AF - 46156�
iJ
City of Friclley, Minn.
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BUII.DING PERMIT N° 3453
�j_ -�� �.�/
Date�: . �Y.....� ................�......... .
Owner . . . .. .. . ... .. . . .. . . .. .. . . .. .. . .. ... . ... Builder .�'!{r!!icq % l�/�'�'� �� .
... ...................... .. ... .
Addreee...................................... Addrnss .............................................
LOCATIOiV OF BUILD[NG
No. .it ��"!. Y. . Street . . � . . . . . . . .. ..�./.4tdC .. ... Part o Lot . . . .. .. .. . .. . ... . . . . � D
y .�.../J .. . . .
Lot . .iJ. . . .. .. . Bkack . . . . . . � .. .. .. . . . Addition or Sub-Division � �i/rl�sep-!1. � ••�.
.r ... (. �.. .. . ....
c�r �c . . . .. .. .... . �ae �t . . . X,.. ..... secn�x 3�. `� . s�aer�a . /. .Q. .: �� . ... . . . .. . . .. ..
DESCRIPTION OF BUILDING
To uaea a,: _ �p� G
. �.�:,�, .. �,t . ya: � � � Si.o H�t � ,�/�,� d � S4. Ft. �Q.YO. . Clt Fk �.7. �: ��
� �. ,
........ �rat ./.5!..0. ne�n ��-g x�bt /.Q: �" sq. Fc. a.9.`�. � Fc .�9. .Yti
Type o Constructlon ..!':�:/�t!K.,�... f`t Coet ..................... To 6e Completed ...................
In oonaideiation oP iLe is�ance to me oS a permit W camstntct the bullding desribed above, I agi�ee to do
t2� propoeed work in accordance with ihe desQiption above set fo and In c�Pllance with all provuioms of
ordinences of t6e city of Fridley.
.?t ..... ............�:. ���L�e�........
Ea conmderation of the payment oP a fee of ¢. .°!:� . .` .— Permit is hernby granted to . .. .. .. . . . . .. . . .. . .
......................... to construct the hu11d'mg or addition as descrlbed above. Ti�3a permit Is 8+'�ted upon
the exprnas condiUon that ffie person �to whom it b gianted a� h1s agents. employeea end worlrmen, in all work
done in, amund and upon said bvllding, or atly part ffiecmi, shall conform in a11 respects to the ordinances of
FY�id1eY. Minnesota regaz'd1n8 local3on� crot�sh�ici5am. atteratlon. roa3ntenance, repair and moving of bulldings with-
in th¢ city limits and this� permit may be revWced at any time upon vlolatlon of any of the provlsiona of said
ordinances.
� ! �
.. �.. Building Inapector
NOTICE:
Thk pe�mit does not cover She conatructlon, installatlon o� alte�atlon fo� wl�ing, plumbinp, par heaUnp, �
�we� or water. Be suro to sea the Bulldinp Infpector fo� separate permlb fo� lhws items
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STPtJDPAD HEPTIhlG & PIR COPJDITIONING C0.
SERVINf THE TWIP� CITIES SINCE 1930
HEPT LOSS CALCULPTIOW FOR OSTLUNDiq5770 NPCKMPNN AVE.�JE
Fti{iiA'iMIIWfM1i1�41NSAW1 "rVY�19HYYdAI�1+A4SNM��Fi1WIY5R1i41WI�yMY�WWTIM13�Np1�1RN1lMNMf�N�FWN4MMM411AN �iqWO�IMNIY
h�PIhJ LEt;GTN 41 WIOTH 25 HEIGHT 8
q�NiWIN�tlWtAfA1�qINlNM�IfMW�ILMNI�'dlWNARA 1M��M�ti+IW9lMaey��iPl4idrn�ldM�R4�iMK�X�{Nf/flqH�AtAWtpWA�IRqq#
WIP:DOtJS & DOORS <a CRPCY.PGE PtdU PREP
WIDTH HEIG!{T PJO. LIhI FT PREP
FIO. PPNE PP�JE LIGHTS CRPCK SQ FT
1 42 43 1 16.5 16.9
2 20 48 1 25.7 17.7
6 28 20 2 94 61.3
2 23 2U 2 31.3 20.4
-- — � �� �6— _ _ � __ �3.3 3.�� _ _
1 36 80 D 19.3 20
1 32 80 D 18.7 17.8
COEFF
IPJFILTRPTIOIJ ................. 218.8 20
GLPSS.............................. 161.5 50
EXPWALL ........................... 132
FlETEXP WPLL ........................ 844.5 11
DELOId GI2PDE...... 0 ................ 0 5
CEILING ............................. 1025 11
FLOOR............................... 0 0
VEPdTILPTION...... 0 ................ 0 0
TOTALBTU .................................................
