AF - 46336„� .
Ci.ty of Fridley, Minn..
6431 University Ave. 1�. E., Miuneapolis, Minn. 55432
BUILDING PERMIT
�ate: T�� v 20, 1�� i
e �
11098 �
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pQp�; Joe Pereg;rin ' 8wtider Sussel Camn���
�_ 5272 Horizon Drive N.E. �,d�e3� 1850 Como Q,ye�nue�, St=�ul
LOCATIOiV OF BUILDIfVG
No 5272 s.�� Horizon Drive N.E. p� of ��
Lot 9 Siock 1 Addil3on or Sub-Division Carlson's Sut�it Ma.nor, North
Corner I� Inside Lot X Setback _ Sideyard
.Sewer Elevai3an Foundal3on IIevation
DESCRIPTION OF BUtLDING
To be vsed as:
_ Gara�e �nti 14' �p� 26' Height - 10' - Sq. F� 364' �, �, 3; 640'
Front Depth Height Sq. F't. _..� Cu. Ft.
Type of Consiructfon - Framp F�t. Cost .��� s.�.94-�� To be Completed 9Q da�c
Set garage grade same as � house. Provide a hard surface driveway.
In conaideration of the issuance to me of a�t to construc� the bwtlding described above, I agree� to tlo
�he proposed work in accordance with tlne desc�ipt3on above t forth and ia compliance with all provisiona of
Ozdfnances of the dty of Fridley. ����_�r,r���
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Ia consideration of the payment of a fee of $ 7. QD , permit is hereby granted to �34�Se1 Com,pany
to construct the buil8ing or addition as described above. This permit is granted upoA
the express condition that the person to whom it 9s granted and his agents, employees and worlunen, in all work
done in, arotmd and_ugon said building, or any part thereof, shall confortn in all respects•to the ordinances oP
1�`rfdley, Minnesota regarding location, construction, alteration, maintena.nce, repair and moving of build9ng8
��� dty ]imits and this permit may be revoked at any time upon viola.tion of any of the provisions of sattd
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- CL�IRENCE BELISLE A
NOTICE:
This permPi doea dot eore� the conshuation, installaHon fo� erirfng, plumbing, gas heaHng� aewa� or water. Be wro fo ses
fhs Butldins inspactoe fo� aeparate permits for theae iterds.
�
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITiON BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
owx�'s ru�: �� � ��� � q �s � BuiinEx: ��� ��' �
AnARESS : �a ��3- �/� �l� ���., C��- anni�ss : f�.sc� �z� ��-
NO:. STREET:
LOT: BLOCK: ADDITION:
CORNElt LO�: INSIDE LOT: SETBACK: SIDEYARD:
Appli¢aat attach to thia fosm �to Certificates of Survey of Lot and propoaed
building location drawa on these Certificates.
HESCRIPTION OF BUILDING
To Be Used As t Q�`� ����� G�-� �-� �.
, / `{ Front : 2 c,_, Depth : f �' � Height :
Square Feet : ��_Cubic Feet : � � �% �
.
�roat: Depth: Height:
Square Feet; Cubic Feet:
�ipe of Construction: �re�� Estimated Coat: / � �
To Be Completed; `�e �
The undereigaed hereby makes applicativn for a permit for the work herein
apecified, agreeing to do all work in attict accordance with the City af
Fridley Ordinaaces and rulinga of the Depas�tment of Buildiaga, and hereby
declares that all the facts and representations stated in thie appllcatioa
are true aad corxect.
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L1ATE s �,� � � - 7 / $IGNATURE : ��' C-� - ��°a �� �(%.�;�%/
(Ses Resvexee Side For Additional Iafora,ation.)
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�BUILDING PERMIT FEE SCHEDULE
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SE�TION 2. The Iuspector of Buildings shall, before iasui�g pe=mita for the
erection of aay building or structure, or for aay addition to any existing
buildiag or structure, or for any alteration or repairs to aay existing
building or stxucture, upon application therefore, require the payment by the
applicant �or euch permit of fees to the amount herein below set forth and in
the manner herein provided to-wit:
UNIFORM BUILDING COAE: Zjrpe 1, 2� 4-$2.15 for each one thousand cubic
feet� ox fraction thereof, in such cubical contents. 1�►pe 3� 5-$1.85 for
each oae thousand cubic feet.
