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AF - 463740 sue�ecr P R O. City of Fridley 18 70 7 AT THE TOP OF THE TWINS g U I L D i N G P E R M I T r ; � R T NO. � �L _ _ COMMUNITY DEVELOPMENT DIV. � L�� r � � PROTECTIVE INSPECTION SEC. �» 1 i � � /"'1 � CITY HALL FRIOLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �""� � ,�� 612-571-3450 910-F15 /. / JOB ADDRESS ( o ,� � � �� 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION e � � SEE ATTACHED DESCR. � � ��0� 5�� , � SHEET 2 PRO RTYOWNER MAILADDRESS 21P PHONE �21C. Z t�l. L� 2� �� 3 CONTRACTOR MAIL ADDRESS . Z�P PHONE LICENSE NO. S ��.� ,' ��'�.cac, ca d ARCHITECT OR DESI(iNER MAIL ADDRESS ZIP PHONE LICENSE NO. �—, 5 ENGINEER MAIL ADDRESS ZIP PHONE UCENSE NO. � B USE OF BUILDINCi ' • 7 CLASS OF WORK O NEW O ADDITION � ALTERATION O REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK � S�'[ � I�. . U�fc. � n1 t3 U�.. -�3 ro 8 CHANGEOFUSEPROM TO STIPULATIONS � �� ` � 1 R� � �-I��ft►d►'1� SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY CiROUP OCCUPANCY LOAD VENTILATING 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 �� 1 OR WORK IS SUSPENDED OH ABANDONED FOR A PERIOD OF 120 DAYS AT '�^"'�" �°'� ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STAL�S GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND.ORDINANCES GOVERNING THIS TVPE OF WORK WIL� BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �� DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR �OCAL LAW REGULATING CON- � �� STRUCTIO OR THE PERFORMANCE OF TRUCTION. % Y PLAN CHECKFEE TOTALFEE �� — ys - —'°°—_' a C�U SIGNATURE OF CON i RACTOR OR ORIZED AGENT IDATEI EN PROP L A IDA D THIS IS YOUR PERMIT �0-17 �� SiGNATURE OF OWNER IIF OWNER BU�LDERI IDATEI iNSP nATE NE� I 7 City cf Fridley Effective �/1/8c ADDt; . [ ] �A-t AtiD R-2 ( pLTER. Building Permit Applicatioa � Construction Address: c��i"�� 'te'�h`e-S rt�v"� Legal Description: � �? _ i .�- , .!/0 2 L i ��.�-/�'z-. Tel . � �s7 � -F� � ,ca( Ownez Name i Address: �� ' '"' ' Contractor: , ,�� '� �-� CA.vs '�`�,. � �«"� _ Tel. • • Address: � ��Z/ �S'ri,v�� ./aJL �'��,.:� D�-�c �,� �S3 � LIVING AREA: GARAGE AAEA: DECK AREA: OTHER: Corner Lot [ ] Attach to this applicatioa, a Certificate of Survey of the lot, vith the proposed construction draWn on it to scale. DESCRIPTIOP OF D+1PROiE!'IEh'T Length Length ,__ Length Z e2o - G�� wl V� U - �c � ��- Inside Lot [] FL. Yd. Setback _ Side Yard Setback Width _ Height Sq. Ft. Width _ Height Sq. Ft. Width _ Hgt/Ground Sq. Ft. .,.r.�. `�.�,ca�r� /�sv.� �l��r`on- — Type of Construction• Estimated Cost: �� °� Approx. Completion Date: ��- �� Alt. A Alt P Proposed DrivevaS• i�'idth If �iew Opening Is Desired: � a - See Back Page for Explanaticn DbTE: �� -� ` � Per�it Fee Plan Check State Surcharge SAC Cbarge Park Fee Sever Main Charge z�� STIPULATI02:S : � �-Dv�� 5� C � 6 !% APPLICAt►T: Tel. � �' �' CITY OSE ONLY � �,�� Fee Schedule on Reverse Side � � 25x of Building Perait Fee � . �.50/�1.000 Valuation �e �u75 Per SAC U nit �ee Detea�ined by Engineering � � �, c�c� �� / Agreement Necessa�ry [ ] Not Necessary [ ] , �� G �° �} c��Zvvr S, � 1�-- J�` vU �X � �'z ` �"� 0 � �� ( �, �� BII�.DING PERMIT FEE SCBEDIILE Yhe Chief Building Official ahall, Defore iaauing permits for the erection of ar.y Duilding or structure� or for eay addition to any existitig Duilding or structure, or for any alteration or