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AF - 46584n /'�1 � City of Fridley, Minn. BUILDING PERMIT � � �� /lX�' �` N° 6961 s�a�r � �.�..._.. Addrese � LO I N OF UILDING No. c �• � Stceet �� ___.��,.�_�. Part t _ Block Addition or Sub-Div�lei� _ �i�' / e � Coraer Lot _ Ine3de Lot �.. � Setback '.��._�__.....__._.._ Sideyard _�' �•� /� R , Sewer IIevatton Foundation IIevation DESCRIPTION OP BUILDING �To Used • � e - Front ��v�" Depth �Lf�� Height � Sq. Ft (�. �� Front Depth FTeight Sq. Fk Cu, Ft, Type of Conatruction � 't� Fs� C'6�t �� To be Completed In con�derat[on oP the isauance to me of a germft to construct the building described th� proposed work in acc�rdance with the description above set forth and in comp�l�a� orciinanc� of the dty of FrYdley. p� �`� v �� I agree to do provisiona of In conafderat4on of the payment of a fee oP $�°� , permit is hereby granted to to construct the building or addition as described abave. This permit fs granted upon the express condition that fihe P�n to whom it is granted and hia agente, employees anc� worl�nen, in all work done in, around and upon safd building, or anyp�r� thereo� shall c�nform in all respecta to the ordinancea oP FridleY� Minn�ota regarding loc�tion, conatructfon, altera.tion, maintenaace, repair aad moving of buildings withiu the dtY limi't� and this permit may be revoked at aqy time upon violation of aay of the proviaiona of said ordinaac�. �.. . �� NOTICEr 'nds peemh de� asf eever t6s eoe�kodioe, Ie�alFatioe �vr;�tde& P��9. 6b 6�9� awer or vate�. B� wre !o see dn 6oildie� i�tsr ior pp�raM parmht /or 16as �.. ;'" '` °�� :� _ _ _ r.� , _ ; 1,and Ploi�nir� 6875-N�hwoi� ;GS At.E. �3t�veyirt9 . Minirevfao/s3Z, .�t,s �� ` E�[� G! N�E R i N G, [ N C. ��f� Cvi1 fr=A+tun"u✓pal ' , � SUn�ef4-&066 � �y��;�9 -- En9►i�e��s E �'ur ve` yors --= �!��*s��C�t� o� s�,*�"e f �:,� u �e �� 'l. �� <� ,� � �� ' �� ---- ��E ,.� V�' � � Q' '. ' _ . ' 4 5 �,a• t : �� ,°" a��: � .� � �.� � �. _ ,e � ' �'s` .r •s. '''v� '� � „ "��; , � h . � � Z + � �. ' � . . � ' � 4� •� `` . � � m ' �n , Q" �� . �t ..� . ti�+:� � � a U n . y � . . � _., e�' � . _ .- ^x t . � �. . � �� . � � _ � � � . .., � �� ,, _ �� 0 ` ,� � � �� - ,L: a f s � s � � � 8�'�� . , " `. ' � � ° .' ...,.�... . _ � � � ' �_�, f� A �'��%" 1,�/�L'l�v /��a/ �1 �, ti+ ;� ,d.�. ., � �e � _ t � i �y;y:� �; � �s — I3 .P � e:t 6.� f: a�r ,e°�`/ .� �'16$ e `� i.� � x � � � � �� +: � 0 �� r ra ��L�" `. �1 � � �4 �ar°� �' � � ( � . v; t, . - e b I � � (� °'r '� .�- 1 � �.� � �� .� , �- � �.� � :: ` - .�--��''"" � � � � I h�br� �i�y ��1»S r's o hve mrG aarr�cf represenfofian c�('a su^retf qi'fbt 6�v�rdor�s ��!'ie obo� descri6�d t�ed a�d � 0�11 e! ' 0�4/1 �vil�ur9s, fhrrean , ord alJ ris�b/e r.m�avchmenfs ,►�'ony, �'i�dn or pn said /mtd. As svrve.yed b� me ffus� �ib� `. q�' �'' ,` s° ��, A.v. !9� . � S,�uR8�1 ENGIIVEF/ZING, Jl1lG. _ `�� . eers fr Su�re, yors ' �� ..i t'!! � f �` � E°^ `�. d� � . . 6� , � ": rs'i'�� r>. _ �'`.��.�.. a � `� �"� � � ,�, _. : ._. . , � G � � � � �b �x y p ��1 : y . x : � . m . m : M . M • O � a . m . .'�� -. �. . N � � ►+ � � � W � �p �+7 � �' o � � � o � � o • o � : o. � l�d : : � . . � � � � N r � O O O � � H O � � � x � � � � 8 w � � � z � � � g n M � � A � � � � � �� 7 a� � � : a � � p 27 ¢ Q � 'a0 o g ,� ° : � a N � � : � W °o : � : � � . � . . O . � . . . � : � : : : : � O �e k x k k x� W t� W �-+ ►+ ~ � c�i� p c�i� o 0 0 !� C7 �Ffs ifl V) ifl ffl {A H H �� O Q x t N c-- � � r � m �^ l I 2 m C r m Fn0 � � Z w �� `�-.�� a �� , � � � �. �r 0 � 0 b � m a .�. . � w p .. pd x „� � w p• � � Storles 8 � WATER �� URINALS � � e�rH o � a ewvrs 'O � I StNKS � � _ W�►, rRnrs DRINK. FOUNT. SI'IWR$. �ooa DRAINS UTCH �i B�SINS � AUTO �t w,�sr�en $ GAS ��• MPL GAS � RANGE GAS i OPENINGS � ��g $ ,��y � ., v • 2 • \ � N � A m � n p y a cz � � � �� J � �� ti oco�o� , ��a�,, � ��.