AF - 46562�.s,.--�� �
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City of Fridley, Minn.
BUILDING PERMIT N•° 3 fi 4 5
Date: . . / � . �.� `. �°.'. . .� .. .. .... .. .
e
Owner�:'�i!��.. � .. . G"�l.�.rZ�,�if�� Builder . .. .... .. .. .... .... .. .. .. .... .... ......... ...
Addr�s . . �1.� • �: • . .����<'4i�' ',� Addresa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
LO�CATIO�V OF BUILDING
No.���(d. .�J .. . 5treet . .. . . .e�!��. . .. .. . . . Part f Lot
/...............................
Lot ,��'�: . �P. � BYock . . .
... .. �.... Addition or Sub-Dfviaion ��t�!i,�1df.I�e�.
a . . .... .... .......
Uoraer Lot . . . . . . . . . . . . Inside I.ot . %�. . . . . . . . 3etbaek . � �.'. . �.� Sideyard . .A . �. . ��6•
'� � � ?��,�� � 1 S �ta� �3�1 l°L � � O� �4E�.�r7�Y �il u���a—��?,�s�i��i
DESCRIPTION O� BUILDING
To Used • , � p , _ �
. . �r� . . . . . . F`ro�t �/ � Depth � / . .� Height . �J��. � Q Sq. Ft. �ll./ !. . Cu. Fk � /�.�� �
................. Fro�t ........ .Depth ........ Height ........ Sq. Ft ........ G�. F`t. ........
... of Construct3on .........
Zj►pe . . .. . . . . �t. Cost. .��. �rl. / �. . . To be Completed . . .. . .. . .. .. .. .. . . .
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Ea consideration of tihe is�uance to me of a permit to construct the building desribed above, I agree to do
the proposed work in accordance witli the descrlpt[on ahove set forth and in compliance with all provisions of
ordinances of the dty of Fridley.
.� .................................................
/�
In consideration oE the payment of a fee oP $. �l..'�,., permit is hereby granted to .........:
. .. .. .. .. .. . . . . .. . . . . . . . . to construct the building or addition as described above. Th�ts permit is granted upoa
tt►e express condition that the person to whom it 9s gisnted and hfs agents� employe� and worl�en, in all work
done in, around and upon said building, or any part the�of, shall conform in all respects to the ordinanc�s of
Fridley, Minnesota. regarding location, construcGion, alteration, maintenance, repair and moving of buildings with-
in the dty limits and this permit may be revoked at az�y time upon violation of any of the provisfons of said
ordinances. �—
�s :��t��
NOTICE:
Thla permlt does not cove� the construotlon, Inst�llation o� alteratlon fo� wl�ing. plumbing, gas heating,
sewe� o� water. Be su�e to see the Bulldtne inspeato� f�r separate permits fo� these Itoms
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"�-�°° MORTGAGE LOAN SURVEY
CERTIFICATE OF SuRYEY
Fot STEVE �u�►iRICK e� �+������ �"���
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DESCRIfT 10N; —
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LoTe 59 wNO 6d, B�ocK H.
R�VERVIEW HEIGNTS•
Sc�►�E: 1" - 30 �
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We hereby certify thet this is a true and correct representetion of a survey
of the boundaries of the land above described and of the location of ell
buildings, if eny, thereon, and all visibie encroachments, if any, from or cn
said lend. This survey is made only in connection with a mortgage loan now
being placed on the property and no liability is assumed except to the holder
of such mortgage or eny other interest acqui�ed by the reason of such
mortgege. It is understood end agreed no monuments heve been placed fo� the
purpose of establishing lot lines or bounda�y corners.
