AF - 47549City of Fridley
AT THE TOPi OF THE TWINS
i �
� �
� ; L _._.__ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE �NSPECTION SEC.
� . �
� � �"'1 � CITY HAIL FRIOLEV 55432
�•--'�"� ,'� 612-560-3450
SUBJECT
BU ILDING PERMiT
NUMBER REV. DATE PAGE OF
910-F15 i n /d /�ti � �
JOB ADDRESS 510 Janesville 5treet N.E.
1 IEGAI LOT NO. BLOCK TRACT OR ADDITION
DESCR. Y, 2, 3, 4 F Ri.verview Heights
2 PROPERTY OWNER MAIL ADDRESS
Dennis Larson
3 CONTRACTOR MAILADDRESS
The Rottlund Co., Inc. P.O. Box 32082, Fridley, Mn.
4 ARCHITECT OR DESIGNER MAI� ADDRESS
ZIP
ZIP
. ° 13804
RECEIPT NO.
�
APPROVED BY
SEE ATTACHED
SHEET
PHONE LICENSE NO.
PHONE LICENSE NO.
5 ENGINEER MAILADDRESS 21P PHONE LICENSENO.
6 USE OF BUILDING
Res iden�tial
7 CLASSOF WORK
�1 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK ��RN�G
Gonstruct a 38' x 24' Dwelling and a 22' x 22' Garage
�y �E'%rE dl�gtfl� GBi� i0C8i
nc�t�fc�lATC -o�car��T� R�ail1RED Fi�{ ����G• Tti[ou�tYnr �� r�,...... .
9 CHANGE OF USE FRO1G1 ����
I�ATIN6, PI.UM$�NG ANO StG�S. iLEQU1Q�� R
STiPULATIONS provide a hard surface driveway. Provide a verifying survey before-
capping. Provide sod in the front and side yards. Provide truss design.
SEWER LOCATION: (Approx. 9' Deep) 7' West of Manhole (Inv. 855.74)
WYE ELEV: 855.58
TOP OF FOOTING: 859.08 Minimum
WATER IACATION: 10 east of sewer service
11i� fkiY Qt lR1Df�EY pplS t�pt
��*� Of NTHlTY LpCATf� ��� TH!
iMS QA`'tl� � H�R pVFORMA ���NS.
�ON ptJP.Pp$�g pl,�Y �
O�M � � � �h � � �ORAAAI�
TYPE Of CONST.
SEPARATE PERMITS ARE REQUIRED FOFi ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOd Frd�le
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED {S NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R�-
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �-
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $29,48Q
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $92 � 32
STRU TION E PERF RMAIJCE OF CONSTRUCTION.
��--a �� P k r� �• TN � PLAN CHECK FEE
yr L /D .. �jl� �[ $23.08
SIG TUfiEOFCONiR CTORO AUTHORI2EDAGENT IDATEIF _ WHEN PROP
���'��F.OWNERIIF OWNERBUILDERI IDATEI
--11VIP R1`AN?'..
Np71FY TME FRIDi.E`f ENGR.
DiViS10N AN� R�P���MENT
R��p��IENiAY Of ENt{YGS�
STALLS
GROUP IOCCUPANCY
CU. FT.
18, 240 +4
OFFSTREET PARKING
IGARAGES
SURTAX
�%87t� $14.74
SAC CHARGE
$350.00
TOTALFEE
$480.14
D THIS IS YOUR PERMIT
� /D-� ��
�t�i.
W
-- �' S �rL � �.
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38 �X .� y � = 9> z _ X �'' _ �z ��
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l.�ST — " _
�8� .Z Ya
-- _ _ _----
�.- .� z�- � .� � _- _-_ ��y X � � = �8 y� _
�_� 3�_�_�!��1DV�_�
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- - ?-�°-- ----s�Q�.�.-- --- ----
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d
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EXTERIOR ENVELOPE AVF:RAGE °0U" COMPUTATION
Page 1 of 4
- OWNERs �o_n��'.1 ar�c� C a.V�p La�;-C.C�rti DATE _�- I(D�%�O
- ... _...
SITE ADDRESSs ..��..n .*�i`,`;�.. S'T�iV , PHONE: �']f-,��f;Ai� , .
CONTRACTORa —C%�4, l�C�€'��e'tc�+ CA,,=3..f>C. � .
Determine working square footage of each � � .
_ 1. Total exposed wall area. o e e o. /�� �/, � iL sq. fte x .17 = ��� ,
2. Toal roof/ceilinq area o e e o., � J� sqa ft. x .05 =_ L�l�(p
Rbtat exposed wa7,1 area above �loc�r =
0
a. Total wra11 window area.o y�.�..o.vo..o,....e..e......
b• TOt8�. C�OOi dr�d •.s..s..o..oe<eee.a......see....�r�e..e
c. Total sliding glass door area .........................
d. Total fireplace wall area .............o...............
e. Total wall framing area (average 10�)ee...e..e....�....
f. Total rim joist area ...o.....e.o.o. .e........�....
g. ,-,�a1:�+n '' wall area above floorJ:�':"o :r '� �Q4?r. . . . . . . e . . . . .
h. �.�,a wal� area above floor.,,'::�.4��.°�"���e .... �,
i. �.n•,�c � wall area above floor.�t1C?:�^:�^ �0.Vera �., !O/o,�
7. Lawer wall area above floor.l'�� Y�� �.��ol�n�:-�� J. .. e�...
4
sl
� Total exposed foundation area =
��,y 3t
�LY�
�3, 35�'
�
� z,Z9�.
ln Z5• 7 ��/
t L� i�l .� 4 q
�,� J
�/ l 3,�,=,
L.o Wer �e���.t
k. Total �Ada+�or� wi do area.. o ..........:...... (�(o, ��/�( -
l. Total net foundation�� a�ea above•grade .......... . �Z, �
e.� ... 1 �
Determine�"U" value of each wall segment
(e.g. window, door, each separate wall sectiona
a. '7 t'� ; � � 1 X "U'° ' I 5� - �/0 � 4�5
Y
b• 7_(� � � L7 ( X ��U�o � � � � � / % , U U
�• l 3 , �?�; x °U,� ,s£s = �9,33
d, —._.____ ___....�, X nU�o �
e. g9, � X�.U.. '.,�t 3 � if,��
f. �.�,z9 z x nvn � �o� � _ �,a�
5• rn?�, ?�5�/ x "U° Jv� — �f0. (a �S
h. i �-; �i, � �a � X ,.U„ - , � «�. - �- � �
i. � 3,3 x��U�� , t t� _ (o, 3�-/
j o �-? i � ,'� � �p X ��U�� i (��o {0 — Z �, Z "%
k e .t.� c o . �� y X „U„ a :� � _J ? , —�
� ry �T
� 1 • �.� � / i� X ��i]u � � � .
N
/J' •
�w
s. ..........................e.. �� -� � a,9
If item #3 is the same as,
or less than item #l, you
h�ve met the intent of
SBC 6006 (c) 2. '
.
