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AF - 45235�; _ _ _ _.. ... .. Y� �' __ .. __ . . ' J � � . .�, . y ' ' . . .. � . " . { ' ;. '.'�u ,� . .'� , 1� . �, .�_�.. ..� . ,.°.'.',: ,, .,:.. . . .. .: . �. ��. .. -. -.-. .I , ; . . . -. . - . . �IF' ' . ' . . .. ' �- f :. ' .. . .. . :_ ,�' � : . . . ' '., .... �., ' > .. . '. � � ` �illage of Friclley, Minn. : � BI��LDING P�RMIT : �0 16 �4 0 ,, .: . : � � w,.�� r�,� ' .� , ,� � Date: . , , . .4�'.,. :�:`.�. . . . . �,�. . t . .fr:�'�.�iw . �.:. " , . . ? �, t . . i � _ . �_ � , p , ��.��°�'+" • Builder � • � Address � . � Address .. ... ,.. .. .. ,� ... ...... ....>. ..... ..... _ , , , � ; ° �� LQC�TI )rN O� BUILQING `I No. ./. . #�? .0: . . Street . ,t,�' :�'�,�'�'�,'.": �°'.i�t1�� • . . - +`. . . Part oE Lu� . . . . . . . ! Lot . . . . Block . Addi#on or Sub Divisi�n .� a �:� : ,� • ; Corner I.ot .. -Inside Lot ..°.. Setba.c.�c �`�" Sideyard .�.� � r ° DESCR�PT[O1V� OF BUILQ[P�tG � To be Used as ., � � �' �:� ��.�;"�: :A:�,,:� `�. . Front ��. . . Depth . .��- �efght Sq- F� . . C�. Ft. frr . . . . �'r�in'k . . . . . . . <; ' Depth . . , Height Sq. F'� .'. . . . ' C,u. Ft �, �' � • � �` � �%":� r � . TO be Completed . • • �i Type o€ Constru.eiion �. • Est. Cosi � '� . ' 1 . :, . , ., ,, � _ :: :s < , , � 1nn eon�iderati�sn oP the issuance in. m.e �sf a permit to constr�ct ; the buildinffi described above, I agaee to do the proposed work in acs:ordanee with :the description above ,�set forth and in compliance with all provis�tons of 6rdinances of the v4llage of Fridley. � _ �� : ; , . _ � .:� .a , • � � ent of a fee of r rmi� is hereb� anted to +� � ,' �` t�.e �`" Tn co 'dera#ion of tY►e PaYm $ ��,�_ ;'; � . � Pe � .�:`��•t'. ��c : . . . . ��.��.'.�+��`. .'�', .. _ to mnstrnet the building or addition as described a�ve. This pernnit is gran'ied nPo� 'tbe express �on • n that the p�raon to whom it is'granted ax�$ his _agents,. employees �nd worl�n�n, in all wPrk ' done m, around d upon said building, or :any. part thereoP, s$all conform in a11 resp�cts to the ord9aaric�s of Fridley, Minnesota regarding locatfon,. construct3on, alteration, maiutenance; _ repa3r and moving of buildings vvith- ux the village limfts and tbia permit inay be revoked- at any tirne upo�► violation of amy of the pxovisions aE said ordinances. - ,l`r ',.�'� � A - ` � j'� .� f ;. - . .��:' .:r� `� �:�5.. B�c7ing Inspector ��''�''� �'� .. �� * =� = , NOTIGE• ?his,permit does not cover ihe:'consiruction,` installation or'a(teratlon far wiring,. plumbing. gas hea3ing, ; __ sevver or water. ge sure #0 8ee �uilding lnspector for separate ioe�rrr�lts tor�e items. �� - . ; . _ ' - . ..a.a.�..;s °_ _ O V. x r t� � � x � � r � o � x z x � ��c�o � � � z ��c� ��-i �i f�A 0 t' � O a 3 D � � O � � D F�+ �� N � � � � � � a p m ��' �n � � � m � M c�a� y � a' � � ¢ W 4�'� � a � � � � � � O � � ;n N � y O C � i.� . o m : o . ty1d : : Q : : a . . . -.�a oa �a o n� � po 0 0 � � {A Efl {i! � L7 0 � �.yy � � � � � '�1 � � 0 IP O 0 O 0 0 bi � cn c O � 4 � � � o � � � iU �. o � � � � � � � � z � � � -- ` - - �--- � � b b � � � � � � � �� b ro � � � � 0 O " � r �� o � a � � � " � � a a � � � " � o o � � y w � � G' �c r� R° R° � � � b � :-� :� � � � 4! 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'� � � �' b� � � � y o w � : G �• O . � P � . . � O o . . . � � � � : � w tn �zrn W po O O O O O � � � � t�1 H Q '�'r O H (A Q V1 � � � � � � � h � f�il �.