DTU
4376
3075
9839.5
0
11275
0
0
33565.5
II49W�i2! N'L11446MNilii�qM41N59A%F! 1?IFMN NM iwl�N �hiHWM L1tAWM.11!1Nytp �TNIkHH �MtiiM�141M1�k1V1 iNN4WW1A�itlNvINNNIi
E3ASEt�tENT LENGTN 41 WIDTH 25 HEIGHT 8
�+�4NN�inV�I9d��1�l�awiai+NMil�+s�a�u�Wpl�wa.Fi9��tAi�C+Pi:�MM6�w4NUHMU9�kuJ�ifi�iAd?fal;ilwi�WyMiN1�FtSi�Skr
WI�VDOldS u DOOP.S n� CRPCKPGE P;JD PREP
WIDTH HEIGf1T IdO. LIN FT PREP
P10. PPtJE PPN� LI6HTS CRPCK SQ FT
G�EFF
BTU
INFILTItPTIOPJ ................. 0 0 0
GLPSS .............................. 0 0 0
[XP WPLC" _ � 13'L _
....................... ...
iJET EXP iJPLI ........................ 0 0
QELOVZ GRPDC...... 8 ................ 1056 5
CEILIN6............................. 0 0
FLOOR ............................... 1025 3
VENTILPTIOII...... 0 ................ 0 0
TOTPLI3TU .................................................
0
5280
0
3075
0
8355
6288 LK
132 R.FT
132 R.FT
TOTPLf3TU OF PLL ROOhiS/FLOORS ....................................... 41920.5
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BUIICIIIIg
Inspectia�s .<
763-572=3604
DATE � — �c��—
S[I'EADDRESS�_,LL
THIS APPLICANT IS:
PROPERTY OWNER
TENANT
BUILDING Pemrit No.: '�`
RESIDENTIAL APPLICATION Received By:�
CITY OF FRIDLEY �te xec'a:L
OCONTRACfOR
ettoc�: 7G3 >B6 �572
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Building PLUMBING Permit No.:
Inspections RESIDENTIAL APPLICATION Received By ����
763-572-3604 CITY OF FRIDLEY 1�at� '�i. )
narE Julv7,2007 YOURE-MAILADDRESS wnelson�larsonplumbing.com
S[TE AbDRESS
THIS APPUCANT 1S' ❑ OWNEA �CANTRAC70R
PItOPERTY N,�: Jean Stephenson
OWNER/ ,,��5 5770 Hackmann Avenue NE crrr Fridley STATEMNZiP �J.�Z
TENANT pyo�: 763/786-8572
CON'fRACTOR N„n� Larson Plumbinsa. Inc.
