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AF - 45611City of Fridley, Minn. BUILDING PERMIT �� soo4 �� Date: r� � �'�.!'_':.� _��..._".'—.------' ...� _� Fr�./,y, j/'J� Owner: � � �. � �dF-�i�+�s.f _. Builder ��/�4�:�'— . . ..I�:`r�.�.�� Address---�:.—.-------•--�.._._.—�_`.__.._ Address — � .._... __._..____.___._.._.—.�_.__..._. Na�� Street Lot --{� .Block � Sewer Elevation l ---------...._----.._...____..._ Foundattoa IIevatiom ....____ DESCRIPTlON OF BUILDBI�lG T Vsed /� ` r'�/ �y Q�J' ._ ' J .d.:�^ . EYront I �� DEPth .x�..j��_}.., HetgFt �::_� �q. Ft. ��%.e..t�.^u. �tn�;�ex�.��,7�. .��'��, ,�,.�-.. Depth _... ��{H/eight �-t�� S�. Ft �'�""�� !� Cu. Ft ��f✓ Type of - nstruction �Q�`Ti�i:k'--.. Est eoa�'��'L�'6+��-�'.".."."..""°'mo b2 compi�ee� _.. _._......--- ....._.._ In cronaiderat[on of t6e issuence to me of a peraiit to construct �the building described above, I agree to do the propoaed work in accordance with the description above set forth and 3n compliance with all provisione of ordinances ot the city oP FricIley. � . In consideratioa ot the payment of a fee oi $..��'�� ., pernut 1s hereby granted to coostruct the building or addition as described above. This permit is granteQ upan the expreas c�dition that the person W whom ft is granted and his agents, employees and workmen, m all work dame in. around and upon seid buildiag� or eny part thereof, shall confwm in all rnsP�ts to the ordinances o� FridleY. Minneeots reS�nB loeation, construction, alterahon, maintensnce. rePau' and movuig of buildinBs within the city I�mite aad this permit may be revoked at aqY tixne upon vlolatton of ax4y of the provieiaas oE said ordinances. �.., � BulldinB Inspectur NOTICE: 7fift pNmB dea �m eerx fh� censtrvNden. inmllMion for �rtenY, Pw°��6. Y� hNIFO. w�wr ee w�Mr. B� wn ro aw IL� BuiWiop Intp�ebr fot s�qnN p�emhs for 1hu� Ibm. . . Owner's APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEX, MINNESOTA Addreas S�ZoS� !7�4�,G.r/�.t> �_ Address 3voo �� , . , . , LOCATION OF HUILDINC3 � , . ' No.�_,�[/�� Street, C�'.�i�r 1i9.�r.Part o� Lot � Lot„� �_Block Z. Addition or Subdivision�,/?� Corner Lot Inside Lot^ �Setback 3-� Side-Yard SEV�ER ELEVATION FOUNDATION ELEVATION Applicant attach to thie form Ce�tifi�ate�of survey of Lot and propoaed building loca£1on. To be used asa DESCRIPTION OF BUILDING Front Depth He3ght Sq. Ft. Cu. Ft. Front Depth Height Sc�. Fti. Cu. Ft. Type of Construction Estisnated Cost To be Completed The undersigned hereby makea application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and ruling of the Department of Build- inqs, and hereby declares that all the facts and representations stated ii ,\this application are true and correct� "' �� (Schedu� of Fee Costs can be found on the Reverse Side). - '-. � � -_ - :� �� P i� � n • e �N w R� � M � a � m�`� � � � LL O � U � � � � � � � 00 30 Q � O� F � la�l W� am 'e z � � '��W a„ � � w' � oo� 3 � �a °'�m ,�,U�.: w��o �� A�� w��d a�� o�w�a. � u � � . u � '� a yyyy.� � � � � � M O � � 3„ A � �..� �b�� y S a� 6i (� w � �� •1+ � N pa �bf7 M o � � � a y'+ $vv U m a � �� < 3 � • a • L"� s�NiN3a0 rs 39NYL � � 'WM svo a3HSVra o� SNISY9 IqLV] SNIVtlO � aomi 'SVM115 i uuai u�� F> L`IFi sNim �� ruve SIVNItlfI 5135017 � � z � b � �� U d q q � � 'O a ? �. \ L: � � p 00 ,; z � � � � a � � c G v a '� � O � •� a U P� o 'd � �. o � ° � z x �g c obi � a v � z O � 5 E r i O p�G f:, m m m � �� s� 1 � � � U % • �: � C'� � o z w� 6'' N e�"i a• x� w J � 0 V.I U N W Q � J � a �� F o . 