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AF - 46799• � City of Fridley, Minn. BUILDING PERMIT ��; April 3, 1969 �: Vernon Vagle B�� Mike Adams Blders. ��7� ' �`� N° 10166 � `_ _ �,d� _ 4720 Wingard Lane _ ___ ___ _ LOCATION OF BUILDING No. _.___.. 185 Stceet ._.___._Hartman Circle --------.___—._._._ Part of Lot .._.........__ Lot _____ 2 2.._.___ Block _.____.... 2...._...---.----.----� Addition or Sub-Divisi� ._.._..._.. Sandhurs t Addn . � � Corner Lot � Inside Lot .._._..._.?�---_. Setback 45 �._ Sideyard __ 10 Sewer II�,wat[� �—_.._____..._.__829.25 ....._..832162 Top of Footing DESCRIPTION OF BUILDING To be Used as: DwellingF�t _..._64'._ �� 25' Height �0!.� �, �, 1300 �� 26, 000 �arag� �ont __�.�.�._._.. Depth ?� Height ._.._.�� Sq. Ft. _.�$$_ (�. Fk �$�� 7j�pe of Construction __Frame .� �, �_�35_, 000 __ To be Completed — SEWER LOCATIOft 52' West of Manhole WATER LOCATIOft 58' West of Manhole In consideration of the issuance to me of a permit to canstruct the building described above, I agree to do the ProPosed work in accordance with the descriPtion above set forth and in oo�plianoe with all provisions of crrrlinances of the dty of Fridley. °��...��1. �'�- $100.00 Sewer Connection Charge In caisideration of the payment of a fee of � 48. 00 _..___� p��t is hereby granted to._._. Mike Adams Blders . to construct the building or addition as described above. This permit is granted upoa the expre�s oaidition that the person to whom it is gi�snted and his agents, employees and workmen, in all work doae in, around aad upon said building, or any part thereof, shall conform in all respects to the ordinanoes o� Fridley, Minnesota regaiding location, construction, alteration, maintenance, repair and moving of buildings within tl� dty limits and this permit m�y be r�oiced at aqy time upon violation of any of the provisiona oi said orclinaaces. Official � • NOTICE: TMs p�nait dea ao1 eowr th� eomfrueNou, innalla�lon fer wirfno. Plumbie�, oa hwNno. swwr x wst�r. B� sun to sM f6� Buildlao IntpMer for ap�rah p�emils for fM� ih�s. ..; - �; <. . " ' �. 1lPPLZCATION FOR BUII.�INC PgtMIT �ZTY OF FHIDL�it, MINNESOTA � �, �. i . , .�ii / .� / :�� z' l �G _ � _� %�i � �:: '!. � � • �. `�► . .� . i LCCATION OF BTTILDING j' N0. % � Jr STR.FET �fQ��_i (��1 LOT____�,e� BLOCK � A'JDITION OR SIIBDIVISION f CQR'CbR LOT I1ySIDE LOT ` SETBAc;E v� � SIDE7ARD /4 � SEWER ELEYATION TOp O�F' FOCPII�G Applicant attach to this form Two ^ertificates of 3urvey of Lot and p�opoaed buildiag loca.tioa drawn on thes� Certificstes. DESCRI.PT:ION OF SG*ILDING To Be IIsed Aa: - � Fro.nt �c � � Depth 2 � � Height 2 � � Square feet / j O O Cubic Fe�t .2 �r O b O • . � ` ,� Front Z � Depth 2 � Height % a Square � Eet S$ `� �ubic Feet �� g�� Type of Constructio.n ��.,y,� Eetimated Cos� ��v ��• To Be Completed �� The undersigned hereby makes application for a permit.for the work herein apecifie3, ag�reeing to do all work in strict accord.ance with the City of Fridley Ordinancas and rulinga of th� Department of Buildinge, and hezeby declares that alI the facts and i.:.