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AF - 47028_ _ .._ .. . , ._� . ; ._ .. sus�ecr RMIT NO. City of Fridley � 16 5 5 4 AT THE TOP OF THE TWINS B U I L D I N G P E R M I T � ► ' R � `. . � • COMMUNITY DEVELOPMENT DIV. /_ / v 7 r � y '� PROTEC7IVE tNSPEC710N SEC. �� / O� � , , � '� /•"1 �. � CITY HALL PRIDLEV SS432 NUMBER REV. DATE PAGE OF APPHOVED BV ti----�' '•' 5/3J82 612-571-3450 910-F15 / / 10B ADDRESS 6175 Heathe r Place 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 Heather Hi 11 s WeSt sHeer 2 PROPERTYOWNER MAIIADDRESS ZIP PHONE Mr. & Mrs. Thomas Elwell Hackman Drive Fridley 3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO. Brickner Builders, Inc. 6249 Ben More Drive N.E. 574-9871 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. SAme 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING residential 7 CLASS OF WORK p NEW O ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 1l a oescR�BEwnew house and garage (approx. 45' x so� ) 9 CHANGE OF USE FROM TO ^ - STIPULATIONS p�d $1, 000 park fee. ��` �; , 1. Provide a hard surface driveway �QV�R� 2. Provide a verification survey ��� ��r $�� 3. Provide sod in the front d�e�� �"" �tA� Y _ . c WATER LOCATION: 28' 5outh� S�n,`Manho�e. SEWER LOCATION: (9' Deep Iri' �� � ater Service. Expose , -�� service to est. tAp o£ foo '' DRIVEWAY DEPRESSION COST: N/ . � Park Fee $1,000.00 TYPE OF C NST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED fOR ELECTRICAL, PLUMBING, HEATING, W�� fra YENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. 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 3167 �' E)%2 ANY TIME AFTER WORK IS COMMENCE0. NO. DWLG. UNITS OFfSTHEET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STA�LS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WQRK _WILL BE COMPUED 236 � 300. �O � � H. ��J WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRAWT�NG OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIQLATE OR CANCEL THE pER 1TFEE SACCHARGE PROVIStONS OF ANY OTHER STATE LOCAL LAW pEGUTATING CON- �8�j,�Q 4Z5.00 STRUCTION E PERFORMA OF ONSTRUCTION. � PLAN CHECK FEE T T F E ,�( 8 � �`z�. os IGNATUREOFCON7RAC ORIZEDAGENT IDATEI WHE PROP RL A D T HIS IS YOUR� PERMIT �,3��� SiGNATURE OF OWNER��F OWNER BU�IDERI IDATEI�_ INSP, DFTE . .�. °`.�'-- . .E: . CITY Of FRIDLCY Effective Auq. 1, 1981 Ai'PLIG117I��i f0f; RESIDLi�TI11� IIUILpIitG PL(L'�ITS (Ne►•r, Alterations, AddiLions, or Repairs) ��`^ /p► �' ONINER: � / r/� �� ADDRESS: �2 � ����� 7EL N0: I3 E -e��� � JCc'�� . UI LD R : C�� ADDRCSS: CG�S ���— � �� TEL t10: f �� ��� �� 7^— Construction Location - STRI�TsT NO: �� � � STItF.ET: / LOT: � BLOCZC: _� ADAITION: �� Corner I,ot: Inside Lot: v SetbacY.: ✓� � Sideyards : � d �/� Ap�licant attach to tliis form two Certificates of Slirvey of lot and proposed building location drawn on certificates to scale. DESCRIPTIOid OF COt1STRUCTIO�� Front: Depth: Square Feet: Ctibic Feet: Height: . Front: Depth: Height: Squar.e FePt: (l�bic Feet: � a'3�, 3��. Estimated Cost: $ Zype of Cor,structian: Rb Be Q�r.�pleted: � // v �/ proposed Driveway kidth If New Opening Is Desired: Alt. A Alt. B $ $ , SE� Re.VERSE SIDE OF SHEET � �iie undexsigned hereby mal:es application for a permit fcr the �:vrk herein specified, agreeing to do ,all Work i.r, strict accordance with the City of I'ridley Ordinances and ruli»gs of tl�e Delhzrtm�nt. of Builc3in�s, and here*�y declares that all tl�e facts and repres�ntatiens stated in this application are e and correc . C- � /� D.3TL: ,r �� � ' � � SIGNATUI�.: ��i���7 � C�"Y—^ Stipulations: PAa�t F�.