AF - 46659City of Fridley, Mi.n.n.
BUILDING PEI�.MIT
�...__ W _-�_� ;
N° � 50'74
Date: _�� `�"�"�'� �.��".. .
,/� �.
Owner: �'�r-�i:,�_�. �.w_1_��. ��-f uiider _ ..---------�--�-------�---------��-�---•�-----�-----�--.....--�--._..._.._.
.._._. ..--•-
Address _.._._._._.__.__..��._.__ Address _.__...�,,,..�.:_._. ..
'',��'"'�. ..�j _••----_...._•--.._......----_. _._.
TION O B�1ILDING �
No. f��L..•� •--- Street �._ .._ ����.__L_ Part of ----- �--••- .•-----_._.
--�� , I �L
Lot .—_�.._�.__ Block _� Addition or Sub-Division� ..___ :��,��',+�'r��
Corner Lot ._.._.___— Inside Lot _._.. �` Setback �� -� �._�� Sideyard _��_::3""
Sewer Elevation __�_____._._.._....� _._____... Foundation IIevation
DESCRIPTION OF BUILDING
To Used � �` ,t,r� .f
� ` �,, .. , � f , g .. r• - 1`,• ; f
' � :�. ` �..�f _ � � �" t. f,�
� a.:_..__ � Front �___.t.�_ Depth �.�,; Height ----::.f Sq. F't. .�_ _ Cu. Ft< <�-.._
f f •h �...,�
..� {_ '"��.. ...,a Fron� .�.��__ Depth _.�.�'fieight ...,��.E�:.,E Sq. Ft. .__L��..�-- Cu. �'t. .'��_v��_:,+°'"""C.�
k.�,.�t ' R: Cj j.,,. s r:
Z`S�pe of �nstruction _--•.--R'"` -�'- � �-- Est. Cost --!'-- -:.<- _` r ------_. _`, To be Campleted .................._.--- _----........-.---: .:...--
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
�
�::
In consideration of the payment of a fee of $� {"�'..���, permit is hereby granted to....__.._..
._ to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildin�
withiu the city limits and this permit may be revoked at any time upon violation of a�y of the provisions of said
flrdinauces. s''"'�`` .r .� .: '""'1
Building Inspector
NOTICE:
This psrmit do�s not cover ths consfrucfion, ie�ailation fo� wiring, plumbine, pu heatiag, sswer or wata. 6� wn ro s�a
fhs Buildfng tsqreeror for sepawte permib for thus iMm:.
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� SUBJECT � �
c�ty of Fr�aley 2 0 6 6 9
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
; , o.
i �• COMMUNITY DEVELOPMENT DIV.
r � v �� PROTECTIVE INSPECTION SEC. 3�yyS'
� .
� _ �
� �'�'1 � CITY HALL FHIDLEV 55432 NUMBEF REV. DATE �AGE Of AVVROVEO Bv
�""'�'� ,�' 612-571-3450 9t0-Ft5 11�14/90 / /
J08 ADDRESS �21 Hartman Circle N.E.
t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. Fi 2 Sandhurst Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Margaret Greshik 121 Hartman Circle N.E. 571--3180
3 CONTRACTOR MAIL ADDRESS ZIP PMONE LICENSE NO.
American Remodeling 3700 Annapolis Lane, �lymouth, NAi 55447 553^0020
4 AfiCHITECT OR DESIGNER MAIL ADDFiESS IIP PHONE IICENSE NO.
5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Res ident ial
7 CLASS OF WORK
O NEW ❑ ADDITION O ALTERATION (� REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Install soffit/fascia & gutters
9 CHANGE Of USE FROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV LOAD
SEPARATE PERMITS AfiE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING.
VENTILATING OFi AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEfiEBY CERTIFY T1iAT I HAVE READ AND EXAMItJED THIS APPLICATION �' STALLS GARAGES
ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WOFiK W�IL BE COMPUED $4 � OOO S 2• Q�
WITH WHETHER SPECIFIED HEREIN OR NOT. �HE GRANTING Of A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEI THE pERM1T FEE SAC CMARGE
PROVISIONS OF ANY OTHER STA7E OR LOCAL LAW REGULAT�NG cow- $63.00
STRUCTION OFi THE PERFORMANCE OF CONS�RUCTION.