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U [� �'o � m a � U E � � . ,� � ' . � a � ; . � N 4 � �'�, rs n � a v�i 4�3� O q N O � K K z i i i �d l! 0 � c � N � on � � A �y= � .� u x 3� � � ^ � N d � � m � U (�, \ � � � O F m w � � � � g �q . g � p � W : ,.�� . OG . � 8 � � ' � � � $� � � B �� ' ; � � �� 4 � . � � � � � � � � � � ° � � � w ~ � � � � � � � � � �,'� � � $ � a ..� � �� x m�' � w�N ��a � ' t.a.z S� � m w W;i�s �„�c� � � ya ^^l �' �� i W�� $ a�i v o c°v S y� ? W % p G z N� dl � � ° � � � �.� � �, M � � , o � w �,�t � dd d! � ,o te $ WoG t7 M� a� F�� x ��m.�.� �� •�•� a��"� � o"C �,F,,,w".dt�7 �'e4a ��'aa�a �� aar� x��w a m�w a�zF o� �. _.,� tl � � o � � e W>_�a x w W 'o Y � t i : , _ ,_ ,, . �,% „� a �,a (��Pv55- �!, �S7 1tJ�T- 3��?� ,_ . . ttenr �oss ca�cut.a,noNS ��,vt�rn'exr oF su�Lnirres iwNr�apous, tMxtv. Weatherstrips A'S' 'V• ' Coastmetion No. Insulation Guide I Windowa I Doora I Referenee I Ou�. Wall Int. Wall Ceiling Raof F]oor II Kind How Applied Yei �t o Yes—� 19— � F7.� y� 1J l Room LenBth j Width 1.� 4 Height 1 FI.� Room Leneth Width 1 HeiBht Windowa and Daora—Crackage and Area Windowa and Doora—Crackage and Area Nidth HeiBht No. ot Llneel [4. Area WSdtT XeigTt Mo. ot Lineal tt. Ams NO. ot D�ne of pane tl8hta of cnek aq. t0. No. ot pane o[ D0.ne ll¢�[s � of Cnck ea. [[. ��i `'� l �b il_ 2 3.3 3x ! 2� 1� Infiltratioa Glaaa F�cp. wall Net exp. wall �l.i.�..tL j I Ceiling Floor . Total Btu. Required sq. ft. : F7.� Windowa and w it:�� 7.A. L.eader area I O—� Widch and Area CAef. BN In6leration 1 Glass S � Exp. wall Net exp. wall Int. wall Ceiling i Floor �„ }� e Total Bm. Required sq. ft. E.D.R. or aq. ins. W.A. l.eader area Fl. i!�F � Room � l.e�ch Wirhh � Hei�6t Windowe and Doora--Cracicage aod Ana N� oD M oteDSna I NsCb � ot�ortek artt. Infiltratioo Glasa Exp. wall '� � Net exp. wall Int. wall Ceilmg Floor � i or aq. ma. W.R. L.eadet ann I 1n61tration Glasa Fzp. wall � Net eap. wall loG W.�� Ceiling .,,,,, � � Floor � iC, X !G �1f7[}{ rotal &u. Required aq. h• E.D.R. or aq. ina. W.A. L.eader area FI.� »� � Room � Length / Width f Wiedows and Doore—Crackage and Area � In6lvation Glaaa Fsp. wa � K Net ezp. wall Iat, wall Ceiling t�ao� !'� x � G� ! 2 �, Towl Btu. Required aq. &. E.D.R. or aq. ins. W.A. L.eader area j F1• f� �'j" RoomlLengt6 /+S Width 1 Wiodowa aod Doors—Crackage and Area � � Infiltratiun Glasa Eap. wall i Net exp. wall laG wall Ceiling Ffoor Total Btu. � 0 � �. ins. W.A. l.eader arca Btu . . �� l�9 . :. HEAT LOSS CALCULAT►ONS Weatheratripa A ' I Guide Window� I Doora 1 Reference I Out.ti Yes— o e1T�o 19_ t Ft.l D E N�►,�� h � 3 4 w Windowa and Daora—Crackage and Area �iTa� DEPARTMENt OF BUILD[NGS Construccion No. Nall Ceiling Roof Floor I Kind Height j� II F7.� Room { I Q�indows and Uoors—G� Coef.l Btu Glesa � E,cy. wall !1 f c Net e:p. wall Int. wall Ceiling Floor X � � Total Btu. Required sq. ft. E.D.R. or aq. ias. W.A. I,eader area FI.� Room � Length Width Windowa aad Doors—Cracicage and Area N�ot oana ot�wne Ils�b a[ cract w� [t. Glau Exp, watl Net exp. wall lnt. wall Ceiling Floor Total Btu. Required sq. Et. E.D.R. or aq. ina. W.A. Leader arca fl.