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AF - 42002�i Ca.ty of Fi-�.d1ey, Mi.nn.. ` 12 0 4 6 6431 Univeraiby Ave. N. E., Minnea�lis, Minn. 55432 BUILDING PERMIT ��; Feb�cuarv 27, 1973 p�; _Greg T. Shipahock g�� Castle Homes Inc. ,Add�ts Address 7913 01d Central Avenue N.E. �ocATia�v oF Buo�DeN� No 8071 s�t Fairmont Circle N.E. part of Lot I.ot 9 8iock 2 Addition or Sub-Division �oupdea � a SBri,ng B�ools Ct�rner Lot inside Lot X Setback 36 � 6" Sideyard 5' & 28 ° �/.E:levai3an �.e ��. I�ot%�i��t���d�v4ii6�i/ See Man ��pjyp Tou of Footin� DESCRIPTION O� BUILDING To ]� vsed as: .,Dt��� l� nd_____r F'ront � Depih 28 � Height 20' Sq, �, 1344' �, �, 23. 520 .G��� Front 22 � 2" Depth 24 t 2" Height 10 � Sq. Ft 537' Cu. Ft 5. 328 � op ���� Wood F�came �, �st .$29�.999 To be Completed Ju1yz 1973 .. - Stipulations: Provide a hard surface driveway. Provide a verifying survey before capping. Approved as per Council Meeting on Feb. 26, 1973. $275.00 SAC charge paid. WATER LOCATION: See Ma.p SEGTEIt LOCATION: See Ma.p In considerai3on of the issuance to me of a perrmit to construct the btulding described above, I agree to do � proposed work in accordance with the description above set forth and in compliance with all provisiona oP pldinances oP the dty of Fridley. „ , ,_ n 14.99 State Surcharge In consideration of tbe payment of a fee of $ 54 _ 00 , permit is hereby granted to • s t� ji�m_ -�s,. Inc . to construct the building or addition as described above. This permit is granted upoII the express condition that the person to whom it fs granted and his agents, employees and worlflnen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects •to the ordinances oF 1'rYdley, �linnesota. regarding location, construction, alteration, maintenance, regair and moving of bwlltliags ��� city limits and this permit may be revoked at any time ,pon violation of any of the provisions oE 88id , � BuildinE Inspecto�r 'nARRF.T. f!T.ARK - N0710E: �ais permit does not eover the wnstruetion, InatallatPon for �erfring, plum6ing, gas 6eating, sew�r or water. Be auro to soe ths Building Inapecto� fo� aepa�ate permits fo� theae itema �`" <"- .* a a-t&. %� �� a . : � '�I � I • V y �� � l � � � � �� � � � � �� � ���G��v'���� ^s �� �,f,� si��������� � � O O W�ST '! 2� f1� STR�'L�T �____-- _ F�UR.NSVlLLE, M/NNESOTA ` � C^�f lfic `e of Survc�y �'or�.��� � �� ��1� ._. � . � � � �,� � � � � � ,� ' `���� �, � .�� a � - 4� tJ101�...!'i"' ` � � � _ - �� , � J � �, ,* ,_` �a �-� � ��;; . �. � 9�, a � � . . r. � � r °OD'OG7"'� �� "__'--_ _� , a �. ---*-----�--=_ � � � . ,� ` ^ i , ° � �i Q' �•b a..a � s � � ,�% ` C I L� ' �� i ,. � � , '. � � f k , e o� ' � N � �� \ �� Vfi� � � 1 � �v I + . C� �� ' ` c°� � , > �S � � �� t 4 e � � �L , ti`� �/0' I�a— U Tt i.. �' D�I �.t AdC�� f,;; � %Te �, ` ' �e�,�a t�.