PIAN CHECKfEE TOTALFEE
SC $4.00 9.00
S�GNATUREOFCONTRACTOpORAUTHO�i1ZE0AGENT IDATE� WHEN OPERIY V T D IS YOUR PEFMIT
_ - �� �s 5v
SiGNATUF7E OF pWNEFUf QWNEA BUILDEAI �DATE� INSP n�TE
� []
� [ J
�� [ J
coa�structiw� Address:
Legal DescriptioaZ:
� ��/ �.z�a��� � � �.�"�'"��3�
i�l AND R-2
Building PeYmit Applic�tian
`/ ,
/�/ /`�11.t �� �i��� /t�� .
Effective 8/16/90
owr�r Name & : ��l O �lIC Te1. #ca.%%�/��D
Cbntractor: P�.� �'2.r �in � � � �e], , �•���d ��D
��: � %aa �ti'-�`-� .� ` l� ��� ��7 - -
, ,
, Attach to this applicatian, a OertificatQ of SuYVey of the
lat, with the prq�osed c�t�tioci drawn � it to scale.
D�IPTI�T O�' II�i�VHYff�Tt'
LiVII�IG AREpi: Lez�gth Width Heic�t Sq. Ft.
Q1RAGE AREA: Length Width Heic�t Sq. Ft.
T�7CK AREA: Lerygth Width Hgt/G�raur�d Sq. Ft.
O►�RR:
Cbrner IAt [� Insic�e Ft. Yd Side Yard cks
Zj�pe of Gbr�stn�ction: � Q�fG1 ra x 6'L.� Estimated oost: $ D�D
Approoc. t�letioa� Date: /.7�b -90
Prc�osed Driveway Width If Ne�a Openir�g Is Desired: Ft. $ $
nAZ.�: �l '�i� '�D p,pp�C��; ll� ���� idth + 6' �See Back Page
#
Permit Fee $ � '� d4 C.�
Fire S�arge $ �`�Ol�_Q�
S'-�.a� ����e $ . D� DI �_
SAC Ct�an�e $
Driveway Escraw $
Park Fee $
Sewpx Main C�arge $
• v
i l� `
��M�4i��VM �.�`��`�
CTTY USE �TLY
Fee SChedule ori Reverse Sic3e
.00l x Permit valuation (1/loth $)
�.50/��., o0o va�uati�
$60o Per sAC unit
Al't. nA�� OY' Alt. nBn 11bOVE
Fee Determined bY �gineerur3
A9� ��azY i ] Not NeoessaiY [ ]
._ � -
��
o� �o � -� �l� � tx�
o�-� S ��-
C�
SuBJEGT • �
City of Fridley 2 6 8 6�
AT THE TOP Of THE TWINS g U I L D I N G P E R T
�
� � REC _ O.
� • COMMUNITY DEVELOPMENT DIV. �
i
r � v �� PROTECTIVE INSPECTION SEC. �`��
� ` .
� �'�'1 � CITY MALI FRIDLEV 35132 NUMBER pEV OATE vAGE Oi APPPOVED 8Y
��°�� � �'' 612-571-3450 siaF�S 7/2g/98 / /
JOB ADDRESS
121 Hartman Cir
t IEGAI ��T NO. BtOCK TRACT OR ADDITION SEE ATTACHED
DESCii. 6 2 Sandhurst Addition SHEET
2 PROPERTY OWTIER MA4L ADORES$ ZIP PHONE
3 CONTRACTOR MAIL ADDRESS Z�P PHONE IICENSE NO
k • • • 780-3561 3112
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO
6 USE OP BUILDING
Residential
7 CIASS OF WORK g
O NEW ❑ ADDITION O ALTERATION ❑ REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and ara e 24 S Tear-off
9 CHANGE OP USE FROM TO
STIPULATIONS
Underlayment must comply with State Building Code.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING. MEATING.
