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AF - 47157BUILDING PERMIT Village of Fridley, Minn. N� �� 3 �- .. � � Date ...F� mr � � `� � . . . .... ... � ' '�-Z-��:e �Ci�' v , �'� ........ r��ua�� ; Owner ... � ...... .... .......... ..... �.`. ...... ... ... �. . � � � � �7 ,^ , i � Address ....J..v.�� ............ ..�?. a .;...''�-C: .\dJrrss . ' -` � � .... ... �..:. .:�....... f ............ LOCATION OF BUILDING .. .., � !,e ....� ?" • ✓ No . ................. Street ..................................�..:..... Yart of Lot ....................... . � C Lot ................ Block ....... ........ Addition or Sub-Division ....................................... � /' ! � y�i Corner Lot .....b�.. Insidc I.ot ............ S-4hairl: ..._��;+r.... Sideyard .�rl ...................... DESCRIPTION OF BUILDING To be Used as: i .�l!� � ' C �.L, � .....,........... Front .�...... DePih ........ flcight �..CS.... Sq. I't. ........ Cu. Ft. ........ .................... Front ........ Depth ........ Heiqht ......... Sq. Ft. ........ Cu. Ft. ........ Type of Constivction ::l. �. a.'."'Y.. Est. Cost ��. 6.O. �. ......... To be Completed ��RL�"Q •/••:...... d'/ .�fC In consideration of the issuance to me of a permi� to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all procisions of ordinances of the village of Fridlcy. X�f�;�A�C��.. /��5.,�--.-,..:'!!R;5/. �. r. ,�? consider ion of the nayment of a£ec of $..�.... , permit is hereby granted to .. .-. Cl'�!C............ '�f�P".`.-`r: L:�...... to construct the building or nddition as deSCMlfed a6ove. This permit is granted upon the express condition that the person to whom if is granted nnd his agenCS, employees and workmen, in all work donn in, around and vpon said building, a� any p:�rt thcreof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding ]ocation, constructioq aiteration, m<�intenance, repair and moving of buildings with- � in the villagc limits and this permit may be revoked at any tirnr upon violation of any of the provisions of said ordinances. Y , �'� ,! � � ¢'. � ...�:�.�.. �E�!.`:fl?�... Building Inspector _ ____ .__. ..__ , .__--- - NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. � � " , �� - �� " ��'�f'�' � eE� � � ,� �� l��. ��PB'd'��af� �� !1 � ��' �� 0� i�#8� �t�� - PARTtAL RATE SCF�4��OJLE n.�t. � s�a�.. �«.. s�o-saeo a�vrr�r w�►ax ArR: �u►� To�u. . L��.._� ��.�d �P1�.2. ��,��`g �� sh�n a� �e wo� . . . . . . . . . sio.00 = Refllacement or Fliraace ' s.00 � cfty o! Fl�taley: Rcpairs & Altcratioes---up to s500.00 g� � 'I'he undersigned hereby makes application for a permit for the work Aeref: specified, agreeing to do aq work in strict accordance with the City Ordti�nce Repairs & Alteration� each add. t500.00 3 W = and ruling of the Departm�ni of IIuildings, and hereby decisres that sIl ths f� ' � and representatiuns stated in this application are true and . 1QCM. WAR�i AIR. p F4�idley ' n �- Fl�,j_, plunace SheIl dt Ihict Work to 190,000 BTU .. E10 00 i e�rh add. 60.000 BTU ._..:...... .. 3.W ; Cr+vner ReALcemmt of Furnace 6.00 i Kind �f Huilding �/l,/i/y7��C , Rlyairs & AlteratloiLS—vP to ;500.00 6.00 ; . tJse� as . : i%pairs d� A}terations each add. 5500.00 3.00 ; � To be compteted about, 1 3TEAM or HOT WATER $YSTEi[ . o � ilirnace Shetl & Lines--Eo 400 �q. it. 11DR Steam �10.�J0 S Estimated Cas� a 1 �l 0� Flirnace She11 & Line---to 640 sq. ft. EDR Fiot Water 20.00 3. Id New. Building Permit No. _—_ _ p�tmit No.�� Each add. 200 aq. tt. EDR Steam A.