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AF - 47608� � , . City of Fridley, Minn. BUILDING PERMIT ,�.�,� ,� � �� N° 7375 Date: _�_.��_r..._...�r._...�.L...._ ____ , , ..__..._..._._...._._..__.__ Owner: l.��a�� . �� Buflder . .. Address___..._._._..�._._ ...,.__�_..._.._..�_..._._..... Addreas _._._ ..._._�_.�_._.-•-._.._.._.._.._ _..._. . :�� . No. SE.� �..�_. Street �� Lot Lot.'��.. "' ... .11Block . Addition or Sub-Divisfon . ----- - �'� ' . .__._.__. ._._.._.. __.-- �• /' / Corner Lot _.___.._..._.__ Inaide Lot ._._....��_�.__ Setback -�.,c:,l_..----.__.._ Sideyard .--.,�1� ___ _.L._�..— Sewer Elevati� �c.r�._!_�_�%� _... _..._.�.__ �� IIevation _. � d- �._� yT,� � of /�o 0 9 ir�le �, DESCRIPTION OF BUILDING T V . _ Front _..��° Depth __.� r! Height ._„�l_ Sq. F'� �� Cu. FL l�U� ._. . . .�... t __,�� Depth _.�� eight ._.�.� � Sq. Ft. �.�..� Cu. P't. .cJ �! �- � D �pe of nstruction _ .._. .. . . .__ Es� cost ��„_Q�_..�ibe cosnpletsa _..._.. Ea consideration of the issuance to me of a permit to construct the building deecribed above, I agree to do th� proposed work in accordance with the descriptioa above set forth in compliance with all pravisions o! ordinances of the dty of Fridley. � ^ � r /�/ �--�� pr In comsfderation o! the payment of a fee of �. � perrnit is hereby graated to._.._. to construct the buiiding or addition as described above. This permit is granted tip� the expre�ss condition that the person to whom it is granted and his agents, employees and worlunen, in all wark done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances a� Fridley, Minnesota regarding lceation, construction, alteration, maintenance, repair and moving of buildin�s �� dty limits and this permit may be revoked at any time upon vio� n of any of the provisioas of said Buildia8 Inspecta� NOTICE: ihis p�rmit doa net eowr th� eo��rueNoe, tnM�lidia� fer wtrtny. Plusbh�W Ya MNin�, swK er w�hr. i� �on te sN �h� doiWiaa Intp�eloe for ap�wh p�nails for 1h�» ItNns. .. � -•� SUBJECT City of Fridley °_ 17 2 7 b'� AT THE TOP OF THE TWINS g U I L D I N G P E R M I �r � R � . � • COMMUiJITY DEVELOPMENT DIV. ' j b' - // r � � PROTECTIVE INSPECTION SEC. Q� � � � � �� A� /'��1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY i.��J\•/ �.J 612-571-3450 g10-F15 10/5/83 / / JOB AODRESS 654 Janesville Street N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oESCR. 38,39,40 Q Riverview Heights SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Rudy Kalan 654 Janesville Street N.E. 3 CONTRACTOR MAI� AODRESS ZIP PHONE IICENSE NO. Richard Hastings Contr. 6331 Riverv iew Terrace N.E. 574-9966 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING Residentidl 7 CLASS OF WORK ❑ NEW ❑ ADDITION �1 ALTERATION O REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Reroof Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd layex' but not 3zd. Install ridged galvanized valleys. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. �Sphdlt THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 GRANTING OF A PERMIT $l12OO $.6O 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- STRUCTION OR THE PEAFORMANCE OF CONSTRUCTION. y�2O. SO PLAN CHECK FEE TOTAL fEE ' �_ fb • - .,,� $21.10 SIGNATUREOFCONTRACTORORAUTH ZEOnGENT oAi i WHEN PROPERL ALIDATED THIS IS YOUR PERMIT � ro � SiGNATURE OF OWNER iIF OWNER BUILDER� iDATEI BLDG iNSP pTE � CITY OF FRIOLCY . Effective Auq. 1, 1981 /►('PLIC/1TIQ1 FO(t 1',CSIDLi�TIP,� t3UlLO1t�G Pc('�iITS (I�ch•�, Alteratiuns, Additions, or Rc�airs) Ot��NER: _ �u�y iCAL�� t3UILDER: _ I��c%a�p I�AS�I<<�ci6S ADDRESS: _ 6 S5l �'A,ntE s v��LL � IIDDRCSS: C 33 � ?��, �� c2 �� r;.,� �'FQ TEL K0: TEL 110: S"�� 99�',�` Construction Location STJiT�T 1J0 : 6� STJ2EF T: ��N�Sc��` L C l_ L07': BLOCX : ADAITIO:i : Corncr Lot: Insidc Lct: , Setback: Sideyazds: Ap�lic�-tnt attach to tl�is form ta.�o Certificates of SUrvcy of lot anci pzoposed building location c]rawn on certifirates to scale. DESCRIPTlO�� OF C0�lST��JCTION � FXOnt: Depth: Height: Squarc Feet: Oubic Fcet: . Front: Depth: Nefght: Square Fe�t: CUbic Teetz 'a7�pe of Co;a�truction: -C-�-F C,�" Zb Be Cbr.:plcted: /a�3 o�_j Estimated Cost: $ �Z O O Alt. A Al t. B Proposed Drivc��ay Sr'idth If New Opening Is Desired: $ $ . S�� PEVF.R;� SIDL OF S}IELT 9iie unclersianed hereb:� m�l;c� ��p1ic�lticn for a per�sit fcr the �:ork herein specified, agreein3 to cb .all �ork ir, strict accordsnce �ith the Ci�y of Pridley Ordinances a�id zuli»�� of the Department of Bui2dings, and hereby declares th��t all the facts and reprecc� �itiens stated �n this applic�tion are true and cosrect. . D: �: /o, S /t�3 slc�rnzvr� : SLiI�u la tions : �'�o.s� .�� ' . � � � - - - a 0 ,.�� MQUSE HEATING TES? RECORD ADDRESS _ �_�Z ` �� AP7. FLOaR CIT7 �UdURB OCCUPANT �'��'�G—+'� OrrNER HEAT LOSS DATE NTG IN T, l— �� SOLD 87 ��—Q—��--= IHSTALLED 8Y El�e�rical Mre�k Br �s lin� By TYPE OF HEAT GA FA H1M STEAM _SPACE HTR. UNIT HTFt. OTNER ��`��.� N MAKE � AIAKE MoJ�I /V•T "��'=�� Mod.l s«,a� L-Ci'�'3Go2�C�"j9_S' Mex. I tNPUT ��.T,n�x� - IAAKE bled�l / CONTROLS THERMOSTAT G� H.o� PI„� Velv• � � 3�£' L � nu e L'/ c Limit S�n�na � fon S�Hinq �i Pilot Yyp� . N�� Pilet A1ek• �/� Pilot ►dod�l _.�:.L°- Pilot Timin� .3�"�"�'�'�� L.w. Cv� Of{ f Pr��sw• � � � P�re�nf COZ � �nyu► CfH � Pere�nt 0� � Swek 7�mp. 3 j� PMernr CO COHYERSION OF BI:RNER {TU Rotiny OF FURNACE• /L' �t V�nt Si:• 4l KIND OF LINER SIZE NONE Oroh Nood R�yvlator Filr«s Si:• ��'y ►�un�r Q�i�nn�y Lotatien Inaid+�Ovrtid• C3,�e,n.y Gn.r�.ctio� �'�'�'G' Spillaqe � Smek� Boe+b ✓� w��9 t� aas, ✓ r..� To, v" Do« Pr�asur• � liqhlin9 !