�� $�a � ��"° � � �. � b �� p � � � o �� p �. ,.�� ►e M �� A p w t D � � � a� �� o��" �`�my ��A � � 0 � a. os' � � �� ro � 3 � €•.° a � � � � �' G� � � a R � O p M � � ,�a 3 � Q• , � � � � � � �� • I 0. 0' � �� j � � '0 . � -�� ,� City of Fridlep, M�nr- 6431 Univeraity. Ave. N. E., MiiYneapolis, Minn. 55432. BUiLDING PERMIT Date: June 4, 19 71 �-�s=7� �10:35�� p��; Don Kersten g�� Sussel Comn�r _ Address —S�fiS_Ht�g� _S 7' -Pt .1�..E� Adrlress � 8 SO_..C�m� Aves�ueTS� i'aul LOCATIOiV OF BUILDING No. .�bS...v._ Street —H» � S rp t N F. , Part of Lot Lot _25.�2b_...._ Block ��._.__._._.. Addition or Sub-Divisian R�S7PY'V�AG7 HP��hYR Coraer Lot ._ Inside Lot �X Setback Sideyard Sewer IIevation � _ Foundation IIevation To be Used as: DESCRIPTION OF BUILDING Detached Gara�e Front � Depth —2�. Height �]..� Sq. Ft, Cu. Ft. �� Front .— Depth Height Sq. b't Cu. Ft. Type of Construction _F.S.�� Es k Cost -.-� 1��.50 . Q.Q To be CompleteS 9 0 day�_ Hold Slab 4 inches Above North End of Existing Deiveway. Pxovide Hard Surface Drive. In consideration of the issuance to me of a perinit to construci fihe building described above I agi�ee to do �he pro�sed work in accordance with the description above set forth and in compliance with a�l prov3sion8 of ordinances of the city of Fridley. < � ' �-�i aF� r— ' . In consideration of the payment of a fee of $ 6s� , germit is hereby granted ta Susael Comnan� to construct the building or addition as descxibed above. This germit is granted upon the express condition that the person to whom it is granted and his agents, employees and worl�en, 3n, all Work done in, around and upon said building, or any part thereof, shall conform in all respects •to the orc�ia�ntCeB oP Fridley, Minnesota. regarding location, construction, alteration, ma.intenance, repair and moving of bwildfags vpithin the city limits and this permit may be revoked at any time upon viola.tion of any of the provis�tons of aaid ordfnances. � �, ��c�- ' � ' �' ° ' � � Swilding �nspectOr MUHICH NOTICE: This permh does not eove� the eonstruetion, inatallaHoa fo� wPring, plumbing, eas heating, aswe� or waie�. Be snra to sN t6s Buildfng InspecFo� fo� seperata permits for fheae hems. R .� � � � APLICATION FOR RESIDENTIAL, ALTERATION, OR AllllITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME:_ ��- �er� �c... BUILDER: �..s�� ADDRESS :_ '�� fl �i C,i ADDRESS : /�eS � �erz � � �c� �� NO:. ' STREET: LOT : �'�-� � BLOCK: ,� ADDITION : �� u � ui �.J 6r0�� CORNER LOT: INSIDE LOT:��_SETBACK: SIDEYARD:_�_ Applic:ant attach to this forni Ztao Certificates of Survey of Lot and propoaed building location drawn on these Certificates. BESCRIPTION OF BUILDING To Be Used As: � �'0�� ront • � � DeP�' 2� Height • ,�f � Square Feet: Cubic Feet: Front; Depth: Height• Square Feet; Cubic Feet: Type of Construction: �r� Estimated Cost: $/��''� µ�� To Be Campleted: _ �'A � � � The uadersigned hereby makes applicativn for a permit for the work herein specified, agreeing to do all work in stiict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in thia application are true and correct. �ATE : � - ��a � � � �,l S IGNAT[TRE : � � (See Reverse Side For Additional Informatioa.) � ; t ' � , ?, ,, � �� - '� r' --�"' �� r .;�...�e.�... - .. 'L °��, /'j J,�'';� , ,r.. f° , , 1 , � # �, �_' ,� � �„ rh, G�f R ,�, , .. - r l./ r� � � � , Q ' � � � t.� � " , �' <� - �r �- _ .� .E•., .. a:. BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building or structure, or for aay addition to any exiatiag building or structure, or for any alteration or repairs 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 aad in the manner herein provided to-wit: U1�IFORM BUILDING CODE: �►pe 1, 2& 4-$2.15 for each one thousand cubic feet, or fraction thereof, in such cubical contents. 