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AF - 47888y y sue�ecr PEORM115042 Cit of Fridle AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � R CEIPT NO. � • COMMUNITY DEVELOPMENT DIV. E� ' j L _'��'� . r � ; PROTECTIVE INSPECTION SEC. n`�� ' � 77 4 � /'��1 � CITY HAIL FRIDLEV 55432 NUMBER REV. DATE PACaE OF APPROVED BY >""� � ,�� 612-560-3450 910-F15 12/13/78 � � JOB ADDRESS 6160 Kerry Lane N. E. 1 LEGA� LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ( 2 Heather Hills 3rd Addition SHEET 2 PROPEFITY OWNER MAIL ADDRESS ZIP PHONE 5teve Bertgusain 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Commercial Erectors 5298 Fillmore Street N.E., Fridley 571-8865 4 AFCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL AODRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential � 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK � Construct a 44' x 28' Dwellin and a 24' x 24' Gara e utilitt�s TEIEPMON�. 9 CHANGE QF USE FROM TO REQUlREb ��Y STIPULATIONS provide a hard surface driveway. Provide sod in the front and side yards. Provide a verifying survey before capping. SEWER LOCATION: 9' Southwest of water service. Expose service to establish top of footing elevation. WATER LOCATION: 28.4' East of 10" Cottonwood, 68.7' N.E. of Water serving lot to the south. DRIVEWAY DEPRESSION �sT: N/A gEPERATE PER'.MITS RE(�UIRED FOR V1tiRlNG - HEATING, PLUNIBtNG AND SIGNS. T� G1Y OF fRlptli pp�S • 1dpT GUARANFE: TkE AGCUfU►CY OF tA1Lli' LpUfpNS AND ELEVATtG,� ; � 't1iIS DAi'A IS � �+�,1 ��5 ��Y AN� : _ --' p�SONS ti8�IG � �MOt�D YIAlr �'A# WFOr�TIQN oN niF sn�, SEPAAATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. WOOCI Frc'�[L2 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 �1 1232+36+576 30,832 Total OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS A7 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PAFiKING 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 544�700 yS22.3S DOES NOT PRESUME TO GIVE A HORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIO OF ANY OTHER ST E OR LOCAL LAW REGULATING CON- STR O. HE P: E OF CONSTRUCTION. $�.23. 33 $400. �� PLAN CHECK FEE TOTAL FEE `� 2 $576. 00 SIGNATURE FCONiRACTORORAUTHORIZEDAGENT (DATEI WHEN PROPER Y A D T THIS IS YOUR PERMIT ' 3, , SiGNATURE Of OWNER IIF OWNER BUILDERI IDATEI LDG INSP ' I)ATE ��1ERGY CONS�RVnTION SUPPL�MENT.TO BUILDING PERMIT APPLICATION pI,ANNING AND INSPECTION DEPAIt�'M�NT CITY OF FRIDLEY, MINNESOTA 'I".�is supplement is provided to assist the applicant in computing EXTERIOR ENVELOPE AVEI�AGL "U" FACTOR INF'ORMATION. This information is required so the BUILDING OFFICIAL can determine that submitted plans comply with the ENERGY CONSERVATION DESIGN CRIT�RIA of the ST�TE BUILDING CODE (Section 6000). It is the APPLICANT'S responsibil.ity to accurately compute the data; reflect the proper DESYGN CRITERIA in the plans; submit product specifications, if needed to support the "R" and "U" factors used; and to assure construction is per approved pl.ans. JOB LOCATION: OWNERf CONTRACTOR : (,.,d%j'l /1"/L��Z.�iQl�✓( L ��°" i-4 `�� r � -- ADDRESS : `" 7' CJ ,( �7 `�l�� 5�� PHONE: �� O 0 �� A. Determine the Total F�posed Wall Area as follows: 1. Total wall window area 2. Zbtal door area 3. Total sliding glass door area 4. Tota.l f ireplace wall area 5. Total wall framing area (average .10�) f8��'' 6. Total net wall area above flooz(average 90�s) 7. T�tal rim joist area i�IL� �� Subtotal: Total exposed wall area above floor' 8. Total foundation window area � • g. Total net foundation area above grade � 5ubtotal: Total. exposed foundation area ' ��" --��— �� _� � ,� -- � GRAND TOTAL EXPOSED WALL AREA �J B. Multiply the GRAND TOTAL EXPOSED WALL AF2�A X.17 = C. Determine the Total Exposed Roof/Ceiling Area as follows: 10. Total skylight area ,"�`� 11. Total roof/ceiling f_raming area (10�) �� 3� { �� 12. Total net insulated roof/ceiling area �2 �� GRAND TOTAL EXPGSED ROOF/CEILING AREA �� Multiply the GRAND TOTAL EXPOSED ROOF/CEILING AREA X.05 = s . Item I �� I tem II �', u E. Determine the "U" value af each segment (1-9) and multiply by the area as follows: 1. I J i X I�U11 � S� = ��F � � 2. �CJ - X ,�� . � = tf . �P � � 3. � � X ��U�� t- .� _ _ ,,�� -sa--� ,. 4. � X •��U�� _ . 5, i v r CL _ X ��U�� '� _ 22� - �.4 � 6. �P � � X ��U�� .O�'� _ • � . p-t, �✓ X „U„ , oG / _ _ a. X „U�� _ z 9. X ��,U�� ` . . � '� � 's7L— ADD 1-9 FOR TOTAL WALL SEGMENTS = IT�q III F. Determine the "U" value of each segment (10-12) and multiply by the area as follows: io. �ti�� X �i. x ia. x ��U„ �,U�� U�. � o`�"`� _ �.�- � ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS = ' ZTEM IV S�"� G. If Item III is the same as, or less than Item I, you have met the intent of State Building Code 6006 (c) 2. H. If Item IV is the same as, or less than Item II, you have met the intent of State Building Code 6006 (c) 1. ' . z. Aaa zt�n z �ei � + zt� zz �6 � ^ S�� J. Add Item III ��) �_ + Item IV � Z =�� K. If the sum of Items III and IV are less than Ite�ns I, and II, you have met the intent of the Code for t�otal envelope system. The undersigned, as applicant for a building permit, hereby affirms the above information has been prepared and submitted by himself or under his direction, hereby acknowledges the information to be correct and accurate; and hereby ' presents the information with required plans in support of the building permit application. B1' = DATE: f �/� �/� � � .� . . k ' . . 0 _ CITY OF FIZII)LCY . ° JIPPLICATI01� fOR (t�SIllI=fJTI/1L BUILDIMG PEf�1�1ITS , ' (I�IL"W, �LTLR/17I OfJS, I�UDI T I OlJ�, OR RE('A1 RS ) " �.'i ow��r�: `�;C�.,^�' j�,c.�._.,�(_,�;;��t � � � �1,,�, = � :, � �-� . Aaar�s� : �� , � . f No. ,G/ � ° LOT: � 5treet: BIACY.: ' ' �. r' � :..) ��_ . ' ti �uzLUr•.�z: , _ c �1� 1,� LG-�.� �- �� •� �_ J' �/I /' � � /.,r ) �d � ," . Address : � � �% �i%L�' ,�! Tel. t1o. � �� CORNER LOT: ' INSIDE LOT: v S;sTBACY.: vc�� SIDL'YARD5: f� � � � � Applicani: attach �to L-his form ��o Certificates of Survey of Lot and proposed building locatian dravm on these Certificates. . DESCRI PTIOPd OF BUI LDI �G To Be Used 11s: � � �� Front c � Depth : c�"� � Height : � � Square Feet: Cubic Feet: .� I`xon t : �_�_ Depth : _�`, � � . He ig ht : r� � S uare I'eet: Cubic Feet: q . 3�,.$�� Type of Constructionz �� _ Estimated Cost: $ ,. �� _ � '�►. �o� xb 8e Completed: �� Alt. A Alt. B Proposed Drive�vay Width f New Opening Is Desired � $ $ � (S�� R�VERSE SIDE OF SHEET) The undersigned rereby makes application for a permit for the work herein specified, agreeing to do all ��ork in strict accordance with the City of Fridley Ordin�,nces and rulings of the Department oL• Buildings, and hereby declares that all the facts and representatians stated i�i t}iis application are true and coLrect. See xeverse side £or acld�tlOtl�l infozma-' . DATE: �a SIGNATURE: � �� v Stipulations: �-�y ! U 1�� v,ptk-�,�f� /�U, � P�..�►; �. rZ3,, 33 3c�. 3 -L - 'L'L.3� 5�� n o. o � -�--------�,. �% �t •d � 0 e a , , a s .� ' " . _�oPEw. a �.p � �� —?��+c___44_=__i 23'1- �s �, �,,, ---�-� �_�c __�_ 9$ S(. c. -- ?$ x-�±� '=_! 2.�t ^5�,� �c la, : � 4' 7$�j _C V� r -- 4 x 5= 3G Sr ��e � s t ---_�_t c.. �?r. ---? 5f__Y �V --- 5� (s ----St-'� x/ � s S"� Gt� c.� Q- r: -- -- ------ �'n��.---- 30 $ 3 2 X �L � •�—= � �. � 3 p� �.w►. t -_- __� 3b�'�Z �t P�- z � L��x zs.st = 5')� x �_zv z 9�d.��.. � `� �_2. � c, lC ��/��r � ZZ.3� CItY 0� FRI�LEY AppLfCATfON �OR pLUMBING AND GAS FITTt�VG pERMI'� m >, N 'b o • k a� water uf N N � �� m q � n, w � Heater � s� v ro c m E,.��;° � s� � c 6 a�'i � • s� O � O � .N N�.�i � Q $ U•^I O.0 U N � � U � rroA mro � 3 A w ai w U w� 3 � � � o as lec � i .� � r , �S� � � � � � 2nd 3rd 4 th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: N0. RATE Number Fixtures F�ture Fixture Opening New Fix*_ure, Old Opening Catch Basin Water Heater - to 99,000 BTU 100.000 BTU to 199.000 B2U Water Sof tener New Ground Run Old Building Electric Water Heater GAS FIT'TING FEES: lst 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS f� ALTERATIONS First $100.00 each add. $100.00 oY fractio� �� x S3. C10 x $2. 00 x $2,00 x $5.00 _L x 55.00 x $10. 00 x $7.00 x $5.00 x $5.00 _� x $3,00 x $1.00 x $10.00 ds.aa $2:04 stgte 9ur�hgry� TOTAL FEE REINSPECTION FEE csio.00) TOTAL $��U' S $ S $ �6 $ $ $ $ , Job Address d � Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein speciPied agreeing to do all work in strict accordance with the Citf Codes and rulings of the Department of Buildis�gs, and hereby declares that all the facts and represel�tations stated in this application are true and correct Fridle�� Mn. �.� a� � Q( . 19 �6 OS4NER ��/�� KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD 7r/N� ^� �It 1ILDING PERMIT NO. �J �`t �—PERMZT NO. �C�" _%� �/ , Company Signed Hy mei. No. FtOUGH iNSp. 17ate FINAL INBP. ,�'/2 �i � � / . $ � Q � Date $ $ APPROVAL FOR PERMIT 8 $ . 9 .50 s �so MiNiMUM �'� P'dit ANY f�LUM�3N� p�1tM�T i3 S9.9fi pLU9 $.9tl STA7'� SURCHAf�c� .. � .,. � t �i�" i l�. �v��1 �PPLICATION FQR QaYdER PLANTS AND HEATIfi6, COOLING� VENTILATION, REFRIGERATICN AND �.AIR CONDITIONING $YSTEMS AND DEVICES PARTIAL RATE SCHEDULE ctu�vt� w�axr� aiR: Furnace Shell s Dact Wozk Replace..^ient of Ftirnace Repairs 6 Alteratians-up to $509.00 Regairs s Alterations each add. $500.00 MECfiA!vICAL WAR�1 AIR: � Fv rnace Shell & Duct Work to 100.000 BTiI each add. 50,000 BTU RepYace^�ent of Furnace Repairs � Al:eratioits-up to $500.00 Reraizs s Alterations each add. $500.00 STFAb1 OR liOT WATFR SYSTE.'