VENTILATING OR AIR CONOITIONING.
THIS PEHMIT BECOMES NUII ANO YOID IF WORK OR GONSTRUCT{ON 20NING SO. FT. CU. fT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OFI WORK IS SUSPENDED OR ABANDONE� fOfi A PERI00 OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFfSTREET PARKING
I HEREBY CERTIFV 7HAT I HAVE READ AND EXAMINED TNIS APPLICATION ]. STALLS GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS yALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WOFK WILL BE COMPLIED !
WITH WNETHER SPECIFIEO HEREIN Oii NOT. TNE GRANTING OF A PERMIT �y2OO1 �I..00
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OH CANCEL TME pERMIT fEE SAC CHARGE
PROVISIONS OF ANY OTHEA STATE OR LOCAI LAW REGULATING CON-
STRUCTION OR TNE PERFOfiMANCE OF CONSTRUCTION �7�F. %S Fire SC �Z.00
PLAN CHECK FEE TOTAL FEE
License SC $5.00 $82.75
S�GNATUREOFCON:RACTONOAMUTMOA�ZEOAGENT IDATEI ,PROPEA�Y A�IOATED THIS IS Y� P�iMIT -
�j�� 0
S�GNATUQEOFOWNEFl�iFOWNER8U�l0ERi IDATEi g� �ysp f�RTE
NEW
ADDN
ALTER
[l
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CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: ��� ��f/�a9� �, �
Effective 1/1/98
��� .�\
�� ��
Legal Description:
Owner Name & Address: Tel. #
Contractor: Sf�—�� i��� ' t� - MN LICENSE # 3/l Z
Address: .Z � 5 ������ �'� ��� Z°�r ��, �j� Tel. # ��� r .�56 /
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF Il1�IIPROVEMENT
LIVING AREA: Length Width Height
GARAGE �AREA: - Length Width Height
DECK AREA: Lengtlf� Width �_ Hgt/Gr�un.d
OTHER:
0
Sq. Ft.
Sq. Ft.
Sq. Ft.
-- (� �
� - .
Construction Type: o� i� � Fstimated Cost: $ ��,� �`'
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: �/ a( � �h" APPLICANT: Tel. # 7�� ' �� �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
7
$� � . 7S�"
$ . Ud
$ l - OU
$
$ S � ��
$
$
$
�
$ c�3�. ��
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
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [] Not Necessary [ J
,.�:� ,.:.r,
0
sus�ctT � PERMIT
c;ty o� Fr�a�ey 31114
' , AT TME TOP OF TME TWINS g U I L D I N� P E R M I T RECEI
�
� � COMMUNITY DEV�IOPMENT DIV. � /!, ��
� � y � PFIOTECTIYE INSPECTION SEC. L� U
r � ,
, _ ,
� /���1 � GTY NA�� FRIOLEY SSIa$ NU4�EN NEV O�TE ��GE OF AVPAOVEO 0�
����'�" �'' 612-571-3450 s�aF�s 6/28/00 / /
JOB ADpRESS 121 Hartman Circle NE
1 IEGAL �OT NO. BLOCK- TRACT OR AODITION SEE ATTACHED
oesca. 6 2 Sandhurst Addition SHEET
2 PROPERTV OWNER MAIL AOpNESS ZIP PMONE
r4argaret Greshik 121 Hartman Circle NE, Fridley, NIN 55432 571-3180
3 CONTRACTOR MAIL ADORESS ZIP PMONE UCENSE NO
Margaret Greshik
4 AiiCNITECT OR pESIGNEF MAIL ADDRESS ZIP PMONE UCENSE NO
5 ENGINEER MAII ADDqESS ZIV PHONE LICENSE NO
8 USE Of BUILDING
Residential
7 CIASS OF WORK
O NEW �J ADDiTION O AITERATION O REPAIR O MOVE O REMOVE
8 OESCRIBE WORK Addl't10II �, se arate ara e
Master Bedroom P g g
9 CHANf3E OF USE FROM T�
STIPULATIONS
For stipulations, see attached plans. Provide a hard surface driveway.
