AF - 45419�► PLANNING DIVISION
. �
MEMORANDLIM
u-nroF
fRlDLEY
!rE!'D �: Jock Roberts�n, Coc�miuiity Developaent Director .
NEND �OM: Darrel Qark, �ief Building Inspector
p�t� �A�E: March 13, 1987
gDGARDING; Bail ey Tiller Lot Spl it � rst Appraved b� Ci tY Council J une 21,
1965. .
Mr. �ller, the one-time vwrer of all of Lot 20, Auditor's Subdivision No.
92, petitioned for splitting his property into four residential lots. �e
petition was appzoved bi► the City Cbua�cil on J�a�e 21, 1965.
Zb date, he has only sold the northerly lot where a house was built,
therefore, i�e is presently the awner of parcels B, C, and D. as shawn on
E�d�ibat 'A'.
�e aode at that time did not have a reootding time limit, nor did it require
a park f ee on lots spl its, as it does currently.
9he Tillers r�aw would like ta c�ve parcel D to artiother e�n for him to build a
house on Sinoe the present oode has a time limit and a park fee, he has
sutxnitted a letter requesting the City Co�ci1 to reaPPrwe the sptitting off
of parcel D anc3 that he rot be requi ted to pay a park f ee.
�e survey and the lot descriptions are attad�ed as exhibits B-1 and 8-2-
All lots have been servioed with sewer and water, and all special assessnents
have been levied and are paid in full.
DC/lmn
r�-87-66
0
0
sue�ecr P MIT NO.
City of Fridley o 19293
�
ATTHETOPOPTHETWINS g�iLDING PERMIT
� � ' ECEIPT NO.
� `y ______ COMMUNI7Y DEVELOPMENT DIV.
r � � PROTECTIVE iNSPECTION SEC. �
i . �
� � �'��1 � CITV HALL FRIOLE� 55432 NUMBER REV. DATE PAGE OF APPpOVED BY
�.__.11.' '•} 612-571-3450 s�0-Ft5 12/2/87 / /
�os aooRess �
� Gardena Avenue N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. Pt . 2Q Auditor `s $llb. 9z SHEET
2 PROPERTYOWNER MAIIADDRESS ZIP PHONE
Jerr and Annie Tiller same 275-2325
3 CONTRACTOR MAIL ADDRESS 21P PHONE I.ICENSE NO.
Tiller's P.O. Box 222 Dassle MN
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENGINEEf; MAIL ADDRESS ZIP PHONE 410ENSE NO.
8 USE OF BUtLDING
Residential
7 CLASS OF WORK
�I NEW ❑ ADD4TION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
New Dwellin . 42' � 23' Gara e: 22' .� 20'
SEPARA�"� P�1�Mii'S �t�QUIRED FOR
9 CHANaf pF USE FROM � t AND SIGNS,
STIPULATIONS pxoy�de Ci.t� Hti,th cczpy o� veri�y�,n� �nzye�r he�Qrs. capping, P�ovide sod in
the �ront and side yaxds. Q�oyide a haxd sux��ce driveHray,
Building must have State of Minnesota Building Code seal.
SEUtER LOCATION: "y" 103� West of Manhole "Y" ELEVATIONc 967.59.
TOP OF �'OOTTI�; Minimum Elevatican 970.59
WATER LOCA.TTON : 10 � W.est af SeHrer ,
THE Ci'i"y' (0F FRIDLEY DOES NOT GUARANTEE THE �������
ACCURACY OF UTILiTY LOCATIONS AND ELEVATI^f�:�. 68fOte t�ggi�g cali iocaf utilif+�
7HlS DATA IS FOR INFORMATION PURPOSES ONi_Y, j���j�}{QW� - f1ECTR�C - i�S �f�.:
�ND PERSONS USING THIS INFORMATION SHGU�.il
VERtFY IT 6N THE S4TE. R��;iiRED �� �.:A�'
SEPARATE PEFMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, 7YPE OF CONST. OCCUPANCV GRQUP OCCUPANCY LOAD
VENTILATING OR AIR CONOITIONING.
THIS PEFMIT BECOMES `NULL AND VOID IF WORK OF GONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHOFi12ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEU FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. N0. OWLG. UNITS OFFSTREET PARKING
I HEFEBY CEfiTIFY THAT I HAVE REAO AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yqLUATION SURTAX
AND ,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WI7H WHETHER SPECIFIEO HEREIN OF NOT. THE GRANTING OF A PERMIT FjH �+OO �3�! . ZO
OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PFOVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. yfi3�FO.00 $525.00
PLAN CHECKFEE T07ALFEE
$85.00 $984.20
. SIGNATUREOFCONTRACTORORAUTHORIZEDAGENT IDATEI WHE PRO RLY E T S IS YOUR ERM T
GN UREOF WNERUPO � RBUILDER� IDATE� BIDG �NSP qpTE
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ADDN. C �
pLTER. � l
City of Fridley
R-1 A1tD R-2
Building Permit Application
Effeetive 4/1/86
t;ongtruetion Address:. � �� 3 S� '" "''�' � � � �
Legal Description: e
, �,�- �- n �., �1 . �F ,� � r �'n � 1 �-�'�
Su{���vlzlow. � 9�_�._t�NOt�t� Co<.i.,��� 1►1',�w ; T Tel. ���,_���
Owner Name & Address:
C�.i.._--� Tel . # _ � 7
Contractor • 1 � L Le rt � s
Addr�ss• � �`
LI�TI�iG AREA:
GARAGE AREA:
DEC1C ARBA :
OTHEa:
Attach to this application,`a Certificate of Survey of the
lot� with the proposed construetion drawn on it to scale.
