PRE 2010 DOCSCity of Fridley, Minn..
BUILDING PERMIT N° 7364
Addresszafz� Builder
�} J LOCAT�� IAV F B ILDING
No. �C s� �e -- Street _ Part o t
Lot Block clition or Sub.Division e °
Corner Lot . Inside Lot Setback ____ deyard �re�
Sewer Elevation _ _ _— on Elevation
, L' P -6 f= Fdy '/-/' 4JG
DESCRIPTION OF BUILDING
T 9.6 V r
o d
Front Depth Height Sq. Ft. Cu. /&
Front Depth_CHeight Sq. Ft. Cu. Ft.
Type of Construction _ Est. ,F.- To be Completed
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
~Ainnnnen n4 +He M+%r n4 ii w A1—
in consideration of the payment of a fee of $dj, permit is hereby granted to
the express condition that thecepeerssoon to whom it the tIs or addition as described above. This permit workmegrin ed upon� work
done in, around and upon said building,or granted agent:, employee: and to the
Fridley, Minnesota re location,ons ru part thereof, maintenance, repairconform in all s and moving ordinances
dings
within the d limits and coon, alteration, atan
ordinances. city � permit may be revoked at any time upon violation of any of the provisions of said
Building Inspector
NOTICE:
Ub permit does not cover the eonateuethn, hmaaation for whdng, plumbing, gas hadng, sewer or water. Be sure to we
dw Beading Inspector for seperab pernft for these items. •
F.
APPLICATION FOR BUILDING: P' MEET -
CITY OF FRIDLEY, MT-NNESGTA
OWNER'S NAME BUILDER
ADDRESS ADDRESS
LOCATION OF B ILDING
No.o2 a Street Part of Lot
Lot_ % 9f' /6 Block J I Addition or Subdi ion
Corner Lot Inside Lot Setback .3S Side -Yard /a
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two.Certificates of.SurveY.of Lot and proposed build-
ing location drawn on these Certificates.
To be used as:
DESCRIPTION OF BUILDING
Front _ aprh .2 P Height / ±r:!!!2
Sq. Ft. 9 / 9- Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction Estimated Cost .12-
To
rteTo be Completed 1_21�1 f__ / G
The undersigned hereby makes application for a permitfor the work herein specified,
agreeing to do all work in strict 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_L1. /, J t G S SIGNATURE.
(Schedule of Fee Costs can be found on the Reverse Side).
a
BUILDING PERMIT FEE SCHEDULE
Section 2. The Inspector of Buildings shall, before issuing any permit for
the erection of any building or structure, or for any addition to any exist-
ing building or structure, or for any alterations or repairs to any existing
building or structure, upon application therefor, 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:
2.1. For any such permit for the erection of any fire -proof building, other
than a garagep warehouse, factory or grain elevator$ or for the erection 'of
any fire -proof addition, for similar occupancy, to any existing building
shall be at the rate of $1.40 for each one thousand cubic feet, or fraction
thereof, in such cubical contents.
2.2. For -any such permit for the erection of any fire -proof garage, warehouse,_
factory or grain elevator, or for the erection of any fireproof addition,
for similar occupancy, to any existing building shall be at the rate of $1:25
for each one thousand cubic feet, classified as "fireproof" by Section 502 of
the Minneapolis Building Code,
SOUSES
2.3. For any such permit for the erection of any non -fireproof building other
than a garage, warehouse, factory or grain elevator, or any non-fireprcof
addition, for similar occupancy, to any existing building - permit $1.00 for
each one thousand cubic feet.
GARAGES
2_.4. For any such permit for the erect.in-t of Any non -fire reof garage,
warehouse, factory or grain elevator, c." e%m-tioa of auy non -fireproof
addition, for. -similar occupancy, toL:as.3;ng or for each such
-building or addition - ninety cent.-: ;,s ; > �0' a^r eF.� ;i one thousand cubic feet
or fraction thereof, in the cubical thereof with a minimum of. $4:`00. -
For the purpose of computing fees fez but: .ding permits, the cubical contents
of any building or addition to a uniferr-a helSht throughout -by multiplying the
ground area covered from a point six (6) inches below the floor line of..t;be
basement or cellar to the average height of the upper surface or to thd'
average height of the roof surface of the main gable of a pitched roof.
2.5. For repairs or alterations to an existing'structure, the fee shall be
at the rate of"$3.00 per each Five Hundred Dollars ($500.00) or fraction
thereof in the cost of all proposed work.
2.6. In no case shall the fee, -charged for.any permit as set forth in
Section 2 be less. than $4.00.
City of Fridley, Minn. N 1068
BUILDING PERMIT
Date: June 3, 1970
Owner: Ilan ie 1 Gessi n o Builder She
Address _ _ 259 Tdiaerty S trpP NL -F - Address salm
LOCATION OF BUILDING
No. 2U-- Street Liberty Street N . E . ____ part of Lot
Lot 9 & 1.Q__ Block 11 Addition or Sub -Division . Spring Brook Park
Corner Lot _ Inside Lot X Setback —_ Sideyard
Sewer Elevation _ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Garage Front 24 ' Depth 22 Height 10Sq Ft. 528' Cu. Ft. 5280'
Front Depth _ _ Height Sq. Ft. _ _ Cu. Ft.
