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AF - 467871 _ � � City of Fridley, Minn. BUII.DING PERMIT N° 3� 9 7 �t�: . .� � �. �O. . . . �. �. . . . . .: . Owne� ....................................... Builder .. ............. ......................... Ad�dress ...................................... Address ................ ............................ ATION OF BUtLDING `/ � No. / .1�. �. . . . Street . . . . .. . . . . . . .. .. . . . . . .. . . . . . . . Part of . . . . . . . . . . . . Lot . . . � y►. . . . . Btock . . . . . . s�. . . . . . . . . Addition or Sub-Division . . . `�L��! . Corner Lot . . . . . . . . . . . . Inside Lot �it . . . . . . . . . Setback .�: �~ Sideyard . ,/ . Q � � . . . . . . . . . . . . . DESCRIPTION OF BUILDING 1b Used : �r . • . . . Frunt ��. .`a Depth � *. ' � . �ieight �.7C .' �. ~ Sq. F't/�..�.Y. .1 Cu. Ft. Li �� ni y . .. . Front � Q�.'0 Depth �¢'. � Height �Q' t! Sq. Ft. . ��Q G�. Ft. �. . .Q.� Tj►pe of Co on . . . . . . . . . . . . . . . . . . . Est. Ccst. !.�'.� .�1. �.�.�'. .". To be Completed . . . . . . . . . . . . . . . . . . . :,��','"- . In aonsideration o! the issuance to me of a permit to c�onstruct the building dE tite proposed work in acoordance with the de�tiption above set o and in con�f ordinances of the cRty of Fridley. � C_, above, I agree to do witji all provisioas of .. ......................... _ oe v _ In consideration of the payment of a fee oi �!�!:......, permit is hereby granted to ................... . . . .. . . .. .. . . . . . . . .. . . ... to construct the building or addition as described above. This permit is grat►ted upon the express oonditian that the person to wha�s ft is gisnted and i�is agents, employees and worlmzen. in all work done in, around and upon said building, or ar�y part mereof, shall c�onform in all respects to the ordinanoes of Fridley, Minnesota regarding location, con�tructioai, aiteration, maintenance, repair and moving of buildings with- in the city limita and this permit may be revaked at aay time upon violation of any of the provisions of said ordinances. _ � �. ..,%. Building Inapector NOTICE: This permit does not cover the construction, installation o� alteratton to� wi�iny, plumbinq, pas heatinp, eewer o� wate�. Be sure to sea'the Buiidinp Inspector for separate permib for these items. .. . _ �� -�`Td � ��+'�.J � ,,t' ` e � �� m "Q � � L,L � O C � U � �� , � Q � � � a M '� �w O o 3a� � � oa f+ � a �� Q m .L2 x � � 0 � t� .� V y � c°o ,1? � � � � I � v c'�. s�+ •� o p r+ 3�a a,�� Vy+s ��o �a�� p�,,. �� + c° a�'i �' . 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W �a 0 �i a � Ho �Y a u dd � a A � x -�.. . ` y � � � . � � � • � / � �� C � � .� � u� '� � �Q D � i Q � � � � � l � ' � � � � 0 � A � D � x a � oa O � W J � W _ U H W Q � J �"" � a � N � � N q"� .r. y x y 0 3�� M � ��r�� My� � �+ �� a � �aa a� �.�� o'�d a�� o�� m��o A�+�' ,��+' u �y�;� �� a, � pq � '� o�� yY D,.� q A ��.� �� A N y �5.," N O d d "�� a �; 0 ��d i� � N'O'O U v�'i � c�"a N F M K f9 !fi (a O O O O �y O O O �[! � OD W � N : : : $ : ' a g � • o . . � � . �. � N � � � x � � � y � � �, /�� o 0y � � F`I j;d Y� '� �?3 .N cc°+ y � o � +, �i � q Q' � 3 � °' �3 �1 � �}I �9 V ..�i E''" � ~ a� m 4 a a a � �� N ti H � O � � x . � �', � � � � � � a � � � U � .Q 'J E-+ � b vs �s arr v� eFa O O O O � CO N . �[i �[! N � : : : g g : : o g . a � • • � � .S � � 0 0 � a � � � � O � � �; � � � �� a��a � '� i �� U iy iy � � �� a� � z � a m V} ^�'� � � U � '� d +'� 'iJ W O � w O O a � A v� efr vs ss� O O O O O O � u� � � N N � aFi : : rg' � : : � � : : xp � : W � ; : + � : � � � � � � .