�.y y i 8 � � � � � � � � � m � g � � � O m � N` � � �� S ��_� � y � � m � R� R° � � y � � � �� a � � � a �' . . � . . � ° : : C � . . � : : : t.� rn o� oo � en o 0 0 p O O O � 0 � op.a� � �� O ��'� � m � y � �� o �5'� � � doa °t� � �, ��y � �y p �=1 � � 'f p p ��C � �o�� lD y � y � �� m �� py�� . � � p•G p a' �, o �M � �� b � ��.� �.� �� y �M s►�� o a' i-� f� �. � � �� 8 O� o� G D � r � � m � 2 m C T d M M bs � � � � A a V O �� '.' � � � � � � �w � = �w � .M� � , � �� N a � �a v � e. � � p• 3. � � � � :i. � �, �� c� � � �pz � � x � � x � � � w z � � � � c n � y. �'' �° c h7 � G� ~ pp � � � � o y �0 dn �, � � x � � � ° �� o � °� � M � � '� � � .. � � � � �'''� �C� � O � � o.. �[p b � o w �° v � � � � � �' P�~1A : e � � . . � � . � � ; N � � . P�y � . . 0 � ; ; . G � : � � : : : � ' ; � • �. . . � . � W N • � : � o 0 �y ; 10 i! iC M ia OC k iC iC k �t� � `� �p �j�j��JJrr �p � �p � �p � N �, y : � � O ;,,� O � O � O � O ,,�,� � M a � � � � � � � � � N�y I C � o g� � � I r � 1 ) 0 O x 0 � � � � a � cbD I� � " o G. I r � ,_ ��.. �v: I �� 0 � � r � T H^ ♦I T v � m �. • �? w � N .� p� �L °� � I a �' � � � �� o � �i � �p $� � � � I � �� -�—� � i 8� ❑p I i � °� a � � d � � ro K a � � o °� € � �D � � � w p�, � O •"' f� p I (D � Q I tD � �� I a.o�rs ua�w� MTM � s�v�c SINKS wASN TIIAYS FOUNT. SMMI�S. FLOOR DitA1N5 GTG� sASINS AUTO WASNBR GAS � RANGE �� OPENINOS w � z • � �� A � � � � a � � o �� M � � g� � � � � R7 � Q � � � � �' `4 � M � � ra � 'b0 � � � C ,� R. � �' ��'�� w�. � M A M �� . � � � a��y �.��A �r�p�i" A M A m n 3 �6 w � M � � �� O �Q � � p � M � � �a � � 0 � � � � � � o � �., 1 � � � � � � � � � � � � � City of Fridley, Mirm.. BUILDING PERMIT DB�; �,gril 22, 1971 pwaer; Dale Otterness g��. _ S�,mn� Addr�ss 167.. Gib�"a�ta7' Roa.d N E p�d�s Sam� s- � ° 10986 LOCATION OF BUILDING No. —..16�- Straet � Part of Lot Lot 11 _ Block 2 Addition or Sub-Divisfan ._S'':�r1 a^'^ � c c„n„3 t Ms�nnr en„tt, Corner Lot Sewer IIevation 7ns�tde Lot —. X Setback �_ Sideyard Fo�mdation IIevation DESCRIPTION OP BUILDING To be Used as: Gara�e �t Z6 � Depth 24 � Height 10' Sq. F't 624' �, � 6240' , Front Depth I�eight Sq. F't. Cu. Ft 7.�pe of Construction Frame ��_ 2 000.00 _ To be Completed 1 year Provide hard surface drive In consideratlon of the issuance to me of a permit to construct the building described above, I agnee to do the proposed work in accordance with the description above set Porth and in complfance with all provisiona of ordlnances oP the dty oP Fridley. � � ., r �� Ea consfderaiion of the payment of a fee of � 12.00 , permit fs hereby gran,ted to Dale Otterness to conatruct the bufld3ng or addition as described above. Thia �t fa granted u�n the express condition that the person to whom ft is granted and hfa agente, employees an worl�nen, in all work done fn, around aad upon said building, or any part thereo� shall conform in all reapecta to the ordinanc� oE Frldley� Minnesota regardfng location, construction, alteration, maintenance� repair and mov3ng of buildings within the dty liaoits and this pernoit may be revoked at ar�y time u�n violation oE of the provi of said ordinance�. --�� Building Inspecta� AL BAGSTAD NOTIC� 1�is psnelf d� eef eover t6s eomtrueHon, ImtaQ�loe toe �rhtea, plumbiea, ga 6eaNas, awa er watsr. 