DB3CRIPTIOIt OF IMPROYEMENT
r
Length �-/'� Width _ Z3 Height �.
�
Length 2. "Z- [iidth ?� Height __!_?,�___
Length _________ Width � H8t t Ground
l b�o�
Sq. Ft. �
Sq. Ft. �L�?
Sq. Ft. _
Corner Lot [] Inaide Lot (,� Ft. Yd. Setback _ Side Yard Setbaek
Estimated Cost: � �h � r` �r-
Type of Construetion: ���� (p � 00
Approx. Completion Date: m °7 �
Alt. A Alt B
Proposed Driv�way Width If-Alew Opening Is Desired: _-_ $ $ �
See Back Page for Explanation
DATE: I /— � � - �?
Permit Fee
Plan Cheek
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
1 .
APPL�CANT: � �-- '�j�j � Tel.
CI� IISE ONLY �����J
�
� 3 4b,(� Fee Schedule on Reverse Side
$ ��� 25% of Building Permit Fee
� 3�.c70 $.50/$1,00o valuation
$ ��.UO $ 525 per SAC Unit
� "'— Fee Determined by Engineering
� �
9 d,�.
# �./? �- o Z'� i
g� �v Agreement Necessary [] Not Necessary []
$
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� J�st.►�-ATEp
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� � Material (Desc�ibe)
.�— .�.�
,,�
t� R�tkta�
' l �.iSU `�4'i' l O �..� � i
CEt �..t �,sG.
Interior Film Coefficiant
Excerior Film Coefficient
Total Assembly The�mat Resist�►ce
Assembly U•Value
'hlckness R-Value
_...._.__
s/8" . s�►xs
11. 3`� 40. t�
. co 1
. co 1
�1.'78
. O Z3aj
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�ysti.►�..,o,TE.Q Ex-r.1�1�►►.�. � K�.�.Ietu
Mat�rial (Do�cribe) Thickness R-Value
DR�) W 46.�.. ��?. .'4 S
I+�s��.q-c �o..i 5'/z'' �°� •o
�'JHE4TH1 +�J 4 '��g � q'�►
'S � o�.a�,- '— . '11
� Interior Film Coeffictie�t . �,a
; ��ct4rior Film Coefficient •. � � �
"�� Total Assembty Thermal Resistance
Z�.48
� Assembiy U-Value . o4�O
�./
. .� _
.
�� �
Exterior Envelope Thermal Transmittance Worksheet
SITE ADDRESS 1 CITY
�.AR 5c�r.J �-1 C M E,S �,�Z� i!{ M�,
NAME PERSON COMPLETING FORM DATE
/1 �..t �.- �c'�-t �o �f FE..� 4- � z� ��7
Assembly Area (Sq Ft) U-Value U-Value x Area
Insulated Area °��`��, aj('j� ,(' � „ p�?j�j z, �,(� �
Framing Area j t'jio � (�U � tr -'�j � O �°j (v �, . °j ` 7
,� Skylights
0
¢° Other
o►
c
� Totals � i i�'g' - �� • � ��- . � 8
Average U-Value: � Z'`E . � � - � i • 5 CQ , �j Z.C� �'j
Required U-Value (from Energy Code) Q,� j Z(�"�
Insulated Area � � ��;� ��5 KiJ►:_E WAi,,�.. °�O`% I � � (�, . ► '7 , U•�(� (a 5� . S
Framing A�ea i,�it,U�.iOr S �C�i�� L�IAI_L� 10`�0 1�� .�� . t C)�� ,�• dj �
Wi�dOWS � � a��.ua t s KiJ 1..� �.iALi„_ j�J it> , gg ,��"� � 1.`�U
Doors - 1��.�' ► 0 3�,�'j� . G� �C) i S,�3
Rim doist j Cj �'j .�,(o � Cj 5�(o �j •`7 �
Fireplace Wall
3 Foundation Wall (above grade) 8� , g� �( 4'-] � ��'j ,��
a�°, Foundation Windows
N
O
K �1h@f
W
Totals � 1`7 �.Z..lo C� ! 5� . S�3
Average U-vaiue: (d � 5� � g3 -��� �. Z(� g � Qc� �3
0
Required U-Value (from Energy Code) �. � � d� •
tf Q is greater than nQ , or � is greater than �, complete the following to determine the design necessary to meet th
o envelope criterla of the Energy Code.