�,reoer.tations atated in thie application are true ar� correct. . � DATE t c3 �9G � SiGNATURE��.-�� /./! _�,e�,_uc� (Schedule of Fee Costs can be found on the Reveree Side.) � �/�, .� �� a , �1.�� ,�d -�S � � Q''Di / � � S G , c� , � , 1 ry \ .+ � � en V � � � a� 'd oa 0 � � 4 � d � � � O � � � � C 0 � � d + � � �w O� 30 O '� za N � a M .� W u ,� M � ti z .0 � M � M � � � � Q O rl 3 �� '�� M � � LI a-� �. � V v �3b� g�� y � ~ Y � Q O � � 0 � _ r � O 'a i�r � l0 ay�� °'�•�a ffi � � x w q 0 0 .� � 3 „ � A�v� d � '� � � '�p�� y � y 0� .�., +"1 � ��o� � m y d y'q O. o �� bC � U v, td to �� W � w S a H ; � C� . z • . � � o � � � � � � � r ; � ❑C f I M .y � _I S'JNIH3d0 � � � i �� I �� j � ,.� sv� � � '�M I I oirw sNisva � I � FDlh � $NIViIO � I 1100V 'SLAVIS •i� ��Hiao ! � � sxwl � ' I � MSVM ' I �N�S .� g g p,mn c� � A O �' � �uw I � sivN�an � � �� I • �" atv,x � � � i p i , a � i��°l�l � i �,o i.p ;� i 4 X I WI .�`,'� c.t"il �il a� • �► U � Ey «± 0 U � � W J � W U H �u � � J H � a ♦ _ � V O Q � c .' ov � � eo C '� � co 3 z � O L ` �� o � � °a � � I O � �� 0 N � �"� !R W N K Ni �? 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" Q�i .ON � � .., � � .� � �s �.,o ti O� � ,�, p � �C � d �� .� � � � y �4 a°' �eT o � � "�"' '�' �'�' o� a �N � c�i .� �� °'.�� '�.w�� v�, � oo d � "� �;� � � � N � �o��o� � •� � � � �� w�o ��., •"�'�, � O ?' ,� •N � � � • N .Y.'� �y wi � ^ O t�1� � �0 qd i� ^ Q% ,��a� � o� Q° � � � ,�.� O � � � 0 ,� � � 'N � �iQ � � . 0 � 0 � � � N �'4 � � � ti � 0 0 � � � � I' � I � N � � City of Fridley, Minn. 6431 University Ave. N. E., Mmneapolis, Minn. 55432 :. BUILDING PERMIT ��; _ .7une 24} 19�1 Mike p�; _ J. V. Grundmanis B�� Adams Builders _ �pgg 1 RS Harrman C:i rcl N_F _ __,y, Ad� 4720 Wi ngA�'(�_T•�.n�_._.._._ �6 106 - LOCATION OF BUILDING Na 185 g�t Hartman C ircle N. E. __ __ p� of Lot Lot �.2 Block - 2 Addition or Sub-Divisio� SandhurstAddition Corner Lot Inside Lot �X Setback _w Sideyard - 10' to Foundati.on. �ewer E1eva13on Foundati� IIevation DESCRIPTION OF BUILDING To be Uaed as: AdcL.t ion Front r1�! Depth __1h! iieight � Sq. Ft. _.__.16.Q.'. Cu. F't 3-� Rncl�se Patio Front 16 ` Depth $' Height 20 � Sq. F't. _...__128! �, �, 2y560' Type of Ccostntction �EramQ Est, Cost �12�000 To be Completed October, 1971 ��,K,a� �.�.�.x,�� fi�.�, .�c:rv tla�.c,c.(� �aC /d, i� � In c�oa�deration of the issuance to me ot a pertnit to caostruct t6e bailding described above, I agree to dp the pro�o�ed work in accordance with the desc�iption above set forFh and in compliance with all provisions o! �c+�oances c� the ciiy of Fridley. � . --� =.rl�C" � r In consideratian of the payment of a fee of ��9 - �Q .—�, permit is hereby granted to.....