� WARNING
SEPARATE PERMITS Before digging call fo�
REQUIREO FOR: ��� ����Y tocations
WIRING HEATIN 4�002
PLUMBING� ANO S�s REQUIRED BY LAW
TYPE Of CONST. OCCUPANCY GROUP OCCUPANCV LOAO
SEPARA7E PERMITSARE REOU�RED fOR ELECTRICAL, PLUMBING, HEATING.
VENTILATING OR AIR CONDITIONING.
TMIS PEfiM1T BECOMES NULL AND VOID IF W01iK OR CONSTRUCTION ZONING SO. fT CU FT
AUTHOR12E0 IS NOT COMMENCEO V�!ITHiN 60 OAYS. OR IF CONSTpUCT10N
OR WORK IS SUSPENOEO OR ABANOONEO fOp A PERIOD Of 120 OAVS AT
ANY 71ME AFTER WORK IS COMMENCEO. NO OWLG. UNITS OfFSTREET PARKING
I HEpEBY CERTIfV TMAT I HAVE REAO ANO EXAMINEO THIS APPLICA710N �- STAIIS GAqAGES
AND KNOW TNE SAME TO BE TFUE AND CORRECT. ALl PROVISIONS Of �AWS yq�UATION SURTAX
ANO OF101NANCES GOVERNING TNIS TVPE OF WORK WI�L BE COMP�IED
WITM WHETHER SPECIFIED MEAEIN Ofi NOT TNE GpANTING OF A PERMIT �41,833.00 �ZO.9O
DOES NO7 PRESUME TO GIVE AUTMORITV TO ��OLATE OR CANCEL TMH pEqMIT fEE SAC CMAFGE
PROV�SIONS Of ANY OTHEFi STATE OR LOCAI LAW REGUTATING CON-
STRUCTION OR TME PERfORMANCE Of ONSTRUCTION �rJ62.95 Fire SC �41.83
P�AN CNECK fEE TOTAL FEE
� •�'� ag ao � a5 . 6s
S�GN• pE O� ON'i7A(;TQR Op AUTMOp�ZEO �GENT iO�iE NE PROP L ALIDAT TMIS �S YOUR PERMiT
0� � - -rszS
S�GN4TUQEO�OWNEp��%OWNEpBWIOEp� i AiE� 8 G�NSo' �ttE
� �
NEW ( j EfFective 1/1/2000
ADDN ( J CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 `�
BUILDING PERMIT APPI.tCATlON �� �
��\ �c
Constru�tion Address: / o� � T7� KT !??A /1% Ci R c 1_ � � �iP � 8 � E s�
Legal Description:
Owner Name & Address:
L
G
# s7/- 31 �o �:�
Contractor: SE L F MN LICENSE # ��-/- i��� �
Address Te�. #
�14 s�/�7E /1�T
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
� s- ,9 �� -� �� �sx 3s.� s� �'�
Length �� r Width / g� G�� Height 8� Sq. Ft. 3.�i� ��S ��'�
Length � y� Wdth s31 � Height 9� Sq. F� "7(� �
Length Width Hgt/Ground Sq. Ft.