� ���� O.� Tx s� /, o ov �$t'. So � ti b .� � � 2��;0� ��g•�� . Z� y�. � 1 "- ._ , �� � _ _ _ _ .__ - - - _ _ _ T._ __ _- - ---- _ _ _ ._. _ _- --- - --- _ _ _ _ _ - �c��c z 3�t z �_ (�72 �X = _ _ ���i,�� � _ _ (�Adt�r+� --- �2.�e�- 45.3 = _ I'�gd. . y _ . _: I� = Go � " _ �_�c . �__ �� } .._. __ _R.__'_ _ .___ _____._ _. ___ __.. ._ ��.-. __. � �� ' - _ _._._... � �. Z.iY ��, "s � �... _- _ _ _ _ _. _ -4�.5- __ _. _ _ -- _ _ _ 42. 3 X �i.�r `_' -- -Z � _ - - ------ - --__-- -- __ _ . - - - -- - - - --- . _ -ot'3 � 7'�. �.I�' ------_ ___ ___ -----_�o, � Y �. �� 4�'3 � t �� � ?o.s x _� � G �� _ _ _ t_'3�.�_ x _�..' _ � __ _ 4� - _ _ . _ _ __ _ -- __-�' Z� ?` _ � = _ _ _ _ �t _ _ . _ _ _ _ _ _ - _ �_ - - _ _ _ _ _ t _ _ _ - - =- - --. _ __,_�_ _x._ s� _ _ ----- _ _ _ _ __ - - _ _ _ --- c�� �tQac�r!�s -- _ _ _ _ , . - - , 3'�.� ��' _ _ IV yt� - _ , _ 42 x � �.Z� - z -z. _ _ ____ __ ___ _ _ _ _ . . _ __ _ �I_�.s_� �Z _ � _ _ ,__ �7�-- -- - _ _ ..�_ � ._ _ _- - -- - - - --- - _ _ "iL - - ___ .__ ��--_L��,'-�- ±�l `- ----1_ �l�____ _ --- - -__ -- -- - - _ _ __ _ ._. � � o �j� � I I�., 3�9�.��! .� - . _ �_� �� .s:.� �..:.�.._,_ °[�_._ � _ ____- _ _ _ -- - _ _ _._ _ _ __ __ �x � � � I S _. - _� _ _ _ 3=_���_ ��'� + _ _ u� _ - - ------ ___ �.?,S_ X _i._�a` + _ Z a _ _ _-�_� �c 3; �S _ : _ _ _ � / -_ _ _ _ _ _ _ _ --_ _ _ _ __ _ _- - __ - _ _ -- - _ . � - ' _ _ 4 U�'�- �, - -=� ..�� . .�- : _ � _ -_ _ ,,.� . __ :� "- . __ _ '�_ _ _ - -- - >� �` - - - ,f -- - � . -_ - _ , _ � .. _ .. .� .- e �. . � T y , . �, .. .,- - - = ° fi, � - . :�.., . . _z . . �. � :�. : ;�,_. . _ , - - �_ - - ' r � RONALD F. MEYER � � . �' � � T � - _ _ = I.A��TD SIIRQEYOR , _ -- - _ _ �e suwve�r�na SU�DIVI�ION Dp+av " rnrr.+oN� �zi.aaes aes �sss�� sT.. aT. �,w�, �wrv. ss�o� � I he�eby certify fhat this survey was prepared by me ond tha# 1 am a duly Registered Land Surveyor urtder the laws of the State of Minnesota. � /' Reg. No..9051 Date: ri1 f �_ , �%Z ��. � :. \ �- w � CV �v �' � �5 � V � � � � � / / . o Denotss iron monument plac�d. Scale: 1" = 30' .S'd�./iy Er.e� f � �•— � Lot 9• Block l, HEAT� HILLS WEST, Anoka County. Minaeaota. � � '� � ', • . . � , <- � .- EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION � OWNER %lX � iil/Q S��0 yYl�{ � E G(N E L L _ SITE ADDRESS � � % � �F� �� « P��� E _ � 7 � 3^�L PHONE ��I �' �0 7% CONTRACTOR �/I / G XI1J ErC /J �O�C°S j��� �� � Determine working square footage of each. l. Total exposed wall area ....3 g� sq. �ft. x'�7 = 6�b -� 3` 2. �otal roof/ceiling area ....37 S�O sq. ft. x-�s/ _ �.�� V` r a. b. c. e. f. 5• Total exposed wa 11 area above f loor = Total wall window area .......................... y�.�• �3 Tctal _ cloor area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 7 � 6� Total sliding g�.ass door area . . . . . . . . . . . . . . . . . .. s133 • / Total fireplace wall area..� ..................... Total wall framing area (average 1096) . . . . . . . . .. •� 7`t- �s� Total net wall area above floor . . . . . . . . . . . . . . . . ., a � / g• 6 3 Total rim joist area. ........................... 3�� Total exposed foundation area = % �-�7 h. Total foundation window area .................... �'� i. Total net foundation a�ea above grade........... '70•1�1 Determine "U" value of each wall segment. a. yL6- �3 X��U�� - 3 Q = b 3�- 6q � .,U„ . �� _ . �. L33 - w X„U„ . 3� _ a x °v" . e. � ` 7• �� X nUu f . � ��� i� � • � � X ��U �� g � �a � g ��U �� . h. � - � X "U" �. � � • ?