� Raom Length Width Windows and Door�--Crackaae and Area � Net e:p, wall lnt. wall Ceiling Floor Btu Btu I ,� A . . . < MINNEAPOLTS. MINN. Insulation Eap. wall Net e:p. wall ]nt. wa11 Ceiling Floor Total Btu. Required aq. #t. E.Q.R, or sq. ina. W.A. Leader exa FI.{ Room � Length Width Vlindows and Doora—Crackaxt and Area �`.� Infiltration � � Glasa Exp. wall Net e:p. wall int. wall Ceiliog Floor 7'otal Bm. Requirod aq. ft. E.D.R. or aq. ins. W.A. Lead� E7. Room I Length Wi Windows amd Docra—Craekaee and Area E�cP. wa{1 Net ezp. wall Int. wall Ceili¢g Floor Total Btu. rr+s area h Height k. E.D.R. or sq. ina. W.A. Les�r ara � II Required p:`ft E.D.f2. or sq. ins. WA. i.ea&r area Btu . � � sae�ec* � � PER NO. '� City of Fridley � 1712 5 PTTHETOPOFTNETWINS gUILDING��PERMIT , � RE � • COMMUNITV �EVELOPMENT OIV. � -.: ------� 93�� r � PROTEGTIVE WSPECTION SEG. . ' � � �""� � CITY NALL FRIOLE� �55432 NUMeER Aw. oATE PAGE OF � APPPOVEO BY �'""'� � ,�' 612-571-3450 gto-F15 � 5/9J83 / / 108 ADDRESS 1437 Gla�i�er Lane N.E. � 1 LEGAL LOTNO. BLOCK �� TRACTORADDITION � � SEEATTACHED DESCR. �. �. IIll1SbYI1CIC 4Y�1 A(.�d1t10R �SHEET . . 2 PROPERTVOWNER MAILADDPESS � ZIP PNONE � June Collins 1437 4lacier Lane N.E. 3 CONTRACTOR . MAILADORESS � ZIP PHONE ., LICENSENO. Richard Hastix�gs 6331 Riverview Terrace.N.E. 574-9966 4 ARCHITECTOR�ESIGNER MAIIADDRE55 � ZIP PHONE LICENSENO. 5 ENGINEER MAiLAODRESS .� � ZIP PHONE LICENSENO. � 8 USE Oi BUILDING � � Residential 7 CLASSQFW�RK � ❑ NEW � ❑ ADDITION X ALTERA710N ❑ �AEPAIR ❑ MOVE ❑ REMOVE 8. DESCRIBE WORK Reroo£ Dwellin 9 CHANGEOFUSEPtiOM TO STIPULATfONS � . Roof can be 2nd layer but not 3rd, Tnstall ridged galvanizzd valleys. TYPEOF GON$T. OCCUPANCYGAOUP OCCl1PANCYLOAO � SEPARATE PERMITS ARE HEOUIRED FOR ELECTRICAL, PLUMBING, MEATING. �� . VENTILATING OF AIR CON�ITIONING. THIS PERMIT BECOMES NULL AND VO10 IF WORK OR CONSTRUCTION ZpNING SQ.PL CU.FL � �AUTNORIZED IS NOT COMMENCED WITMIN 60 DAVS, OR IF CONSTRUCTION � OR WORK IS SUSPENOED OR ABANDONED GOR A PERiOD OF 120 DAVS AT � � ANY TIME AFTER WORK IS COMMENCED. � . NO. DVJIG. UNITS OFF57REET PARKING � I HEREBV CERTIFV THAT 1 NAVE READ AND E%AMINED TMIS APPLICATION �. � S7ALL5 GAPAGES ANDKNOWTNESAMETOBETRUEANDCORqECT.AILPROVIS10N50FLAW5 yq�UATION � SUpTAX AND ORDINANCES GOVERNING TMIS TYPE Oi WORK WIIL BE COMPLIEO �'Z�OOO SL.00 � WITH WHETMER SPEpFIEp MEREIN OR NOT. THE GRANTING OF A PERMR � DOES�NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE PERMITFEE � SACCHARGE . PROVISIONS OF ANV OTMER STATE Ofl IOCAL LAW REGULA7ING cor,- $J2..�5a � � STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � PIAN CHECKiEE TOTALFE ��_�y� S P 83 S3�.s� SIGNHipREOF�ONTRpGT080RAUTN ZEDAGENT I TB . WHEN PROPERLY DATED T IS IS YOUF PEPMR � SIGNATpREOFOWNERtlLOWNERBUILOEP� VOATE� BIOG iM1SP � <i C1TY Or FRIOLLY �tteeti�e �ug. 1, 19s1 APP1lU1?1Qi FOR RCSIDLNTIAi, DU]LD1i1G VERt+lITS (NE,r� Alttrations, Additioni� or Rcpai�s) ONt�ER: �4K& �oLL,`nr r � ADDP.FSS: ry3? r Lpci t r2 Li1/. TEL A0: ' iTRLST M0: dUILDER: _/� �c%��A PD � IIAS'�! c��6S' ADORLSS: _633 t �2� u�,e �, � 4, rj'� TEL p0: S'7 �F ' �lP�,� , tonstrvction �ocatf�n i1'7tFET: LOTs � fIAOCs ^�_! �pAIT7D�s �KN S L i�ooR c,, 6 �CQ�' � � CozneT IAt: Inoi�e Lotz iclb�ek: Sidgyazds: J1p�7ieant attaeh to this fone tvo Certifieates of Survey oi Iot and pzopose8 Duildir�g locatim drawn on eertific�tes to scele. Fmnt: DEStRIPT10�i OF COr�STRUCT10r� Depths iquare Feeti Q�bic Feet: Front: y�p�= Height: Sei9ht: Squere Fest: Q�bic Peete 1�rpe Of Corstzoctions __��n� tsitaateQ Cost: i•Zbpo. o�o 40 Ee Lbr..plctsa: __ ��/ S�� j � J►lt. 1► 7�1t, 8 Droposed Drivcti+sy iiidtA If Nc++ Opening is DesireQs =' _ . 