665 Foam Core, F789 Thin Wall, SDR-35, D3033, D3034 All PVC requires a two step process of joining; first a colored primer; second the solvent cement. � ' /�• �v% Building Inspections 763-572-3604 STfE ADDRESS fl��j%� �Q / TEIIS APPLICANT IS: PROPERTY OWNER/ TENANT BUILDING RESIDENTIA,L APPLICATIQN CITY �F FRIDLEY YOUR E-MAIL ADDRESS . _ i_ .��— ■ • �� ADDRESS: V � `� CITY, PHONE: / �p� ° �%�'�' ��d� CONTRACTOR � N,�: SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE OF WORK: u . i �� I'ermit Jo.: Receiv d Sy: ?`� � Date R c'd: � � ' I � '�� S1 TE --ZIP STATE LICENSE #�� U�- �c� �� EXP DATE :'r�/ � IO 7 __ ann�ss: 5(o�i7 /77�m � r �'�./ �' i1/. crrx_�$7�/_�i6 �*�' PHONE 18�1 I• `%� �J• 5��[3 FAX G�� •�O l =� ❑ SINGLE FAMILYlNEW CONSTRUCTION SIZE ❑ TWO k'A.MILY/NEW CONSTRUCTION STORIES _ ❑ BASEMENT FINISH ❑ DECK DESCRTBE WORK BEING DONE: [tOOF ❑ DRAIN TII.E SIDING O OTf�R SWIIvIl4IING POOL ,ADDTI'ION REMODEJ.ING t��( ve��n . SIZE OF IlVLPROVEMENT LENGTH �OOFING � ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE 8c GARAGE GARAGE3 ❑ ATfACHED GAR.AGE PROPOSID SIZE: ❑ DETACHED GARAGE PROPOSID HEIGHT: SIDING ❑ Vitryl OSoffif ❑ Aluminum ❑ Trim ❑ Other ❑ Fascia WINDOWS IN EXISTING OPENINGS OYes QNo LOCATION OF WINDOWS OR FOR NEW OPENINGS-DESCRI$E SIZE OF OPIIVING CHANC3ES & WIDTH HEIGHT STATF/�ZIP�o'T� BASEMENf REMODELI G SUBMIT: i. F�tisting Floor : in 2. Proposed floor • an 3. List of structur. I members to be used Ft. FORNEW CONSTRUCT � �N INCLUDING DECKS, ADDI'1'IONS & PORCHF .` SUBM : 1. Site Plan/Surve shon+ing the existing structures and proposed p � iect. 2. Tmo sets of cor - ruction plans 3. Energy Calcula � ms � WINAOW TO Bb 1NSTALLED NUMBER OF RRNDOWS I AI.L FEES ARE BASED ON VALUATION, Il�TCLUDING THE COST OF LABOR AND MATERIA 1,5: {USING TH� 1997 U.B.0 FEE SCHEDULE) TOTAL JOB V Permit Fee Plen Review Fire Surcharge Surcharga License Surcherge SAC Cherge Curb Cut Escrow Erosion Control Pazk Fae Sewar Mam Charge Total Dae $ �'�j _;2 S�' See Back Page for Fee Schedule $ 65% of Build'mg Permit Fee $ � .001 times tha total job valuation $ f, .0005 x Permit Valuation Miniznum $.50 $ $5.00 (State Licensed Residential Contractors) $ 51550 per SAC Unit (Plans to MWCC for determinati � i) $ ft+6ft= ftx$21 =$ $ $450 Consarvation Plan Review $ Fee Determined by Engineering $ Agreament nacessary ( ) Non Necessary ( ) $ �. l�� Malce checks payable to: City of Fridley A1 t �c6 THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a buildiag permit and I acknowledge that the information above is complete and accurate; hat the work will be un conformance with the ordinances aad c�es of the City of Fridley and with the Minnesota Constzuction Codes; die : I understand this is not a parmit but only an application r a permit and work is not to start without a permit; that the work will be in acc� �� 3ance with the approved plan in the case of all work w' requ's s ev' d approval of plans. SIGNATURE OF APPLICANT PRIIVT NAME �" ' � DATB_ f6 ,�[ �