Type of Construction Frame Est. Cost _ $1, 9 5 0.0 0 __ To be Completed Sept.' 1, 1970
Provide Hardsurfaced Driveway
In consideration of the issuance to me of a permit to construct the building d bed a ve I agree to do
thore� pose f the city ooaccordance with the description above ae nth and �� a'll provisions of
In consideration of the payment of a fee of $---!-0- _00 , permit is hereby granted to Daniel Gesino
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and. moving of buildings
within the city limits and t� permit may be revoked at any time upon violation of of the provisions of said
ordinances. y�/
A / / i7 A I% is
NOTICE:
lhb perm* does not cover the construction, installation for wiring, plumbing, gas hosting, sewer or water. Be an to we
the Building Inspector for separate permits for these *ems.
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NANE:_,Dy( C_ c_ies.,4)C)BUILDER: 3
ADDRESS: ��� k i-/2 A), ADDRESS
NO • . o� S� STREET • It �' e L !
LOT: a BLOCK: zz ADDITION:
CORNER LOT: INSIDE LOT: ETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
1�a k e- Front: Depth: Height:
Square Feet:- .S� Cubic Feet: S o� 0
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost:�S
To Be Completed:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in sttict 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.
v
DATE:'. ` 3 '� SIGNATURE:
a
(See Reverse Side For Additional Informati.,
BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings 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 repairs 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:
UNIFORM BUILDING CODE: Type 1, 2 & 4 - $2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. Type 3 & 5 - $1.85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
For the purpose of computing fees for building permits, the cubical contents
of any building or addition, is determined by multiplying the ground area
covered from a point six (6) inches below the floor line of the basement
or the cellar to the average heights of the upper surface or to the average.,
height of the roof surface of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the
rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in
the cost of all proposed work.
In no case shall the fee charged for any permit as set forth in Section 2 be
less than $5.00.
VERIFICATION OF FOUNDATION
NOTE: 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 Certified Survey of the lot,.showing the location of the foundation, once it
has been constructed, will be required before proceeding with the framing.
CERTIFICATE, OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior
to the use or occupancy of any structure for which a building permit has been
issued; and said structure shall not be used or occupied until a Certificate
of Occupancy has been issued.
�. Cj. Co�u aid �4ssoe�ates� 9'IIIC. LAND SURVEYORS
10130 HIGHWAY 65 NORTHEAST - MINNEAPOLIS, MINNESOTA 55433 Telephone
784-5480
Certificate of Survey- DAN GES IN0
AL Lt%X
60
71 F
30 30
�v
r A
SCALE : 1" - 30I
2728- /4/- /4
,� DEtior�s /�dw
1
� 30
rb0
LIBERTY
_ots nu lu, dock 11,
4
) Spri, n brook Park,
of '-•
ui pt Ar,,)ka C{ jnty, Plio.nesota
l
�n. t
ST,
I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES
OF THE ABOVE DESCRIBED LAND, AND THE LOCATION OF ALL BUILDINGS, THEREON, AND ALL VISIBLE EN-
CROACHMENTS, IF ANY, FROM OR ON SAID LAND.
AS SURVEYED BY ME THIS...�4.U....DAY OF...........lay......... ........ ......... A D. 19... 7.u.,
N. C. HOIUM AND ASSOCIATES, INC. - LAND SURVEYORS
0
1978
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
Mr. D. Budzeak
259 Liberty Street N.E.
Fridley, MN 55432
TELEPHONE ( 812)571-3450
Re:. Depositing of Grass Clippings & Yard Wastes in the Alley Right of Way
Dear Mr. Budzeak:
It was brought to the City's attention and confirmed by an on site
inspection on July 14, 1978 that the unimproved alley right of way
in the 200 block between Ely Street and Liberty Street N.E., Fridley
was being used as a depository for adjacent property owner's grass
clippings and yard wastes.
Section 113.12, Refuse Disposal, of the Fridley City Code, prohibits
the disposal of any grass clippings, yard wastes, or any refuse on
the public right of way.
In addition, it is the adjoining property owner's responsibility to
maintain any unimproved alley right of way. Therefore, the City
must require you to clean and maintain your property and the adjoining
right of way free of all grass clippings and yard wastes found there.
We are confident in your cooperation and desire to make Fridley a
better community to live in. If any questions or problems result
from this letter, please contact me at 571-3450.
Sincerely,
STEVEK J. / OLSON
Environmental Officer
S JO/mh
SUBJECT
PER
City of Fridley
179 '
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
�
ECEIPT NO
� • COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
�
�r"',•� CITY HALL FRIDLEY 55432
NUMBER
REV.
BATE
PAGE OF
APPROVED BY
L J` 612-571-3450
910-F15
4/12/85
JOB ADDRESS 259 Liberty Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
9110
11
Spring Nvielliff Brook Park Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Don Budzeak 259 Liberty Street N.E. 786-8082
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,
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION X❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
Roof can be the second layer but the 3rd layer. Install ridged
galvanized valleys.