�1: 8oiler & Lines up to 100.000 BTU each addn. 50,000 BTU Boiler only up to 100,000 STU each a3dn. 50.000 BTU OIL BUR\ER- to 3 gal. per hour each add. 3 qa1. per hour .�- CiAS BUR`ER- fron 100,000 BTU to 199,999 STU (over 199,999 BTU see Fee Schedule) RATE S12.00 7.00 7.00 4.00 $12.00 4.00 7.00 7.00 4.00 TOTAL S S S S $� U Ob 7 S S $ S $12.00 $ 4.00 $ 7.00 $ 6.00 S $io.00 S 10. 00 $ $10.00 $ o� � `�o S GAS FITTING FEES: lst 3 Fix tures x$ 3.00 Additional Fixtures x S 1.00 Gas Range to 199,000 STU x$10.00 AIR CO\DITIOVING � � ' FAN HEATING SYSTE:�SS See Fee Schedule VE\TILATI\G SYSTED4S ALTE�+TIONS $ REPAIRS State Surcharge ' TOTAL FEE PDUGH IrSP. Date FS.*i]1L 2NSP. '��'%c Date JiPP�USiAL F1pR PERMIT �N=I� REINSPECTION FEE I.S10. 00) S 3°° S S_ S S S S $ 50 $�. MiDIIHU:i FEE FOR ANY ifEATZNC PER'�SIT IS S7. SO PLUS $. 50 STATE SURCHARCE , Job Address (� l � � Department of Buildinqs City of Fridley Tel. #571-3450 ,� � '. The undersigned hereby makes application for a permit foz the r+ork hezein specified aqreeing to do all work in strict accozdance with the City C«?es •. and rulings of the Department of Huildings, and hereby declares that a12 the facts and representations stated in this application are true and corzect. Fridley, Minn. � � � . 19� � OWNER ��/G�1`Z..� v KIND OF BUILDING ��L(�/YYL�2 ' � An • USED AS TO BE COMPLETED ABOUT ✓7 � � " � / �c%Op °, � ESTIMATED COST � OLD NEW UILDING PEPMIT NO, PERMIT NO. /� /� . DESCRTPTION OF FURNACEf BUR*IER --�• �S� �-�?r.�c�o HE.RTING oz' POWER PLANTS, Steam, tiot Water Wazm AiY- No..,� G S !C' cS. e� C�o Trade Name � Size No. p� � O G� i tl m c; Capacity 5q. Ft. EDR BTU � Total Connected Load _� r �(% Kind of Fuel � BURNER - Trade Name � � Size No. r} '� �n 6. Q O C� Capacity Sq. Ft. EDR STU FiP Campany c��l�U�� d�Jl�� `%i�� Siqned By f� � ^ • Tel. No. � O 7�� Y� • _ _ _ _ _. _ . . . �..: .. .. . . . �... . .. . ..._ ._. . . .. :... �... M �,.., ,�....�..�,...,...,�w. .' `" ENERGY GONSERVATIOru SLTPPLEMEr?T TJ HFATING PF'RMIT APPLTCATIDN BUI?�DING & SAFFTY �EPARTNF1�tT CITY OF � ~ . DA'['E . �.� � " % �f JOB ADDRESS (' 6� HEATTNG CONTRACTQR : ,.��_`��,� G�, R�iONE �� S�o� � BUILDIPdG CpN?'RACTOR OR Olsnv'�R �%? �e Q�,��Y '`' __ L: �� _ PHOr1F� � � � � ----,..-...,., The basic information belaw must be ascertain�d f.rom the cale�Iations a�d plans submitted by thE contractqr at the time of obtaining a huilding pertnit. 1. Sq. feet of exposed wa11 area above ground. �� x rrufr �� 87 �egree design temp. _ �� 2, Sq. fee� o�' ceil.ing area. ��'S O 7� ��Ii�� .�`S8 % 8% . �� f� ,�. Sq. feet o� basement ��.00r �rea. 3�5~�} � 3 _ �. p Sz� !�. Sq. feet ef waJ,l area below grade. f� 6 d X 6 -- - �?�� . Lin. ft. Q�' �niiltration for Wdos. �g_ g-(.5� g ( l. as ) x 87 _ � � / �--�— 6. �in. f£, of inf'iltration for doors. x (1.08� x($�) � � ��.�5) �' L��g �, Lin. ft. of infiltration for sliding doors. -� � (.75) 'X (1.08) X 87 ' - �I'�3� $, Allcnaance for Kitchen and Bath Fans. , � f Kitchen fans C� 6Ct0 STtI. e2. ((� C� #f ; ( Bath: fans n 20b BTU� ��. �. a Z3 � 9, A1lowanee for Fireplaces. � 2�'� td 32�' n�t�On BTU, ea, „ � .�.� ��t" to G 2" C� 130Q BTL', ea. _ �� 6 � �l �t2" & larger. C� 3,�04 �TU. ea. � : lp, 'iotal BTtT loss for all abo�re i terns. _ ..s`z..�� 4 � X allowable increase of 1�� _ �', S� � O �� To arri�ae at ft�rnace i�lput abr�ve answer X 125� � �. G s-� �: - _ 1X. Add fox combustion air. (.OQlj �f net impu ��m anSwer aboae. ,� x{z2.5) x f.o7S> �' {87) � G 9 9 - �, ' Answex� f rom above X(1, 25) _�3 7 y i2.. Ac�d answer #'rom above to answer @�� fvr to�al furnace; imput. ��0 v`� �� .- ._,_...r. The undersigned, as applicant for a Heating Permit, hereby affirms the above . in.f'ormation has been prepared and submi.tted by himself or under his direetion hereby acknowledges the information to be correct and accurate; and hereby presents the information with required plans in support of the Heating Permit APPlicatxon. Signature-�e��'� � � Date �% �- a_? C� , �� . t`, say.�+,a`i:+FeG' �,.� � °° � � CITY OF FRIDLEY 6431 UNIVERSITY AVENUE N.E., FRIDLEY� MINNESOTA 65432 TELEPHONE ( 812)571-3450 Apn,i,E'. l3, 1919 Commelcc,i.a.0 �cec.tana 5298 �.�.2Qmone S�icee,i Na�liea.a� �n.id.Cey, M.i.rth.e,�a�a. 55421 Re: 6160 Kelvty Lane N. F. Vean S.f�cb : P�e.a,ae be adv.i.aed �hcr,t �'h.e C.�ty a� �n,i.deey'.a -i..napec,ti.an a�a.�� hab camp.2e.te.d �he �.i.na.e .in.apec,#,i.arvs a� �'he above ne�elcenced pno- peh.iy and haa �ound �hat .i.i dae.a mee,i xh.e C-i,iy'a nequ,i�cemen�a �oh a b�.ng.2e �um�,ey dwe,P.P,i.ng. The �o.2eaw.i.ng .i�ems wehe na�ed and mu,�� be comp.2e,ted be�ane �h2 a�cuc,iwce can be ��.na.ee.d au,t: 1. 