�e!: . �ot� Teat�d ___�_- '�-`� 9' 4 GoTPany T.,ri�q Nonw o( T•s�« Certificate of Compentency_ # rr�o CiTY O�.FRiDLEYtNSPECTIQN DIV. Effective On January 1, 1993 643t UMversityAveNE F�idiey, MN 55432 APPLtCAT10N FQR POWER PLANTS AND HEATING, COOLING, VENT!lATION, 512-3604 REFRIGERATION P,ND AiR CONDITIONING SYSTEMS ANp QEVICES i . L i Residentiaf Fumace Shell and Duct Work, Burner – Also Rep{acement Furnace Gas Piping (Needed with new furnace) Gas Range Gas Drye� *Air Conditioning – Atl Sizes All Others/Repairs 8� Alterations (LIST ON BACtq 1�0 of Value of Apptiance or Work Ccmmetciat/Industrial 1°/a of Vafug of RApliance or Work Rate �.30,.Od � $ 10.00 $ 10.00 $10.OFJ $10.0� State Surcharge TOTAL F�E Pi,US THE S 50 3TATE SUEiCHARGE REINSPECTION FEE g30.00 ,*Air Conditioners can not be placed in a side yard without written pertnission irom adJcining property owner. JOB ADDRESS�p�y- a.,�/� 1/i`!� �� The undersigned hereby makes appiication for a permii for the work herein TO '�� specified agreeing to do aH work in strict accordance with the City Codes and culings oi the Building Division, and hereby declares that all the facts and � representations stated in this application are true and correct. —�--o2�P ,199� $ � OWNER ��1.(��I ,U� /1 Caf �f � �� e – 6 � � � $ $ $ BUtLDING USED AS ESTIMAiED COST �D�S� DO PERMIT NO. o�/ DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating nits Circle One (Steam) (Hot Wa.t,e�rj arm Air) Trade Name m G-k�v Size No.___�� 81�1_ ZS� boc� HP EDR � $ Fuel N:p�#- Aa Total Connected Load � ',!'�;�, �i � � �'Vr/ � V � �'� 1� V Burner Trade Name Size No. � BTU , HP EDR HEA App�oved By . �75�– ��44�0 Raugh–In Date Fina1 Date F1Ll OUT BACK SIDE FOR STACK VERIFlCATION ON REPLACEMENT FURNACE sue�ecT PE c�ty of Fridley ` AT TME TOP OF THE TWINS g U I L D I N G P E R M I T � O O Z r ; ;, IPT � ; y �� COMMUNITY DEVELOPMENT OIV. f � � Pq07EC71VE INS�EC710N SEC. ��!�� '�'1 � CITY NA�L FRIOLEY 551�2 NUMBEA REV D�TE v�GE Oi �PVROvEO !r �----� • •,' 612-571-3450 9t0-Ft5 g�4�gg � � JOB ADORESS 654 Janesville Str e t LEGAL ��T NO. BLOCK TfiACT Op ADOITION SEE ATTACNEO oescR. 38 39 40 River i w 1 SNEET 2 PHOPERTY OWNER MAIL ADDRESS ZIP PHONE Rudol h Carol Kalan 3 CONTRAC70R MAIL ADOAESS ZIP PHONE LICENSE NO Owner t ARCH17EC7 OR OESIGNER MAIL ADORESS ZIP PMONE UCENSE NO. 5 ENGtNEER MAiI ADORESS ZIP PNONE UCENSE NO 8 USE OF BUILDING Residential 7 CIASS OF WORK O NEW � ADDITION ❑ ALTERATION O REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Construction of 14' x 16' livin area includes as;E fire lace-built-in 9 CHANGE OF USE FROM TO STIPULATIONS See stipulatzons on plan TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV LOAO SEPARATE P�RMITS ARE REOUIREO FOR EIECTRICA�, PLUMBING, MEATING, VEN71�A71NG OFt AI{7 COND1710NING THtS PERMIT BECOMES NULL AND VOIO If WORK Ofi CONSTRUCTION ZpNING SO. fT CU FT. AUTHORIZED IS NOT COMMENCED WITNIN 60 DAYS, OR IF CONSTRUCTION OA WORK IS SUSPENOED Ofi ABANOONED fOR A PERIOD Of 120 OAVS AT ANV TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OfFSTHEET PAqKING I HEREBY CERTIfV THAT I HAVE READ ANO EXAMINEO TNIS APPLICA710N S7ALLS GAAAGES ANO KNOW TME SAME TO BE TRUE ANO CORRECT. ALl PFOVISIONS Of �AWS VALUATION SURTAX AND OROINANCES GOVERNING THIS TYPE OF WORK WILL 8E COMPLIEO WITM WMETHER SPECIFIE� MEREIN OFi NOT. THE GRANTING Of A PERMIT IS OOO %. SO DOES NOT PRESUME TO GIVE AUTMOR�TY TO VIOLATE OR CANCEI TME PEqM1T fEE SAC CMARGE PiiOVISIONS Of ANY OTHER STATE Oii LOCAL lAW REGUTATING CON- STRUCTION OR THE PERFORMANCE Of CONSTRUCTION 251, S Fire SC iS.00 PLAN CN CK FE TOT fEE S�G • qE F ON'aAC�Op OA AUT�OA�ZED �GENT IO�TE, EN RO ALIOA TNIS IS�Y4yR= E� � L � �G T O� NEQ��OWNEiiBU�IOER� �OATE� Bt �ti5� ��tE h NE�J [ ] ~ ADDN ALTER Effective 5/10/99 L � CITY OF FRIDLEY [] SINGLE FAMII,Y AND DUPL�XES R-1 AND R-2 BUII.DING PERMIT APPLICATION Y., ^,; ^J .: �:� ��U� r,� ,� j �� Construction Address: ( S `7� ��v� �� T • ,j�.� � Le al Descri tion: �aT �� - �' g P 3g• yo �,�c = � �v�� `�rs , _. Owner Name & Address: �k �� /�� ca j �,� Tel. # 6� Z��BG • �8 / — � Contractor: _ �x� s�t. MN LICENSE # Address: LIVING AREA: GARAGE AREA: DECK AREA: OTI�R: Tel. # Attach to this applicadon, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT , / Length � Width 16 � Height �' l�T� Sq. Ft.�e� Length Width Height Sq. Ft. Length Width Sq. Ft. Construction Type: ��; �� o,�� Estunated Cost: � %��a Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ - , _7 �� 6�z�7fro •16�v �w� DATE. / �Q9 APPLICANT: �u �� 1 � Tel. # Gi z��d-� � �a B'1 �H�� CITY USE ONLY Permit Fee �s�'O2� , Fee Schedule on Reverse Side Fire Surcharge%�� $ � .001 of Permit Valuation (1/lOth%) State Surcharge %S� $ $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement ivecessary [] Not Necessary [) a . � . TOTAL ' STIPULATIONS: , � , .f�.. Y / 1.. .. ... , . h' `'�� fi r, �. , .. � 7 � �� "� > 'ti# 1 � � � � .?u :. ; r . a a.,� 4,�. ' �, ..;" / ♦ .. ... � � , : . ,. . , �. . ��'� � 'j� �� O�O�' tpMS�N�rta.r�ta R�Cfl�D�i40F n,' ��iCaHT ,�`.s, . ��; ��., .,: . .. . . ,. E{��sr�'��u�iMSry'� as' '`�j NitR R.YiY� . .. , � :. _ �R!'�'�� _ �; � �A ND S�UR �YE YO_R,S , ' ' c R�.� saNO�+oR� ?:,.� ' ' ' �"�` � CIVIL ENOINBiR ` '� ��1+�N� z �:� . !1[OIfTtRiO�YNDtR' �LAYV� .OR� f7AT[� OR tMIN11ifOTA � _ � ';�sTw��NHmj,tso� , �, , � ^ , . , 6� "��` i} � � ` ' lIC[NS[O� �Y.� ORDINANGR Or^ CIT1' O�..MINNLArOLIa ,. _' �� ,�,a�L, : yt: � :.. , . , , . . JAMES<NE ` N . ' '�,�� 326•P,L''YMOUTH BtJ,14DING: ` �: FEO[11A� 6,67_21 � 3� ��; ��SuRV�YOR -= �� , . '� E� iLTM1.MN:G; f�ii {� % . iiENNEPI[+i AT $IXTH • 'MIN4VE/1POLIS 3 MINNB9QTA "� , � ' METROPOLITAN'LAND t tlultiCA4 � �;�a�> � t�.c ~ .�ltili'31tZ►Dl'.� ��1'tl�k�A<<. , � ••g.uRVCrOns. C�TA�l1{M60 Afst ��.�y,"hi�'4Hr��1 A 4 �� + 'i.ilYY��"G�G� S ��.�.,�R� � � � � :: 7D2��1 �n y r+ f� '!:r i a r _ �. �. ��;`�n&W"'y�r� r" �t, a, „ ; .�.�,,, , �,�'� �t * ' -. � �..� a� •—..,.,„ v y "' F,�, A { k k � y;.�� r '.� � ,�. � �1�►� .. ��'�, �� rr� �'�!