ADDITIONAL INFORMATION
For the purpose of camputiag fees for building pe�nite, the cubical contents
of auy buildiag or addition, ie determined by multiplying tt►e ground area
ca►ered from a point six (6) inches below the floor line of the base.�ent
os the cellar to the average heights of the upper surface oz to the average�
height af the roof aurface of the ma.in gable of a pitched roof.
For repaira or alterations to an exiating structure, the fee shall be at the
rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in
the cost of all proposed work.
Ia mc case shall the fee charged for any pe=mit ae set forth in Section 2 be
lesa than $5.00. '
VDRIFIC�ITION OF FOUNDATION
NOTEs Periai.ta for tonetructioa will be isaued a mini�um of 24 hours fram the
ti�me of application, to allow for proper review of the proposed etructure and
af the copstructi.on aite.
A Ce7ctified Survey of the lot, ahowia� the location of the fouadation, oace i�
ha� been conetructed, �i�l be required before proceedin� with the framin$.
CERTIFICATE OF OCCUPANGY
Appl�.cation for a Certificate of Occupaacy ahal� be made ten (10) d$ye priox
to the use or occupancy of �y etructure for which a buildiag pe�nit has beea
iseued; and eaid etructure shall not be used or occup�.ed until a Certificate
of Occupaacy has been isaued.
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SALESMAN
�ONTRACT DAT
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JOB ADDnESS '��
BLDG. CODE
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SEL J03 � ��_%����. CONTRP,CT # 300-f�3
INDICATL TI-� ITEMS BELOSd ON LAYOUT
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SB2B • 24TX AVENU6 BOUTH
MINN6APOLtB, MINN880TA 88�08
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SUBJECT PERI�A�I-Y__, _..,�- ��t
City of Fridley ���4 -6? �
AT THE TOP OF THE TWINS ��'��—_""
� BU ILDING PERMIT RECEI�I' -
;�
COMMUNITY DEVELOPMENT DIV.
r � L � PROTECTIVE INSPECTION SEC. ��%�
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� _ � ,:
�1 /��'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV
----� � �'� 612-580-3450 3/23/76
910-F15 � �
JOB ADDRESS
5272 N.E. Horizon
1 LEGAL �OT N0. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 9 1 Carlson SUIDIIL].'t MSIlOY' Af�C�]."L"].Ori SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Joe Peregrim 5272 N.E. Horizon
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Sussel Company 1850 Como Avenue
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
residential
7 CLASS OF WORK
❑ NEW Cj; ADDITION ❑ ALTERATION ❑ REPAIR ❑ MQVE ❑ REMOVE
8 DESCRIBE WORK
13' x 8' addition
9 CHANGE QF USE FROM TO
STIPULATIONS
�.��f���ATE �'c:ki�il d�� k��11l�Et� F�J� �'����-�E, a :
���'�N�� PLUAA�Ii�G ��9�i �fG(N��
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTHICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WO,Of� fraIlt
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTAUCTION ZONING SQ. 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 ZO4 832
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE GOMPLIED. $3 � lOO ],. 55
WITH V,�VHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOE$�jNOT PRESUME TO GIV AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PR9VbfS10NS OF ANY OTHE STATE OR LO L LAW REGULATING CON- ].O.O%
ST,ft CTION OR THE PERFO q{�10E OF CON UCTION. �
d) / PLAN CHECK FEE TOTAL FEE
,� ��� � —� �� �.�..62 �
SIGNATUREOFCONTRAC1pRORAUTH RI EDA6ENT IDATE) W EN PROPEFLY VALI TE THIS IS YOUIi PERMIT `-'-�
�v�� (% � c� d � � � �
SIGNATUREOFOWNERIIFOWNERBUILDERI IDATEI BLDG INSP qA7
' � • �ill'j�J��i.i�llUld 1'1�1C 1(1.:.i1U1:��{11/�L.� 11Lae.a��a�.v.,��
� OIt AllllITIUN.I3UILDItiG PLItA1IT
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� • � C�TY OF %RIDLL•Y, hiINNESOTA • �
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O��tiER' S NlLl�i� : BUILb�F.:
' DDI�S S : �� ��i s �"a � ADDItES S : /�� ��W �—
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T•OT: 9 13ZOCI�• � � ADDIT201� : ����CS �� ��c �Ii%°/<T /Iib�/t�Nd/2
COItIv'ER LOT:, __ INSIDE LOT: )C SETSACK: SIDL'YA��D:_ _
J�pplicanL a.ttach �o this fox�r. �•JO Certiiicates. �f Surve .oi Lnt an3 _pxoposed
building ?ocation di:�wn on these Certificates. .