� As Designed i'otal: � + Q QI
�
a Ceiling Budget: QD x� QJ
0
� Wall Budget: � x Q �
w Total �Envelope Budget: Q +� QL
�o
� As Designed — Budget: �I — �L t0
If � is greater than zero, adjust R-Values or areas and recalculate so that (�I is less than or equal to Q.
�
�
�
+� � , �
grade and the area of the fioor, then
calculate the heat loss.
Befow grade wal/ heat loss:
� Z7, 3�t� X Z B�nt-f ���
(wall a�ea) (heat loss)
_ ���q' �"'g' etu/hr
(enter on Line O )
Below grade l/oor heat loss:
I(;C' �j • s� X Z Fj'Tll ��R.��
(tloor area) (heat loss)
� �� � Btu/hr
(enter on Line—� ,�
Place the results on the appropriate
focation on the heat loss worksheet.
Infiltratton Heat Loss
This heat loss factor is important, but
unfortunately, is the most difficult to
estimate accurately. The method shown
here uses an estimate of air changes per
hour for the above grade portion of the
building at design conditions. Some com-
monly accepted numbers are 0.75 air-
changes per hour for new houses, and 1.5
air-changes per hour for old houses.
7hese numbers could be smaller or
larger if the building is exceptionally tight
or unusualfy loose.
Calculate the above grade volume of the
building in cubic feet. If a floor is partially
below ground, measure its height from the
grade line to the floor of the next levei.
Muitiply interior length by width by height
to find the volume. Then apply the foliow-
ing equation:
IntlMratlon heat ►oss: �
0.018 x •'� 5 X I�J�Z.Z.� _
(air-changes (votume)
per hour)
= I �� . S S Btum�
(enter on Line )
Put the result on the heat loss work-
sheet,
Design Temperature Dlfierence
Check with your local code ofticial (or
call the Energy Information Center) about
the correct design temperature to use in
your area. This will vary from -16°F to
- 29°F, depending on your location in the
state. Note that this is not as cold as it ever
gets +n the location, but it does not usual{y
get colder than this for long enough to be
a problem. Put the design temperature
number on the blank below and calculate
the design temperature difference (T.D.).
Note that since the design temperature in
Minnesota is less than 0°F the design
temperature difte�ence will always be
greater than 72.
Deslgn T.D.:
72 - L ` ZV = __L= _____� ° F'.
(design '
temperature)
Put the design temperature difierence
number in 3 places on the heat loss work-
sheet.
Heat Loss Worksheet
Heat Ioss rate calculatJonc � . B
Total UxA for roof/ceiling QB 2-� "S � Btulhr/°F
Total UxA for exposed wall � � SG'��3 �
I11�`�'��' ; °�Z.G � 1:��0 � ,
Below grade wall heat loss '. � - _ ;
(Design T.D.) �
G �
Below grade floor heat loss ' � Z'� �=� Z a�'1 ��� �
(Deslgn T.D.) �
Infiltration heat loss'' � l 7�. SS �
Heat Loss Rate (tota{ of above) ���° z�OBtu/hr/°F
Design heat loss:
3°�3.`Z(a X,' "1Z`.
(Heat Loss Rate) - ; (Design T.D.)
a 3�, �"1��,`�jZ �cwnr
Annual Heating Cost
A very crude estimate of heating cost
may be obtained with the following equa-
tions. Actually, it is safest to use these
estimates only for estimati�g the possible
savings due to modifying a given design or
house.
You will need a multiplier value (M� de-
gree day adjustment, the annual fuel effi-
ciency (AFUE) of the heating system, the
heating degree days for the location, and
the cost per unit of the heating fuel {$/Btu).
The heating degree day adjustment
multiplier value should be chosen using the
following guidelines:
Thermal Characteristics Muitlplier
Value (Mln
Above Average 16.5
(very well insulated, tighter
than average, and above
average solar gain)
Average 18.4
Below Average 20.4
(poorly insulated, more than
average leakage, and below
average solar gain)
Cluantity of fuel purchased: � " � ';
x �
(M� (heating degree days)
x� - � � �
(heat loss rate) (AFllE� �
S'
= Btu/year �
Annual cost: �
' X p
(etutyear, ($lBtu) �
from above)
_ $Fyear � ;.
r
�.
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.—_----=--------- --_ � -
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UNRO�WNER'S BINDER-RECEIPT ���a
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OFFICE USE ONLY
on wrcut , sae
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. , Pending issuance of a PolicY� et which time this Bindev will be vad. and.subjed W all the declarafions. terms and canditions of ihe PolicY herebY ePP� �
,..,as curre�y. bein9' ��� bY ��P�Y �'be�aon, this !ComPanY i�hereby bound W tl�e insured epqicant and legal rapresea�s on'the propeAy a
described. hereon for a term not exceedin9 ninetY (90) days from the effective date.