'Exterior Envelope Average "U" Computation
Page 2 of 4
►
" Total expose@ roof/ceiling area = 9}�_
m. Zbtal skylight area ..........a...o...e.........
n. Total roof/ceiling framing area (average 10$)... /,2 .
o. Total net insulated roof/ceiling area......:.... k ZU•c;
Determine "U" value for each roof/ceiling segment •
m. X "U" _
• ne �j 1�2 X o,U�� ,�3:a = � , :�c
, �r
� �o �C.�i.l� C: X il*i10 � lfN 1 6 . �.�f Vll�� � � . � � � . � .� � � � � . � .
M
�i.......o.o.o.oao....o...... 'POtd�. +��� r �. .
Yf total of #4 is the same as, or less n#2 you e met�the intent of
SBC 6006 (c) l. �
Alternate Building Envelope Design
To utilize the total envelope system method. the values established by the sum of
items #3 and #4 shall not be greater than the sum of items �.Z,�
le � `�lo, � i + 2. ��� iv ,9�
r „
3i .;� `�� c�i :_; + 4. � 6i� �.. = 3 �v
`n��.,-�.�' lev e�� r�e-� VJG;1 Cy,.rec� . ('j0�[�� �Q. ', ���� "'::�
� . _ /� /�C
.r
_.��1 � f� i. '11 �' y r"' � ��,'.. L%� lS� C � � �
- ----:_ _ ___ . _...___ �,�._�e.� ^ _ _�,r �4j _� U,qZ
_ _ ___-- --.- --
_t,r � _ � w• _._._..�__
? ► j �'� ' r. � t_ y�� �"
='.?._2. _ ---1,'' "�' C`'•�'.�r`.,._ _ • � � < <7u _ _. �`Z �t +�,�C`�_�'Td`SJG..iS�_-_____ � �-
'iC... �i .` . - .
�..,�J b.`��� f-`�i_ e.��,.� ; 3,%2u q,�, .....____f_� .
-- __ -��
�je� Y" _ � } _ _ __� � � S�� r o _-.� _ _ ___..
, _. . _ u"- --- - -- �-��
,.
_ _ � _ .r. --.�., ,� • r _�.b.�:�, l.� 4 � � ______.�� . _. �e,k- t'��e.. 2�c�
. . ..
, { SI �t ___.._._._�__ .__ �?_.,
_�� },e.r�,,�t .t�� , �_ ; �•,��. D�l'1 — —�__ -_���c �,ac:tt _
_ ,a _.. _ ... i5?._--- . .
ie4^l t5 ,�5 R 6x�1-e�t��r A�r �'� t,�� ��t 2
,�a�n :o �;t Tc�ta� . t S, q 2. R
t'� �'� c.k i.�,J -.'. �. , t>t02. U�
-,- . • _
_,. ,
... _ , ,,�'�c,c'_____1...�_._��.:ti.,,�,. �,�c�____
� � i �. i . , �..
_ w �z- �n��„�>'G-,��T���._ 1I �o�
�`�'� __?. b'�ik C' :-�:�' _ 2 ,ato -
jE; F., r�� ,�,. V, I-�
,_ . -' _ _ ...�c�,n�rV.o�� _ �f'� c._4., O � ;�?
. 4: `�,�-t' i. i 3( � l,�
_ i��r _C��,.�- �1'1
� `? cX. C�'�, i t. ( , =� � ! t�
' �:�1�'� l,t •
0
• WALL 5ECTIONS
:dOTE: Use 10% of oF�aque wall area for
" f�ame canstruction
.. � ..
F�� ti�
•, .
• ` �^ ` Ll
� `'� f':: � ' �'
=1G. #3
.�. � y a d , ` � •
• � �� � � • � t « , ,
♦ ,° �
� `, ` ' , � � . � ' 1,; -
Page3ofQ
Construction R-Value
1. Ynterior air film 0.68
2. / z r � .r•� iti +��-� �I"[�L�< �� S
3.' Fr4+Yr�na U,3S
4. �`���? h'ti 1� -�-i �-C. � 2� O lo
�, . y
5. �/2. � r±� L�. t'� � P �. t�.; n� . i, 1
-� _�
6. Exterior air f ilm 0.1?
R�otal � . $ � �
_ .t � 3 u
l. Interior aix film p.6g
a e '/ " � ' �
z �_a�.u�-� r�,�.Y �,
3._ 3'/�," i r� s u.10�.�' �:�r: J �� B 0
4• Zsf��.�� b\ 1��r��-P. 2,b�
s . -!I� �, �, n � u1'��e, �- �,:::.za fi � � �, � y
6. F�cterior air film '� 0.17
Total ! S .57� f?
� OioS c�..
1. Interior air film p.6g
2. �: �/2,� ����, �i��:'���.. I(. ao
, ��,�
3. f� r��. � r; t�,= ;
4. 2�• r� �'' lb'� `�- C' ��-�.. 2, D lo
5 . i�� � a • � t. � 1, � ;1.. a jr- �,,.� , ," �'; � � �
�
6. Exterior air film � � 0.1?
�otal j t? �i� %�
. , , O�J U
�. Q lJ�.i C.i �,.�-�l �.'.., �_f=i' G.�`(� q �` l`� �
1. Interior air film 0.6g
2 . _ _ � 1A.�1�r'� r<<� �'� �
3._� ��:�.,•r �.. I U�o ��r 3 S
4. ���;�- J� �i ��.1-� �C1'ce. Z.��O
s. _'/�, " i n.g�A i� d.e. ��tc�',�_ 1� 1 y �
6. Exterior air film 0.1?
Total � �.I-�� I�
• �' � 11 �1 t�..
• . � 6 • � �"' � • � � � M
FF � � � �
.�T-�'"���1�`� . • !, , �. .� • � � • .
� /!( � � . • .6 . . .
r--- .
FIGo �#4
NOTt::
I� � V . . ti
^ , ` 6 ' ' � �111 '
,.. _ , �
!ll . : . . . , i ._ / ► t
---- ' ' /t! .
-- - . - � ,,.,_ /��
!!t t� ' •. p �
' ' /' � �j. . . �
��� � , � • � • • . �� ��� .
• %/t � l� i � f/� '
Indicatc tyne, "?." �value, depti� anci
�lacer.ie�t of in�ul�tion. '
.
F200F/CEILING
`lented
�teat flow
up • � �
�'IGB �5 .° .
sn,! .!.� �u-�•;tia,t�+!1.;�:�,. �.��.c�.,r,���csa�.ca�
. `�J `L�� z`'.J -L�"i .
i:eat floaa up � . �e ;•ven�ed
. , . ' :
. FIGe #6 �.. .. . . ' ' ` , .� _
3 � � - 5 t,
r� .•{
� a D �•� :Z�.S ; :��:•`�
o�l���.,�,_ ,. ,~:
' ' -- � � � r. r4s3.`.�.:�; ;''t� ; _ , .•�..�i"�-"'"�� ���
0
�
0
> >.
° N0.'_PEh*Tr'�� ,' � ' ' ' .
, , •e. • .