1�pe 3� 5-$1.85 for each oae thousand cubic feet. ADDITIONAL INFORMATION For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average.r height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing 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. In no case shall the fee charged for any pernnit as set forth ia Section 2 be lesa than $5.00. VERIFICATION OF FOUNDATION NOTE: Permits for construction will be issued a miaimum of 24 hours fram the time of applicatioa, to allow for proper review of the proposed structure and of the construction site. A Certified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before proceediat� with the framing. CERTIFICATE.OF OCCUPANCY Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy qf auy structure for which a building pexmit has been iasued; and said structure shall not be used or occupied until a Certificate of Occupancy has been isaued. • ` 0 s� � � , , � . - „ ,,., �.,�„ _�u�� +5- ., •. ,,;rn nvr•r:ur suurH- vn.r. tiroU0..u'�Nr.uTA67oaB . :d •.1 W �� t� ,y z_ � !j c: /;�;, ;i,_; , , _ , � � // � � " � J �"� � ��'��'�( i y%l,�/��1..� I./�• 1 /�y ��I„�.•�i_� �.1�! . lr'�'C�% •�:.>piiJ I``�i��. � r� .o t w. 1 f l , � c, i'+ �' ` p ' r f•-%''' y � ' i %f:�; . ,� -' '•.f M ��,-'- L . .f:':'"= .. r' if / ' f.��' G . i i � ' i �_ . � � y/,•.��i i . � . , ; ,;' _. _ ."r �;,, �j:�, l %�3't, c'�.� `I ,�, cy,�,:.�� , �; � „ '.�iii . , %,:;f;�;,"(i ,�_�1 Y�,"'til�•. .,�, �r. ��.,r�,:,✓t. r��.�L� �:..:' �liC!!%/ �1' rt✓? %l/'�::�y✓ �.i f . ,• � r . . . .�-> .��; ,�, .� . , �. �,� ,��,{;, �� rt r � .. _ . , � f' • ' ' � �� f��,/y% ,� � ; �.� /.. ' ti�lt i / � �'L % � �� • ,� �', 1%�ti��',.' �� ,�,_�, �r \�..v♦� s�.� �aL.\A v.'.L`...\J �. q �'�L� �� o ' .� � �': 1.�. � . NAME l� r� �� ,-, �- , ,._ ., � � -- ',- , 9�50 C�G�A� Q.!!�. 5Y. ��U6. i t�;' , � �.... _^ -- , c . PHONE # �: �. � CAL�: 6�&5-�33� JOB ADDRESS � ' � � ��'r��' . ' ' ��°~ BLDG, CODE _ AREA f%`�l �� - �� SALESMAN --��"% % f?P.--L �Z' 1 e �ONTRACT DATE y ,7� ?� CONTRACTOR �—� � - �'�-� �� JOB # � °�"`� SUSSEZ JOB �` �' .�� CONTRACT �` 300-�� I CATE THE ITEMS BELOW ON LAYOUT . ��Conduit � � 2-Startings Points Only ,.�-i-O.H. Dr. Offset ��`� ��-�' e�� ; ` S.P.L. � House � [� S.D. Lo.cation j�� <r S.S.P.L. F. S�reet q � .:I�ocks . � �operty Lines 7 ' R.P.L. Other �-�Windows /��-.'N--`C-� ;�ase�ne.Frt .,__ A�ley �, "°�Square �it�t' �i� � -: . . : � �.F � �;� � �� - - ---- _ -- ; S� Rods ;--�- � �_' ll� l."� G-- S._��:�d . ; - - - ; - � ; -� � � ,, - f��.--t�esh ,—; _+ !--r � -,- a _ . ; � � .. , l , - , _ ; , , � L _�, �_c�. �'L�. �.�s � � . _ ,I��od Rem. —By� `, �..: ev ,,�. r • � = i - - - - � . -- � - . - . _ � �� _ _, � , . ._ , � .. � � �� ; ; ❑ 5-Bag Mix . ..� _ . ,. , � - �, , i� I k � ' j � �6-Bag Mix -� � �—� � �--, ` - --� + �- -� I , _ � � j ; . ,_ , - �__..._. i _�. ,� __ � _ � _ , _ ._ .. � : � , ---� � - — " -`amin �-(+_!''i` �, � �, ' - - ', -�}� P g � _ � � � � _ � _ � a. � _ _ � ; _. � / ' __ _ _ _ _ , ,. No Tamping c. �r � --i- ,`i f ; ` r I ,—r _ , �.. ; ,__ � ;� � , :_ , � -,�,�_.A.B.U. ' ( �5�.(� i �4 1_.f..� �; '__ � t ;�.�_..,�L _ . _ _ __1 � _ ' , . � �� " j_ j t ! � I ' � , .. � _ - � , . _ .. , - '— - � : �. � ; , - r , � I _ _I + 1 .- �_ � � - -' - r-- , s l 1 � � I I � � '. 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O ;F. N � m � � � 00 3 � � a (,y r � � ty � �+. w '% ° K �q �`�` y 9 � � m mcor� �'�� o Qgg m �G. LLM�t W ►-� x �a 1 `C � W t! 1~+ . � � �am a � " w �w o (i • �W m � .`! ►b-' P� Ai O w � n M na�p o��'�° � a�e � � ^� � � w o � ��h �mm� a�.r+►n-� 3 n $ o"r I� R F~+ e0W O F� • � � � � H Z Cn G� � � N -�-11 �7 3 O y y r p°r a z � � � � + m m 0 N n �. m � H � -i . w\l Z ad qy ` 6 � m � 70 � � m a, A . ,,,� O ,_ z D � d � C'1 �--a � O 'T1 T � d �C GEO. SEDGWICK HTG. & AIR COND. CO. ��°� �� HOUSE HEATING TEST RECORD � ADDRESS -� �� 1�� .