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AF - 46380,^ � �� City of Fridlep, n�.. � 15 � 3 6431 University Ave. N. E., Miimeapolis, Minn.. 55432 BUILDING PERMIT na�: August 11, 1972 ��; Margy Schain B�d� Sussel Address 5 03 7 Hughes S t. N. E. , Ad�,� 185 0 C amo LOCATIOiV OF BUILDING No.. .� 03 7��t � Hug es S t. N. E. p� og �� Lot .— 5 Block �._.— Addition or Sub-Division _ Ca7clson� s Summit South Corner Lot .__�.._..— Inside Lot Setback Sideyard Sewer IIevaiaon _. _ Foundation IIevation ___.._ DESCRIPTION OF BUILDING To be Used as: Garage Front ?� � Depth 22 � Height _ 10' Sq, �, 440 �, �, � 4 440 Front Depth Hei�ht Sq. Ft Cu. Fi. Type of Construction � Wood Frame �� 1,993 .00 To be Completed 90 days Provide a hard surface drive � In consideration of the issuance to me of a�rmit to construct the buflding described above, I a.gree 'to do the propased work in accordance with the description above set forth and in compliance with all provlsions � Ordinanc�s of the city of Fridley. J��.� In consideration of the payment of a fee of � 8• 5 � ,�rmit is hereby granfed to S us s e 1 to construct the building or addition as desc�ibed above. This permit 3s granted upon, the express condition that the person to whom it is granted and his agents, employees and workmen, 3n aII work done ui, around and upon said building, or any part thereof, shall confoxm in all respecis•to the ordinaaces oi I'ridley, Minnesota. regarding location, construction, alteration, maintenance, repa3r and moving of 'titlileiiagB � th�e city limits and this permit may be revoked a t any time upon viola.tion of any of the prov3sions oE ss�id �� 6 B1$1d3IIS I�Sp2C�Or NOTICE: ihis permit does not eover fha eoestruetion, insta11a0ion fo� wirine, plumbeng, gas heatpng� sevyer or water. Be sore to �e the Building Inspedo� fo� separate permhs for iheae items, , . �/ AP.PL�CATION �OR RESIDENTIAL, A�T�R.ATION, QR AllllITIO� $UI�DjNG P�,RMIT CITY OF FRIDLEY, MINN�SOTA OW1,vER,' S�TAME t C.� BUILDIIt : � �� Anrn�ss : ��D� 7 � �-t- � ann�ss : � �o:,,��3�,_ s�E�: , IAT ; � BLOCK : c� ADDITION !��:�� xC��,�,� G°r� • ,,, �,....��.. CORNER LOT: INSIDE LOT: SETBACR: SIDEXARp��A ,Applicant attach to thia form ltao Certificates of Survey of Lot aa,d pxop��9e,d building location drawn on these Certificates. �o �e IIsed As: HESCRIPTION OF BUILDING / Front: ��d� Depth. oZ � � Height: /O Square Feet: v Cubic Feet: ��SL v � I A �IRaw�q ' Front: Depth: Height: Square Feet; Cubic Feet: '�►pe of Conatruction: ,��,,..-✓ Estimsted Coet: $ . �,�„ �'a 13e Completed: � � � � The undersigaed hereby malcea applicatitin for a perp�it for ti�e .wQfil� '�41�+�� spec��,ed, agreeiag to do all work in attict accordance with ti►e G�ty +�$ F��,d�eir Ordinancee and svlinge of the Department of Buildiage, and be��bir dec��ee that all the facte aad representatione atated in this appi�,e��,� a7re txue and correct. � �A� ; SIGNATURE : � — (Se� Reverae Side For Additional Infot�ation.) ; �,��- v . �---° � r� f � � � � .. � $UILDIN� PERMIT FEE SCHEDULE SECTION 2, The Inspector of Buildings shall, before issuiag pe:mit� fox the e7cection of any building or structure, or for any addition �o any existi.n� building or structure, or for any alteration or repairs to any ex;�stiag bui,lding ox