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AF - 46697City of Fridley, Minn. BUILDING PERMIT Date: ,,f� � � � +�'� Ovvner: �� Builder �"'�"'� � Address Addresa �� N� � s17s ,,,,r, LOCAT O UILDING No. ��tL.f i� Street _.� ��'°�� — Part o! Lot Lot _ Block Addition or Sub- on .� Coraer Lot � Inside Lot —�� *,�e'tback Sideyard � Sewer IIevation — — Fo dation IIevation DESCRIPTION OF BUILDING To e vs as• // � u � � �� ' —�9� �`s� Front Depth Height FL Cu. FL �� Fro Depth ��T t � Sq. Ft Cu. FL T y p e o f C o n a t r u c t i o n ..._.. Fas� Cost _�To be Completed --- In consideration of the issuance to me of a permft to construct the building described above, I agree to do the proposed work in accordance wlth the description above set forth and ia cwmpliance wlth all prov3sions oP ordinancea of the dty oY Fridleq. � In canafderation oP the payment oP a fee oP $� � Permft is hereby granted to to construct the buflding or addition as described above. This permit is granted upon the express condition that the peraon to whom it is granted and 1�is agents, eaiPloyees and worl�en, in all work done in, around end upon said building, or any gert thereof, sYxall conform in all respects to the ordinaaces of Fridley, Minaesota regarding lacation, conatruchon, alteration, maintenance, repair and moving of bufldinga within the dty limits and this permit may be revoked at any time upon viola on of aay of the provisiona of said ordinancea . �'��!! .___� suilaing Inspector NOTICE: 'Ihts ps�mtt does aof eowr t6s eoeslrueH�, ie�allaHee for �o, �Mm6tea �n h.aHna swwe e� rrahr. B� sun to a� th� Bnlldla0 le�p�etor foe apuaM p�emhs fee t6a� tt�. �� .;r., � f+ � � N fn � � �� O cD � �o � � m � � � � � � � � � O �y�� z � � � w � G� O R° � � w � � � � � � � � .��' m � � � o $�, � � m � Y a w a + y � � W � ac�aa � y�e' � a � � � �, � �, � �i . Q ' O y • ra : : � : . �e � �c o N � °o o � � -Fi� {R {A � W 0 � r 00 I � � � � 0 H (] o �w � � o � � @ o ¢ o � 0 � �rt1 � V � � � C � °. w � � � �/'� s'� \ � °� x ro � N a � � '� 0 � 0 0 0 0 0 � A t" � � � < � � � eo � � � °r oa � � N � � � � � � : � . A • � • �: �� w w i �' p' � � �� a,a�. `° �u x w N � � y o °o � G � �� °�� O O � e+ � � � � s� � ' � � . . � � � � o � . . �,. : : � � : : ; : w cn � n� ao ao °o °o 0 0 °o °o {fl {A E9 {fl {fl {�i � � � � ro � M � � � � � � o � � � h � � � � �� o � O i-o � io � b� �, �� °, � a !� � �. � 0 0 � � � � � e� Q �' �' � � � � � � • O ¢ � : � `-. O . � � pO . : � O O . : � .° : : : � n� c�+ a N ao o °o °o °o 0 �A iA <A Ef! A � 0 R � � m � � � �" m � � O � � y � � �1 O N � l J � � � � � � � �, � � � � � � � 0 0 , � �/` � I � � i� � � ►+ f+ f+ m m m � I` � � �°�,��'S �y�� o � � �� w 0 o d m � � � � � � � a � • � � � . . � . . � �p ' ; Op o . . O . . . � � � � � v� o 0 0 p o o p fA V! � � � aa� �' N � � �y� �� p�� o �� e� �� .aa� ��o� � � 5' � �� H m � i%i' �� w Etmnn p- `�Ei m ��d�p �' o �� ~ �� y�� f�yD��y r��n� e�+eW7fD �`9 8 M � � lD �y. ro �� /� � � � � m H _ m C r m G ro �. o, a � a � b � � � V O `a � k � -�� i �b � �i �i � � �� '• � � � � � �� . �y � �i �� :o �� • �o. , �• • � O. � � R �� D�16 ,:_'i az HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E, Construction No. Guide VY.�dows Doors Reference Out. Wall Int. Wall Cxiling Roof Floor Kind � � es� o ( ` es�-No 19— FI.