: R i�� a,condition of tbis Binder, that in the event of a loss befae the expication oi this Binder, the pcemium due tltis Company shall be fixed M the fuN annuat
premium for the sum insured.
_ .-: Tldt Binde�'� is made and ec;cepted subject M. aY the foragoing and shalF not be valid unless cour+Eersigned by the d�dy autliorixed aperK d tltis Company.
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Secretary
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�� � ��������a��, �w� MICHAEL McGRAW
d» Com���. ti�e arw �e. and is.ub�.G b►wieion. ��
"a"',�� 1���Z�..'�J . �L���� � Mifler
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_ FRI DLE.Y
CIVIC CENTER • 6-131 UNNERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONG (6l2) 571-3450
�
December 3, 1987
Mr. Jerry Tiller
P.O. Box 222
Dassel, MN 55325
I�e: Building Permit Stipulations for 1555 �ardena Avenue N.E., Fridley
Dear Mr. Tiller:
When your building permit was issued on Decemlier 2, 19.87 for your new dwelling,
the following City Code stipulations were omitted in error frodn being typed on
the permit;
l. Provide City with copy of verifying survey before capping.
2. Provide sod in the f ront and side yards. •
3. Provide a hard surf ace driveway.
I am enclosing a copy of the building pezznit with tlie stipulations added. If
you have any questions on the added stipulations, please feel free to contact
me at (612) 571-3450.
Sincerely,
- �
� �
, __ �n . _ .�
DARREL G. CLARK
C�ief Building Official
DGC/mh
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C11YOF
FRIDLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. IV.E. FRlDLEY, MINNESOTA 55432 • PHONE (bl2) 571-3450
�
Flebruary 16, 1988
Mr. Jerry Tiller
1555 Gardena Avenue N. E.
Fridley, I�A1 55432
Re: Final Inspection at 1555 Gardena Avenue N,E,� Fridley
Dear Mr. Tiller:
A final inspection was aonducted on F'ebruary 12, 1988 of the above address
and the following items were noted which must be completed before the
structure can be finaled:
L Provide a hard surfave driveway by Juie 1, 1988.
2. Pravide sod in the f ront and side yards by J�ne 1, 1988.
3. Provide the garage floor by Juze 1, 1988.
4. Provide the f ront step by Jtaie 1, 1988.
5. Sewre the s�anp basket o�ver by F�bruary 22, 1988.
6. Provide a door closure on the door from the house to the garage by
F1ebr uary 22, 1988.
7. Pravide handrails on the stairs by F�bruary 22, l9gg,
We will expect the abwe items to be aomgieted by the scheduled dates when
reinspections will be o�nducted to determine compl iance. If you have any
questions on these items, please feel free to wntact me at 571-3450.
Sincerely,
/� �
.t � L i _ � �r, _�
�• � �
M - . . •
DGC/mh
d
1�
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- ���_t:
`< ; _
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C���F
FR[DLEY
C[V1C CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 57i-3450
�
March 7 , 1988
First Capital Mortgage
Attn : C:athy
6200 Shingle Creek Parkway, Suite 615
Brooklyn Center, MN 55430
R�e: Street Address on Tiller Residence in Fridley
Dear Sirs:
Please be advised that the assigned address for the South178 feet of the
East 75 feet of Lot 20, Auditor's Subdivision #92 is 1555 Gardena Avenue
N.E., Fridley, MN 55432.
If you have any questions on this matter, please feel free to contact me
at 571-3450.
Sincerely,
DARREL G. CLARK
t�ief Building Official
DGC/mh
�t ����� �_ �rll/► � ���� ���� �
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sue�ecT PERMI .
City of Fridley 1995�2
AT THE TOP OF THE TW1i4S g � I L D I N G P.E R M I T
r
; ` � RECEIPT NO.
� `L _____� COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTIpN SEC. �
� �
1 ��� � . � � � �
� � ��'�1 � CITV HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPqOVED BY
�""'� � ��� 612-571-3450 9�0-F15 6/13/89 � �
J08 ADDRESS 1555 Gardena Avenue N,E.
t IEGAI LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
�escR. Part of t 20 Auditor's Subdivision #92 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Jerry Tiller 1555 Gardena Avenue N.E.
3 CONTRACTOR MAIL ADDRESS Z�P PHONE UCENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO.
5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUIIDIIyG
Residential
7 CLASSOF WOiiK
❑ NEW � ADDITION O ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
S DESCRIBE WORK
Cqnstruct a 14� x 4.67' Deck Addi.tion
9 CHANdE 0� USE FROM TO
STI PU LATION S
������ � �
SFp Before di�gi�g catl J����,� ���; �,,: ,
y�,���ARq TE p 1���pH�i�� �����i��Ji�r - tit� j�,i1!<.
