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AF - 47909SUBJECT c��y of Fridley ° 14058 � AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � T � ` ._�_. COMMUNITY DEVELOPMENT DIV. r � L � PROTECTIVE INSPECTION SEC. %f �c�C��' � � v �- � � �"'1 � CITY HALL FRIDLE� SS432 NUMBER REV. DATE PAGE OF APPROVED BY �""� � ,`� 612-560-3450 910-F15 5/4/77 � � JOB ADDRESS 6191 Kerry Lane N.E. LOT NO. BLOCK TRACT OR ADDITION 1 LEGAL 3 2 Heather Hills 2nd A+ddition SEEATTACHED DESCR. SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE Gregory Mortenson 3727 Foss l�ad N.E., Mpls. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. . . . �� 4 ARCH{TECT OR DESIGNER MAIL ADDRESS 21P PHOhE l{CENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUIIDING Residential 7 CLASS OF WORK C� NEW ❑ ADDITION O ALTERATION ❑ REPAIR ❑ MOVE � REMOVE 8 DESCRIBE WORK ¢yS�I�,�jd���g�yl Construct a 40'x 35' Dwelling and a 20' x 21' Garage SEP'E�lt�E PERMITS RE UfRED F VWIR11� 9 CHANGEQFUSEFROIv`��.r�� �t'�B�1•G ANQ SiVNS• ����.A t.6 STIPULATIONS Provide a hard surface driveway. Provide a verifying survey before capping. Provide sod in the front and side yards. SEWER LOCATION: (Approx. 21' Deep) 12' South of Ma.nhole (S. Inv. 928.30) WYE ELEV: 928.35 TOP OF FOOTING: 931.35 with 35' Setba�k WATER LOCATION: 33.3' S.E. of Manhole DRIVEWAY DEPRESSION: N/A F�cisting Surmountable Curbing. W���� rH� unr oF �,� ppeS� , � »s Betore di68i�8 ca� toca! �ti�lies ACCURAC�t OP ��TM 1O�°� p�RP03�5 ONtY AND �EILEPNOPI� - ELEC�RIC • 6A� EtC. 'RiiS DA?A {S fOR iNF4RMATlOt�1 �,�QUIRED 8Y LAW , � U� R sHOUt.� vE�r �+� �owN�►tRON �TM�� SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. WOOCZ 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 R—�. 12%2�'4H1 29,034 Total ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEfiEBY 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 547� �-HrJ $23.59 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 PERFORMANCE OF CONSTRUCTION. � 5�-16.14 $375.00 PLAN CHECK FEE TOTAL FEE $29.03 $543.76 S TUREOFCONTRACTORO THOR EDnGEtv7 IDn7E� • WHEN PROP RLY VALIDATED HIS IS YOUR PERMIT � i Si NATUR F O E ItP NER BUILDERI ATEI I� BLDG. �NSP ATE � �- CI�Y �F �=RI�LEY APPLICATIQT� FOR RES�DEt�TIAL Bl1ILDING PERt�1ITS t1VEW, ALiERATIONS, ADDI7TONS, OR REPAIRS) ,, ,� > '� � � � - _ QV,TSIER: �c �����e"! / � ► d[`� f�.N�� BUILDER: S� /-1 • / ► 1 � i � G�S� `��S % . Addres s : ?�'7� ;i �Q� � �i � � . Addres s : p��� ��/Q � �, , /V, �'r, , � � i..g, Tel. No. :_��_ D��.� r � No.:���_ street: ��ERRy L/�.(�J[ LOT: 3 BLOCK: �_ ADDITIJN: �-{ Ef}-�Nfl� �f LI.S �� Cdjljb �d� CORNER LOT: INSIDE IAT: iC S.:.TBACK: SIDEYARDS: Applican� attach to this form Ztao Certificates of Survey of i,ot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: L Sl►�Y.l,�. �i�j1�41/ly _ Front: _�! Depth: �� Height: _.���TOjZy Square Feet: %Z %Z. Cubic Feet: �2 �.Z Z y � � IT{�.1}�� coR� , Front: _,�(� Depth: Z� Height: �Q Square Feet: �g� Cubic Feet: �g�d i------ Type of Construction: W Q(�,� �j����' Estimated Cost: $ �' � � Zb Be Completed: �� I . % � �� �g`�'� Alt. A �lt. B Proposed Driveway Width If New Opening Is Jesired � N F $ $ (SEE �EVERSE SIDE OF SHEE�) The undersigned hereby makes application for a permit for tY:e work herein specified, agreeing to do ail wor.k in strict accordance with the City of Fr�.dley Ordinances and rulings of the Departmeazt of Bui.ldings, and hereby declares that all the facts and representatier.s svated in this application are firue and correct. See�reverse side f additional information. DATE: �-%''� ,Z � % SIGNATUR�': , Stipulations: ''_--, ��r. � ,/// � �,�! �irG �i �. /�i �� O . ST� � ������ � (I ''� � c. at +a.?.tw.� ��- �-�- °� q' ° 3 � . �� ��� v��� s� ; ,JA ✓ �a3, s5 � � � �p' ,a��,�>-�o � �-�3, �� ,> �./�'' � s- do � .� � $ .76 � l �r � E '�[-+�- y' �.4� � _ a2'� 3/ = G�z z 3 x /� - � l09� X 8 �__ �%!�"� ��►.a.C' ��-r-Aeti.. - 2 z,r 3/_ G 8.t . _ - � _ _ Z ,� x �8 = yr y _ � _ �� x l6 = / �'� . _ __ __._. s.� _ _ _ . /.? 7 Z . X g � - , !v / 7� . . o?,�•�.iC ���,cn.., .. .� 2� �o � 4�4/o X/ 2 = , Z 8 c► :_. : : ��°�Zy� , � : , , . : .. _ . _ _ , - s�,ic�l.��j�- _ oL/ X o2/ � T �� , _ _ , . : _ . . / . ._ , �� x �l = SlG _ . -_ : : �I' /,:� = _ `���Q . �. _ _ _ �t.�/ . . : _ _ . . _. � � 03 y [__ . . : _ . _ . . . . : �9 0� �' �� y� ��/..,,, � 1 _ _ _ �' _ ���._i�!.- _---.--=-- - G��- _ �-�-� �' ?' -- ---: _ - - . o2�e _ � _ : _ � -- - � - - . _ _ _ _ __ . _ cg– �t� 9G ,r �� �_ 5� 9�3 Z., — _ - - __ __ /- /z�t.r' �'z,4o = -2 7��', Lo . _ _ _ . __ _ ,.