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
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
$4OO
$.50
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-
$15.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
LAN CHECK FEE
TOTAL FEE
$15.50
GNAT RE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
WHEN PROPERLY V L DATED THIS IS YOUR I RMIT
BLDG )NSP f�AT
SIGNATURE OF OW ER IIF O BUILDER) IDATEI
NEW
[
] City of Fridley Effective 4/1/84
ADDN.
[
] �R-1 AND R-2
ALTER.
[
] Building Permit Application
Construction Address: /, IXY-227Ty
Legal Description: A oTs 9
Owner Name & Address: 2i'1,1J %S'!/OZPf -9le' 125�J 4 IIT—QTY fir, �/� Tel. 91
Contractor: so6ir Tel.
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA:
Length
Width
Height
Sq. Ft.
GARAGE AREA:
Length
Width
Height
Sq. Ft.
DECK AREA:
Length
Width
Hgt/Ground
Sq. Ft.
OTHER:
/2e—c SNS &&A
E r//�
Corner Lot [ ]
Inside Lot [
] Ft. Yd. Setback
Side Yard Setback
Type of Construction: ir-1
L A SS
Estimated
Cost: $
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: -/-7 - 5-5 APPLICANT: - Tel. # ?27L
CITY USE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ e5: �—D
Fee Schedule on Reverse Side
25% of Building Permit Fee
$.50/$1,000 Valuation
$425 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
BUILDING 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 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 Valuation Fees
$1.00 to $500.00 $10.00 (Minimum Fee is $15.00)
$501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for each
additional $100 or fraction thereof, to and including
$2,000.
$2,001.00 to $25,000.00 $32.50 for the first $2,000 plus $6.00 for each
additional $1,000 or fraction thereof, to and
including $25,000.
$259001.00 to $50,000.00 $170.50 for the first $25,000 plus $4.50 for each
additional $1,000 or fraction thereof, to and
including $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 ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus
6 feet times $13.50
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 $15.75
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 been constructed will be required before proceeding with the framing.
STATE OF MINNESOTA
DEPARTMENT Or HUMAN SERVICES
444 LAFAYETTE ROAD
ST. PAUL. MINNESOTA 55101
Date
City of Fridley
Zoning Authority
6431 University AVe. N.E.
Street Address
Fridley. MN 55432
City State Zip Code
RE: ZONING NOTIFICATION OF APPLICATION FOR LICENSURE
Subject:
Name o Day Care Home Applicant
Street Address/(
City State Zip Code
DHS -2722 ( 9 85
PZ -02722-02
Type of License:
Family Day Care
Group Family Day Care
Licensed Capacity /a _ /9-1
Phone No. %� 6— 70 8 y
This is to inform you that we are in receipt of an application for
licensure under Minnesota Rules, parts 9502.0300 to 9502.0445 (formerly
Rule 2), Family Day Care and Group Family Day Care Standards. Issuance of
this license is subject to compliance with the provisions of Minnesota
Statutes, Sections 245.781 to 245.812 and 252.28, subdivision 2, known as
the Public Welfare Licensing Act and the rules of the Department of Human
Services.
You should note that under Minnesota Statutes, Section 245.812, Subvision
3, a licensed day care facility serving 12 or fewer persons shall be
considered a permitted single family residential use of property for the
purposes of zoning. Subdivision 4 of the same section indicates that a
licensed day care facility serving from 13 through 16 persons shall be
considered a permitted multi -family residential use of property for
purposes of zoning.
If we do not hear from you within
will consider the above-mentioned
your local zoning code.
Sincerely,
LicLn`sing Wor@cer (-f
Street Address
30 days after receipt of this letter, we
day care home to be in compliance with
COMMUNITY HEALTH & SOCIAL
SERVICES DEPARTMENT
COUNTY OF ANOKA
COURTHOUSE, FOURTH FLOOR
Name o A ency Organization
City State Zip Code
AN EQUAL OPPORTUNITY EMPLOYER
S ATE OF MINNESOTA
DEPARTMENT OF HUMAN SERVICES
444 LAFAYETTE ROAD
I J G _ -1 ST. PAUL. MINNESOTA 58101
Date
City of Fridley
Zoning Authority
6431 University AVe. N.E.
Street Address
Fridley, MN 55432
City State Zip Code
RE: ZONING NOTIFICATION OF APPLICATION FOR LICENSURE
Subject:
Name of Day Care Hom ,' pApplicant
/�'
Street Address
City QState Zip Code
DBS -2722 (9-85)
PZ -02722-02
i -moi d'�
Type of License:
Family Day Care
Group Family Day Care
Licensed Capacity
Phone No. -7 $ b - K D �—
This is to inform you that we are in receipt of an application for
licensure under Minnesota Rules, parts 9502.0300 to 9502.0445 (formerly
Rule 2), Family Day Care and Group Family Day Care Standards. Issuance of
this license is subject to compliance with the provisions of Minnesota
Statutes, Sections 245.781 to 245.812 and 252.28, subdivision 2, known as
the Public Welfare Licensing Act and the rules of the Department of Human
Services.