N�- ��TR�irs � RF�UiR�� �� t.���=
NG. P���p� j���4
Rj�y� ��� o�.
s���s�
SEPARATE PERMITS AFE REQUIRED FOR ELECTRICAL, PIUMBING, HEATING, TYPE OF COWST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTIIATING OR AIR CONDITION�NG.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AF?ER WORK IS COMMENCED. N0. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIfY THAT I HAVE READ AND EXAMINED THIS APPUCATION 1 STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVtS10NS OF LAWS VALUATION SURTAX
AND,OROINANCES GOVERNING THIS TYPE OF WOfiK WILL BE COMPLIED $1,55Q $,%S
WITH WHET.HER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TNE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW R,EGULATING CON- 3'J.00
STHUCTION OR THE PEHFORMANCE OF CONSTRUCTtON. $
PLAN CHECK FEE TOTAL FEE
$37.78
. SIGNATUAEOFCON�AACTOAORAUTHOAl2EDAGENT �DnrEi WHEN PROPERLY LIDATED THIS IS YOUR PERMIT
� �.:.Sw�+O. �.,
SiGNATUREOFOWNERiIFOWNEiiHU1LDEii/ IOATEI BLDG �NSP
qATE
. . � �, '��r � �.
.. _�x'{fiii�
� []
� [ �
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C'onstruction Addres�
Legal Description:
Effective 5/1/88
R-1 AND R-2
�,; � ding P�mit Applicaticn
Ou�r�r Name & Address: _��i�-�7 ?'► �•�i � Tel. #
Contractor: _ Gu,tJ�d�- � . #
�S: S,A-�r'L
A'ttach to this application, a C�estificate of S�vey of the
lot, with the pro�o�ed oonstructior► dra�wn on it to scale.
rr: w• • •i� � i• •.� � s i:�
I1VIIVG AREA: I,etigth Width Height Sq. Ft.
DEC'R AREA. •� width , Height Sq. Ft. �
' �� Width �— Hgt/Gz�au� sq. Ft. �
OT�R: �
�
a�7�a 7, t 3� i S�t �
Corner Lat [ j Inside Iot [] Ft. Yd Setback Side Yard SetbacJts
�YPe of �xuction: Fstimated Cost: $_ /SS�
Approx. oampletion Date:
Proposed Driveway Width If New Openirig Is Desired: Ft. $ $
Width + 6' See Back Page
DA'1'E: APPLICAt�r: �. #
Permit Fee S i o0
State S��e $ 7�
SP'C Criar9e $
Driveway Escrow $
Park Fee ' $
Sew�ex Main Charge $
� $�3`I.��
S'I'IP�7LATIOdds :
�I'I'Y L� �II,Y
Fee Sc�edu].e oaz Reverse Side
$.50/$1,000 Valuatioa�
$575 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Detenained by �gir�eerinq
Agreemexit Neo�ssaYy [ l Nat Neoes-saYY �]
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SUBJECT . . -�Q�.--..
City of Fridley 214 6 9
AT THE TOP OF THE TWINS g U I L D i N G P E R M I T
; � RE •
� �� COMMUNITY DEVEIOPMENT OIV. / fi
r � L +� PFiOTECTIVE INSPECTION SEC. y'� �(��/
� �
t . �
� : r'�'1 � CITY HALL FHIOLE� 55432 NUMBER HEV. DATE PAGE OF APPHOVEO BV
�'•""�'� �'� 612-571-3450 910-F15 7/30/92 / �
J08 ADDRESS 1555 Gardena Avenue NE
t IEGAI LOT NO. BLOCK; TRACT OR ADDITION SEE ATTACHEO
DESCR. Pt. 20 Auditor's Sl]b. #9i SHEET
2 PROPERTY OWNER MAII ADDRESS ZIP PHONE
Jerome Tiller 1555 Gardena Avenue NE 572-8740
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Rainbow Construction 1715 133rd Ln NE, Fiam Lake 55403 867�7557 7057
4 ARCHITEC7 OR DESIGNEA MAtL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Res.idential
7 CLASS Of WORK
O NEW O ADDITION �i1 ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCFiIBE WORK
Finish Basement
9 CHANGE OF USE FHOM TO
STIPULATIONS
See nqtatiqns on plan
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATINCa,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. fT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITH{N 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT 1 HAVE READ AND EXAMINE� THIS APPLICATION 1 STALLS GARAGES
ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS YALUAT{ON SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 8E COMPLIEO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $S � OOO $2 .�JO
DOES NOT PRESUME TO GIV AUTHORITY TO VIOLATE OR CANCEL THE pEpMIT FEE SAC CHARGE
PROVISIONS F ANY OTHER TATE OR LOCAL LAW REGULATING CON-
STRUCT N THE PERfORM NCE.OF CONSTRUCTION. $72.00 Fire SC �S.00
' �A' (�� PLAN CHECKFEE TO7A�FEE
�'� %�7 License SC $5.00 $84.50
SIGNATUREOFCONTRACTOAORAUTH . EDAGENT IDATEI WH � P PE LV A ATED THIS IS VOUR PERMIT
�
� �! �
S�GNATUAEOFON�NEA��FOWNERBUILDEAI IDATEI BIDG �NSP n4TE
�EW i � Effecdve 3l 11 �2
ADDN ( ] CITY UF FRIDLEY
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Conshvction Address: j J�J' � l� 1�-�� !l� l�i
Legal Description:
� e� r-, Tel. # ✓'��.� � ���
Uwner Name & Address: r,,� ���1'�1�- �" � i �
Contractor: ;1�'�i• ��.�� �.1�'�� �"" MN LICENSE # %QS %
Address: � � � S � 3 �0. �. N _ _ Tel. # g (0 7 ' % JS %
' Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DBCK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: �': U ► S �., 1j'I�S,�. �M�°rS�
Comer Lot [) Inside Lot (] Ft. Yd Setback Side Yard Setbacks
Type of Construction: t1,� n d C� '��� E Estimated Cost: S,S' ,".°0
Approx. Completion Date: .