� � � m v� x � �, � W W � a � � w 3 �3 �3 m� � L"� � � N M � � � o � � � � U U �i � W i� .��-- - � ` � �. � z� �a z � � � � W � � � z � � b � 0 � O O ie] : °..' : '� :� : � : � : W . �, � o � .[ o �. � � � � � � M � M � � W � z a � aa a 0 O O N O O � H 0 0 0 0 0 � ° � a W z � � � � x �. � �� o a �i � AO �i� �J �� Q N Y u � Y O V v cV ""� U E1 z d � �n d 'd � � � � 00 a � E H F� � � a � � O .-� � N �} 0 �C k SS x i i i : : � 0 � � o � o 0 y � � � � � w o W � � o W � y tl3 x M x N � � E � � � w � � a-'�'+ .0 iL � U � � � � \ � � 0 � 0 1 err ta � � � u N o� w � ��-. a � � w W z�.�P x m � � N z z z M H F O �H x F W � w > � � aE {�i d � a � � � .� co � � n ; � N 0 rl ., �, : � f ._ n.� :.�6 �►T �.oss ca�cut�►noNS n�a�trn+�rrr oF evu�nit�cs HnNr�►PO�ts• �m�nv � Weatherstrips A'S' 'V' Coaatruction No. Insulation Guide Windows Doora Reference Oat. Wall Int. Wall Ceiling Roof Floor Kind How Apptied Yes—No ( Yes--No 19� FI.� ��, � Room Length Width Height F7.j Room Length Width Height Windows and oora—Crackage and Area Windows and Doors--Crackage and Area tVidth HelBht Na. ot Lineal L. Arer Wldth HolBbt No. oL Lt�eal [t. Are� No. ot D�ne o[ pane I��ht� ot crack �q• ft• No. of pans ot pane If�hts of ertek W. 1t. � i.' Y Coef. Bn, Coef. Bn, �" In6ltration Q ;_' '. . � ✓ Glas: �- �,�% , Esp. wall � r,�t �xQ. W8u � � a� S . Int. waU ,�Ceiling � �Floor � Totsl Btu. i /.� $t � (. % '. D �. � .., »., ......e.. .,.e.-- w�a�.� ana rs--Crackage aad Area Wid 6 Hd�ht No. ot Lineal [t. Ar�a No. ot pan� ot pane Ilibt� ot crack �p. ft �__,._ __... a. ....._ _ , �, _ , : Coef. Btu Ia6ltration Class � il S E�cp. wall " Nec ezp. wau t'��l l/ � g'�l4 Int. wall Ceiling Floor Total Btu. Required aq. ft. ED.R. or aq. iaa. W.A. Leader ana Fl• ' e H Room � Lcngth Width - Wiadows and Doors—Crackage and Area Wldth H�I�At No. ot Llneal tt. Area No. o! �an� ot yso� Il�ht� o[ crack p. [t t Infiltratioa 7 ' f ^` � Glass Eup. wa{I j � Net esp. waU Int. wall Ceiling Floor Tbtal Btu. f� E.D.R. or sq. ins. W.A. Leader are� , � Bc„ I Infiltration � g 3 � Glau I S � Fsp. wal) � Net �p. wall 1 1 5 In� wall Ceiling �3 I Floor 0 Total Btu. 0 Require� aq. k. E.D.R. or aq. ina. W.A. Leader area Fl.t t E•t R�..•I l.engch widrh Ek;ghc Windows and n—Crackage and Area WWth Hti�ht No. ot Lfnetl tt. Area Na ot pae� o[ pan� if[hts ot crack p. tt f. tu infiltration o � r a .� .; 6law- o r � 1 Fap. wall Net ezp. wall i Int. wall Ceiling p S % � F1oar ? Total &u. Requued w. k. ED.R. or sq. iria. W.A. Le�der area Fl.� Room I l,.engeh W�dth Height th Windovrs and Doon—Crukage and Area WfAtb �ht Na ot Llnsal ft. Area No. of naa� ot.we� 11�6t� o[ cracic �u. tL Infiltration ' C.lau � �. w� s� Net eip. wall ► In� waf! Ceiling F'loor . Total &w Requind p. k. E.D.R. or sq. ia� WA. I.eader ura Bcu D�S6 z.��s HEAT LOSS C�►LCULATIONS DEPART-INENT OF BUILDINGS FRIDLEY, MINN. Weatherstrips A.S.H.V. . Construction No. Insulation Guide Windows l Doors Reference Out. Wall Int. Wall C,eiling Roof F7oor Kind How Applied Yes—No � Yes—No 19_ Fl.� Room Length Width Height FI.� �' Room Lengt6 Width Height Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area �Vidth Height No. o! Llneal tt. Ares Width Helght No. ot L1nea1 ft. Area No. ot pane of pane lighta o[ crack sq. ft. No. ot Dane o[ pane Ilghte ot craek sQ. tt. Coef. Btu Coef. Btu Infsltration / 3� O In6ltration � 3 Glasa S (� �� j Exp. wall Ezp. wall tv�t �xp. Wau a i 5 Int. wall Ceiling 3 a � g Floor 'a -�r' Total Btu. Required aq. ft. E.D.R. or sq. iaa. W.A. Leader area F7.