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AF - 43560City of Fridley, Mi.nn. BUILDING PERMIT �� s� o l'� Date: �i�, �. � ' � "°' I�3 �'` Owaer: � �uil� __ Address `�` -�' � �—.�- �� °-�'— pddress " �m�� _ / .�!. �_..w,,. _ � CATIO F BUILDING No. .�� Street ��. P o! Lot Lot �-� _ Block .—.._� Addition or 5ub-Divieion Coraer Lot — In�tde Lot � Setback �� _ Sideynrd �' � �+ Sewer IIevation — `� ._ Founda.tion IIevation DESCRIPTION OF BUILDING T Used `'� Front �.� Depth -.,��=-L--- Height �.� Sq. FL Cu. Ft Front ..�� Depth ��,/ I�eight � Sq. F't. Cu. Ft Type of � c�ton Es� Cost �.��.� To be Compieted In cbnsideration of the issuance to me oP a permit to construct the buildin� descriUed above, I agree to do th� proposed work fn accordance with the description above aet forth and in compliance with all provisions oP ordinances of the dty of Fridley. � In consfderation of the paqment of a fee of $��e� � permit is hereby graated to to construct the building or addition as described above. This permit 3a granted u�n tt►e express c�ndition that the person to whom it ia granted aad his agents, employees and worl�en, in all work done in, around and upon said building, or any �art thereof, shall �nform in all reapects tn the ordinances oP Fridley, M3nnesota regarding location, construchon, alteration, maintenance. repair aad moving of buildinga within the dty limits and thia permit may be revoked at any time upon violatifon�,o'f aay of the pmviaions of said ordinancea � �*y r. Buiiding Inspector NOflCE: 'I6b permit does eof corer fhs eoe�lrucHoe, In�taUNioa fe� wWey, 'Ivm6tno, �as hat�o, s�w� er v►�ter. B� sors to a� t6� eotldtne Inq»ete� for aparafr p�rmhs foe f6a� thmt. :^ � ,�, ., - r..:�,� _y r . ` � +' � / ! OWNER° S P7�iME ADDRESS A.PPLICATION FOR BUILDING PERMIT CITif OF FRIDLE�i, MIId1�SOTA LOCATIOAT OF BUILDING �� Z No. Street Part of Lot Lot � Block J Addition or Subdiviaio�l��G2�� G�i�� Z� Corne� Lot Inaide Lot�_Setbeck 3-� Side Yard �^� � s� SEWER II�EVATION_� �� FOUNDA�'TION EL.EVATION �� " Y Applicant attach to this form �.'wo Certificates of Survey of Lot and proposed build - ing location dr�wn on these CeYtificatea. To be used as: DESCRIPTIOAI OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth Aeight Sq. Ft. Cu. Ft. Type of ConsCruction Estimated Cost To be Completed ti— 7-- (0 3 The undersigned hereby makes application for a permit for the work herein apecified, agreeing to do all work in atrict accordance with the City of Fridley Ordinances and rulings of the Department of Buildiags, and hereby declarea thet all the facts.aad xepresentations atated in ehis application are true and correct.. nA� /U � �j �6 i- s �Sctaeciu].e of Fee Costa can be found on the Reverse Side). / \ � M� � � • _ _ � ♦ .� e BUILD?.1�1G PEIiMIT F8E SC�iEDULE Seczion 2. �he Inspector of Buildinge shall, bc�fore is�uing any pea�mit far c_h� erection of aay buildiag or structure, or foY any addition to any ex�.s�- ia� bu3.lding or structure, o� for at►y alterationa or repaira to any eacis�ing bu�lding or sicructure, upon agplication therefor, require the paymen� by the applican� for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit; 2.1. For any such permit for �he erection o.f any fire-proof building, other than a garage� warehouse, .factory or grain elevator, or for the erection of any fire-proof additioa, for aimilar occupancy, to any exiating buildi�.� ahall be at t�ie rate of $1.40 for each one thousand cubic feet, or frac�iQ� t�ereof, in such cubical content�. 