� • � �� � . �, �� � I � ti . � �a� � � �y c�'e�� �j ` , _. �"�,r \ ; r � -S � . . ` � � ` \ � �J . , . �� o . . �. � � - �1 I . - �,` ��nA�� � � ur��.�rr �as� r��-�r� . ( � � � � e i ` _ . .. � � — a �.�� — — , ., ` - � . Aj /�p �+�arA/'�` .� "I�. � �/ �Y 'J V« %�+ '�' c�� �" '�'�� �'"�� ����''��� I hereby cercify thac t h i s sur�•eY, Plan o r �� 1� �� ��+�' � b'"++ r.: report was �►repatcd by me a r vnder my direct ��?V,��`�j�, �;� g,' �, �x �,�� J�/� r;,�,� ���;: -�;'��,�.��'�,1d'�' supervision and chat 1 am z duly �E'�egistered ���',,,,�� .������. ��� .� .M � y--.� Lan SuneYo=� nder the la�vs4of the State t - of Mi nesc ta. �.�° �� _ ��c� �.� � .,��,'v.�i�� ' i e, °�' .i.:� - „°��'a ". -- �""' -- A �r .. _ ' . : . �� ° �/A�,� � � � / �p,��-. ,2 c� ���.�' i '�� .: �i . � 1 � � ,,.� 4,, ,ir'"'�, "�, � �L 4 � ��% .Y t�1r �.7:� � .r. ��`" '.. 1,' �At['�+.�, "�" �' ['�. 14 r?...-+�-,==�.. i ,3 �� .� _z_ %� i � , ,1 � Iy , 9 ^ � � ',I i �;� , , F i ; �' � d ; � � � � ' � � � ,� ��� ;� , __ _ ____ _ —_ _ _ __.: , r.._�._.�__ _� ��_ � ; _ , � , �� � � ' � — �— �— � ------:— _— -- --- --�----- --� : d � :, i ' , , � � � _> -_%_� � __ �_;_ _.__._...____ _-. .- _ � _ - � � � � � � ' � , � , _. __ - - - - , .._......Y �. . " _._'_ , . ' .______� _____.__ . , � . . 1 v � -.. a." 2 ` - -_ _ , �_ �. � ' _'_.—_' �_'-�._ �-"__ 'H'` `�4 �. , S•.-- . ' � 6 �f/E 77'� .: t � - — - --t-- ---- � ` �. i i1t1� '�'Y ; ""i._. Q �. • �S � � AP.��TC��I�� ��� R$�IA���T��, �+��R�►TI��, �� 4�A�TiON ��ILDT�G ��I�N1T� C;�T`X (JF F1ATA�.,�Y'e M�NIVF•SQTt�# ^ /, QW��S Nl�E:��o�_��.���,�y��ioc � BUIL�?ERa �,.,iAs7' P �0 �rS �!+��, AD�2ESS : a!+?uq�,r.SrR i /� / � � ^Q LC� �, , C P/�l �`'�'A� `� /� !/,P , �� . Q �AK�� � �+AMP�+�� �C\„�� � �� � G I � � �VC � :. R ..s w &� R �LOCK t 'L ��ION �,�,� e� v'd e A U�Y �-?' ,-5'� ri'v�y , l3ra o� �R LOT: �� T�OT:,, , S$TBACRt SIDEY�IiD:�,�,��, ,����� �#,�t� ���+� io Certi�i.cates of Suzv@Y of Ls�t axtd prop�a�ed �,�.t�3� �.�catio� d� c� t�ese Certificates, � i3�5�I��PTIQiV OF BUILDING � � vs� �a : Sw91. �'A M, LY �1 � � �C� �� �o � s. � � ��: � � ,���t: R" � , . s��a=e ���� / cu�►� ��a �� YN �� 4 a�� i�� ,� 0' ��� t. d� s�" Hei�ht � �' � n■ � a� e .w+ s s ei e i �quax� �'get;�,'��-¢--�-Cubic �eett �{� o� �oA��r�te�ti.a�� „��'e; �, Eati�ar.ed C�at: $ �� � O��o{� ��ww�T�R le"i' r', w E � , �� � ���a�e�t� ,�'c�LY 3�, ! �,?� _�� ° � i !' ''� - 7 (,(;,��! �.�,� C� �, � 7 ,_. �:., �� �� ���� `�1�C C� •_� - .�2 C� - %_, J � � � r� � s����'ted herebp �s a�1�c�Civu #or, a pe�t fQ� th� wprk �i�reia� #p�i,�#..etl� ag�ee;Lag� tv da a�1 i���rk �a stt;ict aacordance witY� ths +�3.�r s� �'i�.�d8.�' tlx4�ps�ces �d s+t�.i�� �f �e Ae#+ari�ten� qf Bui.