�'L�� CITY � OCCUPAAIT OWNER - �- HEAT LOSS DATE HTG. INST. SOLD BY INSTALLED BY- - •�' ��-�� Electrical Work By Gas Line By �' � L�' � TYPE OF EAT GA_ FA_ HW_ STEAM SPACE HTR. UNIT HTR. GAS DESIGN MAKE �� MAKE OF BURNER Model _��'� �� Model 5erial Max. BTU Rating — INPUT ��'' �� MAKE OF FURNACE Model CONTROLS THERM STAT ' � Heat Plug Valve �`�� Limit �'�� d� Limit Setting �'�� Fan Setting �'`'� �� Pilot Type � Pilot Make Pilot Model Pilot Timing � L.W. Cut OfF Pressure -a �� Percent CO e� d�` Input CFH �� Percent 02 -�� `� Stack Temp. �'� Percent COa � '`� �'� Form 235 OTHER CONVERSIOIV Vent Size � ^- KIND OF LIN R � SIZE NON Draft Ho� Regulator �'�� Filters Size �� Number _ / Chimney Location Inside_�_ Outside Chimney Construction Smoke Bomb Wiring Draft �B� Test Tag Door Pressure Lighting Inst. _ Date Tested � �� " Company Testing - �� ' ` Name of Tester �' ` P. 'd ,•, 't , h 7 �'' 'a � • . » r" : :°. I �_ a- a :�.. � ev x � x � z � �m � � �� C �, � � s � � _ � � � ' ' � p K y �o �+ w ►. n c� h r n �r �a n .. m� p, ►� „ � o �.. o �+ z Q r W 5 � "'� O F O �� o M M�o � _ � � � � p' � z � G. R O R r r�'1 n7 N "'� > g�� 5°M ° `°�� '" xm r o �-. o ° M � �c m � n � h °7 � p m � '.x.� � � ' c� r a c °o � o � ;;� v a o � a '� � m � � y � t� �O O K � n- p o o W r�o �►�- � a o n tzi� 0° � � =° o° 5 w � � - ,$ � n � � o° ° `4 y .-. ? � � � :J o Cf � r 7 � � . �� w a y � � . � O • - � —i rn � o � � � � z c � � • , � "' a o D� % 9C, k X �C �t DC iC DC �t �C � r N y � tA V► F' tA N N tA tA F+ N N f!! fA N � N{71 O ►-' W ' (!1 {J1 V O Vi U1 N N W 0 0 0 0 0 ' o 0 0 0 0 0 0 0 o y � 00 0 0 0 0 0 0 00 0 0 0 0 � � m � 'f K(p E fA tA tA tA N N N iH N N N tn tA N N N I{ Iy A � � O O o r f M x rr � � O � � tp'� tO � � - H � N • V � O r , � � !!1 . O � - � � � � � � `N N • � �d . M � �0 � � � �� ._ � �� m � � . `' • a� � ' H tn ~ 5 �O a w � � '< � Storiea Closet� Urinals sach zvbs Basins • • � Sitilcs Wash Trays Drinkinq ' Fountzins Showers Floor Drair Catch Basins Automatic ��asher- G�s Apgl. Misc. Fixt: Gas Ranqe Other c+ x E m �y r m M m e{ O P7 . H C ?� � N m H A C 4 t" m O tn H � �'O m 1� r� O � �-yi o0 0 o W� o � %J'� a � $ci �t t�l M M W fp �i y � t+j O y M R F�- fD 7 �t �!p a E O � W m 7 P. G i-� '+7 7 � � m n � ►��, m m a n �►�- `� m L'~ H M r�i � �►�u e� o t~o � o v x � K �� c � v1 � � � ~ � K �� r � � � �[�+1 H � (�o N O ►0t � '�" ►�+ � � WK h O `C � LsJ ►i o � 7 �� . o � m�,£� • o N N M n r�e n O O We r- a x R� . I � m c rr f O o�o � a►`�-� � n �' r o. m a - 7 r n rt � R �o ►~�- O ' 7 m A 7 Ihf m� �H M�t Di � A M � S '�O fL yC A� . y r~�- � O� 'tt � � Q M 0� A O � � O � � � � � • � ; � � � 1;+ M O9 unno , p r �r �t k. � . • � � � � . L • ' ° �r� _. �, r a a M �o � rr � x . - I O }+ � h • . , � � . � � � � � O F��+ SuB�ECT City of Fridley _ 19653 AT THE TOP OF THE TWINS gU I L D i N G P E R M I r � � RECEIPT NO � ; y _ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. � �� i j , l--_.� ��;'� CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BV i 612-571-3450 910-F15 8/31/88 / � JOB ADDRESS 565 Hugo 5treet N, E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oescR. 25,26 G Riverview Heights SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Ted Ankrum 565 Hugo Street N.E, 780-7367 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Res idential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION �i REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Dwelling (15 Squares) 9 CHANOE OF USE FROM TO STIPULATIONS Roof can be 2ni3 layer but not 3rd. Install ridged galvanized valleys. SEPARATE PERMITS AHE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD 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, OF 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 1 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 WITH WHETHEF SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $750 $. rjO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STAT R LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMAN O CONSTRUCTION. 