�;� .F2'�j �.' , ,''. - y , �� L?s� �' {� 2;� r. , ,� 'R� 14 ��' � , . '1��"''F,T_ \gi�.�, � 1 A � �T �� Y i C � � ¢j d 'r ; �� N �� j � ' . ,�;�. t.... r�.t �Y k� lN .' I' I . y rr tK.� Y� � .'f;/'^" . .. + t '�''�* R'�, � - M p . . � , al .' � � f , . �y "�' q .+• z - ..`.> �r• a ; n � : ., j!� , :�f d,y r�„''r� �, t��, �' c � � 1.� � t s �� J s C .;�,, �«a . ; t;;. Q �. r �Y°�.i fi j4`-"' �� ;��;� �' �� ,� . .3'� � .z •(� i <: 2'�'t � �r�7�� r ° y»•y�� . N 5 � � r y+�,'�c.•y J �� T'/� ,��"� . �#'��'i��x� � � �y �"� J. �\ 'V" p��"' �J.w M � � 'e '% `�4:. .e�' r�`i��t � ,Y�y ., � �.'L' .. �, i,' , :� ,�•_s r �: 3 � t �� :�,� ...� ,16 � " � ra � , a i a�,... a . '}AS��h i� �' ��J 7 '��^� ., r : �� . . o,`" � � . � r � � � +"�CS . N �,� F � Y �� z�.' z � '� ,y,;. ' r. � , 1 .4 �a -4r a ' �', . �{ � �� r w �, , r ti � `�` s , -. ,� � .. ` � � }; +'rts;S a n. y, . . ', x�� ,� M r i�� f {d T{ �� '� 1 � , ♦ , - i�� . -..�'� _� � F - . b.� � � . � '� # � . .. . .. .. � ,s , ��;Z'S � �7.� p,. . � � � �`� ,`+ _' r -r l:�'D� � C� rf� ' �� '`. �'�'�""�._ `� ,-�,fl e�.l '�� n� � •1 � ,.�r ; � �� # . ��. . Ci�"` :e Q��e ��o� . �:�, ; , �.� S � �.l • � D �� a. k � ,r ' � „ . ! ',_ �� 1 �� '� � �•. � � � �x�Fiz 1 �t c: .:' .` .� �, � .�� , » ��. . .. y . :�� } is aF trua� and correct re�rer�ent�tion'� o� a�urv'eY � o� - T ._'" �� .,�', . ,ar^�ity tbat �?�3.s � '� ; �'}+�� +,y+�w�w� C _ ' S x � � h4� � � R= � � �/'z*� s Q -� (� �� `M • ��.,� • ' �}�� - y, 1 c } �� '.: t _k < �' 3f �.Mi�� 7� y�39" � �1�0�,�'�1QC+� Mi,� .��YC�G YJ.BW"II��YEi x�- .r t r �'t`�" * r:4 � _ M:� { �.., ;� �"7t,� :4d , � { �; ' , , ,�. *,`: � 3`r '.' � d ��Y i 4 . A ri7. 1964. � ,, , , RC�. .,b,�'� ItiB} "��:8` ��'�; '•d�' �� p � A r i � '`, t; w r ,{ ht�� . , •''' . _ x, e �y � t k'.. . - � ., . . . !�� ± } . #* k a��/` #. � � }�i� ;.i F . � �F �} ��.�' �. Y.�,.n��T;� '. i. � '..� #} : �T t x � i 9 +. �4 P�"-� y, 3 �S.h: 6�, . .. �.x iii�� :• _�/ �''M��' �}r+�M�� "'�' J.�,�'. � � . i .1+4 ��"y �4es$ j� K j . ,}�J }f�/ Y��°� .S. � I 4.. � 4 �� 'VT T j'' '" ��t`4 .�*C 'x+�•� dy' .��n �a ae x �� { , :r r�r. `'!, i -i�Ml.��r�•� .. � ��; � s��1i. �'�,}�' Y.� - . � . . . �.�.y : � r, ...�....,,. . . . . . ,�, .ft y�id�"� ``lr�a �` y .� r�. , �'.�$..�`'�r`�,. ^��' �� , . sua�ecT PERMIT NO. C�cy of Fridley 30243 AT TNE TOP OF 7HE TWINS g U I L D I N G P E R M I T r ; � RECEtPT NQ,, � � • COMMUNI7V DEVELOPMENT OIV. � �/ f � y � PFI0TEC71VE INSPECTION SEC. �,�a 1 . � 3••' � � �""1 � CI?Y HAIL FRIOIE� 55�32 NUMBEA REV O�tE vA�E Os •VVROVEO 8r �""�� '' 612-571-3450 9to-Ft5 9/20/99 / / JOB AOORESS 654 Janesville Street NE t tEGAI LOT N0. BLOCK TRACT OR ADDITION SEE ATTACMEO oesca. 38,39,40 Riverview Hei hts SMEET 2 PROPER7Y OWNER MAIL ADORES$ ZIF PHONE Kalan 3 CON7qAC70R MAIL ADOAESS ZIP PHONE LICENSE NO Owner 1 ARCHITECT Ofi DESIGNER MAIL AOORESS ZIP PHONE LICENSE N0. 