2.2. For any such permit for the erection of any fire-proof garage, warehouses �actory or grain elevator, or for Che erection of aay fire-proof acditioa, €or similar occupancy, to any exiating building shall be at the r�te of $1.25 for each one thousand cubic feet, clasaified as °1fireproof" by Section 502 of t�e Minneapolia Building Code. f��USES 2.3. For any such permit for the erection of any non-firepsoof building other thaa a garage, warehouse, factory or �rain elevator, or aay non-fireproof addition, for similar occupancq, to any exis�itag build3ng - permi.t $1.00 for each one thousand cubic feet. �ARACES 2.ts. For any such permit for the erection of any non-fireproof garage, w�rehouse, factory or grain elevator, or fox the erection of any non-f�eprooi addit�o�,, €or similar occupancy, to a�ay existiag building or for each such bnilding or addition - nine�y cents ($0.90) for each oae thousand cubic feet os fr.action thereof, in the cubacal cantents thereof with a minimum of $�+.04< For the purpose of compu�ing fees for building permits, the cub�cal contents of any building or sdditioa to a.uniform height throughout by multiplying the g�ound area covered from a poirat s3x (6) iaches below the fl.00r line of tne basement or cellar to the average height of the upper surface or to the ave�age height of the roof surface of the main gable of a pitched roof. 2.5. For repairs or alterations to an exis�ting structure, the fee ahall be a� iche rate oi $3.00 per each Five Hundred Dollgrs ($500.00) or frection thereof in the coat of all-propoaed work. 2.6. In no case ahall the fe� char�ed for anp pernd� as set forth in Section 2 be leas than $4.00.° /'� � �� _ ,. %„`� ��Y i � . .'' � Lcmd Planninq 6B7'S -Hi9h�voy ;6S A[E. l�d survey,r� � M�nr�o�O�s 2/. .�l,sTs'�9 � ENG 1 NEERI NG, I NC. ��°f° C�vr� b A�luniapivl SUnset4-6066 � ��"�9 -- En9ineers ` � Surveyo�s — ce:ta,�icate o� s�,s�re �o: �RCc� rNC. l C lao� � 0 � � I ___- _ _ _ r — �� _,_;� '', to L �fitlity �' Jr�ii�� . � � �?�' +�' , ,y �Iz�>u ---- �� :men� " � * � � Proposed ` GAR. 1. '� ,, - � �- 1 Nbust=, �, ' W 2. e � �� I 0 �. r� a ItimN � IRoN ' �.Ak�`"?�"'/1/,� AI,�E. NCRTH �`�'�� ,,. ¢�, . �O T 5 ,�L J�� 1 y �� .�9 A.�.�r. � ;: '_':�,G�e� N��.:i_�5�� _Y=� a . _ A n c%C c� �.'v . d'�m� : M•� /fier�6r� u�i�y ��s o hue m,�d mrr�cf �e�rtese�o!'�an o�'a sa'r9ry �'� ��'!Le �db� af�u�iQrd /ai0, aoad of'�/e lcw�ivii q�'alI 6r,�Idui�s, fJ,r�ean, andd/ ris�ble ar�r/imarrfs ,�f'any. �mn ar a►��said l�d. As s�yrd 6rJ mie fJss abtf � � e�} P � � � � A� �' SUB UQBAN ENG/NEER/NG , /NC. �r ��.� � �'��.'�.t__ :� � - -.-- � � __- -„-�z--_ -_� . _ � � M � � y � � � tx y p ��'qI : y : x : Y m . m : N : o . a . m yr! . t' : � • {� . � N � � � r � � � � � � � � o � w� � N � o � � � : o . o . o. W : : � . . � 0 � � � t�a r � O O O � � � � 0 � � Cf � � � � � � pnj � � '7'i 7i � � � 8 �y �� n (y�� Wj fD r� f7 a �' � � y 6C � � � � � : o � b a o � � � ,� � : � �°�.N: ��•: � bd _o° : 0° : 04 � � � . . ' 0 . . . . � bd : : : : . � . . . . � >C �e iC >C i: >: w tV W r. r. r �! e�i� p C�» o O o � tfl <A {iJ {!i {A � o ,� ' � �'I � � � n� O Q x 1 `i'' � 1 � � t�n H O � D � r � m �/� �I _ m C r m O � z � � �D a � � � � ro � � � � � I 6t � 0 � � O � R� g � � � � p. p 'r Od � � w �' � Stori� � " z WATER 8 � � � f:LOSETS � � URINALS n�r►+ O � � � ewstn� � RT � - SINKS �,� W�, �� DRINK. FOUNT. sHw�. n , FLOOR `V DRAINS G7CFI �I BAS�NS AUTO H/wSFieR GAS APPL � GAS RANGE GAS OPENINGS 7 i 2 • � �� - � > 8 "' A 8� �❑ � i n � cti o, � � p� M m � OA _ � � � � (°� � � � b �' aa� � � � A b y ,Q' � � y � � �� + y �4 Of�D P� r�• ��o� � ��° � fD � � �� 8 �� ,�,y O � � h7 � � � � �'� O` "' W p m o to �y � O � �' '�, o ��w a � a��. o�� m � yO �Oy Cr �' A � ro � 3 `� � � �' d � A ro a0 �x �L M p � M � �, �i � � 'b �. � ' � � � � � � �, � � � C O. �- � � M � � � � . b ' g 'R1 � � A �v r � _ ,� `' -y..