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. � • DESCRIPTIOh� OF BUILDING . � �
. . - . . .
' Ta Be Used As : • � . • �, .
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� ��., Tront : � Depth • � Height • —
, . . . . Square Feet : /� �{ � Cubic . i'eet : �� �
' � � De tYi . • � Height :
� Front• P ' , .
'.. _ � � Squa�e Feet; Cubic Feet: � ':
' ' �- Estimated Cost: � �/��" ���
� 3�jtpe of �Cvnstruction: -- � .
To Be Completed: �O l�� � • • • .. '
-� .
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� The undcrsigned hereby malces applicativn•for a permit fox the work hexein �
� speci.tied, abreeins to do all worlc in stiict accordance �aith the CiCy of
° Fxidlcy Ordinances and rulinss oi the D�partmenC of �uilciings, and hex�by
de�lares tliat al� tlie taci:s an� �i:pr���r.��Lio:�s st�ted in this applicati�n
axe true and corrcct. �. � ••
. . • • .
• • . . ' � • .
• � .� 3 % . S�G���� : � .
• UATE a .
• eSce l�evc�rse Side For Additional Inforcnation. )' � �
. �� ,
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• • BU 1 Lll 1 N l; !.'.L• ltl�l 1 1 r L• L• �1,� � Lli u L� ---`-�
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. ' . , ' . •
• • . . • . • . .
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� S�CxION 2. T11C Inspector oi Buildings �hall, befoxe issuin� permits for the
GxecL'ion os any Uuildin� or sL•ructurc, ox tox any addition to any cxis�ing . �
buildin� or �L•ructurc, ox tor any altexation ox rcpaixs to any existing i
bui.l.ding or struc.Cure, upon appZication thereiore, reqtii.re thc paymcnt by Che ;
aPpl.icant ioic such pennit ot fees to the a�:ounC hexein below seC foxth and in'"
, the mannex l�crein provided to-�ait: . . •
. � . . ' �
• �
. UPiJ.lOI'Si l3UILDIT�G COD�: Type 1, 2&�: -$2.15 fox each one thousand cubic ,
iee�, or ixaction Chcrcof, in such cubical �ontents. �pe 3& 5-$1.85 £or '' • •
' each ane thousand cubic feet. �• " �
. . .,
� • � ADDITIONAL TNFORI�fATION •� �
. . . ,
� .Tox tlie purpose �f .:�mputing fees fox buildin� pexmits, the cubical conten*s �•
of any building or addition, is detexmined by multiplying�the ground area
� • covexed from a point six (6) inches below the flo�r line oi the basement � .
. ox the c81].ax to• the average heiohts of the upper surface or to the avexaoe �
height �f the•roof surface of the main gable of a pitched roof. � '
' .. . . i
• For xep�irs.or altexations to�an e�istino structure, the fee shall be at the _
• rate of $3.00 per each five hundxed•dollars ($500.00) ox frac�ion thereof in .
. tlte cost of all Proposed work. ' . . •
�� �� In no case shall the fee charged for any permit as set forth in Section 2 be .
� Zess than $5.00. . • • • '�
. , . • ' . . , � , . .. .
� ' VERIFICATION OF�POUNDATION � �
� • � . • � � ► � .
1�01'£: Pexmits fox construction will be issued.a minimum of 24 hours from the `
ti.me ot application, to allo�,r for proper review of the pxoposed structure and, �'
• of the constxuction site. , . • , .. .