repair to any existing Duilding or structure� upon application tt.erefore� require the payment Dy the applicant for auch permit of fees to the amount herein belox set forth and in the manner herein provided to-vit: ' Total �aluation =1.00 to �500.00 �501.00 to �2�000.00 52�001.00 to S25.000.00 l2:�OOt.00 to 550.000.00 �5o,a�t.00 to Stoo,000.00 1100�001.00 an� up Fees �10.00 (Minimu� Fee is �15.00) �10.00 for the firet �500 plus �1.50 for each additional �100 or fraction thereof, to and includinE �2.000. �32•50 for the first �2�000 plus �6.00 for each additional �1�000 or fractior. thereof, to and including �25�000. �170.50 for the first additional �1�000 or including �50,000. �2E3•00 for the first additional �1�000 or includinE �100,000. �25�000 plus �4.50 for each fraction Lhereof, to and �50,000 plus �3.00 for each fraction thereof, to ar.d �433•00 for the first �100.000 plus �2.50 for each additional ��,000 or fraction thereof. DRIVEiiAY DEPRESSION ESCROY (Concrete CurD Streets Only) Alternate "�": Recoval and replacement of curb and gutter only - Drive�+ay Width plu� 6 feet ti�e� �13.50 �lternate "E": Recoval and reFlacecer.t of curb and gutter and in�tall a 3 foot ui�e aFproacr with 6 inch derth - Drive�a}• vidth plus 6 feet times �1;.75 VERIFICATI�N OF FOUNDATION Ferzits for eonstr�etion �ill be issued a air,i6u� o.° 24 hours froc the time c:' aFFlication to a:low t°or proper revieu of Lhe propose� structure and of thc construction s:tee A Certificate of S�:rrey o� ih� le�t. �i�araia�g t�e lc�cetic� o�' tre foundatior, once it has Deen constructed xill be r�quired before proceeC:r.� xitt tt,e framing. � s�e�Ee, pEq c;ty of Fr;a�ey 27921 AT THE TOP OF TNE TWINS g � I L D I N G P E R M I T ;, ,� . y � COMMUNITY DEVELOPMENT DIV. r � � � PfiOTECTIVE INSPECTION SEC. �i� � � 1 ; � L---.� ��"','� CITY MALL fRIDLEV jS132 NUMBBP REV OATE PAGE Oi �pvpOVED 8� t 612-5��-3a5o 9�aF�s 9/22/98 / / 108 ADDRESS 5012 Hughes Ave NE t LEGAL �OT N0. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 7 Carlson° s Summit Manor SOtittl SNEET 2 PROPERTY OWNER MAII AOORES$ 21P PHONE Marvin Mansfield 55421 792-2642 3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO Owner SAme a ARCHITECT OR DESIGNER MAIL ADDRESS IIP PMONE �ICENSE NO. 5 ENGINEER MAIL ADORESS 21P PFIONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS Of WORK O NEW O ADDITION 0 ALTERATION � REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house & garage (25SQ) TEar-off 9 CHANOE Of USE FqOM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV �OAO SEPARATE PERMITS ARE REOUIRED FOR EIECTRICAL, PLUMBING. HEATIN(i, VENTILATING OR AIR CONOITIONING- THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION 20NING SQ. fT CU fT AUTHORIZEO IS NOT COMMENCEO WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 12p DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWIG. UNITS OfFSTREET PARKING 1 MEREBY CERTIfV TNAT I HAVE REAO ANO EXAMINED THIS APPLICATION STA�LS GARAGES ANO KNOW TME SAME TO BE TRUE ANO CORRECT. ALL PqOVIS10NS OF LAWS yqLUATION SUii7AX ANO OFDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMP�IED WITH WMETHER SPECIFIEO HEpEIN OR NOT. TNE GRANTING OF A PERMIT �2a 142.00 �I.O% DOES NOT PRESUME TO GIVE AUTMOFiITY TO VIOLATE OR CANCEL THE pEqMIT FEE SAC CMARGE PROVISIONS OF ANY 07HER STATE OR LOCAL LAW qEQUTATING CON• @74.75 Fire SC �Z.14 STRUCTION OR TME PERfORMANCE