` j� < .,; " , 8rco, I�c�rgo�aee8 3231 Ce�eral Av�nue �]. 8. Mianeap0lis 28, M�nc►esota aniy 16, 1963 lte¢ Aeta$ni�g Walts 1221 �►rd��►aE Av�nnue N.E. gtte�tic�: Mr. (fll#.e Ericka�o9a GenCiemsa; Ia �r teleph�e c�rarsaescg of Jui� 16. 19f,3, yau staesd tl�t with s 1�it a!� r�inforctn$ that yau intend to do� tbeae �wa11s wi11 sesud as goc�d cr� baet� eitan any athar waii ttuC y� m•Lght puc i�. �uite frankiy. I vt�uld i�a 3t�cliae�d to d�bt yasi but dae ta �he �act �h�t I� nat stit�. I will accepe the�e �lla �i�h �ite rei�fo�ic�g t�at y�o� suggese. �u� if c6es� waiis a�a aat itandiag 4a good crmdi�icEn bg Jalq of 196�, q� �iil be rmquisad to ragiace e�� ith s properly eagi�nee�re�d �11 �or the eaaditi� �cistiag at �bi�r place. I a� a�ar� o� tt�e €act thae t�e �aa1Ze eouiel �� ec►�°n da�n wry easilp 1�� m� �equ►�remeat ie 6aaed �n► nstuYal �o�di.ci�s f�r� w�aCh�r of �il tppss. a� e�vuld a�ayane d�3ibarately sam�ne e�� p�� of ��.i.e �aii o� c�use ie to Sali, ya►n viil �t be h+�id i��►s�3bie. Thie �'haii be my da�i*�o� ae1�e. I e�ct t�a Wat�C to be dc�ae !.a reiafarci.ng thes� wa11s by n� ister ebsnt Jnl� �Bc6. ae wh�ch time I w�uid lik� c� '6e noe�.�lr�d ao t6at I caulcl �heck �ha �rark. AaJ:cke ca : Mr . b l�t. , Sr�hu�her Si�ace�elY. Al1en Gi. Js�ert Suilding Ias�t�c ;�+. . /' 1' ' ��_c' , '��!. . • �� , �r�, i��a�� 3�31 cen�ral Ave� �i. L. �Iiaueagoile 18, M�oaen�ta J�� a�, ��i �es 122� �ardams Avt�aua N.E. Q�nClma�s : I r�se �p amd �� ya� rae�3n� waxla '(�' j�oa bot6 th� l�� a�d eh,� Wsst �ide of ��ie grcger�y. 2 d�'t �nv� vhat yan i�ce� to retain wi�b tihe�s wa�ls. i made a�.eCake aad 1�a�d c� aae o� �th�m as�d part c+f i� fal� dow�. � On Page �4�, �+a�g�r 2$, &ecti� 28�4 €�i tt�e Q�nifoYm 8u�1d» , ing Code, ic ep�ciffcaliq states ttiat whe��a a�►y eacaveeioa is m�de� �etsin�.ng �n11s aa�st b� l.aetail� of so#��ent stre�gEk to r��in the adjdining ec�i3 �re�qa t►aturai vr eu�r-�harg�d 1�rade. Thia ts . ts��b a psot��ti�e ��t pe� and fc� che �es �"�t te defin3�teiy a Stse+� L�w e�t y�v �amwt a�m dmnag$s�g mstes�i�� e� anat�et pares,s �� +r�rry. T°he reC�iai�ag �s11s y� t�ave i�ta11�_.wiil have eo he r�p3,taa€i w��b d�w weils aF e�ff��eat strengt� to �s�pg�t th� load an� of auF�ictent len�i� �a ta�ce ��e r�f any �ail.:f�tam ea�h inslivtdu�l �Q�. If thesa a�re e� q��iona �rith ��erctee t� tbis mat�er, kindly contac� t�ai �f�'��te. AGJscke cc: Mr. � Mrs. Schum�cUer Y+�rB ve�'Y �r�r1Y. Ar•L� G. J&ETB� �uilEling Iaspe��ar � d � � � '� r EL y p t,� . � . 7i : � . � : M : o . � 0 ' � : � • � N � � � � � a�. � y p� � m�� x � � W z �8 � � � n �� ~ �' � � � � � �� m �� " � o�o � �i p' y � `D � �j � ,�' '� � : � � � � � � �, � o � �' �. : � `': �� M a a � � : eA �: : °��: ��: pn Q OQ . . . On o . . . . : : : : � : : : : : : : : � : : : : I~ I I � I I I I I I � aa aa �a 01 oa oa x �e k x � � � � � � � a � � �, � o�i � � � �i � 6�, g g' � ;,� � � r R1 � sn �n s� � C � H H Q •�•� i'� D � � � m � � _ m C r m .� . �. w p � �p � � °' a � � m � 8 �@ �� 0 a ffi � i �� ►+ M � � � � o � � Q i � � � x E a o � � � n b � s} � t � � �� w �J � � � � � C �' � � o � Gi � � � � ti � t � � � I � ° � € � wK p � M d � C� � o � K � �e � � WATER � URINALS e�r►+ � e��Hs SINKS W,� rw�vs DRINK. FOUNT. sHwRS. FLOOR DRAINS UTCH BASINS AUTO ia/�tt� GAS APPL GAS RANGE c�s OPENINGS +� • z • c� � � A � � �. � � � �. � �� b p� M �y 04 w ��,�� o m �' �' ;4 ��,� ��o� �' �° � �a �� 0 'b ►°�, bd � w � Ry �� ,q � y � m �a°p c�o a ° M �a.� w � � b a �, � `° a� �� ti .�� O y� � a t�' � m�fD 3 `� � � �' d G� n � M a� R � � � p � M � �, i� � � � � � 0� � � ` I � � O � -�' � � � r � O. � ; � '` r�. � �a N b � � o � m � � � � �' � � � N � V, � � �"� � � � � � : a > . � a I O � .'