� X ��U" .�g • � . {� .3$ � '�7 3. ..............................Total � e /.�9- 83 �.1. �� ��- �� 1�.3 - �l_.�_ = i •�v _ �. �.2r = 3 3. L� _ yy s� � �--. . , . � ,� ' � ,` • _ 2 _ If item #3 on previous page is the same as, or less than item #1, . you have met the intent of SBC 6006(c)2. Total exposed roof/ceiling area = � I Sp , j. Total skylight area .......................... /� — n�� k. Total roof/ceiling framing area (aver ) 6l. ����p�7 1. Total net insulated roof/ceiling area........ 173 -1. Determine "U" value for each roof/ceiling segment. � q� X „Uu .s�s �'L-� ;. _ /I��f' . k . � L � X ��U„ � `U t = � 1- • '��i - `�-� 1 t 13 G X�.,Un� . o-L = S`�• � v . - ' 4 ..................................Tota1 = / L � � ' If total of #4 above is the same as, or less than #2, you have met the intent of SBC 6006 (c) 1. � A lternate BuildinQ Envelope Desicln To utilize the total envelope system method, the values established by the sum of items #3 and #4 shall not be greater than the sum of items #1 and #2. i. 3. +2. +4. d d , , R � � D T � � � e .�i u � � � . � � � 2 H W � J t/� A Q «.» � � LL A Z �J.. a O Z ~ � V � � � 0 � z O F- u d a ¢ � � . `o � � �a:8 x>.++e � � wp a� a 4 .� iUat+i � � a=i 4 � v O � � O �. " s �v � 1 a � v Q y � pp � e °w u° �e°� ,� � ~ �O w w.5� w � `� �� � � � O � emv-�i �— �i. .°, e .^'+ o Q' � � ���� � � � °��om � � O ��m� � ° °�+�+ �1 � � ��$� Q M O+�O o0 � � ,o C tp a �`((C�� ' y M �J dl � w.-�i v�i ..�i M O '0 m � +�i � M �0 m q �m■�� � m�� N O aNC � w � q A A. ym V M W � h OU� F m qs+ � � V.% � � V ' Q U � � � � v� 4 � 7 4 � O � \ � � � � � o C Z o � � � � f'� ' M � � � � � � g��� M 7 o � 8 [� � 0 � m � 1 i � � a� o M W .� y a = Z � X a`rsp � `d � ab� c� m = �xTd •as�W • Taar s� ,,,t � saqsrM s aT�Qmo�mt � su�srg o u�ap� � .�p� =�j� �,� $ � ssawa[S �.�. � -� suFY�uno3 0� buF�i� e � g SrC42y t(iYM � � �FS � . O �o � o cu�s4e . i �' w � u�4e S � ST�FsA a'3 � syasoT� � � � f ., �d �o r� °: `. SaF3o3S � n � v Y � � M � {V ( y M � � � a �r O� M K � N W w a 0 0 0 .r N � .� M N � aW R1 S V a a v�i iZ'� ii� �C � a ai w�o O i� W y w� '.7 H M tA �a �a �O � Q Q O p < 41 O p • ": O ` � f? M fl? W N W N i4 t4 M i? tll N tl) fll �Q Q 0 0 0 0 0 0 0 0 0 0 0 0 0 � c u+ �n o 0 0 0 0 0 0 0 0 0 F, • . . . . . . . . . � I!1 M .�1 V' u1 U1 U1 Y1 U1 n U1 O O W � � a n00, M q q W M s► w M �s b N vl v1 M a a _J p � � e ° � z E+ o m 8 p� e o c�n � a + w 4 4 m � � R � M � � o y Y C r 1-al M [��+ "'� E� '� O�i M g o� ~ M o� a a.�+ �+ . : e • � � : x � �' � °d � z w e N> s o� « p r., �+ e.� •.r .� o � \ o � x M t� C O�.Ci M� • y � �� C u' +�+ � a a w d+�+ ..�i � w o°~ �'� o � M O+� W iq O.i M N L C � a> � x -+ � a o o s� o � M M � r� ,,,, � w o � e w s ac c x w m °� � ++ �o 0 o a4+ .Ci '�C i a°+ .+ � � � e • 7.� •.�1 y O A y • O q r �� � J 76 • O O A N OC �. a0 S � C� C7 ►7 .-1 � a � sue�ecr P MIT NO city of Frialey � 9 0 2 s , AT THE TOP OF THE TWINS gU I L D I� G P E R M I T f S � RE . COMMUNITY DEVELOPMENT �IV. `�` �� L PROTECTIVE INSPECTION SEC. � • i � r � -•---; � , , ' � �'��1 � CITY HALL FRIOLE� 55432 NUMBER REV. DATE PAGE OF APPROVEO BV �•."�''' : �.' 612-571-3450 9� 0-Ft 5 / / 6 24 87 �os no�aess 6175 Heather Place N.E. t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 9 1 Heather H1.11S Ttd2S.'t SHEET - 2 PAOPERTV OWNER MAIL ADDRESS ZIP PHONE Tom Elwell 6175 Heather Place N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE _ LICENSE NO. Jansick Construction 6480 Squire Drive N.E., Fridley 574-9679 d ARCWI7�ET OR DESIGNEH MAIL ADDRESS ZIP PHONE UCENSE NO. 5 ENGIN�ER MAIL ADDFESS ZIP PHONE LICENSE NO. ' 8` USE OF BUILDINO l�es identi al 7 CLAS$ OF WORK � NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a gZ 21� x 12' Deck and a 14= Octagon Porch.