2. 3. 4. 5. 6. 7. �. Sod �nan� and .a�,de ycvcd,a Pnov�i.de hcvcd-acv�.�aced cih,i.veway Comp.2e.ie ex,telu.an o� hau,6 e Pas� addnea.a an hou,ae Rende�r. upa�a.ut.a per,t,i.a daon .i.n.ape�ca�',i.ve Comp,2e,te vapotc ba�c,i.e�c .i.v►. .eawe�c .�eve,e Puat awt.� and wa�he�ca on anchon 6a.P� f.ix cove�c an .2oweh. 2eve.e �<i�c.e a.ecvrm P.P.eczae canxac,t u�3 �.� you have any que,ax,i.an.�cc on xhe abave .i�emm.a. S.ince�ceeN, �L . K Ch.i.e� Bu.i.ecling �S��.c,i.a.e UGC: �.Fz , .._. , _... .... �. _ �. ,"'"�_. sus�ECT P . `�. City of Fridley �" 17 0 3 9 AT THE TOP OF THE TWINS B U I L D I N G P E R M( T f ; � RECEIPT NO. � ; �_______ COMMUNITY DEVEIOPMENT OIV. r � � PROTECTIVE INSPECTION SEC. 99�� , i � A� r"�1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF � APPROVED BY `'��'J\•� �.J 612-571-3450 g10-F15 7/11/83 � � JOB ADDRESS 6160 Kerry Lane N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ( 2 H� Heather Hills 3rd �ddition SHEET 2 PROPEFTY OWNER MAIL ADDRESS 21P PHONE Steve Butgusaim 6160 Kerry Lane N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. S�a.r Hoanes 7691 Central Avenue N.E., Fridle 780-5500 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING 1�S1C�PSlt1d.�. 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X X 8 DESCRIBE WORK Co nver t exis ti n deck to s c r 9 CHANGE OP USE PROM TO STIPULATIONS SEPER�ITE PERMITS REQUIRED FOR V�iRti�� HEATING, PLUMB�NG AND SIGNS. TYPE OP CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. WOOCI FrdiRe 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 EXAMINEO THIS APPLICATION �. STAILS GARAGES AND KNOW THE SAME TO BE TRUE AND CORFiECT. ALL PROVISIONS OF LAWS VALUATION SUfiTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERM{T S'4�000 �Z.00 DOES NOT PRE TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISION F AN OTHER STATE LOCAL LAW REGULATING CON- T CTI OR T PERFORMANCE F ONSTRUCTION. 544. 50 None PLAN CHECK FEE TOTAL FEE $11.13 $57.63 SIGNATUAEOfCON' TORORAUTHORI2EDAGENT IDATEI �y . WHEN PROPER VALIDATED THIS IS VOUR PERMIT SiGNATURE OF OWNER iIF OWNER BUIIDERI IDATEI BLDG INSP D E CITY OF F(tIDLCY Effective Aug. 1, 1981 Af'PLICIITIO'1 FOft RCSIDL"i•JTII',� [3UILDlilG PERi�ITS (Ner�, Alter��tions, Additioitis, ar Ren�irs) . Ot�NER: �'..��.v� ��.c i l'4 s� i�- I3UILDER: ��•� f�ortc.L S ADDRESS: ��oa !`C�/�/�Y �� ADDRESS: %G �/ d�D c�.�%.e.�� '% �Jr,�'. TEL �0: TEL t20: ��D �-�-�D p Const-ruction Location STRI•�T NO : f CO � STREET: �CFj�IZ � �w� L07' : BLOQC : ADAITI0;1: Corner Lot: Insicie Lot: �� SetbacY.: Sideyards: Ap�lic�-�nt attach to tl�is form two Certificates of Survey of lot and pr�sed building location drawn on certiiicates to scale. C� v� k'-C �'l�- � �� DESCRIPTIO�� OF COf�;STRUCTIOtJ — � Front: c�v� � Depth: � �� Height: � o�� Square Feet: Qibic Feet: ��0�� _ Front : Depth : Height: Squar.e Fe�t: �bic Peet: (.�vD �.t�-r�� . iype of Construction: Sa M—�stimated Cost: $ D� �•�� Zb Be Cbnpleted: ��-��/ Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ S , S�� F.EVER�j' SIDL OF SHEET . Ziie undex sianed hereby ma};c� applicaticn for ' a permit £cr the �•ork herein specif ied, agreeing to do .all work ii� strict accordance r�ith the Ci�y of Pridle}� Ordir�ances a�id zulis�gs of t1�e Department. of Bui�dings, and hereby decl�res th�t all the iacts and represen�itiens stated :n this application� true and cor�ct. DI:TE: � / - ° � SIGNATUF�e^.: Stii�ulations : p,�„�,� y� sv ��G � � , � � �-y 2. d� s�,4 r/ f�/ / /' i /� S T,¢-.� �1.n-, � � �. i� � , � .,� _ _ �� ;, r �� ''I _ . �; _ _ _ . _ i _ _ __ , � _ ,i _ �; �; � ; _ , �; � , � I;� - - _ � ;! �:,: _ _ _ _ _ i�i . , ,� �.i ;!► _ ;:� �ii , __ ii� �.� _ __ - - -- ,� � s'�4�¢S _. ,i _ _ ;i, �,; _ _ ;:; _ „� _ I' _ � � i! � i'' ,:; �� / ,_ I _ _ ; i '' 1_ __ , ��° j , - ; 4 � V� 1��i�,i�� tl�l:i�� - _ �� : i �� _ � __ ___ _ _ __ � �„k � eiA`. r.'i3i�' H c Yk'i� � .," . % t }* 0. 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I i i �.y' �:t"?.� i�'I�'�I'�'j = : � � — , � � � ��;I��il''�� '!' �` � ' � � `. ��('�j ��i� ,:, !� , N � �'� ' �,'�if'�I �,++'� �.J J ��..l,''i';11'�� . !t i. t \ . .',j: �j � 'i'+'; .I• ii i•� :.� �-�.��.... -+.�.. . �, � . � � f � h . � � � �� .. .._ �......_ �'��'�.� ��f �:;;'�:'; O •. -- ----�- :1; �,i� � j; � :: �'!.' � -# �� -. . �;i�.;�:�;�,.,�,. � _�-; �_� � 1��;;�i ;.�.�� ' ` �'� � - .._:-�,. ;c,j,'r i �j ;;i N �-. .�,,..�_ ; �'++�' �! • i i! i -� -'--` ��...� �! :��+ ►i� �.� w� �. :,;I�j;�ij i ;:i'� --� � -� -- - #� :�i►��f �� I� .;:�l� � .;..�.�._ _ r�._ :{., � , , . r..� ': . r��... �1� �,! � � 'i'�i . � � —� N N � : � -� � � 0 ' � I � � � � . � N �l 1 � 4 � �!.