The URL can be used to link to this page

AF - 45679Village of Fridley, Minn. BUILDING PE1tMIT N O 8 g 0 Odfice ot INSPEGTOR� OF BUII.DINGS `w : �� . � owner L.� .. ,�t;. ,�:-�r�..-ti.a....�..-r�.,, . \ / t' Architeet . ..�J.� � Fridley, Minn.� , ��%�"�'G r %f... , 19,� `��'�:,.: Builder LOCATION OF ;BLTII�DING [ 1 �Y No. � d C: Street ��'y-6-;� .,: -t� !�..0 part of Lot Lot Black Addition or Sub-Diviaion DESCI$IPTiOI`P OF BUiI.I3ENCa ,, Front ' Depth � Height Siories - Manner of Construction ` " � "� � � Tb be used zs_ ` "� '`� To be completed �� -� Estimated Cost .'-f:i,,.,....,. �, � ��}�j ! r ff Permit ie hereby gra.nted to �-'""f'�......t�• !��,,,.-•..�-,�,-Y.�,..t_ to il�� the bulld3ng� �`��°� J described fn the above statemeat. This permit is granted upoa the express conditton that the peraon to whom it ia granted, and hia agents, employees and worlmien, in all the work done in, e.round and upon satd building, or any part thereof, ehall conform in all respects to �the ordt- nances oE.Fridley, Minn, regarding the construction, alteration, maintenance, repair and moving of bulld[ags withla the city limits, and thie permit may be revoked at any time upon violatioa of any of the provlsions of said ordinaneea. � � �,, ��{`"'" .-.`L,�.�d'�'"�-�—�n'c�'ector of Buildings. AGREEMENT AND SWORN STATEr�TT In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of the ahove permit, I hereby agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Fridley, and, being first duly sworn, I hereby sta.te and say that the facts stated by me and contained in the above permit are true as therein stated. . ;.,' �: . , ,,. ;. „ . . ,, �_ _ - Subscribed and sworn to before me at Fn'c}ley, Minnesota,_ � `� -�F day of `% re2�:c:K: a.D. 18.. �`f C.-�•�.� ..,. 1-,',�=stiG .�.__.,..� r �/ % a � � � sue.EU � � - � � . MI7 NO. ,� Cit of Fridley 572L�ep�TME7WIN5 gUILDING PERMIT 283s9 , . RECEI NO. � � �� COMMUNITY DEVEIOPMENT DIV. r ��' PROTECTIVE iNSPECTION SEC. 7`S7 � r r � � /•"t � CITY NA�� FRIDLE� 551�2 Mu4�Ea �EV O�TE v�GE OF �a�ppYEO Sr 1'""'� � �'� 612-571-3450 9t0-P�5 10/23/98 � � lOB �DDRESS . 500 Glencoe Street NE 1 LEGAL �OTNO. BLOCK � TAACiONADDITION . SEEATT�CHED oescn. 59 & 60 1 Riverview Hei h SMEET 2 PHQPERTYOWNER MRIIADDRES$� 21P PHONE Carol Evanov 7 CONTRACTOR MAILADORE53 ZIP PNpNE LICENSENO Ma le Rid e Suilde — � ARCNITECTOADESIGNER MAILAOORESS ZIP VNONE UCENSENO. 5 ENGINEER MAIIADDFE55 . 21P PMONE LICENSENO 6 USEOFBUILDING Residential 7 ClA55OF WORK � NEW ❑ A�DITION ❑ ALTERATION ❑ REPAIH ❑ MOVE ❑ REMOVE B OESCRIBE WORK Construct a 24' x 24' detached ara e 9 CHANGEOFUSEfROM TO STIPULATIONS See notations on plan. ��/! v Provide a hard surface driveway. ��7g�jh� E�� fdl a�i ut�lf�y ie��t�nr R��U��2� �Y LAW TYPEOFCONST. QCCUPANCYGFOUP OCCUPRNCY�04D SEPAR4TE PERMITS AAE REOUIFED:OR ELECTRICAL, PIUMBING, NEATING. VENTI�ATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL RND VO10 IF WORK Op CONSTpUCTION zONING SO.FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 OAYS. OR IF CONSTRUC710N OR WORN IS SUSPENDED OR ABANDONED FOA p PERIO� OF 12p DAYS AT ANY TIME AF7ER WORN IS COMMENCED. NO. OW4G. UNITS OFFSTREET PAPNING I HEREBY CERTIFY TMAT 1 HAVE pEAD AND E%AMINED THIS APPLICATION STA�L$ GARAGE$ ANDNNOWTNESAMETOBEiFUEANDCORRECT.RLLPRO�I510N50F�AWS yp�UATION SUaTA% ANO ORDINFNLES GOVERNING THIS TVPE OF WONK WIIL BE COMPLIED WITM WMETMER $PEC�FIE� MEpEIN OF NOT. TNE GRANTINC OF � VERMIT 10 944 S.