D� ted th i s 3�day of DECEMlE11 � , 1958 . EGAN, F I ELD b NOWAK
'-- Surveyors r
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F i l e No. 4835 Book t`� 1460 — 38 b�� . -�-.>� �� '�'�-�, $�� q
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N�i 1.@� CAI,E'i)L�'iI0A1S DEPARTAIENT OF IAISPECT[ON �**-� --�-�� �,�. ,
Weatherstrips A• G��� • Conetruction W0. Ina�ilata�0
I Windowa ( Daors Refereace Out. WeU Int. Wall CeJing Ftoof Floar Kind
Y�s— o v�s— o r9_ wow /�ppu@d
f!'i!F`1.� ';�e`�!-- Room (�ngth �'/ Width 1 Height � �.
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_ Windows and Doors—Cr�ckage and Area �i7indowa and Doars—Crackage and Area
�Vldth He�g�t No. ot Llneal tt. Area
�:JO. o[ pana o[ pane Ilghea ot cracic w• te. wlath Helabt No. ot Lloe�l ft. Ara�
No. o[ pane of pane 116ht� ot craet sp. tt.
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. Net exp. waU ` - � � i , — � � 7G
In� wap
Ceiling - r J ���1
Floor G�'�
' Total Btu. ` '°"' +�
Required sq. k. E.D.R. or aq. ina. W.A. (,eader area
'"" �.� `la Roam Leagt6 ' Width �� HeiBhc ��
'Windowa and Doors--�rack�ge asd Arca
Wldth Hela6t No. ot Ltnenl tt, prea
No. of pane ot prne Ilsht� ot enc� �p, tt.
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Esp. w�ll � /
Net e:p, wall �
lat. taall �j � _ ' �� )
Ceiling .
Floor t�L�
1 ��tal Btu.
li�;equired sq. ft. E.�.R. or aq. in�. �il.A, [,,�der area
� F7• Room � Lengeh Q/idth
_, Windowe and Doors--Crackage and Area
Wldth Hel`ht No. of le��l t{, Area
���• a� Dnne ot paoe Its�t� ot crack �p. tt.
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1': .6ltration
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I cp. wall
i : :: «p. Wau
]r�t. wall
(�' riling
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Glaaa
Eap. waq
Alet eYp. wap
Inc. well
Ceiling
Floor
Total B¢u. _
Required aq. ft.. E.D.R. or sq. ina. W.A. Leaaar area
Fl.l �m ( Lsn�th 93/idth
Windows and Doora—CraeDtage amd /�lrea
Wldth Helght No. ot Llneal [t. Area
ot pano ot pane IIg6t� ot craek eo. [�
Cda�
E�p. waU
Alet eup. wa11
Int. waU
Ceiling �
Floor
Total Btu.
Required aq, k. E.D.R. or aq. ioa. WA. Leader area
F1. Roo� I l.ength Qlidth
Wiaidawe and Dooro--Cracl�aee rsnd Aeea
Wldth lIe1�At Na ot Llnul [L Are�
No. ot yane af paos Ile6t� o! onok aa. tt
Ia4ltratioa
�Inao
Eap. wall
Flet exp. wall
In� wall
Ceiling
Floor
1'mtal Btu.
_Required tq. ft. ED.R. oe �. ins. �il.A. Leadz' r area
��
Heigi►t
Hei�he
Bcu
--,a�, _._
SUBJECT P '�
City of Fridley _ 17 3 3 5 '�
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ��
r
; � R IPT NO.
� • COMMUNITY DEVELOPMENT DIV.
� � V � %
r � PROTECTIVE INSPECTION SEC. /�� �/
i �
I i �
� /�"1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV
�'"'"� � ,�� 612-571-3450 910-F15 / /
11/14/83
JOB ADDRESS 506 Hugo $'tL'P.G�'t N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oesca. 58,59,60 H Riverview Heights SHEET
2 PROPERTYOWNER MAILADDRESS 21P PHONE
Adelir� Gabrick 506 Hugo Stxeet N.E. 784-7136
3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO.
Anoka County Comm. Acti.on Program 7150 East River Road 572-0060
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADORESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Re sidential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
x
8 DESCRIBE WORK
Reroof Dwelling
9 CHANGE QF USE FROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 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
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 COMPLIED $2�350 S�-•18
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LO L LAW REGULATING CON- $38 *�
T UCT OR THE PER RMANCE OF CO RUCTION.
