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AF - 43566City of Fridley, Minn. . BIJILDING PEA�.MIT N� ��oo nate: _� yZ """' � � ' Owner: ��,��s�-- Builder � Address r.�. Address � �� o TION� oF o� i�G No. � - Street -+�'� - of Lot Lot Block Addition or Sub-Di ��n � �� —�--'-- -----� ��_�+ �,+� Corner Lot Inside Lot �'''"'�- Setback Sideyard � ,�, � J' Sewer IIevation __.__.. _. Founc�ation IIevation �' DESCRIPTION OF BUILDING , ,, T, eUs f " ` '� '� Front ��; f`— pth Hefghi �' Sq. F't .��Cu. Ft � !� �� t� Depth Height �� Sq. Ft � Cu. F't. � of nstructio�n .. Es�. Co __ To be Completed — �'Y� �— �' ,��G{�' Ea considerat4on of the issuance to me of a permit to construct the building described above, I agree to da �he prnposed work in accordance with the description above set forth and in compliance with all provlsions of orriinanc� oP the dty of Fridley. � . In eonsiderat3on of the payment of a fee of $.�_'""-.�, permit 3s hereby granted to to cansiruct the bwtlding or addition as described above. This permit is granted upoa the express condition that the person to whom 9t is grauted and his agents, employees and worlanen, in all work done in, around and upon said bwilding, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regardiag location, conatruction, alteration, maintenance, repair and moving of buildings � th�e dty limfts and this permit may be revoked at any time upon vio of any oP the�rovlsions of said i�.�+f i!�' � Buildirig InspeCtOr NOTICE: T6is pemilt does aof eower ths coestruetion, ie�alletioe fo� wirine, plumbing. 8as heaHa9, sewer or water. Be suro to see ths Buildin8 la�►odor for separafe pem�its foe th�e Itsms. � � �y �� 4 �+ �� :' APPLICATIO�T �Oia BUTLDING PEiil►3IT C%TY OF Z:"RTDLEX � NL,TI�1iESOTA / �`' _ �--> Owner `s Name f, ��, Cl ��' d`'� Builder �_��''� �-��" �--� �T.., rt� �� ,�� . �,. Address �=��>�'�F�- ��f%`� Addre�s LOCATION OF BUII�DING %� l� ii � No.-,�=�---, Street ��-��dl`:.��, P t or Lot �� `�= �,•�1 �"� ��1� �� `� -�`1��- Lo �� Block Addit�cin or S��divieion � Corner Lot �nside Lot �� Setback •f��:1 � Side-Yard - � SEV�'E� ELEVATION �� % �' FOUNDATI0I�T ELEVATYON �� Applicant attach to this �orm Certi�icate of survey of Zot and proposea building location. DE�CRIPTIOIV OF BLTILD�NG 3'o Ioe used as e�fL� r�� ` c.l� ight 1� � Sq. Ft. Cu. Ft. Front�,,,,�Dep•r.h,_,�Height � � Sq. Ft. Cue Ft. lype oi Construcicion `(��/; -° �-'-�_'` Estimated Cos�t � �' - f To be Completed �=�� .� The undersignecl he�ce�y makes application �or a pe�mit �or the work herean specified, agree�.ng to do all.work in strict accordance w3th the City of Fridley Ord�tnances and ruling o� the Deparf�aeat of Hu31d- ings, and hereb�r declares that all the facts and �cepresen�ta�ions s�tated in this p,�l cation are true and correct.��;; . '' , . � � �� C� a� _r � �� Sz�� 54-� � ,�: �'�=� (Schedule of Fee Cos�s caaz be found on the Reverse �idej. /"�, n �, . s a� � 'r.,e � / �U3LDING PER@RIT FEE SCHEDULE S�ec�3on 2. The 3nspector of Buildin�s shall� before 3.sauing any per3nii: for the e�ec�ion o� any bu3lding or structure, or for any addit3on to any exis�� buil�ing or st�uctwce, or for any alterationa or repa�.rs to any oxis��n� building or structure,_ upon application �h�refor, require �,tie paya�nt by iche applicaat �or euch pera�it of �ees to the amount here3.ri belaw set �orth and in the marui�r herein p�covided to-wite 2.1. �eor any such pe�nait for the erection o� any fire-prooi building, ofi�iier than a�cjaragro, warehous�, �acto�cy or grain elevator, or for �he erec�ioa or a,riy x�re-p�oo� acldit3on, �or similar occupancy, to atiy ex3.a�cing building sha11 be at the rate of $1.40 for each ono thousand cubic seet, or iraction thereof, in such cubical ccntents. 