2]..00 A CHECKFEE TOTALFEE $21.50 . SIGNATURE OF CON i R OR 0 AUTM AGENT �Dn �, �o HEN PROPERLY VALI - D THIS IS YOUR PERMIT 85 ` _ � � s 4 Si ATUR O P IIF OWNER B I DATEI 8L G INSP n TE F �1 �� City of FYidley EEfec;tive 5/L88 �1 � � R-1 Ai�ID R-2 AL"lERR [ l (bnstruction Address Legal Descripticxa � � ��T � � �,; � cling Permit Appl. ication Owr�er N�ne & Address• � � a� Tel. #'7�0 -7�6/ O�ntractor: Tel. # AcYlress: _ �'� / Attach to this appl ication, a Certif icate af S�rvey of the lat, with the proposoed construction dra�m on it to scale. L�Sa.tIPrI�i OF I1�R+OVII�aT r�TVr�r. AA�a; �y� Width Hei t --- --- gh 9q. Ft. c�RAGE AREA: L�g� Width Eeight SL�. I�t. � �.M; ; i �' - . ' . � � ��y:ia�; - � / / � •. - . . - . .� - .: .- . . _ .� . / - ��.-� '_ . �.. •, .ii. .� �: - � j'� � _ � �� • %� e� � � _ Side Yard Setbacks v °l ,.r F+St]It13�� COSt: $ Al� A Alt. B Proposed Driva� Wi� If New Opening Is Desired: S $ W + 6' See Back Page L1ATE: � APPLICANP: e�� Tel. # O- CLTY OS� �Y ��;t � Stat�e Surchatge SAC Cbarge Driveway F�cra�w9 Park Flee Sewet l�ai.n (harg� � 3J.'IPITI,A�I�: $ � /_ U � S �� $ � S S � �/.,5� l�ee Sdne�le on Reverse side 5.50/51,000 Valuation $550 per SAC Unit A�..t. RAa OI A1$. �B° AbOVE F�e Dete�fr�ed by E�gineering Agree�ent Neaessary [] No� Neoessary I) „ � ,. : 1) � �• � �3;iv14 �i�i `��i:l��l) 7�e Chief Building Official shall, before issuing permits for the erection of any builcling or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, u�n application therefore, require the payment by the applir.ant for such permit of fees to the amount herein belaw set forth and in the manr�er Y�rein provid�ed to-wit: � TOTAL VALOE $1 to $500 5501 to �2,000 S 2, 001 to $25, 000 $25,001 to �50,000 550,001 to 5100,000 5100,001 to $500,000 �__E�-� S15 �iinimtan Fee is S15 plus surcharge ) S15 for first 5500 plus S2 for �ch ac�itional. �100 or f raction thereof, to and ir�luding 52,000 $45 for f irst S2, 000 plus S9 for each aclditional S1, 000 or fraction thereof, to and including 525,000 5252 for first 525,000 plus $6.50 for each additio�a7. 51,000 or fraction thereof, to ancl inclucling 550,000 �414.50 for first 550,000 plus $4.50 for each additianal $1,000 or fraction thereof, t�o anc7 i�cl.uding 5100,000 S 639. 50 for f irst $100, 000 plus $3.50 for each additional Sl, 000 or fraction thereof, to and ir�cluding �500,000 5500,001 to 51,000,000 52039.50 for the first 5500,000 plus $3 for each additional 51,000 or fraction thereof, to and including 51,000,000 51,000,001 a¢�d up 53539.50 for the first 51,000,000 plus S2 for each additional 51,000 or fraction thereof (Concrete Curb Stteets Only) Alternate "A°: Renoval and replaaement a� curb and gutter o�ly - Driveway width plus 6 feet times $13.50. Alternate "B": R�naval and replaoemerit of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. i�; :� ; M • � � ° �a•i�1� ! ; M •)�I Permits for construction will be issued a minimum of 24 hours from the time of application to allaw for proper review of the proposed sstructure and of the aonstruction site. A Certificate af �uvey of the lat, ��!wing the locatian of the foundasLicm once it has been a�nstri�cted will he requireci before prooee�ling with the fr�ning a, - - - � sue�etf ,�p.EAM1T NO. � City of Fridley � 3 2 2 4 6 AT TNE TOP OF TNE TW�NS � U� L D I N G P E R M I T � "`- r _ __ _. ; � RECEIPT NO. � `y _____ COMMUNITY DEVEIOPMENT DIV. �� -- �� r � � PROTECTIVE INSPECTION SEC. �yq ' `�/ � _ � � �"'1 � CITY MALL FiiIOLE� SS132 NUAIBEN REV O�TE v�GE Oc �6vROVED Br �'"'"� � �'� 612-571-3450 9tQ-F/5 10/12/O1 / / 10B ADORESS �65 Hugo Street NE t LEGAL LOT NO. BLOCK TRACT OR AOOITION SEE ATTACNED DESCR. 