'� a� PLAN CHECK FEE TOTAL FEE
� $39.68
SIGNATIJR CONTRACTORORAUTHORI onc3 tDaTE� WHEN PROPER Y AT D IS IS YOUR P�E/R'M(IT/�
�I� t —I'� O �
SIGNATUREOPOWNERUFOWNERBUILOERi IDATEI G WSP DATE
CITY Of FItIOLCY , Effective Aug. 1, 1981
APPLICA71a� FOft RCS10Ci��T1Pw BU1LD1iSG P�tL'•iITS
(I�ch�. Alter�tions. Additions. or Rcpairs)
O�sr�ER:
ADJi;ESS:
TEL K0:
STJtIST NO: ST1tEF.T:
'[3UI LDER: �
noaz�ss:
TEL I10:
Construction Location
LO7': Bj,pp( : l►DAITIO:i :
Corncr Lot: __ Insiiie Lota _ SetbacY.: __ Sideyazds:
Ap�lic�-tnt attach to tl�is form b.�o Certificates of S1�rvcy of lot and
p_oposed building locstion drawn on certificates to scale.
DESCRIPTIO�� OF CO�tSTF:�JCTJON
Fzont: Depth : Height:
Squarc f'eet? O�bic Feet:
Front: DePth: Neigl�t:
Sguare Fe�t: Cvbic I'eet: _
Y •
:��pe of Corw,truction : EstimaCed Cost: S
Rb Be Cbr.�pleted:
�
Alt. A A1 t. 8
Propos�d Dziveway Kidth If New Opening Is Desired: _ S s
S�L PF.VFR;L' SIDE OF StIF.ET ,
9iie undersianed hereb;� ma1;c:� t►ppliclticn for a perr�it fcr the �:ork herein specified,
agreein3 to cb .all �.or3; it, striet accordance r�ith the Ci�y of Tridley Ozdii�ances a�id
rulin�� of tl�e Departme��t. of Dui2ciincs, and hereby declares that• all tl�e fact� and
zepresc��itiens stated in this applic.�tion axe true and correct.
D: TE: SIGNRTUIr :
Stii�ulations :
.:, _K
. - �„ _ _ .
Tbe Chief Building Otficial aball, before iasuing permits for the erection
of any Duilding or atructure, or tor aay addition to any ezisting building
or atructure or tor aay aiteratioa or repairs to any existing building or
atructure� upon application therefore, require tbe paymenL by Lhe
applicaat for auch permit of lees to the amount berein below aet fortD and
!.a tbe manner herein provided to-t�rit:
Sotal Valuation
=1.00 to =500.00
Fees
=10.00 (Ninimum �15.00)
=501 to =2,000.00 =10.00 for tbe fir�t =500 plus �1.50
for each edditional �100 or fraction
thereof, to and includiag �2,000
=2�001 to =25.000 =32•50 tor the first �2�000 plus �6.00
for eact� additional �1,000 or fractioa
thereof. to and includiag a25�000
=25�001 to =50�000 =170.50 for the firat =25 � 000 plus
=4.50 for each additional a1�000 or
Praction thereof, to and including
=50,000
�50�001 to =100,000 =283.00 for the first =50, 000 plus
�3..00 for each additional �1,000 or
Praction thereof, to and including
=100�000
=100�001 and up =433.00 for tbe first �100,000 plus
=2.50 for each additional �1�000 or
• fraction thereoP
Plaa Cheak: 25 percent of building permit fee.
Drivevay Depresaion Escroy: Coacrete curD atreets only.
_ Alteraate •A": Removal and replacement oP curb and gutter only -
Drlver+ay vidth plus 6 feet times =13•50
A1Lernate "B": Removal and replacement of curb and gutter and
install a 3 foot wide approach vith 6 iach depth - DriveWay width
plus 6 feet times =15.75
.. � „-
Pe�ita for constructioa vill be iasued a minimum of 24 bours from the
time of application to allov Por proper review of tbe propcsed structure
aad of tbe constructioa aite.