2,.,2_. For any such permit �or the erec�ion o� any fire-proof garage, wa�ehouse, factoacy or gra�.n elevator, or for the erection o•r' any f3re- proo� additioa, io� similar occupaney, to any existing bu�i].ding shall be at the rata o�' $1.25 cor �ach one thou$aad cubic feet, clasa3�ied as "�`i�eproo�" by secicion 502 of the l�i.r�neapolis �uilding Code. HO� 2.3. For� any such permit for the erection of ing other than a garac�e, warehouse, fac�cory or non-�ireg�roo� addi��.on, fcor e�nilar occupancy, Permit $1.00 for each one thousand cubic teet. Gt�AGEs any non-iEireproof buiid- grain elevator, or any to any existing building. 2.4. �'or any such �er�it �or the erection oy any non-fireproof garage, warehvusa, factory or grain e�.eva�orc, or for the erection of any non-fireproof addit�.on, ror aimilar occuparscy, to any existing buildiag or ro= each such building o� adalition. Ninoty Cen�ta for each one thousand cubic �eet og fraction �hereof, 3n the cubical contents �thereof `vi�h a mininnum oi $4,00. �`or the pur�ose af com�outing fees for building permite the cubical con- tents o� any buildi.ngr or addition to a unitorm height throughou� by multiplying the ground area covered ;rom a point aix (6) inches 3�elow the rloor line o� the basement or ce11a� to the average he3ght of the -. upper surface or i:o �che average height of the roof eurface of the main gable of a p�tched root. �� 2; For repairs or alteratione to an existing etructure, the fce,e . shall be at the rate o� $3.00 per each_Five Hundred Doliars ($500.00) o� �raction thereos in �the cost oi all proposepl work. � 2�,.6e in ao case shall the fee charged aor any pesmit as set torth in 3ectic,�� e less t�'�ci $4,00. � _,� . . . , . -.� �_.0 -,tJ' Lmrd P/annin� [azd Surveyiir9 Snils Testiny Clvi/ b A�1cvi�cipial En9inreerrn9 / / �87'S-Hiyhrrvr� ;tS A/.E. MinneoPn/s 2/, EN G I NEE R I N G, I N C. M�n�esofa SUnsef/J-6066 — En9ineers � Surveyo�s cests,��cate o� s�s�eT �o: lv � �l- \ _. � � — 2U': � ,-, � ! �1 � ? �� , � M � � - �� S � .,.� ., ( v � 4ILJI � �� I r � s .� v�rJ ;a :� �- � 9 P�-op��e�� , t� GU5 n \ AZ � ��_ � / GA�P�?�NA L � a � I� i�'` I a � o, ,4 �'��V�/�r E,r?� a /NG. 4r�/�: l'°= 3D � �T Z �; �.._ �c.'�f 2 /��Qr?i�� _ L., AIfF NlL L S A�"� .�q_D�? //r�dy �i�y !� �Iiis �s o lras ar� mrr�cf re�artese�otraar o�'o suwty q�"il�e bavmalor�es q�'!/� ab�o� af�w+►6�d /mr0, ond o�� la�viion o�'o!/ d wldv�s , i4vecen , md o1/ rrs'�6/e ax�avdima�fs ,��'ane�. fnrn cer arisaid /m�d. As surveyed by m�e �/u3 - dv� � S��P.h6er- A.D. �9�..1.= SUBURBAAI ENGINEER/N6, INC. . F�inerrs Sur ors � �r � � � ��:: -� .e... �. � _ �, � �� d � �o � p o� t' : � � � � N � � �i c�a�y � � � � � p � �� o � � � � � . o • o � : o . . � : : � . . a � � � {n �N r o O O � 8! if! fA H � V` � � x � � � z� � z� z x fD m rt lp � � � � � � � y � � � � 5� � m � � � � � : o � � � � �o c�' p � � a � : � � : � N . ly � • .. � O . t�' Oq . � � � � . � � . . . . : � : : : : � � . . . . 0 �a oa �e k x �e ca t� c.� r+ � ►�+ � c�ii p c�i� o o O � {-i! {fl ii9 {fl fA � , � Q � �I� � � � O A x e � � � �� 5' � � � p m � � r � m � n 2 m C r m O ,� Q Z �' � � a o � n b �� `� a � � w � g � I , ,x, . �a w p •� pd x � � a. a � � � � WATER � @ � 4.o�s � �% URINALS � e�rH o � � p e�sin�s �d �i I SINKS � � WASH TRAYS DRINK. FOUNT. s►+wes. ` FLOOR �� DRAINS G7CH BI\SINS �uro WASHER GAS APPL �� RANGE �� OPENINGS a • 2 • �D in D A m � � p � � 8 $h 7� � � � � � �' � aa�D � �� M �p'fD N � � d �� d ��.� ��o � � �.��p°� 4 �' r �� °�y� y � y b �� b �Q�� o `� �' � /l�" p � m c V� � p, o p \ �' 'Cl�, o �! � � n � ��ro a� �� : �� n� �. � � w � � y }7'i � 0 � � � �� A ro wM Rx � M p � M O M �a � � ,�a �� i � � �� i '9 . d 0. �- v� � ;• � `� M o� �T � � �Q � A A �� f'' �D ..