� - ��o �- � 2, � o = 9 yy, - _ _ _ __ c� ��'/ ,r �' �o = � � j'�% 5�d _. _ _ - - - � _ _ . . � _- - _ ' - - -� /Sz ,Gc� _ _ _ _ _ -- . . :_ .__ . : . �7 /�, � � 3� � �t �- r.�.3 . �9 _ . ,_..,� _.�, -� ..._....�. .. ��. ��-' °a _ _ - � _ ��� �� - __ _ , _ . _ . '----t__ : _ . __ -- . ; .. . _ . . . .. . .. . . . ... .. . " .__". .__. ._ .. '..__"..'�"__ 7.__.__�.. . ._. .; . ' ..... ._ _.._ s a �� . \ F�"'t�''AF :c � Page 1 of 4 EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER: ����Q._.DT�- t 1 �0�, �i�,\O� DATE ��_�) � �� SITE _ ADDRESS : � �/�! �;�� �%}� �.l. (t PHONE : � � �S �. � � ^ ��� �OZ.(� CONTRACTOR: S� I-1� �TZ� ��, C�NS� ---. � Determine working square footage of each 2. Total exposed wall area...... � Li� sq. ft. x .17 = �% �' � 2. Toal roof/ceiling area ...... U sq. ft. x .05 = ��i �. Total exposed wall area above floor = a. Total wall window area ................................. b. Total door area ................................. ..... c. Total slicling glass door area ........ ........:...... d. To�al fireplace wall area ............................. e. Total wall framing area (average 10�) .................. f. Total r�. joist area .................................. g. �'(,i�' �aal, �.rea above floor. . . . . . . . . . .. . . .. . . . . .. . . h. �.- ��'�iaN`l`� area above floor .......................... i. � 5�,,,�� �wall area above floor .......................... j. wall area above floor .......................... Total exposed foundation area = � 1/ ;� �� k. Total £oundation window area ........................... � 1. Total net foundation area above grade ................. 3_ Determine "U" value of each wall segment (e.g. window, door, each separate wall section) �� �� � _ � a. �a� x U �'�Jr b. � • 7 X ��U�� ��,'' � _ -� ` 1 c. ���i�—. X ��U�� ✓; � �i = d. `�, �o , � X e. � � J � X f. , / X g. /�/7�- x h . �_ X i. � x ��U�� _ ��U�� _ . nU�� V , O � _ . „U„ _ Itrfll/ � X � lT V ,. , , � � � _ . � �� X nUu a k . � t X "U' ;�,�7 - -, l. � X aUu . `L � ' = YS�/'T`� .......................... �tai = S `� � � , � r�� `/'_ L/ � �t �a.J, J Y! i � � � ° �. h+•. r� f ! Ik: +' � � / I�I ,i�'+� i� �... i� �Y i e� �� F� If item #3 is the same as, or less than item #1, you have met the intent of SBC 6006 (c) 2. Z T� ` Exterior Envelope Average "U" Computation Page 2 of 4 " , � i�'" � Total exposed roof/ceiling area = m. Zbtal skylight area .............. ............ Q � n. Total roof/ceiling_framing area (average 10�)... o. Total net insulated roof/ceiling area........... Determine "U" value for each roof/ceiling segment m. � X •�Uo - n. �3�- x ��U�� _ ` . o. °I� X„U„ ,�, �l 3=�- 2, s � 4 ........................... Total = � a �� � If total of #4 is the same as, or less than #2, you have met the intent of SBC 6006 (c) 1. . ' Alterrtate 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 #1 and #2. �. �� -� -� 2. � •�S = �3 a- I ' S' 3. �.�� + 4. ��_ - �� ! �� � � 0 WALL SECTiONS Di(JTE: Use 10� of opaque wall area for ,� frame construction S�t Z �Scr, [ �� �it�eral � __ `__ •1_ 7 S , •, ,, -, � . �l.«�` '. � '�� E.IG. #3 �� -� F a `� � . ' o - . ` � cs. , . • . C► � : ' -! - . . FR7�1E TPALL ..�:_..._....v_._� � b` - ..�� .�� . �J `°J_ . . ' : ... .. Page 3 of 4 �onstruction R-Value 1. Interior air film p,�g 2. ' — � yP��, i� � '�--- 3 . � � . T ,� � � ' 4 . �: t.•tT�C''/T `c � (i s. �1L�Gl�1T� �� ...._.. 6. E�ctermr air film 0.17 Total �. ��o 1. Interior air film 0.68 2 . � �i , �' � ,S� 3 . c� , d D 4. -�- �i� r , v;L s . �, i , 6. Exterior air film 0.17 � Total / y, �� 1, Interior air f ilm 0. 68 a.= .� G f�f r , p 3. ' ,�" 8' � 4 . `� s/_3 ,t Q �i s . �t, /T � , � 6. Exterior air f il.m 0.17 Total �t �, 1. Interior air film 0.6$ 2. 3 . i7�G. .��k c. �2 s 4: _ ��' naNc. � /G 5 �: �, i5_ 5. 6. Exterior air film 0.17 Total ys p C� , • • ! e . ,r- • • �. �L . . .���-5->!F � r X ' ; �' � � ` • ` �` /If = • � :.-� �• • • 6, . i! j r=- , , : ' " ' V � � � � � ( . • � ��i � . 6 , i!f : -` , • - • --- / � 1 . ...� � � ��� ' . FIG. #9 ^" � ' t ` -" /�/ : /!t t� ' � • • C� r' "` ` � !/ ( ;� ' � �ir � x�x : ��� • ' • /! { c. / [ ( _._. / / t _ �JT1;: , Indicate type, "_T2" �value, depth and � p]aceMent of insula�ion. _ . . . . '"'�'�.. �' ROOF/CEILING � . . ,°�i . : ��:%.� • J` ��� IL .., j �, , �--�3 . �'�'" ,. �' � �' � j�tl��,���r��j('' ' ' '1 �}� .i, .� ���1�1\ . • YG.I� _ � .. �•___••�_L���""� ./� :..- Vented � -\ ` --lJ � � � � � � Heat flow � up � FIG. �5 � . , r.. . _ �:/ \:./ \'./ �.i' . � };eat floc•� up . . �, ;•ven�ed . . . _FIG. #6.�.. ... . � _ . ' . . 3 �, _ 5 . . � .� � t; � o :-it°,3�'�R''�'•��� . � , �0..s..