1 Certificate of Survey ot tbe lot� aho�ing the location ot the toundation
once it 6as been constructed xill be required before oroceedin� with the
framing.
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����� AIR CONDITIONING
HOUSE HEATING TEST RECORD
� AND ELECTRIC. INC.
ADDRESS �D �U a S �
OCCUPANT
r v
HEAT LOSS DATE HTG. INST. 3'� "�1 �
SOLD BY � ,
Electrical Work By ��"/�
FA HW STEAM � gPACE HTR. �
TYPE OF HEAT GA 1]�
FL�R C� �j/�aI SUBURB
APT- —
OWNER
INSTALLED BY
(ias Une ey
UNR HTR. OTHER
CONVERSION
GAS DESION
MAICE OF BURNER
MAKE o Model
Model C � AAaz BTU Rating
Serial Mp,KE OF FURNACE
INPUT �f� --- — -- --
Model _ —_
�Ol+CIA014-
TfiERMOSTAT � .�t% Heat Plug
Yaive
UmH c
Limit Setting
Fan Setting
Pilot Type
Pilot Make
Pilot Model
Pilot Timing '�
L W. Cut Off pe�ent CO,
Pressure �
��P� �� Pereent O,
o Pereent CO �
Slack Temp.
Form 235
Verd Slze � �1 NONE
KIND OF LINER � s�g �
Ragulator
DraR Hood � � Number
Fiiters gi� �
x o�iaa
Chimney Localion Inside
Chimney Constructlon �'`� �
Wlring ✓
Smoke Bomb
Test Tag
�k Llghting Inst.
Daor Pressure c
Date Tested � ' � " �
Company Testing
Name ot Tester
sue�ecT PE
c�ty of Fridley 2 2 3 5 6
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
� �
� � •
� ; L __�__ COMMUNITY DEVELOPMENT DIV. ���
r � � PqOTECTIVE INSPECTION SEC.
� _ �
� /"'1 � CITY HALL FRIDLEY 55432 NUMBER f1EV. DATE PAGE Of APFROVED 8Y
�""� � �'' 612-571-3450 sto-F15 3/24/94 � �
JOB ADDRESS 506 Hugo Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oescR. 58,59,60 H Riverview Heights SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Sharleen Stueland 506 Hugo Street NE 784-1291
3 CON7RACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Merchants Ma.intenance & COnst. 12020 Radisson Rd NE, Blaine 755-0904
4 ARCHITECT OR DEStGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PMONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CIASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION � REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Miscellaneous repairs including e ress windows, new storm doors
9 CHAN�E qF USE FROM TO
STIPULATIONS
See notations on plan.
TYPEOFCONST. OCCUPANCY OROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATtN(i,
VENTILATING OR AIH CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 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
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GAHAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $"SOO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
T CTION OR THE PERFORMANCE OF CONSTRUCTION. LOS OO
� P PLAN CHECK FEE TOTAL FEE
� �2 �P � � �'`T�f
SIGNATUREOFCONi OROfiAUTHORj AGENT IDATE� WHEN PROPER VALIDATED THIS IS YOUR PERMIT
u �_ � �y�9 `-1
SiGNATUREOFOWNERiIFOWNERBUILDERI IDATEI " BLDG �N p �aTE
NEw
ADDN
�,�
[l
[7:
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ConstructionAddress:
� ' � CITY OF FRIDLEY - . �
��.SINGLE FAMII,Y AND DUPLEXES' R-1 AND R-2 �
� ' ' Building Peimit Application �
�` � 6-� C',-r.c.7 �`�, � � •
Effective 1/1/94
�� ���
Lega1 Description: � �
Owner Name & Addre.ss: � �.�c.�.�-t--� � �c- L.� `� Tel. � � �"s � � � � � C
Coniractor: lrti��-/:���,z C�� �.�, ���� � MN LICENSE #� 4��� `�
Address: f � � �`a�, s�� (Z � e � � �-ra � Tel. # �55 � � � g{
Attach to this applieation, a Certificate o� Survey of the
lot, with the proposed constriiction dr'awn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING ARfiA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
-.�
DECK AREA: Length Width Hgt/Ground Sq. Ft.