� �ii�ls3�� i -� � � m s � i � � � `,,. ~ O z � � �a � � � a p � r M � �+ H �' �,' hd � r � o � x x x � � � 4� O �� o � � � m � {n � C� � � 0 00 � � a � � � _ m z a �� m � � � v� z < c„ m = z m T � m � � � C] w � w � � � � [�i � Q b � � M m a. � '� � � w � � � � � ... o '� m ,��, N � y O � O ' O � • t� . : � : : p! �C x O N � °o o c � {� {� {fl � O r' � o n�i � � b �. � O � I � � � � � �' z � � � � W � � � � � \ r ` � 6' � a N °. aJ Q � � , � ro Y � a Q �o � � � 0 � O O O O 0 � � 0 0 {� O [' oa �i � z < � '� o w oa W � � � � M � y x o p• � o � � m m m : e� . �: �. � � � H � m � � z � � M 0 � � 1 �i P 0 � � �' �� o �y O � � x � � � m � � � � ,a°'. a `D fD x w N p" � „�,� No�� 0 0 � p ,,�� c R° R° y �� :d?d��-� a � o o � `� � � o � � �" � � � : : � � � � o � . . � � : : � � . y . � N � � � o° o o °o o° C!> {!i &! {A {!� � � � O M O � � � � ib � � � � � 0 4 � � m � 0 r � � � � � � � O � O h7 � � g � � M � � x �° ,� � � �'�'� � � � � � � � � ��'�'� ��°b�� 0 0 � � � � � n Q � � � � � Od m � � y o a � : G �• o : ' � g ° : : � 0 O . . . �, � � : : � N � � N � o °o o° °o o° in iA Ep QA � G � � p. f�il y 8 � �f �f +C � � � z��(p�S Qf 01 �' � �' �' � � � � R� R° � � y �a�� u y � �, � � � � � � � y e# �. � � o � a � � � a �' . ca . . � � �: : ,°o $ : : � : : : N � � � � en o 0 0 Q O O p � � 0 C' aa� � � � � � ro ��w� � a��a, a �� `� �� d°° � �, ��, o �� Q.a ��o� � pp�`C �� 'M 'i�i � �S�S� R1�M � pv'`+� w �a�p �ma� M ��m �� Q. �p �� O •+ ��I�DM �� .I"'+ (� �p'! ��DG' � � � !Pi 5� \ D � i � � m H _ m C m G b .�,. � `� a � b "0 � � 0 � � O � � �O 0 � ' � � �i �' '. Z � � �� 3 � H 0 � 0.� v< < .i �. �, n � �' �. � � � � � .7 � O. .. v : � �� S��Y �/c�//�� HEAT LOSS CALCULATYQNS DEPAltTMENT OF BUILDINGS , MINN. Weatherstrips �•S.H.V.E, Construction No. lnsulation Guide t�irtdowa Doors Refere ce Out. WaU Int. Wall Cerling Roof Floor `Kin —No �—`3—No 1'9� Ec� � �' � — r > � F7. ° Room � Length j� Width /,ji Height '/ F7 Rooan Leag f� Windows a Doora—Crackage and Area Windows and Doom—Crackage and Area �Yldth Hel6ht No. ot Ltneal ft. A�ea Width Helght No. ot ,Llneal LG J No. ot pane o[ pane . Ilghte ot crack eq. ft. No. ot pane ot pane Ifghts o! crack e� / — � � `3�' � � � 6 �. �w .3 , Coef. Btu lnfiltraHon Infiltration � Glaas Glaas Exp. wall Eap. waq ; Net esp. wall �J°DO Net exp. wall lnt. wall Int. wall Ceiling o? � 21,� l'� . Ceiling Floor Floor Totaf Btu. � Total Btu. Required sq k. E.D.R. or sq. ins. W.A. Leader area Required aq. ft. E.D.R. or aa. ina. W.A. l.eader area �� `'F7. ` oom Length� � Width / Height �-/ �,� Room I 1.ened► �/ Width / Heigh � � W�ndowfr and boors—Crackage aad Area Windows and Doors—Crackage and Area W1dth Helgbt No. of L�neal tt. Area W/dth Hefsbt No. of Lineal It. Area No. ot pane ot Dane llghte ot crack sq. !R. No. of ppne ol pane llghb o! crack eq. [t. . � � �3 � � � �f l i �� c��f. s�u co�. s� In6ltration � yp Ini'iltratioA Glasa � ' � - a Glasa } . � Exp. wall Exp. wall Net ezp. wall +y � Net eap. waq � int. wall - Int. wall CeilinB (� ��i (a Ceiling `!�' — Floor Floor Tocal Btu. Total Btu. Required sq. ft, E.D . or sq. ins. W.A. l.eader area -y Requued aq. f� E.D.R. or sq. ins. WA. Lsader area Ft, m � Length � VVidth /�y Height �'� �,� I�oom I[,,ength / 1A/idth ///Height f Windowa and Doors—Crackage �nd tirea Windows and �oora--Crackage aad Area Wldth Hefght No. ot Ltneal tt. Ares W1dth Heig6t No. ot Llneal !t. Area No. ot Dane bt pane Ilghte o[ crack eq. it. No. o[ Dgne of D�oe lights o[ crack ep. tQ i (O / f% Coef. Btu �oef. Btu In6ltration 3i Infiltration � � Glasa , � p Glass Oi Z Exp. wall Exp. wall Net exp. waU � /(� �Z Net exp. wall t� Int. wall � Int. wall Ceiling /� � Ceiling � !'