�=...:. .: :�� T�. • , • on !.w3.t�:..: -`. . _ . . - -- - • = •—�-;,:".:,,- '. � tVU.�'-YL'1V'TED • ' . , - � � • � . �ieIIi •.`• • . ; • • � f low up - .. - . . � . • .•: • � � . • . � f.*T.r,. i�7 • . , � . . � . � . � Page 4 of 4 Constniction R-Value �l. Int rior air film 0.61 2. '-� � ' ��011�e� • � � 3 . .1�:/�- - f�i��3�2 �9. o 0 4. Exterior air film (still) 0.61 Total � f1 � �'j v � � l. Interior air film 0.61 2. 3. 4. Exterior air film (still) 0.61 Total l. Inside air film 0.61 a. S ,�� • �S� s . � .OD 4. � � r"t`� v.� �� � lo � 5. Outside air film 0.17 Total Note: ilse additional sheets if more space is needed for details and calculations • ''� CI'iY OF FRIDLEY APPLICATION FOR I�OWER PLANTS AND NEATIN6, COOLING, VENTILATION, �EFRIGERATIOtV AND aIR CONDITYONING SYSTEP�IS AND DEVICES PARTIAL �ATE SCHEDULE GRAVITY WAR,�1 AIR: Furnace Shell & Duct work Replacement of Furnace Repairs & Alterations-up to $500.00 P.epairs & Alterations each add. $500.00 i41ECHANICAL WAR,�4 AIR: Furnace Shell & Duct Work to 100,000 BTU each add. 50,000 BTU Replacemen± of Furnace Repairs & Alterations-up to $500.00 Repairs & Alterations each add. $500.00 ST'E�1��I OR H�T WAT'EFt SYSTEI�1: Boiler &?,ines up to 100,000 BTU each addn. 50,000 BTU Soiler only up to 100,000 BTU _ each addn. :0,000 BTU OIL BUI?vER- to 3 gal. per hour ee�ch add. 3 gal. per hvur GAS $URNE R- from 100,000 BTU to 199,999 BTU (over 199,999 BTU see Eee Schedule) RATE TOTAL $12.0o S 7.00 $ 7.00 $ 4.00 $ $12. 00 S��! 4.00 $ O O 7. 00 $ 7.00 $ 4.00 $ $12.00 $ 4.00 $ ?.00 $ � 6.00 $ sio.00 10.U0 510.00 GAS FIT'iING FFES: � ist "i Fzxtures x $ 3.00 Additioaal Fixtures x $ 1.00 Gas P,ange to 199,000 BTU x$10.00 AIR CO\DITICN:NG � F�:V HEATI\iG SYSTEMS ,' ✓FNf � a�� FRtis, See Fee Schedule V��ITILATIr<G. SYSTE?�S \ A�.TEFviTIOiiS f� R�2AI RS _ J ROUGH INSP. Date FiNAZ, INSP. �! /G�-`7 % Date APPROVAL FOR PERM.IT y�� State Surcharge TOTAL FiE REINSPECTION FSE (.$10. 00) MINIMUM FEE FOR AIIY HEATING PERMIT IS $7.50 S S $ ,�a� S S � � S + � S S�Op S S S_�� 0 Job Address �� � "6 Department of Buildings City of Fridley Tel. #571-3450 ° � . 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 and rulings of the Department of. Buildings, and hereby declares that all the facts and representations state3 in this application are true and correct. Fridlep, Minn. . 19� OWNER // J / C�''L.��JI'7V _ KIND C USED P TO BE COMPiE:EU ABOUT " — ESTIMATED COST ��(/ D� OLD - NL BUILDING PERMIT NO. PERMiT NO. /�/ / DESCRIPTION OF FURNACE/BURId�R HEATING or POW PLANTS, Steam, Hot Water Wazm Air- o. , Trade Name • Size No. �� �1 D�'�aZS Capacity ��,� Sq. Ft. EDR BTU HP ->-�---- /' Tatal Connected Load /�� S�` Kind of Fuel �/�,�. C�/��S BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU HP ' � < Company �j-s�.�. ' b Signed By � TeI. No. �� � _ R 3 � /�� i u�►��y ��N� o-sb � 4 z C=Kc�c.. �u�� /1'Jc,2 f��a ��' l � ��' � �� HEAT LOSS CALCULATIONS DEPARTMENT Of BUILDINGS /� ,2 FRIDLEY, MINN. Weatherstrips A.S.H.V.E. Construction No. 7 sr� Insulation Guide �Wind s Do ,, Reference Out. Wall Int. Wall CeiliAg Roof F7oor Kind How Applied Y� No I —No 19_ � Fl.j Room � Length / Width HeiBht Fl.� Room Length, � Width /- Height Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area �Vld[h Height No. o[ Llneal It. Area Width He18ht No. o[ Lloeal ft. Area No. ot pane o( pane lighta of crack . aq. ft. No. � ot pane ot pane Ilghts ot crack �p. tt. Coef.l Btu Infiltration Glass a Exp. wall .Y � Net exp. wall Int. wall Ceiling �• , Floor q ) � Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F7.� Room � Length Width ( Windows and oors--Crackage and Area Wldth Helght No. ot Lineal ft. Aree No, ot pane ot psne Ifahts ot crack �Q. tt. � � � � .� � .f / w / O —7 / �-r C In6ltration Glass Exp. wall Net exp. wall Int. wall Ceiliag Floor Tota! Btu. X � v Coef. � Btu sq. ft. E.D.R. or sq. ins. W.A. Leader area � Fl.� �/�`�(, Room � Length � Width Windows and Doora—Crackage and Area Wldth Helght No. ot Lineal ft. Area No. of pane ot pane Ilght� ot crack sa, tt. � lnfiltration Glaaa Exp. wall Net exp. wall Int. wall Ceiling ' Floor Tbtal Btu. ired sq. ft. E.D.R. or sq. ins. W.A. L.eader area -�a� _� �` Btu Btu Infiltratiom Glaaa Fsp. wall Net eap. wall Int. wall Ceiling Floor � � 7 ITotal Btu. — —r Required sq. ft. E.D.R. or aq. ina. VV.A. Leader ares F7.1 —� �` Room ( I.ength ,� Width / Height � Windows nd Doora—Crackage and Area Rlidth Aefght No. oi L1nea1 ft. Ares No. ot pans o[ pane Ilghts ot crack eQ. ft. % _� c� 2 /9,3 �� Inhltration 3 Glaas Q ,$^ Exp. wall `,-S'" ' � � Net ezp. wall d O lnt. wall Ceiling � � � Floor �� �' ��j� 7'otal Btu. Required aq. k. E.D.R. or aq. iria. W.A. L.eader area F1.