�iJ DOES NOT PRESUME TO GIVE AUTNORITY Tp VIOLATE OR CANCEL THE pEpM1iFEE SACCM4RGE GROVISIONS OF 4NY OTHER STATE OR LOCAL LAW PEGUL�TING CON� TRU P THE '� FORMANCE OF CONSTRUCTION 1]/{. ]rj Fire SC $I0.94 : `— . PIAN CMECKFEE . ! AIFEE ��i_�✓i 0�' � Licen 5. 146.16 5� unEO�CON-waGi0A0Aao1e0A4E��GEh� iD�iE� E pR VALI T D TMI$ IS VOUA PEAMIi - ' /v-�3 'S'� $�GNaiVnEO�OWNEAn�OWNfABU�lOERi iD�16 9l w$o DaR NEW [� EFfective 1/1/9% ADDN [ ] CITY OF FRIDLEY � ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 p, BUILDING PERMIT APPLICATION ,��'yj� ``(��, ( � ) _I�-- � v._�Q � ConstructionAddress: SU b �C � n� Cd � SZ� - e�' • � . i-- i2 �a � �' � / Legal Description: Owner Name & Address: C��o � �✓A r� a✓ Tel. # �� C�� Contractor. �%� P/_� � i(J 6'-� ��.�1 �-Q�j MN LICENSE # o� ��/ � 7�— Address � 6r(7 T-t�N (c5 �� : _J.:_Sftrl7rr,/lA/✓, ��`aTel.{iC1��2I 'f¢�F'�,3 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIP'PION OF IMPROVEMENT LIVING AREA: Length Width f� Height � GARAGE AREA: Ixngth '�� "T Width o2� Height � DECK AREA: I.ength Width HgUGround _ OTFIER: Construction Type Sq. Ft. Sq. Ft. �S j � �i � Sq. Ft. S�'� �i Y '`�"lo� �'Y�`• "" -21� Estimated Cost: $ '� (Fee Schedule on Back) Driveway Curb Cut Width I3eeded: Ft. + 6 Ft = Ft x$ _$ DATE: D f J i �APPLICANT: `� � � �_ Tel. �� f yN - �� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Cantrol Park Fee Sewer Main Charge TOTAL STIPULATIONS: CTl'Y USE ONLY $ �, 7 Fee Schedule on Reverse Side $ /b�9'� .001 of Pemut Valuation (1/lOth%) $ ��'sl7 $.50/$1,000 Valuation $ �� $1000 per SAC Unit $ <<j—. DU $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ J Not Necessary [] ��L��° f 9l0- /(o �� . � �. �� n �" � ✓ � � � � � � � � � � �� 1.. d f V ` � �J ` � � �• 3 Y m; 1 -'� .'�. .. ' .-.. `.�^ q � � V' 3 .6 0. Y . �� J ' �?,:. ? � " '� o � � J w a�� 11 II il �I II I� u �°� '�� .... ��. , � � u g a ti_.: _`� ' O .�J� .'. . �. .� .�. _' .. . . � . � o � o � a g � g � N J Z o � r'=�•y g'-z . �;4, wy < i a i G � � � � � � Q� � � -�� .� . . � 1 Y X% X X X% fC Q� 1'�' . U .� -� ; �1 � ' ` - ` y„ \ � ` _ ' . J ( � Vv 1 : ` A �0 � ) �0: �� : � ✓1 � � � � r . b _ W �' x�, .� J �4 {'� 7I � � � � � . � i "«� ° `! al . �� a � } W o � pW' � z �,`�"�. 3 � i � �,O . . . ��....� �. �� > 3 �,� u u n u i n u N '� � S § - � ' `� �... �� ' .. : _, . . .,�. � x x x x . x x . . :�_ _ _...; _,_ . • .,__ � ';.. _.. j__,� . . . :_ . o � z � , r , . �;-.; . ; _ � . .� . . ,- . . _ _. ., ,. . _ . _ .. .. , � °o '. � �._ _ . _ '�.. . _ i_7_ t_ � . � o • � . f , ...M. .,. .... . F , _.. V ' u . . ?_ _ _ ..�.._� . . r � . t a- [ �� e �_ i.}�.� i ._.. �. � 0 � '. - , . . . � � `9 . . � '- i . .�_� � � ' , . - �7 II II II II It II II II � � ��.. ' ac ac �c x x x x x'�� . �:.., z �... 0 4 �. [ y � , Z r 'L� �„ � O � � s 0 C 1 $ � d < a _ o � 0 1 a � � �I: _ , � � o < � W — 1�■�� '� w � � � -3 = �1 3 ��e�e I 1 0 .�� _ H. H. BRADLEY �� o ��o� LtY �l�TM AV[NU[ f011TN �. MIINf11101JR=MOOfI�00 7LMi7M � �G!' �,� a ��.' �,E•' � %� N% .S � c,•rv c y 72. � � �E'i��r c��/e a?cl, � �: -� � 7 � �� Ay:;�� . �' �.� � � , v C IeM c a e .�t. �, � � , � ; , r so` � ��' ' � � T RoYoSEb MN o„�� I ,a� �� •� /� \ � . a ��. �:� ` `., , . ,. o ',�\� . •\ � � � .,. ` �. •\ o \ � . �. \ h �� . � /O +� ,9ti. �. : s.. e9 �' �;�; ✓,...a`�: �, �� . � 0 w � . � z� � � i Q o I � � - ' � 25 � � � 23� . _ 30� .5cafe /" = 2a' o benofes property cor crs ----- --_a...,..,, .., ., !` � � � �� r D � �0 � � r � � .��. �,�j(. � � r ' � a � .� o v � �^'� . Q � iy i� � ,3 y � j .o .L w`1 � , � i �� '� � � C .� � ,.�,-� } Y c a � �` ' :r v � � p�� a ' �'� � � � v a^ 3` � � 1 �� r � � � � � —1 aS. � 4` �Vi.. o -� ��'. ��1 J � 1 �� 1� v, 1 � � � 0 � i a C7 "� � � � '�\� � � �i,�,, n �4 •penss� uaaq sBq 6ousdnaop �o iTe axn�ons�s p�ae pua :panssF __ . _ _ _ I. _ _ _ _ __ -- ....