•• � e � Hell t . ',. � • �
, � • • �1dW tlp ' .. . ' � • •
, .o . . „ , •
F. xG. !�7 � . , . . .
Paqe 4 of 4
1
Construction R-Value
1. Tnterior air film 0.61
2• �I,
�s �lY1 D�"� /~:''�° T'. f J 7
�� r
3. ID t nG �'��n,�.' �� r.. ?,7 ,�'J
4. Exterior air film (still) � 0.61
' Tatai � � ,`j � t�
. ,C��. E ��\
'5,.,�.�� to�' �. r F �� ��n U, Ea t
�.� �v.t a-�;•. prt, to" pv�.,r ��. �� 18 , C�c�
1o�s� �F ro.��� y �,Zc�
S��_°' _S1��e.e�-co��., __- D,5?
E x�l-e.�R►a� A'��' F����'+� t�
�_____Q �_.._�,
: `ta�a\ �� � � �7 P.
. v3(� +..�
1: Interior air film � d.61
2.
3. �
4. Exterior air film (still) 0.61
Total
l. Inside air fiZm 0.61
2. • -
3.
4.
5. Outside air film 0.17
Total
Note: Use additional sheets if more space is
needed for details and calculations
,
APPLICI�,;�IOPJ F-OCt FESIDEP;�TIAL ALiE.R�iiIQid,
ADD13I0(r', Orl RfP�1IR QUILDII�G PERMIT
OWNE12' S NAMT :�P,�/ S ( A v S o�_`BUiLD�F.:�/,�.� 7"� /� �r �- �i�+
ADUIZESS : ADDRESS :�• O �D X � Z D Q Z,
NO : �� � .,._�. S TREET : _ i�� ��. S lLl / l -e, �7` . _
LOT :���BLOCK :�__�__�_. ADllITIOIv : f��/U � r,y i �° w i7` �� 9h �
COIiNF'R LOT:_,�( INSIllE LOT:_ SETBACK.:__�__S?DL'YARll::73 d y3• 3d
�pplic�znt attach to this form �io Certificates ot Survey of L�t and proposed
building location drawn on these Certificates. �
UESCRIPT'ION OF BUILDI:�G
Tc B� Ilsed As : S/N y/.e �A�nr C X
_��is--v S -e Front: � � Denth �_ 2 �.� Height _ �
t� E.�, y P 9y y_ .�
Square Feet:� Cubic Feet: � �� ��/ _
/ o V 1�'
�r� r� % Fx.ont : � 'Z Depth : 2 Z H2igtzt : �
Squa.re Feet; �/�� Cubic Feet•�
Type of Construction: �rA M E Estimated Cost: ��O, 900 . O O
To Be Completed: TAn� `. ,,L9��.
The undersigned Iiereb}T makes applicativn f.or a permit for the *��ork herein
specif.ied, ag.ree�.l�g to do all. wort: in st�ict accardance with the City of
I�'r9.dley Oxdi.na;tces and rulings of the ll��pa�:tmen.t of Buildixigs, an�4 hereby
declares that all the facts and-�epxeser�tations s�ated in tltiis applicatian
ar�.txue and coxxect.
�,-'�'" •�Y /�� ,f-� l�.V�,l �e . �-.�r r .
DAT�: p'-- �� — 7(� SIGi�AT(JIZF: � ��'�ct'
—�—°
(See R�verse Si.de Fox Additional Infox�natian.)
�C.��-t'' �' Qt , 3�
/r�"` �+�l,e,,�,�
d�, � 8
s �t t��� c � �. �5�
5/-�-C_ 3.�, d "
� �ySo,1�
S rp u � � °''�. _.._._.5 ..w..�.., , _ .
,� p,eo d, o� T2u s s v�s� 4'.�c�
.
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.
CITY OF FRIDLEY
� - `�� �� �'
APPLICATION-FOR POWER PLANTS AND HERTING, COOLIR�G, VENTILATION, REFP,IGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCHEDULE
GRr1VITY 6YARM AIR:
Furnace Shell & Duct Work
Replacement of EUrnace
Repairs & Alterations-up to $500.00
Repairs & Alterations each add. $500.00
i�tECHANICAL WARi�1 AIR:
Furnace Shell & Duct Work to 100,000 BTU
each add. 50,000 BTU
Replacement of Furnace
Repairs & Alterations-up to $500.00
P.epairs & Alterations each add. $500.00
ST�'�i OR HOT h:aTrR SYST�1:
Boiler & Lines up to 100,000 BTU
each addn. 50,000 BTU
Boiler only up to 100,000 BTU
.
each addn. 50,000 BTU
OIL BUR:VER- to 3 gal. per hour
� each add. 3 gal. per hour
GAS BURNE k- frcm 100,000 BTU to 199,999 BTU
(over i.99,999 BTU see Fee Schedule)
GAS FITTING FEES:
lst 3 Fixtures _�
Additional Fixtures
Gas Range to 199,000 BTU
AIR CONDITIONING �
FAi� HEATING SYSTEI�IS � See Fee Schedule
VENTILATING SYSTE�tS (
ALTERAT:ONS $ REPAIRS J
ROUGH INSP.
Date
FZNAL INSP. �- -
Date
APPROVAL FOR PERMIT ►1'"
RATE
$12.00
7.00
7. 00
4. 00
$12.00
4.00
7.00
7.00
4.00
$12.00
4.00
7.00
6.00
$10.00
10. 00
$10.00
x $ 3.00
x $ 1.00
x $10.00
State Surcharge
TOTAL FEE
REINSPECTION FEE
(,$10. 00)
MINIMUM FEE FOR AIdSC FIEATING PERMIT IS $7.50
TOTAL
$
$
$
$
S /�-�v>
$ y'_ v v
S
$
$ __
$
$
$
$
$
$
S l�, v�
S
$ 3. vv
$
$
$
S
S
S
$ .50
$ 1 �l. 5�'
Job Address s! � ✓ G h t.f' ✓% l�t�
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a permit for the work here�n
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Department of Buildings, and hereby declares that ail the
facts and representations stated in this application are true and correct.
Fridley, Minn. / tJ ' l � , 19 .� G
OWNER � � ���t n �i �V h � ?�
KIND OF BUILDING ���' � rn`1
usED AS � �sv � / �' r
TO BE COMPLETED ABOUT / � ` � - % �-
ESTIMATED COST � � %i � v
OLD C ET UILDING PERMIT NO. PERMIT NO. _ IIJV/�./
DESCRIPTION OF FURNACE/BURNER
HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. �
Trade Name �in � r/ a,.. Size No. Cl7 l � S U� .�
,�s ���
Capacity Sq. Ft. EDR � BTU HP
Total Connected Load i % v�rf Kind of Fuel � G, f
BURNER - Trade Name Size No,
Capacity Sq. Ft. EDR BTi) HP
,..���� e_,G•! � V!�, �
��1 I�EPj';�� g, ��R �,, {�:. o Edmpany
' . S���i����f: �� � }
t^' ��.� � G� XEN' n�' Signed By �
j�lll`���-�F�°'`� R''�i:. Tel. No. � �J' .
