AF - 47949,--�
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Caty of Fridley, Minn.
BUILDING PERMIT
Date: DECEN�ER 27, 1966
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Ovvner: �. LOR�R�iINE WINRLER Builder SAME ..._
,p,d� 1641 GARDEL�A AVENUE N.E. �,d�.� �
FRIDLEY, MZNNESOTA 55421
LOCATION OF BUILDING
No. 1641 Street GARDENA AVIIVUE N. E. _ Part of Lot
Lot ._._ 1�__ Block 1 Addition or Sub-Div9sion .—._�,��ONS
Corner Lot —_ Inaide Lot ...__.._. Setback —.. ...__._._ Sideyard
Sewer IIevation � .� Founda.tion IIevation
DESCRIPTION OF BUILDING
To be Used as:
REMODTs]',ING KIT. �nt Depth Height Sq. F't. Cu. F't
Front Depth fTeight Sq. Ft — Cu. Ft
7�pe of Construction � Est, Cost � 1 000 ..__ To be Completed ...._
In cans�tderation of the issuance to me of a germft to construct the building described above, I agree to do
the proposed work in accordance with the descrlpiion above aet forth and in compliance with all proviaions of
ordinances oP the city of Fridley.
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In conafderat[on of tbe payment of a fee of $�' • 00 , permit fs hereby granted to M� •���
� to construct the buflding or addition as described above. This rmit is gran�"ed upon
the expresa condition that theperson to whom it ia granted and his agente, employees an�worl�en, in all work
done in, �around and u�n eatd building, or any part thereof, skxall conform in all reapects to the ordinaaces of
Frldley, Minnesota g lacation, construction� alteration, maiatenaace, repair and movin� of bufldings
wltl�in the dty ]irnfts��an�this permit may be revoked at any time upon violation of any of the provisions of said
ordinaaoes.
(;LARENCE BELISLE B��g �r
NOTICE:
flds pstmit d� eo� eovsr ths coaatrueHon, i�hllattee for wirta8, plumbteg, ea huNee, ssw�e or watsr. B� mn to a�
tlro Buildiag Inspsetor for aparats panehs Por t6as tt�m�.
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ClWNER' S
APPLICATIO� FOR BUILDING PEItMIT
CI�"Y OF FRYDLEYk MIN�IESOTA
ADDRESS � � ��� � � _ �t� ���°� ADDRESS
..�._.�._.r_
/ LOCATION OF BUILDING
NO..�� � .
STREET ����.��� �` P T OF LOT
LOT�,_ BLOCK / ADDITION OR SUBDIVISIO ���-�� a� �'�°�`�-
CORNER LOT IATSIDE LOT ;
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SEWER �EVATION FOUNDATIOP ELE�ATI01�''
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�ppliceat attach C� this form T�ao CertificaCes of Survey�of Lot and proposed
buildiag location drawn on these Certificetes.
DE$CRIi',�ION OF BUILDING
Uaed A�: � �--�
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Front Deptl
ight
Sq. Ft. Cu. Ft.
• •• Front Depth Height
Sq. Ft. Cu. Ft.
Type of Canstruction ° Estimated Cos� %� �-�'�1� d�
To Be Completed �� ���.�/
/
...�_���.+.�...�
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The undereigned herebq �a,kes appli��tion for a permiC for the work herein specified,
agreeing to do all work in strict �iccordance �aith the City of Fridley Ordinances
and rulings of the Dep�,rtment:=of Buildings, and herebq declarea that all the facts
and representatioqe s."tated ia thia applicatioa are true and correct.
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(Schedule of F'ee Costs caa be found on the Reverse Side).
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BUILDII�TG PEi�'!IT FEE SCHEDULE �
SECTION 2. The Iaspector of BulYdings ahall, before issuing pe�Lts for the
erection of any buildin� or structure, or for any addition to anq existing
building or structure, or for any alteratioas or reg�irs to any existing buildia$
or etructure, upan appl3,catioa.�herefo�e, require the payment by..the applicant
for such permit of fees to the amount herein below set forrh and in'the menner
herein .pr.avided, to-wit: .. _ ,
2.1. For any euch petmit for the erecti.on oi aay fire-proof buildiag,
other than a garage, �arehouae, factiorq or grain elevator, or for the erectian
of any fire-proof.additioa, for eimiler occupancy, to any existing building,
sha11 be -at the 'rate of $1.40 for each ane ehousansl. cu�tic feet, or, fractiou
thereof, in such cubical conteata.
2_2s For anq such permie for the erectioa of aaq f�.re-proof �arage,
warehouse, factory or grain elevator, or°for the erection of any fi�re-proof
addition, for similar occupancq, to any exieting buildiag aha11 b� at the rate
of $1.25 for each oae thousand cubic fe�t,.classified Be "fireproof'! by Section
502 of;the Mian�apolis Building Code. ,
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2•3• For anq auch permit for the erectton of anq aon-firegroof buildin�,
other than a garage, warehouse, factory or grain elevator, or anq non•fireproof
addition, for similar occupancq, to any exi.sting building permit fee $�.,Op far
each aae thoueand cubic feet.
GARAGES .. . .
2.4. For any such permit for the�erect3on of aay aon-fireproof garage,
warehouse, factory_ar grafn elevator, or for the.erectian_of aay aon-firepro�f _
additiou, for aimilar occupancy, eo any enisti.ng building or for�each such
building or �ddit�:an - niaety ceqts. ($0.9Q) for.each oae thousand cubic feet
or fractian thereof, in the cubical contents thereof with the mini.mum of $4.00.