A Cextificd Sui-vc�y of .the lot, s.hQ��infi the locaCion o£ th� foundation, �nce it ;
� has becn constructcd, will bc required befo-rc proccedin�;�aith the framing. i
. ,
. . � C�RTIrICATE OF� OCCUI'ANCY • . '
Application for � Certiiiczte of Occupancy shall be made ten (10) days prior 4
, Co the use ox occupancjr of any* structure for whi.ch a building permiC hZS been
�ssuec�; nr.d said structure sh�ll noC be used or occupied un�il a Cert-iti.cate �
� • ' �ot Uccupancy has Uecn issucd. , . , • ' •
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� MINIMUM RE I[?CD
ATi'IC VENTIL TION
1�3Q0 0� e°90R Z�JRlTAL
PROJCC I 80�1 F P��F
AREA-1/2 � 63E IIJ
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� � EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION ,,
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OWNER J OL... ��t�ECa�.1t�
SITE ADDRESS 5��� N .L �--\02�2o+J
�
CONTRACTOR �USSCZ. DA7E 3 Z-Z ' PHONE ��S ���� �
" Determine working square footage of each. �
1. Total exposed wall area ...... ��'� sq. ft. x .17 = ��
2. Total roof/ceiling area ....., e� �r sq. ft. x .05 = S.z
Total exposed wall area above floor = Z�'Z �.
a. Total wall window area....... D�
—
.................... �
b. Tota] door area ... ............. ��y.
............... — �°"
c. Totai sliding glass door area ................. �
�Y
• 3a.5o � Ve-
d. Total fireplace wall area..... � —
e.� Total wal l frami ng area (average � 10°6) . , . : . , . , , , , , 23,Zv .
f. 7ota1 net wall area above floor ................. _Zpg,go �
g. Total.rim joist area ................... ...... 29,oc�
...
Total exposed foundation area = I Z2 S.'F .
h. Total foundation window area.. 5.2.'1
i: Toal net foundation area above�grade�............. (� �
�� 3 __
Determine "U" value of each wall segment.
a. X ����� _ r--
b. � X ����� _ �
c. 3�.�q X ����� �Sc� v�
Zi� i�
. d, X ����� _
e. 23 ,20 X����� ► I 1 =
f. �A�� 8�] X ����, , p(e, _
g. Z9�OU X ����� ,b'l =
� n. . �,2'1 x „�„ � 55 =
� ;. 1 �(�,�3 X „�„ _
�
.
�
2►SS
�2.53
,{�?�
g,.��
, � 1 ��
. � �t a 1 � " �
3 .....................................Tota1 = ��,.�q � ' .
If item #3 is the same as, or less than item #1, you have met the intent
of SBC 6006(c)2. , �
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Total expased roof/ceiling area = � C��-
j. Total skylight area.... ...... . —
...... .,,
k. Total roof/ceiling framing area�(average 10%.).�.. �p,
1. Total net insulated roof/ceiling area........... �3„� v
Determine "U" value for each roof/ceiling segment.
j, X ����� _
k. � o,c�d X„�„ ,11� = 1,22
1. �3,1fl� X ����� ,o� � 3,�d,1.
4 ..................................Tota1 � - � �
� �
If total of #4 is the same as, or less than #2, you have met the in�ent of
SBC 6006(c)'1. �
Alternate Buildirtg Envelope Design •
To ytilize the total envelope system method, the values established by the
sum of items #3 and #4 shall not be g�reater than the sum of items #1 and #2.
0
1. + 2, s .
3. �� + 4. _
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City of Fridley 180 9 8
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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r � � PROTECTIVE INSPECTION SEC.
1 i �
� /"��1 � CITY HALL FRIDLEY 55432 NUMBER iiEV. DATE PAGE Of APPROVED BV
�----� � �'� 612-571-3450 9t0-F15 7/3/85 / /
JOB ADDRESS
5272 Horizon Drive
1 LEGAL. LOT NO. BLOCK TRACT OR ADDITIQN SEE ATTACHED
DESCR. Q 1 - Carlson's Summit Manor SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Joe Peregrin same
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Sussel Cor . 1920 Como Avenue, St. Paul
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS Z�P PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW �] ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Attached garage
9 CHANGEOFUSEFROM TO
STIPULATIONS
Variance approved by City Counci7 6-3-85 for 3 feet.