5 ENGINEER MAIL ADDRESS ZIP PHONE IICENSE NO 8 USE OF BUILDING Residential 7 CIASS OF WORK O NEW O ADDIT�ON O ALTERATION � REPAIR O MOVE O REMOVE 9 DESCRIBE WORK Reroof house (20 SQ) Tear-off 9 CHANGE OF USE fROM TO STIPULATIONS ihiderlayment must comply with the State Building Code. TYPEOFCONST. OCCUPANCVGROUP OCCUPANCVLOAD SEPARATE PERMITS ARE RE�UIqE� FOF ELECTRICAI. PlUM81NG. NEATING. VEN71LA71NG OR AIR CON01710NING THIS PERMIT 6ECOMES NULL ANO VOIO IF WORK OR CONSTqUCT10N 20NING SQ. FT CU FT AUTMORIZEO IS NOT COMMENCEO WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENOED OR ABANDONED FOH A PERlOD OF 1pp DAYS AT ANV TIME AFTER WORK IS COMMENCED. NO DWLG. UN175 OfFSTqEET PARKING 1 MEREBY CEfiTtFV TMAT 1 MAVE READ ANO EXAMINEO TNIS APP�ICA710N STA�I.S GARAGES ANO KNOW TME SAME TO BE TRUE AND CORRECT. AL4FROVISIONS Of LAWS yq��AT10N SURTA% ANO OROINANCES GOVERNING THIS TVPE Of WORK WILL BE COMPLIEO WITH WHETMEfi SPECIFIEO MEREIN OA NOT. TME GRANTING OF A PERMIT �174H . 8% OOES NOT PRESUME TO GtVE AU7HO�tI7V TO VIOLA7E OR CANCEI 7ME pEqM17 fEE SAC CHARGF PROVISIONS OF ANY OTMER STATE OR IOCAL lAW REGUTATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION �C)�J. IS. ire SC .� .%S PLAN CNECK FEE TOia� FEE Licens $5.00 $70.7 S�GNAT i F .FACTOAOAAUTNOA�ZEOAGENT iO�tE� E PROP ALIDATED S VO PEiiMIT � � HaruaEO�OwHEQ��OwNEQeu��OEp� �O�TEi OG �NSP OLfE NEW,[ ,] �, Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [] SINGLE FAMII�Y AND DUPLEXES R-1 AND R-2 BUII.,DING PERNIIT APPLICATION Construction Address: � -� 7 ��'`��'�� //� �T � �� r """0"( �� Legal Description: Owner Name & Address: Tel. # Contractor: �Gt/J�—� MN LICENS� # - Address: LIVING AREA: GARAGE AREA: DECK AREA: ��'HER: _ Attach to this application, a�Certificate of 3r�rvey:of the �. lot, with the proposed �canstrueti€m drawn o� it to scale - DESCRIPTION 'OF IlVIPitt}�TEMENT Length Width Height Length Width Height Length Width - Hgt/Ground � 1►-.� l £� Ulri tlS �f_ �� Tel. # Sq. Ft. Sq. Ft. Sq. Ft. ��3 ...� k►?� — �9rt, d � Construction Type: � Estimated Cost: $ � �� Driveway C�ub Ciit Width Needed: Ft. + t= Ft x$ _$ � DATE: 91 �� APPLICANT: Tel. #� ��6 - 6d�1 / Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY � $ �� ..� Fee Schedule on Reverse Side .� $ , S .001 of Pernut Valuation (1/lOth%) $ $.50/$1,000 Valuation $ $1050 per SAC Unit $ S d�j $5.00 (State Licensed Residential ,Contraciors).: � . _,.. $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $�,o, �` CITY QF FRIDLEY INSPECTION D1V. 6431 University Ave NE Fridley, MN 55432 572-3604 fl�T,�,�CH� Rosidentiai APPUCATION FOFi POWER PLANTS AND H�ATIIWG, COOLIhIG, VENTILA�'101d, AEFRIGERA710N AND A!R CONDITIONING SYSTEMS A�1� DEVl�ES Furnace Shell and Duct Work, Burner — Alsa Replacement Furnace (Side Vent — Fiil Out Back) Gas Piping (Nesded wlth new fiurnace) Gas Range Gas Dryer *Air Conditioning — Ali Sizes All Others/Repairs & Aiterations (LiST ON BACK) 1% of Value