For the gurpese of computiag fees for building perm3te�,�the cubical contents of
anq building or,ad,�litioa..to a uai�orm height throughout bg multiplyiag the ground
area covered from a point six (6) iaches below the floor �line of the basement or
cellar to the average height of the upper surface or to the average height of the
roof surface of the main gable of a pitci�ed roof: :. �
�, �.
2.5. For repairs ar alteratioas tv aa exi�ting�str�cture, the fee s.hall
be at the rate of $3.00 per each Five Hundred Dallaus�($500.00) ar fractian
thereof in the casC of all proposed work.
2 6_ �n na case shall �he fee chsrged ior.anp permit as set forth ia
Section 2 be leas than $4.00.
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sue�ecr PERA
City of Fridley _ 16 4 2 3
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
�
; � RECEIPT .
COMMUNITY DEVELOPMENT DIV.
r � L � PROTECTIVE INSPECTION SEC. �� Q�
1 . i
� � /�"1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BV
�""""� � �'� 612-571-3450 910-F15 / /
10/7/81
JOB ADDRESS 1641 Gardena Avenue N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 2�j Aud. Sl]�. #g2 SHEET
2 PROPERTYOWNER MAILADDRESS 21P PHONE
Roger G. Ettel 1641 Gardena Avenue N.E. 571-5753
3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO.
Same
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
0 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WOFiK
Install a Blaze Ki. "Prince s" ICBO 3634 Wood Surnin Stove
9 CHANGE QF USE FROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WOFiK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 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 tii`�. OOO S. SO
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 OFi THE PERFORMANCE OF CONSTRUCTION. ].�. QO
PLAN CHECK FEE TOTAL FEE
$19.50
� SIGNATUREOFCONT ACroa Ailr RI � AGENT �DATE� ,. ya1HEN PROPERLY VALIDATED THIS IS YOUR PERMIT
JD���g � 88� Ll
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� E OF O A iIF OWNER BUILDE IDATEI BLDG iNSP �A E
e
CITY Of" FRIDLEY Effective Aug. 1, 1981
APPLIC/ITI�J FOf; RCSIDE(VTI/1i [3U1LDIf1G PEf�`�fITS
(t�e►•r, Alterations, Additions, or Repairs)
Otl�JER: � �`���- [3UILOER: � av� � J .
ADORESS: _ ► �y � (��c����c� �� � ADDRCSS:
TEL N0: 5��- 5� 5� � TEL I�O:
Construction Location
STRITT NO: STItEET: !� �� �rQr�'��cc'l � f°t U�
LOT: . o�S BLOCK: ADAITION: _ �Q� . �G%�
Corner I,ot: Insii3e Lot: Setback: Sideyards:
Ap�licant attach to this form two Certificates of Sti.irvey of lot and
proposed buildi.ng location drawn on certificates to scale.
��y,�/� <<p��e WESCRIPTIOIS OF COt�STP.UCTION ,
�� �"�"� I�'ront: De th: Hei ht:
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Square.Feet:
Qibic Feet:
Front: Denth: Height:
Square� Feet: C1�bic I'eet:
Type of Construction :�����,` ��p � S'�'�� � Estimated Cost: $ � O�Q e��
Zb Be Wr,�pleted:
Alt. A Alt. B
Proposed Drive��ay Width If New Opening Is Desired: $� $
, SE� REVERSE SIDE OF SiiEET _
T'iie undersigned hereby ma3:e� application for a permit for the t:vrk� herein specified,
agreeing to co.all work ir� strict accordance ��ith the City of I'ridley Ordinances and
rulings of tll� Department of IIuilc3ings, and hereby declares tha all the facts and
representations stated in this application are true �nd cor�c�,�
D.3T�: � () - � ' � � SIGNIITUF�E :
Stipulations:
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BiJILDING PERMIT FEE SCHEDULE
The Inspector of buildings shall, before issuing permits for the
erection of any building or structure, or for any addition to any
bxistinq buildinq or structure, or for any alteration or��repairs
to any existing building or structure, upon application therefore,
require the payment by the applicant f or such permit of fees to the
amount herein below set forth and in the manner herein provided to-wit:
'PO�AL VALUATION
$1.00 � S500.00
$501 to $2,000
S2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
FEES
$10.00 Minvnum Fee $15.00 plus surcharge
$10.00 for the first $500 plus $1.50 for each
additional $100 or fraction thereof, to and
including $2,000
$32.50 for the first $2,000 plus $6.00 for each
additional $�,000 or fraction thereof, to and
including $25,000
$170.50 for the first $25,000 plus $4.50 for
each additional $1,000 or fraction thereof, to
and including $50,000
$283. 00 for the first $50, 000 plus $3. 00 for
each additional $1,000 or fraction thereof, to
and including $100,000
$100,001 and up $443.00 for the first $100,000 plus $2.50 for
each additional $1,000 or fraction thereof
PLAN (�QC: 25 percent of building peYmit fee
DRIVII�IAY DEPRESSION ESCROW: Concrete Curb Streets Only
Alternate "A": Removeal and replaceJnent of curb and gutter only
Driveway width plus 6 feet x$13.50
Alternate "B": Ranoval and replacesnent of curb and gutter and install a 3 foot
wide approach with 6 inch depth
Driveway width plus 6 f eet x$15. 75
VERIFICATION OF FOUNDATI�ON
Permits for construction will be issued a minimum of 24 hours from the time of
application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Suzvey of the lot, showinq the location of the foundation once it
has been constructed will be required before proceeding with.the framing.
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SUBJECT PE O.
City of Fridley 14'739
' ` AT THE TOP OF THE TWINS g U I L D I N G P E R M I T REC .
