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City of Fridley, Minn. BUILDING PERMIT e • �r �� a .rr. %� .. A F.r' / ( VX?4848 Builder Address CA/T ON OF WILDING No.„�.�.�..... Street _.._,�L�i�,N'... ---_!._._._.. -pa of Lot _..._.._.___._ Lot ....._:. . ...... Block ...... ............ ................ _........ Addition or Sub -Division ... - _... ,--- _..------.._. Corner Lot .......... .... ........ Inside Lot .------------------ ............... Setback .....i5_......._...._._..._ Sideyard ..,,..�� ._..._..................... Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To Used as: / Q y _.._ Front l ._.. Deptho4*_.. Height .. "� Sq. Ft.//-',, g- Cu. Ft. t1j?.f A_ Front ....._.:.....-----_.. Depth .:..._........... Height ........................ Sq. Ft. _• .-----......_.. Cu. Ft. ----------- --------=--------..._..... -- Est....a.....4....._ ..._... To be Completed ....._............._..... Type of Construction AJTHORIZE VIOLAT- ION OF ANY P.... A (L LA,,D COVENANTS AND BUILDh;G R�;i i rtjC'FIONS. 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 Lin compliance with all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $a4 .."'."�"... ..... permit is hereby granted to. .... _...... _..._.._....... _................. _. 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 this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ,/"°1 /,J' �► / Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owners Name. Builder Address :4ne;11 _ j1& 174.14-1 �� Address LOCATION OF BUILDING No. A Street & &AMWv Part of Loot Lot Block Addition or Sub.Div Corner Lotide Lot Set Back ��� Side -Yard SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: Front DESCRIPTION OF BUILDING Sq. Ft:� � Cu. Ft. 'y Z zp Front Depth height Sq. Ft. Cu. Ft. Type of Construction ..�._ Estimated Cost____ To be completed�� The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representa- tions stated in this application are true and corr"t. DATE , /% A:�� SIGNATURE (A Schedule of Fee costs can be found on the Reverse Side.) 4 City of Fridley Appkatiw for Plumbing and Gas Fitting Permit DESCRIPTION OF WORK Number, Kind and Location of Fixtures O rn now! Zw g U' ? oK a N WATER HTR. GAS ELEC. Base r 1st f 2nd 3rd 4th ' Future Connection Openings New Fixture, Old Openings I Connected with Sewer Cesspool E] PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... x $1.50 Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ 2-c' New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ I •.S® Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code j�P f " 1 a Dept, of Bldgs. Phone SII 4-7470 Locafion City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, AD= 19 6 e Owner 19- 67 Kind of Building 9L -a"- 19_ Used as To be completed about .. Estimated Cost, $ 4M—New. Building Permit No- Signed o � Sign By Business Phone No. r =s. ! o 5-- /0 fid_(,® Description................................................$ TOTAL FEE $ fra QW11 POST 1M-12-58 -1�1�V PARTIAL RATE SCHEDULE tet. of Edge. Phoar 9 -NO QRAV TY WARM AEA: RATE TOTAL. Fummace Shell & Duct Work .. ... .910.00 $ Replacement of Furnace 6.00 $ Repairs & Alterations—up to $W.00 6.00 Repairs & Alterations each add. 6500.00 300 611MML WARM AM Furnace Shell & Duct Work to 190,000 BTU .410.00 $— each add. 60,000 BTU 3.W i emeat of Furnace 6.00 $ Repairs & Alterations—up to $500.00 6.00 �— Repairs & Alterations each add. $500.00 3.00 STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam $10.00 Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00 Each add. 200 sq. ft. EDR Steam annEach add. 320 sq. ft. EDR Hot Water 3.00 OIL BURNER—to 3 gal per hour 8.00 S.—_—.— over 3 gal. per hour --See Fee Schedule GAS BUR1fER (up to MM BTU) B 00 = ower 195,000 BTU See Fee Sehe"o GAS FrMNG FEES: NO RATE TOTAL 1st 3 Fixtures -- x$ IN) E--- --- Additional Fixtures x .75 GasRangeRange to 199.006 S r.JI City of Fddley: The undersigned hereby makes application for a permit for the work herd specified, agreeing to do all work in strict accordance with the City Ordinaneer and ruling of the Department of Buildings, and hereby declares that all the factr and representations stated in this application are true and correct. Fridley, Mnn __ owner _.._. [�� 1146�� Kind of Building ..___.._ Used as we, 4 � To be completed about Estimated Caet, $ _ //90..