� �� F1oor Floor Total Btu. ' Totat �tw ,� r j Required aq. ft. E.D.R. or sq. ins. W.A. l.eadcr area � Required aq. ft. E:D.R. ar scp. ins. WA. Leader area /._ .-- igh / f.i Btu SUBJECT �R�M IO. City of Fridley , 150 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � RECEIPT NO. � • COMMUNITY DEdELOPMENT DIV. � � Ly �� r � � PROTECTIVE INSPECTION SEC. 1 . � � � ��"1 � CITY HALL FRIDLEV 55432 NUMBEH REY. DATE PAGE OF APPROVED BY 1•---�' �•� 812-580-3450 910-F15 11/13/78 � � JOB ADDRESS 1243 Gardena Avenue N. E. 1 LEGAL LOT NO. BIOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 1 Moore �Ce �11�.3 ZIlC� SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE R�bert Sroka 1243 Gardena Avenue 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Western Remodelers 2529 Nicollet Avenue 823-6Z72 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP . PHONE LICENSENO. B USE OF BUILDING Re�identi.al 7 CLASS OF WORK 0 NEW ❑ ADDITION X ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 OESCRIBE WORK Insta.11 altunin� tsim 9 CHANGE QF USE FROM TO ' STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- 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. �`Z�4OO �`1.ZO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS ANV OTHER STATE OR LOCAL LAW REGULATING CON- $].rJ.00 S RUCTION T ERFORMANCE OF CONSTRUCTION. �/' PLAN CHECK FEE TOTAL FEE � � // �� $16.20 G TU EOFCONTRACTORORAUTHORI DAGENT (DATE1 WHEN PROP Y VALIDATlE`D THIS IS YOUR PERMIT I V � �� SIGNATURE OF OWNER IIF OWNER BUILOERI IDATEI ' BLDG INSP I nAT �� CITY or- r-«iv�cY . ° APf'LIC/1TIOiJ FOR (Z�SIll(:NTI/iL BUILDIP�G PEI2t�1ITS ' ��L'W, �LTL"R/1TIOfJS, IIDUITIO(JS, OR REPAIRS). ' � . OWt��R: i ' f . . �- Addres s e � �'� `� � . t�„�l�� /� �' /'a �3 tZo. : 5treet: � %�} LOT : BLOCY.: _� . ]3UYLU�R: � � '''�`-o�� Address :`L� `7 di' I� Ll--t c�/� �Oyi� Tel. No. : �� 6 / 7 � � i%z' � 7`t- (�-e .C� � %�z . ��. _ _ _ _ _ ADDITIOP� : CORNER LrJTs ' I2ISIDE IAT: SLTIIACK: SID�YI,RDS: Applica'r�t attach 'ta this form �•�o Cert-iiicates of Survey of Lot and proposed • building locatian drar�n on these Certificates. • 0 To Be Used ��1ss DESCRI PTIOfd OF BUI LDI NG �� . Frontr ' Depth: � � Aeight: ' Square Feet: Cubic Feet: Ficonta � Depth: � Height: ' Square Feet: Cubic Feet: ' �,Q� � `, Type of Construction: C�h �-� Estimated Cost: $� 7�� -- Zb Be Completed: / A1�. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ ' . (SE� R�VERSE SIDE OF SHEET) The undersigned hereby makes application for a permit for the wor3: lierein speeifi.ed, agreeing to do all �aork in strict accardance �aith the City of Fridley Ordinances and rulings of the Department ot £uildings, and hereby declares i:hat all tlic facts and representations s�ated in this applica�ion are true and correct. See reverse side i aclditional iniormation. . � � . ��; �''� �� % SIGNATUI'.E: � . Stipulations: � � �� .�� a� _ � 0 0 � s t- ' r BUILDi(�G PERt�7IT 'FEE SCNEDULE SECTION 2. The Inspector of Buildings shall, before issuing pennits for the erection of any building or structure, or for any addition to any existing building or structure, or for any aZteration or repairs to any exis ting 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: NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet. PLAN CHECK: 25 percent of building permit fee. DRIVEWAY DEPRE5SION: (Concrete Curb Streets Only) • Alternate A: Removal and replacement of concrete curb and gutter only; Driveway width plus 6 feet x$14.50 Alternate B: Removal and replacement of concrete curb and gutter and install a 3 foot wide approach with 6 inch depth; Driveway width plus 6 feet x$17.20 :11 � � � �' � � For the pur,pose o€ computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the flpor line of the basement or the cellar to the average heights of the upper surface or to the average height of the roof surface of t;he main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 �ier each five hundred dollars�($500.00) or fraction thereof in the cost of all proposed work. In�no case shall the fee charged for any permit as set forth in Section 2 be less than $7.50 plus $a50 state surcharge. • _' � � � � �1' �1 NOTE: Permits for construction wi11 be issued a minimtmm of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. R Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. C ` ! � ':1 Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a building pe�it has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. • � � ,,. � �� a � � 0 � �' ?�D � �►► M � � � 61 o � �� N J N 0 a �. N N O � 1 � ' r � � � � � � � �' � 1 � a . � � r. � N y O b � V � °z � � � . � � � � H � ~ a b � R' � . m t' � � � � m r�� Y � � ►� ` � �t cn cn r • �~x0 r�r < C C � � ►-� r H H ►i '�v' � b ►r ''� M y � � � � � M p�...� �., Q, v, •.• r,, tn p� h7 Z Z 7; H a W R� �o � q 7o n O �¢+ (/I L] G� O W L� �O � 1 Q' 1 p' �� 4"��'L � o M`n � n a o a� a� M H�-� 3 c r i �►a-� � tMi, W 8 a w � ro� r�n 9 iy �i o'►�+1. M �c r y' a tn l�' tn'�d ��"o'� y� F' X N N O y r� O r�0 tn _�� m o ~� °oo 0 0� `�'Y�� °o �' � Hm rfDt a' m°oa w°o �C 5' C o„ �''�]' � o o W � �i C `� ►.� � r � m Y� K G I I I �y (� � C xxx . 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Y K 0, � 9 R� � � � M��''� � ��°n�r N � M � n c o ',,.Y�., ��t a "�,? � � '-o � 7 5 �G O�� .� F'�:�'W�� v .. 0 �l � O E � N� f�D .i; A � O ' � x � O x � ao � o ao m o ° o c N o °o ° • °o o °o z O � O o e O � H O � G �d � � � r»aaN aa.�N � °o°o°o°o°o °oo°o°o� NfAtANN NN4ff/f v "� O O r n a•m ��y� �v rr n.. a� ''� W �` � rr"- `� N M � a' aaa� �„�° � !�D � W m ��O � m �° w � ° �e � � m w °' r � o�g� � °� � m � � � � N � N hJ � r ► � 1 D a a M�'S N F„ 1�q �.. x !o � � � w a w � � w � �� o K �"o = � � < fi � Fb'�+ M 0� O � w 7 o M � �! O M 0 t�D � � � 7 M m .� W r� „ � \ ~ ��a►°s � • m n � K � � m m m °'�wO N � ry N R K '�' � M K `C iC t✓ N n a x � � r K � � � � �,+ m � m � y 'v '9 r � a � O Z � O .'O O � m � a� � Z � � N Z � 2 -� G z m •• a � � N Cz+� � � -Nmi !"� 3 O v+ r d � m m ..�i � � � m N � 0 a a m � � � m a -� 0 2 a Z C c� � O 'TI � d r"' -�G . sue�ecT � PER . City of Fridley _- 1618 4 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ;, ,� . � `L _____ COMMUNITY DEVELOPMENT DIV. a 6 �� r � � PROTECTIVE INSPECTION SEC. � ' i ' � /�"1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV �"'°� � ,'� 612-571-3450 910-F15 5/14/81 � � JOB ADDRESS 1243 Gardena Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 1 Moore Lake Hl.�.�.5' ZIl.fl SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Robert Sroka 1243 Gardena Avenue N.E. 571-4848 3 CONTRACTOR MA1L ADDRESS Z�P PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Resident�al 7 CLASS OF WORK ❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR � MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 12' x 18• Addfition to rear of H�ae 9 CHANGE OF USE FROM TO STIPULATIONS provide fixe ala�. Frovide com'�usti.on air to furnace area. �/�-o e� S.�F� L'IU d,tJa'�'�i ��t�� cu�S �F� �uJ�UF� , w �R��G ilifies Before diggin8 catt b�a� uY TEt�Q��NE - ELECTR�� °�� SEPERATE PERAAITS REQ�JIRED Ft�? �� (,�UIRE� 8Y �'� HEATI�(3, PLUMBIIVG AND 51C�S, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. �fVTQOC; Frc'IIRe THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTHUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION , w.,, OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT Z�.0 ��;s, °� �^ � ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFF�S�jiEET 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 WI�L BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S7�2OO yS3.GO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �'4'rJ.00 NONE PLAN CHECK FEE TOTAL FEE $11.25 $59.85 SIGNATUREOFCONiRACTORORAUTHORIZEDAGENT IDATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT �.-� � /S�' � �� SIGNATUREO ERiIFOWNERBUILDERI 1 ATEI BLDG �NSP l.TE _� � . CITY pf FftIDLCY • � APPLICJITIO;�J FOf; RESIU(:f�TIlli_ BUIL()ItlG PERf�ITS ' � � (tdew, �1 ter��tions, IlddiLions, or Repairs) � OtJt:1ER: �i�g T 3'Ro�eA � E3UILDE.R: s��_ � � � ADDRESS: 1��,Q,�wA /9uu�E, ADD�CSS: • TEL N0: �,/- y� �a� TEL I�O: ' ' Cansi:ruction Location ' � � STIi3•�T NO: /;��3 STF2EET: �qR�G�A A�f E NE. Lox: 7 � sr,ocx: � AnnzTZOrr: � �.��L�s �� .s,�� Corner Lot: `�� Inside Lat: SetbacY.: Sideyards: Ap�licant attach to this form two Certificates af Survey of lot and proposed building �.ocation drawn on certi.ficates to scale. . � , ./r L DESCRIPTIOid OF CQt��STRUCTIOPd - . � ./� X l 2 I`/S� � f'r f o-,-� �, �n� 2 r-� f-%Ti.-r--� . I'ront: �� Depth: �_ Aeight: Squa�e. Feet: '� {s, CXibic Fcet: �ront: Depth: � Height: , Square• Feet: - Ctibic Feet: 'tt�x 33� V�3 7 �Z�.Bt Type of Co��ruction: FA� �Zoo�n /�Xl�. � 7� Estimated Cost: $� �+� _, - �b $e Oa��pleted: t � Alt. A Alt. B Proposed Drive��ay Width If New Opening Is Desired: $� $ , SL'E REVERSE SID£ OF SHEET , �9ie undersigned herebv ma};es applic�tion for a permit fcr the �nrk� herein specified, agreeing to c� ,all work in str�ct accordanee �•�ith the City of I'ridley Ordinances and ruling� of tlte Depzrtment of Builda.ngs, and hez:eby declares thzt all tlie iacts and rcpresenf�ltians stated :n this application are true and correct. AIiTFs: j'— �Q� g� SIGNRTUF�: s �tii�ulations : � p��; ,� �. s� G Ac � = y S.o 0 11.'t�' .� ��s � �, �7� �r . PAO� t 0� . Pnoa�� R�r •a�'� C•�a ��.� 0 • IIUII_J)Jh�G I'(:fifll'f ("L:l: SCfIf:I�Ut_E� � � , ;1::C'1'701�� 2. '�'1�� 7n�.:��ectar. vf llui.lc?i�uJ ; s;liri].J., ��cto�:c. i.�; ,uiu�� cnniL•s f�r ti�e crc:cL•i.on ut .��iy 1�u�.)_�l.ii�� ar :,t:ruc;t:ttrc:, or faz tiny adQi.�:S��n +�o atiy er.i;;i:3.i�� Ltiildi.ncl or utzlicL•w:e, . cir. i:c�� r�ny a].t.cr�tir,» or. r.clr�ir.:� i:o •any c.:a.r:L•incf },Lli.l.di.�rJ or st��ucturc, u�wn aj�pl5.c:at.i.o�� ilirr.�for.c. zcquirc t3�� ra�►mc��L• }�y tlic �-�r,z>>.;.�a„t: ro�- :,uch ��cr.m9.t• ot.� fce, tn tlia arnount hcr�in bcJ.c�t•r sc:t for.th �uxl a.i� tltc mnnnez h�rcin provi.dc:cl to-wa.C: . ' ' . . • . J�Il:I•� CONS`17;UCxIOIJ: Singl.e Famil.y ilotaes and Gar.aqcs: Y4.00/�,p00 cubic tec:t.. �'I.Fst� Cit):C1;: 2.5 ��crcer�t: of bu3:lclincl }�e�-miL- ice. Ult]:��E�•:11Y ll�l'P1:SSIOtd: (Cpncratc, G1irb Si:rcets Only) � �' ' Al.ternai:e A: Itc:moval and rej�lac�ment of concrete curb and qutL•er only; nriveway �:�idth plus b feet x$13. �0 Alt�ernate II: i's�moval and re��.acemcnt of concrete curb and •� gut-tcr and inst� 11 a 3 foot� ��ide approach �.�ith '' .• 6 inch depth; Dra.veway a�i�th �pZus G feet x$15..75 • � �DDIilO�/1L tr�ro��nr�or i'ar the purj�se of compui.ing tees for building permits,. the cubical cor.tents of any bui�d5.nc� or addition, is deter.m9_ned by rnultiplyir�g ihe ground area cuvered from a p�a.nt six (G) inches below the floor ].ine oi tlle bas�men� or th� cellar to 'thc average heights af ihc •upper surface or to the average i2eight of the roof. surf:ace of ilie raain gable of a pa.tched rooE. . ' For re�ai.rs or a].terations to an existing stnicture, the fee sha17� be at the rate .. of $3 . 