structure, upoa application therefore, require the paymet�� by �h� appl�caat for such permit of fees to the amount herein below set faxth and �.nn the ma,aner herein prwided to-wit: UNIFORM BUILDING CODE: Z�pe 1, 2� 4-$2.15 for each one thousand cubi.c �e�t, ox fraction thereof, in such cubical contents. Zj►pe 3� 5-��.85 �Qr each one thousand cubic feet. ADDITIONAL INFORMATION For the purpose of computing fees for buildiag permits, the cubical conteats of any buildi�g or addition, ie determined by multiplyiag the grouad area covered from a point aix (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average� height of the roof aurface of the main gable of a pitched roof. �pr repairs or alterations to aa existing structure, the fee ehall be at tt�e rate of $3.00 per each five huadred dollars ($500.00) or fraction thereof in the cost of all propoaed work. Tu ao case ahall the fee charged for any permit as aet forth ia Sectiaat � be� lese than $S.Op. VFRIFICATION OF FOUNDATION LiTpT�; Permits for eonstruction will be isaued a mini�um of 24 hours f�op� �he� �ime of application, to allow for proper review of the proposed structuze atid a£ the conetruction site. �i Cextified Survey of the lot, ehowiag the location of the foundat�,o�� V�� b8a been constructed, will be required befo�e proceedin,g with the f�am�ag, CERTIFICATE OF OCCUPANCY Applicatioa for a Certificate.of Occupaacy ehall be made ten (10) days $iC1A� �� the use ar occupancy of any structure for which a buildiag permit has 1�� iseued; and eaid atructure ehall not be used or occup�ed until a Cesxif�.aat� o� Occupancy has beea issued. ` �, � ,Ln io G�ade_ �TYPICAL SLAB DETAIL Y., 2- 4 Re-8a�s c - � tD • _ —�v 12�� Mi�t e � 66 x IO�o �rire mesh 45° 8�� Min. c � m E .� i,s. '° � , � v The above ia a substitute design for frost footings, ho*aever, it is not yet accepted by the State as an amendment to the Uniform Building Co3e, Section 2905,a. Therefure upon using this method of construction, I agree to hold the City of Fridley harmless of any possible claim for foundation failure or structural damage caused by foundation failure. ., a � Ir � vi itness operty Owner Date Address of roperty /Legal Desc., V ~C. _ �w� � �s-� r v v r' i � d �i�E SUSSEL CO. � 1850 COMO AVE. ST. PAUL CALL: 645-0331 Sl�LESMAN SA tTLlZ!_EE _ CONCRETE WORK ORDER NAM� �D � C N LI� �f N PHONE #� ` � JOB ADDRESS ��3 � ��U ��/�S A V � ni.�c�. c�i�F nr�rn ��2!: ��"-� -�--- --------FUFZ OFFICE USE ONLY --- - --- - - � CONTRACT DATE �-Z S- 72 CONTRACTOR �2w1 S� JOB �f � SIZE 7 v X Z Z�I/�,�LG,��T SUSSEL JOB # �� 7 7 CONTRACT # 300- �''� �Permit bySiiScFL � Legal Description ❑ Lot ❑ Blk � 1 Add'n D Value _ � �i 3 � Type Const. �iF'.4.v� E �'Square With,/�c.%.�� - Rods � esh �,Sod Rem. - By ��S cZ r' 5-Bag Mix �6-Bag Mix �Tamping � No Tampi� �� -,A.B.U. 2-St�tings Points Only S.P.L. --________ S.S.P.L. R.P.L. Alley /D ' — House F. 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L ��'F.+tN r w� F+� �� x�i p � J'i��r.� ' . . _ .. ___ �. _ . . . ,rr __ c�-� .�s .. _ _ ' � _ _ ' �J sue�ecr E . c�ty of Fridley 2�427 AT THE TOP OF THE TWINS g � I L D I N G P E R M I T r ; � O. COMMUNITY DEVELOPMENT DIV. �/- �� f � ~ � PROTECTIVE INSPECTION SEC. !