8� wro to � tho Buitdiu0 Inspeeror fo� �parat� parmtb for thas Itfms. � a� _� APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITiON BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA � � ,��o - ��,� OWNER'S NAME:�� T�p /�55 BUILDER: �s/�r�' annx�ss : f� / ��,��/�� ,e �� annx�ss : �,� ,� N0 : . STREET : ( � r l� ✓c'O 7>4 { LOT: BLOCK• �� ADDITION CORNER LOT; INSIDE LOT:�_SETBACK: SIDEYARD; AppliCant attach to thia form Ztao Certificates of Survey of Lot and proposed building location drawn on these Certificates. ➢ESCRIPTION OF BUILDING To Be Used As: � ��'�-C E Front • � Depth • � $� � Height • �4 r Square Feet: �� Cubic Feet: �'� �� Front: Depth; Height• � e�/ Square Feet; Cubic Feet: � Tqpe of Construction: �%� �/� Estimated Cost:_$ O,�OeJ• �O %,,2ar�U� �o To Be Completed: f 1/�f/�° � The undersigned hereby makes application for a permit for the work hereia apecified, agreeing to do all work in stiict accordance with the City of Fridley Ordina.nces and rulings of the Department of Buildings, and hereby declarea that all the facts aad representations stated ia this application are true and correct. DATE : _ %" o2v2 ` �� ' S IGNATURE : � � %2 �'fa,� —__ (See Raverae Side For Additioaal Information.) � 0� �I� " � � .,. BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings 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 repairs 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: iTNIFORM BUYLDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic feet, or fraction thereof, in such cubical contents. Type 3� 5-$1.85 for each one thousand cubic feet. ADDITIONAL INFORMATION For the purpose of computing fees for building pez�its, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches loelow the floor 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 the ma,in gable of a pitched roof. For repair� or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. In ao case shall the fee charged for any permit as set forth in Section 2 be less than $5.00. VERIFICATION OF FOUNDATION NOTE; Permits for construction will be issued a mini�um of 24 hours from the time of application, to allaw for proper review of the proposed structure and of the construction site. A Certified Survey of the lot, showing the location of the foundation, once it hae been constructed, will be required before proceeding with the framing. CERTIFICATE OF OCCUPANCY 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 permit has been issued; and said structure shall not be used or occup�ed until a Certificate of Occup�cy has been issued. • � � � H .+ , — -- -- --- -- - ---__-- .t ( � U? � � 4�y ��,., ;, , �� , ��° ' .\' 9s ��' � � �, ey \. rh �N � � � N � a°- ih �62 � � ' 3t.f �ti • 3S z ..�� 6 �d � � � Iti u°y � 1� I u._°� n � � � � 125 =' � �� N, 1 I � - " `� -- ty",1 � \ E�� N � � it� tt1 24.2 . ' ' ° r25 � b. 2 . ^ `°�� i " �i �1 7– „ . •; ta . ia_° ---��tL� � � �� ? Cu,� J � � � _, � n �� —� �� 10 y�� 1 � 2? 1 � ---P9,g---- '`t � ` o .., N Z o -`��. v � N � `— 25�2 ,,.�-,.a,_.., -•--':1 _�••�i �,✓°�'�,�,.�"" I '�►''�C4� .!' ,.r e 1L•6� ' •+1 .j�j __— ; �' '�� L _ � � �' � � \� � � 1 �� -- ---_' ` ' i rt�•� �d•� \ �\� � ts7•. � ry� 4. ,.%� m ��w �� "'� _ � a ` � �•>�5 ..� � \ Z...Z � �-- -- --IU� �.� �i� � _�_ _----� _ �-- .� ;� � � / �4.Z . :�-�� I� � I N �� . ; � � \/ � 1 � �.`'_,�.`-�;---3��9---- � ' �., • ..+� � , � �3G �,� �� _ ,- -� I ' _ P i° • .�i �`t 1 �"I � ,� f�P 'P``sEn/, �� __�_,- - 1�,-g" o . - � ar� I c P�s�� 4'. I�� .��' `� ► :; � � . I I �262 � � 130 , ,�� w � � I.,j f� �_ 1 __ 1 I �-�'� ---Zy,-e � I N�\ � � 0� �� r � I ' t . �,�' ` o za• t i � p6.2 � a ~` � .