00 �icr eacli five hundred dollars -($500.00) er fraction L-her4af in tiie cost oi all proposed wor.k. . In •no c.ase sha�.l the fee charged far any pennit as set iorth a.n Secticsn 2 be less • than $7.50 plus $.50 state surcharge. � . - . T F I C�TI O�t OF F�U�IDt1l'I ON " NOTE: Permits �or construetion ��ill be issued a minim� oi 24 hours from Uie time oF ap�lication to al.].o�� for proper review of the proposed s�ucture and oi the construction site. - � 11 Certificate�of Suxvey of the lot, showing the location of the foundation once it has been cons�nzcted �.*�11 be required bef.ore proceeding �aith the iratning_ . �F�TIFIC�TE OF OCCUPA(��Cl' ' ' � 1►PPlicatic+n ior a Certificate o:C Oceupancy shall k�e madt� ten (lOj days prior to the use or occug3ncy of an}► structuze for �ahich a� Liuilcling permit l.as heen issued; and sc�.icl struct�c shall iiot l�e usccl or. occupied Luii:il a Cexi:i.iicate of OccuPlncy has bcen xssued. 0 0 0 . ` • '. • t . 0 , ��, i � � 3 f � i� .r� � #' � � '; { ;f � - 'i ;. , 1 � �I I ' _ .. _.. _. ... .�. _ .� ' _'.__ '_ ' ' "_ ..___ . __ . �--, - _�"'._. - .. . . . . ...._.�_.�. . - � . . .._ "__"" _. ' �_"' .. .. _. . . ._- . . _:..___._ �... ...... . _. _. ..._ . y� d • • � a �� n m =� z � � N � _ "O � � f7 �` = _-i �' � 0 vi � Z N �� m -.. c� m � � � o +' � �, ,� v O o � ° �� S �' °' -� OII n c� � _°' o � � �' N � �- o � � � . � a � � 0 c � � D � � 0 < m a. � 0 c � � v a> m _n � � D � X � � • � m � � � m r # , -� �. J � t � N N � o �� fD � < � pt \ m a _ � O y D _ � �. o�' � n m 0 � � 0 � � o � N D fD r � m � � r,.� s . .. � � � � � � � � � O -�+, �' < � � � N \ C �D (�p v o �, D � � y _' D � � O rt �o � o �' � .-. � r � -� 0 Z D c� � � D O � O � � D � N m N ' L� G� G� D-n e�p Cl � pl N C N N N N p= Q � .� � � ;� � fD � � 'p. (n tD � rt � � � � � � N S Q'^ C (np fD � � � � d � Q • > > o � .� ,-* a m Q"=c ° � � �� ' �' � � �3W�o �p � c�i x- 7 "" v v � W � c � � m fD � � � � � � o 0 0 0 � °o o° °o °o °o rt c� � � � � � � d o d � m ��n --� W W � �D -i z rn D � ?. � ? -I �, o cn c� � C � � C p. ' � z m � m � � � � � � Q Z = D � o O' � � � m -i a� ,..� u� '. a, � � �, m n =�oay Q. � v O v�i W�. m z 0° m O �Q� � � � � � � o � N _ a � fD �b �•oo� � -e � �i � ,� <� � � ^- O > �.°'v m � "-' °1 = Z V �A= � ? o N = o � � ° �� C � �� n n N $ O � � c'"+. m _ �• � O � C P D ��'� a � � T�1 n ,-� w m-� �, `� °' � cn m N > �m-nir" m a c"i o N� °- cn m Z � i ?' � �� D r rv °' 0 m m� . � a�. � °' .. Z . n°�. m �° � . p � ni � � m m� . Q"�o _.3 � �° � .., o � . --� � �„ oG Q- � 3.. ..� . . o 0o z. � fl, � .'+ _ .� _ O.. ' �° '"' �-' -•- `� � � ,..�, ° : _ �' m �_.m.=�...«, . - f+s. - - C� �m c)� - ,�'�..��.--. ��. ��o�- . � N o � �, Q � _ - � `� a� m � _. W C � � Z G� C fA rn 0 � -�i m N n 2 rn v C r rn O ` �O W ��_- ► � � .. � . . . _� v � � n w� w� r tJ� `-� C � V � N � c' 'r1 w Z (p �7 � N � ,°p c" � m W C � N � � Z � rn� m n �--I � z v < � a � -o z � r � � � � Z �� 11 �� o �� O� Z� � a� v .� a� � ON Z� _vz -� o o= Zm Z -D-� �z � � � n m O O N r aZ � vrn vZ < � �a N '� O Z � . m � m � � < m � • O �� . � ._. __ ._._ . ` d . � c � . � . ' o 0 N THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPUCATION WILL BE RETURNED S:OMMnN VFNT, V NT .(�NN CTnR AND C�MAl1STl(�N AIR V RIFI .ATInN When [sn�a�i g an _Yic ing f�rance, the undersigned hereby verifies that the � venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes No () The venting system is plasticlPVC and meets all current codes and manufacturer speaflcations including sizing, length, number of elbows and termination. Yes (� No () The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers spea�=ications. This does -- include�A-�� ry I�entraf Fu�rac�itentirig 'fiabies for fan assisted and natural draft appliances. ThQ PY�Gf'111g _ome ��t�en air is sized and installed to meet the current