�- '
�,� �:��,�,�-�..� �..��-�.u. .� _ . ,
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r i oor e�� %
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�
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.� . . *ie�qht � No. of ' L�nea- ' _
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t�c�utreci sa, ft E.O.�. or sq. �ns. 4U_A. teader �s�
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Height
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Infil2ra::cr ��
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Exp. wati f
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Fl, Room ; Length Width
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F i i�Q�
TOTB� $':..
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—p_ .
CI1Y UF FRIliLEY
APPLICATION FOR PWMBING ANI� GAS �I'TTIi�6 PERMIT
� X v Watez
v; •�+ �
,� v c� � � c„�, m I o �;; y w � Hcater
v r, .� '; 1� i. , f� Li
{{�.� y � r Xv H ^ � J � ^�-�+ ( G� � U �J
•� U V +1 L •Vl C N �.1 ^� � C � V: N tn N N N .0
y �_ ,.�, 4 r, ro �.1 ro i. U � .-� rJ r; � 7 r,; �U •.-i ro i=
(n Y:J i 7 �� �`+ tn '� '-� t+. � tf, 4. U q 2'� l� £ C7 O i..ZS :LC'C
/
�� � �
1sL /_ � �
(�.3I -+ I
� 3r�' I
; t�': �
(�) 3:Lt;.ze Coanec:ioa Gpenizg Conr.ected with Sewer
(*) ..e��r c^uture, O'_'= Ope�ing Water
t ..
t
PARTIAL RATE SCHEDULE
PLL'�:�Ii<,; FiXT'JRE R,'�TES: ti0. RATE
\•.z:r � �ir.:l:zes � S3. C10
r^at:ire _ ixt�ze C�eaing �^ x $2. DO
::e�.r Pixtuze, Old O�ezing x S2.00
Cztca 3�s:a x $5.00
wa��z ?:eater - to 99,G00 SiJ �_ Y 5�.00
2CO,G�O BN to i99,000 BTU x$10.00
nater So_teaer x S7.00
2ze�+ Gro•,:�.d ?.:r. 01d Building x $5.00
Electsic '+:a=er F:ea:er � x 55.00
GAS FITTI::G FiES:
lst 3 Pir.tures � x 53.00
�3d:tio:al Fiictures x 51.00
Gas Ftar.qe :0 193, 000 BTU x $10. 00
REP„lRS �$ :�L'I'EA.ATIOtiS
Fi_st S1C0.�0 55.00
eacn a�3. S100.00 or fraction 52.00
State Surcharge
TO:AL FEE
TdTAL
$ ���
S .tr
S
$
S s� ��
S
$
$
S
$ � p�
S
S
S ��
S
S .50
S =�
REIhSPECTZO:S FEE .
. (S10.00)
Job Address '
�epartmi�nt o£ Buildings
City of Fxidley
Tel. #571-3450
T
;���
`�,�2
J'
Thc undersigned hereby makes application for a perr�it for :he MvrX herein
specified ayreeing to do all •.rork in strict acrorflance with the Ci=y Codes
and rulings of t'�e Depar:r.icnt o: Buildinqs, and hereby declaxes that alI
the facts and represen�ations stated :n this applicatioa are true a^d c�rrect
� °rid�, �1. �� �� , 19�
04NER
KIND OF BUILDZ.IG �
USED AS
TO BE COMPLETED ABOUT
cSTI?7ATED COST '
OLD - NEW BUILDING PER":IT P+O.
Company �
Signed By
Tel. No.
ROUGH INSP.
Date
FINAL ID7SP. ) � ^ 3 " � �
Date
APPROVAL I'OR P�R�1IT
MINIML'bi FEE FOR ANY PLUM.B2NG PER�±ZT IS S7.50
T NO.
GEO. SEDGWICK HTG. & AIR COND. CO. ��� ��I, ��,�
HOUSE HEATING TEST RECORD •
l
ADDRESS --� �� � CITY
OCCUPANT OWNER
HEAT LOSS DATE HTG. INST. ,�- �, s��-• q -
SOLD BY
Electrical Work By
TYPE OF HEAT GA_ FA�_ HW_ STEAM_
GAS DESIGN
MAKE � �-J
Model r1�' f� /C. Ei /�E 3
Serial
INPUT � � � �
CONTROLS
THERMO TA� — Heat Plug
Valve -
Limit "
Limit Setting �
Fan Setting �V � � � 3�
Pilot Type �c
Pjlot Make
Pilot Model
Pilot Timing 7G
L.W. Cut Off
� L � �
Pressure Percent CO2 �
lnput CFH Percent OZ j� �� 2
Stack Temp. �� Percent CO 0�O 0`� ��U
Form 235
INSTALl.ED SY -�� �
Gas Line By �'� �l � �
SPACE HTR. UNIT HTR. OTHER_
CONVERSION
MAKE OF BURNER _
Model
Max. BTU Rating —
MAKE,OF FURNACE
Model
�- �/ r�
Vent Size - ` �
KIND OF LIN R S12E � NONE
Draft Hood ���'�� Regulator /� *�v AG _
Filters Size L� 1� 2 s X/ Number �
Chimney Location Inside � Outside
Chimney Construction
Smoke Bomb Wiring �
Draft � Test Tag
Door Pressure Lighting Inst.
Date Tested � — ` 76
Company Testing
Name of Tester '"'
53-R�-��x�o51
CITY OF FRIDLEY -
APPLICATION FOR PWMBING AND GAS FITTING PEi:�IIT
� '^ '^' . x m Wator
� ° c� a a u a w e Heuter
M U Q� C. W �?C J.� 01 ►p1 A rl �� � U � 0)
Sa J 71 •.CI � Yl � ' N�.�i � 7 � O �'N JJ N R! N VI .0
a.�+ � .-Oi f� A �1 ��� q ►+ 0 .0 rl �0 rtf 7 �0 �tl ..1 M1i •�l
' N U 7 W � � y 3 A W V7 W U W�t 3 l9 .$ l9 O 83 ' 1@C
lst �
, 2ad
I3 rd
ach ' �
(R) � Fliture Connection OAenic►g Connected with Sewer
(•) � Nev Fixture, Old Opening Water
PARTIAL RATE SCHEDULE
PLU�IBING FIXTURE RATES: N0.
A -.'.�et Fixtures '
FvLUre Fi�cture Opening
rew Fixture, Old Opening
Catch 9ssin
Water Heater - to 99,000 81V,
100;000 BTI) to 199,000 BTO
Water Sottener
Ke.r Gmur:d Iau� Old Suildinq
Electric Wa�er Haater -
GAS FITTI�G FEES: �
lst 3 fixtuses
F.3ditioaal Fixtures
.Gas Ranqe to 199,000 STU
REPAIRS fi ALTERATIONS
First 5100.00
each add. $100.00 or lraction
AATE TOTAL
x S3.Q0
•� X $2.00
x S2�00
x 55.00
x S5.00
x S10.o0
' x S7.QO
x 55.00
�.,—
x $5.00
x 53.00
x 51.00
x 510.00
State 3urcharqe
TCTAL FEE
S5.00
$2.00
s
S
S
S
S
S
S
S
S
S
S
S
S--,__,_�_
S
$ .50
$ 8_00
0
Job Address �l Q T I�I i 59ILL �TR" �'T
,� Department of Buildinga
� City of Fridley �
Tel. 11571-3450
The undersigna8 hereby makee application fo: a permit for the work hereir
specified agreeing•to do all work in strict accordance with tha City Codes
and rulinqs of the Department of Building6, and hereby declares that all
the facts and reprasentations stated in this application are true ar.d corzi
Fridley, Ma. 12-� 75 , 19
owrtER ROTTLING C0. �
KIND OF HUILDING fT'3m2
USED AS re S .