� G' Room I[.ength „�,2. Vf/idth � Height Windowa and Doora—Crackage and Area Wldth Hsl`ht No. of Llnsal It. Area No. ot pane ot Dans tl[ht� ot crack �a. tt. Infiltration / C.laas j Eup. wall Net exp. wall / � Int. wafl Ceiling ,�� j� �� Floor i j Total Btu. Required sq. ft. E.D.R. or aq. ins. WA. I.eader area / Btu . , , D46 � _ __'- , a z HEAi LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN. Weatherstrips A.S.H.V.E. Construction No. Insulation Guide Windows I Doors Reference Out. Wal1 Int. Wall Ceiling Roof F7oor Kind How - Ygs—No �'is—No 19_ FL� oom � Length f- Width Height " � FI.� Room Length / Width Windows and oors—Crackage and Area Windows and Doors—Crackage and Area tVidth Helght No. o[ Lineal ft. Area Wldth HeiSht No. ot Lineal tt. Aiea No. o[ pane o[ pane lighte of crack eq. [t. No. o[ pane o[ Dane Ifghts ot crsek p. 1t. / � l .3 � , . f � / Coef. Btu Infiltration • Glass Exp. wall Net exp. wall Int. wall Ceiling � Floor '% �� �-- Tota1 Btu. ��� Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl.� Room � Length I Width Height Windows and Doors--Crackage and Area W1dth Hetght No. ot Lfneal tt. Area No. o[ pane o[ pane Ilehts ot crack �Q. ft. r � i , Coef. Btu In6ltration Glasa Exp. wall % �( � Net exp. wall , Int. wall Ceiling Floor � � � Total Btu. Required sq. ft. E.D.R. or sq. ina. W.A. Leader area Fl. Room � Length Width Windows and Doora—Cracl�age and Area Wldth Helght No. ot Lineal ft. Area No. of pans ot pane Itghts ot crack sq. tt. In6ltration �-�� Glaaa � Exp. wall ,� � Nec exp. wall � Int. wall Ceiling 1r` � � Floor `' �'�j Tbtal Btu. Required aq. ft. E.D.R. or sq. ins. W.A. L,eader area Gf. B:U I � ,r . -� .� /) Infiltration Glaaa Eap. wal! Net ezp. wall Int. wall ICeiling Floor � Total Btu. X Sr Required sq. ft. E.D.R. or aq. ina. W.A. L.eader area �Fl.l Room ( LenSCh Width He't Windows and Doors—Crackage and Area Width HetBht No. oL Lineal tt. Area Nu. o[ yana ot pane lights ot crack sa. tt. � /!. �� / ��v �� 2 .� / , f. Infiltration �.-5 ; (p c 1,� Glaaa Exp. wall Net exp. wall Int. wall Ceiling � � Floor � � , Btu ?otal Btu. S Required sq. ft. E.D.R. or aq. uia. Vf/.A. Leader area Fl.� Room I L.ength -7' Widt Height Windowa and Doors—Crackage and Area Width Hsisb� No. ot Llnsal tt. Are� No. of yana o[ Daae ttghts ot cr�ek p. tL. Coef. Btu In6ltration Glasa Exp. wall /02 Net exp. wall Int. wall Ceiling Floor Total Btu. ft. E.D.R. or sq. ins. W.A. Leader arra � c � � .. � . D•ss , -. : a z � > H'EAT �LOSS CALCULATIONS DEPARTMENT :�Weatherstrips A.S.H.V.E. Conatruction r • Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling Yes—No i Yes—No 19— �? Fl.� Room � Length Width -� Height � Windows and oors—Crackage and Area tYldth Hefght No. ol Llneal tt. Area _ No. ot pane o[ pane lighta of crack eq. [t. In6lttation Glass Exp. wall . Net exp. wall Int. wall Ceiling Floor Total Btu. 1 � Coef. � Btu Required sq. ft. E.D.R. or aq. ins. W.A. l,eader area .� Room Length ,��.- Width Windows and Doora—Crackage and Area Wldth Hetght No. o[ Llneal tt. Area No. of Dane ot pane ll`hts o[ crack p. ft. I � In6ltration 41a� I ExP• wall Nec exp. wall Int. wall I Ceiling / Floor ��, Total Btu. f ,�J 7i � _� _�� ' �m r � �� � % � • _- ' —� �.��t�_ � Required sq. ft. E.D.R. or aq. ins. W.A. l.eader area Fl. Room �Length Width Windows and Doors—Crackage and Area Wldth Helght No. ot Llneal tt. Aret No. ot pane ot Dsne Ilghts ot crack sa. it. � Infiltration Glaaa Exp. wall Net exp. wall Int. wall Ceiling Floor Tbtal Btu. aq. ft. E.D.R. or sq. ins. W.A. L,eader area Heighe Btu . , • . CITY OF FRIDLEY APPLTCATION FO R PLllMBING AND GAS FITTING PERMIT N I �N., N �ro u • x a� � Water u� �n m � � G� m q � n� w �� Heater N y1 �—i UI E •'1 rt Sa m N l�a LL t� •.I Si N a1 C N X +� N Ld � G � v FC • GG Sa N tn G .0 •� .� .0 G C 3 O U•� O.0 � o O O ••i +J N N •.i � O O J-� fn =� N N N UI �C .� �e .a s� ro ro -�+ ro�+ o.� ,-, ro ro a m ro .� ro.0 cn v o a1 aI cn 3 Q G+ �� [:. U aa RC 3 C� � c7 O as le� lst � ' 2nd 3rd 4th (R) = Future Connection Opening (*) = New Fixture, Old Opening Connected with PARTIAL RATE SCHEDULE PLU�IBING FIXTURE RATES: N0. RATE Number Fixtures � x S3.Q0 Fizture Fixture Opening x $2.00 New Fixture, Old Opening x $2.00 Catch Basin x $5.00 Water Heater - to 99,000 BTU �_ x $5.00 100,000 BTU to 199,000 BTU x$10.00 Water Softener x $7.00 New Ground Fun Old Buildinq x $5.00 �:lectric Wuter lle:at�t x $5.OU GAS FITTING FEES: lst 3 fixtures _ _^ x $3.00 Additional Fi�ttures x $1.00 Gas Ranqe to 199, 000 BTU __ __ x $j:0.00 REPAIRS t� ALTERATIONS First $100.00 SS•�� each add. 5100.00 or fraction $2.00 State Surcharge TOTAL FEE REINSPECTION FEE ($10.00) Sewer Water TOTAL $.