� _ __ _ _ __ __ -- ---___ __ _ __ _ _ _ _:__-- __ i�- - - _ _ - _ _-- w- _ __ _ . � _ _ , _ o � --_.- - __ * _ _ , o. __ . �_-- _ __ _ _ _ _ _ __ - c�l � _.__ _ _ - � _ -_ _ _ , _ _ - - _ - _ . __ � �, cv --- -- _ _ _-- _ _ s� _ �. _ -� _ l .._ ir "�1 - _ _ _ __ _ __. _ _ _ � � �� -- __ _ .__ . _ .. _ c�,,, _ _ _ _ � .. _ _ __. _ ' � _ �i- .� - -- __ . _. . . . . ._ _ h _ . . . -. _ - -- _ . . . T .., . . �.. �_ ___ � . _..__ _ ... _ . . . _ _ .. ... ._- ` � � O � _ ___ i _ _ � _._ , _ C__�j .. _ _ -- _ _ _ _ �, � _ _ .. _ _ _ __ _ _ _ _ t� . _ _ '�. . ��-- -- _ _ _ _ �"'�..._ _ _ __- _ _. � - -_. . _ _ _ _ _ -- - _.._ ._--- ; ; __-- -- --� ---- -=- --- --- _- - __ i ; , , � � ; � _ ----�- �--- ;-�_ � - - - - - + - � ----- - , : - I � � , , ; , , _; � ; , ; � i , � � ! �._.�_ �__�_�_: __ i_ __ i I � � ' i ' ! � � i .i � � � � . � i I � � ..:__ . �:� � ; : , �._ __..__ ,._ i _...__ . _._.r. . ._ __'_ _ __.'-r_._' i ._-----.__ ' , , I . .. i � , .. . : , � , ; ��. . � ; . . , ---�-- - - -`--._.- ------ ' __.__r �...._._. , -'..-- ---:: r- � ...---------, . �, � � . � �. . �. . : � , , . . . . , .. , � ----.-�-j _. _. ._.---- ...--�--�- � �--�------------------------ � ------�---'----_. .. _.- -�-- ----'._._-'---.'_-.. ... _.•_--`-----'-�--�`-----_.�----- - � I � .. ___-_ ._.____-----------_?.� .. __ _.. _, ... _ ...._... _--_..____.---..._ .______._._._._._._._.__--- ----�-� --_.._. � -- -. -.. . . . . _. . . .... _. ._.. _ . . ._._ . . . _. . _.. .. _._ _.. _ . _ ��' � -- .__-- ----... _ w _ _ ___ _ _ - - - - --- - . . � __ _ _ _ __ _ � �. ___ __ _ _ --- ___ _ -- __ � . _ . _ _ __ _ _-- -- ______ ,� ,� - _ - - -- -� �; _ _ __ __ __ __ _ _ _. _--- - -- � �� _ _ _ _ ' � � _ , _ , __ _ _ __ _ __ _ _ _--- _ �° o � : _ _, __ _ =-_- -- __ - --,� - ; _ _ _ _ --- ;� � _ - - - -- � _ _ __ _ � - _ __ � _�� _ _ __ __ _ _ ___ __ __ _ _ ___ - -� � �c _ _ - � - -- -_ _ � __---- _ _� _ __.___ _ __ -- ------ - _ _ �. - , _ _ -- - __ _ _ �- _ _ ___ � _ _ _ -- -- _ ___--- __ _ _ __ __ _ __ _. _ _. _ __ _ _ ____ _ _ __ _ __ _. __ _ ,� � C9 � � � � O , /� ) J \V � "Y � y v � 0 � �� 'r,:'� T V) �� ,'! I li (/1 -'�''"� � � � � � � � � � : �. � ., ' �� CU, r� x 44 h �, -#{ o � �� 7 � � � � r.�� Q_�� -� �, � � � .� � � � o � � w� � .: .� ��-� ,� = � `' � J ,74 t\:\ s Q o �� v - . � � n�� : -�;, �� 4i - � � .l` � � � U � � � - �� . ° ^� � � �C y K _` Y � �n � _ �� 0 C � U � � K� Y � .. . .. i v G �� 1- � .� � - O1 y G � � � �_ � � � j 2 � - � i � _ v � � � _ `y _ �,X � ��1 �b � � Z �� - b �:_�. b � � � Z o_ _ � �Gq �� . � �_J...J� _ � \ c �, c � � _ _ , ,_ i__ __ ___ _ _ _ _ _ .___ ___ ._._ __ __ _ � _----___-----______._ _____ ._ ._.._____ _____ _ _ . __ -- _ __ __ . - -- -- -- - ' ' � _ _._._ -___ - - _ . _ _ , _ _ _. - - _ _ - "� - ------------__ _ ---- --- ---- _._ _ _ o__ _ _ -_--' _ _---- -- _ _. _ -- -- . . _ _ ---- �'t-- -- ----- - --- -- =-- _: ; --- - _��. E' _.. _ - - - - . : _ ; _ __ _ _ _ __ - -- �- .� _ - _ _ _ - � ---- ---_ __ _ __ � . !-._ _ ��_ _. _ -- � __. ��U . ..._ _- _._ _ . �--`� -- - ----- ---- _ __ _ __.. ;r._ ' _ " _ . �r._._I!� ---- __,—,_ --- _ � ; _ _ _ �--- - , a - -- _, ___—__-- -- ----� --- .1_ _ � _ _ _ _ . _ _ _ _ �o-_ a J �� i . . : . _ _ _ _ _ -- - ___ --- __ --- -_ ... _ _ � y,� � \ , -_\. �:-� __ -- _ ____ �_: �i a _ .� - - _-- - � � Q �' ---- --- �----- --------_._.... .�.__._'...� � -- _ __ - I � - .