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
, c ,/
DATE: APPLICANT: i� TeI. #�S%'l��01 7`
��F������
Permit Fee $ ��• �'� Fee Schedule oa Reverse Side
Fire Surcharge � �.°° .001 of Permit V aluation (1 / l Oth %)
5tate Surcharge $ �1- ��' $.SO/$1,000 Valuation
SAC Charge $ $700 per SAC Unit
License Surcharge $ �.°° �5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary j] Not Necessary (]
n � �� �
TOTAL $ <"= �
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CIIYOF
FR[DLEY
FRIDLEY MUNICIPAL CENTER • 6431 UN'IVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
January 25, 2002
Mr. Jerome Tiller
1555 Gardena Avenue NE
Fridley, MN 55432
Re: Final Inspection at 1555 Gardena Avenue NE
Contractor: Norblom Plumbing Co.
Dear Mr. Tiller:
A plumbing permit was issued on February 8, 2000 to install a water heater at your
address. According to Section 4715.2800 of the State Plumbing Code, a final
inspection shall be conducted on the work authorized by this permit. As of this date,
no final inspection has been called for.
The pemut fee that was paid covers the inspection to make sure the work was
completed according to the Code. We will keep your permit open for another 30
days and if we do not hear from you within this time to set up the inspecrion, we will
mark the permit "no inspection called for" and take no further action.
To set up the inspecrion or to have any questions answered, please contact the
Building Inspection Division at (763) 572-3604.
Sincerely,
�
����
DAVE NSEN
Buil ' g Inspector
DJ/mh
w �,.:,
- sus�Eti PERMIT
c�ty of F��a�,�� � 24 s�
AT TNE TOP OF TME TWINS � u I i. � I N G P E R M I T
r
; � RECEIPT NO.
� `� ����_ COMMUMITY DEVELpPMEN7 OIV. � /
r � � pROTECTtVE INSPECTION SEC. U /�
' 7 �J
i . ,
� � /'��1 � C�TY NALL f qIOLEY SS�32 NUMlER pEV OATE P�GE Of APPAOVED BY
�""�' �'' 612-571-3450 910-Ft5 3/28/02 / �
�oe nooaess 1555 Gardena Ave NE
1 LEGAI �OT NO. BLOCK TRACT OR ADDITION SEE ATTACNEO
oescR. Pt 20 Auditor's Subdivision ��92 SHEE7
Y PpOPEpTY OWNER MAIL AOOR�S$ ZIP VMONE
3erry/Ann Ti13.�r 1555 Gardena Avenue NE
3 CONTRACTOii MAiL ADDRESS ZIP PMpNE UCENSE NO
Ayn Builders Inc 308 Lawson Ave W, St Paul, MN 55117 651-487-0283 20033458
4 ARCHITECT Oii DESIGNER MAIL AOORESS iIP �MONE LICENSE NO.
5 ENG�NEER MAIL ADORE$S 21P PHONE LICENSE NO
6 USE OF BUIIDING
Residential
7 CLASS Of WORK
O NEW O AOOITION O ALTERA710N 6� REPAIR O MOVE O AEMOVE
8 DESCRIBE WOFK
Replace 1 window unit
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all Ievels of the dwelling
per Section 310.9.1.2 of the 1997 Uniform Building Code.