25,26 G Riverview Heights SHEET 2 PROPERTY OWNER MAIL ADORES$ 21P PMONE Marc Rounsville 565 Hugo St NE 763-783-5992 3 CONTRACTOF MAII ADORESS 21P PMONE LICENSE NO Same a ARCNITECT OR DESIGNER MAIL ADDRESS i1P PMONE LICENSE NO. 5 ENGINEER MAIL AODFiESS 21P PIiONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION 0 ALTERATION �! REPAIR O MOVE ❑ REMOVE B DESCRIBE WORK Reroof Garage (5 Sq) Tear-off 9 CHANC3E OF USE FROM TO STIPULATIONS SEPARATE PEFiMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, NEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SQ. FT CU FT. AUTMORIZED IS NOT COMMENCED V�(ITHIN 80 OAYS, OR If CONSTRUCTION OFI WORK IS SUSPENDED OR ABANDONED fOR A PERIOD OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. NO, DW4G. UNI7S OFFSTREET PARKING I HEREBY CERTIFV THAT I NAVE READ AND EXAMINED THIS APPLICATION STALLS, GARAGES AND KNOW TFIE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAW$ yq�UATION SUR7AX AND ORDINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMP�IED WITN WHETHER SPECIFIED HEpE1N Ofi NOT. TNE GRANTING OF A PEFIMIT �S3C) �. SO DOES NOT PRESUME TO GIVE AUTMORITV TO VIOlA7E OR CANCEI TNE pERMIT FEE SAC CMARGE PROVISIONS OF ANV OTHEA STATE OR LOCAL LAW REGUTATING CON- STRUCTION OR 7HE PERfORMANCE Of CONSTRUCTION �LE).SS Fi e SC �.S�F P�AN CNECK FEE TO A� FEE $27.59 S�GNATUpEO�CON'FACTOpONAUTMONiZEDOGENT iD�iEi ME P O Y VA�I AT D TMIS IS VOUQ PERMIT �l �1�� V ' �- ' /o-/�s-. r�s� S�GNATUqE OW EA��OWNEABWLD@Ri �b�rE� DG �N$ qp}E ��e ' NEVV [ J Effective 1/1/2001 ADDN [] , CITY OF FRIDLEY .(763) 572-3604 Bldg Insp ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: �(�� 7�t, N o'�, Legal Description: Owner Name & Address: Me�,src�, L, j�,�� /15 i�i � le Tel. #� b`'a - �$ 3-�"�'� �-- Contractor: MN LICENSE # Address: Tel. # LMNG AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. FL Length Length Wdth Width � �� Height Sq. Ft HgUGround Sq. Fk i /� Construction Type:��? f�� QC�.4'CcQ� Estimated Cost: $ � �c0 Driveway Curb Cut Wdth Needed: Ft. + 6 Ft = Ft x$ _$, DATE: �� APPLICANT: f��i]l� ��.c1/� Tel. # 7tS 7i `% �3'S �� CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $��p� J�� Fee Schedule on Reverse Side Fire Surcharge $ .��y .001 of Permit Valuation (1/10th%) State Surcharge $ , �'Q $.50/$1,000 Valuation SAC Charge $ $1150 per SAC Unit License Surcharge $ $5.00 (State Lice�sed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] i — � - BUII.DING PERMIT FEE SCHEDULE The Chief Building OfFcial shall, before issuing permits for the erection of any building or structure, or for any addition to any e�asting 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 $1,000 or fraction thereof, to and including $50,000 $6�13.7� for first $50,000 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 tirst $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. 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 lacation of the foundation once it has it has been constructed will be required before proceecling with the framing. New Houses Onlv �. _ 5'i m N � -� � Op?j D � r � m m ,,,► � � R11 y \ � � °, d�� N� � � � O � -� v C � O � �o o m3 D� v � v N �v rD- -� m � 0 z � � .. . � � �—I � � � 0 0 W � � � f�/1 N T � p�j �� i < N 7 � � � c � a ... � N � Z o , , � N 2 m °: � � N i � � c m '�+' � � 7 1 � � 2 � 7a d � � � � � � • r � � �• �o m y �n a A � ,,. � N n. � � � � A m � (� W � O Z r' m � � � � a �°��.�' u►, o� 'c� 9 ., ' N. f�/1 � N � � � f C lD � d+ �► v+ `n t�n tn En d+ �r+ d+ �► t� 0 0 0 � o � � �'`i �' 1' � °o °o °o o °o 0 0 0° °o °o °o °o � y �� D � n c�D � � � � � a � Z a �c � � � o � � O N a � � � � D � � 0 c ta � S o�i W � � � � � o v d � '� '� � 00_ N � � � � � '0 m � � =i z � � � � � N ( � 'D r C � Z � � � m � �' z � � m � O r D 0 r � � W � � 0 � m z � � r m 0 O z � n 2 � r O � � �- w a � � V :� C � w� � z. -n c� Z cu 'n �� I w'� � N L � � Z Z � �m� m n Z v < � _s � � G � .