�
� `L _ COMMUNITY DEVELOPMEN7 DIV.
r � � PROTECTIVE INSPECTION SEC. ���"/�i! /
1 � � � 7�
' �'��1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BV
�""� � ,'� 812-580-3450
910-F15 6/%/78 � �
JOB ADDRESS 1641 Gaxdena Avenue N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ZS AL1C�. S'llv. #92 SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
James Sovada 1641 Gardena Avenue N.E. 571-8827
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
S ame
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS Z�P PHONE LICENSENO.
6 USE OF BUILDING
ReS1C�P.11'tl�.
7 CLASS OF WORK
❑ NEW ❑ ADDITION C� ALTERATION 0 REPAIR ❑ MOVE ❑ REMOVE
S DESCRIBE WORK
Repair basement
8 CHANGE OF USE FROM TO
�TIPULATIONS
W�RHING
gE'P�RAT� PERMITS REQUrREQ FOR W1RN'V%►, 8ctore �i�ging call locat. utilities
HEATIt�tC. � P1.UM81NG �NO StGNS. 7�PHONE •��ECr�ic-- r�s �t�.
� ,#tE�QU1RE� BY LAW
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 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 �- STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROYISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. �•12pO�00 $.rJQ
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
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- $7� 5O
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
$8.. �Q
SIGNATUREOFCONTRACTORORAUTMORIZEDAGENT IDATEI, WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
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CITY 0� rIZIllLCY .
/til'1'L1C/tTIUI� f'0(t ItLST1)CNTIIIL �u1LD1(�!G f'Cl2MITS
(�'�L"W, �LTEft/1T1UtJS, /1UU1T10(JS, 0(2 R�P�IttS)
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OS•:12�R: 6`�-�� d U 7T�� RUILUI:12: -'' �
�aaz�sr : l � � � •� � ��i r►aar�::� : �
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Tel . t�o . :
t1o. Cy Street: � 19 � IJ� N j� � P
r,o�r: � � »r�ocr.: nnDxTZOr� : � � � % 2
C0121J2:R LOT: IIJSID� IIJT: SLTI3J�GY.: SIUL•'YARDS:
Applica'r,t attach �to i:}iis f�rm 1�ao Certificate_ of Survey oi Lot and proposed
bui.lclinc� locaL-ion dra�r�n on these CerL-iLicates. .
�
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DESCRI PTIOhd OF BUI LDI l�G .
73e Us ed As : �
. n G � .
Front: Depth: Height:
��,�-� � � 5quare Feet: Cubic Fe�t:
I'�cont: � Depth: � Heic�ht:
:
' Square Feei:: ' Cubic I'eet: '
�Ype of Construc�ion: EstimaL-ed Cost: $
�� � � �_
�'o Be Com�lei:ed:
Alt. A Alt. B
Pro�osed Driveway tti•idth If ldera �pcning Is Desired � $ $
(S�r P.�VEF•SE SIDE OF SHEET)
The undersicined hereLy makes application for a permit for the work herein
specii'ied, agr�eing.ro do all �:ork in strict accordance wit.h the City of
Fxidley Ordinances and rulings oi' the llcl?sltraent of l�uildii�gs, and hcreby
dec�ares th�t all the facL-s and regrescnL•aL-ions staL-ed in i:his applicat:i�i� .
��re L-rue .7nd correct. e xeverse s' e for aclditional into�ziation.
Dt►T�: (,�v�-2_ SxGn��rvr.i.: ��Z��o `�`-`�--
£tipulaL' ns: .
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BUILDI(JG PER��II1' FEt SCilEDULE
SECTiON 2. The Inspector of IIuiJ.dings shall, before issuing pennit� for �he erection
of any bvilding or struc�ure, or for any addition to any existing huilc�ing �r structure,
or for any alteration or repairs to any existing building or structure, upon'aL�plicatior.
therefore, rcquire the payr�ent b�� the appli.cant for such pennit of. fees ta the an�ount
herein belor: set forth and in the manner herein provi.ded to-wit:
NE�•7 CO2JSTRUCTION: Single Family Homes and Garagc�: $4.00/1,000 cubic feet..
PLAN CHECK: 25 percent of building permit fee.
DRZVESal�Y DEPRESSION: (Concrete G�rb Streets Only)
Alternate A: P.emoval and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x$14.50
Alternate B: Removal a:,d replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 teet x$17.20
• AnDITIONAL INFOR�1ATION
For the pur�se of cor.tputing fees for building permits, the cubical contents of any
building or addition, is determined by r.►ultiplying the ground area covered from a
point six (6) inches below the floor line of the basement or th� cellar to the
average heig�ts of the upper surface or ta the a�►erage height of the roof surface
of the �ain gable of a pitched roof.
F4r. repairs or alterations to an existing structure, the fee shall be at the rate
a£ $3.00 iier each five hundred dollars ($500.00) or fractior. thereof in the cost
of a11 �rc�posed work.
In no case shall the fee charged for any pez-mit as set forth in Section 2 be less
than $7.50 plus $.50 state surcharge.
VERIFICATIOid OF FOUNDATIOfV
NOtE: Permits for construction will be issued a minimum of 24 hours from the ti.me
of application tc allow for pr�per review of the proposed si.?-ucture and of the
consfiruczion site.
A Certificate cf Survey of the lot, showing the location of the foundation once it
has beEn constntcted �vill be required before proceedir.g with the framing.
CtRTIFICATE OF �CCUPANCY
Apglication for a Certificate of Occupancy shall be made ten (1�) days prior to the
use or occur�ncy of any structure for which a building permit has been issued; and
• said structtare siiall .^.ot be used or occupied until a Certificate of Occupancy has
been �.ssued.