� B� d Room � Length ' Width Height Windows and Doora—Crackage and Area Wld h Hetght No. ot Lineal it. Area No. of Dane ot Dane Il�hta ot cracic p. tt Coef. Btu In6ltration 3 /„ � 5 Glaas Exp. wall Net e:p. wall io�. Wau Ceiling Floor � Total Btu. Required aq. h. E.D.R. or aq. ins. W.A. Leader area Fl. d Room � Length Width Windows and Doors—Crackage and Area Wldth Hel�dt No. ot Linesl tt. Are� No. ot can� ot wns IIrAt� ot crack w. tt. � In6ltration Glaaa Exp. wall Net exp. wall lnt. wall Ceiling Floor Tbtal Btu. Required sq. ft. E.D.R. or aq. ina. W.A. Leader area 0 O 11 Btu b� I �7D Net ezp. wall Int. wall Ceil;ng Floor 76 11 > I � a S p O Total Btu. Required sq. k. E.D.R. or aq. ina. W.A. L.eader area Fl.� Room I 1-�� w� Height Windows and Doors—Crackage aad Area Width Hef�6t No. ot Llneai ft. Area No. of woe ot yans ll�nts ot crack W. tt. In5ltracion Gla� Exp. wall Net ezp. wall ' Int. wall Ceiling Floor 'Total Btu. Required sq. k. E.D.R. or aq. in:. W.A. L.eader area Fl.� R�oom 1 Leagth Vflidth Windows and Doors—Cracicage aad Ana Wtdth Hel�ht Na of Llneal tt. Area No. of �n� ot�oaaa Iir6t� o[ crtck w. ft. Inhltration Gla:a Eap, wall Net e�p. wall In� wall Ceiling Floor Total Btu. Required p. k. E.D.R. or sq. ins. Q/A. Leader area Btu �C�'�,' 0 � � oC i � .� � � 0 �� C � � �� .� . � C ... = O •— �� V a � � � . � \� � � �� _'` D � � � 1 0 � � � a � � � a b �o O m Q J � W _ U N W F�— � J H � a � �� „�w � �, �� Io�~ 3�a °'�m �� w�� .,��o ��'�° d a '� a � � � � Fy�y� v' O x+ y Ov�� v v y o G�y � u a � .� � �� Pa � ��o� �� b �� a� � A� �no � ��o .,., ��, �, � � ��'oo� � � °° � q � o �� a�t�i � a�i'��a U �� F � � �o 0 0 0 000� � 00 �!! � N : : : g : : g g ' ' o . • �n zi . , � .�: . w � � Ci I N Y � y q � o O w A � +� � °� o � � a � � � 4 ai � 3 � �a1� � �i s. `� ��„ `° :° �� '� �� d � O qj � a�i O DC b � � e�s �as v� v� o° o °o, °o u°� 0� N W �f! CV � : : : o o : : g $ °�- : : a v r, : �. ti a4 -�i : o � � �° o° � i a�i � � � � � � � 't3 p� F�i i�i 4 � � o d �¢ � a� � "a� � a�i � a'� a�3 "� V CJ fr � �� a� � U a� � E� U � � G] z � a m M � � z � � w 0 O a U A ssa vr eFr �a v� o° o � �°n °o 00 CO N N � � a�'i : : � � : : � � : : x : : � � : : � : � � � t'r ��' O O y � EW+ "' m v� 'x a � �,ww a � w w � "V � V�J N E'� � � N M � v m O � � � � �� W W W Ey � i � � o � i �a z � °' N � � � � r-� x � � 0 3�r ►�i z d � � a� o � a � � O .� ° � ° � I � z � U W � � � � Z" � � � �+ U Ey P�0 i� : °; : �i :� : � . � :w . � � � � o `' � � 0 � � a � � a � DD � M � O M �� ti a o W z a � � a O O 0 �� vs 0 0 tp � 0 0 0 0 0 � � � w z � ov � 4 (9 aa ,� ,- O N . �,,''� csr �sr v� Pr+ � � o � � N � O � k � x i i i . H � � o � S � c � o � �N 0 w � a � � ° r�►�. M �.�. „ � �, F '" d' C7 w 4 t7 � O a m � � � CQ O err eta W ° 4 ti E x N �] w a�r � �� a F W W N a z�y�' H x z x ,.., H F O 0 4 4 � � V F W � w > a o�c 4 W a � � � � � O ; SUBJECT City of Fridley _� � � 2 3 g AT THE TOP OF THE TWINS g U I L D I N`� P E R M I T r ; � RECEIPT NO. • COMMUtJITY DEVELOPMENT DIV. i ` , , �: ------, l � r � � PROTECTIVE INSPECTION SEC. O Q 1 . � � ( � /'�'1 -� CITY HALL FRIDLEV 55432 NUMBER REV- DATE PAGE OF � APPAOVED BY � �� .J 612-571-3450 910-F15 g�g�83 / / J08 ADDRESS 161 Hartman Circle N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCFi. ],Ej 