�- � ` m m � <' � O � m � ',� o 0 J � "�'e--� G COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacin4 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 flrestopped where required. Yes () No () The venting system is plastic/PVC and meets ail 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 manufacturers specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The existlns� combustion air is sized and installed to meet the current codes and manufacturers specifications. When required to install a new combustion air�_it will be sized and installed to meet the cuRent codes and manufacturers specifications. Yes ( ) No ( ) Yes()No() Yes ( ) No ( ) When installin�f a new ventlnct svstem, the unde�signed 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 Tables for fan assisted and natural draft appliances. Yes () No () Is the common vent and vent connectors sized and insta9led correctly after an appliance has been removed from the common vent and vented Yes () No () separately as per cuRent codes. A liance T e 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 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 : _ CIIYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 February 14, 2003 Mr. Marc Rounsville 565 Hugo Street NE Fridley, MN 55432 Re: Final Inspection at 565 Hugo Street NE Contractor: Homeowner Dear Mr. Rounsville: A plumbing permit was issued on October 12, 2001 to install two fixtures at your address. According to Section 4715.2800 of the State Plumbing C�e, a final inspection sha11 be conducted on the work authorized by this permit. As of tliis date the inspection has not been requested. 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 inspection called for by homeowner after notificadon" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. sue�ett M(T NO. < City of Fridle� 3 2 3 0 8 AT THE TOP OF THE TWINS g u i L D I N G P E R M I T r � � COMMUNITY DEVEIOP�ENT DIV. RECEIPT NO. ; :,: _ b�t � � r � � � PROTECTIVE INSPECTION SEC. � .1 � � 1 /'�'1 � CITY MALL FRIOLE� SSI$P NUMBER pEV OAT@ GAGE O� APVROVED BY �""'�" �'' 612-571-3450 etp-Ft5 11/7/Ol � � J08 ADDRESS 565 Hugo Street NE 1 LEGAI �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO oesca. 25,26 G Riverview Hei�hts SHEET 2 PROPERTY OWNER MAIL ADDRQS$ 21P PHONE Marc/Stephanie Rounsville 565 Hugo S�reet NE 763-783-5992 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Narth Central Builders Inc 7401 42 AVe N, New Hope, i�'II�T 55427 763-533-6168 4 ARCHITECT OR OESIGNER MAIL ADORESS ZIP PMONE UCENSE NO. 20265918 S ENGINEER MAIL AODRESS 21P PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION O ALTERATION f� REPAIR p MOVE • O REMOVE 8 DESCRIBE WORK Insta.11 basement repla.cemen� wixadows including one egress; repiace entry door & gutters 9 CHAN(3E OF USE FROM TO STIPULATIONS � Provide smoke detectors in all sl.eeping rooms and on a1I levels of the dwe�ling per Section 310.9.1.2 of �he i997 Umiform Building Code. Cau1k and flash all exterior openir.gs. �er�1� ��sp��n �iill g� Cards T� Horrt�,�eA��,Mailcd . �� " TYPE?O�CONST OCCUPANCY(3ROUP OCCUPANCY�OAD SEPARATE PERMITS ARE RECUIRED FOR ELECTRICAL, PLUMBINti, FIEATING. VENTIIATING OR AIR CONOITIONING 7NIS PEAMIT BECOMES NULL AND VOID If WORK OR CONSTiiUCTtON IONING SQ. fT CU FT. AUTHORIZED IS NOT COMMENCED VjIITHIN 80 DAYS. OR IF CONSTiiUCTION OR WORK IS SUSPENDED OR ABANQONEO fOF A PERI00 OF 120 DAYS A7 ' ANY TIME AFTER WOqK IS COMMENCED. ' NO DWLG. UNITS OFFSTqEET VARKING I HEREBY CEqTIFY THAT I MAVE READ ANO EXAMINEO THIS APPLICA710N 1 STALLS GARAGES AND KNOW TME SAME TO BE TAUE AND CORRECF. A�L PROVISIONS OF LAW$ yq�UATION SURTA% AND OFDINANCES GOVERNING TMIS TYPE OF WORK WILL BE C(JMP41E0 WITH WHETHER SPECIf1ED HEREIN Ofi NOT. TME GRANTING Of A PERMIT �4 � 6OO �Z .3O DOES NOT PRESUME TO GIVE AUTMOii1TY TO VIOLATE OR CAMCEL THE pEWM17 fEE SAC CMARGE PROVISIONS OF ANY OTMER STATE OR �OCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION �LLI.ZS Fire SC ��F.CO PLAN CMECK FEE OTAI FEE Lice e C $ .00 $123.15 S�GNATUAEOFCON'AACTOAOpe�TNOA�ZEDAGENT IDATE� NE PR LY V L� a� ED 7►+iS i5 r0 F PERMIT_ ! � �' S�GNATU�7EO�OWNEAi�FOWNEpBU4DER� �OAiE� ' B �N qpfE � �� b+hSl ; ��r-. � � Effective 1/1/2001 �; '' `" ` ''��'�' � � CITY OF FRIDLEY (763) 572.ssod �Idg I�ISp � ''� �`�R � � 31NGLE �AMILY AND DUPLEXES R-1 AND R-2 � r`f �� 4, : , . k-<?