-- Remove existing deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations an plan. Variance on rear yard approved by Appeals Cawmission on June 23, 1987 clown to 16 feet. WARNiN� 6etore digging call local u�'h'ti� SEPARATE pERM1TS RE TEIEPNONE - ELECTRIC • G�S �t�. WtRtNG, HEqTING, p�� Q�� � F�R REQUIRED 8Y = �6 AND SIGNS. ��►� F •',. SEPARATE PERMITS ARE HEQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTIIATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR �F CONSTRUCT�ON OR WORK IS SUSPENDED OR ABANDONED FOR A fERl00 OF 120 DAYS AT ANV TIME AFTEH WORK IS COMMENCED. NO. DWLG. UNITS OfFSTREET PARKING I HEREBY CERTIFY THAT I HAVE REAO AND EXAMINED THIS APPLICATION �. STALIS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VA�UATION SURTAX AND,ORDINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMPUED W�TH WHETHEA SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT SS � OOO S2 . 5O DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- T �TION OR THE PERFORMANCE OF CONSTRUCTION. $SO. SO PLAN CHECK fEE TOTAI. FEE �D �� J',Z $12 . Fi3 $ 65 . 63 si ATUREOFCON�Aa UTMOAIZEDAGENT IDATE� �" WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT � SiGNATUREOFOWNERUFOWNfABU�IDEAi IOAtE1 BLDG �NSP Da G�eSA�-:�. . . NEW [ ] ADDN. .�� pLT ER . [ � Construetion Add City of Fridley Effeetive 4/1/86 R-1 AND R-2 Building Permit Application Lega1 Description: � "' Owner Name & Address: q Tpm �I r.c�e/I Tel. # � Tel. # ,,��%/ Contraetor: Address• �D��'D ��/,[ /�/' e � � ic��-¢••+ - Attach to this application, a Certificate of Survey of the lot, �ith the proposed construction dratan on it to scale. DESCRIPTIOA OF IMPROYEMENT �-t Yx. B-vt. I Z Y o`L l $q . Ft . LIVING AREA: Length __ Width Height GARAGE AREA: Length __ Width Height Sq. Ft. _ Dg�g y�gA: Length 2�� �Tidth / Z. Hgt/Ground Sq. Ft. _ i � (�, .� v OTFiER : I�� x i3,S� -� � 3�. �� a- a��,a� =�I��� �� y Corner Lot [] Inside Lot [�] Ft. Yd. Setback __ Side Yard Setback Type of Construction: Estimated Cost: $ -- Approx. Completion Date: �u�u !- �`. /9�7 5�,00 � (�6C �2X�► � 2�Z +1��7Z�-/� z 3Z x(,.�t� '���'�.a�� Ait. n ait s proposed DriveWay Width If New Opening Is Desired: See Back Page for Explanation DATE: o ` �—d � APPLICANT: �'- , Tel . # S7 -Q�7 CITY IISE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge C�/1 q� $ .�✓, V� Fee Schedule on Reverse Side $ � a��3 25i of Building Permit Fee $ o�.�d �.50/$1,000 Valuation � �525 per SAC Unit $ Fee Determined by Engineering $ ,�^ Agreement Necessary [ 7 tiot Necessary [ 7 TOTAL $ J � �� � �^ � STIPULATIONS: �q-,2,. (�µ2di (iA�A-UC�., �R.o(YZ �_ i� �� � � �G�, r� - ��- � 7 zoG �— � 3,�s . �bC� . �� , , 3� .;� t� � J� ��osoa� ����� *xo� 'zs� srr� �z� 't �[�TS '6 �� � : •0£ = MT =otB�S f �j'� '�{/'f/�, s � � N � , •� �1/ •pootld �ueamuo�rc uo�� sa}o�aQ p � -- . • �� � -9 �= . � �. . � ac . � sr� � �� .. . � ��o�r� : 0` yc �6 . � ��b S9 ZZ/�. '/•o� . \ .�`� �� ��, �� b bl ti � .t � � \ � / � . ` f �4 � � � � oS � � � , c� � � _ :-�� � \ ., L: ' s �r.�o�y tB-S2-L •eo� Z / /:� =a�oo IS06 '�N '6a2i ./ �'/ / / -c�osauu�W }o alo�s ay� �o sMO� ay� �apun �o�(an�ns puo� pa�a�s�6aa �t�np � wo ��oy� pu� aw �q pa�oda�d s�M �(a��r�s s�yl �oy� �(�il�a� �(qa�ay 1 �o«s •wN�w •�rnd •�� •i� a�ssar zes �� . 