2 Shcl�ll71"S't Af3t�lt.lOI1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dean Yorsixin 161 Hartsnan Circle 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Richard Hasti.ngs 6331 Riverview Terxace NE. 574-9966 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEEH MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILOING Residential 7 CLASSOF WORK ❑ NEW ❑ ADDITfON � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling 9 CHANGEOFUSEFROM TO STIPULATIONS Itoo£irig can be 2nd layex but not 3rd. Install ridged galvanized valleys. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE.PEFiMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. �Sphdlt THIS PEFMIT 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 HEREBY CERTIFY TNAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORD�NANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED !� WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S21 OOO �lS3S� yS`�..00 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �j•32.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. • � • PLAN CHECK FEE TOTAL FEE � � 8 $33.50 , . SIGNATUREOFCONTRACTOROFAUTH 12EDAGENT IDP:TEI WHEN PROPERLY V DATED THIS IS YOUR PERMIT _ � �3 SiGNATURE OF OWNEA�IF OWNER BUILDER� IDAiEI BLOG �NSP �a � CITY Or fitIDLCY HPPLICATIa1 FO(� RESIOL"i�TII'w [3UILQ1i;G PLfL''ITS (l�thr, Alterations, Additions, or Rcpairsj Oti�NER: I�'�N S/o�s�� n��r,ESS: �G / �A�'fiuA�t/ C�; �ec L � TEL R0: Effective Aug. 1, 1981 �I3UILDER: ��c-��h� p �A�S'i<<'�CS no�t�ss: G33� ��JEiitv��.,.� �, TEL tt0: .S'7��t,6 Construction Locati�n STItITT NO: `I STJtEF.T: /�+��/uAtY C �ICCCL� L07': BLOC9C : ]1DDITIO:i : Cozner Lot: Znsicie Lot: _ SetbacY.: Sideyards: Ap�licant attach to tl�is form two Certificates of SUrvey of lot and preposed building location dr�wn on certificates to scale. DESCRIPTIO�� OF COi�lSTF�JCTIOP� UO�_ Front: Depth: Height: Squanc Feet: Clibic Feet: Pront: Depth: Heigl�t: Square Fe�t: A�bic Feet: _ 'iype of Con�truction : � Rb Be mr.�pleted: �t� �/S�� Estimated Cost: $ � b0o • � Alt. A Alt. B Proposed Drivc�iay tiidth If New Opening Zs Desired: $ S . , S�E PF.VF.R: L' SIDL OF SiIEET _ 15ie undersioned hereby m11:c� appliclticn for a perreit fcr the �:�ork herein specified, agreeing to do .all work ii� strict accordanee yith the City of Fridle�• Ozdi»ances aiid rulii��s of the DeparCm��t of Buildings, and hereby declares that all tl�e facts and represc��itiens stated :n this applic�:tion are true and correct. DT.T�: SIGNATUI� : Stii�ulaLions : ��_ s� �. vU �� . s2� � ..-� sus�cct PE City of Fridle� 6 7 4 , ` AT TME TOP Of TME TWINS � u I L D I N G P E R M I T NO. r � ; y �� COMMUMITY OEV�LQRM�N7 OIV. �� r � � PFOTECTIVE iNSPECTION SEC. � . , i•--•� �'�','� CI7Y MAIL iR10LEY S51a2 NYM�Ep REV O�TE P�GE O: �MROVEO Sr L 612-571-3450 s�aF�s 6/10/02 / / J08 ADDRESS 161 Hartman Circle NE t IEGAL LOT NO. BLOCK SRACT OA AODITION SEE ATTACHED oESCa. 16 2 Sandhurst Addition SMEET 2 PROPERTY OWNER MAIL AOOiiE55 tIP PMONE Bob Baumer 161 Hartman Circle NE 763-574-2525 3 CONTRACTOR MAIL AODRESS ZIP PHONE LICENSE NO Fridley Roofing 830 W Main St, Anoka, MN 55303 763-780-6210 20269030 1 ARCMITECT OR DES�GNER MAIL AOORESS ZIP PHONE UCENSE NO 5 ENGINEER MAII ADDFESS Z�P PMONE LICENSE NO B USE OF BUILOING Residential 7 CLASS OF WOpK O hEW O AD�ITION D ALTERATION f� REPAIR � MOVE O REMOVE 8 DESCRIBE WORK Reroof House & Garage (26 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TVPE Of CONSL OCCUPANCY GROUP OCCUPANCV �OAO SEPARATE PERMITS ARE REOU�iiED FOR EIECTR{CAL, DLUM8ING. MEATING. VENTIlA71NG OR AIR CONDITIONING 1MIS PERMIT BECOMES NULL ANO VOIO IF WORK OR CONSTRUCTION 20NING SQ. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTpUCTION OR WOfiK IS SUS�ENDED OR ABANQONEO fOR A PERIOD Of 120 DAYS AT � ANV TIME AF7ER WORK IS COMMENCED. ' NO OWLG. UNITS OFFSTREET PARKING I MEREBV CERTifV THA7 I NAVE REAO AND EXAMIN�D TMIS APV�ICATION 1 S7A��S GARAGES AND KNOW TME SAME TO BE TRUE AND CORRECT. ALl PROVSSIONS Of �AWS VAlUA710N SUpTA7( ANO ORDINANCES GOVERNING TMIS 7YPE OF WORK WILL BE CpMP�lEO @ WITM WHE7HEA SPECIFIEO MEREIN OR NOT. TME GRANTtNG OF A PERMIT �2 a 787 'P 1.39 �OES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEI 7ME pEpM11 FEE SAC CMARGE PROVISIONS OF ANV OTMER STA7E OR LOCAL LAW REGUTATING CON- TRUCT ME PERFOR ANCE OF CONSTRUCTION �S3 . ZS � re SC �2. 79 PLAN CNECK fEE OTA� FEE Lic e C $S 0 $92.43 5� ATUAEO�CON"AACTOAOp�UTNOQ�ZED�GENl iO�iEi H P R�V V I TED THIS IS�OUR PEQMI ' ` � S�GN�TUAEO�OMVNEp��FOWNEpBU40EA� �OATE� � ' OG �N � Q�TE NEW [] CITY OF FRIDLEY Effec6ve 1/1/2002 ADDN ( J 6d31 Universily Ave NE. Fridley, MN 55432 (763) 572�604 Bidg Insp ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Cohstruction Address: I �l I�-td 1' y-r�-� (+ , rc.i -� Legal Description: Owner Name & Address: �r� Tei. # S7y� aS� � Contractor. ��: �<<�, 1�-00 �inq MN LICENSE # 1-��(yQ03p Address: �3a '^�� ✓''� � S�- /�iv �Cz 5�3U 3 Tei. # LMNG AREA: GARAGE AREA: Attach to this application, a Certificate of Survey of the lot, with the proposed construdion drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Fk Length Width Height Sq. Ft DECK AREA: Length Width HgUGround Sq. Ft OTHER: �9 � � Construction Type: (�� ` rOO� %��_7�� Estimated Cost: $_�'� � �� / Driveway Curb Cut Wdth Needed: Ft + 6 Ft = Ft x$ _$ DATE: 4 4 a-- APPLICANT: �a✓�`� Tel. # 7�O G�l� Call (763) 572�604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ �3�� $ $ /- �� $ $ �66 $ $ $ $ $ � CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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 [ ] STIPULATIONS: r ti � 7 V � � � 0 a� > � U N � JJ > � � � � W Z a� > Q M +T. �� 0 : > Z M C � ti � � � t'7 V � ' (�p LL � � � � Q m O � O � � N � � � N 3 O �o a� N � � 'D m' � \ V � � O z F- � � w a � 0 U � N � E � w � 0 Z J w F- �n W M �o 0 m c LL � Z Q a � O U �' m � m m w � �! O 7 � X a a v� uQ. ¢ 0 0 0 0 0 0 0 0 0 0 0 0 0 W o 0 0 0 0 0 0 0 0 0 0 0 0 � ti .� ,� � ^ � �.: o � o 0 0 �ci � ��va��v��v�� z I I ( I I I � I I I I I 0 z � � v � � W � ¢ `� U N W X Y � ,U � � c — L . � � � a� I� n aUi � c � N � p� Q W i.7 � = Z N C y .0 � � ' � � � v> c �c�o � ` -a w :? u3 *: s a Z �,�., �C �- m N� N � N N �� 3 m x U�.. N� m �� L== c0 �' lL y � �y- O � �.0 � Q. � � �. 'G L p V C f�-'0 N N Y H 3 � v� rn � a zOmmU�c'n��C�C�m i O O ti d' � N � C O U � Q N C � � f •e � � Z O ¢ � w H J Q � v Z � Q � � •— � a QQ ao W � � � X O� Q = � � W � = O 0 � J � J � Q O � � rn m s � � � Qi c��a � . � w w � � t-a- O H w 0 � Y U Q m Z O O w z H z w > z O � � 0 U Q co w J m Q I--� � Z Q Q v 0 � Z O H U w � U � � � w a � W � O � a W m J J Q 2 � � Q Z O f'- � � m � � U ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, NIN 55432 s�i-�bu4 r��: : 161 HARTMAN CIlt NE : 153024120053 : SANDHIJRST ADD : LOT 16 BLOCK 2 : PLUMBING : RESIDENTIAL : ADDITION/ALT'ERATION 571-1Zif7 —� '� PERMIT N : 200401880 � DATE ISSUED: 10/14/2004 VALUATION : $ 0.