6EC RiVER;E 57DL OF SNi�T �S�e undersigned Tereby aal;es �rp]ieetion for a per�cit fcz t?�e �azk herein specified, ♦greeiny to M,all vork ir, etriet •ceordsnce with the City of Fridley Ordtnanecs end ruli��yz of the Del�.�zta�+ca�t of Duildings, end Tereby Eeclares thrt �11 t]ie facts and rcpresa�trtiens sc.c�a s�, ti,is applieation are true and correct. a,rE: _�S"��133 sica�nzvs�: Stilwlations: 3 2, �� 1--� �3.� a v � �� - � � ' SuNFCt �� . � � City of Fridley 0 3 5 9 . , •"MET°°°F'HE'w,"5 gUfLDiNG PERMIT TNO. ,. � • COMMUNITY OEYE�OPMENT OW. �' [/ � � """" . � ( / � � � � PROTECTIYE INSPECTION SEC. � i.---� �'�'1�', CITV XA�� FRIOLEV y§�7i NuM�EF pEV D�TE P�GE 0� �ivROVED !Y L 612-571-3460 910-F15 10/6/99 / / IOBAODRESS 1437 Glacier Lane�NE � I LEGAL �aTNO. BIOCN TRACTONAOOITION SEEATTACHED DESCR. 1 1 Innsbruck� SUU LOt A � . SNEET 2 VROPERTYOWNEN MAILADOpES$ . ZIG GMONE Jime Collins 571-8473 7 CONTRAGTOR MAIL ADDRESS 21P PNONE LICENSE NO Tabor f, Sons Inc. 10547 Terrace Rd. Blaine 55434 789-1902 20014248 � aRCNITECTORDESIGNER MAILADDRESS ZIP � VIiONE LICENSENO- 5 ENGINEEN MAILAOORESS . Zli pMONE LICENSENO B USE OF BUIIOING Residential 7 CLASSOiWORK ❑ NEW ❑ ADDITION ❑ AITEpATION aQ REPAIR O MOVE ❑ REMOVE B DESCRI9E WOFN � Reroof house and garage (27 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPUlAT10NS . Underlayment must comply with the State Building Code. TYPEOFCONST. OCCUPnNCVGROUO OCCUPANC�IOAD SEPAHRTE PERMITSApE REOIIIRE� FOR ELECTRICAL, PLUMBING. HEATING. VENTILATING OR AIP GONOITIONINC. � THIS GEHMIT BECOMES NULL ANO VO10 IF WORK ON CONSTpUCiION ppNING SO.FT CU FT. AUTMOR12ED IS NOT COMMENCED N/ITHIN 80 DAYS. ON IF CONSTRUCTION OR WOAK IS SUSPENDED OR ABANDONE� FOA A PERIOD OF 120 OAYS �T ANY TIME AFTER WpRK IS COMMENCED. NO. DW4G. UNITS OFFSTREET PARKING I HEFEBY CER7IFY TNpT I MAYE NEAO AND �%AMINEO TNIS APPLICATION STALlS GAPAGES ANDKNOWTMQSAMETOBETRUEANOCORREC7.4��PROVISIONSOF�AWS YAlUAT10N � � SURiAX FN� OpDIN4NLE5 GOVERNING TMIS TYPE OF WOAK WILL BE COMP�IED � @ WITM WHETMEH SPECIFIED HENEIN OR NOT. TME GRANTING OF � GERMI7 $2360 �pS. ].H DOES NOT PRESUME TO GIVE AUTNOPITV 10 VIOLAtE OR C�NCEI TNE pEqMITFEE SACCMARGE PAOVISION$ OF 4NY OTHER ST�TE OR IOCAI lAW REGUl�i1NG CON� STRUCTION OF 7ME PERFORM NCE OF CONSTRUCTION $83.25 � � Fire SC 2.36 --� ---<<� �� PUN CMECN fEE TOTAL F License 5.00 9 9 YGN�t�RfO�CON'A�ClOAOA�U*�OA2E��GEN1 �O��Ei EN ROPE Y LIDAT IS �5 YOUR PERMIT S�GasivaEO�OwNEA��OwraEABW�OEA� iD�*E� �a_�r B �NS� ryclE NER� ] " Effective 5/10/99 r, ADDN [ ] C1TY OF FRIDLEY ��N\ ALTER [] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 � �1 BUTLDING PERMIT APPLICATION I�� ConsmicrionAddress: ! �.3 '� Glac.'P,- ��-�P Legal Description: Owner Name & Contractor. � / � I; Tel.# 57/-�'%J3 MN LICENSE # Address: `OS�� -�rrGCC R � Tel. /f 7�'��5'0' � LNING AREA: GARAGE AREA: DECK AREA: Attach to this application, a Certificate of S�rvey of the lot, with the proposed construction drawn on it to scale. Length Length Length DESCRIPTION OF IMPROVEMENT Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground _ Sq. Ft. OTi�R: � �f O� 7 ��-'f`.