Of CONSTRUCTION W PLAN CNECK FEE TOTA� F $77.96 S�GNGTUAEOFCON'FACTOpOAOUTNOA�2EDOGENT IDAfE� N P OPE Y ALIDAT D IS IS PERMIT \ ? t,��.l� / �J �GN4TUAEO�OWNEAi�FOWNEpBU D@p� � �O�i i BL �NSo � r��rE �K fr NEW ADDN ALTER [] [l [l ConstructionAddre� Legal Description: Owner Name & Contractor: Effective 1/1/98 CITY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ��-� \ �� Tel. # MN LICENSE # Address: c��}i`%'L� Tel. # ��07 -��o `,��— 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: Construction Type: DESCRIPTION OF IlVIPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Len Wid Hgt/Ground Sq. Ft. � ` °�S -CI r Driveway Curb Cut Width Needed: DATE: ��. � APPLICANT: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL . STIPULATIONS: Estimated Cost: $ �f �� (Fee Schedule on Back) Ft. + 6 Ft = Ft x$ _$ Tel. # CITY USE ONLY $ ,.S Fee Schedule on Reverse Side $ � / .001 of Permit Valuation (1/lOth%) $ , � $.50/$1,000 Valuation $ $1000 per 5AC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ . , ` BUII..DING PERMIT 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 $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 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 $1,000 or fraction thereof, to and including $100,000 $887.25 for first $1Q0,000 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 gutter only - Driveway width plus 6 feet times $13.50. Altemate "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. �; - � � sue�eei PERMIT NO. c�ty of Fridle� 32304 � AT TME TOP OF TME TWINS ��J I L D I N G P E R M I T ; � REC�IP;NO. � ; y � COMMUNITY DEVELOPMENT OIV. �� r � � PAOTECTIVE INSPECTION SEC. «�� , i . , � _ �'�'1 � CITY MALL FRIDLE� SS�32 NUMBER REV D�Tfi PAGE O� APGROVED B� �'""�" �'' 612-571-34b0 9t0-F15 11/5/O1 / � J08 ADDF;ESS 5012 Hughes Avenue NE - t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACMED DESCR. 2 7 Carlson's Summit Manor South SHEET 2 PROPERTY OWNER MAIL AOpR�$$ ZIP PNONE Marvin Mansfield, 5012 Hughes AVe, Fridley, MN 55432 763-571-5878 J CONTRACTOR AAAIL ADORES3 21P PMONE LICENSE NO Lloyd Hockaday, 2544 Cresliine Dr, White Bear Lake, MN 55110 651-777-5044 a ARCNITECT OR DESIGNER MAIL AODRESS 21P PNONE LICENSE NO. 20175032 5 ENGINEER MAIL AOORESS ZIP pMONE LICENSE NO B USE OF BUILDING Dwelling 7 CLASS OF WOFiK �I NEW O AOOITION ❑ ALTERATION ❑ REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Egress �a window 8 CHANGE OF USE FROM TO STIPULATIONS � Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulking & flashing for all exterior openings. " TYPE Ok CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS AqE REOUIRED FOR ELECTRICAL, PLUMBING, NEAT�NG, VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NUIL AND VOIO If WORK OR CONSTRUCTIOM 20NING SQ. FT CU FT. AUTHORI2ED IS NOT COMMENCEO V�IITHIN 80 DAYS. OR IF CONSTRUCTION OF WORK IS SUSPENDEO OR ABANQONEO FOR A PERIOD OF 120 DAYS A7 ' ANY TIME AFTEi; WORK IS COMMENCED ` NO. DWLG. UNITS OFfSTREET PARKING I HEREBY CERTIFY THAT I MAVE FEAD ANO E%AMIN�D TMIS APP�ICA710N S7ALLS GARAGES AND KNOW THE SAME TO BE TF1UE AND C04iREC�. ALL PROVISIONS Of LAW$ yALUATION SURTAx AND ORDINANCES GOYERNING TMIS TYPE OF WORK WILL Q� COMPUED WITM WHETHER SPECIFIEO MEREIN OR NOT. TNE GRANTING OF A PERMIT � 1� C)OO.00 �. 