codes and manufacturers speafications. Yes(�No( Yes � No ( ) Whet1 �Equl�ed to inctall a n_w r_emh �e+ien ai �it will be sized and installed to meet the current codes and manufacturers specifications. Yes � No () When in��A a new ventina�,y�, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturers speaflcations. This does include AGA-GAMA Category° I Gentral Fumace Venting Tables for fan assisted and natural draft applia�lces. � Yes � No O ,r � Is the common vent and vent connectors sized and ins�alled correctly after an appliance has been removed from the common veni and vented separately as per current codes. Yes��No () � • • . � ' •.' . � • ' • 11 11 � / ' �!) . � • ' �1 • � � ' y • � • UI . 1 � � Appliance #1 Type t�U( (11 BTU Input �0 (�T Fan Assisted or Nat IV(,� _, Appliance #2 Type BTU Input � Fan Assisted or Nat App�ance #3�1"ype � � � — - -�TUTnput - -- ��Fan Assis�ed or Nat Total Appliances � Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type � � 1•► �- ..- ., . � HEATING CO: ��s?NOKA MN 55 04N�� G �1n Signed By: en. �- � Date :� b JD !� CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, NIN 55432 .a=� -• a PERM N0..2004-01295 DATE ISSiIED: 08/10/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 1243 GARDENA AVE NE PIN : 243024240023 LEGAL DESC : MOORE LAKE HII,LS 2ND ADD : LOT 7 BLOCK 1 PERMIT TYPE : BUII.,DING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING VALUATION : $ 3,577.00 NOTE: UNDERLAYMENT AS PER STATE BUII.,DING CODE. REROOF HOUSE & GARAGE (30 SQ) TEAR-OFF. STATE LICENSED CONTRACTOR 1 APPLICANT BUII.,DING PERMIT FEE 97.25 JD ROOFING CONST INC (20219241) FIRE SURCHARGE 3.58 11345 UPLANDER ST STATE SURCHARGE, VALUE 1.79 COON RAPIDS, MN 55433 LICENSE SURCHARGE 5.00 TOTAL 107.62 PAID WITH CHECK # 6409 OWNER SROKA BARBARA J 1243 GARDENA AVE NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This pemut 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 l�ow the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permi o s no sume to give authority to violate or cancel e pro io of any ther state or local law regulating rio perf ance of construction. Applic f � Date � Bldg '� (' Dat� �0 �� SEPARATE PERNIITS REQUIRED FOR WORK OTI�R 1?�`�N�D�SCRIBED ABOVE. - � y 3 0� N�y �� CITY OF FRIDLEY Effective 4/1/2004 ADDN [] 6431 University 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 Construction AddressL,-�� °�� /�� %�� Legal Description: Owner Name & Address: Contractor, LMNG AREA: GARAGE AREA: DECK AREA: OTHER: Tel. # MN LICENSE # Tel. # �'�,�f� � �c�� 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 Heighf Sq. Ft HgUGround _ Sq. Ft �� Estimated Cost: $ �� Construction Type• 6 Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft =$ DATE• � l� C APPLICANT. � Tel. # Call (763) 572-3604 for Permit Fees ' mai g in application. Fax to 763-571-1287 ff using credit card and we will call you for card number. CITY USE ONLY - o,�Q7 � Q/a �� Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ � �� $ � � �, v $ t $ .$ �-00 $ $ $ $ � .r. 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 [ ] STIPULATIONS: _� _�� BUII.DING PERNIIT 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 $25,0� $25,001 to $50,000 $50,001 to $100,0� $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 $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,0(}0 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,OQ0 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,OOO,WO $5,608.75 for the first $1,OOO,Q00 plus $3.15 for each addidonal $1,000 or fraction thereof CURB CUT ESCROW (Concrete C�rb 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 construction 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 .e y