�l -- -- — _ ___ __ ; ''�t ! .. _ _ _ _ i �- --� , ��. - _---- ---- — ----- -- - ---- _ � �, ; i-- -- -- ---- ------ _ __ , _ __ _ _ . - x _ -�— - � -��---- ---- - -- _ ._I. _ : _ _. _ _ _ _ _ _ ,�-- � - - -- ----__ -- - --- _ _ _ _ , . _ _� ..__ _ . _. __ . . _. _ _ . __------------------- LG -�... _.___. , _ _.—,—_----- ---- -____ __.._._ --._. _ _ _ ------------ - , __ . -- - - -- - ! � _ ___ _ .. - , .___ _ - -- ____--- -- - ;__- -___. .._ , _- __ - . _ _ ._. � , ,. a, -- _ . _.�_ �. �_. .. __. , _ _._ . _.... _....__ ._. .. ... . ... ___ _ ... �" _ - • � � � _ .. .. .._._.._. . _ --�-- -.- --= - - - - �---- - - -- '. � T_�-__i_ _ . I -r i . . T j_�-� -•--r : i , -r--j- ,-T— . i . . �� i i � � I� � . � ' . '' � i . � i i � __ ._.� . __'�__ i ____'— , . .-_r-r_-i . __r'._;'_-! . .___'.. _"�- .. , _' , '— . . �. � '� . � � - - .. � . . � . . i � . � . ..__"'-__ "-_.._._ _.-.. _.._' -_' _'_ ., � ' . � , I . ,-T I . . ' �'-____ —'__—._"___—'-•_______._'- i � . . . . � i . . � . . � i � .� I � i � �. . .i . .'__'_ "-.-" _.__ _'..- __.. _.._ . _ _ . .. . I . ' _ _�_�� . i i �_ � • �. � ' . . i � . . i . ' . .... .. .......... . . . _ . __._ ._. _.._.. . _ _ _ .. _.. -.__... . ........ ... �� .._� ..._.. �..__.. ._. ' .:. ._ . . .._ .. � . � _. ... ... .. . �. ._ .. ...... ._ .._. ._ .. . _ .. . . . .. � � . . . _ . .. . .... .... . . .. . . .. ... . . .: . � . ._. � . . . _ ._..._ ._ . _ . _. ._ _ .. . . . .. � . . . .__ .._ . _. .. .... � . .. ... ... .. . . . . . . . � . ��j/ ..� . . __ . . . . .. . . . 1/ .__. . . . . ... . . .. . . ... .. ..... . . . . . ... .. .. . . . _ _ . . . _ . . . . �. . t� . . . . . . . . . . .._ . _ .. . . .. ... .. . . . . .. _. . . . . _ `1 8 _ . . . . _. ..w,-q . . . . __ ... ._-_ _ ._ _ _. _.._ . .. . .. .. ... . .. _ . .. '•4) _ ..+.�. � _"._ ..... ._ _._.. .. .___ ._ .._.._ ._.. ..... . .. ... _ . . . . _. . ..... YF . � __.. .. ._'_ _.'__' _ _ _ "... . . ..... _ ._. _ _. . . . . _ .. _ .. ._. . .. ._... ': y� . . _ .. . . . . . . . - .. _T .T,. .__.`7 _ . . ..... .---- - �- � � -- -. . . _ _ _ . . V+ , t �--- ..\v � . .. .. . ... _.. .. . . . _ . _. . V _ji,{1 _.__... ___-_ .- ___ ___ . .. . � _.. � ._ .. . . . ___ .y . . ... . . .. .. .. . . _ _\ . . ... '__' . ._._ .. __. ... � . _ � .� a .. .._ ._.. .. ___ ..__ . .. . . - _ . . .. . . . -^i,.l _ . 1 _. . . . . __ � ___ . -__ .._ . _ _ - . . . ... _ . _ . .. . ._ . � ' _. . ._ . . _ . .. . . . .. __._.� _. . . . _.. ..._ _ . .__ - .. . . .. . . . . ... _._. . ._ . _.. _. _ . _. _ . .. . .. . . . . . .. . . . .. . .. . .. � . . . _ . , . . . .. . .. ...._. _... ._. . . _ . . . . .. .. . . . . . . . . .. . , . . . . . - � _ .., � . , � . . � � we�ca - . . � . � � . City of Fridley 3 0 6 6 3 ;� •i'�E'°°°°'"E�„"5 BUIlDING PERMI � • RECEI � � _ COMMUNITY DEVELOPMENT DIV. ' / j � v � � PROTECiIYE INSPECTION SEC. /'�� ./ `_-_-� �"';•� LITV MALL . FHIDLE� SS172 MuY�EM �EV O�iF o�GE OF edvnpvEO !r t 612-571-3450 gt0-F15 2/14/00 / / JO6 ADDpE55 500 Glencoe Street NE � 1 LEGAI � �OTNO. BLOCK TpACTORA0DITION SEEATTACNED oescn. 59,60 I Riverview Heights sNeer 2 7ROPERTYOWNER MAILAODR@5$ Z�P VMONE ] CONTRACTOR MAILADDNESS 1�P PHONE LICENSENO Marshall Adams Building & Remodeling 24138 Verdin St, St Francis MN 55070 1 ARCHITECTOq�ES�GNER MAILAODRESS ZIP PHONE LICENSENO. 