�' -�' Construction Type: �f�r p��y�c+ R�/('.y< Estimated Cost: $ ��0� Driveway Giub Cut Width Needed: _Ft. + 6 Ft =_Ft x �$ DATE: l�� APPLICANf: ��..�(d � Tet. �i 1/ 1-70 4 9 Permit Fee Fire Surcharge State Surcharge SAC Charge License S�ccharge Driveway Fscrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ �3,�5 $ a..�� $ 1, /�� $ $ � UO $ $ CITY USE ONLY Fee Schedule on Reverse Side .OQL of Pernut Valuation (1llOth%) $.sor$i,000 v�,�c�on $1050 per SAC Unit $5.00 (State Licensed Residential Contractoxs) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] � l� ? 0 0 O N � � 3 C m � C � N > U � W z O N '> � Z � H U w Z Q F" W J V �" � Z p > C � Z Z a N �� W U N 2 y � W Z =O C f' Zp ¢ Z u� O F U Z J Q ao W Z �a OZ ao �Q O � W 2 tJ a � Q W C.1 � J a a Q a W N z z �� ¢ M � J w � � ` Ifl � � Z �- c�`7 �= T� ,� m M " � M'ON .. 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'Q C 4 '�u�o n u„=+r U.a`"-o _ a � c a � Y R n. s° o � 3, y R y = E�'>= �:� mT p � • � � � �� O C � N �+ L �� N �* C � m � ��w�$�� °' a o c 'O � N � N N � i .�n�m H � � � n rfr � Y 3 O U C m � a Y ¢ � O 3 C � \ j m �y O d � � � £ N t� � � � s w i W � � � � w.d+ F w 0 � � 2 O n � � w W � Z 0 U W d � Z UJ � O � � N i� 10 � 10 c ii :: m � C t � 3 0 � � > O Q n ¢ � � O r 3 i >, 3 � O � � 'N i ro °'a � O � a V � N � a� 9 '0 +• � C O i � U C N O ~" N N y C •�O L V °� C �' U m .""'-� .. .� a 3 N O 0 � i � � c m C � � > u W m 2 0 F- y W J V rW ao i a � Z � a J y O W v� Z y � W Z = O Q � 6 Z Z� � aa wZ �a oz a� c Q o� W �' O� _ � � � Q W , V � J a z �- o a � i � Z � F- U ww a z � z � m Q J .'-' � Q � y � � � � Z M i �.0 �^ O > >+ � ,.y N � � M "O � v L � c.�co�.. _� U • J 7 G W S V N W Q �. Z O � w N � c� z � J � m V �1 � Z F- � a W 6. � �*� F N O U 0 w H a � H � w E� A � a� R� � 0 � � E z � R N J � � � v � U N � C C O O y U U � U o a �-- I� N G Q � Q m � N � �� =z � � � O � F-- j Z � F- � �] t.� C C � dN� � � � O N Y U u o�;� � U d m • t m w i�. w t _ � �, w+ � i . 0 L ` .�,, Y O b V � � � N a W N V � tO C � ° a'° m � Z � � V .�•-� N � � Z3 � fn C A T �p ° '� c � ,U i O U ` � '_ e. � - � U �. T7 .- a.� c a d � � C R = s 3 .� w � _ N � � l6 � C T O O d � �� m a`, ° � � � L �� H �a -p C j Z a� a� 0] '^ c a� y� �' a� o a oo y � � � � ~ � N y N � N C � 3 �V � a � r L °' '- a 0] 67. H a i i� . ¢ $ o $ o �° � � ba w bs v� w � � o 0 0 0 0 m o 0 0 0 0 « o 0 0 o ui M � � � N � � � � � G1 U C (p � i � 07 ^ .��. C Y Y U � �a� m c aEi � � L � U � O '� O. > j _ 3 m � w � � � � . � � � d � Z � L U � �o m 00 m r 41 � � Q � Q� t�6 CY `'' a � ;0 � O �n v� N a � a c� c� L � � � 16 c5 N N N Q m C � 0 D C O U Q Y U ¢ m Z � � N v � N O O � _ s, +� O � C Q !o d! o. a �¢ � O Q � � � � L y N � � o � � a� o�u� . Q � c,4 esr Y >O > O N U C � � O' � 4 '^ o 7 C 7 \ �6 � >. •y � y o � � � N t� �' m A L w � W � � � J N Q :° o � � � � � V ,� W �F ¢ C� � � � �I � � � � I i � � � � C . LLI J I W � � N � Q c L m � � � � I V O 1r � � � z i" a� it C w � x 2 tn t¢i _ O O n � � w w Li_ Z Q F' U W d � Z w � � � 0 0. a Q � 0 L 3 � � � �p C >. 3 � O � � N � �v a C � .� a N pp U � R C a O d � ti c � c ° � � U C y O N `� � N � � � � C a O C U � .