��. ;a 4� �.,: _ Room � Length �" Width �-� "� Height �'� ,�'" F'I � � � Room � 1 Windows and Doors—Crackage and Area Windows and Doors—Cr �Vldth Helght No. ol Llneal [t. Area Wldth Helght No No. ot Dane o! pane lfghte ot crack eq. tt. No. ot pane ot Dane 116 � s vl ", � e i' ,,f; �� d rii �3 � :' ; " � '-'`". �' :.; �' �� - >� L� i^d" �� "�� ' e,✓ r' y _" ,�' � �° ;� � �"�, � d� ,� Coef. Btu � In6ltration �� f � " {" Glaas c��,�_" <, °�-:� F.Xp. Wa�' r , Net eap. wall ` � r _Int. wall - - - - _ . Ceiling � ra � ` « � .r-� Floor , f � ' �' - Total Btu. 1 "e:.� �� ':� t;� Required sq. ft. E.D.R. or aq. ins. W.A. Lxader area F F7.�,� �� ?�:M= Room � Length �;�'� W�dth'�:,�: Height Windows and Doors—Crackage and Area Wld'th Helght No. o[ L1nea1 1t. Area No. of Dane ot pane ,. IlBhte ot erack ep. tt. N�. :_�, ; � �=_ �>,� r n � ' a':t �.� � � - ,e� a:-�_ F`�„• _ � . . Coef. Bcu Il1�I�tf8tI0A �� :P 'r; Glasa � "' . ,� °` � Exp. wall - Net eap. wall ` �'- , Int. wall Ceiling ' a"� � �, �•� Floor �",�_� =' ,,�.. �'otal Bm. � _ �> �', � - ;, r r � Required sq. ft. E.D.R. or aq. ins. W.A. Leader area v °' Fl. Ew; k;�;;�`. <.��: Room � Length '`��' Width �r'' Height " Windows and�Doors—Crackage and Area Wldth Helght No. ot Llneal tt. Area No. ot pane ot Daae IlBbts ot craak eq. tt. ,ti',� - r , _ _ �,�,_ Y,`�_� s_ � c-#f ; � �; , yY_c, Coef. Btu lnhltration ;s R�° r=f ;: ,-; Glasa � - n � , :. :_ Eap. wall x � N t exp. wall „ . - ,; ` - �Iti�'Lwall � C�='lin �q � � - � g �.rc=° d i� Ioor � �. - �: � Tbcal Bw. ' ;� : Requircd aq. ft. E.D.R. or aq. ias. W.A. Leader area FRIDLEY, MINN. Insulation How Applied :' Width and Area �eal tt Area crack eq. [L Coef. Btu Infiltration - �' �� Glaaa = ,��: Eap. wall � � � � Net ea wall � II p• C �d t�' C= °"; - Mt. wall - - - - - r�,d A'r,:.__, .,y�,� ��. Ceiling ,,> � Floor �'�� ;� ,,'� :� � equned sq. k E.D.R. or aq. ins. W.A. l.eader area � r � F7.1 ,� ,', _ :�,:s< Room ( Leagth��'.�- Width �'�;� �- Height 1�/indows and Doors—Crackage and Area Wldth Helght No. o! Llaeal tt. Area i, of Dane of pane 116hte of crack aq. tt �A.;r = ; � a_ '� , r a. ,�' ;� a+'= ii'., ',,x Infiltration Glass Eap. wall Net eap. wall Int. wall Ceiling Floor Total Bta Coef. Btu ��4 � S'�. � � ; � ,.°, , �',:� : u .,:., � �= , f �: t . .�,`� :�� ' Required aq. k. E.D.R. or aq. ins. W.A. l.eader area F1.� Room I Leagth Width Windowa and Doora--Crackage aad Area I Widtb Helght Na ot Llneal tt. Area No. of Daoe ot Dane IlBbts o! crack sQ. tt. Infiltration Glass Esp. wall Net eap. wall Int. wall Ceiling Floor Total Btu. IRequired aq. k. E.D.R or sq. ins. QIA. l.eader area Btu SUBJECT P City of Fridley �� ° 15 9 7 6 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � RECEIPT NO. • COMMUNITY DEVEI.OPMENT DIV. � � y ------� r � � PROTECTIVE INSPECTION SEC. � . � � � /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BV !"""