�d:�.n��, �t1 �e=eby d�,s$,�� � all the �$cts �d r�reseata�3.o�s �tated ��hie ap�I�,catiaa �'� �liL.' � CDiTeC�'y . ��; � - �� ^ � � ���r,�,�: ` �n0�sq� ! ! wes� ! /�s� ��� ��` � �'��Q ���'�S ��� 1''OS �Af�l�i��.+OZ18..�, IA�0�8C�pTl.,r � �',E a .�1" � �,✓� ' � --�f' '�`�' � ,'`y - _ � �'� •°,G � F:A s � � R � a� + "� . .,,�-._ !: �:s. �:,-.. _ - ,e.+�r- - - u _,- �� , � + � � _ �r ! � L, , a 0 �_ --BU����N� PERMIT F�� ��H�AULE ����ON �. �'h� I�s�ec�o� pf �u�ldin$s shal�' befpx� �esuiag pernnit� for the �����ion o� a�y building p� structure, ox for a.ny addition to any �is�i�g ��i�d3�,� o� s�zuC�ure, ox fo� any alteratioxx or repairs to any exi�ting ��:����a9.� o� stxuc�uxe, upon �pp���ation the�ef�xe, requ�re the paymemt by �ite ���11��� �px such pex�nit o� �ees t:o the �mount herein below set �Ar�h �d �� �'�� ��,a�� he�x��� p�c�v�.ded � �c��wwi� s UI►Td]FORM �U�LIIING �OAEs �pe �.�, 2 & 4 - $2.�5 �or each �ae t.I�iousa�nd cubic �e�t� p� ��actipn th�7��a�, in �uc�► cubical con�ents. �ype 3& 3-$�..8�5 �o�e �+c,b o�nQ �ousand �abic ��e�,. . ��DiT�ONA� �NF��tMATION Fo� ��: pu�pQ�e of c�npu��u� fees for building permits, the cubical contents o� �cy building or addition, i� deter�ai�ed by mui�$.ply$n� �he �xound area �ov+e�'� �'pm a p�i�� �f�x (�ij i.n�,�ies below the floor line �� the basement t� i�e �C��la� �o Ci�e average �eights of the upper surface or to the averag�.s ��t �s!� �e �oo� �e�face a� �1te uiaiA �ab�.e pf ,a pi�ched xoo�. ?�' �4ix^s ox' Ri���a��-oa�� � aaz existin� $���ey �ae f�e si�a�l. be �� �h� "���� o� $3 s Ofl #�x' s�h f�v� h�da�ed dol lar� {$�004 QO) .� f��t�.a� the,�so� �.n ��+ ca+�g ,a� �al� �a�ca�ssed wo�'�C.,. . - I� � cat� sh��l �#� i�,e� fo�c �y pe�it as set fo� �Cu Se���,o�a 2 ba � �r�n $S.t�A. _ � V���I�l�TiQja1 0� ��9�TNAATIDN �� Ps�its �o� �cr�s�����iaa wil�, be i��ued a�iC� o� �4 hnurs ��am �Iae � a.� �pp2icat#.c>r►, �c a��cxw fox prage� rev�ew af �he �xapo��d a�xu��,re �d p� �e �st,�u�tion �i�e. '' ��C���i� fu�� v� �i.�e 3.�� ��ix►� t� �.ocati�a Qf Gh� �ou�cla�tia�, o�� �,t �aa� ����t.+edA wiil � ze�uir�d b�€ore �srar.eedin� w�.�hh � fr�af�g. , Ci�1��'�F��A�'£ Q� f��1�P�i1V�Y A��i�t�io€a �a� �����.�.��a�a s�� oceug�n�y �hal� bs mad� tem (�ti? �y� px�ox �o fihe ��e ��r �c�upa�e� a� ���rkec�nre €�r which a bu�.ldia� �ex�aa�� has b��rt issu�d; �tttd sa�f.d st��t�� �ital�, �ot 6e used Q� occup�ed ustil a Ca�gifi.cate af p��uga��y h� b�t �s+��. • , : � 3 > ■ � � O t � � \ � � � � �`~ � � � C � c°a s v � � m {� I� � r � � � � � � � � � �;o ���� � � Q � � � � � � � :3 b1 �a�� � � W � a °n � � � � � � �ti " � � �� � � �� � � � �� • . . � i � � � : ,�,� M CI O • � M � a � $ a 8 y M U► �� � O �r C � I � � 0 H c� � � � � � �_ S� �� �' � � � � � � b a $ 0 O r e� � <� ti � w� �w � � �� � � M � � � � �u E � � � � � ;� � � $ � � 0 � m � � � a a N $ �� x � � � o � � � � 00 � � � �x � � � �� � � � � a �O � � � � � �u po 0 0 g '� 8 g � � � � Ij I ! � d � � O � � M 8 p � � � x � 0 � O w : � A � L � � � `n °° I A I � � r � O � � i s � 0 � � 0 � b � `�. S � �� � � � $ �t� R� � � y " � � � ���.