of Appiiance or Work Commerciat/I ndustriai 1.25% of Vatue of Appliance or� Work Rate TOTAL $ 30.00 $ 10,00 $ 10.00 $ 10,00 $ 25,00 State Surcharge TOTAi. FEE $ $ $ $ $_� Effective On March 1, 1996 JOB ADDFIESS �Q J� r�� 5�� fi�j � i'he undersignod hereby makes appiicatian for a permit for the work herein specified agraaing to do all work in strict accordance with the City Codes and ruUngs of the Building Divfsfon, �nd hereby cleclares that aff the facts and representation3 stat�d in thfs application are true and correct. — . _ .l f//� ,199� OWNER � � t�`G � C�,i �� I I�,� II�.� ,%�� BUILDING UuED AS ESTIMATED C�ST bcUZ�� PERMIT N0, %� f�fJ ! : �► • :.:. �: ' _: _: $ No, of Heating Units Clrcle Ono (Steam) (Hot Water} (Warm Air) Trada Name Size No, 6TU HP � EDR $ Fuel ` Total Connected Load $ �, .50 ` Burner Trade Name Size No, ��--� BTU ` HP EDR .� � MINtMUM FEE FC,jR ANY H_ EATt�1C�C(�p, L�P{GNENTII..ATIOH REFRIGERATION/AIR CONDiTiONING PERMIT tS $25 00 PLUS THE S 50 STATE 3URCHARGE REINSP�CTION FEE $42.00/Hr HEATING COMPAN iZ�� 5�� SignQd 8y Tel No. �� 1�`��,L�.. Approved By Hough—In Date Final Date �� *Air Cond+tione�s can not be placed in a side yard without FI�L OUT BACK SIDE F R STACK VERIFICATION ON .� wri en perm(ssion from adjoining property owner, REPLACEMENT FUFiNACE 4 �-�,� �a�, � �o -.�,�� •�°l'� , � '�' �� Building Inspections 763-572-3604 DATE�� StTE ADDRESS d THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOURSTATE LICENSE WITH APPLICATION PERNIIT TYPE TYPE OF WORK: PLUMBING RESIDENTIAL A.PPLICATION CITY OF FR�DLEY YOUR EeM�L ADDRESS ❑ OWNER '�CONTRACTOR Permit No. Received By: �. �" :� i' � A' $TATE LICENSE # Champion EXP DATE - -��40 CI.fY STATE ZIP ADDRESS: PHONE ��n �AAi srr�"°� i t29� - �QGLE FAMILY � ❑ NEW DETAILED DESCRIPTION OF WORK ❑ TWO FAMILY D TOWNHOUSE �'REpLACEtv1ENT PER MS 16B.665 the permit fee is a minimnm of $15.0 fo�e� xcluding the fixtures� (Thisshould reflect on� the cost of labor ) improvemen installation or replacement of a residen i ,T, x.OS� La or cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor __ 1�.� TOTAL FOR PROJECTS WHERE i.ABOR EXCEEDS $500, FEES ARE BASID ON $10.00 PER FIXTIJRE, EXCEPT �`'HE� NOTED. WFIX�RSP i� TIUMBER OF EACH BELOV� FLOOR DRAINS SHOWER — WATER SOFTNHR ($35) _ BATH SINK/LAV '— GAS PIPING (n'�o Crn'�r�� _. Sv`'IMA'IING POOL — BACKFLOW PREV. ($15) BATHTUB '— �TCHEN SINK WATER CLOSET — FOR IRRIGATION CLOTI�S WASHER —" LAUNDRY TRAY �WATER HEATER ($35) OTHER DISHWASHER — WATER METER — �� A I _ _ .�,.�....-- Permit Fee $ TOTAL DUE I� Number of fixtw'es @$10.00 x$10.00 =$_________ .50 Number of fixtures @ $15.00 x $15.00 = $ � I•iumber of fixtures @ $35.00S�te Surcharge = $ .50 Tota1= $�.!