SUBMIT A COPY OF STATE LtCENSE q 3341 PM EXP DATE 12l31 l2006
YOUR STATE nDUxsss: 3095 -162nd Lane NW c.�rr Andover srarFMN zte 55304
LICENSE WITH pHONE 763/427-7680 FAX 763/427-9448
APPLICA710N
pER�.1y.p$ WSWGLEFAMILY ❑TWOFN.IILY ❑7'OWNHOUSE
TYPE OF WORK: � NEW � REPLACEfvIIT17
DE7'AILED DESCRIP'CION OF WORK Water Heater Replacemeni
PER MS 16B.665 the peimit fee is a miaimum of 515.00 or 5% of t6e total cost up to SSOD.DO, whichever is greater, for ihe
improvement, installation or replacement of a rosidential fixuue, excluding the futures. (This should roflect only the cost of labor )
Labor cost under 5300 = S15.00. Labor cost between 5300 to 5500 = cost of labor x.OS =
FOR PR07ECf$ WHERE LABOR EXCEED$ 5500, FEES ARE BASED ON $1 �.DO PER F[XIVRE, EXCEPI' WFIERE NO?SD. flXTURES: (INDICA7E T07AL
NUMBER OF EACH BEL04�
BATHSiNK/IAV FLOORDRAWS SHOWER WATERPIPING
BATHTUB GASPIPRJ6�[m'Lrc&rsaj SWIMMINCiP00L WATERSOtTMER(S35)
CLOTtIES WASHQL KiFCHEN SINK WATERCF.OSET BACKFiAW PREV. (SIS)
D15NWASHER _ LAUNDRY TRAY X WATER HEATER (S35) FOR IRRIGA110N .
. WATERMEfER OTf�R
:Y r:�'�iF+LSCV:�" .P��l.t�;.'': . ..�,iTY *i`",��..a�. '"r,"�i �•�'�i..,.�Y, ,.$r�l.:��'c�.i���L„�'Q���JL.V'1J�`VYOA:i�Q��::
Permit Fee . $��_.� Number of fixtures (a� $10.00 _ x$10.00 = S
Surchar e .50 Number of £ixtures Q$15.00 x$15.00 =$
'f'OTAL DUE $��.�Q Number of fixtures (a3 535.00 x$35.00 =$
State Surohazge � S .50
Total = S
T}{IS 7S AN M�LI,^,ATION FOR A FERM{T-?30T YALID UNC]L PROCESSW
I hereby appty for a building permit and I acknowlodge that the information above is complete and accurate; that the work wilt be in
conformance with the ordinances and codes of ihe City of Fridley and with the Minnesota Conshuction Codes; that [ understand this is
not a permit but only en application for a permit and work is noi to start withoat a permii;j�at the work will be in accordance with the
approved plat� in the jll w rk which requ+'� review and approval of plans. }'� ��!' �� /' � Q� �� ��
\,// i �t Y2 I 7/6/Q7
SiGNANREOFAPPLICA � I�,rs�(� PR1NfNAME Wendy Nelson onre
'.��IYLSf.�ilL'�� �[.VI'Yl .:..:. .. ��".t'9l2.1[Jl{b�£�li! ...a�` , e •�...r. .�;:iV1L.U11J]I`11V`.�Y'11.����'w��F�:
City of Rridley
Building Inspections Department
6431 University Avenue NE, Fridiey, MN 55432
763-572-3604
FAX: 763-502-4977
Building
Inspections
763-572-3604
STTEADDRESS �
THIS� APPL[CANT IS:
PRO�ERTY OWNER/
TENAIVI'
SUBhIlT A COPY OF
YOUR STATE LICENSE
WITH APPLTGTION
BUILDING
RE5IDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR
YdOWNER �CONTRACI'OR
SCATEIdCENSE# E�DATt
ADDRESS: CITY
PHONE FAX
�-SWGLE FAMILY/NEW CONSTRUCfION SIZE
❑ TWO FAMILYMEX' CONSfRUCf70N S7'ORffS
❑ADDITION ❑GARAGFIS}Im �WQiDOWS
�BASFh1EN'1' FINISH ❑ ROOF ❑ DRAIN'1'D.E
❑ DEOK ❑ SIDING O OTH6R
DESCRIBE WORK BEIIVG
SIZE OF IMPROVIIdENC
GABAGES
PROPOSm SIZE
PROPOSEDF�IGHT:
SIDING
❑ Vinyl
❑ Aluminum
❑ Other
❑ HOUSE & GARAGE
❑ ATTACHm GARAGE
❑ DEfACHID GARAGE �
��t
❑ Trim
❑ Fascia
WINDOWS �('�vt � p�i��
IN E70STING OPENINGS OYea ONo L�� 770N OF WIN WS
OR FOR NEW OPENINGS-DESCRIBE S¢E OF / S� 3C 'I"C��//c .�.9'�J7 E
OPENING CHANGFS & ,
ALL FEES ARE BASED
Permit Fee
Plan Review
Fve Surchazge
Surcharge
License Surcharge
SAC Chazge
C1vb Cu[ Fscrow
Erosion Control
Park Fee
Sewer Main Charge
VALUATION, INCI,I7DING THE (.'OST OF
(USING THE 1997 U.B.0 PEE SCHEDULE)
Permit
Received
��
� S�Ss!3Z
I�
BASIINFNI' RFAfODFLNG SUB[rffl': �
1. Ecisting Foor Plan
2 Aopoaed Floor plan
3. IJs[ d sWCtural members to be used
FOR N6'W CONSfRUCfION INCLUDRJG DECKS.
