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AF - 46172-- _ . : .. . ; , _ . ��-.,� �-. � �� ,.�= Yilla.g� of Fr�iclley, Minn. �i' -� - :. - �iT° 1�7'7 �-=��.DTNG P�I�MIT � _ Date . . �i+��`�. -�. . �.�. '� '�� ' "��, ° * Owner . . . . . . . Builder ,. 'rt�'�? . . . . . , . � • • . ,�.'�, . � Address-......:...::.............., ...:...... Adtlress : ....-• .. I , _ : � �,. L AT�O OF BUILDING � � s.�! .`�',��'� StreQt : �!�� • Part of I,flt . . . � . � • No. • � �. , Addition+or. Sub-Division ��- +��• • Lot .�. Block : . '.` ' � � ,r � . . . . . . . Inside Lot �. . Setback . � ".�. Sideyard ` �, � '� �' � Corner Lot ,.: , •..... •. . DEBCRIPTCON OF �U[LD[NG H To be Used, as; . � �� ...., . Front .'��'. . Depth ..�'`.'.°:�:. Height .�.!� . Sq. Ft. . C�- F't. . , • � .�!�. � �*� : Hei f . J� : �: . 5q. Ft. . . . . . . . . Cw �"'t. . . . . ; . . , . � . ��p�i�s� , . Front . . . Depth . �r. � , . . .,.... ; , . To be t�ompleted ... .. _, : r... .. TyPe af Co�truction �!�'`��. : . ... Es� Cost � ..... : .. .... . ... .. �t ' �.. � } , : _ " - � � I , . :' :- --"" , !, � ' _ , i . . � _ . .._ _ , � � . _ , - � M. _ , _ .,, .. _ � l .: � '� � � � � + 7n consideratian of the issuance to me o€ a Permxt to construct the buil�iing described above. Z.' agree to do ''' the proposed work in ac:corda�ce with ttie descriPiion above set forth and in .comPliance with all Provisfions of , � V - ��. ordinanc�s of the village of Fridley. ,' , , ' . , �� . . 1 - ...... � ��s.. .��' '� ., " . $; , � � t is �iereby �ranted 'to . . . . . . . . ., . . • � in considerat%n of f�e payment of a fee of ... ., permi - - �� , . ` � �, upo� -�' or_ addition as d�scribed abaue. This Permf.t $� .. to consfruet the buil�ing the exAress condition that the� A�n to whom it is granted and hia agenffi� emP�oyee� amd �r� or8inan� . done in, around and upon said building. or any Part tbereof, aiiall conform in a11 rea� - Er3dley, Min�aesata. reg�x'dir►g loca.tion, c4nstruciic�n, alteration, mait�tenauce, repair and moving of bu3ldings with , : in=the eillage, limita and ;tliis permft maY � revoked at' anY , time uPo� violation of any of tk►e Provisiorjs of saici � ordinances. . , ; . ' _. .� � {� , . �. . 8t�iiicling �t , NOTICE: as heatin This permit does not oover the conatruction, instatlation ar alteration fo� wiring, plumbirtg, g 9, sewer or waier. Be sare io see thi+�iulidtrtg Inspecto� for seA��ate permits' for t� items. f t � _ ,� : �` , _ - SUBJECT City of Fridley AT TFIE TOP OF THE TWINS g U I L D I N G P E R M I T � � � � �• COMMUNITY DEVEIOPMENT DIV. � � -------. r � � � PROTECTIVE INSPECTtON SEC. � � � � �"'1 � CITY HALL FRIDLE� 55432 NuMBER REv �""� � �'� 612-571-3450 910-F15 10B ADDRESS 1351 Hillcrest Dr 1 LEGAL LOT NO. BLOCK TRACT OFi ADDITION DESCR. 3 4 Moore Lake Hills 2 PROPERTY OWNER MAIL ADDRE&$ Merle Thompson 3 CONTRACTOR MAIL ADDRESS DeMars Const 8401 166 Cir NW Ramsev 55303 4 ARCFIITECT OR DESIGNER MAIL ADDRESS 5 MAII OATE 8/13/98 ZIP VAGE OF � � 27165 �"'/�5"9 APPROVED 8Y SEE ATTACHED SHEET PMONE 571-5260 PNONE LICENSE NO. 6614 PNONE LICENSE NO. PMONE LICENSE NO. 8 USE OF BUILDINCi Residential 7 CLASS OF WORK ❑ NEW ❑ ADDiTION ❑ ALTERATION � REPAIR O MOVE O REMOVE 8 DESCRIBE WOFK Reroof house and f�arage (23 Sq) Tear-off 9 CHAN(iE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. SEPARATE PERMITS ARE RE�UIRED FOR ELECTiiICAL, PLUMBING, FIEATING, '' r� v VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NINO AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OF IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DN I NEREBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VALUAT AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OH NOT. THE GRANTING OF A PERMIT ], DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OH CANCEL TNE pEqMIT PROVISIONS OF ANY O ER STATE OR L LAW REGULATING CON- STRUCT ON R THE FOR CE TRUCTION. PLAN CI S�GNATURE OF CON7RAC10R OR AUTMOA�ZEO AGENT IDATEI STALLS OCCUPANCVLOAD CU ET PARKING �. i �-.