—. New. Building Permit No. --- Permit DZSCR PTION OF WOAH HEATING or POWER PLANTS—Steam, Not Water, Warm Air --No . Trade Nama (tmw� �L gin No " I Capacity—.. — Sq. Ft. E.D.R BTU—,I Hp - Total Connected Load Hind of P1nt BURNER — Trade Name give Ns- Capadty Sq, Ft FLD-A--/� BTU aw COOLING LOAD ESTIMATE 13. ROOM SURVEY LRIOV01 1122 -1.4- -jxL BASE LOAD CORRECTIONS ADJLOADUSTED SUPPLY GRILLES F1 I Tota) CFM Capwjtl-- -T5 x 20 o 10 12 44 4tov 1 .1 ft, 411, A LRIOV01 1122 -1.4- -jxL 6 6 of CFM Addtions or Grilles Size Capacity Changes 11 F1 I Tota) CFM Capwjtl-- -T5 x 20 6 6 10 12 1 1 1 .1 16 x 25 7 7 r 10 13 4 De' 12 x 18 > 6 6 9 Family 6 6 10 2 Room 16 x 25 7 10 13 4 KitchdIC 7 9x 13 7 19 0 10 x 15 7 9 11 11 2 Dining 9x 12 1 2 311 1 Room 11 x 16 2 3 4 2 12 x 20 2 3 5 3 Bed- 49 2 4 rA-12 x 1 FOOM 6 3 4 5 11-71*% 2 #1 12 x 20 3 4 6 3 Bed---, '9x 12 4 room _T� 3 5 2 #2 12 x 20 3 4 6 3 Bed- 9 x 12 room< 4 RxXF 2 3 3 4 3r 1 1 #3 3 4 3 Bed. i om ro4 2 -3-- 3 4 16�3 #IRL2160 3 4 Fo y M. Ut1w 1 2 3 1 B. Nook Bath 3 Bath 1 3 e P2 Total Adjusted Load—Units -TYPICAL 15 SQ WINDOW 14. Cooling Load: BTUH; __CFM RETURN GRILLES Rooms of CFM Addtions or Grilles Size Capacity Changes Tota) CFM Capwjtl-- SUBJECT PERMI of Fridley a 18300 AT THE TOP OF THE TWINS BUILDING PERMIT _ RECETPTIqT. Jr?City COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. I . � `.-•_ ,/'ten CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L J`j 612-571-3450 910-F15 11/25/85 JOB ADDRESS 5332 Matterhorn Drive N.E. 1 LEGAL LOT NO. 1 BLOCK 6 TRACT OR ADDITION Innsbruck lst Addition SEE ATTACHED DESCR. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Robert Oulicky 5332 Matterhorn Drive N.E. 571-5781 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Milton L. Johnson Co. 2513 Central Avenue N.E., Mpls 781-9548 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 Kitchen alterations (cabinets, counter, floor) 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS 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 $8,000 $4.00 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- $68.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE 72.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPER64 VALIDATED THIS IS YOUR BLDG IN5P 9PERMIT W nA E SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE) I NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ ] �R-1 AND R-2 I ALTER. [ ] Building Permit Application Construction Address: 5-3 SA — a " I A --T 1 e:o-�-t0 Legal Description Owner Name & caress: 3 e A -T vLA- t,iC-K Tel. # '�' Contractor: N'// Tei. v Address: aZS/ 3 Cl --0772-01 L- X, , LIVING AREA: GARAGE AREA: DECK AREA: OTHER: 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. Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback ow Type of Construction: 'K 1 N g v' / ev&'LN r OT r' Estimated Cost • $ Approx. Completion Date: lP O o Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: I `�Z �� APPLICANT: Tel. # 791-24-48 CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ DOTAL $ �,,56 Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: ?6 UU Low,— 3a"Sj CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $ Future Fixtures $ 3.50 m Old opening, New Fixture Water Cd a� e $ 4.00 $ Blow Off Basin .04 e $ m N pQ', �`' Rain Water Leader Heater -1 54 0,ACL $ 5.00 S Sump or Receiving Tank $ 5.00 W w .94o 6p v a Hot Water Heater w $ .C.Zs Gas Range O $ Gas Dryer $ 10.00 $ +1 O O a� ai W N of � O lec la of Value of Fixture or v D o0 a� c'n 3 09 IN w U t� ao 3 t�7 � FEE $ 1st 2nd 3rd 4th (R) a Future Connection Opening Connected with Sewer (*) a New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $ Future Fixtures $ 3.50 $ 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 S Sump or Receiving Tank $ 5.00 $ Water Treating Appliance $ 7.00 $ Hot Water Heater $ 5.00 $ .C.Zs Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ Back Flow Preventer Required. Yes ( ) No ( ) Type $ 5.00 S ALL OTHI:�!S AND/OR REPAIRS AND ALTERATIONS la of Value of Fixture or Appliance $ State Surcharge $ .50 Reinspection Fee $ ($15.00) TOTAL FEE $ Job Address Department of Buildi City of Fridley Tel. #571-3450 Eftective Date May I, 1988 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. 19 OWNER KIND OF BUILDING USED AS C/ TO BE COLLETED ABOUT y I ESTIMATED COST "'f 0 V C� OLD — NEW BUILDING PERMIT NO. PERMIT NO. S Company i Signed BY °7,2 Tel. No. - ii ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE HEATING COMPANY PL-2Ce�� 1 �/I�r�iicr,�� C� � MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By Tel No.