ADDITIONS. &. PORCHES SI7BMIC:
l. Site R�IS�uvey sLowiog the exisling awc[ures
and pfoposed projecf.
2 Two sa., of emabution plaos
3. Fne� CalcWatioos
See Back Page fce Fee Schedule
65% of Building Permit Fee
.001 fimes the total job valuation
.0005 x Pe�mit Valuation Minimum $.50
$5.00 (State licensed Residwtial Contractocs)
$1675 per SAC Unit (Plaos to MWCC for determination)
fr+6ft= ftx$21=$
$450 Cooservalion Plan Review -
Fee De[erroined by Fngiaering
Ageement necessary ( ) Non Necessary ( )
THIS IS AN APPIJCATION R7R A PFRAfff-NOT VAUD UNTIL PROCF_SSED
I heceeb} apply for a building pelmit and I aclmowledge tLai the infom�a5on above is complete and accurate; t6at the work will be in
conformance with the ordinances and codes of the City of Fridley and with tLe Minnesota Construction Codes; that I understand this is nat a
permit but only an applicatiou fw a permit and work is mt [o sYart without a pecmit that the woik wi0 be in accordance with the appmved
plan in the case oF aIl work which requires review aud� ap�p�rovJal of plans.
SIGNATURE OFAPPL[CANT�c�,�S%�P�'�CJYf/ PRINT NAME� �^�A�Y))l � DAT£ V�i _�y .�ZMi
07/91/2007 TUE 17:09 ��,FAI 763425'9445 Larsons Pluutdns & Heati
�
Larson
PCum6i:ng
Andover, MN 55304
3095 1 E 2"� Lane NW
Phone: (763) 427-7680
c�x
■ ■ ■ ■ r
& .�-featin��
Fax: {763) 427-9448
To: ' Inspections De a!tment _ From: Patrick _
Company: City of f"ridle _ Pg. 1 of: 3 _
Fax. 763-57�{-1287 Date: 07r31/2007
Re: i 5770 Nadctnann'Ave NE combustion air analysis _
Here is a copy of the cc mbustion air anal}+sis from the Center Point Er.ergy Mech. �ode
guidetines software. I apologize for not sending it in with the permit application.
I don't believe that a reinspection .uould t�e required with this docume:�tation.
Please call me if I am i iconect on this or if y ou have a�ry question
Patrick
I,arson Plumbing & He:ating
www.la rsono tu mbin �.com
:sx�.s>er.a«sa:esss�« rAX CONFI�ENTIALl1'Y DISCLAIMER t•"*;Rf� "Ft°'ssxa.xs zea«s
'[liis fax message may contain privilege� or contidential information. If you are not the intended ecipienk
you may not disclose, use, disseminare, dis[ribute, copy or rely upon this fax in an} Way. If you nxeive
diis fax mesSaoe in error, please return it [o the sender.