���po $ $ $ $ �� $ S S r 9 $ �DO _ $ S S $ $ .50 s ��.�i / Job Address Department of Buildings City of Fridley Tel. #571-3450 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 and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. � � � �% , 19 � � OWNER KIND 0 USED AS r �� TO BE COMPLETED ABOUT �� S ��,� ESTIMATED COST S���I� � �—�� �- NEW BUILDING PERMIT NO. _, ROUGH INSP. Date Company 5igned E Tel. No. FINAL INSP. �Q ' � O - � � llate APPROVAL FOR PERMIT 'yG_��""' MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 SUBJECT City of Fridley � AT THE TOP OF THE TWINS g � I L D I N G P E R M I T ,, � � � ; y _.___ C�MMUNITY DEVELOPMENT DIV. { � � PROTECTIVE INSPECTION SEC. , ; , � � �"'1 � CITY HALI FFiIDLEV 55432 NUMBER REV. DATE �'""'�� ,�J 612-571-3450 910-F15 9/16/87 JOB ADDHESS 6191 Kerry Lane N. E. t LEGAL LOT NO. BLOCK TRACT OR ADDITION oesca. 3 2 I�eather ii%lls 2nd Addition 2 PROPERTY OWNER MAIL ADDRESS Z�P Gregory Moxtenso¢� 6191 Kerry Lane N.E. 3 CONTRACTOR MAIL AODRESS Z�P Same 4 ARCHITECT OR OESIGNER MAIL ADDRESS Z�P 5 ENGINEER MAILADDRESS Z�P PAGE OF � � PER O. _ _191?7 ECEIPT . �b ay� 4PPROVED BV SEE ATTACHED SHEET PHONE 571,0411 PHONE LICENSE NO. PHONE LICENSE NO. PHONE UCENSE NO. 6 USE OF BUI�DING Residential 7 CLASS OF WORK � NEW C� ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 24' x 16' Addition and a 12' x 16' Porch. Addition 9 CHANGE OF USE FROM TO STIPULATIONS Side yard variance approved to 4.4' on September 14, 1987. See notations on plans. WARNiNG Before digging calt �es TELEPHONE - ELE��`�����fe. aEQ�iR�D �Y ��W S�PARATE PERIt�tTS REQCl�REp FOR VIIlR1�1fG, HEAtT[l�G, PLi1M6[�I� �t�p S���S. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPA VENTILAT{NG OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOF A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS AND KNOW THE SAME TO BE TRUE AND CORFECT. ALL PFOVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMPLIED 14,550 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $ DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FE£ PROVISIONS OF ANY OTHER STATE OR �OCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $ZZO. SO AN CHECK FEE $ 27.63 . SIG TUREOFCONTRACTOAOR TMORIZEDAGENT IDATFjI WHEN PfiOPER�Y V,Ii �i��/�.� /.u� I��� //.� �'i ��--�- /_ ��i — �7 � h n Q i � OCCUPANCY CU. FT. STREET PARKINC GARAGES ITAX $%.28 TOTALFEE � $145.41 D THIS IS VOUF PERMIT N� [] City of Fridley Effective 4/1/86 ADDN. [%U R-1 AND R-2 AI,TER. [ ] Building Permit Application Construction Address: .�.� � ,����� �-N ���D �-� -T Legal Description: L�,""[' �� �LC���--�—� �kY�T►�-2 I�IU.S 7- =� RDD1T_1nN Owner Name & Address :� ���A �''+ I�' � ��'T���o^� G� g l I:f��-`' Cti, �RwlfyTel. # S`? /- ° y�! Contractor: S � �nn � Tel . # S � � � ° y � � Address• � �A �^^ � - � Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to seale. DESCRIPTION OF IMPROVEMENT l!� LIVING AREA: Length �`f �T. Width ��- F'f Height 5"s� � Sq. Ft. 2�y b� GARAGE AREA: Length Width Height Sq. Ft. a�c V�,T� w ( S-c o a ti �,-� h � Length ► a �:. Width 1 lo F� � Hgt/Ground FT• Sq. Ft. _��___ OTHER : '? i.C� Z d-- 6Ct "t- 16 l.if i'� � . n 1 � S�ili► ��. ay � �c �s. � :. � � . Corner Lot [] Inside Lot [�C] Ft. Yd. Setback 3 S �T, Side Yard Setbaek Type of Construction: c�=,aod ��ww.� Approx. Completion Date: i � �`� Estimated Cost: $ ��8—J J�P.s�� Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: � $ $ See Back Page for Explanation DATE: APPLICANT: Tel. #� �?l -OY// CITY IISE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ � ��.� $ �� .�3_ $�a?3 $ �' $ � � $ ) �t� ,�l 1 � c�,y a��"�' � Fee Schedule on Reverse Side 25� of Building Permit Fee $.50/$1,000 Valuation $ 525 Per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] �- ►y�7 � 1 y, SZIo a pou l3�4G 3a?.� 7�. CTU i1v�� sue�ecr IT N O. c�ty of Fridley 2� 5 6 AT THE TOP OF THE TWINS gU I L D I N G P E R M I T i � RECEIPT NO. � � � • COMMUNITY DEVELOPMENT DIV. � �,.------ , y � y r � � PROTECTIVE INSPECTION SEC. � � � � � � � /�"1 � CITY HALL FRIDIE� SS432 NUMBER REV. DATE PAGE OF APPROVEO BV �.---� • •'' 612-571-3450 9�0-F15 9/23/92 / / �oe no�aess 6191 Kerry Lane NE 1 L£GAl �OT NO. BIOCK TRACT OR ADOITION SEE ATTACHED DESCR. � 2 Heather H111S 2rid SHEET 2 PFiOPERTY OWNER MAIL ADORESS ZIP PHONE Gregory Mortenson 6191 Kerry Lane NE 571-0411 3 CONTRACTOR MAIL ADDRESS Z�P PHONE IiCENSE NO. Sci.Iile 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP pHONE LICENSE NO. 5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR � MOVE O REMOVE 8 DESCRIBE WORK Add dormer (:10� x 15') 9 CHANGE QF USE FROM TO , STIPULATIONS $ee notatiQns on plan. Smoke detectors must be installed in dwelling if not already installed. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR If CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO 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 �- STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE Of WORK WILL 8E COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTWG OF A PERMIT S6 � 2OO $3. �.O DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $9O. OO Fire SC $F). ZO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $99.30 ATURE OF CON'AACT fi A HORIZED AGENT IDATEI � EN OP LY VA DA THIS IS YOUR PERMIT , � . �-�_�.�`� �- • / � Z3� iGNATUR F. ERU NEABUILDERi IDATE�° LDG �NSP OF7E NEW [ ] ADDN ( ] ALTER [ j Construction Address: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application _� ��� Effective 3/ 1 /92 �,�' �� � y� � Legal Description: �.h � `� �L�-'. �_��.�-�i� }�►t �S � ��� Qwner Name & Address: �o� ^�z- � � Diz i CNSc� t� � ��m C Tel. #�% �- � y 1 l Contractor: �Q 2�(�.,,o R.,`, l� I� 21 �.SC� N MN LICENSE # Address: � f�Wt L Tel. l� Sc�r�n E Attach to this application, a Certificate of Survey of the tot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPR4VEMEI�iT LIVING AREA: L.e�►gth Width Height Sq. Ft. GARAGE AREA: I:ength Width Height Sq. Ft. DECK AREA: Length Width HgtlGrow2d Sq. Ft. OTHER: �'� 1� i�o �-w� ��R � � � i� � x 1 � � Comer Lot [) Inside Lot j] Ft. Yd Setback Type of Canstruction: Approx. Completion Date: Driveway Cttrb Cut Width Needed: Ft. + 6 Ft = Side Yatd Setbacks Estimated Cost: . $ (Cost on Back) �a Ft x $ _ � , a'0.7 DATE: aJ- ��-- (a- APPLICANT: Tel. # 1� ii�`� Permit Fee $ �� � 6 Fee Schedale on Reverse Side Fire Swcharge $ li �� � .001 of Permit Vatuation (1/IOth9b) State Surcharge S 43 �� �$.SO/$1,000 Valuation SAC Charge $ �` $704 per SAC Unit License Surcharge $ --�"'- $5.00 (State Licensed Residential Contractors) Driveway Escrow $ `� Alt. "A" or Alt. "B" Above Park Fee $ -�' Fee Uetermined by Engin�ring Sewer Main Charge $ Agreement Necessary [] Not Necessary []. . ��•3�' TOTAL $ � • STIPULATIONS: '� 0 , ' ' • ' � , . , .�.� , , . . _ rrw ' . � ;'�� , . . .� , e . . . ' • 4 u ; n'�' , '• , ' � /! .i ` . r " � . ! 6r I ' . . . , � � . . • � . 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' _ . , • ' ' � • � � , � _ . � � - _ . � .. - � - - - - -__. � � _ __ �:..� ' ------. _^ ^ �-^-='��_ _ -------- ' -�S�►f?D)�3/�S _ _ . . - " . . . - -- - - _ . -: . . - - ._.:..:._..�-----�_ -.. .. -....�._.- !!9�{D'745 . . - . � ��_.__ _ . -HS�A�/'1l1�� __ � • • - . . . + , . . ' . - , ' � . . � . . -. . . . � - . -.. � � � - . ' � . _- �, ..._ sue�ecr PEFi City of Fridley i 7�4 A7 THE TOP OF THE TWINS g U I L D I N G P E R M I T r ' ' REC � � • , . COMMUNI7Y DEVELOPMEN? DIV. ��2�604 � tV'�'��� , . f � � pROTECTIVE INSPECTION SEC. � . , i•---����"' �'% CITY MALL fRIOLE� 55��2 NUMBEP pEV O�fE PAGE Oc �av Ov 0 r i 612-571-3450 9tQ-F15 4/17/O1 � � 108 ADDRESS 6191 Kerry Lane NE t IEGA� �OT NO. BLOCK TRACT Ofi ADOITION SEE ATTACMEO oesca. 3 2 Heather Hills 2nd Addition SHEET 2 PiiOPERTY OWNEF MAIL ADORESS ZIP PMONE Greg Mortenson 6191 Kerry Lane NE 3 CONTRACTOii MAIL ADORESS 21P PHONE IICENSE NO Citywide Home Imp. 1005 W Broadway, Mpls., M13 55411 612-529-2489 3013 1 ARCHITECT OR DESIGNER MAIL AOORESS ZIP PMONE LICENSE NO. 5 ENGINEER MAtL AOORESS IIV PMONE IICENSE NO 6 USE Of BUILDING Residential 7 CIASS OF WORK O NEW ❑ ADOITION O ALTERATION C� REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reroof House & Garage (17 Sq) Tear-off 9 CHANGE Of USE fROM TO STIPULATIOfVS Underlayment must comply with the State Building Code. Permit inspection Cards To will Be Mailed Homeowner To Post TYPEOFCONST. OCCUPANCVGROUP OCCUPANCVLOAO SEPARATE PERMITS ARE REOUIREO fOR ELECTRtCAL, PLUMB{NG, MEATING. VENTI�ATING OR AIR CONOITIONING. TMIS PERMtT BECOMES NULL ANO VOID If WORK OR CONSTRUCTION ZONING SG. fT CU fT. AUTHORIZEO IS NOT COMMENCED Vy1THIN 60 DAVS. OR IF CONSTpUCTION OR WORK IS SUSPENDED OR ABANOONEO FOR A PERI00 OF 120 OAYS AT AN� TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OifSTREET PARKING 1 HEREBY CERTIFV THAT I HAVE READ ANO EXAMINEO TMIS APP�ICATION 1 STA��S GARAGES ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PHOVISIONS Of LAWS yALUATION SURTA% AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMP�IEO @ WITM WHETHER SPECIFIED MEREIN Oii N07. TME GRANTING OF A PERMIT W 1� 738 �• 87 OOES N07 PiiESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEL TME PEqMITFEE SACCMARGE PiiOVISIONS Of ANY OTMER STATE OR LOCAI lAW REGUTATING CON• STqUCT10N OR 7HE PERFOfiMANCE OF CONSTRUCTION �C).3.15 Fire .SCi �1.