`-vv D /- � j!/ � v/��+ I O��'J
/>? �� � rP��.n a..����- � ` `
Constn.iction Type: Estimated Cost: $"6 0
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x
��
DATE: Ca APPLICANT: c� Tel. #.5�%/��,3/d'D
CITY USE ONLY - Catl (763) 572�604 for Permit Fees if maiiing in application
Permit Fee $��Oa •� Fee Schedule on Reverse Side
Fire Surcharge $ �/�• �-3 .001 of Permit Valuation (1/10th%)
State Surcharge $ �D. �'a $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTA�
STIPULATtONS:
$ $1100 per SAC Unit
$ $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 []
$ �s� �8
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MNcheck COMPLIANCE REPORT
Minnesota Energy Code
MNcheck Software Version 3.0
COUNTY: Hennepin
STATE: Minnesota
ZONE: 2
CONSTRUCTION TYPE
DATE: 6-21-2000
TITLE: greshik
COMPLIANCE: PASSES
Single Family
Required UA = 106
Your Home = 92
13.2% Better Than Code
/�/ �u�l�ra�i
Permit #
Checked by/Date
Area or Cavity Cont. Glazing/Door
Perimeter R-Value R-�Talue U-Value
---------------------------------------------------------------------------
CEILINGS: Raised Truss 360 38.0 4.0
WALLS: Wood Frame, 16" O.C. 448 19.0 2.0
BSMT: Conc. 5.0' ht/0.0' bgj5.0' insul 224 0.0 10.0
BSMT: Wood 4.0' ht/0.0' bg/4.0' insul 224 19.0 2.0
GLAZING: Windows or poors, Above Grade 82 0.350
---------------------------------------------------------------------------
COMPLIANCE STATEMENT: The proposed building design described here is
consistent with the building plans, specifications, and other cal.culations
submitted with the permit application. The proposed building has been
designed to meet the requirements of the Minnesota Energy Code.
Builder/Designer
� /� d2 fnA-�C � T
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Date 2i�zo�d
, �
Minnesota Energy Code
MNcheck Software Version 3.0
greshik
DATE: 6-21-2000
PLAN REVIEW AND INSPECTION ISSUES
This list of items may be helpful for Plan Reviewers and Building Inspector
use as a guide for enforcing the Minnesota Energy Code. The items apply to
Group R, Division 3 Occupancies, one- and two-family residential dwellings.
The items marked with * apply only to detached one- and two-family
residential dwellings.
PLAN REVIEW ISSUES
FOUNDATION INSULATION
- foundation wall insulation R-5 minimum
- foundation insulation extends from top of wall down to top of the footin
- exterior foundation insulation is covered by a protective coating finish
CONCRETE SLAB OR UNDER-SLAB INSULATION
- slab on grade perimeter insulation R-5 minimum
- slab insulation extends from top of slab to design frost line or top of
footing
- floors over unheated space R-30 minimum
WINDOWS / DOORS / SKYLIGHTS
- average U-value is 0.37 maximum for windows and glass doors (excludes
foundation windows)
- window U-value consistent with building plan and MDTcheck Report
- window and door area consistent with building plan and MNcheck Report
MECHANICAL VENTILATION ISSUES
- residential mechanical ventilation system provides adequate ventilation
per code requirements*
- furnace efficiency is consistent with MNcheck or building design plan
- protection against excessive depressurization is installed per code
requirements*
ENVELOPE INSULATION FOR PLAi�T REVIEW
- interior basement insulation R-5 minimum (if no exterior insulation)
- ceilings with attics R-38 or consistent with building plan and MNcheck
Report
- wall framing and insulation level is consistent with building design
and MNcheck Report
INSPECTION ISSUES
CONCEALED INSULATION
FRAMING AND SHEATHING
- wind wash barrier installed at attic edge
- exterior wall corners framed so that insulation can be installed after
exterior sheatihing is installed
- intersections of interior partition wa11s and exterior walls are frame
that insulation can be installed between the partition and exterior
sheathing after exterior sheathing is installed
- gaps between framing less than one-half inch are eliminated by securin
framing together or are insulated at the time of assembly
- all penetrations between canditioned and unconditioned spaces made
?. ' ° w
v
prior to framing inspection are sealed
INTERIOR AIR BARRIER
- all fire stops are air sealed
- pipes, ducts, wires, equipment and flues and chimneys through the inte
air barrier are sealed
- a sealed continuous interior air barrier is installed on the warm side
the building envelope at ceilings, walls, and floor rim joist areas*
- air barrier behind tub and shower is sealed and protected
- recessed light fixtures are sealed
ENVELOPE INSULATION
- basement insulation R-5 minimum
- wind wash barrier on wall separating house and garage is sealed
- loose fill insulation is prevented from entering the eaves
- insulation on skylight shafts and walls exposed in attics is supported
on the unconditioned side
ATTIC INSULATION
- attic access panel insulated to R-38 for ceiling panel and R-19 for
wall panel
- attic card attached to framing near access opening
- notification of attic R-value and date of installation posted near
permit inspection card
This is a summar�r only. Other requirements may apply. See the Minnesota
Energy Code. Questions? Call the Department of Public Service Information
Center at 651-296-5175 or 1-800-657-3710.