(1(t j�,,, Each add: 320 sq. ft. EDR Hot Water 3.00 S - DElSCRIP?i01� OF WO � - OIL BIIRKEi�—to 3 gaL per hour 6.00 S._� F�TTNG or PO ot a r, arm -No- �� over 3 gaL per hour—See Fee Scheaule Trade Name Size No Z= GAS aIIRM£R CuD to 199,000 BTUi •, 6.Od = aver 199,000 BTfT Sk F�e scladul• CapacitY�`--�_ Sq. !'t E.D.A� ��,� `i�%BTU __ H.F GJ►S FITTING FEEB: NO AATE 707AL Ist 3 Flxtures xf 200 S TotaI Connected Load lUnd of PLe Add;tfonal P9atvres a .76 i-- . ` BURNER — ZYbe Namp Siu No Gas Range t� 199,OOQ :: 6.OP S ' �ilt CoIEDtTtoitilto State Surcharge �1 D.SQOb Capadty sg. 1R. E.DR BZV � 1 . FAA BT�LYI2[G sTl2LiE � F�s Scbsdnt� - �i.n�ra sYSr�t � . �►�.�u►Trors � n��s rori►i. rss � s� - . �r � �S Hudaass lr6o� � l Z � ` � �% � _ Fn�u � - i ? - � 7 ' � (MMANtL01rlR) , ..., 3 � sue�ECT PER . City of Fridley � 16 9 41 AT THE TOP OF THE TWINS gU I L D I N G P ER M IT , r ' ' R � � • � • COMMUNITY DEVELOPMENT D�V. � ►a: --��--� r � � PROTECTIVE INSPECTION SEC. � 7/ � � 1 � � � � /'�'1 � CITY HALL FRIDLE� 55432 NUMBER REV. OATE PAGE Of APPROVED BV � �----� • •�� 612-571-3450 9�0-F15 3/15/83 � � JOB ADDRESS '700 Helene Place N.E. 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACNED DESCR. �. 9 1�OI1T1Ay � S Ldlt@VleW MdIlOY SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Thomas Sibansky 700 Helene Place N.E. 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Leo O. Sanders Contr. 7813 Jackson Street N.E. 786-2860 4 ARCHITECT OR DESIGNER MAIL AODRESS ZIP PHONE IICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION � A�TERATION ❑ REPAIR p MOVE ❑ REMOVE 8 DESCRIBE WORK Install drain tile 9 CHANGE QF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTI�ATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULt AND VOID IF WORK OA CONSTRUCTION ZOIVING SQ. F7. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPUCATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF IAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMPUED WITH WHETHER SPECIFIED HEREIN O(i NOT. THE GRANTING OF A PERMIT 52��-00 $I..OS DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEI THE pERMIT FEE SAC CHARGE PROVISION F ANY OTHER STATE OR LOCAL LAW REGULATING CON- S7RUC71 R THE PERFORMANCE OF NSTRUCTION. $3S. 'rJO PLAN CHECK FEE TOTAL FEE r � $3 9. 55 SIGNATUREOFCON� CTOROFAUTHOR12EDAGENT IDATEI _1/�/�N PROPERLY VALIDATED THIS IS YOUR PERMIT � SiGNATURE OF OWNER �IF OWNEF BU�LDERI IDATEI BLOG INSP DAT � CITY OF FRIDLCY Effective �ug. 1, 1981 APPLICATIO�� fOfi RESIDCNTIII� BUlLOIi�G PLRi�iITS (Nc�r, Alterations. Additions, or Repairs) � . 1 q // ONNER: ^ � 7ruz-� `� � BUI LD�R: � � � `G��:t�t,o . , _ ADDA.ESS: `z� � D ,�-�.�� ;,� ________ ADORLSS: TEL M0: �. � TEL N0: ��' �'� P'� a Construction Location • STRI�:T NO s STItEET: lAT: _ �� / BLODCs �__� ADDZTION: _� .��/ /II .%r. . —%� � � i��-�#L�— Cosner Lot: Insiae Lot: Setback: �� Sideyards: � �l►p?licant attach to this fozm Lwo Certificates of bvzvey of Iot ar�d pzoposed buildfng Iocatia� ![rawn ot� certificates to scale. �ESCRIPTIOi�! OF COWSTRUCTIOt� � Front: Depth s Height: Square Faet: Aibic Feets , Front: DepLh: Hefght: Square Fest: A�bic Peet: —� �O Rype of Oor,struction :_ e�l,� /, L� � Esttaated Cest: S o�� Rb 8e Cbr.�pleted: �iit. A a►lt. 8 proposed Drivc�+�ay t�ii8th If New Opening Is Desired: �" $ , . . SE� RiVER;E SIDE OF SHEET � Ziie undersigned hereby makes aPplict,tion fer a penait fer the work herein specffied, agze�irg to cb ,all vork fr, strict accordsr�ce With the City of Fridiey Ozdi»ances a»d tuling� of the Delk�rtmc�t of Duildings, and hereby declares that all tl�e fact� and represc�t�tieas atated in t?