�'.. � ` ¢ 3 0 THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR 7HE APPLfCATION WILL BE RETURNED rc�ti�A�nN VEhT,y��+r rnn�niGCTnR eTJ1� (`f1MR11ST1(lN AIR VFRIFICATION Wh2n r?ynlar.inD an eYictin� �ranr. , 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 O The venting system is plastiGPVC and meets all current codes and manufacturer �/ specifications including sizing, length, number of elbows and termination. Yes �Cl No () /' The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufadurers specifications. This does inGude AGA-GAMA Category I Centrai Fumace Venting Tabies for fan assisted and natural draft appliances. The PYi�r�ng cnmh��st�on air is sized and installed to meet the current codes and manufacturer's specifications. WhEfl �2qUi�2d t0 in�tall a new r.omhustinn air it will be sized and installed to meet the current codes and manufacturers specifications. �'jQ(� j11G�9II1� H f1?W VB11tif1� stPm, the undersigned hereby venfies that it is a listed assembly and meets the cuttent codes and manufacturers , specifications. This does inGude AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Is the common vent and vent connectors sized and i�staifed correctly after an appliance has been removed From the commo� vent and vented separately as per current codes. Yes �j 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 Appiiance #3 7ype BTU Input Fan Assisted or Nat Totai 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 _ ��C 9 � � `/.z %m /DO0 L'f� ,�6rDq� 6Tu. 13.0 �� L HEATING CO: / / Signed By: � Date : '`��/ �/o z— ADDRESS Hb�6E �NEATING TEST RECORD . . , APL-1L'FUpOR CITY HEAT LO '�—DATE HTG. INST.�S]�.� " � � �_ SOLD BY T,��.1y�(a-C� V INSTALLED 8 �Do,� El.ctrical Work By �� Gas Lin� 8 ! TYPE D HEAT GA _ FA ' W_STEAM — SPACE MTR. _UNIT HTR. —OTHER � � GAS D�SIGN MAKE MAKE OF BURNER_ Mod�l Modsl Sxial Max. BTU Ratinq — "INPUT��`��y� MAKE OF FURNACE Mod.l GONVERSION � � -i- � � ,. • : � , o,� {( � CONTROLS `'�i THERMOSTATq�' Hsat Pluq V�nt Si:• �� Valr� � A� _ KIND OF LIMER �� SIZE � NONE . Limif �r . Droft Hood _� �/�� R yul � � Limit S�Hing Filt�r• Si:.%' � lumb�r Fan Settin9 Chimn�y Location Insida x Outsid� Pilot Typd. � Qimn�y Constmcfion %W��y�� . . PilotMak� i..,a-a��\..-��CU� �-, ._. . Pilot Model � Smoke Bomb V Wiring ✓ u'� ✓" Pilot Timinq � Draft T�st Tap L.W. Cut Of( Door Prassurs Liyhtinp Inst. Prossur � P�rc�nt COZ "' Oate T�ate Input CFaF'?�� Pares�f 02 � Company T Stock T�mp. Perc�nf CO � Noms o( Ta Form 435 � �. ADDRESS PIN LEGAL DESC PERMTT TYPE PROPERTY TYPE CONSTRUCTION TYPE YALUATION CTTY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 : 1437 GLACIER LN NE : 253024120087 : INNSBRUCK SLTBPLAT 4 : LOT 1 BLOCK 1 : ELECTRICAL : RESIDENTIAL : ADDITION/ALTERATION i �►��r�x��.�r�� rs:y� PERMTT NO.: 2004-01543 �� DATE ISSUED: 09/07/2004 NOTE: ELECTffiCAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMTT ISSUE DATE. MISCELLANEOUS WIRING THROUGHOUTHOUSE. # INSPECTIONS 1 APPLICANT HARRISON ELECTRIC INC 3440 KILMER LANE N PLYMOUTH, MN 55441- QWNER COLLINS JUNE C 1437 GLACIER LN NE FRIDLEY, MN 55421 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if wotk or construcrion 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 Imow the same to be true and correct. All provisions of laws and ordinances governing this type of worl� will be complied with whether specified herein or not. The granting of a permit does not presume to give authority tA violate or cancel the provisions of any other state or local law regulating construction or the performance of cons�ruction. Applica�t Date Bldg Insp. ELEC PERMIT FEE - MIN (RESI) STATE SURCHARGE, ELEC FLAT TOTAL PAID WITH CHECK # 027762 S�;rAKA�1�� Y�;KMIl'S 1Zr:(2U11t�D r'OK WURK 01'HEA THAN DESCR1BEll A130VE. 20.00 0.50 20.50 ADDRES5 PIN LEGAL DESC PERMTT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 )631572-3604 FAX: (763) 571-1287 : 1437 GLACIER LN NE : 253024120087 : INNSBRUCKSUBPLAT4 : LOT 1 BLOCK 1 : BUILDING : RESIDENTIAL : WINDOW/DOORREPL PE O.: 2004-016 DATE ISSLrED: 09/24/2004 VALUATION : $ 7,400.