�(n PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved ByRough—In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACKSIDE F R STACK VERIFICATION ON 1N2__'111q written permission from adjoining property owner. REPLACEMENT FURNACE CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1997 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING -SYSTEMS AND DEVICES JOB ADDRESS RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in. strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $32- 06 representations stated in this application are true a d correct. /ZS (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) $10.00 $ �L,1997 OWNER. Gas Range $10,00 $ — BUILDING USED AS iZazl r G Gas Dryer $10.00 $ *Air ESTIMATED COST a Z_ G) L PERMIT N0. Conditioning —All Sizes $ 25.00 $_25- �,c.� _ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK 1 % of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water)�armAir Trade Name C 0-yz-at � Size No._ � rk Commercial/Industrial BTU_t 06)1 C)6y HP EDR 1.25% of Value of Appliance or Work $ Fuel ppf!Total Connected Load State Surcharge .50 Burner Trade Name Size No. TOTAL FEE BTU HP EDR . HEATING COMPANY PL-2Ce�� 1 �/I�r�iicr,�� C� � MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed By Tel No.�(n PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Approved ByRough—In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACKSIDE F R STACK VERIFICATION ON 1N2__'111q written permission from adjoining property owner. REPLACEMENT FURNACE . • % Remarks: . List ALTERATIONS Being Done: HEATING CO: Signed By: Date: CEnAMY AND STACK VERIFICATION The undersigned hereby verifies that the. existing chimney or stack:- tack:1. 1. . Has been c are"y examined Yes O No ( ) 2. Is free from rust or deterioration Yes O 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's connected Yes () No ( ) 6 Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes () No. ( ) 8. Has combustion air been provided for water heater Yes(') No ( ) Remarks: . List ALTERATIONS Being Done: HEATING CO: Signed By: Date: Orsat Test Address: 5332 Matterhorn Br. City: Fridley Occupant: Mike & Kathe Sherer ra- ?-I'l Pemdt # / 10 Date 10113/97 Test, Install and Gas Line For. Preferred Mechanical Services, Inc. UV47, Electric by: B.C. Anderson Electric Heat Type: Forced Air Make: CARRIER Model Type: 58TUA10010112 Furnace-SeriaW 3897A04743 Input: 100,000 Thermostat: T870010539 Valve: White -Rogers Pilot Type: Hot Surface Lb*: Totaline Limit Setting: 180 Fan Setting: Electric Pilot Type: Hot Surface Pilot Make: Totaline Pilot Model: LH33ZS004 Pilot Tbning: 10 Pressure: 3.5 %CO2: td Input CFH: 100,000 %02: 9 Stack Temp: 325 OAC0: 0 Vent Size: 4" Filter Size: Space4ard 2200 List ALTERATIONS Being Done: HEATING CO: Signed By: Date: preferred heating & air 7643 Logan Avenue South Richfield, MN 55423 Bus: 866-7611 Fax: 866-012E I .J CHIMNEY AND STACK !Vl✓CA" The undersigned hereby verifies that the -existing chimney or stack: 1. Has been carefully examined yes,o 2. Is free from rust or deterioration 'Yes 3. Has no foreign objects.lodged within yes 4. Is securely supported yes ( o 5. Meets all current Code requirements for size and total BTU's connected yes (/) No ( ) 6 Has total heating B'TU's of All other BTU's p® o A /OF W- - BTU's /& CC) (� .TOTAL 7. Has a liner been provided for water heater Y { No ( ) 8. Has combustion air been provided for water heater Yes ( No ( ) Remarks: . List ALTERATIONS Being Done: HEATING CO: Signed By: Date: preferred heating & air 7643 Logan Avenue South Richfield, MN 55423 Bus: 866-7611 Fax: 866-012E I .J CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 1997 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE JOB ADDRESS_ Residential Rate TOTAL Furnace Shell and Duct Work, Burner — Also Replacement Furnace $ 30.00 $ (Side Vent — Fill Out Back) Gas Piping $1000 $ Gas Range $10.00 $ Gas Dryer $10.00 $ *Air Conditioning — All Sizes $ 25.00 $ All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work $ Commercial/Industrial 1.255/6 of Value of Appliance or Work $ State Surcharge $ .