-.. . �i � � �� I: �'! � �' ' �.�: , � ��'ry� nn� �'� � 4 ,, II � � �� •�y�~ �1�M'!'� I • ( �I7 ' � � � , . � . � '�MM� .I I 1�� . i I �' '' 1 , � � I � �� 1 . � . � 1� II�� ti � � w �• �� . _. � � ;� . � ,' � ;� � � °� .Q . � � N � � Q •� � � �" � � ,: � �i � �' ' :� �x � � �f f. r � �. � /1 / �� . SuB�ECY City of Fridiey AT THE TOP OF TME TWINS g � I L D I N G P E R M I T r � . � � � • COMMUNITV OEVELOPMENT DIV. ' � �.------ , r � � PROTECTIVE INSPECTION SEC. � � �""1 � CITY HALL FRIOLE� S5�J2 NuMeER pEv �""�" �'' 612-571-3450 9�0-F15 /OB ADDRESS 6160 Kerry Ln TE I P�GE Oi /22/98 � � 1 LEGAL �OT NO. BLOCK TRACT Oq ADDITION DESCR. () 2 Heather Hills 3rd Addition 2 PROPERTY OWNER MAIL AOORESS John Payne 3 CON7RAGTOR MAIL AODRESS Midwest Roofing & Siding 18979 Gladstone Blvd ! ARCHITECT OR DESIGNER MAIL ADDRESS 5 ENGINEER MAIL YteF77Vf1 I IV V . - ..�. /� 27923 R NO. 6�� APPROVEO 8Y SEE ATTACMEO SMEET 572-2693 IIP PHONE LICENSE NO Grove 55311 416-4804 20010277 21P PMONE LICENSE NO. ZIP PMONE LICENSE NO 6 USE OF BUILDtNG Residential 7 CLASS OF WORK O NEW O AODITION O ALTERATION � REPAIR O MOVE O REMOVE 6 DESCRIBE WORK Reroof house & garage (32SQ) Tear-off 9 CHANGE OF USE FROM STIPULATIONS Underlayment must comply with the State Building Code. tYPE OF CONST. OCCUPI SEPARATE PERMITS ARE RE�UIRED FOR ELECTii1CAl, PLUMBING, MEATING. VENTII.ATING Oq AIR CONDITIONING THIS PERMIT BECOMES NULL ANO VOID If WORK Op CONSTRUCTION IONING SO. fT AUTHORIZEO IS NOT COMMENCEO WITMIN 60 OAVS. OR If CONSTpUCT10N OR WORK IS SUSPENDED OR ABANOONEO.FOR A PERI00 OF 120 OAYS AT ANV TIME AFTER WORK IS COMMENCED. NO DWI,G. UNITS I MEHEBV CERTIFY THAT I MAVE REAO ANO E7(AMINEO TMIS APPLICATION STA�LS AND KNOW TME SAME TO BE TRUE ANO COpRECT. ALL PROVISIONS Oi LAWS VA�UATION AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED @ WITH WHETNEii SPECIFIEO HEQEIN Ofi NOT. TNE GRANTING OF A PERMIT W2 f 742. OO DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL THE pEqMIT FEE PROVISIONS OF ANV OTHER STATE OA LOCAL LAW REGULATING CON• $74.75 STRUCTION OR TME PERFORMANCE OF CONSTRUCTION Lice�,a�jSC $5. S�GNITUQE O� CONCaAC�OQ Oa �UTHOp�2ED �GENt IOATE� S�GaaivaE O� OwNEa ��c OWNEQ Bui�O@Ai � AiE�� OCCUPANCVLOAD CU FT. OfFSTREE7 PARNING ,GARAGES SURTAX $1.37 SAC CMARGE F' SC $2.74 TOTA F E $83.86 ,� �. � r AuG-�8-2998 10:04 FR�M CITY OF FRIDLEY �� AtDDN [ ] ALT'ER [ ] con�ucuo��aar�ss: L�egs1 �esc�ipt�oa: � CI'�'if QF F�t.�3LEY SAITGLE FA�'�I�Y AND D�TJ?I.E�S R-11�►AiD � 2 BUILDI�iG PERN� A�PPLiCATION �1 Ai649� P.�1�2 EffeCtive 1/ I/9$ n C��h 2�� C�� pwner I�tame 8c A�ddr�ss: Tel. �� ,�i.�II� Co�racto�r: ' 1VIN �CEI3SB �� (CS �-�% Atldress: S ZSU� ?�I. �! �-�. � t Q r� A�� Au� co c�,s ��►n, a ccrn�� F s�y � rt,ernn �3 l 1 iot, wit#� th� p�oposed �o��uccion dcawn on it tv sc�1e. D�.SCRIF�'i01�[ OF Il�i �Q�+� LI�'II�TG A.'l�A: L�ngth � VSTidt� �� Heigi�t Sq. Pt. GA�AC:E A�lEA: �mgth � Width Iiei�ght ��_____ Sq. F� AECi� AREA,; Le�tk� �'4Vidth HgtlOra�msi Sq. �t. �M ' f :�I � w v v � l�j ` a � l!�/ �tn�On 1`,�pe: l7 Fst�d Ca�c: $ � .... — _.. (Fee schedu�e on Hsck) arivGway �rb Cut Width Naeded: �t. + d Ft � �t x� �$ � � oA�;: al. Q �tic.�►rrr: �l � Jl 1_ i� �r�a. � y t l� —�. S_ D� Y- - �� F� �irc Surcharge s� sw�� SAG Charge Lio�ns� Surcharge Drivea►�y E�c�ow Erosion C:oatrol Pa�C Fee S�vYer I�in �h�arge TOTAL S1'�LATIUNS: � 7N.�S � �-•`7 �-t � 1.3� � S, o0 $ $ � $ $ � g3•�C� }.`S !�\� �� s�a� �n � s� .Oti1 of �it Vah�atioa (1/itHh9G} �.so�$�,v�o van� $1000 per 3A� Unit �5.00 {Sita�e Y.icx�scd Re�is��1 Co�o�s} /�L. "A° � �1�. °�" �1bOYC $450.00 �o�ervetfon Plan R,�view Fee Deteatmi�i 'by' 'Eegi�eriu8 Ag�t N�arY [ l NoR 1�tecessarY [ I •� - � �' , I �� -2Z.,� CITY OF FRIDLEY INSPECTION DIViSION 6431 University Ave NE � Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATtNG, COOLING, VENTILATION, 572-3604 REFFtiGERATION AND AIR CONDITIONING SYSTEMS AND D�VICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but nat replacement) Gas Range Gas Dryer *Air Conditioning • All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1 J of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate TOTAL $ 30.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ $ 25.00 $ $ �_ `��_ State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $. 0 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. �::��: OWNE v � SUILDING USED AS �J � _s�` � ESTIMATED COST Effective On January 1, 2000 PERMIT N0. �� >�� DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Si2e No. BTU HP EDR Fuel _ Total Connected Load _ Burner Trade Name Size No. BTU HP EDR $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all `work in strict accordance with the City Codes an $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in tFiis application are true and correct. $ �S � 1Mh/1#riM� #� DATE � /�� HEATING CO 1�� 651/633-25�Z Signed,��i, TEL# �57-6�.