JUN-19-2000 MON 11:47 AM LITTFIN LUMBER FAX N0. P. Ol
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FADRICATOR UP RUOf- 6 FLOOR 7iiUSS SYSTEMS j/� / ����i11
55a UAKEH AVFNUE WINSTED, i�lN, v$395 /v� I ��i��
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MN FAX: (612)47'3-1245 / METF#O: 1612)473-2551 I WATTS: t80��786-3861
� �AX TRANSMISSION COVER SHEET
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iransmissiar�, ploase cali and ask our operatar for assistance.
Thank You
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�°-"� � �'' 612-5��-3450 s�aF�s 5/17/01 � �
J08 AODRESS 121 Hartman Circle NE -
t LEGAL ��T NO. BLOCK TRACT OR AODITION SEE ATTACHED
DESCR. ( 2 Sandhurst Addition S►1EET
2 PiiOPERTY OWNEii MAIL AODRESS i�P PNONE
Margaret Greshik 121 Hartman Circle NE 763-571-3180
3 CON7fiACTOR MAIL ADDRESS ZIP PMONE LICENSE NO
Same
4 ARCHITECT OR OESIGNER MAI� AODRESS ` ZIP PHONE UCENSE NO.
5 ENGINEER MAII ADDpESS 21P PHONE UCENSE NO
8 USE OF BU1l01NG
Residential
7 CLASS OF WORK
C� NEW O ADDITION O ALTERATION O REPAIR O MOVE O REMOVE
8 DESCp�BE WORK
Construct a 20' x 14' and 5' x 1G' Deck
9 CHANGE OF USE FROM TO
STiPULATIONS
See notations on plan.
TYpE OF CONST. OCCUPANCV GROUP OCCUPANCV LpAD
SEPARATE PERMITS ARE RE�UIREO fOR ELECTRICAL, PLUMBING. MEATING.
VENTILATING OR AIR CONDITIONING
THIS PERMIT 9ECOMES NULL ANO VOIO IP WORK OR CONSTRUGTIQN jONING SO. fT CU fT.
AUTHORIZED IS NOT COMMENCEO WITMIN 6� OAYS. OR IF CONStiiUCT10N �
OR WORK IS SUSPENOED OR ABANpONEO fO�i A PEAIQp OF t�Q OAY$ A7
ANV TIME AFTER WORK IS COMMENCEO. NO OWIG. UNITS OFFSTREET pARKING
I HEREBV CERTIfV THA7 I HAVE REAO ANp EXAMIN�O TMIS APPIICATION 1 STA��S GAfiAGES
ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALl PROVI$IQNS Oi LMWS yAWAT10N SUR7AX
ANO OROINANCES GOVERNING TMIS TVPE Of WORK WIIL BE CpMP�IED @ @
WITN WHETHER SPECIFIEO MEREIN OA NOT. THE GRANTING OF A PERMIT W3 � 8SO W 1.93
OOES NOT PRESUME 70 GIVE AUTMORITY TO VIOIATE OR CANCEL TME pEpMIT FEE SAC CMARGE
PROVISIONS OF ANY OTMEFi STATE OR LOCAL LAW REGULATING CON-
STqUCiION OR TNE PEFiFORMANCE OF CONSTRUCTION �I%.25 Fire SC �3.HS
PLAN CNECK FEE �OTAL FEE
$103.03
S�G T RE OF CON"AACTpN Op �UTHOA�ZED • ENr � iD�rE� N PROPERLY VALIOATED THIS IS VOUp ERMIT
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ALTER [ ]
Effective 1/1/2001
CITY OF FRIDLEY (763) 572-3604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: ��'� ��/g /P T/rl h'- /V C/� C G E
Legal Description: � of �i B�-�°c /� a- SttniD u i2 sT ��id�'fi oh
Owner Name & Address: /r1 ft R� f1' R C T �it � s/�'�� Tel. # 7� 3- � �� " 3 ���
Contractor: ��� � MN LICENSE #