� � �� 612-571-3450 910-F15 / / 10 16 80 JOB ADDRESS 615 Iingo Street N.E: 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ],� 2 R Riverview Hei hts SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Sam Liane 615 Hu Street N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO. Richa.rd Hasti s 6331 Riverv' - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE �ICENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK 0 NEW ❑ ADDITION 0 ALTERATION O REPAIR ❑ MOVE ❑ REMOVE S DESCRIBE WORK In a a 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT 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 WHETHER SPECIFIED HEREIN OR NOT. THE GFANTING OF A PERMIT $3� OOO $1-•�O 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- �`18.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE �� o �.� � � i� !6 �' � �.�' �� $19. $0 SIGNATUREOFCONTRACTORORA , iORIZEDAGENT IDA7E� .� �'WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT ��e�� c�� /�� c� SIGNATURE OF OWNER�IF OWNER BUILDEi:I IDATEI BLDG iNSP �p E o . `�drr cr7Y ar r-►iio�.cY • A('Pl.IC/1TIO,�J i�Ort R�str�t:i�lTI/1i_ I3UILDItiG PCRt�iITS ' (tJe►•r, A1 �eratians, Additions, or Rcpairs) � �tdldER: s�d�� L i ,� .�� [3UI LQE�:: �� c;�� }� �. � ' 7�t4 � �6,� � � . ADQRESS: � r`S �I�� .� c� �`� ADDRESS: 6;�� o �,� k';� � �b�� ( �� ,_,.. TEL �i0: TEL ��d0: � � �/ — '�'�� C Y � � Construciion Location � ' STRI�T NO : (� � S STREFT: �� ^ � L07.': C, � BLOCK: �� I�DDITION: �lu.r�' it ✓��/' H c( 5�i�S , Corner Lot: Insicle Lot: SetbacY.: � Sideyards: Ap�licar►t attach to this form twa Certificztes af Survey of lot and � proposed building �ocation drawn on certificates to scale. . DESCRIPTIOft OF COF�STP.�JCTIOPJ • � I'ront: � Depth: Height: _ Squ�e. k'eet: Cubic Feet: Froiit: Depth : Hei.ght: Square� F'eet: Cubic Feet: � f,u nn . C-c � 8. +.�; : nt.p r �LO � - ij�pe of Con�truction :/-��c; n�a 5 r�,1 � N`� ��P,, r� Estimated Cost: $�CC`�c�o s c:� -T - �.b Be O�r,�pleted: //�.a'I�§ � . . —r--- , � Alt. A Al.t. B Proposed Drive�•�ay Width If New �pening Is Desired: $� $ . , S�� REVERSE SIDE OF SFIEET , 7.�ie undersigned hereby ma}:es applic�-�t5.cu �or a perniit for the t:�oxk� herein specified, agreeing to c.�o ,a].7. work in s�L-ixct accordanee �vith the City of I'ridley Ordinances anc� rulings ot i:]Ze Department. of Buil.dings, and ]lereby declares �hat all tlie iact� and represent.:itions �tated :1� this applicatinn are true and correc�. D.'�T�: /�6��'G� SIGNATUF:c:: � -----,--- Sti��ulai:ions : /��°v ,.� z� /' � �, 01 V ''A� � i i 0 � ' ' ' _ .� � . �u��n�ric c>r_r,r�t-r r�:►_ sc��r:nu�� ` . S1,C'rx01•7 2. � 7.'1�L Tn�.c��cctc�r. of )3ua.ldiu�J :::}u�].1, b�tor.c: i.:,:;ui.�►g ��enniL•;; tor t:he arr.cLi.on af uny 1�u�.1.�1.i�7�� ar :.L:.-uct:ure, c��: f•ar. t�ny adcli.t:ir,n +.:o a�,y cr.i�L•i.nc� l�tiilding or ::tzucL•w:�:. . ci�' i:c�r cu�y a1.i:r.rc�L•ic-�» or. r.cl,�li.r.:; L•� •any c.:S..i:lll�j })Ll).�.Cll.11<1 or. sL-�.ucturc, ul�c,n ar��,�].i.cati.on 'L•hcr.�:for.c, r.equi�:e t•li� ��aymc��t: 1�y tl�c ar�p7.i.car�t: foi- :;ucl� ��cr.m9.L• ol.� fecs to L•lic ��n�unt hrr�in bcl.cn•� sr.L- for.th �uid i.�i �lic �nanncr ticrcin �»:oviclacl L•�-�:a.L: • I�31:1•7 CONS`PI:UC'xIOt�: 5111(J�.0 l.'amil.y llotacs and Ga�'ac{c:s: Y4.00/J.,0�0 cubi.c �cc:t:. . 1'LFsFI CiII:CJ:: 2S i�axcent: ai• 1�ui.lcli.ng ��er.mit fce. U1tYV�l•d11Y llLl'P1:SSIOI•:: (CvncreLc, C�irb �trcets Only) �' • Alten�at:e n: lu:moval and replaccn►ent oi' conczete curb and qui:L•er only; l�riveway c•ridth plus 6 feet• x�:15.75 J1lternate II: Removal and rep�acem�•nt of concrete curb and .� . gutter and install a 3 foo� a�ide approach �.