__Mike Adams Ruilders to construct the building or addition as described above. This permit is granted upoa4 the elcpress condition that the person to whom it is granted and his agents, employees and workmen, in all work do�e in, arouud and upon said building, or any part thereof, shall conform in all respects•to the ordinances of 1�7ridiey, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildi�tgs FYi�� city limits and this permit may be revoked a t any tixne upon violation of any of the provisions of said � �spect� CLARENCE BELISLE NOTICE: Tfiis p�rmi! does not eow� th� consfruefion, installatios for wiriag, plumbing, pas heating, sewer or wat�r. B� wn b sN t6� Buildinp Intpoeto� fo� separata permits for thss� items. � [ � . ..,. * APLICATION FOR RESIDENTIAL, ALTERATION, OR AllllITiON BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA owxEx's rur�:./ {! G�I,�Or�IA�Y/5 BUILDER: /li,�E slO�iS �._y��,� ADDRES S: ADDRES S: 477.,� !!�/�Y./�K� L�YE NO : . 'J� S TREET : /!/9/�T �/v%iQ/SI �i'�� LOT: �� BLOCK: �J,�. ADDITION: �sJr�YOffr/.e,ST �De.c/ CORNER LOT: - INSIDE LOT: � SETBACK: � SIDEYARD: /D , cs- ' AppliCant attach to this form ltao Certificates of Survey of Lot and proposed buildiag location drawn on these Certificates. �ESCRIPTION OF BUILDING To Be Used As: �it/rol� �/y.!!/Gy ,��✓G�/C.� l�/G1.7'�/(� /��O/i/Gyf/ '�� .�v�i Front •_ �� Depth • �lt � Height • 2 � i �� Square Feet :� Cubic Feet : ��2 O D ��c"�r-- Front: % Depth: $" Height: 2 p� � Square Feet;_ �_Cubic Feet:_ ��/ � 1�pe of Construction: �(/ODO �i41,G1 Estimated Cost:_ $ %2, 040 To Be Completed: 7/ The uadersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stiict accordance with the City of Fridley Ordinancea and rulings of the Department of Buildings, and hereby declares that all the facts aad representations stated in this application are true and correct. �� DiATE: — "� ' _,__ SIGNATURE • � (See Rev�rse Side For Additional Information.) �� 4'L% ___ � _ , � � 6'-dl- , � �—� � � � � _ �_-_�_ a b � � '� �O CS C � � � � �� .� � � �� .' �. � x 14� 3a 0 o� � � �� iay.9 � i4 W Q � � x � � O U u�`V° � « t � y � ��a � U °0 � M � � �+ M � � V �3�,�� av b q Y � C � � � ^ o.�,g a ��: a � a °Q'�°a �� q � oo� � $m�� b�� o .� � � � o � �m �j M L. � �� N � !0 " �� S �^ � 1../ d � o � O y U t0 C 'C 'p +1 O dC � E-° W f � ❑C � W � � 3 � � � � V • Z • . 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'-- _. ..� SUBJECT • • City of Fridley 2 � 3 g g AT THE TOP OF THE TWINS BU I L D I N G P E R M I T r � . . � � COMMUNITY OEVEIOPMENT DIV. r � �' � � PROTECTIVE INSPECTION SEC. � � � _ � � �'��1 � CITY HALL FRIDLE� 55132 NUMBER REV DATE PAGE Of APPROVED B� �""'� � �� 612-571-3450 910-F15 8/25/98 � � JOB AODRESS 185 Hartman Circle t LEGAL �OT NO. BLOCK TRACT OF ADDITION SEE ATTACNED DESCR. 