8O DOES NOT PRESUME TO GIVE AUTMOqITY TO VIOLATE OR CAMCEL TME pEqMIT FEE SAC CMARGE PROVISIONS OF ANV OTMER STATE Ofi LOCAL LAW NEGUTATING CON- $57.OS Fire .SC, .p1.6� STRUCTION OF THE PERFORMANCE OF CONSTRUCTION PLAN CNECKFEE TOTALFEE License $5.00 $64.45 S�GN4TU OF CON"A CTOA Op 4UTMOA4E0 AGENT �OATE� WHEN PROPERIV VALIOATED THIS IS VOUR PERMIT S�GNnTUAE O� OwNEA��F pWNEp BU40EA� �OAT�i '� BIDG� �NS� - � �iarE e: NEVN ( ] ADDN [] ALTER [ j Construction Address: Legal Description: _ Effective 1/1/2001 CITY OF FRIDLEY .(763) 572-3604 Bldg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Owner Name 8� Address: ""'�w� ��8� Tel. #�7% -5�7� Contractor. � !Ga �v� 1�dlmar MN LICENSE # ��'7�PJ� Address: ��#� �ns��=e �v"� [�-l�6'1��2 �� L-� � �el. # 6S %� �'17 S'i� . ��o Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: �!1_��:�IiIC•I:[•I3 il'ill��•i�L�iL�iY� Length Width Height Sq. Fk Length Width Height Sq. Ft DECK AREA: Length OTHER: Width Hgt/Ground Sq. Ft. ' n � n � _' T _ �i A � Construction Type: �.� Estimated Cost: $ 1� Oc�3 Driveway Curb Cut Wdth Needed: Ft. + 6 Ft = Ft x$ _$ DATE: ��il�b� G( APPUCANT: �:t�� i�G%�'-1i Tel. #�/�'7%/I S��i CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application ��i.�� $ ��' �1� Fee Schedule on Reverse Side $ (. �.-,c� .001 of Permit Valuation (1/10th%) $ � �_a�:� $.50/$1,000 Valuation $ $1150 per SAC Unit $ �,�.��'�:`� $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] � � � g �� . -� =� BUII.DING PERMIT FEE SCHEDULE 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 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 $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,Q00 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.Q0 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. 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 $23.25. VERIFICAT�ON 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. New Houses Onlv * m c) � O � � � o N� � N. � O y � A 1 � O � 3 � O �, ^� a� 0 �' � �• d � � tD .D a O =. � � .��' n: o fD � � ,`�° a � � 0 c � D U v O < m o. � m z � '� m � � z 'T'1 m m �9 .p V 0 0 \ 2 � � � , •� i �' 1' 1 = 1 � III � I � i � � � d m � � .-. -�� V � � �r � � � � m � � rn r � � � � � � 2 � z � � � � o � 3 p� A Oy, e1. O<1 \ fD Q„ C -�r. N � � n��i � � m 0 C� G 0 � 0 h n u r- tn m � s d oa m �D �4 p O �' � 3 < `� � N y \ cD � a � d D '� � y j' D rn `�° O .-�r, �o � N O ^ �- r � O z � c� � � � � ' � i.�' O � � � � � � m c � � C � � tn � �: C (D �oaa� � .+ -,. cD . ---i � O f3D � OG� � Q' N N W�. (=D .� a � � � �� O � � a �v a � �•oo� s�`,'� � � �' � o m ° 2 d � y � "� 01 � N _ _' '� n � a N — h � 1 (�. .-Y D � � � h o- o m m a � � cn -�, • ,� m o ° � m � � � � Z � � -o 0 00,�CD�cu rn' .---1-- n- ,"' m � � v .J c� n?s � r+ � � o r+ '* -,, � � �, ? o �— � '+ � ,n.�. � cD ? N C� � .,� � � O y O � � °- m c� n. �' m � _. � D � n O a 0 � � QU D N m y d d n�i D c � NI N 4/ N 't � :i7 ��d � � � -p' cn co � � `�° � ��d = z� � cu � � ,�.� � Cl �, � � � a -, a-�Tp � �_ � � � f� ��-�'�� o � � � � �v v � � � � � 1 n � . � � � � � � cNr� o 0 0 0 � O O O O O �" m � � � � � � 0 v �� r S+ TQ7-IZ m C � � — ao m ,�, � _ � � C1 m =� � � c � N _ � � n � �. n � O � > > � � cD .