� � o � �, � � � � g 8 � � � � w � � � . � � "' ' O $ � ' Q w w a+ e.: o 8 g g � 8 M i1 � � � a o � � i � a i � , � 0 � ao �o �d � � � g � m ��� �� � � � C � � " � m� � � � � � •. Q � � � � '� � O� � . �p �p . O o . . 8 : : 8 8 $ $ � � f � ' � � I � •�.. G.O�� •+ � k b��� �► � a� � ��+ � m o���- � � �o� � � � �. �° a �' rg � o �ep� ��C� '. w� O N ~�,�+ rr��ti ���� p� �� m � O� e�' i�! M � M G � � a m � a��� ���. .. �� � `.��� � ��r � A � � � T H _ T C m � �. '� �� � � �� � � � � � _ � N �� A Ae � D w � � 0 � � I -� s ►. A p. c � � I � � s� � C� . ,� 1 �� �7 I �c�i���� Cjea. �.�eacy,cr�c� ��`°� � l, '3-�y?�� HEAT`LOS\S CALCULATIONS � °� � "�VIIftlN�'APOLIS MINN. p H EATING � AIR� �°011��ITIONING CO. 1 - Weatherstrips A.S.H.V.E. Construction No. Insulation Windows Doors Guide Out. Wall Int. Wall Ceiling Roof Floor Kind HowApplied Reference Yes—No Yes—No 19 FI�( ��' Room Length Width Height � FL � J—C Room Length �� Width /o Heigh Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area No. Width Height No. of Lineal ft. Area No Width Height No. of Lineal ft. Area of pane of pane lights of crack sq, ft. of pa/ne of pan`e lights of crack sq. ft. � � X . � � O � /�9 � /� � � Btu Infiltration Glass Exp. wa I I Net exp. wal l Int, wall Ceiling li Floor Tota I Btu Required Sq. ft. E.D.R. or sq. ins. W.A. Leader area �' FI.�" Room Length '-� Width Height Window and Doors—Crackage and Area No. W�dth Height No. of Lineal ft. Area of oana of oanei liahts of crack sq, ft. Btu Infiltration Glass Exp. wall' Net exp. wal Int. wall Ceiling ' F I oor 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. w�dth Height No. of Lineal ft. Area of oane of oane liahts of crack sq. ft. B tu Infi Itration Glass Exp. wa l l �� Net exp. wal I Int. wall. Ceiling Floor Tota I Btu. Required Sq. ft. E.D.R. or sq. ins. W.A. Leader area Infiltration � � Glass � Exp. wa I I Net exp. wall � Int. wall. Ceiling �� F loor �' Total Btu. Required $q. ft. E.D.R. or sq. ins. W.A. Lea r area FI��� Roo�Length I/ Width Windows and Doors—Crackage and Area Width Height No, of Lineal ft. Area No. ..c ........ ..s .....,., i:,.�..,. ..c .._....�_ �.. f� Infiltration G lass Exp. wall Net exp. wall �� Int. wall Ceiling �� Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 'Fl�h'����� Room Length � Width Windows and Doors—Crackage and Area Widrh Height No. of Lineal ft. Area No. ,.� _.._.. ..� ........ �:_ti... ... __....