►ith '' ' ,. 6 inch depth; Drivevray �•�ic:th �plus G feeL- x$17.85 � • . _ ADDIi"IO��L I��r-on��nLror� I'ar the pur��ose oi computing Lees for. building permits, L-l�e cubical contents of any l�uilcli.ng or. addition, is deL-cr.mi.ned by rnultip.lyirig i:he ground area covered irorn a p�int si� (G) inches belo:•� th� floor ]_ine of L•he basement or the cellar to 'tiic average heights oi thc •upper sur_face or L-o the average height af fhe roof surf:ace oi tiie r�ain gab].e of a pitched roof. �, For reF�ixs or a�terations to an existinq structure, the £ee shall� be at the rai:e .. of $3 .00 �icr. cach five hundred dollars '� ($500.00) er fraction L-liereof in the cost oi all proposed wor.Y.. . , ' In -no case sha�.l thc. ��e cliarged fc�z any pP_nnit as set forth i.n 5ectian 2 be iess � than $7.50 plus $.50 stat-e surcharge. . � - • � VERI F I CATI 0�! aF r-��;�nn� i ow NOTE: Permits : or canstiuciion taill be issued a minimiun c,i 24 hours from tlie time oi application to aJ.lo�v for proper review of L-he proposed structuxe and oi ihe construction site. � A Ceri:ificate � of 5urv�,j of the lot, shoc,ring the location oi fihe foundation once it has been coiis�nZCted t��a.11 be required befare pr.oceeding with the �ram3.ng. �FRTI�=ICQTE OF �„�GUPAf��CI' � ' nPPl.i�ation tor a Certificate oi Oceupancy 5h?11 Lie made ten (10) days prior to the u�:e or. accur�ncy of an}� stzucture for �ti�hich a liuilt3ing permit l.as been issued; and saic2 struct.ure : iiall �iot k�e used o2- occu�icd t;iitil a Cert�.ticate of Occul�ancy h�s bcen i,ssued. ❑ , • ' ,.s , • . i' 1 • R � � n � �,�'�. � t �:� 1� , .0 * � D �« �' � O � � a � o y' � y. � N � n � � � _ � Q a� 0 �• � �' 01 Oq � a Q' � _ 'a i�i m .� a O � � � � m a . � �« ? O C � � rn Z � � m � 0 z � m rn � � V O O � 2 � � � O �* � D D r N rn � � m �. � a4 �D � � tr � � ., - O , �,..t �.,..a`ta?: . .._.. . _7. ,e _...._ , _ .._ � D - fn _ '� -� � � � `m Q' a W �, � O c aq � � v � � m � � � v � �t� _ 7 � 00 O � rn r � v v, � 0 0 0 n � o CJ1 � � A o � �1 N � � a C � rt D 1 � � � m O � O � r D � Q �. S < fD p� N \ fD (�p �. � D y. v Qo .a � � m `-.° o °.+', �O � N � r � O Z W D c� � D _� n O � 0 � OQ. � � N m � � N ()'1 O O � � �.� � �kc; :' S,r .. . „ � ,� _. „ �. � � v�' =i "� �. � S � � n � � � � � � y N 7 �ii � z ,•�•F-�i.�'f�D n �: � o�v y. I � � � � y W �, (D y _. � Q. rr Q4 � h7 'y. � O � � (7 a °a a o- �•va� � O D �.y. �� ' 3 �� tn�0�� <�= d��N ?�� °—� �v � �. � 'a -'S '°I N z� ��. �' w � � m �. �+; � � � °� `� c41y � .�v ma�o � � � � � m��-o � N � � �as� 3 � � o °:�o � � � � m -��, ,.n.�. � fD �' N Ci �D �� o v o 'c � �" N fD Q � C�_D > > -=m �l� C � � m 't � � a cD Z 01 c�D 2 � � N m z 0 m' v � G� � N � N � G) L� D �'I e�D C) N y � fl1 � �� A � � �' N � � � � � m n��i tn ai ? Q' � C � fD •�,'� �,� d � Q • > > �.�--n�^o � _ � � O � � � �' r' °' � �=oo�o � � � � � ~' v v � � C � 1 � � � � t-+ � �+ (N O O O O � O O O O '* cD � � t� t� � � ... .. .� .. . _ ��w� � , N C � � — ao c� � Z = 3 � � �� 0 c ''' � y � n N � � Q = Z � � n O � � C n CD � ° � Z � � ° n ,� � m a N� D .� Z r N p �mfD� aoo � � o C � � m � � �.�i � � � v � O � D r .