. r � � � � � �� O � � � Q p �� O � O �i � � M � i � � � �..., �� y m �� a�� ` W � �� ti �s� ,�s �� i . � � � _ � s : � � M k De O M 6� el1 $ a � y M M i � � o � r � � � � JD � � � � � I � x � Q 0 � � � � a � a � a 8 M a � � x 0 r � � °< � ti �I+ W o �W � � �� g �6' ~ A � � E � z^ V/ M � � � � a � � � x 0 � $ � � � � 0 � � � � �� ,�a. a � � x ��o N � ~ � �"� o $ � � � � � � � �� d � �� °�� m � � � � � o � � � � W ;p O O 8 � 8 8 � � � :� ; � ii , �� a W { = � � � � � n � � � d' ro i � '� z � c I'� i : p �;' 1 s � 0 � O � 0 � � N d. S � � �� a� �� ➢1 01 ~ � � � �°�� m � � � 8 � � �, s � a �O . � M O � � ' � � . : : � W O� al G: O 8 $ 8 8 8 � �r � � �m o i � � a S � �� I�' i�' � \ � �, � \ t°� � �� : .. � I � �'�� m� �� a � � �pn �Q : O " . . 8 . . w v� oi O � 8 8 8 8 r� r� � � � I� �� a b �. �, � �� 0 �a. �� s� � �� o tg m 5�� xo 0 � M�� R' 'C : t7 p� C � o�� m �,a��pp�� M M � � �� 5 a A � � �� . D � � � T H n T C � � M P �� I � � � ; � � �. �_ � � �:�i �� e w � � O �. � �. 'l3 �� . � � � � ,' �`' � o `.. 1 �, � � � �v � r. � � � � � � : i� N� � � � �� Q � � R ° � �Y t� � � �� ` ` � � ��1. � � �1 � � �o � � � � .� V_ � � Q`� � * � � �: � 7 O � � a � o y' � N � O N � A -� n� O � � � 0 d Q� O �• � �• c� Oq n N � .d -� � 'p fl1 C�D y �G �- o CD � � m � . � � � O C � D � a 0 < � � � a � Oq � � 0 � m � m Z � � m n -� O z �'1 m m � � V O � \ _ � � oq � m a D -� m _n � _ \ � � 0 � m � ! i � 2 D � z � n � � O D r '�'I m m ii9 � � a m � C � � � � lD in 0 0 � `:.o11 � p� � °, � C1 � � CD Q� O � � � v °—' d' � (7 co 0 � � O � � D � Q 0 � < �D fl1 y � C m m °, � � y a � j D lAD � o .= � o � O N � I""' N � � Z W D ci � ._,, D n 0 � o. 0 � � D � N m N G� C1 N � m � G) G� D � � fl1 01 y C N � � � � c�) 7 � �' � 1D i� _ m � c�"c � cn ci �- � Z � � m ""� � � � � � Q • � � o� � .... a � a = C � a `�-�; o � � � �'« � r2 ��oo�o � � C� T� �� .�i�v W � � N � � � � � � IV � �-+ � W U7 O O O O O O O O O � fD GA {f� � Efl 6A �A {fl � 0 D � r � � y � a � c�p � � c� �D m � o � � �°,�-m 01 r.�. � y O fD y � � . f D N C � Q" .� -� ov � � � o � a � a a- ��vo� r.5�'3 � v�' a� � �• � N a c� �- c� �•Q.Na °� � ` o�i. � � � =� � � � � r° rn o ° c � Q- c� � � � � = N � � a3� � � � � o h � o � °1 .+ � � � m � :+ fD i�i � � �G O w O � � as m � Q N m � _. � C W � m � � Q. m z � m S -o N m Z 0 rn v � �a�--iz �-��,o — C � o Z = w � � �' CD � Oq c � N I � I O � �% � � c� � o p > > � � � � ^ N a cn m .� r N n. r" z 3 v �o,� _ 0 � � m v � � D v m � D � m � n O � --� �� m � � � z O �� `�y �� W C r � z � C � rn 0 � � m N c� 2 m v C r m o � � O W � � tn � O� C� v�.�+— iv a'� � 1=-� W � 0 � � � ��•-n Z fD %i7 CnN•� �� m w < -�G N m Z zN m� m n � � Z � C � 8 � � Z � r � � � � � �� Z =-- Rt � •�O � ---�_ -� � w � � Z O � Z � v aD � Z ON za vz �v o= Zm Z -D-1 � Z �� rn A N r aZ Z -� vm vZ <� �a �O z � m n < m O � � � f-+ O �--� �o � � � � L FA CHIlYINEY AND STACB VERIFICATION The undersigned hereby verifies that the e�cisting chimney or stack: 1. Has been carefully examined Yes () No () 2. Is free from rust or deterioration Yes () No () 3. Has no foreign objects lodged within Yes () No () 4. Is securely supported Yes () No () 5. Meets all current Code requirements for size �d total �TU's c��nnected Yes ( } N� { ) 6 Has total heating BTLT's of All other BTU's � TOTAL BTU's 7. Has a liner been provided for water heater Yes () No () 8. Has combustion air been provided for water heater Yes () No () Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: � ��"3, ."i _ ,.�>": ,,r.