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 ,1998 OWNER + z14-1 BUILDING USED AS_ 'e'.;J ESTIMATED COST 3 PERMIT NO. L-3/ DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water)arm Air) Trade Name_ �-{ — ,y ze No. BTU L HP EDR Fuel ymoi— Total Connected Load Burner Tradq(Name Size No. TOTAL FEE BTU HP ,��S�d HEATING COMPANY MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Signed BY749 ;7,zll,' PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr Rough—In Date EDR Tel No. p P 0'�_c _ *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE F R STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNA E Final Date 1/_:30_7W CHEVINEY 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 ( ) U 6 Meets all current Code requirements for size and total BTU's connected Has total heating BTU's of Yes ( ) No ( ) All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater Yes ( ) No ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: . List ALTERATIONS BeingDone. HEATING CO: Signed By: Date: SUBJECT PE N City of Fridley/27358 AT THE TOP OF THE TWINS BUILDING PERMIT NO. COMMUNITY DEVELOPMENT DIV. i V _____ • r PROTECTIVE INSPECTION SEC. s� f'd, ,s{� � F � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 8/24/98 JOB ADDRESS 5332 Matterhorn DRive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 6 1 Innsbruck 1st Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Michael Sherer571-3239 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Renewal by Andersen 350 73rd Ave NE #R FRid1py MN S5412 502-4777 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 ❑ ADDITION ❑ ALTERATION Jc REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 5 windows in home with pocket insert windows 9 CHANGE OF USE FROM TO STIPULATIONS Install smoke detectors to meet the State Building Code - in each sleeping room and on each level of house. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIREO 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 1 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 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. 187-25 Fire SC 3.35 PLAN CHECK FEE T TAL FEE SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI0�14 19- 7-27 PR P LY VA ID D THIS IS YOUR PERMIV. SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEIS 641E NEW [ ] ADDN [ ] ALTER [✓]� ConstructionAddress: Legal Description: Effective 1/1/98 CITY OF FRIDLEY : SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION :: Contractor:Owner Name & Address:7 :re auL "'; 1, I _ • LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Attach to this application, a Cerfi`ficate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF M'ROVEMENT Length Width Height Length Width Height Length Width Hgt/Ground n Sq. Ft. Sq. Ft. Sq. Ft; Estimated Cost: $`— (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: $ i R g APPLICANT: Tel. CITY USE ONLY Permit Fee $ S-7 • QS- Fee Schedule on Reverse Side Fire Surcharge $ -3.3s- .001 of Permit Valuation (1/10th%) State Surcharge $ 1•<e-7 $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ S. no $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 STIPULA IONS:L 9 SuB.,ECT O#RMIT NO. City of Fridley 29614 AT THE TOP OF THE TWINS BUILDING PERMIT f RECEIPT NO. b ------COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r E i ��"'f;•� CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By .___� L 612-571-3450 910-F15 6/3/99 10B ADDRESS 5332 Matterhorn Drive 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 6 lInnsbruck. 1st Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Michael & Kathe Sherer 571-3235 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Renewal by Andersen - 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 ❑ ADDITION ❑ ALTERATION AN REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 6 Insert windows 9 CHANGE OF USE FROM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Sec. 310.9.1.2, 1997 U.B.C. 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 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 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ISTALLS 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 3525 $1.76 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $97.25 Fire SC $3.52 PLAN CHECK FEE TOTAL F E Lice Sc 5.0 .53 SIGNATURE OF CON'RACTOR OR AUTHORIZED AGENT IOATE, ENP PE BLDG NSP ,DATE $ I R PE I i FIAtE SIGNATURE OF OWNER„F OWNER BUILDER, (DATE, 9 Pf'epai-d Plan Check $ Effective 1/1/99 Estimated Cost $ CITY OF FRIDLEY Receipt # R-3, COMMERCIAL & INDUSTRIAL (� BUILDING PERMIT APPLICATION Construction Address -5 312 rcW{�4rt�crc N t . • L . �c :o� %eq ZCning Legal Owner & Address rn: c�n-e1 �;,o. SL b�- V, x cw:o o b,0" V4 Tel# -30 O�ITRACPOR & P�DRESS Q)e (� .