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER R317 OF Tf� 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTEffiOR OPENINGS. REPLACE 14 WINDOWS WITHIN EXISTING OPENIAIGS. STATE LICENSED CON'TRACTOR 1 APPLICANT LAMPERT EXTERIORS (20103953) 2986 N FAIRVIEW AVE ROSEVILLE, MN SSll3 OWNER NDITH & NILE HARPER 1437 GLACIER LN NE FRIDLEY. MN 55421 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authoriud 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 Irnow the same to be true and correct. All provisions oF laws and ordinances goveming this type of wor} will be complied with whether specified herein or not. The granting of a permit does �ot presume to give authority to violate or cancel the provisions of any other state or local law regulating con�truction or the perfom�ance of construction. BUILDING PERMIT FEE FIRE SURCHARGE STATESURCHARGE,VALUE LICENSE SiTRCHARGE TOTAL PAIA WITH CHECK # 5708 Permit �nspection Cards Wili Be Mailed To Homeowner To Post SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 153.25 7.40 3.70 5.00 16935 -�.-- FEB-26-�03 09 � 30 FROM C t TY OF FR I DLEY �C �.y �� L� � f 651287�4�IaQ 2i05 Ci NEW ADDN ALTER � CITY OF FRIDLEY Effective 1/1/2003 � 6431 University Ave NE, Fridley, MN 55432 (763) 572-360r3 Bldg Insp j SINi'iL.E FAMILY ANO PUPLEXES R-7 AND R-2 (7BS) 571-1287 Fax BUILDING PERMIT APPLiCATION Construction Address: l Y3 T t7ltt i e r � a Lt P!�1 E Legal Description: Ou�mer Name & Address: /U �' v� ret. # 7� 3 S �// 6 9 G/ Contfac�or. L!,� � r�- � �xr �i� �'i r S _ MN LICENSE #%I/ �� 9�� — �ei.lwee� 27Q'L� A/{-,.�✓�ri/ri,v�l �</95Ef////p l�in �_��2 Tel.# 65-/ L�/S �6(S,Q_ Attach to this applica6on, a Ce�ificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT WING AREA: length WWth Height Sq. Ft. C3ARAGE AREA: Length �dfh HeigM Sq. Ft. D�CK AREA: OTHER: �ength Wid1h HgtlGround Sq. Ft. Construction Type:l `� �i ��, �� u s� r'� v� rr��s6mated Cost: S ]y�� pdveway Curb Cut Width Heeded: YFt. + s Ft =�Ft x$ =$ DATE: �'� APPLICANT: ,�lt%/-i �� 7e1. #�5 /��lfS 5�''YS Call (76S) 572-3604 Tor Permit Fees ff mailing in application. Fax to 76SS71-7287 if using credit card and we will call you ior wrd number. CITY U5E ONLY - Permit Fee Fire 3urcharge 5tate Surcharge 5AC Charge I_ic�ense Surcharge Curb Cut Esanw Erosion Contro� Park Fee S� Main C arg� $ s �� —`--- . , , � �/ �ILL' � � -� � f I i Fee Sd�edule on Reverse Side .001 of Permit Valuation (ll10th°�) $.50!$1,000 VBfuation -'�-��i $1275 per SAC Unit 55.00 (State Licensed Residerdial Contractors) Alt. "A" or Aik "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreemer�t Necessary C] NM Necessary [ 7 .� C9.r � c-� � � � � � � t � i Z f d 7 Q � L � � c `N Z �'/ � � n � y, � � � M m a � C � m O � C L � � 3 � � U y U N t .. � lp OCt w L � � .� � c . � � � � � 2 m m 'o d � Ppp � m C U y Q .s�p R t �p U 'C C U a �c � W a . m .. c _�.. _�. -. �o:�� m ; 'p c E@g,� D � � b � L O � C m V c d � �'a,�� ?