TO HE CONiPLETED ASOUT 12 -1 �-7 5• ' .
ESTIMATED COST ZO.00
OLD - NEW BUILDING PERMIT N0. PERNIT NO. //��
—���� a
' Company
, Signed Sy
Tel. No.
ROUGH INSP.
� Date •
FINAL INSP. � ' 3 ' ( '�
uate
APPROVAL I�OR PERMIT ;�
�
MINIMUM FEE FOR ANY PLUMSING PERMIT IS $7.50
�"� �' ��'� � .;r�{1.., r_
� REINSPECY'ZObI BEE .
($]0.00) • •
560•3450
�it o �i�t�e .
c� �
ANOKA COUNTY
6431 UNIVERSITY AVENUE NE January 3, 1977 FRIDLEY, MINNE50TA 55432
The Rc�ttlund Co., Inc.
P.O. Box 32082
Fridley. Mn. 55432 .
Re: Final Inspection at 510 Janesville Street N.E. '
Dear Sirs:
A final inspection was made on December 29, 1976 of 510 Janes�ille Street
and the inspection found everything completed except the installation of
sod in the front and side yards. We will expect this to be completed by
June 15, 1977 when a reinspection will be made to determine compliance.
If you have any questions on this item, please feel free to contact me -
at 571-3450.
Sincerely,
RONALD E. HOLDEN
.
Building Ynspector
REH/mh
CC• Dennis Larson
510 Janesville Street N.E.
,..... ...._._._...... . . ...... . _. ... ��...... . ...: �;.. . ... � .- . . . � . . .. _ . � .. . . . .. �..:e�•_
sue�ecT PERMIT
City of Fridley 20298
AT THE TOP OF THE 7WINS g U I L D I N G P E R M I T
r
; i. RECEIPT .
� ; L _ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. 3,r�� 9
' 's '
� /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE Of APVROVEO BV
�'""'� � ��' 612-571-3450 g10-F15 4/13/30 / /
�oe Aa�Ress ggg 51Q Janesyille �treet NRE.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION ' SEE ATTACNED
DESCR. �-^4 k` R].V2Y'jT12W H21 JI1tS SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Hamid S:ajady 510 J'anesyille Street N.E, 786^7621
3 CONTRACTOR MAIL AODRESS Z�P PHONE UCENSE NO.
S;ame
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Resi dent i a,l
7 CLASS OF WORK
❑ NEW C� ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Construct a 14t x 16� Deck.
9 CHANGEQFUSEFROM TO
STIPULATIONS
See notations. on plan.
�� ����>
Before d! �
gg►�g call for
a►1 utrtity locatrons
� �`�'�•'Q j� � 454-000�
�f��, �F� ���t��-� R� REQUIREp gy �A�/
��r PC��,4�`�R� F. � I
��.t�� � oR
tZ y��,�S,
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONlNG SQ. fT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 224
OR WORK IS SUSPENOED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
1 HEREBY CERT{FY THAT 1 HAVE READ AND EXAMINED THIS APPLVCATtON �" 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 $1, 650 $• 83
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROV�SIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING corv- $39•OO
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PL CHECK FEE TOTAI. FEE
$39.83
/�/ SIGNATUREOFCONTRACTOAOAAUTHOAIZEDAGENT IDATEI HEN PFOPEF V VA ED THIS IS YOUR PERAIT
� �I� ��
Si NATUREOFpWNERiifOWNERBUILDERi iDATEi BLDG INSP aTE
��a
��
jf. �Y �
l�'�J
� �
CITY OF FRIDLEY
R-1 AND R-2 �
&i11C1].T1[� F�2Yiltlt A�Z 1CdtlOri
oo�tstxuctioa� Addtes.s: 5 i v�Ja ��� � r 11� S+. , Jt i C.
Legal D�criptioai:
Effective iJl/90
Owr�eY' Ndme & Addres�s: _�a s�1i��Sc�� �i �`� S/r� J� ✓�v Ilico S f l►� �='. 'l1e1. � 78� -76 Z/
O�traG�tor: _ _ f-/��r/r� .�� �ac�"f 'rel. � 7�� -7LL/
A3dr+es.s: rild JrrIG9v�1� S�f �t/E. �-�.trl�� ----
Attach to this application, a Certificate of S1�rvey of the
lot, with the prq�osed constxvction drawn oaz it to scale.
DE�CRIPTI�T OF
7�IVII� Att�: Ierigth Width Iieight Sq. Ft.
C� ARF�i: Length Width Heic�t Sq. Ft.
D�C.R AREA: I�ength 1 Width �,(� Hqt/Gz�uxi Sq. Ft. _���
O�I'i�it•
• �i . � a'1 �
Corner 7�t [ j�j 7nside IAt (] F't. Yd Setback Side Yard Setbacks
Z�pe of Cbnstruction: _ w�u F2R�t_ Estimated Cost: $ � b�
Approx. Uc��letion Date:
Prc�osed Driveway Width If New Opening Is Desir+ed: Ft. S $
Width + 6' See Back Page
L�TE: �{ -/1- �I D APP'LICAI�TI': f l�' rr, cc/ s�/��y Z�el .#_ 7�E -7GL /
Pe.xmit Fee $���0�
State Surrharge $ �� -?
SAC Ct�arge $
Drive�way Escr�ow $
Park Fee $
Sewer Main Qlazge $
•r
• �� •t�. .
i
CITY USE �II,Y
Fee Sdzedule on Reverse Side
$.50/$1,000 Valuation
$600 per SAC Unit
Alt. "A" or A].t. "B" Above
Fee Detezmi�ed bY �3��'�9
Agreement Neoessary [ ) Nat N�saxy [ ]
�6�'
��
� �j0"1�
���
��Y
3� u v
:�1 � � � • :r�'� � " �" : �:tr� f
The Chief Building Offici.al shall, before issuing permits for the erec�tion of any
build.irg or stnicture, or for a� addition to ariy existirx3 buildir� or stxucture, or
for any alteration or rep�ir to a�ny existir�g building or sttucture, upcan application
therefore, r�+eqizi.re the payment by ti�e applicant for ��r++;t of fees to the anaw�t
herein below set forth ar�d in the nanner herein provided to-wit:
Z�►TAL VALIJE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
Sioo,00l to SSOO,000
���
$15 (Mininnm� Fee is $15 plus surrharge)
$15 for fiYSt $500 plus $2 for each additioa�al $100 or
fraction thereof, t,o ar�d includi.ng $2, 000
$45 for fixst $2,000 plus $9 for each additiolzal $1,000
or fraction ther�of, to and includirx3 $25,000
$252 for first $25,000 plus $6.50 for each additic�nal. $1,000
or fraction thereof, to ar�d includir,g $50, 000
$414.50 for fixst $50,000 plus $4.50 for each 8dditianal
$1,000 or fraction theraof, to aryd including $100,000
$639.50 for first $100,000 plus $3.50 for each additiaa�al
$1,000 or fraction thereof, to ar� including $500,000
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and ir�cludirg $1,000,000
$2,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional
$1,000 or fraction thereof
Dtt1�EWPiY L1�PRESSIO�T FSC�O�W
(Cbncrete Curb Streets Only)
Alterna'te "A"; Removal and replacem�.nt of curb and gutter an2y - Driveway width plus
6 feet t]mes $13.50.