� � m N � _ m v C r 1�1 , ;"� -W � = G D � Z o � C 0 0 '"'� D i/i � � i � � � � m � 3 z 0 � � r:� �� COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing 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 cuRent codes and manufacturer spec�cations 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 Fumace Venting Tables for fan assisted and natural draft appliances. The existina 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 current codes and manufacturer's specifications. Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes () No () Is the common vent and vent connectors sized and installed coRectly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No () Apaliance Tvpe 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 o� Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Keight ft Length �t Diameier 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 : City of Fridley AT TNE TOP OF THE TWINS i� � � � ; � __�__ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. � j �"'1 � CITY MALL fRIOLEV SS�J2 �""'"�� '� 612-571-3460 EU ILDING PERMIT �9EN NEV DATE vAGE Oi 910-F15 8/10/00 / / JOB AODRESS 615 Hugo Street NE t LEGAL ��T NO. BLOCK Ti;ACT Oii AODITION DESCR. 1,2 R Riverview Heights Addn 2 PROPERTY OWNER MAIL A�ORES$ 2 Sam Liane 615 Hugo Street NE 3 CONTRACTOR MAII ADDRESS 2 Showcase Builders Inc 16026 Lakeshore Dr, Eden Prairie, MN 4 ARCMITECT OR DESIGNER MAIL ADDRESS 2 5 ENGINEER 8 USE OF BUIIDING Residential 7 CLASS OF WOF;K MAIL ADORESS O NEW O ADDITION ❑ ALTERATION 8 DESCRIBE WORK Replace windows 9 CHANOE OF USE FROM TO ZIP 31295 RECEIPT NO. / ! 16iROVED BY SEE ATTACHED SFiEET 763-784-4800 � PFIONE LICENSE NO 55347 952-934-1490 ' PHONE UCENSENO. 20078380 PNONE LICENSE NO �] REPAIR O MOVE O REMOVE 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. SEPARATE PERMITS ARE REQUIRED FOF ELECTRICAI, PLUMBING. HEATING, ''r� vr vv•J• VENTILATING OR AIR CONDITIONING I TMIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING AUTHORIZED IS NOT COMMENCED V�!ITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 12(1 DAYS AT ANV 71ME AFTER WORK IS COMMENCED. NO. OWLG. UN17S I MEREBY CER7IFY THAT 1 NAVE READ AND EXAMINED THIS APPLICATION 1 ANO KNOW TME SAME TO BE TFUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UATION ANO ORDINANCES GOVEFNING THIS TVPE OF WORK WILL BE COMPLIED �[�, � 9OO WITM WHE7HER SPECIFIED HEREIN OF NOT. TME GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLA7E OR CANCEL TME pEqMITfEE PROVISIONS OF NV HER STATE OR �OCAL LAW REGULATING CON- $111.25 S�UCTION O RFORIyANCE OF CONSTRUCTION �` PLAN CMECK FEE OCCUPANCV GROUP OCCUPANCVLOAD SO. FT CU fT. OfFSTREET PAqKING STA�LS IGARAGES U°'�� ` � r Licens C $5 . �GNATUpE O� LON'AACTOp Ot1 vU�NOA�ZEO AGENT iDATE� ue nene S�GN4TUNE O� OWNEA �i� OwNEA BUi�DEp� iD�iE� o•y I � $2.45 SAC CHARGE Fire SC $4.90 TOT FEE 3.60 I�A1 TMIS 1�=��M1�� q�fE NEVV [ ] ADDN [] ��R I ] Construction Address: Leaal Descriqtion: Effective 1/12000 CITY OF FRIDLEY (763) 572-3604 BI� Insp SINGLE FAMILY AND DUF�LEXES R-1 AND R-2 � B ILDING PERMITAPPLICATI �G� � c� � � r � �.-��2 �j ��1 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. Ft Length Width Length Width Height Sq. Ft HgUGround Sq. Ft � Construction Type: C�2.� i�.