You should note that under Minnesota Statutes, Section 245.812, Subvision
3, a licensed day care facility serving 12 or fewer persons shall be
considered a permitted single family residential use of property for the
purposes of zoning. Subdivision 4 of the same section indicates that a
licensed day care facility serving from 13 through 16 persons shall be
considered a permitted multi -family residential use of property for
purposes of zoning.
If we do not hear from you within
will consider the above-mentioned
your local zoning code.
Sincerely,
Kathy Speggen/pf
Licensing Worker
Street Address
30 days after receipt of this letter, we
day care home to be in compliance with
COMMUNITY HEALTH & SOCIAL
SERVICES DEPARTMENT
COUNTY OF ANOKA
COURTHOUSE, FOURTH FLOOR
Name o A ency Organization
City State Zip Code
AN EQUAL OPPORTUNITY EMPLOYER
sue,JEcr
RMIT N
City of Fridley
(__20360
AT THE TOP OF THE TWINS
?
BUILDING PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
v PROTECTIVE INSPECTION SEC.
1
1 I
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
%J 612-571-3450
910415
5/16/90
JOB ADDRESS 259 Liberty Street N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
9,10
11
Spring EFOOT{ Park. SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Don B.udzeak. 259 Liberty' Street N,E. 786^8082
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
j] NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Remove existing 241' x 221' Garage and constructing a 261, x 341 Garage
9 CHANGEOFUSEFROM TO
STIPULATIONS
Provide a hard surface driveway.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR LECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND V ID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$13,155
$6.58
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON -
(CONSTRUCTION.
00
STRUC OR THE PERFORMANCE OF
CHECK FEE
PLAN CHEC
TOTAL FEE
$159,58
PROPERLY VA ATED THIS IS YOUR PERMIT
SIGNATURE OF CONTRACTOR 94CAUTHORIED AGENT (DATE
aj,
/ !
SIGNATURE OF OWNER OF OWNER BUILD,
I IDATEI
BLDG INSP CfJATE
NEW [ ] Effective 1/1/90
ADEN [ ] R-1 AND R-2
ALTER [ ] Building Permit Application
Construction Address: A,�e
Legal Description:
Owner Name & Address:
l J,
Tel. # tg6 1� f -I—
Contractor: _ �� Tel. #
Address:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DIOF ncPROVEMM
LIVn G AREA: length Width Height Sq. Ft.
GARAGE AREA: length h 2 to Width 3 y Height Sq. Ft.
BECK AREA:77r Width Hgt/Ground Sq. Ft.
OTHER:L e'V.2x'7,2,
Corner Lot [ ] Inside Lot [,] Ft. Yd Setback Side Yard Setbacks
Type of Construction: �COA T7"W,7<�- Estimated Cost: $
Approx. Cmpletion Date:
Proposed Driveway Width If New Opening Is Desired: Ft. $ $
Width + 6' See Back Page
DATE: 5'!G EeAPPISCANT: e Tel. #
Permit Fee $
State Surcharge
SAC Charge $
Driveway Escrow $
Park Fee $
Sewer Main Charge $
STIPULATIONS:
CITY WE CMY
Fee Schedule on Reverse Side
$.50/$1,000 Valuation
$600 per SAC Unit
Alt. "A" or Alt. "B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
Zhe 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:
$1 to $500 $15 Minim= Fee is $15 plus surcharge)
$501 to $2,000 $15 for first $500 plus $2 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000 $45 for first $2,000 plus $9 for each additional $1,000
or fraction thereof, to and including $25,000
$25,001 to $50,000 $252 for first $25,000 plus $6.50 for each additional $1,000
or fraction thereof, to and including $50,000
$50,001 to $100,000 $414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000 $639.50 for first $100,000 plus $3.50 for each additional
$1,000 or fraction thereof, to and including $500,000
$500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus
6 feet times $13.50.
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 $15.75.
Permits for construction will be issued a minirmm 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.
A.
JC
owm aRd ssocaes,gRC. LAND SURVEYORS
10130 HIGHWAY 65 NORTHEAST — MINNEAPOLIS, MINNESOTA 55433 Telephone
784-5480
Certificate of Survey �AN GEs►No
ALLI-;
60
` 30
SCAL E•I=30
2728 - /W/- /4
DEQ, OTS - co v
_.
(p0
UBERTY ST.
Shr i n brook F irk ,
An:;ka C� ,inty, 11-1i•;nesota
I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES
OF THE ABOVE DESCRIBED LAND, AND THE LOCATION OF ALL BUILDINGS, THEREON, AND ALL VISIBLE EN.
CROACHMENTS, IF ANY, FROM OR ON SAID LAND.
AS SURVEYED BY ME THIS.. -Cl U) DAY OF. �y A D 19 T'4
N C HOIUM AND ASSOCIATES INC - LAND SURVEYORS
• anssf uaaq seq &*uvdn300 10
,.,.. TIvus a.znjunzls pigs Pub :Panss�
Lill Ur rni IiLLY
APPLICATION FOR PLUMBING AND GAS FITTING PERiir.
RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
New Fixtures. 5 5.00 5
Future Fixture* S 3.50 S
Old Opening, New Fixture $ 1.50 5
Beer Dispenser — S 4.00 S
Blow Off Barin $ 5.00 $
Catch Basin $ 5.00 5
Rain wrier Leaden $ 5.00 5
Hydraulic Valve S 5.00 S
Sut•p or Receiving Tank S 5.00 $
water Treating Appliance $ 7.00 $
Hot water Beater 5 5.00 5
Cae Range 5 10.00 5
;.ae Dryer ; 10.00 g
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS A�
1% of Value of Fixture or Appliance
State Surcharge 5 .50
Reinspection Fee 5
(515.001 TOTAL FEE 5
Job Address
Department of Buildings _
City of Fridley
Tel. 1571-3450
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--cf-iuildings,_ind hezpby
declares that all
the facts and representations -_4U ted --In this application are true andzorract
Fridley, Mr1.19 �J
OWNER ► - ® (e2® Q
KIND OF BUILDING -
USED i1S
TO BE COMPLETED ABOUT -- �- - �-C� 91- �- - -_ - ----
— ESTIMATED COST -
OLD - NEW BUILDING PERMIT NO. PERhIT NO.
' 9
Company
Signed By /
Tel. No.
kou: h INSP.
Date
FINAL INSP.
Date
AFHF.OVAS. FOR PEFISIT
!1INI1VJ4 FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE 5.50 STATZ SURCIIANCE
water
a
i
W c
b..
;
•,x,
w
a.
Heater
j •.+
e
,•
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as
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let
2nd
--
3rd
4th
(R) - Future Connection Opening
Connected with Sever
(•) - New Fixture, Old Opening
Mater
RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
New Fixtures. 5 5.00 5
Future Fixture* S 3.50 S
Old Opening, New Fixture $ 1.50 5
Beer Dispenser — S 4.00 S
Blow Off Barin $ 5.00 $
Catch Basin $ 5.00 5
Rain wrier Leaden $ 5.00 5
Hydraulic Valve S 5.00 S
Sut•p or Receiving Tank S 5.00 $
water Treating Appliance $ 7.00 $
Hot water Beater 5 5.00 5
Cae Range 5 10.00 5
;.ae Dryer ; 10.00 g
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS A�
1% of Value of Fixture or Appliance
State Surcharge 5 .50
Reinspection Fee 5
(515.001 TOTAL FEE 5
Job Address
Department of Buildings _
City of Fridley
Tel. 1571-3450
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--cf-iuildings,_ind hezpby
declares that all
the facts and representations -_4U ted --In this application are true andzorract
Fridley, Mr1.19 �J
OWNER ► - ® (e2® Q
KIND OF BUILDING -
USED i1S
TO BE COMPLETED ABOUT -- �- - �-C� 91- �- - -_ - ----
— ESTIMATED COST -
OLD - NEW BUILDING PERMIT NO. PERhIT NO.
' 9
Company
Signed By /
Tel. No.
kou: h INSP.
Date
FINAL INSP.
Date
AFHF.OVAS. FOR PEFISIT
!1INI1VJ4 FEE FOR ANY PLUMBING PERMIT IS $10.00
PLUS THE 5.50 STATZ SURCIIANCE
MIT NO.
SUBJECT
City of Fridley
5 5 9 7
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
`
RECEIPT NO.
L ______ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r I
1 =
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE Of
APPROVED BY
612-571-3450
910415
10/16/9
JOB ADDRESS 259 Liberty Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
9,10
11
Spring Brook Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Don/Carole Budzeak 259 Liberty Street NE
786-8082
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.
"8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW C� ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 14' x 1714" Three Season Porch Addition
9 CHANGE OF USE FROM TO
STIPULATIONS See notations on plan.
WARNMG
Before digging CA fot &AU W PERMIT'S REQUIRED FOR
all utility iocabolss NIG, f<ATING,
PLUMBING AND SIGNt
454.0002
REQUIRED BY LAM
SEPARATE PERMITS ARE REQUIRED 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$6,316
$3.16
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-
$ 124.75
Fire SC $6.32
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
T AL FEE
$134.23
SiG UR OF CONTRACTOR OR AUTHORIZED AGENT IDATEo
EN R
Y VALI V D THIS IS YOUR PERMIT
BLD INSP
DATE
S-RE OF OWNE �i OWNER i ERi IDATEI
MIT NO.
� � 4 r ��2 /' 6 i� r%9 1 � t a• e
�:.�+•^ � tip ."�`'
Yeti
I � °
.. j► S
;
NEW [ ] Effective 1�/.d/97
ADDN [ ] CITY OF FRIDLEY (ki
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R -Z
BUILDING PERMIT APPLICATION
ConstructionAddress: .22 lIE"7-- S?