� ni 1 s \M �~! �V-�i j�q /�1 ! ��• I �� _�--- ----- �.c� -- 241-- ,_.� --- � � I25 � �, 9S.o .,, ' ` N �� ,wT �r" , aO� � N 1� �,� =° i :� �� M � � � , � ---3a:a�-- z�-�, . �.^.� .��/� ��; - I �•t•� i'�5�.'D_ N ��• r . 9 v — I I- -- -- -- — - M -- y'c. /.'�.,? � �'� ��+ �n � � �3d -- � � 2 t . � , . � r •••• 21.9 • ----�-- ____ �- '' � �zs.s+ � : �• ,N i � .q � �� . 1 i ir! ��j,`�,%��, cn s ifo ---,��Z� 1 �i�� YJ v � ,'• ---�—'� � � 1 �j y ! � _ , r� � `° '; =',yy� �j- - - - - �;- - � � �:+' � � o �• ` � ` . Q�L� . �y� `, n:D .� . �, 11 �. � � 3 - , • � � _ __ii�. lo ,'� _ ,�� o� t. �? �( --<`''.' ~ J o � e ,` o' ' � ' "; G --.-',• , + �.F � � :� • � .. � ' ��• . _. _� � Z� Z ` . ... —' "_.'_._�' i � �Y � � � 1 � ' �♦ � I ~ ��w�� .+i za v i��.b� .� G I I 212 ` c x ��` �' ,., .' ``�F. � . . � S s3 � r. � �� n I �t �. ,,�� i ` a� ' .• D�'�� •F - ..y �+`•' I ( ' \� , . . .s � �� - i . -. ' / ` � - • *� --- - iz5 ---- ---�--•-�,-_ - � ,� � �o� . .. ,•. e: {'4.7 . �; ., �,, . � ; — ,. , ,� �� r � r ` � Y, � • . ' � - Jt ��'� �f ► ' --"�q,L�" \\�� \ I � .. , � 2w.; `� `0 I ' � . � ~ I .� ` ,.: ' , ' I `n ^ 4 1 � � � �.,,._ i ; �._..,_.4' � _,_ _ 1 'n � �.� .., ---- ' !lZ - --?$Q -•-f'� `. . � ��'��jE` •. � �` . ��• ' zei_ .F�..----� Zi 1 � -.� "�4 � � A � �� -- �� ,��= -=:s. 1� z � �, , � 1 � \N/� - J .� _ ;. � `L. i --- ��LL �J . �� , f �= 1 '�n �' ---� 26. z�j � � 1N �� (� U � ?�'-7 - - � t� I '.� � �1 � ,� I —= �� Y SuB�BCT City of Fridle� AT THE TOP OF THE TWINS g � i L D I N G P E R M I T ;, � � � • COMMUMITY DEVELOPM�NT DIV. i j V •"�� , - ' r � � PROTECTIVE INSPECTION SEC. i = , � �"'1 � CITY NALL FRIDLEV SS132 NUMBEii �""'� � �'' 612-571-3460 9/0-Ft5 JOB ADDRESS 161 Gibraltar Road t LEGAL ��T NO. 9LOCK TRACT OR ADDITION DESCfi. 2 PROPERTY OWNEi; MAIL AOOR�S$ Dale Otterness 3 CONTRACTOR MAIL ADORESS Owner 4 ARCMITECT OR DESIGNER MAII ADDRESS 5 ENGINEER k1AlLADDRESS 8 USE OF BUILOING Residential 7 CLASS OF WORK nev o�rE 10/5/98 21P oAGE Oi � � PNONE PNONE PMONE �28100 HECEIPT NO. �� AVPROVED BY SEE ATTACNED Sh1EET LICENSE NO LICENSE NO. LICENSE NO O NEW ❑ ADDITION O ALTERATION � REPAIR p MOVE ❑ REMOVE 8 OESCRIBE WOHK Reroof house and �ara�e (16 Sa) Tear-off 9 CHANOE Of USE FqOM STIPUTATIONS TO Underlayment must comply with the State Building Code. SEPARATE PEHMITS ARE fiEOU�pED FOR ELECTiiICAL, PLUMBING. HEATIN(i, �� VEN7I�ATING OR AIR CONDITIONING 7HIS PERMIT BECOMES NULL AND VOIO If WORK OR CONSTRUCTIOM �ONING AUTHORIZED IS N07 COMMENCED VjIITHIN 80 DAYS. OR If CONSTRUCTION OR WORK IS SUSPENDEO OR ABANQONED FOF A PERIOD OF 120 DAYS A7 � ANV TIME AFTER WORK IS COMMENCED. ' NO DV1 I MEREBY CERTIfY THAT I MAVE iiEAO AND �XAMINEO THIS APPLICArION AND KNOW THE SAME TO BE TRUE AND CORRECi. ALl PROVISIONS OF LAW$ yq�UAT AND OROINANCES GOVERNING TMIS TYPE OF WORK WILL BE COMPLIEO WITM WHETNER SPECIFIEO HEREIN OA NOT. THE GRANTING OF A PERMIT 13] DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE Oii CAMCEL THE pERMIT PROVISIONS OF ANY OTHER STATE OR �OCAL LAW REGULATING CON- STRUCTION OR TME PERfOFiMANCE OF CONSTiiUCTION ,�',/y5 _ NATUNEO� NA AUTHON�2EOaGENT IDAfE� i. �.�� —0� � � � BWLOEN� �o�rE� � SQ. FT STA�LS ROUP OCCUPANCVLOAD CU FT. OfFSTREE7 PARKING IGARAGES �C CMARGE ir S� 1.3 IT L FEE 47.81 7HIS IS YOUR PER � /D �� r NEw- ADDN ALTER ..� � [� [] ConstructionAddress: Legal Description: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/98 � � l .' � Owner Name & Address: �,¢G� �%'%E'�/�5.