TVPEOFCONST. OCCUPANCY GROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL. PLUMBING. HEATING,
VENTILATING OH AIR CONDITIONING. fl'�dlll2
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES (iOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT LOO O 4'.55
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqM1T FEE SAC CHARGE
PROVISIONS ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTIOj� J�ZHE P ORMANC F CO_NSTR TION. $O. 'rJO
��'�iI1�J �f� ����� �/ PLAN CHECK FEE TOTAL FEE
° vJ �OJ
N TUREOFCONT TO Oi7AUTH RIZEDAGENT IDATEI WHEN PROP RLY V LIDATED THIS IS YOUR PERM T
�- � ��� ��r� �-1�31��
SiGNATUREOF OWNERiIF OWNER BUILDERi IDATEI BL�G iNSP r1ATE
N� [] City of Fridley Effective 4/1/84
ADDN. [ ] R-1 AND R-2
pLTER. [ � Building Permit Application
Construetion Address: s�-� �- �'t't71Z f 2 ��) j�f� /-�c � t✓%�,
Legal Description: �''�""'' �1 !�L-0�.�� 1 � �'2C.�"v � `� �"ti' `� �'�'g� �� �
Owner Name & Address : 1,�� �� R Q°a � � °'� '�� � 2 /'I(1� �? +`� i71�Te1. �
Contractor: �1�A:� %� - D /' �i n�o Tel .� �- D 3 3/
Address • � �'f � �- U �`�^ � � � S � �
Attach to this application� a Certificate of Survey of the
lot, With the proposed construction drawn on it to scale.
DESCRIPTION OF II�IPR09EMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length 3�,._ Width Z Z Height Sq. Ft. �_
DECH AHEA: Length Width Hgt/Ground Sq. Ft.
OTH_._---
� �$� I�.I� � �',1 ��.11- , °
Corner Lot [] Inside Lot [v� Ft. Yd. Setback Side Yard Setback 3
Type of Construetion: ff"!��`� Estimated Cost: $
Approx. Completion Date: O � � 1�� � �/ � 18� • � �
Alt. A Alt B
Progosed Drivexay Width If New Opening Is Desired: $ $
See Back Page for Explanation
� G�N�'L`1� �°'7�
DATE: � � � � � � APPLICANT : ` Tel . �i �D � S�d 3 3 �
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Serrer Maia Charge
���
STIPULATIONS•
.
U�� � ��
CITY IISE ONLY
$ ��� " Fee Schedule on Reverse Side
$ °"'-" 25$ of Building Permit Fee
$ �i.� � $.50/$1,000 Valuation
� °-�' $425 per SAC Unit
$ -�' Fee Determined by Engineering
$ �
Agreement Necessary [ ] Not Neeessary [ �
$ ��`, O�
v
,��.a���, �.C�
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BIIILDING PERMIT FEE SCHEDIILE
The Chief Building Official 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 applicatio n
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 Valuation
�1.00 to �500.00
�501.00 to $2,000.00
$2,001.00 to $25,000.00
$25,001.00 to $50,000.00
$50,001.00 to $100,000.00
$100,001.00 and up
Feea
$10.00 (Minimum Fee is $15.00)
$10.00 for the first $500 plus $1.50 for each
additioaa7. �100 or fraction thereof, to and including
$2,000.
�32•50 for the first $2,000 plus $6.00 for each
additional $1,000 or fraction thereof, to and
ineluding $25,000.
$170.50 for the first
additional $1,000 or
including $50,000.
$283.00 for the first
additional $1 , 000 or
including $100,000.
#25,000 plus $�1.50 for eaeh
fraction thereof, to and
$50,000 plus $3'.00 for each
fraction thereof, to and
$�33.00 for the first $100,000 plus $2.50 for eaeh
additional $1,000 or fraction thereof.
DRIVEWAY DEPRESSION ESCROii
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus
6 feet times $13.50
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approaeh With 6 inch depth - Driveway Width plus 6 feet times $15.75
�ERIFICATION OF FODNDATION
Permits for construction �ill be issued a minimum of 24 hours from the time of
application to allo�► for proper review of the proposed strueture and of the
construction site.
A Certificate of Survey of the lot, show3m� the location of the foundation onee it
has been eonstructed will be required before proeeeding with the framing.
��� �
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. _
C11YOF
FRIDLEY
CiVIC CENTER • 6431 UNIVEFiSITV AVE N E. FRIDIEY MINNESOTA 55432 • PHONE 16121 57t-3450
September 20, 1985
Sussel Corporation
1920 Como Avenue
st. Paui, r�T 55108
Re: Attached Garage Construc tion at 5272 Horizon Drive N.E., Fridley
Dear Sirs:
A final inspection was conducted on September 19, 1985 of the garage constructed
at the above address. The following items were noted which must be completed
before the structure can be finaled out:
1. Complete the fire wall between the garage and house by installing the
fire door.
