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PRE 2010 DOCSCli¢y of Frid Icy ""ECT , Permit No. r AT TK TAP OF THE TWINS I I.% HEATING PERMIT APPLICATION G� COMMVNITY OEVBLOMENT M. e i {AOTIECTIYX *•ad,"¢CY1QN MPT. v'e.t i CITY HALL RRIOLCY 8&q2 �....i �.J 58C6 RLQ Rev,®AYE FACE 0+� AGPROVED ®Y 910-F17A 0 2/15/73 JJob 1 1 800 Address _ 7 l Address Pone Contra o�s t P n41e Kind of B ilding Use 74_0_� Completion Date st mate ost UatAV! Z W ANEI ANA: RATE TOTAL Heating/Power Plants # Tzurnace Shell & Duct Work ..$10.00 Steam Hot Water Warm Air Replacement of Yurnace .. 6.00 Trade Name Repairs & Alterations—up to $500.00 6.00 Repairs & Alterations each add. $500.00 3.00 Size NO. WECM WAMI AM rurnace Shell & Duct Work to 120,000 BTU ...... . .. $10.00 each add. 60,000 RTU .... .. 3.UU Replacement of Furnace . . ..... 6.00 Repairs & Alterations --up to $500.00 6,00 Repairs & Alterations each add. $500.00 3.00 STEAM or NOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. F.DR Steam $10.00 Furnace Shell & Line—to, 640 sq. ft. EDR Riot Water 10.00 Each add. 200 sq. ft. EDR Steam 30) Each add. 320 sq. ft. EDR Hot Water 3.00 Capacity Sq. F t , S 81-- EDR BTU Ton. Total Connected Load Kind of Fuel $ Burner C Trade Name Size No. i - - Capacity Sq.Ft EDR BTU ion. IOIL BURNER—to 3 gal. per hour 6.00 $ _ over 3 gal. per hour—See ree Schedule GAS SUFt11EIt cup to It 3,03D F3TYT> 6.00 $ over 199,M BTU Seep Fog Schedule GAS FITTING FEES: No BATE TOTAL 1st 3 Fixtures x$ 200 $�� Additional Fixtures x .75 $ _ Gas Range to 199,COO z$ 5.00 $ AIR CO"I.DITIONING FAN 1-1EATI-ITO SYDTL"l VENTILATING SYST ALTERATIONS & REPAIRS ROUG FINAL See Few Seh4dr,20 'i:OTa° L rZZ .50 State Surcharge S1lbalrban Air Conditioning Coe ' 841`.4 1lenter Driv;� f uvwapoiis, Minnesota 5514.32 igS'gnature I 01 ;'l001 U� 0 0 LO M O N r N qW Ln LO Q F- O co LU z z_ W 0 cc LL w H z w U U_ U June 6, 1975 S.J. Construction Company 6305 East River Road N.E. Fridley, Minnesota 55432 Re: Final Inspection @ 7591 Lakeside Road N.E. on June 3, 1975 Gentlemen: After making a final inspection at the above captioned property, the following must be completed before occupancy will be allowed: 1. Post outside address. 2. Sod front and side yards. 3. Patch fire wall in garage. 4. Provide joist hangers on out joist by water closet. 5. Final Electrical Inspection must be made. When these have been completed, please call this office for a re -inspection. DC/cs Yo very truly, DARREL CLARK Community Development Administrator Building Official 5603450 city 4 Jidfy ANOKA COUNTY 6431 UNIVERSITY AVENUE NE October 25, 1974 FRIDLEY, MINNESOTA 55421 Leigh Investment, Incorporated 6305 East River Road N.E. Fridley, Minnesota 55432 Re: Change of House Numbers Dear Sirs: It has been necessary for this office to change the address of your house FROM 7590 Lakeside Road N.E. TO 7591 Lakeside Road N.E. LEGAL DESCRIPTION Lot 3, Block 2, Ouimette Terrace We have notified the Post Office Department, Minneapolis Gas Company, Northern States Power Company, Northwestern Bell Telephone Company and various departments in City hall of this change. Sincerely, DARREL G. CLARK Community Development Adm. DGC/mh 560-3450 Cif ANOKA COUNTY 6431 UNIVERSITY AVENUE NE October 25, 1974 ' FRIDLEY, MINNESOTA 55432 Minneapolis Post Office Department Superintendent of Delivery 1st & Marquette Avenue Minneapolis, Minnesota 55402 Re: Change of Address City of Fridley Gentlemen: We are listing the following change of address in the City of Fridley; NAME: Leigh Investment, Incorporated FROM: 7590 Lakeside Road N.E., Fridley, Minn. TO: 7591 Lakeside Road N.E., Fridley, Minn. LEGAL DESCRIPTION: Lot 3; Bl. 2, Ouimette Terrace We have notified the occupant of this change and we would appreciate it very much if you would change your records accordingly. . Sincerely, DARREL G. CLARK Community Development Adm. DGC/mh CC: City Water Billing Dept. City Assessing Department Minneapolis Gas Company - Brooklyn Park Office Northern States Power Company Northwestern Bell Telephone City Voters Registration Homeowner VLVMING FIXTMM RATES: NO. RATE TOTAL Nurr:w Fixtures ................ am ` 65 Adwe Inature o'ipen .. o . o ..... a -- x $1.50 $ .. New Fixture Oflee Opening .......... x SIM $- -Catch Bazign .................... x $3.0 =- Water Hester (Up to 10.000 FM.... _ L x 53.00 t 3 ? ® o New Ground Run Old Bldg. . . . .. . . . x $3.28 s Electric Water Hester .............. a $100 5 GAS MC. NO. RATE TOTAL 3 Fixtures • x $100 $ r ®r> IM ...... • • • ...... — Additional Fixtum ... . . .. ... s e ... x 5 .78 i Gas Romp to 1W.000 11'i'tl . , .......... x $8.00 a • State Surcharge MWAMS IItA�LTERATIONS—Aaser to Cc" Descriptione.. s...... a. e.. ....s.o. o o..... .... TOTAL.�./.�.p.e®off. Fu l 1 � VLVMING FIXTMM RATES: NO. RATE TOTAL Nurr:w Fixtures ................ am ` 65 Adwe Inature o'ipen .. o . o ..... a -- x $1.50 $ .. New Fixture Oflee Opening .......... x SIM $- -Catch Bazign .................... x $3.0 =- Water Hester (Up to 10.000 FM.... _ L x 53.00 t 3 ? ® o New Ground Run Old Bldg. . . . .. . . . x $3.28 s Electric Water Hester .............. a $100 5 GA_ S F1TT XG FEES: NO. RATE TOTAL 3 Fixtures • x $100 $ r ®r> IM ...... • • • ...... — Additional Fixtum ... . . .. ... s e ... x 5 .78 i Gas Romp to 1W.000 11'i'tl . , .......... x $8.00 a • State Surcharge MWAMS IItA�LTERATIONS—Aaser to Cc" Descriptione.. s...... a. e.. ....s.o. o o..... .... TOTAL.�./.�.p.e®off. Fu City of Fridley: Fnirwa. ,L / 2 — 7,S7— 0 Let.) SUBJECT PERMIT City of Fridley 127 AT THE TOP OF THE TWINS BUILDING PERMIT EIPT NO. • COMMUNITY DEVELOPMENT DIV. INSPECTION r PROTECTIVE SEC. 1 . � CITY HALL FRIDLEY 55432 %j NUMBER REV. DATE PAGE OF APPROVED BY "'•- 612-560-3450 910-F15 10/11/74 JOB ADDRESS 759 Lakeside Road N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 2 Quimette Terrace SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE© Leigh Investment, Inc. 6305 East River Road N.E. !� � --jqfj® 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. S. J. Construction, Inc. 6305 East River Road N.E. 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 33' x 321&221 Dwelling and a 22' x 22' Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. Provide a verifyin survey before 'capping. SEWER LOCATION: 80' East of Manhole (,Inv. East. 893.112 Wye Elev: 894:07 Top of Footing: 897.07 WATER LOCATION: 10' East of Service for Sewer SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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-1 962 24,080 Total 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. $23,850 11.93 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 $300.00 14 N O TH ANCE OF CONSTRUCTION. 11 $45.00 PLAN CHECK FEE TOTAL FEE r c d $356.93 SIGNATURE OF CONTRACTOR O 'UTHORIZED AGENT (DATE) WHEN PROPERLY V ED THIS IS YOUR PERMIT oQ az lL�t. v�� e_� ��A , 0111 iNSP DATE SIGNATURE OF OWNER( IF OWNER BUILDER) (DATE) IBLDG 0 Let.) APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER' S NAME : t, E 16 td 1,0 ✓ . 1 1'j C- 1.5 i ? 0 6 7-"i 0A-; / i /C_ ADDRESS • 6 � o S ( NST " IZ `fZ! ADDRESS : � .3 o 5 E P 5 T r2, �/E 2 ?4' 7 STREET LOT: BLOCK: ADDITION: O 0 1 M€ TT E_ `T c R R A c f CORNER LOT: 9/.6y INSIDE LOT: SETBACK: SIDEYARD•%/ Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. d DESCRIPTION OF BUILDING To Be Used As: e 57- V vv a Front: Depth: _ o Height: �A Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; 4 o/ a Cubic Feet: � 1)- v 'PI -/7 T of C struction: _fie q14 Estimated Cost: To Be Completed: /moo XW9g AFTER ��r.