AF - 45640Date: - �����'�P i�69
Owaer: �l�����, T�,� ,
City of Fridley, Mirm..
BUILDING PERMIT
Builder ��e
�� �11 C�tetr�.1 �nre . lq. E . Address ��'e
N�� 1034 ''
LOCATION OF BUILDING
No. %�'28 8treet - ��$3��� ��re�t' N. E. Part of Lot
Lot 1 .� Black 3 Addition or Sub-Division .r ��on' ���h '_e3.t?b�a .
Corner Lot 7n�itde Lot —�- Setback 3� � � Sideyard 15 '
Sewen IIevation , 886 .32 � ��c�� �� �p�� .
Top a� F�ot3.�n�
DESCRIPTION OF BUILDING
To be Used as:
�a�e1? in,;; �nt 45' Depth � 2 Height �Q` Sq. F't. 11i5 �, � 2�.,500
Gs�a�e Front 20' Depth 24' I�eight �o' Sq. Ft �Q Cn. F't.
Type of Constrttction 61'e�'� F�t Cost _. �'2i,�C�t). ��C� To be Completed
�Ei�IEA i3OC:�TI�� - 8 o South of ��aniaol�
WF:�'C� L�4�1'IC+14 - 2' Nortl± of RL��.t�o? e
In con�lderation o4 the issuance to me of a permft to construct the building described above i agree to 80
the proposed work in accordauce with the descript3on above set Porth and in compliance with e� provisfona oP
ordinaaces oE the dty of Fridley. =�
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S!,(10.00 �er��t� C6fanect�.c�r� Ch�r�e
Ia considerat[on of the payment of a fe� of $ 37 ��� , permit is hereby granted to C� gr`����"• ��e .
to construct the buildfng or additton as described above. Tl�i��rmi t is granted upon
the express condition that theperson to whom it is granted and his agents, employees an� worl�en, fn all work
done in, around and upon said building, or any part thereof, shall conform itt all reapecta to the ordinancee of
FrirIIey, Minnesota regarding local3on, construction, alteration, maintenance, rega3r and moving of buildings
within the dty limits and this pernnit may be revoked at aqy time upon violatfon of any of the proviaions of said
ordinancea
St�ilding Inspector
fle�: y k' . R��t. st�i�.c13
NOflCEa
'I�is psrmt! d�s aof eevee �6s eee�sfion, imlall�lon �o� vrWnp, plambieg, �a hsMi�, ssw�� or wmr. B� sQ» to �
�e Bnildio8 Insptcror io� apsnb pormNs for thas iiw�,
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APPLICATION FQR BUII,�INC P�MIT
CITY OF F&IDLEY, PqINNESOT9
0� �S NAME BTJILD� Clamrnn . I�n� _
•--- --
� Lot l. Blk � ADDRESS l�Li.�.l Ceatral ��e. N.E.
LOCATION OF BIIILDING
N0. '�� .�` STBE'aT
LOT 1 BLOCK i; �DDITION OR SIIBDIVISiOAT Don T s�th Add.
COR'C� LOT INSIDE LOT�_SEI'BAE.'��_SIDEXASD,�
SEW� ELEV�TION TOP OF FO(3'i'ING C�r4� - 2�-6
Appliaant attach to thie for� 'I'�wo Certificateg of SurvQy of Lot and
propoaed building locatio� drs.ara on thea� Ce�tificatesa
DESCRIFTION OF BtIILDING
To Be IIsed Aa:
_ Dw� lli]�$ Front 1�.5 Depth 25 Height �� �- ��
Square feet 1125 Cubic Feet ' � � „� , �;� � � -�
Gar�ge 3n Bsmt.
Front 20 Depth 21.� Height 7�btT
Square feet �,t80 Cubic Feet
Type of Conetruction Frame Estimated Coet 27,500•00
To Be Completed 10/1/69
The undereigned hereby makes application for a permit for the work
herein epecified, a,greeing to do all work in strict accordance with the
City of Fridley Ordines�.cas and rulinge of thr� Depar Building�s,
and he�eby declares that alI the facts and �.ti:�re .tations s ated in
thie applieation are true and correcto
DATE Tr�l ��� . lA 9 �
(Sehedule of Fee Coete can be fourid on the Reverse
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BTTILDING PEI�MIT F�EE SC�IILE
SF,CTION 2 o The Inspector of Buildinga� shall, before iaauing perraita
for the erection of sny building or �tructure, or for �.ny addition to aay
exiating structure or building9 or for any alteration or repaire to �ary
eaieting bnilding-or etructure9 upon application therefore, require the
payment.by the applicant for such permi� of feea to the amount herein
4° k�eiow eet forth and in the mann�r herein provided to-wit:
IIniform Buildix� Code: Type 19 2, 8� 4-=1 ,75 for each one thousaad
cubia feet, or fraction thereof, in auch ct�bical Qontente. Type 3& 5-
�1050 fo� each one thoueand cubio feete
� . �
For the puxpose of computing feea for building permite, the cubical
contente of any bu3ldi_ng or addition to a uniform height throughout by
multiplying the ground area covered from a point sig (6) inches below
the ,floor line of the baaement or the cellar to the average height of
the upper eurface or to the avere.�e height of the roof surface of the
main g�,ble of a pitched roof .