.�-; ,
•�„
SUBJECT Q,
City of Fridley o 19380
AT THE TOP OF THE TWINS g U i L D I N G P E R M I T
�
� � EIPT NO.
COMMUNITY DEVELOPMENT OIV.
f i L � PROTECTIVE INSPECTION SEC. ��� ���,
i ` , d
' �'��� � CITY HALL FRIDLE� 55432 NUMBER REV DATE PAGE OF APPROVED BY
�L.__.Jl.' '•� 612-571-3450 910-F15 4�8�88 / /
JOB ADDRESS 1641 Gardena Avenue N. E.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION . SEE ATTACHED
DESCR. P't. 25 Auditor's SllbdlVlSlOri #92 SHEET
2 PROPERTY OWNER MAIL ADORESS ZIP PHONE
Mike Bohan 3720 Foss Road N.E., #16, St. Anthony, MN 789-6631
3 CONTRACTOR MAII ADDRES$ Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS Z�P PHONE LICENSENO.
8 USE OF BUILDING
R2 S1CZP.T1.'t11�.
7 CLASS OF WORK
� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 20! x 24� Garage
8 CHAN(iE QF USE FROM TO
STIPULATIONS p�ovide a hard suxface dxive�ray, Garage can not be.3auilt any closer
to street thaz� the existing hAUSee Ga�age slab to �e 9'� above existing sidewalk.
Garage ca,n never be attached to hause because it arill not ha.ve frost footings.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, �PE OF CONST. OCCUPANCY (iROUP OCCUPANCY LOAD
VENTILATING OR Alii CONDITIONING. WOOi� Fl"dIIIE
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
OH WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R�1 9`8Q
ANV TIME AFTER WORK IS COMMENCED. • NO. DWIG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS GARAGES
AND KNOW THE SAME TO BE TFUE 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 $6892.00 53.45
DOES NOT PRESUME TO GiVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $G2. SO
LAN CHECK FEE TOTAL FEE
, $65.95
SIGNATUREOFCON'RACTORORAUTHORI2EDAGENT iDATEi WHEN PROPEFiLY LIDATED THIS IS YOUR PERMIT
i�d%✓'r?� , / � � (J
SiGNATU E OF NER iIF OWNER BUILDERI 1 ATEI LDG iNSP rjq
,� tM
� °
NEW [ ]
ADDN. ��
pLTER. [ ]
City of Fridley
R-1 AND R-2 �
Building Permit Applieation
Effective 4/1/86
Construction Address:�% � l .Ca �� �J� ��
Legal Description: �f�� ,- ('�f= �'� 2 � - �� � � i �� r ��/3 - G�i�ooJ �o ne '� °' "Z
/ „
Owner Name 6 Address : ����-"�'�77�' ° � Tel .�
Contractor:_ _�_r,��'� �3 UL(f9� Tel . # % �5 - � � �/
Address: � � � � FpJ's %�'� , h�,,�� ��b - �%_ 'i}i✓i � uw i � i°�/'i�v.
Attach to this application, a Certifieate of Survey of the
lot, with the proposed construction draWn on it to scale.
DESCRIPTION OF IMPROYEMENT
LIVING AREA: Length Width Height
GARAGE AREA: Length 2 0�� ��lidth � �"' 9 Height �� ' P
DECR AREA: Length Width Hgt/Ground
Sq. Ft.
Sq. Ft. �
Sq. Ft.
OTHER:
Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setbaek
Type of Construction:
Approx. Completion Date:
Estimated Cost: $ 6� S 2
Alt. A Alt B
Proposed DriveWay Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: S $ o
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
APPLICANT: ���''��'��� Tel . 4 � �5 - G � .3 /
CITY IISE ONLY
/ So
$ b Z� Fee Schedule on Reverse Side
$ 25� of Building Permit Fee
$ � �- $.50/$1,000 Valuation
� $ �50 per SAC Unit
$ Fee Determined by Engineering
$
$ j�, Q�°� Agreement Necessary [] Not Necessary []
l
STIPULATIONS:
�,+ �A 2 raG r�. ��.� Nu, 3�
�� � �� ��� ��s� �
T��- �`R�� �'�rJ/�v� �'tC �i���iG /�0 �s Q� �
G �A2A�� Se��O � �� �' " I��IOt� �i,c,��� Si��w�
� �B�L�C � � ' C'q�'JK J��� �rtl� �� ''� �� � l�iL�SC
! T W �►�. �l.l l� AZ
BIIII.DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any
building or structure� or for any addition to any existing building or structure, or
for any alteration or repair to any existing building or structure, upon applicatio n
therefore, require the payment by the applicant for such permit of fees to the amount
herein beloW set forth and in the manner herein provided to-wit:
Total Valuation
�1.00 to �500.00
�501.00 to $2,000.00
$2,001.00 to $25,000.00
a25�001.00 to $50,000.00
Fees
.
$10.00 (Minimum Fee is �15.00)
$10.00 for the first �500 plus $1.50 for each
additional �100 or fraction thereof� to and including
�2,000.
#32•50 for the first a2,000 plus $6.00 for each
additional �1,000 or fraction thereof, to and
ineluding �25,000.
$170.50 for the first �25�000 plus $4.50 for each
additional a1�000 or fraction thereof, to and
ineluding �50�000.
$50,001.00 to $100,000.00 $283.00 for the first �50,000 plus $3.00 for each
additional �1,000 or fraction thereof, to and
including �100,000.
�100�001.00 and up
�433.00 for the first $100,000 plus $2.50 for each
additional $1,000 or fraction thereof.