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL A GAS WATER HEATER. # ELEC WATER HEATERS 0 # NEW FIXTURES (EXIST OPENINGS) 0 # GAS WATER HEATERS # GAS RANGES VALUE (FOR MINIMUM CALC) APPLICANT H P PIPEWORKS 3670 DODD RD STE 100 EAGAN, MN 55123- (651) 365-1340 OWNER BAUMER ROBERT J 161 HARTMAN CIR NE FRIDLEY, MN 55432 1 # GAS DRYERS 0 # OF NEW FIXTURES 200 # WATER TRMT APPLIANCES 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 tnne after work is commenced. I hereby certify that I have read and examined this application and la►ow the same to be true and correct. All provisions of laws and ordinances governing this type of wor� 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 provisions of y other state or local law regulating construction or the p ormanc of construcrion. Applicant Date � � Bldg PLBG PERMIT MINIMUM FEE PLBG FIXTURES (NEW OPETiINGS) PLBG FIXTURES (EXIST OPENII�iGS) WATER TREATMENT APPLIANCE WATER HEATER - ELEC WATER HEATER - GAS GAS RANGE FEE GAS DRYER FEE STATE SURCHARGE, PLBG FLAT TOTAL PAID WITH CHECK # 9937 SEPARATE PERNIITS REQi7IRED FOR WORK OTI�R THAN DESCRIBED ABOVE. 0 0 0 0.00 0.00 0.00 0.00 0.00 35.00 0.00 0.00 0.50 35.50 s., � J � � � ;J f %\ Q. V ' �� m � 4� � � ;.t.f i�- � � i3.1 � � t- E- i.i� � � Z � � � � � [L O � � O � a J d a ¢ 0 Z O � � � � � � � � � � w � w � x _1 � � '� � st cn � � �� u � �- 7 �` �' � N O C r+ ,,i �►#� � � u� - � M � � �,�;�c�a �.ti ; �'�.i,� r • d m O � C N � y U N C? � G? � • '�,�' _ U U � � .G � U � � c � � c� � � � � � N � a c`a o � U � _ U y .0 i6 � ia �y � U .Y � Q N � Q � G � Q � o `� � � � .E — � � ro �� -°� � .� Q •� � � � C � � 0 � O � a�°i � a � ` � Q � � � � � Q C � w z 0 � - � -- �J 1 �` � � C C 1 ! � E � ' � � � � LU O.. . � � � � . r^ � V Q � � p W � � W � r z n � � r m W � � 1 � J w F- � � � C7 U � � � z o m W � z � � � � � � O � Q o 0 �W O 4 4 �� O� C+ r3'"__ Q- F-- o 0 0 0 o d o ui �ri �ri ca o u�> T T r 'i" �` �"' r M CrI M T r � � � � � � � � � � � � �" � � °z { I I � I I � � �� ? I � w � w � � � Lt_ � z m � � _i � � -g a� .� a� � � � � X �C � ,v * LL ,,,, c�a a. u in °� d � ~ d � (� � � � rn u� > N � � �N .��1 .} C � � �` a N� C(d � L q� " N y 3 * � c a� m •�, �, � � � � � �- 3 x�� '�iQ tO�h'�z ta Z'Q N ti 0 � � � Q' L � L i.. �(� (� � Q.. 3 a� 3�,' � E�.' �: °r' � u, �� N N � � � ?� m r�n .� �,��Q I 21� �0 l,l I � � � O Q � w � ¢ 0 z Q• � � La _� 0 °�. 0 �� » ❑ as � �� ,U � a F- e C � � �CI J �S:BZ N ❑ � C LL � G C i � � � Q � �r^ � � W � � J �a m m � Q � — F- � aw � � c Z� � ¢ �O ¢ � 0 � z 0 � � U � W c� c�i U � � � W a 0 w � � � Q � ¢' t�-- � a � o w m o V' � a� � � � x LL � Q Q a� Z = O � � o � � � � � � Q r� b90Z-LZ-�flf 0 � �� JUL-27-2004 10�50 CITY OF FRID�EY P.03i�3 ' i F�L�. IN COMPLETELY FC�R REPLACEMENT FUEL BUF�NING APPLIANC� �ERMITS COMMON VENT� VENT CONNECTOR AND COIVIBUSTION A�R VERtF1CATION V1/hen �plaCinq an exi�tinq furnace, the undersigned hereby ver'ifie� that the venting has been examined and is free from n�st, deterioratien, abstru�:tions, artd is siecufely supported �nd firestopped where required� The venting sysfem is plastic/PVC and meets all current codes and m�nufacturer s}�eciftG�iions in�ludirtg siaing, lengih, number of elbows 8nd terminatidn_ The unc�ersigned also veri�ies that the repiacement unit is a listed assembly and me�ts the current codes an� manufacturer's specifications. This dbes include �AGA GAMA Category I Cen4ral Fumace Venting Tables for fan assistet�l and