8 � �� �6Gf-ILL !NO►w=171 ��� NpIpQ NOIi1/�10�11Q ONIA71WAS ONY7 xoa3exns ahTv-t ��I�i '3 Q'1dI�I42I � ���' : s� � � ADDRESS PIN LEGAL DESC CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 E•7►�►�11�L !�l►.�;F : 6175 HEATHER PL NE : 133024430082 : HEATHER HILLS WEST : LOT 9 BLOCK 1 571-llIf% PERMIT NO.: 2004-00360 �� - DATE ISSUED: 03/18/200 D ���� PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION . NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERNIIT ISSUE DATE. RECONNECT FURNACE AND AIR CONDITIONER # INSPECTIONS APPLICANT DEPENDABLE ELECTRIC INC 2619 COON RAPIDS BLV COON RAPIDS, MN 55433 (763)757-5090 � ./►I : ANDERSEN DALE C& PATRICIA L 6175 HEATI�R PL NE FRIDLEY, MN 55432 1 STATE SURCHARGE, ELEC FLAT ELEC PERNIIT FEE - NIIN (RESn TOTAL PAID WITH CHECK # 28305 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 lrnow 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 construction or the performance of construction. Applicant Date Bldg Insp Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. (t- ' 0.50 20.00 20.50 ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY PERMIT N0.�04-00397 ` 6431 UNIVERSITY AVENUE NE y-�--- FRIDLEY, MN 55432 DATE ISSUED: 03/29/2004 163) 572-3604 FAX: (763) 571-1287 : 6175 HEATf�R PL NE : 133024430082 : HEATI�R HILLS WEST : LOT 9 BLOCK 1 : HEATING : RESIDENTIAL : ADDITION/ALTERATION VALUATION . NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A REPLACE FURNACE (WARM AIR, BRYANT, 110,000 BTU'S) AND AIR CONDITIONER # A/C iJNITS 1 VALUE OF APPL OR WORK # FURNACES 1 # GAS DRYERS # GAS RANGES 0 APPLICANT RIVER CITY SHEET METAL INC 9928 BLLJEBIRD ST NW COON RAPIDS, MN 55433 (763)754-2199 OWNER ANDERSEN DALE C& PATRICIA L 6175 HEATI�R PL NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or const�vction 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 ihat I have read and examined this application and lrnow 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 pernut does not presume to give authority to violate or cance the provisions of any other state or local law reguta �' cons ction or the performance of construction. Annlicati� t \ Date . Bldg Insp HEATING PERNIIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE AIR CONDITIONING FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT TOTAL PAID WIT'H CHECK # 12675 ARATE PERMITS REOUIItED FOR WORK OTI�R THAN DESCRIBED ABOVE. 0 0 0.00 30.00 0.00 0.00 25.00 0.00 0.50 55.50 . � ��s3 � . e � � ' ^ V) \ %h � � � � � � Z O 1= y ,- J V �} 2w ?C p riz Za � N O� W U y 2y C? Z � n� az No ?v Ja ao �z .�a 2 .a o Q~ 4 �� 'L CD 0 � a cai a � a • � a O a N � � z 0 H V W a W ^ �Z � — y N � � Q Q � J.� � � e� � '^�� '� � ; z m .�. �+. .= � cv ch O � T � �o � .., a� .. " H M??� X U t0 ti � kC+ w � O � m O � _ C1 � W N � � � O w � � C7 Z O J � m � � � � � a� O z H g � % a � O U � W t-- ¢ � � W .Q A Q� � � i o C v � � p � W � � N W J Z � (n � N v �"� � c> � � c �� o � �s--- i3 0o a ►-° z w � I � � C [ � Z d = ro � Z ~ w � a� a� � v � — c f0 N L � Zf-L10�i CDm A Q � a 0 4 � � � � � � � °' QU o � o 0 0 0 0 0 0 m r, ., .. � t� e�* v� � � 4J V � � � C � i. i-. � x .� C 1 U � � A j N � G G7 � tU0 � � f_VG � c � +� a�i Cu�.=-v � i�. v � , .a o � � C 41 r � � � 7 Z � cU Vi �d d m d � � y�'a c ���~a � a: 0 t/7 N N � � ro �o ��Q Ci C'3 £0�Z0'd 8062bSZ L a 4 t"v C7 Ol g N !e� �X !q C.` �z 0 �� N � v O � o �' Q ,� ` O a�i � � d N + ,� U N � d � `tQ� n v� Q m1. a O s) o � � � 'O i j c � ,,.. 