�. �., a. Infi Itration L�L� Glass � Exp. wall Net exp. wall Int. wall Ceiling ' � Floor Total Btu. Required Sq. ft. E.D.R. or sq. ins. W.A. Leader area B tu � �`'' Height Btu �' �� Height Btu S � � � � � , � ` � HEAT LOS3 CALCULATIONS HEATING � AIR,CON�TIONING CO. MINNEAPOLIS, MINN. VYeatherstrips 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 19 FI. � 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 Width Height No. of Lineal ft. Area of ane of pane lights of crack sq, ft. NO' of pane of pane lights of crack sq. ft. � � 5�D � y� � z � � � �� 19 i Infiltration G I ass Exp. wall � Net exp. wall Int. wall. Ceiling � Floor iotal Btu. � B tu �� � Required Sq. ft. E.D.R. or sq. ins. W.A. Leader area �� v I. j,� Room Length Width � Height Windows d Doors—Crackage and Area No. Width Height No. of Lineal ft. Area of oane of oane . liahts of crack sq. ft. Infiltration Glass Exp. wall � Net exp. wall Int, wall Ceiling Floor Total Btu. a� Coef B tu Infiltration � � � G lass ,�T � Exp. wal I � t,/ Net exp. wa l l Q o,1° Q�Q Int. wall. Ceiling %� �/� °�(� Floor /� � � 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 pane of pane lights of crack sq. ft. B tu Coef B tu � � � Infiltration ' �D � Glass Exp. wall ��"0 Net exp. wa I I � y� /� �!J`-'� � ,� � Int. wall. Ceiling Floor /� 5 �Q � ��J Tota I Btu. — Required sq. ft. E.D.R. or sq. ins. W.A. Leader area � Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI. Room Length Width Height FI. Room Length Width Height Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area No. Width Height No. of Lineal ft. Area Np Widrh Height No. of Lineal ft. Area of oane of oane liahts of crack sq. ft. of pane of pane lights of crack sq. ft. �- I nf i Itrat i on Glass Exp. wa I I Net exp. wall Int. wall Cei I ing Floor Total Btu. Required Sq. ft. E.D.R. or sq. ins. W.A. Leader area Bt� Infiltration G I ass Exp. wall Net exp. wall Int. wall. Ceiling Floor Total Btu. Required Sq. ft. E.D.R. or sq, ins. W.A. Leader area Bt� � 560-3450 , �l�L O JHLaL� � � ANOKA COUNTY 6431 UNIVERSITY AVENUE NE May 24, 1973 FRIDLEY, MINNESOTA 55421 Mr. Da.ve Rotter Castle Homes Inc. 7613 Central Avenue N.E. Fridley, Minnesota 55432 Re: Properties Abutting Spring Brook Dear Mr. Rotter: This letter is to confirm our.conversation with Mr. Roy Lund in which we informed him that granting building permits on properties along Spring Brook does not obligate the City to maintain this waterway. Care should be taken in grading the rear yards in such a m�nner th.at erosion will be minimized. If you have any questions, please feel free to contact this office. CJB/mh Sincerely, � ,��� , CE J. BELIS � Building Inspector 0 HOUSE HEATING TEST RECORD D-2037? ADDRESS 8071 Fairmont Cir� APT. FLOOR CITY SUBURB �idley OCCUPANT Greg. T. Shipshock 01NNER Yea HEAT LO55 DATE HTG. INST. GAS C0. METER BADGE SOLD BY INSTALLED BY edg�eick