7
Legal Description: 1,a7'5 q'9 -1'!P
Owner Name & Address: c��o� E ua� z �/ Tel. #�-
Contractor: 5-14M,5 MN LICENSE #
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
ME Length 1,71
Width 17'y/" Height y' Sq. Ft. z yZ
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Lent Width Hgt/Ground Sq. Ft.
OTHER:®�
Construction Type: u> m o I G✓ryl F Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed Ft:- + 6 Ft`* °Ft x $ _ $°
DATE: APPLICANT:Tel. # 7.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
5
$ ; ..3 1-
s
$ 3. /4
Sewer Main Charge $
TOTAL
STIPULATIONS:
$�Aj
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 [ ]
z
BUILDING PERMIT FEE SCHEDULE,
1 ltc Chief Building Official shall, before issuing. penuits 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 buildint 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 FEES
$1 to $500 $21 (Minimum Fee is $21 plus surcharge)
$501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$2,001 to $25,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fractic n thereof, to and including $25,000
$25,001 to $50,000
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$50,001 to $100, 000
$574.75 for fust $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$100,001 to $500,000
$887.25 for fust $100,000 plus $5.00 for each additional
$1,000 -or fraction thereof, -to and including $500,000
$500;001 to $1,000,000
$2887.25'r the fust$500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000;000
$1,000,001 and up
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement -of curb and gutter only - Driveway width plus 6 feet times $13.50..
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 $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued- a minimum of 24 hours from the time of application to allow for prop--r-
review of tite proposed structure and of the construction site.
'1 crtrtrcate 01 survev of the lot, showing the location of the foundation once it has it has been constructs:::'.
- ':: rCyuirc:d he1iore pro".-ccdin4, with die framing- ,
154oiwu nd,-,&Souatm�9
.Iftes,. LANb,,SURVEYORS
10130 HIGHWAY 65 NORTHEAST — MINNEAPOLIS, MINNESOTA 55433 Telephone
Certificate of Survey DAw-GF-SING
A
CDO
k n
2- y
40
SCALE
P\
2728 Idl- 14
7
--4°4T
s
01 c
In
1
60 ,O, 4
LIBERTY ST.
-rlu I -j,
Sr r- 1 n brook i irk,
At; ka c .,tity, it-li-,nusota
11
6
I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES
OF THE ABOVE DESCRIBED LAND, AND ,THE LOCATION OF' ALL BUILDINGS, THEREON, AND ALL VISIBLE EN.
CROACHMENTS, IF ANY, FROM OR ON SAID LAND
AS SURVEYED BY ME THIS., � L,; DAY OF A -'.4
wo;;aq pwx"bol
10- 0AMIS 30 ;@q20T;T
UM -1 L
buT j eta L14Tft
a0uo uop%=10; ma -;0 UOT4ZOOT auk .anis uor.40=49UCK3
0
jadbad 20J POTTe r4 uc
ax 10;
jo malt
a! -cl-cm. UOT
�.T
. �J v C 94otuhi and LANDSURVEYORS
10130 HIGHWAY 65 NORTHEAST — MINNEAPOLIS, MINNESOTA 55433 Telephone
784-5480
Certificate of Sur,,ey' DAN - -GF-s i tq o
60
so
SCALE:
2728- 140,0- 14
�:,ri n brook Pirk ,
At: -Aa Cz -Anty, "i-musota
I HEREBY CERTIFY THA:'T THIS 15 A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES
OF THE ABOVE DESCRIBE LAND, AND THE LOCATION OF ALL BUILDINGS, THEREON, AND ALL VISIBLE EM.
CROACHMENTS, IF ANY, FROM OR ON SAID LAND.
AS SURVEYED BY ME THIS.7.1
DAY OF A D 19.
;,q T -Um
elao; o
itr4TIAa> fxz? 'VT aq4 Jo
j eta jo uo'-4z-�01 ";34TS UOTIOTLTISUCIC)
;3cuo uo-PW7
Lclde
zoo
r0TV
04 u0jjv0T
20;
p,.&,ad aq4 J0 ""'T' -[T-Vm uo-F:P=�--' '0-;
yl'::�nqsT ;3q
A
-Y
O"i" OL.
01
I ui tb
(n
G0
LIBERTY ST.
�:,ri n brook Pirk ,
At: -Aa Cz -Anty, "i-musota
I HEREBY CERTIFY THA:'T THIS 15 A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES
OF THE ABOVE DESCRIBE LAND, AND THE LOCATION OF ALL BUILDINGS, THEREON, AND ALL VISIBLE EM.
CROACHMENTS, IF ANY, FROM OR ON SAID LAND.
AS SURVEYED BY ME THIS.7.1
DAY OF A D 19.
;,q T -Um
elao; o
itr4TIAa> fxz? 'VT aq4 Jo
j eta jo uo'-4z-�01 ";34TS UOTIOTLTISUCIC)
;3cuo uo-PW7
Lclde
zoo
r0TV
04 u0jjv0T
20;
p,.&,ad aq4 J0 ""'T' -[T-Vm uo-F:P=�--' '0-;
yl'::�nqsT ;3q
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
Effective On January 1, 1997
PLUMBING FIXTURE RATES; NO. RATE TOTAL JOB ADDRESS ot$_9'<8
New Fixtures
Old Opening, New Fixture J
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater —Electric
Water Heater — Gas**
Gas Range**
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance xB.do
State Surcharge
TOTAL FEE
$ .50
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.