0 �� o � �C q ." � y � � � � a�U«�. a. U � �w m V � . � � � � � � Qi ��_ ���� •� �e u Ea► u, c � A R � � a� V..". � V � N C � �T (0 O C .ti��o v � °� A ••p.y�� U a.5 c ' a�'i o`� � �R 0 y � To 'S � ��p0._ � � � m ��.�.. .� m� y � c � c a' m c .� � � .� �v :a � m `o a�i C ;� N y a7 � � C � H N � � d h� v� tff y N io Rf i • - I.ij � u. N � .� � N F.C- r � 0 t U U C m �9 � '� ¢ N Q 7 'fl y C > \ ;tO 'u o m� U ~ A3�Q I 21� �0 J,1 I J 4 � `_, � � O U � Z � Q W z b1021� d� � • V ' �. � � J � F"' 17 C7 C OD � I � x � � _ C � O O h b�4 W W �.t I z � F= v W a N Z ' W rc ZO:Zi 1 � �, � o �� c �I � � � °: QI '0 U � � _�_ _ � 00 � C � � a � m� v'�� � . o Q Q a 4 � � � 0 � .� � `m C �, � � O v ?� � l0 Q G � � G a� m v � ti � O a � O � � o u e N O � �� C h O F � � �Q O c C� � 4 �� bOAZ�-21tiW -..t--,--_ MAR-25-2004 12�03 FROM CITY � FRIDLEY TO 7542906 P.03iO3 THE BELOW MUST BE F�LED !N WHEN REPLAClNG FUEL BURNiNG APPI�WCES OR THE APPL1CA71�N W1�1. 8E RETURNED ,•, ��,� i ►� •� � •: s, � •, t�. � � ��� When �epl�taa a� eY��^� b�r.e, the undersigned hereby verfies that the ve� has been exemined and is fr+ee from n�si, detenoratian, obsbvctions, / ar�d is securely supported and flrestopped where required. Yes (�S No ( The venting system is ptastidPVC and meets all cuRent codes and manufadurer specificabons indudir�g sizi�g, IengU�, number of elbows and termirsation. Yes () No � The u�tdersigned also vetifies that the �eplacement unit is a lissted assembty and meets the wtret�t codes and manufar�urers specifications. This does include AGA-GAMA Category I Cerrtral Furnace Vendng Tables for fan assisted and rk3tura! drait appiiances. 'T'� oY_ i`�� cen�e�+�+�en ��r � S�ed and insialled tn meet the wirent codes _ ar�manufadure�s specfications. _ VNhert neqt�ed to " ' w� be si�ed a�d insf�ed to meet the cume�t codes and manufaettxe�s speaficatiorts. , VVhen ' the undersigned hereby ve '�fies fhat it is a 6sbed assembly and meets the cun�ent codes and manufachuers s��tio�s. Thls d0es indude AGA-GAMA Category I Central Furnace Ventir�g Tables for fen assisted and natuta! dratt appfiaances. (s the comrt�on vent and vent c�nnectars saed and instaNed comedly after an appNanoe has been rernoved from the common vent and vented separately as per curreM codes. Yes (� No ( Yes (�o { ) Yes (�J No ( ) Yes (.� No ( ) Yes (�) No ( ) �.� ..« i.._ . .. .:.� . �� �� . . :,. . � . :.n .,� �._.«�.. .� . .�� . � . , Ap�iance #1 Type BTU Input //6 Oy'v � Fan Assisted or Nat ��� Appliar�ce #2 7ype BTU Input �, Fan Assisted or Nat Appflar�ce #3 Type � _ STU Input Fan Assisted or N�t Total Appiiances Total Btu Input �� GaTUnon Vent Type J`�� Vent Height � �iameter % r inches Appliance #1 Vent Connedor Height ,�„�ft Length ,�ft Diameter in 7ype Appfiance #2 Vent Con�ector Neight �,�ft �ength ,�ft Diarneter in Type App{i�anc�e #3 V�nt Connedor Height w�ft Length �R Diameter in 7ype � � ' � � � �.- . .,� HEATING CO: S+9rx'd BY: Date : 3l � S` TOTAL P.03 Building Inspections 763-572-3604 763-502-4977 FAX DATE '�(� U 2 SITE ADDRESS � THIS APPLICANT IS: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS � OWNER jd'CONTRACTOR PROPERTY OWNER/ N,4,�,E: A,�dersoh TENANT �pRESS: 6 � 7S /-/�a-itier �i CITY PHONE: Permit N • - - - • : ,, /�. �. ����-,�. ► � . � i; ATE %%%/iirZlP NAME: /'10o e j1 ! n (' ' rf CONTRACTOR ,�D�SS:6ay� ✓Jeca�ur Ave l�/ _CITY oo�� TATE�IPSS SUBMIT A COPY OF pHONE 76 �' 36 6-� O I O F1�X YOUR STATE LICENSE STATE LICENSE # a d 6�� 4 a F EXP DATE �Z,� - O�T PROPERTY TYPE PERMIT TYPE