Alternate "B" : Removal a�x.i replao�+ment of curb and gutter and instal]. a 3 foat wide
approach with 6 inch depth - Drivetiray width plus 6 feet times $15.75.
`�/���y �+_ M !;, �I' ��.11���: M •;,
Permits for oonst.ruction will be issued a minin�nn of 24 hwrs fram the time of
applicatioa� to allvw for proper review of the proposed structiire at�d of the
vonstnictio� site.
A Certificate of S�rvey of the lot, shcxaing the location of the fau�datiaa� � it has
it has been vorti�tructed will be r+equired before proceeding with the framirg.
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MEMORANDUM
PLAS�TNING DIVISION
DATE: March 19, 1997
TO: FILE
FROM: Michele McPherson, Planning Assistant
SUBJECT: Nonconforming Properties Adjacent to East River Road
As a result of Anoka County acquiring additional right-of-way for expansion of East
River Road, this properly was rendered nonconforming. Please refer to the attached
chart which indicates the extent of the nonconformity.
MM:Is
M-97-137
EAST RIVER ROAD PROPERTIES AFFECTED BY ANOKA COUNTY RIGHT OF WAY
ACQU1S1T10N
ADDRESS EXISTING NEW REQUIRED SETBACK CONFORMING
USE SETBACK SETBACK SETBACK TYPE
7845 East 97.02 ft 89.1 ft 35 ft front yard yes
River Road
apartments
Apartment 46 ft 38.28 ft 35 ft front yard yes
garage
321 79"' Ave. 53 ft 36.3 ft 35 ft front yard yes
apartment
7948 East 32.34 ft 17.49 ft 17.5 ft side comer yes
River Road
132 28.38 ft 27.Ofi ft 17.5 ft side comer yes
Stonybrook
7950 East 34.65 ft 28.7 ft 17.5 ft side comer yes
River Road
Garage north 24.75 ft 23.76 ft 35 ft front yard no, before and
of above after
8051 East 41.91 ft 30.36 ft �5 ft front yard no, after
River Road
305 Liberly 93.06 ft 72.93 ft 17.5 ft side comer yes
440 Ely Street 79.2ft 61.38 ft 17.5 ft side comer yes
8161 Fairmont 93.39 ft 65.01 ft 35 ft front yard yes �
Circle
450 Hugo 73.92 ft 43.89 ft 17.5 ft side comer yes
8191 East 71.28 ft 40.92 ft 35 ft front yard yes
River Road
500 {ronton 55.11 ft: 31.15 ft 35 ft front yard no; after
97 Craig Way 47.5 ft 23.1 ft`- 35 ft.- front yard -, no, after
7680 East 37.95 ft 13.5 ft 17.5 ft side comer no, after
River Road 38.94 ft 23.76 ft 35 ft front
119 Craig Way 63.69 ft 40.92 ft 17.5 ft side comer yes
50.82 36.3 ft 35 ft front
7942 East 49.5 ft 33.3 ft 35 ft front yard no, after
River Road '
8080 East 58.74 ft 33.9 ft 35 ft front yard no, after
River Road
8100 East 50.16 ft 50.16 ft 35 ft front yard yes
River Road � .
Laundromat 31.68 ft 1.65 ft 35 ft front yard no, after
499 Glencoe 38.28 ft 8.58 ft 35 ft front yard no, after
ADDRESS EXISTiNG NEW REQUIRED SETBACK CONFflRMING
USE SETBACK SETBACK SETBACK TYPE
8164 East 43.56 ft 9 4.19ft 35 ft front yard no, after
River Road
8180 East 37.95 ft 8.58 ft 17.5 ft side comer no, after
River Road , ,
8182 East 38.28 ft 14.19 ft 17.5 ft side oomer no, after
River Road
8184 East 38.28 ft 14.52 ft 35 ft front yard no, after
River Road
8200 East 34.98 ft 9.9 ft 17.5 ft side comer no, before and
River Road after
510 Janesville 38.61 ft 12.54 ft 17.� ft side c:omer no, after
421 /432 39.27 ft 8.58 ft 17.5 ft side comer no, after
Ironton
461 Hugo 33.66 ft 3.63 ft 17.5 ft side comer no, after
Street
8114 Fairmont 36.96 ft 8.58 ft '17.5 ft side comer no, after
Circle
8902 Fairmont 33.99 ft 5.61 ft 17.5 ft side comer no, before and
Circle 33.99 ft 17. � 6 ft 35 ft front after
8104 Fairmont 35.31 ft 26.73 ft 35 ft ftont no, after
Circle
8027 Fairmont 21.45 ft 9.9 ft_ 17.5 fi side comer no, after
Circle 46.53 ft 17.16 ft 35 ft front
7899 East 52.8 ft 33 ft. 35 ft front no, after
River Road 0 ft 20 ft hardsurface
7663 East 64.35 ft 34.65 ft 35 ft front : no, after
River Road .
Fire Station 29.7 ft�. O ft �';:;�; 35 ft ;� , fron# no, before and
_ after
7709 East 80.19 ft� 62.37 ft: 35 ft fron# yes
River Road
8061 Ea�t 90.09 ft 78.54 ft 35 ft front yes
River Road
� -� SU9JECr ..
c�ty of Fridley
AT TNE TOP OF TME TWINS g � I L D I N G P E R M I T
r
� �
� �
COMMUNITY OEVELOPMENT DIV.
i ♦V'�'��� , .
r � � PROTECTIVE INSPECTION SEC.
� ,
� � �"'1 � CISY MALL FRIDLE� SS�32 NUMBEP pEV
�""�' �'' 612-571-3450 9t0-Ft5
J08 AODRESS 510 Janesville Street NE
t LEGAL �OT NO. BIOCK TRACT OR AODITION
DESCN. 1,2,3,4 F Riverview Heights
Y PROPERTY OWNEFi MAIL ADOR�S$
t3C$X��B1III$�t AIlO1C1 COLIl'lty
3 CONTqACTOR MAIL ADDRESS
R �, M Associates 3482 Au�er Ave. V�Fhite Bear
� ARCHITECT OR DESIGNER MAtL ADORESS
5 ENGINEER MAIL ADDfiESS
6 USE OF BUIIOING
Residential
7 CLASS OF WOFK
9/9/99
21P
P►GE O:
� �
PHONE
-770-932
PMONE
PHONE
�� NO.