TYP OF CONST. OCCUPANCY GROUP OCCUPANCY �OAO
SEPARA�E PERMITS ARE REQUIRED fOR ELECTRICAL, PLUMBING. MEATING,
VENTILATING OR AIR CONOITIONING
iHIS PERMIT BECOMES NULL ANO VOIO IF WOpK OR CONSTRUCTION ZONING SO. f7 CU fT
AUTMORIZED IS NOT GOMMENCEO WITMIN 60 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDEO OR ABANQONEO FOR A PER100 OF IZp DAVS A� ¢
ANY TIME AFTER WOFiK IS COMMENCED. ' NO DWLG. UN17S OfFSTREET PARKING
1 MEREBY CERTIfY THA7 I HAVE READ ANO El(AMIN�O THIS APP�ICAi1QN 1 STA�LS GARAGES
ANq KNOW THE SAME TO 9E Tt�UE ANO COAa�CT. A�l PROVlS10NS OR LAWS VA�UATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL 9E COMPLIED
WITM WNETMEA S�ECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �4�000 �Z.00
DOES NOT PRESUME TO GtVE AUTHORITY TO VIOLATE OR CAMCEL TME pERMITFEE SACCNARGE
PROVISIONS O ANY OTNEii STATE OR LOCAI LAW RECULATING CON-
T UCTION O T E PE FOfiMANCf OF CONSTRUCTION �97.25 Fire SC ��F.O�
PLAN CH�CK fEE TOTAI FEE
� '�Z _ i�icen e SC $5 .00 $108 . 25
S�GN• OFC 'RA(;TOpOp�UTMOpIZEDAGENT iD�rE� MEN PHOPE:iIY VALIDAIED THIS IS OUQ PE iT
�
S�GN T O�O NEA���OWNEABUiIDEA� i A1Ei . '� � BLOG �h5o � �� r�r,�E
f .
`
NEVV [ J CtT( OF FRIDLEY Effecctive 1/1/2002
ADDN ( j 6431 University Ave NE, Fridley, MN 55432 (763) 572�604 Bidg {nsp
ALTER � SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: ��.�s �nrr�(��,a �v
Legal Description:
Owner Name & Address: V i� le.� ��r v�� � Ah�, Tel. #
Contractor. � f,U Sh,'1,��� �n c MN UCENSE #�4eS'.��5�
Address: 34g La„����� � ie �,1'_ S� �c�u � SSI1 � Tel. # ti.�/- �/R,�'�28��
LNING AREA:
GARAGE AREA:
OECK AREA:
Attach to this application, a Certficate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Wid� Height Sq. Ft
Length Vlhdth Height Sq. F�
Length Width Hgt/Ground Sq. FL
„ � r —� - t
sii!��'�7
• � I� �a���//f/���:�siiiir.�'�:��T�� �r°.��'��il
- - ��--- - �
l
. . .- � „ � , _ -. . .�,:,,.��� _.�r
Driveway Curb Cut Width Needed: Ft + 6 Ft =
�ATE: B3 - 2g ��2 APPLICANT:
Catl (763) 5T2�604 for Permit Fees if mailing
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ . as
$
$ � C�Z�
$
$ �,�c�
�
$
$
$
x $ _�
rei. # 6Sl - y�1 "� D 28 �
or Fax to 763-571-1287 if using credit card and we will
C{TY USE ONLY -
$ 10 ° ��
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1 �000 Valuation
$1200 per SAC Unit _ __
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Gonservation Ptan Review
Fee Determined by �Engineering
Agreement Necessary [ J Not Necessary j]
STIPULATIONS:
" ` •r
Building MECHANICAL Permit No:� � f�(D
�nspections RESIDENTIAL APPLICATION Received By:�_
763-572-3604 CITY OF FRIDLEY
763-502-4977 FAX EFFECTIVE 1-1-08 ��:�
DATE �� YOUR E-MAIL ADDRESS eQ Yi-� I.l� S� C71`i' ! C P.� •�
S1TE ADDRESS S Y'
THIS APPLICANT IS: ❑ OWNER CONTRACTOR
PROPERTY NAME: "�1�
OWNER/ ADDRESS: � J � L�C,t,�_�iLQ, iTI�Q_ CITY STATE /L%h�1P �`73
TENANT pxorrE: �' �. � ,�� 9 -' �,�j,�j
CONTRACTOR COMPANY NAME: 1 ` (
NOTE:
SEPARATE CITY CONTACT PERSON: L2 P t'1�.
LICENSES ARE STATE LICENSE # % 0 D � EXP DATE � �
REQUIRED FOIt GAS a�
AND HVAC. ADDRESS: � Yi CITY / STATEJ�f1�IPSs
SUBMIT COPY OF BOND pHONE %`p3 —_] �(�CY� FAX
AND INSURANCE
PERMIT TYPE GLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: � NEW �'ICEPLACEMENT ❑ ALTERATION/REMODEL
DETAILE SCRIPTION OF WO
n.ct eM - r-n c
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
OR
Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES AItE BASED ON $] 0.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXNRES: (INDICATE TOTAL
NUMBER OF EACH BELOW) /j n
Equipment Installed MFG: 1'� h� .m MODEL: F-��% SIZEBTU �0� b O �
MFG: MODEL: SIZE/BN
MFG: MODEL: SIZEBTU
AiC $25.00 FIREPLACE (GAS) $ I5.00 GAS RANGE/OVEN $10.00
AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00
_BOILER $35.00 �FURNACE $35.00 _GAS iJNIT HTR $10.00
CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00
�DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
,> � �� — - �
� _ �� � � x.,;r� � �' �� �
Permit Fee $ 3�.� Number of fixtures @$10.00 x$10.00 =$
Surchar�e $ .50 Ivumber of fixtures @ $15.00 x $15.00 = $
TOTAL DLJE $ �s . $� OR Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
MINIMUM $15.50 MINIMUM $15.50 Total = $
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a mechanical permit and I acknowledge that the inf ation above is complete and accurate; that the work will be in conformance with the ordinances
and codes of the City of Fridley and with the Minnesota Con uc ' n des; that I understand this is not a permit but only an application for a permit and work is not to
start without a permit; that the work will be in cordance � roved plan in the case of all work which requires review and a proval of plans.