� c.C) '��u�,� rstimated Cost: $ �� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �� 1 � ' APpLICANT: - ��i Tel. # �S� Z " � .3� / e(S�' CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ %� �� S Fee Schedule on Reverse Side Fire Surch(arge $ �� g� .001 of Permit Valuation (1/10th%) State Surcharge $ �- �/S $.50/$1,000 Valuation SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ $1100 per SAC Unit $ .� - U� ) $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 [ ] $ �o�� - (o� � 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 $5(10 $501 to $2,000 $2,001 to $25,�0 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,0�,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,�0 or fraction thereof, to and including $50,000 $643.75 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,Q� 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 $1,0� 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 he 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 constnact�d will be required before proceeding with the framing. New Houses Onlv SuB�ECT PE City of Fridley 313 2 9 AT THE TOP OF THE TWINS � � � L D I N G P E R M I r ; � T NO. � `� __�__ COMMUNITY DEVEIOPMENT DIV. r � � PqOTEC7IVE INSPECTION SEC. % � � 1 ; i � � �� CITY HALL FRIOLE� SS�� NUMBER pEV DATE PAGE Of AOPqOVED 8t �'"'"� � �'� 612-571-3450 9t0-F15 8/21/00 / / �oe nooaess 615 Hugo St NE 1 LEGAL LOT NO. BLOCK TRACT OR AOOITION SEE ATTACHED DESCR. 1�2 R Riverview Heights SHEET 2 PROPERTY OWNER MAIL ADORESS 21P PHONE Sa.muel Liane 615 Hugo St NE (763) 784-4800 3 CONTRACTOi; MAIL ADDRESS 21P PHONE LICENSE NO Builders F� Remodelers, Inc 3517 Hennepin Ave So Mpls., NllV 55408 (612)827-5481 d AHCHITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO. 0001100 5 ENGINEER MAII ADDHESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION ❑ ALTERATION C� REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WOFK Reroof Tear-off (2 layers) 102 squares 9 CHAN(iE OF USE fROM TO STIPULATIONS Underlayment must comply with the State Building Codes SEPARATE PERMITS ARE REQUIRED fOR ELECTRICAL, PLUMBING, MEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTI�ATING OR AIR CONOITIONING. THIS PEqM1T BECOMES NULL AN� VOID IF WORK Oii CONSTRUCTION ZpNING SQ. FT CU FT. AUTHORIZEO IS NOT COMMENCEO V�IITHIN 60 OAYS. OR IF CONSTAUCTION OR WORK IS SUSPENDED OR ABANDONED fOF A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARK�NG I NEREBY CERTIFV THAT I MAVE READ ANO EXAMINED TMIS APPLICATION 1 STALLS GARAGES AND KNOW TME SAME TO BE TRUE AND CORREC7. ALL PfiOVISIONS OF �AWS yq�UATION SUR7AX AND ORDINANCES GOVERNING TNIS TVPE OF WORK WILL BE COMP�IED WITH WME7MEfi SPECIFIED HEREIN Ofi NOT. TME GRANTING OF A PERMIT �961 e QO �� SO OOES NOT PqESUME TO GIVE AUTMOfiITY TO VIOLATE OR CANCEL TME pEpMIT FEE SAC CM RGE PROVISIONS OF ANY OTHER STAT LOCAL LAW REGULATING GON- �3H•%S F1T SC .�.96 ST_ RUCTIO R THE PERF AN O CONSTRUCTION �� PLAN CFIECK F E TOT FEE 0 � ► Lice C $5. 