�'ox re�aixs or alterations to an existing structure, the fee ehall be
at the rate of $3.00 per each iive hundred dollaxs (=500°00) or
fraction thereof in the cost of all proposed worko
In no case shall the fee charged for any permit as set forth in Section
2 be leae than $50000 _
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NSSSD Connection Chasges based on location - Area 1 or 2.
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HOU E HEATING TEST RECORD
ADDRESS r Y� �� APT. FLOOR CITY SUBURB ''���
OCCUPANT OWNER
HEAT LOSS DATE HTG. INST. ^AS C0. METER BADGE # �'
SOLD BY INSTALLED BY ° '- `
Eleetricol Work By Gaa Lfne By ''
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT H . OTHER �
/� �A,�D�IGN ' CONVERSION
MAKE /� 1`Z-%'>�+-i �� � �• - _ � � :�.• MAKE OF BURNER
Model �'', �' ' Model
Serial „' �, f@� `-� Max. BTU Rating
INPUT ,� �--��r MAKE OF FURNACE
Model
CONTROLS � ��
THERMO AT Ha t Plug Vent Size
Valve � � KIND OF LINER SIZE NONE
Limit g �r��,,� Droft Hood Regulamr
Limff Setting E7'��A� � Fi Iters Size �� � �� mber �
Fan Sattine � Chimnoy Location n id Outaide
Pilot TYPe `r ��'� Chimney Construetion � -�
Pilot Maka
Pilot Model Smoke Bomb Wiring
Pilot Timing— �� -o Droft Test Ta �-G'�
e
L.W. Cut Off � Door Pressure Lighting Inst.
s� .--�
Pressure �` � d% Pareent CO2 �� J' Date Tasted �' -�� ��
Input CFHr � `� F°ereent OZ 7 � Company Testing ���
Staek Temp. --_���(� Pereen! CO �� � Name of Tester
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SuBJECT
City of Fridley
AT THE TOP OF TME TWINS g U I L D I N�G P E R M I T
i �
� �
' • COMMUNITY OEVELOPMENT DIV.
� �V �'��� ,
r � � PROTECTIVE INSPECTION SEC.
i---•��� "' �,; CITY MALL FRIOLE� SSIJ2 Nu�ABE11 REV
L 612-571-3450 910-F/5
J08 AODRESS 7528 Hayes Street NE
t LEGAL �07 NO. BLOCK TRACT OR ADDITION
oescp. 1 3 Don's 5th Addition
2 PROPERTY OWNER MAIL AOORES$
Julie Ampe 7528 Hayes Street NE
3 CONTRACTOR MAIL AODRESS
Master Remodeling Inc 32 10 Ave S, Hopkins, MN
a AiiCF11TECT OR DESIGNER MAIL AODRESS
5 ENGINEER MAIL ADDRESS
5/23/00
5343
21P
VAGE OF
� /
kl•
.
�� O�
AVPROVEO BY
SEE ATTACMED
SHEET
PMONE
780-4634
PMONE LICENSE NO
269-9525 20012916
PMONE LICENSE NO.
PHONE LICENSE NO
8 USE OF BUI�DING
Residential
7 CIASS OF WOFiK
❑ NEW O AODITION O ALTERATION � REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Soffit & Fascia; replace one window
9 CHANOE OF USE FqOM
TO
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.
SEPARATE PEIiM17S ARE REOUIREO FOR ELECTiiICAL, PLUMBING, HEATING, TYPE OF CONS�f.
VENTILATING OR AIR CONDITIONING.
TMIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHpqIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONED fOR A PERIOD OF 12p DAYS AT
ANY 71ME AFTER WORK IS COMMENCEO. NO DWLG. UNITS
I HEREBY CERTIFY THAT I MAVE REAO AND EXAMINED THIS APPLICATION 1
ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UATION
AND ORDINANCES GOVERNING TMIS TYPE OF WORK WILI BE COMP�IED
WITM WHETHER SPECIFIED MEREIN OR NOT. TNE GRANTING OF A pERM1T �2 � OOO
DO�S NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pERMIT FEE
PqOVISIONS OF ANV OTNER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $69.25
PLAN CHECK EE
Lice S
S�GN4TUAEO�CONCRACTOAOA4UTHONijEDaGENT IDAiE� , _� �
�D�iEi
OGCUPANCVGROUP IOCCUPANCVLOAD
SQ.FT CU FT
OFFSTREET PARKING
STA�LS GARAGES
SURTAX
y�1.0�
SAC CMARGE
Fire SC $2.00
70TALFEE
$5.0 $77.25
EF1 �� IOAT 7MIS �S �pUR P�RMIT
!Uf•1-1b-17'y�i 11�3y FkUln C11Y uF FR1ULEr TU
HEW i J
ADDN [ l CITY pF FRIDLEY
�-T� [ l SINGLE FAMILY AND DUPLEXES R-1 Al�'D R-Z
BUILDING PERMIT APPLTCATION
C o nstructionAddress : 7 .�o�
Legal Description:
93?5�1b P.bl�b�
Effective I/1/98
4�E3/ r/N�r�a: � ,� w�
��.;� � �'
�
�.oa�0 �.�
Owner Name & Address: T� ���,P S�-Q- _ - Tel. # 412, 7 PO ♦�(, � c�
Contractor: .����Y� �I��D �� �� �.'�?�, �'1��, 141IV I.ICENSE # Z�0 / 2 9i Li
�� ����h A����� ����6a
Address:_ r�,�,„�a�o�,� - �
- lw������6 � ���a.�� Tel. �
�� ��'�� �'`� �pplication, a Certificate of Survey of the
lot, with the proposed coastruction drawn on it to scale.
LIVING ATtF.A:
GARAGE AYtEA:
AECK AREA:
OTI�R:
DESCRYPTION OF YMPRO`'EMENT
�n8� W idth Height
�Ag� Width Height
�� Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: �j �- F I ,4roQa�v�l Estimated Cos�: $ ��%
(Fee Schedule on Back1
Driveway Curb C�t Width Needed: Ft. + F� Ft x$ _$
�� GcZ
DA'TE: S- 1`) � APPLICANT: �i"' Tel. �.� Ge'! ° 9�"L S"
Permit Fee
Fire S�trcharge
State Surcharge
SAC Charge
Licease Surcharge
I}riveway Fscrow
Erosion Concrol
Park Fee
Sewer Main Chazge
TOTAL
CITY USE ONLY
$ ��� Z r Fee Schedule on Reverse Side
$ �� °'� .001 of Permit Valuation (1/lOth�ol
$ (� � $.50/$1,000 Valuation
$ 51000 per SAC Unit
$_ S � � $5.00 {State Licensed Residential Gontractors)
$ Alt. °A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [] Not Neressary [ J
$ �7.2�
STTPULATIONS: `���Y�D� ��i�� ������"c�T�� /
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O'" ii—W L s: =
�u���s� �t � �
M AY 19 2000
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THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNiNG APPLIANCES OR THE
APPUCATION WILL BE RETURNED
�pII�ILnpl` <�I�T� t/GI�T CC)IIf�FGTnR AA!D CDIl�Hl1STIC)I� AIR VFRIFICATI�N
When !r �a � an eYictin0 �ran __, the undersigned hereby verifies that the
vendng has been examined and is free from rust, deterioration, obsbvctions,
and is securely supported and firestopped where required. Yes (;► No ()
The venting system is plasticJPVC and meets all current codes and manufacturer
speafications including sizing, length, number of elbows and termination. Yes ( 1 No ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturers speaflcations. This does
indude AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
me o,.i •��eme ��en air is sized and installed to meet the current codes
and manufacturers specifications.
When r@qUl�d t0 ����� a new cemb��ctien air it will be s�:ed and installed
to meet the current codes and manufacturers specifications.
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
When it�stallia: � ne�' �'entin��y�gm_, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
spec�f"tcations. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes () No ()
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes () No ()
• � • , 1 M' I � ' , � � Y ' • 11 11 • 1 ' � . � • ' � • � � ' M • � • / 11 . � • �
AppGance #1 Type BTU Input _ Fan Assisted or Nat _
Appliance #2 Type BTU Input Fan Assisted or Nat _
qppr�ance #3 Type BTU Input _,._ Fan Assisted or Nat
-- °Fr�a1 �►p�,tiartt�s---- - - Total �tuJn,r�ut �
Common Vent Type Vent Height � Diameter _ inct�es
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
qppliance #3 Vent Connector Height ft Length ft Diameter in Type �
I � • ► �:- . .�-
HEATING CO:
�9�� g� Date :