30190
T NO.
� ` /
,PVnOVED Br
SEE ATTACNEO
SNEET
LICENSE NO
4391
LICENSE NO.
LICENSE NO
O NEW O ADDITION 0 ALTERATIQN F9x REPAIR O MOVE O fiEMOVE
8 DESCRIBE WORK
Reroof 1/2 of house (5 Sq) Tear-off
9 CHANGE OF USE FROM
STIPULATIONS
TO
Underlayment must comply with the State Building Code.
TVPE OF CO
SEPARATE PERMITS AqE REOUIflEO FOF EIECTRICAI, PLUMBING. HEATING.
VENTILATING OR AIR CONOITIONING
� THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING
AUTHOR12ED IS NOT COMMENCED V�1ITHIN BO DAYS. OR IF CONS7RUCTION
OR WORK IS SUSPENOED OR ABANDONEO FOR A PERIOD OF 120 DAYS A7
ANV TIME AFTER WORK IS COMMENCED. NO OWLG.
1 HEREBY CERTIFV THAT I MAVE REAO AND EXAMIN�D THIS APPLICATION
ANO KNOW TME SAME TO BE TRUE AND CORiiECT. ALL PROVISIONS OF �AWS VALUATION
AND OROINANCES GOVEFNING TMIS TVPE OF WpRK WI�� BE COMPl1E0
WITM WMETMER SPECIFIED HEREIN OF NOT. TNE GRAN7ING OF A PERMIT $437
OOES NOT PRESUME TO GIVE AUTHOqITY TO VIOLATE OR CANCEL THE pEqM17fEE
PROVISIONS Of ANV OTHER STATE OR LOGAL LAW REGULATING CON-
STRUCTIO R TME PERFORMANCE Of CONSTRUCTION .�23.SO
PLAN GHEC
Lice
S�GN♦ RE FCON'AACTOpOp�UTwOpIZEDeGENT ID�Tpi
/
S�GNntuaEO�OwaEQ��FOw. QBwIDEA� �O�iE� � � � Aip�
IST. OCCUPANCY GROUP
S�.FT
UNITS OfFSTP
STALLS
SURTA)
.50
SAC CM
Fire
fE TOTAII
SC '5.0 29.
;N ROP� ALIDATED IS
OCCUPANCVLOAD
CU FT.
T PARKING
(GAAAGES
.43
l ��
_ ... .,. .,. __ .. : ':-. .: .,.,, ..... . : . . . . : . � -- ir �� . . ...,�.�.� ..:.:.,.,;, .,.,.... .:.:.,.:.
NEV� - ! 1
ADDN �)
ALTER ( (
CITY OF FRIDLEY
SINGL� FAMII.Y AND DUPLEXES R-1 AND R-2 l
Building Permit Application
ConstructionAddress: .� /�
�
Effective 8/ 1 /95
. C�O �
o� ,� �Q
� `° )
Legai Description: —
Owner Name Address: �}�p�a, rq.�,�,� Tel. # l,2-- 8' +�'�7-3 �
Contractor: -t-/✓1 Soc� _ MN LICENSE # y3
Address:�i � Tel. # SI r -� 322
Attach to this application, a Certificate of Survey of the �
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IMPROVEMENT
Length � Width Height
Length Width Height
Len Wid Hgt/ ound _
�' U o� ��us�
�
Sq. Ft.
Sq. Ft.
Sq. Ft.
—�—
.�5� _ � �.��e �
Comer Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks
Type of Construction: �,� Estimated Cost: $ _
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + Ft = Ft x$ _�
DATE: �! ���_ APPLICANT: Tel. #
Pemut Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
���. s o
$ .�
$ �D
$
$ S-Oo
$
$
$
$
$ ��' .�
C'ITY USE ONLY
�ee Sche�ule on Reverse Side
.001 of Permit V aluation (1 i l Oth �)
$.50/$1,000 Valuation
$850 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary ( ) Not Necessary [ ]
sue�ec* P,�Aff"NO: -,
c�ty of Fridley l�3 3 3 7 7
AT TME TOP OF TME TWINS g U i L D i N G P E R M I T �"'
f
� ` RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV. �
r � v � PROTECTIVE INSPECTION SEC.
� �
� � �"'1 � CITY NALL FRIOLE� SSIJ2 NuMBER pEV DATE v�GE Oi •vvnOVEO Br
�"""'�� ��� 763-571-3450 910-F15 3/ 18 / 03 / /
JOB ADDRESS 510 Janesville Street NE
t LEGAL �OT NO. BLOCK TiiACT OR ADDITION SEE ATTACHED
oescA. 1, 2, 3, 4 F Riverview Heights SMEET
2 PiiOPERTV OWNER MAIL AUDRESS 21P PMONE
Anoka County
7 CON7qACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
MN Su erior Exteriors 1048 Pa ne Ave, St Paul, MN 55101 651-774-5582 20219220
1 ApCHITECT OR OESIGNER MAIL AODqESS ZIP PMONE LICENSE NO.
5 ENGINEER MAIL ADDFiESS ZIP pHONE IICENSE NO
6 USE OF BUIIDING
Residential
7 CIASS OF WORK
O NEW ❑ AODITION O ALTERATION �1 REPAIR O MOVE O REMOVE
8 OESCRIBE WORK
Reroof House & Gara e 20
9 CHANGEOFUSEfROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
Prov�de smoke detectors in all sleeping rooms and on a�l levels of the dwelling
per Section 310.9.1.2 of the 1997 Uniform Buiiding Code. Cau1k and flash all
exter�or openings.
TYPEOFCONST. OCCUPANCVGROUP OCCUPANCV�OAD
SEPARATE PERMITS ARE REOUIRED FOR EIECTRICAL, PIUMBING, MEATING.
VEN7ILATING OR AIR CONDITIONING.
TMIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSTRUCTION 20NING SQ. fT CU iT
AUTHOR12ED IS NOT COMMENCED WITMIN 60 OAYS, OF If CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED fOF A PERIOD OF 120 OAYS AT
ANV TIME AfTER WOFK IS COMMENCED. NO DWIG. UNITS OfiSTREET PARKtNG
I HEREBV CEFTtfV THAT I MAVE REAO ANO EXAMINEO THIS APPLICATION 1 STA�LS GARAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS VAIUATION SURTAX
ANO OROINANCES GOVEFNING TNIS TVPE Of WORK WILL 9E COMPLIED
WITM WNETMER SPECIfIED HEREIN OA NOT 7ME GRANTING Of A PERMIT $11,OLS �S.SI
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OF CANCEL THE pEqM1T FEE � SAC CHARGE
?:iOVISIONS OF ANY OTMER STATE OR LOCAL lAW REGUTATING CON• �2O9.ZS Fire SC �ZL.OI
STRUCTION OR TME PERFORMANCE Of CONSTRUCTION
��� / / �L/ ;//� PLAN CMECK FEE TOTAL FEE
/ /' /1 �/
��,-��� ` 'cens SC $5.00 $230.77
S�GNITUAEOFCON"F4�TOQOQ�U OQiZED�GENi �D�rE� W N PROPEpIV VALIOATED THIS IS VO PEp iT
° � �.p D'�
S�GN4TUQEO�OWNEQ���OwNEpBU��DEA� �O�iE� Bl G��HS �i�TE
NEW
ADDN
ALTER
[] CITY OF FRIDLEY Effective 1/1/2003
[] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
[) SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-4287 Fax
BUILDING PERMIT APPLICATION
Construction Address: .�'lD � �- /V �
Legal Description: "
Owner Name & Address: �r�m � � Tel. #
Contractor: �y ���^� ��- ����� MN LICENSE # a?O� qo�� d
Address: l0 �1 �" /��yyt- ��f- S1'. ��'l i✓ Tel. # ri�'L'77Y-SS k�.