^'l � , �.O 1 = � � /"'1 � CITY HALL FRIDLEV $$A32 NUMBER REV DA�E PAGE Of APPROVED BY �""� � �'� 612-571-34b0 9�0-Ft5 8/26/98 � � J08 AODRESS 5037 Hu hes Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR AODITION SEE ATTACHED DESCR. 5 6 Carlson's Summit Ma.nor South Ad ition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP ' PHONE Ma.rgy �a�s� Schlavin 3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO. Owners 4 ARCHITECT OR DESIGNER MAII ADDRESS IIP PNONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WOFiK Reroof house and ara e 21 S Tear-off 9 CHANOE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, �PE OF CONST. OCCUPANCV GAOUP OCCUPANCV LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SQ. FT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WOHK IS COMMENCED. N0. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I MAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND COFiRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND OFDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEHEIN OR NOT. THE GRANTING OF A PERMIT 1]S1 8 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEpMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. SC').7S Fj.I S ' PIAN CHECK FEE TO UFEE S�GNATUEIE OF CON � RACTOA OA AUTMORI2ED F�GENT IOATEI EN VALIDA THIS IS�i U�RMIT �1 � // J Q I � S�GNaTUAEOF E WNERB R E � ATEi Bl �NSP O�TE NEW - ADDN ALTER [-1 [l [l �onstructionAddress: Legal Description: � Owner Name & Address: 1% Contractor: / \Address: LIVING AREA: GARAGE AREA: DECK AREA: u OTHER: (� Construction Type: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION r � Effective 1/1/98 1 �� Tel. # ��,z �� MN LICENSE # Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IlVIPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Driveway Curb Cut Width Needed: Fstimated Cost: $ � ��.� � (Fee Schedule on Back) Ft. + 6 Ft = Ft x$ _$ � , DATE: y 1 � APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License 5urcharge Driveway Escrow Erosion Control Pazk Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ � �• �-��Fee Schedule on Reverse Side $ l °7� .001 of Permit Valuation (1/lOth%) $ �� $.50/$1,000 Valuation $ $1000 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 [ ] � � �q.� .:;�-' 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 $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 $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) 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. � n m Z � O � m n, n � � � o � Z �� m a� m � � � A1 � N O fD O 3 '� _ 1 � n -a a � 3 c� � ,.�. 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S�ll.LS ia�o IId . � �� S�nig $Un�u i�o� seH 9 ( ) uH ( } s�a� pa;�auuo� s � . �f1.Lg I�lo� pu� � � azis..�o� s�uamannbai apo� �ua.vn� ii� s�aay� •S ( ) oH ( ) sa� pa�oddns �Ciain�as sI •� () oH () sa�C ' uir.�inn pa3po� s��al'qo u�taJO� ou sEH '£ () oH () sa� uoqpaoua�ap io �snl tuo.r� aa.� si •Z () oH () sa� pauiwexa �CJIn�a.�� uaaq sEH ' i :��s io �auuiTu� �ui�sTxa a� �Ey� sayuan �{qaiay pav�is�apun"ays N I.L�'�I�I?1�A ?I V,L Q d' �C� WIH �` , CITY OF FRIDLEY 6431 U1�TIVERSITY AVENUE NE FRIDLEY, MN 55432 ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE 572-36U4 l�'AX: : 5037 H[JGHES AVE NE : 263024230111 : CARLSONS SLTNIlVIIT MAN SO ADD : LOT 5 BLOCK 6 : PLUMBING : RESIDENTIAL : ADDITION/ALTERATION 571-1Z87 PERMIT NO.: 2004-02168 DATE ISSiTED: 11/24/2004 VALUATION : $ 0.