DRIVEWAY DEPRESSION ESCROiI
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway aidth plus
6 feet times $13.50
Alternate "B": Removal and replaeement of curb and gutter and install a 3 foot wide
approach xith 6 inch depth - DriveWay Width plus 6 feet times $15.75
VERIFICATION OF FOONDATION
Permits for construction �aill be issued a minimum of 24 hours from the time of
application to allow for proper reviex of the proposed strueture and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been eonstructed will be required before proceeding with the framing.
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CIVIC CENTER • 6431 UMVERgi1'y AV�. N.E. FRIDLEy, MINNESOTA 55432 • PNONE (612) 571-3450
May 9, 1988 -
Mr. Mike Bahan
31� Fbss Road I�L E,�16
St. Anthmy. M11 55421
Re : Address Q�ange for I.a� 11• 8eather Qaks in Friciley
(Effective On or Heface August l, 1968)
Dear Mr. Bo�han:
We must change the aa�re6B of your lo�t as it was incorporated into the
Heather Oaks plat � w� }�e aooess fram Rristin Court after that roaC is
a�mgleted whi� should be by August l, 1988. Please note the following:
FRCM;
7.0 :
1641 Cardena p�� ��, � gti��,� � 55432
1631 Rristin i,burt i�ii. g, gri��,� � 55432
�: Miciiael �. Hahan (mwing in approximatel�� Ju�e 1, 1986)
L�GAL, : (�T) Lot 11. �eather �iks
�� � t� Lat 25. Auditor's Subdivision #92
We have notified the follawirig comp,anies of this change and also various
departnerns in the Civic Center. If you have any que�tions on this change,
Please v�ntact me at 571-3450.
Sinaerely,
G. Q�ARR
CY�ief Building OF'ficial
DGC/mh
OC: Minresota Gas Q�mpany
Nbrthern States p�er �. _
Minneapol is Pbst 4if iae
Fri dl ey Pbst Oif i�e Bra�ch `
Northwestern Be11 �'elephcae Co.
Fridley Water Billing Dept.
:Fridley Assessing Dept. �,
FricIley Pblice Dept,
FricIley FSire D�ept.
�oka Golnty Court House
-- _��_
SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
� �• COMMUNITY DEVELOPMENT DIV.
v PROTECTIVE INSPECTION SEC.
� .'_'—
r ; ;
� ,
� ` ��"1 � CITY HALL FRIDLE� 55432 NUMBER REV
�""� � �'� 612-571-3450 910-F15
J08 ADDRESS 1631 Krist�n COl1Y't NE
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION
DESCR.
2 PROPERTYOWNER MAILADDRESS
Mike Bohan 1631 Kristin Court NE
3 CONTRACTOR MAILADDRESS
Biddle Remodeling Inc, 2644 Ulys.ses NE, Mpls
4 ARCHITECTORDESIGNER MAILADDRESS
5 ENGINEER MAILADDRESS
DATE
7/8/91
ZIP
ZIP
PAGE OF
� �
°�0919
RECEIPT N�
�/a���
APPROVED BV
SEE ATTACHED
SHEET
PHONE LICENSE NO.
788-6335
PMONE LICENSE NO.
PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASSOFWORK � NEW ❑ ADDITION ❑ ALTERATION 6� REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof Ds�elli:�g (22 Squaxes) Tear-�o�f
9 CHANGE OF USE FROM
STIPULATIONS
TO
Roo�ing must comply w�,th-State Code �or ice & water shield.
SEPARATE PERMITS ARE REOUIRED FOR ELECTNICAL, PLUMBINCa, HEATING,
VENTII.ATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZO�
AUTHORIZED IS NOT COMMENCED WITHIN 60 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCEO. NO.
I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAL
MP I
SO
.G. UNITS
1 STALLS
AND ORDINANCES GOYERNING THIS TYPE OF WORK WILL BE CO L ED 1 144
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRAN7ING OF A PERMIT $ r
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqM1T FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON- 2� � QO
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $
�� PLAN CFIECK FEE
�O (�
SIGNATURE OF CONTRACTOR OR AUTNORIZED AGENT IDATEI -.y —yy�� PR PERLY
P OCCUPANCYLOAD
CU. FT.
�FSTREET PARKING
GARAGES
JFTAX
$.57
4C CHARGE
Fire SC $1.44
�TAL FEE
ssi.oi
� []
� [ ]
�� � �
I�1 ATID 1�2
w,; � dir�q Permit Applicatiaci
oa�LSttvctian Address: /� 3� I-�r,.ct�... G�' �•es .
' a� . � w « .�1 •'�
0
Effective 1,/1/91
Owt�er Na�e & A���: __�; l�2 1� �4� Tel. #
ClCeltraetr0�': �� d� Le y-�, d.e l: .���, 'I�el .# `� �'6 i 3�
Addre�.s: i�6 K�! (� `.��s � nliL- f/X� `.f -
7�TII�' I�S
�iRAGE AREA:
� ARE�i:
d�:
Attach to thi,s applicatian, a Qertificate of �vey of ti�e
lot, with the p�+oposed caLSt.ruc.-tian drawn ar► it to scale.
Ielf�l
I[.'rgth
Width
Width
Width
.�• ���;;•�'is���,r
He.ic�t
Heic�t
�/�
Sq. F't.
Sq. F't.
Sq. Ft.
