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PRE 2010 DOCS01 t 6 SUBJECT P City of Fridley ®19541 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. `y _ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. // r PROTECTIVE yr 1 ` � CITY HALL FRIDLEY 55432 "t ��j NUMBER REV. DATE PAGE OF APPROVED BY .... 11.� 612-571-3450 910-F15 6/16/88 JOB ADDRESS 6500 Lucia Lane N. E, 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Pt. Lot 5,1 lying s. o N 85' of said Lot 5 and that part of the EHM.99' of 2 PROPERTY OWNER MAILADDRESS lyIng S. Of N 851 of Lot Gtip PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Jerry Tollefson Const. Inc. 311 Sunrise Lane, Champlin, MN 55316 867-1845 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. (Name change from Brandon Const.) 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO, 6 USE OF BUILDING Residential 7 CLASS OF WORK I� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 35' x 42' Dwelling and a 28' x 30' Garage NIj4G SEPARATE PERMITS REQ!_IIRED FOR 9 CHANGE OF USE FROM VVIC U1991119 call local UtillYira,WRINUP HEATING, rE%EPNONE- STIPULATIONS �p �p� Provide Cdfl61+�1t-CC,ot-fying survey before capping. Provide sod in the front and side yards, Provide a hard surface driveway. SEWER & WATER LOCATION: Services in same trench off Lucia Lane - 169' NW of 6" valve at Mississippi Street; and 110' W. of the NW corner of 6517 Lucia Lane DRIVEWAY ESCROW: 16' + 6' = 22' x $13.50 = $297.00 Owner signed bikeway/walkway easement for southern 151. The 10' sideyard setback on north side of lot is to cantilevered wall - soundation must be setback 11'. THE CITY OF FRIDLEY DOES NOT GUARANTEE THE ACCURACY OF UTILITY LOCATIONS AND. ELEVATIONS. THIS DATA IS FOR ,INFORMATION PURPOSES ONLY, AND PERSONS USING THIS INFORMATION .SHOUL& VERIFY IT 6N THE SITE. 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 SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION l 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 $93,200 $46.60 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- $612.50 $550.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 'le/no, PLAN CHECK FEE TOTAL FEE r.' �� , z' $Xi 6aH N/A 1$1209.10 + DW SIGNATURE OF CONTRACTOR OR AUT RIZEDA ENT IDATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT - STGNA4RE OF OWNER BUI RI]�OeIDATEi BLDG IN BP GATE 01 t 6 AMN ALTER I I Construction Address Legal Description City of Fridley R-1 AND R-2 Building Permit Application / ",e t vi- I a IL Ir. giggFna--2 --ZWERff- t- U a- 1,4 " of Z.+"D L -e) r S- � /) -"AAr- Effective 5/1/88 Owner Name & Address: A) Tel. Contractor: JTy"" Tel. 61/0 e # of # Address:-- 1// 6 Attach to this applications, a Certificate of Survey of the lot, with the proposoed construction drawn on it to scale. EESCRIPTION OF IMPROVEMEM LIVING AREA: Length width � Height sq. Ft. GUMM ARFA., Length Widths Height Sg. Ft. DECK AREA: Length Width Hgt/Gromd — Sg. Ft. MUE& Corner Lot Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks TAM of Construction: — lee- _,z Estimated Cost: 6 Approx. Completion Date: '57 - 31 "Ic 1:21 Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: I" I $ Q().06 $ Width + 61 See Back Page DATE: f -1-J APPLICANT: Tel. CITY USE ONLY Permit Fee (0 ISO Fee Schedule on Reverse Side State Surcharge $, 41c.. (Do $-50/$1s,000 Valuation SAC Charge $, 550.00 $550 per SAC Unit Driveway Escrow $ 29;1►00 Alt. RAN or Alt. NBO Above Park Fee Fee Determined by Engineering Sewer Main Charge Agreement Necessary Not Necessary TOTAL S0100 IONS: F PrMACLL4 IS ""ft" q 00 CjAA QCwoo 104 �s Mri Ukl rk #Th�c- -1 kod 155 STRUCTURAL WOOD CORPORATION MINNESOTA 5 ® PHONE (612) 484-0281 (P��S oc 1175 AS' i 6 • PAUL, i j r s I f V k-6 9--,F;p Hit i� .w. xs ems/ PROPOSED HOUSE LOCATION FOR BRANDON CONSTRUCTION Tal �$ °9I Qj�° 6 Q °•r.Y r ..-r �• 1;,eOf LO ✓ gyp ' L 6 W", SCALE : 1 inch = 30 feet 7-Ae S. "A— a1,07.7 �- 1 iso 2 E oT 1: E C t 1VY OF FRIDLEY DO ij� UTILITY LOC DATA*79 FOR INFORI PERSONS USING THI Y IT ON THE SITE. :S NOT GUARAN kTIONS ANDLE' IATION PUR SE V, NFORMAT a Utility and Bikeway/Wblkway Easem t ` 33 �1 CE 30 DAY :4�� 9Z. 35- DIV - QUIOD FOS ��� . REP CEM Rei I04. I. At'1KINGS. T pRIVE�A M rEE THE /ATIONS. :S ONLY, SHOULD '� _ Mississippi Street !,ylm0 SAFETY CONTROL °fl Nor P� That Dart of Lot 5 lying South of the North 85 fee �H� ��aP LA R9R5P Abitt part of the East 14.99 Meet of Lot 6 lying South of the R1�o�'tP�8bHEf��� 8 �s�i�P-Lot 6, Lucia Lane Addition,`,, ;riles of P.egistrar of Titles, County of Anoka, `'a�Ye of Minnesota. HOUSE LOCATION ONLY — NO FIELD SURVEY PERFORMED I hereby certify that this survey, plan plat, preliminary plat or report was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota. J Reg• No. Date Job No. Book No. V/ CSF �f �r /1,,4 V F✓ po 651 16o� % V7`1114` 5T— /2f� y Ms 14— � wr"Ir utc. �•►� of CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures 7 $ 5.00 td Future Fixtures U $ 3.50 a Old Opening, New Fixture Water $ 1.50 m Beer Dispenser $ Fei $ q o $ 5.00 $ Catch Basin $ Heater $ Rain Water Leader ro m $ ro u o ca 5.00 ro Sump or Receiving Tank $ 5.00 $ Water Treating Appliance ,4 W .