� • / NEW [ ] ADDN [ ] ALTER � ConstructionAddress : CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION � � + l�r��l � re�' �� Effective 1 / 1/98 `�� hl Legal Description: Owner Name & Address: �¢( �. T%+a�S'O� I 3�� r C�el. #.s%l S� ��es O Contractor: � MN LICENSE # % � % y Address: a"� � � " �� .`�'� � W �} 1 �� Tel. # y �jl / %d $ � Attach to this application, a Certificate of Survey of the �-�-�� lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IlVIPROVEMENT Length Width Height Length Width Height Length Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. �G�f� Q Construction T e: %1Jt �'�� Z3 �E.stimated Cost: $ ��U yr (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ � � /C/J� DATE: g APPLICANT: Tel. # y�I ?�$� ,��e` 62 � oy� y CITY USE ONLY . Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ ��- �S� Fee Schedule on Reverse Side $ % 9� .001 of Permit Valuation (1/lOth%) $ � � (� $.50/$1,000 Valuation $ $1000 per SAC Unit $ ,,� D �% $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.Q0 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ �o � �� BUII.DING PERNIIT FEE SCHEDULE The Chief Building O�cial shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $1 Q0, 001 to $500, 000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,(}00 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Altemate "A": Removal and replacement of curb and gufter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will he required before proceeding with the framing. . _wa'.� '.- �b PL4JIVIf RlINI� RESlQENTIAL ,!'�f�P'�.I�ATION City of �r icllE� y �� -��s �� PertNt Nianber �-�-��- � � �B�Y� NOIE: [� PftOPER7Y I$ NOt OWNER/�' C+;�UI�tEP- A LICENSEO CONTRAC�'4R Mlt$T OBTAIN THE P�RMIT. - -- - � —.—. DA7E �j %� a�J �� VOtlR E lW111. A�dpREBS _ Sli� AD1DR�83 � � 177(.[� ��r �,�� APPLICAW`f IS: (CIRCLE tN�tE} �VYP�R �; C� DN7RACTOR NAME �� :_:�/�.�G�i2. �-=�.�1�/i!/a 1`f/4�'�'t� PROPERTY OWNER! ADDRESS ,�5 , �i1,=� C.��T �� T�NANT CITY L��' Z._, wSTATE /Y7/V LP��,�,� PHON� ��:� Zt1.'" �� NAAAE � � ,�: � UC�NS�#--- CONTRACTOR ADDRESS .�:�� S CITY t! �. � _STATE �YJN ZIP .��-u_-�� 7 PHONE �R�—' /: �r_:��C.� FAIC� -- P�RMCf 7YpE I V SINGLE F. 1MIL1' 1YPE OF WORIt � CJ NEW � IiEFLACEINENT DETAILED DESCRMTIt7N OF WOIiK I�I%fJTA'L.. ::�� y G� I�'� J�%/�' T��+ /�',�� — FEES ARE BASED ON s10.00 PER FIX'�t7RE. EXCEPT' yl�II:R� NOTED I FlXiURES: (lNQICATE TOTAL NUMBER GF EACH) B�ATH SiNWLAV FLOtlR DRAINS S HQWEft BA7`Nl1JB GA9 PIPIN� (N�; ad Cit��llcensg) ___.._SWfMMING POOL c�QtNes wa9HER IQTCHEN fi1N!( WATER CLOSE7 DISHWASHER _ LAUNQI�Y TRAl' �Y�ATER HTR (s35) YrATER METER P�►rmlt F�e Plan Revtew 5urcharge TOTAL DUE S � �5 -�2 s ��50 � 3� �'t� wA1'BR P�IP�N� WATER $ClFTENER (s�� E�acK��ow g�v. (s+51 FQR (RRI{4ATI�N O'TFE�R ti11PlIMUM: �1�.pQ or 5Yo at eost of the improvement whichever Is g�•�ater on vvark le�s ihan $300 tilake chacks payable to: City of Fridley ��w�w--^"--"^— IQ �I F' �R A PERMIT — i hen�by apply for d p1t1�1bing permit and 1�CltnolMedge t� at t�e infortnatlon above Is cpmplete arrd aocurate; that the w�Drk will b� in ca�tortnan� with the prdiitiBnCes �nd oodsa of tlts Ciiy of Fddley and K; h the Mlnnaspt� Cplstruction Codes; �t I understand thlS iS not a pennit but oniy an applica� ior a perrnit 8r1� WpA� i9 rrot to staR wl�l0ut a F� �mi k Ihat the wak vu1B be fn accrndance with the approve� pf� In the ease of e1i work which requlres ravlew and Approral af plans. NAME OF AI�LIGANT �" " �'�CfJ; % ��; �.� DATE _ %Cl 'iJ �+ e type or i�rir i�r�� SIGNATtiRE OF APPUGIM ' r' • � . _LL: is t-rL[y ' �t r': • i -'� �S��a°' ' ' '" ' ��.' J �j�:•4k-�•'•! � � + '`'&~.