Htg. i� Elsetrical Work By Gas Line By TYPE OF HEAT GA � FA x HW STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE Williameoa MAKE OF BURNER Model 1117-10�5 Model Serial 7303337 Max. BTU Rating INPUT 100'000 Btu Hx'. MAKE OF FURNACE Modei CONTROLS THERMOSTAT �7f Heat Plu Vent Size ��� Valve M•g• ��OC KIND OF LINER Alnm. SIZE 6�� NONE Limit Robshaw Rl� 75Q Draft Hood VePt1c81 Ragularor M�xi tTnl R2.ri_� LimitSetting 200�f Filters Sizelg�� g 25" P�lumber � Fan Setting 90°f & 120°f Chimney Location Inside Ye� Outside Pilot Type �ouple Chimney Construction Metalbe�toc Pilot Make Pilot Model Smoke Bomb Pilot Timing 61 Secouds Draft L.W. Cut Off Door Pressure Wiring .Test Tag 1'e� Lighting Inst. Yeg Pressure 4,6��W.C. pereentCO 8•��° Date Tested 10�3�73 Input CFH 99 Parcent OZ 7• � e Company Testing CO b s O 2 Staek Temp. 540 f Poreent CO �•���° Name of Tester Form 235 0 D r � m m En � O C � � m � c � 01 cc m � � D� � �cD 3 0 0� 0. = n N � 7 c � � o z� -� v �O� c•�o o m3 �' D D — v � �v � ni �, �v D � m � O z � �� y f�A G<< C 01, N �� O ID N N N 3 � n � Q. � '� 7� v � f�D t� (�D .� � � O � � ,T� � � N � � N � N .�.► N � v � � � �'� � � � •_�•, "' � 7 � j �p fD -+ � -, -, � �' r v+, y v► � � � �c � � � � Z m � � d � v —I m i � v, � �°— 01 � � � � ° � '� � � � m � a .�. � m N .� Z 0 ( I I�I I I( I I I I I � *����tr���ss�ss��+►t��+a C]1 O O O y O� v v�� A V 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 D v� � m o0 'o � r' y, 5. �� oo cn o Z � 3 a ��o�= � rn � °= � °r v�i a � Z a C �� D= W � n o �, °��� o � �zO- y� c�i, � m < � �p N � 77 d m� o �� Z in ? 0`� ra � I w W � m � � � � Z � fl � � !(� ;� �.y,` � W � -i ? A � � c ; � � a °� m N N � � , � � � a I � ? O � � � Q � o .� °_' 3 � � � , o � .� � °� v N � ; C�, � �� O . N d A � , � N �' � ' �► � � � � C) � � � � 3 , N � 7 �O r C � W Z � � � C � m � � z 0 � m � O D r � • ., � � _ �.I 1 I �F FR[DLEY FRIDLEY MUNICIPAL CENTER • 6431 UrTIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 January 25, 2002 Ms. Beverly Shipshock 8071 Fairmont Circle NE Fridley, MN 55432 Re: Final Inspection at 8071 Fairmont Circle NE Contractor: Norblom Plumbing Dear Ms. Shipshock: A plumbing permit was issued on April l l, 2000 to install a water heater at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this permit. As of this date, no final inspection has been called for. The pemut fee that was paid covers the inspecrion to make sure the work was completed according to the Code. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspecrion called for" and take no further action. To set up the inspecrion or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. � Sincerely, DAyJE JENSEN By�ing Inspector DJ/mh Building Inspections 763-572-3604 DATE BU�II,DING RESIDENTI�L APPLICATION CTTY OF FRIDLEY YOUR �MAIX. ADDRESS Permit No, Received By: S1TE ADDRESS THIS APPLICANT IS: ❑ OWNER CONTRACTOR '. PROPERTY OWNER/ N,�: TENANT . ��.,.,,,,, d'\ °'1 ► _ aes v � h: _ �_ ... � � ► __ . �..._�_ � '].!