22 2 Sandhurst Ad 't � SHEET 2 PROPERTY OWNER MAIL AOORESS 21P PHONE Ieva Grundmanis - 3 CONTRACTOR MAIL AppRESS ZIP PMONE LICENSE NO Renewal b Ander n 4 ARCHITECT OR DESIGNER MAIL AODRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PMONE LICENSE NO 6 USE OF BUIIDING Residential 7 CLASS Of WORK ❑ NEW O ADDITION O ALTERATION � REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Re lace 3 windows with ocket insert windows 9 CHANGE Of USE FROM TO STIPULATIONS Install smoke detectors to meet the State Building Code - in each sleeping room and on each level af house. TYPEOFCONST. OCCUPANCY GROUP OCCUPANCVLOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PlUM81NG. MEATING, VENTILATING OR AIR CONOITIONING. TMIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SO. fT. CU. fT. AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENOED OR ABANDONEO fOR A PERI00 OF /20 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLICATION STA�LS GAfiAGES AND KNOW TME SAME TO 8E TRUE ANO CORRECT. ALl PROVISIONS OF LAWS yA�UATION SUFTAX AND ORDINANCES GOVERNING THIS TVPE OF WORK WI�� BE COMPLIEO WITH WMETHER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT �Z�LLO �1. ZO DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEL THE pERMiT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL lAW REGUTATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCT�ON �J�F.7S Fire SC �2.41 PLAN CHECK fEE TOTAL FE Licens 5.00 83 S�GNATUAEOFCON�AACTOpOpAUTNOp12EDAGENT IDATEi N P PER IDATED T I�R P RMiT � i S�GNATURE OF OWNEA �if OWNEp BU�LDE:�i �DATE� Sp r��iE 'r • r NEW [ ] ADDN [ ) ALTER [ � CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Effective 1/1/98 BUILDING PERMIT APPLICATION �j�� - � �� G� _ �ConstructionAddress: , � , Legal Description: Owner Name & Address: ��1� ('�r UIYY'� YY�+(Z�C I►gS I�.Y'1�Yi�(1C�r .Tel. # rJ�7 �-$ 1-1 ) � Contractor: �y,N��,,j�(1(��,� __ MN LICENSE # t��X�'-((�(4� Address: �j�"�3�— a1'� Q N�C � �Y1C� �P�I �{ �. Tel. # �a-�1 "� � _ . ; --- - � LIVING AREA: GAd�AGE AREA: DECK AREA: OTHER: Construction Type: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length DESCRIPTION_ OF IlVIPROVEME�T'I'_ _ _ _ _ _ Width Width Length Width �o nl�r�, :� �,.��r�l i,�r�t� � �� ( Height � � Height Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. , . � - Estimated Cost: $ � , `"1 � � � (Fee Schedule on Back) 0 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: APPLICANT: � Tel. # � �ro2-gS� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ � �l �-I • `Z� $ a-y I $ 1-20 $ $ 5-u� $ $ $ $ � $ 83- CTTY 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 [ J Not Necessary [] G��''? �,�� c"� i�� GL STIPULATIONS: ir�f/�� G �� c�� G C.�li�G �- d�' �"'��- �k/�CC/.c�L �L� ��'`'l� �o�-r� � ' • � �� SuB�ECT . �. � � P . City of Fridley 2 8 8 3 4 AT THE TOP OF TNE TWINS B� I L D 1 1 \� P E R M I T � ; � R NO. � `y ��_ COMMUMITV OEVELOPM�NT OIV. r � � PROTECTIVE INSPECTION SEC- D/�� 1 . � � , �'�'1 � CITY MALL Fi110LE� SS�$2 NUMBEp NEV O�TE v�GE Oi AVVROVEO OY �'""� � �'� 612-571-3450 9�0-Ft5 1/12/99 / / �oe �ooRess 185 Iiartman Circle NE t LEGA� ��T NO. BIOCK TRACT OR ADOITION SEE ATTACMEO DESCR. 