2. lain the sheetrock up to the roof sheathing or sheetrock the ceiling in the
g ar age .
We will expect the above iteins to be completed by October 4, 1985 when a
reinspection will be conducted to dete nnine compliance. If you have any
questions on this matter, please feel free bo contact me at 571-3450..
Sincerely,
DA L G. CLARK '
Chief Building Official
DGC/mh
CC: Mr. Joe Peregrin
5272 Horizon Drive N.E.
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�SI�iSY AND BTACE VSRIFIGATION '=
The undersiqned hereby verifies that the existinq chimney or stack:
1. Has been carefully examined Yes (�j No ()
2. Is free from rust or deterioration Yes (� No ()
3. Has no foreign objects lodged within Yes (� No ()
4. Is securely supported Yes (� No ()
5. Meets all current Code requirements for
size and total BTU's connected Yes (� No ()
6. Has total heating BTU's of (p�T � �
Al l other BTU' s ��, �� � ,
TOTAL BT[T' s ���� � .
Remarks
List Alterations Beinq Done:
- �LAYIU� HTG, A/C & ELECT. INC.
13562 CEN � RAL AVL=. N.E.
HEATING COMPANY NG4Ll'� rJl 55304
.
S igned By ��'�'
Date ./D°-c�5 9� �
b
�
���,�� HEATING HOUSE HEATING TEST �ECORD
AlR CONDITIONING
AND ELFCTRIC. INC.
ADDRESS �oZ %�++ �� P� Z'BN 1J lr APT. FLOOR CITY 1'r'd�"f' SUBURB
oCCUPANT � cnecA d �=� OWNER
HEAT LOSS DATE HTG. INST.
SOLD BY INSTALLED BY
Electrical Work By (iae Llne By
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNR HTR. OTHER
(� GAS DESICiN CONVERSION
MAKE �7r�,Y Kr MAKE OF BURNER
Model M'1� � ��'0 �0 0 Modal
Serial �—� �jeQ�O#O�J Max. BTU Rating
INPUT ��,�90 MAKE OF FURNACE
r
Model
CONTROLS
THERMOSTAT � � Heat Plug
Valve �"�
Llmft � 1!e
Llmit Sefllna O6 � `(0 �
Fan Sening i � �e �
PUot Type �oi �J rp
PIIotMake %�0��`�
Pilot Model 2i �
Pilot Ttming �e 0
L. W. Cut Off
Pressure �j Q � Percent CO�
Input CFH Peroent O= �
Stack Temp. � � 0 Percent CO (7
Form 235
vom s� z °' pV �
KIND OF LINER SIZE NONE
Dra9t Hood .'� � Regulator
Fittara Size � ��� Number
Chimnay Locatlon Inaide Outalde
Chlmney Conetruetlon
Smoke Bomb Wlring
Drak Test Tag
Door Pre�ure Uphting Inst.
Date Tasted
Company Testing
Name of Teater
SuB�ECT
City of Fridley ,
AT THE TOP OF TME TWINS g U I L D I N G P E R M I T
�
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� `v _���� COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
�
� i �
� �"'1 � CITY MALL FRIOLE� SS�J2 NU4BEF AEV o�TE PAGE OF
�'""� � �'' 612-571-34b0 s�aF�s 4/30/99 � �
J08 ADDRESS 5272 Horizon Drive NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION
oesca. 9 1 Carlson's Summit Manor N
2 PROPERTY OWNER MAIL AODRES$
Dean Renander 5272 Horizon Drive NE
3 CONTRACTOR MAIL AODRESS
_ Midwest Roofing & Siding 18979 Gladstone Blvd, Mapl
4 ARCHITECT OR OESIGNER MAIL AODRESS
5 ENGINEER MAIL ADDRESS
B USE OF BUILDiNG
Residential
7 CLASS OF WORK
29357
��
RECEIPT NO.
��77
1PPROVED Br
SEE ATTACMED
SHEET
572-8007
21P PMONE LICENSE NO
�ovee MN 55311
ZIP PMONE LICENSE NO
572-8007 2001027
ZIP PHONE IICENSE NO
❑ NEW � ADDITION O ALTERATION � REPAIR p MOVE O REMOVE
B DESCRIBE WORK
Reroof House & Gara�e (24 Sq) Tear-off
9 CNAN(3E OF USE FROM
TO
STIPULATIONS
Underlayment must comply with the State Building Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
SEPARA7E PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST
VENTILATING OR AIR CONOITIONING.