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE # NEW FIXTURES (EXIST OPENIlVGS) 0 # GAS WATER HEATERS # GAS DRYERS 0 # GAS RANGES # OF NEW FIXTURES 0 VALUE (FOR MINIMUM CALC) # WATER TRMT APPLIANCES 0 APPLICANT NORBLOM PLUMBING CO 2905 GARFIELD AVE S NIlNNEAPOLIS, MN 55408-2173 (612) 827-4033 OWNER SCHLAVIN MARGY V 5037 HUGHES AVE NE FRIDLEY, MN 55421 PLBG PERMIT MINIMUM FEE PLBG FIXTURES (NEW OPENINGS) PLBG FIXTURES (EXIST OPENII�TGS) WATER TREATMENT APPLIANCE WATER HEATER - ELEC WATER HEATER - GAS GAS RANGE FEE GAS DRYER FEE PLBG REPAIR/ALTERATIONS STATE SURCHARGE, PLBG FLAT TOTAL PAID WITH CHECK # 29543 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construcrion or work is suspended or abandoned for a period of 120 days at any time atter work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wor� will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regula constr�ion or the performance of construction. Applicant � � Date � Bldg ��I�u II� \, SEPARATE PERNIITS REQUIItED FOR WORK OTI�R THAN DESCRIBED ABOVE. 0 1 0 400 0.00 0.00 0.00 0.00 0.00 35.00 0.00 0.00 0.00 0.50 35.50 � � .m � �� -�-I Z � � � r � m � O v m v � m C � n � m � O z w � D Z v � m D 0 D r � m m � � � � m � c �' � c� . . a � < � � O c � � m � -n � � � az J � � o � N � °, rn ni U�i 3 � Z c� �, v � 'n � o � o 0 c3 � � 0 � � -� � �v rD- � � 0 Z � � G) Z v � � r z 0 6` N N � I � W W ��z��oz �Gii: ;� � y y N f"�D fD � �� C� � =� � �i c� o�� 22� �� oo °��'• � � c� � � # � � � � ' � °� � � � -, -, � �' r y � � � � �c � � � m m � m y�O a '' m � � y �. ; � �, � � � � � � �. � .. � � ... I� I I I�--I I i IIIIII � � 0 0 � C 3 � z c� � � � . C �� oo�.�w+�0000000 °o °o °o o° o° o °o °o ' °o ' °o °o °o � � m 1 � v n O � o�. O lV � � Z O � C � z c� c � m v � � N n� 1G.� O � � I v � �' � rn�wc) � O v = N � c < �3=Z Nz�� ro m -' Z c m z 0 _ D � � H O 4 � � � . a c� � 2 �; � � �, a y � f�/ � , °. � �c z`s � :�� s � o �° a a Q � n � v � n3, �. O � N � ffl ? � � � v, v a g g � d o � � ,��a a n� d �� d y � � „r��. � O �. cu �r a� n c� � `� o c� �. � � m � y N � � r C � Z � � � � m � � z O � 0 � ` W g � � � � waw� cn � C O N�z,� � � � � �� N�v c� � m� � N V � � m s V � Z . < a � n a � O Z � � r 3 a Gi a � N "f1 . � c1i � m � � � � � D v �. � 0 � FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacin�a an existin� furnace, 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 current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Fumacs Venting Tables for fan assisted and natural draft appliances. . The existin�a coanbusti�n a6r is si�e�d and instaA�dtg mee# thc� current 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 manufa�turer's specifications. Yes( ) No( ) Yes() No() Yes ( ) No ( ) When installin� a new ventin�a svstem, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's spec�cations. This does include AGA GAMA Category I Central Fumace No () Venting Tables for fan assisted and natural draft appliances. Yes () Is the cflmmon 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 () Aqaliance Tvae and Size/Common Vent 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 Tdal 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• (Describel HEATING CO: � Signed By: Date : :