22 2 Sandhurst Addition SNEET 2 PROPERTY OWNER MAIL ADpRESS ZIC PHONE Seva Grundmanis 185 Hartman Circle NE 571-8171 3 CONTRACTOR MAIL ADORESS ZIP PMONE IICENSE NO Renewal B Andersen 350 73 Avenue NE Fridle MN 55432 502-4777 20040630 1 ARCMITECT OR DESIGNER MAIL AOORESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDqESS 21P PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WpRK O NEW O AOOITION � ALTERATION ❑ REPAIR O MOVE O REMOVE s oesca�ee woRK Re lace 3 windows with new com letes 9 CHANGE O: USE:ROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling. tYPEOFCONST. OCCUPANCvGROUP OCCUPANCr�OAD SEPARA7E PEFiMITS ARE REOUIiiED FOR EIECTRICAL. PLUMBING, FIEATING. VENTILATING OR AtR CONDITIONING THIS PERMIT BECOMES NULI AND VOIO If WORK OR CONSTRUCTION 20NING SO. fT CU FT AUTHORIZED IS NOT GOMMENCED WITHIN 60 OAYS. OR IF CONSTRUCTION OR WORK IS SUSPENOEO OR ABANqONEO FOR A PER100 OF 120 OAYS AT ' ANY TIME AfTER WORK IS COMMENCED. ' NO. DWIG. UN17S OfFSTREET PARKING I HEREBY CEpTIfV TMAT I MAVE FEAO ANO EXAMINEO TMIS APPLICATION 1 STA��S GAfiAGES AND KNOW THE SAME Tp BE TRUE ANO COARECT ALL PROVISIONS OF {.AWS VALUATION SURTAX ANO OROINANCES GOVERNING 7HIS TVPE OF WOpK WI�L BE COMP�IED WITH WHETMER SPECIFIEO MEREIN Ofi NOT. TME GRAN?ING OF A PERMIT ��1�000 �Z.00 OOES NOT PRESUME TO GIVE AUTMORITV 70 VIOIATE OR CAMCEL TNE pEqM1T FEE SAC CHARGE PROVISIONS OF ANY OTNER STA7E OR LOCAL LAW REGULATING CON- STRUCTIpN OR TME PERfORMANCE Of CONSTRUCTION �H7,25 Fire SC ��I.00 PLAN CMECK FEE TOiAL FEE License SC $5. $98.25 S�GN�1UpE O� CON'FA(;TOp OA �UTMOA�ZEO �GENT �OATE� WHEN PiiOPERI AL�OA ED THIS IS VOUR PEpM�T /A/ � ! �v -- S�GNATUAE O� OWNEp�� OWhEpBU4DEp� �OA�E� ' � �pgp � q��E � � NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [� SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �J� . . ��3� ConstructionAddress: �g,� %fr� j�y��n �,(',(� Legal Description: Owner Name & Address: �,�� _Q/ 1 f�n.lm n� .� �/ $S f fQ It }�yY'� n�' /j , Tel. # S7l — 8 I"7 l Contractor: Address: MN LICENSE � aOUyO(o�p Tel. # 5�'�/`7i7 � � . � of the lot, with the proposed construction drawn on it to scale. DESCRIPTI�iN OF 1MPROrVEM�NT LIVING AREA: Length Width Height Sq. Ft. _ GARAGE AREA: Length Width Height Sq. Ft. _ DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: �� [',cC_P .� �l)L�(�-1L��1 o m�.e t.� �hp .� ) C'c�m ��p�7�"� 1� Construction Type: Driveway Curb Cut Width Needed: Fstimated Cost: $ , � (Fee Schedule on Back) Ft. + 6 Ft = Ft x$ _$ DATE: /01• �D • %b' APPLICANT: Tel. # (��J�'a-$'S� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ g��s $ �.va $ c�-l� $ $ `7.(� $ $ $ $ $ 9 g,as CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOch%) $.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 [ ] STIPULATIONS: �`'� f�/p� G��1�� '�C"C i/'� /� � L S,c'�-�/.�/�— ��-r� �i0 e�.s.�r �L� �Y�.C� a'`' �"�� l,<l�.(��,�/� y. , ' � � ' Sul�ECT . . � . . , � � . c�ty of Fr�a��y 32000 AT TME TOP OF TNE TWINS B u I L D I N� P E R M I T i ` Np. � `y _.�� COMMUNITY OEVELQPMENT OIV. 5?2_36�4 �� PROTECTIVE INSPECTiON SEC. 1 . . � � �"'1 � CITY MALL FRIDIE� SS�32 NUMlEp pEV O�TE P�GE Oi �PVNOVEO 9r ��-�� '' 612-571-3450 910-Ft5 7/16/oi / / �oe �ooaess 1g5 Hartman Circle NE - t IEGAI LOT NO. BLOCK TAACT OR ADDITION SEE ATTACMED oesca. 