��Nc� �.✓sTl�, ^� °,y "' s" ` The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stfict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: �/?, 19 711- SIGNATURE : , (See Reverse Side For Additional Info tion.) �� Main Office 784-6066 USURSAN 6875 Highway No. 65 N. E. E molmmmmtmo Minneapolis, Minnesota 55432 ING 11 © South Office 890-6510 Cavil & Munwipal Engineenng • Soil Tesang • Land Swueying • Land Planning 1101 Cliff Road 8umsrille, Minnesota 55337 402 c` 1 Certificate of Survey for S. J. �ON �T. �w_. IV 1 ` �. '�,i'�i:a`! �'� i~'►fir '� `��' -11.5G -- I�J a 1 hereby certify that this is a true and correct representation of a survey of the boundaries of the above described land, and of the location of all buildings, yhereont and all visible encroachments, if any, from or on said land. As surveyed by me this day of t4 NQ A.D. 196¢ 1 SUBURBAN ENGINEERING, INC. Engineer. Burveyprs by L.0 C.,oq r®* e% l.J �' 6 (FL-zv,- F?y',07 ovcr- 7 SUBJECT City of Fridley AT THE TOP OF THE TWINS BUILDING P E R M I T 7RECEIPT r NO. COMMUNITY DEVELOPMENT DIV I �__ '___ L' r � PROTECTIVE INSPECTION SEC. �✓'✓® NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 5/13/97 JOB ADDRESS 7591 Lakeside Road NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3 2 I Ouimette Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Eugene Pilipanko 7591 Lakeside Road NE 784-2415 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (20 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS XKXXXXXXNxHM Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD 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 ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED NO. DWLG. UNITS OFFSTREET PARKING 1 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $1,650 $.83 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $54.00 Fire SC $1.65 ST TION OR THE PXAFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE /3- "RALIT..RI�EDAGENT $56.48 SIC&TUREOFCONTRACTOR IDATEI WHEN PROPERLY LIDATED THIS IS YOUR PERMIT B G INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI NEW [ ] Effective 1/l/97 ADDN [ ) CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress:L#4kc S d e CQ Legal Description: Owner Name & Address: Contractor: MN LICENSE ## Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER:r -C .. « r a .. _ I s e e. . rG Construction Type: �: � a a o % Estimated cost: $ /a D a o I & S p (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ c_ DATE: E' 13 — % APPLICANT: Tel. it Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ 12 CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $950 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] SUBJECT PE City of Fridley 3428 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. �� r E 1 . � NUMBER REV DATE PAGE OF APPROVED BY i �,� CITY HALL FRIDLEY 55432 ----;"' L 763-571-3450 910-F15 4/14/03 JOB ADDRESS 7591 Lakeside Road NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3 2 Quimette Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Eugene Pilipanko 7590 Lakeside Rd NE 763-784-2415 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Rum River Lumber Co 10141 Woodcrest Drive, Coon Rapids, MN 55433 763-862-7300 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20036086 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside House & Garage 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 for this provision would be if sheathing is an approved weatherproof panel or when the siding is an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in their application guidelines. Call for inspection of wrap before covering or take pictures. Caulk and flash all exterior openings. SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. 