� 001/OO+i
.,
07/31/2007 TUE 17:09 �FAI 763421'8448 Larsons Plumbin6 6 Heati
Date: 07I03t2007 Revieion Date: 07/03l2007
Site Inf___,_ ormahon
Address 1: 577Q Hackm2n Ave
Address 2;
Ciry: Fridley County:
Appiication Infermation
Business Narrie: Larson P&H
Contact Parsqn: Patrick
Office Ph: 763-427-768C Fax: Cel{ Fh:
Address 1: 3095162nd 1_ene
City: Andover State: MN ZiK Code: 55304
Existing Consfruetion: Pre 1f494.
Project #:
l.ot: Slack:
Subdivision:
MN Contractor LiCense #:3c<#1PM
¢J 00::/00:1
Combusfian Appliance
Water Heater: Nafurai Cratf Inpu# BTUs: 40,000 )ndependently Venterl
Fumace/Boiler. Direct V�ntfSealed Combustion input BTUs: 66,000 Indepencte�'�tiy Venied
IWake-U Rir
fVo Make-Up Air Required by Code
CombustiomAir
Minimum Combustion A r Requirements Mlet.
qpplicant Name (print):�,� /�L,1�] SignaiureJDa:e: �7oC �'42-,
� ��� �
Code Qfficiai (printj:_ ._.._. ____._ __—_-_ Signaiure/Date:`_____--.___. —
� 20U4 CenterPoini Iinerr„y � linn�asca. 24X14 Mechr�nir,al C;ocYe CxuiAetines.
� � :;
N2�,� �
Building
Inspections
�63-572-3604
763-502-4977 FAX
SI7E ADDRESS
1"HIS APPLICANT IS:
PROPERTY OWNER/
TENANT
SUBMIT A COPY OF
��, YOUR STATE LICENSE
AND CERTIFICATE OF
INSURANCE
PROPERTY TYPE
PERMIT TYPE
BUILDING
RESIDENTIAL �PP�,ICATION
CITY OF FRIDLEY
EFFECI'IVE 1-I-09
,Z Gi �! YOURE-MAIL ADDRESS c:' �� c?Ci V� ��
f�YOWNER �CONTRACTOR
Nnn�: " ' � �iJ - N
qnnRess: L �; ' C[7'r,��l �
PHONE: ��L �c� �ZS.°+
NAME:
STATE LICENSE # EXP DAT7
❑ SQ'JGLE FAMILY/NEW CONSTRUCTION
❑TWOFAMILY/NEW CONSTRUC770N
❑ ADDIT[ON ❑ GARAG
❑ BASEMEN'I' FINISH ❑ ROOF
,�DECK 7 ❑ SIDING
TYPE OF WORK: I � A1EW HOME CON5TRUCTION
❑ MAIIiTENANCE/[tEPAIR
DESCRIBE WORK BEING
ROOFING
NUMBER OF SQUARES _
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
�
❑ HOUSE ONLY
❑ HOUSE & GARAGE
L] ATiACiIbD GARAGE
❑ DETACHED GARAGE
❑ WINDOWS
❑ DRAW TILE
❑ OTHER
Lc/
rermic
Received By:.
Date Rec'd: �
;�
BASEMENT REM9DELMG SUBMIT�
1. Existmg Floor Plan
2. Proposed Ooor plan
3. List of suucnusl members to be usW
� 3�-
FORNEW CONS7RUCTIONIIVCLUDQdGDEC7iS,
�5�� ���-.\ AnDIT10NS & PORC}iES SUBMIT-
❑ Alommum ��'�.y 1. Site PladSuevey slwwing �he erzisOmg stne;Nms
O Other f7, � and proposed pmject.