SIGNATURE OF APPLICANT 'L_.�--�- PRINT NAME (r'��///!� rL�DATE���"—`t—v
APPROVED BY DATE
� � � ����
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
�7
�
City of Fridley Residential Mechanical Application Page 2
REQUIRED INFORMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMES/ADDITIONS XISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note belaw)
a. Oil or solid fuel IMC Chapter 7 with MN Amendments
b. Natural Gas or Propane/IFGC Chapter 3 with MN Amendments
2. Make-up Air (See note below)
a. IMC Chapter S with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel other than gas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a. Required on new construction IMC 1346.0312
5. Ventilation
a. Per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for
combustion and make-up air calculations.
Building
Inspections
763-572-3604
763-502-4977 FAX
DATE O � l � �
SITE ADDRFSS 1 S`.
THIS APPLICAI3T IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
INSURANCE
PROPERTY TYPE
PERI�IIT TYPE
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTIVE 7-1-2010
_ XOUR E-MAIL ADDRESS _�Y���P�1 �-�
�dl �A %�/'2, �
O OWNER �ONTRACTOR
xn�: r r
ADDRESS: S S CITY_�l _ PM
PHONE: / % � 5 � D� ' 7 �U — ---�
I3AME: $ �
STATE LICENSE # _ ��1 � �P11 i � _ _ _ EXP DATE
[oxE 7(,3'aG3-�58�
$IAIGLE FAMILYINEW CONSTRUCTTOI3
TWO FAMILYMEW CONSTRUCTION
O BASEMENT FINISH 1�k00�
O DECK ❑ SIDING
SIZE
TYPE OF WORK: O NEW HOME CONS7RUCTION ❑ ADDTI'fON
�IAINTENANCF/REPAIR ❑ REMODELING
DESCRTBE WORK BEING DONE:
SIZE OF IMPROVEMENT ENGTH WiDTH
ROOFING O NOUSE ONLY
NUMBER OF SQUARES � `,�IOUSE & GARAGE
GARAGES ❑ ATTACHED GARAGE
PROPOSED SLZE: 0 DETACHED GARAGE
PROPOSED HEIGHT:
❑ DRAiN TILE
0 OTHER
HEIGHT
Permit No.: �iCi �; �i �
Rece
�
Date � .
� 55��a.
Atrr-//�IP SS3D9
BASEMENT REMODELING SUBMIT•
l . Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
�� FOR NEW CONSTRUC'fION INCLUDIIVG DECKS,
❑ Vinyl OSoffit ADDITIONS & PORC S S� blIT•
p,v��� p T� 1. S+te PIan/Survey showing tfie existing shucdires
O Other ❑ Fascia � P��P� Pmject.
2. Two sets of conshvcdon plans
wnvnows 3. Energy Calcularions
IN E3QST[NG OPENINGS OYes ONo LOCA'l10N OF WINDOWS FOR WINDOWS – PROVIDE U-VALUE AND
OR FOR NEW OPbT1IIVGS-DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES 8c
TYPE OF WiNDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATTON, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
'OTAL 30B VALUATION S _ _ _ _ _ _ _ OCCUPANCY TYPF.
Permit Fee
Plan Review
Fire Surchatge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrpw
Erosion Control
Park Fee
Sewer Main Charge
Total Due
S �'/ % ds See Back Page for Fee Schedule
$ 65% of Building Permit Fee
S .001 times ihe Wtal job valuation
S .0005 x Permit Valuation Minimum $5.00
$ $5.00 (State Licensed Residentisl Contractors)
$ $2100 per SAC Unit (Plans to MWCC for determination)
S ft+6ft= ftxS24=$
S 5450 Conservation Plan Review
S Fee Determined by Engineering
$ ^ Agreement necessary ( ) Non Necessary ( )
$ ,. Make checks aavable to: Citv of Fridtev Attnr
THIS [S AN APPLlCATfON FOR A PERMI'T-NOT VALID UNTIL PROCESSBD
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 City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a permit and worlc is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of al ck whic equires review and approval of plans. p
SIGNATURE OF APPI,ICANT __�7��� PRINT NAME S'�CC �a,[, I I DATE 0'!U -` U
APPR(1VAi. iNSPF('T('IR Cil:NA