natural draft appliances. __ T�e gx%Stin�o�7lbu�tion 2�ir_is_sized ��d installed to meet the curren� codes -- - -- __ _ and mahufacturer's specifications. INhen required to ittstal[ a new combustion air it will be si�ed and insta(led #o meet the current codes and manufacture�s specifrcations. Yes ( ) Na ( ) Yes ( ) No ( ) Yes ( ) No ( } Yes ( ) No ( ) Yes � No ( ) V1�hen ihstallin a new ventin s stem, the undersigned hereby ve�es that it is a li�ted assembf� and meets the. curreni codes and rnanufacturer'sS specific�ations. This does inciude AGA-GAMA Cafegory t Centra! Fum�ce V�ntin� Tables for fan assisted and natura! draft appliances. Yes (}� No () 15 the Common vent and vent connectors sized and installed correctly 2fter an appliance has been removed from the common vent and vented separately 2s per current codes. Yes (� No () �_ � liance T e and SizelCommon Vent and Vent Connector Information Appliarice #1 Type G V�-� B� ��P� � Fan Assisted or Nat ,_ Appiiartce #2 Type __ _ BTU Input � Fan Assisted or Nat Appliarlce #3 'fype , B7U Input _ Fan Assisted or Nat � Tot'ai Appliances Tda! Btu input C�mmbn Vent Type V�nt Height _, _ piameter inches #1 Vent Gonneetnr Height f# Length ft Diameter in Ty�e #2 Venf Gonnector Height �,___,._ft l.ength �ft Diameter _ _in Yype #3 V�nt C.onn�ctor Height ft Length ft Diameter `___._in Type _ HEa-rt`N� co: / Signed By: Date : � `•� l� __ _ � _ __ __ .! � M �� TOTAL P.O� � � -�: Building MECHANICAL Pe��t No.: Inspections RESIDENTIAL APPLICATION Received By• 763-572-3604 � 15oa CITY OF FRIDLEY D��'� DATE �1n 3C� ��` O O� YOUR E-MAIL A(DDRESS SITE ADDRESS ,�Q � C't0.C� ��I.YZ � iC l�° � THIS APPLICANT IS: ❑ OWNER �7CONTRACTOR PROPERTY N,�: O .Q c� owNER/ ,,,Dpx�ss: t l� ' NEcrrY r� �-a.�-i STA'TEM� ZIPSSy3�. TENANT pHONE: �to?�-S��-1 • a5 a�s CONTRACTOR COMPANY NAME: CENTERPOINT ENERGY SUBMIT A COPY OF CONTACT PERSON: 'TOANN Z INREN YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ,,�DRESS: g 3 2 Q EVERGREEN BL� STE Ht�r ''COON' ' RFiP IDS STATEMN ZIPS �J �i 3 3 APPLICATION PxoxE �63 — 757 -- 6202 F,,,X 763--757--6701 PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY O TOWNHOUSE TYPE OF WORK: � �W �PLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK � c�.�l �'�l�-` C�J►''1 c� C. PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEFS ARE BASED ON $10.00 PER FIXTURE, EXCEPT WF�RE NOT�D. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOVi� /�� Equipment Installed MFG: Lt�l.'r►'r� i�r MODEL: S�Y �Oq O SIZF/BTU 9 0 ooa MFG: rri �cr MODII.: �� SIZE1BN�h MFG: MODEL: SIZE/BTU �A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGFJOVEN $10.00 AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _NEW GAS GRILL S 10.00 _BOILER $35.00 1 FURNACE $35.00 _GA3 UNIT HTR $]0.00 CHIMNEY LINER $10.00 GAS DRYER $] 0.00 POOL HEATER $35 00 DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 PERMIT FEE PRO7ECTS FOR UNDER $500 � �: PERNIIT FEE FOR PROJECTS OVER $500 Permit Fee $ Number of fixtures @$10.00 x$10.00 =$ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 �_ x $25.00 = $ �S.m Number of fixtures @$35.00 1 x$35.00 =$ 35.� State Surcharge = $ .50 Tota1= $ (p0 • � THIS IS AN APPLICATION FOR A PERMIT-I�IOT VALID UNTII. PRQCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT P-� �' � x.v� ROGER HOFFHE IN DATE r',�jD `OQ PLEASE NOTE:= SEPARA PERMITS ARE RE UIRED FOR BUII,DING, EI:EGTRICAL AND MECHANICAL WORK- City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 City of Fridley Residential Mechanical Application Page 2 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS �EXISTING HOME � MAKE-UP AIlZ REQUIRED FOR NEW/EXISTING HOMES _ . �� o_�sti�n�ir�See not�belo_w) _ _ _� _ _ _- - � -- - 6 _ _ . _--_- --- - - _ _.