� as� � l� Approved By Rough•In Date Final Date'` �. � COMMON VENT. VENT CONNECTOR AND COMBUSTION AlR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from nrst, deterioration, obstructions, and is securely supported and firestopped where cequired. Yes O No O The venting system is plastiGPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No () The untlersigned also verifies that the repiacement unit is a listed assembly and meets the cuRent 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 () The existin� combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No () When required to install a new combustion air, it will be sized and installed To meet the cuRent codes and manufacturers specifications. Yes () No () When installina a new ventina svstem, the undersigned hereby verifies ihat it is a listed assembly and meets the current codes and manufaeture�'s specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natura! draft appliances. Yes () No () Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No () Appliance 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 or Nat Total Appliances Total Btu Input �^ °� "' � � .� y .t_` fV $ } ni Common Vent Type Vent Height Diamet '� ��ches . � x �i Appliance #1 Vent Connector Height ft Length ft Diameter e Appliance #2 Vent Connector Height ft Length ft Diameter �pe Appliance #3 Vent Connector Height ft Length ft Diameter in ype ALTERATIONS: (Describe) HEATING C4: Signed By: Date : sue�ecr PE, . �� City of Fridley 3 i 824 1 AT THE TOP OF TME TWINS g �� L D I N� P E R M I T r ; � RECEIP7 NO. i • COMMUNITY OEVELOPNIENT DIV. ��0� �� ; V��'�� , r � � PROTECTIVE INSPECTION SEC. � _ + � /'�'1 � CITY MALL fRIDLE� SS13Y NUMBER pEV OATE oAGE OF APPROVED e� �.---�: �., 612-571-345Q 910-Ft5 5/16/O1 � � 108 ADDRESS 6160 Kerry Lane NE .. t IEGAI �OT N0. BLOCK TRACT OR AD01?ION SEE ATTACMEO oescA. 6 2 Heather Hills 3rd Addition SMEET 2 PFOPERTV OWNER MAIL ADDR�,$$ ZIP PMONE Sharon/John Payne 6160 Kerry Lane NE 763-572-2693 3 CONTRACTOR MAIL ADORESS ZIP PMONE IICENSE NO Renewal By Anderson 350 73 Avenue NE, Fridley, NIN 55432 763-502-4777 20130983 a ARCHITECT OR pESIGNER MAIL AOORE35 ZIP PMONE UCENSE NO. 5 ENGINEER MAIL ADORESS ZIP PMONE LICENSE NO B USE OF BUIIDtNG � Residential 7 CIASS OP WORK ❑ NEW O ADDITION � ALTERATION � REPAIR O MOVE • O REMOVE B DESCRIBE WOFK Replace 10 full frame windows and 1 patio door withir. existing openings 9 CNANGE OF USE FROM TO 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. Caulk and flash all exterior openings. Permit Inspection Cards Will Be Mailed � To Homeowner To Post TVpE OF CONST. OCCUPANCY GROUP OCCUPANCY �OAD SEPARATE PERMITS ARE REOUIREO fOR ELECTfi1CAL, PLUMB�NG, HEATING. VENTI�ATING OR AIR CONOITIONING THIS PEfiM1T BECOMES NUII ANO VOIO IF WORK OR CONSTRUCT�ON 20N1NG SO. FT CU FT. AUTMORIZED IS NOT COMMENCED N(ITHIN 60 DAYS. OR IF CONSTRUCTION � OR WORK IS SUSPENDED OR ABANQONEO POR A REH100 OF 12Q pAY$ A7 ANV TIME AFTER WpRK IS COMMENCED. '` NO OWLG. UNITS OffS7REE7 PARKING I HEREBY CEHT�FV THAT 1 MAYE REAO ANp EXAMIN�O TNIS APP�,ICATION 1 57A��S GARAGES AND KNOW TME SAME TO BE TRUE ANO COp�ECt. ALL PROVI$IQNS OF �AWS VALUATION' SURTA% ANO ORDINANCES GOVERNING TMIS TYPE OF WORK WILL @� COMPI,IED 12,676 $6.3�F WITH WHETHER SPECIFIEO HEREIN OR NOT. TME GRANTING Of A PERMIT � DOES NOT PRESUME TO G1VE AUTMORITV TO VIOLATE OR CANCEI TNE pEpMIT fEE SAC CHARGE PROVISIONS OF ANV OTHER STATE OR LOCAI lAW REGULATING GON• �223.25 Fire SC �IZ.6H STRUCTION OR TME PERFORMANCE OF CONSTRUCTION PI,AN GNECK FEE T � FEE Lice C $5.0 $247.27 S�GN4TU�7EO�CON'A�(;TOpOQ�UTMOQ�ZEO�GENT IDATE� p O VALIOA ED TM�S �S YOUp PE MI�� G ' �'��' S�GN�TUAE O� OWNEA��F OwNEp Bu��DEp� �OATE� . ' DG� �hSP � � �i�TE ' y �a ^ �� I l ADDIeT ALT�R Effe�tive 5I10/99 [ J CT�'Y OF �I.�� L � S�t��,� �'A��,� � �u��x�S �-� � � 2 BUILDING PERMI�' APPLICATI�N �onstruction Address: l�ll�� ,(c� �c,.�, � I.egal Description: ' . Owner Name & Address: 5�,,.� � $�,� "�a,��, «� Tel. #� � • � � . a c�9 3 Cvntractor:, �NEWAL BY ANDERSON � Y;,I�NSE # 350-73RD AVE. NE. Address: FRIDLEY, MN. ' Tel. # Attac 763/502-4777 ;�e of the � LICENSE# 20130983 y IOt� W s... ....� r- -r -- - ,II lt t0 SC.ill@. LNING AR�A: GA�2AGE AREA: DECS AREA: OTHER: �onstruction Type: DESC��l�i C1F .��iL?..' , � � . _ � ' Length Wi3th � Height � Sq. Ft. Length Width Height Sq. Ft. Length Widtli - Hgt/Graund Sq. Ft. l�Jx i �i U�GV C�Ir1+Y�0 • � �� J EStlIDaied COSt: $ t7 � �j n� ls�°✓ Driveway Curb Ciit 'W idth Needed: Ft. + b Ft = Ft x$ _$ ..