753-0210 20186497 5 ENGINEER MAIL AOORESS 2�o iXONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WpRK � ❑ NEW ❑ ADDITION O ALTERATION �7 REPAIR ❑ MOVE O REMOVE 8 OESCRIBE WOPK Repair leaks in roof; approxi.mately 10-20 shingles; replace patio door 9 CMANGE OF USE FROM TO sriau�arioNs Underlayment must comply with the State Building Code. TVPEOFCONST. OCCUPpNCVGROUP OCCUPANCVLOAO SEPARATE PERMiTS ARE HEOUIRED FOR ELECTFICAL, PLUMBING, MEATING. VENTI�ATING OR AIR CONDITION�NG � � TMIS PEfiMIT BECOMES NULL AN� VOID IF WORK OR CONSTRUGTIQN ZONWG 50. FT CU. FT. AU7MORIZED IS NOT COMMENCED W�THIN 60 OAYS. OR IF CONSTRUC710N OR WORK IS SUSPENDE� OR ABANOONEO FpR A PERIOD OF tp O�YS AT � qNY TIME RFTEN WORN IS COMMENCED. NO. OW4G. UNITS OFFSTREET PARKING I MEREBY CEA7IFV THqT I NAYE READ AND E%AMINEO TMIS APPUCATION 1 STALLS GARAGES ANOKNOWTHESAMETOBETNUEANDCORNECi.ALIPROVI510N50FLAWS yp�VATION � SUAtAX ANO ORDINANCE$ GOVEANING TMIS TYPE OF WOAN WI�� B� COMPLIED @ r WITM WHETMEA SPEC�FIED HEAEIN OR NOT. THE GRAN7ING OF A OEAMIT y�SOO �•SO DOES NOi PRESUME TO GIVE AUTMORiTY TO VIOLATE OA CqNCEL TME pEqMITFEE S�CCMppGE VFOVISIONS F ANV OTMER 5T E OR LOCAI lAW REGULATING CON� �23.SO � F�TB SC �.SO RU TION TME EFF R E OF CONSTRULTION pLAN CNECNFEE �OTALFEE - t�U Lice SC $5 0 $29.SD 5� H�ru EO C�+�a� O On�u�rOARED�GEN• •*Ei WM .P L� VA A D TM�S V$ Y UA �E�i < .. ��b $�GwlVAfO�OWNEA��iOwNfABUIIpERi �O�TfI pG�NS Ilf �O ` NEw I] ADDN [] ALTER [ ] Construction Address: � Legal Description: CITY OF FRIDI.EY SINGIE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMITAPPLICATION Effective 1/1/20QQ (763) 572-3604 Bldg Insp g� 3a�G 3 , ._ ,,, ., Qwner Name & Address: 5��0 �/f `��,r 5�! ,�d/�� Tel. # E�,�- ��' -36 b'�/ contractor. �A-PS�fA// Ada.� ,. MN LICENSE #�i2/�fi_' 1/ 9 5 Address:�%/ 3is Uz� � Sl. •1. ��.�h � M,c, S,Sv�i� Tel. # 6/a- 75�3 -�bti� LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width HgtlGround Sq. Ft �a.�b f��tA�-t P�-nd' r�o�2 V Construction Type: �-t5 � �i �� Estimated Cost: S �`70 �°� Driveway Curb Cut Width Needed: _Ft. + 6 Ft = Ft x$ _$ DATE: i� AppLICANT: �G! �s�L, Tel. # �S � �u�i� i CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Pertnit Fees if mailing in application $ c2 3 �� Fee Schedule on Reverse Side $ „ �C ,001 of Permit Valuation (1/10th%) $ ��r'� $.50/$1,000 Valuation $ $1100 per SAC Unit $ '�� DC7 $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ a � 50 > � �� a ��`L ��,,� O O N C N � C O > .� W 1 0 Z 0 U W aW zZ N J a � O .� � � N Z LL � � o O}� �M ~ M ;� N Uc�otiv�i O a� N � h � 2 � m O � ¢ O F � � e � � ` il � a � � � d€ � b � 5 m � � K a ( �� w 0 U � E w 0 0 0 0 0 0 o a o 0 0 0 W o 0 0 0 0 0 0 0 0 0 0 0 r r� v ui � r r� r� o � o 0 0 � ui rn us vs us en �a rn � u9 u> r� U z �t, �'�.� : �. pz: W .3 ........:.:..::::......::�:..� F- � � c� � v � N � � O � � 8 S o 8 X m ll IL LL tL �^ N C7 d Z � m � � � a z I I I I I � � I� I I o z m .}.. � .� j U Ii N LL c f0�� Y N '�O ~ Q � (� d z d � � � °' W � � C �7 � � � � � � � � � O c N C� K F S 2 c� Z— O � � U� Q�`m `m � o LL � y y U O m m U� ci �� c7 U'� m C� � \ . � . t (7 Z m � � J a o° � � a fT �� o � 1 \�^ ^ ` C)' v � ^^ + �` 1 \ N �Q p 0 z � W �- F � � ro 0 C OI 7 � m� m O � w a z a � � � N Z O ¢ w � Q Z U Q (Cp � �n aa = W `o p � 3 � � � LL y Z O ti a � C � 1p 4W> � 2 `o a F" � 0 C J � �¢� �I ` °I � w w � J m F N U O 7 � � m � W 0 y Y Q m Z O O LL Z I-- z w � Z � � � Q U a;ed :�(8 pau6ig �O� JNI1t13H aqi�asao :SNOI1VN31'1'd — adRl w �a;aweip g yl6ua� � }y6iaH �o�auuo�;uan � aouei�ddy — ad61 w �a;aweia g y�6ua� g �y6iaH �o�auuo�;ua� Z# aouei�ddy — ad�tl u� �a�aweip }} y;6ua� � =y6iaH �o�auuo� }ua� �# a�uepddy sayoui �a;aweip �y6iaH;uan ad,tl;uan uowwo� ;ndu� n;8 �e�ol saouei�ddy �e�ol }eN �o pa;sissy ue� �du� �19 addl � aouei�ddy �1,d LeN �o pa;sissy ue j o00 ;ndul f118 ad�� Z# aouei�ddy- fJ ,M+J ;eH �o pa3sissy ue� �ndul f118 ad/1 �# a�uei�ddy uoqeuuo;u� �o;aauuo�;uaq