—`�/ 2, Two se6 of wnstruc[ion plans
WINDOWS 3. EnergyCalculatiore
IN EX[S1TNG OPENINGS OYes allo LOCATION OF WiNDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPEN[NG CHANGES .@
TYPEOFWAIDOWTOBEINSTALLED NUMBEROFWIIJDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDWG THE COST OF LABOR AND MATERIALS:
(U�SjNG THE,1997 U.B.0 FEE SCAEDULE)
Permit Fee
Plan Review
Fire Surcharge
Surc6arge
License S�ucharge
SAC Chazge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$
$
$
See Back Page for Fee Schedule
65% of Buiiding Pertnit Fee
.001 times the total job valuatiou
.�005 x Peimit Valuation Minimwn E.50
$5.00 (State Licensed Residential Contractors)
$2000 per SAC Unit (Plans W MR'CC for detemiination)
ft+6ft= ftx$21=$
5450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks uarsbk to: Citv oiFridlev Attsc
TFIIS IS AN APPLICATTON FOR A PERMIT-NO'I VALID UN'1'IL PROCESSED
I hereby apply for a building permit and I aclrnowtedge that the information above is complete apd accwate; that the waic will be in
conformance with the ordinffices and codes of the City of Fridley and with the Minnesota ConstrucHon Codes; t6at I understand this is not a
permit but only an application 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 which requires review and approval of p� �
SIGNAT[JRE OF APPLICAN'F' )t 1� S��715^/fLY� PRINT NAIv� I.E 1� J/�P/7 PJ�� l/�Q /�
Building � BUILDING � Pe�t
763-572-3b04
763-502-4977 FAX
0
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUA
THIS APPLICANT IS: �OWNER OCONTRAC"f'OR
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
INSi,IRANCE
PHONE: � �Z �6a �z�
STATE LICENSE
❑ SINGLE FAMILY/NEW CONSTRUCT[ON
❑ TWO FAMILY/NEW COTISTRUCTiON
PERMIT TYPE u nullrrtuN u Un�cnci
❑ BASEMEN"f' FIT]ISH � ROOF
❑ DECK .�SIDMG
OF WORK: � t9EW HOME CONSTRUCTION ❑ ADDI770N
❑ MAIN1'ENANCE/REPAIR $REMODELIIJG
DESCRIBE WORK BEING
SIZE OF IMPROVEMENT
�.�
NUMBER OF SQUARES _
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ v��yi
❑� A�l,uFminum
➢"""'� �
W�{DOWS
IN EXISTING OPEN[NGS OYes �AIo
OR FOR NE W OPENQJGS-DESCRIBE SIZE OF
OPEMNG C}IANGES & _
O HOUSE ONLY
O HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACF�D GARAGE
OSOt6t
�3Trim
❑ Fascia
❑ DRAIN T[LE
❑ OTEIER
� • • ��
�i � � �r.� •
Received By:
�wz=��1
('� %QCe r/1C W .
¢�EMQJT REMODELING SUBMI'C�
1. Existmg Flooc Plan
2. Proposed floor plan
3. List of structmat members to be used
FOR NEW CONSIRUCTION MCLUDMG DECKS,
p�nniTlnNC, ffi PORCHF_S SUBMIT:
1. Site Plao/Survry showing the eacisang struclu�es
� P��Po� P�J�.
2. Two seCS of conslmc[ion pl�s
3. Ecergy Calcula[ions
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND
(USING TfiE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $� � O= OCCUPANCY
Permit Fee
Plan Review
Fire Surchazge
Surchazge
License Surcharge
SAC Charge
Curb Gl�t Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
��1'
�l1
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Petmit Valuation Minimum $.50
55.00 (State Licensed Residendial Contractors)
52000 per SAC Unit (Plaus to MWCC for determination)
ft+6ft= ftx$21=5
$450 Conservation Plan Review
Fee Deteimined by Engineermg
Agreement necessary ( ) Non Necessazy ( )
THIS IS 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 with the ordinances aad codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application far a permit and work is not to star[ without a permit on si[e; that the work will be in accotdance with the
approved plan in the case of all ork which requues review and approval of plans. (
SIGNATURE OF APPLICANI' � - /'I� PAINT NAMF.'��D . rF.(ISO�ATE 23 �
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