22 2 Sandhurst Addition SHEET 2 PiiOPERTY OWNER MAIL AOOR�SS ZIP PMONE I Grundmanis 185 Hartman Circle NE 763-571-8171 J CONTRACTOR MAII ADDRESS 21P PMONE IICENSE NO Pella Windows & Doors 15300 25 Ave N STE 100, Plymouth MN 55447 763-745-1400 a ARCHITECT OR OESIGNER MAIL AOORESS 21P PHONE LICENSE NO- 201658$4 5 ENGINEER MAIL ApORESS ZIP PMONE IICENSE NO 6 USE OF BUILDING Residential 7 CIASS OF WORK O NEW D ADDITION ❑ ALTERATION �] REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Replace three patio doors within existing openings 9 CHANGE OF USE PFOM TO STIPULATIONS Provide smoke detectors in all sleepi�g rooms and on ali levels cf the dwelling per Section 310.9.1.2 of the 1997 Uniform Buildir.g Code. Caulk and flash all exterior openings. Permit tnspection Cards Will Be Mailed To Homeowner To Post TYPE Of CONST. OCCUPANC� GROUP OCCUPANCV LOAO SEPARATE PERMITS ARE REOUIRED fOf� ELECTRICAL. PLUMBING. MEATINCa, VENTI�ATING OR Alp CON�ITIONING THIS PEpMIT BECOMES NULL ANO VOIO IF WQRK OR GONSTRUCTION ZONING SQ. F7 CU fT AUTHOR12E0 IS NOT COMMENCEO WITHIN 60 DAYS, OR IF CONSTRUCTION { OR WORK IS SUSPENOEO OR ABANQONEO FOR A PERI00 Of 120 OAYS A7 ANV TIME AFTER WORK IS COMMENCED. " NO DWLG. UN17S OfFSTREET PARKING I MEREBV CERTIFV THAT I MAVE READ ANO EXAMIN�O THIS APPLICATION 1 S7ALlS GARAGES AND KNOW TME SAME TO BE TAUE AND CORRECT. ALl PROVISIONS OF LAWS yA�UATION SURTA% ANO ORDINANCES GOVERNING TMIS TVPE OF WORK WILL 8� COMPLIED WITM WMETMER SPECIFIEO HEREIN Oii NOT. TNE GRANTING OF A PERMIT �9,931 $4.9% OOES NOT PRESUME TO GrvE AUTMOR�TV TO VIOLATE OR CANCEL THE pEqMIT FEE SAC CNAqGE PROVtSIONS OF ANY OTMEFi STATE Op LOCAL LAW REGULATING CON- @ STRUCTION OR THE �ERFORMANCE OP GONSTRUCTION �IS1.25 ire SC y�9.93 PLAN CMECK fEE TOiA E Licen S $5.0 01.15 SiGN�TUAEO�CON"NACTOpOp�UTMOQ�2ED�GENT IOATE� EN OP ALIDATE �S tZYO�PEpM� - % .i i S�GH�TUAE O� OwaEA�� OWNEpBW�OEp� � i AT�i . � �� . Bl0 �NSP � � O6�E .�j°`'�•1►'�,.... r�w t � ADDN AL1'ER Effective 5/10/99 I ] CITY OF FRIDLEY [] SINGLE FAMII.Y AND DUPLEXES R i AND R-2 BUII.DING PERMIT APPLICATION �onstruction Address: � 1�� 10.�r��i�� C-isa`C �IV . �C.. • Legal Description: Owner Name & Address: ��Q.�. G c urri nnr�,r► :S Tel. #�103 .S�' 1•$ J�� Contractor: , PELLA WINDOWS & DOORS � j,ICFNSE # ' 15300-25TH AVE. N. STE# 100 Address: PLYMOUYH, MN. 55447 Tel. # Attacl �63/745-1400 rvey of the lot, w, LICENSE# 20165884 i it to scale. LNING AREA: GARAGE AREA: DECg AREA: 01'HER: DESC�iflN OF ��Q�'�;11ZFNT _ Length Wi3th Height I.ength Width Height Length YVidth Hgt/Ground � Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: Fstimated Cost: $�9 3133 �.r;�h�.nn sn:s�►v� c�(�t�n� Driveway C�rb G�t Width Needed: Ft. + ti Ft = Ft x� • _$ � DATE: 1a •'��1�{ -O\ APPLIeANT: JQ�� Tel. #�; a'3 �{S• �� i�" Permit Fee Fire Surclialge s�� s��n�ge SAC Charge Lic�nse S�zrcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL � ��. as $ q -9 3 $ 4 9�- $ : � �.00 $ $ $ $ $ �O1.15 CITY USE ONLY Fee Scheduie on Reverse Side .001 of Permit Valuation (1/lOth%} $.soi$i,000 �an�aon $1050 per SAC Unit $5.00 (State Licensed Residential Cornractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined bY Engineering Agreement Necessary [ J Not Nece.ssary [] v�.