TMIS PERMIT BECOMES NULL AND VOID IF WORK OR CONS7RUCTION ZONING
AUTHORIZED IS NOT COMMENCEO WITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AF7ER WOHK IS COMMENCED. NO. DWLG. UN!
I MEREBV CERTIFV THAT I MAVE REAO ANO EXAMINED THIS APPLICA710N 1
AND KNOW TME SAME TO BE TRUE AND CORREC7. ALl PROVISIONS OF LAWS yp�UATION
AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETNER SPECIFIE� MEREIN Ofi NOT. TNE GRANTING OF A PERMIT �2sOSC
DOES NOT PRESUME TO GIVE AUTMORI7Y TO VIOLATE OR CANCEL THE pEqMITfEE
PROVISIONS OF ANY OTHER STATE OR IOCAI LAW REGULATING CON-
STRUCTION OIi TME PERFORMANCE OF CONSTRUCTION �74. %S
S�GN4iU�7E O� CONCRACTOA OA 4UTM0�7�ZED AGEN1 IOATE�
�GNnTUAE O� OWNEp ��i OWNEp BWlOER� �OATE�
� .
OCCUPANCYGROUP OCCUPANCY�OAO
SO.FT CU FT.
OfFSTREET PARKING
S7A�LS IGAfiAGES
$5.
$1.03
AC CMARGE
Fir SC $2.06
�T F E
2.84 ,
IT
r�w
ADDN
ALTER
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CITY OF FRIDLEY
SINGLE FAMII,Y AND DUPLEXES R 1 AND R-2
BUILDING PERNIIT APPLICATION
consiructionAddress: ���
�r
Effective 1/1/99
�
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v
�� Lega1 DescriFtion: - - .
Owner Name & Address: _ � DJl �el. # �%� —��Q �
Contractor: l 1'1_ � � MN I,ICENSE #�� / D�� %
Address: � 1 1' � Tel. � J�� —g��
Attach to this a�plication, a Certificate of Survey of the�� l�
lot, with the proposed construction drawn on it to scale. '
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
O�R: � � �� /�� �aJP,e�r� �.� � �
� �
Construction Type: `��l � ��� � Estimated Cost: $ v� � 5�
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
�
DATE: �/a I �1 APPLICANT: �,��2� �� Tel. # 7! l!/ ` Ll0 D
�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ 7 �, ��
$ 2-D�
$ �� ��
$
$ �.OD
$
$
$
$
$ �1Z • �`f
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuatiom �i/1�Jtt�%)
$.50/$1,000 Valuation
$1050 per SAC Unit
$5.(� (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
STIPUI.�TIONS: �
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BUII.DING PERMIT FEE SCHEDULE
The Cluef Building Official 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
$100,001 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 additionat $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, 000 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
DRIVE�IAY DEPRESSION ESCROW
(Concrete Curb Streets On1y)
Alternate "A" : Removal and replacement of curb and gutter 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 be required before proceeding with the framing.
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COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, 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 venting system is plastic/PVC and meets all current codes and manufacturer
speciflcations including sizing, length, number of elbows and termination. Yes O No O
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturers specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
The existins� combustion air is sized and installed to meet the cuRent codes
and manufacturers specifications.
When required to instalt a new combus�ion air, it wiU be sized and ins4alled
to meet the cuRent codes and manufacturers specifications.