��
�
OTHER: ��s E ��E�� C� �'-� ���3 � 4�� -� , Nc� � � �
Corner Lot [] Inside Lot [] Ft Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $ �� �, `�
Approx. Completion Date: ,
'veway Curb Cut Width N�ded:
�C A'I'E: APPLICANT:
Permit F�
Fire Surcharge
State Surcharge
SAC Charge
L1CC� $11IC�tgC
Driveway Escrow
Erosion Control
Park Fce
Sewer Main Charge
TOTAL
STIPULATIONS:
$ ����
$ � �
$ �{ z S
$
$ � o�
$
$
$
$
$ f�9�s_.
�o2s��
(Cost on Back)
Ft. + 6 Ft = Ft x$
�, CITY�,TSE ONLY
_$
Tel. #
F� Sch�ule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation _ _ . ._
$800 per SAC Unit
$Jr.� �$tdtC I.1CeIIS� Re.S1dCII� C0111TdCtOTS�
Al� "A" or Alt "B" Above
$450.00 Conservation Plan Review
Fee Deteimined by Engineering
Agreement Necessary [ ) Not N�essary [ ]
�
BUILDING PERMIT FiE SCHEDULE
�: - . . . � .
The �f Building Official shall, before issuing pemiits for the erection of �any building or structure,
or for any, addition to any existing building or stiucture, or for any alteration or repair to �any existing
building or structure, upon application theaefore, require the pay�nent 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 $S00
$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,(101 to $1,000,(�0
$1,UOU,001 and up
FEES
$15 (Minimum Fee is $15 plus surcharge)
$15 for firsi $S00 plus $2 for each additional $100 or
fiaction thereof, to and including .$2,OOU : � .
$45 for �first $2,000 plus $9 for each :additional $1;000 -
or firac�ion thereof, to and including $25,000 � -
.$252 for first $2.5,000 ples $6.50 for each additional $1;000
or fradion thereof, to. and including $50,000
$414.50 for fust $SO,OOU plus $4.50 for each additional
$1,000 or fraction th�eof, to and including $100,000
$639.50 for first �$100,OW plus $3.50 for each additional�
$1,000 or fraclion thereof, to and inciuding $SQ0,000
$2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,�O,U00
$3539.50 for the first $1,000,000 plus $2 for each additional
$1,000 or fraction �thereof -
DRIVEWAY DEPRESSION ESCROW
_ (Concrete (�rb Streets On1Y)
Alternate "A" : Removal aad replacement of curb and gutter only - Driveway width plus b feet times
$13.50. �
Alternate "B": Removal and replacement of curb and gutter aad install a 3 foot wide.
approach with 6 inch depth - Driveway width plus 6 feet times $15.75_
VERIFICATION OF FOUNDATION
Permits for constiniction will be issued a minimum of 24 hours from the time of application to allow
for proper review of the proposed stxucture and of the construction site.
A Certificate of Survey of the lot, showiag the l�on of the foundation once it has it has been
constructed will be required before proceeding with the framing.
�
_a
Sharleen Stueland
506 Hugo St. NE
Fridley, MN 55432
Phone: 784-1291
�
Living Room:
1. Install new window replacements (4 DH), vinyl framed with welded corners, insulated
glass, full screen, hardware, weatherstripping and lockset. Set into existing
openings. Benada or equal. Reuse trim. Owner's choice of color. Haul away
old units tvith combinations.
Kitchen: ..
1. Install new window replacement. (Spec. same as living room.)
2. Redo floor covering. Remove exis�ing covering and install new structural grade
plywood and vinyl sheet flooring of owners choice of cvlor and pattern. Armstrong
or equal. Edging of floor covering shall be covered ( confirm material/finish
with owner).