�+ ^ m � a �� r N' °' arnz3 0 �o,� 2 0 � r+ N v � 3 3 � -� n --I m � n 0 � � � m � � _� Z O � � �� . W C r 0 Z � C � m v � � rn N C'1 2 m v C r m O �- S� O W m n � � cn�o�c� .. v�•� . ivaw� W fD �'-'' � O1� C O o � � ��•T Z fD :I7 ,�p `� m W D '� N � Z Z N m� m � � O z 0 < � a � -� z � r- � � � � � �� Z � � � �' � � �. Z O �-� � � � v� � v � � �. � Z � �; Cl --i `-`� ON � Z v z �� -� � � O = Z �-Di "� N � n� N n '�. m O � a� � Z� n o m ie Z --� � � � N � �, � z � m � <' m O � L � � C fll � N O O O COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacina an existina 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 specifications including sizing, length, number of elbows and termination. Yes () No () The undersigned also verifies that the replacement unit is a listed assembly and meets the cuRent codes and manufacture►'s specifications. This does include AGA-GAMA Category 1 Central Fumace Venting Tables for fan assisted and natural draft appliances. The existing combustion air is sized and installed to meet the cuRent codes and manufacturer's specifications. When required to install a new combustion air. it will be sized and installed To meet the current codes and manufaeturer's specifications. Yes ( } No ( ) Yes ( ) No ( ) Yes ( ) No ( ) When installinct a new ventina system, the undersigned hereby verifies that it 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. 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 () Appliance Tvae and Size/Common 1�ent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input 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 ALTERATIONS: (Describe) HEATING CO: Signed By: Date : � � _ CIZYOF FRIDLEY FRIDLEY MUMCIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 February 1, 2002 Mr. Darin Mansfield 5012 Hughes Avenue NE Fridley, MN 55421 Re: Final Inspecrion at 5012 Hughes Avenue NE Contractor: Sharp Heating & Air Condirioning Dear Mr. Mansfield: A mechanical permit was issued on August 8, 20(}0 to replace the air condirioner condenser at your address. According to the 1991 Uniform Mechanical Code a final inspection shall be conducted on the work authorized by this permit. On August 10, 2000 we were called for the final inspection but were unable to get into the back yard. The pernut fee that was paid covers the inspection to make sure the work was completed according to the Codes. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspecrion called for" and no further action will be taken. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. Sincerely, I� � Inspector SuBJECT City of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � i � � � � ; y __�� COMMUNITY OEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. l_---�; �"','� CITY HALL FRIDLE� 55132 NU4BEP NEV OATE 7 7/03 P�GE Oi L 763-571-3450 910-F15 / / JOB ADDRESS 5012 Hughes Avenue NE t LEGAL LOT NO. BLOCK TRACT OR ADOITION DESCR. Z 7 Carlson's Summit Manor South Additicrn 2 PNOPERTY OWNER MAIL AOORESS 21P Marvi.n Mansfield 5012 Hughes Avenue NE 3 CONTRACTOR MAII ADDRESS ZIP Home Improvemezts of Nsi 13789 Fordham Ct, App1e Valiey, N�T 55124 4 AHCHITECT OR DESIGNER MAIL AOORESS ZIP 5 ENGINEER 8 USE Of BUILDING Residentia� 7 CLASS OF WORK B DESCRIBE WORK Reside House 8 CHAN(3E OF USE FiiOM STIPULATIONS MAIL ADDRESS ❑ NEW O ADDITION O ALTERATION TO 33671 � �� APVi1pVE0 8Y SEE ATTACMEO SNEET PMONE LICENSE NO 612-598-9554 PMONE LICENSE NO. 20184826 PNONE IICENSE NO � REPAIR ❑ MOVE O REMOVE Per Section 1402, 1997 U:�iform Building Code, requ�res that a weather resist�ve b4rrier be placed over exterior sheathing to pro�ec� the in.te�ior w�.