�1 } , 1997
Owner _ l ,'!n"
Building Used As
Estimated Cost S`p 0 _ PERMIT NO. / "
Ll
PLUMBING COMPANY
SIGNED BY TEL N0.
Approved By_ Rough—In Date Final Date
MINIMUM FEE/FOR ANY PLUMBING/GAS PERMIT IS $20.00
$,56 PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES.
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
7631572-3604 FAX: (763)571-1287
ADDRESS 259 IBERTY ST NE
PIN 0330 4310101
LEGAL DESC UNA AILABLE
LOT BLOCK
PERMIT TYPE HEAL ING
PROPERTY TYPE RESENTIAL
CONSTRUCTION TYPE ADDITION/ALTERATION
PERMIT=2004-01180}
DATE ISSUED: 07/28/2004
VALUATION :
NOTE: AIR CONDITIONERS CAN IOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM
ADJOINING PROPERTY OWNER. OMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A.
INSTALL A FURNACE (WARM A RUUD, 70,000 BTUS) AND AN AIR CONDITIONER.
# A/C UNITS 1 # FURNACES 1
# GAS DRYERS 0 # GAS RANGES 0
VALUE (FOR MINIMUM CALC) � 6400
APPLICANT
11
HEATING PERMIT MINIMUM FEE 0.00
FURNACE SHELL/DUCT WORK 35.00
CENTERPOINT ENERGY/MINNEG
SCO
13562 CENTRAL AVE NE
GAS RANGE FEE 0.00
ANOKA, MN 55304-
GAS DRYER FEE 0.00
AIR CONDITIONING FEE 25.00
STATE SURCHARGE, MECH FLAT 0.50
TOTAL 60.50
PAID WITH CHECK # 5867
OWNER
BUDZEAK DONALD J & CAROLE
259 LIBERTY ST NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN�STATEMENT
This permit becomes null and void if ork or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned fo, a period of 120 days
at any time after work is commenced.
I hereby certify that I have read an examined this
application and know the same to be a and correct. All
provisions of laws and ordinances governing this type of wort
will be complied with whether speciff�d 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
reeulatine construction or the Derform mce of construction.
Bldg Insp ""UA_ Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF FRIDLEY BUILDING INSPECTION
M
a 3431 University Ave NE
9=ridley, MN 55432
L
763-5723604 FAX 763-5711287
9
D
RATE SCHEDULE
Residential
Furnace Shell and Duct Work, Burner &
also Replacement Furnace
Gas Piping (New Furnace, Fireplace, Insert)
Z) Gas Range
Gas Dryer
ma
Effective 4/1/2004
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS -.' 6e r`t'e t
@8 Total
Owner � r) k z e cr_�_
$35.00 $ —1:L CBuilding Used As Re S id e Inc e—
$10.00 $ ESTIMATED COST U PERMIT NO D ` " Ol oo
$10.00 $
$10.00 $
*Air Conditioning -All Sizes $25.00 $ 9_f 00
rNlxuu'� V(AnnCa--:sO3r z
AII Other Repairs or Alterations (List on Back)
1% of value of Appliance or Work $
a Minimum Fee $15.00 for Residential or 5% of cost of
Y Improvement whichever is greater on work less than $300.00
� Commercial/industrial/Institutional
1.25% of Value of Appliance or Work (List on Back) $
Minimum Fee $35.00 for Commercial/industdai/institutionai
YState Surcharge $ .50
TOTAL FEE $
v
v
REINSPECTION FEE $50.00/HOUR
IT *Air Conditioners can not be placed in side yard without written approval
rm from adjoining property owner - copy to City
o-
N
FILL OUT BACKSIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
DESCRIPTION OF FURNACE AND BURNER
# of Heating Units j Circle One (Steam) (Hot Water (Warm Air)
Trade Name `' `� L1 b0 "] Size No.
BTU p J 000 HP EDR
Fuel , & as Total Connected Load
Burner Trade Name
BTU
HP
Size No.
EDR
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes
and rulings of the Building Division, and hereby declares that all the facts
and representations sated in this application are true and correct.