Southwest Bedroom ist floor:
1. Install new windota replacements (1DH, 1 CSMT) (Spec. same as living room.)
One window must be sized to meet egress requirements. Confirm location and type
of window with owner.
North��rest Bedroom 1 st floor :
1. Install new window replacements. (2DH, 1 CSMT) One window must }�e sized to
meet egress require�ents. (Spec. same as living room.) Confirm location and type
of window with owner. .
Basement North�aest Bedroom:
1. Replace window with egress type unit. Install new casemen� type SJindoV�, vinyl
framed with welded corners, insulated glass, screen, lockset, hard�rare and
weatherstripping. Benada or equal. Install new wood casing and trim with painter's
finish. Owner's choice of colors.
2. Ir�stall areawell of galvanized material with base filled with drainage rock.
Basement Southwest Bedroom:
1. Replace window with egress type unit. (See spec. for Basement NW Bedroom)
Homeowner to stain and varnish.
2. Install areawell of galvanized material with base filled with drainage rock.
Bathroom: �
1. �zrnish �nd install 36" vanity with cultured top. Owner to finish if custom.
Exterior:
1. Remove gutter, add (3) diverters.
2. Install new storm/screen door for south entry, solid core, baked enamel prefinished
aluminum, with weatherstrippinq, self-storing storm and screen inserts, hardware
and lockset for complete assemY�ly. Benada or equal. Ocan�r's choice of color
3. Chimalater - Chimney cap in lieu of glass front for fireplace.
� .
� -
;�
�
Sharleen Stueland - Paqe 2
Heating:
1• Install new furnace
Installation shall � forced-air, natural
�:a include combustion airgas� AGA or UL listed, Carrier or
pproved flue. Reconnect e�istin intake, netr the �al.
_ to g�lenurn and distribution systemnting to
Plumbing:
1• Install new shoiver/bathtuh fixture, anti-scal
Delta Monitor or equal,
2• Install back flow d' ��Ome and with 3
preventers to la�d 9pm shoiaerhead.
Correct leaky shu�-off Yy and e�;terior faucets
3• Install netT water �lve to south exterior faucet. � self-draining.
State or � heater, 40 gallon
4. p �al� Plumb and vent. ' natural gas, AGA or UL listed, ener
Re lace flex conriection Haul at�ay old
5• Replace flex co and ball va�ve on �lt. �i' saver,
6• �eta faucet for bathroam and ba12 v�lve on gas range.
vanity, installed,gas dryer.
El
ectrlcal:
1• Protect wall receptaeles within 6
2• Install wall receptacle �d ' of kitchezsink
3• Wire installed furnace, protect ioith GFI in �'l�h GFI. (1�
both bath,rooms (2�
SEP�tRAT� PERP!�tTS RE�UlRED fdR
WiR��d�, H�ATIiV1G, PLUnl1�iNG ANfl S�GNS.
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City of Fridley 3 3 4 8 5
AT THE TOP OF TNE TWINS g � I L D I N G P E R M t T
�
; � RECEIPT NO.
� ; v __��� COMMUNITY DEVELOPMENT DIV.
r � � PpOTEC7IVE INSPECTION SEC.
� . �
� � /�"1 � CITY HALL FRIDLE� SS�3Z NUMBER pEV OATE PAGE OF A V110VE0 BY
� "'"� � ��� 763-571-3450 910-F15 5 / 1 / 03 / /
J08 ADDRESS 506 Hugo Street NE
t IEGAL L07 NO. BLOCK Ti;ACT OR AODITION SEE ATTACMEO
oescR. 58,59,60 H Riverview Heights SNEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Sharleen Stueland 506 Hugo Street NE 763-784-1291
3 CONTRACTOR MAIL ADORESS ZIP PNONE LICENSE NO
Grayhawk Builders 3020 Centerville Rd, Little Canada, MN 55117 651-486-9888
4 ARCHITECT OR DESIGNER MAIL ADDpESS ZIP PMONE LICENSE NO.
20174611
5 ENGINEER MAII ADDRESS 21p PHONE LICENSE NO
8 USE OF BUILDING
Reside�.tial
7 CIASS OF WORK
O NEW ❑ ADDITION O ALTERATION � REPAIR ❑ MOVE 0 REMOVE
8 OESCRIBE WOFK
Reroof flouse 17 S Tear-off
9 CHANOE OF USE FROM TO
STIPULATIONS Underlayment must comply with the State Building Code.