� Tel. # Contractor: S � �� MN LICENSE # Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length Length DESCRIPTION OF IMPROVEMENT Width W idth W idth � Tel. # Height Sq. Ft. Height Sq. Ft. HgdGround Sq. Ft. <�� .��` � Construction Type: ��✓t,�� Estimated Cost: $ ��Q� �� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ > DATE: ��`/G� �`��PPLICANT: � _ �, � � � � -� � Tel. # s %? ��--� �� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: � �5. ��' $ � $ �� $ $ $ $ $ $ $ s / CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1, 000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.(� Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] ° '`_ 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 $100, 000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $l,OQO or fraction thereof, to and including $1,000,000 $5012. 25 for the first $1, 000, 000 plus $2. 75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCIaOW (Concrete Curb Streets Only) Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Altemate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION 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. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. � * � � � O � � .o �n m � � � A O 7 �� a� o m �a co c�i v a o � m � � N o m � � m Q � O � � m Z'^ V/ m � O Z m m � 3 � m � aas �� Z 2m n � D � Z Z mZn -i tn 'v O D � �] r v� ^ Z . � 1 � � m � � � 17 T � f'r' O m � � �� ` m �� c �' � � v m '11 ci m � 7�C c � � � 3] � � � � � � I O z O Z � a v � m `': � � cQ � a � , � �;, !. � . � _ � z � � Az � � � � � �� m � Z � 0 � �. � � � � � �� m � � � z 3 N �2 � v� m Z � m v � �� N � \ � o � � w m � O C "� � -� �; � � � m 0 0 � 0 0 O � � � m � O � D � � � �� , o ='• � o o � � r � O z D C) � � � � � � o a �o ��'� . � � 7 � � �c ` N � � � � _ � o � � n a, � � � � � � � � > > � ��D (p �.� m m � � � 0 � �i i11 a � o 0 � r' �� ' U � D a � � � N Ul O � � � m � = m 0 � � cfl � D � (ND � � � � N � -� U1 O O g g g � � .� m � � v 0 � � � m � � � z 0 � � � � c 6 � c � 0 � 'f � /" � D(�J -'� � N v � � � � � � m � co � � � �� m m � �� I � Q � ?� � v �� A m � �° � c � Oo c � m � �. � � � O � � g S � O .� m � Sl � r� �./ ^ ) � � � � � O � � m 2 a � v � � � �N�=` � o � � � -- � . �W�.n � _. � n. 0► Bs � � a� o � � v o � � u�-i' Q' 3 N o � � a� ? o m n' Q 7 � 'Q O � _ � � �D � �2�1 `'� n � � o 0 n � � � � �_ � A � Q. ,� m o ��` �� %�. �-► m� s � n m � � o � o '� /� � � �. Vl � � > > ao Q � � n _ m v C � O 00 v v � m � � � � � � r, � � n N p. � —j � �� O � � O � Z � T cn �• v w � � Z Z m � m c� � O Z aSi �� z � C m a � O O Z Z � Z � � � D � � O � Z � v� � o ...,, z� Z � G7 v� v r�i � � � z v� v� S � c� � Z � � � D Z � � 0 � � � � j � I co � CHI1VIlVEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefiilly examined Yes (�) No () 2. �3. 4. 5. 6 7. �� Is free from nist or deterioration Has no foreign objects lodged within Is securely supported Meets all current Code requirements for size and total BTU's connected Has total heating BTU's of All other BTU's TOTAL BTU's Has a liner been pmvided for water heater Has combustion air been provided for water heater Yes()No() Yes()No() Yes()No() Yes()No() Yes()No() Yes ( ) No ( ) Remarks: . �� .�� 1iVl,o N Ne � �r�,�c � ��.� ��e�er.��ec�, �� ey- �11,e � �ao List ALT'ERATIONS BeinQ Done: HE�►TING CO: Signed �y: Date: �..L• �f. aP ° � Cl �12° �\ -(i�, �1,�� { �N r �,�. � * � D = o � � � a � _ 3 0 y' � N. � O H � A � � o � � � O a� o• co _� � �• d � n m �O n' O �• m °' � y `C fl- o � � d � c�o Q . � � O C �r � m Z i1� � m � O Z �'1 m m � � V 0 0 \ 2 � � �' _ v °� � n. � a � `W O .. 