Address: /oZ / f/f1 �cT ��9-�I/ C� Rc �..E Tel. #%�3�57/"3id'o
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LtVING AREA: Length Width Height Sq. Ft
GARAGE AREA: Length Width Height Sq. Ft
DECK AREA: Length �^ �� Width � HgUGround �_ Sq. F '�r, 3�d
OTHER: �� � �
Construction Type: o��� _ Estimated Cost: $ �� �
Driveway Curb Cut Width Needed: Ft. + s Ft = Ft x$ _$ ! -
�
DATE: 4 APPUCANT: G Tel. #��v-� J�%�3���
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�604 for Permit Fees if mailing in application
$ , Fee Schedule on Reverse Side
$ , .001 of Permit Valuation (1/10th%)
$ �� q $.50/$1,000 Valuation
$ $1150 per SAC Unit
$ $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 [ �
$ �� Je �
. �. •J:�{:i '.. . Y,t1!i ... ... . . . _. _
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: ; � ENGI NEERS AND SURVEYORS
_ L�ND auqvEY�n+o Soi�� TESTINO
GIVII. i�, MUNICIPAL ENOINEERINO LI�.NO PLIsNNINO
6418-5GT� AVENUE N.
MINNEAPOUS 2T. MINN.
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� CITY OF FRIDLEY
- 6431 iJNIVERSITY AVENUE NE
_ -- i� FRIDLEY, MN 55432
57Z-36U4 r'AX: (763) 571-1Z87
PERMIT NO.: 2004-02244
DATE ISSUED: 12/07/2004
ADDRESS : 121 HARTMAN CIR NE
PIN : 153024120043
LEGAL DESC : SANDHURST ADD
: LOT 6 BLOCK 2
PERMIT TYPE : BUILDING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITIONIALTERATION
VALUATION : $ 1,000.00
NOTE: SEE NOTATIONS ON PLAN.
CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS.
PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF TI� DWELLING PER R317 OF TI�
2000 INTERNATIONAL RESIDENTIAL CODE.
APPLICANT
GRESHIK MARGARET M
121 HARTMAN CIR NE
FRIDLEY, MN 55432
OWNER
GRESHIK MARGARET M
121 HARTMAN CIR NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
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 l�ow 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 to
violate or cancel the provisions of any other state or local law
regulating co ucrion or the rform� �ce� of construc n.�
Anni' .�' �/u.oN�[�/c l�atel' 2�71 s 5
Bldg Insp
Date
BUILDING PERMIT FEE
PLAN CHECK FEE
FIRE SURCHARGE
STATE SURCHARGE, VALUE
TOTAL
38.75
25.19
1.00
0.50
65.44
NEW [ j
AQDN [ ]
• AL�`fER ( ]
�
CITY OF Ff�IDLL-Y tr�ecave �+i i��vuw
6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bidg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
_S
_ ,
� Construction Address: I� 1�-i%t RT►'�'!� �1% C� Iz c L�
Legai Description:
Owner Name & Address: � A- �2 � �- 7� � �` �� � S � � K Tei. # 7G3 S" 7/- 3 / �'a
Contractor. � �' �-1 "� MN LICENSE #
Address: Tel. #
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
bt, with the proposed construction drawn on it to scale.