°� U $ oa / y S o w . 4 ro y ro 9 Gas Dryer $ 10.00 1ec Back Flow Preventer Acquired. . Yes ( ) Type . No ( W w Uasa3 U 5.00 $ o s ( Appliance $ Reinspection Fee $ State Surcharge $ .50 ($15.00) TOTAL FEE $-EC2.� 2nd rd L4t h (R) Future Connection Opening Connected with Sewer (*) n New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures 7 $ 5.00 $ 3,5 -- ,5,Future Future Fixtures -:S $ 3.50 $ 10. S" Old Opening, New Fixture $ 1.50 $ Beer Dispenser $ 4.00 $ Blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Water Leader $ 5.00 $ Hydraulic valve $ 5.00 $ Sump or Receiving Tank $ 5.00 $ Water Treating Appliance $ 7.00 $ Hot Water Heater / $ 5.00 $— Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ Back Flow Preventer Acquired. . Yes ( ) Type . No ( ) $ 5.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS le of Value of Fixture or Appliance $ Reinspection Fee $ State Surcharge $ .50 ($15.00) TOTAL FEE $-EC2.� Effective Date May 1, 1988 Job Address L2 d o L�L Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this /application are true and correct 1 Fridley, Mn. f SAA - ( , 19 6 OWNER KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST O - NEW B ILDING PERMIT NO. PERMIT NO. Company _ 4 --Ao tJ ,a D v f J_�-/ G, Signed By Tel. No. ROUGH INSP. Date FINAL INSP. 4 - X 3 -& O Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450 September 29, 1988 Jerry Tollefson Construction 311 Sunrise Lane Champlin, MN 55316 Re: Final Inspection at 6500 Lucia Lane N.E., Fridley Dear Sirs: A final inspection was conducted on September 28, 1988 of the above address and the following item was noted which must be. completed before the structure can be finaled: Provide a deck or secure the patio door by October 15, 1988. We will expect the above item to be completed and a reinspection called for. If you have any questions on this matter, please feel free to contact me at 571-3450. Sincerely, 4J( -? DARREL G. CLARK Chief Building Official DGC/mh CC: 6500 Lucia Lane N.E. CITY OF FRIDLEY Effective Date May 1, 1988 a APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE A �Isoo Job Address RESIDENTIAL RATE TOTAL Furnace Shell and Duct Work, Burner (Also replacement furnace) $ 10.00 .r� $ Do .oc) Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley Gas Piping $ 10.00 $ (Y-> Tel. #571-3450 (piping needed with new furnace) Gas Range $ 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 Gas Dryer $ 10.00 $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. * Air Conditioning (all sizes) $ 10.00 $o Fridley, Minn. Atrl All Others/Repairs and Alterations OWNER C2 % 147 ECOQ l .ZIti�C^ 1% of Value of Appliance or Work $ ' KIND OF BUILDING F-4-ftiL COMMERCIAL/INDUSTRIAL USED AS h LA) LU, 60 �2_. 1% of Value of Appliance or Work $ TO BE COMPLETED ABOUT ? n ESTIMATED COST State Surcharge $ .50 OLD-CNEW)IIJ)ING PERMIT NO. PERMIT NO. TOTAL F= $ Reinspection Fee ($15.00) $ L DESCRIPTION OF FURNACE/BURNER Rough Insp. Date EATING or POWER PLANTS, Steam, Hot Wate , Wa Air No. /_� �/ ���.g, -7r Final Insp. -9. 3 ®0-� Trade Name Size No. Date Capacity Sq. Ft. EDR BTU -�'®®z, HP Approval for Permit /� Total Connected road Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR BTU// HP MINIMUM FEE FOR PERMIT IS �,7V-1 4 7 Z11 ANY HEATING $15.00, Company PLUS $.50 STATE SURCHARGE Signed By 442:L' *� Tel. No. -7 ' 3 *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. Fill out back side for stack verification on replacement furnaces CHIM14EY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes ( ) No ( ) 2. Is free from rust or deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes ( ) No ( ) 5. Meets all current Code requirements for size and total BTU connected Yes ( ) No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL Rema rk s Company Signed By Date CI I Y 01- I MULL k. 1 1014 1 AV 6431 University Ave NI__ 1=ndley, MN 55432 ,'763)572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBFR nF FIXTI IRFc Tr) Pr IMQTA1 I [Zn nki CAe�iA r„ L Ilective Un Jan 1. 