pue;uaq uowwo�/azig pue a 1 aouei� y . ( ) oN ( ) sa� •sapoo;ua�ano �ad se R�a3e�edas pa3uan pue luan uowwo� ay; wa; panowa� uaaq sey a�uei�dde ue �a�ye �(��aLO� pa��e3sui pue pazis s�o;�auuo� luan pue luan uowwo� ay; s� () oN () sa� �saouei�dde ue�p �e�n;eu pue palsisse ue; �o� sa�qel 6ui�ua� a�ewn� �e��ua� ��Uo6a;e� yyyy�-y�y apn��ui saop siyl �suoi�e�yi�ads s,�a�n�e�nuew pue sapoo �uaLn� ay; s;aaw pue �(�qwasse pa�si� e si;i ;ey� saguan Ilqaaay pau6is�apun ayl 'wa;s s ui�uan nneu e ui��sui uayM () oN () sa,� �suoile�yi�ads s�a�n�e;nuew pue sapoa �uaLn� ay� �aaw ol Pall�isui pue pars aq ryim � ��e uo�;snqwo� nnau e ��su� o; pa�mba� uay/�/� ( ) oN ( ) sa� �suoi�e�gi�ads saam�oe;nuew pue sapo� �uaLno ay� 3aaw o� pa��e3sw pue paz�s si �ie uoi;snqwo� ui;s�xa ayl () oN () sa� �sa�uei�dde ue�p �e�n�eu pue paasrsse ue; �o; sa�qel 6ui;uan aoewn� �e�lua� � tio6a3e� yWy�-y�y apn�oui saop s�yl •suoi;e�yi�ads s�a�n}oe;nuew pue sapo� auaLn� ay� s�aaw pue �(�qwasse palsi� e si �iun �uawa�e�da� ay; leyl saguan os�e pau6is�apun ayl O oN O sa,� •uoi3euiuua3 pue smoq�a �o �aqwnu 'y�6ua� '6wzis 6uipnpui suogeo}ioads �a�n;oe}nuew pue sapo�;uaLno ��e s;aaw pue �ndp�i;se�d si wa;s�(s 6ui;uan ayl O oN O sa� •pa�mba� a�aynn paddo;sa�y pue pay�oddns ��a�noas si pue 'suo��ru;sqo 'uoi;e�ouaaap `�srv wou aau s� pue pauiwexa uaaq sey 6w;uan ay; ley� sayuan �tqa�ay pau6is�apun ayl 'a�ue�n; ui;sixa ue u�oe� a� uayM NOIlV�IdIa3A 211`d NOIlSf19W0� ON'd a01�3NN0� 1N3A 1N3A NOWWO� <"1 0 0 N -� T �0 � � � tl �� N � > 7-I � 1 u V! u N w J Z � � N W � V ~ W Z 0 7 � � Z Za J N O � V N 2 y � io_ C � ax Z U � a4 W Z �4 2 -p O �4 �a Z (,� O� ~ W V � 1 a V z a O a � i ❑ Z � H W �w � cn z m z > CV .N.� �w Tt� � n J !-' !1 � i � � � �, m u�.?�N � i. C � iD C� � T� v r, a� .-. FM'O� Ut�Oii� � �\ u • J � C W 2 w W �"' � W N � C7 Z Q J � m �� `V \ � 0 Z H � � W a � �1 � � � U � W ¢ � N w J `V ¢ H 0 � 64 tfi .�.. O O � O p M � w c� i Q � � � 3 � A � v C N N (n v N C � m U U I I N .0 � ou ' C � N £ S z O d v O R Z F-� J '6 N U N C C O � U N O 1 F- m Q U 4 � � W O Z N N � , a 2 � N E � A Z � � Q � R O H N � m m ffi 64 ffi 69� 0 0 0 O O O O O N tri w �s C ro � 7 i .� m ,1^ .,.3.. c 3 °1 Y � £ ?� U m � U �, f6 j � t6 c � 3 � 3 m o�-a � � � 'O � , -6 O � � C N +" � �jZA] � � m d � o°'o a 'D C U d �.�" �0 m m � n, � ,a i y an m � ii Q C7 (7 N N (!) ¢ m C 'c O � � i a p o U U` ¢ Y U m Z � H � v � y O C� O L O N U "' C ¢ �? � a i Q � O Q � � � `m > L p O� Q ~ �_ . R y� N � d � � L � Y U w L O T �a 3 " '� 'ti y U � � N w' U L _ � L V � L p L i 3r� � � .. a \ Q � d R �i �p � N lE Y L � N � U -O i7 � � � R H � V i O � U y L R a N .0 U a� � a f6 Y t0 Q s ° o � N � tC � �y L � � R > .' NT O � C > � m� y � � +�+ 3 L �� y � -p c j d �N m � ��.o � L R R � °''ooc C �� N y � ^ � � � � ' \ Q fL- a i i O � Efi 64 Y O � O U C t6 � a '� ¢ � O 3 C j \ > m '� o �� N U � Od0 `m L W � w � � � J N Q � � � � fn F- � U � Z Q W 2 � J U.I H a N C q0 � 0 � � � (6 0 � C !� # X 6 � 2 � � O n � s� W W � Z � U W a � Z {IA � N R Q C s � O � m v a> O a Q a 3 O L 3 � L m � 3 T � O -p T N L m a C � � Q N � U W = Q c O a 'O � C � C � U C i � � N C y O � a � C �- U m Y L Y .` a 3 i , . . n � �� -,�— .�8 ��8� � �, ' a;ed °-(/ �O� �JNI1tl3H .. ,� ��r � � - -- — ad�(1 ui �alaweip u 436ua� u 34�H �3�uuo� �uan g# a�uegddy � ad�il ui �a3aweta u--� y�6ua� }y--�r, 3y6iaH �opauuo� aua� � a�uei�ddy �, ed�(1 u��a;aweia u'�yi6ua� u:.a�l48iaH�o�auuo�;ua� 4#��!Iddb' �� sayoui �'-�a�aweip ��46iaH 3�eA —�— a�l lua� uowtuo� �du� ni8 �eaol saouei�ddy ��o�, ;eN �o palsissy ue� �ndu� �,�,g ad�Cl � a�uenddy �eN �o pa�sissy ue j—�E;ndul f118 a�l Z# ��!I�b' '�;eN �o pa�sissy ue� a.