�� s:. r �e , . . , . � : BUILDING PERMIT APPLICATION f�� }?'.��, . � , , , �1��s4rllction Address: 5 � u � , �� L��1 Desctiptian: �VVtter Name 8 Address: lI?A� ,� ��-� �� l� Gi�rttracto►° �2 �E�T u�s U1 L.L.� Tel. #�3 _� g� -�'��o� � � �ddr�ss: � y0 �" ; r . �o � � E MN UCENSE #�/, �. �o � rj'C �� A 5S Tel. # � . tt�ch t� this applj�tion, a Certificate of Surve lot, with the p�oposed construction drawn on it y of the to scale. DESCRIPT�pN OF IMpROVEMENT LI1/1' • . . NQ AR'E4' Length . , • .. ' ��tAG�,��Eq; Lengt� -- Width —_ Height ��CK AREp; - —�� Vlydth �_ Sq. Ft. l�rH�R: �ength __' Vlhdth Height �� Sq. Ft. � H9�Ground TN � S9• Ft. Construction TYpe: Tr� �� E� ��ur--/,�l/NpouJ ��a�- ,S D�v��aY Curb Estimated Cost: $ �/� Cut �d � ,-- � � th Needed: —�� F + �i�t�: � �, � t + g Ft _ �_Ff X $ ,,_ APP41�NTt �' _ $ _ �• : , - ; '� , C�� USE ONLY. , Tel. # 2'� -� Call (763) 57Z-3604 for Perrnit ��6� pe�l� FEe Fees if rriailing !n �"Ire Surcharge _� l l, a� Fee apP�ication ,`d "�t�t� Surcharge Schedule �`�" � . ��C Ch�r � `� .001 o f p °n Reverse Side 9e $� � `� � �o • $.50/ e�it Valuation , �i Ll��s� Surcharge ��,000 V i�/10th %� � �1150 � a�uation �'�'1V��Y �scrou� � Per SAC ,. . �rt�sio � � �� $5.00 Unit n �ontrol A�t (State Licehsed Reside p�� ee $ ��A., or Alt. ��e�� A� ntia� Contr Sewer � $450. 00 Cohse �Ve actors j Ma'n Charge � F�e Determi ryation Plan Revi ��i `:'Y.wA.. ned b ew : �`OTq� $ Agreemen f NecesSary gmeering �� j I 1 Not Necessary f � `��L41�Ip1�►g. �- 1 ��-��a�� ia, 9, l ,� �i�'��- �j- �,� � �9� � 3-�'� �� - � ��'��i�,� «u ��C. � � "�i�� .�i-�� s ,� BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or strucrurc�. �� I��r :�� addition to any existing building or structure, or for any alteration or repair to any existing huild in�T �� ;i � nt: t ��, upon application therefore, require the payment by the applicant for such permit of fees rc� thc: an��u�i i,��• i�, below set forth and in the manner herein provided to-i�it: 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 $SOU,001 to $1,000,000 $1,000,001 and up FEES $23.50 $23.50 for t7rst $500 plus $3.05 for each additional � 1(��l �� fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additic�n;il $1,U�!i) or fraction thereof, to and including $25,�?0 $391.25 for first $25,000 plus $lO.IU for each additi��nal $1.�1(��► or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each addition;�l $1,Q00 or fraction thereof, to and including $100,0�1(► $993.75 for tirst $100,000 plus $5.6U for each additi��nal $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additi�n;�l $1,000 or fraction thereof, to and including $1,000,0��t) $5,608.75 for the first $1,OOO,Q00 plus $3.15 foc- each ac(cliti��n,�l $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCRO�V (C�ncrete Curb Streets Only) ; Alternate "A": Removal and replacement of curb and gutter only - Drive�vay width plus e� Icet tin��: � I�� 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. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time �f applicati��n t�> all��:�. i�� r� , review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the lacation of the foundation once it has it has heen ��>> i ��- �� I�� I I be required before proceeding with the framing. New Houses Onlv �,