0 $ .21 - S�GN4TUAE OF CON7i7ACTOQ OA oUTM ED nGENT io�rE� EN P P Y VALIDATED� HIS IS U�� S�GN4TUAE O� OWNEQ��F pyyNEA BUILDEp� iD�iEi BL �h5� � r�ciE v P') NEW [ ] ADDN . [ ] ALTER [ ] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: li� �� Legal Description: Owner Name 8 Address: � Effective 1h/2000 612�72�60�4 Bldg.lnsp � `��e � � �� Tei. # i� 3 - ? ��( - � � 4v Contractor. ODELERS, INC MN LICENSE # Address: 3517 HENNEPIN AVE. d—��49��512..82Z��1 Tel. # L{CENSE #0001100 LNING AREA: GARAGE AREA: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIP'nON OF IMPROVEMENT Length Width Height � Sq. Ft Length Width Height Sq. Ft DECK AREA: Length OTHER: Sq. Ft � v v V Construction Type: Estimated Cost: $ � �. � -�� Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft $ _$ � DATE: �S � 1 � APPLICANT: Tel. # �l�' � a� i' � �' � � CITY USE ONLY - Call (612) 572-3604 for Permit Fees if mailing in application / Permit Fee $ 3�. 7� Fee Schedule on Reverse Side Fire Surcharge $ ��.001 of Permit Valuation (1/10th%) State Surcharge $ C� $.50/$1,000 Valuation SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee $ $1100 per SAC Unit $ �� $5.00 (State Licensed Residentiai Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary (] Not Necessary [] TOTAL STIPULATIONS: $ ��1 � Building Inspections 763-572-3604 DATE / / � l srrE a,Dnx�ss C� THIS APPLICANf IS: -o �- � PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY �� Permit No.: �1 PP�� - By: YOUR E-MAIL ADDRESS 1�i O� , T 2�� ,a� � /1:�� f oo� . ,� �,� .� - - - ___ O OWNER �ONTRACTOR Na,�: ��o--►r+ � � ( ;�1 �-.�' � �DxESS: Eol 5- /e°C��' o �o� /'O'� crrY PHONE: �% 3 � �✓ � S�d B'� STATE LICENB��#w� �wo nrwwv �� p DATE ADDRESS�•w P ONE � FAX WGLE F ON S12 ❑ TWO FANNIII.Y/NEW CONSTRUCTION STI 0 ADDITION ❑ GARAGE/SHED ❑ BASEMENT FINISH �[tOOF ❑ DECK 1l�SIDING �7 SVJIlvIlvIING P��. TYrE oF woRx: I o_ �W DESCRIBE WORK BEING DONE: SIZE OF IlVIPROVEMENT ROOFING ,,( � ❑ HOUSE ONLY NUMBER OF SQUARES � ��y'� @�HOUSE & GARAGE �� GARAGES � ATTACI�D GARAGE PROPOSED SIZE: �/� �� ❑ DETACHED GARAGE PROPOSED HEIGHT: % SIDING ❑ Vinyl ❑ Aluminum. n �IOther Sf� �✓ �� ❑Soffit � Trim ❑ Fascia WINDOWS IN EXISTING OPENINGS ❑Yes ONo OR FOR NEW OPENINGS-DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED LOCATION OF WINDOWS OF a,TE��"�5�3 Z " STATE ZIP ❑ DRAIN TILE ❑ OTI�R . �� } � �'� �'�"`�% � i -� ��.; HEIGHT BASEMENT REMODELING SUBMIT: 1. Existing FI�r Plan 2. Proposed floor plan 3. List of structural members to be used Ft. FOR NEW CONSTRUCTION INCLUDING DECKS, ADDTTIONS. & PORCHES SUBNIIT: 1. Site Plan/Survey showing the existing structures and proposed projecG 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee Plan Review Surchazge Fire Surchazge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ � �, � r $ $ $ eCl� $ �/�.i4 $ ,'� C� D $ $ $ See Back Page for Fee Schedule 65% of Building Permit Fee (.0005) times the total job valuation — Minimum $.50 .001 x Permit Valuation (1/10%) $5.00 (State Licensed Residential Contractors) $1450 per SAC Unit (Plans to MWCC for determination) $+6ft= iix$20=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks payable to: City af Fridley Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acl�owledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and code f the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application f e' and wor is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work w' r'e approval of plans. SIGNATURE OF APPLICANT PRIlVT ATAME ''�vN��(/!