�„ Q lndu� �lg "_`�a F'7 �� ''� �l L# a�uei�ddy .,wr-i�i�ura�t�r-�l�•m== �rna�i.n�i��ulirr-z��y•ni� :.rnr-ri�ii �c.�r, () o� �sa,� �sapo� 3uwrb �ad se R�a�edas pa;uan pue 3uen uowwm a� wa; panowa� uaaq sey a�ueydde ue �aue �tp�ayon pellelsui pue paz�s s�o�auuo� luan pue;uan uowwo� atp s� O oN �sa,� �sa�uei�dde �e�p le�n3eu pue pa;sisse ue; �o; sa�qel Buguan a�ewn j �eRuaa ��GoBa�e� yy�y�-b�t/ apn�ui saop siy1, �suoge�y,peds saa�n�e}nuew pue sapa� lua�rr� ay; s�aaw pue �qwasse pa�,� e s� 3� leyi sayuan �(qa�ay pau6�apun ay� ' . �!It��? �B�IM ( ) oN �a.� ( ) oN�sa� �suogeoyr�ads s�rq�e�nuew pue sapa�;ua�irr� ay; �eaw ol Pall�sui pue pazis aq II!M .. . 03 P�lnbe� ue4M �suoge�yr�ads s�aan�e�uew pue sapo� �uayrc� ay� l�W ol P�ilelsui pue pazis si . . . 841 () oN<�sa� �sa�ue��dde ue�p �eirueu pue pels�sse ue� �o; sa�qel 6w;uan a�ewn� �e�ua� ��UoBa;e� yy�y J-y�y epnpui saop siyl �suoge�yr�ads saaml�e;nuew pue sapm �ua�rb ay� s�aew pue R�qwass¢ pa;si� e si liun �uawa�e�da� ay� ae�p seyuan os�e pauBis�epun ay,�, �oN !) sa,� �uogeuiuuai pue snnoq�a;o �aqwnu 'y�8ua� '6ums Buipn�ui suogeayaeds �am�e;nuew pue sapao;uaLrr� ��e s�aaw pue ��gse�d si we;s�(s 6uguan ey.1 �� oN �a� �pa�mba� a�aynn paddo3sa�g pue pa�oddns R�airr�as si pue 'suogaru�sqo 'uoRe�oua3ap 'isru wa� aa� s� pue pawwexa uaaq sey 6uguan aya;ey} sayuan �(qa�ay pauBis�apun ay3 ' . . �yM i�'L�1� \�N]FIt:F/�Z:11�1��1�1�b'f I1-1'1[�i�l�l��1�t=(�1NFI�'IJt�H��`F/�M�li`F/�!�`l�1h'Ih'N3� 03N21fLL32i 39l'iIM NOLLb�fldd�' 3H1 a0 S3�Mdfldd�l JNINLI(18'13f)d JNI�tl'1d321 N3HM N� 43T7�� 381Sf1W MO"139 3HL Building Inspections 763-572-3604 SJ7'EADDRESS_ Tfi1S APPLICANt I5: M�CHANICAL re`�"""�°.:�' RESIDENTIAL APPLICATION Received By:_ CITY OF FRIDLEY Dat��d;!! -K�ot � ❑ OWNER YOURE-MAILADDRESS M��KMI �r�rz � ��k!/��'i'EjUP/lfy.C,6t�- x� PROPERTY Nnn�: SAGL /fELL�f�,U �/�� 'e, OWNER/ qpDRESS SOO �s�CRC?'� �J�YU.f� �- CI'I'Y T��K STATEhiA1ZIP�� TENANT PHONE: '� L3 7�i ' HS'OS CONTRACTOR COMPntaYNnME: �1Rk�i-r�o�nf �N�6� — CONTACT PERSON: �A�l/.[ll� �/LTZ .. �� SUBMIT A COPY OF + YOUR STA'fE 57�A'fE LICEqNSE 8 EXP DATE • L]CENSEWTfH ADDRESS:13d0 El/t,e6�2Gt� B(UCt� SU� B CITY C� �ty�i�5 STATEN� ZIPSS`�33 APPLICATTON PHONE Cc /a 3X SS`�f7 . gq7t [i/a 'a3/.�3N7 PERMIT TYPE "..."" TYPE OF WORK: � �W DETAILED DESCRIPTIdN OF FAMILY ❑ TWO FAMiLY ❑ REPLACEMENT 0'fOWNHOUSE ❑ ALTERA770N/itEMODEL //J/jJ� {�( � -•-i- FER MS 16B.665 the permit fee is a minimum of 515.00 or 5% of the total cost up to 5500.00, whichever is greater, for the improyement, installation or replacement of a residential fixwre, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under 5300 =$15.00. Labor cost between $300 to 5500 = cost of labor z.OS = FOR PROJECTS WI-�RE IABOR EXCEEDS SSOD, FEES ARE BASED ON 510.00 PER FtXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OP EACH BELON� � Equipmrnt Instatled . MFG: MODEL: S1Z&BTU . . MFG: MODEL: S1ZEB7U MFG: MODEL: S2FlBTU A/C 525.00 FIR£PLACE (GAS) $15.00 GAS RANGFJOVEN S10.OD AIR TO AIR EXCHANGEER S15 FIREPLACE (WOOD) 535.00 _NEW GAS GRILL 510.00 BOILER 535.00 FURNACE 535.00 GAS UHIT HTR SI0.00 CHIMNEY LfNER S70.00 GAS DRYER S] 0.00 POOL HEATER 535,00 DUCT WORK SI0.00 GAS PIPING EI0.00 _VENTILATOR 515.00 `��R3vTi��A��'�R �JNDER�300-. . � . . � w�*.*'�`:�-'�` ` tik `�Ci'�iZ�i0t1: Pertnit Fee $�s .� Number of fixtures @$] 0.00 x$10 00 = S Surcharge $ .50 Number of fvchues Qa $15.00 _ x$15.00 = S TOTAL DUE $/$- .