• • �� • • //\�'. . �_ l� � _ ♦� � � .1� �� Permit Fee Fire Surcfiazge State Surcharge SAC Charge Licsnse Siircharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIl'ULATIONS: � aa3 . a� � I a.�3 $ �.� $ $ �5.0p $ $ $ $ � � .a' CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Vaivation (1/lOth%) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (State Licens�d Residential Contractors) Alt. "A" or Alt. "B" Above $450.OU Conservation Plan Review Fee Deternained by Engineering Agreement Necessary [ ] Not Necessary [ ] � �� ` � sue�ect � � � � � � � P t N . , , c;cy of Fridley 3 2 7 7 5� AT THE TOP Of iNE TVNINS g u I L D I N� P E R 1V1 i T � _ ; � RECEIPT NO. � • COMMUNITY pEVEIOP��NT OIV. a� �� f �~ • � PROTECTIVE INSPECTION SEC. � j i._-.�'��"';'� CITY MALL FRIDLE� SS�32 NVMBEa NEV O�TE vAGE OF AVaaOV£O Br L 612-571-3450 9�0-Ft5 7/11/02 � � ,oe nooRess 6160 Kerry Lane NE . t IEGA� LOT NO. BLpCK TqACT OA ApDITION SEE ATTACMEO DESCR. C) 2 Heather Hills 3rd Addition SHEET 2 PROPERTY OWNER MA�L AOOR�S$ IIP PMONE Sharon Payne, 6160 Kerry Lane, Fridley, MN 55432 763-572-2693 3 CONTqACTOR MAIL AOORESS ZIP PMONE UCENSE NO RMA Home Services inc, 3200 Cobb Galleria Pkwy, ste 200, Atlanta, GA 30339 � ARCNITECT OR DESIGNEA MAIL AOORESS ' ZIP PHONE UCENSE NO. 763-542-8826 20268257 5 ENGINEER MAIL ADORESS ZIP PHONE IICENSE NO 6 USE OF BUIIDING � Resider�tiai 7 CLASS OF WORK �I NEW O AODITION O ALTERATION ❑ REPAIR O MOVE � O REMOVE 9 DESCRIBE WORK Res�de home with select ciapboard vinyl siding 9 CHANGEOFUSEfROM TO STIPULATIONS Per Section 1402, 1997 Uniform Building Code requires that a weather- resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions to this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl sidi:�g is not a weatherproof covering unless the manufacturer states this in the application guidelines. Call for inspection of wrap before covering. TYp OFCONSL OCCUPANCVGROUP OCCUPANCVLOAD SEPARATE PERMITS ARE RE�UIREO FOR ELECTRICAL, PLUMBING, HEATING. VENTILATING OR AIH CONOITIONING THIS PERMIT BECOMES NUII ANO VOID IF WOiiK OR CONS7RUCTION 20NLNG SQ. fT CU iT. AUTHORIZED IS NOT COMMENCED V�IITHIN 60 DAYS. OR IF CONSTRUCTION j OR WORK IS SUSPENDEO OR ABANQONEO FOR A PEA100 OF 12q OAYS A7 ' ANV 71ME AfTER WORK IS COMMENCEO. ' NO DWLG. UNI7S OFfSTFEET PAfiKING I HEREBY CERTIfV THAT I MAVE REAO ANO ExAMIN�O TMIS APPlICA710N STA��S GARAGES ANO KNOW THE SAME TO BE TRUE AND CORRECl. ALL PFOVISIQNS OF �AWS VA�UATION SURTAX ANO OROINANCES GOVERNING TMIS TVPE OF WOAK WIL4 B� COMP�IED $1S�ZHt7.00 ��.59 WITM WMETMER SPEC�FIED HEREtN OR NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE AUTHOii1TY TO VIOLATE OR CANCEL THE pEiiM17 fEE SAC CMARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �GEjS.�S . . F��i2 SG �LS.LH STRUCTION OA THE PERfORMANCE Of CONSTRUCTION PI,AN CMECK FEE TOiAI fEE Lic se .00 $293.02 SIGNATUQEOFCON'�7��TQAOpAU1NOp�ZEOAGENT IOA1E� M PROPERLY VAL�DATED TMIS IS VOUF ERMIT � �� S�GN4IUAE O� OWNEQ��F OWNEQBU��DEp� �O�TE� � � � OG �NSo �. � � - qst . ' � �w [ ] ADDN ALTER [l [l �onstruction Address: � Effective 5/10/99 CITY OF FRIDLEY SINGLE FAMII,Y AND DUPLEXES R-i AND R 2 BUILDING PERMIT APpLICATION Legal Description: ' lJwner Na�me & Address:s�c�,c o�.� �0. � Tel. #�-(p 3•�'� a•� Contractor.; � HOME SERVICES INC. jy�j j;,j��j�E # Home Depot Installed Sales Address: 3200 Cobb Gaileria Pkwy., Ste. #200 Tel. � Atlanta, GA 30339 A 763-542-8826 i�vey: of tiie � 1cBC-2026825 r__r____ _..r._..�...,�....».... „111��1t LO SC�L'. LIVING AREA: GARAGE AREA: DECK A,REA: OTI�R: DESCi�.�3i'�i` OF ��4��i�NT .. . �ng� Width Height � Length Width Height Length � Widtli � � HgVGrottnd Sq. Ft. Sq. Ft: Sq. Ft. _ V Construction Type: Fstimated Cost: $� � 5 � g t� � Driveway C�rb C�.it'Width Needed: Ft. + 6 Ft =_ Ft z$_ —$ _ DATE: �� • Q� APPLICAIVT: Tel. � o� •�JyS• (00��' -�—_ -.�. Permit Fee Fire Szzrctiai�ge � State Surcharge SAC Charge License Siircharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STII'ULATIONS: $ at�s . as � 15,1 $ �.5� $ $ �� Q(� $ $ $ $ . � �• . CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Vaivation (1ilOth�) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (State Lxcens�d Residential C.ornractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] a ' ' ' • City of Fridley AT THE TOP OF THE TWINS r � . � �� COMMUNITY OEVELOPMENT DIV. � ; V �� r � � PROTEC7IVE INSPECTION SEC. 1 � i � � �"'1 � CITY MA�� FRI�LE� SS�32 �'""""�" ��' 763-571-3450 JOB AODRESS 6160 Kerry Lane NE SuBlECT BUILDING PERMIT NUMBER REV 04TE oAGE Of 910-F15 7/19/02 / � t IEGA� LOT NO. BLOCK TRACT Op ADDITVON oescR. 