Yes ( ) No ( )
Yes()No()
Yes ( ) No ( )
When installing a new ventina svstem, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Fumace
Venting Table� 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 ()
A liance T e and Size/Common Vent anc� Vent Connector Information
Appliance #1 Type BTU Input ' Fan Assisted or Nat
Appliance #2 Type BTU Input e Fan Assisted or Nat _
Appliance #3 Type BTU Input _ Fan Assisted or Nat __
Total Appliances Total Btu Input
Common Vent Type Vent Height e Diameter inches
Appliance #1 Vent Connecior Height ft Lengih 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
w��rcoATIAAtC./1'1n���iF►ol ��l.9Vld �,�IlllA I��IO�I� _lJ��"��0.°\ °-��'
HEATING CO
Signed By:
�.-
Building MT CHANICAL Pe�t No.:
Inspections RESIDENTIAL APPLICATION Receivea By:
7.63-572-3604 CjTy OF FRIDLEY Da����UL 3 2
Da� (� r1 � l�-� r7 YOUR E-N1AIL ADDRFSS M� 2!/k� y, �� �t2 fl��k' �,'n. t�ev�a y�, eer�-
srrE,�wnxFSS Sa7� �'`�rm ��' Gv� i'��
TFIIS APPLICANT IS: ❑ OWNER �ONTRACTOR
PROPERTY Npr,�: � � a1 C�P_dY�6 �
OWNER/ aDDltESS: So17aZ /i7��/ZdYI ,�/�L � CITY �rLi�C-� STATE�/ zIP a f
TENANT Pxor�: �ia ao9 7L�L
CONTRACTOR Co�axY N,vv�: �� r�r�d ��
SUBMIT A COPY OF �NTACT PERSON: _/� �t %��
YOUR STATE STATE LICENSE � EXP DATE
LICENSE WTfH �n�ss: 93� �^�- ✓ cv�� ��v��C 3 c� ��S STATE�'?�zrnS�
APPLICATION Pxo� � /� ��( ��"} - __. FpX �,� �a ( Sa�f �
,
PERNIIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: ��W O REPLACEMENT � ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK � " � �
PER MS 16B.665 the. permit fee is a miaimum of $15.00 or 5% of the total cost up to $500.00,: whichever is grea.ter, for the
improvement, insta.11ation or replacement of a residential fixture, excluding the fixtures. (T his should reflect flnly the cost of labor )
Labor cost under $300 =$15.00.. Labor cost between $300 to $500 = cost of labor x.OS =
FOR PAOJEGTS Wi�RE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FiXTURFSt (II�iDICATE TOTAL
NUMBER OF EACH BELOVI�
Equipment Instailed , MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZEBTU
MFG: MODII,: SIZFJBTU
A/C 525.00 FIREPLACE (GAS) $15.00 _GAS RANGF/OVEN $10.00
AIR TO AIR EXCHANGEER $IS _FIREPLACE (WOOD) $35.00 NEW GAS GRII.L $10.00
BOILER $35.00 _FURNACE $35.00 GAS UNIT HTR $10.00
CHIMNEY LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
"�(�Lr����'-�F. . a .: �,�:`�.Oc�`"4� , „���'J�" Q'{'F.,.��' �� Fa������t t�'c"��Y.�.; !�� .�; �'S�"'�v'L .:3� �y�' �<r�}'�i� � q'. r E 1� ��'n ,�1��.±•Yp�.
Permit Fee $�. oo Number of fixtures @$10.00 x$10.00 $
Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $�. SD Number of fixtures @$25.00 x$25.00 =$
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
Total = $
TEIIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclrnowledge 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 approt�al of plans.
SIGNATURE OF APPLICANT �''� PRINP NAME 4"� �til� �" �" �� �Z DATE D�"�d -v7
,. �t7Li�� .}...... . ' . �,, Yl .., ' ..r .. . 4..i . I .Pr� p�.... 7�,7 . + ��� � p .. ,.„,„ ' ��� k�
_' �. �:��.,.�.'� .. , , _.. �� i`t'. + ��?r�a
; ° � . • .
�
. � - b
. . - ,. .... . . . _z.- �. . .. , .. :.. . . .
City of 1+'ridley - -
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 '
FAX: 763-502-4977
t•
REQUIRED INFORIVIATION NEEDED TO PROCESS PERMIT
� RESIDENTIAL PERMIT APPLICATION HVAC
❑ NEW HOMESIADDITIONS ❑ EXISTIMG HOME ❑ MAKE-UP AIR
REQUIRED FOR NEW/EXISTING HOMES
1. Combustion Air (See note below) �
a. Oil or solid fuel IMC Chapter 7 with MN Am��°ents
b. Nat1u'a1 Gas or Propane/IFGC Chapter 3 with MN Amea'�m�n�s '
2, Make-up Air (See note below)
a. 1MC Chapter 5 with MN Am.endm.ents
3. Venting
a. Gas appliances IFGC Cha.pter S with MN Amendm.ents
b. Fuel other than Sas IMC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
a, Required. on new construction IMC 1346.0312
5. Venfilation .
a. Per MN F-nergy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D
N
pTE: Centerpoint Energy Mechanical Code Guidelines sofiware may be used for
combustion and make up air calculations