�A: C[7YOF FR(DLEY � FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 March 16, 2001 Marsha Berg 1221 Gardena Ave NE Fridley, MN 55432 Re: Final Inspection at 1221 Gardena Avenue NE Contractor: A-abc Appliance & Heating Dear Ms. Berg: A mechanical permit was issued on July 27, 1999 for the installation of an air conditioner at your address. According to Section 305(a) of the 1991 Uniform Mechanical Code, a final inspection shall be perFormed on the mechanical permit. As of this date no inspection has been called for. The permit fee that was paid covers the inspector's time to check to make sure the appliance was installed correctly. We also need to check for the installation of combustion air, vent and connector sizing. If you would like the installation inspected, please contact us within 30 days to arrange the inspection. If we do not hear from you we will expire the permit and note that no inspection were called for. Any questions can be addressed to myself at (763) 572-3603. ly, DAVE�J�NSEN Builc� Inspector DJ/mh ADDRESS PIN LEGAL DESC PERMIT TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 ►63) 572-3604 FAX: (7631571-1287 : 1221 GARDENA AVE NE : 243024240021 : MOORE LAKE HII.,LS 2ND ADD : LOT 5 BLOCK 1 : BUII,DING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : RESIDING PERMIT O.: 2004-01814 ` DATE ISSUED: 10/06/2004 VALUATION : $ 10,697.00 NOTE: PER R703, 2000 INTERNATIONAL RESIDENTIAL CODE, REQUIltES THAT A WEATHER RESISTIVE BARRIER BE PLACED OVER EXTERIOR SHEATHING TO PROTECT THE INTERIOR WALL COVERING. EXCEPTIONS FOR THIS PROVISION WOULD BE IF SHEATHII�TG IS AN APPROVED WEATHERPROOF PANEL OR WHEN TI� SIDING IS AN APPROVED WEATI�R BARRIER. VINYL SIDING IS NOT A WEATHERPROOF COVERING UNLESS THE MANUFACTURER STATES THIS IN TI�IR APPLICATION GUIDELINES. CALL FOR INSPECTION OF WRAP BEFORE COVERING OR TAKE PICTURES. RESIDE HOUSE & GARAGE. STATE LICENSED CONTRACTOR 1 � APPLICANT CHAMPION WINDOW CO (20449672) 7155 W COMMERCE CIR NE FRIDLEY, MN 55432 OWNER BERG ROBERT L& MARSHA L 1221 GARDENA AVE NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construcrion authorized is not commenced witin 60 days or if construction or work �s 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 wor� will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or c el the p isions of any other state or local law regulating c c' or the performance of construction. Applican Date tm1l�/�m�r Bldg Insp BUII.,DING PERNIIT FEE FIRE SURCHARGE STATE SURCHARGE, VALUE LICENSE SURCHARGE TOTAL 6 � SEPARATE PERMITS REQUIRED FOR WO1�K OTI�R THAN DESCRIBED ABOVE. 195.25 10.70 5.35 5.00 21630 N�► [] CITY OF FRIDLEY EffecWe 4/1/2004 ADDN [] 6431 Unive�sity Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION �� u"7C��3 � .'��- Construction Address: 1 Z.Z 1-ia. r.��.�� u.� �� Legal Description: Owner Name 8� Address: o �Z o,i- ��"Tei• #�-� c.3� 5� �—� S�� Contractor. ��ra,o.. ��..� cc�. o-F- M-P l� MN LICENSE# Zo�ky..q.�1? Add�eSS: i�SS �Ov�✓�R.rt-� CLrG�2 , W ��_ e�.+ SSZ{c�32 Tel. #('�c. �� -Zp5'� LMNG AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this appiication, a Cert�cate of Survey of the bt, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Length Width Hgt/Ground Sq. Ft Sq. Ft Construction Type: �� w.�i.. �v � S��j Estimated Cost: $ � ��a� Driveway Curb Cut Width Needed: F+ 6 Ft = Ft x$ _$ DATE: O v`�( APPUCANT: �" TeL #C'��3�ZZ�- 4� �� Call (763) 572-3604 for Penr�it Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ / ^ �• �� $ � $ /� •r%� � S'•.� $ .