��;,,�,' � �! gl.�p°: w;;� ^ ` ` �:.�=_ � 'IC�"v�1P ' a��:^:. ��it'aIIi �5��;:t:•.. pnr �7F FRIt� _�r' C��M�IUNI7Y DEVEL PI��NT DEPAiz7nA�H� 649'I Ui NLESITY ANEI�IYE NE, FRJULEY, Hfrl B54S2 I78315T2-3�4 '�L' 1{VORi(�' ' ';;�;4; � . _ . .. _ .. � s•. . oi�li�2aoz oe:�s Fax Qate: 1/10/2007 Revision D�ts: 1170/2007 Site infarmation Address 1: 1351 Hillcrest Drive �xisting Construction: Pre i 994. Project #: 89725 Address 2: Lot Black: City: Fridley Gounty: Hennipen Subdivision: Aoolicetion tnformetion Business Name: Soderlin Plurr�bing, Heating & Air MN Gont�actor License #:OU1745PM ContaGt Person: Jas�n Office Ph: 612-721-40$0 Fax: Cell Ph: Address 1: 3612 Cedar Av�nue City: Minneapolis State: M�1 Zip Cod�: 55407 Mlnlmum Mechanicai Code R�u�rem�nts Me�t Wi11 you be repl�cing or adding a we�ter he�tsr� furr�ace, ar boiler? W;II you be installing a dec�rat�re solid-fue3 appliance? Will you be instailing an exhaust fan 300 +CFM or greater? You have me# the minimum requirements fc►r make-up eir and combustion eir as required by 1�e irrternatlonal r��echanicsl code� as adop'ted by the state of Minn�ota wtth amendments. Applicant Name Code Off'icial {pri �ao�rvo2 NO NO NQ Signature/Date• /"/.'• :�7 3ignature/Date: � f� � � 2004 CenterPc�int Fs�rgy Minnegasaa. 2004 M�chanical C«ic C;uidelines. 1�agc 1 Buildir�g MECHANICAL Permit No.: o a-I� Inspections RESIDENTIAL APPLICATION Received B: 763-572-3604 CITY OF FRIDLEY D�� - DATE � I�� YOUR E-MAIL ADDRESS 1 t �'Yl GO�r' �'1�0.h @ 0.. t T• t�1Cfi� st�AnD s 135 l 1-4'i��cres 17r. NG �ri t�� Pil�l THIS APPLICANT IS: �4.QWNER ❑CONTRACTOR PROPERTY N,v�: r o�.l�a�r1 A.� . �e. o w�r s— C a r rto�a.r� OWNER/ ,�Dx�ss: 13 5t H� Il�e.s�' pr. N�' CITY rr�d�.v� STATE ��ZIP �$�3 TENANT PHO,�: 7 b 3— S 7�" S�f'� �a CONTRACTOR COMPANY NAME: SUBMIT A COPY OF CONTACT PERSON: YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH qDD�g. CITY STATE ZIP APPLICATION pHONE FAX PERMIT TYPE �Q SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: � NEW �REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK ��.i`' 1 p ,��",Iiit.ovr-�� J PER MS 16B.665 the permit fee is a minimam 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. L.abor cost between $300 to $S00 = cost of labor x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $]0.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: ([NDICATE TOTAL NUMBER OF.EACH BELOV� Equipment lnstalled MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU MFG: MODEL: SIZEBTU A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGElOVEN $10.00 AIR TO AIR EXCHANGEER $IS FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00 BOILER $35.00 _FURNACE $35.00 _GAS UNiT HTR $IO.dO CHIMNEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENT[LATOR $I5.00 ;�. , . � ° �� = �, �� .:'� , . .. .. a � .��. � „�-�� y. .��. �. . �.� � t, � ��' �-��`��,��° � � �,_. . .,o....a _.,_.. . �� 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$25.00 =$ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $� THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and 1 aclmowledge 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 ork whic requues review and approval of plans. SIGNATUREOFAPPUCANT �%��—��^- PRINTNAME -1-. 'i�e.vl�e.Gbfoers-�+rnrr�DATE 7 � D ��' �� . :� ., " '� �`'�� . �� >��.��:�� €�.: . �.��'��. �x��; 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 APPLI�ATION HVAC � � NEW HOMES/ADDI�'IONS 0 EXISTII�C� �IOIVi� � d MAKE-UP AIR REQUIRED FOR NEW/EXiSTING HOMES 1. Combustion Air (See note below) 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. Hea.t loss & cooling load per room a. Required on new conslruction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make-up air calculations. �- a . • � � � ,