Oorner Iat [] Inside Is�t [] Ft. Yd Setb�3ck Side Y Setbacks
Zj�pe of �ian: Estimated O�ost: $��f � �
Approx. Qaag�letiaaz Date:
Pi�oe�ed Driveway Width If New Openir�g Is Desired: Ft. $ $
Width + 6' See Back Page
DATE: � � 8r�g � APPI�CANr: /� l�� °�d �e Zp1. # � �� `6�3�'
Permit Fee
Fire S�
State Suni�arge
SAC Qzar+ge
Driveway Esaew
Park Fee
Sew�er Mai.n Criarg,
: v�
STIPULATI�TS:
�
$ 2�, � �
$ �� �
$ ec5 /
$
$
$
S
$� �
CLTY D6L� �Y
F�ee �ule ac� Revers�e Side
.001 x Permit Valuat3a�az (1/lOth $)
$.50/$1,000 Valuatiaci
$650 per SAC Ur1it
Alt. "A" Cr Alt. "B" Above
F1� if�or�ni r�ari � F�ti ��ri m
� ��Y [ ] � ��Y [ l
f:_11� � �� C Y'i�'v�5,1 .r,�' '�..I:�� I)
The Chief Buildir�g Official shall, befa�+e issuin� petmits for the erectio� of ariy
buildinq or et�e, o� fa� any additian to any e�dstir�g building ar stn�cture, or
for any alteratian a� regair to any eadstir�q buildirn� cr st�cGure, u�i aPPlicatioa�
ti�erefoz�e, raquire tl�e PaYment bY the applicsant fcac eucii p�+smit of fees t� the moo�t
hereill be1Cw set forth a1�d 3T1 tile �anr,pr �, jn pa�vi�d to-wit:
'1dI'AL VAIIJE
$1 to $500
$501 to $2, �0
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
_�
S15 (Miniliun Fee i8 S15 Plus �a�e)
$15 far first $500 plus $2 for eadi additiaa�al $100 or
frdCt3C�'1 thereof, to al�d ineludiTg $2, 000
$45 fG�' fit'st $2, � plus $9 for eac31 8dditioa'ial $1, 000
o�' fractian thereof, to at�d includit�q $25, 000
$252 fCr first $25,OQ0 plus $6.50 fa�r eaCh addit3a�31 $1,000
ar frdCt,iCil tl]e��ecf, to at�d it�Cludiin� $50, 000
$414.50 for fitst $50,000 plus $4.50 for each additional
$l, 000 a�r fraCtian ti�er+eof, to ar�d incl.udiryg $100, 000
$639.50 for fiYSt $100,000 plus $3.50 for ead'i additional
$1, 000 oY' fxackiari thereof, to at�d includir�g $500, 000
$500,001 to $1,0OO,OQO $2039.50 for the first $500,000 plus $3 for each additional
$1, 000 or frdGfi3C[i thex'eof, to and includi T1g $1, 000, 000
$1, 000, 001 and up $3539. 50 for the fitst $1, 0�, OQO plus $2 for each additional
$l, 000 or fractian tl�ereof
L�tIV�IY �:Pl�SIQ� �
(�+eke Curb Streets �lY)
Alternate "�," : It�oval and re�laae�eitt of airb and gutter anly - DriveWay width plus
6 feet times $13.50.
Alternate "B" : R�o�ral arid re�lao�t of a� ar�d gutter ar�d ir�tall a 3 foat wide
approa� with 6 irrh de�th -�ive�ray width plus 6 feet times $15.75.
[/:���;� �+. M • , •r ��_�i,�� � M •'.I
P�rmits far caa�stnicticn wi11 be is��ed a minim� of 24 halrs fr� the time of
applicatiaez to allvw fa� p�oper review of the pYO�osed � and of the
co�t�,ctian site.
A Oertificate of Stinvey of the lot, et�owin3 the locatioaz of the faur]atiaai cnce it has
it has been co�structed will be required before prooeed.iryg with ti�e fr�i�g.
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93/29�1999 16:26 E H RENNER & SONS � 6125711287 �(� : i'1 `; �e� 1 E� N0.499 P02
� ' rr. �-3c1-`�s� ��,'�.
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� WELL AND 60RING S�ALING R�CORD �,,��a�:a un(que No.
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�6--fa,n�..--� � in. Uom � m� fl, �Yes Q No ❑ Yos � Nn '� UnMorm
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WROPER�/O'WNEA'SWWE � m.lmm.� � to fl. ❑ Yes . �a ❑ Yes �NO ❑ Unitrterm
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E�3`5�', !� 5543� scree�nom �o rt. ove�KOU�rom.�,$� oe�3S— R
08STRUCTIONS '
wa� ow�aArs ru� p aoa�raoa �'roe D o�,eo� vaive�sl ❑ ooe�s I� Fui �ivo o��+
Nk/awwy.�q�o�Lmi�qe�nnpepenyro+n+alsaa0m�indzeaaae(�eve. TypeolOC�ruction9f0eseNDe1
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� ' Ti�
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FaRl1A110N
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❑ No AnI�uW Sp9A8 Erlp
❑ Anmilpr cpmee groule0 vlD� irem�6 D�Oe
y� � p OaeMg PaAoratioMRen�arel
A11� JC�S �' � 1� 5—� �n, rmT �� e, !�',r�. n. �a�raae O rt�we
14I�i $� �. �'J' � 3$D �^� �'O"' lo fl. 0 Pe�eoe�d ❑ wsmoree
rypo 01 peAOraWr
❑ Other
�GR8U71NG YA7QUAL(S�
�i�'�fie� �� 5 4 15
Groutl� Metertai �ram to R Ym+�e p�W
, aan to R y�s: p�
IrMt � R yaiAg �yy
hom to . k � �
I�W�$dOUAtl�mFQ11f1�.01F�1CYL�p19FJIJHO OrF1EAt9EtL6ANP80R1NGR � .
���G� �,�: � �� � $t Qi`'� useo�eua�ooringona�avmfi� ❑Va No HoWmanyr
A� � i� �ld�11$ �� :� �'c OA AE61S7ERE6 CONTRACTOA CE�RT1FeCAr10!!