$ ��. a � $ $ $ $ Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 [ ] TOTAL $ �I (o • �C� STIPULATIONS: BUII.DING 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 �low 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 $3.05 for each additional $100 or fracdon thereof, to and including $2,040 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fracdon thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each addidonal $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,OQ0 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,�0 $3,233.75 for the fust $500,000 plus $4.75 for each addidonal $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,�0 plus $3.15 for each additional $1,000 or fraction thereof CURB CUT ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined rate 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 construcdon site. VERIFICATION OF FOUNDATION A Certificate of Survey of the lot, showing the location of the existing foundadon will be required before proceeding with the framing. New Houses Onlv � -- , CITY OF FRIDLEY . ` 6431 UNIVERSITY AVENUE NE " FRIDLEY, MN 55432 (7631572-3604 FAX: (763) 571-1287 PERMIT NO.: 2004-02240 DATE ISSUED: 12J03/2004 ADDRESS : 1221 GARDENA AVE NE PIN : 243024240021 LEGAL DESC : MOORE LAKE HILLS 2ND ADD : LOT 5 BLOCK 1 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOW/DOOR REPL VALUATION : $ 5,066.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF THE 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENINGS. APPLICANT CHAMPION WINDOW CO (20449672) 7155 W COMMERCE CIR NE FRIDLEY, MN 55432 OWNER BERG ROBERT L& MARSHA L 1221 GARDENA AVE NE FRIDLEY, MN 55432 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 worb will be complied with whether specified herein or not. The granting of a permit does not presume to give authoriry to violate or cancel the provisions f any o her state or local law regulatingconstruction or the�rform�ice of construction. Bldg Insp. BUILDING PERMIT FEE FIRE SURCHARGE STATESURCHARGE,VALUE TOTAL PAID WITH CHECK # Master � SEPARATE PERMITS R�QUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 125.25 5.07 2.53 132.85 NEW AD[�V , �1LTER �� I] [I CITY OF FRIDLEY 6431 University Ave NE, Fridley, MN 55432 SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 4/1/2004 (763) 572-3604 Bldg Insp (763) 571-1287 Fax Construction Address: �� I�a�. rc�� c� � f� �� e N� Legal Description: Owner Name & Address: a�� rG �zZ1 1�,��e�Qr��. �� '� Tel. # (� �3 � 5� � " 3 �`�U Contractor. C�,�,n�p��.� �,��,,.�ow c� �-F �� MN LICENSE# 2oy�}�� Z Address: �t `c� f��..,n�e�c..o C.r�.�-e u� F-�� , �+.+� s-,��z Tel. #C�c�3� S�y- Z��l LMNG AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the bt, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft Length Width Hgt/Ground Sq. Ft Construction Type: 1��.o� Q.�.�� w� �- � Estimated Cost: $ s��o � Driveway Curb Cut Width Needed: F� + 6 Ft = Ft x$ _$ DATE: 1Z � t� APPLICANT: Tel. #C��3� ZZ �`��O�y" Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge � � �� -2�-- $� $ �-" lJ � $ $ .$ $ $ $ $ Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 [ ] TOTAL $ � � • � � STIPULATIONS: BUII.DING 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 $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $1(�,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 $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,�0 plus $14.00 for each addidonal $1,OOQ or fracdon thereof, to and including $25,�0 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,�0 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,�0 or fraction thereof, to and including $5�,000 $3,233.75 for the fust $500,000 plus $4.75 for each additional $1,0� or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,OQ0,000 plus $3.15 for each additional $1,Q00 or fraction thereof CURB CUT ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determi.ned rate Pernuts 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. VERIFICATION OF FOUNDATION A Certificate of Survey of the lot, showing the locadon of