�� - � �--�1�• 9 /, � STIPtTL,ATTONS: �� c��'�zS�� • l�� GI�C. C��-��--f�-�o l!=i�.�✓.r�/�.- s�� _ �',� ��,�i,�� „ -� .. ..e. - . . _ . . ., . . _ ....,,. . . _. . � � SuB�ECi �'C -- City of Fridley 3 3 8 7 0 ' , AT TME TOP OF TME TWINS g U I L D i N G P E R M I T NO. f � t� � COMMUNITY DEVELOPMENT DIV. /^ �� : '- �U r � � PROTEC7IVE INSPECTION SEC. � _ � � �'�'1 � CITY MALL FRIDLE� 55��2 NUMBEA NEV D�TE PAGE O� APPROVEO !Y �'""� � ��' 763-571-3450 9t 0-F t 5 9/ 10 /03 � � J08 ADORESS 185 Hartman Circle NE 1 LEGA� LOT NO. BLOCK TRACT OR ADOITION SEE ATTACHEO oescA. 22 2 Sandhurst Addition SMEET 2 PROPERTV OWNER MAIL ADDRESS 21P PHONE Bill Hamlin 185 Hartman Circle NE 763-593-1213 3 CONTRACTOf1 MAIL ADORESS ZIP PHONE LICENSE NO Standard Water Control 5337 Lakeland Ave N, Crystal, MN 55429 763-537-4849 � ARCHITECT �R OESIGNEFi MAIL AD�RESS ZIP PMONE LICENSE NO 1522 5 ENGINEER MAII AODRE55 ZIP PHONE IICENSE NO 6 USE OF BUILOING Residential 7 CIASS OF WORK O NEW O ADDITION O ALTERATION 8 DESCRIBE WORK Install drain tile system 9 CHANGE OF USE FROM TO L� REPAIR Q MOVE O REMOVE STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. Permit 1ns�e�tion Card� Will Be �laited To Homeowner To Post TVPE Oi CONST SEPARA7E PERMITS ARE REOUIRED fOii ELECTfiICAL. PLUMBtNG, MEATING, VENTILATING OR AIR CONOITIONING THIS PERMIT BECOMES NUII AND VOID IF WORK OR CONSTRUCTION ZONING AUTHORIZED IS NOT COMMENCEO WITMIN 60 OAYS. OR IF CONSTRUCTION OR WORK IS SUSPENOEO OR ABANDONED fOR A PERIOO OF 120 pAYS AT ANV TIME AF7ER WOqK IS COMMENCED NO DWLG. UN 1 HEREBY CERTIFY TMA7 I HAVE READ AND E%AMINEO THIS APP�ICATION 1 AND KNOW TME SAME TO BE TRUE AND CORRECi ALl PROVISIONS Oi IAWS yAl,UA710N AND ORDINANCES GOVEFNING 7HIS TYPE OF WORK WI�L BE COMPLIEO WVTfi WMETNEfi SPECIf1E0 HEREIN OR NOT THE GRANTING OF A PERMIT �2sSSO DOES NOT PiiE$UME TO GIVE AUTMORITV 70 VIOLATE OR CANCEI THE pEqM1T FEE PROVISIONS Of ANY OTHER STATE OR LOCAI LAW FEGULATING CON- OCCUPANCYGROUP OCCUPANCYIOAD SQ. FT CU fT OifSTHEET PARKING STA�LS GARAGES SURTAx $1.29 STRUCTION OR TNE PERFOFMANCE OF CONSTRUCTION �pH3.2S Fire SC �Z.SH PLAN CNEC fEE TOTAI FEE Licen SC $5.00 $92.12 S�GN�TUpE OF CON"A�CTOQ OQ �UTMOQ�2ED �GENT iD��Ei � yy N PROPEfiLY VALIDAiED THIS IS YO Q PEp IT � �D�TEi 0 r FR�"1 : . / , � Owner f��me 8a.A dress: Contractor: n d.d.s n �. •�( ,�C .0 % l.v n/i�..n �l WING AREA: GARAGE AREA: DECK AREA: OTHER: FAX N0. : 7635371882 I�/1 .o?i1 � '.