� � O � �' m �u w 01 a � �' v � � ` d L a c c F- h co m O N M M O � r N S O Z W �v � � F- � � � Wa � � �� J a ui - __ :_ � _,- ¢ � --z 8( � ° .� �� o S. .o O � 2 'i� Q F- ¢ M W ° o U V � 0LL1 V, } � Z ~ ? m Z o � � z F � � O m w a rn O � 0 0 0 0 0 o a o 0 0 0 0 H0 0 0 0 0 0 0 0 0 0 4� 0000000uiuivioo .Q �_....- .-_�_r.r_r s-<nso.c!i_�_� . � u��aer�usvsuiu�wusv►�+s� Z I I I I I I I I I� I I? N i (/1 'a W d � '� � c °� � � 2' lL C � = d: N '�O ~ Q (� N X Z a`� c � c� W. � > � � � "c' m 'vc, � .c�i '�" m m � t n' Z �� y� m� m v m m � m o Gl � a � O m � � ` _ = N �` � � d a d o R m>;>; m m m N R ❑ C lL .�-. O C r --<�° °o tn � O �s-- � I � J 0 U Z G a !-° � n LY Q Q �. � 0. O 2 W � O � 3 O � � � � � � � O a� Z d LL 4 � c � j a W "- .0 s O N p, �-- o F c � N _� J � m w Q a Q 1G71 v>I N 07 `m U � � N N �� v3 W W ll.. Q 0 F- Q � w J m FQ- O Q Q �f O N Z � U W � U � � � __aw- � W 0 � � a LLI m J J S � � Q Z O y � m � � Building Inspections 763-572-3604 763-502-4977 FAX �6b - (t�5114 - 08 %�.,r� Tec `�1��-.Q6 Che�k-�_ lb?� BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY DATE YOUR E-MAIL ADDRESS srrEnnDaESS 1q� Q�lpniQ� L1� �� T[-IIS APPL[CANT IS: ❑ OWNER C�ONTRACTOR TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE STATELICENSE ❑ SINGLE FAM[LY/NEW CONS7RUCITON ❑ TWO FAMILY/NEW CONSTRUCI'fON PERMIT TYPE ❑ BASEMENL FINISH � ROOF ❑ DEIX �SIDING DESCRIBE WORK BEING ROOFiNC NUMBER OF SQUARES _ GeLR9GRS PROPOSID SiZE: PROPOSED HEIGHT: SIDING ❑ v;mt ❑ Alumi�um 6�ther� WINDOWS INEXISTINGOPENINGS �Yes ONo OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & FEES Permit Fee Plan Review Fire S�rcharge Surchazge License Swcharge SAC Chazge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due ❑ ADDITION ❑ REMODELING ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACI-IED GARAGE ❑ DETACHED GARAGE Permit No.: Received By: STATE�,NZIP� �zt FAX EXP DATE � I O ❑ DRAIN TILE ❑ OTHER BASEIv1ENT REMODELING Si36MTT: t. Existing Floor Plan 2. Proposed floor plan 3. Lis[ of sVUCtural members to be used FOR NE W CONSTRUCTION MCLUDING DECKS, OSoffit ADDITTONS. & PORCHES SUBMIT: � T� 1. Si[e Pla�✓Survey showing the ezistmg structures ❑ Fascia and proposed project. 2. Two sets of consWCtion plans 3. Energy Celculations LOCATION OF WINDOWS (NCLUDING THE 1997 UBC FEE SCI � �1 "I �d S See Back Page for Fee Schedule $ 65% of Building Permit Fee $ .001 times [he total job valuation $ .0005 x Permit Valuation Minimum $.50 $ , p'Q $5.00 (State Licensed Residential Contractors) $ $1825 per SAC Uuit (Plans to MWCC for determination) $ ft+6ft= ftx$21=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ � Agreement necessary ( ) Non Necessary ( ) $ i � Make checks navable to: CiN otFridlev Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply For a building pertnit and I acknowledge [hat the informatio� above is complete and accurate; tlta[ [he work will be in conformance with the ordinances and codes of the City of Fridley and witH the Minnesofa Const�uction Codes; fliat understand this is }wt a pecmii buf only an application for a petmit and work is not to start without a pemiit on sih; that [he work will be in accor(da�nc�e, ,withy te apprgved p n in tl case of all work wfiich requires review and approval of plans. � SIGNAT'URE OF APPL i� LY 1� `� � PRINT NAME {��q � 0 Yl(S� IL DATE� ".�7T/ i APPROVED