� � �� � �������� ����
�II � ailed
T� Ho��ourner T� Post
SEPARATE PERMITS ARE REOUIHED FOR EIECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV �OAD
VENTILATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULI ANO VOID IF WORK OR CONSTRUCTION 20NING SO. FT CU FT.
AUTMOR12E0 IS NOT COMMENCED WITHIN BO DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANOONEO FOR A PERIOD OF 120 DAYS AT
ANV TIME AF7ER WORK IS COMMENCED. NO OWLG. UNI7S OFfSTREET PARKING
1 MEFEBY CERTIfV THA7 I NAVE AEAD AND EXAMINED TNIS APPLICATION 1 S7A�LS GARAGES
AND KNOW TME SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS yq��ATION SURTA%
AND ORDINANCES GOVERNING TMIS TYPE OF WORK WILL BE COMPLIED @
WITM WME7HEFi SPECIFIEO MEREIN OR NOT. TME GRANTING OF A PERMIT `P1,968 �,98
DOES NOT PRESUME TO GIVE AUTHORI7Y TO VIOLATE OR CANCEL THE pEqMIT f EE SAC CMARGE
PROVISIONS OF ANV OTHER STATE OR LOCAL lAW REGULATING CON- @
STRUCTION OR THE PERfORMANCE OF CONSTRUCTION y�F)9.ZS Fire SC �1.97
PLAN CMECK fEE TOTAL FEE
icen e SC $5.00 $77.20
S�GNGTUAE O� CON'AACiOA Op AUTNOA�2ED OGENT IOATE� EN PROPERLV VALIOATED TMIS IS VO R PE MIT
s
$�GN4fUAE O� OWNEp��i OWNEi1 BU�IDEA� �DAiE� � LOG �NS� �� tE
1� -
HIJG—��-2C_�►�1 11 � 41 FF'CIPt �: I T'r' OF FR I DLE'�' TO
NEw j )
ADD" [ ) , CRY OF FRIDLEIf
�„LTER [ j ��GLE �AMtLY AND DUPLEX�S R 1 AND R-2
./`�'�, BUIl.D1NG PERMITAPPLtCATlON
Construction Address: `7
Legal Descxiption:
Own�r Name � A�
UVING AREA:
GAR/�GE AREA:
DEGK AREA:
OTHER;
�1�c��c^�b..�:_' P. �1.'�c ='
Eff�ctnve 9I�I2007
{?63j 5T2-36U4 Bldg Insp
�'i�.g'ir� �
.< r
- i� � /��.i?
• s •• •
Aitach to this application, a Certf�cate of Sunr�y af the
�ot, wit� the proposed carYStructior, drawn on �t to sr�le.
DF.�RIF'T1Q�1 OF t�ROV�lI�MT
��9�'► Width _____ Height� $�. F�,
�e� V1fi�ith Height Sq. Fi _�_
!�_ Sq. Ft
�.f
Canstructron i'ype: � ,� Es�mated Cost S� ����
�� . .
L. ,.ew�y Gurb Cut Width Needed: +Ft + 6 Ft �_^,Ft x$ _�
'� 4 1
DATE: APPL(CANT: � Tel. # � �'fz'��
CRY USE ONLY - Catl (753j 372-3644 for Permit Fees if maiting in appCrcation
Permit Fee �
$ %�S Fee Schedufe on Reverse Side
�'ire �urcF�arge 3 P�' .�i of Pecmit i/atuation (7/loth°�a}
State Sur�harge $ � $.50/$1,000 Yaluation
SAG Charg� $ $1150 per SAC Unit �
License Surcharge $ �� o� C� $5.00 (Sta#e Lic�nsed Residenfia! Co�tractors)
Driveway Escrow $ A!t "A" oc Alt, "6" Above
Erosion Cor�trpt $ $450.00 Conservation Plan Review
Park Fee $ Fee Oete�mined by Engirmeering
Sewer Main Charge � Agreernent Necessary (] Not Necessary �]
TOTAL
���L/�liONS:
�.•..