� � ��1\ n Sep. 10 2003 09:16AM P3 � r 7e1. # � ff� �°�> ��'�a��' MN UCENSE # /`��oZ„� �,_,_Tel. # 7� : 2r�% �`�� T Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCaIPTTQN OF lNtPROVcNiEhT � � Length Wdth Height Sq. Ft. Length Width Height Sq. Ft. Sq. Pt. Constcuction Type: Estimated Cost: 5 07��. �� Driveway Curb Cut Width Nesded: Ft. + 8 Ft = Ft x$ = S DATE: O/ APPUCANT: Tel. #%� :..V % y �� Cat1 (T63j 572�3604 fo� Pennit Fees if mailing in application. Fau to 763-671-1287 �f using credit card and we witl calf you for card number. Permit Fee �ire St;rc�;ar5e. State Surcharge SAC Charge license Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - � �-�� Fee Schedule on Reverse Side $.� . . : , .001:-of Permit Valuation (1/10th%J • $ % $.50/$1,000 Valuafion , � � $ $1275 pe� SAC Unit $ �. 0� $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt "B" Above $ $450:00 Consenration Plan Revi�w $ Fee Determined by Engineering � P�qreement Necessary [ ] Nat Necessary [ .] � � r� STIPU AT10NS• � � n n � Buildi Inspections 763-572-3604 BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY Penmit No.: Received By:_� Date Rec'd: � a ' � DATE �� J ` L% �O YOUR E-MAIL ADDRESS Srr� D SS t g S� �td r�f- �►-•� � C� rG [� ��' �_ l.Ac, �`-f THIS APPLICANT IS: � OWNER "9�ONTRACTOR PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE TYPE OF WORK: �5�� ,�wnxESS: S� v� ��. x PHONE: ATE ZIP, NAME' � �S � CO Y� S �S ( [�C C. `"�' � d � - STATE LICENSE # � q �� EXP DATE ,Ann�ss: t � �� 3 � �"`" 1�� l�l � crnr v✓1� l�_srA�� u { . ,.. � . � _ �-, ., �. -� --� PHONE ❑ TWO FAMILYMEW CONSTR.UCTfON 0 ADDITION � GARAG 0 BASEMENT FINISH �ROOF ❑ DECK ❑ SmING ❑ SWIMIvI DESCRIBE WORK BEING SIZE OF IMPROVEMENT R FIN -- -- a D Ni3MBER OF SQl3ARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING O Vinyl O Aluminum D Other WIIVDOWS IN EXISTING OPENINGS OYes ONo OR FOR NEW OPENIIdGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE WSTALLED � AX SiZE STORIES �HED ❑ WI[�iDOWS ❑ DRAIN TTLE ❑ OTHER 3 POOL f ,ING �.c � � � W1DTH HEIGHT ❑ HOUSE dc GARAGE ❑ ATTACI-�D GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia LACATI013 OF WINDOWS BASEMENT REMODELING SUBMIT: 1. Existing floor Plan 2. Proposed floor plan 3. L.ist of structural members to be used Ft. FORNEW CANSTRUCTION MCLUDING DECKS, Afl�IT10NS & PORCI�S Sth3NIIT� 1. Siu Plan/Survey showing the existing structura and proposed project 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING TI� COST OF LABOR AND MATERIALS: (LJSING THE 1997 U. .0 FEE SCHEDULE) TOTAL JOB VALUATION $ � � 3�9 ��P��' TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ � �.a � $ $ 3.4 y $ 1. 7�. $ �- OO $ $ $ $ $ $ 10''7 � See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.00 (State Licensed Residential Contractors) $1550 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftxS21=S 5450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to__City of Fridley Attac THIS [S AN APPLICATION FOR A PERMTT-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 conforcaance 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 w h requ es ew and approval of plans. SIGNATURE OF APPLICANT �� "� � pRI1�TT NAME �°�QS �� ►`( pp� �� ' � O'CJ �