-r 0 614a i . �,,35b - 7P���a N . ic:d I�e,&, h Tel#� 1. Architect Reg. # Eng neer Reg.## BUILDING CONSTRUCTION TYPE OF WORK [] New [] x. Addition (d, Alteration .-Describe uz i hn, w-�) OFC. AREA: Length Width Height Sq. Ft. MM AREA: Lezxjth Width Height Sq. Ft. OTHER AREA: Lexxgh Width Height Sq. Ft. APPLICANT Tel Date VALUATION Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) Co Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ $ Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) TOTAL VALUE Building Use Construction Type Occupancy Group Air Conditio*i; ng [] Yes [] No Fire Protection Provided. [] Yes [] No Perfoxmance Bond Amount S See Reverse for Schedule Received []Yes' []No Pexmit Fee $ 01-7 . a -S Plan Check $ Fire Surcharge $ State Surcharge $ (,Q SAC Charge $ 5.00 Erosion Control $ • Park Fee $ Spec. Assessments $ Driveway Escrow $ T07AL $ id See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side .001 x Permit Valuation (1/10th o) $.50/$1,000 Valuation (See Sched. for > $1 Million) $1050 per SAC Unit (Plans to MCC for determination) $450.00 Conservation Plan Review Fee Determined By Engineering Agreement Necessary [] Not Necessary [] feet x $13.50/foot .2 ATTACH STIPULATIONS SUBJECT City of Fridley =1!�3 AT THE TOP OF THE TWINS BUILDING PERMIT f RECEIPT NO. COMMUNITY DEVELOPMENT DIV. l � � PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED Br CITY HALL FRIDLEY 55432 L 612-571-3450 910-F15 9/5/00 JOB ADDRESS 5332 Matterhorn Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 6 Innsbruck 1st Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Kathy/Michael Sherer 5332 Matterhorn Drive NE 763-571-3235 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Renewal By Andersen 350 73 Avenue NE, Fridley, MN 55432 612-502-4777 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20120983 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION j] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Replace 6 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. Permit inspection Care Will 08 Mailed To Homeowner To Poi 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 OWLG. 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 $ 5,830 $2.91 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT W DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACC ARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW $125.25 Fi Sl,' $5.83 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TO AL FEE Lice e C $5 138.99 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE, HEN I UR RN7,11 p _%/RVQ) PP7VALIDtyTHIS S,GNATURE OF OWNER„F OWNER BUILDER, (DATE, IN O BATE NEW[ ] _ Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address:i 0.lt i Contractor:. RENEWAL BY ANDERSEN 350 -73RD AVE. HE `n Tel. #�o(a-5-f(' -3o")-5 MN LICENSE #_ Address: FRIDLEY, MN 55432 Tel. # At (612) 502-4777 LICENSE #20130983 urveyof the 101 y _ __- —...,u .,n it to scale. DESCRIP',UON OF. ;IMP]K,0VENffNT LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. "I A- _ % _ r _. Driveway Curb Cut Width Needed: 0 • \"���j Estimated Cost: $-a 3 o Ft. + 6 Ft = Ft x $ Tel. #95-0.3(S - C0Oy-1 TOTAL $132295 S TIONS: l�y�© CITY USE ONLY Permit Fee $ a�J acj Fee Schedule on Reverse Side Fire Surcharge .001 of Permit Valuation'(1/10th%) State Surcharge $ o� � $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ 0 $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 Faigineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $132295 S TIONS: l�y�© FENCE REPLACEMENT AGREEMENT RON AND DIANE MILLER together with MIKE AND KATHE SHERER (Household #1) (Household #2) agree to replace the existing fence along the property line between V, 5316 and 5332 Matterhorn Drive NE in Fridley, Minnesota 55421. This agreement includes each household sharing one-half the cost of new fencing materials, labor for installation, and removal of the oak tree which extends into the fence line. Signed this day of August, 2002: Ronald Miller Michael Sherer Diane Miller Kathe Sherer CITY OF FRIDLEY INSPECT ioN DIV. I 6431 University NE Fridley, MN University AveA APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 763-572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Auto. Nvlm •l;� Wash �:..,:.,A?