'l/' i � .o C � � � � a� m � � m r � �P � e � � O � D �D r � m � m s �, oq m � o � 3 �� °, �. d n► C m Q, °C , .'^. '�v °—' � m 0 � � O � � EA {q �� o � � N � '� �• m c�n m � m � a �. °, °- m � � � � o c�u � mv' v=i W �, c�v � _, � a � frtD � p � a Qv a v �•oo� ,�,. <_ °-' 3 �' N � d ?• � y "0 � � N 7 �"p n� �- 'D fl« s ;�. �. c� =. � D � m �. =� � � o m �+�� c� a � --� � � ° o � c � � n� n� � � m m � N -� �+ °- S fD 3 � � � � Q � � � � ? o - � .,. �sm �- m f� fD � � � 0 y O � �, a � N a � m _ �. � D �o o. �' < `� � m N � c �D � �. � D �� N n►' D rn `-.° � r-��i- � o � O y � r "i � Z � D n � 6� �W C 1 � m � � � Q.. m Z a� m 2 "O N m Z 0 v � D c� 0 � a � 0 � 7 Oq D � N� m N N N y D � � N 0 � � _°• '� � c°�i � .'� � �° cn m fD = � � ��d ��<� m '� � � � G1 ° . c�-c ' � . Q -. Q- -"• � v _ _ � � � � n N � rt 01 � ��W�o � � � � � �x v W � � N �' 7 � � t� t� �a t� tfl N �-+ �--� � W Cn O O O O O O O O O � <D b�1 �1 6�1 {fl EA �. o �� -�oo-+z m C � ° — ao rn � z= n� � � � cu =� � � � N _ O � C� N � n C7 � � O > > � � m ,-�+ ^ �o N a �� o m � ar"z3 � � o ,� _ 0 � d � : � � v rn � � D -� rn O n O � -i � 1� � m � � z O � � W C � � Z � C � m 0 � O Z l►� 7D "'� f'r1 N n _ m v C r m O W D � � � cn�rnn nViaw� � rn� c O o � � �•3�•T Z c� � ,�p `� m W D '� �" m` z Z � m � m n � O Z � < N a � "� z � r ma ��. - O mZ � � "� � � � Z o c Z � v� n� � O N vZ �� o= Zm Z �-�1 '� Z � � � � m� N O Z v< v "' � � n � N � � Z � m �. <' m 0 � � n� � c � '•� N O O O COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacina an existing furance, 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. The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. The undersigned also verifies that the replacement unit is a listed assembly and meets the cuRent codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The existing combustion air is sized and installed to meet the cuRent codes and manufacturer's specifications. When required to install a new combustion air, it will be sized and installed To meet the current codes and manufaeturers specifications. When installina a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Centra! Fumace Venting Tables for fan assisted and natural draft appliances. Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common ven� and vented separately as per current codes. Yes No ( ) Yei%�No ( ) Yes ( No ( Yes�(� No ( �` Yes No ( ) Yes No ( ) Yes No ( ) Appliance #1 Type �� BTU Input � Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #� Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input �v � Common Vent Type �^�� ent Height �� Diameter inches ApRlia+�ce #1 Vent Connector Height �� ft Appliance #2 Vent Connector Height �ft Appliance #3 Vent Connector Height ft Length ft Length �ft Length ft Diameter in Diameter �in Diameter m Typ� � Type �-� Type � Building � PI,UIVIBIlOTG Permit No.: � Inspe�tions �i �j�,1]+��jT�Aj,� APPLICA,�`][O�T Received By: 763-572-3604 �;ITY OF FR]C.DLEY Date 1� S�P �.� �+ � og 763-502-4977 FAX E�crn� 1-,-os DATE � Ob YOUR E-MAIL ADDRESS STCE twuxraa i c�rri �� iti r°i �� i �'� THIS APPLICANT 1S: ❑ OWNER OCONTRACTOR � PROPERTY Np,�: � (� F�E'/1/� � OWNER/ ADDRESS: �� R� � CITY f l��X� STAT�ZIPS�riZ� TENANT PHOAiE: �Co�-- .