�� coveri�g. Exceptions for this provisioa� would be if sheath�ng is an approved weatherproof panel or when the s;dizg is an a.pproved weather barr;er. Vin�I sidi:�g is not a weatherproo� covering unless fihe manufacturer states this iz �he�.r applicatior� guideZi:.es. Ca�l for inspec�ion of w�ap before covering or �ake pictures. Cau�k and flash ai� exterior opezings. d TVPE OF CONST. OCCUPI SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING. HEATIN(i, VENTIl,A71NG OR AIR CONDITIONING THIS PERMIT BECOMES NULL ANO VOID IF WOliK OR CONSTRUCTION 20NING SO. fT , AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. Op IF CONSTRUCTION I OR WORK IS SUSPENOED OR ABANOONED fOR A PER100 OF 120 DAYS AT ANY TIME AF7ER WORK IS COMMENCED. NO DW�G. UNITS I MEREBV CERTIFV THAT 1 HAVE READ AND EXAMINED THIS APPLICA710N 1 STAIL$ AND KNOW TME SAME TO BE TRUE AND CORiiECT. ALL PROVIS�ONS OF LAWS yp�UATION ANO OROINANCES GOVERNING THIS TVPE OF WORK WILL 8E COMPLIED @ WITM WMETHER SPECIFIED HEREIN Oti NOT. TME GRANTING OF A PERMIT W7 �SOO DOES NOT PRESUME TO GIVE AU7MORITV TO VIOLATE OR CANCEL TNE pERMtT FEE PROVISIONS OF ANY OTMER STATE OR LOCAL LAW REGULATING CON• TR CTION OR TH PERfOFMANCE Of CONSTRUCTIO $153.ZS � PLAN CNECK FEE i.ice�se SC $5.00 S�G UpEOF ON'A CTOpOAAUTMOp�ZEDAGENT DAT � N PROPEiiLV VA n ro•re� ROUP OCCUPANCVLOAD CU fT. OFFSTREET PARKING IGApAGES SURTAX $3.75 SAC CMARGE Fire SC $7.50 TOTALfEE $169.50 D 7NIS IS YOUR PEAMIT � I� I �' NEW [] CITY OF FRIDLEY Effeative 1/1/2003 ADDN [] 6431 Unive�sity Ave NE, F�ldley, MN 55432 (763� 572-3604 Bldg Insp ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name 8� �c Contractor. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: �� l�v 4.� �d�l� ` �9 Tel. # � ' MN LICENSE # � �� -rei. # G `� �5`�� - 5'�',� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length �dth Height Sq. Ft. Length �dth Height Sq. Ft. Length �dth Hgt/Ground Sq. Ft. � pG Construction Type: �l V`"�� Estimated Cost: $ �S O�. Driveway Curb Cut wdth Needed: Ft. + 6 Ft = Ft x$ _$ . DATE: �%- 7- o� APPLICANT: Tel. # G��Z ,�1� �� Call �763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will � call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY - � /�3• a�°� $ � $ �3. 7�^ � $ � � C� $ $ � $ Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1275 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] TOTAL $ ( . �r� STIPLILATIONS� �, � . BUILDING PERMIT FEE SCHEDULE The Cluef Building Official shall, before issuing pernaits .for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteradon 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 $5� $501 to $2,000 $2,001 to $25,000 $25,001 to $50,�0 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEFS $23.50 $23.50 for first $500 plus $3.05 for each addidonal $100 or fraction thereof, to and including $2,000 $69.25 for first $2,�0 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,�0 $391.25 for first $25,000 plus $10.10 for each additional $1,004 or fraction thereof, to and including $50,000 $643.75 for first $50,� plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 .. $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof CURB CUT ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined rate. Permits for construction will be issued a minunum of 24 hours from the tune of applicadon to allow for proper review of the. proposed structure and of the construction site. VERIFICATION OF FOUNDATION A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Onlv n . - . s