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 $13,610 $6.80 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTALFEE Lice4e SC $5.00 $262.66 SIGN A TUBE OF CON'RAC TOR OR AUTHORIZE O AGENT IDATEr HEN PROPERLY VALIDATED THIS IS YO R FERMI S-GNATURE OF OWNER.-F OWNER BUILDER, IDATEI LOG -NSF' GATE NEW [ j CITY OF FRIDLEY Effective 1/4/2002 ADDN [ ] 6431 University Ave NE, Fridley. MN 55432 (763) 5724604 Bldg lnsp ALTER GS1 SINGLE FANDL.Y AND DUPLMMS R -'t AND R-2 BUILDING PERMIT AWLICATION Construction Address: _75q 1 l�a Ke�S►rj_e Legal Description: Owner Narne & Address: Eat r, e- D. P i t'ipcjnKn l s0 ­n e> Tei. # Contractor. 9\ � �„ ls�rn ha �° MN LiGENSE # o"-tGo�1oCJ? l0 Address:_I01caGrQ`k- D( -,,j e�Tei.#�(v3-Alva-7�3U0 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT L PANG AREA: Length Width Height Sq. Ft GARAGE AREA: Lenge Width Height_ Sq. Ft DECK AREA: Length Width HgtlGround _ Sq. Ft OTHER: Construction Type: S ► 6A ,n cA Estimated Cost: $ 1, �. /0.00 Driveway Curb Cut Width Needed: _____Ft + 6 Ft = Ft x $ —=$ DATE: X% wAPPLICANT: p jZ, ---__--- Tel.#7(03_$(00 - 7�Qr, Call (76'3) 572-36044 for Permit Fees if mailing in application or Fax to 763 571.-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee $- Da -7-9,5 Fee Schedule on Reverse Side Fire Surcharge $ _ _ t 3. Lp 1 .001 of Permit Valuagon (1/10th%) State Surcharge $ (o. %0-- $.50/$1,000 Valuation SAC Charge $ $1200 per SAC Unit License Surcharge $ p $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by'Engineering Sewer Main Charge $ Agreement Necessary[ ) Not Necessary [ ] TOTAL $ - '9lpa . (n (n STIPULATIONS: t7o/TO'd sTOgege 01 A3-lQINd d0 J,lIO WO�JA 6S:0T ZOOZ-ET-Ndd rAT0_ 1611 7 SUBJECT City of Fridley 33703 AT THE TOP OF THE TWINS BUILDING PERMIT r 1 , RE �. COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. 3a71 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 763-571-3450 910-F 15 7/15/03 JOB ADDRESS 7591 Lakeside Rd NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 2 1 Ouimette Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Eugene Pilipanko 7591 Lakeside Rd NE 763-784-2415 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Rum River Lumber Co 10141 Woodcrest Dr, Coon Rapids, MN 55433 763-862-7300 d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20036086 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION Q REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 15 windows within existing openings 9 CHANGE 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 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 SO. 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 $15,342 $7.67 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTALFEE nse SC $5.00 $293.26 SIGNATURE OF CONTRACTOR OR AUTHORIZE D AGENT 'DATE, WHEN PROPERLY VALIDATED THIS IS YOUFj PERM BLDG INSP FATE SIGNATURE OF OWNERIIF OWNER BUILDERI IDATEI rAT0_ 1611 7 NES/ [ ] CITY OF FRIDLEY Effective 1/1/2002 ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 5� t ii o i �� �� til Legal Description: Owner Name & Address: U R d i aLj'l iL6 _ Tel. # -7(o3--794-0415 Contractor. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: YJ On e - MN LICENSE #O) U __2>0Q&0 Tel. # 703- &►a-1 ' c,00 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft Construction Type: inSi-a_LL 15 ", r jlUv-A�� Estimated Cost: $ Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ —=$ DATE: APPLICANT: Tel. # 7(0 3 ^ &&a- 7 cb Call (763) 572.3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge $ acs •a5 Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by'Engineering Agreement Necessary [ ] Not Necessary [ ] TOTAL $ QC1 3 . ,�kb STIPULATIONS: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY. MN 55432 572-3604 FAX: (763) 571-1287 ADDRESS : 7591 LAKESIDE RD NE PIN : 123024110032 LEGAL DESC : OUIMETTE TERRACE LOT 3 BLOCK 2 PERMIT TYPE HEATING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION PERMIT -90': 2004-00388 DATE ISSUED: 03/25/2004 VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A REPLACE FURNACE AND AIR CONDITIONER AND INSTALL COMBUSTION AIR # A/C UNITS 1 VALUE OF APPL OR WORK # FURNACES # GAS RANGES APPLICANT PILIPANKO EUGENE D 7591 LAKESIDE RD NE FRIDLEY, MN 55432 PILIPANKO EUGENE D 7591 LAKESIDE RD NE FRIDLEY, MN 55432 1 # GAS DRYERS 0 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 work 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 regipatilig construction or the performance of construction. Applicant Date Bldg Insl, D�� HEATING PERMIT MINIMUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT AIR CONDITIONING FEE TOTAL PAID WITH CHECK # 11567 SEPARATE PERMITS REOUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 100 0 0.00 30.00 0.00 0.00 1.00 0.50 25.00 56.50 CITY OF FRIDLEY INSPECTION DIViSION Effective January 1, 2004 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES FAX (763) 571-1287 / JOB ADDRESS. I L � le-S� d e eD t/ C- / RATE SCHEDULE ' OWNER—g Residential Rate TOTAL Furnace Furnace Shell and Duct Work, Burner - 1 BUILDING USED AS jq0 h'l Also Replacement Furnace $ 30.00 (Side Vent - Fill Out Back) d• �� �®��. ESTIMATED COST�� PERMIT N0. Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ No. of Heating Units Circle One (Steam) - (Hot Wat ) (Warm A' Trade Name Size No. *Air Conditioning - All Sizes $ 25.00 00 $ �, BTU HP EDR Fuel Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) of 1% oofj Iue of ppliance or Work o� $ - Burner Trade Name Size No. BTU HP EDR lSu 100, _02 'q't Commercial/Industrial 1.25% of Value of Appliance or Work $ 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 State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and TOTAL FEE $�a m �0 representations stated in this application are true and correct. DATE ' O MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING 0 REFRIGERATION/AIR CONDITIONING PERMIT IS $25 00 PLUS THE $.50 STATE SURCHARGE Signe TEL # :5'7 � ` ; / S FAX # REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved By Rough-In Date' Final Date Le written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When , the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes &A No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes V No ( ) The 'undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does Include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes (y No ( ) The eY efin enmhuetinn air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No;Q() When required to hnctaii it new cnmhtictinn air it will be sized and installed to meet the current codes and manufacturer's specifications. Yes (� No ( ) When In-cfAllipg a naw �►enfing system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes o 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 0 No (: ) Appliance #1 Typ Appliance #2 Type Appliance #3 Type Total Appliances _ BTU Input _ BTU Input Total Btu Input Fan Assisted or Nat Fan Assisted or Nat Common Vent Type Vent Height Diameter inches Appliance #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 Height ft Length ft Diameter in Type HEATING CO: Signed By:0-4Date: J - Q S- - �� CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 JFAX: (763) 571-1287 PERMIT NO.(2:0:0 0:0 4:4 97 " DATE ISSUED: 04/06/2004 ADDRESS 7591 LAKESIDE RD NE PIN 123024110032 LEGAL DESC OUIMETTE TERRACE WATER TREATMENT APPLIANCE LOT 3 BLOCK 2 PERMIT TYPE PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION : $ 0.