�is applicatien �t� true and correct. D��TEs SIdJATUAE s --�2� C� �'%S /�19��/,0- Stipulatfons: 0 �6 S �;0 � � �� 5 . .. - 0 �. � �Ltective January l, 111U:� CITY OF FRIDLEY IhSPECTION DIViSION 6431 University Ave NE Fridley, MN 55432 APPLICATI?JN FOR POWER PLANT5 AND HEATING, COOLING, VEN fILAT10N, (763) 572•3604 : REFM2IGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1287 T JOB ADDRESS � d �J `l�e.(en� pl�., � �. RATE SCHEDULE T � _ , � , Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning • All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1�'/0 ofValue of Appliance or Work Commercial/Industrial 1.25 jo of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VEtVTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. TOTAL $ � $ OWNE u BUILDING USED AS �.�2�aQe�QJ ESTIMATED COST PERMIT N0. •`��'�% DESCRIPTI�N OF FURNACE AND OR BURNER $ No. of Heating nits�._ Circle One (Steam) (Hot Wate (Warm Air $ Trade Na e n�1� �► Size No. BTU U � HP EDR $ �� Fuel _ Total Connected Load Burner Trade Name Size No. $ BTU _ HP EDR E� $ .50 $�� -C - �od� m�..n a'� � The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an rulings of the F3uifding Division, and hereby declares that all the facts and representations stated in this application are true and correci. DATE ��r� � HEATING CO � � tn. ��1� v Signed TEL # S� � C� �-(s� FAX # �� C�..., %_ �� Approved By�� Ruugh•In Date Final Date ��/� �C � THE BELOW MUST BE FlLLED IN WHEN REPLACING FUEL BURNiNG APPUANCES OR THE APPUCATION WILL BE RETURNED (��e�ep� t/cILT� t/FI�T nI�ItEGTnR AItD C�I��BLISTIC)I` AIR VFRIFIGATION �en rr la� rin� an _Y� i�c_tinQ f�r�ancp, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes� No () The ven�ng system is plasticlPVC and meets all cuRent codes and manufacturer specifications including sizing, length, number of elbows anci termination. Yes � No () The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufaeturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The eY.��^^ �^"�ti�'�'en 9�r is sized and installed to meet the current codes and manufacturers specifications. Wi1en ('equit'ed to +net�:l a nQ�•_ cemhi�stien air� it WIII be SlZed 8�d 'InStalled to meet the current codes and manufacturers specifications. Yes� No ( ) Yes ( ) No ( ) Yes� No ( ) Whgn jpS�lljpQ a ne�•� ��r�tin�,i pm, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's speafications. 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 connedors sized and installed correctly after an appliance has been removed from the common vent and vented � () separately as per current codes. Yes No A�q�i nce w�� and Si��IGnmmon 1lent and Vent (`onnecter Infeanati�n Appliance #1 Type n� BTU Input Fan Assisted or Nat �� •� S��"� Appliance #2 Type dTU Input C� Fan Assisted �r Nat �• Appliance #3 Type , BTU Input _ Fan Assisted or Nat � T��•a! Appli?n�� l-- TOtal Btu Input C Common Vent Type Vent Height _ Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type N � r r•► ■,- ••- � � � HEATING CO: � �� _ , � CQ .2�c �� Signed By: Date : Building Inspections �i�� 763-572-3604 � 3p-- P SITE ADDRESS _ THIS APPLICANT IS: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS ❑ OWNER �CONTRACTOR PROPERTY OWNER/ I NAME: d�+-� TENANT ADDRESS: SIOC% CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE TYPE OF WORK: PHONE: % � 3 ' 7fi �I' � .� o� �C NAME: / �s7 0��, STATE LICENSE # � DO ADDRESS: La �� % ...