__-- a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/IFGC 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 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat 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.-A ianua-t�_______ _ .�_ _ __ —_ _ --- -- -- -- -- NOTE: Centerpoint Energy Mechanical Code Guidelines software may 6e used for combustion and make-up air calculations. Building �nspections '76�`572-3604 763-502-4977 FAX DATE�,o �a 1� SITE ADDRESS _ THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE AND CERTIFICATE OF INSURANCE PROPERTY TYPE PERMIT 71'PE TYPE OF WORK: DESCRIBE WORK BEING SIZE OF IMPROVEMENT ROOFING NUMBER OF SQUARES _ �ARAGES PROPOSED SIZE: PROPOSED HEIGHT: BUI�,�NG RESIDENTIAL APPLICATION CITY OF FRIDLEY EFFECTIVE 8-19-09 YOUR E-MAIL ADDRESS I yv� v� C ► �G�° - ❑ OWNER �ONTRACTOR NAME: ,1 ADDRESS: I� I 1/-� �� CITY� PHONE: Co �J I � � � `�-� �G �!� NAME:�G�-� IL� ,�Y % U�C i STATE LICENSE # � Q � � �`Y % '�j , ADDRESS: oCU �{ `'1 ( �""'f61.� I PHONE7i0�'��5 ��Jq � SINGLE FAMILY/NEW CONSTRUCTION O TWO FAMILY/NEW CONSTRUCI70N ❑ ADDITION ❑ GARAG O BASEMENT FINISH O ROOF D DECK ❑ SIDING HOME CONS7RUCTION rt NG POOL ❑ ADDI770N ❑ REMODEL. �� Pa,/�h ❑ HOUSE ONLY ❑ HOUSE 8c GARAGE ❑ ATTACHED GARAGE O DETACHED GARAGE � EXP DATE FAX SIZE STORIES ❑ WINDOWS ❑ DRAIN TILE �[OTHER r i1/, .� ��v Permit No.: - �JO R�a . �, ZOD Date Rec'd: ATE Z[P A��IP �s FT BASEMENT REMODELING SUBMIT: l. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used � FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Virryl ❑Soffit ADDI7'IONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I. Site Plan/Survey showing the existing structures ❑ Other Q Fascia and proposed project. 2. Two sets of conswction plans WIIYDOWS 3. Energy Calculations IN EXISTING OPENINGS OYes ONo LOCATlON OF WINDOWS FOR WINDOWS — PROVIDE U-VALUE AND OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES 8c TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: 'OTAL JOB VALL Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due (USING T�IE 1997 U.B.0 FEE SCHEDULE) -� OCCUPANCY TYPE 3 a5 See Back Page for Fee Schedule $ � � 65% of Building Permit Fee $ �, c9C� .001 times the total job valuation $ [,5""Z) .0005 x Permit Valuation Minimum $.50 $ ,5,� $5.00 (State Licensed Residential Contractors) $ $2000 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftxS22=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ n. Make checks oavable to: Citv of Fridlev Attach THIS [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 with the ordinanc s and codes o the C'ty of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an applicat for a permit d is o s rt without a permit on site; that the work will be in accordance with the approved plan in the case f re ' s i a proval of plans. SIGNANR�OF APPLICA / �tI NT NAM�►1(/�vCJ� tp , I lw' �'C'19 DATE � � � . / I , W � • `s'°2 t� � ! �� N � �� w � � � ' � �� _ �� i � �-' . � ry v� ' � ;� S � � � �( W .� � � - � �° � i 1 W � ' � .� � ,Ay-1 i � /' !O, � I I � � � � � f ��--- u, `-� � I 1/ 1 - v� C� I ! � I t � l i ; + � �� i� y f � _� ; � (�. r f � I . 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