/�� "'l� DATE /�r'�7 `�� Page 2- Building Residential Application _, ,. BUILDING PERNIIT FEE SCHEDULE The Chief Building Official sha11, 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 aznount herein below set forth and in the manner herei.n provided to-wit: ' VERIFICATION OF FOUNDATION Pernuts for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceed�ng with the framing. New Houses Onlv - — - - — - - - - City of Fridley - - - - - --- - - - - - - - -- Building Inspections Deparhnent 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977 Building Inspections 763-572-3604 DATE .�Z � � — � �" SITE ADDRESS (fi/� TMS APPLICAtVT 1S: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PROPERTY TYPE PERMIT TYPE TYPE OF WORK: BUILDING RESIDENTIAL APPLICATION CITY OF FRIDLEY YOUR E�MAIL ADDRESS � OWNER �GONTRACTOR J�/�i� !/6 � � � �s�/ /FCC• ir�/�' /��/�'� � N� • ��w� �.. � NAME: ��tAA■•�1 �l11� • STAT'E LICENSE #_�t�� 'E ADDRESS: FAMILY/NEW ❑ BASEI��NT FINISH ❑ DECK DESCRIBE VJORK BEING SIZE OF IlVIPROVEMENT OF SQUARES GARA PROPOSED S1ZE: PROPOSID HEIGHT: SIDING myl � Aluminum O Other V1'INDOWS IN E7QSTING OPENMGS OYes DIJo OR FOR NEW OPENDdGS-DESCRIBE SIZE OF OPENING CHANGES 8c TYPE OF WINDOW TO BE INSTALLED �❑R F ING ❑ HOUSE & GARAGE ❑ ATfACHED GAR.AGE � DETACHED GARACrE offit rim O Fascia LOCATION OF WINDOWS . �;� i'ernut No.: (D 'C�c Received By: Date Rec'd% �� fY�� ' STATE Z� ❑ DRAIN TILE O OT!-�R HEIGHT Ft. BASEMENT REMS?DELING SUBNII7': 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUC7'ION INCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: 1. Site PlanlSurvey showing the exisUng structures and proposed projecL 2. Two sets of construction plans 3. Energy Calculations ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTA�, JOS VAE�UA�'ION S��'� -� OCCUPANCY TYPE Pernut Fee $ /�� ZS� See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Surcharge $ � (.0005) times the total job valuation — Minimum $.50 Fire Surcharge $ � .001 x Permit Valuation (1/10%) License Surcharge $ �; $5.00 (State Licensed Residential Contractors) SAC Charge $ � $1450 per SAC Unit (Plans to MWCC for deterniinarion) Curb Cut Escrow $ ft+ 6 ft= ft x$20 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary () Non Necessary () Total Due $ ��, 2. S� Make checks payable to: City of Fridley Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I 6ereby apply for a building permit and I clrnowledge that the information above is complete and accwate; that the work will be in conformance with the ordinances codes f the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application f ' and w k is not to start without a permit; that the work will be in accordance with the approved plan in the case of a(1 work w' uir e d approval of plans. SIGNATURE OF APPLICANT PR1NT NAME ON��'�✓��vDATE I z- Z�—d f Page 2- Building Residential Application BUILDING PERNIIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any �ddition to any existing building or siructure, or for any alteratian 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: VERIFICATION OF FOUNDATION Permits for conslruction will be issued a minimum of 24 hours from the time of application to allow for proper review of proposed structure and of the construction site. 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 City of Fridiey Building Inspections Department 6431 University Avenue NE Fridley, MN 55432 763-572-3604 Fax: 763-502-4977