� CONTRACTOR SUBNIIT A COPY OF YOUR 5TATE LICINSE WITH APPLICAITON PROPERTY TYPE PERNIIT TYPE �rYrE oF wo�: STATE LICENSE PHONE (J�IOI' 7.�1' ( ��� ❑ SINGLE FAMILY/NEW CONSTRUCTiI ❑ TWO FAMILY/NEW CONSTRUCTION ❑ BASEMIIVT FINISH O DECK i❑ DESCRIBE WORK BEING I SIZE OF IMPROVEMENT NUMBER OF SQUARES _ GARtl.GES PROPOSED S1ZE: PROPOSED HEIGHT: SID ❑ Vinyl ❑ Alumintim � Other NEW r•n E}CP DATE FAX 0 DRAIN TILE -- -- � t3�iffit -- - — — tG POOL N LING �J' , , WIDTH HEIGHT ❑ HOUSE ONLY ❑ HOUSE 8c GAR�GE ❑ ATTACI�D GA�tAGE ❑ DETACFIED GA$tAGE OSoffit ❑ Trim ❑ Fascia wn�mows IN EXISTING OPENINGS ❑Yes ONo LOCATION OF WINDOW� OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLID NUMBER OFI\ ALL FEES ARE BASED ON VALUATION, INCLUI�I TOTAL JOB VALUATION Permit Fee Plan Review Fire Surcharge Surcharge License 5urcharge SAC Chazge Curb Cut Escrow Erosion CoMrol Park Fee Sewer Main Charge Total Dae BASEMENT REMODELING SUBNIIT: 1. Existing Floor Plan 2. Proposed iloor plan 3. List of struchual members to be used Ft. FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & FORCHES SUBMIT: 1. Site P-lan/Survey showing Ure existing structures and ProPosed P%jcxt 2. Two sets of construction plaos 3. �e�gy cat��taaon� �1G TI� COST OF LABOR AND MATERIALS: FEE SCHEDULE) OCCUPANCY TYPE $/53.o�3S ScelBack Page for Fee Schedule $ 65°/p of Building Permit Fee $ �_p� .00Ij times the total job valuation $ s�L (}� .00qS x Permit Valuation Minimum $.50 $ ��� �fjj $5.(�0 (State Licensed Residential Contractors) $ $16'�5 per SAC Unit (Plans to MWCC for determination) $ � ft+6ft= ftx$21=$ $ $45(1 Conservation Plan Review $ Fe.e �etermined by Engineering $ A�� ent necessary () Non Ne�sary () �/ �/ �. 2� Make checks uav$ble to: Citv of Fridlev Attach THIS IS AN APPLICATION FORIA PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acl�owledge that �e information above is complete and acxurate; 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�mut and work is not to stazt without a permit; that the work will be in acxordance with the approved plan in the case of all wor h,r revi d approval of plans. SIGNATURE OF APPLICANf��, '1;��' 1��. P�tIN1' NAME���, �`��re� DATE �� ��i �� '� W� � Cf �� From: City of Fridley To: 952-881-4491 Page: 213 Date: 8/1/2006 9:25:40 AM Building MECHANICAL P�it No.:� Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY �f'�°I�� DATE ���/�D SPl'E ADDRESS �� THIS APPLICANT IS: u PROPERTY N�:�� OWNER/ ADDRESS:� TENANT �� � � nvn�rc• CONTRACTOR SUBMIT A COPY OF YOURSTATE LICENSE WITH APPLICATION PERNIIT TYPE CTfY ATE ZIP COMPANY