TYPE OF WORK: DESCRIBE WORK BEING SIZE OF IMPROVEMENT -BSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES ❑ ADDIT[ON ❑ GARAGFJSHED ❑ WINDOWS O BASEMENT FINISH jd ROOF ❑ DRAM TILE ❑ DECK ❑ SIDiNG ❑ OTHER � SWIMMING POOL ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR � REMODELING ROOFING NUMBER OF SQUARES � GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING � Vinyl ❑ Aluminum ❑ Other WINDOWS IN EXISTING OPENINGS ❑Yes ❑No OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED LENGTH ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE 0 DETACHED GARAGE HEIGHT � BASEMENT REMODEL(NG SUBMIT: I . Exisiing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Fascia and proposed project. 2. Two seu of consuuction pians 3. Energy Calculations LOCATION OF WINDOWS NUNIBER OF ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LA$OR AND MATERIALS: ` SING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ J�� � OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ ,�,�•as See Back Page for Fee Schedule $ 65% of Building Permit Fee $ a .001 times the total job vafuation $ .0005 x Permit Valuation Minimum $.50 $ S'"� $5.00 (State Licensed Residential Contractors) $ $1825 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$21 =$ $ �450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ , Make checks payable to: City of Fridley Attach THIS IS AN APPLICAT[ON FOR A PERMIT-NOT YAL1D UNTIL PROCESSED I hereby apply for a building permit and I acknowledge thaY 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 pertnit on site; that the work will be in accordan 'th proved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME �%, n� Q� O�'lf DATE APPROVED BY DATE ;uildin�v L�s�e�zions %6�-=7=-�60� 76�-��0�--!!�; � r_a�� SIT'L ADDRL•SS T'HIS:�.PPLlC.�NT is: PROP�'tT': oyviv�v T�N��(T CONTR�iCTOR SUBMIT A COPY OF YOUR S'I'ATE LICEtiiSL. DOND AND CERTIFICATE OF INSi7RANCL _' ? s1� M�' Q OWNEP. ��; � 1 �' ! -1 �i ; � � �� �.-�� ('T'�,_�; ,� �����..; � �����I �..�,�, :� � _ -,-�-„ �- -�.� , ;� � � , � � �.. � �� r�::���. _� LrF�:c:rv� ;-?-as `!QU[t L--�V1Ali. .�DDRESS N � NAML•: I�QiTYCU � nI�I�Lt-S'(YI ADDRL•SS: �I � i'���'i� �I i�,� PHONG: �D�L � RI "I' OS� ST.4TE LIC -�i ISE m STATE BOND � ADDR.ESS: �?�ID MM� PHONE ��/3� 7'%�`f� TYPE OF WORK: I� N� n°nnit No.: i'�ec�ived Bt�' • �a�9� �? � T � 20� STA �4' DATE _w..........•�,-~"' L":CP DATL F�.x ��'t,.�' �,r FAMILY ❑ TWO FAMILY � TOWNHOUSE DETAILED DESCRIPTION OF WORK . • �� M� �a �� ' � PER MS 168.665 the permit fee is a minimum of �15.D0 or 5'/0 of the totai cost np to ��00.04, whichever is �eater, for thc improvement„mstallation or replacement of a residential fr�e, excludin; the fixt�res. �(This should reflect only the cost of labor ) Labor cnst undsr $300 =�15.00. Labor cost between �300 to �500 = cos# of labor x,OS = plus .50 s�ch��e � OR `� FOR PROIECTS yVF�RE LABOR EXC�DS �500, FEES ARE BASED ON � 10.00 PER FIXT'iJRE, EXCEPT Wi�RE N1]TED. FIXT'URES: (Il�iDIC�1TE TO'15AL NTJIvSSE�t OF EACH BEL01�. MII�tIIvfIJM FEE S 15.50. BATIi SINKIiAV ' FLOORDRAINS SFlOWER WATERPIPING ; BATHTUB GAS PIPING (NEED QTY LIG� SVVIbIIvIIl�TG POOL WATER SO FTNER (53� CLOTI�S WASHER KITCf�N SINK WATIIt CLOSET _BACI�'LOW PREV. ($1� _ DISHWASHER _ LAUNDRY TRAY " 1WATERHEATER (S3� FOR IRItIGATION _ WATER METER ,_ OTFIER Permit Fee � Number of fixsures (cr� �10.00 x� 10.00 =� SurcharQe .i0 Number of fixiures cr � 15.00 x$15.00 =� TOTAL DUE $ OR Number af fi.