$ ��`,��
.� . �'
Building
Inspections
763-572-3604
763-502-4977 FAX
PLUMBING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
Pernut N
Received By: (�
Date Rec'd: �0 '3 �
DATE YOURE-hfAIL ADDRESS �I � g l Sg �j � f'F- L� (iC
srrE avnxESS ��G -1 { t,�-� S�r 't�lg ,^�t p L�`/ ,� r4
THIS APPLICANT IS:
PROPERTY
0^1\L'i�
1L' 1\�
pd owr�x ocotstR.ac1'ox
NAME: �A (�. S N� i�D1T� �
ATTDi7CC• S� � i'�G1.E�e � ��
�ox�: �6s - �3 • �E 6L
CITy ''FR.I pL$�_STATE �ZIP 55�3
CONTRACTOR N�:
SUBNIIT A COPY OF STATE LICENSE tt ElP DATE
YOUR STATE E� DATE
LICENSE. BOND AND STATE BOND �
CERTIFICATE OF �DRESS: CITY STATE ZIP
INSURANCE ��� FA.l"
PERNIIT TYPE ��GLE FAMII.Y O TWO FAMII.Y O TOWNHOUSE
TYPE OF WORK: � �w �I �-AC�NT
DETAILEDDESCRIPTIONOF WORK ��'R-�p°� `K,���k �-�— o�'�'C�'P�S
PER MS 16B.665 the permit fee is a minimnm of $15.00 or 5% of the total cost np to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixt�e, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 =$15.00. Labor cost betw�n $300 to $5� = cost of labor x.OS = plus .50 surcharge
FOR PROJECTS WT�ERE LABOR �CEEDS 5500. FEES ARE BASED ON $10.000 PER FLl"PfJRE. E10EPf �VFIERE NOTED. FZl'TCTRES: (INDICATE TOTAL
�ER OF EACH BELOK�. MI1�IIMIJM FEE $15.50.
/�BATH SINK/LAV FLOOR DRAINS � SIiOWER _ WATER PIPING
BATHTUS GAS PII�ING (1VEED CTfY LIC) SWA�IlVIII�TG POOL _ WATER SOFIIVER ($35)
CLOTf�S WASI�R K1TCF�N SINK WATER CLOSET _ BACKFLOW PREV. ($15)
DISHWASHEIZ LAUNDRY TRAY WATER HEATER (S35) FOR IRRiGATION
— — WA'TER METER _ OTfiER
Permit Fee
TOTAL DUE
UNDER $S�p pERMIT FEE FOR PROJEC:1'S V v K��uu
g Number of fiYhn'es r$10.00 1$10.00 =$
.50 Number of fistures n $15.00 � $15.00 = $
$ OR Number of fi.�-tnres (a� $35.00 � $35.00 = $
State Surcharge = $ .5
MCTM $15.50 Tota1= $
THIS IS AN APPLICATiON FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing permit and I ackno�vledge that the information above is complete and accurate; that the �vork �vill be in
conformance �vith the ordinances and codes of the City of Fridley and �vith the Minnesota Con.�truction Codes; that I�derstand this is
not a permit but only an application for a petmit and work is not to start without a permit on site: that the work will be in accordance
with the approved in the case of ��i�+ h requires review and approval of plans.
SIGNATURE OF APPLIC PRIN"P N.41�1ES /'-" P�iW V�-T�R� DATE 3�I LI N�.�S
r�.PPROVED BY
� � DATE �_
BUII,DING, ELECTRICAL �AND
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977