%�F P�AN CMECK F TOTAL FEE Licen C $5 $70.76 $iGN4TUpE0FCONIFACTOQOA�UTNOA�ZEO�GENT IDATEi y.� p V VA�t D TMIS IS VO PERMIT - � �S�Ga�ivaE O� OwHEQ��� OWNEQBw�DEA� � �O�tE� OG �w - � n E NEW I l ' 1��� U ADDN [] , ALTER [ ] Construction Address: l�l �� , Legal Description: Qwner Name & Address: Contractor: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Ty� G Effective 1/1/2001 CITY OF FRIDLEY (763) 572-3604 Bldg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Tei. # MN LICENSE # 3�� � � Tel. # �2 SZ�f ;2��� Attach to this application; a Certificate of Survey of the lot, with the proposed constnaction drawn on it to scale. DESCRlPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Length Width Height Sq. Ft. Wdth HgUGround Sq. Ft. �°��„� �� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �` / �"G( APPLICANT: Tel. #��,6-. , �'���f CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application $��15 Fee Schedule on Reverse Side ___ $ ) .001 of Permit Valuation (1/10th%) � � �� $.�C1/$1,OOQ ��lalu�t��n $ $1150 per SAC Unit $ S, GU $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ J Not Necessary [] $ �� .� �1 V y/��/a/ sue�eC"r PERMI N . c�ty of Fridley 3 i 9�i0 ' , AT THE TOP OF TME TWINS g �� L D 1 N� P E R M i T qECEI . r � �• COMMUNITY QEVELOP�ENT DIV. /� r � V � PFOTECTIVE INSPECTION SEC. �7�-360�t �q , . . � � �"': � CITY HALI FRIDL�� SS�32 MuMBEP � REV O�TE PAGE O: APPqpvED 0v ���°�"� �'' 612-57�-3450 s�aF�S 7/9/01 � � JOB AODRESS 6191 Kerry Lane NE . t LEGAL �OT NO. BLOCK TRACT Oq ADDITION SEE ATTAGMEO oescA. 3 2 Heather Hi11s 2nd Addition SMEET Y PqOPERTY OWNER MAII AOORQSS, z�p PMONE Cindy Mortenson 6191 Kerry Lane NE 763-571-0411 3 CONTRACTOR MAIL ADORESS ZIP PMONE IICENSE NO Spruce Builders Inc 2425 80 Ave N, Brooklyn Park, MN 55444 763-566-4881 � AFiCHITECT OR OESIGNER MAIL AOORESS ZIP PNONE IICENSE N0. 20040330 5 ENGINEER MAIL ADORESS IIP PMONE LICENSE NO 6 USE Of BUILDING ' Residentiai 7 CLASS OF WORK ❑ NEW G� ADDITION O ALTERATION O REPAIR ❑ MOVE D REMOVE 8 �ESCRIBE WORK Construct a 14' x 15' Deck 9 CHANGEOFUSEFROM TO STiPULATIONS See notations on plan. WARNING Before digging call for SEPARATE PERMITS afl utility locations �EQUIRED FOR: 454-0002 pLU�gi��� an�io�si�irs REQUIRED BY LAW tYpEOFCONST. OCCUPANCVGROUP OCCUPANCVLOAD SEPARATE PERMITS ARE REOUIREO fOR ELECTRICAL, PLUMBING, MEATING. VENTILATING OR AIR CONOITIONING TMIS PERMIT BECOMES NULI ANO VOID If WORK OR CONSTRUCTION ZONING SQ. FT CU fT AUTHOAIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANQONED FOR A PERIOD OF 12Q pAYS A7 ` ANV TIME AFTER WORK IS COMMENCED. ' NO DWIG. UNITS OfFSTREET PARKING I HEHEBY CERTIFY THAT I MAVE READ ANp �XAMIN�O THIS APPLICA710N 1 STA��$ GApAGES AND KNOW TME SAME TO BE TqUE AND CORRECT. ALL PROVISIQNS pf LAWS VA�UATION SURTAX AND ORDINANCES GOVERNING THIS TVPE OF WORK WILI B� COMPlIED $2�310 �I.IS WITH WHETHER SPECIFIEO MEREIN Op NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEI THE pERMITfEE SACCMARGE PROViSIONS OF ANY OTHER STATE OR IOCAI LAW REGULATING CON• $83.25 Fire SC �2.31 STRUCTION Oi: TNE PERFOFiMANCE Of CONSTRUCTION � P�AN CMECK FEE TOTA EE �'����j� % % Ol Licens $5.00 91.7I SiGNAfUAE OF CONCFACTOa OA �U�MQFIZEO �GEN~ iD�iE� � � NEN ROPE ALIOAT TMIS t5 V UR P AMIT � � rO S�GN4TUQEO�OWNEQ���ON�NEpBWLOEp� �OAiE� . � � .y � B G���vSo � � � �i�tE NEW [ ] Effective 1/1/2001 ADDN [] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: �D%Q/f ,��z�/ �� Legal Description: Owner Name & Address: _( -i � !'?%.�T�'`�S'v� Tel. #_ '7(,� �"'7/-py// Contractor: c.5d��l�E r�/L�2�S .�i�� MN LICENSE #,(�'-1D1� 5'03.�0 Address:_,2y,?� gD°"�i4vE �a �r'cy�s�.s.cc� Tel. # 7L.�-s"�G-5'8'8J LIVING AREA: GARAGE AREA: DECK AREA: Attach to this application, a Certificate of Survey of the (ot, with the proposed construction drawn on it to scale. DESCRiPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length �y , Width /S� HgUGround 3� Sq. Ft. co�� OTHER: � ,b�S Oti Sc s �� Construction Type: Estimated Cost: ��� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �o �� COl APPLICANT: � � "��� Tel. # %L.���- �S�/� CtTY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application $ �� � °��Fee Schedule on Reverse Side $ ` .001 of Permit Valuation (1/10th%) $_/! f� $.50/$1,000 Valuation $ $1150 per SAC Unit $ %, , �9� ,$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 [ ] � l� �� �M S�� u��` ��r� ��r.