,
DESCRIPTION OF IMPROVEMENT �
Length Width Height Sq. Ft
Length Width
Length Width
Height Sq. Ft
Hgt/Ground Sq. Ft
Construction Type: /�i 7��r ��-��� Estimated Cost: $ l, o o e
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$,
DATE:IZ �% G APPLICANT: ���' L G
��� 7 �3 -- .�-7/-.3l ��
Call (T63) 572-3604 for PeRnit Fees if mailing in appliclati'on. Fax to 763-571-1287 if using credit card and we will call
you for card number.
CITY USE ONLY -
Permit Fee
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ Fee Schedule on Reverse Side
$ Z,7 •/ 65% of Permit Fee
$ l- � .001 of Permit Valuation (1/10th%)
$ , 3 $.50/$1,000 Valuation
$ $1350 per SAC Unit
_$ $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 [ ]
$ `,- T7 STIPULATIONS:
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�c CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
(�b3) 572-3604 FAX: i7b3) 571-1287
PERMIT NO.: 2004-02255
DATE 1SSUED: 12/09l2004
ADDRESS : 121 HARTMAN CIR NE
PIN : 153024120043
LEGAL DESC : SANDHURST ADD
: LOT 6 BLOCK 2
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION(ALTERATION
VALUATION : S 0.00
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A
# ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE
# NEW FIXTURES (EXIST OPENINGS)
# GAS DRYERS
# OF NEW FIXTURES
# WATER TRMT APPLIANCES
APPLICANT
GRESHIK MARGARET M
121 HARTMAN CIR NE
FRIDLEY, MN 55432
OWNER
GRESHIK MARGARET M
121 HARTMAN CIR NE
FRIDLEY, MN 55432
0 # GAS WATER HEATERS
1 # GAS RANGES
2 VALUE (FOR MINIMUM CALC)
0
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
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 know the same to be true and correct. All
provisions of laws and ordinances governing this type of worF
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authoriry to
violate or cancel the provisions of any other state or local law
regul onstructio or the performance of construct n.
Applicant � Date��
Bldg Insp
PLBG PERMIT MINIMUM FEE
PLBG FIXTURES (NEW OPENINGS)
PLBG FIXTURES (EXIST OPENINGS)
WATER TREATMENT APPLIANCE
WATER HEATER - ELEC
WATER HEATER - GAS
GAS RANGE FEE
GAS DRYER FEE
PLBG REPAIR/ALTERATIONS
STATE SURCHARGE, PLBG FLAT
TOTAL
�
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DBSCRIBED ABOVE.
0
0
1
100
0.00
20.00
0.00
0.00
0.00
0.00
10.00
10.00
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40.50
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ADDRESS
PIN
LEGAL DESC
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
�631572-3604 FAX: (763) 571-1287
: 121 HARTMAN CIR NE
: 15302A120043
: SANDHURST ADD
: LOT 6 BLOCK Z
PERMIT NO.: 2004-02256
DATE ISSUED: 12/09/2004
PERMIT TYPE : ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUGTION TYPE : ADDITION/ALTERATION
VALUATION .
NOTE: ELECTRICAL PERMIT BECOMES VO[D 12 MONTHS AFTER PERMIT 1SSUE DATE.
# 0-100 AMP CIRCUITS 1 # LIGHTING STANDARDS
APPLICANT
GRESHIK MARGARET M
121 HARTMAN CIR NE
FRIDLEY, MN 55432
OWNER
GRESHIK MARGARET M
121 HARTMAN CIR NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin b0 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 know the same to be true and correct. Alf
provisions of laws and ordinances governing this rype of wor4
will be complied with whether specified herein or not. T'he
granting of a permit does not presume to give authority to
violate or cancel the p visions of any other state or local law
re tructi or the rformance of constructipn. /
A p icant / � Date / l
Bldg Insp
SEPARATE PERMITS
STATE SURCHARGE, ELEC FLAT
ELECTRiC FORM FEE
ELEC CIRCUIT FEE (0-100 AMPS)
ELEC FEE LIGHTING STANDARDS
TOTAL
FOR WORK OTHER THAN DESCRIBED ABOVE.
4
0.50
l .00
6.00
8.00
' �I 5:50 � - �
- j- . it