' i�'' i$�!� L�D"•'�a i►� '1'J� :�2— �.3—C 9 rnre Wan m emvq wae weiea �o a000.�e,�an� u�n�m nwes. c+�aomr or�s. ine uemenaaon arua�hed s� n,m �eyoet �n
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-I./ �� � � � ��Olry.� N8R7B � „_ ° IJOe�r� aRA�Aa�an 1:0.
: i, •�'"
Acc+ordingto MN State Regulations ����°�" �� � � ` �'��s,��
�ac��� �e�aa�x�E�v� ���s
COC�. Co�r � H ���'� �� "�° or �„ sso�a wasa. aatnp
. . ��
• ?J97 R
_ __ �
sue�8tt
, c�ty of Fr�a�ey
� AT THE TOP OF TME TWINS g � I L D I N G P E R M I T
;,
I ' ` -----.
� `V_ � COMMUNITY DEVELOPMENT DIV.
r j � PROTECTIVE INSPECTION SEC.
l.-_.�� �"" �•� CITY NALL FRIOLE� SS132 NuMeEP
t 612-571-3450
910-Ft5
JOB ADORESS 1631 Kri sti n Court NE
t LEGAL �OT NO. BLOCK TRACT OR ADDITION
DESCR. 11 Heather Oaks
2 PqOPERTY OWNER MAIL ADDRQS$
Vince Labrandz
3 CONTRACTOH MAILADDRESS
Pennington Const. 4347 Central Ave NF
/ ARCNITECT OR DESIGNER MAIL ADORESS
5 ENGINEER MAII ADDfiES3
B USE OF BUILDING
Residential
7 CLASS OF WORK '
NEV
6/11/99 � /
P --�,
29675
EIPT NO.
� /�
Oi AP7RQVE0 B�
/
SEE ATTACHED
SNEET
r�P PNONE LICENSE NO
ia H�ts 55491 7RR_[LRRA 9(llti4�a1
ZIP PMONE LICENSE NO.
� Z�P PHONE UCENSE NO
0 NEW O ADDITION O ALTERATIpN �( REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and detached 4araae (21 sal Taar_nff
9 CHANGE OF USE fROM
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMI7S ARE REOUIRED FOp ELECTRICAL, PLUMBING, MEATING, TYPE OF 1
VENTI�A7ING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK Ofi CpNSTRUCTION ZONING
I AUTMORIZEO IS NOT COMMENCED V�1ITHIN fi0 OAYS. Ofl IF CONSTpUCTION
OR WOi;K IS SUSPENDED OR ABANDONEO FOR A PERIOO OF 120 DAYS A7
ANY TIME AFTER WORK IS COMMENCED.
NO DWL
1 HEREBY CERTIFV THAT I NAVE HEAO AN0 EXAMINED THIS APP�ICA710N
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PqOVISIONS OF LAW$ yALUATIC
AND ORDINANCES GOVERNING THIS TYPE OF WpRK WILL BE COMPLIED
WITM WHE7HEF SPECIFIE� HEREIN OR NOT. TME GRANTING OF A PERMIT $1835
DOES NOT PRESUME TO GIVE AUTNO ITY TO VIOLA7E OR CANCEL TME pEqMIT FI
PROVISIO S OF ANY OTHER STAT q �OCAL LAW REGULATING CON-
TRUCT R TME PERF RMANC OF ONSTNUCTION $6�.ZO
PLAN CHE
� Licens
�GN4TUAE OF C ' ACTOA OR 4UTMpR12ED • N IO�TE�
$�GN4TUAE O� OWNEA��� OWNEA BWlOEA� IDAiE� e,
UNI7S
S7ALL$
NCY
OCCUPANCY�OAD
CU FT
�FSTREET PARKING
GARAGES
JR7AX
.92
1C CMARGE
ire � $1.84
1TAL F
�
��.�
��-
�� � -� � Effective 1/1/99
ADDN [ ] CITY OF FRIDLEY /
AI,TER [] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 vj
BUILDING PERMIT APPLICATION Ip� �
� ��
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ConstructionAddress: ��� � �� � S+ � � � � �
Lega1 Description:
Owner Name & Address: l� � �1�C �R�l3i �1�Z ��Gt��� Tel: # � j ��'-��6�'����
co��tor: Pe �� � � � �fi��, � � s��� _Nnv �c�vsE # � � l � � �__�t� __
Address: � � � �i � e rri °f' �'�1 � � c✓ �� Tel. # (�o (��°� ���" �f�"�l �'
LIVING AREA:
GARAGE AREA:
DECB AREA:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
�ng� Width Height Sq. Ft.
Lengfih Width Height Sq. Ft. �
�ng� _ Width Hgt/Ground Sq. Ft.
� 01'HER:
��s��e � (�-f-a +�G�� Gad'�9'� °� � � `' �.
Construction Type: � Fstimated Cost: $ , � ��S
(Fee Schedule on Back) .