� 5 C THIS IS AN APPLICATION FOR A PERMTT-NOT VALID UNTIL PROCESSED that the work will be in I hereby apply for a building pertnit and I acla�owledge that the information above is complete and accurate; �at I understand this is conformance with the ordinanc tion fo �ae ermit d1workFs not o startlw thou a permit; tha the vvorl� �'�'11 be in accordance with the not a permit but only an applica p roval of lans. approved plan in the case of all wark ch re s e�'v and aPP 'P �� C� �� A�� _� �;� �rW� . �'�.�1::��`; �-- SIGNATURE OF APPLICANT +�� "4 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 ��5� � Building BUILDING Permit No.: ��'�- �`, i, I�i1 L' Inspections RESIDENTIAL APPLICATION Received By: •'`�' ?, 763-572-3604 CITY OF FRIDLEY D��.'�'� ' 763-502-4977 FAX EFFECTIVE I-1-2010 DATE � O' �`'�' 1O YOUR E-MAIL ADDRESS SITE ADDRESS S`I G'R °C��7 V�\ `� S�. THIS APPLICANT IS: ❑ OWNER ONTRACTOR PROPERTY OWNER/ NAME: c� C� � C�:O`n TENANT qDDRESS: �S i�G,'Ii °� V� �, �°.7T,__ CITY t STATE�ZIP PHONE: I Z' 7� I" S� L CONTRACTOR NAME: K�f1u�'S[iv1 Ro�'rr`na �S; +n4 SUBMIT A COPY OF STATE LICENSE # zSO� EXP DATE 3' 31'� I� YOUR STATE LICENSE y AND CERTTFICATE OF ADDRESS: �3O f � i��S i � Dr. �� STATE�ZIPSS� INSURANCE p NE � — Z"T�Z FAX �Y3 "' PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ �t1RAGF/SHED ❑ WINDOWS ❑ BASEMENT FINISH �ItOOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑jdEW HOME CONSTRUCTION ❑ ADDITION �MAINTENANCFJREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: GS� — C� Ct-t S� Ca C�-/�2. SIZE OF IMPROVEMENT Z LENGTH WIDTH HEIGHT S FT R FIN ❑ USE ONLY NUMBER OF SQUARES 2� SE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, S� AD ITI ' ❑ Vinyl OSoffit ❑ Aluminum ❑ Trim 1• Site Plan/Survey showing'the existing strucWres ❑ Other 0 Fascia and proposed project 2. Two sets of construction plans WINAOWS 3. Energy Calculations IN EXISTING OPENINGS OYes ONo LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U-VALUE AND OR FOR NEW OPENINGS-DESCRIBE S1ZE OF MANUFACNRE STICKER ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION,INCLUDING THE CUS"1' Vr 1.a�sux alvll niw i r;xiaL�: , THF. 1997 U.S.0 FEE SCHEDULEI TOTAL JOB VALUATION Permit Fee Pian Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Totat Due � %_+� ANCY $ �'� � �,%� See Back Page for Fee Schedule $ 65% of Buiiding Permit Fee $ .001 times the total job valuation $ .0005 x Permit Valuation Minimum $.50 $ ' G' ~ � $5.00 (State Licensed Residential Contractors) $ $2100 per SAC Unit (Plans to MWCC for determination) $ ft+6ft= ftx$24=$ $ $450 Conservation Plan Review $ Fee Determined by Engineering $ Agreement necessary ( ) Non Necessary ( ) $ I D !;� Make checks payable to: City of Fridley Attach THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the 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; that I understand this is not a permit but only an application for a ermit work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all wo w c qu' es review and approval of plans. SIGNATURE OF APPLICANT PRINT NAME ��'sG. �� Ll �S� DATE �G �y �D