CENTERPOINT ENERGY MINNEGASCO
HEATING CO 13562 CENTRAL AVE ivE BLAINS, MN 55304
Signers Tel # 763-757-6202
FAX # 763-757-670 Date "cy'T
Approved by Rough -in Date Finai Date
eo ' d 1ti101
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 ()o 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 Mmtem, 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 91 Type CQtrilc - BTU Input7157iO�i Fan Assisted or Not
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
i
Common Vent Type dA5$ 2 Vent Height JW _ Diameter Q- inches
Appliance #1 Vent Connector Height _A__ft
Length25
ft Diameter min
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)
CENTERPOINT EIIERGY MINNEGASCO
HEATING CO: 13562 CENTRAL AVE NE BLAINE, MN 55304
Signed By:
�ML
Date: '-�-C�ZO-01F
?A/;7911 A TWA1SL 01 A31G I NA 3O AM WON -1 SF : t t b002-LZ-8r4d
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-36U4 VAX: (763) 571-1287
ADDRESS : 259 LIBERTY ST NE
PIN : 033024310101
LEGAL DESC : UNAVAILABLE
: LOT BLOCK
PERMIT TYPE : ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
PERMIT NO.: 2004-01181 y0%
it 0
DATE ISSUED: 07/28/2004
VALUATION
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. WERE FURNACE AND AIR
CONDITIONER.
# INSPECTIONS 1
APPLICANT
CENTERPOINT ENERGY/1VIINNEGASCO
13562 CENTRAL AVE NE
ANOKA, MN 55304 -
OWNER
BUDZEAK DONALD J & CAROLE R
259 LIBERTY ST 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 know the same to be true and correct. All
provisions of laws and ordinances governing this type of worn
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.
Applicant Date
Bldg Insp Date
STATE SURCHARGE, ELEC FLAT 0.50
ELEC PERMIT FEE - MIN (RESI) 20.00
TOTAL 20.50
PAID WITH CHECK # 5867
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Page 1
LOUISIANA-PACIFIC CORPORATION / WOOD -E DESIGN 97.1
QQMPANY: SCHERER BROTHERS LUMBER
JOB I D : / I , 7
STATE: CODE • I `'
PRODUCT:2-PLY 1.750" X 14.000" GANG -LAM LLVL'295OFb 2.OE
**WARNING- DO NOT USE_ THIS DESIGN AFTER: 1-31-98
VERIFY YOUR INPUT TO:AVQID DESIGN AND FABRICATION MISTAKES. YOU ARE SOLELY
RESPONSIBLE FOR ERRORS RESULTING FROM WRONG INPUT. THIS PROGRAM IS A DESIGN
TOOL AND SHOULD BE USED WITH EXTREME CARE THAT INPUT UNIFORM AND CONCENTRATED
LOADS ARE ACCURATE INN MAGNITUDE AND LOCATION. IF YOU HAVE ANY QUESTIONS OR
UNCERTAINTIES, PLEASE CONTACT LOUISIANA-PACIFIC'S ENGINEERING DEPARTMENT.
THIS COMPONENT DESIGN IS SPECIFICALLY FOR LOUISIANA-PACIFIC ENGINEERED WOOD
PRODUCTS. USE OF THIS PROGRAM TO DESIGN ANYTHING OTHER THAN GANG -LAM LVL OR
LPI -JOISTS IS STRICTLY PROHIBITED.
DESIGN CRITERIA FOR ROOF BEAM
LIVE DEAD SPAN ALLOWABLE ALLOWABLE
(PSI') (PSF) CARRIED SLOPE LOADING LL DEFLECT TL DEFLECT INCREASE
----- ------------- ----- ------- ---------- ---------- --------
40 15 25.000' 0.00 TOP L/240 L/180 15%
SPAN CARRIED IS NOT CONTINUOUS.
STRUCTURAL GEOMETRY
-------------------
SPAN 1
16.000'
TOTAL -.SPAN: 16.00 FT
CONNECTION
*** DESIGN ASSUMES COMPONENTS CARRIED ARE APPLIED TO TOP EDGE OF BEAM,
SUCH THAT LOAD IS DISTRIBUTED EQUALLY TO EACH PLY.
*** ATTACH 2 BEAM PLIES WITH 3 ROWS OF 16d COMMON NAILS ON EACH FACE
STAGGERED AT 12.00" C/C.
*** COMPRESSION EDGE BRACING REQUIRED AT 3" O.C. OR LESS.
INPUT LOADS
SHAPE TYPE
----- ----
LOADING
-------
SOURCE W1 W2
----------------
X1
X2
+UNIF LIVE
TOP
----------
ROOF 500 PLF
--------
0.000'
--------
16.000'
+UNIF DEAD
TOP
ROOF 197 PLF
0.000'
16.000'
+ INDICATES
LOAD IS
BASED ON SPAN CARRIED AND
INPUT LIVE
OR DEAD LOAD-PSF.
MAXIMUM SECTION FORCES: MOMENT = 21613 FT -LBS SHEAR = 5489 LBS
MAXIMUM SUPPORT REACTIONS (LBS)
I - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
BP,G#1: 5576 BRG#2 : 5576
REQUIRED BEAR;SIC $TSS (IN)
Page 2
---------------------------
.$RG#1: 3.00 BRG#2: 3.00
LIVE LOAD DEFLC. TOTAL LOAD DEFLC.
SPAN ACTUAL ALLOW. L/? ACTUAL ALLOW. L/?
---- ------ ------ ----- ------ ------ -----
1 0.438 0.788 431 0.611 1.050 309
MAXIMUM STRESS INDICES: MSI = 0.684 VSI = 0.504
SLENDERNESS RATIO = 4.00 LIMIT = 10.0