��Z —� �2 � CONTRACTOR �,�: SUBMIT A COPY OF STATE LICENSE i# EXP DATE YOUR STA'iE LICENSE, BOND AND STATE BOND # EXP DATE CERTffICATE OF ,�D�S: CITY STATE ZIP INSURANCE . PHONE F� PERMIT TYPE � SiNGLE FAMILY ❑ TWO FAMTLY O TOVdNHOUSE TYPE OF WORK: ❑ NEW ❑ REPLACEMENT DETAILED DESCRIPTION OF WORK ��(,l'I` C� �i � Vl��l7�. �� PER MS 16B.665 the permit fee is a minimum of Si5.U0 or 5% of the total eost vp to 5500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of 1a6or ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = plus .50 surcharge OR FOR PROJECTS WHFJ2E LABOR EXCEEDS 5500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (MDiCATE TOTAL NLJMBER OF EACH BELOVi�. MINIMUM FEL $ I5.50. BA't'H S1NK/LAV FLOOR DRAINS SHOWER _ WATER PIPiNG — gp'I'H'�'Ug GAS PIPTNG jNEED CTfY LIC) SWIMMING POQL _ WATER SOfT'NER ($35) CLOTHES WASHER KITCHEN SINK WATER CIASE7' _BACKFLOW PREV. ($IS) DISHWASHER LAUNDRY TRAY WATER HEATER ($35) FOR (RRIGA7ION — — WATER ME7ER _ OTHER . , £:� , .., _ 4. c� : Permit Fee $ � Number of fixtures @$10.00 x$10.00 =$ Surchar e .50 Number of fixtures @$15.00 x$15.00 =$ TOTAL DUE $ OR Number of fixtures @$35.00 x$35.00 =$ State Su�charge = $ .50 $15.50) (MIMMUM $I5.50 Tota1= $ THIS IS AN APPLICAI'lON FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 Const�vction Codes; that 1 understand this is not a permit but only an appGcation for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all work w'ch r' uires r+' rrd approval of plans. n//Z �� SIGNATURE OF APPLICAN'f ' PRiNT NAME ' DATE � APPROVED BY flA� � � € „ � , , ��-�.� City of Y+�ridley �uilding Inspections Department 6431 University Avenue NE, Fridley, MN 55432 � 763-572-3604 FAX: 763-502-4977 Building SUILDING Permit Ivo:�� -� Inspections RESIDENTIAL APPLICATION Received By: (� 763-572-3604 CITY OF FRIDLEY vate xec'd: 1� a 763-5�2-4977 FAX EFFECTIVE 8-19-09 DATE �0 2 O/ YOUR E-MAIL ADDRESS SITE ADDRESS [lp � �/� Y'� 7�-P�� 2 D THIS APPLICANT IS: ❑ OWNER ONTRACTOR PROPERTY OWNER/ Np�: J� �/� �� N�'S TENANT pDDRESS: � IYIP CITY STATE ZIP PHONE: r/ b � S7 �— � � �� CONTRACTOR NAME: P� � %'� (, / G �v SUBMIT A COPY OF STATE LICENSE #�p � 3(, �% /� EXP DATE YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS: f]Q L CITY STATFjM�ZIF� 1NSURANCE pHON �� i FAX 3� � � )� PROPERTY TYPE INGLE FANIILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION O GARAGF/SHED ❑ WINDOWS ❑ BASEMENT FINISH �OOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL Tl'PE OF WORK: ❑ NEW HOME CONSTRUC7'ION ❑ ADDI770N ❑ MAINTENANCFJREPAIR ❑ REMODELING DESCRIBE WORK BEING �NE: � SIZE OF IMPROVEMENT LENGTH W[DTH HEIGHT S FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES � ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: l. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: IDING FOR NEW CONSTRUCI'ION INCLUDING DECKS, � Virryl OSoffit ADDI170NS. & PORCHES SUBMIT: O Aluminum ❑ Trim 1• Site Plan/Survey showing the existing structures and proposed project. ❑ Other ❑ Fascia 2. Two sets of consVuction plans WIIVDOWS 3. Energy Calculations IN EXISIING OPENIIVGS DYes ❑No LOCAT[ON OF WINDOWS FOR WINDOWS — PROVIDE U-VALUE AND OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE S1'ICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINBOWS ALL FEE.S' AKL+' BASEll UN VALUA'1'IUN, 1NCLUll1N(G "1'HE CU5"l� UN' LABVK ANll MA"1'L�'KlALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ I�°7� OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surchazge License Surchazge SAC Charge Curb Cut Escrow Erosion Control Pazk Fee Sewer Main Chazge $ $ � $ ,`l� $ !