�, �'-� ZS�ZS Sd`,`' /4vE /Vo �.����.: y.� �,�� , �.� s.�y�y �b.�-„�b�- yaa/ n / '�� / Cj�v�iy /�v,�Tz--�vSV�v � � jz �, q� ,���ly ,� f�,��= y �ti �y: � -��3- s�/• oy�/ � �x�fr�� G ,�,��sE � - 6'-� — � ����� c� ��� ��i ��s-� . — . / ��c �c��i�'�/ /�' /b�1/ �'i�/ � � F�i,�r..�G, ���s � Foaa�1 T �ON %�.f+r� . �, .._..___'._... /� y -= - � � _' '___ . ...... .. �ax C�N� .� � p�, D� �� �- -' -� --�- � �� -�, � f� /� �� / { -- 7= � "X 7 x 5a UB �ArppR4V p Ws���TQ f�FlO � �6S = 0 � `�� � �� � 4 � ► i � � � , ;_ � � - ,va�/M�N��� /G'i L� � 9' �/ yZ X y" �..4 �s ,G o,c . �ash ��/ ��,�/o� + Z X /Q_ T.CE.� - /6"o.C. ��v. ,r� /�A� �� U� �C��VF �/r�✓ _ _�,� � ��►1� -- � -- ,�i/,tl// �la/F� � n�; t'�ass Sfcr�o� Nor ro sc•a � t' � 2 x2 c��� s.. o�. �C 17CC�'�Nf3 • � �.� „�� Nt'.��v��Z � �� .'�ir►� ' � ♦ / . � � � � 1 � I t � � � � � � � I i . i � ! � 1,� J �' v rl , � � Q � �{� ' C � �� � 1� N. � � ; j � � ' � � /_ �s l. 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P � .Gyc �� �,�--�-�-�.-���r_7.v.. � G U:'' /� f3 ./• O a:.eY T. f<�c' :47'iy' _F.� �= r�/G / S' a5�'C'Uit/7 A.00/1'/l�itl /�.R..•O��'A r:'!'.� U'�5:.' `l J�' �/.�/1.: n�� iL.�E"J U Ti.' , SG'B.. :�'.!� .' �'J E' �'7 u,YG'iYi e9'.•�./ ; :..^" e:)�" , . r' _FC'p .C�'✓. . � . �•� - . � , • • t �#r ' SCALE: i ".�- .,�^U ' Q O�:C/orES /F�Gkt/ i39G�.�.it/n4c�::/:• .f4T /� - 7• 7� � I hcrrUy certify that tl�i� survcy,� plzn or rr.�►ort was prepared by mc or undcr my direct st�}�ci��ision and that I am a duly Rc�tistcred I,and St:rvcyor undcr tlic laws of llic Statc --- . of-A�Iit�i;csot�. ,�T� 1 .� .��y io8.� z. �/.��/�� ..���� i� �--� / Rc.�;. Na Dafc JoU No. � � ` i 1 �.i ��� . / �'�, / . i:a�'.�i,.Vi�t� .%q� : . f -W �I _.T ✓p ^ � ��- '�:�•• . .. �� � V��� �� ' \ � .. i �.: •° �.. `� . �..�'��: �YFI'.).:.. . . •�K ;�' YT-.' � ,� j � . CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 s�z-�bu4 r�ax: ADDRESS : 6191 KERRY LN NE PIN : 133024430050 LEGAL DESC : HEATHER HILLS 2ND ADD PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE : LOT 3 BLOCK 2 : PLUMBING : RESIDENTIAL : ADDITION/ALTERATION 5%1-1Lii7 PERMIT NO.: 2004-00162 1 � � ; DATE ISSUED: 02/05/2004 �'�' � VALUATION . NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A REPLACE GAS WATER HEATER # ELEC WATER HEATERS # NEW FIXTURES (EXIST OPENINGS) # GAS DRYERS # OF NEW FIXTURES APPLICANT NORBLOM PLUMBING CO 2905 GARFIELD AVE S MINNEAPOLIS, MN 55408-2173 (612)827-4033 OWNER MORTENSON CYNTHIA A 6191 KERRY LN NE FRIDLEY, MN 55432 0 VALUE OF FIXTURE/APPLIANCE 0 # GAS WATER HEATERS 0 # GAS RANGES 0 # WATER TRMT APPLIANCES AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl� will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. An �'�caif�. . Date Bldg PLBG PERMIT MINIMUM FEE PLBG FIXTURES (NEW OPEIVINGS) PLBG FIXTURES (EXIST OPENII�IGS) WATER TREATMENT APPLIANCE WATER HEATER - ELEC WATER HEATER - GAS GAS RANGE FEE GAS DRYER FEE PLBG REPAIR/ALTERATIONS STATE SURCHARGE, PLBG FLAT TOTAL PAID WITH CHECK # 27688 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 1 0 0 20.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.50 20.50 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridiey, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: NO. R,4TE New Fixtures � $ 7.00 Oid Opening, New Fixture : S 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7A0 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 , Water Heater -Efectric $ 7A0 1Nater Heatec - Gas'• �_, $10.00 Gas Range*� $10.00 . Gas Dryer*' $10.00 � TOTAL JOB ADDRESS `�"J�FJ�f� �I"s aui�J �. I �� _.—,--�,_ Back Flow Preventer Required OYes O No Type �15.00 � -- _. . Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIOMS 1.5% of Value of Fixture orAppliance State Surcharge TOTAL FEE 0 �, �� � ; The undersigned hereby makes appiication for a permit for the work herein �specified agreeing to do all work in strict accordance with the ciry codes _�� and ruli�gs of the �uilding Division, and hereby declares that all the facts and representations stated in ihis application are true and correct. MORTENSON, CINDY 6191 KERRY LANE NORTHEAST FRIDLEY, MN 5543� Owner (�63) 571-0411 r 1�3 , 20��1 8uilding Used As 'ES �°/ls C��,, � � � 00 � / ? Estimated Cost _ PERMIT NO. �i�� �� �(c�?� PLUMBING GOMPANY ,� OY�C��iJ� ?�U!✓IC�/I�G �� SIGNED BY TEL NQ �Z"S�7` �O �� Approved By ough-In Date Final Date .: MINIMIlM FEE FOR ANY PLUMBING/GAS PFR�u� �S S20 00 PLUS THE 5.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A COMMON VENT INFO ON BACK SIDE