the existing foundation will be required before proceeding with the framing. New Houses Onlv Building Inspections 763-572-3604 PLUMBING RESIDENTIAL APPLICATION CITY OF FRIDLEY Permit No.: Received By: DATE I� I I� l A� � YOt)R E-MAIL ADDRESS SITE AIIDRESS A L Z A G fa P�? a� � PaJ A . THIS APPLICANT IS: ❑ OWNER �ONfRACTOR PROPERTY OWNER/ TEI�TANT CONTRACTOR SUBMIT A COPY OF YUUR STATE LICENSE WITIi APPLICATION NAME: i�1'+ A 2�. e A ��. � ADDRESS: � 2, Z. f ��! �� E.iJ f! � V� CITY �2 + r� G F.,I STATFI'�t•'� ZIP _�i S"��' 3� PHONE: �� 3 �� e 3 S y y NAME: STATE LICENSE # � � 'o w �' � � EX ADDRESS: PHONE FAX Terry Overacker Plumbing, Inc � 502 E Main St Anoka, MN 55303 'IP PERMIT TYPE I� SINGLE FAMILY 0 TWO FAMILY O TOWNHOUSE TYPE OF WORK: I � �w t�nt.�cs�rr DETAILED DESCRIPTION OF WORK ��,•,s� �,� �¢_,, ,�,,,�;{.�, PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost ap to 5500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixi�ues. (This should reflect onty the cost of lat�or � Labor cost under $300 =$15.00. Labor cost between $300 to $5� = cost of labor x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.� PER FIXTURE, EXCEPT WHERE N07ED. FIX7'IJRF.S: (INDiCATE TOTAL NUMBER OF EACH BII.OV� BATH S1NK/LAV FLOOR DRAINS SHOWER WATER PIPING _ BATHTUB _ GAS PIPING � cr�rucF� SWA�IIvIING P(�L WATER SOFTNER ($35) _ CLOTHES WASHER KTfCHEN SINK WATER CLOSEC BACKFLO'W PREV. ($15) _ DISHWASHER _ LAUNDRY TRAY �WATER HEATER ($35) FOR IRRIGATION _ WATER METER _ OTHER Fee $ _�. c� � �rge .50 � -� � Number of fixiures @ $lO.Od x $10.00 = $ Number of iixtures Q$15.00 x$15.00 =$ Number of fixtures @ $35.00 x $35.00 = $ Stai.e Surcharge = $ .50 Tota1= $ THIS IS AN APPLICATION FOR A PERM]T-NOT VALID UNTIL PROCES3ED I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; that the work wil] be in conformance with the ordinances and codes of the City af 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 vt�ithout a permit; thax the work will be in accordance with the apgroved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPUCANT ,-�'��r , o �' !�y,� PRIAIT NAME � P+a: Et. �� G 2 0.�J e DATE '�� e v B u-w � City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, NiN 55432 763-572-3604 FAX: 763-502-4977 Building Inspections 763-572-3604 763-502-4977 FAX DATE�d(Ot'( SiTE ADDRESS � THIS APPLICAIdT IS: 0 OWNER BU�I;DING RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE I-1-08 YOUR E-MAIL ADDRESS PROPERTY OWNER/ NAME: I��(� 1- l��:E� �c�,�, _ TENANT ppDRESS: f ��-t �a'.eoc�u-�. CITY PHONE: CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE PROPERTY TYPE PERMIT TYPE TYPE OF WORK: ADDRESS: �r�� .,��•-� d�% - ..5� CITY � PHONE FAX STATE LICENSE # ��3 �4a/ � EXP DATE ❑ SINGLE FAMILYMEW CONSTRUCTION 0 TWO FAM�LYMEW CONSTRUCTION � ADDITION ❑ GARAGE/SF ❑ BASEMENT FINISH �ROOF ❑ DECK ❑ SIDING O SWIMMING ❑ NEW HOME CONSTRUCTION ❑ � ❑ MAINTENANCE/REPAIIt �E DESCRIBE WORK BEING DONE: ROOFING NUMBER OF SQUARES I� GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other WINDOWS IN EXISTING OPENINGS ❑Yes ❑No OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE SIZE ❑ WINDOWS ❑ DRAIN TILE � OTHER Permit No.: - ��"� � �� r?� Received By: � Dat�d� � ATE +M �%' ZIP STATE�� ZIP � �v`�� BASEMENT REMODELING SUBNIIT: l. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ❑Soffit ADDITIONS. & PORCHES SUBMTf: ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Fascia and proposed project. 2. Two sets of constrvction plans 3. Energy Calculations LOCATION OF WINDOWS NUMBER OF ALL F�ES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: ING THE 1997 UBC FEE SCHEDULE) � TOTAL JOB VALUATION $ �� OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Swcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Chazge Total Due $ —- $ $ $ `�.