NAA�: CONTACT PERSON: ,�g.q � 1AJe� eF� n�� ��i�� /l.... �. _ � STATE LICENSE # . ' nA �_��� �'� �. ADDRESS: � C1TY STATE PHONE FAX �INGLE FAMILY 0 TWO FAMII,Y ❑ TOWNHOUSE TYPE OF WORK: I��W ��LACEMENT ❑ ALTERATION/REMODEL � DETAII.ED DESCRII'TION OF WORK ZIP PER MS 16B.665 the permit fee is a minimam of $15.00 or 5% of the total cost up to $500.00, whichaver is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This ahould 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 EXCEIDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (II�TDICATE TOTAL NiJMBER OF EACH BELOV� �/�1, �,—e5-r�� Equipmerd Installed MFG: MODEL: SIZE/BTU ! V, lJ�'c� MFG: MODEL: 4/ MFG: MODEL: V A/C $25.00 FIliEPLACE (GAS) $15.00 _AIIi TO AIIt EXCHANGEER $1 S FIREPLACE (WOOD) $35.00 BOII.ER $35.00 �/F'URNACE $35.00 CHIMNEY LINER $10.00 GAS DRYER $10.00 DUCT WORK $10.00 GAS PIPING $10.00 SIZEBTU _�� SIZE/BTU GAS RANGF/OVEN $10.00 NEW GAS GRILL $10.00 GAS UNTf HTR $10.00 POOL HEATER $35.00 VENTII,ATOR 515.00 Parmit Fae $ /D�. (%U Number of fixtures (u� $10.00 x $10.00 = $ Surcharge .50 Nus�nber of fixtures (u� $15.00 x$15.00 =$ TOTAL DiTE $ Number of fixtures (a� $25.00 x$25.00 =$ Number of fixtures (a� $35.00 x $35.00 = $ State Surcharge = $ .50 Tota1= $ THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building pertnit and I aclrnowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City f Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and rk is not to start without a permit; that the work will be in accordance with the approved plan in the case of al rk which reqy�res r iaw and approv� of plans. � , SIGNATURE OF Chty of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 � From: City of Fridley To: 952-881-4491 Page: 3/3 Date: 8/1/2006 9:25:41 AM O City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS �XISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Co�bastion A�-(�'se� no� be�ew) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments 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.ObQ3.2 a. 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' ' .L•.,E�a�iL;� .i��.`^..�C_1����1�� • .z herebp certify �thai t4�is sur�•ey, glan or ' ' ".�. �.� ..� ,� L 0 L �� ;� .' zcport was .prepared by me o r under my dircct � .! � , •' ; � - �r' !; d � p �� (� �� �,� .'. ,.'�� �� !l�/(�i ��'� li�j�� ' � ���,"�,��J',€��' supervision and that I am a duly �I'.e>istesec� � i �%}���` G�q ���`�ni.r•�,a. � f°,�t��'g4,.� ��i� , Laz�d Sutvey�z undez the Ir.�vs of tl�e Sta:e �; �I7 +�i !� � of Mi nesc+t�. f�-�..�'"�� � ' ' I it � . �i � � � � ' ���" ,.�^`�•��'.�� � � ' SC� �.F . % : .��% . � '; t, � , !: �.o;; lNDIC�hT'E�� ' ��onr��i�v�.�.. , ,,: pat 2•�• ��. No. ����' � �—. i ; ���G�. a��/�c'INC�,S .ASS�t1'� ��:'1�� . � . , �;,� ' . . ;