2UO2 PLUMBING FIXTURE RATES New Fixtures Old Opening, New Fixture 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 () Nc Type Reinspection Fee $47.00/Hr NO. RATE $ 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 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE TOTAL JOB ADDRESS 1� 'n �C _( A AK 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 50 av�p �" e-1 . 20 CZ Owner Building Used As / IUM Estimated Cost — PERMIT NO. PLUMBING COMPANY_ )1)Y4A1' j J`�' �./� �AA v ,h 'k . L SIGNED BY// �,,�� TEL NO FAX # "e ,7— 447 t? n Approved By Rough -In Date Final Date- MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT-- IS $20'0.= PLUS THE $.50 STATE SURCHARGE t T COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When rapiacinn an pxicting f uranre, 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 plasticlPVC 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 manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing rnmhustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When required to install a new comhustion air it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When installing a new yeanting,syctpm, 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 correcUy after an appliance has been removed from the common vent and vented separately as per current codes. Appliance Topa and-Size/Commas Vent Yes( )No( ) and Vent rnnnpctor Infonnarion Appliance #1 Type BTU Input _ Fan Assisted or Nat _ Appliance #2 Type.___. BTU input Fan Assisted or Nat _ Appliance #3 TypeBTU Input Fan Assisted or Nat _ Total Appliances _ Total Btu Input Common Vent Type Vent Height Diameter y 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: Date : CINOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 May 11, 2004 Mr. Richard Oketch 6500 Lucia Lane NE Fridley, MN 55432 Re: Final Inspection at 6500 Lucia Lane NE, Fridley Contractor: Northwoods Mechanical Dear Mr. Oketch: A plumbing permit was issued on September 11, 2003 to install a water heater at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this permit. As of this date the inspection has not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Code. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for by homeowner after notification" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. Sincerely, DJ/mh CITY OF FRIDLEY PERMIT NO.: 2004-01473 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 09/01/2004 572-3604 tAX: (763) 571-1257 ADDRESS 6500 LUCIA LN NE PIN 133024240107 LEGAL DESC UNAVAILABLE LOT BLOCK PERMIT TYPE ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL SAVERS SWITCH. # INSPECTIONS 1 APPLICANT HUNT ELECTRIC CORPORATION 2300 TERRITORIAL RD ST PAUL, MN 55114 - OWNER OKETCH RICHARD J 6500 LUCIA IN NE FRIDLEY, MN 55432 ELEC PERMIT FEE - MIN (RESI) 20.00 STATE SURCHARGE, ELEC FLAT 0.50 TOTAL 20.50 PAID WITH CHECK # 117431 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. L IL 'i�wt) , V ; & FOUNDATION LOCATION FOR TOLLEFSON CONST. INC. 74e A.,. /i7,e e/G TII 7-.fv S. Ag 21. 7 �trss�ss/P�% Sf \ �' G�,✓ � G�.isft \ d t/mood SCALE : 1 inch = 30" feet Nei Utility and Bikeway/Walkway Easement 33 vso' 9�. 3s _ ? aqZ, 7 n � n -- M _ Mississippi Street s� That Dart of Lot 5 lying South of the North 85 `eet of said Lot 5 and that part of the East 14.99 feet of Lot 6 lying South of the North 85 feet of said Lot 6, Lucia Lane Addition, Files of Registrar of Titles, County of Anoka, State of Minnesota. // • De&ales /roe+ /�1p/�ui.ven fovhd I hereby certify that tl.- ��irw y, pis,,. plat, prcliminary plat or report was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State V innesota. 1633 Reg. No. Dave Job No. Book No. _� V11 it, FOUNDATION LOCATION FOR TOLLEFSON CONST. INC. ,8M. -rvl- a/ r.ss/s:r PPS Sf X97 sz SCALE : 1 inch = 30 -feet 7-4 h;;, 'V- I Ag 7. 7 i - �-� i -- ------ - 3-T. 17 �� 09 G a i GJ6 h G��sfc 1.1 .a 84Y �s z9 BT 3o,3S Utility and Bikeway/Wbikway Easement _ 33 _ 7 aqz' M V 7 J _ Mississippi Street gam That part of Lot 5 lying South of the North 85 feet of said Lot 5 and that part of the East 14.99 feet of Lot 6 lying South of the North 85 feet of said Lot 6, Lucia Lane Addition, Files of Registrar of Titles, County of Anoka, State of Minnesota. • De'ry le.5 AJ.00 Cn f 14-4101/ I hereby certify that tl :. -,n-%o_-y, pL.. plat. preliminary plat ov report was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of innesota. 1033 Reg• No. Date Job No. Book No.