<::::: Floor. �a1>�:: A;.. ' L:CQr.'•i:.:::•. f. !stn�pc Urinal 'i`it>«:xs Shower �`' f Tray Washer ::: Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 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 () No Type $ 7.00 $4.00 0 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ -50 TOTAL FEE $ 02 �;b Effective On Jan 1, 2001 Water Heater Gas I Elec 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. -/ .20 002 Owner Building Used AsJ�'`^ Estimated Cost0 PERMIT NO. 13c� q41 PLUMBING SIGNED BY Approved COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, 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: SUBJECT P � City of Fridley 33331 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. �• COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 4367 1 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 763-571-3450 910.F15 1/30/03 JOB ADDRESS 5332 Matterhorn Drive NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 6 Innsbruck 1st Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Michael Sherer 5332 Matterhorn Drive NE 763-571-3235 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Renewal By Andersen 1920 Co Rd C W, Roseville, MN 55113 651-264-4777 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20130983 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION (j REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Replace one patio door within existing opening 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. Inspection Cards }SISI Mailed f'® Homeowner To post 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 W 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 $4,369 $2.18 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 FEETOTAL FEE Lice SC .00 $122.80 SIGN ATUREOfCON 'RACTOP ORAUTHORIZED AGENT IOATEI WH N PERLY VAL ATED THIS IS YOUR PERMIT _ 1,10-s3 BOG 'NSP OATS S,GNATURE OF OWNERoF OWNER BUILOERI [DATE. NEW[ ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: ,53.3 ath6wrNtlQ� Legal Description: Owner Name & Address: tin c�r�a,-et �1�-e�-c,,�r Tel. #_-*b3.ss�--i- Contractor:;?6twC \ -in" M&Uns',� MN LICENSE # a01309�'� Address: is a czss n 7f!,d C We -S4, %stk � m� Sys ll Tel. # (o`�I • alo4.y�1-�- Attach to this application, a Certificate of Survey of -the lot, with the :proposed zonstructiondrawn on it to scale. DESCREM— - ON OF IM..FR4. EN +' LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Estimated Cost: $ �} , 3 (09 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ M DATE: ;M -5&m, 03A,PPLICANT: Tel. # qSa •34,55-Wq - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: . 1, CrrV TIRR ONLY $ Fee Schedule on Reverse Side $ 1 of Pe it Valuation (1/10th l ) $ oZ . (6 $.501$1,000 Valuation $ $1050 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 [ ] so— $ IvZo1 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 r63) 572-3604 FAX: (763) 571-1287 ADDRESS : 5332 MATTERHORN DR NE PIN : 243024430009 LEGAL DESC : INNSBRUCK 1 ST ADD LICENSE SURCHARGE : LOT 1 BLOCK 6 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : RESIDING VALUATION : $ 7,800.00 PERM N0.:2004-01561 DATE ISSUED: 09/09/2004 NOTE: PER R703,2000 INTERNATIONAL RESIDENTIAL 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. RESIDE HOUSE & GARAGE. STATE LICENSED CONTRACTOR 1 APPLICANT NORTHLAND HOME EXTERIORS INC 308 SW 15 ST FOREST LAKE, MN 55025 OWNER SHERER MICHAEL L & KATHE L 5332 MATTERHORN DR NE FRIDLEY, MN 55421 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 wort 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 BUILDING PERMIT FEE 153.25 FIRE SURCHARGE 7.80 STATE SURCHARGE, VALUE 3.90 LICENSE SURCHARGE 5.00 TOTAL 169.95 PAID WITH CHECK # 2910 SEPAR-{1-W PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW (] CITY OF FRIDLEY Effective 4/1/2004 ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION Construction Address: i`3 3 a A dw orn 0, e kF Legal Description: Owner Name & 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 GARAGE AREA: DECK AREA: OTHER: Length Width Length Width Height Sq. Ft. Height Sq. Ft. Hgt/Ground Sq. Ft Construction Type: �.� :moo Estimated Cost: $ 7 00 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$ DATE: APPLICANT: Roman Tel. C/ D- ?;. Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge $ Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 [ J TOTAL $ �' STIPULATIONS: