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AF - 41720� -�. .�,�. :���,� � � A � � `� � O� � > �� _ � t� 1 Land Planning land Surveying Soils Teating Civil Engineering Municipal Engineering Su�u�c��a►n � . . �zz�z-�zpe�ii��, ���tc. Engineers & Surveyors , Mortgage Loan Survey , � > � � 1 a�n�� _ --���'% 6875 Nighway No.6S N.E, Minneapolis � Minn. 54032 Telephone 784-6006 Area Code 612 for Ro�T�`��� �oi����� q„ LOT 5� PLOcK 2., �DURDE�UX'S �P'�ING� �R�Q� A'DDITION ANOKp couN°rY ,- � _Sc�le : i.`�� 30'+�� This js a true and correct representation of a survey of the boundaries of rhe land obove described aM! of �he location of all buildings� if any� the►eon� and all visible encroochmeets� if any� froro or on said land. This survey is made only in connecfion with a mortgoge loan now being placed on the propartr and no liubilitr is assumed � except to the holder oi such mortgage or a�y other interest acquired by the reason of such mortgoge. It is understood and agreed � monume is have been 1 ced for the purpose of estoblishing lot lines or boundory corners. Oafed fhis�day of�A. D. 19� SUBURBAN ENGINEERING, INC. L3�+� Q Enb� �rs�� i�i'F��� �,l.y u�fJ y^� s �C�� (` p ��ZyS / , /� ./ Number Fixtures �� x $2 . 00 � • � u � Future Fixtures� 3 x $1.50 .� New Fixture-Old Open. x $1.50 Catch Bastn x $3.25 Water Heater-99,000 BTLT �_ x $3.00 �,ud Ground Run Old Bldg. x$3.25 Elec. Watex Heater x $2:00 Gas Fitting Fe�s: ]�st 3 Fixtures /Y � x $2.00 Additional Fixtures x $ .75 Gas Range-199,000 BT[1 x $5.00 Repairs &-Alterationa See Description; Code 3 3.�J State Surchar�e .50 TOTAL FEE $ �, o�� The undersigned hereby makea appl�ication for a permit for the work herein specified, agreeing to do all work in strict accordance w ith the City Ordinancea and rulin of the Department of Buildings, and hereby declare that all�the)fact� �d representations atated in this n.,.,�in�f��.,,, �,. �-,...e �.,a ....«......� � sue�ecr PERMI City of Fridley � 12460 � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � � R . � • COMMUNITY DEVELOPMENT DIV. � Ly ������� r � � PROTECTIVE INSPECTION SEC. ��J�C,�� 1 = � �� /'�'1 � CITY HALL FRIDLE� � 55432 NUMBER REV. DATE PAGE OF APPROVED BY ----�' �•' s,2-�so-aaso 910-F15 3/15/74 / / JOB ADDRESS g121 Fairmont Circle N.E. 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. S 2 Bourdeaux's Spring Bxook Addition SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Ralph Barris 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. The Rottluad Company, Inc. 4220 Central Avenue N.E. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDflESS ZIP PHONE LICENSENO. 6 USEOFBUILDING Residential 7 CLASS OF WORK � N� ❑ ADDITIOId ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK C0118'�1"ltCt $ X 8 SII S X 8.T3ge 9 CHANGE QF USE FROM T� STIPULATIONS provide a hard surface driveway. Provide a verifying survey � before cappizig. SEWER L�ATION: 5' South of Manhole (Inv. 847,54) Wye E1ev. 847.56 Top of Footing : 850.75 Miniun�m WATER iOCATION: 11.3' South of Sewer Service �'�'��ERATE PERMITS REQUIRFD FOR ��I�IN�p �-t�ATING, PLUMBiNG AND SIC;NS� TYPE OF CONST._ OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. WOOCZ FiB�le THIS PERMIT BECOMES NUIL 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 ABANDONEO FOR A PERIOD OF 120 DAYS AT R�1 1146 + 636 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �. STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT Z�F .509 �.2 oZS DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �`)r1.00 300.00 STRUCTI O PERFf�RMANC OF CONSTRUCTION. '��P d�i'tGfo � G�O. .�"' � �f-��' `e-� _ PLAN CHECK FEE TOTAL FEE � r-.6 —,�_ �a�x $363.ZS � SIGNATUREO NTR CTOR RAUTHORIZED GENT (DATEI . WHE P,RO E LY I AT THIS IS YOUR PERMIT � 1 J � � n SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI iNSP DA7E � ` r aPPi,TCATION FOR RLSIllENTII�L, ALTEIta1'Ii�;V, OR �1i)U1"I'I01� �UII�DING PERMIT CI'!'�" OF 1-1:1UL�:Y, 11J�tiNf�SO'T.A ���" ' YY/ %� / awr��x � s r�rr� : � BUILDER: � ���c t�, u ' �� . ,��,,� /AADRESS �-�-� � , . �, - -�,l/,,�'ADDRESS • yz 2 8 ��o�rj''�� � d�� .CI � N� ; . C.� � �- � S TREET : �� � r �u o �* 7` � ! r �e / .�. ,�1 /. � Lfl� : S� BLOCK : �- ADDITION : � �„� t.- ,^.� p„ ;v '� .S.,�i--1,�. � ,8 r a r/,� CORN�R LOT : INS IpE 1.OT : �+ SETBACK: 3� � SIDEYARD: / s ��� ' Ag�l.ican� �ttach to this Lorm Ztao Certificates of Survey of Lot and proposed bui.ld�.xig location drawn on these Certifi.cates. �ESGRIPTI�N OF BUILDING TO $� Used As: �i°r°v9'� j��M �lX �{Sv.�,o� � � ��r'� � , - - a v � �e Front • � � Depth : G1 Heigh� • ��` �,� Square Feet:��,Cubic Feet:� ,��,rp�e Fxont : � Depth : 2 � ' Height : �� '� � I�, � °�^ j.'P, � ,b ,; (, J Square Feet; _� Cubic Feet: J; '-, � �� �� 'I�►p� Of Constxuction; ��t�,A�s�- Estima.ted Cost: $ ;3o_ooc. � � ,. �; � � , s � � !� ���? �o Be C�mpl.e�ed: I �- 3/ — � � .� The undexsigned hereby makes applicativn for a permit for the work herein apeci.fied, agxeeing to do all work in sttic� accoxdance with �he City of Fxidley Ordinances and rulings of thc� llepartment of Buildings, and hereby declares that .ill the facts and representati in t is a lication axe true and � urr��c t. .� O iy ��' ��o -��� Q � ^f DATE: �- /,�_ °� � S IGNATURE: 'Sy�.� �' � � � (Se� Reverse Side For Additional Tnforma,tion. ) � � �� ;� ,� � �-_ � j �/ ,� ' �' �,?'� � ,� � (.r`Y - ��b , � � � � � � �, p" � � f �,, r ' �� �% < � � � _� � �. �"� �,r .� _�' � �, — . � �� _ + -� P �. 11: A ; .. __...,..�-�. ._ _ .� 2� , � � ��. �� �i" S (� / ;' � / � �, .� � ' `[€ BUILDIN� k'�1L'�9l'I' I��E 5Cl-I�UUI_�: S�GT�pN �. The Inspect��r uf BS►ildin�s shall, before issuing p�rmits for the exection of any buiiding or stru��t�,re, ur fo� any addition to .iny existing building oz structure, or jor ..uiy .� lterat i.on or r�pairs to an_y e?:isting buil.din� or structure, upon applicati�n thereior�, r�q�,irc the payment by the applicanl fox such permit of fec:s tc r.h�� :3mouut herein below se� forth and in the manner herei.n provided to-���it: TJN�FQRM BUILDING CODE: Type 1, 2& G-• $2.15 for each �nc: thousand cubic feet, oz fraction there:of, in such cubical contents. T}�pe 3& S-$1.85 for �aah one thousand cubic feet. �1U1)ITIONAL [UFURh1ATI01V Fox the purpose of computing fees f�r building permits, the cubical contents of ar►y buildin� ox addition, is determined by multiplying �he gxound area cov��:�d fxom a point six (6) inches below the floox l�tne of the basement ox Ch�i Ce7.la� to tl��� average l�eiKlits ,>f the upper surface oX to the average � h�+i�i�t �£ ths roof surface of tlie ma.in gahle of a pitched roo�. Fox x�pai�ra ox al,texations to an existing structure, the fee shall be at the 7Cate o� $3.00 pex eacl� five hundred dollars ($500.00) or fraction thereof in the �os� af all proposed work. �rt x�a ��,s� shall the £ee charged for any permit as set forth in Secti.on 2 be 18a8 than $Ss00. VERIFICATION OI' FOUNDATION NQT�� Pexmit,s for construction will be issued a minimum of 24 hours from th� t3�+2 of application, ta allow for proper zeview of the proposed structure a,nd +a$ �he ao;nstruction site, � Cartified Survey of the lot, showing the location of the foundation, once i� ham been eonstxucted, will_be required before proceedin� with the framing. +' GRT I F I CATE �F �JCCUPANCY Applica�ion for a Cerkiiicate o� Occupancy shall be made ten (10) days prior tA the uee or occupancy of any structure for which a building permit has been $.a��t�d; and s;�id s�ructure sha11 not be used or occupied until a Certificate oi Oceup�cy haa been issued. . r � '� � �:���r,:�.e:.,..n,,.�. -,.r•,�,, , '�«-, ..� v�. �..,...y,,.,.,.,. . ..i,�. e' ' � �• • . -. . .. �: .. . . . o . . . �. . 1 �M - 1 . A . . Y ' �� � � � � �' - ����� ����a : ����.��� . �°������� � . � . � ►�S�G66`��'��S . �Q� �.�/��r� �..��d� �.f�YC��� � �O� WLST -, ;'/����h'._.STF'��7'°�... . . 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'..' �+� �t� ': n . . . ,//�� ' . �� �� '.__ rr� .Vo v�P,l� �°' ' . � � .� ' ./1� �� ^ ' � , . C•y ,� :. � _ . . � �- . . r� ' , `.;>� 3��. � .. _ �- . . . � _ _ . . � � � � -��� � � ��. , -° , .; , : � . . o.� .'. o >:'.1Nr�:lcAi'�'� _. . e���°� � , � � _ . . � .ACL,, ����,1��.5 �l�SUr°��� . . � _,�; ', . , �. � . -__ �Z E GA L :�D�S�: �-���'� At� . : , . ` • certify that this survey, Plan os � , ,__ LQT_- 5 . �.. _- -_F.� L:OC �C 2 �- � , 1 , hereby .: • rrport was'prepared by me or under my direct ,�4l�(.RDk'A�l�e`�'S�::SP21/YG.._.:6'ii0'�K:.::�la������!� � � " , , . supervisio�x and that I am a duly �e�istered ' _ . I N�1 � a��'f� : - .�q /y pg� �t1j' �-�Ol� �l T Y�,_, M Land Sut�eYor ummder la�v � t e.�ate . . ' , ; of M' esuta. � -�`- � , . . ' �i ` s''�` �'..� � "'I' _'°'-.�"''°"`�`,�'� r ' �. � � � � . �d ) 3 �" �' - V ; . . D� "� �,�-- �� I�To. Y : � ' I . 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N y ��' �� � q �9 �.��� ?oa�y � M � m 9t �p C ... � n � �'9 H � 7 ���� O� ~� � i�a0� ��,0 �1 ��pm w`� �� ���� �� f�B w 1 � ja �0 ` � O � � � � � i� n, � � � f � � � �i � � � i�r: A �. � � � ► � � � . � � � � � � � � � �� � � �� � �� � �; �� �. � �� � � � � �� � � � � m � � �� � �' � � , � � � � � � ,�,� � � 4/� �i i � �D!�T,.G���o . � � r :_ , � D p °`k GC�¢ '�'" 5�.�� � / / . HEAT L�?SS CALCULATIONS � p� E�i1�01G 8� AIR �UNDITIOiVING CO. �►INNEAPOUS, ��AtN1€•J, Weatherstrips A.S.H.V.E. Construction No. Insulation Windows Doors Guide Out. Wall Int. Wall Ceiling Roof Floor Kind HowAnplia_d ^ Reference Yes-No Yes-No �g FI��`/��j/� Room Length Width � Height FI. Room Length � Width Fie�� !, Windows and Doors-Crackage and Area V'dindows and Doors-Crackage and Area � No. W�drh Height No. of Llneat ft. Area � No Width Height No. uf Uneal ft. Area of oane of oane liohts of crack sq, ft. of pane of pane Iiahts of crack S4- �t. Infiltration Glass Exp. wall �� I Net _exp. wa I I Int. wall. � Ceiling � �� Floor' Total Btu. nequirea sq. rc. t.u.rc. or sq. ins. w.A. �eader area �FI.�����G Room Length/� Width Windows and Doors-Crackage and Area Widrh Height No. of Lineal ft. Area No. - ---- ..s ........ �:_�.,. ,.� .._....�. �., s. I nf i Itrati on �� G lass Exp. wall , Net.exp. wall InL wall Ceiling Floor - - . Total Btu. B tU Height B tU Required sq. ft. E.D.R. or sq. ins. W.A. Leader area FI. '�'C � Room Length � Width Height Windows and Doors-Crackage and Area No. w�dth Heiqht No. of Lineal ft. Area of pane of pane lights of crack sq. ft. /� �� � �,� � � Btu Infiltration Glass Exp. wall � Net exp. wall Int. wall Ceiiing �� Floor Total Btu. � Required sq. ft. E.D.R. or sq. ins. W.A. Leader area et exp. wa Int. wall Ge i I i ng F loor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Infiltration � � � lass Exp. wall d� Net exp. wall % Int. wall Ceiling � � Floor 7otal Btu. Required Sq. ft. E.D.R. or sq. ins. W.A. Leader area %FI���� �� aoom � Length �� idth� ! Windows and Doors-Crackage and Area No. Width Height No. of Lineal ft. I,rea of nane of nane tiahts of crack sq. ft. Infiltration �° e G lass . Exp. wal l� Q C� Net exp. wall Int. wall Ceiling /� L� � Floor � Total Btu. � Required sq. ft. E.D.R. or sq, ins. W.A. Leader area FI. ��� Room Length 7 Ylidth � Windows and Doors-Crackage and Area No. Widih Height No. of Lineal ft. A-�a of �ane of oane liahts of crack `_a. `t. } Infiltration I off ef + j(�i' � Glass � '. Exp, wall � ; 2 � Net exp. wal l _ �/L�i� %�j' ---«-f Int, wall � j Ceiling ��� �i ;/� ;/ �' Floor �� �' f�J � J i Total Btu. � Required sq. ft. E.D.R. or sq. ins. W.A. Lead�r area Int. wall Cei I ing ! F loor ' Total Btu. Requiretl sq. ft. E.D.R. or sq. irs. :`�.A. Leader area a 0 G U: � �:� Heig+st �%, er�-'�2 � < �' .:� , �� � • , i,."". �.�����v� HEAT L�'.�S G4LCl1LATI0NS HEATING � AIR �GNDITIONING CO. MINNEAPOLIS, Mfi�R�. Weat�e�strips A.S.H.V.E. Construction No. Insulation Windows Doors Guide Out. Wall Int. Wall �eiting Roof Floor Kind HowAppti_wi Reference — Yes—No Yes—No �g �FI.��/ � Room Length fD Width Height FI. Room Ler�gth Width He��,t�_ VJindows nd Doors—Crackage and Area Windows and Doors—Crackage and Area No. Width Heieht No. of Lineal ft. Area Width Height No. of L�neal ft. Area of oane of oans liahts of crack SQ• f�• . _NO' of ane of pane Iiehts of crack sq. ft. Coef Btu Coef� �*.:� Infiltration � � � Infiltration Glass �` � Glass . Exp. wall � . �p Exp. wal I Net.exp. wall Q—Q Net exp. wall . Int. wall. 1nt. wall � Ceiling ��� O Ceiling . Floar �� Floor Total Btu. Total Btu. Required Sq. ft. E.D.R, or sq. ins. W.A, Leader area Required Sq. ft. E.D.R, or sq. ins. WA. Leader area FI. Room Length Width eight FI. Roam Length . Width li�igE�t Windows and Doors-Crackage and Area Windows and Doors-Crackage and Area No. W�dth Heieht No. of Lineal ft. Area Na. Widrh Height . No. of Lineal ft. Area of oane of oane liphts of crack sq_ft. of pane of pane Iights of crack sq. ft. Btu I nf i Itration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Tota I 8tu. FI. Room Length Width Height Windows and Doors—Crackage and Area No. w�drh Height No. of Lineal ft. Area of oane of oane liahts of crack sq, ft. I � Infiltration Glass Exp. wall Net exp. wal I Int. wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area B tu Coef �s�� Infiltration G lass Exp. wa I I Net exp. wall Int. wall Ceiling Floor Total Bfu. - Required sq. ft. E.D.R. or sq. ins. 4Y.A. Leader area FI. Room Length Width -9F;�'r Windows and Doors—Crackage and Area No. W����� Height No. of ��nea1 ft. Area ot oane of oane liohts � cf rrack sq. it. Infiltration ! � _ ___ G lass Exp. wal I , --__ � Net exp. wall � Int. wall e Ceiling ° � � Floor ' Total Btu. ' Required sq. ft. E.D.R. or sq. ir.s. dJ.A. Leader area ; � � � y •� r O M � i : � . � • M N � O � y � ti . � � � • t' ' � ' i �+ ♦ • � � 0 � � � , y � C � � � � 0 � � � � � x w � 6 � r M � �1 � c� a� M E�z �� x�� x �' � w x�� 8 � J� � G� � o Ki � � � � � � � o� � � � � � � C � � � � � r o !+� e��o � � a � � '�° � k � ��r �° ° '° � �e ; �� b. 2 o N y � � � •' d p�p � � �. • � � � • :i: t0 • �� � � ' : a $ . "' ' : •� � � . . . � . i : : . ,� • . : . . . . . . . : . . . . . . . • . . . . . � • � � . � f/ il 11 M �t X i� X i! ii �p N ,t�p� .h) NA GS Wp.� r�+ ►�+ i�q`� �iI C OJ1 , O � O Gi� O � G � O .'4j M M �� W M f!� M M d► � . � O O � � O o � I I r � � � � � � N v ( , � i i D � i � � iEi � � i � v � m � �.. ■, - : ■..■1 ,� � ..���1 � � ■■■■, . . ����� • �..�, ���r�� �� � M �D � » O m 3 Q' � � z � � � � � E � C'J n q � O c y ;: a � �. �' �. � � � �" g � ¢ � � '� y C] fA (D O � O �1 � W o � � �0 � o� m Cy� 'mJ `mV \V � � � V � � W N WA7IR a,os�s uauw,s MTM T{AS �ws�� SINKS W/WI rawK ORINK. FWNT. Si1vYRS. 1-� DNAINS .--� G7CM F'� 6ASIIVS AUTO �� W� � G� �� � G� � RANGE m cws OCENINGS � • s • N � a � � n �aaA � �. � �� � � � � �~�a � A ���o y .. o A 6 "' ���$ � �� �'� �p � O a � �� �� . � ' �. � bd o ��� ����� . N $ . !'. � \ b�. " � �,�7,�.. � A�^ � � � 1�z� �V �.� ��. aa ~ � � � h �m�� ��s � � m ..� n I 3 �'� 0 x � � � �C �('� P. H � � A. � �x �°� � � M O M A �! � I F � � � m � W � 1 � � � � f� � w � � � � 'n � � � � � � � � '� � � . M � � � d� � � N � � � � � � ° y �i � � � � � � c� � � N � � �° � y .� r o �� � :�O . ��� •� i .N� � �N �� O !A /j�� i Y ' �-a • �o .y : f~-+ . r , � : � � : � � , N � N: D . � .� U7 �Ji � O O O � s° � � �" � m 0 �. . � �S n � . � � r � � � a � � R � � °' x � � c�i � W cxi �� � � s � � � M n � � � � � .� :: � M � °c 'x° m � � '-1 ° � � °•° � °' " � 1° � � �i `'� C m � � • � � � �' � '1°^ =� n � � $ m ; ;� 0 � ' �3 � � M G� '� fA � � . • G' � . 04 � . • . . .. c° � . . . � . . . : : : . . .� . � . . . ' . . . . . . . . . . . . . . . . . O . O �f 91 M • M ff il % X il i6 • � � N � � � � � � � �o S a,8 �8 � 8 � $ � 8 � M M 'N W ts tA d► M M O � I O •1 I� H t�' I t�' � O [' � i. � V � � � � 0 A 0 � "-� 1!' I� '� rn t/Y � 19'1 C r m � � c� c. � � � � p. o � � � � � � o. � Sm � r► � M � O � � � fD Q F'd (� ( � • � � m a � � , x • v a. O. � � �, � � o� o p, � '� A e 5 '° � O A � W ��s� �C: � m C �i � � ��G� F.��{+ �S + ~ g '7 �W � M � � � •tn ym � �, `� m � b �� � �m �m�� oo��o.. a�p � A � ti � �'! � m � �.�E�. r :�' » ���"1 .��� ��e � p' r A � � � n 3 2�� A 0 � � � � F � d. '� i� �A 90 � H � A. �x � �� p � � '9 9Q � � � w �� � � `� � � � � � � � � - � � � � � � � � � M � � Q, � � � �� Nu � r � 6; � �� � w � � � �. . �+ w n � � � �O � � �"� HOUSE HEATING TEST RECORD D-21063 ADDRESS 8121 Fairmont Circle APT. FLOOR CITY SUBURB �idley OCCUPANT Henery R Baxisa Yes OWNER HEAT LOSS DATE HTG. INST. GAS C0. METER BADG�edgt�ic Htg. SOLD BY INSTALLED BY a n Electrical Work By Gas Line By TYPE OF HEAT GA FA x HW STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE WilliaIDSOn MAKE OF BURNER M�e� 1117-10�5 Model ���a� 7412119 Max. BTU Rating INPUT 100,000 Btu HI'. MAKE OF FURNACE Model CONTROLS THERMOSTAT M g60 Heat PV�OOc Va Ive • Limit Rob9haw RFL 750u Limit Safting 200 f Fan Satting 90 f& 120 f P�Ior Ty� Conple Pilot Make Vent Size 5" � KiND OF LINER A1�• SIZE 8�� NONE Draft Hood Vertical R�ulaiorMazitx'ol 325-3 Filters Size16�B25�� Number 1 Chiipney Loeation Inside Ye� Outside Chimney Construetion M��1'1b�8t'� Pilot Modal Smoke Bomb Wiring Pilot Timing s� S�onde pra{t �g Test Tag Yea L.W. Cut Off Door Pressure Lighting Inst. Ye$ Pressure 4,3"fflii�C� PereantCO 7��0 Date Tested 11�7�74 2 input CFH �-�0 Pereent OZ - $.a7��/ Company Testing C+ Staek Temp. ����f Pereent CO ��0��• Name of Tester Form 235 560-3450 l �' � �8�dt �' � � ANOKA COUNTY 6431 UNIVERSITY AVEfUUE NE December 30, 1974 FRIDLEY, MINNESOTA 55432 Mr. Ralph Bariss 8121 Fairmont Circle N.E. Fridley, Minnesota 55432 Re: Final Inspection of Your Hause Dear Mr. Bariss: We would like to set up a time, when it would be convenient for you, to make a final building inspection of your house. This inspection is to make suze the house was built according to the approved plans. The inspection should only take about 20 minutes and can be done anytime between 8:00 A.M. and 5:00 P.M. We would appreciate your contacting us at 560-3450, ext. 41, to set up an appointment to get this house finaled. Please contact us also, if there are any questions or problems about this inspection. Thank you, CLARENCE J. BELISLE Building Inspector CJB/mh � N x r b o �,q o �0 vx � 0 t� � O � � � 0 M�p cy� .d �r�,, 'o t/� M � � �C n � wC� r � 9 � �h � ►t7 f�f � � A f1 L G � � M p rt 70 � r► w y �r � h►� p?�v n r. 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(1 • '� Y� �1 � �' ` I� � �� b f� 1 • I t /� q � t• �� 1 � ti � • N q [_ ' ' �� �/ �t �� tL ' 4 II ;� n � ^ � �� � 0 f� � I' : � T ^ t� �. r� l• w �- - w � o ^ r � = A � � �4. � � s . o ' n � .. � � P r �' �� L r � 7r a r. � i'. _ ( �f � �. �� . — r - V � c r G 4 a v 1� F--' IV F-' � � I"�' � U a C"i' n F$ � � � �V � � Building Inspections 763-572-3604 763-502-4977 FAX SITE ADDRESS � THIS APPLICANT IS: PROPERTY OWNER/ TENANT BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 1-1-09 � YOUR E-MAIL ADDRESS ��e�� �.� �/lG`S�O -/�, Dh � C r J` /d/_ � . ❑ OWNER �ONTRACTOR O -e�r .�ss: �-1 � �r � � e� 1' �ITY � E: �'vla -�9.��1 -�'ci�,'� CONTRACTOR NqME: SUBMTT A COPY OF STATE LICENSE # YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS:� INSURANCE pH01•rE ���} - PROPERTY TYPE I�.SINGLE FAMILYMEW CONSTRUCTION ❑ TWO FAMILYiNEW CONSTRUCTION PERMIT TYPE TYPE OF WORK: DESCRIBE WORK BEING ❑ BASEMENT FINISH ❑ DECK ❑ NEW HOME CONSTRUCTION ❑ MAINTENANCE/REPAIR .. .� ( �hl/1 f ROOFIIVG NUMBER OF SQUARES �� GARAGES �,�1� PROPOSED SIZE: PROPOSED HEIGHT: SIDIIYG � � VinY� �..,, l� U � Aluminum ` ❑ Other %ih Permit No. • � ��'� Received By Dat��:�� � � LU�� id EXP DATEQ� v% CITY��1`! Cv � %s�-�1-i0 � - .A � STATE �iLZIP� ��� stzE C � - � `� STORIES �7 P ' I ❑ GARAGE/SHED ❑ WINDOWS �ROOF ❑ DRAIN TILE �SiDING ❑ OTHER ❑ SWIMMING POOL ❑ ADDIT[ON �'n �REMODELING � (�V l � ��A r � .�. 0/h� IrVI �tl I/� �I� ❑ HOUSE ONLY ,� HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE �1Soffit � f fe�Trim _G� � �( Fascia • � ' ��,(1` ,J• BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project � 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXIS1'ING OPENINGS �.Yes ONo QCA ON OF W�S I OR FOR NEW OPENMGS-DESCRIBE SIZE OF �. ��ey��/�la I+h� ��Q 5� OPENING CHANGES & / TYPE OF,WWDOW TO BE INSTALLED NUMBER OF WINDOWS /� ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: SING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ ��� � OCCUPANCY TYPE Permit Fee Plan Review Fire Surchazge Surchazge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee � Sewer Main Charge Total Due $ �� 3 a $ $ $ $ � .,. See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the totai job valuation .0005 x Permit Valuation Minimum $.Sd � $5.00 (State Licensed Residential Contractors) $2000 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$22=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridlev Attach THIS IS AN APPLICATION FOR A PERMI'f-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 ' of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a r�is_nflt to start without a permit on site; that the work will be in accordance with the approved plan in the case of all i ' s review and approval of plan �� � SIGNATURE OF APPLICANT �RINT NAME Q/�G� ��. DATE �/�� Page 2- Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE FEES $1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for lg` $500 plus $3.05 for each additional $100 or fraction, to and includin $2,000 $2,001 to $25,000 $69.25 for 1�` $2,000 plus $14 for each additional $1,000 or fraction, to and includin $$25,000 $25,001 to $50,000 $391.25 for 181$25,000 plus $10.10 for each additional $1,000 or fraction, to and includin $50,000 $50,001 to $100,000 $643.75 for 1�` $50,0�0 plus $7 for each additional $1,000 or fraction to and includin $100,000 $100,001 to $500,000 $993.75 for 1�` $100,000 plus $5.60 for each additional $1,000 or fraction to and includin $500,000 $500,001 to $1,000,000 $3,233.75 for the 1�` $500,000 plus $4.75 for each additional $1,000 or fraction to and includin $1,000,000 $1,000,001 and up $5,608.75 for the 1�` $1,000,000 plus $3.15 for each additional $1,000 or � fra.ction VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to a11ow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Onlv City of Fridley Building Inspections Departrnent 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977