� �� $ $ $ $ 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) $2000 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$22=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( Make checks aavable to: Citv of Fridlev THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED Attach 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 pe it and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case o ' s review and approval of plans. �� SIGNATURE OF APPLICA PRINT NAME �� h- ATE � `a— � Page 2- Building Residential Application BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building. or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE FEES $1 to $500 $23.50 (Minimum Fee is $23.50 plus surcharge) $501 to $2,000 $23,50 for 1� $500 plus $3.05 for each additional $100 or fraction, to and includin $2,000 $2,001 to $25,000 $69.25 for 1� $2,000 plus $14 for each additional $1,000 or fraction, to and includin $$25,000 $25,001 to $50,000 $391.25 for l�` $25,000 plus $IO.lO for each additional $1,000 or fraction, to and includin $50,000 $50,001 to $100,000 $643.75 for 1�` $50,000 plus $7 for each additional $1,000 or fraction to and includin $100,000 $100,001 to $500,000 $993.75 for 1�` $100,000 plus $5.60 for each additional $1,000 or fraction to and includin $500,000 $500,001 to $1,000,000 $3,233.75 for the ]�` $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 1ffi $1,000,000 plus $3.15 for each additional $1,000 or fraction VERIFICATION OF FOUNDATION Permits 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 Fax: 763-502-4977 Engineering WATER AND SEWER Permit No.: U� � 5�� 763-572-3551 pERMIT APPLICATION Received By:� 763-571-1287 f� CITY OF FRIDLEY nat d�- � �� EFFECTIVE 6!9/09 APPLICTATION DATE: YOUR E-MAIL ADDRESS: THIS APPL[CANT IS: ❑ OWNER �CONTRACTOR JOB ADDRESS: I�i � �� % y'74 f�� NEW CONSTRUGTION PERMIT# (IF APPLICABLE): PROPERTY N.vv�: 1 , .�� - OWNER/ ADDRESS: I�a � �� .►.a�'q. i� ,�2 CITY � STATE Z[P TENANT PHONE: �4��% CONTRACTOR Ivqtvl�: ^C�� i �.J � f-,�t2,. ��.,.,.�a �';,,�a,,�� . SUBMITA COPYOF �DRESS: �� 2 �� - Z•-%� �'" =�i- .3�F.'°�'�I'�'y OJ�o�., YOUR STATE ►� �_�y STATE '►�z'�ZIP 1� t� LICENSE R7TH PHONE Fal L°' %,i f- �1' �% CELL PHONE: �; Z— �'� i� Z� �'�1� APPLICATION STATE LIC # STATE BOND: EXP DATE: 1. : Narr�tve/written description: I Ld ta� ��i ,ac-�__ �i y�z. � v�`� f'� .r� 2__Please attach sketch showin�curb line, utili line, building, etc. with distances. __ _ PERMIT TYPE ❑ SEWER CONNECTTON PERMIT $50 ❑ WATER CONNECTION PERMIT $50 �WATER LINE REPAIR $40 y L� J ❑ sEWER LINE REPAIR $40 ❑ ADD STATE SURCHARGE $.50 , �� ❑ SAC CHARGE @ $2000 = �� , �l1 OTHER CHARGES (IT APPLICABLE) PAY TO UTILITY BILLING NEW WATER METER COST — SEE UTILITY BILLING SPECIAL ASSESSMENTS — SEE FINANCE WATER TAP — SEE ENGINEERiNG NOTE: WATER METER REPAIR, INSP OR SHiJT-OFF / WEEKENDS & HOLIDAYS $125/HOUR-BILLED THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a water or sewer (new connection or repair) 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. I understand this is not a permit but only an applicarion for a permit is not to start without a permit. SIGNATURE OF APPLICANT �� ;� PRINT NAME: �� D A T E: C� '? --. _ -. ' APPROVED BY: �`' DATE: ! D°' 7� �CI COPY G N TO: ❑ UTILITY BILLING (only if new meter) ❑ PUBLIC WORKS 0 ENGINEERING C;ity of Fridley Engineering Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3551 FAX: 763-571-1287