� PHONE G/� - 7 f� q"l ❑ SINGLE FAMILYMEW CON ❑ TWO FAMILY/NEW CONSTI ❑ BASEMENT FINISH ❑ DECK ❑ NEW ❑ MAINTENANCE/REPAIIt DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT NUMBER OF SQUARES _LZ rT , Sf ;/ GARAGES �, PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum O Other CITY Permit Na `i � (� � j j ) Received By: Date Rec'd: � ,_t`J�- 'ATE ZIP � EXP DATE CITY STA'f�1ZIP S.SY3y FAX ❑ ROOF ❑ SIDING ❑ SWIMMING POOL n TH � HOUSE ONLY O HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim O Fascia WINDOWS IN EXISTING OPENINGS ❑Yes ONo LOCATION OF WINDOWS OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPEI�IING CHANGES & ❑ DRAIN TILE ❑ OTHER HEIGHT BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used Ft. FOR NEW CONSTRUCTION LNCLUDMG DECKS, ADDITIONS. 8c PORCHES SUBMIT: 1. Siu Ptan/Survey showing the existing structures and proposed project 2. Two sets of construction plans 3. Energy Calculations TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS � ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ ��[S�e _/ 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 $ $ -�l $ /. d"� $ �' .c� $ $ $ $ $ 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+6tt= 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 APPLICATION FOR A PERMIT-NOT VAL[D 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 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 ��o� �G'�i Z� PRINT NAME ��"!VO �i �� Ol�' DATE .S " �O —0 � Building BUILDING Permit No.� —0 Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY D ' r►-r 1� �nno 763-502-4977 FAX EFFECTIVE 8-19-09 �� DATE jU/ �S/ S 1 YOUR E-MAIL ADDRESS SITE ADDRESS �O I�e �tht P! N E THIS APPLICANT [S: ❑ OWNER �[CONTRACTOR PROPERTY OWNER/ NAME: porK.+�, L^'t+'l,ti.ce•- TENANT ADDRESS:�M�' CI'rv STATE ZtP PHONE:�p� d2�3(o CONTRACTOR NAME: de S'✓?� �- InI S SUBMIT A COPY OF STATE LICENSE # fiO D�Z EXP DATE 3�31 �!O YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS: ��(S/ �r�a«�n.e Cl�. � CITY /74D1Q Gne�rc STATE ZIP� INSURANCE PHONE � 3 Z ��O FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILYMEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGFJSHED WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE � DECK �SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTtON ❑ ADDiTION MA(NTENANCFJREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: T O ef h�G t�,Ot}SZ Q � �Z{�, Wi sv � t,ir/SJ�� e�'��4 .i SIZE OF IMPROVEMENT L6NGTH W(DTH HEIGHT S FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES � HOUSE & GARAGE 1. Existing Floor Plan GARAGES � ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of swctural members to be used PROPOSED HEIGHT: ��„�,,, FOR NEW CONSTRUCI'ION INCLUDING DECKS, on u�v � ADDI770NS. 8c PORCHES SUBMIT: ,a� Vinyl ❑Soffit ❑ Aluminum 0 Trim I• Site Plan/Survey showing the existing shuctures ❑ Other ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXIST[NG OPENINGS �es ONo LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U-VALUE AND OR FOR NEW OPENINGS-DESCRIBE SIZE OF �.-�.�� nOvSP MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED �L Ini NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ N, S�YO � OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Char�e Total Due $ �/ /, o� �" SeeBack Page for Fee Schedule $ 65% of Building Permit Fee $ r 5 .001 times the total job vatuation $ �.�,$ .0005 x Permit Valuation Minimum $.50 $ � , $5.00 (State Licensed Residential Contractors) $ � $2000 per SAC Unit (Plans to MWCC for determination) $ $+6ft= ftx$22=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ Make checks aavable to: Citv of Fridley Attac THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge thai 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 on site; that the work will be in accordance with the approved plan in the case of a,�r w� ich requir�iew and approval of p�77- SIGNATURE OF APPLICANT �� l PRINT NAME q,�ck L- Mcc� DATE l0