�1� $ $ $ $ � See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1825 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$21=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City of Fridley Attach 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 accurat • ork will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Cons o es; that derstand this is rmit but only an application for a pertnit and work is not to start without a permit on site; that the work will be in accor with the approved pla i •a all work which requires review and approval of plans. � / SIGNATURE OF APPLICAN PRINT NAME �SV �� 7'f°f ��' DATE �( �' ��%6 APPROVED BY / __ DATE Page 2- Building Residential Application Bi7ILDING PERMIT FEE SCHEDULE The Chief Building Official sha11, 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 perm.it 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 l�` $500 plus $3.05 for each additional $100 or fraction, to and including $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 1�` $25,000 plus $10.10 for each additional $1,000 or fraction, to and including $50,000 $50,001 to $100,000 $643.75 for ls` $50,000 plus $7 for each additional $1,000 or fraction to and including $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 including $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 fraction VERIFICATION OF FOUNDATION Pernuts for construction will be issued a minimum of 24 hours from the time of application to allow 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 Department 6431 University Avenue NE Fridley, MN 55432 ' 763-572-3604 Faz: 763-502-4977 ri vn i. � u,�,� r cuvu� r a�e. u i vate. ai r � ��t�� t, i�, ua r �w ..�_. .... �........ �. �...��. . � �._�. ........ . . �........_..e .........�........... .��,'' �Yi.P'`-�` ._. Building PLUMBIlYG Inspections RESIDENTIAL APPLICATIQN 763-s�2-3�04 CITY' OF FRIDLEY 763-502-4977 FAX _ SITB ADDRESS � THIS APPLICANT IS: OWNER! TENAN!' SUBMiT A COPY OF YOUR STATE LICENSE, BOND AND CERTIFICATE OF 1N3U.RANCE PERMIT TYPE YOUId F.bSAIL ADbRESS �idt I C�e7rc��r�. A� �iOWNBR 0C7pNTAqC7tDR � s: t d,�t I G�,r c��vro. Cc f.�t _ �.�2t� - I�r � n N�:�� N �c C) v,e�tae9�,� '!"�1h� �irlcr 3TATE LICENSE ii �O � t� �' �' BXP DATR STATE BOND # ADDR�99: J�a 2 � C1TY r�v PHQNE r. ,S (� F� � �9INGLE FAMILY � 7W0 FAMII.Y � TpWNgOUSE TYPE OF WORK: I � � DETAILED DESCRIPTION OF WC1RK �PLACEI�+NT EXp DATE � - . ._ — , _ „ , t�L_ � - ►i1� �, ��.��;� `� � o-'�. _srnre. 'll-�_ � �'3 3TAT�ZIP� � � �� PF.F� ARE BASED ON $10,00 PF.R FIXTUItE, E}CCgPf VVHERE Np?ED gJX1'UR�g: (I]�DlCATE TOTAL NUMBER OF EACH B6I,OW). NBNII�J�( � $3530. � BATH SINIULAY �F[ApR DRAINS ` SHOUVER _ BA7iiTUB � GAS PIPWG (NEID CITY LIC) 3WiMMING FOOL WATERPLPING _... CLOTHES WASHER KTTCHEN SINK � UVATER CL.OSBT -- WATER SOF1NIIt (S35) _ DISHWASHER _ I.At1NDRY TRAY _WATER HEATER ($35) FOR I1tRIGATION •($1$) � WATER M6i'ER �07�R +� 1-,r ...r 1. r. . t i 4!ld11�11��1 __ 'TH73 E3 AN APPLICATIpN FOR A PERMI'I'-NOT VAL1D UlYTIL PROCESSED I hereby apply far a plwnbiag permit and I acknowledge thax the information above is compl�e and accu�te; d�et fge work will lis in confoimanc;e wit.� I$e ordinances and codes of tt►e City of Fridlesy and with the Minne,sota Construction Codes; that I und$r�ad t�is is not a pern�it but only an application fnr a ' and work is not to start wit}rout a permit on site; that the work wi11 be in accordance wlth the approved plan ase of all wor 'ch requires review and approvel of pians. SiCiNATURB OP APP PR1NT NAME �I � DATE �I City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-582-4977