�IVING AREA:
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.
GARAGE AREA: Length
Width Height Sq. Ft.
DECK AREA: Length Width HgUGround Sq. Ft.
OTHER: R.E�42o� 1-�� tF �•�/t•a9s�- ca?Dser� --T£.9� •�, A%31�r�•
/:zG� �� L/d�v� � i Y tl 'l� .../ O,s� g'�m0 "s;
Construction Type: Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: 8' m APPLICANT: G✓.c.��:��Z� Tel. #(03!' �!'�'' 4'YO �
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763�71-1287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
$ �2�9. �?�°'
$ I l. L�/
$ � �/
$
$ � Od
$
$
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th°r6)
$.50/$1,000 Valuation
$1275 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [] Not Necessary []
TOTAL $ ��• / / STIPU�ATIONS�
._
Building BUILDING Permit rlo. �)Uq-�(��(p
Inspections RESIDENTIAL APPLICATION Received By: �'Yl�1G
763-572-3604 CITY OF FRIDLEY vac� '�: ��� 2 2 200
763-502-4977 FAX er•r•�crive i-�-os
DA7C �'�1 I� U� YUUR E-MAIL ADDRF.SS j')'1i C I'1 P, �' i)1 '�'7_P. Y1 C�� Px( P. ! rvC��-i n p i, ►'Yi • Y) �. i'
SITG ADDRESS �� (} ,�(i Y1 P S�i I � �(_' S i' i�i � ��
'1'I�IIS APPLICANT IS: ❑ OWNF,R �CON'fRAC'POR
PROPERTY OWNER/ NAME: N{a�ZY U Yl O r1 qe r�
TENANT ADDRESS: S I(1 , iC� h C 5 V i�� C. S�• i� � C[TY Fr i cl le .� STATE M N 7,ip `'S �.3 •�
PHONE:___`ilo�' �'J"7� � C.j"`)S$
NAME: - C �. • n C
CONTRACTOR AD�RGSS: �lO 1 W• Mf1 Yl Q 10 }� JQ�f- CITY �oKIA S"1'A'1'EMI�I Z[p J5�03
SUBMIT A COPY �1� PHONE _�710 3 • �i 12 � 4�� -I PAX -1 ln 3 � -1 i � ' � �S � S
XOUR S1'A'['E LICENSL'
srnr�c L�csNSB a�01 lp � t c3 $ EXP DATG 3• 31 � O�i
PRUPERTY TYPE srN�LE FAMII.Y/NF.W COtVSTRUCTION s[zc
� TWO C'AMILYMEW CONSTRUCI'ION S"I'ORIES
PERMIT TYPE � ADDITION ❑ GARAGF./SI�IED O WItJbOWS
O BASEMF.N'1' FINISI•1 ❑ ROOP Q DRAIN "Cli.E
O UECK � Y�$tDINC ❑ OTHER
�d`SWIMM3tJG•POOL
TYPE OF WORK: O NEW I�IOME COIJSTRUCTION � ADDI'f10N
MAINTGNANCPJREPAtR O REMOUEI.ING
DL•SCRIHE WORK E3GING UONF: (JQY�t'i UI S� Cj � rtq YC�c.1�Y'
S12EOF1MPROVEMI:N'C LGNG'i'H WID7'H HEIGHT S FT
R4QfIlVG C] HOUSG ONLY IIASEMENT REMODELING SUBM]T:
NUMBGR Of SQUARGS ❑ IiOUSB & GARAGG i. Existing Floor Plan
GARAGF',S ❑ ATTACHED GARAGC 2. Proposed Aoor plan
PROPOSGD S1ZG: (7 nE'[ACIiED GARAGE 3. l.isi of structural members to be used
PROPUSGD HEIGH7':
SIDINC POR NEW CONS'I'RUCTION 1NCLUDING DECKS,
�T� � ADDtTtONS_ & PORCHES SUBMIT:
Y ❑Sofiit 1. Site PlanfSurvey slwwing the existi� structums
❑ Aluminum D Trim
Q Other ❑ Tascia and proposed project.
WtNAO'VVS 2. Two scts oFconswction plans
` 3. Energy Caiculations
IN EX15TiNGaPENiNCS OYes C]No LOCA"I'ION OP WiNpOWS
OR FOR N�W OPENII�GS-DF.SCRIBI's SIZL OF
OP£iV[NG CHANGGS &
7YPC OC W INJ)OW 'i0 F3F: INS"fA1.I.k3D NUMf3LR OF WINDOWS
ALt, FEES ARE BASED ON VAI.UA'1'ION,INCLUDING TI�iE COST OF LABOR AND MATERiAI,S:
/:� r!1 U7 ��'I
Permit Fee
Plan Review
Fire Surchar�e
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Controt
Park Fee
Sewer Main Charge
Total Due
THE 1997 UBC FEE SCIiEDULE)
OCCUPANCY
�3 � 5� See Back Page for Fee Schedute
$ � 65% of Building Permit Fee
$ .001 times the total job valuation
$ .0005 x Permit Valuation Minimum $.50
$ • .��` $5.00 (State Licensed Residential Contractors)
$ $1825 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$21=$
$ $450 Conservation Plan Revisw
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary { }
$ ,� Make checks nav�ble to: Citv of Fridlev Attach
THIS IS AN APP[.ICATION FOR A PF:RM!"1'-N07' VALID UN77L PROCES3F.D
[ hereby apply for a building permit and I ncknowledge ihat lhe information above is complete and accurate; that the work will be in conformance with the ordinances and codes
of the City of Fridley and with the Minnesota Construction Codes; [hat [ understand this is not a permit but only an apPlication for e permit and work is not to start without a
pertnit on site; thal the work will be in accord ce with t e approoe pl8n in the case of all work which requires review and approval of plans.
SIGNATURE �PP�ANT � PRINT NAME �vi i ChC' 41 � G� ti_e t-� DATE � 12 � I O�
� • � : �ii.'J1�►1` � •
PLEASE NOT�S�EPARATE PERMITS ARE REQUIRED FOR PLUMBING. ELECTRICAL AND MECHAMCAL WORK