� Numbei of fixrures @$25.00 x 525.00 =$ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Totat = $ TFIIS ]S AN APPLICATION FOR A PERMIT-NOT VALID UNTiL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance witt� the ordinances and codes of the City of Fridley and with the Minnesota Conshvction Codes; that I understand this is not a pertnit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plaa in Ihe case of all work which r quires review and approval of plans. SIGNATURE OF APPUCANT PRINT NAIv1E �"��`/ �� - DATE Ob •OS-� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 �. REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ N�W HOMES1ADDfTIONS XISTING HOME ❑ MAKE-UP AIR � REQUIRED FOR NEW/EXISTING HOMES . ' 1. Combusrion Air (See note below) a Oil or solid fuel IMC Chapter 7 with MN Amendments --- __---1k -�iatural Gas o�Pr�anel7FGC Chapter 3 with MN Amendments • 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances IFGC Chapter 5 wifh MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUfRED FOR NEW HONfES 4. Iieat 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 sofiware may be used for combusfion and make up air calculations Building Inspections 763-572-3604 iITE ADDRESS i HIS APPIdCANT I5: r . TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE � WITH APPLICATION PROPERTY TYPE ' PERMIT' TYPE TYrE oF wo�c: �ESCRIBE WORK BEING SQUARES >ARAGES �, 'ROPOSED SIZE: 'KOPOSED HEIGH'f: � 'IDING ] VNyI � ] Aluminum , 7 Other � BUILDING RESIDENTIAL APPLICATION CITY OF FRII?LEY Ci OW13ER . B(',ONTRACTOR pxo�: Z� 3�� ? - 3 Y�'7 NAME: "�'-' ni- n�iiic �ci vi�c�, ui�. srA�u<2690 Cumberland Pkwy, Ste 300 ,,,DDxrss Cumberland Office Park Atlanta, GA 3 03 3 9-3 91 3 Lic# 20268257 Ph. 763/542-8$26 ❑ BASEMENT FIMSH ❑ AOOF � DECK ❑ SIDING , VIATiOWS J EXIS7TNG OPENINGS�C es �No ��R FOR NEW OPENTNGS DESCRIBE SiZE OF ' �?ENING CHANGES & � .. lau Review urchazge :re Surcfiarge icense Surcharge AC Charge nrb Cut Escrow rosion Control azk Fee �wer Main Charge ❑ HOUSE & GARAGE ❑ ATfACHED GARAGE ❑ DETACHED GARAGE �Soffit ❑ Trim O Fascia LOCATpNQI ��WS �5 � -r- NUMBER OF WII�IDOWS I . ALUATION, WCLUDING THE COST C t 997 U.B.0 FEE SCHEDULE) 'i. �� nnl-rtro x nrr� $ i. [ $ � , l. $ 'rj.GO $ $ $ $ Permit No.: Received 3� RS�_(3Y5-(.Oy7 . � CITY STATE ZIP ❑ DRAA1 TII.E ❑ OT1�ER I:[�7(e7:11 BASE]v�1T REMODELING�SUBMIT� 1. Ezisting Floor Plan 2. Proposedfloorplan 3. List of strucnval members to be used FOR NEW CONSiRUCTTON INCLUDiNG DECKS, ADDITIONS. & PORCHES SUBMIT� 1. Site PlanfSurvry stwwing flw existing structures end proposed projecc � 2. Two sets of conswction plans 3. Energy Calculations See Back Page fos Fee Schedule 65% of Building Permit Fee (.0005) times the total job valuation — Minnnum $.50 .001 x Permit Valuation (1(1�%) $5.00 (State Licensed Residential Conh�actors) $1450 per SAC Unit (Plans to MWCC for determination) ft+68= ftx$20=$ $450 Conservation Plan Review Fee Determined by Engineering Ageeement necessary ( ) Non Necessary ( ) Make checks paYable to: City of Fridley Attac THIS IS AN APPLICATION FOA A PERMIT-NOT VALID LIN'IIL PROCESSED hereby apply for a building permit and I ac}mowledge that the information above is complete and accurate; that the work wi11 be in mformance with the ordinances and codes of the City of Fridley and with the Minnesota Conshucrion Codes; that I understand this is not a :rmit but only an applicafion for a permit and work is �ot to start without a permit; that ffie work will be in accordance with the approved an in the case of all work which requires review n approval o€plans. ��' J, (� � % GNATURE OF APPLTCANT 'I PRINT NAME l(� S L/)��1 [C AATE 7 T( t V