6 2 Heather Hills 3rd Addition 32910 RECEIPT NO. ��D AVPROYEO Br� SEE ATTACHEO SHEET 2 PROPEATV OWNER MAIL ADORESS 2�P PMONE John Payne 6160 Kerry Lane NE 612-316-2571 � CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO RMA Home Services Inc 3200 Cobb Galleria Pkwy STE 200, Atlanta, GA 30339 � ARCMITECT OR DESIGNER MAIL AODRESS 21P PMONE UCENSE NO. 763-542-8826 20268257 5 ENGINEEH MAII AO�RESS ZIP PHONE IICENSE NO 6 USE OF BUILDING Residential 7 CLASS Of WOFiK p NEW ❑ ADDITION O ALTERATION �7 REPAIR O MOVE O REMOVE 8 OESCRIBE WORK Replace 6 windows within existing openings 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on a11 levels of the dweZling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk and flash all exterior openings. SEPARATE PERMITS ARE REOUIRED FOii ELECTRICAL, PLUMBING, MEATING. VENTILATING OR Alfi CONDITIONING TMIS PERMIT B£COMES NULL AND VOID If WORK OR CONSTRUCTION ZONING AUTHOR12E0 IS NOT COMMENCEO W17HIN 60 �AYS. OR IF CONSTRUCTION OA WORK IS SUSPENDEO OR ABANOONEO FOR A PERI00 OF 120 OAYS AT ANV TIME AFTER WORK IS COMMENCED. NO OWLG. UNI I HEREBV CERT�fV THAT I HAVE READ ANO EXAMINED TMIS APPLICATION 1 AND KNOW THE SAME TO BE TRUE AND CORRECT. A�l PROVISIONS Of LAWS VALUATION AND OROINANCES GOVEfiNING THIS TVPE OF WORK WILL BE COMPLIEO WITM WHETHER SPECIFIED MEREIN OF NOT. THE GRANTING OF A PERMIT �4 � 977 �OES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE Ofi CANCEL THE pEqMITfEE PROViS10NS OF qNV OTMER STATE OR LOCAL LAW REGULATING CON• �111.25 STRUCTION OR THE PERfORMANCE OF CONSTRUCTION PLAN CNECK FE Liceas�e � SiGNATUAEO�CONCii1CTQFOAOUTHOA�2E0�GENT iOATE� iO�iE� OCCUPANCVGROUP IOCCUPANCVIOAD STA�I,S $5.00 CU iT. GARAGES $2.49 SAC CHARGE Fire SC $4.98 fOiAl FEE �ZZ .�2 �. is is roua PEpti rr�w � � ADDN ALTER [l [l �onstruction Address: � Legal Description: _ Effective 5/10/99 CITY OF E'RIDLEy SINGLE FAMILY AND DUpI,EXES R-i AND R-2 BUILDING PERMIT APPLICATION Owner Name & Address: Jp� �'O�, . �� Tel. #�j J o� '��p' �� Contractor:. �� HOME SERVICES INC. � �iC��E # - ' Home Depot Instalied Sales Address: 3200 Cobb Galleria Pkwy., s�. #20o Tel. # Atlanta, GA 30339 A 763-542-8826 i�vey°ofthe � 1cBC-20268257 --c---_ -`�YY_��y WY.'4f�n•it to scale. DES.C��IY OF iM$�b�MENT �. . � ' LTVING A,REA: GARAGE AREA: DEC$ A,REA: 01'��R: Length Width Height � Sq. Ft. Length Width Height Sq. Ft: Length � Widtli �- HgtlGround Sq. Ft. �� n � ,. � � _ . _ .� .� .._ _�-. _ � � , . . .---T_ � Construction T , � • 3'Pe� Estimated Cost: S .' �'�'a'/ Driveway Cbrb Ci�t 'Width Needed: Ft. + 6 Ft =_ Ft x$ _$ . DATE: ��v�l�,_0�1 APPLICANT: Tel. # 9�' 3ys• lOC1YT' Permit Fee Fire Surcliaazge State Surcharge SAC Charge Lic�nse Surchazge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ 1�•a $_ . $ a. �d � $ $ �� $ $ $ $ � Jo�3 ��a� CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOtb.9o) $.50/$1,000 Valuadon $1050 per SAC Unit $5.00 (�tate Licens�d Residential Contraetor�) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [] Not Necessary [ J Building PLUMBING Pe�it No.:,�� C�� 7�� Inspections RESIDENTIAL APPLICATION Received By:`�� 763-572-3604 CITY OF FRIDLEY vate ' 07 DATE � � � Y�,O`�JR E-MAIL ADDRESS SITE ADDRESS � / V THIS APPLICANT IS: ❑ O ER NTRACTOR PROPERTY NAME: i'l ��/.� OWNER/ ,�DRESS: CITY STATEI�kZd'-�21.LJ TENANT PHONE: � 7 �- CONTRACTOR N,�1vtE: J� SUBMIT A COPY OF STATE LICENSE # �✓ � EXP DATE l�' 3 I'�7 -��/ YOURSTATE ADDRESS: ��' �/ZdG[,[� l�`�-`�� CITY /►l��F�^�-- STATE %N�ZIP 53Z�/a LICENSE WITH PHONE �! ti�� 0 Q" f! Cl � _ FAX 7�.� �.3 5� � Y APPLICATION PERMIT TYPE 1Q °1"'GLE FAMILY ❑ TWO FAMILY O TOWNHOUSE TYPE OF WORK: � NEW PLACEMENT DETAILED DESCRIPTION OF WORK PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor l � B• x.OS = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (WDICATE TOTAL NUMBER OF EACH BELOV� BATH SINK/LAV FLOOR DRAINS SHOWER WATER PiPING ' BATHTUB GAS PIPING pv� cirvrrcFrvsE) SWiMMING POOL �, WATER SOFTNER (S35) CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. (S15) DISHWASHER LAUNDRY TRAY WATER HEATER (S35) � FOR IRRIGATION — WATER METER _ OTHER Permit Fee $ � Number of fixtures @$10.00 x$10.00 =$ Surchar e .50 Number of fixtures @$15.00 x$15.00 =$ TOTAL DUE $ 3,f �U Number of fixtures @$35.00 x$35.00 =$ State Surcharge = $ .50 Total TH1S IS AN APPLICATION FOR A PERMTT-NOT VALID UNTIL PROGESSED I hereby apply for a building permit and I acknowledge that the information above is camplete 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 permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all k whic re uir review and approval of plans. SIGNATURE OF APPLICANT �� PRINT NAME ��'el�r U�K. DATE S� �� 7 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977