�ctures ��35.00 � s 535.00 =$ �0� � • State Surc��ge = $ 50 fMUM �i5S0) ' � � � (MINIMLJM �1550) Total = � � THIS I5 AN rLPPLICATION FOR A PERMIT-NO'C VALID UNTII. PROCESSED l l�ereby apply for a plumbin� permit and I acicnowledge that the information above is compiete and accurate; that the wor!c will be in �- con%rmance with the ordinances and codes ofthe rity of Fridley and ,vith the Niinnesota Consmaction Codes: that L understand this is '; -_ � not a permit but oniy an appficarion t'or a permit and wori: is not to start without a permiC on site: that the worl: �,vill `be in accordance i-- �I �.:vith the aoproved plan in the case of all �,vorlc �.vhich requires revietiv and approval ofplans. li •� . •. ' '� :iIGi•1ATZJPS l)f r'�I'PL:C."�NT !'P.1rIT7lAML''. ,�/l/i"� ��� _-17ATL /ti � �� i �� :I �' :i�rPOVr:� i3v o,n�rr:' i ;�r��:��_Si,:',I •�T?j: '''-�;� �r�:IviIT'S.,_P..E'?'r'i�i"IF�.r =�7P. �.1�( " 1.l�ICi: — ..,...,.Pic, ,1„ ;, vT, r;,� �r. - , C' ,r_�. R:-TL':�� � � .: ? L✓ ..�i.;y::; � : � i � G'� r� i�I iC,"�.L.. .�/i�RL;: _.�� �)J[ .,� :'i��8'�r jiflllQlzl.`� �ST•.28�:�:UI1.5' .::'f'.T).:1�'":::1F�*,1' � ?1= , _ ::lve:"�IL�,� . leilu� � �. '..ic11�:" ::�i l .i : � -- — -'i� _ --_-: �1�1'1 - . . _;'� ; : i �-. _ J,-. ,--- Building MECHANICAL Permit No.. t V� Inspections RESIDENTIAL APPLICATION Received By�� 763-572-3604 CITY OF FRIDLEY D�� 763-502-4977 FAX �� EFFECTIVE 1-1-08 DATE � � IO YOUR E-MAIL ADDRESS SITE ADDRESS � I JS � L"`� THIS APPLICANT IS: ❑ OWNER I�CONTRACTOR PROPERTY NAME: P� R� C j� A� �� se� OWNER/ ADDRESS: �i7S H��� PL�1"�E Cp['y �I{ IG/ STATE/H�ZIP SSy3 TENANT pHONE: 7b3— �N�P� �g0� CONTRACTOR COMPANY NAME: MARS%I HE'+'ff/�1 /W� ,/Q'rK C� oN0 i'��Ni'^� NOTE: / SEPARATE CITY CONTACT PERSON: , P I`�1 �MA��N - LICENSES ARE STATE L[CENSE # EXP DATE //� ,/ REQUIRED FOR GAS ADDRESS: (pLNg LA���L9� .%i�'; � CITY [3/�+�+I�� � STATF/ "�'�ZIP �SS7 � AND HVAC. SUBMIT COPY OF BOND pHONE �63- 5 36 -obb� FAX 76 3'�i .'fb ^ 02� Z(o ANDINSURANCE PERMIT TYPE � SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: � NEW � REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK I<�� C�o��^�_�1Z ��� �� � L�^�°�� t D�us*+ 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 ) OR Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON S]0.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOV� Equipment Installed MFG: ��"�� MODEL: ��y' � Z`i SIZEBTU Lyaou MFG: MODEL: SIZEBTU MFG: MODEL: SIZEBTU �A/C $25.00 FIREPLACE (GAS) 515.00 _GAS RANGFIOVEN $]0.0(1 AIR TO AIR EXCHANGEER S 15 FIREPLACE (WOOD) 535.00 NEW GAS GRILL � 10.00 �BOILER $35.00 "��'URNACE 535.00 GAS UNIT HTR S 10.00 JCHIMNEY LINER $10.00 �`��GAS DRYER S 10.00 POOL HEATER $35.00 �DUCT WORK 510.00 GAS PIPING 510.00 VENTILATOR $15.00 P�RI�I�' F�� P'�(i7ECTS FpR UNL?ER`$SQQ PERMIT FEE FOR PR03EGTS OVER $504: Permit Fee $ . Number of fixtures @$10.00 x$10.00 =$ Surcharge $ .50 Number of fixtures @� 15.00 x$15.00 =$ TOTAL DUE $ OR Number of fixtures @$25.00 x$25.00 =$ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 MINIMUM $15.SQ MINIMU�QTotal = $ f� THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a mechanical 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 accord nce with the approved plan in the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT i�y"" %� PRINT NAME I��y Oy�s� DATE ��b�to APPROVED BY DATE �� �'. ; A�� N : �k�, �'4�1RA�'� I'�1�11�I� 1�RE RE [:TIl��T� Ft�� ��I�I�T�y� ..` . , �AI, AND�;,11� ,�`,�,���T�G'.r�i.L ����,p'.„. : City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977