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A INSTALL GAS WATER HEATER # ELEC WATER HEATERS # GAS WATER HEATERS # GAS RANGES # WATER TRMT APPLIANCES APPLICANT PILIPANKO EUGENE D 7591 LAKESIDE RD NE FRIDLEY, MN 55432 �1 . PILIPANKO EUGENE D 7591 LAKESIDE RD NE FRIDLEY, MN 55432 0 # NEW FIXTURES (EXIST OPENINGS) 0 1 # GAS DRYERS 0 0 # OF NEW FIXTURES 0 0 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 cocti o t�e_perfonance of construction. wl Date J-4- ou PLBG PERMIT MINIMUM FEE 0.00 PLBG FIXTURES (NEW OPENINGS) 0.00 PLBG FIXTURES (EXIST OPENINGS) 0.00 WATER TREATMENT APPLIANCE 0.00 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 35.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 STATE SURCHARGE, PLBG FLAT 0.50 TOTAL 35.50 PAID WITH CHECK # 11576 CO LD AD ATL` DLDXTTTC! D L/IT TM LI'% LP1D TT 7nDW fNq=D TLT AAT TIL CTD TD CTI A 0 MTV CITY Y OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 Effective April 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader NO. RATE TOTAL JOB ADDRESS 75 9 C L 'i� Ike Std e ED /V6 Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range** Gas Dryer** Back Flow Preventer Required ( )Yes () No Type $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $35.00 $35.00 $35.00 $10.00 $10.00 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 Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: — (G� "" , 20 M" OWNER 35= e—G BUILDING USED AS 14 ®M ie ESTIMATED COST a 000' $15.00 PLUMBING COM PERMIT NO. Reinspection Fee $50.00/Hr SIGNED BY TEL N0. lS ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance C Approved By Rough -In Date Final Date State Surcharge $ MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST TOTAL FEE $ Sosa OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped 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 manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing 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 current codes and manufacturer's specifications. Yes () No( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural 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 Type 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 Common Vent Type Vent Height Diameter inches Appliance #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 Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date : Building MECHANICAL Permit No.:. Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: I F� DATE /V g44 —07 YOUR E-MAIL ADDRESS ,f , srrE ADDREss �/ -d 4 C <-r 4 e N v THIS APPLICANT IS: KOWNER ❑CONTRACTOR PROPERTY NAME: , -1-i=10 a ADDRESS: o� E CITY STATEM1 ZIP OWNER/ TENANT PHONE: -s�a 457 CONTRACTOR COMPANY NAME: SUBMIT A COPY OF CONTACT PERSON: YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS: CITY STATE ZIP APPLICATION PHONE FAX PERMIT TYPE '� SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: NEW ❑ REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK /lamS7-,14<ze S 2 / I Il✓ PER MS 1613.665 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 x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU MFG: MODEL: SIZE/BTU. A/C $25.00 LACE (GAS) $15.00 GAS RANGE/OVEN $10.00 A/C — TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 $35.00 $35.00 _GAS UNIT HTR $10.00 _IMBOILER _FURNACE LINER $10.00 AS DRYER $10.00 _POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00 —DUCT �._..3t Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ /5" (go Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a 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 ork pie requires re iew and approval of plans. PRINT NAME @Gl SIGNATURE OF APPLICANT City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977