Driveway Gbrb Cut Width Needed: Ft. + 6 Ft = Ft x =$
DATE: � �% APPLICANTs , Tel. #
CITY USE ONLY
Permit Fee
Fire Surcharge
5tate Surcharge
SAC Charge
License 5urcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ �.�o
$ � cg 5�
$
$
$ D
$
$
$
$
� .9�
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1050 per SAC Unit
$5.00 (5tate Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineerin8
Agreement Necessary [ ] Not Necessary [ ]
�
BiJII..DING PERNIIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure; upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,0�
$2,001 to $25,OQ0
$25,001 to $SO,OQO
$50,�1 to $100,000
$1�,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62. 25 for first $2, 000 plus $12. 50 for each additional $1, 000
or fraction thereof, to and including $25,000
$349.75 for first $25,000 plus $9.00 for each additional$1,000
or fraction thereof, to and including $50,000
$574.75 for first $50,000 plus $6.25 for each additional
$1, 000 or fraction thereof, to and including $100, 000
$887.25 for first $100,000 plus $5.00 for each additional
$1,Q00 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1, 000 or fraction thereof, to and including $1, 000, 000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete G�ub Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Alternate "B" : Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued. a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
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FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
� , , � -��
COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When reolacins� an existinsa furnace, the undersigned hereby verifies that the
verrting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and flrestopped where required. Yes () No ()
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes () No ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufa�turer's specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
The existina combustion air is sized and installed to meet the current codes
and manufacturer's specfications.
When required to install a new combustion air. it will be sized and installed
to meet the current codes and manufacturer's specifications.
�fes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
When installina a new ventina svstem, the undersigned hereby verifies that
it is a listed assembly and me.ets the current codes and manufacturer's
specfications. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes ()
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.
No ( )
Yes ( ) No ( )
Aapliance 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 Tdal Btu Input
Common Vent Type Vent Height Diameter inches
Applianc� #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Hei�ht ft Length ft Diameter in Type
ALTERATIONS: (DesCrlbel �� s��. �� �� c � r� � Ic� e e.v�' �'-� li. 5%r'n�
r�ea �ae
. �e
ibn�se i�»
2f00 N. Falrvlew Ave.
65U833-2581
HEATING CO:
Signed By: �� -� Date :
ADDRESS
PIN
LEGAL DESC
CITY OF FRIDLEY
6431 iTNIVERSITY AVENUE NE
FRIDLEY, MN 55432
s�i-36u4 r��ix:
: 1631 KRISTIN CT NE
: 243024110122
: HEATHER OAKS
: LOT 11 BLOCK 1
PERMIT TYPE : HEATING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIREPLACE
VALUATION .
NOTE: INSTALL GAS PIl'ING FOR HEAT N GLO FIREPLACE.
VALUE (FOR MINIMUM CALC) 300
APPLICANT
FIltESIDE HEARTH & HOME
2700 N FAIRVIEW AVE
' ROSEVILLE, MN 55113
OWNER
LABANDZ VINCENT H
1631 KRISTIN CT NE
FRIDLEY, MN 55432
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 l�ow the same to be true and correct. All
provisions of laws and ordinances goveming 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
regµ� co ction or the performance of construction.
Applican� _ Date
Bldg
Date
571-1Z87
�—��
PE N0.:2004-01147
e
DATE ISSUED: 07/19/2004
HEATING PERMIT 1�II�TIMUM FEE
STATE SURCHARGE, MECH FLAT
TOTAL
PAID WITH CHECK # 607452
15.00
0.50
15.50
�
Building BUILDING Permit No.: -
Inspections RESIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY vate Rec'd: (o-� --oQ
DATE 05/28/08 YOURE-MAILADDRESS estherdC�probuiltam.com
S[TEADDRESS 1631 Kristin Court
THIS APPLICANT IS: ❑ OWNER OCONTRACTOR
PROPERTY OWNER/ NAME: Vince Labandz
TENANT �p�ss: same as site ci� sTaTE zir
rxorrE: 763-586-9783
CONTRACTOR Na�E:ProBuilt America
SUBMIT A COPY OF STATE LICENSE # B C- 2 0 3 5 6 8 4 7 EXp DATE U j/ U y
YOUR STATE LICENSE ADDRESS: �� 11 11tt1 AV2 � CITY North S'lm STATE ZIP �� l�
WITHAPPLICATION pHONE 651-770-5570 F� 651-770-0495
PROPERTY TYPE � SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE ❑ �DITION ❑ GARAGF/SHED ❑ WINDOWS
❑ BASEMENT FII�IISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK: ❑ NEW ❑ ADDIT'ION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBEWORKBEINGDONE: Replacinq 4 window, not chanqinq sizes
SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT S. Ft.
ROOFING ❑ HOUSE ONLY
NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT:
GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan
PROPOSED SIZE: ❑ DETACHED GARAGE Z• ProPosed floor plan
PROPOSED HEIGHT: 3. List of stcuctural membets to be used
SIDING FOR NEW CONSTRUCTION INCLUDING DECKS,
� �'�Y� ❑Soffrt ADDITIONS. & PORCHES SUBMIT•
���� � T� I. Site Plan/Survey showing the existing siruchues
� �� ❑ Fascia
and proposed project
�Npp�,�,s 2. Two sets of constr�ction plans
IN EXISTING OPENINGS ❑Yes ONo LOCATION OF WINDOWS 3• Ene�gy Calculations
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS 4
ALL FEES ARE BASED ON VALUATION INCLUDING THE COST OF LABOR AND MATERIALS•
TOTAL
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
� .
(USING THE 1997 U.B.0 FEE SCHEDULE)
VALUATION $ 115 2 OCCUPANCY TYPE
$ See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ B• .001 times the total job valuation
$ . �� .0005 x Permit Valuation Minimum $.50
$ d; .�� $5.00 (State Licensed Residential Contractors)
$ $1675 per SAC Unit (Plans to N1WCC for determination)
$ ft+6ft= ftx$21=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ 5�.� Make checks payable to: City of Fridlev Attacb
THIS IS AN APPLICATION FOR A PERMIT-NOT VAL[D 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
pern►it 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 work which �ires revi�w and approval of�ns. � A
SIGNATURE OF APPLICANT ��� �G �:� p r� he r Dahl DATE 0 5/ 2 8/ 0 8